How best to put an end to the Covid-19 pandemic? At the moment, after an irresponsibly late start, many countries in Europe and the United States are attempting various extreme forms of “social distancing” and “sheltering in place”, sometimes referred to as “total lockdown.” The goal is to prevent people from mingling in close quarters as much as possible to cut down on the spread of the highly contagious virus. Unfortunately, because many people can harbor the virus without knowing it, and because Europe and the U.S. have so far provided inadequate testing of the general population, Covid-19 has already done a fair amount of spreading; keeping everyone, pretty much, at home and isolated is merely a desperate measure to compensate for the initial failure to do, for example, what South Korea did: test a whole lot of people very quickly and isolate those with the virus very quickly.
A mask can be fashionable, accentuating the eyes.
But we, thanks largely to the propaganda and incompetence of the Trump administration, have missed the chance to contain this virus quickly. Now we have decided to keep everyone away from everything and hope for the best. Is this the best we can do?
Dr. David L. Katz, director of the Yale-Griffin Prevention Research Center, thinks there is a better way to approach this dangerous virus. Katz has published an op-ed in the NY Times that argues for a middle way:
The clustering of complications and death from Covid-19 among the elderly and chronically ill, but not children (there have been only very rare deaths in children), suggests that we could achieve the crucial goals of social distancing — saving lives and not overwhelming our medical system — by preferentially protecting the medically frail and those over age 60, and in particular those over 70 and 80, from exposure.
Focusing on the old and most vulnerable to isolate and treat would allow younger and healthier Americans (and schools and hospitals and businesses and cultural organizations) to return to near-normal routines fairly quickly–in a matter of weeks rather than months. Furthermore, a general “herd immunity” among the young and healthy can be achieved that will help prevent the virus from regaining strength (once we are all released from mandated captivity) until an effective vaccine is available.
Thomas Friedman, columnist for the NY Times, talks to some scientists and writes about this idea of focusing more narrowly in terms of isolation:
But we also need to be asking ourselves — just as urgently — can we more surgically minimize the threat of this virus to those most vulnerable while we maximize the chances for as many Americans as possible to safely go back to work as soon as possible. One expert I talk to below believes that could happen in as early as a few weeks — if we pause for a moment and think afresh about the coronavirus challenge.
And, finally, there is this important research out of the tiny, isolated nation of Iceland, where widespread testing for the coronavirus has been relatively easy and the percentage tested of its people rather large:
Iceland’s population puts it in the unique position of having very high testing capabilities with help from the Icelandic medical research company deCode Genetics, who are offering to perform large scale testing,” Thorolfur Guðnason, Iceland’s chief epidemiologist, told BuzzFeed News.
“This effort is intended to gather insight into the actual prevalence of the virus in the community, as most countries are most exclusively testing symptomatic individuals at this time.”
Of 3,787 individuals tested in the country, a total of 218 positive cases have been identified so far. “
. . .
“Early results from deCode Genetics indicate that a low proportion of the general population has contracted the virus and that about half of those who tested positive are non-symptomatic,” said Guðnason. “The other half displays very moderate cold-like symptoms.”
What is becoming clearer is that we may not have to punish small businesses and younger, healthy Americans to contain the coronavirus. We may, in fact, be making things worse by throwing everyone into isolation together. Here Friedman quotes Katz:
“As we lay off workers, and colleges close their dorms and send all their students home,’’ Katz noted, “young people of indeterminate infectious status are being sent home to huddle with their families nationwide. And because we lack widespread testing, they may be carrying the virus and transmitting it to their 50-something parents, and 70- or 80-something grandparents.’’
David Katz, according to Friedman, lays out a short-term plan to address the virus:
Katz has created a rough template for the two-week-plus-sequestration-of-the-most-vulnerable strategy and how to think about coronavirus risk stratification, and different responses, on his website.
As the days and weeks go by with more and more harm to our economy and culture from extreme and possibly detrimental social distancing measures, we may want to rethink our shut-it-all-down approach to this pandemic. It’s comforting to know that some have started the necessary thinking.
Important Update: 3/27— Scientific consensus now seems to be that, given the late start on testing and containment in the U.S. and much of Europe, we now have no choice but to stay home and isolated as much as possible for the next month or two.
Categories: health care