Are we there yet
“Are we there yet, Daddy?”
Many of us can identify with this childhood query as we long for a return to normal. In our eagerness to return, however, we would do well to remember the young girl in, “Charlie and the Chocolate Factory” who said, “I want it, Daddy. And I want it NOW!” As I recall, the results were not good. Perhaps we should adopt a more deliberative and orderly approach to decisions about our future.
Here are some facts to consider: We really don't know the extent of the epidemic, because the U.S. has not endorsed widespread testing. Perhaps 20 percent of infected individuals do not show symptoms but can still spread the disease. Others are not sick enough to require hospitalization and also evade notice. Deaths are a late indicator that follows infection by 3 to 5 weeks, so this number is not useful for planning purposes.
There is no cure. There is no treatment. Results of testing one anti-malarial drug have not been released, but those who have read the study say it was virtually useless and perhaps harmful. If you become sick, we can wish you well but do little to help you. Yes, supportive care, such as ventilators, may prolong life in hope of spontaneous recovery, but 90 percent of patients on ventilators ultimately die.
There is no vaccine. Experts keep saying another 12 to 18 months, but there is no xed date.
We do know how to prevent the spread in the population, and how to stay well as an individual. In this county, we have been fortunate to have had only 12 cases and no deaths among 7,500 residents. Our low population density makes social isolation easier, tho counties around us have not fared so well. Whatever we're doing here is working, and we should keep on.
Social isolation works. Face masks, gloves, and hand sanitizers are part of this strategy. Additional information comes from tracking contacts of infected individuals. A single infected individual who attended a birthday party or a funeral spread his infection among other attendees, causing several deaths. Meat packing plants are particularly hazardous. In part, because employees must shout to each other in that noisy environment, thus creating an atmosphere of infected droplets in a small enclosed space. Riding in a car more than 10 minutes with an infected individual practically guarantees transmission.
The severity of your illness depends on the viral load you acquire. A brief encounter may produce a mild illness, but prolonged, intimate contact or contact with several individuals will lead to a more serious illness. (Healthcare workers beware). There are also patient factors: If you are sick, you will get sicker. If you are old, you may not get older.
Various countries have adopted varying strategies, and we can learn from their experiences.
Sweden chose targeted isolation of vulnerable individuals. They banned visits to nursing homes but did nothing to protect the residents. They closed high schools and universities but kept day care and grade schools open. (Young children seem to be less susceptible or have a milder illness).
New Zealand closed their borders and sent police to arrest anyone seen in public. They recently declined a proposal to allow travel to and from Australia.
When South Korea re-opened a few bars and night clubs in Seoul, infection rates shot up and the clubs were closed again.
What do we need to make it go away?
1. An e ective vaccine will stop it. Remember smallpox and polio.
2. Herd immunity. Over time, an increasing percent of the population will become infected, thus reducing the number of vulnerable people. To be e ective, about 70 percent of the population must have been sick.
3. Expanded testing and contact tracing to allow isolation of infected individuals before they can pass the virus to others. Tuberculosis is one example of this.
4. Personal Protective Equipment (PPE), primarily face masks. The surgical mask pattern that ties over your face protects the rest of the world from your coughs and sneezes. To protect the wearer, you need a tight tting mask that lters air in both directions. The N95 designation indicates that the lter material will capture small droplets that might carry a virus.
Listen to the experts. There is a vast experience with epidemics from the past. Any decision about the future will involve compromises, but these decisions must be made with full cognizance of relevant facts and due regard for expert opinion.
No, we’re not there yet.