Arkansas Democrat-Gazette

How we can save ourselves

- DAI-YUAN WANG AND JING WANG Jing Wang (BSC, MBA, MHA), who served an internship at Johnson Regional Medical Center in Clarksvill­e, and Dai-yuan Wang, a practicing cardiologi­st, live in Russellvil­le.

The pandemic of covid-19 presents significan­t health, economic, political, and social challenges to our country. It has infected nearly 15 million people in the United States and is on the rise. Although we can treat covid-19 infected patients, we do not have a proven effective treatment; prevention will be the best way to contain the disease.

There are three ways to handle the epidemic of covid-19: the first one is to develop a vaccine for it, the second one is an epidemiolo­gical method: isolating the infection source to stop the transmissi­on in the population, and the third way, so-called population immunity, has been ineffectiv­e in covid-19.

Historical­ly, we successful­ly used a vaccine to control or eradicate infectious diseases, such as smallpox. However, it is not always as successful since the virus may quickly mutate to a new strain.

Any vaccine developmen­t will base on existing strains of a virus. It may not be effective in preventing new mutated strains after the vaccine’s developmen­t. It may be why flu vaccines are not always effective and may be one reason why some patients may have a second covid-19 infection after recovering from their first infection.

Covid-19 is a single-chain RNA virus, which is relatively easy to mutate compared with a double-chain DNA virus, such as smallpox, which is more stable and less likely to mutate. It determines that a vaccine alone may not be effective in preventing covid-19 infection and stopping this pandemic.

Yet it should be a part of the control of the pandemic. The price is too high if the vaccinatio­n fails.

Another method to control the pandemic is to prevent the spread of the disease. Social distancing and face coverings are part of our effort to isolate the source of infection. It requires, ideally, the participat­ion of every member of our society. It is not very successful yet, since it involves many people. They do not want to do it due to our social culture and misinforma­tion.

We also can isolate the patients from the general population until the patients are not contagious.

It will involve a much smaller population over a much shorter period than it would take to shut down the country and is much easier to achieve. It has been successful in China without the vaccine. However, it will not work in the U.S. since covid-19 has been in every state and city.

Locking down a city with travel restrictio­ns will not stop the transmissi­on of covid-19. Public education in layman language will spread knowledge about covid-19, including how it infects us and how to prevent its spread.

Education will provide a factual scientific basis to support what we need to do instead of merely telling people what to do. It will help the public to accept current preventive measures and actively fight the pandemic and return to work without fear.

We also need to give the public a realistic expectatio­n for the vaccine. It will help to fight the pandemic. It will not replace other measures in fighting the pandemic.

Over the last 10 months, the public has received different and conflictin­g informatio­n. It confuses them about what is right to do, makes the battle against the pandemic ineffectiv­e, and contribute­s to our failure. It is time to put everything in a relatively simple and large picture to lead the public in a standard direction that will prepare us for future pandemics.

We will have covid-25 in 2025, covid-30 in 2030, and so on in the future. It is essential to realize that a vaccine will work 12 months after the disease has started, when other measures may break the pandemics.

Quarantine of infected patients until they are not contagious is the smallest population to control. Most of them are asymptomat­ic or minimally symptomati­c and require no treatment. It will cost much less compared with the treatment of severely ill patients if those contagious patients return to the community and infect more people.

The quarantine­d patients must stay in a specific location. Currently, most quarantine­d patients are still in the community. They may come in contact with the community through their families, which needs to be addressed. We also need to test more people for covid-19, which will find those patients requiring quarantine.

A reconfigur­ed rented motel could serve as a supervised quarantine location. It can provide housing, meals, and low-level care to the patients. Those stable covid-19 patients can stay there until they are no longer contagious. Covid-19 hurts the hotel business significan­tly. We may be able to rent a motel at a bargain price. At the same time, we will help the motels to pass a difficult time financiall­y.

People not infected or recovered should return to work and everyday life with social distancing and face coverings. If they can work at home, they should do so. The country’s shutdown will not stop the pandemic since patients are in every state and every city. It only works when the disease is in a local area. A shutdown will only cause an economic and social disaster, which we will be unable to afford.

Federal and local government­s, health-care organizati­ons, and communitie­s should be involved in planning and financing education and quarantini­ng and enforcing rules. Only a small percentage of patients need quarantine at a given time since most people will recover and return to their everyday lives. The total number of patients will decrease, resulting in fewer patients requiring in-patient care. Costs will decrease. And restarting businesses will improve our economy.

It is almost sure that in the future, there will be similar events like covid-19. Let’s learn from this pandemic and avoid its repetition by preparing our society through education.

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