We are at a point where carping about what was or wasn’t done in the past is useless. We have to move forward in ways to savie lives and, at the same time, preventing a deep depression. Many solid ideas are floating around to help make this possible. This is our attempt to combine them into a workable program.
Segregate and Protect the vulnerable. It would’ve been much better to have done this right from the beginning, but better late than never. Virtually all the at-risk are known to the medical community. Those with underlying conditions young and old have been treated by a doctor. Someone writes their prescriptions. Doctors need to immediately contact patients with instructions to self-quarantine. This should be accompanied by a letter identifying them as at-risk with a barcode, and directions to an online questionnaire to find each person’s ability to comply. Also, this should include a release to share the info with others at the end of the survey. This is needed to resolve medical confidentially issues in allowing others to asist. It would be best if these forms were quickly created at the federal level for speed and uniformity. It would help if there were public service announcements to make people aware of these forms and the need for a quickly filled out questionnaires. This will allow us to know who needs help and support. We can then center maximum efforts keeping them from being exposed. If they’re not exposed, they won’t need the ICU or to be put on ventilators because of Coronavirus. Remember, anyone needing intensive care is a failure to protect them from exposure. Nursing home residents still dying from Covid-19 shows us we haven’t even protected the most easily identifiable at-risk group.
Extend Testing and Tests. We need to know who is presently infected, who isn’t, and who has recovered. To identify the infected, we still need to quickly expand the quantity and speed of Covid 19 tests. Also, we need two other types of tests. The polymerase chain reaction test (PCR) presently used to determine the genetic signature of the live virus to identify those very recently infected. Now in development, a serology test studying the serum and other bodily fluids to identify antibodies formed in response to the infection. The knowledge of who is or isn’t infected and who has recovered will provide us with better tools. These can be used to keep the space between people having the disease and those in the greatest danger. Knowing who is immune can be a game-changer. Just having them available to care for the vulnerable would significantly improve safety. The tests will provide us the data to move forward.
Speed Trials of Therapies in our Arsenal. The therapies have had some degree of success in past epidemics need to be speedily evaluated. Chloroquine has been used for 70 years. Blood infusions from survivors have been used against measles, SARSs, and Ebola as well as others with some success. Both have proven relatedly safe. France, with the former and China with the latter, already are using these therapies. There are others on the list of possible treatments we have to get moving on. Anything that improves our chances against the Coronavirus was needed yesterday.
Stop giving primacy to the Health Care Community. We love those in health care, but they have a certain mindset. In approaching war, the pacifist thinks no lives should be lost protecting “the American Way.” The General realizes soldiers will die but believes it’s worth it to preserve”the American Way.” The medical community will always put saving lives in their care first. That is at it should be and is what we expect. However, the world is more complicated, and circumstances often demand a balancing point of view. Right now, the policy is driven mainly by medical experts. They, in turn, pointed to deaths in Italy and Neil Ferguson’s predictions to close down a good part of the world. Dr. Anthony Fauci has become the face of the medical point of view. He has expressed the perspective, he would rather overreact with extreme measures than the opposite. When asked to contrast the trade-offs with highway deaths to the present situation, he dismissed the comparison as inappropriate. Of course, searching for a reasonable balance is always proper. If only saving lives was considered, we’d still driving 55mph or less. Dr. Fauci has every right to forcibly present the medical point of view. Still, the other side has to be given to achieve a balanced solution. Someone has to ask at what point the cure is worse than the disease? Is there another way?
Re-open the country except for the at-risk population when we’ve done our very best to secure the vulnerable. If we really put our minds to it, this shouldn’t take too long. We know who the endangered are, where they are, and how we contact them. With a real effort, this could be accomplished in less than a month. Better testing will significantly increase the distance from the infected. Maybe even more important is to test to find out who has recovered and is now immune. We know herd immunity develops when 40 to 70% of the population has become resistant. We may find we are closer to this than we think. In any case, knowing who is immune opens up many positive possibilities. Hopefully, therapy will prove to have a positive effect.
We will need to have our ducks in the row, to overcome fear-induced resistance. The clash will surely come. Pres. Trump only had to suggest some re-opening by Easter to be reviled by a large segment of the country. How could he place the economy above the lives of our parents and grandparents? If the choice is framed as the economy vs. saving lives, we’ve lost already. lost. We have to change the narrative. We need to point out we’ve done everything possible to protect the vulnerable they care so much about. It is necessary to show they and their children will pay a horrible price in a depression. Many sources point out a minimum of 10,000 suicides were directly attributable to the last recession. Many more succumbed to drugs and drink out of despair. Lives will be ruined. We will be left with the highest debt burden ever. These consequences will grow every day we stay locked down. Even if we lift the bans and open businesses and schools, the public has to feel OK with it. They know this is a rapidly spreading disease. We have to make clear there is good news. Coronavirus is a rapidly spreading disease. The sooner it moves through the less at risk, the sooner we achieve herd immunity. There are only two ways these epidemics end; we have a vaccine, or we have herd immunity. A vaccine is at least a year away. Does anyone really think we can stay locked down till then? That leaves herd immunity.
This plan not only can get us up and running but will give us a road map and mindset to better tackle epidemics in the future. We cannot afford another performance similiar to this one. Those we rely on to prepare for calamities must act with imagination and a sense of speed. After all, in what future epidemic would the elderly and compromised not be at the top of the list to be segregated and protected? In what coming epidemic wouldn’t we need as wide as possible testing to determine who has the disease or not and who has recovered and is immune? In what future pandemic wouldn’t we need to have immediate trials of therapies in our arsenal? These things will be needed then, and they’re needed right now. Waiting a year for a vaccine before we get out of lock-down just isn’t a viable option.