The COVID-19 pandemic has upended life for more than half a year now, and virtually everyone looks forward to the day when this experience will be behind us. Unfortunately, despite our cautious reopenings, we’re having more people testing positive, being hospitalized and dying.
Even under the best of circumstances, the coronavirus is here to stay, not just for months but probably years. Simple lockdowns and blaming people for not complying are not long-term solutions.
Science shows that humans need to interact with each other to survive. Socializing is necessary for our mental and physical heath. So, let’s lean on science to guide us on how to live in this new reality.
First, a look at the numbers. Even with lockdowns, in the United States we’ve had more than 4 million cases. Deaths had declined to a few hundred a day nationwide, but as of this writing they’re back up to more than a thousand a day. Similarly, in Indiana we were down to about 500 positive cases a day in June, but now we’re back up to more than 800 positive cases a day.
Equally troubling, the percent of tests that come back positive is also increasing. We were down locally to 4.8% of tests being positive, but now we’re up to more than 10% positive. The WHO recommends at least 14 consecutive days with a positive rate of less than 5% before lockdowns are eased.
So, we are all wearing face coverings and holding our breath for a vaccine. Indeed, science is moving at light speed to produce effective vaccines. But even the best vaccine may not, by itself, be the panacea we are hoping for.
A good vaccine may be about 70% effective. Then, we need to vaccinate over a quarter of a billion people in just the U.S. If we have a vaccine that is 70% effective, and we vaccinate 70% of our population that will mean about 49% of our citizens (70% x 70%) will have antibodies. Science suggests we need at least two-thirds of the community to have antibodies to have “herd immunity.” Getting herd immunity will likely take a few years, not just a few months.
So, how do live with this for at least the next couple years—better supporting our children, our college students, elderly and businesses? How do we support ourselves being social creatures in a pandemic? Here are some thoughts:
- Do more outdoors: Science clearly shows that outdoor activities carry significantly less risk (for instance, none of the 284+ cities that recently had protests had an outbreak). Schools and colleges should consider holding classes outside, in tents, etc. Restaurants are clearly safer with outdoor seating. Whatever can be done outside should be, even if that was not typically done before.
- If not outdoors, adjust the airflow: Fresh air is what makes outdoor activities safer. Indoors, airflow is critically important, and air conditioning may actually make things worse depending on the air flow. We need to look at our HVAC systems in schools, colleges, restaurants, manufacturing plants with a focus on large volume negative airflow. This will be even more important as we approach winter and can’t do things outside. Think about it: There have been no outbreaks in airplanes, where people are sitting much closer than in a restaurant or classroom. Masks, air flow and air filtration work.
- Create social bubbles: We are meant to be social creatures; as such, we need to be creative in social distancing, adopting such concepts as dividing groups into smaller bubbles that stay together. In school and college classes, for example, you have one cohort that meets every other day or every other week, then another cohort that meets every other day or every other week. As long as students remain in smaller cohorts or social bubbles, one infected person won’t infect the entire community. Cohorts for businesses, including manufacturing plants, should also be considered.
- Upgrade lighting: Research has found that a certain type of light known as far-ultraviolet C (UV-C) light has antimicrobial properties and can kill airborne viruses. Installing far-UV-C lighting may have a potential to help mitigate the coronavirus. This is still being investigated, so don’t go to your hardware store just yet. This is NOT the ultraviolet light from tanning beds—those are UV-A and UV-B rays, which can cause cancer.
- Face covering. This is not high-tech, but it works. Studies have shown up to 40% reduction in transmitting the virus by wearing a covering. Be creative in what you wear and make it fun.
- Test, test, test and test. Finally, we really need a nationwide testing capability, where ideally everybody can be tested every three days. One area that needs to continue to be aggressively pursued is pooling of tests. Pooling or batch testing means combining respiratory samples from several people and conducting one laboratory test on the combined pool of samples. This would reduce the amount of supplies needed. For instance, if there is a class of 20 college students you want to test weekly, you can do one batch test. If the batch is negative, then all the students are negative. If the batch is positive, then we test each student. But it potentially saves 19 tests. This is not for all settings, but may work better in large groups of asymptomatic individuals such as college students and workers in manufacturing plants.
Let’s embrace science and work together to learn how to live better, together.
Ram Yeleti, MD, is the Chief Physician Executive at Community Health Network in Indianapolis.