Opinion: The way we’re handing the current COVID-19 spike is not realistic. Is there a better way to live with the virus?
There are two major reactions to the latest COVID-19 spike.
Neither is realistic.
One presumes the goal now that we have vaccines is to prevent all illness, but that was never the case. The goal of countless policy decisions to this point has been to keep the health care system from tanking.
The other presumes that government should not only be hands-off in mitigating outbreaks, but that it should also actively stop others who feel compelled to try.
All or nothing? Neither is realistic
The problem with the first reaction is that some of us – even those who have been vaccinated – will continue to get sick from COVID-19. People are still vastly better off with the vaccine than without, particularly against the delta variant. It’s highly unlikely that you’ll die or be hospitalized if you get the shots.
But staying isolated forever is not an option. And if we’re out in the world, there’s a chance we could get sick.
The problem with the second reaction is that the pandemic isn’t over. While vaccination remains the best thing we can do to protect ourselves and others, a percentage of people refuse to get the shots.
And unfortunately, it’s still a large enough percentage to strain our hospitals, which also have less capacity to handle spikes, thanks to growing nursing shortages. That also can compromise critical care for others, such as heart or cancer patients whose procedures may be delayed.
If the goal remains to keep our health system intact – and it should be – we can’t completely throw up our hands (much as I’d like to) and say, “This is solely a matter of personal responsibility.”
That means you might be asked to do some things to help reduce spread.
What might this balance look like?
It’s not all or nothing.
Life in this world requires balance.
So, what can we do now to strike a better one, knowing that COVID-19 is not going away? Here are three often overlooked ideas.
1. Change the mindset about testing
Families of school-age kids are scrambling to get COVID-19 tests, which is making it tough in some areas to find an open appointment. I spent way too much time last week finding a free, available PCR test – and even then, I ended up driving two cities over to get it.
We need to make this a lot easier as flu season approaches, given that both viruses have similar symptoms. It’s important to know – quickly – if those symptoms are COVID-19 or just another virus.
But testing folks who feel ill isn’t enough. We also need to do a lot more testing for those who don’t feel sick.
This is particularly important, given that at least a third of COVID-19 cases are asymptomatic, and that kids are more likely than older folks to be without symptoms, even when they are positive.
If we want to get a better handle on cases in schools – and avoid quarantine, which is highly disruptive for students and working parents – we need to identify more cases before kids show symptoms. That means we need far greater participation in the state’s free, pooled-testing program, which allows parents to opt their kids in to be tested weekly at school, using a non-invasive swab.
I know. That may require a change in mindset to understand why it’s a good idea to do this before we feel ill. It’s a shame that surveillance testing remains so underutilized and that more organizations aren’t doing more to tout its benefits for parents.
2. Keep raising the bar on data
The Centers for Disease Control and Prevention made a mistake when it decided to only track breakthrough infections in vaccinated people that were hospitalized or who died. We’re learning now that mild to moderate breakthrough infections – though still not terribly frequent – are more common than once thought. If we’d been counting all cases, we might have been able to see that trend emerging quicker.
If there’s one thing we should have learned by now, it’s that we should err on the side of collecting more details about the who, what, where, when and why of COVID-19 outbreaks.
We must continue to invest locally in testing, contact tracing and genomic sequencing. But we can’t stop there.
Our ability to compare conditions among states is still woefully lacking (could we at least standardize the age of a child, please?), and that’s important, considering that we are not an island when it comes to COVID-19.
Outbreaks are going to occur, and the virus will continue to mutate. Public health needs sustained capacity to quickly identify, explain and respond to both.
3. Figure out how we handle illness
Before the pandemic, sick people still worked or went to the store if they were functional on cold medicine. And kids? The unspoken rule then seemed to be that if they weren’t feverish but had a few sniffles, they’d be fine to go to school.
That has changed.
But while working from home is an option for more people now, it’s certainly not for everyone. And we haven’t fully fleshed out how sick time should work – for ourselves or our kids.
Putting 2,000 kids in quarantine for possible COVID-19 exposures cannot be a routine thing, given how disruptive that is. And until surveillance testing or take-home rapid tests become more ubiquitous, that also means time off to seek testing or a doctor’s visit. Even people who have been vaccinated but have been exposed to someone with COVID-19 are recommended to get tested within 3-5 days, whether they have symptoms or not.
If we want people to stay home when they’re sick, we need to make these expectations – and plans to help people stay home – a lot clearer.