Covid This Week: The Virus Strikes Back
(Original article published on Tom Frieden’s LinkedIn account https://www.linkedin.com/pulse/covid-week-virus-strikes-back-tom-frieden/)
People are tired of fighting the virus, but the virus isn’t tired of infecting people. As parts of Europe and the US show, if you turn your back on Covid, it will come back to bite you. Cases are trending up again in many states, and are likely to hit 50,000 a day in the US in October.
Trends in positivity are hard to track, and getting even harder to track. Per the Covid Tracking Project, only 9 states currently followthe best practice of reporting antigen and PCR tests separately. States should also report the proportion of unduplicated people who tested positive, cross-referencing the two types of test.
What starts in the young doesn’t stay in the young. The MMWR reports that young adult infections were followed a week or two later by infections in people over 60. We’re all connected. The sooner we recognize that, the sooner we can move forward more safely.
These are some of the top Covid hotspots.
Universities
Meatpacking factories
Jails, prisons
Homeless shelters
Meatpacking factories are driving spread in many communities, with persistent failures in prevention, response, and transparency. It’s crucial that we take action to stop spread in hotspots.
Covid is spread by particles – some large, some small. It's a continuum, not a dichotomy. In crowded indoor spaces, Covid can spread widely, but it’s much less infectious than measles. Measles commonly spreads through air that can stay contaminated for hours -- for example, people in an emergency department can get infected hours after a patient with measles has left. This is likely much less common with Covid than with measles. Transmission depends on the index case, ventilation, whether people are wearing masks, what activities they’re doing (singing, shouting, etc.), and who is exposed.
Recent spread in Orthodox areas of NYC is concerning. Given crowding and alienation from government, spread within the community is a near-inevitability, but wider spread in NYC can be prevented if the city does much better at rapid isolation and effective contact tracing.
For eight months, the US government has ignored, sidelined, and undermined public health and scientific recommendations. They have taken the tools we have to fight Covid and broken them. Masks. Testing. Effective communication. Contact tracing. Strategic closures. Careful reopening. These are all things we should be doing better.
Operation Warp Speed, the effort to deliver a Covid vaccine, has gotten some things right. For example, they’re testing multiple vaccine candidates, manufacturing in parallel with studies, and providing good CDC guidance on vaccine preparation. But if vaccine studies are stopped early, we’ll lose essential information on effectiveness in the elderly and safety for all.
Vaccines are our most important tool in the fight against Covid. We can only hope the administration doesn’t break this tool as well by meddling with the science and the approval process. Errors by the administration have already cost lives and jobs. Politicizing vaccination would be the most dangerous and costly mistake yet.