The virus currently ravaging the world is a highly infectious piece of genetic code (not really an organism) specifically designed to infect as many hosts as possible and to cause extreme damage to the cells of many of those infected hosts. Make no mistake, the COVID virus is a formidable opponent in this contest and should not be taken lightly. If you make a mistake, you will pay, as we are currently witnessing. However, humans have one great advantage over the virus – we are sentient beings. We can reason and learn (well, most of us anyway). The virus is leaving clues on how to successfully manage this pandemic. The question now becomes: are we smart enough to adapt our ongoing response based on this information or will we continue to blunder along? Most of the world is adapting. The US is blundering. Let’s review.

Second wave – The rapidly spiking epidemic-curves in the Carolinas, Florida, Texas, Arizona, Arkansas and other states do not represent the much-dreaded “second wave” of this epidemic. The thousands of people now being infected throughout the south and west are evidence only of inept state governors who believe that political ideology can somehow overcome scientific facts. The United States would not be suffering tens of thousands of unnecessary COVID cases had these states followed any sort of scientific basis for their re-opening plans. CDC guidance and lessons from the experiences of other nations were summarily ignored as the mostly Republican governors in these states rushed to curry favor from the fat, orange man. This great country allowed an extremely limited moron in the White House to politicize basic public health precautions such as distancing and mask wearing, so that attempting to protect your fellow citizens became a sign of liberal elitists and breathing on people was as American as a pickup truck gun rack. You have to get through the first wave before you see the second wave. We’re still picking ourselves off the ocean floor from the first one.

COVID INFECTIVITY – Science is continually discovering important information on how this virus infects people. The basic science that results from these studies will inform the public health practices that we will continue to need in the months to years until an effective vaccine becomes widely available. The main pathway of exposure is from droplets in the air, both large droplets and aerosolized, finer sprays of liquid. This virus does not spread well from touching contaminated surfaces, nor from outdoor exposures. People with COVID seem to be most infectious in the 2-3 days before they become symptomatic and become less infectious the longer they have the infection. The data are currently unclear whether asymptomatic people (people who never develop symptoms during their infection) are infectious and can spread COVID, at all. We know now, clearly, that people are being infected by sharing indoor breathing space. So, limiting these indoor exposures and requiring social distancing and mask wearing by EVERYONE is prudent public health practice and would dramatically reduce the spread of this disease and save thousands of lives. The economy would still be up and running, but the US epi curve would finally begin to flatten and we could begin to look beyond this first wave towards whatever “normal” is going to be.

Contact Tracing – Identifying each new COVID case, interviewing them about whom they may have been in contact with, connecting with those contacts, and isolating everyone for the disease incubation period is the standard epidemiological process to contain an infectious disease outbreak. Unfortunately, contact tracing is not going to work in this country. The most basic reason is that for the areas with major outbreaks, there are way too many cases to effectively interview the cases and then followup with the contacts. Another reason is that contact tracing is tough. It is hard to do and takes an experienced interviewer and knowledgeable tracer for tracing to even have a chance to work. A bunch of poorly-trained novices will never be successful. I did this for CDC in the STD field for over 4 years. It is hard work. People do not want to talk to you and they surely do not want to share their personal information. That leads to the final reason why contact tracing will not reduce the COVID curve in the US. Too many people do not trust the government or science. They are not going to cooperate. Contact tracing is not going to be a productive path to control the COVID epidemic in the US. That is my opinion, but it soon will be obvious to all.

Medical Advances – I am not a physician, so this field is outside my expertise. However, I have always been amazed, in all outbreaks, how much medicine and treatment regimens rapidly advance to blunt the worse symptoms and outcomes in infected patients. Lower proportions of patients are now being intubated or placed in ICU beds. New and old anti-virals are being tried and some seem to be having success. We are treating COVID patients better now than in the initial months of the pandemic and, I have no doubt, that we will see in the coming months rapid advances in the care of these patients. Keeping people alive and out of hospitals is always good practice – even better in a pandemic.

We know enough now that we can co-exist with this virus until a vaccine is developed. The US is just not adequately applying this knowledge. We are currently seeing an explosion of cases in the south and west in people under the age of 30. Yet, we open the bars and increase the seating capacity of restaurants even as new infections climb alarmingly. What is the thought process? Do they believe this virus will suddenly vanish? Are old people viewed as expendable?  Do they believe that none of these young people will suffer long term effects or even death? Don’t look for logic or empathy. You won’t find it.

VOTE.

Be well. Be informed. Be safe.