Friends, here are my thoughts on Ohio and COVID-19 after another day of good news. Here is how we get back to work safely:
As we’ve learned from my friend Mike Wilson’s daily COVID-19 advanced data analysis, Ohio’s mitigation efforts have been very successful, and we are in a consistent downtrend on the backside of the growth rate curve. Congratulations, Ohio, as our hospital systems were never significantly stressed and the model predicted surge was minimal. The downside to our social distancing efforts has been the economic woes caused by the closure of our businesses and the rapidly rising unemployment rate. Now that the mitigation of severe health system stress is complete in Ohio, I believe that the physical and mental health threat of personal and systemic economic collapse is greater than the threat of the virus itself.
Ohio needs to get back to work now. How do we do that safely? How does Ohio transition from the successful disease mitigation phase to a COVID containment phase with a return to work?
First of all, we have to realize that the COVID-19 virus is still with us, and it isn’t going to completely disappear. We’ve suppressed it, but it’s still going to be around. We must respect it in order to contain it moving forward. Respecting the virus means that we continue to do the things that we’ve learned to do : wash hands frequently for 20 seconds, don’t touch our faces, clean surfaces frequently with sanitizer at home and at work. These are basic hygiene habits that we should use forever. We should also continue social distancing measures in public spaces for the time being, and we should encourage mask wearing in more populated public spaces where social distancing is shaky at best. In other words, respect the virus and those around us, and remember that any of us could be an asymptomatic COVID-19 carrier.
With those protections still in place, we will pivot into the COVID-19 containment phase, while returning to work. The containment phase consists of an expansion of CV-19 testing, isolation of COVID-19 positive individuals at home, identifying and finding/tracing all of those COVID-19 positive individual’s contacts, and quarantining those contacts for 14 days. Meanwhile, the healthy return to work, and they are screened for fever and symptoms daily (temperature check and a questionnaire) as they enter the workplace. If they feel ill, they are sent home and tested for CV-19. If they are COVID positive, their contacts are rapidly identified, notified, and tested/quarantined. This is the containment strategy that has proven to be quite effective in areas of the world where the epidemic was detected early.
Critical to our understanding of COVID-19 and “us” is that we cannot eliminate this virus with any strategy. Mitigation just slowed down the spread and allowed us to catch up to it medically. Containment will just box it in and control it, while we go back to working and living our lives. Until it makes its way through our population for 2-3 seasons, or until we have a successful vaccine, it will be with us, and we have to accept it. More of us will have immunity in the coming seasons, and we will be much better prepared for the next time.
The big question today is, “What is stopping Ohio from immediately moving to the containment strategy with a return to work?”. We need to know the answer today so that time isn’t wasted and our economic decline is stopped before it costs more lives through unemployment, depression, alcoholism, opioid abuse, domestic violence, and frank poverty. Some would say that we don’t have enough COVID-19 RNA test kits to “mass test” Ohio’s general population. That is true, and the fact is that we don’t need to “mass test” Ohio’s citizens for COVID-19 in order to return to work “safely” through our containment strategy. COVID-19 RNA testing expansion merely needs to be ready to rapidly test all newly symptomatic individuals and their contacts, not the asymptomatic population.
The following questions need to be asked of Governor DeWine and DOH Director Dr. Amy Acton, so that Ohioans can clearly understand what is preventing an initiation of the containment strategy and our return to work:
1. “How many CV-19 test kits does Ohio have today, and is that number adequate to initiate the containment phase?” “If not now, when?”
2. “Are the fast Abbott test processors operating at 100% capacity now?” “If not, why is that?
3. “Does the Ohio DOH have the personnel and protocols in place to initiate effective contact tracing at this time?” “If not, when will you have that piece ready to go?”
PPE (Personal Protective Equipment):
4. “You have repeatedly told us this week that Ohio’s hospitals are currently experiencing a “severe shortage” of PPE for our fantastic medical providers. Yet, reports from providers in Ohio contradict these reports, hospital and ICU census is down, and advanced data shows Ohio to be on the backside of the curve. Please provide us with specific details on the PPE shortage. Could you provide us with PPE stock volumes and identify the hospitals with the severe shortages?”
Ohio’s citizens deserve and need transparent answers to these critical questions today. It is time to get back to work safely, and once we have affirmative answers to these 4 questions, we will be able to do so. These specific questions need to be asked tomorrow in the daily press conference, and very specific answers should be expected. Knowing that the Ohio DOH is ready and able to execute this plan will be comforting to all Ohioans, and it will ease the tensions that are building in our State.