On COVID-19, Don’t Let the Perfect be the Enemy of the Good

This commentary by Dr. Gary Voccio, Director of Public Health for Northwest Georgia, was published May 3 in Hometown Headlines of Greater Rome and is excerpted with permission.

By Dr. Gary Voccio

Are we ready to open up? Doesn’t matter. We’re going to; we can’t exist otherwise. The real question is how we reopen in a way that gives us our best chance to stay open.

If we do it wrong, the pandemic will speed up again, our hospitals will get overrun again, and we’ll need to go into lockdown again. If we do it right, we can transition to a New Normal – a New Normal in which a lot of us will s-l-o-w-l-y get infected, and some of us will succumb. We need to understand that going in.

The lockdown hasn’t been healthy and not just for the economy. Someone with early-stage breast cancer didn’t get her mammogram today because of the pandemic. Someone having a heart attack was too worried to go to the ER for fear of catching coronavirus. Many of us are frightened and miserable, emotional states that are guaranteed to do well-documented damage to our health.

Still, perpetual lockdown is less deadly than reopening the state and our Northwest Georgia communities will be. We need to understand that going in too.

The virus hasn’t disappeared. It’s still circulating. We know more about it than we did several months ago, and we’re constantly learning more, but there’s still a lot we don’t know.

Ask yourself a few simple questions: 

  • How many of us have been infected by Covid-19?
  • What is the fatality rate of this disease?
  • What percentage of those infected are asymptomatic?
  • If I’ve had it, am I immune?

The correct answer to all those questions is we don’t yet know and may not get all the answers.

We don’t have an effective treatment, although there are some promising developments. Unless we get lucky, we’re likely a year or two from having a vaccine – if we ever do. After many decades, we are still waiting for an HIV vaccine.

This virus caught the world off guard, and its trajectory is still highly unpredictable. We simply don’t know what the future holds and what the end game for controlling the pandemic will be.

We need to understand we’re only in the top of the second inning of a nine-inning game, maybe just the bottom of the first. We need to realize we have a long road ahead of us.

As we reopen our communities, we expect to see an increase in virus transmission. We hope we’ll also see, as we saw at the beginning of the pandemic, people changing their behavior to wisely continue to protect themselves and, more importantly, unselfishly help protect others, especially those at highest risk of complications and death – older adults and those with severe underlying health conditions.

Public health is working hard to do more widespread testing to identify and isolate infected individuals so they do not infect others. That so many people with this virus have no symptoms complicates this process.

Our epidemiologists (think “disease detectives”) and other public health workers are doing around-the-clock contact tracing to identify others these sick people might have exposed to the virus, so they can be quarantined and monitored to help stop its spread.

The diagnostic testing (via a nasal swab) we’re doing identifies people currently infected with the virus, so we can begin our isolate-trace-quarantine process. As of April 30, we’ve tested 2,123 people, a tiny sliver of our Northwest Georgia population. This voluntary, random-but-screened testing has produced less than 5% positives (compared to a statewide number of about 17%).

It’s hard to read anything into these results other than that they may indicate the small percentage of our population that’s been exposed to and infected by the virus, another indication of just how far we have to go before the virus runs its course.

Eventually, we’ll need to ramp up serologic testing (via a finger prick) to determine who has had the virus and may – or may not – be immune. We’re not at that point yet, but we’re beginning to see serology tests being offered by some private providers and the CDC in certain locations.

FDA oversight of these tests is by emergency authorization, and test results vary widely in reliability. So, we caution people about relying on them to determine if they might have had the virus and possibly be immune.

We wish we’d had more testing capacity available in Northwest Georgia earlier in this crisis. We didn’t. Failure of foresight, faulty strategy, technical flaws, and regulatory hurdles led to a national coronavirus testing shortfall we are trying to resolve.

We do wish we had more people contacting us right now to be screened for free COVID-19 testing. For the moment anyway, we’ve got reasonable testing capacity and have four test sites set up in Bartow, Floyd, Paulding, and Walker counties. We will be opening more of “pop-up” sites, and you do not have to reside in the county where a test site is located to be tested.

Anyone with symptoms of COVID-19, such as fever, dry cough, shortness of breath, muscle aches, or lack of sense of smell or taste, may receive free testing. We especially encourage anyone with symptoms and chronic medical conditions, such as diabetes, lung problems, heart problems or obesity, to call for screening.

We’re also providing free testing to people without symptoms, including healthcare workers, public safety workers, first responders and other critical workers that may have been exposed to the virus while continuing to work during the shelter-in-place lockdown.

Administrators of long-term care facilities, such as nursing homes and assisted-living communities, with at least one confirmed COVID-19 case are urged to contact us to arrange free testing for residents if this hasn’t already been done.

Our call center is open from 8 a.m. to 7 p.m. Monday through Friday and from 8 a.m. to 5 p.m. Saturday. People may call to be screened for testing.

So, we’re reopening. Even if we do it right, the decision to reopen the state and our Northwest Georgia communities without a treatment or vaccine is a decision to accept more illness and more death for the sake of resurrecting our economy sooner.

Right now, our two biggest non-pharmaceutical weapons against the virus are still hygiene and social distancing. Obviously, both require action on the individual level.

The government can’t wash your hands or decide for you not to go over to a friend’s house or remind you to call an elderly neighbor who’s home alone – but you can. You can also wear a non-surgical mask in public when you can’t practice recommended social distancing.

Whatever course this pandemic follows – waves, peaks-and-valleys, slow burn – we must be prepared for a lengthy period of significant COVID-19 activity with hot spots appearing sporadically. There is no safe way to emerge from our collective shelter-in-place orders and restart the economy before an effective COVID-19 vaccine arrives – but there are smart, science-based ways. Let’s work together to do it.

This commentary by Dr. Gary Voccio, Director of Public Health for Northwest Georgia, was published May 3 in Hometownheadlines.com and is excerpted with permission by the Georgia Public Policy Foundation. Access the full commentary online here

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