Saturday, April 04, 2020

How to Eliminate COVID-19

How to Eliminate COVID-19
Nicholas Johnson
The Gazette, April 4, 2020, p. A6

There is a way to eliminate COVID-19.

Because we refused to use it months ago this lifesaving approach has passed us by. But it still holds lessons for what we can do.

Ironically, the best illustration of the strategy comes from Italy, the nation second only to the U.S. in numbers of infected people.

In the Veneto region of northeastern Italy lies the community of Vò Eugeneo, home to 3,300. It was the first Italian town to record a COVID-19 infection and death. [Photo credit: unknown]

On Feb. 21 two people were discovered to have the infection. The next day one died. By March 6 the University of Padua had designed and begun a study that required testing all Vò’s residents. Researchers discovered 90 infected people, traced contacts in their families, workplaces and neighborhoods. All who might be infected were quarantined. Two weeks later there were three. When their quarantine ended everyone was tested again, found free of infection, and the Veneto region’s Gov. Luca Zaia called Vò “the healthiest place in Italy.”

In another “community” with about the same population (3,700), at about the same time (Feb. 3), 10 people aboard the Diamond Princess cruise ship showed symptoms of COVID-19. On Feb. 4 the ten were put in a Yokohama hospital. The others were quarantined on the ship. When they disembarked, Feb. 19, all were tested. Roughly 20% (619) had contracted the virus. [Photo credit: Diamond Princess in Yokohama - wikimedia - By NEED - Own work, CC BY-SA 4.0]

In one case the number infected went from 3 percent to 0 percent. In the other it went from less than 1 percent to 20 percent.

In that difference is found how to eliminate COVID-19 — along with a warning why what Iowa is doing is so unnecessarily deadly.

It is as if our ceilings are leaking and our response is to mop while teenagers go buy more buckets. We are treating those with COVID-19 symptoms — as of course we must — while simultaneously increasing the number of those infected.

The brutal facts are that you don’t have to have symptoms to spread the disease. In Vò, everyone was tested. Those infected — with and without symptoms — were quarantined. On the Diamond Princess (as in Iowa) the focus was on those with symptoms.

How many infected people, capable of spreading the disease, have no symptoms? In Vò it was 45 percent. On the cruise ship it was 46.5 percent. [Chart: Increase in Iowa COVID-19 cases March 8-April 6; 946 confirmed, 25 fatal; Chart credit: Bing COVID-19 Tracker]

Even if we knew how many Iowans have symptoms, the number infected potentially spreading the disease is at least twice that.

The primary strategy we’re left with is mandated and enforced shelter in place. Governors who refuse to do that — and forbid their counties and cities to do it — will necessarily bear some responsibility for the resulting unnecessary deaths.

We lost the opportunity to test-trace-quarantine-and-test-again, so successful elsewhere. We failed to heed years of official and fictional predictions of this pandemic. We failed to resupply our stockpile of materials to fight it, and wouldn’t use WHO test kits. We cut support of federal public health programs and staff and were either unaware of or rejected their tested proposals for response. The costs of those failures in unnecessarily lost lives and trillions of dollars are behind us.

The least we can do is to not make it worse.

Nicholas Johnson, Iowa City, was co-director of the Institute for Health, Behavior and Environmental Policy. Comments:

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Related Posts

COVID-19: Your Reading and References List; The Story, The Sources April 2, 2020 (sources used in the preparation of this op ed column, organized by categories)

"Find Your Household Thermometer" (blogpost: "COVID-19: Home Test Kits & Other Thoughts"), The Gazette, March 22, 2020, p. D2

And see the somewhat more upbeat but still relevant, "Celebrating 'возникают и расцветают'"

Tags: #asymtomatic, #CDC, #COVID19, #CruiseShips, #FlattenTheCurve, #hospitals, #Italy, #PPE, #PublicHealth, #SocialDistancing, #TestKits, #Ventalators, #VoItaly, #WHO

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