From Dr. Stuart Weiss, Intelligent Crowd Solutions

What’s missing in our CoViD-19 response?
Yesterday, one of the readers of our newsletter kindly took some time out of his day to write to me. He was concerned that I was trying to make our President look bad by not reporting successes in our pandemic response. That disturbed me quite alot and I have spent time today pondering whether my comments have been fair to the current administration.

So before I get into that question, let me answer a question he posed about why I wasn’t writing about the steady decline in deaths. The problem is that we had a very appreciable decline in deaths until a week ago and now we are in a steady state with no appreciable change day by day which the modelers athealthdata.org (Institute for Health Metrics and Evaluation, Univ of Washington) predict will remain constant until we begin to spike up again in September. These guys tend to get their models right so far and are used by the White House pandemic team. Take a look at https://covid19.healthdata.org/united-states-of-america and scroll down to daily deaths chart. So I haven’t written about it because it doesn’t seem to be happening any longer.

So back to the question at hand. I have decided from a public health perspective, that if any President was handling a pandemic the way the current one is handling it, I would be as critical. This is not to say that they haven’t gotten some things right but from an overall perspective, their grade is at best a C+.

Here is what is missing. If we look at other countries around the world that have successfully reduced their new case counts low enough where they are reopening society and opening borders , we see a key strategy emerge: What they are doing is actively and aggressively breaking the chain of infectivity of this virus. They find an active case, they then do contact tracing and figure out everyone who has come into contact with that person. All of those people are contacted and told to self quarantine. Those people are tested to see if they are infected or become infected. Testing is readily available and results come back quickly. People reduce the risk of infection by wearing face coverings and maintaining social distancing. It is a sign of respect to wear a face covering in Asia following the premise that I honor you by protecting you from my germs, and you honor me by protecting me from your germs. I protect you and you protect me. Its a sign of respect.

So why are world leaders watching in disbelief at what we are doing in the US and why is the NY Times reporting that the European Union is planning to ban travel by US citizen to Europe because we are too dangerous. Its because we not doing many of the things needed to break the chain of infectivity. This is a national crisis that needs a unified national strategy. Allowing piecemeal decision making by individual Governors lets the virus grow in areas with looser restrictions instead of cutting it off uniformly across our country. I have been doing infectious disease planning for over 20 years and that is a basic planning principle. Second, we are not actively seeking out sick people and doing active contact tracing uniformly across the country. Some states are getting organized, others are not. Instead, we should have activated all of the Americorps or Peace Corps young volunteers that have been brought home and trained them to be contact tracers. How about activating Army Reservists to help with contact tracing. Under Posse Comitatus Act they can’t do domestic law enforcement but I don’t think that applies to contact tracing. We have many resources to use across our county that are not being used. Finally, not having widespread testing available with rapid results reporting by this time in our pandemic is unbelievable to me. This is something that could have been organized nationwide using the Defense Production Act and our wide array of medical laboratories. We should be able to do a test and get a result in a few hours. I can order stuff online and get it the SAME DAY, why does it take 3-4 days to get CoViD-19 results. That’s 3-4 days of spreading the virus if someone is infected.

These basic pandemic response strategies have been written about and planned for over the past two decades. Starting with work I did on the Biologic Weapons Improved Response Program to pandemic planning a decade ago, smart people have gotten together and planned for what we are going through right now. This is not new, we have been waiting for this to happen and were actually over due.

So getting back to the question. These critical actions are Federal actions and not State actions. By delegating these actions to Governors, President Trump has made a critical error in his response strategy. From a public health perspective, this strategy is a failing one. So my critical evaluation of his response is not political, it is based on the science we used to do these many years of planning. He is making an error in judgement by not listening to his science advisors who have been doing this planning for many years.

That is the difference between us and many other countries. They are succeeding because their leaders are basing decision on the science of viral spread and not on political ideas. The virus doesn’t give a rat’s ass about politics. It follows specific rules and we are not doing what it takes to stop it. So we will limp along at our current death rates until September when we will begin to skyrocket again.

Thank you “R” for writing to me and asking your question. It gave me the opportunity to write this column today.

Be well and practice good social distancing. Also, take care of yourself. The number of out of hospital cardiac arrests is way up. You can still have heart disease and diabetes and asthma during a pandemic. Don’t skip regular checkups.
–Dr. Stu