Keys and Lockdowns

When an outbreak occurs, the FIRST thing you need to do is isolate it. “Lockdown” is one, usually effective way to do this. It should be undertaken along with tracing to determine whence it originated and who might be susceptible. Until those are determined, the only way to stop the spread is isolation. Full stop.

Innoculation (whether by vaccine or exposure) is, in a sense, a form of isolation. Vaccines, however, take YEARS to develop. The vaccine itself may take relatively little time (months or even weeks) to create in a lab. Determining whether it is safe enough, and effective enough to distribute to everyone is what takes the bulk of that time. With CoVID-19, exposure and infection can result in serious illness and death, and it is not yet clear that any immune response the body may have developed to fight it will last more than a year. Someone once infected could in theory be infected again.

Even after that is determined, a manufacturing process that can produce billions of doses will not be set up overnight. You’ll read of companies that are doing this now. This does not mean a vaccine is imminent; it’s simply smart logistics, not waiting until the last minute to set up and test the process so that it will be ready once the (safe, effective) vaccine is available.Do NOT expect a vaccine to be available within the next two years, in spite of all the hyperventillating stories you read or hear. There is a slim chance it could be ready sooner. SLIM.

The best thing we can do right now to avoid general lockdowns is come up with inexpensive tests that do not need to be adminstered or evaluated by a medic. These tests exist today.

They are called ANTIGEN tests. Currently they cost between $5 and $10 each, as opposed to PCR tests which cost $30 or more each. Antigen tests can be as simple as a card you lick or spit on, wait 15-20 minutes, and see if the card changes color. Depending on the color, the test will tell you if you are negative, or if further testing is needed.

Here’s the thing: antigen tests have a relatively high false positive rate, whereas PCR testing gives a very low false positive. In other words, if a PCR test says you have CoVID-19, you very likely (almost certainly) do have it. On the other hand, a positive result on an antigen test may mean you have it, but there’s at least a 10% chance you don’t. BUT — the antigen tests are at least as good at telling you you DO NOT have CoVID-19 as PCR tests are at telling you you do have it.

So, you distribute these cards widely, and freely — to everyone. Each day, you wake up, spit on the card, wait 20 minutes. If the card doesn’t change (or the change indicates you don’t have it, you go on about your day. If the card indicates you may have it, you (and whoever you’ve had contact with who is likewise not testing negative will go get a PCR test to confirm whether or not you really have CoVID-19. If it turns out you DO have it, you go into quarantine and start getting immediate treatment to lessen (and hopefully shorten) the disease’s impact on you. No further locking down of entire cities would be required.

To do this requires governments doing what we create them and elect them to do: manage our common resources for the benefit of all. Orginsing the resources necessary to do this is something government should be doing. Spending money to make those testing cards freely available to everyone is something government should be doing. That is what government can do to keep the economy going and maintain a semblance of “normalcy”, and avoid or altogether eliminiate the need for widespread lockdowns.

Collateral Damage

Ellen stops off at the grocery store on her way in to work to pick up a few things she’ll need. She pauses by the hand sanitizer and thinks, “I just washed my hands a little while ago. I don’t need to bother.”

She peruses the aisles that have the items she’s after – among these a box of tissues. She’s about to pick up her usual brand but notices another is on sale, so she puts the one down to pick up the other, compare them. She decides to go with her first choice and puts down the “cheaper” one.

Unbeknownst to her, Lachlan was looking at those same tissues a few minutes before. Lachlan didn’t know it at the time (and won’t know it for another few days) but he’s infected with CoVID-19. He doesn’t know what all this mask fuss is about and though he wears one, it tends to slip down around his chin, he frequently scratches his nose, touches his face … and boxes of tissues he’s picking up to decide which one to get.

Ellen takes her items to the checkout, pays, and on her way out does use the hand sanitizer, since she has after all been picking up things other people have been touching. Ellen’s smart and she’s trying to do the right thing.

Mark comes into the grocery store a few minutes after Ellen. They don’t know each other, and they never will. Mark is doing the week’s shopping for himself and his wife Margot, who’s at home recovering from her latest round of chemo. In better times Margot would have gone with Mark. Grocery shopping is one of the hundreds of little things they love doing together. But, today Margo must stay home. She’s “neutropoenic” meaning her immune cells are nearly gone, having been wiped out by the latest round of chemo. They’ll come back as her stem cells reconstitute her immune system. In the mean time, she needs to avoid coming in contact with germs that could make her sick, germs that a normal healthy immune system disposes of thousands of times a day without us being the least bit aware.

Mark has “box of tissues” on his list, and he heads down the aisle and picks up a couple of their usual brand, which he’s pleased to see is on sale this week. Mark pushes his cart to the checkout, pays, dowses his hands with sanitizer, and heads to the car where he loads up the several bags of groceries and supplies. When he gets home, Margot asks, “Did you remember the tissues?”. “Of course, here.”, he says, opening and handing her the box.

A few days later, we find Mark sitting outside the ICU. Margot is inside, fighting for her life. Margot “spiked” a fever a few hours after Mark got home from the store. Mark brought her to the ED, as he had once or twice before. Trips to the ED are not uncommon for neutropoenic patients, and these all had a happy ending after a round of broad-spectrum antibiotics. This time was different. Each time before they’d tested her for CoVID-19 and both times she’d tested negative. This time she tested positive.

Margot never met or saw Lachlan, nor did Mark, nor did Ellen.