This week my dog Biscuit and I saw a number of questionable ideas that have gained attention in the press and social media. He says it is time to call out the eight worst ideas about the coronavirus this week.
1. Using Navy hospital ships for coronavirus support. The US Comfort has been barely utilized for coronavirus support in part because they aren’t allowing infected patients on board. There is a good reason for this. The ship is set up for orthopedic injuries and medical evacuations, not to treat patients with an infectious respiratory disease. The bunks are put very close together and are not like a hospital bed. The quarters are so close that anyone who doesn’t have coronavirus will quickly catch it. Therefore, while this was a nice symbolic commitment, this ship is unlikely to help in an infectious disease outbreak.
2. Assembling large” holding hospitals” in convention centers. Most coronavirus patients requiring hospitalization need intensive respiratory therapy or ICU care. Putting lots of beds close together with patients that may (or may not) have coronavirus makes for a breeding ground for the infection. Appropriate precautions really can’t be taken to avoid spread, and patients would be better off at home unless they have no support at all. In these dire situations, every single patient who goes into a convention center facility must already be infected.
3. Virus PCR (swab) testing to determine the extent of COVID disease in the population. This has been suggested by several “authorities,” however PCR testing only identifies people who are actively shedding virus. Shedding, however, is only a small part of the coronavirus infection cycle. People can be infected before they shed virus and certainly have evidence of having been infected after they stop showing the virus. Screening with PCR will not give any idea of what the extent of infection is in the population (which should be done with antibody testing as I’ve talked about in some of my other blogs).
4. Not social distancing. Data now validates the concept of social distancing to control this peak of the pandemic. Unfortunately, many areas where social distancing hasn’t been effectively implemented are setting us up for more difficult times ahead and the prolongation of the acute phase of the pandemic.
5. Holding the Wisconsin primary. Wisconsin has been effective in social distancing, but holding a primary election with in-person voting has the potential to reignite the epidemic in that state.
6. Cutting off Canada. Maybe I’m biased because I live in Michigan, and Canada is nearby, but enough people come over the border that Canada is essentially another state. The decision to prevent 3M from sending masks to Canada probably won’t help the US in the long run. Also, enough people come over the boarder to Detroit for work that anything that prevents them from wearing a mask is not helpful. For example, 40% of the nurses in Detroit are from Canada!
7. Screening stool samples for virus. While screening sewage for virus may have some merit, it seems less valuable relative to other screening methods of individuals. You can also find the virus in almost any human secretion.
8. Not taking precautions if you are in a high-risk group. Refusing to wear a mask or taking other types of CDC directed precautions when in a high-risk group is the worst idea of the week. People in high-risk groups (such as the elderly) tend to be around other high-risk individuals. Since even many high-risk individuals can have asymptomatic infections, wearing a mask will protect others!