Why the Surge, Really?

“Because they have failed to make the requested and greatly needed reforms, we will be today terminating our relationship with the World Health Organization and redirecting those funds to other worldwide and deserving urgent public health needs… The world needs answers from China on the virus. We must have transparency.”                            

Donald Trump’s statement on withdrawing the United States from the UN’s World Health Organization on July 7^th.

As one of those older folks with vulnerabilities to infection from the novel coronavirus, I watch the numbers and look at the behavior most likely to subject me to infection. Because my blood type is type A+, I was not heartened by this statistic: “A European study published last month in the New England Journal of Medicine found that people with Type A blood were 45 percent more likely to develop severe COVID-19 requiring oxygen supplementation or a ventilator than people with other blood types and that those with Type O blood were 35 percent less likely. The study involved 1,610 patients with severe COVID-19 and 2,205 control subjects.” NBC News July 7th. 

New York has restricted travelers from 19 states when they arrive to the state, and other regions have imposed similar quarantines: Traveling from California to New Mexico – by train, car or aircraft – welcome to a 14-day quarantine order. While many in deeply red states still resist orders to wear masks, that wall of resistance is crumbling in all but the most diehard Trump-supporting constituencies. The list of subsequently infect world leaders who have marginalized or dismissed the significance of the virus has witnessed two interesting cases: The UK’s Boris Johnson is much more concerned with the outbreak as he himself barely survived a serious bout with the virus, and we are now watching to see if Brazilian strongman, Jair Bolsonaro who tested positive, will develop horrific symptoms as well. 

That we are now experiencing the majority of new infections in the under 45 age group might surprise some of us, but when you see which of the habits of the younger matter, you will understand way. They might feel invincible, although there are mounting fatalities and hospitalizations in this demographic; they are generously able to spread the virus to their older family members… and often do. We’ve learned a lot, and some of the results are not what we expected. The July 7th Los Angeles Times summarizes what we know and what we should do about it: 

“Because the new coronavirus is, well, new, there’s still a lot we don’t know about what makes a situation safe instead of a potential COVID-19 hot spot. But tentative answers are coming in now, sometimes at great human cost. 

“The [Black Lives Matter] protests don’t seem to have caused any major health problems, even though the participants often were in close proximity and were frequently yelling, which increases the exhalation of droplets. Demonstrators in Boston were no more likely to test positive afterward than the city’s population as a whole. The rates of positive tests were similarly low among demonstrators in Minneapolis and Seattle. A national study by the National Bureau of Economic Research found that overall, coronavirus rates were no higher in counties that were the sites of large protests than those that saw no demonstrations. 

“These findings are far from definitive, however. In Los Angeles, demonstrators had trouble getting testing appointments, which could mean that some cases are unknown and uncounted; in New York City, city officials instructed contact tracers not to ask people who tested positive whether they had attended protests, as though ignorance was going to make people safer… Massive gatherings still aren’t a good idea — some protesters did in fact become infected — but there’s no indication so far that the protests were super-spreader events. Being outdoors almost certainly helped. 

Instead, the most common sources of recent COVID-19 surges have been some of the smallest venues, especially bars. People there are socializing indoors, often in close proximity, talking loudly to be heard over the chatter, alcohol loosening their sense of caution, their masks coming off as they drink or not worn at all. A single Michigan bar has set the stage for more than 150 COVID-19 cases so far. 

“The long-awaited reopening of indoor restaurants also appears to be a contributor. A J.P. Morgan study found that increases in on-site restaurant spending — not takeout — strongly predicted rising COVID-19 rates over the three weeks that followed… Private get-togethers are repeatedly cited by health officials as problematic. Contact tracing in Sacramento found that the biggest sources of recent spread there were graduation parties, funeral gatherings and the like. Caution falls away when we’re with people who are known, loved and trusted… 

“It would be premature to draw too many lessons from the limited data we have at this point. Still, the lectures given by public health officials appear to have been borne out in key ways. Outdoors is clearly less risky than indoors. Social distancing is needed, as are masks, masks, masks. COVID-19 is apolitical and without judgment; it neither rewards protesters nor punishes people who want a drink and some company. It just follows the laws of science. 

“Those are laws we have to understand much better if reopening — and re-reopening — are to work. People need to know which outings and activities minimize risk while providing a semblance of normal life. Most local beaches were closed for the July 4 weekend, but were those beaches, even if crowded, more dangerous than the block parties or backyard barbecues that replaced them? Is a beach significantly more dangerous if it’s crowded? And is that more or less risky than a visit to a salon or a workout at the gym? Do trendy, open office spaces need to return to high-walled cubicles? People are guessing, and guesswork doesn’t make for good public health policy. 

“That’s where contact tracing comes in. The goal of tracing is to reduce the spread of disease by finding and contacting people who may have been exposed so they can be tested. But it also can provide a mountain of data about the relative safety of different activities and environments, just as it did with the private celebrations in Sacramento. Some tracing exists, but as with many of the nation’s efforts, it is not nearly robust enough. That would take concerted support in terms of money and policy at the federal level, which so far has been missing… The task is monumental and costly. But gaining a better understanding of how the virus is spreading is key to learning how to live with COVID-19 until the disease is tamed.” 

We also need massive doses of common sense, truth and transparency, vastly more PPE supplies, a reprioritizing of human life over earning money (with concomitant government financial support for those impacted), the depolitization of safe distancing/mask wearing and, most of all, for people who think that it is their right to move freely about without masks even in hot spots to accept responsibility for their actions… and their potential to kill or infect others. There is no constitutional right to move through society freely without personal responsibility… or drunk and reckless driving would be legal. We do not need is to avoid coordinating pandemic responses on a global level. Everybody loses when the US leaves the World Health Organization. 

I’m Peter Dekom, and as long as any area of the United States is at risk from unchecked increases in infection rates (36 states as of this writing), we are all at risk!