Open smart, I and other economists argued back in March. Don't just shut lock down the whole economy willy-nilly. An auto-body paint shop (they wear masks and respirators anyway) is not likely to spread covid-19. Parks too. Test widely, randomly, to stop the spread of the disease, not just to diagnose the sick.
At last, perhaps, we may be headed this way, reports the Wall Street Journal
Scientists are settling on a road map that can help critical sectors of the economy safely conduct business, from meatpacking plants to financial services, despite the pandemic’s continued spread.
After nearly a year of study, the lessons include: Mask-wearing, worker pods and good air flow are much more important than surface cleaning, temperature checks and plexiglass barriers in places like offices and restaurants. And more public-health experts now advocate wide use of cheap, rapid tests to detect cases quickly, in part because many scientists now think more than 50% of infections are transmitted by people without symptoms.
We have a long way to go before vaccines stop the spread of the disease. Tests could do it now, if the FDA would get out of the way. Yet
a year later, sufficient testing remains a critical issue.
Test detail
One of the largest studies of asymptomatic transmission to date showed that frequent testing was essential in identifying infections among a group of nearly 2,000 Marine recruits...
The study looked at cases identified with lab-based tests that search out and amplify the genetic material of the virus, but those tests aren’t as easily scaled as so-called rapid antigen tests, which search for viral proteins.
Results from lab-based tests can sometimes take days, while results from rapid tests are usually available in less than an hour...
The shift toward using frequent, inexpensive and rapid tests on the same people multiple times a week to screen entire populations—instead of one-time tests on individuals who have symptoms—will be important to efficiently break transmission chains, epidemiologists said.
“Unless we’re doing really broad, frequent screening of the people at large, we’re completely missing the vast majority” of infections, said Michael Mina, an assistant professor of epidemiology at the Harvard T.H. Chan School of Public Health. “We have to change how we’re doing this.”
I'm sure Paul Romer is saying, great, now the scientists finally get it. Well, they do. Next the FDA.
Ventilation
Indoor ventilation has been on my mind. Why is outdoor dining safe and indoor not? Is it really safe to dine "outdoors" in a plastic tent, as has become the hilarious practice around where I live? If outdoors is safe, but indoors is warm, can we not make indoors as safe as outdoors with ventilation, HEPA filters, and UV light?
Fresh air and effective filters indoors are important because they can remove virus particles before they have time to infect.
So this is a non-grumpy post. We have a long way to go with covid, and the next one after that. To see some durable wisdom breaking out is refreshing.
All of the things you note were known months ago (I was writing about all this in my daily newsletter that I started in late March). It's not rocket science. The difficulty is some of the remediations are costly such as making changes to indoor ventilation systems. In some old buildings (lots of bars and restaurants fall in this category) it is hard to do. Think about your old stomping grounds at Univ of Chicago and how many older buildings with inadequate air flow, particularly during the winter, there are. This is one of the key reasons we see more cases of infectious disease transmission. There are a large number of people in the US that refuse to believe simple public health measures can stop the transmission of SARS-CoV-2.
ReplyDeletePart of the problem is that our infrastructure wasn't designed to deal with pandemics. It was designed around the formation of capital and prosperity. Interruptions of normal behavioral patterns wasn't really factored in, because who can manage many horrible scenarios that may or may not come to pass?
ReplyDeleteLike Mike Tyson said, "Everyone has a plan until they get punched in the face."
Well, we got punched in the face alright. Will institutions and the economy resurface to be more durable? Hard to say. Again, preferences matter.
I'm all for reopening "smart" but who really has a bead on what "smart" is? We're still arguing in politics what constitutes a fact and everyone wants their own version of reality.Being smart is a function of analysis, being able to diagnose the right problems and the will to actually fix them. But, we'll probably stumble along as we've always done through time.
Agree entirely that widespread testing with rapid turnaround of results _should_ have been a key part the overall strategy. The Trump administration was adamantly opposed to that because the data failed to support Trump's magical thinking.
ReplyDelete