The Need for a National Health Policy

When it comes to controlling a pandemic, the fact of states’ rights makes no sense.  Since all states are connected in many ways, but especially commerce and freedom of movement, it is critical that there be a national policy controlling the actions of people.  

For those who say that under the constitution states have to be left to go their own way … nonsense!  The interstate commerce clause allows the government to regulate anything that impacts interstate commerce.  This has been read broadly and is the basis, for example, for federal civil rights laws.  Certainly it would provide a basis for a national mandated policy on efforts to control the coronavirus pandemic.  To not have a mandated national policy in this situation would be madness.

People are the key to either containing the virus or spreading it.  There is thus only one effective way of controlling the virus.

That is testing and contact tracing combined with quarantine.  Everyone who has symptoms should be tested, and if that is not available, should self-isolate on the assumption that they have the virus.

Every contact an infected person has had (which could be as minimal as being in the same room or talking) needs to be traced and told to self-isolate for 14 days, the incubation period, and be tested before being free to be out and about since one could be asymptomatic and still pass the virus to others.

Everyone arriving in the U.S. by plane or any means of transportation must at a minimum be temperature screened for the virus before being allowed to enter.  Interstate travel should be restricted to critical travel and all arriving passengers should be temperature screened.

Initial testing and tracking should occur within a short period of time.  Ideally, during that time people should be told to shelter-in-place and non-essential business closed to minimize the spread of the virus before everyone is tested and tracked.  Once that has happened, life can go back to normal for all but those who have been ordered to self-isolate.

We have not been able to follow that scenario because we were  not prepared; testing capacity was minimal.  The virus therefore has spread unrestricted for probably 2 months.  We also had a very unscientific attitude about the virus … there’s only a few cases, what’s the big deal.  Well, every epidemic starts with only a few cases, and that’s when one has the best chance to contain it.  

We instead waited till there was obviously a serious problem and then resorted to restricting the movement of everyone, indiscriminately.  There was no other choice.  Much of the country is now locked down and we have only begun significant testing in New York City and a few other places.  

The rest of the country needs to be locked down as well.  As soon as the testing capacity is available, the above steps should be followed.  

Once most everyone has been tested or contact traced. and appropriately isolated, business can go back to usual.  There will still be some new infections, but that’s just the way it is.  With continued testing and contact tracing the virus will be contained.

Self-Responsibility during the Pandemic

Each of us has a responsibility to ourselves, our family, our friends, and everyone who comes across our path.  It is only people who can either contain the virus or spread it.  If all people acted responsibly, the virus would come to a halt.

Therefore all people should follow these rules:

1.  If you have any of the following symptoms, stay home and call your doctor.  If you can, get tested.  If you are around other people, wear a face mask.

- loss of sense of smell

- diminished sense of food taste

- fever

- dry cough

- difficulty breathing, shortness of breath 

2.  If you have been exposed to someone who is infected, stay at home for 14  

     days and check for the symptoms.  The virus takes 2-14 days to incubate.

3.  Regardless whether you are infected or not, wash your hands frequently for at 

     least 20 minutes, or use generous amount of hand sanitizer.

4.  Regardless whether you are infected or not, wear a face mask whenever you 

     are in an enclosed space (store, office, public transportation) with other 

     people.  Although a regular face mask is not the best, it will help protect you 

     from air-borne droplets.

The Proven Way to Contain Coronavirus

Most of the world is struggling to contain the coronavirus,  With most countries approaching the coronavirus in a decidedly low tech and not very effective way: limiting the mass movement of people.  

The problem is that the people whose movement you really want to limit are those that are infected, but since there is inadequate testing, you don’t know who they are.  So you have to resort to mass shutdowns. Which helps but doesn’t stop infected individuals unwittingly infecting others in non-mass settings, for example the local grocery store.  

What shutdowns do effectively instead is strangle the economy, hurting almost everyone.  This should be the last resort of government, not the first resort.

But other countries - South Korea, Taiwan, Hong Kong, and Singapore - have successfully used the high tech way to contain the virus: aggressively test and then track the contacts of those who test positive.  Free testing must be provided to all individuals who think they might have the virus or have been exposed to the virus.  You can’t have a successful quarantine and tracking program without adequate testing.

The companion to testing and tracking is low tech face masks.  Free face masks should be provided for all individuals who test positive or who have any kind of respiratory problem.  Face masks for those infected are essential to inhibit transmission.

What about face masks for the rest of the population?  If you live in an area of medium to high population density, and there are reported cases, then everyone should wear a face mask when they are out and about.  It makes it less likely that you will contract the virus.

Certainly no one should be allowed on public transportation … whether a bus, subway, train, plane, or ship … without wearing a face mask.  In each of these situations, you have people packed in a confined area.  Since there’s always the possibility of having contact with someone who is infected but asymptomatic, everyone should wear a mask.

So what do we need to do, at a minimum?  

1. We need to have millions of tests available ASAP, and the lab capacity to handle tests in large numbers.  All testing should be free.
2. Quarantine and tracking should be rigorous.
3. Daily temperature taking should be universal.
4. We need to assure an adequate supply of face masks and they should be supplied for free at convenient locations.
5. We need a smart nationwide marketing campaign to encourage people to practice good hygiene, get tested and to wear masks; mandatory on public transportation.
6. People need to take responsibility and self-isolate and report themselves if they feel they may have the virus, even if testing is not available, or if they have come into contact with someone who is infected.
7. Screen everyone coming into the country.

Yes, the Coronavirus Is Different from the Flu, but Acting out of Fear Is Not Smart.

I live in Massachusetts, in the Berkshires ... 7 cases as of today.  When I went to the supermarket today, the place looked like it had been ransacked.  The shelves were almost bare of canned goods, paper products, broth … all kinds of products.  What is going on?

The President has basically said, what’s the big deal?  Each year we see deaths from the seasonal flu of between 12,000 and 60,000, but the media mentions not a word about it.  In this case, even if you look at China, deaths are at around 3,100, Italy 600.  Why is the media making such a big deal about this?  It reminds me of what they do these days with bad weather events; everything is catastrophized.

There is one big difference between the seasonal flu and the coronavirus: there is a vaccine each year for the flu.  Millions of people, around half of the U.S. population, get their flu shot each year.  Because of that, people feel comfortable engaging in all normal activities during the flu season.  And because of that, there is no slowdown in production, travel, events, etc. and thus no major economic consequence, despite all the deaths.

But because there is no vaccine for the coronavirus, it’s an unknown, and it can result in death, albeit in only 1-2% of cases, people are very leery of going about their usual activities.  Especially since undoubtedly many people are walking around infected because they don’t know they are as testing is hard to come by and there is much confusion.  This fear, and the fear of countries, leads to drastic measures.  It is these measures, not the deaths or illness, that cause the economic disruptions that investors fear.

A recent article raised the question, specifically regarding China, whether the “cure” of lockdowns is worse than the danger.  That is a very good question.  If people went about their business as usual while being very conscientious about washing their hands frequently and thoroughly, you would almost certainly have more spread than with a lockdown, and more deaths,   But you would have to have 500,000 cases of virus before hitting the lowest number of deaths from the seasonal flu.

It really comes down to fear … on the part of individuals who don’t want to get sick and possibly die, and by governments that don’t want to see their citizens overwhelmed with this new “plague.”

If I look at the situation rationally, on balance I would say that healthy people should go about their business as usual unless they live in a virus “hot spot,” but they should maintain social distancing, that is not go to crowded bars or theaters ... actually such places should be closed ,,, and not go on a cruise or fly in an airplane, both of which pack people in intimate quarters.  And they should wash their hands often and thoroughly.  If you use public transportation, wear a mask.

People who think they may be infected or have had contact with someone who is or may be should be tested immediately.  People who are infected or think they may be should self-isolate so that they do not transfer the virus to others and they should wear a mask, both at home and if they do go out.  Shutting down the country is not necessary if people act responsibly.

Think about it.  You have a greater chance of dying or being seriously injured from a car accident or the flu than from the corona virus.  You should act accordingly.  For once, Trump has the right idea, even if for the wrong reason — his political self-preservation.