The Virus of the century
COVID-19 has been a pandemic for the record books. So many schools, offices, and government departments have closed. This pandemic has turned into a panic, mostly because there has been a lack of clarity on the issue. The panic has led to drastic declines in the stock market and a run on stores. The response to this pandemic is unlike anything seen in our lifetimes. Currently, tens of millions of Americans are under quarantine or restrictions, and that will not be ending anytime soon.
The National Discourse
The national discourse on the response to COVID-19 is based on a false dichotomy.
The dichotomy is presented as shutdown versus reopen. One side of the political discussion promotes shutdowns in the name of protecting public health, while the other side of the political discussion promotes reopening in the name of protecting the economy.
The health of the economy is contingent on the health of the nation, and the health of the nation is contingent on the health of the economy. Myopic political discussions fail to grasp the interdependence between the two variables. There are valid arguments to both perspectives, and this simple fact is enough to prove that a nuanced discussion and a nuanced approach are needed to safely return to normal. This presentation will attempt to provide a balanced and nuanced discussion of our battle against this invisible enemy. Please note that every idea listed in this presentation is a suggestion.
The seen and the unseen - Balancing the costs of both
There are people dying. When evaluating this statement, one must remember that it is true every day. On one hand, people are dying from COVID-19 at an alarming rate, on the other hand, people are dying due to the effects that COVID-19 has had on the nation. There are patients in need of blood who are going to die on waiting lists. Every year, 1.7 million people are diagnosed with cancer, but many patients have had their procedures delayed.
The side effects of shutdowns can also take a toll on people's health. Violence and suicide increase during times of crisis. This effect is exacerbated due to the negative economic effects of the shutdown.
While shutdowns have had negative effects, they are intended to prevent the overwhelming of health care systems. If infections rise too rapidly, there could be negative effects for people in need of care for unrelated issues. If ICUs are full with COVID-19 patients, where is the gentleman with asthma going to go if he has an attack. Also, hospital infections are one of the leading causes of death in the United States. For every person who dies in a car accident in the United States, more than two die of hospital infections. With a dangerous virus spreading, it is important to remember that the risk of overwhelming the health care system is exponentially more hazardous.
Where we are today
"At this point, 48 states are either fully or partially reopen. Now is the best time to implement meaningful steps to avoid acceleration infections and serious illness. If meaningful steps are not taken, the American People will be back at square one." - Logical Policy Organization, May 2020
As of September 2020, this prediction has come true. Failure to take meaningful steps to combat the virus has resulted in an explosion in virus cases. In essence, our leaders pressed pause by issuing a national shutdown. Reopening essentially "pressed play," and here we are today.
Managing the effects of covid-19 on our health
We must A.I.M to beat this virus using this three-step approach:
Avoidance - The steps taken to avoid coming into contact with the virus.
Interception - Efforts to prevent the virus from infecting anyone.
Mitigation - Mitigating the damage the virus causes if a person does become infected.
Managing the effects of covid-19 on our Economy
According to economists, we are already in a recession. With unemployment levels the highest since the Great Depression, the economic ramifications of COVID-19 on our economy can not be overstated.
It is estimated that around one-in-three Americans did not pay rent in either March or April. Since 78% of Americans live paycheck-to-paycheck, unemployed Americans are in danger of losing necessities (food, housing, etc) as each month goes by.
In response to this crisis, the American people need a safety net.
VEARN , Voluntary Agreement to Retain Necessities, is a voluntary agreement between companies, landlords, banks, and tenants, etc. VEARN is the brainchild of the Logical Policy Organization. It would allow consumers to delay payments on their necessities, such as rent, in exchange for paying off the balance over time.For example, if Kimberly pays $1,500 per month for rent, but she does not have the ability to pay, she could face eviction if she misses a few month's payments. With many sectors of the economy shut down indefinitely, returning to work is not an option for millions. With VEARN, Kimberly could get her payments delayed while she searches for another job or waits for shut downs to be lifted.
Other suggestions for managing consumers' inability to pay bills, particularly rent, entail empowering government to prevent landlords from charging rent. This is harmful because landlords pay bills just like renters do. If the government wants to help landlords and renters, they should consider canceling property taxes, and taxes in general to give both landlords and consumers a reprieve.
VEARN is superior to other suggestions because:
- There is no legislation required, so political cronyism will be non existent.
- It is in line with industry practices (e.g. payment assistance for car owners.)
- It helps consumers by preventing a tsunami of payments after the crisis ends (for example, payment assistance for three months that require a customer to pay entire balances on the fourth month.)
- It considers the needs of businesses and consumers.
- It provides clarity to the consumers, businesses, and the entire economy.
We need an agreement that stabilizes the economy, gives landlords and businesses the money they need to pay their bills, and gives consumers the time and flexibility they need to pay their bills. VEARN does all of the above.
How would VEARN work? Banks could give loans to people to finance their necessities. These loans would be long-term, low-interest loans, say 1% - 5% interest over 60 months. It is likely that those with the best credit ratings would receive these loans, and that banks would be extremely hesitant to loan money to those with bad credit. If this is the case, the funds flowing in from those who would receive these loans could give landlords and businesses at least some money to work with. Something is better than nothing. In addition, the loans would generally be made for rent, food, car notes, etc. These loans may total a few hundreds to a few thousands every month. This fact would make these loans significantly less risky than home loans during the housing boom of the 2000s. Still, there is risk. Given the uncertain nature of this economic environment banks would be justified in exercising heavy caution.
VEARN is not legislation (the V stands for Voluntary), so there would be no requirements for anyone to participate. It is just a suggestion to help mitigate the economic fallout resulting from COVID-19.
If there is a Major second wave of COVID-19
During the Spanish Flu, the second and third waves of the virus were deadlier than first. According to some experts, we are still in the first wave. If there is a major second wave of COVID-19, it is important to:
1. Remove Restrictions on hospital construction (e.g. Certificate of Need Laws), doctor licensing by state, PPE, and rapid testing.
2. Isolate the sick and the susceptible as opposed to the healthy. Boost the immune systems of the sick.
3. Hire grocery delivery companies like Instacart, Shipt, FreshDirect, Walmart, Amazon, Boxed, PeaPod, Kroger, Target, and others companies to deliver food, water, and necessities to at-risk citizens if they are isolated.
4. Allow the healthy to continue normal life. Those who are healthy (and particularly those who live alone) to continue living normal life with precautions.
5. Allow businesses to create COVID-19 safety guidelines as opposed to shutting businesses down.
Getting ahead of the virus
Countries that took aggressive actions to attack the virus and prevent its spread have low case numbers and few fatalities. Countries that dithered have high transmission and high fatalities. All countries that avoided the wrath of the pandemic perfected two things: testing and quarantine. To quarantine effectively, you must test. To test effectively, you must have low numbers of cases. To have a low number of cases, you need to effectively test and quarantine. Countries that have low case numbers tested and quarantined before the cat was out of the bag. Now that the cat is out of the bag, identifying people quickly enough to prevent the spread of the disease is impossible in the current iteration of the United States’ testing apparatus. The current system of testing is tantamount to running on a treadmill. It would be impossible to get ahead of transmissions until herd immunity is reached. At that point, every effort to contain the virus will have been for naught. After shutting down the economy and putting millions out of work, putting the country into a recession, and disrupting the lives of millions of Americans, we cannot afford to fail.
To get ahead of the pandemic, we must effectively “reset” the pandemic. Politicians left and right call for a ‘surge in testing.’ Where is anyone going to find 330 million tests in one day, one week, one month, or even one year? Currently, the US is creating 500,000 tests per day. And each test is useless the second a person who tests negative comes into contact with another person.
Operation Cover and Catch is the brainchild of Logical Policy Organization. This plan is designed to quickly identify cases by pool testing large groups, then testing those in the large groups who have symptoms of COVID-19. This plan is similar to other pool testing strategies, but differs in from other strategies in its end goals. This plan is designed to get ahead of the virus as opposed to other plans that only intend to identify cases.
Pool Testing is the testing of multiple samples at once. Pool testing will allow us to test more people more expediently. The key to beating this virus is fast testing. If scientists combine people into groups of, say, 10, we could test half of the country in one month. Groups should be based on proximity. For example, offices could provide company-wide testing, or testing centers could test by family, as opposed to the current on-demand, symptom-based testing strategy that does not provide a path forward. While pool testing would not provide an answer for each individual, the data this testing strategy produces is invaluable to scientists.
This testing strategy will tell us how many cases are in the USA. If, say, 40% of networks of 10 test positive, we know that at least 4% of Americans have the virus. That will put us at a minimum of 13.2 million cases. It will also inform doctors of how lethal the virus is. 170,000 deaths in a total of around 5,000,000 cumulative cases in the United States is different from the same number of deaths among 13,000,000+.
This testing strategy protects the privacy of Americans. Instead of relying on contact tracing, a switch to network testing provides scientists a more reliable network for testing. Network testing is superior to contact tracing because it serves to predict the future of transmissions, not analyze the past. Also, this testing strategy will highlight infection hot spots quickly. This will allow resources to be surged to those places. After resources are surged to hot spots, scientists can begin to test those who have symptoms within networks that test positive. This will drive transmission down and put us ahead of the virus - the position that we need to be in to successfully fight the virus.
The size of networks is paramount to Operation Cover and Catch. The size of networks will be based on random testing. Scientists will randomly test a given number of people (say 1500) in a given area. The same way a pollster randomly calls phone numbers. Those people will be tested. The positivity rate will be used to establish the size of testing networks. If the positivity is less than 10%, a network of 10 could be used in that area for offices. If positivity is greater than 10%, but less than 20%, a network of 5 could be used. If positivity is greater than 20%, but less than 33% a network of 3 could be used. For positivity rates above 33%, antibody testing is likely more advisable.
Operation Cover and Catch is designed to bring the testing to the people, eliminating the long lines and wait times that occur when the people have to be brought to the tests.
Concurrent Testing is advisable for those showing symptoms. Concurrent testing is testing wherein a person is a part of two networks. While being a part of two networks is redundant, it could help isolate a positive case within a network. For example, if an office tests 10 workers, and the results come back positive, a worker experiencing symptoms could be tested as a member of another network, say the worker and his family. Workers who are experiencing symptoms should be tested first, and a worker who tests positive should have his family tested with antibody tests if the family members are not experiencing symptoms, and regular tests if they are.
Rapid tests would be useful for concurrent testing. Any network that tests positive could tests its individual members and their contacts with rapid tests.
The use of these strategies together could contain the virus within months, but definitely by the end of the year.
tentative COVID-19 Information
Humidity & Temperature - COVID-19's potency could be reduced at certain humidity and temperature combinations. Studies have been done that shows temperature and humidity can diminish the potency of coronaviruses. In a study that was chronicled by the Annals of Internal Medicine, COVID-19 positive patients were given face masks and were instructed to cough into a petri dish. The outside of the masks had COVID-19 on them, while the inside of the masks did not have as many COVID-19 particles on them. This supports the idea that heat and humidity can attenuate COVID-19. Office buildings and schools could experiment with heat and humidity.
Ultraviolet Light - is being used as a disinfectant in some hospitals. This method of disinfectant is currently being used in rooms when absent of people, but methods to develop a UV disinfectant that can coexist with people.
COVID-19 Spray - It has been reported that a spray has been developed that can prevent surface contamination by COVID-19 for up to 90 Days.
COVID-19 & Dogs - It has been reported that Britons are training dogs to detect COVID-19.
Reopening Schools, Businesses, and Institutions
School districts that use an August through May calendar should consider moving to a September through June calendar. This will give schools more time to prepare for the virus.
Eventually, all students will have to return to school, whether physically or otherwise. There are several options that school officials can use to continue education in the fall.
School districts could divide students into two groups and alternate physical and online schooling for each group. Group A could attend physical classes on the first and third week of the month, while Group B attends classes on the second and fourth week. This would allow for a regular, predictable cleaning schedule.
It is definitely advisable that all schools switch to a flipped classroom model. The typical classroom entails lectures in school and practice (homework) at home. With time being of the essence, all face-to-face time must be used to its maximum efficiency. A flipped classroom model entails taking notes at home, and doing practice in class. A flipped classroom model would also drastically reduce homework. Contrary to popular belief, a flipped classroom model would be best for those with limited/no access to internet. They, like other students would have a textbook to reference. In addition, switching homework to classwork gives students more time to practice in a supervised environment, while being able to ask for assistance from teachers. In a traditional model, students without access to online resources would spend precious time taking notes and being lectured. Afterwards, they would be sent home with no resources available to help them. In a flipped model, students without access to online resources would have more time for assistance. A flipped model would buy school district more time to adjust to the virus. A school district could provide notes and practice digitally for a quarter or even a semester, then use the rest of the school year to review. This works well because students will already be familiar with the concepts due to the notes and practice.
Business & Institutions
The 2005 National Strategy for Pandemic Influenza calls for businesses and institutions to devise their own strategies for responding to pandemics. While COVID-19 is not an influenza, the strategy to fighting it will have overlap with strategies for fighting influenza. It is imperative that businesses and institutions experiment with different strategies to see what works best for them.
Shutdowns, blanket rules, and restrictions are not followed because they do not fit everyone. Some jurisdictions have established curfews. These curfews could increase virus transmission by forcing more people into the same spaces in smaller windows of time. For example, the 24-hour grocery store that is forced to close at 8 p.m. will have less physical distancing because the same number of people will shop. Allowing stores and businesses to create their own guidelines allows for flexibility and avoids the unintended consequences of blanket mandates.
Offices should consider abandoning the 9-5 schedule, and allowing workers to work remotely as much as possible. If remote working is not possible, businesses and institutions should consider adjusting their hours. Physical distancing is more achievable in an office that provides flexible hours for workers.
Also, businesses and institutions should evaluate their production strategies. The average worker is only productive for three hours in a day. Companies should evaluate how to maximize productivity while minimizing time used. Businesses could also invest in plexiglass "bubble" dividers to replace the cubicle floor design model.
Schools, businesses, and institutions can all look into real-time mapping of human traveling inside of their premises. Areas of consistent contact could be redesigned. Air samples could be taken and tested by professionals. Air samples from schools, businesses, and institutions could be used to identify hot spots of transmission.
How to conduct Elections
In the midst of this pandemic, one common concern revolves around the 2020 elections. This year is a year of presidential, congressional, and gubernatorial elections. With voter turnout in presidential election years higher than other election years, conducting successful elections during a pandemic is on the minds of many politicians and concerned voters. During the primaries, many poll workers refused to show up, and elections all over the United States are still undecided, weeks later.
The S.A.F.E Plan, Successful, Accessible, Fair Elections Plan, the brainchild of Logical Policy Organization, may be the solution to this dilemma. The S.A.F.E Plan allows for voters to request absentee ballots in all 50 states and deliver those ballots to precincts the day before and the day of the election in a drive-through precinct. This plan also calls for absentee ballots to be delivered to precincts regularly to minimize the risks of outstanding votes not being counted. Many African American voters worry about voter disenfranchisement, and with elections still being decided months after, and ballots lost in the mail, allowing ballots to be dropped off at the precincts before and during election day ensures that all ballots will be treated the same. This will help to assuage the fears of those who suspect voter suppression and voter fraud. This will also allow for shorter lines for in-person voters and increased space for physical distancing.
Ballot collection services should also be created to collect the ballots of those who lack transportation. Each ballot collector should be outfitted with a body camera, and each ballot should have a tracking number to assuage fears of voter suppression or voter fraud.
Due to physical distancing guidelines, state and local governments should agree consider alternatives to ballot access petitioning and ballot initiative signature requests. Organizers should have the option to use online signatures or threshold polling. For example, a state could request that an organization provide external polling that shows at least 3% - 5% support for a ballot initiative or a candidate before putting that initiative candidate on the ballot. This step will reduce the health risks pollsters and political activists present to the public. Deadlines should be shifted back to mid- October.
States should provide resources for increased voter registration, and shift voter registration deadlines back to late October. States could consider creating a voter registration hotline that voters could call to request information and paperwork for registration. The states could mail the paperwork to the homes of those who request it and pick it up after it is complete. This enables those without the resources to register to vote to get registered. This hotline could also be used to request absentee ballots and information. All states should provide same day registration.
The United States should provide funding for more machines, PPE, training for poll workers, and the treatment of poll workers as essential workers.
Lessons to be learned
There are lessons to be learned from COVID-19. We are the solution. The position that we have been put in is a consequence of poor preparation and poor policies by governments at all levels by both sides of the aisle. As a result of decisions made in offices instead of the real world, health care is attached to employment instead of to people. People have no choices in health care because politicians have restricted patient choice. Politicians have limited hospital beds with legislation such as certificate of need laws, thus limiting the capacity of our health care system.
If we are to recover and have a functioning society, we have to take charge of our lives. We must work together. We must spread information, not fear, not disease, not anger, not emotions, not platitudes, not hatred, information. Luckily, people have taken up the task. Everyday people are making big differences in the world by doing what they can to fight the virus or its effects. The Coronavirus Tech Handbook is an example of that. It is a one stop shop for crowdsourced information about COVID-19. If there is one takeaway of this pandemic, it would be that we are the solution. Hopefully, we can use this pandemic to work together to solve our problems, and prepare for other problems. Hopefully, we can build emergency funds, design a patient-centered health care market, better prepare for future natural disasters, boost our immunity/ health, and work together more often. This pandemic is a tragedy, but it is a learning opportunity for us all. If we fail to learn anything from it, that would be the biggest tragedy imaginable.
Created with images by CDC - "This illustration provided a 3D graphic representation of a spherical-shaped, measles virus particle, that was studded with glycoprotein tubercles. Those tubercular studs colorized maroon, are known as H-proteins (hemagglutinin), while those colorized gray, represented what are referred to as F-proteins (fusion). The F-protein is responsible for fusion of the virus and host cell membranes, viral penetration, and hemolysis. The H-protein is responsible for the binding of virions to cells. Both types of proteinaceous studs are embedded in the particle envelope’s lipid bilayer." • Martin Sanchez - "untitled image" • Joshua Sukoff - "The United States Capitol Rotunda" • Justin Case - "untitled image" • John-Mark Smith - "untitled image" • Online Marketing - "Doctor with a stethoscope" • CDC - "This Centers for Disease Control and Prevention (CDC) scientist was shown implementing molecular testing, in order to test for different types of polio. The 6-assay screening can determine which samples are polio, the specific serotype of polio, and whether they are vaccine, or wild strains." • Ava Sol - "We should all wear curtains... just sayin'... Vibes: "Just Like Honey" by The Jesus and Mary Chain" • James Lee - "Social Distancing, Lego Style." • Sandie Clarke - "untitled image" • Dimitri Karastelev - "surgical mask" • United Nations COVID-19 Response - "Physical Distancing. Image created by Kyle Mueller. Submitted for United Nations Global Call Out To Creatives - help stop the spread of COVID-19." • Elena Mozhvilo - "untitled image" • Dan Gold - "w/ Platterz" • Victor Freitas - "untitled image" • pina messina - "untitled image" • Jude Beck - "Young girl silhouette" • Jared Rice - "A morning yoga session peering into the jungle in Ubud, Bali." • Viacheslav Bublyk - "Money" • Adam Nieścioruk - "Street art - graffiti with facial mask on the wall during the current Coronavirus (COVID-19) pandemic in Warsaw, Poland" • National Cancer Institute - "Laboratory Researcher. National Cancer Institute researcher Chanelle Case Borden, Ph.D., setting up genetic samples and primers for polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA. Photographer Daniel Sone " • Giulia May - "untitled image" • Gautam Krishnan - "It was the summer break and there were no students here. They were all probably gone on a vacation somewhere, but this structure has suddenly turned quiet and lonely. It witnessed batches of students having the time of their lives, but now, all it can hear is the rustle of the leaves, sound of the breeze and a bird or two chirping. With nowhere to go, will this school not miss its students?" • Element5 Digital - "untitled image" • AbsolutVision - "Things to do"