Pandemic theater versus the things that matter
Look around and you’ll see that we’re wasting tons of time, effort, and money on pointless COVID mitigating exercises that aren’t actually effective.
I call these activities “pandemic theater” because they give the appearance of doing something but aren’t actually useful.
These activities are the pandemic equivalent of putting your carry-on liquids in a plastic Ziploc bag. We all do them because we’re told to do them, because we see others around us doing them, and because we think that they might be helpful.
For today’s newsletter, let’s contrast some of the pointless things that we’re doing with some of the more important pandemic fighting activities that we should be investing in instead.
Stop cleaning off every surface with Lysol
At the start of the pandemic, I remember being worried about bringing groceries into my home without grabbing a container disinfectant wipes to stop the COVID.
You couldn’t buy Lysol wipes anywhere because they were all sold out.
I remember having a detailed discussion with my parents about the precise number of hours they should have a package wait outside before bringing it inside and wiping it down.
At my office, we deep clean every patient room between visits. And at my gym, everyone is given a spray bottle to wipe down each weight that they touch and each machine that they use.
We’ve since learned that COVID isn’t a disease spread via fomites. It’s through aerosolized droplets that we encounter risk.
And so I would argue that our time and resources spent deep cleaning surfaces is at best an inefficient use of resources and at worst a complete waste of time and money.
Stop taking my temperature every time I walk into work
The majority of people who have COVID don’t have a fever. Which means that even a perfect temperature screening technology is going to miss more cases than it catches.
But these temperature checks aren’t even close to perfect.
I can’t tell you how many times I’ve had a reading that would render me hypothermic because I just came from outside. Or how when my temperature is elevated the screeners just tell me to go through if I don’t have any symptoms. Even Dr. Fauci tells a story about how his temperature registered at 103 degrees Fahrenheit this summer.
We have data to back up these anecdotes. Airport screening, predominantly comprised of temperature screening, doesn’t seem to work.
Plus, let’s just say that I came to the hospital while infected with COVID and had a fever and was appropriately caught by the temperature screen. I still waited in line with 10 other people to get my screening and stood within a foot of the person taking my temperature, potentially increasing overall risk exposure under the guise of lowering it.
So when organizations are taking employees out of their normal jobs to serve as temperature screeners, it seems like this is a waste of time that may lull people into a false sense of security.
There’s no need to wear a mask when you’re exercising outside
We know that the majority of COVID spread occurs via superspreader events that occur in crowded, closed spaces with poor ventilation and close human contact.
These are the times when mask wearing becomes imperative.
So when you’re outside in the park, there’s no need to mask up. We should be encouraging time outside and recognizing that the risk of spread from outdoor activities is incredibly low.
It’s great that the majority of our state and national parks are open. But count me skeptical about point of the recommendations to wear a face covering when you’re at the park, even when you’re outside and keeping physical distance from others.
Alright, that’s enough negativity. Let’s move on to the non-theater portion of this newsletter.
What we should be doing: focusing on ventilation
Ventilation is incredibly important in preventing the spread of COVID. Experts on COVID are focused on the nitty gritty details of HVAC systems and HEPA filters to reduce spread. (It’s possible that part of the reason Vivek Murthy got paid $400,000 from Carnival Cruises was because they suspect he will be shaping federal policy regarding ventilation standards).
The reason these details matters is all about viral spread.
We know that COVID is passed from one person to another via droplets of our spit. Tiny respiratory droplets - AKA spittle - that float through the air are why indoor dining may carry such a high risk of COVID spread: it’s a process of repeatedly opening our mouths and talking in close quarters.
And so when we see observations that there’s much less viral spread outdoors than would be predicted based solely on particle exposure and that HEPA filters may be able to trap the SARS-CoV-2 virus, it makes a focus on ventilation seem that much more important.
It remains unclear exactly how to optimize ventilation to slow the spread of the pandemic, but the weight of the evidence suggests that there’s something there.
Spending more of our efforts spent understanding ventilation better seems like it would make a lot more difference than checking our temperatures.
The other part of stopping this pandemic that I still can’t believe we aren’t doing: rapid, frequent testing
I’ve written about this a number of different times in this newsletter.
It’s simply insane that we aren’t scaling rapid, frequent testing across the country.
Widespread testing is the kind of idea that once you learn about, you can’t understand why everyone isn’t shouting from the rooftops about this:
“The U.S. government can produce and pay for a full nation-wide rapid antigen testing program at a minute fraction (0.05% – 0.2%) of the cost that this virus is wreaking on our economy.
The return on investment would be massive, in lives saved, health preserved, and of course, in dollars. The cost is so low ($5 billion) that not trying should not even be an option for a program that could turn the tables on the virus in weeks, as we are now seeing in Slovakia—where massive screening has, in two weeks, completely turned the epidemic around.
The government would ship the tests to participating households and make them available in schools or workplaces. This program doesn’t require the entire population to participate. Even if half of the community disregards their results or chooses to not participate altogether, outbreaks would still be turned around in weeks. The point is to use these tests frequently so people are likely to know their status early, before they transmit to others. It is frequency and speed to get results, and not absolute sensitivity of the test that should take center stage in a public health screening program to stop outbreaks.
At the beginning of the pandemic, these mistakes are understandable and forgivable. Now, not so much
It’s not surprising that we wasted a lot of effort early on.
But now that we’re learning what makes sense and what doesn’t, I hope that we can start to get a little bit smarter.
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