Ricardo Rossello: Containing COVID-19’s next wave | Commentary
By RICARDO A. ROSSELLO-NEVARESGUEST COLUMNIST |MAY 03, 2020 | 6:00 PM
Even as COVID-19 continues to kill thousands of Americans every day, Florida’s beaches are beginning to reopen — a move many in the public health field consider premature and dangerous. Gov. Ron DeSantis indicates a statewide economic and societal reopening is to follow shortly, which puts Florida residents at grave risk for a post-wave reinfection crisis.
I believe there is a path forward, but we must first acknowledge that there exists dangerous potential for a post-wave reinfection, which could prove deadlier than what COVID-19 has wrought to date if we are not prepared.
Based on the successes and learning from the failures I have experienced leading disaster recovery stemming from Hurricanes Irma and Maria in Puerto Rico, let’s address one of the most pressing questions: How do we prevent another wave or at least minimize its effects?
Today, some are confronting containment (very important), others are tackling the potential threshold capacity of our healthcare system (even more important). Yet there are other downstream issues that will follow, and which could trigger an even deadlier and more widespread second phase of this global crisis.
The most important is the post-wave reinfection, which will happen even as the curve of infections in some places is flattening or even declining.
In fact, areas that have been very effective (or very lucky) in the first wave could be in a more dangerous position in a post-wave. I call this the post-wave infection paradox: Those countries or regions that were more effective (i.e., fewer infection cases) will be more vulnerable in the coming waves.
Many — including those protesting lockdowns in states like Michigan, Texas and elsewhere — will not like my answer: Instead of relaxing when infection rates are going down, we need to double down. Here’s how:
Having more tests ready: In case — or, more realistically, when — infections rise again, be ready to test quickly and effectively. Abbott recently came out with a quick test. While they’ll be producing now, and the demand will be greater than the supply, it is important to plan and keep stocking up on these tests. If you can identify a focus before it becomes a big problem, you are in a better place because of it.
Keep social discipline: Again, human need and pressure to kickstart the economy might lead some to declare victory or a safer path. It would be a colossal mistake to do that immediately.
Implement human tracing: This has been one of the most successful techniques available. It is inherently a balance/decision between privacy and security. Extreme circumstances require extreme solutions.
Rest for medical professionals: Medical professionals are exhausted and will need rest. As the number of cases falls, start designing a scheduling mechanism to sustain and prepare for another wave. Otherwise, the healthcare system will be ever more vulnerable to collapse.
Train the first wave of infected individuals to do critical jobs: If immunization is acquired, these survivors could do important tasks at no risk to their health. Therefore, for critical work that needs to be done, including voluntary work in hospitals, they should be enlisted.
Food supply: Establish safe and consistent supply mechanisms for vulnerable populations, not unlike what is done in the aftermath of a major hurricane.
Do not immediately downsize or close temporary hospitals: Instead, refurbish them, see what the limitations where on the first wave, and be prepared for a second one.
Most importantly, we cannot let human complacency or impatience drive decision-making on critical health policy. Even countries that were effective in the first wave and are widely regarded as highly disciplined are having problems containing a second wave. Singapore is a current example, and there are reports from the Chinese-Russian border of an uptick in cases. A second or third wave could add more stress to the system, provoking disruptions in supply chain and even causing social unrest.
Every indication is that within 6 to 12 months we will have either a vaccine or drug therapies to effectively combat this virus. Let’s prepare for the long haul, and together, beat this worldwide pandemic.
Dr. Ricardo A. Rossello-Nevares, who served as governor of Puerto Rico from 2017 to 2019, holds degrees in biomedical engineering and neuroscience, including a doctorate from Michigan.
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