Public health has an old saying about a village near a river.
The story goes that every few days, villagers hear the cry for help from the river and pull people out of the water. The cycle continues over and over. The village constructs floats and trains search-and-rescue teams. As time goes by, more people drown and it seems like an impossible battle. Some villagers start to argue that they should let the people drown. Then, one day, they realize that the people drowning are coming from the rapids higher upstream. A sign was put up by the village warning boaters of the rapids. Boats stop capsizing and drowning passengers don’t drift down to the village.
As we endure yet another Covid-19 variant flood, I am left wondering if we are still only saving the drowning, and not looking upstream.
As we endure another Covid-19 variant surge today, I am left wondering if we are only looking upstream and not saving the drowning.
Yes, researchers and doctors have developed some amazing tools to assist drowning Americans who have been infected with SARS-CoV-2. There are quick tests that can be done at home, intravenous and oral antivirals, monoclonal antibodies, and cutting-edge methods to manage those who are hospitalized despite all our efforts. We can reduce the chance of becoming infected by Covid with high-quality masks and vaccines.
Even though we are heading towards an endemic world we still think small, when we should be big. We are here, one year later, insisting that this is a temporary surge and that the water will eventually stop flowing downstream.
Let’s be very clear: Now is the time to plan.
It was easy to forget that there was no plan back then, during the initial surge in spring and summer 2020. It was a new virus. There was no personal protection equipment, no treatment options, and no prevention tools. We had no other option than to stay at home if we needed to save lives.
However, politicians and scientists knew what they needed to do to help the drowning and identify the rapids before anyone else. It was clear that the virus could mutate by the beginning of 2021. We had high hopes for vaccines but we knew that we needed to plan for unexpected surges.
We are still too quick to make plans during another surge.
But I don’t feel angry at the virus. Variants are inevitable and viruses will evolve. Instead, I am angry at the inability of our country to see beyond an all-or-nothing response to SARS CoV-2. The country is constantly caught between the desire for “zero Covid”, and the desire “let it rip.” Neither of these options works. Despite President Joe Biden’s recent statements that “Covid is not here to stay”, the sad truth of the matter is that Covid will always be part of our reality in some way.
This reality may be very different from the one we are currently living in. If we are lucky. If the fates are right, maybe omicron will take us to an “endemic” state. It’s possible that we all will catch omicron. But, there’s no guarantee that long-lasting immunity will be provided by infection with this variant. To be clear, the Great Barrington Declaration’s idea is that we should just expose the children and let them fall where they may have been found to be harmful. Covid is one of the most common causes of death in the United States for all ages. It is morally irresponsible to lock down older people or people with chronic conditions.
Importantly, the virus is still evolving and it is not certain that future variations will be mild. It is possible that there will be more surges in the future, especially for those who are not vaccinated.
We can convince ourselves once more that we are fine as long as they save the dying. We are setting ourselves up to be overwhelmed again.
We can hopefully change the pattern if we stop celebrating too soon and start preparing for the next, almost inevitable surges.
What’s the alternative? We can change the trend if we stop celebrating too early and start preparing for the next almost inevitable surges.
It is not difficult to see how this can be done. This is what we have all been requesting since the beginning of the pandemic. And what the Biden-Harris administration proposed in January 2021: To practice public health at its best. Yes, people need to be vaccinated. The Biden administration has done a remarkable job of saving many lives by making this the first step. There is more to be done. Also, we need to invest in data systems that can detect a surge and provide clear metrics about when to increase protections (like Masks) and when they can be reduced.
We need to have more readily available tests, affordable and equitable treatments, consistent high-quality ventilation, and better community engagement. It is also necessary that it be set up so it can be called upon if and as needed. We know how to do it. This has been highlighted by colleagues. To prepare for tomorrow, we can and must do this today.
If we wait until the boats capsize or people drown, it will be too late.
This post was written by a medical professional at The Wellness Firm. The Wellness Firm services include workplace flu clinics, wholesale rapid antigen tests, onsite event Covid testing, physical exams for employment, as well as American Heart Association CPR certification classes. Founded by local Firemen, The Wellness Firm has been providing a safer Tampa Bay since 2006.