Do-It-Yourself Covid Testing!

 I want to highlight an article I read today in the Harvard Gazette about a new approach that has not been suggested before. This idea is from Michael Mina a Harvard epidemiologist and expert in disease testing. He is calling for a shift in strategy toward a cheap, daily, do-it-yourself test that he says can be as effective as a vaccine at interrupting coronavirus transmission. He believes it is currently the only viable option for a quick return to a normal life.

Dr. Mina, is an assistant professor of epidemiology at my alma mater the Harvard T.S.Chan School of Public Health. He suggests that this would be a better strategy than closing down the economy and keeping schools closed which is really the only other viable option.

These paper-strip tests (similar to the popular pregnancy tests) have already been developed and their shotgun approach to testing cheap and widespread provides a way back to the workplace, classroom, and other venues.

The strategy, “could put hundreds of millions of tests in the hands of consumers within weeks, at a cost far less than repeated rounds of economic stimulus” Mina said. Several companies have produced these tests which can be produced for less than a dollar. With tests like these, ordinary people can perform their own tests each day or every other day. They are not as accurate as the current diagnostic tests but they are effective at detecting virus when a person is most infectious. If everyone who tests positive stays home, the thought is that the widespread effect would be similar to that of a vaccine because people would stop the transmission chains across the country. If people are concerned about false positives they could then follow up with a formal test with their doctor and stay quarantined meanwhile.

So whats the catch ?

First of all unless the tests are FDA approved and federal government sanctioned, companies are not going to invest and produce these tests in the numbers that would be required to be effective.

The currently available tests take time and are expensive. Which makes them impractical for daily in- home testing. These tests may not be perfect but the nation’s current testing strategy catches less than 3 percent of cases early enough for a person to proactively prevent transmitting the virus. Now if those testing positive stay home, “a cheap, at-home testing regimen has the potential to provide a kind of artificial herd immunity, interrupting enough transmission nationwide to cause the pandemic to stall”

Another catch is one that relates to all fields of prevention: it still requires people to take some level of responsibility and motivation to actually do the test and then follow through if the results are positive.

According to Dr. Mina what’s needed, is the federal government’s financial and organizational clout to both provide resources and get companies working together. Though even a $1 per day test gets expensive, if the federal government provides them free to all Americans, the cost would be far less than recent stimulus efforts. We could get these tests up and running right now unlike the vaccines.

“It will stop the vast majority of transmission and it will cause these outbreaks to disappear in a matter of weeks,” Mina said. “This is something we can actually do at warp speed.”

If you would like to read the full article you can read it here:

https://news.harvard.edu/gazette/story/2020/08/cheap-daily-covid-tests-could-be-akin-to-vaccine/

Its not over yet! The 'state' of the state.

There have been 3600 deaths in Maryland so far with huge differences between the counties. For example: deaths in Howard county 106, PG county 741 and Montgomery county 767.

Presently there are 488 people hospitalized in the state, 117 in ICU.

We were doing so well until the July 4th holiday when people became very lax.

I know you are tired of the restrictions but please don’t quit while we are ahead!

We now have to look forward and figure out how to keep our children safe as people press for a return to the classroom.

Even though things are ‘opening up’ please be cautious and don’t go overboard. Just because you can sit inside in restaurants now doesn’t mean you need to.

Your nails can wait another two weeks, two months if they have to!

Covid misinformation and actions that you need to take to stop the pande...

Talking Numbers and Preventing Deaths

Let’s talk numbers

There is an infodemic going on and it is easy to get lost in the numbers. Let’s try and keep it basic. What two numbers do we really care about?

The number of cases in hospital and the number of deaths. If you follow these two numbers you will be able to appreciate trends which will give you a better sense of safety especially those numbers close to where you live.

Quite frankly the “number of cases” is a worthless number. Why? Because it depends on how many sick people got tested. If everyone doesn’t get tested that  number tells you nothing. When there is more testing there will be more ‘cases’ and when fewer people get tested there will be less.

On Saturday there were 1500 people in hospital, today 1460. A nice trend but not huge.

The number of deaths is a grim reminder of the seriousness of this condition. Isn’t it incredible that we now measure success by how many people died?

Sometimes you have to go back to basics to make sense of it all.

It sounds easy for people to say what should have been done and what should be done now. But believe me it’s the basic measures and simply following epidemiological guidelines that will get us through this.

Watch this clip from the BBC News.

Is it not amazing what people with little or no resources were able to achieve yet we, the ‘most powerful, richest’ country on earth have left 92,000  and counting dead bodies in our wake?

Now I want to talk about ventilators vs testing. 

Do you remember when there was all the brouhaha about who had enough ventilators and why New York didn’t need 30,000?

It costs $20,000 to $50,000 to make a ventilator and that doesn’t take into account the oxygen and all the pieces of equipment and highly trained personnel that go into making them actually work. Third world countries know they cannot afford ventilators. If you dropped off a 100 in the Navajo Nation health clinic they wouldn’t know how to use them. It would have to come with staff and PPE’s and so on.

It took a presidential decree to convert car manufacturer factories into ventilator producing plants so the country could get 'enough' ventilators.

It cost $1 to $5 (worst case scenario) to make a corona virus test kit. You do the math! The only life a ventilator saves is the one person on it at the time and then it needs to be disinfected and recalibrated, you get the idea.

The first day in an ICU bed in the United States costs $10,794 and tapers to $3968 per day by Day 3.

The average stay in the ICU with Covid-19 is between 8 and 14 days.

A regular bed hospital stay costs  $1488.

I know, its enough to make your head spin!

Do we get it yet?

Please follow the prevention measures I have been discussing in these emails. Believe me: Money and time spent on prevention is 100s of times more valuable than chasing cures.

HOW TO GET BACK TO SCHOOL AFTER A PANDEMIC: SOME IDEAS

GETTING BACK TO SCHOOL: IDEAS It seems everything about this pandemic has caught us off guard but now we have an opportunity to plan ahead for a change. One must understand that things are never going to be ideal, corona viruses will not disappear from human existence now they are here. The best we can hope for is containment, something that a vaccine could help with, but which can still occur without one. The vaccine is a year or more away and we cannot wait another year for our kids to go back to school. We all need to be clear that there is no such thing as ‘zero risk’. So we should work with what we have and plan ahead. Here are some ideas on how to reduce the risk for students. I hope if you know someone in education, you will forward this to them. First, I truly believe kids could return to school in September. That gives us 4.5 months to get ready, ample time. Kids should be encouraged to bring the minimum amount of extra stuff to school. Show and tell maybe a thing of the past! School bus/ transport: Parents who can, and who want to, can take their kids to school themselves. They should be encouraged to do so. This reduces the crowding on the buses or there can be alternating days when some parents drive and some bus. The bus drivers should wear gloves and masks and squirt hand sanitizer (first grade and up) onto the kids hands before they get on the bus. (This will require prior consent from the parents stating they allow hand sanitizer to be administered to their child for the common good). On the bus the seats should be marked to allow for social distancing maybe 2 or 3 seats apart. The windows of the school bus should remain 3 inches open to significantly decrease the concentrations of airborne contaminants. Each bus can be sanitized at the end of the day. At the school: On arrival all kids should pass through the contactless temperature scanner. Any child with an elevated temperature should not be allowed in. No temperature, then next stop would be the bathroom for hand washing. On the way into each class a little hand sanitizer. I took these building suggestions from the Harvard Gazette (4/24/20): Engineering for healthy building strategies like: Optimize the building ventilation, filtration and purification. Increase the flow of outside air, install portable air purifiers and swap out existing filters in air circulating systems for ones that can capture smaller particles. Rearrange the desks so that they are staged and children are not sitting directly opposite or in front of each other. Gym should be held outside where possible, when not maybe shorten the day? Teachers should wear masks because they have to speak loudly and therefore aerosolize droplets. Public Health Education: (This is key!) Educate the school nurses, teachers, parents, students and staff about virus infections and how they spread. Train the custodial staff on sanitization protocols. It sounds like a lot but most of these measures actually don’t cost a lot. The fact of the matter is the world has changed forever and we must adapt to it. I would love to hear your comments on these ideas and please forward them to the educators. Let’s at least start the conversation. Everyday health in extraordinary times: We are staying open so you can stay healthy! We have special protocols in place in the office to keep you safe and minimal waiting. No walk-ins. Anyone who doesn’t have a mask waits in their car until their appointment. Extra sanitation procedures daily and hand sanitizer for everyone!