The coronavirus projections coming from experts have two major components: How mobile we are (that is, are we leaving home) and how well we “socially distance” to six feet or more unless we are wearing a mask. The other parts of the models are important, but all are easier to predict on the basis of what happened in each locality when 100% of the country was supposed to be on “lockdown.”
This isn’t that complicated. Since the projections are based to a real extent on mobility and distancing, by definition the projections will change as we open up the economy and how we do it. We will be heading right back toward the same deadly peaks unless we socially distance — because social distancing is how we got the curves to go down in the first place.
Wear a donut or use a hockey stick
►This 6-foot separation is not a joke and people are just plain irresponsible if they don’t pay attention to it. A man in Italy has created a 6-foot donut to wear; Canadians use hockey sticks. In Germany, a restaurant gave patrons hats with pool noodles on them to remind them to distance. We need an easy foldable device; patent it and make millions.
“It won't happen to me!” That’s not the issue. Everyone gets counted in the projections – including the people on the beach. We are already seeing it. The latest projections are 147,000 U.S. deaths by August. This is more than double the projections just a month ago. What happened? Better modeling? No. Massive uprising against social distancing? Yes. If we don’t social distance, and soon, numbers will reach the tipping point and locality by locality, we will all be forced to stay home — just like last time. No one wants that!
►That 6-foot distance has been determined scientifically, but I am concerned with the effectiveness of the masks we are wearing at distances less than six feet. If they don’t work then this is the worst case of more certain transmission. We should only be able to buy masks that prevent transmission to, say two feet, when worn correctly. Each mask should have instructions enclosed for how to wear it. I have an N95 mask, and it is difficult to breathe. Hopefully other masks can be effective for those who are not first responders.
When do negative tests expire?
►Testing for presence of the virus. As we increase testing (and hopefully make it more accurate), we of course need to understand that just the math will decrease the number of cases per million people. A nationally-comparable statistic must be developed and continually published that accounts for increased testing or we will develop a false sense of security “blaming” the increase in positives on increased testing. Publishing each state’s number of tests per million people and number of positives per million people will help to avoid the false sense of security by “blaming” the increase in positives on increased testing.
Coronavirus pause: People need people, but it's risky to resume social activities so soon
There is an important issue raised by people in the White House not wearing masks and turning positive. All had been tested negative – until they weren’t. So we must ask the question, “How long is a negative test good for?” Maybe three days or five days? At least food in the grocery store has an expiration date. No one has told us the expiration date for a negative test.
Nobody is no-risk in Russian Roulette
Everyone who is tested once as negative has to be re-tested very frequently. Same for the contact tracing. Have we dialed those numbers into our testing procedures? If we don’t test this frequently, then we are kidding ourselves that testing means anything: you are negative until you are exposed to the next positive person who may be asymptomatic.
Does everyone need to be tested for the virus, or for antibodies? Some have said no. But if not, then how do we deal with the five presumably low risk people who contracted the virus recently at a birthday party where no one was social distancing or wearing a mask? Seems like a game of Russian Roulette; you can't predict who gets the bullet.
Reaching teens:Why are young people so bad at coronavirus social distancing? Blame their brains.
Pay close attention to Gov. Andrew Cuomo and New York, which has returned to where it was March 19 in deaths and hospitalizations. New York is re-opening extremely carefully. If the hospitalizations and deaths in New York, start back up, I believe we will see that for the rest of the country.
From what we know today, until there is a vaccine that is available and works for all, we are stuck with this virus and must socially distance and wear masks. Every one of us can do that right now. If we don’t, it won't be their problem, it will be your personal problem when we are all shut back in. Right around election time.
Arthur “Tim” Garson Jr., a pediatric cardiologist and director of the Health Policy Institute at the Texas Medical Center in Houston, is former Dean of Medicine at the University of Virginia and past president of the American College of Cardiology.