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Sanity in Reopening the Country

The world has seen an unprecedented event called the COVID-19 pandemic.

This pandemic comes with a number dating the year it started (2019). The amount of anxiety and fear this pandemic has created is unprecedented compared to Spanish flu or prior plagues the world has experienced, maybe because of the information age and the internet. Society, political, and religious leaders are struggling to make sense out of this pandemic.

First, let us talk about what is known. This pandemic is from a novel virus that has spread across all continents and has cost human lives all over the world, sparing none. The spread was assisted by population density and mobility. It is highly contagious and more lethal than what we initially thought it would be.

Second, we have a lot of unknowns.

To list a few:

  1. Is this pandemic going to continue and resurge every season or year?
  2. Is there a danger of this becoming endemic in certain parts of the world like Malaria?
  3. What are the drivers of this pandemic other than population density and mobility? How effective are measures of mere social distancing and lockdowns?
  4. Does the COVID virus have the potential to mutate?
  5. Will we have an effective vaccine for COVID?
  6. Are treatment therapies for the acute illness of COVID able to save lives and limit morbidities like neurological or pulmonary complications?

Public health measures are currently focusing on tracking acute infections and behavior of the pandemic. PCR antigen testing of this virus proves this is an acute infection. Testing is becoming widespread and evolving for rapid on the spot testing via saliva, nose or throat swabs, and fingerstick blood tests. This is promising for isolation and quarantines. These are patients in the first group: known infection, treated via home care or hospitalized, and survived. Most or some of them will have natural immunity for some time.

The second grouping of patients is those who are not known to be infected. If they are checked for a reliable antibody testing with Ig M and Ig G titers, we can establish if they have some immunity and were infected in the past without their knowledge. If they acquired immunity in an acceptable range of antibodies titer ( unknown), they are hopefully less vulnerable to COVID reinfections.

The third grouping of citizens is those who are not known to be infected and who test negative for COVID antibodies. These folks are non-immune and are vulnerable to COVID infection. They are in need of stricter social distancing and measures to prevent COVID exposure. They can be considered fortunate in hope of an effective vaccine yet to be established.

How do we apply science to reopening the country?

  1. Learn from Asia and Europe as they are ahead in timelines of the initial epidemic and second waves. Gather epidemiological data and apply this to scientific models of predictions.
  2. Initial case tracking, preventive measures for isolations and self quarantines, as well as sick care at hospital settings based on technology, data, and scientific application thereof.
  3. Establish guidelines on herd immunity and future vaccine-based immunity. CDC guidance based on FDA approved serological testings and clinical trial data as they emerge.
  4. Establish public measures on social distancing based on immunity status, subgroups of immune vs. vulnerable vs. high-risk individuals. Population density and mobility are key drivers and will guide how facilities and events will occur in the new world order.
  5. Establish trusted registries of citizens who are immune via natural way or vaccination. Consider immunity passports via technology that is readily available and trustworthy.
  6. Public health guidance as to the new designs and architecture of places with high population density for living, travel, and gatherings. Do we provide safe or immune zones vs unknown/high-risk individuals zones? Do staff serving those sites need immunity status? Will the new building plans or renovations follow airlines and airports with separate lines and zones for terrorism threat like the movement of people.
  7. Hotels, office buildings, closed spaces like churches, etc. will need to be redesigned or renovated for social distancing needs. Consideration of new airflow engineerings like industrial-grade filters or negative pressure areas like a hospital isolation room or operating theater may be the future.

Closing remarks:

As science evolves around the COVID-19 pandemic, more knowledge and guidance will need to be applied to our next new normal and world order. Technology will play a key role, starting with mobile devices, to blockchain to Artificial Intelligence and Machine learning in the digital age.