Surgeon, writer and public health researcher Atul Gawande has written an excellent feature story for The New Yorker (5/13/20) on the changes needed to make reopened communities safe. His guidance is based on lessons learned from success in preventing SARS-CoV-2 infections in the hospital system where he works (Mass General Brigham, with 75,000 employees). Beyond the now common-sense advice for a combination of frequent handwashing, mandatory face masks, regular screenings for staffers, daily self-reports on symptoms, and daily disinfecting of high-touch surfaces, he writes that staffers conduct meetings by video even if they work across the hall from one another. If in-person meetings are unavoidable, plexiglass separates the speakers. Transmission evidence shows that “physical distancing is so important,” he writes. The hardest, key part, he writes, is getting people to commit to new norms for keeping others safe, not just themselves.
Julia Marcus, a Harvard Medical School professor of population medicine, advocates for a harm-reduction approach to social distancing and reducing risk of infection with the new coronavirus, in a 5/11/20 essay at The Atlantic. The approach gained popularity in public-health circles addressing the AIDS epidemic in the 1980s and 1990s. Applied to the new coronavirus pandemic, harm reduction means, in part, helping “the public differentiate between lower-risk and higher-risk activities; these authorities can also offer support for the lower-risk ones when sustained abstinence isn’t an option,” Marcus writes.
A 5/11/20 essay in The New York Times presents a “10-4” workplace and schools reopening plan that exploits the three-day delay on average between someone becoming infected with SARS-CoV-2 and their capacity to infect others. The authors, computational biologists at the Weizmann Institute of Science in Israel, say their research shows it could be effective at reducing transmission. The idea is to repeat cycles of four days in-person at work or school, followed by 10 days at home. Schools in Austria are set this month to test a version of the approach, the essay states.
Following decades of research on HIV and Ebola, virologist Peter Piot, director of the London School of Hygiene & Tropical Medicine, has written a moving essay about his experience with being hospitalized for and recovering slowly from COVID-19. “Let’s be clear,” he writes. “Without a coronavirus vaccine, we will never be able to live normally again. The only real exit strategy from this crisis is a vaccine that can be rolled out worldwide.” An endnote on the piece suggests that Martin Enserink, an infectious diseases reporter at Science, translated the essay into English for publication in the magazine (5/8/20).
In the latest weekly COVID-19 research round-up by Ben Johnson at Springer Nature (5/8/20), he highlights several new studies including ones on the prevalence of testing in the UK and U.S. and the rarity of viral transmission six days after symptoms.
A 5/6/20 blog post by Erin Bromage, an immunologist at the University of Massachusetts Dartmouth, explores the risks of becoming infected with the new coronavirus via respiration in indoor public spaces and gatherings. The post suggests that high-risk environments are those in which several people are gathered and speaking, singing, or yelling for an extended period of time (hours) in an area with limited ventilation. Bromage lists some known super-spreading events and sites: meat processing plants, a wedding, a funeral, a birthday party, conferences and other business networking events, a restaurant, and a workplace (a call center). He advises people assessing the risk of inhalation infection in indoor settings to think about the volume of air space, the number of people present, and the duration of time you’re in the room. Successful infections are due to a combination dose and time factors — exposure to a sufficient dose of viral particles (maybe as few as 1,000, the post suggests) over a non-fleeting period of time.
“Is it safer to visit a coffee shop or a gym?” asks the headline of a 5/6/20 essay in The New York Times featuring interactive graphics illustrating cellphone and survey data that pertain to factors thought to contribute to the risk of SARS-CoV-2 infection in various types of multi-establishment businesses. The essay focuses on factors such as weekly visits per square foot, average length of visit, and the extent to which visitors interact with others or touch surfaces. The idea, write Katherine Baicker, Oeindrila Dube, Sendhil Mullainathan, and Devin Pope, all at the University of Chicago, with New York Times graphics editor Ben Wezerek, is to identify potential “super spreader” businesses among malls, gas stations, nail salons, museums, parks, and restaurants — some are identified by name.
Scientific American is providing free downloads of its latest Health & Medicine magazine, which features a cover story: “Sprint for a Cure: Researchers are pulling out all the stops to battle coronavirus: Novel treatments, repurposed drugs, vaccines.”
An essay “F*** the bread. The bread is over” by Sabrina Orah Mark for The Paris Review (5/7/20) describes her experience interviewing for an academic job followed by sheltering at home for the coronavirus pandemic.