Almost every day now, I get emails and texts from people I know who, after being “so, so careful” for a long time, have COVID-19.
They have not been in hospitals, but they have been sick in bed. They tested positive with home tests that, for the most part, went unreported. None of them know where they got it, but all had been letting down their guard as restrictions were loosened and most everything was considered “back to normal.”
I am CEO of a Bay Area nonprofit that serves people with developmental disabilities. We are considered health care providers and are subject to much stricter coronavirus safety rules. As such, we watch the trends more than others do, on both a local and a regional level.
I am not an infectious disease specialist by any means, but simple observation has demonstrated predictable, disturbing trends. There is a proven science to flattening a curve during a pandemic or epidemic. For all kinds of reasons, many of them understandable, it has not been possible to follow that science.
When public health officials cannot find a way to tackle real prevention of problems, mostly for lack of resources or lack of public will to accept them, it can be forced to default to harm reduction alone. Currently, as far as I know, there is little or no contact tracing. The main metric is hospitalizations and deaths. And now, Bay Area counties have spikes in reported infections. Some have reinstated COVID-19 safety restrictions. The Centers for Disease Control and Prevention recently estimated that only 13% of cases nationally are recorded.
When mask mandates and most restrictions are lifted, cases predictably rise and there is a consistent pattern of spikes after major holidays. With little information about the true number of cases, it puts us all in a position of figuring out for ourselves what the risk is and how to keep safe and healthy.
We may or may not see news articles that have pieces of the information we need. When mandates are removed, we may or may not pay attention to the second lines saying the mandates are still being strongly recommended. We go to stores and see more and more people unmasked and tend to figure it must be safe to do the same.
Basically, we are guessing. Home testing is confusing. It is hard to figure out when to test and how much to isolate while you are waiting to test. How long do you keep testing and what if your symptoms are gone but you still test positive? Isolating an infected person in a family setting is easier said than done.
If we do not know how or when we became infected and it takes a while to confirm an infection, how can we warn others with whom we may have come in contact?
What about Paxlovid? The latest factual information needs to be more readily available.
What are the new symptoms that are caused by emerging variants? Does swabbing a nose effectively detect the gastrointestinal version? What about the trends for variants to make even vaccinated individuals sicker than before and better able to sidestep our immune system responses? Can the vaccines keep up with the variants?
If it is up to individuals to figure all this out for themselves, we need more information and more help.
An expanded and centralized, 24/7 COVID-19 telemedicine-type help line might be a good start. We can find general guidelines on websites, but real-life situations tend to be way more complex than general guidelines. It could also be used to report cases, suspected sources of infection, new symptoms, and the effects of treatments. At the very least, it might show patterns that need further study.
I know there are resource and public will issues with all of this, but if we stop doing many of the science-based methods to flatten a curve, and if we continue to face a crafty virus that keeps getting craftier, how can we shorten this saga? If, instead, we work together to balance conflicting needs, we could make more headway.
Diana Conti, of Mill Valley, is CEO of PARCA, an organization that serves people with developmental disabilities. She vice president of the College of Marin Board of Trustees.
