What countermeasures are effective against COVID? As best I can tell, there are three that are pretty unquestionable:
- Vaccination
- Indoor masking
- Stopping superspreader events
Vaccination is obviously #1 by a large margin. Indoor masking has been shown to be moderately effective by several good studies. And superspreader events—typically large indoor gatherings—were a clear problem in the early days of the pandemic. At the time, there was no solution except to ban them, but today we can simply restrict them to attendees who are vaccinated.
I suppose I should add testing to this mix, since it seems highly likely to be useful even though I'm unaware of any rigorous research to back this up.
What else? I'm open to correction here, but this seems to be about it. Business lockdowns, school closures, travel restrictions, working from home, and all the other things we've done have little evidence to support them.
As COVID moves ever closer to its eventual endemic status, we need to decide just how to react to each new wave. At this point, I'd put our efforts into the three things listed above along with recommendations to get tested if you feel symptomatic. Aside from that, there's probably not a lot more to do in all but the most severe outbreaks.
Social distancing? Standing 10 feet away from someone rather than 4 or 5? That still seems valuable.
A doctor I know said that the covid-spreading droplets are about the same size as cigarette smoke. So if you do whatever you need to mitigate getting (or giving) a good dose of cigarette smoke to other people, that will work well with covid, too.
And some schools are having major outbreaks...so back to online learning until next year.
That's about it. It would be great if better masks were widely available.
Once the vulnerable population is boosted and we have meds to treat Covid early--then it will be masks at school and work if you're close contact with others. Basically, we have to minimize the risk of those not vaccinated. Better outreach programs to those willing to take a shot, e.g. inner cities, and still present non-judgemental vaccinations options to those who've been unwilling to get a dose.
Kevin, isn't a high school with approx 1500 students (like in my hometown of 30k people) a superspreader event every change of period, as kids stream thru the halls to their next class ? [yes, that no longer happens in well-run schools] So when you say that school closures don't work, what you really mean is that well-run schools don't need to be closed. But in the real world, lots of schools are poorly-run.
Ditto restos/bars: I went to a bar in the Mission in SF. OK, well, a beer store with small bar inside. The beer we wanted wasn't available from the window at the front, so I went in to get it from the fridge. No vaxx check, no masks in sight, temp much higher inside than outside, noticeably more humid (all this, thru my N95, so it was much warmer). I'm sure a lot of restos/bars are like this, b/c proper mitigation costs $$ and can only be done if you weren't a hole-in-the-wall already.
I'll be going back, but next time, I'll ask the bartender to fetch the bottles (which is what I should have done this time, sigh). Or gone to a better-run bar.
I should have added: the small bar inside was *packed*. I. Mean. Packed. We sat at outdoor tables. It was cold, but well-worth the peace of mind.
Where is the study of the value of masks between vaccinated people? I'm not aware of one. I suspect given the greatly reduced viral load and resistance to infection that the utility is almost nonexistent, but I welcome any evidence. Also, I have been trying to get data on hospitalizations & deaths separated by vaxxed and unvaxxed, but LA County does not provide that.
Probably more just as a practical matter it is easier to implement an universal indoor mask policy than it is to implement one just for unvaccinated folks. Added with the fact it is not like it is going to hurt (it's not like vaccinated folks are going to spread the virus more. Worst case scenario it does practically nothing, best case it could help marginally.)
Marin County provides data on vaxxed vs unvaxxed:
https://coronavirus.marinhhs.org/vaccine/data
Not L.A., of course, but at least it gives a pretty good idea regarding the value of getting vaccinated. According to their web site unvaxxed are 49x more likely to need hospitalization.
Let me say: Marin's face turn on vaxxx is amazing.
That is a great site. I've passed this on to LA County health as a model.
“I suppose I should add testing to this mix, since it seems highly likely to be useful even though I'm unaware of any rigorous research to back this up.”
Highly likely to be useful. Since it’s the only way to find new variants, yeah I’d say it’s highly useful. JFC, Kevin. You don’t need research to know that lack of testing allows new variants to spread widely before their victims can be isolated. We better hope a super killer variant doesn’t emerge in the US, cause we’ve never been good at testing enough Americans to catch any new variants.
Not only this, but it's very useful to use rapid tests prior to family gatherings if everyone is vaccinated. The idea is that they'll catch symptomatic people before they can spread it. Then we can have safer gatherings and not kill grandma.
Contact tracing seems to work well when the government can enforce it, or if there are easy ways to opt in.
Far UV lights for disinfecting seem promising, but there do not seem to be many studies on it.
Does hand sanitizer help?
One thing that could help a lot would be to scrub the air and control the direction of air flow in indoor spaces like offices and classrooms and restaurants.
The basic idea is to make the air flow from the ceiling to the floor and then run it through a scrubber. A scrubber is simply a box that contains a lot of stuff with complex shapes to provide a huge surface area in a small volume. Then you spray a lot of water in this box while pushing air through it. Virtually anything in the air gets caught in the water.
This is not new engineering. Semiconductor fab engineers have built fabs like this for decades. The idea is that any particle of dust that makes it into the air falls directly to the floor. It doesn't go sideways where it might land on a wafer. This is what we want in classrooms, restaurants, and offices. We want the air to go straight down and be cleaned, not blow it sideways where it can transport a virus from person to person.
If we made it a priority I'm sure these engineers could find a relatively inexpensive way to apply this to standard size rooms like classrooms. You'd need some plastic or cardboard tubing with appropriately sized vent holes. Mount them in the ceiling and floor, add in the fans and a scrubber box. What if it costs $500 to $1,000 per room? It would be worth a few billion to implement this. Not only would it knock down COVID but also the flu virus, colds and allergens that affect those with allergies.
Your list is of smallish things, KD.
Big things are shut downs of air travel, of cruises, of indoor retail spaces, schools, and offices. They're of national mask and vaccination mandates, including the free distribution of N95/KF94 masks to everyone.
Omicron is an order of magnitude of infectiousness that is almost incomprehensible, bordering on ludicrous. London saw infections double in 1.5 days. NYC saw it in 3. Hawaii just tripled its infection rate from 10 days ago.
You're not getting it. Delta was a big leap but Omicron is Bigfoot jumping on Mars. And it's happening at a time when large parts of the US have relaxed its rules and allowed vaccinations to substitute for mask-wearing.
If your goal was to stop Omicron, your frame of mind needed to have made a paradigm shift two weeks ago, not today or next week.
As contagious as Omicron is (perhaps on a par with measles), I don't think there was any stopping it.
Which is why I'm hoping and praying that Omicron is so mild and fast that it'll burn itself out, and the pandemic comes to a sudden, lucky end. Omicron is a big paradigm shift but most pundits don't recognize it...yet.