The likelihood is Covid-19 is not over and done with at the end of May or June. The curve may be flattened, but unless new cases are identified through testing followed by contact-tracing, the US will be buffeted by the continuing emergence of hotspots. The most likely places for new hotspots are the same heavily populated areas that have borne the brunt of the “first wave” of infections. In this scenario, the US population experiences “rolling infections” in continuing waves with shutdowns of affected areas. Under current policies and apparent lack of preparation for future contingencies, this scenario is likely to play out even if new variants of the Covid-19 do not emerge. New variants would simply exacerbate US health and economic challenges.
I believe it unlikely that epidemiologists advising the Federal government have not considered this likelihood, but given past performance, Federal preparation through training and hiring of contact specialists is unlikely until “mitigation efforts” have proven hopelessly inadequate. Current practice indicates that Federal response occurs only when near disaster is on the doorstep.
In the face of this track record, how might offices, businesses, and educational institutions which require personnel presence prepare? The following steps are essential:
- Assure that personnel are free from infection. Workers, staff, or students may be tested for presence of Covid-19 antibodies. If antibodies are present, further testing is not required. For personnel without Covid-19 antibodies, schedule Interval testing for Covid-19 infection. Testing should occur at sufficiently close intervals so that asymptomatic personnel are quickly identified. Given current data on infectivity, weekly or biweekly testing may be required for endeavors in traditional settings. Given that Covid-19 “home tests” that provide results within 5 to 15 minutes will soon be available, frequent testing will be practicable. Individuals with Covid-19 cannot return until free from the virus.
- Identify exposed personnel. Contact tracing within offices, business, and educational institutions is simpler than contact tracing in larger communities. Persons with whom an infected person has been in contact may be quickly identified and furloughed or transitioned to “work at home” for two weeks. If free from infection, these persons may return to the workplace or educational institutions. Thus, even within hotspot communities, offices, businesses, educational institutions may continue to function.
- Mitigate spread. Workplace, business, and school personnel ought to employ recommended procedures to attenuate infections. Procedures include frequent cleaning of surfaces and handwashing and donning masks at meetings. At schools and institutions with stipulated times for breaks, toilet use should be staggered and toilet lids in the down position when flushing since flushing may aerosol the virus.
In summary, responses to Covid-19 are not limited to Federal, State and municipal governments but can and should involve local businesses and institutions. Responses by offices, businesses, and schools would complement and enormously strengthen Federal and State efforts. Although the recommended policies may be viewed as intrusive by some workers, staff, or students, testing and contact tracing is necessary for the greater good and constitutes a temporary measure in extraordinary times.