Doom or hope?

If we act to prevent the surge which has already begun, there is hope. If we deny the real danger, we will be doomed. COVID doesn't despair or hope, it mutates, multiplies, and has the advantage. To survive, we should use the vaccine in a strategic way, reduce indoor gatherings, and enforce mandated masking.

"Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, warned today that she has a feeling of "impending doom" as COVID-19 cases, hospitalizations, and deaths continue to rise. "We have so much to look forward to, so much promise and potential of where we are, and so much reason for hope," she said during a White House briefing today. 'But right now I’m scared.'" Boston Globe, newsletter, March 29,2021. The next day, in the company of several officials, she stressed hope. "Walensky said today there is "so much reason for hope." Walensky visited the mass vaccination site at Hynes Convention Center today with several other state and federal leaders, including Governor Charlie Baker, US Senator Ed Markey, US Representative Stephen Lynch, and FEMA Administrator Robert Fenton." Boston Globe, newsletter, March 30,2021.

Why did Walensky not state in strong terms the excess risks that come from reopening? What if she had urged the Governor to pause the reopening in order to save lives, at the Hynes with the cameras rolling...

We know what to do

A deadlier and more transmissible variant has taken root, but now we have the tools to stop it if we want, according to Zeynep Tufekci, The Atlantic, March 30, 2021.

Even as our vaccines continue to work very well against [a new variant of COVID], the particular variant we’re facing in this surge is both more transmissible and more deadly for the unvaccinated.

Tufekci goes on to urge rapid vaccination of as many as possible, but with special focus on areas of outbreak.

The solution is obvious and doable: We should immediately match variant surges with vaccination surges that target the most vulnerable by going where they are, in the cities and states experiencing active outbreaks—an effort modeled on a public-health tool called “ring vaccination.” Ring vaccination involves vaccinating contacts and potential contacts of cases, essentially smothering the outbreak by surrounding it with immunity. We should do this, but on a surge scale, essentially ring-vaccinating whole cities and even states.

A vaccination surge means setting up vaccination tents in vulnerable, undervaccinated neighborhoods—street by street if necessary—and having mobile vaccination crews knock on doors wherever possible.  Zeynep Tufekci, The Atlantic, March 30, 2021.

On the broader national and state field, the urging of many public health experts , including Tufekci, and the evidence of surges following reopenings should lead to a shutting down of gatherings, rather than a reopening; and to a mandate on masking that is actually enforced.  Research published on March 12 by the Centers for Disease Control and Prevention (CDC) in the Morbidity and Mortality Weekly Report (MMWR) has found that restaurant dining leads to an increase in infections; wearing masks reduces infections.

Restrictions on gathering and communal masking mandates together reduce the spread of infection.

Evidence-based prevention strategies can reduce the transmission of SARS-CoV-2, the virus that causes COVID-19. Consistent and correct use of masks can prevent SARS-CoV-2 transmission, which predominantly occurs through inhalation and other exposure to respiratory droplets from infected persons. Mask use is particularly important because presymptomatic and asymptomatic spread is responsible for nearly 60% of COVID-19 cases.1,2 Universal and proper masking results in substantial community benefits.2 To better leverage the prevention benefit of masks on community transmission, many states require that people wear a mask in public. As of March 1, 2021, 36 states and the District of Columbia had a mask mandate in effect.

Indoor venues such as restaurants, where physical distancing (≥6 ft) is difficult to maintain and consistent use of masks is not possible, can increase the risk of transmission. Gery P. Guy Jr, PhD, MPH et. al, Mask Mandates, On-Premises Dining, and COVID-19, JAMA. Published online April 1, 2021.

Our public health advisor, Michael Siegel, MD MPH, Professor of Community Health at BU, argues that state and national leaders have failed to define public health policy in terms of valuing human life over other considerations. He has been critical of the policy of holding in-person classes at Boston University because of what he sees as unnecessary risk.

"The accelerating pace of inoculations has not been sufficient to fend off case increases as more-transmissible variants circulate in the United States, especially among young people who have fallen sick in outbreaks tied to schools." Washington Post, March 30, 2021

We are In a race between vaccinations and COVID. COVID doesn't despair or hope, it mutates, multiplies, and has the advantage. 

We know what we must do to justify hope. Let's do it.

Advocate with facts

One way to change policy is to provide good data. I was able to get the attention of Governor Baker by telling him facts that surprised him, facts that I could demonstrate. Today, we don't know how bad the epidemic is in housing. As residents of public and subsidized housing throughout the Commonwealth, our observations and reports can help replace the vacuum of official data. Use your best estimate of COVID infections and deaths among tenants and staff in your housing facility, and let me know so I can include in our research and advocacy efforts. Of course, your identity is confidential. Please take a few minutes to do the Little Red Hen Survey . The survey program is a bit quirky, please be sure that the required questions marked * are filled.