Reprinted with permission from the Fall 2020 issue of The Prairie Progressive, Iowa’s oldest progressive newsletter. The Prairie Progressive is funded entirely by reader subscription, available only in hard copy for $12/yr. Send check to The Prairie Progressive, Box 1945, Iowa City, 52244. Archived issues available @ theprairieprogressive.com
by Dan Gervich
Mitigation is the starting point. The key to making this condition livable is a mask.
Cloth masks with enough layers to reduce transmission between two people wearing them by 95%, but increases the work of breathing and is pretty hot. A paper surgical mask, which sells for a dime on line, accomplishes that 95% reduction of transmission with less than one-fourth of that increase in work of breathing and heat retention of a multi-layered cloth mask. The raw material for these masks and for N95 masks is recycled plastic bag material made into blown polypropylene paper.
A “War Powers Act” would command and reward mask makers in the US who otherwise balk at gearing up. Instead, President Trump is willing to depend on China and Japan. The federal government could send 10 paper surgical masks to every citizen at no charge. The impact on the federal budget would be infinitesimal. If you like a fashionable and washable cloth mask, make one with just two layers and slip the paper mask in between the layers as an insert. Iowa’s Governor Reynolds should at least mandate masks indoors in businesses and facilities, and enforce the mandate while continuing to encourage other public mitigation efforts.
Testing capability needs to be built until well below 5% of tests performed are positive. The current 10% rate of positivity spells uncontrolled spread. Recently approved Covid-19 antigen tests never wrongly identify someone as infected, nor do they identify someone as contagious who is not. Antigen tests may miss a few people who are infected but not highly contagious. They are cheap to produce at around a dollar a test and are fast (a 15-minute turnaround). Like a urine pregnancy test, they can be done on site with little training.
A “War Powers Act” should make these tests available at every essential workplace and at schools for screening two or more times a week. They would absolutely catch those “super spreaders.” Instead, Iowa struggles in competition with other states to obtain testing materials. To add insult to injury, State Epidemiologist and Medical Director Pedati inexplicably decided not to add thousands of these positive Covid -19 antigen tests to Iowa’s reporting, dismissing them as inconclusive. She is well-trained and knows better. Shouldn’t Dr. Pedati resign if she is making this case but Reynolds blocks her?
An army of contact tracers needs to be built to meet the challenge of the numbers of positive tests and to track down the contacts they have exposed for quarantine. Currently that’s 700 or more new cases a day. Mitigation needs to drive that down to a manageable number, as has been successfully done in Canada and elsewhere. Public health workers need to enforce quarantines and support those quarantined with medicine, food, and even a place to stay if needed, as well as monitoring their illness. Currently, public health workers can’t possibly keep up effectively. Don’t tell me that unemployed trainable talent cannot be found.
The way to stop the spread and lift economically and socially onerous aspects of mitigation doesn’t require an understanding of molecular biology or rocket science. Our current leaders are like parents who don’t know the meaning of discipline, giving in to childish right-wing temper tantrums over infringing on their freedom to do harm. Covid-19 transmission at the Sturgis motorcycle rallies is estimated to have generated 266,796 new cases in the US between August 2nd and September 2nd, at an estimated cost of care of $12.2 billion. If the Sturgis riders had been paid $25,000 each to stay home, the US treasury would still be ahead! Conservatives’ economic arguments don’t hold water.
Governor Reynolds shrugged off the 65 Covid-19 deaths of Tyson packing plant workers in June. Then she and Trump forced the survivors back into the packing plants. Who feeds those dead breadwinners’ families or pays for their children’s education? Reynolds and Pedati are posers, clearly content with the deaths of more than 200 Iowans a month from now until who knows when, as is Trump, who dismisses more than 20,000 deaths of Americans a month as too expensive or unworthy of saving. We as citizens and patients must bring an end to this malpractice.
—Dan Gervich is a retired infectious diseases and critical care physician, healthcare epidemiologist, and Chief Infection Control Officer at MercyOne in Des Moines.