116 3rd St SE
Cedar Rapids, Iowa 52401
There is a way to eliminate COVID-19.
Because we refused to use it months ago this lifesaving approach has passed us by. But it still holds lessons for what we can do.
Ironically, the best illustration of the strategy comes from Italy.
In the Veneto region of northeastern Italy lies the community of Vò Eugeneo, home to 3,300. It was the first Italian town to record a COVID-19 infection and death.
On Feb. 21 two people were discovered to have the infection. The next day one died. By March 6 the University of Padua had designed and begun a study that required testing all Vò's residents. Researchers discovered 90 infected people, traced contacts in their families, workplaces and neighborhoods. All who might be infected were quarantined. Two weeks later there were three. When their quarantine ended everyone was tested again, found free of infection, and the Veneto region's Gov. Luca Zaia called Vò 'the healthiest place in Italy.”
In another 'community” with about the same population (3,700), at about the same time (Feb. 3), 10 people aboard the Diamond Princess cruise ship showed symptoms of COVID-19. On Feb. 4 the ten were put in a Yokohama hospital. The others were quarantined on the ship. When they disembarked, Feb. 19, all were tested. Roughly 20% (619) had contracted the virus.
In one case the number infected went from 3% to 0%. In the other it went from less than 1% to 20%.
In that difference is found how to eliminate COVID-19 - along with a warning why what Iowa is doing is so unnecessarily deadly.
It is as if our ceilings are leaking and our response is to mop while teenagers go buy more buckets. We are treating those with COVID-19 symptoms - as of course we must - while simultaneously increasing the number of those infected.
The brutal facts are that you don't have to have symptoms to spread the disease. In Vò, everyone was tested. Those infected - with and without symptoms - were quarantined. On the Diamond Princess (as in Iowa) the focus was on those with symptoms.
How many infected people, capable of spreading the disease, have no symptoms? In Vò it was 45%. On the cruise ship it was 46.5%. Other reports have been higher.
Even if we knew how many Iowans have symptoms (not all have reported) the number infected, potentially spreading the disease is at least twice that.
The primary strategy we're left with is mandated and enforced shelter in place. Governors who refuse to do that - and forbid their counties and cities to do it - will necessarily bear some responsibility for the resulting unnecessary deaths.
We lost the opportunity to test-trace-quarantine-and-test-again, so successful elsewhere. We failed to heed years of official and fictional predictions of this pandemic. We failed to resupply our stockpile of materials to fight it, and wouldn't use WHO test kits. We cut support of federal public health programs and staff and were either unaware of or rejected their tested proposals for response. The costs of those failures in unnecessarily lost lives and trillions of dollars are behind us.
The least we can do is to not make it worse.
Nicholas Johnson, Iowa City, was co-director of the Institute for Health, Behavior and Environmental Policy. Comments: firstname.lastname@example.org