Is there a practical strategy for return to the normal life as we knew it, or did we yield to the coronavirus invasion?
1/
Waiting for mass vaccination would be a passive acceptance of 100,000s more deaths, millions hospitalized, long covid quality of life, and severe economic consequences.
2/
Imposing restrictions to combat transmission (shut downs, stay at home orders) appears in some places politically suicidal, still the question whether to close or keep open becomes mute. Once hospitals overflow, and deaths are out of control, there is no choice but to close.
3/
Waiting for covid to tell us when to close has led to the recurrent destruction of our normal life, and it is already almost a year that we are in an ailing economy with frustrated social and cultural life, and coping with mass deaths and hospitalizations.
4/
So the question is not whether to close, but when and how to close.
Long term partial closure has a much worse effect than short term strong closure.
Getting the cases down rapidly is much better.
Acting sooner is much better.
5/
Observe the wave of COVID cases, when allowed they grow exponentially reaching unbearable values within about 4-6 weeks. When this triggers a strong shut down, it takes 4-6 weeks exponentially to reduce the cases.
Sooner or later and not that much later, you have to close.
6/
The more substantial question is how and when to open—the EXIT strategy.
The only exit strategy is elimination, or sufficiently close to it so that contact tracing and “fire fighting” stop a few cases or small outbreaks. Everything we know says this is the way out.
7/
The goal has to be understood.
Getting there is like landing a plane, you have to do it intentionally.
What is helpful is that the closer one is to zero the more control you have. The best strategy is the “Green Zone” exit strategy, opening areas that are free of the virus.
8/
For a short period of time restrict travel between zones, open them safely, and relax travel restrictions as multiple areas become COVID free.
9/
For some reason, despite the success of this strategy in other countries* many are concerned about doing it successfully and are ready to give up if they are not guaranteed success. But most of the benefits are already gained even if the ultimate goal is not reached.
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*Including Australia, Taiwan, New Zealand, Singapore, Vietnam, Thailand, China, and Atlantic Canada.
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Many are concerned about whether others will cooperate, and the experience is that the vast majority do, and the strategy is robust so that if some don’t participate they can’t stop success. Enforcement is justified, diminishing their importance (ignoring them) is helpful.
12/
Let’s stop focusing on the difficulties and start focusing on getting to the goal of normal life, the one we want for the new year.
13/
Many things that are worthwhile take effort and sacrifice, in this case effort of 4-6 weeks to put the fire out by preventing transmission, and then to be alert to any sparks by testing and tracing.
Others did it. We can do it.
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1/ I’m here not to address HICPAC directly, but to speak to those listening—healthcare professionals, patients, and advocates—who are committed to public health and safety.
Let me highlight several critical concerns.
2/ Members of HICPAC and the organizations they represent have significant financial conflicts of interest.
This issue, documented in a complaint submitted to the HHS Office of Inspector General, raises serious questions about the integrity of their guidance.
3/ Additionally, HICPAC has operated in secrecy, with workgroup meetings closed to public scrutiny.
This violates the Federal Advisory Committee Act, which mandates transparency. Such closed-door decisions erode trust and undermine accountability.
"Prevention of COVID-19 is of utmost importance. For several years, many in our society largely based their COVID recommendations on a one infection and done strategy. We now know that many are coming down with multiple bouts of the disease.1/ kentucky.com/opinion/op-ed/…
"We were told that severe outcomes were hospitalization and death, otherwise you had a mild disease. Now we are faced with crippling long COVID which has ravaged many in our society. In the United Kingdom, long COVID affects as many as 33.6% of healthcare workers.
2/
"At the same time, we were assured our children are safe, they will almost never get severely sick from the virus. However, we started seeing long-term effects from COVID-19 in some of the children we know, and hoped they were outliers. 3/
Effective Oct 1, 2024-March 31, 2025, NJ Hackensack Meridian Health is requiring all patients, visitors and staff wear masks during patient encounters at all of its patient care facilities (e.g. hospitals, physician offices, rehabilitation facilities, etc) hackensackmeridianhealth.org/en/patients-an…
About Hackensack Meridian Health
"...a leading not-for-profit health care organization that is the largest, most comprehensive and truly integrated health care network in New Jersey, offering a complete range of medical services, innovative research and life-enhancing care. 2/
"The network has 18 hospitals and more than 500 patient care locations, which include ambulatory care centers, surgery centers, home health services, long-term care and assisted living communities, ambulance services, lifesaving air medical transportation,
3/
"As a parent, I want my son to be safe at school, so that was a key part of my motivation to do this," says Mr Kinner, the Brisbane creator of COVID Safety for Schools, a free online course that aims to correct misinformation and teach school staff and parents how to reduce ..
2/
"..the risk of the virus spreading. "But also, having spoken to lots of other parents and teachers, it's clear that most schools are lacking an understanding of some of the absolute basics of COVID. And in the fifth year of the pandemic, I find that very troubling."
3/
"What if a troublemaker simply decides to disguise his face with large sunglasses and a hat, instead? Are we going to criminalize sunglasses and hats, too? 1/ nj.com/opinion/2024/0…
"Even with an exception for people who wear masks for medical reasons, it’s a threat to personal freedoms, because it leaves it up to the cops to decide whether someone has a legitimate medical reason for wearing a mask at a public gathering.
2/
"... in its current iteration, this bill would do little to deter actual criminals, while only further stigmatizing mask wearing for vulnerable people.
"Ask anyone still masking because of a weakened immune system, or to protect a loved one, ...
3/
As COVID Surges, the High Price of Viral Denial @TheTyee
"Although the media routinely dismisses all COVID infections as an inconsequential nuisance, that’s not what the science says. 1/ thetyee.ca/Analysis/2024/…
"An important new Nature study, for example, has now proven that the spike protein of the virus can bind with a blood protein, fibrin, setting off a chain of blood clots resulting in chronic inflammation and brain damage.
2/
"Repeated studies show in the bluntest terms that the initial acute infection is only the tip of the iceberg. Even a mild bout of COVID can leave a legacy of blood clots, heart failure, diabetes, decreased brain function long COVID and immune damage.
3/