Back to School

To my Patients and Friends,

I’m back from a brief hiatus, so for this installment, I thought I would address issues related to returning to school.

Amidst all of the frustration, confusion, uncertainty and mixed messaging we’ve encountered thus far over the course of the COVID-19 pandemic, there are a handful of certainties upon which we can rely as we make decisions for ourselves and on behalf of our families.  I believe that we’d all be better off by focusing on what we know- and avoiding being distracted by what we don’t- as the school year rapidly approaches.

What we know:

Masks work. Period.

However, some have been shown to be more protective than others. Of note: gaiters are NOT recommended; in fact, they may cause harm in that they tend to break larger respiratory droplets into smaller ones, which can linger in the environment for longer periods of time.  Cotton bandanas are also not recommended.  That there remains any controversy about the importance of face coverings is mystifying and infuriating.  Please don’t listen to the naysayers.  Plus, it’s now the law in Connecticut.

Physical distancing works

The closer we are to an infected individual or the more time we spend in his or her vicinity, the more likely we are to catch the virus and pass it on to others.

Hand hygiene works

Studies have shown that hand hygiene is at least as important as the use of face coverings in fighting the pandemic.

There is no COVID-19 “season

As it turns out, COVID-19 is not a seasonal infection as had been suspected.  Early in the pandemic, many had surmised that the virus would take on a pattern of seasonal spread similar to that of other viruses like influenza.  However, this has turned out not to be the case.  There was speculation that the virus my lose viability in warmer environments or would be less transmissible as we began to spend more time outdoors… we now know that this was wishful thinking and what we are really seeing is one big wave.

The virus will spread in schools

We know that children can spread the virus as easily as can adults, and that cases among children are rising.  Children who are infected with COVID-19 are more likely to be asymptomatic and less likely to experience severe disease (though a small subset becomes quite sick); however, they are capable of transmitting to both children and adults.  There is some evidence to suggest that children under the age of 10 years are less likely to transmit the virus; at the same time data have shown that their nasal passages are more easily colonized with the virus.  So the jury is still out as to the degree to which younger children pose risk to others.  Additionally, the true incidence of coronavirus among children is not known due to lack of widespread testing.  Gatherings on college campuses– which are difficult to regulate-  will also contribute to ongoing viral spread.

Testing and contact tracing

Unfortunately, there remains a significant false-negative rate among the tests that are currently available.  To compensate for this, we ought to be testing as many students as possible on a regular basis; this would enable us to pick up any “signals” within a community that might suggest the emergence of a COVID-19 spike.  Unfortunately, as testing capacities in many communities remain woefully inadequate, we’ll need to come up with strategies to test efficiently and- importantly- to continue reinforcing and relying upon the sound behaviors of all members of our communities in order to keep the most vulnerable among us safe from COVID-19.

Temperature checks can be misleading

Screening protocols such as temperature checks are blunt instruments that will not pick up all disease… some will sneak through.

We will need to be fluid and to expect the unexpected

Although we hope that schools that choose to reopen in the fall will remain open for the full semester, some will not.  In many cases, decisions may be made on a classroom-by classroom basis.

We have some control

We can support our immune systems by exercising regularly, by following a healthy diet that includes lots of fruits and vegetables (and perhaps even sourdough bread!), and by maintaining a healthy weight.

What we don’t know:

What’s the incubation period?

Recent research suggests it may be longer than we previously believed.  This may impact recommendations for time in quarantine after an exposure, as approximately 10% of COVID-19 patients may develop symptoms more than 14 days after exposure.

How long will the pandemic last?

The bottom line: nobody really knows.  But if we were to find it within ourselves to adopt a full-throttle E pluribus unum approach, we’d save thousands of lives (and perhaps the economy).  Short of that, we’ll need to sit tight and hope that a vaccine becomes available sooner rather than later.  Even so, it’s unlikely that a vaccine will bring the pandemic to an abrupt end… but it will certainly slow it down tremendously.

When can we expect a vaccine?

Probably not this year.  And when one does arrive, it’s unlikely that we’ll know for sure how long its protection will last, or whether or not one or more boosters will be required.  Additionally, it’s likely that more than one vaccine will hit the market.

Will the virus spread on athletic fields?

Many believe the answer is yes.

For more clarity

This podcast is one of the best around.  Dr. Osterholm is a balanced, highly respected and informed expert… I encourage you all to tune in for unbiased updates on all things COVID-19.

That’s all for now.  Please be safe, heed the science and have a great week.  I’ll see you soon!