What differentiates countries that are managing the pandemic well from those that are experiencing a second wave of infections and deaths is the concept of dynamic management. We can only hope to understand a virus that, through a mutation, has infected our species through research, research and more research. On that basis, only science can guide us, and it is possible that, as a result of new tests, experiments and discoveries, we will need to change our approaches on a regular basis.
For example, at the beginning of the pandemic, we believed that we should disinfect surfaces, wear gloves at all times, use hydroalcoholic gel and wash our hands constantly. Now we know that the transmission of the virus through surfaces (fomites) is practically irrelevant, and that the vast majority of infections occur through respiratory aerosols, which can remain suspended in the air for quite some time in closed and poorly ventilated places.
What are the implications of such a discovery? We need to change many of the protocols we use to prevent the transmission of the virus. Hydro-alcoholic gels and obsessive cleaning of surfaces do little, and that what really makes a difference is wearing a mask properly at all times when indoors or with non-household members. That means with friends, acquaintances or non-immediate family in any closed place, with special concern for spaces such as houses, bars or restaurants where we eat or drink, and therefore take off that mask. The vast majority of new cases happen because we arrive at a friend’s or family member’s house with our mask on, but when we enter, we take it off and start talking, eating and drinking inside. That’s the problem, and not whether we wear the mask on the street or not.
As we in the northern hemisphere enter fall and winter, we’re going to be indoors a lot more. The only way to avoid widespread contagion is to take extreme precautions with masks in those circumstances, rather than on the street, where transmission through aerosols is much less likely. The job of the authorities is to tell us what we need to know about the use of masks. Which are suitable and for what, and how and at what times they should be worn. If we focus instead on fining people walking around in public, we will simply lose support for the measures. A war against a virus becomes about avoiding the authorities. And that will simply send the infection rate up further.
It’s going to take a long time before we have a truly effective vaccine, much longer to get it distributed massively, and much longer — maybe never — to get denialist idiots to get on the program. For many years, we will have a reservoir of the virus thanks to such people, which will unfortunately continue to lead to outbreaks. Fortunately, science and technology are helping come up with better treatments and diagnostic tests: soon, the tests will be very cheap, with immediate results, very reliable and practically ubiquitous.
A pandemic is a dynamic phenomenon, because the information we have about it is constantly changing, and it must be treated as such. In many countries, guidelines that were issued at the beginning of the pandemic are still in place, even though we now know that they are of little use. The authorities seem to have stopped informing us about developments, perhaps worried that they will be seen to be inconsistent.
Until we are clear about the dynamic nature of the pandemic, meaning that we must trust our research and alter our practices to incorporate new evidence, we will not be able to adequately address it. To understand that, we need to act on scientific, not political, criteria. Scientists know and understand that things change. Politicians, on the other hand, tend to be obsessed with saying something and then sticking to it.
If this pandemic has served any purpose, it is for us to realize the enormous cost of electing people who are incompetent into positions of responsibility. But for more than a million people in the world, it is already too late.
(En español, aquí)