By Noah Bergam (V)
The first night my dad came home from treating COVID-19 patients at Newark Beth-Israel Hospital, I asked him what the situation looked like.
His immediate response: “No one knows anything.”
Ground zero, according to him, was a welter of confusion. In the midst of a growing influx of cases and a narrowing supply of masks and ventilators, it made sense: no one working there had seen or been prepared for this kind of situation before.
The situation at the hospital has since improved, but confusion has continued to sweep the entire population as we realize the power of our quarantine, and the fact that, if we break it, we risk restarting a vicious battle on the front lines.
We have a long road ahead of us, and we’re all looking forward to the day when we can walk away from this pandemic. But when will that day be? How do we reach it? And how do we make sure this never happens again?
These are the core questions I seek to address in this investigation.
To truly put down the virus at this point, we have to reach a status called herd immunity.
Herd immunity occurs when a significant majority of the population (about 70%) have been exposed to the virus, developed antibodies, and reached a point where they are no longer contagious. This creates a situation where those who cannot survive the virus (i.e. the immunocompromised) are surrounded by a “herd” who can act as a buffer from outbreaks. Life can then go on as normal.
Herd immunity can either happen naturally or artificially (i.e. through a vaccine). According to the WHO, “there is not enough evidence” to suggest that surviving COVID-19 will naturally grant long-lasting immunity. But even with that assumption, the death rates we have seen so far suggest that it might take well into 2021 and over half a million American deaths before we reach that point, according to Johns Hopkins Coronavirus Resource Center.
And then there is a vaccine––a scalable treatment that can give someone a “dumbed down” version of the virus and allow their immune system to develop the necessary antibodies to protect themselves. If we develop a vaccine, it can accelerate us to herd immunity with much more certainty than the natural route.
The vaccine time-table we have been hearing from government officials, like Dr. Anthony Fauci, is 12 to 18 months, which would have us waiting through mid-2021 … but there’s no guarantee that we will remotely follow this timeline, or that we will even be able to develop one. And if we do, we will have to develop a much stronger global supply chain to satisfy an exceptional demand.
In any case, we have a long road ahead of us. But that doesn’t mean we won’t progress. Reopening the economy can happen in steps; Governor Murphy has outlined a six-part plan that includes gradual reopening of specific businesses, as well as significant expansion of contact tracing and testing.
Beating Future Outbreaks
The position we find ourselves in reflects what I like to call the Fundamental Theorem of Public Health: the fact that ad hoc treatment is a more expensive and more painful alternative to prevention.
Keyword is prevention. How do we prevent a virus from wreaking this kind of havoc in the years to come?
To get answers, I talked to my sister Scarlett Bergam, a candidate for a Master’s Degree in Public Health with a concentration in Global Infectious Disease at Brown University.
One of the main things she stressed was quicker action. When asked what contributed most to the situation at hand, Scarlett pointed to a lack of testing and the ramifications thereafter. “While this was not completely in our control, it led to many people infecting others without knowing. To combat the inevitability of not knowing who was infected, we should have shut down our economy much sooner.“
It’s important to understand that testing alone is not enough––those who test positive need to immediately be isolated from the general population, as well as those who they came into contact with in the meantime. Hence, contact tracing: a tool that, if used on a wide enough scale, can turn a virus’ growth rate upside down.
According to Scarlett, “This would be incredibly efficient if people consented to it. However, ethically, there is always a fear of giving up one’s data.” She acknowledged the fact that most contact tracing would probably have to include GPS information, and that tracking of people’s locations could discourage signups (mandatory contact tracing, of course, would invoke some hefty constitutional issues).
However, she expressed some faith that a partnership between local government and the private tech industry could maximize both the effectiveness and the appeal of contact tracing. (Additionally, I found in my own research some clever methods of contact tracing that wouldn’t impede privacy.)
In terms of what we need to do to make these systems a reality, Bergam stated that “policy definitely has the biggest impact—new laws and funding allocation have the power to save mass amounts of lives, much more efficiently than any one doctor can.” Ultimately, making these kinds of long-term investments can save a lot of money and life down the line, and if there’s one good thing that COVID-19 has given us, it’s the amount of incentive we now have to follow through.
It’s incredibly scary to not know when life will go back to normal.
We can rest assured that one day it will. But in order to reach that day, we need solutions, widespread cooperation, and, perhaps most importantly, knowledge. “No one knows anything” is a scary prospect in the hospital but also in the general population––we need to understand the science and the policy surrounding this pandemic. We cannot afford to fall for misinformation, political understatements, or the illusion of blissful ignorance.
We are living in a time of historical proportions, with historical mistakes that will be studied for decades and centuries to come.
So let’s be clear on our situation, and the solutions at hand. Let’s face this world head on and come back to our changed world, not defeated by this present suffering, but empowered by the future in our hands.