There Is A Giant Hole In Our Covid Control Strategy

With cases continuing to surge across the US, it is clear that we need a different approach. In the US, we never really effectively implemented an entire arm of Covid control basics, namely identification of the virus through border control, testing, wastewater surveillance, and genomic surveillance and then isolation of those exposed, through contact tracing which takes advantage of digital technology and supportive quarantine systems which could eventually be replaced by prophylactic drugs.

Biden’s recent vaccine mandates are sorely needed to increase vaccination rates. With a wealth of vaccines available, only 53.2% (as of September 13) of Americans are currently fully vaccinated. Yet is it is clear from the example of Israel that we need more than vaccines to control this ever-evolving virus. Despite having one of the earliest vaccine rollouts and leading the way in vaccinating children and rolling out boosters, Israel is now experiencing a surge of infections, hospitalizations and deaths. Israel acts as the canary in the coal mine for us all. No single public health measure or medical intervention will accomplish perfect results or will be solely responsible for controlling outbreaks. Instead, we need to build layers of protection through a multimodal strategy for long-term Covid control. Relying on vaccines alone is part of what has lead us back to this crisis point.

Our focus needs to shift to prevention and protection working in tandem with medical interventions. The first priority should be protecting your own country via stronger border controls, mandatory testing for both domestic and international travel along with temporary closures for high risk countries. Quarantine for both vaccinated and unvaccinated should be mandatory on arrival from high risk countries. The second priority is effective masking, testing and tracing systems to contain outbreaks within the country. Vaccination and other medical interventions should be the final layer of protection, not our sole modality.

Countries such as China, New Zealand, and Taiwan that have instituted rigorous border control, testing and tracing, and quarantining systems, have been successful in controlling Covid outbreaks even in the wake of highly infectious variants. In a population of almost one and half billion, daily cases have not spiked in China above 150 all year. By comparison, the US is averaging 150,00 daily cases. Research from the University of Georgia found that with a robust contract tracing team in place, an outbreak in Zhejiang was suppressed by isolating cases within five days and a third of infected contacts quarantining for the entire virus incubation period. Implementing these measures in the US in combination with high vaccination rates and other medical interventions is the best defense we have against this ever-evolving virus.

Biden’s recent announcement to use the Defense Production Act to increase production of rapid tests, including at-home tests, and dramatically reduce their price, is a welcome change. I have long advocated for the use of mass rapid testing throughout the pandemic. Yet the increased capacity and accessibility to test means nothing if there are no consequences for a positive test. A mass testing push will not succeed without effective tracing and quarantine systems.

Read the full article on Forbes

Originally published on Forbes on September 13, 2021 

© William A. Haseltine, PhD. All Rights Reserved.