New York Daily News: MANHATTAN, NY, By Andrew Cuomo – While politics rages, the economy suffers and nerves fray, the COVID virus progresses.
COVID is now deeply entrenched within the American home. How the virus was allowed to migrate from China and enter our airports from Europe without warning, and how our nation was so unprepared to deal with an outbreak after having experienced MERS, SARS and Ebola is a topic for another day. But all along, the virus has been one step ahead of us.
As summer turns to fall and fall turns to winter we see the next COVID battles looming. Let’s finally plan ahead.
The winter, still several months away, will be the “season of the vaccine.” We can identify the questions concerning the vaccine but not yet the answers. When will a vaccine be developed? Will the American people believe it is safe? How long will it take to accomplish the massive undertaking of vaccinating the entire population? (This nation has only performed 128 million COVID tests over the past seven months; vaccination requires more than 300 million injections.)
Will the federal government develop the competence to effectively administer the vaccine, or will the states once again be left to manage on their own? Can state administrations even manage such a task? These are the questions to anticipate, discuss and resolve. Last weekend, the National Governors Association sent President Trump 36 questions on vaccine administration that have yet to be answered.
While we plan for the vaccine, we must deal with the here and now.
The fall, as expected, has seen an increase in the viral transmission rate. Scientific experts predicted the increase as congregate activity expanded, schools and colleges opened, people moved indoors and “COVID fatigue” set in. Once again, the federal government is without a substantive strategy or program beyond the president’s admonition “Don’t be afraid of Covid. Don’t let it dominate your life.” In his final debate with Joe Biden, Trump repeated his wishful thinking that we are “rounding the turn,” that the virus “will go away.”
A goal without a plan is just a wish. As 217,000 lost lives demonstrates, COVID is something to worry about and we need an intelligent prescription to address the current viral surge.
In New York, we are deploying a new strategy of targeting viral “micro-clusters.” Testing and contact-tracing to date have largely been used to monitor a statewide or regional level infection spread. On this large a testing scale, once an increase is detected, the virus has already infected many people and is hard to slow, not to mention contain, and any mitigation efforts can only be employed over a large geographic area, making them highly disruptive.
Monitoring micro-clusters involves increasing the testing regimen to identify low-level spreads on a small geographic footprint. This allows containment before a large number of people are infected and reduces the economic and political disruption in implementing new restrictions.
To detect these smaller surges, a larger number of tests must be performed. Testing must move beyond regional or even county-level data to a granular neighborhood-level analysis capable of detecting a number of cases, often in the single digits in a limited area of several square miles.
That is how this virus spreads. That is the level of pinpoint analysis required. The consequences of even one mass gathering that violates state rules can be devastating. One Sweet 16 party in a restaurant on Long Island turned into a not-so-sweet 37 cases and counting. One bar in Broome County and a few nights of libation created several hangovers and dozens of COVID cases.
Once a micro-cluster is detected, targeted remedial actions include increasing testing and contact-tracing, a reduction in the size of mass gatherings, restaurant and bar limitations, and most importantly, increased enforcement activity.
While this is time-consuming, requires a high level of government competence and is politically difficult, it is the only way to stop the spread. Importantly, this is critical at a time when many states are moving in the opposite direction: actively reducing the number of tests they are taking. Less testing means once a state detects an increase, it will almost be unstoppable, especially as more states are reluctant or opposed to enacting more stringent public health restrictions.
How we detect and manage these micro-clusters will determine how effectively we can keep COVID under control through the fall and until a proven vaccine has fully defeated the virus.
Now more than ever, government matters and science matters. It is the only way to return good health to the American home.
Top Feature Photo: New York Governor Andrew Cuomo holds a facial mask during a news conference in Manhattan – Luiz C. Ribeiro/New York Daily News