Finding the Path Forward

Posted by on May 27, 2020

Our society is currently consumed with finding a way back to “normal” after months of staying home. But what of the other part of that line–staying safe? We have succeeded in “flattening the curve” here in Oregon, meaning that we have slowed this disease from tearing through our population at the deadly pace at which it began. But we have done so at great cost, through the extraordinary measures of closing down businesses, schools, recreation, and non-essential medical care. How do we keep from undoing all of our good work by allowing the virus to travel freely among us? This is a question we will be grappling with for months to come.

In picking our path forward, we seek the least harm possible to our community. We’re finding the balance between two significant threats: on one side, we must avoid harm in the form of loss of life, and permanently damaged bodies; on the other end, we want to limit harm in the form of loss of livelihood, housing instability, and starvation. Long-term, questions remain around what our nation will do to support families experiencing job loss, food insecurity, and other immediate threats to well-being due to the economic impact of COVID-19. Short-term, people have needs that will not wait, and are looking to get back to work and to their paychecks.

Contact Tracing

With this in mind, we consider our first tool for controlling disease spread: Contact Tracing. Contact Tracing sounds complicated, but the concept is simple: tracing the steps of an infected person, to create a clear picture of who they may have unknowingly exposed to the disease. (For an excellent primer on what Contact Tracing is and why it matters, check out this article from our member organization Community Pathways.) Contact Tracers are a lot like disease detectives, gathering all available information to demystify the presence of COVID-19 in our communities, thereby helping us to control its spread.

Contact Tracers are disease detectives, collecting clues to help us trace the progress of disease exposure throughout communities.

Oregon is hiring and training hundreds of Contact Tracers to do just this for all of Oregon’s residents. (Interested in joining the fight against COVID-19 in Oregon as a Contact Tracer? You can fill out an interest form here.) If you become ill and are found to have COVID-19 through testing, or presumed to have it due to your symptoms and interaction with an infected person, your physician will inform the local public health department. Soon after, a Contact Tracer will call you to gather more information about where you have been recently, who you have been with, what you were doing, and when you became ill. The information you share with a Contact Tracer is protected health information, and cannot be shared along with your identifying information for any reason other than pandemic response and control. This may feel odd, to give information to a stranger, but these small details of your daily life are the key to controlling the infection and death count of COVID-19.

After a Contact Tracer has interviewed you to gather the “clues,” they will follow the trail and contact the people you listed. They will find out from each of these people whether they have developed any symptoms of COVID-19, and recommend a course of quarantine to make sure that they do not spread the disease any further.

Contact Tracing works because it helps people who may not have developed symptoms know that they have been exposed, and therefor may be carrying the disease. Changing their behavior during this crucial window makes all the difference in controlling the spread of COVID-19.

Testing

Oregon is currently able to process over 2,000 COVID-19 tests each day.

As previously referenced, following the life and spread of a COVID-19 outbreak requires us to confirm its presence with a positive test. Testing is one of the important tools that will need to be used wisely in order to resume safe social activity. People have many questions about testing–hundreds, in fact. The Oregon Health Authority has an ever-growing Frequently Asked Questions page, and you can filter them to focus on the topic of testing. Testing is another concept that is simple, but can get complicated fast.

We are all likely aware that some people who have COVID-19 do not have symptoms, and therefore do not know that they have the disease. These asymptomatic carriers are hard to track with testing, because they do not feel symptoms that would prompt them to seek medical help. You might wonder, why don’t we just test everyone in Oregon and be done with it? Even though we have the capacity in Oregon to test thousands of people each day in commercial and state laboratories, we still don’t have enough for every Oregonian to be tested at the same time. And timing is key: we would need to know the results and then act to control those affected within a short time frame. Testing only serves to confirm the presence of COVID-19 at a single point in time–as time moves forward, the test becomes less relevant. A test is also only as good as the sample used: a person may be swabbed in a manner that does not access the area of infection, and because of that test negative even when they do have COVID-19. Testing is a critical tool in controlling COVID-19 spread, but it must be used wisely in order to be effective. You can read more about the Oregon Health Authorities plan to use expanded testing in this document, on page one, under the heading “Required Actions.”)

In Oregon, testing capacity is being used to:

  • confirm the presence of COVID-19 for people who are showing symptoms.
  • identify people with the illness who live or work in group living situations, like care homes for older adults or adults with disabilities.
  • build a representative sample of COVID-19 that is reflective of the general population in Oregon.

This last bullet point indicates how our testing capacity can be used to give us general knowledge of the disease without testing every person. For example, public health is looking to do this by testing a sample of people who seek medical attention for reasons other than COVID-19 symptoms. For example, they may test every person who comes to an emergency room for a broken bone. This will start to build an understanding of who has COVID-19 without symptoms–do they have anything in common? Are there any commonalities in their experiences? If we are able to get a large enough sample, we may learn lessons about this population that can be used to inform public health decisions, and keep us all safer.

Masks help contain the spread of COVID-19. We protect one another by wearing them in public spaces.

Changing Our Behavior

So much of this process, and this disease, it out of our control. We feel powerless so often these days. We do, however, have power over our actions, and how we change our behavior to support a full community recovery. These are some ways that you can take control:

  • When/if you are contacted by a Contact Tracer, answer their questions to the best of your ability.
  • When/if you are contacted by a Contact Tracer, do whatever they ask of you for quarantine, if you have been exposed.
  • Wear a face covering when you are in a shared public space, or might find yourself closer than 6 feet from a person from outside your family unit.
  • Comply with any screening measures that hospitals, businesses, and other entities put in place–allow someone to take your temperature, for example.
  • Follow any instructions in public places and businesses indicating where to safely stand, walk, etc.
  • Limit your trips into public spaces, and limit the amount of time you spend there. Plan ahead, and make the most of each foray into the community.

Every last one of these actions is meant to protect you, and everyone you know and love. Yes, masks are often uncomfortable. Yes, it’s hard and tiring to learn all new rules for being out and about. But the truth is, regardless of what phase of reopening we achieve, our compliance is still a matter of life and death for far too many people.

Vaccination and Treatment

Widespread community vaccination is the ultimate long-term recovery tool. A vaccine is a preparation containing killed or weakened microorganisms (as bacteria or viruses) that is injected to increase protection against a particular disease. Scientists all across the globe have been hard at work to develop a vaccine for COVID-19 since the start of this pandemic. It is important to emphasize that no vaccine currently exists for COVID-19. There is no well-established and vetted drug treatment for COVID-19 that has been verified by clinical trials for mass use. There is no cure for COVID-19, and if anyone claims that they have one, it is almost certainly a scam. Please do not fall prey to these frauds, and clear any and all treatments or supplements with your doctor prior to purchase and use.

Scientists have also been working to identify, test, and verify various treatments for COVID-19. These would not prevent a person from getting the disease, as a vaccine would, but they might help to minimize symptoms, or decrease the likelihood of death due to the illness. Though medical professionals on the front line of this battle are using creative treatments in novel ways to treat desperate cases, there is not a magic pill for treating COVID-19.

Managing Our Expectations

Does all this sound like a far cry from “normal”? If so, you are paying attention. The truth is, we’re creating a New Normal, right now, together. Our life as a society will forever be informed by our experiences with COVID-19. The process of learning from and adapting to these experiences will go on for years, into the foreseeable future. Recovery is not a straight line. There will be new breakthroughs to support our safety and new set-backs that curtail our social habits, new information and changed plans. We will ride the roller coaster down and then up again.

With this in mind, we must manage our expectations: things won’t return to what they were. What we can do, for our sanity and for the good of all, is to roll with it. Practice flexibility, and resist the urge to throw up your hands as things continue to change. That does not mean that you need to keep a fake front or smile for others–you don’t have to love this, and it’s okay to get frustrated, sad, mad, or any other way that indicates you are, in fact, a human. Just don’t give up.