@Atul_Gawande: How to Reopen

Atul Gawande outlines what has worked at their hospital system –this is a very important read: Amid the Coronavirus Crisis, a Regimen for Reëntry

An excerpt:

Experts have identified a few indicators that must be met to begin opening nonessential businesses safely: rates of new cases should be low and falling for at least two weeks; hospitals should be able to treat all coronavirus patients in need; and there should be a capacity to test everyone with symptoms. But then what? 

In the face of enormous risks, American hospitals have learned how to avoid becoming sites of spread…

Its elements are all familiar: hygiene measures, screening, distancing, and masks. Each has flaws. Skip one, and the treatment won’t work. But, when taken together, and taken seriously, they shut down the virus.

  • a military boot camp found that a top-down program of hand washing five times a day cut medical visits for respiratory infections by forty-five per cent.
  • the six-foot rule goes a long way to shutting down this risk. But there are clearly circumstances where that is not sufficient.
  • testing when people have symptoms is important; with a positive result, a case can be quickly identified, and close contacts at work and at home can be notified. And, with a negative result, people can quickly get back to work…Daily check-ins are equally important (Owing to false-negative test results, you are still required to wait until your fever has been resolved, and your symptoms have improved, for seventy-two hours.)
  • nonetheless, patients who do not yet show symptoms, or have just begun to, are turning out to be important vectors of disease. That’s why we combined distancing with masks. They provide “source control”—blocking the spread of respiratory droplets from a person with active, but perhaps unrecognized, infection. [Most masks] are designed to safeguard others, not the wearer.

Surgical masks are effective at blocking ninety-nine per cent of the respiratory droplets expelled by people with coronaviruses or influenza viruses. The material of a double-layered cotton mask—the kind many people have been making at home—can block droplet emissions, as well. And the sars-CoV-2 virus does not last long on cloth; viral counts drop ninety-nine per cent in three hours

Evidence of the benefits of mandatory masks is now overwhelming. Our hospital system would not be able to stop viral spread without them