Free Tests Will Not Protect Us From Viruses

In communities around the nation, remote learning is enacted due to school closures because teachers, bus drivers, and students are ill, long lines are seen at super market check-out counters because sick employees are not showing up for work, concerts are cancelled because entertainers have lost their voices, and the list goes on.

No, it is not 2020,  or even 2023, but October 2024. This is the time of  year when we want to just put our feet in the ocean and enjoy warm, tranquil breezes before the cool air of Autumn settles in.  But putting our heads in the sand will not protect us from viruses carried in the air. The United States is facing the largest outbreak of COVID-19 infections in over 2 years. Though there is a dearth of rapid antigen and PCR testing, wastewater levels have risen significantly. CDC is reporting that levels are around 8.82 which is a huge rise since it was last checked in May and found to be 1.36.

Wastewater is an inaccurate measurement since there are many factors that can influence the findings including flow of water into the sewage system and the amount of shedding by the particular variant. However, it can be an indicator supported by hospitalizations and mortality rates which are now rising.

But something significant is missing. What is the morbidity from this coronavirus infection? It’s much harder to measure and quantify. Plus, there are many who are infected who may never enter the medical system. Yet, the impact on their lives and caretakers around them can still be significant-both physically, emotionally and even financially.

People don’t want to be sick. They want to carry on with their work, to care for their families and friends and to enjoy activities that bring pleasure. But when a person is ill and doesn’t feel well or have energy, the world can come crashing down. This is the collateral damage of a virus that can impact every system of the body even if it is ‘considered mild’.

If one is not in a hospital or on a ventilator than the infection may be deemed insignificant  We have seen acute Covid infections lasting  a few days to a few weeks, but there is a group that goes on to develop Long Covid which is a constellation of over 200 symptoms lasting more than 12 weeks and can start anytime post the acute infection.

The impact is challenging to assess such the personal and professional toll as well as the consequences for a health care system already overburdened. It is estimated that over 400 million people worldwide and 24 million adults in the US have Long Covid. The global financial impact may be $1 trillion. It is probably an underestimate since some people are not seen by clinicians or are misdiagnosed.

Strangely, it seems that few are concerned.

But some are, including Senator Sanders  who introduced legislation to address Long Covid. From funding new clinics, research studies including for vaccines, registries, affordable therapeutics and PPE and more, there is a fighting chance that a disease that will disable hundreds of millions and potentially billions worldwide can be better managed.

The public has been lured into a false belief that this virus is gone, that it is a simple cold, and nothing works to prevent it. This is not true. A recent CDC survey found that a majority of the public supports waste water surveillance and 95% would support mitigation measures if Covid cases are found to be high.

This virus causes immune dysfunction increasing susceptibility to other pathogens. People getting infected several times a year by a viral, bacterial and fungal stew is not sustainable in the long run. Even if one doesn’t develop permanent disabilities, frequent infections are disruptive to quality of life.

This is the start of autumn when people are still outdoors to enjoy the sunshine, yet Covid wastewater rates are through the roof. Add in more viruses such a Mpox (WHO has now declared this virus, associated with painful boils, a global health emergency), parvovirus, H5N1,  diphtheria, and the start of Respiratory Syncytial Virus (RSV) and influenza season and our public health system will be strained even more to handle this surge.

As people begin to gather at conferences and in schools, we are beginning to see a rise of infections from viral to bacterial and there is more to come.

We never developed  vaccines against HIV.  Through the use of medications and PPE (condoms), this virus is no longer the public health threat that ravaged populations for decades. It took passionate advocacy and education to get us to this point.

We know that ignorance is not bliss. We can’t use denial to get us out of this situaton. We need to get our heads out of the sand.

We have learned that our current vaccines do not block infection nor transmission. For a time, they may decrease the severity of the illness. Until we find more effective and safe vaccines and therapeutics to prevent and treat Covid-19  including Long Covid, we all need to take simple steps so we can fully enjoy our lives now and in the future.

Though more free tests will be available from the government starting in September, the sensitivity of these tests are variable and can be as low as 20-30%. So people may be infectious and still test negative. Furthermore, the CDC changed its guidelines to where people do not have to isolate till they test negative. The use of masks has been recommended, but there has been much confusion to the type  of masks and when to wear them.

We need more robust education campaigns about the importance of ‘clean air’. We have all smelled cigarette smoke in a room when no one is there—it lingers in the air. This is a good way for the public to visualize this virus. The particles (aerosols) remain long after an nfected person has been in that space.

We know that high quality/well fitted N95 or KN95 respirators/masks, ventilation systems (even opening windows) and HEPA filters work against respiratory viruses. It may not completely block transmission, but it can be pretty successful if used correctly. It’s unconscionable that health care systems no longer have mask policies in place especially to protect the most vulnerable as well as their work force.

These tools need to be affordable so everyone can have access. Mis- and discommunication about effectiveness and the stigma surrounding usage have to be stopped.  Decisions can no longer be swayed by political, economic nor psychosocial repercussions.

In the beginning of the pandemic, our messages focused on the need to protect others. By protecting ourselves, perhaps this can be achieved.

Saralyn Mark, MD ,is the former Senior Medical Advisor to the White House, HHS and NASA. She is the American Medical Women’s Association COVID-19 lead. Dr Mark is founder/president of iGIANT (impact of Gender/Sex on Innovation and Novel Technologies) and SolaMed Solutions, LLC. She is author of Stellar Medicine: A Journey Through the Universe of Women’s Health.

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