In 2018 the World Health Organization (WHO) warned that an unknown disease, Disease X, would soon emerge and pose a major public health risk for which there would be few or no countermeasures. This prediction was based on observations that viruses existing in wild animals occasionally pass to humans, for example Ebola, SARS, Zika, MERs. The purpose of the warning was to encourage the world to prepare for Disease X, spot it early and contain it, avoiding a pandemic.
COVID-19 is Disease X.
Few countries were prepared for it, but those that were, such as Taiwan and South Korea, quickly contained the disease and developed methods to control resurgent outbreaks. Because of this quick control, less-affected countries had the luxury of thinking that the global response to COVID-19 was overblown. However, countries that shut down their economies prepared and implemented public health intervention plans and were able to contain and manage disease spread. Both types of countries are now back at work. Countries where COVID-19 was politicized have, and continue to have, far worse outcomes as political concerns take precedence over public health.
COVID-19 is not a political issue — it is a public health issue and it needs to be treated as such to protect all Alaskans.
Containing COVID-19 while reopening and sustaining social and economic activity is not rocket science, and the principles are not new. During the 1918-19 influenza pandemic, public health measures included mandated mask wearing, social distancing, limiting large gatherings, increased hygiene, contact tracing, limiting travel, and quarantine. In that pandemic, banning mass gatherings and requiring mask wearing have been estimated to have cut the death rate by as much as 50%. U.S cities that implemented effective interventions early during 1918-19 and adjusted them as needed were able to produce a middle ground of interventions to minimize the infection peaks as well as disruptions to life activities. With our modern access to information on infection rates, it should be possible to achieve an optimal middle ground where interventions minimize infection rates while still sustaining a tolerable level of social and economic activity. This balance is only possible when health science, not politics, drives decisions.
Alaska benefited from the late arrival of COVID-19 and from observing the responses of other states and countries. To his credit, the governor quickly issued a shelter-in-place order that reduced the rate of new COVID-19 infections from 16 a day to two. Unfortunately, a public health intervention plan was not developed at the same time, or if it was, it was not put into practice. Such a plan would spell out, based on the time-varying infection rates, what steps need to be taken during the reopening of social and economic activities. Instead, we have seen mostly a politically based plan, weak messaging from the top, and the unrealistic expectation that Alaskans would “continue to minimize the spread” voluntarily.
Politically driven approaches have not proved effective in any state thus far, and the governor’s plan is not working for Alaska. On May 22, the day of the Phase 3 reopening, the daily infection rate was four. It trended higher, from five to 26, through June 27 and then increased rapidly to 48 by July 3. On July 4, the 14-day trend of new cases was 125% with an infection reproduction rate of 1.21 on July 1; a number greater than 1 indicates that infection rates will increase rapidly. Alaska is classified as a COVID-19 hotspot by the Kaiser Family Foundation. The Harvard Global Health Institute classified Alaska as “category yellow” on its COVID risk-level chart. At category yellow indicates that strategic public health interventions should be taken to push the spreading rate down.
Continuing our current passive management approach will result in runaway infection rates that will eventually prove disastrous. Time is short for Alaska to develop and implement a public health intervention plan to contain the current surge in COVID-19 infections. Alaska’s approach to reopening social and economic activity should be coordinated with this plan in order to find the optimal middle ground of intervention, a space where we are still able to work and live but where the disease is held at bay. Write to the governor. Tell him you want to see a clear public health intervention plan, one backed by reason and past successful practices, implemented to keep us safe while we still enjoy that great Alaska sunshine.
Jerry Johnson is retired after almost 40 years working as a consultant, applied research scientist and engineer for industry, government, and the University of Alaska Fairbanks. He lives in Fairbanks.