This week we take a look at the various responses around the world at different ends of the spectrum including what continues to be a very aggressive lockdown in Western Australia that locks their borders (land, sea and air) and what that gives the residents. We discuss what the challenge of end point for these approaches with the expectation that COVID19 is not going to disappear from our world anytime soon
Fred covers the helpful twitter thread from Adam Squires that reviews the potential options available in air handling that discusses HEPA filters,CO2 monitors and ventilation and some easy to assemble quick solutions that can be used in any rooms
Raw Transcript
Nick van Terheyden
Hi, this is Dr. Nick, I’m the incrementalist here with incremental insights for better business better health.
Fred Goldstein
And I’m Fred Goldstein with the Campbell health here helping employers payers and health care systems with their population health improvement programs. So Nick, you are an international man, I say should say, of international travel, living in different countries, etc, keeping up with things going on around the world. And particularly with COVID. We’re seeing a lot of variations in how people are handling this stuff. And I know you’ve sort of been watching Perth, Australia, as I understand.
Nick van Terheyden
Yeah, if you’ve got to watch this with interest, and it was a little bit of a surprise to me, because I hadn’t realized that they were still outside of the general principles of Australia as a whole. But it turns out, at least as of the most recent information that I have, that they are still on sort of, you know, Max lockdown, it’s, you know, a bit like that movie with the New York turned into a prison, I forget, forget what the New York was from New York. That’s it. Oh, you brilliant, we don’t need IMDb, we’ve got Fred in the house. And they are essentially not only locked down for air travel, and I guess, you know, sea travel, but also the land borders. So you cannot enter its total lockdown with, you know, very strict protocols. Now, Australia had that New Zealand had that they kept their cases very low, although still managed to enter the country. And what I saw over the course of time was a pullback from that. And, you know, they tried to do it gently because the reality is, when you ask at least I asked the question, when does it end? When do you sort of reintegrate? Or is this is this it? You’re, you’re you know, you’re you’re stuck on the New York Island? And we saw what happened in that movie, if you remember? How do you escape from that? And my challenge with that is that I don’t think we’re ever going to see COVID 19 disappear completely. I think it’s going to be an endemic virus, and what happens to the population as we’ve seen with vaccination, it protects you but doesn’t protect you. And it still ends up sort of overwhelming hospital. So how do you reintegrate friend?
Fred Goldstein
Yeah, I think he has raised a really interesting question. And that points, his whole thing of where are we on this scale of Propecia of potential things to do? And how do we find that point where we can keep things going, keep hospitals to a level that they can handle? You know, and obviously, it looks like, Well, Mary, as you said, we’ll never get rid of COVID-19. So what is that point? Those those various things that we put in place? And I think the way you need to look at this a little bit is, that’s too far out there. On one side, we’ve seen the wide open philosophy and what happens with that, but somewhere in that middle, and I think with the ability to flex, as we’ve seen some of our clients do, you know, as things change, they flex up or flex down the various systems. But a complete lockdown. I think just about everybody has recognized that’s not a viable solution for any long period of time, or potentially even any at this time, given the way Omicron spread so rapidly.
Nick van Terheyden
But But I would tell you, I just received a Christmas card from my medical school colleague, he’s a neath artist who lives in that state. And they were rejoicing, the fact that they had explored much more in the way of travel locally, he’s quite an international traveler, interestingly, and, you know, obviously, that’s, I think you can do it, but exceptionally hard to get in and out if indeed possible. But they love the fact that they were exploring the local flora and fauna. No sense of, you know, frustration. So maybe the folks that are living with it are going this is okay. I don’t know, is there a big enough landmass that you go on? This is okay, I’m going to isolate forever.
Fred Goldstein
And at the same time, is the economy based enough on internal production that it doesn’t need people coming in, that it doesn’t need tourists or things like that? And I think that clearly impacts some of those things as well. Maybe you can find an isolated little place that, hey, we just produce and push it out. And then money comes in electronically, and we’re good to go.
Nick van Terheyden
Yeah, I think that’s the important point about your spectrum is that, you know, this is about creating a life that’s livable. It’s one of the challenges that I think we have masking. It’s certainly an area that you and I we disagree we have, you know, slightly differing opinions on you know, the appropriate masking I view. Any mask is better than no mask. I’ve certainly seen folks that say if you’re wearing a cloth mask That’s pointless. I actually disagree with that. I mean, maybe if it’s a single layer, but for the life of me, I’ve not seen one, even the first one that I bought was, you know, the only one I could find at the time was more than one layer, because it just was, I think, maybe if you made it from a sheet or something, but that’s still providing value. And for me, it’s, it’s more tolerable. I think one of the challenges and I’ve worn, and then 95, when I was doing testing, and volunteering, and so forth, and at the end of that day, and I see it with my colleagues who are doing it all the time, you know, you have sores around the mouth, you it just it destroys your face. That’s very hard to do that every day, every time you interact. I’m not sure unless we find alternatives to that.
Fred Goldstein
Absolutely. I will say I wish I were in your situation this morning, going through a few different stores when I ran out mid day, I can’t tell you how many people want I saw with no masks indoors, but to that would walk by and pull up one of those little gators that you can just about see through the holes in it, you know, and but then again, this is Florida. So what can I say?
Nick van Terheyden
Yeah, so I let’s put that in a spectrum of yeah, those those are really not it’s, you know, that’s not delivering value, you know, wearing a mask and recognize that there is a spectrum and better but, you know, that’s the point, we can do better. And we can surround ourselves on that spectrum. And I think you found that great thread on Twitter, that talked about the air handling, I think there’s a lot of things that we can do even the box that you can build and put in a HEPA filter. All of those tools are available to us.
Fred Goldstein
Absolutely. We’ve talked about this a bunch of times, and there was a great thread by Adam squires at ad squires on January 5, he put it out and went through the four key areas of air handling, you know, you know, get fresh air in there, look at your co2 measurements, there’s the opportunity for HEPA filters, and then uv as well. And and just some very simple things he talked about, obviously, a co2 meter is proven to be fairly effective and understanding what kind of error exchange you have in that room. And when you get above 1000, you should be considering what’s going on, he talked originally about trying to get it to 600. But 700 is better than eight better than nine, etc. But point out over 1000s of problem. And then the other issue that that was interesting, his placement of those HEPA filters, HEPA filters will work, they won’t change your co2 measurements, but they’re cleaning the air of the virus and other particulates in it. And so point putting those in the middle of the room and not necessarily in the corner, understanding how many you need based on floor space, are all critical things to consider. And then finally, there’s the possibility with UV to add that, although that tends to be a little bit more expensive. But there’s some simple things that you talked about, I think was the one that you can build, where you put the filters around a fan and drop it in a room, and you’re good to go. So I think these are things we really need to be looking at. And I think we’ll see more of that. I know in some places, you’re beginning to see buildings where they put a co2 measurement in, as you’re walking in and say, here’s the level in here, which is a fascinating way to show that they’re a safer environment.
Nick van Terheyden
Yeah, and that means that Fred’s co2 meter might become redundant because he won’t need it. You won’t be able to walk around because it’s going to be displayed everywhere.
Fred Goldstein
Absolutely. Absolutely. Well, it’s another great week, Nick, really interesting on what’s going on overseas. It’s always good for us to learn from what others are doing are trying lots of unique things happening. And with that, this is Fred Goldstein. Thank you so much for listening. If you’d like more information, please go to Accountable Health. llc.com
Nick van Terheyden
This is Delta Nick on the incrementalist here with incremental insights for better business, better health.
