This week Fred Goldstein and I discuss his recent article Learning to Live with Endemic COVID-19, published in Security Nexus from the Daniel K. Inouye Asia-Pacific Center for Security Studies (APCSS) which he co-authored with Ben Ryan of Baylor University and Deon Canyon of the APCSS.
Some governmental leaders and others have said we just need to “learn to live with it” regarding the pandemic. Most often that meant a focus on maintaining the economy with no restrictions or implementations of mitigating strategies and a limited focus on vaccinations. The other side of this is those who have locked down tightly and mandated restrictions. Neither of these approaches is correct, the first creates too many severe illnesses, hospitalizations, and death, taxing the healthcare system. And the latter stifles the economy putting people at financial peril.
We need to “Learn” to Live with Endemic COVID-19. Learning is an ongoing process and as we learn we must also be willing to change our approach. The article discusses learning needed in 10 areas:
- Virology
- Vaccines
- Medicine
- Healthcare
- Prevention
- Population Health
- Education
- Behavior
- Flexibility
- Trade-offs and Assistance
The article finishes with
As humanity continues its bitter experience with the pandemic, it is learning what does not work and what does work against this virus. “Learning to Live with It” does not mean complacency, which only serves to increase global inequities. The warning signs are clear and national leaders must ensure we move through this pandemic without creating additional, unnecessary, long-term generational damage to health systems and economies.
You can access the full article here
Raw Transcript
Nick van Terheyden
Hi, this is Dr. Nick on the incrementalist here with incremental insights for better business better health.
Fred Goldstein
And I’m Fred Goldstein with accountable health here working with employers, payers and others in terms of helping them look at the employee health improvement programs, and develop population health programs.
Nick van Terheyden
So Fred, you’ve recently had a paper published, you’re a co author. And it’s in Nexus publication, it’s living with the endemic tell us, is that what we’re going to be doing? And what does that mean?
Fred Goldstein
Yeah, thanks. It’s pretty exciting. So this this publication was security Nexus put out by the Daniel K. Inoue, Asia Pacific center for security studies, and was very excited to work with an individual, you know, well, Ben Ryan at Baylor, and Deon Kenyon, who is at the Asia Pacific center for security studies, and I’ve been thinking about this issue of seeing how different communities states countries respond to the the pandemic and had said, We keep hearing this phrase, well, we just need to live with it, we need to learn to live with it. And as I thought about that, I recognized that people were sort of looking at that phrase incorrectly, that learning to live with it meant to just dump everything, open everything wide open, and just Hey, we got to do it kind of like when you’re a kid, and something happens to you. And your parents say, well, you just need to learn to live with that, you know, get on with your life and don’t don’t do anything about it. And we really got to this point of what does it mean to learn to learn and live with it? What sort of things we have to do. And and so we looked at this issue of shutdowns that completely destroy an economy and wide open, they create these huge amounts of infections and deaths, and really talk about what is that middle road? What do we need to learn about in order to survive with the virus? So the key areas that we focused on were first virology, we need to understand more about the virus, how it works mutates keep up with those mutations, etc. vaccines, we’ve got these great vaccines, they work well, will they continue to work in the future? You know, do they need to be adjusted? might we learn that some vaccines as we’re seeing maybe are a little more effective than others might some be used, more importantly, in certain areas versus others are easy to administer, etc. medicine was the third area we focused on what do we need to do in the medical community? And we’re now beginning to see some potential drugs come out in that were originally we didn’t have that the healthcare system, what is it community to think about from that, and the ability to surge and deal with these increases from the pandemic? and prevention? What are all the interventions that you and I have discussed for a long period of time to use? education, this is clearly shown that our education system has not done a good job educating individuals in the communities about science, how science works, what does it mean, it’s okay to not know things stuff like that behavior, how do we create behavior change, and ultimately, it got down to this point about flexibility. We need to be flexible enough that we can quickly change, we’ve got an approach, something happens in the community, maybe we’ve gotten better. So we can open up a little more, we’ve gotten worse, we need to shut down. And what are those trade offs? And so it was a fascinating piece we wrote about, and it doesn’t mean that we’re going to be complacent, but that we’re going to find the right solutions for the community at the right place at the right time.
Nick van Terheyden
Well, let me ask you, so we live in the United States, I would suggest that the United States has a less than grown great policy towards sick leave, as an example, less than healthy attitude towards wellness in the workplace. Do you think we’re equipped currently in the current setting to be able to adjust I mean, I have personally examples around me of friends and so forth, who struggle with taking sickly because they have a sick bank that goes negative, and if they go negative it uses. I mean, this just seems completely the antithesis of everything that you described.
Fred Goldstein
I think that’s exactly the point. And you’ve raised one of the clear issues. As you look at this in a broad perspective. Employers, countries etc, need to consider areas like sick leave. And we’ve now found that those areas don’t function well in a pandemic. They create problems we need to adjust that just as the system we had with fee for service medicine. Suddenly meant physicians were earning zero under a pandemic. And they need to look at different ways to do it. It also meant people didn’t get in for care, it meant some people didn’t change their behaviors. And so it’s a very complex problem. But I think in these areas, if we can look at the across these different areas, and make the appropriate adjustments, will be better able to do the next pandemic and to continue to operate in this one.
Nick van Terheyden
Yeah, I’m gonna say if you’re an employer, and you’re thinking about this, one of the ways to attract all these people, the 50% plus who are saying no, I’m quitting, I’m going to go to another job is to create a really employee friendly environment. And I would say a central tenant of that is a sickly policy that is highly supportive, but doesn’t economically cripple businesses. So I understand the challenge of that, and having to sort of, you know, funded essentially, but to me that sort of central to all of this. And then the other question I have is around, you know, these responses, you talk about targeted or appropriate responses. What does that look like is that, hey, everybody’s wearing masks for the rest of our
Fred Goldstein
lives. No, I think that that, that that’s going to be a flexible thing, you’re going to look at some communities, they’re going to be in great shape, or maybe the schools are in great shape, and you don’t need the mass vaccination rates are high, the infection rates in the community are low, versus another community that may be experiencing something much different with really high infection rates, etc. vaccination rates are low, they do need to mask up. It’s fascinating. I just saw an article on a community in Colorado 99% vaccinated in that community, as I recall. Wow. And they had you know, no mass required indoors cetera. But they’re a tourist community, there rural, and with this huge influx of tourists, and RV years, etc, who come there for the great outdoors, and then some indoor events, etc. The community itself decided to mandate indoor masks during that period.
Nick van Terheyden
I was not interested in. So so you know, there’s a community that’s really sort of focused on the prevention to get to that level of vaccine compliance. And you know, distribution is I just want to say, awesome, and then you throw a wrench in the works and have all these people that come in sounds a little bit like Sturgis to me, that was one of the things that happened there. And you’ve got very little control unless you say, no, we’re not taking it. But we essentially have 51 countries with open borders, I mean, one or two minor exceptions, but that’s what it feels like to me as a foreigner. It’s 15 different countries,
Fred Goldstein
but the ranch is they want to keep their economy going. That’s how their economy survives. It’s a small rural community, I think was 700 plus people that live there, and they need this influx of tourism. So how do you find that middle road? And I think that’s a perfect example of looking at it at a period of time to do certain things. And then obviously, once they’re through that, because they did see some infections that they didn’t see before in unvaccinated people when the groups came in and suddenly their little hospital has people in it, you know, and and they got to adjust for it. So really fascinating issue.
Nick van Terheyden
Well, I you know, I highly commend them i think you know, it’s a distributed strategy as you’ve rightly identified it taking all of those elements and contributing and then adjusting the way that we focus our response so that it’s not you know, one big hammer that just wipes everything out, you know, shutting down as an example which you know, really didn’t go well for an awful lot of places unfortunately.
Fred Goldstein
Absolutely. So once again, thanks, Nick. Appreciate the opportunity to discuss this article. It was called learning to live with endemic COVID-19 insecurity Nexus. You can look for that online. This Fred goes through the cannibal health. Thank you so much for listening this week. If you’d like more information, please go to accountable health LLC COMM
Nick van Terheyden
And this is Dr. Nick on the incrementalist here with incremental insights for better business, better health.
