My interview with Dr. Paul Byers, state epidemiologist @msdh is live. Remarkable how quickly the flood came in. On Nov. 4, the day I conducted this interview, the seven-day average of new cases was 665. Today, that number is 1,017. Highest since August. https://www.jacksonfreepress.com/news/2020/nov/11/dont-lose-hope-state-epidemiologist-dr-paul-byers-/

School closings are coming in with alarming rapidity all over the state. Hospitalizations are spiking too. MSDH is sounding the alarm. The interview is deeply relevant to how we will handle this third spike, and I want to examine why here.

First, we discuss why Mississippi lagged behind the rest of the country in the explosive steepness of the new spike, a distinction that is less true with every passing day. Climate probably helped: the Mississippi weather has been beautiful. This likely bought us time.

The reason I reached out to Dr. Byers is primarily to discuss contact tracing. There are two forms of contact tracing, broadly speaking. Forwards and backwards. Forwards tracing is simpler. We estimate that Patient C has been infection for 7 days. Who did he expose in that time?

Backwards tracing travels in the other direction. Patient C was necessarily infected by Patient B. Where? How? Can we trace that back to Patient A? Why does this matter? Because sooner or later backwards tracing brings you to a cluster, a mass-spread event.

Coronavirus is an incredibly difficult virus, to state the obvious. The combination of its asymptomatic phase and its absurd ease of transmission means preventing household spread is close to impossible. What you can do is shut down clusters, where one individual infects dozens.

Not all countries are Vietnam, China, or South Korea. Japan is a good example of a country that also botched controlling the spread: by early August their spike was rising too. Backwards tracing and cluster-busting helped them stave off catastrophe.

The question I had for Dr. Byers is are we seeing cluster-based spread, super-spreader events in churches and gatherings that are the engine of the new spike? Following from that, are we investing enough into backwards tracing? The answer was partially inconclusive.

In both cases, it seems to be "yes, and." Mississippi is seeing clusters and super-spreaders. It is attempting backwards tracing to isolate communities and individuals exposed to large, explosive events. But it's also seeing massive community transmission. This is concerning.

To be clear, it's not because it's the "wrong" strategy. It's concerning because it may be evidence that the virus is so deeply embedded in our community that the approaches that have effectively beaten the virus- for the pre-vaccine duration, at least- may be out of reach.

I mentioned Japan earlier, and its curve and raw numbers are coincidentally very close to Mississippi's (110k total vs. our 129k total). But Japan's 126 million population instantly renders that comparison moot. Can we arrest the virus with tracing with a crisis 40 times worse?

Can MSDH even accomplish this goal considering the open state borders? That's an insurmountable problem if the national authority is uncooperative or otherwise unhelpful. (This is a personal observation from me, not a comment from Dr. Byers.)

If the problem cannot be solved with testing and tracing, what options are left to us? There is always a lockdown. It should not surprise you that so many European countries are now returning to this approach. But that, ultimately, requires the consent of the population.

Earlier, I said we needed a new way to express the necessary strategy for protecting our community in Fall and Winter. I still haven't found what that is. It confounds MSDH, too. The information they have for what to do hasn't changed, even if our appetite for listening has.

It can get worse. Now is the opportunity we have to stop it. Vaccine news trickles in, promising a real shot at fighting the virus in 2021, instead of just holding it at bay. But we must get through the cold months. Commit yourself to that goal, Mississippi. So much is at stake.