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I've been thinking more about sustainability in the face of this pandemic. As a vaccine rolls out more and more, how do we create processes now that are sustainable for the future year to come, to improve the way we deal with a mixed immune population of COVID moving to future1/
1. Rapid tests are a part of it. Put rapid tests at every assessment center. Patients with symptoms get a rapid test and PCR - and allow rapid test neg folks out of iso until PCR returns (with some exception for those in vulnerable settings or healthcare) 2/
This may miss the odd individual who is PCR pos but rapidtest neg, but ( @michaelmina_lab ) they may not be most infectious. The advantage is if you bring more people in (make testing more convenient), you paradoxically may identify more pos - which is goal moving forward 3/
2. The border - variants are showing up, and simply banning travel isn't sustainable. As we open, the border should open. Imposing a pre-test, a rapid test on return, a 7 day quarantine, and a PCR at 7 days much more sustainable. 4/
The odd case missed, but based on McMaster work, you'll identify 95+%. Focusing on making sure + people are isolated appropriately is a whole lot more resource centric, rather than assuming everyone from is infected. A shorter quarantine is also easier to adhere to as well 5/
3. Vaccine - obviously our rollout should focus on high risk, over 60, and those in HCW work. But from a global standpoint, we should work to approve AZ, and donate our supplies to COVAX, to reduce the world burden. It's our duty but also will help travel and variant devt 6/
4. Metrics - how we judge success is going to change. As death and hosp scale back in the vulnerable, those should be our metrics of success. There will be cases as this will not be eliminated, but our ability to fxn as a society post vax shouldn't be anchored on cases. 7/
5. Support sick day - this is obvious. Sick days are going to be a long term issue, even in the vaccine campaign. This is going to pay dividends at the end of the day for less healthcare utilization and increasing outputs, and needs to be here now and well into the future 8/
6. Messaging - unfortunately we've become a blame society. As we get back to normal, these effects are going to be long lasting. Everyone is now judging risk, but also judging each other. This needs to end. In the post vaccine world people will need to stop blaming others 9/
Lots more things that are already in play, long term genetic surveillance, pre/post exposure therapy, optimal strategies for critically ill, improving ventilation etc. But starting with the above as things shift is going to be overwhelmingly important so our response is gradual