Four Pillars to Control COVID-194

This has been a long day with three Zoom calls and a lot of heavy discussion with others about controlling the COVID-19 pandemic, both in our own senior living facility and at other facilities as well. There is a wonderful article in the New Yorker yesterday by one of my favorite writers, Atul Gawande. Here is the link. Gawande is a surgeon at Massachusetts General Brigham in Boston, a group of large academic medical centers with 75,000 employees. He notes that they have significantly curbed SARS-CoV-2 infections among their staff by rigorously applying four pillars, what he calls a combination cocktail that can be applied to reopening the business side of our society as we deal with the pandemic.

The pillars are already known to you. They are hygiene, distancing, screening, and masks. His cogent explanations for the science underlying them is written for the lay reader and is crystal clear. The importance of applying all 4 pillars is emphasized with the situation at the facility where his 82-year-old mother lives; applying only the first three, cases still occurred until masks were added. 

He makes a great point about a 5th pillar that also is critical: culture. That means that everyone applies the first 4 pillars constantly and helps others apply them as well. Two words come to mind here, professionalism and communitarianism. This 5th pillar rests on individual behavior. A professional culture, such as the team in the operating room, applies the required culture and helps each other, protecting the patient and themselves. So all of us must learn to apply the pillars assiduously. Surgeons and pilots train and train so that this sort of thinking and behavior becomes automatic. For others, it requires learning the new culture -- harder but the behaviors become the norm. If you check my post from yesterday, about the value of ventilation and fresh air, you will see that we do have tools to begin the reopening of our society. Remember -- these tools must be in everyone's toolkit and they must be used at all times. The all-clear will come -- we all need to live to see that day. 

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