Letter: Reducing community transmission of COVID-19
We are writing in response to the March 14, 2020 article, “COVID-19 testing in Eagle County reserved for ‘most critical cases.’” The opening sentence is “With community-level transmission of COVID-19 now confirmed in Eagle County, testing is not necessary for all patients and is being reserved for the most critical cases, according to Vail Health.”
This statement is internally contradictory. A significant part of stopping community-level transmission of COVID-19 is identifying those individuals who are capable of spreading the virus (those currently infected) whether or not they are at high risk themselves, and this can only be done with wide-spread testing. This case has been made by many epidemiologists in multiple news stories this past week.
Thus, in our view, the statement that widespread testing is not necessary for all patients is deceptive and potentially intentionally so. (This is with the assumption that what Vail Health means by “patient” is someone with symptoms consistent with COVID-19 infection.) To us, what seems more likely to be the case is that, despite previous Vail Daily reporting of community preparations for COVID-19, Eagle County simply does not currently have the capacity does for community-wide testing.
Gov. Polis recently stated as much, as quoted in the March 14 article. He wrote, “Congress just passed an emergency bill to scale up testing but for now we are doing the most we can with what we have.”
So, for now, the most that Eagle County can do is rationing. And, given the circumstances, there is nothing really wrong with this if, first, there is not the ability to do more and, second, the means by which rationing is done is applied equally to all (that is, the criteria for testing is uniformly applied to all). Nonetheless, stating that testing is not necessary for all with appropriate symptomatology is not only wrong but it is dangerously misleading.
Admitting that we do not have the tools we need to aggressively stop the community level transmission is also critical because individuals may better act on the imperative to self-isolate and practice social distancing. Moreover, wouldn’t everyone with symptoms consistent with possible COVID-19 infection (even low risk) and everyone around them (especially those at high risk) want to know and protect themselves if they have or are at risk of being in close contact with someone with COVID-19? How does not identifying cases, even in the low-risk population, reduce community transmission and impact, which is what the public health department currently states is their goal, as was reported in the March 13, 2020, Vail Daily article, “Public health order for Vail, Eagle County limits size of events to 50.”
Accuracy, transparency, and truth-telling at every level are crucial to effectively combat this pandemic. Without them, we lose faith in each other. Loss of faith is very dangerous at all levels, but, we believe, most so among neighbors in the community in which we live.
J. Richard Thistlethwaite, Jr., M.D., Ph.D., Susan Thistlethwaite, M.Div., Ph.D.