Lockdown-weary Pennsylvanians have been cheered by Governor Tom Wolf's recent decision to allow al fresco dining at area restaurants in yellow-phase counties. But I have even better news. In a telephone conversation with NorCo Executive Lamont McClure yesterday, Governor Wolf announced that the state Department of Health (DoH) plans to begin proactive and weekly testing of both residents and employees at the state's long-term care facilities (LTCFs). McClure asked that the DoH start at Gracedale as soon as possible.
Al Fresco Dining
This makes sense because the SARS-CoV-2 virus is far less contagious outdoors. As explained in a recent Vox video, the virus is destabilized outdoors. The airflow is much better. The corona, or crown, protecting the virus, is weakened by sunlight, wind, rain and humidity. But as the video also explains, it's still a good idea to maintain a 6' distance (the average droplets containing the virus travel) and limit duration of contact.
A recent Chinese study (not peer reviewed) concludes transmission of Covid-19 is almost entirely an indoor phenomenon. This is corroborated by a Japanese study demonstrating that respiratory viruses like Covid-19 are less virulent in higher temperatures and humidity. Most recently, Homeland Security's Science and Technology Department has produced emerging research showing that sunlight, can seriously weaken Covid-19 in about two minutes. At lesser intensities, it takes a little longer. In addition to the ultra violet rays from sunlight, heat and humidity also play a role in weakening and killing Covid-19.
It is still possible to contract the virus outdoors, but less likely than indoors.
Proactive Testing at LTCFs
In Pennsylvania, about 2/3 of the Covid-19 deaths have been at LTCFs. Incredibly, the DoH nevertheless ordered nursing homes to accept stable Covid-19 patients once released from the hospital. Dr. Rachel Levine, Secretary at DoH, noted in a news conference Wednesday that this is still the CDC guidance. She defended the practice because, at least initially, there was a concern that hospitals would be overwhelmed. "In retrospect, I don't think there was any other choice," she said.
The decision to begin proactive testing at LTCFs appears to be a recognition that DoH should be doing far more to protect the residents and staff.
At Gracedale, the Northampton County owned nursing home, 209 residents and 49 staffers have tested positive for Covid-19. As of yesterday, 93 residents are actively positive, with 5 residents hospitalized. Fifty-six residents have died. Of the 49 staffers who've been infected, 37 have completed isolation and are back at work.
When the pandemic first hit, the US was hobbled by an inability to test. Slowly but surely, the US has caught up to other countries, but as explained in yet another excellent Vox video, testing has been reactive. It has been limited to those who show symptoms. This prevents you from determining where the virus actually is and how many people have it.
Proactive testing, on the other hand, will help catch people who are asymptomatic. They can be isolated and prevented from unwittingly spreading the disease to others. This also means that many of those tested will come back as negative. Once you reach the point that only 10% of the tests are positive, you can say the virus is contained.
If you just cast the net wide, you'd need to perform 10 million tests per day in the US. A more targeted approach is through contact tracing. You identify the direct and proximate contacts of a person who has tested positive, and then test the contacts. This enables you to catch people who are asymptomatic or mildly symptomatic before they unknowingly spread the virus.
Dr. Levine indicated at her news conference on Wednesday that contacts have been very helpful. "The vast majority of people understand the public health consequences and are very cooperative," she said.
Summer weather, combined with testing and tracing, should enable public health officials to get a jump on the virus before there';s a second wave. Testing and tracing will hopefully make a second lockdown unnecessary.
Updated 10:46 am to add information about Gracedale. Originally published at 12:00 am.