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Keep your distance

Bending the COVID curve’s not enough.

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Since long before any of us heard of COVID-19 (and before most of us heard of Anthony Fauci or Emily Landon), Chicago’s been home to a widely recognized infectious disease expert. He’s Gary Slutkin, the former University of Illinois epidemiologist best known for taking a look at the rampant killing on our streets and recognizing it, literally, as a plague.

Slutkin, a graduate of the University of Chicago medical school, returned to Chicago in the1990s after tackling outbreaks of tuberculosis in San Francisco, tuberculosis and cholera in Somalia, and AIDS in more than 25 countries for the World Health Organization. In 1995 he founded CeaseFire as a UIC project that would apply public health disease control techniques to urban violence. Its success—averaging about 40 to 70 percent reductions—was featured in a 2011 Kartemquin documentary, The Interrupters.

CeaseFire, now an independent nonprofit called Cure Violence Global, separated from UIC in 2019. Cure Violence is currently ranked as the ninth best nonprofit in the world by Swiss-based NGO Advisor, in a field of 500. I wondered what Slutkin would say about the pandemic we’re living through; here’s an edited version of what he told me last weekend.    

Deanna Isaacs: You’ve said that bending the curve is the wrong goal?

Gary Slutkin: The public messaging about this particular epidemic has been disastrous beyond the fact that there are different messages coming from the administration and the scientific community. The two main messages that were put forward early on that I think were both troublesome were bending the curve and opening up. Bending of the curve is halftime. The right goal is to stop the transmission and completely contain it. Go all the way down to near zero.  This is a simple virus in a certain way, because it’s [effectively] human to human only. It’s not in the water, it’s not in mosquitoes. All you had to do is separate people.

Can't we pick up the virus from surfaces?

It turns out that’s a pretty small part of the whole thing. I think handwashing is really important, but we’re talking about that more than we’re talking about not gathering. And how this has been spread has been in restaurants and bars where people have been gathering, and now going to each other’s houses—whether they wash their hands or not. You wouldn’t do that if you understood that you can get this from anybody, you can’t tell who has it, it’s highly contagious, and you can’t be around people you haven’t been around.  

Another whole problem is that America doesn’t have experience with epidemics like this. We got way behind and never fully caught up. If you look at just what is being called the first wave, the curve didn’t get brought all the way down. America quit and the curve just stayed with what the population accepted as a certain amount of daily deaths, rather than pushing it all the way down with a few more weeks of effort.

But some cities have handled it better than others?

In San Francisco they just went up to a positivity rate of 2.2 percent. And they’ve shut down their indoor dining. Same thing for New York—they’re now at a positivity rate of 2.7 percent, they shut down indoor dining. Chicago’s at 15 percent, and now they’re shutting down their indoor dining. Once the curve starts to move it moves faster and faster; you have to jump on things, because once you’re behind, you get more and more behind.

So what should Chicago be doing?

There needs to be better messaging and outreach. I’m driving on the expressway and I’m seeing, "Coming to Chicago from a COVID hot zone? Quarantine for 14 days." This is really not appropriate messaging, because it would make you feel that there isn’t COVID here when there’s something like 2,300 [reported] new positive cases a day, which means really about 12,000 new cases a day, and if people are infectious for five days, for example, you’ve got something like 70,000 people who are infectious at any moment. It’s pretty much uncontrolled transmission in Chicago right now; the virus has jumped out of the box. The thing that should be all over the city is ‘Stay with your own household only for Thanksgiving. It is a substantial risk to share an indoor space with anybody who is not already living with you.’    

The most important thing right now?

It’s a matter of prioritization. This virus is flying so fast in so much of the country that despite people feeling that they want to be with family and friends, the families would be better off to not take the chance. The regrets are too great. You’ve got a lot of people in ICUs who did everything perfectly except they just wanted to do this one thing. It’s a common story.  v

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