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COVID-19
WHERE TO FROM HERE

Lessons Learned about

COVID-19

By Alan Preston, MHA, ScD

There is always much to learn about how to manage a pandemic. LESSONs LEARNED:
They have things in common, but are all a bit different. I have been 1. Travel restrictions in the early stages of an outbreak serve to mit-
watching how this deadly pandemic has been characterized, including igate the spread of unknown diseases, as was the case with the
that health officials recommend everyone, both healthy and sick, stay COVID-19 pandemic.
at home to stop the spread of the disease. This is a change from how 2. Travel restrictions will be met with criticism from the media for
history has managed pandemics in the past. What I mean is, normally both commercial and political reasons.
the quarantine (stay-at-home) focus is only on the sick. This pan-
demic is being strategically approached in new ways that we have In the early stages of the pandemic, there were numerous models
never witnessed. And like all disasters, there are intended and unin- predicting the nature, spread and effects of the virus. Medical experts
tended consequences with every policy decision made. The benefit and the Centers for Disease Control (CDC) familiar with epidemics
of time will usually provide us with tremendous insight as to what and pandemics were drawn upon by the federal government to pro-
worked and what didn’t. vide guidance, strategies and tactics. At the time, when little was
I was fortunate to share a podcast with some of the leading ex- known about the virus, the people of the United States were told
perts on the subject and have kept in close contact with them since not to worry about the virus. People were also advised that masks
the airing of the podcast. What struck me during the interviews was were not necessary, presumably because the virus was not yet preva-
how all of us independently came to similar conclusions as to how lent enough (or because testing had not yet caught-up to establish
federal, state, and local governments are "managing" this crisis. Let's its prevalence). Once the virus spread was established, the need for
recall what has taken place so far, how we got where we are today masks became a key part of the strategy to limit the spread, along
and what we have learned. with hand-washing and social-distancing.
It appears that in Wuhan, China, somehow a virus (with perhaps Masks are recommended to mitigate any droplets from a sneeze,
multiple strains) was transmitted to the local popula-
tion leading to the beginning of what we call COVID-
19. The exact timing is not precisely known; however,
many speculate that it showed up in the general public
around late November or early December 2019. (i.e.,
thus the 19 in the name COVID-19). On January 3rd,
China notified the World Health Organization (WHO)
of the outbreak. The USA announced the first case in
Washington State on January 21st, 2020. Five days after
Washington State, cases were confirmed in Chicago,
Los Angeles, Arizona, and Orange County. On January
30th, the U.S. issued a Level-4 travel advisory, which
is a NO TRAVEL ban to China. On February 29th,
the U.S. had its first reported death as a result of
COVID-19. The President then imposed more travel
restrictions to other infected countries that day. The
imposition of travel restrictions by the Federal Gov-
ernment so early on during the pandemic created an
avalanche of criticism.

12 San Antonio Medicine • July 2020