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By Anne Blythe

Three Duke University professors of medicine shared their thoughts with reporters on Tuesday about testing during the  COVID-19 pandemic, the push and pull over when and how to reopen businesses, as well as whether the country could benefit from more uniform messaging at the top.

Thomas Denny, chief operating officer of the Duke Human Vaccine Institute, Michael “Dee” Gunn, a professor in immunology, and Christopher Woods, co-director of the Hubert-Yeargan Center for Global Health at Duke and chief of the Durham VA Medical Center infectious diseases division, took questions during a morning webinar.

The three agreed that inconsistent messaging from the national level does not breed uniform support for stay-at-home orders and the social distancing measures that have flattened the rate of COVID infection, while costing millions their jobs.

“The political leadership has to be consistent on a day-to-day basis,” Denny said. “I believe they have to take their lead from the public health experts to provide the best scientific information and data.

“The public has a short attention span on a lot of these issues.”

Scaling up capacity

The three academics questioned the wisdom of reopening businesses, schools and universities without an adequate supply for widespread testing, contact tracing and plans to quickly contain any outbreaks that might occur.

“The people that are advocating that we eliminate social distancing right now and that we just completely open up the economy, what they’re really advocating for is that every single person in this country become infected with coronavirus because that’s what’s going to happen if you throw things wide open,” Gunn said.

“If you like your grandmother, you might not want to do that.”

For Woods, a phased approach through the coming months has rationale.

“You don’t want to do things all at once, but I think we do realize there needs to be some progress in that regard,” Woods said. “I suspect most of us agree that will be taking place over the next six months.”

During that time, social distancing and containment measures will be important, Woods added. “We may have to have statewide stay-at-home orders imposed if there’s a new surge of cases in a location. We do need clear guidance, and that needs to come at the federal level, and it needs to be supported and slightly modified at the state and local levels.”

At some point in the next phase antibody tests and research studies related to them could yield important information about “herd immunity,” Woods added.

“We’ve done such a good job of social distancing that we expect the rate of immunity to be quite low, which means we would expect there to be, over the course of the next several months, periodic outbreaks of the disease,” Woods said. “But now we hope to have the diagnostic tools and the public health tools to contain those outbreaks as they occur.”

Porous borders

In South Carolina and some of the other states bordering North Carolina the governors have talked about easing social distancing restrictions sooner than will happen in this state.

Denny said he would recommend taking a regional approach to reopening the country in a fashion similar to what New York Gov. Mario Cuomo has talked about doing in conjunction with New Jersey, Connecticut, Rhode Island, Pennsylvania and Delaware.

North Carolina Gov. Roy Cooper has said he talks with governors in neighboring states, but to date there has been no discussion of a regional COVID reopening plan.

States with looser social-distancing measures can create problems for those trying to adhere to them, the Duke professors said.

“It raises a lot of issues,” said Gunn. “The best analogy I heard is: ‘Well let’s just have one end of the pool that the kids are allowed to pee in.’

“It doesn’t do that much good if there’s places that aren’t being restricted,” he continued. “People drive across the state line and the lovely charming folks of South Carolina will come up and infect us, even if we are doing good social distancing. So yeah, this is a problem.”

Anne Blythe

Anne Blythe, a reporter in North Carolina for more than three decades, writes about oral health care, children's health and other topics for North Carolina Health News.

2 replies on “Border states, social distancing and ‘one end of the pool for kids to pee in’”

  1. Good story. Did anyone ask profs about cost/benefit analysis of an economy with 20%-plus unemployment, massive small business failures, mounting mental health problems under a scenario of a shut-down economy over several months? No one outside of tiny fringe is discounting importance of social distancing, smart responses and opinions of medical experts. Everyone loves grandma. Dave Mildenberg, Business North Carolina

    1. Good question, Dave.

      I don’t think it’s an either/or proposition as it’s currently being posited. My bedtime reading right now is The Great Influenza, and one of the lessons from that time is if you allow hundreds/thousands to die in your cities, it affects business as well.

      I’m recommending to folks to read that American Enterprise Institute report authored by Mark McClellan, Scott Gottlieb and others on the path forward. It’s nuanced in it’s recommendations.

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