Continually wiping down surfaces? That’s nice, but it won’t necessarily help fight against COVID-19. The same goes for those commercial-grade air filters so many businesses, stores and schools rushed to buy.
And those thermal scanners at the entrance of establishments? They may not be doing what you think they are doing, either.
Says who? Says an infectious disease specialist.
Dr. Ronald Nahass has been an infectious disease expert since completing his residency at Rutgers Robert Wood Johnson University Hospital in 1987. That gives him 11 years of training and more than three decades in the field — and an expertise that few have.
He’s happy to share it — he just needs people to ask.
Nahass, the president of ID Care, the largest infectious disease medical group in the state, said he’s glad to see infectious disease conversations move into the mainstream — he just wishes those talking about COVID-19 would consult an expert rather than what he calls “Dr. Google.”
He wishes people in charge would get their information from doctors trained in the field, rather than listening to advertisements, elected officials — or, simply put, the person who is talking the loudest but may know the least.
Nahass calls it hygiene theater.
“It would be an absolute critical point of insight to say, ‘There’s people who understand this stuff,’” he said. “We tell people, ‘You can go do what you’re doing — but, maybe, there’s a more cost-effective way to do it.
“What is it you’re trying to achieve from a germ protection perspective? And let’s actually really talk about it.
“It’s the invisible enemy — you can’t see it. So, how do you fight something you can’t see? You’d better understand it. Who understands it? Infectious disease physicians. That’s what we’re trained to do.”
Nahass said he and his group are eager to discuss germ protection and prevention with companies, school districts and municipalities. His goal is to create a consistent response.
Here are a few insights:
Sanitation: Actions such as cleaning surfaces and air are pursued because of a perception this is an effective means to interrupt transmission. Although it is theoretically possible that doing such action will impact transmission, it plays such a minor role and takes attention away from the major issue of masks and distance.
Many companies have sprung up to take advantage of this fear to sell air purifiers and sanitation equipment, at high cost both for initial outlay and maintenance, when simply good cleaning and opening windows to get air movement is all that is needed.
Entry screenings: Businesses, even hospitals and health care facilities, have extremely varied and inconsistent screening processes at entry. Most of this is hygiene theater, meaning it looks good and people and businesses feel good they are doing something, but a lot of it includes activities that have not been shown to work, are very costly and frequently mislead the person being screened that everything is safe.
For example, some have implemented costly thermal scanning systems that check body temperatures, or touch-screen computer devices that ask screening questions to allow entry. A large number of people who get infected and are contagious have no symptoms — so-called asymptomatic transmitters — so screening with this equipment gives a false sense of security.
Also, it is pretty clear people are not always truthful and, sometimes, individuals with mild symptoms believe that, if they go through the screening and the temperature is OK, then it is OK to go to work. That is simply not true. What is needed are workplace processes that provide support for illness time out.
Schools: Some are open, some are not. This is reflective of our absence of a coordinated response that creates some of the mixed messages. If some are open and with limited transmission, we need to recognize the techniques and ability to limit risk exist and coordinate that state- and countywide. We have not.
Nahass said education — from a credible source — will be a key moving forward.
“One of the challenges that we’ve faced, which I think lots of professions face, is the information expansion and the access to information,” he said. “I’m fond of the phrase ‘Dr. Google’ — the concept that anybody can be an infectious disease doctor by just Googling your question and then getting an answer from Google is a danger, because the misinformation that’s out there can be challenging to overcome.
“Listening to what the infectious disease specialist has to say will give you insight into what is actually real, or what is really important, versus what is not.”
Like surface issues.
“The concept of the surfaces being a primary concern from the beginning of the COVID epidemic has been a pet peeve of mine,” he said. “At the beginning, when everybody started talking about cleaning your groceries or putting your Amazon packages in the garage for a day or two before you bring them inside didn’t make any sense to infectious diseases specialists.
“But it became fanciful to do that, because of the information overload. We kept hounding that this wasn’t an important issue.”
For Nahass, the response should start with the 4 W’s — all of which are free and easy to do, he said:
- Wear a mask;
- Watch your space;
- Wash your hands;
- When sick, stay home.
More than anything else, this will help limit New Jersey’s risk for a COVID-19 resurgence, he said.