Back to Health for West Virginia and the World

Lessons Learned

People wearing masks.

We have discussed power dynamics in dealing with the COVID-19 pandemic. This virus has impacted our state, our country and our world in ways seemingly impossible six months ago.

When the virus first appeared in humans, many said, "no big deal." I thought the same thing. It will be like influenza, and it will be limited to China.

No big deal. That is naive for many reasons, but the most important is the intimate interconnectivity and interdependency of our world. We are all connected.

Well, I was wrong. COVID-19 is a very big deal, and it spread quickly across the globe.

Some countries experienced a massive surge of spread that overwhelmed their healthcare systems, particularly in Europe. Deaths soared - in some countries exceeding a rate of 10 percent.

Once COVID-19 spread from Asia to Europe, it was fait accompli that it would reach the United States. And, it did.

As would be predicable, COVID-19 affected our metropolitan areas first. They are hubs that connect with networks of the world. The first cases were in Washington and California, areas that connect the U.S. most directly with Asia.

COVID-19 spread to New York and New York City, the densest population center in the country. People became sick quickly.

The concern of health and safety for their citizens induced the U.S. and world leaders to shut down person-to-person contact. Many had their citizens stay at home - away from schools, workplaces, playgrounds and parks. They stayed away from each other.

This was called the “suppression phase” by some and “the hammer” by others. By doing this, these leaders saw their economies decline. Unemployment soared. Restaurants failed.

But this approach bought precious time and prevented a rapid surge in the number of infected people by the virus. This phase saved many lives.

But the leaders and the people knew their countries had to reopen. The people wanted to come together. They wanted to restart their businesses and to come back out safely.

Many were nervous about the reopening. Are we ready? What are the measures for the safe reopening?

The scientists and doctors learned about the virus and made their recommendations. Some believed these recommendations, some didn’t.

Some perceived the time of suppression as important. Some did not. Some believed the suppression phase response of COVID-19 saved many lives. Some did not.

So, how do we find out the best ways to reopen safely? How can people come together and be safe from the virus?

The answer is in front of all of us.

Look at countries that did not implement “the suppression” or “hammer” strategy and still remained completely open and see how they did it. See how their people did. See how their countries and citizens did with COVID-19.

We will assess the experiences of three model countries - Japan, Hong Kong and Sweden. All three countries remained opened during COVID-19. Schools. Businesses. Subways.

Japan is a country of 127 million people. Hong Kong is a country of 7.5 million people. Sweden is a country of 10 million people.

So, let’s compare Japan compared to America and compare Hong Kong and Sweden, given their closer population sizes.

Japan at a population of 127 million has 16,804 confirmed cases of COVID-19, 14,000 recovered and 884 deaths. In contrast, the U.S. with a population of 331 million has 1.8 million confirmed cases, 385,000 recovered, and 104,000 deaths.

That is the difference between 884 deaths in Japan and 104,000 deaths in the US.

Let’s look at Hong Kong and Sweden. At 7.5 million people, Hong Kong has 1,083 total confirmed COVID-19 cases, 1,036 recovered and 4 deaths.

That is right - 4 deaths.

Sweden at a population of 10 million has 37,000 confirmed cases of COVID-19, 5,000 recovered, and 4,395 deaths.

That is right - 4,395 deaths.

What could possibly account for this marked difference in lives lost? In the markedly lower number of cases? For the greater percentage of recovery?

What is the power that Japan and Hong Kong are using that the U.S. and Sweden are not?

I believe the answer is a culture of wearing face masks and face coverings.

Sweden decided to leave its country open and not require anyone to wear masks. It is a very trusting country with excellent healthcare. They decided to allow the virus to spread slowly while protecting their elderly. Although their chief COVID-19 architect and epidemiologist denies their strategy is about gaining herd immunity (more on that in a minute), most around the world see the Sweden approach as exactly that.

Hong Kong had a different strategy. They used masks for protecting their identities during protests against China’s moves to take control of Hong Kong. When COVID-19 approached, they immediately adopted almost universal mask-wearing policies. Today, over 98 percent of their citizens wear masks and maintain good hand hygiene.

Sweden can argue that deaths are inevitable as people contact each other and that at some point the strategy needs to flip to having enough people who are infected to create so-called herd immunity that will provide native immunity to stop the spread of COVID-19. However, it will take at last 60 percent of the population to gain that immunity and more likely higher numbers.

To date, 4,395 people have died of COVID-19 in Sweden.

Hong Kong’s experience argues that there is another way. By protecting themselves and each other, Hong Kong has been able to see almost all of their COVID-infected citizens recover.

To date, four people in Hong Kong have died of COVID-19.

Both countries made the decision to remain fully open.

A vaccine is coming, but there is much we can do to keep our citizens safe until then.

Let’s reopen West Virginia safely.

Let’s follow Japan and Hong Kong’s learnings and adapt those to West Virginia -- wear masks and face coverings.

You wear your mask to tell others you love them. To demonstrate altruism. To keep West Virginia safe. To protect others from you.

If all of us wear masks or face coverings, we protect West Virginia.

Two countries – Hong Kong and Sweden. Comparable populations. Both stayed completely open. One with all their citizens wearing masks. One with no masks. One with 4 deaths. The other with about 4,000.

1,000 times more deaths without masks.

Let’s lead and show the world what strong community and a strong West Virginia can do together.

Almost Heaven.