Just eliminate COVID-19

Schools have reopened in Sri Lanka and, as usual, we all get colds. Kids are gross, there’s nothing you can do. My children use my body as a handkerchief. Kids will sneeze directly in your mouth.

We are not depending on these filthy creatures for our security. Instead, we have wholly eliminated COVID-19 to protect them, and each other. That’s it, that’s the secret. Asking how to reopen schools safely is like asking how to live in a burning building.

I don’t know, just put out the fire.

The wrong question

There is a lot of discussion in the west about pointless details. Should kids wear masks? How far apart should they sit? These are not the important questions. It’s like looking at a burning building and asking what wood burns the slowest, and should you build toys out of that. You have to save the house. The house contains everything inside.

For COVID-19, this means an elimination strategy. Not mitigating or flattening the curve, but completely crushing it down to zero, and continuing to crush breakouts as they emerge. Professor Devi Sridhar has been on about this for ages and she quotes Jacinda Ardern of New Zealand for a definition:

‘Elimination doesn’t mean zero cases, it means zero tolerance for cases. It means when a case emerges, and it will, we test, we contact trace, we isolate, and we do that every single time with the ambition that when we see COVID-19, we eliminate it.” (NZ)

Sridhar defines elimination as being within national borders, ie a population that you can seal. And indeed, many countries have pursued this strategy successfully. China, Mongolia, Vietnam, Rwanda, Sri Lanka, Trinidad & Tobago, etc. Places like South Korea are doggedly trying, with the same goal in mind. Elimination.

It works.

With elimination you don’t need separate tactics for schools, sports and business — you have one strategy executed at multiple levels. You don’t need a kids room capable of withstanding an inferno, you just have no fire and extinguishers all over the place in case. This is traditional fire safety by the way. No one is like, hot air rises, so stand on your head.

JUST PUT OUT THE FIRE. Then go back in the house.

For example, Sri Lanka was completely locked down for two months. Like, not even going out for groceries. It sucked, and we did this at less than 100 cases. Therefore, however, we’ve now had less than 3,000 cases total and the epidemic is largely eliminated. Now life is entirely back to normal.

Sri Lanka had (and will have) flare-ups but we have enough testing, quarantine, and tracing capacity to handle them. COVID-19 never really hit our hospitals or morgues at all. Our kids are now back at a schools which are as secure as possible, but we’re not depending on our scrubby children to preserve the country. We didn’t just secure the kids room, we secured the whole house. Our children can be children. They can just go to school.

Because the nation sacrificed together, we’re not sacrificing our children to some grand experiment. Is getting this disease bad for children in ten years? Let’s see! We’re not even having that conversation. Frankly, it’s stupid.

Elimination is both cheaper and faster than the alternative that western countries are trying, which I’ll call the Flaming Roller Coaster of Death. Instead of screaming, they go up and down to the noise of endless, pointless debate. I say pointless because there is only one strategy. Eliminate the virus. Do anything else and you’ll keep getting waves of infection for years. It’s not just that schools won’t be right, kids won’t have jobs to graduate into, their teachers and family will die, they’ll have long term health and mental health issues. It’s a terrible ride. Everyone should get off. And everyone can.

Right now, every country is two months away from elimination. Every country has always been two months away. You just have to start from the right question. It’s not how do we open schools. It’s how do we beat the virus.

The right answer

How do you open schools? Eliminate the virus. How do we play sports again? Eliminate the virus. How do we save our economy? Eliminate the virus. It’s a simple answer.

Honestly, watching western countries debate the merits of masks and disinfection and ventilation is maddening. Yes, do all of those things, together, with a strategy. Westerners seem used to movies where scrappy teenagers push one button to save the world. It just doesn’t work like that.

Public health is not that complicated, but it’s not magic either. It’s a lot of hard work. You must have competent leadership and a population that isn’t suicidally dumb (impossible for America and the UK it seems) and then you have to really sacrifice for two months to get the thing down. Then you have to keep alert but can basically go back to your life. Billions of people have done it. They’re having pool parties in Wuhan.

Western nations are just not doing the work, and there is no shortcut. The latest things is opening up schools ‘safely’, which simply makes no sense. It’s a category error. You can’t pick and choose the parts of your society you want to protect because the virus doesn’t care. We’re all just a giant soup to COVID-19, it doesn’t see us divided into schools and hospitals and homes. There’s no way around it, you have to just do the work across your entire population. You have to eliminate the virus.

How opening schools is easy

If you do the work, then opening schools is easy. At our preschool they disinfect and hand wash constantly (among many precautions) but the kids don’t wear masks (please try with a three year old, for whom socks are WW3) and things are basically normal. Our kids go to school and see their grandparents. They’re safe because the country is safe, not anything special at our school.

Every school is taking precautions, but that’s the last line of defense, not the first. Our schools, hotels, workplaces and homes inherit most of their security from a working national policy. Sri Lanka pursued and eliminated COVID-19. When it inevitably pops up, we test/trace/isolate, and shut down as needed. We have a sclerotic, poor government, but we somehow figured this out. It is possible.

As you can see, if you have the right strategy you don’t need perfect tactics. You don’t even need a lot of money or time. You just follow basic public health recommendations with a goal of total elimination. Then you can open schools easily, because you asked the right questions and got to the root cause. That leads you to the answer. Eliminate the virus. Schools and everything else will follow.