Opinion | The White House coronavirus outbreak shows that testing alone is not enough

But the castle walls were penetrated — presumably by an asymptomatic carrier, a covid-era Trojan horse — and infections among the president’s circle have cascaded out this week. The spotlight is on the Rose Garden reception for Supreme Court nominee Amy Coney Barrett, an event attended by nearly all of those who have recently tested positive: the president, first lady, senators, aides.

Per protocol, attendees were tested before they got near the president. But other defenses were down. According to The Post: “After guests tested negative that day they were instructed they no longer needed to cover their faces. The no-mask mantra applied indoors as well. Cabinet members, senators, Barrett family members and others mixed unencumbered at tightly packed, indoor receptions.” No masks, no distancing and time spent among crowds indoors are a recipe for transmission.

All of this underscores the central flaw in the White House’s approach: Testing alone is not enough. Guarding against covid-19 requires a layered defense.

Don’t take this to mean testing is bad. Testing is a valuable and important tool, useful for screening and for detecting cases before they explode into a massive outbreak. On the former, the White House failed by using testing as a prevention measure without additional measures. With respect to detection, recent testing has prevented the president and others from continuing to spread the virus beyond the initial damage.

It’s only when testing is used in isolation that problems can ensue. And the surprising thing about this sole-strategy approach to covid-19 is that layering defenses is exactly what the White House does for physical security. The fence bordering the White House grounds is hardly the only layer of protection. If someone got over the fence, an alarm would be triggered. Armed Secret Service officers, and possibly dogs, would respond. If an intruder still managed to breach the building, he or she would face additional defenses inside.

So why take a single-strategy approach against the virus? As good as testing has gotten, it still is not perfect. False negatives are a known risk. The U.S. military would not rely on a radar system that is 99 percent accurate without having backups. Multiple layers are core to safeguarding valuable assets — human and otherwise.

Why weren’t redundancies built into the White House strategy to guard against a virus that has already taken the lives of more than 208,000 Americans?

Since April, I’ve been working with companies and organizations on risk-reduction strategies. Not a single one — whether finance, biotech or arts organizations, or universities or other schools — relies on testing alone. Instead, many use a layered defense strategy rooted in the “hierarchy of controls,” a decades-old framework from the field of worker health and safety. Applied to covid-19, it looks like:

Elimination: Prioritize work-from-home strategies.

Substitution: Identify the core people who need to be physically present together and allow only them on-site.

Engineering: Implement “healthy” building strategies, such as higher ventilation rates and enhanced filtration.

Administrative: Maintain physical distancing.

Personal Protective Equipment: Enforce universal masking.

Of course, not all of these controls would work for the president. Everyone who works at the White House can’t be sent home. But that’s the point of hierarchy controls: work down the list, implementing controls along the way, to mitigate risk.

If, say, the first and second controls can’t be done, the White House could still implement healthy building strategies, mandate physical distancing and require all present to wear masks.

These are not controls to be turned on and off based on a feeling; they need to be in place all the time, because it is never clear when an asymptomatic carrier might slip in.

During Tuesday’s presidential debate — at which Trump could have been infectious and where his entourage sat in the audience without masks — Trump said: “I wear a mask when needed. … I don’t wear masks like him. Every time you see him, he’s got a mask.”

That statement reveals the fallacy in Trump’s thinking. Saying you’ll wear a mask “when needed” is like saying you’ll wear a seat belt when needed. The notion that anyone, including the president, would wear a mask “when needed” ignores the threat of asymptomatic transmission.

This outbreak holds important lessons. First, this virus can evade controls, whether the individual control is testing, masking or hand-washing. The only real defense is a multilayered defense. Second, no one — no one — is immune from this virus. Third, this is not about Democrats or Republicans, the United States or China, the old or the young. We are all in this together. We should use this moment — as the unity in our country’s name suggests — to come together to defeat this virus that threatens us all.

Source Article

Recommended Articles