A vision for a post-pandemic world

For any traveler or worker, happiness is taking a weight off. If you are like me, you would like nothing more than to relieve your daily routine from the burden of the COVID-19 pandemic, but we are stuck with this one for a long time. As some of the COVID-19 emergency orders are being lifted, it is prudent to keep present in mind that most pandemic scientists tell us this disease will remain a threat for at best several months and very possibly a year or more. If we are going to control it and any future disease outbreaks, we will have to adjust some of our pre-COVID-19 unhealthy behaviors. The tools and processes from primary prevention are the way to change it. To reopen and remain open safely, we must keep and enhance many of the emergency policies into strong and lasting prevention.

Prevention can be as simple as wearing a seat belt. It involves implementing systems and policies that supersede potentially dangerous or harmful choices to make it easier or unavoidable to make the safe choice and increase the difficulty or negative consequences of making the wrong choice. Prevention is staying home when you are sick, wearing a mask in public places and washing your hands.

What is consistent across all prevention is it is science-based, often inconvenient, and it requires both individual and community readiness to establish. Analysts spent years studying how a virus can spread, and we have a pretty good idea of the right way to prevent this. Whenever this level of knowledge about the science is widespread and accepted by leaders and citizens, the result is often the introduction of a lasting prevention policy. This is when we say the community is ready.

Today we have a rare opportunity to establish important and long needed health policies. The popular mass dissemination of daily death tolls in Italy and New York established a very high urgency and readiness. If we are to lift emergency policies safely, we must support and implement both individual informal and system formal primary prevention practices needed to avoid a prematurely reversal of the gains we have made and assure this does not happen again.

First, the effectiveness and success of prevention will depend on maintaining timely and effective public health monitoring, education, and management. The science tells us we need to enhance our current systems and policies to support widespread and reliable testing and vaccinations and established network tracking similar to the current work of Alaska’s public health nurses and volunteers. It has taken too long to get these systems in place, but now that we know what it takes, these must be permanently enhanced and supported.

Second, we must maintain and reinforce basic public health practices that range from more systematic cleaning and hand-washing to health insurance and employee sick leave policies that allow — or even require — paid time at home when sick. As we all now know, an army of employees with low wage jobs and little or no health care benefits staffs the essential machine of our society’s service industry. It is not possible to contain a pandemic or any communicable disease with this basic employee health care deficit. We learned to appreciate these folks with substantial tips; let’s continue the gratitude and pay to provide some real benefits.

Also important is a better understanding that a vaccination does not prevent anyone from getting infected by a virus; it only strengthens your body’s ability to fight it off. Even those who are vaccinated must constantly avoid getting infected and, when infected, must avoid spreading the infection to others, i.e. isolate and wear a mask. Third, we must improve how we screen travelers and people attending public events. We must be more systematic to reduce the spread of not just COVID-19 but other flus, colds and similarly spread diseases. Wearing masks and keeping space between other people in public spaces may be inconvenient and strange, but these primary prevention policies and practices we do to shield others when we may be ill are protective behaviors that need to be as common and simple as buckling your seat belt.

The biggest lesson from prevention is we need to do more than just take personal responsibility for the health and safety of those around us. We must change the systems in place to make this easier and more accepted. Some elements, such as health care laws, may take longer than this temporary lockdown to implement, but now is the time to push leaders and to get them over the hump. Our world has changed, and we need to support them in making the right long-term decisions. Implanting effective prevention is nothing new to our country. After all, it was our founding father Benjamin Franklin who taught us an ounce of prevention today is worth a pound of cure tomorrow, and right now, that translates to supporting essential health policies and practices and saving lives.

Michael R. Powell, Ph.D., works in prevention, policy, evaluation and executive projects in the Alaska Department of Health and Social Services’ Division of Behavioral Health. This commentary represents his own opinion, not the position of the state or any of its agencies.

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