OPINION: Government needs to engage with religious communities, not fight with them, retired Somerset physician says

By Dr. Kevin Kavanagh

The news media has extensively reported the federal courts' reversal of government’s attempt to mandate the closing of church services and schools as a tug-of-power between the church and government at the expense of the populace. However, similar to other Covid-19 controversies, this is more a politicization of the issue rather than an in-depth look at the reasons behind it.

Public-health strategists should realize these rulings set a template for a unified national strategy that is not perverted by economic or political interests. New York City, the genesis of the Supreme Court case, closed schools and allowed bars and restaurants to remain open, which made little sense. And many in Kentucky question the wisdom of closing schools when sporting events remain open. All this is creating unnecessary public confusion, eroding faith in our public-health institutions and most importantly ineffectively controlling the spread of Covid-19.

Kevin Kavanagh, M.D.

However, these rulings may provide a service in confronting this pandemic. We see similar problems with the control of other dangerous pathogens. Even with MRSA, recommendations differ between hospitals and nursing homes, which also makes no sense. The pathogen does not care where it is; it is programmed to spread.

Governments need to engage, not fight with religious communities. In the 1918 flu pandemic, it was “commonplace” for churches to be closed by enactment of public-health laws. Clergy worked hand-in-hand with our public-health systems, commonly risking their lives caring for those afflicted. In a 2019 pandemic response plan, the Catholic Health Association of the United States said communities should intervene to minimize the risk of spreading the pathogen: “The interventions would include social distancing and closing down venues of public gathering such as sporting events, conventions, and places of worship.”

Uniform, pathogen-based standards need to be enacted; governments can provide grants to the public and private sectors to aid with compliance. Transformation to a safer way of providing service is of utmost importance. If one cannot evolve, another type of business should be considered.

Here is what needs to be done to lower community spread: Masks and eye protection worn in indoor settings. Social distancing of at least six feet. No eating or drinking indoors. Activities with loud vocalization are problematic, since the virus will aerosolize, making it capable of floating in the air and surviving for hours, spreading much farther than six feet and defeating the protection of a cloth mask.

Attention needs to be given to customer flow into and out of venues, in common areas such as restrooms, along with keeping waiting customers six feet away from doors and traffic lanes.

Because this virus can, under certain conditions, aerosolize, ventilation systems should be upgraded to allow for increase in complete air exchanges, and MERV-13 filters or UV lighting should be installed to sanitize recirculated air. Although filters may be an inexpensive option, they may necessitate upgrading the HVAC system to compensate for an increase in air resistance. Extensive Covid-19 guidelines have been developed for air quality and flow by the CDC and ASHRAE.

Repeated and prolonged contact (greater than 15 minutes) with others will necessitate the implementation of strategies for small-group bubbling and three times a week combined-sample (pool) testing in venues such as schools, and in team activities found in sports, theater and industry.

Recommendations such as these will create a high bar for many venues to operate during the peak of this pandemic. Thus, closures would be based on safety guidelines and not type of venue.

A strategy to bridge to the end of the pandemic is an optimistic approach, but does not rely on a forgone conclusion. The virus is already residing in animals, including minks, cats and dogs, and it is mutating. The current USA virus, D614G, appears to be more infectious than the original, and a mutation in the Denmark mink population appears to be resistant to vaccines, necessitating the culling of the entire population, some 17,000,000 minks. Similar to the flu, significant mutations of this virus may emerge in years to come.

If one is religious or philosophical, one may think this is the Almighty’s plan to punish the human population for past abuses of the planet. I for one, view it as a test. One if passed, the virus may rapidly disappear. All we need to do is to become less self-centered, placing the welfare of society above that of ourselves.

Kevin Kavanagh of Somerset is a retired physician and chair of Health Watch USA, a group that focuses on control of infections. This first appeared in the Louisville Courier Journal.