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Will winter bring a new round of COVID-19 outbreaks?

Will winter bring a new round of COVID-19 outbreaks?
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Fall is here and winter is coming, and we are hardly prepared for the surge of COVID-19 cases that the weather change may bring with it. We will be spending more time indoors, for one thing, and, for another, respiratory viruses appear to travel farther in the air in cold, dry weather.

As of Monday evening, the virus has killed more than 1 million people worldwide and 204,000 in the U.S., according to Johns Hopkins University estimates. 

But the biggest problem we have here in the U.S., at least, is not the infectious properties of the virus itself but, instead, the lack of consistent public health response to it. And it isn't as simple as being critical of one political party or another, or one religious group or another; the inconsistencies stretch across the board and aid in a viral spread.

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Though many universities remain open, unsupervised parties occur where few if any precautions are taken and COVID-19 outbreaks occur. In politics, "the party of protests and riots" is finger-pointing at "the party of rallies," and vice versa. And mask-wearing at an outdoor protest is still likely to be somewhat unsuccessful at staunching viral spread — if the virus is there in the crowd — just as social distancing without masks is not expected to be completely effective for "the party of mask-deniers."   

Gov. Ron Desantis (R-Fla.) has removed a state mask mandate, which makes sense since it is so difficult to enforce, can sometimes be irrelevant, and may wrongly take the place of physical distancing in many cases, as Jay Wolfson, senior associate dean of the Morsani College of Medicine in Tampa, said to me. But when it comes to reopening restaurants, bars and other businesses, Wolfson disagreed with the governor: "I do not agree that he should override the decisions of local governments on matters of public health safety with respect to restaurants and other venues."

New York stands at the opposite end of the spectrum from Florida regarding many aspects of its response. Gov. Andrew CuomoAndrew CuomoCardinal Dolan hails Supreme Court decision on churches, COVID-19 Cuomo blames new conservative majority for high court's COVID-19 decision Vaccine skepticism emerges as early test for Biden MORE (D-N.Y.) was presiding over a policy of COVID-19 readmissions to a nursing home early in the pandemic while, at the same time, Desantis was focusing on nursing home safety, communication and proper outfitting of nursing home staff.

Despite one survey showing that 90 percent of New York City's restaurants were unable to pay their rent in August, many NYC restaurants remain closed, with a planned opening to 25 percent capacity finally on Sept. 30 — but, by then, it may prove too late to save many or most of them. 

When it comes to schools, Wolfson disagrees with Gov. Desantis's de-emphasizing tests on younger populations. "They are the point sources that we need to be able to monitor before it reaches out to the people who work in nursing homes," Wolfson said. 

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What is most disturbing about the outbreaks in our schools and universities is that we frequently cannot confine them to the population where the outbreak occurs. This is why identification, isolation and contact tracing are important, especially in the absence of a vaccine. It also is why schools that can afford it should have highly effective HEPA filters in the classrooms, plenty of personal protective equipment for both students and teachers and adequate ventilation, as well as outdoor classroom capabilities.

According to Johns Hopkins University data, the US. reported 55,054 new coronavirus cases on Friday, the highest single-day increase since Aug. 14. We are experiencing a 16 percent increase in cases from a week ago, with cases rising in 22 states. Though most of these states are in the Midwest and Florida isn't among them, I join Jay Wolfson in disagreeing with Gov. DeSantis's policy OF fully opening restaurants and bars. 

What we need more than anything else is public health consistency, which is sometimes counterintuitive. We don't need Gov. Cuomo adding another layer of vaccine-review bureaucracy, which will spread distrust and increase non-compliance when a working vaccine is finally available. We need people to pay attention to basic physical distancing, to wear a clean mask over their mouths and noses when they are near others, and to wash their hands frequently, especially when they are in areas where there is a lot of COVID-19 around. We don't need large gatherings of any kind, which is one of the reasons my synagogue is not holding in-person services for Yom Kippur this week. 

But this wise decision caused me to reflect on the large gathering outside the Supreme Court to honor the death of Justice Ruth Bader GinsburgRuth Bader GinsburgCardinal Dolan hails Supreme Court decision on churches, COVID-19 Cuomo blames new conservative majority for high court's COVID-19 decision Supreme Court blocks New York coronavirus restrictions on houses of worship MORE a week ago, during Rosh Hashanah. Could the virus have potentially spread there, too, at the gathering? Ginsburg, who was proud of her Jewish heritage, once said during a speech at the U.S. Holocaust Memorial Museum: "I am a judge born, raised, and proud of being a Jew. The demand for justice runs through the entirety of the Jewish tradition."  

But for public health to work in the fight against COVID-19, there can be no waivers, even to honor the death of a true "tzaddik," a person of great righteousness who by tradition dies on Rosh Hashanah, so valuable that she was held back by God from death as long as possible.

Marc Siegel, M.D., clinical professor of medicine and medical director of "Doctor Radio" at NYU Langone Health, is a Fox News medical correspondent and author of the new book "COVID: The Politics of Fear and the Power of Science."