Three things to do differently

Evolving our response to COVID isn’t just about doing new things. We could also make our existing approaches better. We do need to test, and we do need masking, and we do need vaccines. Definitely. But could we be doing them in ways that would work better?

Test differently. I suspect that the use of an antigen test (RAT) to help people decide if it’s safe to gather is doing more harm than good. There are so many antigen false negatives. SO MANY. Yet we use RAT testing to determine entry to events, and decide if our kids can eat indoors with grandma. When people know they’re an event with testing, they relax. They take their mask off. Then they get infected by one of the many people who is testing negative for COVID even though they’re infected and contagious. 

We should be using tests to track COVID in populations - the progress of outbreaks. In my opinion, it’s not helping individuals make good choices. It is mostly making choices worse.

Vaccinate differently. Right now we’re treating COVID vaccines like flu vaccines. Predict the next variant, and then develop a vaccine to target it. The problem with this is that influenza evolves in predictable ways. We can, largely, know what variants will dominate the next flu season and have a vaccine ready. COVID does not evolve like this. COVID evolves in sudden unexpected ways and we keep fruitlessly chasing after it with vaccines. We need to focus on vaccines that work even when the virus evolves - for example, by basing them on some part of the virus other than the spike protein. 

I have also been hearing lately about nasal vaccines. A nasal vaccine would have a few different benefits, some logistical and some immunological. The different format might seem less threatening to people on the fence about vaccines, and friendlier to people who fear needles. They can be administered by someone with minimal training. And from an immune standpoint, they would concentrate the immune response in the upper respiratory tract where COVID gets in. There’s more than one nasal vaccine on development right now, but nothing imminent. Medical researcher Eric Topol has actually called for an operation warp speed for nasal vaccines. 

Finally, we could mask differently. Because our effective masks options suck. Mask comfort is also a huge factor. People hate how they feel on the face, and right now any comfortable mask is a mask that’s not doing its job.

Right now, masks need to be tight, and they need to not be breathable. They hurt your nose or ears or both from the tightness. They smother your face, especially in the heat. There has to be a way to fix that.