Since he went back to school a month ago, my son has caught three colds.
He hasn’t gotten COVID in the classroom, as I half-feared (get your booster shot!), but it seems as if other respiratory diseases have exploded to compensate. I’ve grown well-acquainted with the symptoms every parent dreads: the sniffle, the hacking cough, the runny nose.
Almost as bad is the knowledge that, when your child gets sick, you’re bound to catch it yourself. Each sneeze portends days of misery for us and him. We’ve stockpiled tissues and DayQuil, and it’s still been a veritable onslaught.
As a parent, it’s a tough dilemma to have a kid with a cold. It feels wrong to send him to school while he’s sniffling and sneezing. It’s insensitive to the other parents whose kids he might infect (after all, it’s other parents’ same insensitivity that got us into the same mess).
On the other hand, a cold often takes a week or more to run its course. Few parents can afford to take that much time off work to watch a sick child. Even for the privileged ones who can, that’s a lot of learning time to miss for the sake of what’s ultimately a minor illness.
In fact, if we kept our kids home for the duration of every cold, it might prevent them from getting an education at all. The Mayo Clinic confirms it’s normal for children to get as many as twelve colds per year, and it’s typical for each one to last two weeks or more. That means it’s possible for a kid to be sick for a majority of the year, even if they have a normal immune system.
The viruses that cause colds have evolved to fit a niche where they’re annoying but not lethal. However, not all seasonal illnesses are so harmless. Even before COVID arose, influenza killed tens of thousands of people each year. Diseases like RSV are a serious threat to the very young and very old.
After three years of COVID, I’ve come to recognize the absurdity of just accepting this seasonal pestilence. We shouldn’t have to spend half the year swimming in a soup of respiratory viruses. And we don’t have to.
Watch the water
In many medieval cities, plumbing was a luxury of the rich at best, a fantasy at worst. Slum-dwellers with no running water had no choice but to do their excretory business in a bucket. Once it was full, they’d fling the contents out the window and into the street, with a cry of “Gardez l’eau!“—literally, “watch the water”—which was the only warning that pedestrians passing below would have.
More than just disgusting, this practice was a perpetual source of disease. With untreated raw sewage flowing through the streets, diseases like cholera and typhoid struck medieval towns over and over. The fleas and rats that bred on rubbish heaps spread bubonic plague and other scourges.
It’s safe to say that medieval people didn’t enjoy living like this. We can infer their feelings on the matter by the fact that every home had a boot scraper at the door so visitors didn’t track filth in. However, no individual choice could fix this problem.
Even if you took heroic measures to dispose of your waste safely, it would’ve made no difference if your neighbor didn’t do it too. What was needed was a collective solution that covered everyone. Victorian England found one thanks to Joseph Bazalgette, an engineer who designed the sewer system that London still uses today.
Collective action problems
Just like sewage disposal, seasonal viruses are a collective action problem—a Prisoner’s Dilemma—which means it can’t be solved by individual choices. We need collective solutions for this one too.
One of the benefits of everything we did to fight COVID is that it showed how unnecessary all this annual sickness was. During lockdown, diseases like the flu and RSV dropped to near-zero, and some strains went extinct. Obviously, we don’t want the mass disruption of lockdowns just to fight the common cold, but there are less drastic measures that we can hang onto.
For instance, millions of us can do our jobs from home. We don’t have to spend days crammed onto germy trains and buses, or sharing the same stale cubicle air with your coughing, hacking coworker. Those who can work from home, should.
For those who can’t, we should follow Asia’s lead and make mask-wearing a regular practice. If not year-round, at least during cold and flu season. I know from personal experience that they work. My son wore masks his entire year of pre-K, and he had a total of three colds that year. That’s a record low he hasn’t broken before or since.
And, oh yes: Everyone should have paid sick time! No one should have to drag themselves to work for the sake of a paycheck. This is a no-brainer, but it’s still resisted by industries who’d willingly sicken their own customers for the sake of short-term profit. Most horrifying is that, in the U.S., restaurant workers aren’t guaranteed any paid sick days.
Last but not least: We build sewage treatment plants to clean wastewater, instead of dumping it into the nearest convenient river or pond. What if we thought of air the same way?
Air is a medium that can carry disease just as water can. Instead of treating it as a dumping ground where contaminants are someone else’s problem, we should treat it as a commons that we’re responsible for keeping clean.
We’ve known since the beginning of the pandemic that COVID can be spread through droplets, which sick people spray into others’ faces when they sneeze, cough or talk. It took longer to determine that it can also be spread through aerosols: microscopic particles that linger in the air after the sick person has moved on, potentially infecting others who inhale them. Not just COVID, but most respiratory viruses spread this way.
The key to preventing aerosol transmission is good air circulation. Moving air whisks virus-laden aerosols away, diluting them so that no one gets an infectious dose. That’s why it’s harder to catch COVID outdoors. We can achieve the same thing in indoor spaces by adding ventilation systems that turn over the air frequently. If they purify it with HEPA filters or disinfect it with UV light, so much the better. Just as no one should have to drink dirty water, no one should have to breathe in infectious, virus-polluted air!
The pandemic has already prompted, in some schools and workplaces, ad hoc fixes for indoor air: portable HEPA filters, disinfecting UV lights, and even just open windows. But these quick fixes amount to a “Band-Aid” in poorly designed or functioning buildings… Modern buildings have sophisticated ventilation systems to keep their temperatures comfortable and their smells pleasant—why not use these systems to keep indoor air free of viruses too?“The Plan to Stop Every Respiratory Virus at Once.” Sarah Zhang, The Atlantic, 7 September 2021.
Millions of existing buildings weren’t built with good ventilation in mind, and it won’t be cheap to retrofit them. But it wasn’t cheap to build sewer lines to every building, either. The question isn’t just the cost, but the benefit we get in exchange for the cost. If we’re no longer prepared to tolerate the recurring seasonal assaults of viruses, this is something we should consider doing. It would go a long way toward keeping us safe, not just from flu or COVID, but every airborne pathogen—including those that haven’t evolved yet.