Harlan Krumholz

What I think we're talking about is really trying to understand in the home setting whether we can actually reduce transmission.

And the problem I have with this is there's no one size fits all.

Thinking of the size of houses, the ventilation, how many people are living in the house.

It is difficult for me to understand how we'll bring evidence to say, here's what we can do across that complete range of different environments.

So I think what we do want is a range of thought processes about the built environment.

Should there be minimum requirements, for instance, in terms of sizes of rooms?

airspace, ventilation, and I'm particularly thinking about flats and environments where people are crowded in, I would look at them as the highest risk and think, what can we do differently in them settings?

So I thought the conversation about natural history was really important, actually.

One of the key components of what we do in health care is we want to make diagnosis.

But we also want to risk stratify people, understand those that we can send home, those that we need to admit to the critical care units and those that we just need to admit to a hospital bed.

And so understanding that information is incredibly important.

And where that starts with is having an understanding of the next 100 people who come into my emergency department.

What potential proportion of them with certain features might have COVID?

And that's really important to be able to do evidence based medicine with diagnostics.

If you can understand the pretest probability about four or five weeks ago at the height of the pandemic, it might have been 40, 50 percent.

But as we've admissions have come down, as we said earlier, that proportion will come down and down.

So then you having that real time information, I think, would be incredibly helpful.

But this disconnect between research and learning and clinical practice and doing is a real problem.

I am with Harlan on this, that we need to connect the dots here, because I think for clinicians on the ground, having that information would be very helpful.

Well, I think we're in the infancy.