Pandemic ‘Headed in the Wrong Direction at Top Speed’
Ostrich-like federal response blamed as new cases soar
The Covid-19 pandemic in the United States is no longer a potential disaster looming on the horizon. It’s a full-blown national crisis that has forced even the most reluctant governors to tacitly admit their failure to recognize the seriousness of the problem and increase efforts to contain a virus that experts now say is totally out of control, all while the White House has offered virtually no help at all, critics charge.
Scientists who know what will happen next, if something serious isn’t done soon to slow the spread, are sounding alarm bells like never before.
“The acceleration of outbreaks in a number of states is very serious. This should be our number one national priority right now,” says Caitlin Rivers, PhD, an epidemiologist at the Johns Hopkins Center for Health Security and assistant professor at the Johns Hopkins Bloomberg School of Public Health. “We are headed in the wrong direction at top speed.”
The situation today is far more grave than when the number of daily new cases peaked previously at 36,738 on April 24. Yesterday, there were 41,113 new cases across the country, a record, and “the curve” is now on a steep upward slope again, with case numbers rising in 30 states and skyrocketing in several, including Arizona, Florida and Texas and even Montana, Nevada and Utah.
Deaths have been declining, but they’re about to start rising again, epidemiologists agree, following the 3–4 week lag from the time people catch the disease until some begin to die.
“The situation in the United States with Covid is getting quite out of hand,” says immunologist Barry Bloom, PhD, a professor of public health at Harvard T.H. Chan School of Public Health. Many other countries are getting their outbreaks under control, Bloom points out. But here the rise is exponential, meaning if you have 7,000 new cases in a state today, you might have 14,000 new cases a day four days from now. “So we’re way behind the curve and it’s going to be very challenging.”
The acceleration is global. It took the world 100 days to go from zero cases to 1 million, then 12 days get to 2 million, points out Dr. Tom Frieden, former director of the U.S. Centers for Disease Control and Prevention. It took just 6 days recently to go from 8 million to 9 million.
What went wrong
While several countries, and some states, have flattened their curves and brought daily case counts down, the pandemic has accelerated in America in part because lockdowns were relaxed too soon across several states, where case numbers were still rising, health experts say. Now, infections are soaring among young people, and not just in a few locales.
Bars, in particular, have been prime breeding grounds for the coronavirus. Outbreaks linked to bars have been identified in Louisiana, Florida, Wyoming and Idaho, according to Kaiser Health News. In widely shared videos, young adults have been seen packed into bars in Scottsdale and elsewhere in and around Phoenix.
Texas Gov. Greg Abbott announced today bars must close and restaurants must scale capacity back to 50%. Florida Gov. Ron DeSantis today ordered bars to close.
“New lockdowns in Texas and Florida are necessary but are coming late,” says Matthew Fox, PhD, a professor of epidemiology and global health at Boston University. “Even if effective, there will be at least 3 weeks of additional increase in hospitalizations. When will we learn that early action is essential?”
“A few months ago numbers were going up mostly concentrated in a few states. Now they are much, much more widespread,” says William Hanage, PhD, an associate professor of epidemiology at Harvard T.H. Chan School of Public Health.
As the newly infected younger adults and teens circulate among family and friends, it’s only going to get worse, in the near term and especially this fall, when people move indoors more and when any possible damper on the virus caused by warmer weather evaporates, expert say.
“The increases we’re seeing now have the capacity to produce far more disease in the future,” Hanage told a group of reporters yesterday. Meanwhile, he notes, “hospitals are nearing capacity to be able to cope in Houston and in Arizona and soon almost certainly elsewhere.”
Arizona reported 3,428 new cases today, roughly seven times the daily figure when Gov. Doug Ducey lifted lockdowns May 15. Now the state is running out of ICU beds, with remaining capacity down from 40% in early April to just 12% today. Healthcare workers are overtaxed — mirroring what happened in New York City during the peak of its outbreak.
“We’re seriously exhausted and overwhelmed,” says epidemiologist Saskia Popescu, PhD, an adjunct professor of public health at the University of Arizona.
Gov. Ducey had not announced any new closures as of this writing, but after months of ignoring advice to require masks, he now strongly urges people do so. Mayors in Phoenix and other Arizona cities have been critical of his approach, and recently mandated masks within their city limits only after Ducey lifted an order that forbade them from making such rules.
Frustrated that politics and anti-science attitudes are guiding many pandemic-response decisions, health researchers have grown increasingly biting in their criticisms.
Gov Ducey “reopened quickly to curry political favor with the President, ignored Covid-19 epi[demiology] data, and impeded efforts of his own health officials to stem the tide,” Angela Rasmussen, a virologist and research scientist at the Center of Infection and Immunity at the Columbia University School of Public Health, tweeted today.
Ostrich approach
Scientists are shaking their heads in bafflement and sadness at the utter lack of effort by the White House to take any firm, organized action to curb the rising number of infections across the nation.
“The federal government is taking an ostrich-like approach to the pandemic, sticking its head in the sand and hoping it will go away, pushing the responsibility off to the states,” Hanage says.
The federal government “has, with rare exceptions, absented themselves from taking control,” Bloom says. “What do we have a government for, if not to be able to pull the country together with a common set of precautions and policies that every state could implement?”
Scientists also point out that in order to restart the economy, you need healthy workers.
“Protecting health is not getting in the way of economic recovery, it’s the route to economic recovery,” says Frieden, the former CDC director. “We’re still in the relatively early phase of a very deadly pandemic,” Frieden tells the New York Times, indicating that as bad as things are today, they’re far from over. “And the way it’s been handled has obscured the messy truths of reality and created false dichotomies. It’s just not about closed versus open. It’s about how to open safer and how to do it carefully so we don’t have to close again.”
Now what?
Can the curve be flattened again before it grows far worse this fall? Time is running out, the experts say.
At a minimum, they urge, facemasks need to be mandatory in all public settings, particularly indoors. Large indoor gatherings need to be strongly discouraged or banned. Testing and contact tracing and other preventive measures should be added to the full-court press, ideally coordinated or at least supported and blessed by the federal government.
But trying to control the pandemic through traditional means of testing and then contact tracing over the phone isn’t working. It is “very difficult” to do it when a high number infected people don’t know they have the disease, Dr. Anthony Fauci, director of the National Institutes of Allergy and Infectious Diseases, said today at the first public briefing of the White House’s coronavirus task force in nearly two months. These silent spreaders, infectious but not symptomatic, are typically younger, and have created “superspreader” events in which dozens or hundreds of additional infections occur in a single event.
Adding to the contact-tracing challenge is the frequent distrust in communities of color for the federal officials trying to reach them by phone to do the tracing, Fauci said.
Beyond Fauci’s pleas for better social responsibility, the White House once again offered no action or leadership.
“We slowed the spread, we flattened the curve, we saved lives,” Vice President Mike Pence declared, in a statement belied by the data. And in making a promise that might seem against the spirit of social distancing, Pence said he would visit Covid-19 hotspots next week, including Arizona and Texas, for an “on the ground report.”
“Where is the urgency?” tweeted Dr. Leana Wen, an emergency physician and former Baltimore city health commissioner. “They’re saying testing is important. That’s what public health experts have been asking for all along. But where’s the national plan for testing (& tracing + isolation)?”
The lack of any such plan brings us back to facemasks, social distancing and the potential for more lockdown. “Public officials need to emphasize public health messaging and institute policies,” Wen urges. “Require masks. Limit indoor gatherings.”
Hanage and Bloom both suggest that state and local officials also consider priorities regarding what stays open. Rather than opening or closing everything in single directives, they suggest that bars and casinos, for example, might take a back seat to schools. They both say that if the pace of community transmission isn’t brought under control soon, it will make it all the more difficult to open schools this fall.
“If there’s any window of opportunity for action, it’s right now,” Hanage says.
