Update: The World Health Organisation on Wednesday officially declared the novel coronavirus a pandemic. The WHO defines a pandemic as “the worldwide spread of a new disease.”
There are now more than 118,000 confirmed coronavirus cases reported across at least 114 countries.
In the US President Donald Trump squandered two precious months trying to downplay the new coronavirus while attempting to talk up the stock market.
Trump’s passivity may cost lives, but we can still make preparations before hospitals risk becoming overwhelmed by a pandemic that is both more contagious than the seasonal flu and apparently many times more lethal.
Dr. Tom Frieden, a former director of the Centers for Disease Control and Prevention, warns that in a plausible worst-case scenario, this virus could kill more than 1 million Americans.
After speaking to epidemiologists and public health specialists, I have a list of practical steps that the president and other officials should take immediately, while there is time.
1. Invest in a huge roll-out of free testing so that we know who is sick. The University of Washington set up a drive-through system so that certain people can be tested without contaminating a clinic; South Korea did the same.
We urgently need “rapid tests” — offering results in minutes — and before long we will also desperately need tests to determine who has had the virus and now has immunity.
2. Cancel large gatherings in parts of the country where community transmission is occurring. Employers should encourage people to work from home where possible. Even with social distancing, more than one-third of Americans may eventually be infected (a worst case is that 70% become infected, as Chancellor Angela Merkel of Germany has cautioned for her country).
But lives will be saved by flattening the curve so that infections grow more slowly. We are much better off if 100 million Americans contract the coronavirus over 18 months rather than over 18 weeks, and this also gives scientists the chance to test treatments and develop vaccines, and to see if warmer weather helps.
South Korea’s experience suggests that aggressive measures, well short of China’s, do help.
3. Expand telemedicine so that patients can get medical advice while staying home. The aim is for people to NOT go to a doctor’s office or ER unless necessary.
4. Plan for hospitals to be overwhelmed, as happened in Wuhan, China, and in Iran and northern Italy. Epidemiological models suggest that by late April we could have millions of Americans infected, and the danger is that people with other ailments die for want of care in the chaos.
Several epidemiologists suggest that we could easily see 100 million infections of the new coronavirus in the United States, of which 5% or 10% might require hospitalisation and 1% might need a ventilator.
That could mean almost 1 million people needing ventilators just for COVID-19, although not all at the same time, yet we have only about 72,000 full ventilators in the United States.
5. Cancel vacations of health workers, bring back retired doctors and nurses, and repurpose cardiologists and paediatricians to deal with a torrent of coronavirus patients — in expectation of record numbers of doctors out sick. We should prepare to allow military medics to assist in ERs as well.
6. Make nursing homes, assisted-living centers, homeless shelters, prisons and dialysis treatment centers safer, by encouraging use of personal protective equipment and limiting visitors.
7. Make plans in case first responders, such as firefighters and ambulance paramedics, become sick in large numbers. That may mean calling in the National Guard.
8. Ensure that as many people as possible have access to medical care. That means expanding Medicaid in remaining states and establishing a mechanism so that no one needs to pay (including a copay or deductible) for testing for or treatment of COVID-19.
9. Greatly step up production of personal protective equipment needed in hospitals.
10. Prepare for state school students to attend classes remotely in parts of the country most affected. Researchers found that during the 1918 Spanish flu, cities that cancelled schools and public gatherings — and did so early — fared better than other cities.
Nicholas Kristof is an American journalist, author and a winner of two Pulitzer Prizes.