We have no previous experience with a worldwide coronavirus pandemic, so when Sars-CoV-2, the virus that triggers Covid-19, started spreading out, public health specialists leaned on our experiences with influenza pandemics to notify their forecasts. These pandemics are often described in terms of “waves” and “troughs”. Studies of previous pandemics, wars and other times of extreme national stress reveal that people react most calmly and efficiently when management informs them the reality, even if that reality is frightening. Far, the United States has mainly seen the opposite approach: moving-target messaging that is typically scientifically incorrect, crazily positive and leaves the public in desperate confusion over who and what to think, with science the very first casualty. It will for that reason fall to them to choose whether to maintain the status quo and enjoy the number of cases continue to take off, or administer the more aggressive public health procedures required to not only treat cases but avoid spread.
We have no previous experience with an around the world coronavirus pandemic, so when Sars-CoV-2, the infection that causes Covid-19, began spreading, public health specialists leaned on our experiences with influenza pandemics to inform their predictions. These pandemics are often explained in terms of “waves” and “troughs”. We have actually now seen enough to change the ocean example with a better one: wildfire.
Like a wildfire, the virus non-stop looks for out fuel (human hosts), devastating some locations while sparing others. It will continue spreading up until we attain enough herd resistance– when 50 to 70% of the population has actually established protective antibodies– to considerably slow transmission.
We now have compelling proof that Sars-CoV-2 is not affected by seasonality or local weather condition; it spreads out by the human contact and mixing that happens in areas of high population density. We do not yet know whether resistance is long-term or temporary. We also do not know if a vaccine, if and when we develop one, will be a bulls- eye success like the vaccines for polio or measles, or more of a hope-for-the-best representative like seasonal influenza vaccine. We hope vaccine development efforts will prove efficient, but hope is not a technique. Like HIV, Sars-Cov-2 is here to remain, and realism should notify our strategic response
Like HIV, Sars-Cov-2 is here to stay, and realism needs to inform our tactical action.
Research studies of previous pandemics, wars and other times of extreme national stress show that individuals respond most calmly and effectively when leadership informs them the reality, even if that reality is frightening. Far, the United States has actually largely seen the opposite technique: moving-target messaging that is frequently clinically erroneous, crazily optimistic and leaves the public in desperate confusion over who and what to believe, with science the first casualty.
While a complete, Wuhan-style lockdown is unwise, we require to get as close as we can in hotspots of precariously increasing case counts, suspending all but strictly essential services, to get transmission down to a workable level. Locations that observed tight shelter-in-place restrictions, like New York and some countries in Asia and Europe, revealed that we can bring the deadly numbers down and bring back the economy in a safer public environment.
The US has actually typically been far too positive and cavalier: at the first signs of efficiency versus Covid-19, we concluded and exhaled that we were “over the bulge”, even when the case count went beyond 20,000 a day. We told ourselves that the curve had actually been flattened and company as usual could resume. The grim stats, nevertheless, promote themselves.
The level we require to reach is around 2 Sars-Cov-2 cases a day for each 100,000 population in a region. If we dont have the fortitude and collective will to undertake and sustain the level of shutdown that will be necessary in large parts of the US, as well as the versatility to respond rapidly and decisively when and where the virus flares, the number of new cases and deaths could be incredible, far beyond what we have actually experienced therefore far.
We dont expect this to be instituted on a national level by the present management. But guvs on the frontlines understand the financial, political and social crises this virus is triggering, not least the illness and deaths. It will therefore fall to them to decide whether to preserve the status quo and see the variety of cases continue to blow up, or administer the more aggressive public health steps needed to not only deal with cases however avoid spread.
The United States has actually historically been a leader in public health and public health, today we need to look to the example of countries such as South Korea and Singapore and particular EU nations, along with states like New York, which recognized the difficulty previously; offered honest, efficient leadership; and rapidly carried out agreement, mitigation and testing tracing.
We understand that tactical lockdown causes excellent financial and social discomfort, and we must be prepared to continue looking after those who suffer as a result, whatever the rate. There are no easy or sure-fire answers, and even nations that were initially effective in containment are facing renewed spread as their economies resume.
Of one thing we can be certain: the cost of not acting will far surpass the expense of our second possibility to get this. And we may not have the luxury of a third.