Director’s Corner

Status Update #2

By Irwin Redlener

Nation should prepare for more draconian strategies to combat COVID-19 Redlener says: more aggressive policies are called for but are unconscionably, inexplicability late “We will be Italy”, as U.S. hospitals face unmanageable crisis Trump’s “happy talk” and incompetence have endangered America.

Dr. Redlener comments on the current state of U.S. efforts to manage raging outbreak of the pandemic across the U.S.

  • Expect cases and rapidly rising fatalities in all 50 states imminently.
  • Expect one-half to two-thirds of Americans to become infected with novel coronavirus
    • Pandemic could last from months to a year or more; may or may not become seasonal
    • Vast majority of people will have very minimal to moderate flu-like symptoms
    • Some 3% – 10% of infected people may need hospitalization
    • Fatalities could range from 400,000 to more than 1.5 million in U.S. alone
  • America’s hospitals facing a tsunami of sick patients that will overwhelm most hospitals in emergency care, in-patient capacity, as well as intensive care units.
    • Inadequate supplies of protective masks, other personal protective equipment, nasal swabs are already problems.
    • Early signs of severe stress on hospitals have been a reality for at least a week.
    • The Nation’s health care workers including, but not limited to, doctors and nurses, house keepers, dieticians, and administrative staff are at excessive risk of contracting coronavirus infection with serious complications.
    • Loss of workforce, from health care providers to support staff, due to illness and not showing up or staying at work is inevitable.
    • Total ICU beds in U.S. is approximately 95,000 – but we’ll likely need 200,000.
    • Total mechanical ventilators currently in U.S. hospitals is approximate 62,000 andapproximately 30,000-35,000 in federal stockpiles. We could need 2x that number, plus technicians, which are already in short supply.
    • Insufficient available personal protective equipment (PPE), including face masks of all kinds.
  • Widely available specific treatment for or prevention of COVID-19 remains 12 -18 months away
    • Re-purposing drugs used for other conditions is possible.
    • Potentially, use of antibodies from people who have recovered from COVID-19 may offer promise.
    • Re-infection of people who have recovered is possible, not proven.
    • Children still seem resistant to serious manifestations. Why? No real answer, probably has to do nature of immune response in children.
    • NOTE: Journalists need to push for fulsome reporting of true gap between real need and available assets.
    • What exactly is available in Strategic National Stockpile, and what will Departments of Defense of Health and Defense specifically be able to provide?
  • Exponential growth of infection not close to peaking, provoking increasingly draconian containment and mitigation measures. U.S. inching toward unprecedented “national shutdown”, could be announced in days. Possible new policies:
    • All schools, colleges and training programs shut down.
    • Public gatherings now recommended at 50 could drop to 10-20.
    • New regulations to protect highest risk individuals, including elderly and people with certain pre-existing medical conditions.
    • Strict closings of non-essential businesses, restaurants, bars, theater, sporting events of all kinds, and religious observances.
    • New international and domestic travel restrictions.
    • Potential curfews in some areas.
  • Expect major changes in 2020 national presidential election procedures
  • Trump’s failures continue to pile up:
    • Egregious, inexplicable to get rapid start on mass COVID-19 testing; it should have begun in December 2019. (Tests were available from WHO and international sources from the outset.)
    • Continuing problems in developing and distributing efficient, reliable, rapid tests.
    • Mixed messages and unending, self-congratulatory, often grossly untrue statements from the president and vice president regularly conflicting with public health experts has dangerously delayed development of clear aggressive standards among nation’s governors and mayors and undermined public confidence in political leaders.
    • Trump’s team seem oblivious to scale and scope of health care crisis in relationship to what we have and what we’ll need.

Status Update #1

By Irwin Redlener

Coronavirus has killed more than 2,000 people. All but six of them were in mainland China. The virus, officially called COVID-19, has infected more than 75,000 people. There are more than a thousand cases outside China.

Singapore’s Ministry of Health today reported three new cases of the COVID-19, bringing the nationwide total to 84 confirmed cases. The arrival this week of 14 infected American evacuees from a cruise ship in Japan brought the total number of cases in the United States to at least 29 people.

What You Should Know

  1. At the moment, there is no evidence of rapidly growing cases of COVID-19 in the U.S. -or any country other than China
  2. But if you have traveled in the past 60 days (overly cautious!) to China or have been in contact with someone with proven or suspected COVID-19, your health care provider and local public health officials should be informed.
  3. No special precautions for COVID-19 are necessary, other than what experts recommend as good practices to limit spread of any virus, such as regular, thorough hand washing and “cough and sneeze hygiene”.
  4. If you have severe “cold symptoms” with a fever, check in with your health provider; you could have the regular flu! (and stay home, if you can…)
  5. Get the seasonal flu vaccine every year

Challenges Ahead For Public Health And Government Officials

  1. Still not sure of actual duration of incubation period. Most experts say 14 days – but it could be longer.
  2. Still trying to prove that people infected with COVID-19 can transmit the virus before symptoms appear
  3. Vaccine to prevent COVID-19 remains in development; many months remain before being ready for widespread distribution
  4. So far, there is no specific medication to treat people who are infected with COVID- 19
  5. Public health scientists are working on more sophisticated and more effective ways to identify, track, test and isolate contacts of people infected with COVID-19