March 28, 2020


4 disease experts reveal how they'd address the coronavirus pandemic in the US if they could wave a magic wand (Rhea Mahbubani, 3/28/20, Business Insider)

They all agreed that strict, nationwide social distancing is necessary. Because the virus spreads person to person when in close contact, the best way to stymie it is to keep people apart. 

"Pretend that everyone -- 100% of people everywhere -- would stay at home, not go out, and not get near anyone else," Roberts said. "There would be no new infections. Infections are caused by the actual infectivity of the virus, the number of contacts, and the length of contacts. Social distancing decreases the last two components of that."

An infectious-disease epidemiologist from Washington, DC -- whose identity is known to Business Insider but is being kept anonymous because her employer has prohibited her from commenting publicly on the coronavirus -- said she would immediately issue "a full, nationwide stay-at-home order for a minimum of two weeks but ideally four weeks." 

That's necessary, she said, because the US's response is now "behind the virus' spread." Officials did not mobilize the use of public-health tools like testing and contact tracing quickly enough, she added -- if they had, "perhaps strict stay-at-home orders wouldn't be needed." 

A person with coronavirus infects two to two-and-a-half other people, on average. Since it's so new, people have not yet developed immunity, which means it can spread easily.

"Exponential growth is actually a very normal pattern for pathogens that a population has never seen before," Meghan May, a professor of infectious disease at the University of New England College of Osteopathic Medicine, told Business Insider. "If no one has any onboard immunity to prevent them from becoming infected, every infected person has the potential to infect many others, who each have the potential to infect many others."

In that sense, she said, the coronavirus is "not necessarily acting in an unusual way -- we are just having an unusual experience because so much spread had already occurred in the United States by the time we were able to routinely test for it."

The US has lagged behind other countries when it comes to coronavirus testing. The CDC at first developed its own test, which proved faulty, and the subsequent test-kit shortage has prevented officials from understanding the severity of the epidemic in a timely manner.

More than a month after the US's first coronavirus case was detected, fewer than 500 tests had been done, according to the COVID Tracking Project. As of Friday, 626,000 tests had been completed.

The missing six weeks: how Trump failed the biggest test of his life (Ed Pilkington and Tom McCarthy,  28 Mar 2020, The Guardian)

Within a week of its first confirmed case, South Korea's disease control agency had summoned 20 private companies to the medical equivalent of a war-planning summit and told them to develop a test for the virus at lightning speed. A week after that, the first diagnostic test was approved and went into battle, identifying infected individuals who could then be quarantined to halt the advance of the disease.

Some 357,896 tests later, the country has more or less won the coronavirus war. On Friday only 91 new cases were reported in a country of more than 50 million.

The US response tells a different story. Two days after the first diagnosis in Washington state, Donald Trump went on air on CNBC and bragged: "We have it totally under control. It's one person coming from China. It's going to be just fine."

A week after that, the Wall Street Journal published an opinion article by two former top health policy officials within the Trump administration under the headline Act Now to Prevent an American Epidemic. Luciana Borio and Scott Gottlieb laid out a menu of what had to be done instantly to avert a massive health disaster.

Top of their to-do list: work with private industry to develop an "easy-to-use, rapid diagnostic test" - in other words, just what South Korea was doing.

It was not until 29 February, more than a month after the Journal article and almost six weeks after the first case of coronavirus was confirmed in the country that the Trump administration put that advice into practice. Laboratories and hospitals would finally be allowed to conduct their own Covid-19 tests to speed up the process.

Those missing four to six weeks are likely to go down in the definitive history as a cautionary tale of the potentially devastating consequences of failed political leadership. Today, 86,012 cases have been confirmed across the US, pushing the nation to the top of the world's coronavirus league table - above even China.

More than a quarter of those cases are in New York City, now a global center of the coronavirus pandemic, with New Orleans also raising alarm. Nationally, 1,301 people have died.

Most worryingly, the curve of cases continues to rise precipitously, with no sign of the plateau that has spared South Korea.

Posted by at March 28, 2020 8:34 AM