We’ll look more at the details of the numbers in the afternoon article, but Sunday saw almost 26,000 new confirmed cases of COVID-19 in the U.S. and almost 76,000 in the world. Sunday also saw protests around the country and in our own state and city of conservatives protesting restrictions designed to slow the progress of the illness. While the number of new cases and the demand for ending or loosening restrictions seem to be logically at odds, the protests are growing.
There were several articles that caught my attention this weekend, all in the New York Times. Is the Virus on My Clothes? My Shoes? My Hair? My Newspaper? by Tara Parker-Pope is mostly a reassuring look at these and other questions. It’s easy to begin obsessing over and increasingly unlikely exposure points and it’s enough to drive yourself batty. Reasonable precautions should do it.
In America’s Biggest Cities Were Already Loosing Their Allure: What Happens Next?, authors Sabrina Tavernise and Sara Mervosh examine a longer term trend for emigration from our largest cities and wonder if that might not be expedited by the virus. The authors note that some have left the city during the virus and may not come back, while others who may have been considering a move and have now endured the virus may be ready to take the jump.
The life that a New York City or Los Angeles offered before, with its nightlife, museums, concerts and festivals will not likely return soon, so it gets harder to justify the expense without the benefits that drew residents there in the first place. The beneficiaries of the possible exodus would be varied, but could include smaller cities like our own.
The article that most captivated my attention, however, was The Coronavirus in America: The Year Ahead, by Donald G. McNeil, Jr. The upshot is that longterm, we’ll likely see a vaccine and then experience an economic recovery. Mid-term, we have reasonable expectations that we’ll develop treatments that make the illness less severe. Short term? This is not going to be pretty.
For the article, McNeil interviewed twenty experts in public health, medicine, epidemiology and history. They predicted that we will need to start with a “carefully staggered approach to re-opening.” They said it should include widespread testing and surveillance, two things we are not currently equipped to do. The article states, “We face a doleful future,” with months of lockdowns and longer for the vulnerable. As is the emerging view of many experts, they predicted we’ll lockdown, open, lockdown again and so on until a vaccine is produced.
Among the key quotes:
Surges are inevitable, the models predict, even when stadiums, churches, theaters, bars and restaurants remain closed, all travelers from abroad are quarantined for 14 days, and domestic travel is tightly restricted to prevent high-intensity areas from reinfecting low-intensity ones.
The tighter the restrictions, experts say, the fewer the deaths and the longer the periods between lockdowns. Most models assume states will eventually do widespread temperature checks, rapid testing and contact tracing, as is routine in Asia.
China did not allow Wuhan, Nanjing or other cities to reopen until intensive surveillance found zero new cases for 14 straight days, the virus’s incubation period.
Two things are worth emphasizing from the above quotes: Large gathering places are assumed to be continuously closed and check out that last sentence and think about it. Intense surveillance revealing ZERO cases for FOURTEEN days was the marker that China used to reopen Wuhan. We had nearly 26,000 new cases in the U.S., yesterday. Granted, that’s not everywhere, but the standard China used is startling relative to our current situation.
The experts predicted that the next two years will proceed in “fits and starts,” alternating between what is being called the hammer (shutdown) and the dance (attempting to do business while keeping the virus from re-emerging). The experts said, “If Americans pour back out in force, all will appear quiet for three weeks.” Then they say the hospitals will be lit up again.
They also point out that China re-opened with about 9,000 monitors in Wuhan province to trace the contacts of anyone testing positive. The CDC and local health departments in the U.S. currently have about 2200 such persons. Dr. Friedan, one of the consultants for the article estimated we would need 300,000 in the U.S. for similar coverage.
Additionally, China quarantined every person diagnosed, regardless of severity of symptoms, while we send them home and tell them they should stay there. If they do, it is likely they infect their families. If they don’t they spread the disease much more widely.
The group was at its most optimistic in discussing treatment options, feeling those may be coming sooner, rather than later. As for a vaccine, they seemed to question whether it was possible to produce one in twelve to eighteen months as is being discussed. One of the experts noted that the current record is the mumps vaccine which became widely available after four years. Even after an antidote is discovered, manufacturing hundreds of millions of doses and providing that many syringes is no easy task.
So, there are parts of the current lockdown which are not likely to be removed. Is it conceivable that 100,000 people will gather to watch the Vols in Neyland Stadium this fall? That seems highly unlikely. The odds seem long that concerts and other productions can pack theatres. Could they happen at reduced capacity? Maybe. But if people are seated six feet apart and audiences are reduced to 25% or 50%, can artists and venues survive? Will churches be able to safely meet on Sundays anytime soon? It seems doubtful.
There are certainly variables that could shift the realities. A widely available vaccine is a game-changer. If lightning strikes and we have a vaccine by fall, we could potentially get back to much closer to normal. A treatment that reduces the severity of the illness would be a tremendous help. The virus could potentially run its course for the first round or mutate into something less deadly (this happened with the Spanish Flu).
In the short term, all we know is all we know. And that includes social distancing, hand-washing, staying home if possible and certainly if you are sick. The protesters this weekend represent an extreme, but they represent an impulse we all have: to reclaim our normal routine and relationships. If we begin to give in to that impulse, we’ll be in trouble. As we begin to ease restrictions, how successful those are will depend on how well we execute the plan to do so as safely as possible.