Contribute Try STAT+ Today

Public health experts are increasingly worried that Americans are underestimating how long the coronavirus pandemic will disrupt everyday life in the country, warning that the Trump administration’s timelines are offering many a false sense of comfort.

Coronavirus cases are expected to peak in mid-April in many parts of the country, but quickly reopening businesses or loosening shelter-in-place rules would inevitably lead to a new surge of infections, they said.

Meanwhile, other parts of the country are only now implementing restrictions and others have not yet ordered the closure of non-essential businesses, creating a patchwork response that will slow progress toward the goal of driving down transmission of the SARS-CoV-2, the virus that causes Covid-19.

advertisement

Support STAT: If you value our coronavirus coverage, please consider making a one-time contribution to support our journalism.

“The administration has consistently shown a desire to underplay the severity of whatever is coming. And they’re constantly adjusting that — as it becomes harder to deny the reality will be worse than what they’ve conditioned people for,” said Jeremy Konyndyk, a senior policy fellow at the Center for Global Development.

Konyndyk said he and other experts he’s discussed the matter with believe an “intensive period of social distancing and a national semi-voluntary lockdown” will last for months.

advertisement

President Trump, after signaling that he may try to restore some sense of normalcy in the country by Easter, has acknowledged that difficult times are ahead and that restrictions should remain in place until the end of April.

But experts say that, even if some restrictions are relaxed, it’s unlikely life as normal will resume in early May.

A former director of the Centers for Disease Control and Prevention, Thomas Frieden, said this week that it’s understandable that people want to know when businesses can reopen and some facets of life can resume. But he said the focus of public discourse now needs to be on the public health response, not the question of when restrictions can be lifted.

“Decisions to reopen society should not be about a date, but about the data,” Frieden, now president and CEO of the global public health initiative Resolve to Save Lives, said during a briefing Wednesday for journalists. “How well and how quickly we do these things will determine how soon and how safely we can reopen.”

He and others have outlined steps that should be taken before restrictions are lifted to ensure new cases do not continue to grow exponentially, collapsing health care systems under their weight. Frieden stressed the importance of expanded testing to know where the virus is transmitting as well as setting up public health
infrastructures to trace the contacts of cases and monitor them in quarantine.

“We need an army of contact tracers in every community in the U.S. to be ready to find every contact and warn them to care for themselves and stop spreading it to others,” he said.

Those resources do not current exist, said Konyndyk, who also noted that hospital capacity across the country needs to be expanded and protective equipment for health workers restocked. There are currently global shortages.

“If we want to be able to — as I think we need to — turn our economy back on in a safe way, we need to be able to do that sort of thing at scale,” Konyndyk said. “And we do not have anywhere close to the public health infrastructure that’s needed to pull that off.”

“That’s fundamental to getting us out of this lockdown phase. And the government’s not talking about it, much less acting on it,” he said.

Public health experts have said the near-term goal is to flatten the epidemic curve of new cases. There are signs that the San Francisco Bay Area and Seattle are starting to see some results in this respect, but progress is not yet apparent in most parts of the country.

Michael Mina, an infectious diseases epidemiologist at Harvard’s T.H. Chan School of Public Health, said the United States squandered a chance to prevent the virus from taking off here and now must do what it takes to beat it back.

“We let things get out of hand,” said Mina, who is also associate medical director of clinical microbiology at Boston’s Brigham and Women’s Hospital. “So now the place that we’re left in is we have to absolutely beat this down with a hammer and get to near zero cases.

“What the means is we have to be patient. By the end of April shouldn’t be anyone’s consideration at this point,” he said. “We have to assume at the very least this is going through May.”

Others suggest it may be longer before stores and restaurants can reopen, before authorities can consider reopening schools and universities.

Philanthropist Bill Gates warned in an appearance on “CBS This Morning” on Thursday that things like lifting bans on mass gatherings — public meetings or concerts — could be quite a way down the road.

Some activities, like reopening schools, might be deemed low risk and of societal benefit, Gates said. But mass gatherings “may be, in a certain sense, more optional.” Until large numbers of people can be vaccinated against the virus “those may not come back at all,” he said.

Though vaccine development is proceeding at a historic pace, in a best-case scenario a product won’t be available for the general public for at least 18 months, and likely longer. Early supplies, which will be limited, would be used to protect health workers.

Konyndyk and others warn that lifting restrictions will need to be done gradually. And the Trump administration has told state governors it will issue county-by-county guidelines on the level of risk, an effort to help local officials decide when to relax restrictions.

Still, experts are worried that if the current measures work, success could have a paradoxical downside: People who are still vulnerable to the virus will see the risk as over, leaving open the possibility of resurgent spread.

“Success is we have a lot of susceptible people left against a disease for which there is still not effective or proven treatment and no vaccine — and won’t be for some time,” Konyndyk said.

Experts say even a return to normal could come with asterisks. Mina noted, for instance, that restaurants may need to put more space between tables. Others have suggested people in high-risk groups — those over 65 or 70 and people with chronic conditions — may need to practice physical distancing even after restrictions have loosened for others, at least until vaccine is ready.

“We’re at the front end of what will be a pretty arduous few years of something. What the something looks like, we don’t fully know,” said Konyndyk. “But I think our best case scenario is we can pull off what South Korea seems to be managing, which is get the curve down. And our job is going to be much bigger than theirs was. … Dramatically bigger.”

  • I have read some comments. I am glad they have a Stay at Home Work Order, although I haven’t heard anyone mentioning to trust in our Lord he knows what is going on he is in complete control, we just need to trust in God. It is in the Bible about these plagues that have to come to pass. It does make us a stronger Nation. Please trust in God to get us through this rough time. Amen

  • Reading through the comments and thinking this through, there is no real good solution. Ideally, we should test everyone for antibodies and current infections and slowly let those people back to work once they are antibody carriers. I would like to have my elder parents not be affected, but i also think they may be able to get away with social distancing. I am not poor nor rich, but i cant afford this to continue for months and months, I am dependent on income from rental property to pay for my family, parents, and several people i hire. If we want people to go back to work quickly, then we need to be a bit more strict and tolerant of stay at home restrictions for the next two to three weeks. Having large groups of people now meeting in a church to celebrate easter just isn’t a good idea. Looking around it seems like we are one of the largest countries not willing to accept the idea of a quarantine – you cant have your cake and eat it too. People need to sacrifice at this time and stay home.

  • 750,000 Americans die from heart disease each year and we have NEVER shut the economy down for them. Glad to see America has its priorities straight and has considered McDonalds and Burger King drive thru to be essential business that must remain open. I guess I will have a triple cheeseburger, large fries, an Apple pie and oh a large Diet coke to go.

  • So we don’t want to overwhelm our healthcare system- so a good alternative is to collapse our economy? Am I taking crazy pills? I understand there is no good answer and no one wants 2.2 million or 100,000 people to die from this, but how many will die from suicide, drug overdose, domestic violence, heart attack, civil unrest if this continues and we go into an economic depression?? It may sound horrible but I would rather overwhelm our healthcare system for a few months and let this thing run through then deal with an economic depression that will last for years and years. Our world leaders need to strike a balance between listening to healthcare experts AND economic experts- because if the whole economy collapses we are all in trouble- including our healthcare system that we are trying not to overwhelm.

    • Wow, “I would rather overwhelm our healthcare system for a few months and let this thing run through then deal with an economic depression that will last for years and years.” Um, are you on crack?! Wow. Unbelievable.

    • Tom–What is your actual rejoinder to Amanda’s concern (mine, too)? Asking if someone is on crack doesn’t count as a real counter-argument. So, stop hyper-ventilating and answer her. Also, do you work for the government or are you uber-rich? Because the rest of us do have some skin in the game and see the need for balance. What say you?

    • A Great Depression would likely be worse. High risk people can hole up at home, everyone else can wash hands, wear masks, and avoid crowds without a complete shutdown. We should have a vaccine next year for high risk people. Anyway, Sweden is taking this approach so it will be interesting to watch what happens there.

    • Trump tried to do just that on 1/31/2020. And got called a racist and xenophobe by Joe Biden and other Democrats.

      Draw you own conclusions as to what Biden thought was most important.

  • These health professional could care less about the economy, they have tunnel vision on stopping the covid-19 spread with zero ability to calculate cost versus benefit. The media only backs them up because they love a good disaster– it sends their ratings through the roof. We are tanking our economy and causing the first ever self-induced depression just to slow the rate of a cold virus that only kills people who have some other pre-existing health problems. What is amazing is that all the governments in every country are copy-catting this nonsense and tanking their own economies. It’s the same monkey-see monkey-do that has led to all the toilet paper shortage– people are not buying toilet paper because they need more but because everyone else is doing it. Everyone can’t be wrong right? Fifty years ago we would have just told the vulnerable portion of society to stay home and let the rest of us get on with keeping the country running. The days of rational thinking are long gone, it is all pure emotion now.

    • I see you like drinking the Trump orange kool-aid, keep drinking the funeral business is waiting for your business.

  • Randomized testing of each states population should reveal the % who have antibodies, which will tell us the real number infected and the real death rate. It could be that many more people have been infected than we now know. If that is the case, then the death rate is much lower. Of course the opposite is also true, however it highly unlikely that the death rate is higher than the numbers we now have. Either way, without that data we are driving in the dark with our headlights off.

    • More testing would only reduce the death rate because it only increases the total number of cases and not the number of deaths. The death number is accurate because when someone dies we find out why. There is no chance the death rate increases with more testing, it only shrinks and becomes more accurate with more testing.

  • Think about it was does flattening the curve mean does it mean that well continue to get infected until we suppress it an there’s no way to suppress it because it’s all over the world . The first people that are going to get it is our health care providers an soon everyone who needs sometype of medicine to keep them alive will die soon there won’t be people who know how to operate things that protect us were heading for genocide if they don’t get a Cure for this disease. This I THE by product of our goverments for those of us whove been against globalization it is upon us this is a call to arms this is a race for a cure the first thing that has to be done is our government has to work together tirelessly until they find a cure . There is a cure already They need to quit playing with our lives

  • The simple truth is that, regardless of this viruses impact, sooner or later we have to get back to life. I understand it is scary. This is the first time we have been able to track, in near real time, a pandemic as it started and spread across the globe in our species history. Yea science! But, we have dealt with dozens and dozens of large scale epidemics and pandemics throughout the course of our civilization. This is one of the nicer ones relatively speaking. I understand authoritarians are salivating at the idea of laws that keep people in cages, but it won’t stop it from happening over and over again, as we have averaged 3 pandemics a century as long as we have been paying attention. We are doing to right thing now, given our lack of knowledge of this virus and to protect medical infrastructures, but there comes a point when life must go on regardless of the realities of our world.

Comments are closed.