The natural response to a disaster is to at first believe that it is not happening. The Covid-19 pandemic, we are learning, is a disaster playing out in slow motion — when every moment is a little bit worse than one would expect.

In the United States, the result is a grim sense of déjà vu.

Researchers have learned a lot about SARS-CoV-2, the novel coronavirus that causes Covid-19, since it emerged in China at the end of 2019. They have learned more about how it spreads, and how to test for it. They have learned that two drugs, remdesivir and dexamethasone, show some benefit in the sickest patients.

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But they have also learned that the virus takes advantage of human instinct. Its long course means that it is possible to believe that things aren’t going to get that bad — long after they are actually becoming catastrophic. And many experts fear — though they may not be able to say for certain — that the U.S. is nearing the point of catastrophe again.

The virus “defies intuition,” said Caitlin Rivers, an assistant professor at the Johns Hopkins Bloomberg School of Public Health. “People like to see the impact of changes in the data much sooner than we actually observe.” In reality, it takes three weeks, sometimes even a month, for surges in the number of case counts to show up as increases in deaths, Rivers said.

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There are reasons to believe that things could be different in the states that currently are seeing surges, which include Texas, Florida, South Carolina, and Utah, than they were in New York. The people getting sick now seem younger, on average, which may mean that fewer get serious illness. Still, Rivers said, using the cold language of epidemiology: “It’s hard to imagine that this increase in incidence will not be reflected in any way in the number of deaths.”

Remember, after all, how things played out in New York. The first confirmed case was announced on March 1. A little more than a week later, the National Guard was being called into the city of New Rochelle. At the end of the month, 76,000 New Yorkers had been diagnosed with Covid and more than 17,000 had died. Cases swelled to 390,000, and deaths 25,000 before the epidemic there came under control.

“Even though I am a lifelong, serious optimist, I think Covid calls for realism,” said Susan Desmond-Hellmann, the former CEO of the Bill and Melinda Gates Foundation. “And so for me, this is a moment of realism and humans, including this human, love denial. We love denial.”

The facts are the facts, Desmond-Hellmann said. An estimated 2.4 million Americans have been diagnosed, and more than 120,000 people have died of this novel coronavirus in the U.S. “The virus is still here,” she said.

Rivers said what frustrates her is the sense of resignation about the current state of affairs —  to “explain why it can’t be helped and that this is just the way that things are destined to unfold, when the fact is there’s a lot that we could do.” 

“There are many other countries that have gained control of their outbreak and they are in a much better place than we are,” she noted.

New Zealand and Iceland, the best examples, are islands. But the list includes much of Europe. Italy, Spain, and Germany have controlled their outbreaks, even after being hit hard. The solutions are the same simple ones public health experts have recommended from the beginning: further ramping up the availability and speed of testing, so patients know when they are infected. Isolating people when they are sick so they don’t infect others. Avoiding crowds and close contact with other people. Washing hands frequently. And, most experts now agree that face masks reduce transmission, helping to keep the virus in check.

“Opening up doesn’t mean stop wearing a mask,” said Desmond-Hellmann. “Opening up means the opposite.” 

And returning to some parts of normal life, she said, would just not be sensible. “I’m very pro-religion,” Desmond-Hellmann said. “I think religion is very important for people. But do you really want to put people together and sing hymns right now?”

Both Desmond-Hellmann and Rivers said they were frustrated that the simple message of public health has been politicized: Until there is an effective vaccine, we need to use the measures we have — masks, some distancing, and reasonable steps to reduce infection — to try to keep the virus in check.

“I would love for everyone from President Trump to the governor of every state, to the mayors to people in leadership roles to make it a cultural norm, to make it popular, fun, fashionable to wear a face mask,” Desmond-Hellmann said. “Because it’s all we’ve got right now.”

  • How did Bill Gates get to think he is in charge of the world health???
    Vaccines are now his forte? What is his medical degree and experience other than funding? I dont think he should be telling anyone what vaccines they should or shouldn’t be taking !

  • How did Bill Gates get to think he is in charge of the world health???
    Vaccines are now his forte? What is his medical degree and experience other than funding? I dont think he should be telling anyone what vaccines they should or shouldn’t be taking !

  • Pelosi, schumer, biden, leahy, maxine waters; Each have been in politics for over 40 years! They have done NOTHING to right the country… Blaming President Trump after 3 years In politics is a complete cop out!

  • It appears that Americans were in denial about their true nature until Donald Trump came along. His “MONSTERS FROM THE ID ” gave permission for other people to release their monsters.” TRIBALISM”
    Became the norm.a coult following.
    ” I’m exceptional, nothing can happen to me. It happens to blacks and Hispanics. A rubber band that has pulled out of shape to act civilized for years goes back to its original shape of uncivilized. It is the diversity of America and the history of slavery that makes America different from other countries. These are “the others “.

  • Interesting how a scientific health article, elicits and devolves into political responses.

    Trump bashers never mention the maskless “protesters” shouting into bullhorns or chanting simplistic slogans, or the thug protesters wearing masks as they loot, burn and destroy people’s lives. Pelosi walking around SF’s Chinatown was also a stupid non-visionary move.

    Trumps’ weaknesses are also counterproductive, but to be fair, he has done several major things correctly.

    But enough about politics except to opine:

    The enemy is the virus followed by China where researchers curiously worked with gene editing to prevent a virus (Crispr;HIV). Our battle is with them, the approach should not stray into internal fighting and posturing. The Roman Empire rotted from within.

    Thank goodness for STAT and for super talented researchers and business people who will get a vaccine someday. Also thank goodness for a strong USA which positioned us to have many companies and universities who can tackle the issue.

    Please take steps to stay healthy and keep others healthy. Whoever wins the election, it will be up to non-politicians to pull together to get things done.

  • Human instinct = self-protection. Leaders ought to understand, and certainly not trample on that. Like VP Pence did in the Mayo clinic without a mask, among the most vulnerable sick patients. And as Trump does, prancing everywhere, butt sticking out one way, face the other – refusing, no: denouncing masks. Their instinct clearly is to not care one bit. To hammer the message home, Clinic Administrators and Event Organizers need to grow some you-know-what, and refuse access to those flaunting public safety !!!

  • You mean, the Desmond-Hellmann who says she is frustrated that the simple message of public health has been politicized…that opening up means wearing a mask…that facts are facts (yeh, whose facts?)…that until we have a vaccine, we should do what we’re told? The same Desmond-Hellmann who served as the Chief Executive Officer of the Bill & Melinda Gates Foundation from 2014–2020 (yeh, no conflicts of interest here!)…and before that president of product development at Genentech, which supports the use of the controversial CRISPR technology. Yeh, I’ll pass on anything she has to say…

  • Essentially a virus is a non-living particle that injects itself into a living cell and hijacks the cell’s machinery to reproduce more virus particles. But there could be a certain level of cell consciousness once it’s integrated itself into the cell’s machinery that informs it of a kind of social consciousness, enabling it to “learn” and adjust to broader patterns of social behavior.

  • I am regularly shocked, while out in public, to see many people not wearing masks, and not staying 6′ apart from others. I will continue to social distance, and wear a mask, for as long as necessary, even though it thoroughly contradicts my deep desire to be as social as I always was. It’s sad, scary, and frustrating, but seems to be the new normal, for at least, now.

  • Dear Matthew,

    I would take issue with the premise that COVID19 is taking advantage of human instinct as the primary reason for the continuing outbreak and surge in cases. You have seemed to minimize how COVID19 has been politicized by the right wing, uninformed and science/medical facts deniers and it starts with Donald Trump. I firmly believe that the catastrophe building is the direct result of Trump minimizing this disease from the beginning, flaunting his non use of PPE during news conferences, and having irresponsible rallies where his supporters are following his direction. Perhaps you should use a different title “Trump Takes Advantage of Human Instinct During the COVID19 Pandemic”.

    Thank you,

    Irv Nachamkin
    Newtown Square, Pennsylvania

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