Our dear leader continues to insist that the Coronavirus pandemic is under control. The suggestion is made that this disease will just work its way through our population as part of the natural spread of any pathogen new to the human population. After all, the goal was not to stop all people from getting sick, but simply to flatten the curve so that our healthcare system could manage the influx of patients, right? So, let’s see, is it under control? Have we flattened the curve?
One way that epidemiologists study the rate of new infections is by examining doubling time. Yesterday, the US passed a grim milestone when we reached 3 million cases. If one counts from March 12th, it took 84 days for the country to reach 1.5 million cases. Just 42 days later, we hit the 3 million mark. In other words, the disease is now spreading at twice the rate it was spreading in the beginning.
But how? We all stayed home! We are wearing masks; we are social distancing! Didn’t that make a difference?
The state of New York, in the height of the early surge, doubled from 100K cases to 200K cases in just 11 days. California, Texas and Florida have each hit that 200K mark with 30, 17 and 12-day doubling times respectively. In other words, Florida is pretty much right where New York was in April and the other two states are not far behind. Looking at 7-day averages for new case reports in those states, we may anticipate that, unless they take drastic measures to slow down their rates of infection, all three will surpass New York’s 400K+ total case numbers by the end of August
Meanwhile, Arizona and Georgia, both of which skyrocketed past 100K this week, are on pace to break the doubling time records of the previously mentioned states. Currently their curves are so steep, and the plan for flattening them is so unclear, that both will likely catch up with and surpass New York’s totals by October. That may seem far-fetched, given that the number of cases in New York is currently four times higher than Arizona and Georgia, but here is why it is possible.
Back in the not so distant past, when infection rates were incredibly high in New York, New Jersey, Massachusetts and Illinois, those states locked themselves down as tightly as possible. The latter three slowed things down so successfully that they have managed to stay below 200K and will not hit that marker for another 2 to 3 months, unless their infection rates pick up again. New York took longer to get things under control, but by the beginning of June, it had cut the infection rate to a quarter of what it was at height of the first surge. Lockdowns made the difference. Without them, the early hit states would still be in hell. Currently, New York, the 4th most populous state in the country, ranks 17th when it comes to the average number of new cases each day. By contrast, many other states are now preparing to enter into their own versions of hell, complete with full ICUs, ventilator rationing, PPE shortages and morgues overflowing with bodies.
Why didn’t it work? It didn’t work because the lockdowns were a squandered opportunity. The time was supposed to be spent creating robust testing/tracing and isolating programs that would control localized outbreaks. The time was supposed to be spent establishing clear infection control guidelines and mandates that would enable us to carefully re-open business and schools. Instead, we have folks throwing temper tantrums about wearing masks and major cities setting hospitalization records. Instead, we have people refusing to comply with contact tracing requests, while their states have positivity percentages in the double digits and sites are running out of test kits long before the close of business each day.
What are we doing about it? As far as I can tell, pretty much nothing. We need a unified, national plan if there is any hope of getting it under control. The states in the worst shape need to completely lock down again, for at least a month. A virus needs hosts, and if you take away the opportunity for it to jump from one person to another, you can stop it in its tracks. Meanwhile, the states where infection rates are dropping or holding steady, need to freeze in place or take a step back, so that they do not join the ranks of the states on the rise.
Starting over again, and doing it right, will take humility. It will take admitting that we got it wrong the first time. But it is our only hope. It will be painful to go through this process all over again. But if our state governments and national leaders do the hard work, they failed to do the first time around, it is still possible. We have seen it work in country after country all over the world, where businesses are reopening, children are attending schools and people are keeping each other safe by wearing masks and eating outdoors.
So now it seems, we need to do our own version of doubling time. A redoubling, if you will. Does it seem like too much to ask? I certainly don’t think so. And I am sure some of the 300K people, currently slated die of COVID-19 before the end of 2020, would appreciate the effort.
Originally published at http://rebeccafullerdotblog.wordpress.com on July 8, 2020.