When the COVID-19 pandemic started, China responded quickly by reporting the novel disease to the World Health Organization and taking steps to identify and study the virus. Within a matter of weeks, it was clear that the virus was a serious public health matter. China then mobilized its resources and took an aggressive public health approach to contain the spread and care for those who became ill. For this, the U.S. chastised China, calling it “authoritarian” and “draconian,” instead of learning from the success of China.
So far, China has controlled the virus, keeping the total number of cases below 82,000 and the number of deaths in the low 3,000’s. Today, they are easing the quarantine, opening businesses back up and slowly returning to normal activity. The World Health Organization sent a mission to China that commended the government for its actions. Jim Naureckas of Fairness and Accuracy in Reporting writes there is no evidence that China is hiding data. Quite the opposite, researchers in the West have been combing through China’s data to see what they can learn.
Contrast that with the United States where there has been a total lack of leadership at the national level leaving states to compete with each other for resources and fend for themselves. The total number of COVID-19 cases that have been reported is close to 400,000 and is rising by tens of thousands daily. The total number of reported deaths is over 12,000. New York alone has almost 140,000 reported cases and almost 7000 deaths, placing it in close range to Italy and Spain, which rank second and third in the world for the most cases.
Now, evidence indicates that the number of COVID-19 cases in the United States is likely to be much higher than what is being reported. The University of Texas at Austin reports it is likely that only one in ten cases of COVID-19 in the United States is being reported. This means the United States is closer to 4 million cases of COVID-19. They write that: “If a county has detected only one case of COVID-19, there is a 51% chance that there is already a growing outbreak underway. COVID-19 is likely spreading in 72% of all counties in the U.S., containing 94% of the national population. Proactive social distancing, even before two cases are confirmed, is prudent.”
The number of deaths from COVID-19 is also being under-reported. McClatchy found that there was a spike of deaths from pneumonia in the U.S. in late February and early March that were not caused by the flu. They write:
“There has been an increase in pneumonia deaths unrelated to the flu — showing that the deaths could be caused by the coronavirus, according to the Centers for Disease Control and Prevention.
Pneumonia deaths have been on the rise since late February, outpacing the percentage of flu-related deaths, the CDC said. One explanation, according to the CDC, is that some people are dying of pneumonia after contracting the coronavirus….
Doctors said that some coronavirus deaths in February and early March were misidentified as being caused by the flu or pneumonia, The New York Times reported.”
Recently, Mark Levine, the Chair of the New York City Health Council, tweeted this message out:
Grieving families report calling as many as half a dozen funeral homes and finding none that can handle their deceased loved ones.— Mark D. Levine (@MarkLevineNYC) April 6, 2020
Cemeteries are not able to handle the number of burial requests and are turning most down. 4/
A typical hospital morgue might hold 15 bodies. Those are now all full. So OCME has sent out 80 refrigerated trailers to hospitals around the city. Each trailer can hold 100 bodies. These are now mostly full too. Some hospitals have had to add a 2nd or even a 3rd trailer. 3/— Mark D. Levine (@MarkLevineNYC) April 6, 2020
And ABC News issued this grim report today:
“Now, with the public and private hospital networks in New York City overwhelmed to the point of drowning, there are no resources or time to test samples from the dead or resolve statistical problems, officials acknowledged. At the moment, hospitals in New York City are only testing for novel coronavirus among hospitalized patients.”
Testing is the foundation of a public health approach to controlling the spread of infectious diseases. The commonsense approach is to screen everyone for symptoms, test those who are likely to be positive and isolate them until the results are in. If they test positive, they need to be quarantined and monitored for worsening disease and all of their recent contacts need to be located and tested too. This will give a better idea of where the disease hotspots are but it won’t identify everyone who is infectious because about half to three-quarters of those who have COVID-19 are asymptomatic and people are highly infectious in the few days before symptoms appear.
It is unlikely that such an approach will be implemented in the United States. There is a severe lack of everything – tests, personal protective equipment, hospital beds, ventilators, public health staff, and healthcare providers. New York City is in a severe crisis state and there are many other cities that are likely to be just a few weeks behind New York in terms of the severity of the situation.
The best we can do right now is to heed the advice to distance ourselves physically, observe excellent hygiene practices and make sure those around us have what they need to get through the crisis. If we do this, we may be able to hold the number of cases down so the healthcare system can catch up.
We also need to remember that this situation will likely last for months to years. The economic collapse partly triggered by the pandemic is causing rates of unemployment never seen before in the United States. Millions of people who lose their jobs are also losing their health insurance. States are being subjected to a scarcity of supplies and price-gouging. So, in addition to the above actions, we need to demand the nationalization of our entire healthcare system from the hospitals to the pharmaceutical corporations to the medical device and supply companies. We need to invest in a strong public health infrastructure from the local to the state to the national level that can swiftly implement a plan to contain an epidemic when it begins. And we need policies that protect everyone from financial insecurity, homelessness, and lack of food.
Every day, I hear people saying that the COVID-19 pandemic is a hoax. We just need to look around to see the fallacy of that assertion. It is clear that countries with a strong social infrastructure have been able to minimize disease, suffering, and death while those with privatized, for-profit infrastructure have fared poorly. Those who deny the pandemic remind me of climate deniers. The impacts are obvious but they continue their destructive habits placing the whole world at risk. Even if you aren’t convinced the pandemic is real, it is prudent to behave as if it is because the risks of not doing so are too great.