By any objective measure, the U.S. has not been very successful in addressing the novel coronavirus pandemic. The U.S. population is about 331 million, a tad over 4% of the world’s 7.8 billion souls. By the time you are reading this column it is projected that the U.S. will have over 800,000 cases of COVID-19, which is over 30% of the world’s projected 2.5 million cases, and over 50,000 deaths, which is over 23% of the world’s projected 210,000 deaths. Note that these numbers likely have limited accuracy, and they are growing daily and rapidly: see http://worldometers.info for the day’s specific numbers.
So how can we begin to move towards some semblance of normalcy? The answer is to follow the advice of the experts and test, trace and isolate. Unfortunately, there will still be rebounds of outbreaks of cases causing more sickness and loss of life, but with excellent execution of this strategy these can be minimized.
This means aggressively testing people for the active virus, including people with no symptoms but who may have been exposed, and then having those who are positive self-isolate. In addition, close contacts of positive cases must be traced, and those people tested and put in self-isolation as needed.
The U.S. has tested about 13,000 per million people in our country (compare this to the 120,000 tests per 1 million of their small population Iceland has done, the 78,000 per million for the UAE and the over 55,000 per million in Luxemburg). The U.S. testing will need to be vastly increased! And remember, testing is not “one and done.” Someone who was negative a couple of weeks ago may have been subsequently exposed and may need to be retested to see if they are positive now. Someone who was positive may need to be retested to see if the active virus has cleared.
In addition to testing for active virus, testing for prior infection, that is looking for antibodies to the virus showing the person had been infected and hopefully indicating they have some amount of immunity for at least for a while, is also needed.
This will mean tens of millions or more tests, and that is what we need to be prepared for, including swabs, test kits, machines to analyze the samples and give results, etc. We will also need human resources to carry out this massive testing and to do the contact tracing. Maybe it is possible that some of the people who are recently out of work can be hired to fill this gap?
Doing this properly will be expensive. But it will be much less expensive than the alternatives of a) trying to get back to normal while killing many of our citizens or b) not working towards opening things up again. We recently spent trillions of dollars to react to the present economic issues. Instead of repeating this, we now have the opportunity to invest what may need to be billions of dollars to minimize the human and economic tragedy that might still be yet to come.
In addition, we need to plan for how we will be able to vaccinate the population once an effective vaccine is developed. This will be a massive undertaking, and now is the time to figure out how this will be accomplished.
We cannot undo the poor job that has been done so far, but we can do a great job going forward. This will only happen if our government stops shunning its responsibilities and steps up and acts.
Our new normal will NOT be the same as it was before. And we CANNOT rush this, the timing will be dictated by the pandemic, NOT by an arbitrary timeline invented by bureaucrats. NOW is when we need to execute, and to do so in a coordinated and aggressive fashion.
Jeff Hersh, Ph.D., M.D., can be reached at DrHersh@juno.com