We are also woefully behind in building up our testing capacity. We can’t tell exactly how badly different areas of the country are being hit; we can only see for sure which hospital systems are being overrun. After infections run rampant, it can take a few weeks before the hospitals get overwhelmed. We saw that in Italy and we’re starting to see that in the U.S.
Worse, despite our inconsistent, at times half-hearted, efforts, some leaders are already losing their nerve. People without medical or public-health expertise are questioning whether physical distancing is worth it. They’re wondering whether it might be better to let this disease just run its course.
That’s a catastrophically bad idea. The human cost would be devastating, and the economic toll from that devastation might be even steeper than what we’re seeing right now. It’s hard for people to understand just how bad an unchecked pandemic could be. More people could die from COVID-19, the disease caused by the coronavirus, in just a few months than have died in every single war this country has fought since its inception. Such devastation would shut down our hospitals and the entire health-care system. Tens of thousands of doctors and nurses and other health-care professionals would likely get sick. The ripple effects on finances, and on human lives, would be massive and uncontrolled.
Wajahat Ali: Where are the masks?
We understand the pain people are feeling now and appreciate that everyone wants to know when we can call off the distancing measures. Unfortunately, that’s the wrong question.
The right question is: What do we need to do to stop living like this?
Here’s the answer: First, we need a true national pause—a cessation of all nonessential activities. It has to last at least two weeks, and everyone needs to participate. If we all distanced ourselves from one another for that long, the outbreak would slow down significantly. Isolating individual family members may not be socially tenable. Because of that, infections are going to continue within families, but broader spread can be curtailed.
But here is the second part: We need massive, coordinated testing of the population. Even today, we don’t know how many people are infected in the community and how many people without symptoms are spreading the infection to others.
Such testing must be organized by epidemiologists experienced in this area, not by health-care providers. We need to know the full extent of those who are sick with COVID-19, but we also need to know where the virus is hiding. By setting up testing centers across the nation, we can avoid spreading the infection through our health-care system.
Once we have these data, and after a national pause, we can make informed decisions. In areas of the country where the community disease burden is low and the spread of the virus is slow, we could ease restrictions. We would still need to be vigilant in screening, to pick up on new cases early and isolate individuals before they’ve had the chance to fuel an outbreak. A vigorous testing infrastructure will allow us to do this; other countries are showing us the way.