The shambolic federal response to the Covid-19 pandemic has splintered the United States, with coronavirus infections rising in just under half the states (see NYT graphic, right) since Memorial Day and with too many Americans eager to whistle past the graveyard.
The nation leads the world in negative outcomes, with more than 2 million diagnosed infections and more than 100,000 deaths. As states and local governments relax public health measures to battle Covid-19, forecasters now estimate that 124,000 to 140,000 Americans will die of the disease by July 4.
Its trajectory looks grim in some of the biggest states, the New York Times reported:
“Two of the nation’s most populous states, Texas and Florida, both reported this week their highest daily totals of new coronavirus infections, a concerning sign as all 50 states move to ease social distancing restrictions and allow more businesses to reopen. The nation’s most populous state, California, hit a new daily high last week, when it recorded 3,593 new cases, a record it nearly matched it again this week. The rise in cases helps explain why the nation continues to record more than 20,000 new cases a day even as some of the original hot spots, including New York, have seen dramatic declines. While some officials in states seeing increases attribute the rise to increased testing, and the number of cases per capita in Texas and Florida remains low, some health experts see worrying signs that the virus continues to make inroads.”
The virus rages on in other states, too, the Washington Post reported:
“North Carolina reported its largest single-day record for coronavirus cases as it topped 40,000 total cases since the pandemic began. The North Carolina Department of Health and Human Services reported 41,249 cases, up 1,768 from [Jun3 11]. The state has also recorded 1,092 fatalities, up 28 from [June 11]. North Carolina has now seen its daily reported cases rise for the past three days as multiple states become coronavirus hotspots … In Arkansas, the state reported 731 new cases, the largest since the pandemic began. About 200 of the new cases are from correctional facilities. The state reported 11,547 total cases as of [June 1], with 3,294 active cases, 203 hospitalized and 171 deaths. In Oklahoma, the state has reported its single-day high for the first time since April 4. Its cases rose by 222 on [June 12] for 7,848 overall, with two additional deaths reported. Tulsa County reported its second-highest single-day cases (71), with the previous being on June 1. The county has now reported 1,443 cases overall.”
The news site Vox reported that “Arizona is seeing an alarming resurgence of Covid-19, with the number of daily new reported cases increasing by 211% over the past two weeks to nearly 30,000 total cases, according to the state Department of Health Services (ADHS). The state’s hospitals are preparing for a surge of severely ill patients: Cara Christ, director of ADHS, told them June 6 to activate their emergency plans. Banner Health, the largest health care system in the state, says the number of patients on ventilators since May 15 has quadrupled and warned that it has reached capacity for some intensive care treatments.”
President Trump has turned his focus way off the pandemic and onto his re-election campaign, including resuming what he hopes will be large rallies featuring supporters — and without recommended public health measures like face coverings and distancing. Trump moved his expected GOP acceptance speech to Jacksonville, Fla., from the scheduled national convention site in North Carolina after battling with officials in the Tar Heel state about prospective public health restrictions. Those attending his speech in Florida will be asked to sign a liability waiver, shielding the president and others from legal actions if individuals get sick from Covid-19.
The federal Centers for Disease Control and Prevention (CDC), sidelined for months despite its historic expertise in battling epidemics, urged Americans in a rare public briefing to not underestimate the coronavirus and to maintain measures to battle Covid-19’s spread.
These steps include hand washing, distancing, and wearing face coverings, especially in large and noisy gatherings such as protests, officials said, long after demonstrations flared nationwide against excessive use of force by police, including the killing of George Floyd in police custody in Minneapolis.
Alas, the president and other politicians not only have defied the common-sense guidance about face covering and distancing, they have politicized the use of the measures so much that partisans have made them subjects for scorn.
“In the battle against Covid-19, public health workers spread across states, cities and small towns make up an invisible army on the front lines. But that army, which has suffered neglect for decades, is under assault when it’s needed most. Officials who usually work behind the scenes managing everything from immunizations to water quality inspections have found themselves center stage. Elected officials and members of the public who are frustrated with the lockdowns and safety restrictions have at times turned public health workers into politicized punching bags, battering them with countless angry calls and even physical threats.
“On [June 11], Ohio’s state health director, who had armed protesters come to her house, resigned. The health officer for Orange County, Calif., quit [on June 8] after weeks of criticism and personal threats from residents and other public officials over an order requiring face coverings in public. As the pressure and scrutiny rise, many more health officials have chosen to leave or been pushed out of their jobs. A review by KHN and The Associated Press finds at least 27 state and local health leaders have resigned, retired, or been fired since April across 13 states. From North Carolina to California, they have left their posts due to a mix of backlash and stressful, nonstop working conditions, all while dealing with chronic staffing and funding shortages.”
This is not good. In my practice, I see not only the harms that patients suffer while seeking medical services, but also the high value in their staying healthy and away from the U.S. health care system. Until medical science comes up with a way to prevent or better treat it, the coronavirus will continue to threaten to swamp our health resources. In their better times, they already had notable problems with infections acquired in hospitals, nursing homes, and other medical care giving facilities, as well as major challenges with medical error and misdiagnoses. That said, the system and the providers in it need our support.
The coronavirus will not disappear by itself, as if by magic. It is real and cannot be dismissed out of hand. The economic carnage that accompanied the home-stay orders in many states cannot be denied. The markets continue to swing wildly, as investors gyrate between thinking the country will make a swift economic recovery and their realization of the huge joblessness and inequity that exists. The pain and upset over unjust police force and racism has added to the national discord, with protesters taking to the streets across the globe.
But the best available evidence also argues, strongly, that public health measures have played important roles in protecting and saving lives during the pandemic.
Medical experts have tried to keep their Covid-19 messages short and to the point: Keep washing those hands and covering your face, while maintaining safe distances. Adopt “harm reduction” strategies and tactics, as well as increasing your “situational awareness” (as in what are the infection, spread, and mortality conditions in your area). As state and local officials allow greater normality to prevail, consider what some call the 4 C’s:
- Contacts — be wary of whom you spend time with and for how long and how close. Minimize your exposure and keep it to people you know and trust.
- Confinement — know that the smaller the space and the more intense your contact with others, especially potentially infected individuals, the higher your risks
- Crowds — the more individuals who are around, the higher the chances that some of them may be infected and potentially spreading the virus to you, especially if they may not yet have experienced symptoms themselves
- Choices — the person most concerned with protecting your health is you, so know your individual circumstance and how much risk you are willing to take. Look, with some sadness, at your age, gender, race, and whether you have pre-existing conditions.
Six months into the Covid-19 pandemic, the world has learned much and has much to learn about the novel coronavirus. It also is worth taking in the growing evidence that the disease can be long lasting and debilitating to the extreme for those of all ages who are infected. We’ve got a lot of work to defeat the coronavirus, rebuild the economy, improve the fairness and equity in our society, and see that the pain and struggles of recent days helped the world not just to get by but to be better.