On Monday, Donald Trump announced that he would seek to “reopen vast areas of the country” by Easter with the aim of easing the economic impact of Covid-19, a move that public health experts say would risk escalating the pandemic. What is the worst case scenario if physical restrictions are eased, and why is it wrong to think that the cure is worse than the disease?
It would be possible “reopen“The country in two weeks”?
Dr Greogry Poland: We will not reopen in April. The number of new cases that we are seeing now in the United States is increasing by almost 50% every day. We are on the steepest part of the curve right now. What we are seeing is a reflection of the transmission two to four weeks ago, which means that whatever you are seeing now, it will be significantly higher and worse in a few weeks.
Dr. Robert J Kim-Farley: We want to avoid what I call the second wave. It would happen if we let our guard down prematurely – this physical distance – too early.
It is possible that we may be more nuanced in our approach to physical spacing, and that once we have more thorough testing and we can truly guarantee that [certain] areas do not present the transmission of the community, so those people may return to work. But [they’d need to be] under the microscope. Public health officials should test frequently to make sure there are no presentations in that community.
But in our densely populated areas, such as Los Angeles or New York, places that have already seen a major spike in the epidemic, it would not be appropriate from an epidemiological point of view, from a public health point of view, to start relaxing any distance physical while we are still witnessing a recovery of the epidemic.
If we repressed, what could happen?
Poland: There is no point in easing restrictions during an epidemic. You are basically choosing the economy over our lives. Let’s say you live in a community with a 200 bed hospital. They have 5 to 10 intensive care beds, half of which are used for heart attacks and everything else. So maybe they have five beds and five fans. If you admit one person per week, you can provide quality medical care. If you admit 20, 50 or 100, the mortality rates increase.
It means your hospitals are overrun. People are on trolleys in the corridors and die in the corridor awaiting medical treatment. There are not enough fans, intravenous fluids, doctors and nurses. It is a scenario you would never want to see. So if everyone goes back to work, people start dying in droves.
How many cases could we see without significant interventions?
Poland: The CDC released what they think would be a worse scenario: 160 to 210 million people infected since December, 1 million hospitalized and somewhere between 200,000 and 1.7 million people dying. Imperial Medical College has really come up with some really terrible screenings. One is that they are projecting eight times the demand that can be met by the medical system.
When can we start to relax physical withdrawal?
Kim-Farley: We’re going to have to do reliable tests, so we really know what’s going on in the community, not just what they’re getting [sick], but also what is happening in silence. Once we think we have a good understanding of who is suffering from the disease, we could isolate those people and their close contacts. Once we get to the point where we think we can contain the disease, I think it would be a good time to start removing physical distance controls.
What do you say to people who think that the cure – physical departure and business closure – is worse than the disease?
Kim-Farley: We have to make mistakes to protect human life. So we shouldn’t go back to work as usual, at the expense of a second wave. This could indeed be a tsunami that would endanger many other lives.
Poland: I tell them to go on the Internet. Watch the South African Olympic gold medal swimmer [Cameron van der Burgh], who says he has never been hit so hard with anything in his life. Look at photos of young people on fans or who have already died from it.
You’re playing the odds. Put it this way. If I have a gun with 100 chambers and a bullet, are you willing to play? Are you willing to let me hold your sister, your wife, your mother’s head?