Status Report: The Fight Against COVID-19
Wear a Mask, Maintain Distance, and Avoid Crowds
Three keys to staying healthy in this age of COVID-19 by ERIC S. TONER, MD
We are in the early innings of an historic and catastrophic was the remarkable success of the unprecedented effort pandemic. The world has not seen anything on the scale of the at “flattening the curve” by slowing down transmission. COVID-19 pandemic scale since at least 1918. Best estimates Literally, millions of lives have been saved! But not without are that so far only about 5-10% of the U.S. population has cost. yet been infected — meaning that 90-95% of us are still First is the cost to the economy from shutting down susceptible. We have a long way to go before the pandemic, businesses, high unemployment, and cessation of so much our response to it, and the cascading consequences from it are economic activity. The second cost is the prolongation of behind us. the outbreak. As expected, flattening As of July 20, 2020, there have the curve also stretched out the been over 3.7 million confirmed US curve. The goal was to tamp down cases from COVID-19 and 140,000 the number of cases enough that the deaths. These numbers account for healthcare system would not collapse about a quarter of the worldwide and we would have time, among other total. But these are very substantial things, to develop systems for testing undercounts. Serologic (antibody) and contact tracing so that when we testing and other careful studies in started to relax the mitigation efforts which everyone is tested, such as we would be able to rapidly identify the cruise ships, suggests the true and isolate cases, find those who have number of infections may actually been exposed, and have them selfbe 10 times higher than the number quarantine. Evidence-based criteria of confirmed cases. Furthermore, were established to guide a careful routine monitoring of all death and gradual re-opening process. In Dr. Eric Toner, MD certificates in the country shows a states where these criteria have been large and unprecedented spike in faithfully followed, there has not been The only way we deaths during the first four months of a large spike in cases. can safely reopen our the pandemic — 50% larger than the Around the world, most countries number of confirmed COVID deaths. economy is to have most have responded in the same way as the Presumably, these other deaths United States — with mask wearing, people wear masks, are also related to the pandemic, social distancing, teleworking, closing maintain distance, and either deaths due to COVID of high density businesses, cancelling infections that were never tested, large gatherings, and in most avoid crowds, coupled or people who did not seek medical countries, some form of temporary with ubiquitous testing care for unrelated problems because lockdown or stay-at-home order. that reports results in of the pandemic. But as bad as this Most countries saw the same success sounds, it could have been so much as the United States did initially. hours not days and worse. What is different, however, efficient contact tracing. Initial epidemiological forecast is the degree to which many other modeling from Imperial College countries took advantage of the time London in March indicated that without any public health the lockdowns bought them. Many countries have been able intervention to suppress the epidemic, the United States to implement robust nationwide testing and contact tracing could expect more than 2.2 million deaths over the first 100- programs and have had very high compliance rates with day wave. This model assumed a slightly higher fatality rate mask wearing and social distancing. This has enabled many than is now the consensus, but the basic message was right. to gradually reopen safely including schools, restaurants, and The difference between that model and where we are today businesses. Most of Europe, China, South Korea, Vietnam, 12
RIPON FORUM August 2020
