The US has 1 week to enforce social distancing and 'flatten the curve' as the coronavirus outbreak escalates. Here's why these days are so critical.
- The US' response to its coronavirus outbreak this week will decide which way the crisis goes, experts say.
- The US' coronavirus caseload is growing at a rate that mirrors Italy's.
- "We are only about 11 days behind Italy and generally on track to repeat what is unfortunately happening there," Asaf Bitton, assistant professor of medicine at Harvard University, wrote on Friday.
- Putting cities on lockdown has the potential to "flatten the curve" - slow the spread of the coronavirus so as not to overwhelm the healthcare system.
- Social distancing needs to be the foundation of strict and wide-ranging containment measures, according to Bitton.
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The window for the United States to pursue a wide-ranging, aggressive response to the coronavirus pandemic may be closing. Experts say the moves officials and citizens make this week are crucial and will shape the COVID-19 trajectory at a national level.
The US has recorded more than 4,000 coronavirus cases and 71 deaths. Public-health experts are urging interventions that could help "flatten the curve" of the outbreak - slow the virus' spread, in other words, so that the country's healthcare system isn't overwhelmed.
The best ways to do this are to isolate people who are ill, trace who sick people had contact with to find others who might have been exposed, quarantine anyone who may have been exposed to the virus, close schools and offices, and encourage people to avoid crowds.
Without these measures, the infection rate is likely to climb quickly. But flattening the curve buys time for health providers to obtain more tests, beds, and ventilators, and to bolster their arsenal of supplies and treatments to combat the coronavirus.
This week in particular is crucial, according to Asaf Bitton, an assistant professor of medicine at Harvard University and director of Ariadne Labs.
"We are only about 11 days behind Italy and generally on track to repeat what is unfortunately happening there and throughout much of the rest of Europe very soon," Bitton wrote on Medium on Friday, adding, "we must move to pandemic mitigation through widespread, uncomfortable, and comprehensive social distancing."
Why this week is crucial
A new data-visualization tool from a project called Databrew uses data from Johns Hopkins to enable users to compare various outbreaks on the same time scale. The graph above aligns the US' and Italy's outbreaks based on the day each reported their 149th coronavirus cases.
It paints a grim picture: the caseload in the US (red) is growing at a rate that mirrors Italy's (black).
Italy's healthcare system is already overwhelmed - doctors are prioritizing young and mostly healthy COVID-19 patients because their chances of survival eclipse those of the elderly.
In the US, Bitton wrote, there are about 45,000 staffed ICU beds on any given day. That number can be boosted to roughly 95,000 in a crisis, but that's still not enough for an immense influx of coronavirus cases.
"Even moderate projections suggest that if current infectious trends hold, our capacity (locally and nationally) may be overwhelmed as early as mid-late April. Thus, the only strategies that can get us off this concerning trajectory are those that enable us to work together as a community to maintain public health by staying apart," Bitton said.
Tina Nguyen, a reporter at Politico, shared screenshots on Twitter of a text-message conversation with another public-health researcher who also emphasized how crucial this week is.
The source explained that people who ignore calls for social distancing and contract the infection may take around 10 days to present symptoms. (The average incubation period, according to studies, is actually about five days.) However, "the people they get sick are the ones who will die," the source said, because "that's the wave that overwhelms hospital capacity."
The coronavirus' potential for exponential spread
As of Monday, coronavirus cases have been reported in some 150 countries, with more than 179,000 people infected and over 7,000 dead. Localized outbreaks have been reported in South Korea, Iran, Italy, and now a broad swath of Europe.
In countries like China and Italy, where people were not isolated immediately when just a few cases were reported, the number of infected people seemed to skyrocket overnight. The reason for this is the virus' exponential growth trajectory. Studies so far suggest that an average patient infects 2.5 other people, who then pass the virus on to 2.5 more people each.
This troubling infection rate will not level off unless people, infected or not, cut down on social contact.
Some ways of maintaining social distance include closing schools and public spaces, canceling children's group activities, avoiding visits to friends' homes, staying 6 feet away from people when stepping outside of our homes, and cutting down on non-essential trips to stores. Anyone who feels sick should isolate themselves and contact a doctor, Bitton said.
"Social distancing is hard and may negatively impact many people, especially those who face vulnerabilities in our society," he wrote. But he continued: "We have a preemptive opportunity to save lives through the actions we take right now that we will not have in a few weeks. It is a public health imperative … We cannot wait."
Cities and states are enforcing distancing following the US' slow response to early cases
President Donald Trump has been criticized for downplaying the severity of the coronavirus on multiple occasions, according to The New York Times.
He first commented on the illness on January 22 - a day after the first US case was reported - when CNBC's Joe Kernen asked the president if there were worries about a pandemic at that point.
Trump replied: "No. Not at all. And we have it totally under control. It's one person coming in from China, and we have it under control. It's going to be just fine."
However, development and distribution of coronavirus tests in the US have faced a series of errors and delays, triggering a test-kit shortage that prevented officials from gaining a clear understanding of exactly how many Americans have contracted the virus. The Centers for Disease Control and Prevention rolled out a faulty test for COVID-19, then hit bottlenecks in distributing a better one for state and local labs to use, ProPublica reported.
However, cities and states are now taking dramatic actions, including declaring public emergencies, closing tourist destinations, banning public gatherings, and shutting down schools.
The residents of six Bay Area counties have been asked to shelter in place, and the governor of Illinois has ordered all restaurants and bars to close through the end of March. Hoboken, New Jersey, will impose a curfew starting Monday, while New York City's comptroller is pushing for a citywide shutdown of non-essential businesses there.
These moves have short-term economic and social ramifications, but as Business Insider CEO Henry Blodget recently wrote, "once we get a handle on the epidemic, the economy will recover."
When Nguyen asked her source how long social distancing should remain the default, he said simply, "Till it's over."
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