In another post, I noted that that within 24 hours the US would surpass all other nations in the world with the largest number of COVID-19 cases. I was wrong, it happened this afternoon (link). The US now has more cases than China where the coronavirus originated.
Why are there so many cases in the US? Afterall, the coronavirus did not originate in the US, nor was it transferred here by foreign nationals from China, Iran, or other countries. The first people testing positive in this county were US citizens. Early infections on the West Coast were US citizens who had traveled to the Hubei Province in China. And on the East Coast US travelers to Europe and the Middle East brought the coronavirus back with them. Although a travel “ban” was in effect, US citizen were free to come and go from the country. On March 11, President Trump unexpectedly instituted a travel ban on another 26 countries in Europe (link). But by that date, March 11, more than 1600 people around the US were already infected with COVID-19. None of the travel bans had any effect on reducing the spread of the disease in the US. (link)
What it didn’t do, according to experts, was help abate the spread of coronavirus in the US. . . . public health experts say that once a disease has begun circulating within a community, banning outsiders is mostly futile.
Why are there so many cases in the US today? The answer is simple. Failure of leadership. At the outset, the US government failed to convey the seriousness of the disease to the American people and even contradicted public health experts, epidemiologist, virologists, and other scientists who were providing factual information. US government officials were not providing medically accurate information about this pandemic disease, its health implications, or its potentially fatal nature. Ignoring the public health crisis, the rhetoric focused on the economic effects of the outbreak.
Also, at the outset, the US government failed to provide trained pandemic teams that could help local official cope with the first few initial cases. These teams could have assisted with proper infection control protocols. They also could have helped with extensive contact tracing to try and stop the spread of the coronavirus at the local level.
Adding to the failure, was the lack of adequate testing. Without a robust testing program many infected individuals were not detected. Early testing kits were flawed, but when accurate test kits were available, it took several days for confirmation by the US Center for Disease Control and Prevention (CDC) to change the status of a “presumptive case” to a “confirmed case.” Meanwhile, those “presumptive cases” were sent back home to “self-isolate” while waiting for test results from the CDC. Given the contagious nature of this coronavirus how many “self-isolating” individuals spread the infection among household members? We will never know how many cases of “community spread” resulted from “self-isolating” individuals in the US.
On of March 5, less than 1500 COVID-19 tests had been administered across the country (link). According to the COVID tracking project, a website that tracks the actual number of positive and negative COVID-19 tests, on March 5, 2020 only about half of the US states had access to tests. Epidemiologists will later provide a retrospective estimate of how many actual cases were missed between January 21, 2020 and March 5, 2020 because of the lack of testing.
The US outbreak could have easily been contained in the beginning. On February 18, four weeks after the first case was detected in Washington state, there were only a total of 13 confirmed cases in the US in nine different counties in five states, Arizona, California, Illinois, Massachusetts, and Washington. With this small number of cases in only a few locations, the US could have implemented aggressive isolation of infected individuals at these locations. The community spread of the disease across the country was a result of testing failures and lax enforcement of isolation protocols, protocols that could have save thousands of people from the infection and hundreds of at-risk individuals from death.
Also, US government officials failed to explain and warn the public about the consequences of not “flattening” the epidemic curve (link). Because the US failed to implement a vigorous program of self-distancing, limiting gatherings of large groups, etc., the curve has not flattened. Across the US there is now a severe shortage of hospital beds, ventilators, and other medical supplies necessary to treat the growing influx of COVID-19 patients. That is compounded by the fact that health care workers have not been provided with an adequate supply personal protective equipment. Even health care workers are now at extreme risk of contracting the coronavirus.
There is no reason to believe that parameters of the COVID-19 pandemic are going to substantially change in the next few weeks. Fear, turmoil, sickness, and death will be the companions of every America during the next few weeks.