Sixth in a series tracking the COVID-19 pandemic.

NASHVILLE, TN – Twenty-one million people are infected worldwide and 750,000 have died. That’s a fatality rate of about 3.5%. The U.S. accounts for one quarter of all infections and about one third of all deaths. The U.S. response to the pandemic is on a par with Brazil. That’s the bad news.

“I think it’s going to get worse. Up to 30 million more Americans will become housing insecure due to the economic impact,” said Dr. Tung Nguyen, Professor of Medicine at the University of California, San Francisco.

Nguyen cited a recent CDC study that found 40% of 5,000 respondents reported mental health issues and 11% had considered suicide in the last 30 days. In normal times only 4% report such despair.

Three quarters of young adults, 18-24, reported mental issues and one quarter reported suicidal thoughts. Thirty percent of unpaid caregivers reported suicidal thoughts. Black and Latinx young adults were twice as likely as whites to report such thoughts.

Nguyen said COVID-19 struck the earth like a giant meteor and the shock waves have had ripple effects on more than the health care system. It has had disparate impacts on incomes, employment, and housing of minorities.

Five key indicators show six Southern states are in danger of an imminent COVID-19 outbreak.

Countries are using two distinct mitigation strategies to fight the virus. New Zealand is aiming to totally contain COVID-19 and eventually eliminate it. Brazil and Sweden are opting for “herd immunity” to develop within their populations.

Eventually that would happen naturally but with a devastating loss of life. There is hope that a cure will be developed under Operation Warp Speed, a $10 billion dollar Trump initiative. The administration is hoping scientists find an effective and safe vaccine by January 2021.

In a conference call last week a top medical researcher said there are five vaccines in 3rd phase clinical trials now but it will take some time to get them right. Even if scientists can reduce the side effects while still producing a strong immune response, the vaccine is not going to be widely available by January.

“It won’t be ready for prime time. We won’t have enough doses until at least six months later under any scenario,” said Dr. Nirav R. Shah, a senior researcher at Stanford University.  

Dr. Nirav R. Shah is Senior Scholar at Stanford University’s Clinical Excellence Research Center in Palo Alto, California.

Shah noted there are 39 potential vaccines in trials now, 369 diagnostic tests, and 169 treatments.  Meanwhile, states are considering reopening schools and in most of the South the infection rates are too high to do that safely. Missouri is a case in point.

Recent data show how reopening the economy caused a sharp rise in transmission, which a month later, shows up as a sharp increase in the number of positive cases. (see Early Warning graph)

The graph above shows a dramatic increase in illness transmission following Phase 2 reopening on June 16, followed 3-4 weeks later by a steady increase in COVID-19 cases.

“It’s almost all about biology and math and if you ignore it, it’s unlikely you will do well,” said Dr. Ashish Jha,Director of the Harvard Global Health Institute.

Jha has looked at countries that successfully battled the virus.  He said there is no “one way” to deal with it. Vietnam, South Korea, New Zealand, and Germany each took a different approach. He said there are 4-5 major tools, any one of which will defeat the virus if you employ it aggressively and supplement it with other measures.

“In the U.S. we’ve done a half-hearted approach to a whole bunch of different things, politicizing things that clearly have no basis being political, such as whether people should wear masks or not, and have a whole lot of non-science misguided policy implementation that have landed us where we are,” Jha said.

He said the U.S. has the worst response of any country, a spot at the bottom only rivaled by Brazil, Russia, or maybe Turkey. However, Jha said parts of the U.S. have done quite well and look a lot like Western Europe.

Dr. Ashish Jha is Professor of Global Health at the Harvard T.H. Chan School of Public Health and the Director of the Harvard Global Health Institute.

“About one third of the U.S. right now is in reasonably good shape, whereas another third is in very bad shape, and that middle third could go in either direction,” Jha said.

While scientists around the world have rallied to find an effective cure, their political leaders are not always on the same page. Shah said that putting the economy ahead of public health presents a false choice between lives and livelihoods. He said some officials use the term “herd immunity” as code for “we’re not going to fix anything” when there is plenty that could be done.

Shah said there are six requirements to “reopen safely”. They are: an early warning system that predicts outbreaks of the virus, a broad and efficient testing regime, effective quarantine and isolation, adequate hospital beds and therapeutics, actionable data to track all of the above. And lastly, a safe and effective vaccine must be found to stop the pandemic in the long term.

He said we are doing a horrible job of reporting health data about the pandemic and posting timely information about testing, mask usage, quarantine stats, and other metrics.

“As a nation we do not have a good reporting system,” Shah said.  And he said the U.S. doesn’t have an effective quarantine and isolation protocol. Some countries don’t send people who test positive back to their families to infect them. They put them up in hotels with two weeks of free NETFLIX to wait out the quarantine.

Risk levels in six Southern states are high. (see America’s COVID Warning System Actionable Data graph). Tennessee is one of seven states at risk of an imminent outbreak. More than half the states could improve or move into the red zone. While nobody knows for sure what the future will bring, researchers think kids will not be able to go back to school safely until a year from now.

“We will never go back to the normal we had a year ago,” Shah said.

 

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This article was brought to you by Ethnic Media Services and the support of the Blue Shield of California Foundation.