How do you fix a disaster? Start over the right way.
As of today, America is on course to have a million cases of COVID a week. That translates eventually to 10,000 dead a week – the equivalent of four 9/11s every seven days. Add in the social mixing of Thanksgiving, Christmas and New Year’s. Perhaps we will see days this winter where the number of COVID dead is the same as 9/11. Every day.
What will that do to the American psyche?
The number of deaths in this country per person is already 2000 times that of Vietnam, 80 times that of South Korea, 20 times that of Australia, probably the most country most similar to us in their fractious politics and cultural history.
Germany recognizes 50 cases per 100,000 as its red line in the sand. At that stage, health care systems get overwhelmed. Tracing and tracking of cases, the basic public health work of quarantine and isolation, becomes nearly useless.
Now the US is running about 300 cases per 100,000 per week. That’s six times what Germany considers their “danger zone.” And we’re rising. Fast.
How do you fix that catastrophic mess? You begin again, and you don’t give up.
The Trump administration threw out George Bush’s thoughtful 2005 pandemic playbook and all the previous and subsequent versions. The result was 300,000 excess deaths (CDC data) by fall, and probably multiples of that in chronic COVID. That represents deaths and illness in more than a million people that will haunt us for decades.
The first job in a pandemic: communicate the truth. Tell people what they need to know. Explain what’s getting done. Unify the population to fight the virus together.
Instead, the Trump administration told infectious disease researchers like Rachel Chu on pain of jail not to find out what was happening; pushed hydroxychloroquine as a treatment, with truly disastrous results in Latin America; made mask wearing a statement of political correctness rather than a tool to save lives.
The result is a poisoned well, where many think COVID a joke and mask-wearing a fundamental violation of their right to infect. Much of the population does not appreciate this is an infectious disease that spreads through asymptomatic folks just talking and breathing.
And many don’t want to know.
Will truth be the ultimate disinfectant? We’re about to find out.
Countries that did well in this epidemic often put top public health officials on television every night. They told people what was happening, and where. They explained what isolation was for and how it worked. They showed people that masks work like condoms in AIDS; you cut the viral load, decreasing both infection and severe illness risk. It’s harder to fight off five million viral particles than five thousand.
British Columbia’s public health officer, a retired military surgeon, did this extremely well. Andrew Cuomo performed a bit more politically to help New Yorkers live through their hellish pandemic.
When the Biden administration takes power, there will be many possible candidates for the role. Hopefully it will be a respected figure like Dr. Tony Fauci, or even a group. But Americans need to know what’s going on.
Years and years blurring lies and truth has left mountains of coffins. The ratings may not be great, but people need to know regularly what’s happening nationally and in their community. Are schools safe? How safe? Are bars and restaurants the biggest nidus of infection? How risky are gyms? What happens when I want to see my parents in assisted living? What are their risks?
Public health means you try to save all the people.
It’s time for a public commission on deciding what vaccines to back or not. Companies have had a field day getting their stock prices up with PR releases of “great success” and virtually no hard data.
What does “90% effective” mean? Did you prevent 90% fewer deaths? Less ICU admissions? Coughs?
A commission of public health professionals and consumer advocates not beholden to industry or political parties should prove a first start. Tens of billions of dollars have been invested. Billions of lives are on the line.
People deserve some degree of impartiality in determining whether a vaccine is worth spending billions more to produce and distribute. Lots of answers will only come with time. There will be no perfect decisions. Meanwhile, people who have spent their career making and tracking the effectiveness of vaccines should be heard.
Review What’s Known
The 9/11 Commission helped remake American defense and security policy. Now we need a COVID commission to learn from our mistakes.
The mistakes were numerous and lethal. The unprecedented editorial in NEJM October 8th noted the “evisceration” of the CDC and the sidelining of most public health advice.
Is this political? Damn straight. So was the Trump Administration’s stance on the virus. How else do you have Kayleigh McEnany, spokesman for the Committee to Re-Elect the President, declaring February 25th “the coronavirus will never come” to the US? That was the day after the head of CDC Infectious Disease told Congress multiple US epidemics were already starting.
At this point, far more people have died of COVID than Vietnam, Korea, and our Mideast wars combined. Through this horrible coming winter, we may exceed the American carnage of WWII.
Do we want to kill hundreds of thousands more? No. That means we figure out what we did wrong. And in the next pandemic, get it more right.
Epidemics make human history. It’s time to make this epidemic history. Perhaps the truth may not set us free, but will instruct us how to save our future selves.