The novel coronavirus known as COVID-19 (‘Coronavirus Disease’, virus name SARS-CoV-2 for ‘severe acute respiratory syndrome coronavirus 2’), was first identified in Hubei province and the city of Wuhan, China in early December of 2019 (though a case from Nov. 17, 2019 may be the earliest according to LiveScience) and has spread across 151 countries and territories in the time since, infecting and killing thousands. However, with the vast number of various mainstream media outlets, governments, social media, and conspiracy theorists circulating their views on COVID-19, there is little wonder that Americans tend to be confused, skeptical, or dismissive, altogether about the reality and potential consequences associated with contracting the disease. With all of that aside, reality trumps conspiracy, and an acknowledgement of the severity of this global health dilemma is necessary in tackling it.
While President Trump and his administration downplayed the seriousness of the outbreak starting with tweets in late January, he was forced to declare a national emergency by March 13. However, some of the damage had already been done as the belief that the virus and subsequent alarm were really just manufactured by the liberal media became increasingly common. A Quinnipiac University poll published March 9 revealed that the bulk of Trump’s supporters were not alarmed by the spread of or the seriousness of the virus. In fact, 65% of Republicans were not so concerned with COVID-19 while 35% of Republicans said they were not concerned at all about the disease. The lack of concern intensifies our vulnerability and propels people to avoid taking precautions that could help to reduce the spread of the virus.
In the case of the administration, such a lax response to the coronavirus has ultimately led to potential exposure by White House staffers including Ivanka Trump who met with an Australian cabinet member who tested positive for coronavirus and Republican senators like Ted Cruz and Matt Gaetz (who have self-quarantined) after interacting with an infected person at a recent CPAC conference. President Trump, himself, after meeting with a Brazilian delegation that included President Bolsonaro and members of his administration (several of whom tested positive), was also tested for COVID-19. The White House has reported the test was negative. Still, a significant segment of the U.S. population continues to refer to the spread of the virus as a ‘hoax’, while others see it as a political ploy to bring down Trump in an election year. The utter danger in adopting either view is apparent.
What has been most worrisome is the rather pervasive indifference to the pandemic, some of which is the result of a widespread aversion to science, a regular consumption of misinformation, the belief that only a small segment of the population (the elderly) should be concerned about becoming ill, as well as a blinding subscription to ideologies that often see science and medicine as suspicious, especially when scientific views pose challenges to traditional sources of power- namely religious and political leadership. A decentralized public health policy has also stymied a uniform and effective response to COVID-19 unlike what we have seen in China or South Korea where drastic measures to contain the spread of the virus have been implemented such as drive-through testing and complete lockdowns. Instead, states have instituted their own injunctions by closing public schools, banning large gatherings, and shutting down some government offices, although this has not prevented people from going to public places.
Further, our response to the coronavirus outbreak is uncovering the dangerous inequities perpetrated by an economic system crippled by bad policies that cater to corporations and the wealthy, a poor social safety net, and a lethargic bureaucracy that has left 27 million Americans uninsured and 34 million without paid sick leave. These two tragedies make both groups of people not only exceptionally vulnerable but also inadvertent perpetrators of disease spread since individuals are unlikely to visit a physician if they are without insurance and those without paid sick leave are far less likely to stay home from work if they are ill. Public school closings across the country due to the COVID-19 outbreak have also exposed another failure of a broken economic system. In NYC alone, there was hesitation before statewide school closures due to the fact that 114,000 children are homeless and rely on schools to feed and shelter them. Now with a major outbreak of 329 documented cases and 5 deaths in NYC due to coronavirus, the U.S.’s largest city, alarms bells are ringing. Americans, 38 million of whom live below the poverty line, 15 million households that are food insecure, and more than half a million homeless will now have to contend with the added stresses of a nationwide pandemic. All this in the world’s wealthiest nation.
All our institutions will be heavily tested and will likely further expose our abysmal failure to provide moral, ethical, and empathy-driven resource management and allocation, that if utilized properly, could have allowed for a more coherent response to COVID-19. Due to the rapid spread of the virus that ‘blindsided’ the president, the Trump Administration has restricted travel to/from China, Iran and Europe and had to respond to the rapid spread three months after the virus was identified, by passing a coronavirus bill (H.R.6074 – Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020) which has allocated $8.3 billion dollars towards testing and treatment, mainly. Still, in total, only The house, under Nancy Pelosi, has since introduced the “Families First Coronavirus Response Act” (HR 6201), which will also utilize billions in economic relief for those affected by coronavirus (e.g. paid sick leave for some, unemployment benefit expansion, etc.). While these are necessary measures, they highlight the dire need for better and more permanent domestic economic and heath policies going forward, post-coronavirus.
In terms of COVID-19, itself, the following information should help shed light on the seriousness of the disease (as of March 15, 2020).
1. The World Health Organization describes the novel coronavirus COVID-19 as a previously unknown zoonotic virus that is manifested through a variety of symptoms (cough, fever, shortness of breath, and less often diarrhea, headache, muscle pain, runny nose, sore throat, etc.) while more serious ones such as neurological issues, pneumonia, septic shock, organ failure, bronchitis, or severe respiratory distress can occur. Most people who contract it will have few or mild symptoms (81%) while for others, it can be life-threatening (critical cases represent 13.8% of all cases and severe cases 4.7%). The Chinese Center for Disease Control and Prevention has provided data that shows that those whose immune systems have been compromised or have a history of heart or lung disease, diabetes, hypertension, cancer or are active smokers are more at risk, especially over age 50 (50-59 years old – 1.3% mortality) but increasingly between ages 60-69 (3.6% mortality), 70-79 (8% mortality), and those over age 80 have a mortality rate of 14.8%. Those without (known) pre-existing conditions have less than 1% mortality rates and those under age 20 are less likely to show signs or symptoms. Men have higher fatality rates than women and appear to be more susceptible (though this may be the result of deaths in China where men smoke in much larger numbers). The virus is popularly believed to have originated in a wet market in Wuhan, China where animals are freshly slaughtered and prepared to order, but its origins have not yet been confirmed.
2. The virus is spreading quickly and has a transmittable rate (R0 value- reproduction number) of 1.5-3.5 people per every person infected person, according to the London Imperial College (which is much higher than the flu which is 1:1.3). In the U.S. (which has done little testing compared to China or South Korea), 3,447 cases of COVID-19 have been reported, with 63 deaths (See WorldOMeter and COVID19 Tracking). As of today, only 20,795 Americans have been tested in 51 states and U.S. territories for COVID-19. These numbers will climb drastically over the next 3 months as more testing becomes available and as the virus continues to pass from person to person. In the U.S., a shortage of coronavirus tests has naturally led to an under-reporting of COVID-19 cases, but it is suspected that thousands (if not tens of thousands) of Americans have already contracted the virus. Many may be asymptomatic, untested, and therefore unaware and so they are not practicing social distancing or taking extra precautions to avoid spreading it. The incubation period varies from patient to patient, but most fall between the 2-14-day period according to the CDC (U.S. Center for Disease Control). The China Daily (Feb. 8, 2020) reported that COVID-19 is also spreadable through ‘aerosol transmission’ (i.e. airborne droplets that can be inhaled) alongside contact and direct transmission.
3. Depending on the source (CDC, the Lancet, New Zealand’s CDCP, or the WHO) , the COVID-19 mortality rate is between 2.3-3.4% (some health organizations say 2-5%), which is significantly higher than the flu (the flu mortality rate is generally under 1%) so the popular argument that the flu kills more people annually does nothing to contextualize the threat of COVID-19. Propagating this narrative about the deadliness of the flu will almost certainly make people less inclined to take the necessary precautions to deal with this pandemic. COVID-19 is about 10 times more fatal than the flu according to the nation’s coronavirus task force head, Dr. Anthony Fauci (and based on the statistics we have thus far).
The Swine Flu (H1N1 influenza) pandemic of 2009-2010 does not compare in this regard. That particular strand of flu’s transmittable rate was lower, and the mortality rate was 0.02% of those infected and it did not kill more Americans than in other years (12,469 Americans died from the Swine Flu during that time out of some 60 million infected). Context is important and such arguments meant to downplay the severity of COVID-19 that are predicated upon a decontextualized understanding of the number of flu-related deaths which tell us nothing about COVID-19’s severity, especially since we are in the earlier stages of disease transmission. Harvard epidemiologist Marc Lipsitch, during a recent podcast with Noah Feldman asserted that up to 40% of the world’s adult population (some 3 billion people) may ultimately become infected with the disease and that between 1-2% of these cases could be fatal. This, of course, becomes a likelier scenario if we do not enact strict measures to stop its spread such as self-isolation and extreme social distancing (i.e. staying at home, altogether is working in China).
4. As of March 15, 2020, WorldOMeter (an online tracking site endorsed by the U.N. and the American Library Association) has reported that roughly 168,945 people have tested positive for COVID-19 around the world with 6,492 deaths reported globally with about 76,598 who have recovered. China has seen 3,199 deaths out of 80, 849 cases deaths but has managed to dramatically cut down the number of infected patients by the day by implementing strict quarantines and throwing tremendous resources at containing the disease at its epicenter. Italy has seen 24, 747 cases and a staggering 1,809 deaths so far and that number continues to rise dramatically (in part because they were ill-prepared and nearly a quarter of its population is elderly and more susceptible to the virus). Iran has reported 13,938 cases with 724 deaths even impacting its political leadership.
Thus far, there is no vaccine and there are no approved medications to effectively deter it, but a clinical trial is underway for an experimental vaccine in Seattle under the watch of the NIH according to the Associated Press. The World Health Organization (WHO) has urged hospitals to make available oxygen systems (ventilators) and pulse oximeters for those with severe cases of COVID-19 where patients are suffering severe respiratory problems. According to ScienceNews, repurposed drugs like Lopinavir/ritonavir, Remdesivir, Chloroquine, APN01 (used to treat an array of other viruses and serious diseases like AIDS, Ebola, SARS, etc.) and others may potentially offer hope in clinical trials for COVID-19 patients, too, but this is yet to be determined.
One other way that our vulnerability has been further exposed is a well-documented shortage of vital medications. For many years (if not decades now), there has existed a major drug shortage in the United States. Manufacturing has shifted away from the U.S. and, today, most medications (including important antibiotics) are not manufactured in this country, but rather in China. As of 2018, there was a shortage of 182 drugs and other related medical supplies in the U.S. Compounding the aforementioned problem as it relates to COVID-19 is that we also do not have the medical infrastructure to handle a major outbreak in the United States according to the administration’s top immunologist Dr. Fauci, head of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institute of Health (NIH). Furthermore, we have already lost considerable time in trying to manage the disease by downplaying its severity and by hospitals and labs having to contend with cumbersome bureaucratic red tape that has prevented them from widespread testing.
Lastly, we are a nation of 330 million people, but according to the National Health Council, about 157 million Americans have a chronic illness with more than half (81 million) having multiple chronic illnesses. In 2009, chronic illness was the cause of death in 7 out of 10 Americans (ranging from diabetes to cancer, heart disease, lung disease, etc.) The emergence and spread of COVID-19 will further expose our nation’s health vulnerabilities and susceptibilities, but with inept federal management, drug shortages, a lack of administrative competence at the highest political levels, a bureaucracy and corporatist economic culture that loathes poor people and which is unconcerned with the collective well-being of Americans, we have arrived at a moment of reckoning. Our values, policies, our institutions, and our nation’s economic, health, social, and political infrastructure are on trial now, and the verdict is in.
Bonus Video added by Informed Comment: