Reopening the US – despite the continuing upward march of coronavirus cases and deaths – signals that the country has given up on trying to stop the disease entirely, and is shifting focus to trying to reduce harm from it, one ER doctor told CNN.
‘We had a strategy before. That strategy was we would reduce the number of infections and at the same time build up our capabilities to do testing, tracing, isolation,’ Dr Leana Wen, an ER physician and former health commissioner of Baltimore, told CNN during a Thursday night global town hall.
‘We know that that’s what’s going to be effective, but we are reopening before those capabilities are in place.
‘So in essence, we’re saying it’s too hard. We’re not going to be able to get there. And so we’re switching to a new phase.’
In public health terminology, it’s a change from mitigation – trying to stop coronavirus’s spread in its tracks – to mitigation, which aims to minimize the pandemic’s damage, but admits that it will continue to infect and kill people.
It was perhaps inevitable, as top US officials including Dr Anthony Fauci and Dr Robert Redfield warned that coronavirus may well be with us for the long-haul, but Dr Wen worries that the nation and its healthcare system are not prepared for the new stage.
Baltimore’s former health commissioner Dr Leana Wen said she worries that the US is opening before states could get necessary measures for keeping coronavirus infections from turning into outbreaks, ike contact tracing, up and running
Technically, the US switched from prevention to mitigation strategies months ago.
Travel restrictions, beginning with barring entry for people coming from China, were implemented by the Trump administration on January 31 – 10 days after the first US case of coronavirus was confirmed.
At that point it seemed possible to isolate and contain individual cases and prevent a full-blown outbreak of the infection in the US.
It wasn’t.
To-date, more than 1.45 million Americans have been infected by coronavirus and nearly 87,00 have died.
Still, the Trump administration’s March 16 guidelines urging Americans to stay home if at all possible, and state stay-at-home orders were intended to do more than cope with the virus as if it were endemic.
They were intended to slow the spread while scientists searched for a cure or vaccine to prevent coronavirus.
Dr Mark Poznansky, an infectious disease specialist at Massachusetts General, said that the increase in infections as restrictions are lifted is inevitable, but that hospitals and society at large simply must be nimble amid the ever-changing pandemic. Pictured: Doctors tend to a coronavirus patient in Stamford, Connecticut (file)
But Trump’s guidelines expire Friday, and most US states have begun to lift their social distancing measures.
Phase 1 reopening guidelines require states to show two-week declines infections and that they have adequate hospital and testing capacity for frontline workers.
According to an NPR analysis, only about 10 states are at or near their testing targets.
‘Every case that’s out there could be the spark that starts another outbreak in your community that gets out of control,’ former CDC acting director
As for infection rates, it simply may not be possible to wait long enough for treatments and vaccines to prevent or stem them, or for herd immunity to build.
Dr Mark Poznansky, an infectious disease expert at Massachusetts General Hospital told DailyMail.com that about 10 percent of the Boston area is estimated to have had coronavirus.
As states reopen, an increase in infections will be inevitable, but more testing and tracing will help protect the most vulnerable people, like the elderly. Dr Wen worries that the US is throwing its hands up before these systems are solidly in place (file) f
That’s far short of the 60 or 70 percent he says will be necessary for any kind of herd immunity to take hold. He expects that infections will increase up to some 20 percent as things begin to eopen.
‘Hospitals will have to be nimble and adapt to the changing environment,’ he said.
‘By all rights, [increases in cases] will continue to happen and the government is being appropriately cautious.’
But that, he says, is an inevitability of the pandemic.
‘There’s no standing still position,’ other than keeping the whole country locked down.
Among the flexible responses that states can and should put into place are contact tracers.
‘It makes a great deal of sense to do contact tracing to contain outbreaks, it’s a well-proven way of containing outbreaks,’ said Dr Poznansky.
Former Centers for Disease Control and Prevention (CDC) director Dr Thomas Frieden echoed his sentiments.
‘The risk of [reopening] without contact tracing is that you’re going to have cases spread it, and you can’t stop it,’ he told DailyMail.com.
Contact tracing, he said, ‘can help a lot in reducing the risk that cases become clusters and cluster become an outbreak and an outbreak becomes an epidemic.’