Complacency fuels the slow burn of COVID-19

In polarizing politics, it seems that somehow the greater good often misses the very grain that comes together and makes it great — the people.

After we blindfolded ourselves to a warning from China and then Italy, New York witnessed the grinding impact of COVID-19.  Merely two months later, many other states are showing unprecedented growth in cases.  Surpassing 2.5 million cases, we have officially unflattened the curve.  Our failed pandemic strategy is exemplifying a historical inadequacy and is a subject of global shock.  Not surprisingly, Europe has barred American travelers.

All mathematical analyses, whether based on lessons from a century-old pandemic or from AI-based prediction models, described a prolonged phase of infectivity with an intermittent rise in cases.  Not as much heed was paid by the leadership, and public briefings were absent for about two months.

Even with a three-month head-start, once faced with the havoc, we scrambled for ventilators, masks, tests, reagents, and for the swabs.  The problem with damage control is that the dominos have already started falling, and therefore suffering is inevitable. If not at the beginning of the year, the dismantled pandemic preparedness team could have proven invaluable during the lockdown.  It was the perfect time to get the testing infrastructure and guidelines in place, looking for new centers of infection and spread.  Harvard global health institute recommended 900,000 daily tests by May 15, 2020.  More than a month later, on June 20, we had barely reached a 7-day average of a little more than 500,000 daily tests being performed in the USA for the first time.  One recommendation from The Rockefeller Foundation still seems far cry as it asked to expand testing to reach 30 million tests per week by late fall of 2020.

Additionally, the lockdown was the right time to implement masks as a rule in all phases of reopening.  The mild inconvenience of donning a mask would have been acceptable when compared with a prolonged lockdown.  Currently, more than 50 countries require people to cover their faces when they leave home.  As cases are surging, more states have now started requiring masks in public.  Ideally, the mask mandates need to precede this steep wave of new cases rather than follow it.  Due to poor preparedness and inconsistent messaging, policies have been difficult to enforce because they change prior to public percolation and adoption.

Politicization and lack of a uniform directive between experts and leaders have created a deep divide between peoples’ perceptions of the grim reality we are in.  Contrary to public health recommendations, indoor political campaign rallies have happened.  A liability waiver requirement for any illness or injury and exposure to COVID-19 prior to registering for the rally should be proof enough of a looming threat and misplaced priorities.  While evidence suggests that the risk of infection is approximately 19 times higher indoors than outdoors, campaign workers actively removed social distancing stickers from the venue seating.

Complacency continues to propel this pandemic.  The nation keeps breaking records on daily COVID-19 cases for days in a row.  Yes, the demographic is shifting towards the young, but hospitalizations are still on the rise.  They are also more likely to contribute to the asymptomatic pool.  COVID-19 dispersion seems random, and a small number of super spreaders can be responsible for a large, possibly 80% of dissemination.  Either way, SARS-CoV2 is not known to be shy, as evident by the recent desolate reality in Arizona, Florida, and Texas.

We are in for the long haul with COVID-19, and we must find reasonable and intelligent ways to live with it in order for the economy to remain.  It has shown no seasonal variability, and there is nothing that has been successful in lowering infections except social distancing, avoiding crowds, universal masking.  With the baffling paucity of appropriate federal action, now more than ever, we need an urgent and empirical (united) state response.  Strong considerations need to be made to mandate simple public health measures until further notice.  This is the new normal where we continuously lower the risk, all while remembering that low-risk is not no-risk.

There is another clock ticking as fall approaches.  With time, the exhaustion with coronavirus can render us vulnerable for a merciless flu season.  A perfect storm of flu and COVID-19 in the fall could be a frigid brinicle of moratorium.  We must not be complacent anymore because what might follow is a somber viral eclipse.

Raghav Gupta is an interventional cardiologist.

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