Coronavirus: If the United States is my patient

I really thought that we would have a different conversation in this country at this time; I think that together with fireworks, we will celebrate the progress we have made so far. Instead, I must tell the patient, “The infection has returned with all my heart. The infection has spread and risks losing control in some parts of your body.”

And I am worried – worried that we will get to the point where the care we have, the medicines we carry in our little black bags, are no longer effective and we have to use large arms, more aggressive steps.

But at the same time, I still have hope; we still have a little time to turn things around, restart our medicine, take it faithfully – but we can’t waste anymore time.

The best care, the best advice

“If a country, like a human body, becomes ill or infected, it must seek the best medical guidance and follow it, as hard as that,” I wrote in May.

Well, throughout the illness, this patient has benefited from excellent medical care. The country is home to some of the most creative minds, the best doctors and the most experienced public health officials all over the world. And they, along with equally talented international researchers, act, try to decipher the genetic makeup of the virus, learn how it is spread and how to reduce it, find all the ways the disease manifests, find ways to treat symptoms and try desperately to develop a vaccine that will prevent new cases of infection in the future.

But after a few weeks following the doctor’s orders, our patients – our country – have chosen to step down on the advice of these health experts. It doesn’t like what the doctor says and stops taking the prescribed medication because it’s not tasty.

Some recipes, such as social exclusion and limiting daily activities, are uncomfortable and hard to swallow. Others, such as wearing masks, create a little physical discomfort and a lot of political friction. And the most aggressive drug of all, the order to stay at home, triggers unprecedented mass layoffs in many sectors of the economy and its impact has just slipped out of it. In other words, the pain is very real.

But the difficulty of placing the patient in a medically induced coma with orders to stay home to control the infection seems to work.

When I first wrote the work, right before Remembrance Day, during another national holiday, it seemed like the patient was moving in the right direction. Infection rates have dropped significantly in some of the hardest-hit areas, such as Michigan, Massachusetts and New York, and have remained stable in many countries.

Stop treatment too soon

I was worried at the time about stopping the drug too early – and that was what happened.

Patients are taken out of medically induced coma too quickly and in chaos, with each country doing its own thing. Some countries soon reopened, while infection rates were rising (I see you, Georgia), other states, and some cities waited a little longer. But few, if any, states meet all the so-called “gate criteria” for reopening set by the White House and CDC.

In addition to acting too quickly, this reopening is often accompanied by violations of rules, lack of social distance and increasing refusal to wear masks by harsh minorities. We have all seen photographs of crowded beaches, crowded bars, protests in favor of reopening, and presidential press briefings with officials gathering together behind the podium, and few, if any, wearing masks.

It was as if our patient had just shrugged after waking up and said, “It was a strange nightmare. Glad it’s over,” before emerging from the bed and walking out of the hospital. But the infection is still burning below the surface.

Like Cassandra, predictions are ignored

Since then, health experts for health experts have tried to remind us that this pandemic has not disappeared. Not only that, he will be here with us for the foreseeable future. But there is no unifying directive or action plan from the White House. States respond independently of each other. Then the patient continues his business, often unaware of the dangers.

People in that part of the country continue to be out of social distance and the fight against wearing a mask becomes more vocal and rooted, with the President, vice president and other elected officials refusing to model the behavior recommended by health experts: Wear a mask and stay 6 feet apart. For a time, governors from several states, including Arizona and Texas, even blocked local officials to enforce the mandate of masks within their cities and counties.

Is it too late?

As I have said many times, this coronavirus is not strong and because of that, a spoonful of a small drug can be very beneficial. It doesn’t travel far, so staying 6 or 10 feet apart can help. With good air circulation, it spreads quickly, so don’t gather in the indoor space. And wear a mask – that’s a big one. Research shows that it can reduce transmission to others while protecting the wearer. Even bandanas, even paper surgical masks work better than nothing.

In fact, the modelers at the Institute for Health Metrics and Evaluation University project that if 95% of people wear masks, around 24,000 lives could survive in October.

If we can make our patients stick to these small steps – these tried and true public health measures have succeeded in places like South Korea – the number of infections every day can be slowly reduced to manageable levels. And then we can start containment efforts, such as tracking contacts and isolating potentially infected people.

But we are not even at that stage yet, and it’s impossible to talk about containing a virus when there are 50,000, or even 10,000, new infections per day. To do that, we must bring this country closer to one in a million infected people per day. That’s more than 300 new infections per day – not 50,000.

And that brings me to another point: We need more testing, not less. This is the only way to see how the patient is doing, to see whether the infection is decreasing or spreading. Testing in many parts of the country is still difficult to obtain; test components are sometimes lacking in supply and results are slow to arrive. And now because more people want to be tested, testing sites at several new hotspots are crowded, with long lines. This will further increase waiting results because the lab is trying hard to keep up. We need mass access to quick, easy and inexpensive tests that can provide results in minutes, not days, so testing can be done more easily and results are returned faster.

Everything will get worse before it gets better

Make no mistake, patients will feel worse in the coming days until the drugs start working, until public health measures that are once again implemented have the opportunity to do their work. And patients may still need aggressive treatment in some places – we might see certain areas of parts of the country closed again.

In the spring, everyone makes great personal and economic sacrifices in trying to level the curve. Nobody wants to lose that progress and no one wants to go back to coma again.

But we must act now, as a nation, inseparable and with one guiding voice. It will be a nice birthday present for our patients.