With as many as 200,000 U.S. dead already, grimmer days may still be ahead

cdcredfield-150x150The Covid-19 pandemic, with grim outcomes already, may get even worse in the days ahead.

That troubling forecast — from one of the nation’s less-than-outspoken medical leaders (Dr. Robert Redfield, right, head of the federal Centers for Disease Control and Prevention) and as laid out in a seasoned journalist’s detailed reporting — may seem hard to take for already coronavirus-fatigued Americans.

The warnings, however, come atop even more alarms about the disease’s unchecked spread and the hard-to-fathom responses to it.

Even as some Americans race to reopen schools and colleges and universities and fall football, public health experts have revised their estimates on the Covid-19 death toll, saying it likely has exceeded 200,000 lives, not the more commonly reported 168,000+ dead.

The greater fatality count, which experts describe as likely more accurate, reflects the actual and higher — or excess — deaths that have occurred in recent months versus what would be normally expected.

Considering public health experts’ expectations, however, the coronavirus’ rampage has exceeded many forecasts, with infections nationwide zooming past 5.3 million. California, which has acted aggressively against the disease, says it has cleared up a technical gaffe that resulted in an undercount of tests — meaning the state set a record with more than 600,000 diagnosed infections.

While officials also report signs of improvement with the disease in the Golden State, Covid-19 rages on in Texas, Florida, Georgia, Mississippi, and other states, with experts also warning of surges in the Midwest, notably in rural Ohio, Wisconsin, Missouri, and Illinois.

School nightmares

Stress, fear, anger, anxiety, and uncertainty have struck families across the country as schools, teachers, parents, children and teens try to sort out and deal with a patchwork of ever-shifting plans for fall classes — online or in person, or in some mix of the two. The economic and social inequities in the U.S. educational system have become glaring in the pandemic.

Schools are seeking to not only educate but to provide youngsters important socialization, experts say. Parents, especially moms, also struggle with their capacity to work if they must support their youngsters’ online learning at home. Efforts to politically strong-arm schools to reopen are backfiring, and worried teachers are taking labor actions or even resignation or retirement rather than returning to what they fear may be unsafe working conditions.  Still, federal authorities say that the reported number of Covid-19 cases in kids is rising steadily and in worrisome fashion.

Colleges and universities — venues supposedly filled with great minds and deep expertise — have fueled the coronavirus confusion not only with their halting and switching fall educational plans (charging infuriating and steep fees, of course, for remote as well as in person learning) but also with their treatment of supposedly amateur student athletes.

Two of the Big 5 sports conferences — the Pac-12 and the Big Ten — had their leaders, coaches, and medical experts tear into the available information about Covid-19 and players’ safety, leading to their postponing the lucrative and highly popular fall football season. That same information, however, led the SEC, ACC, and Big 12 conferences to push ahead with upcoming games. The NCAA says it will not tell conferences what to do about football but the governing body of college athletics has canceled championship competition in all other sports.

Debacles with testing and data reporting

As Americans young and old worry about their health and yearn for returns to normality, the federal leadership failures loom larger by the day. Testing is becoming an even greater debacle, if that is possible, with states and private enterprises overwhelmed by demand and the need for speed. Results are returning far too slowly to be useful, and data tracking systems are faltering. It may be one of the more contradictory datapoints of the pandemic, but the number of tests occurring daily actually has started to fall, even as diagnosed infections soar. The system is in enough disarray that experts are suggesting a major reset.

The Trump Administration, meantime, is under heavy fire for its flopping revamp of the way that hospitals report Covid-19 to the Health and Human Services agency and not, as traditionally occurred, to the federal Centers for Disease Control and Prevention. The private contractor hired by the administration to revamp coronavirus data collection has declined to answer U.S. Senate inquiries about its contract and work, saying the information is proprietary.


In my practice, I see not only the harms that patients suffer while seeking medical services, but also the real benefits they can enjoy by staying healthy and out of the U.S. health care system. That system had its big problems before the pandemic, including with infections acquired in care giving institutions (hospitals and nursing homes), misdiagnoses, and medical errors — the third leading cause of death in the nation, by some expert estimates.

That said, we need to protect and improve the health system more than ever, notably with big support for public health and medicine based in science and evidence. The pandemic has exposed the terrible consequences of absent political leadership and the endorsing of wild, unfounded, and dangerous gut thinking or policy making by rumor or belief.

We may be left more on our own than ever before to research carefully, think deeply, and act responsibly for ourselves, our loved ones, workplaces, and communities. This means, based on what reputable medical scientists tell us, that we need to maintain distance, shield our faces (yes, with better coverings, research suggests), and practice great hygiene and especially with hand washing and cough and sneeze covering. It’s gotten far past old, but we need to stick around the house as much as we can still and not magically believe Covid-19 will disappear.

Stop the USPS nonsense

By the way, while we’re home-bound, it absolutely, positively will be totally unacceptable for even the hint of political tomfoolery to interfere with the labors of the U.S. Postal Service. The foundational work of this agency provides a crucial lifeline to the far-flung, elderly, ailing, and veterans. As the Wall Street Journal reported of prescription drug supplying during the pandemic:

“During the last week of March, mail-order prescriptions grew 21% from the previous year to bring their share of the prescription drug market to 5.8%, the highest share in at least two years, according to data from SunTrust Robinson Humphrey analyst Gregg Gilbert. Drug maker Eli Lilly & Co., which sees about one-quarter of its U.S. business ship by mail, said more of its products have been processed that way during the pandemic. Pfizer Inc. said that for patients in its assistance program, it is sending more medicines directly and extending shipments from 30-day to 60-day supplies.”

Here is what the news site Vox said about older patients and mail service:

“More than half the people who get their medicine delivered are over the age of 65, according to a report from the National Community Pharmacists Association — and 54% of this group takes more than four different types of medication. If the USPS shuts down, then they will be left without an affordable option to access vital drugs. People with disabilities rely on the Postal Service to mail their prescriptions for similar reasons. Many simply cannot travel to the closest city, let alone leave their houses, to pick up their prescriptions. And a significant number of those who belong to this community are also veterans that have signed up for the Veterans Affairs ‘Meds by Mail’ program, which delivers medications to their house. The shutdown of the USPS could ultimately disrupt the services of another government agency that serves a vulnerable population.”

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