The United States persists as the novel coronavirus epicenter, blowing past previous record numbers of infections to more than 4.5 million. The disease has edged toward claiming the lives of roughly 155,000 Americans. Imagine if the equivalent, the population of Alexandria, Va., died in just a few months.
July went in the books as the cruelest month, thus far, with Covid-19 infections doubling over June’s tallies, deaths surging, and the coronavirus surging or parking at a high and lethal plateau in most parts of the country,
Efforts to deal with the disease have frayed further, leaving the nation’s response in tatters and fragmented as if America were no longer a union of states but disparate battlegrounds.
Testing: overwhelmed and too slow
After dragging their feet and maintaining with chirpy cheer that the Covid-19 testing programs were ramping up, setting a global pace, and meeting needs, federal officials have conceded a different reality: months into the pandemic, there is insufficient testing and the overwhelmed public-private processing of them has become so sluggish as to make their reported results unhelpful.
Yes, the United States may be conducting more than 800,000 tests per day now. But that gets nowhere close to the demand for them, as the lines of wannabe test-takers snaking for miles in the summer weather show (see photo above, from Wall Street Journal video on waits at Miami testing sites).
Because the results are returning in such pokey fashion and the requests for testing have overwhelmed public and private facilities’ capacities to provide them, some public health officials have pushed out new guidelines on who should be tested. It’s no longer the never-achieved claim that anyone who wants a test gets one. It may not be essential workers, either. The testing regimen may be back to a prime square — if someone suspects they have the coronavirus, that’s when they should seek the test, waiting in long lines and feeling crummy. To spare capacity, officials also have altered their view on when those who have been ill with Covid-19 can end their quarantines — without testing.
As media reports show how the administration’s nepotism and cronyism crippled a possible national testing response, including for naked partisan reasons, public health officials and medical scientists are trying to find workarounds to the lumbering system now in place — with new, different, and possibly pooled tests. These may be cheaper and faster. They may be less accurate for an individual.
But they may provide better insights, versus the current collapsing system, as to who has the disease, where the infected may be, and what is the course of the Covid-19 pandemic.
A bungled roll-out of new hospital reporting system
At a crucial moment, the Trump Administration has blinded the medical-scientific community, public health officials, and the public itself to crucial information about the coronavirus by bumbling through a change in the collection of vital data from hospitals nationwide. The White House had assailed the traditional source of this information: the federal Centers for Disease Control and Prevention. Officials said the CDC system was too slow and antiquated, including its reliance on institutions’ faxing each other reports.
But rather than buttressing existing efforts, the administration tapped a private firm with alarm-raising political connections to take over the national data collection system.
The firm’s roll-out of its efforts has been poor, meaning that fundamental metrics — like how many patients have been hospitalized with Covid-19 and how full are intensive care units — are unavailable or unreliable because governments and hospitals say they can’t get the new private system to work as it is supposed to.
Contract tracing in trouble, too
As for yet another crucial effort to combat Covid-19, the tactic of contact tracing (followed by isolation or quarantine of the ill) is crumbling, too. Public health officials say they lack the resources to carry out the work of contacting the recently diagnosed to determine who they may have had sustained contact with to urge those people to get tested and isolate or quarantine if they are infected, too. The numbers of infections are overwhelming the contact tracing plans. The tactic also falls to pieces if health workers can’t get timely information about new infections — it doesn’t make sense to try to contact trace based on test data that is weeks old (as some result lags are occurring now).
No normality without a quelling of the virus
Americans are experiencing the dire consequences of a dearth of federal leadership in the pandemic in other ways, too.
If travel is an important aspect of a return to normality, it has been stymied by the coronavirus and the flawed federal response. The once prized American passport has been debased, with countries around the globe declining to allow U.S. visitors. States within the union are also putting up travel rules affecting non-residents, requiring visitors to self-quarantine for two weeks. Who could have imagined the District of Columbia, typically overrun by tourists in the summer, telling non-residents from “high risk” areas that they must stay in a lockdown for two weeks before moving freely around the nation’s capital? Who could have envisioned interstate suspicion and wariness as the coronavirus hits some geographies harder and areas with more stringent coronavirus responses look askance at lax neighbors?
Professional and college sports teams and leagues have grappled for months now on their best course forward, spending untold sums on research, planning, and even halting restarts of competitions. The NBA bubble seems to be holding, while the MLB road show seems to hit big new bumps in the road every day. The NCAA is putting on a game face but not really committed yet to actually having fall football. The NFL? Camps are on the brink but …
And, of course, students and parents, as summer starts to fade, are grappling with a giant set of glum realities about the new school year. Distance learning, less than optimal, appears to be the unhappy and prevailing option for many youngsters. This will be bad news for already disadvantaged kids. But for all parents, the coronavirus’ crippling effects on public schools has created huge challenges — not only with educating but socializing young people. Moms (especially) and dads also must contend with the harsh reality of how they will manage their work lives and care for homebound kids. Colleges and universities also are a mess for young adults. Many of the institutions also have gone to distance learning or limited on-campus experiences. Can they realistically safeguard their students 24/7 (especially with ramped up medical services) — active, social young folks, far from home?
In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and excellent medical care. This was an ordeal before the pandemic, driven by the skyrocketing cost, complexity, and uncertainty of treatments and prescription medications, too many of which turn out to be dangerous drugs.
The coronavirus, alas, is providing the country with stark, harsh lessons about how much science and medicine matter. So does competent, engaged political leadership. As we head into the heart of the 2020 election year, Americans need to dig in more than ever to their democratic rights. We can ask how well our elected officials have handled the Covid-19 pandemic, with its record joblessness and economic ruin, as well as its reign of infection and death. How do we not only better battle the raging disease but also put the nation in a different and improved place after?