Health experts analyze how the coronavirus may play out in the US
The coronavirus is spreading from America's biggest cities to its suburbs, and has begun encroaching on the nation's rural regions. The virus is believed to have infected millions of citizens and has killed more than 34,000.
Yet President Donald Trump this past week proposed guidelines for reopening the economy and suggested that a swath of the United States would soon resume something resembling normalcy. For weeks now, the administration's view of the crisis and our future has been rosier than that of its own medical advisers, and of scientists generally.
In truth, it is not clear to anyone where this crisis is leading us. More than 20 experts in public health, medicine, epidemiology and history shared their thoughts on the future during in-depth interviews. When can we emerge from our homes? How long, realistically, before we have a treatment or vaccine? How will we keep the virus at bay?
Some felt that American ingenuity, once fully engaged, might well produce advances to ease the burdens. The path forward depends on factors that are certainly difficult but doable, they said: a carefully staggered approach to reopening, widespread testing and surveillance, a treatment that works, adequate resources for health care providers - and eventually an effective vaccine.
Still, it was impossible to avoid gloomy forecasts for the next year. The scenario that Trump has been unrolling at his daily press briefings - that the lockdowns will end soon, that a protective pill is almost at hand, that football stadiums and restaurants will soon be full - is a fantasy, most experts said.
“We face a doleful future,” said Dr. Harvey V. Fineberg, a former president of the National Academy of Medicine.
He and others foresaw an unhappy population trapped indoors for months, with the most vulnerable possibly quarantined for far longer. They worried that a vaccine would initially elude scientists, that weary citizens would abandon restrictions despite the risks, that the virus would be with us from now on.
“My optimistic side says the virus will ease off in the summer and a vaccine will arrive like the cavalry,” said Dr. William Schaffner, a preventive medicine specialist at Vanderbilt University medical school. “But I'm learning to guard against my essentially optimistic nature.”
Most experts believed that once the crisis was over, the nation and its economy would revive quickly. But there would be no escaping a period of intense pain.
Exactly how the pandemic will end depends in part on medical advances still to come. It will also depend on how individual Americans behave in the interim. If we scrupulously protect ourselves and our loved ones, more of us will live. If we underestimate the virus, it will find us.
More Americans may die than the White House admits.
COVID-19, the illness caused by the coronavirus, is arguably the leading cause of death in the U.S. right now. The virus has killed more than 1,800 Americans almost every day since April 7, and the official toll may be an undercount.
By comparison, heart disease typically kills 1,774 Americans a day, and cancer kills 1,641.
Yes, the coronavirus curves are plateauing. There are fewer hospital admissions in New York, the center of the epidemic, and fewer COVID-19 patients in intensive care units. The daily death toll is still grim, but no longer rising.
The epidemiological model often cited by the White House, which was produced by the University of Washington's Institute for Health Metrics and Evaluation, originally predicted 100,000 to 240,000 deaths by midsummer. Now that figure is 60,000.
While this is encouraging news, it masks some significant concerns. The institute's projection runs through Aug. 4, describing only the first wave of this epidemic. Without a vaccine, the virus is expected to circulate for years, and the death tally will rise over time.
The gains to date were achieved only by shutting down the country, a situation that cannot continue indefinitely. The White House's “phased” plan for reopening will surely raise the death toll no matter how carefully it is executed. The best hope is that fatalities can be held to a minimum.
Reputable longer-term projections for how many Americans will die vary, but they are all grim. Various experts consulted by the Centers for Disease Control and Prevention in March predicted that the virus eventually could reach 48% to 65% of all Americans, with a fatality rate just under 1%, and would kill up to 1.7 million of them if nothing were done to stop the spread.
A model by researchers at Imperial College London cited by the president on March 30 predicted 2.2 million deaths in the U.S. by September under the same circumstances.