Coronavirus will radically alter the US
When Jason Christie, chief of pulmonary medicine at Penn Medicine, got projections on how many coronavirus patients might soon be flocking to his Philadelphia hospital, he said he felt physically ill.
"My front-line providers - we were speaking about it in the situation report that night, and their voices cracked," Christie said on Wednesday. They saw how quickly the surge would overwhelm the system, forcing doctors to make impossible choices - which patients would get ventilators and beds, and which would die.
"They were terrified. And that was the best-case scenario."
Experts around the country have been churning out model after model - marshaling every tool from math, medicine, science and history - to try to predict the coming chaos unleashed by the new coronavirus and to make preparations.
At the heart of their algorithms is a scary but empowering truth: What happens next depends largely on us - our government, politicians, health institutions and, in particular, 328 million inhabitants of this country - all making tiny decisions on an daily basis with outsize consequences for our collective future.
In the worst-case scenario, America is on a trajectory toward 1.1 million deaths. That model envisions the sick pouring into hospitals, overwhelming even makeshift beds in parking lot tents. Doctors would have to make agonizing decisions about who gets scarce resources. Shortages of front-line clinicians would worsen as they get infected, some dying alongside their patients. Trust in government, already tenuous, would erode further.
That grim scenario is by no means a foregone conclusion - as demonstrated by countries like South Korea, which has reduced its news cases a day from hundreds to dozens with aggressive steps to bolster their health system.
If Americans embrace drastic restrictions and school closures, for instance, we could see a death toll closer to thousands and breathe a national sigh of relief as we prepare for a grueling but surmountable road ahead.
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Doing that will require Americans to "flatten the curve" - slowing the spread of the contagion so it doesn't overwhelm a health-care system with finite resources. That phrase has become ubiquitous in our national conversation. But what experts have not always made clear is that by applying all that downward pressure on the curve - by canceling public gatherings, closing schools, quarantining the sick and enforcing social distancing - you elongate the curve, stretching it out over a longer period of time.
Success means a longer - though less catastrophic - fight against the coronavirus. And it is unclear whether Americans - who built this country on ideals of independence and individual rights - would be willing to endure such harsh restrictions on their lives for months, let alone for a year or more.
This month began with U.S. officials recommending actions such as hand-washing and social distancing. By Sunday, the Centers for Disease Control and Prevention was warning against gatherings of 50-plus people. By Monday, President Donald Trump had made an abrupt turn from encouraging Americans to go on with their lives, to urging them to work from home, not meet in groups of more than 10, and calling on local officials to close schools, bars and restaurants. (Getting the public to comply has been alarmingly difficult. Young revelers from Bourbon Street to Miami have ignored those pleas, as have some elderly, who are at highest risk.)
Trump's sudden shift was driven by an alarming new scientific model, developed by British epidemiologists and shared with the White House. The scientists bluntly stated the coronavirus is the most serious respiratory virus threat since the Spanish Flu of 1918. If no action to limit the viral spread were taken, as many as 2.2 million people in the United States could die over the course of the pandemic, according to epidemiologist Neil Ferguson and others at the Imperial College Covid-19 Response Team.