Lost time and lost lives
We now know that in early March, the pandemic was taking hold with a vengeance in the U.S. And without a vaccine, an effective therapy or widely available testing, the only way to fight it was by shutting down, staying home and keeping apart.
But from City Hall to the White House, many elected leaders hesitated to give the orders, with all the disruptions and hardships they would cause, until the mounting toll forced their hands.
According to new estimates from Columbia University, if the U.S. had started social distancing measures one week earlier, about 36,000 fewer people would have died by early May. Make it two weeks, and about 54,000 lives — 83 percent — would have been saved.
Why? Because acting sooner would have headed off the worst exponential growth in cities like New York and New Orleans. The surge of severely ill patients who flooded hospitals in late March and April caught the virus in early to mid-March.
“That small moment in time, catching it in that growth phase, is incredibly critical in reducing the number of deaths,” said Jeffrey Shaman, an epidemiologist at Columbia and the leader of the research team.
That is why epidemiologists say that as states reopen, it’s vital to test widely, to monitor infections closely and to clamp down immediately on any new outbreaks. Waiting until people are visibly ill gives the virus too much time to spread.
The Columbia modelers’ estimates for the New York metropolitan area, the nation’s largest hot spot, were especially stark. The region recorded 21,800 coronavirus-related deaths by May 3. If it had shut down just a week earlier — on March 8, instead of in stages beginning March 15 — the toll would have been fewer than 4,300.
“Even slightly earlier action in New York could have been game-changing,” said Lauren Ancel Meyers, an epidemiologist at the University of Texas at Austin who was not involved in the research.
Not just the U.S.: A new study of blood donations shows that the virus was circulating widely in northern Italy in early February, at least two weeks before local cases were diagnosed there and regional lockdowns began. And there is evidence of the same in France, where a tissue sample taken from a patient on Dec. 27 recently tested positive for the coronavirus; the country did not lock down until March 17.
Unnerving flare-ups in China
It may be the “second wave” everyone is worried about: New coronavirus cases have emerged in northeast China, prompting officials to impose many of the same draconian measures seen months ago in Wuhan, where the pandemic began.
The latest outbreak is concentrated in Jilin, a province of 27 million near the border with Russia and North Korea. This one is particularly worrisome because many of the patients have not traveled outside China. The numbers are not large yet — about 130 infections and two deaths have been reported so far — but experts warn that the situation could explode.
Thousands of people in Jilin have been quarantined, and tens of thousands are being tested. But the behavior of the virus in this part of China has complicated efforts to stamp it out: Symptoms are taking longer to appear than the usual one to two weeks, and people are carrying the virus longer, Chinese medical experts say.
A model for contact tracing done well
As state health departments across the U.S. build contact tracing programs to try to contain outbreaks, they may want to emulate Paterson, a largely nonwhite working-class city in New Jersey.
Paterson’s approach is decidedly low-tech, relying on a few dozen employees who work the phones, calling anyone who may have come into contact with an infected individual and asking them to self-quarantine.
The tracers say it’s more an art than a science, gently persuading people to reveal intimate details of their lives. But it seems to work: The tracers have been able to successfully track about 90 percent of the city’s roughly 6,000 coronavirus cases.
Paterson had a lucky head start: It received a grant last year to train communicable-disease investigators. At the time, the main concern was a potential outbreak of a food-borne illness at one of the large catering halls in the city.
Perry N. Halkitis, dean of the Rutgers School of Public Health, said it was impossible to know how much help contact tracing had been in containing the virus. But it “is one of the few tools that we actually have in the absence of a vaccine,” he said. And Paterson’s death rate has been lower than the state’s as a whole.
What you can do
Stretch it out. Ease the aches and pains of working from home with simple exercises for your wrists, back, neck and arms.
Pick up a new hobby. Sales for how-to books have surged. Whatever D.I.Y. activity you’d like to explore — butchery, cheese-making, knitting — there is probably a title to guide you.
Visit the grandkids. One of the safer strategies is to reunite outdoors, with everyone, including children, wearing a mask. Some experts suggest keeping 10 to 12 feet apart if the grandparents are very elderly or have health issues.
What you’re doing
I have an app that alerts me to when the International Space Station will be flying overhead at night. At each ping, I drop everything and head for the highest vantage point in my complex to watch it drift across the sky (or follow the path through my phone, if it’s cloudy).
— Holly Swenson, Winston-Salem, N.C.
Let us know how you’re dealing with the outbreak. Send us a response here, and we may feature it in an upcoming newsletter.