“This is the biggest public health crisis in a century,” Director of Centers for Disease Control Robert Redfield said bluntly Thursday.
In fact, Redfield sees the upcoming flu season in Dickensian terms.
“It depends on how the American people decide to respond. It really is really the worst or best times, depending on the American public,” he said, paraphrasing the opening of Charles Dickens’ classic. A tale of two cities.
The current pandemic, coupled with the upcoming flu season, could create “the worst decline, from a public health perspective we have ever had,” the CDC director said in an interview with WebMD.
On which side of the scale will the US fall? Redfield said it depends on how Americans constantly wear face masks, stand 6 feet apart, wash their hands and avoid crowded gatherings.
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“I’m not asking some of America to do it – we all have to do it,” Redfield said. Somewhere between 95 and 99 percent of Americans will have to follow instructions for the U.S. to escape disaster, he said.
The scenario that health experts warn about is the accumulation of the flu season at the top of an already widespread and active pandemic, the prevailing hospitals and resulting in much greater deaths as people were unable to heal.
One person who does not hope for the country’s ability to escape a catastrophic decline is the country’s best infectious disease expert, Dr. Anthony Fauci.
“When you look at other parts of the country,” said Fauci of regions that have not yet experienced large spikes, “this is what worries me: We are starting to see scratch staining in the percentage of tests that are positive.”
This, as the country reported 1,500 deaths from COVID within a day for the first time since May.
“We know now, from the sad experience of the past, that it is a predictor that you will have more uplift,” Fauci said during a panel discussion held by National Geographic.
“The end is,” he said, “I’m not happy with the way things are going.”
So how many Americans have worn masks? Are we somewhere close to 90 percent compliance?
A Poll Gallup released exactly a month ago found that 44 percent of American adults say they “always” wear a mask when they are out of their homes, and 28 percent say they do so “very often.” At the same time, three in 10 report doing so less frequently, including 11 percent “sometimes”, 4 percent “rarely” and 14 percent “never”.
According to Johns Hopkins, the U.S. on Thursday saw 55,910 new cases and 1,499 new deaths from the virus. Given the lack of testing and contact tracking, it is likely that those numbers are below values.
A recent analysis by the New York Times looking at above-average deaths across the country found very clear spikes of additional deaths that followed the spread of the virus. According to the Times estimate, at least 200,000 more people than usual have died in the country since March. This is with many Americans locked inside, not going to work and just making trips abroad for groceries.
So what does “the worst decline, from a public health perspective we’ve ever had” look like?
The Spanish flu pandemic of 1918 was the deadliest pandemic in history. One third of the world’s population was infected. The virus has killed an estimated 50 million people worldwide, including some 675,000 people in the United States. This was at a time when the American population (in 1917, pre-eruption) was 103 million.
The population of the country in 2019 was more than 3 times that, at 328 million. The current epidemic has already claimed 165,000 American lives.
The lead author of a new study published Thursday in the medical journal JAMA Network Open, Dr. Jeremy Faust, says COVID-19 “has 1918 potential”. Faust is a physician at Brigham and Women Hospital and an instructor at Harvard Medical School.
“If not treated enough, SARS-CoV-2 [the virus that causes COVID-19] the infection may have comparable or greater mortality than the 1918 H1N1 flu virus infection, “according to the study.
During the “Spanish” flu pandemic, the greatest loss of life occurred in just 6 weeks between mid-November and late December. One-third of virus deaths in America occurred during that period.
It’s very likely that the worst of times can still happen.