Covid Epi Weekly: One Step Forward, One Step Back
(Blog initially published on Tom Frieden’s LinkedIn account: https://www.linkedin.com/pulse/covid-epi-weekly-one-step-forward-back-tom-frieden/)
We’re seeing decreases in Covid cases and test positivity rates in much of the country. That’s good news. But there’s also been less testing, less information about how the virus is spreading, and impending explosions with schools and universities reopening.
“A single death is a tragedy, a million deaths is a statistic.” My primary concern is that people may become desensitized to the sheer number of deaths caused by the pandemic. Close to 200,000 people have been killed in the U.S. That’s staggering.
The positivity rate decreased from 5.5 to 5.1% nationally, which is progress. But we’re losing the ability to track the virus—new antigen tests are difficult to track, there’s been less testing overall, and there’s still no reliable information on who is being tested. We should be getting better information each week, but we aren’t.
Most of the US is still failing to contain Covid. There are too many cases to test, trace, isolate. Even in places with fewer cases, there’s very little tracking of actual outcomes of testing and contact tracing. We need to know the average number of days someone is infectious before isolation and the percentage of cases arising from among quarantined contacts. Tens of thousands of lives and millions of jobs depend on this.
It’s outrageous that we STILL don’t have reliable information on cases, hospitalizations, and deaths by week by race and ethnicity. Every place should report these numbers weekly. The disproportionate impact on Latinx and Black communities unacceptably high and indefensibly invisible.
Avoidable cases and deaths are heartbreaking. Avoidable economic decline is grinding. James Carville famously said, “It’s the economy, stupid!” Well, to get the economy back, “It’s the pandemic, stupid”. Unless we control the virus, we can’t get our jobs back.
Deaths matter most. The US will hit 200,000 deaths and the world will hit 1 million reported deaths in the next few weeks. Germany has had less than one-fifth the US death rate, Canada less than half, and South Korea 80 times less. Tens of thousands didn’t need to die from Covid. We certainly don’t want to be #1 in death.
On 9/11, I reflected on deaths. My group is called Resolve to Save Lives for a reason. But we risk getting hardened to tragedy. Ed Yong wrote a superb article on this phenomenon and more in The Atlantic. More than 1,000 Americans a day have died recently from Covid. Even at “only” 500 deaths a day in the U.S. this would represent:
More than all injuries
1.5x all Alzheimer’s deaths
2.2x all diabetes deaths
3x all overdoses
4x all suicide deaths
9x all homicides
32x all HIV deaths
In fighting the pandemic, communication matters. If the goal is to prevent panic and save lives, there’s a proven way of doing it: 1. Be first. 2. Be right. 3. Be credible. 4. Be empathetic. 5. Give people practical things to do to protect themselves, their family, and their community. Is it possible for the US national response to have violated these principles more than it did?
We can control Covid, but to do so we must chip away at it. Close the riskiest places. Mask up. Box the virus in (test, isolate, trace, quarantine). Improve ventilation. Every little bit can help, as long as there are a lot of little bits to get R<1 and keep it there. Vaccination can help if it's safe, effective, accessible, and trusted. IF.