Discussion thread: Is the United States Ready for a Pandemic? Answered: No - March 26, 2020

[JimO]

At this point, I think it’s too late to slow it down much. With people being potentially contagious before showing symptoms, containment measures will always be a step behind. Also, when people refer to the “success” of the measures taken in China, they are assuming the Chinese government has released accurate information. I just don’t believe it and expect that they won’t report much on outbreaks outside Hubei Province.

[JJackson]

JimO you can not hide a virus outbreak with these symptoms for any length of time, regardless of how good how good your media control is, if you do not have it under control.

[Shiloh]

One slide in a leaked presentation for US hospitals reveals that they're preparing for millions of hospitalizations as the outbreak unfolds: https://www.businessinsider.com/pres...zations-2020-3

[Laidback Al]

One slide in a leaked presentation for US hospitals reveals that they're preparing for millions of hospitalizations as the outbreak unfolds: https://www.businessinsider.com/pres...zations-2020-3

According to statista.com, in 2017 there were only about 930,000 hospital beds in all of US. (link). These hospital beds have to be available for more than just coronavirus patients. If these estimates are true, the US will have a SEVERE shortage of hospital beds.

[Shiloh]

Well, so will Canada, which keeps insisting the threat is low at the moment. Likely, the same situation in many countries. China expelled non-Covid patients from hospitals...may well will happen in North America as well. Am sure, elective surgeries will be cancelled at some point. Likely people will die, who are non-Covid infected, due to delayed treatment. The world hasn't seen anything like this in 100 years. What we learn from this will be applied to the next pandemic...and that will come someday.

[Niko]

I find this shocking. Are we really at the point of no return?

"Can I be tested for COVID-19 at an EvergreenHealth Urgent Care or clinic?
In partnership with the CDC, we have updated our screening guidelines for COVID-19. We have halted performing nasopharyngeal testing in our outpatient clinics, including our urgent care locations.

Here’s why:
The CDC has determined that COVID-19 is now endemic, meaning that the virus is now considered to be regularly found in our region amongst our population. Previously, only individuals who had previously known risk factors (including history of travel, exposure to a confirmed case), were considered high risk for acquiring the disease. There is increased risk of transmission when performing any nasopharyngeal testing."

[Shiloh]

Apparently: https://www.nature.com/articles/d41586-020-00676-3

[Laidback Al]

I find this shocking. Are we really at the point of no return?

Niko, we reached the point of no return in late December, early January, when the Chinese could have been managed to contain the initial outbreak in Wuhan. It may have been the unwillingness of the Chinese to take immediate and public action at the time that has caused this world-wide problem.

[Niko]

I agree, the pandemic was inevitable. What I don't understand is why testing is suspended already in the hardest hit area of the USA? Isn't the data important or are there political reasons to stop testing? I know there is a very limited supply of test kits available with production still ramping up. However, are we just going to throw up our hands and stop testing?

[Niko]

Al, I agree the pandemic was inevitable. However, I don't understand the suspension of testing. Shiloh's link was helpful..obviously there is still testing being conducted.

[Niko]

Apparently: https://www.nature.com/articles/d41586-020-00676-3

Thanks Shiloh. That clarifies somewhat.
I'm struggling to keep up with the news and have friends and family who are asking questions due to my past participation on flutrackers and elsewhere.

[Laidback Al]

There is an astounding lack of understanding concerning a pandemic by TV pundits. It is not just an economic issue.

Everyone in America should be given the coronavirus so the economic impact of the outbreak can be lessened, CNBC on-air editor Rick Santelli suggested Thursday.

But what he left unsaid was that such an approach could result in more than 11 million Americans dead.

‘I’m not a doctor ... but maybe we’d be just better off if we gave it to everybody.’ — Rick Santelli

CNBC’s Rick Santelli suggests giving everyone coronavirus to spare the economy

[DataMom]

Santelli's ignorant statement advocates a practice that would realistically end in the demise of the elderly, disabled, and chronically ill. Hitler's agenda?

[Shiloh]

Maybe he agrees with the saying attributed to Stalin: One death is a tragedy; one million is a statistic.” People sometimes forget that we are talking about human beings- an individual's parents, grandparents, aunts and uncles.

[MHSC]

An update on Michigan, there are no cases yet, but they have only tested 27 people, 9 of which are still pending. The updates from the health dept have been painfully slow and there have been 8 pending cases for days, so we suspect there may be some positives in there that they are confirming with additional testing before they release that information. We are told that they don't have enough test kits, so testing candidates are still chosen based on travel to Italy, S. Korea, China and Iran, not a physicians order like other states. We were updated today that the new criteria for quarantine and for screening travelers has changed to 24 days vs. the previous 14 days. The state claims they will be ready to test more people by Monday, so I believe there will be confirmed cases next week.

[Shiloh]

One of the Canadian cases visited MI, IL and OH and was infected sometime during that travel.

[MHSC]

Shiloh, do you have a link for that?

[Laidback Al]

The back log of testing kits, for what ever reason, is now a tremendous problem. When testing become widely available we will see a jump in cases from hundreds to perhaps thousands. The average citizen will not understand why the numbers have increased so dramatically. I would think it is important for the government and mainstream media to start preparing the public for this increase in the number of infected people. Without making clear that this increase is only a reflection of what is really happening, we may again see the public panicking.

[Laidback Al]

How will US citizens respond to the COVID-19 pandemic?

We are asking in this thread if the United States (US) is ready to manage a full scale, nation-wide pandemic. In another thread, about two weeks ago, I posed questions about how will US citizens tolerate extended school closures, elimination of public sporting events, in-country travel restrictions, large scale quarantines, and rationing? These things are now coming to pass.

A number of schools and colleges are closed around the county. Several professional sports leagues have cancelled their remaining season. Local quarantines have been enacted and last night, President Trump unexpectedly announced travel restrictions from Europe. Such restriction will not slow the spread of the virus in United States, as it already has a large foothold in this country. In fact, the lack of test kits leaves the entire population uniformed about the extent of the epidemic here in the US.

News media are now reporting on the possibility of large-scale travel restrictions in the US.

Restricting travel in U.S. a 'possibility' if coronavirus pandemic gets 'too hot'

The internet is rife with of rumors about a nationwide shut. A nationwide shut would cripple the economy, would penalize workers and families of all levels of society, would probably cause extreme anxiety, and would not do anything to stop the spread of the coronavirus, especially if no one can be tested to know if they are infected or not. When will test kits be widely available?

It appears at this late date the US government has yet to develop a comprehensive pandemic plan that will restore the confidence of the general public and provide a clear path forward out of this crisis.

[sharon sanders]

I think the answer to the question in the title is: No.

A dreadful miscalculation on masks. This will cost lives. Everyone in the U.S. should have access to at least surgical masks to help stop the spread. They don't do much to protect the wearer but they can help keep people from spreading disease to others. We can't all stay in our house for the next 18 months. We need masks - yesterday. And don't start me on the need of masks for responders. It is criminal to send people into harm's way without the proper personal protection equipment.

From my perspective pandemic preparation hit the floor in 2008. The pandemic communication office was dismantled in about 2008/09. From what I could tell the entire pandemic apparatus was left to decay as the health focus became universal health care. As for FluTrackers, we lost all contact with anyone in the US government who had been working on pandemic preparedness - since 10+ years. No outreach. No nothing. We were even dropped off the CDC mailing list for a couple of years until I made an issue on twitter about it.

I know everyone wants to blame the current admin for lack of pandemic preparedness - but in reality the abandonment started in 2008/09. The current admin is not off the hook. It has a lot of blame for not responding fast enough once the situation became obvious in China. Who could have looked at the videos of what was happening there and not think to themselves - "Gee - this looks serious." After this is all over it will be productive to look at how we - the richest country in the world - wasted a valuable month not obtaining (or producing) needed supplies like masks and ventilators.

Back to the pandemic.......

[Laidback Al]

The United States Failure to Contain the COVID-19 Pandemic

Three weeks ago, I started a thread about the Three Things All Government Should do to Confront a Pandemic. Here is how the United States (US) Government is responding to these integral steps to protect the public from the pandemic.

1. Provide Accurate and Truthful Information

There is no evidence that since the start of this pandemic, the US government has presented clear, accurate, and authoritative information about the COVID-19 pandemic in the United States. News media are documenting the conflicting messages put out by various government and public health officials. The official health agency of the US government, the CDC, urged limits to public gatherings (link). After stay-at-home recommendations by public health officials, other government official were urging the public to visit bars and restaurants (link, link). And while the disease spreads in Florida and California, American citizens continued to flock to beaches and gather in large crowds (link, link). It should come as no surprised that the American public is confused when government officials make statements that “endanger public heath” (link).

2. Provide Supplies and Protection for Health Care Workers

Health care workers are the frontline defense against this war on COVID-19, not public officials or politicians. To do their jobs safely and to protect their own health and that of their patients health care workers need adequate supplies of Personal Protective Equipment (PPE) which includes masks, gowns, gloves, and other supplies. However, manufacturing of these critical supplies have moved overseas and there are not enough supplies in the US to protect health care workers (link).

Without secure supply chains, the risk to health care workers around the world is real," WHO Director-General Dr Tedros Adhanom Ghebreyesus said. "Industry and governments must act quickly to boost supply, ease export restrictions and put measures in place to stop speculation and hoarding."

March 5, 2020 (link).

Hoarding and speculation continue with these critical supplies even as the crisis worsens.

“I’ll contract with a company for 1,000 masks,” New York Gov. Andrew Cuomo said Sunday in his daily briefing. “They’ll call back 20 minutes later and say, ‘The price just went up,’ because they had a better offer.

March 22, 2020 (link).

Not only are PPE in short supply, but hospital facilities are being overwhelmed and there is no surge capacity from COVID-19 cases. Because of failed messaging, the US has been unable to convince people to help “flatten the curve” (link). In the coming weeks there will be needs all over the US for additional hospital space and specialized equipment, not to mention additional trained personnel. Anonymous nurses posting at Allnurse.com are already registering their concerns and fears about the COVID-19 pandemic and their individual ability to do their job and survive. The US government has failed to step in and protect health care workers and provide them with the supplies and facilities necessary to save their own and their patient’s lives.

Responding to requests from state governments for assistance in PPE, a US government official responded “Respirators, ventilators, all of the equipment — try getting it yourselves” March 16, 2020 (link).

3. Have a Clear Pandemic Plan

There still is no evidence that the US government has an overarching pandemic plan to protect the health and safety of its citizens. The last published plan was in 2007 entitled “National Strategy for Pandemic Influenza: Implementation Plan”(link). The document notes on page 32 that “This Plan will be updated on a regular basis to reflect ongoing policy decisions, as well as improvements in domestic preparedness (e.g., increases in the size of our domestic stockpile or vaccine production capacity).”

No further public updates have occurred.

On page 110 it states (link):

While a pandemic may strain hundreds of communities simultaneously, each community will experience the pandemic as a local event. In the best of circumstances, patients and health care resources are not easily redistributed; in a pandemic, conditions would make the sharing of resources and burdens even more difficult. The Federal Government is committed to expanding national stockpiles of both vaccines and antiviral medications and will provide these medical countermeasures as well as other available resources and personnel in support of communities experiencing pandemic influenza, but communities should anticipate that in the event of multiple simultaneous outbreaks, there may be insufficient medical resources or personnel to augment local capabilities. Additionally, manufacturers and suppliers are likely to report inventory shortages and supply chains may be disrupted by the effects of a pandemic on critical personnel. State, local, and tribal entities should thus anticipate that all sources of external aid may be compromised during a pandemic.

It is not clear that many US government officials have read this plan or are even aware it. Investigative journalists revealed that the current administration was briefed on a potential pandemic in 2017 (link).

The briefing was intended to hammer home a new, terrifying reality facing the Trump administration, and the incoming president’s responsibility to protect Americans amid a crisis.

But as many as two-thirds of representatives in that room are no longer serving in the administration, likely one reason this administration is struggling to handle the COVID-19 pandemic. The only current plan seems to be a 2 trillion dollar stimulus package (link) to provide life support to the economy. But there still appears to be no comprehensive effort to provide a life support plan for all US citizens to protect their health and well-being and prevent any unnecessary deaths.

Summary

About 25 days ago, there were only 30 cases reported in the US. The number has been increasing at an alarming rate ever since. Yesterday, the US was third only to Italy and China in the number of reported COVID-19 cases as depicted in the graph below. Within 24 hours the number of cases in the US will probably exceed those in China. It is only a matter of hours before the US becomes the country with the most COVID-19 infections in the world. It should be clear that the US has failed to contain the outbreak during the its early stages and was completely unprepared for this pandemic.

[Laidback Al]

The failure of the US government to send accurate messages about the threats of this disease has endangered the lives of thousands of Americans.

Not only has the US government failed to provide accurate health-related information to the American people, some government officials and news media outlets are now trying to purposefully undermine and discredit the top US government health expert, Dr. Anthony Fauci (link).

Already the Pew Research Center has documented a remarkable divergence of views about the coronavirus outbreak based on news consumption. Nearly two-thirds of Republicans who turn to sources that cater to right-leaning audiences said that news outlets have greatly exaggerated the pandemic, while 42 percent of Republicans who don’t follow such sources said the same.

The attempt to discredit Fauci draws on a resource for which Trump has professed his “love” — WikiLeaks.

History will pass judgement on how well prepared the US was for the COVID-19 pandemic.

[Daisy]

A good friend of mine has an office which looks out onto the railroad tracks in downtown Sacramento. She sent me this text today:
“Just watched loooooooong train going east loaded completely with military vehicles, a bunch with mash unit red crosses on them”

The tracks she was looking out on feed to the north and the east.

[Emily]

I guess we can look at that as being reassuring. There are other military movements with tanks that don't seem related to the pandemic response, but those medic units sure sound like they are.

https://www.latimes.com/california/story/2020-03-26/rows-of-tanks-national-guard-patrols-police-stops-officials-debunk-coronavirus-rumors