World Health Organization (WHO) Director-General Dr. Tedros Adhanom Ghebreyesus stated, in a briefing last week, “Make no mistake, we have a long way to go. This virus will be with us for a long time…while social distancing measures put in place in numerous countries to slow the spread of the coronavirus have been successful, the virus remains extremely dangerous. Current data shows that most of the world’s population remains susceptible.”
During Monday’s briefing, Dr. Mike Ryan, in response to a Brazilian reporter’s question on his country’s decision to ease restrictions based on figures that are clearly underreported, stated that if countries begin the opening of their economies too quickly, it may have more dire consequences on the livelihood of the nation, as they would have to reimpose lockdown measures to mitigate a second acceleration of the outbreak.
Dr. Maria Van Kerkhove carefully noted that it was insufficient to base decisions to loosen these measures solely on the basis of case numbers and deaths alone. More importantly is the need to have a workforce in place to track contacts, to implement an expansive infrastructure to detect the location and movement of the virus, appreciate the status of hospitalization and critical care capacity, and have schools and workplaces reconfigured to begin slowly receiving people into these physical spaces. The entire population needs to be engaged, informed and cooperative with these processes. “It requires mental preparation,” Van Kerkhove said.
The director-general then added, in one of his rarer displays of measured bluster, that countries that have ignored the WHO’s advice have also been the ones hurt most by the pandemic. He repeated his prior admonition, in response to calls for his resignation over mishandling of the pandemic, that the WHO had made the highest declaration of emergency on COVID-19 on January 30.
At the time when the epidemic was predominately confined to Wuhan and Hubei province, there were only 82 cases outside of China, of which 10 were in Europe. There were no cases in Latin America or Africa. There were also no deaths outside of China. “Every country could have triggered all its public health measures possible,” he said. “I think that suffices the importance of listening to WHO’s advice. We advised the whole world to implement a comprehensive approach. Countries that followed these recommendations are in a better position than others. That is a fact.”
Globally the number of daily cases has been declining slowly since peaking at the beginning of the month and has now reached over 3.1 million cases. Nearly 1 million people have recovered from COVID-19. Similarly, the daily number of fatalities has seen a steady decline, with the number of total critical cases around 56,000. Country after country have been in some form of discussion to begin easing restrictions given these seemingly favorable developments.
However, as much as the response to the pandemic was of an improvisational character, the manner and approach to opening economies are disorganized, woefully unsystematic and grossly premature. Rather than heeding the advice of institutions like the WHO or their own public health officials and epidemiologists, the argument that the economy has suffered too much finds open and unapologetic expression among governors and political leaders.
The United States surpassed 1 million cases yesterday, with only 140,000 of its people recovered. Nearly 60,000 people have died, half in less than two weeks. Yesterday, there were again more than 25,000 cases and 2,500 deaths. Though states like New York and New Jersey find their number of cases and fatalities flattening or declining, several states have seen increasing daily trends, including Virginia, California, Illinois, Massachusetts, Maryland, Iowa, Minnesota and Delaware.
Illinois saw its single highest death toll, with 144 deaths reported in 24 hours, raising the state’s total deaths to 2,125. Many of these cases are occurring in northern Illinois and the Chicagoland area. Health officials say that the state has yet to approach its peak.
Iowa Governor Kim Reynolds has given some businesses in 77 of 99 counties permission to reopen, again with some caveats, which leave significant room for interpretation and are wholly unenforceable outside of large conventions and spectator events. Yet, the trend in daily cases has risen from approximately 100 per day two weeks ago to close to 400 per day. Nevertheless, the number of tests conducted daily has not increased dramatically, with rates of positive tests climbing.
There have been almost 6 million tests performed in the US, accounting for 17,688 tests per 1 million of the population. This week, the number of daily tests consistently approached near 200,000. Still, on average, 17.5 percent of all tests are positive, indicating that the US remains significantly behind on identifying the extent of the epidemic within its national borders. The White House’s health experts, Dr. Anthony Fauci and Dr. Deborah Birx, have expressed their concerns that adequate testing remains a necessary milestone in the White House’s phased approach to reopen the country.
In a bizarre exchange at Monday’s White House briefing, ABC’s Jon Karl asked Vice President Mike Pence, “You said, in March, we’d be at 4 million tests by the following week. We’ve just now got there in the last few days. So, what have you learned about what went wrong over the last month and a half or two months, and what’s going to go right now? What lessons have you learned from the mistakes?”
In a nonsensical and disingenuous response in the vein of Trump, Pence replied condescendingly, “I appreciate the question, but it represents a misunderstanding on your part and, frankly, a lot of the people in the public’s part about the difference between having a test versus the ability to actually process the test.” In the face of 60,000 deaths that need not have happened, in just one month, this response is not only insulting, but also shows callousness and disregard for the suffering of so many. This was not a benign slip of the tongue.