The death toll and infection toll from COVID-19, the disease caused by the coronavirus epidemic, is skyrocketing across the major countries of Western Europe, with hospitals filled to bursting. Italy, Spain and France are all on lockdown, and emergency measures are in effect in most other countries.
On Friday, the World Health Organization declared that Europe, rather than China, was now the epicenter of the pandemic. Italy is under the greatest strain with 24,747 cases and over 1,800 deaths—a far greater toll, in proportion to the population, than in China, where the epidemic has begun to subside after reaching 80,649 cases and more than 3,000 dead.
The United States, however, could well become the next epicenter of the pandemic, as the deliberate failure of the Trump administration to conduct any effective response opens up the American population to losses in the millions of lives. In a blunt exchange on the Sunday CNN program State of the Union, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, was asked, “There have been estimates of hundreds of thousands of people in the U.S. who could die or, in the worst-case scenario, millions. Can you tell the American people that that is possible?” He replied, “It’s possible.”
The WHO warned Friday that, given the inaction on the part of many countries to initiate measures to contain the pandemic within their borders, “any country that looks at the experience of other countries with large epidemics and thinks ‘that won’t happen to us’ is making a deadly mistake.”
President Trump was not concerned about the potential loss of millions of lives, however, but about the pumping of trillions of dollars into the financial markets. On Sunday afternoon, in his opening remarks at a White House press briefing on the pandemic, rather than speaking to the health crisis and fears of the American people, he congratulated the Federal Reserve for dropping their interest rates from 1.25 to 0.25 percent before Asian markets were to open. The Fed also made $700 billion in financial support available, on top of the $1.5 trillion provided last week.
The White House is also interested in gaining an edge in the race to develop a vaccine against possible competitors, hoping, according to a report in the German newspaper Die Welt, to develop a vaccine that would cure coronavirus “but for the US only.” This is the sinister significance of Trump’s offer of “large sums of money” to the German medical company CureVac to get exclusive rights to their work on a cure for COVID-19. It was not spelled out whether the motivation was to gain a commercial advantage, or the power of life and death over strategic rivals, or both.
The state of the pandemic, by all credible accounts, is racing ahead towards a disaster for millions. By Sunday, there were 167,638 cases of COVID-19 globally. The number of infections outside of China now exceeds that in China, which has 80,849 cases. Of the 76,219 patients that have recovered from the disease, 66,931 are in China. That means there are presently 80,658 active infections, the majority in Europe and Iran, of which 5,655 have been deemed severe or critical.
The number of deaths due to COVID-19 now stands at 6,456. Italy, Iran and now Spain have high daily rates of new deaths, running at or above 4 percent. Other nations like France, Germany and the UK, in the early phases of the pandemic, have fatality index rates that are at 2.5 percent or less. Switzerland reported a daily total of 842 new cases as it joins a list of nations that are seeing a catastrophic rise in new cases.
The reasons for such divergence from one country to another are complex. They involve the general health and age of the population, the unknown number of infected in the community due to limitations on testing, as well as the strain that is being placed on the health care system.
The speed of the pandemic is remarkable. Only four weeks ago, on February 20, a 38-year-old Italian man was the first known victim in that country of COVID-19. The local outbreak in the Lombardy region quickly spiraled out of control over the next two weeks. The number of new cases exploded, followed by an alarming number of deaths. Finally, on March 12, the whole country was placed in lockdown.
Meanwhile, the health care system has been imploding as new cases continue to arrive through the emergency department doors. Roberto Cosentini, at Pope John XXIII Hospital in Bergamo, said, “It’s like a wave. We now have around 60–80 new COVID-19 patients per day coming to the emergency. Most of them are in severe condition, and they arrive all together between 4 and 6 p.m. We learned that the respiratory distress worsens at the end of the afternoon, and we now know that we will have to deal with most of the severe cases showing up one after another in a short time, every day.”
The clinical experience with the pandemic in Italy is far more concerning even than in China. According to JAMA Network, the proportion of ICU admissions represents 12 percent of all positive cases and 16 percent of all hospitalized patients. By contrast, in China, only 5 percent who tested positive for COVID-19 required ICU admission.
Health care professionals in northern Italy have been working day and night for the last three weeks without an end in sight. Approximately 350 have become infected, and some have died. Francesca Mangiatordi, a nurse at a hospital in the northern town of Cremona, told Italian television, “We are on our last legs, physically and physiologically.”
Spain, with 7,753 total cases and 1,362 new cases over a twenty-four-hour period, is the second worst-hit country in Europe. It has restricted the public’s movement to buying essential goods, medical attention or work. Yesterday, 95 new deaths raised the tally to 291. According to Prime Minister Pedro Sanchez, all museums, cultural centers and sports events will remain closed until further notice.
France, with 4,499, Germany, with 5,795, and the UK, with 1,372 cases, are experiencing similar accelerations in new COVID-19 infections. However, their death tolls have remained thus far much lower than Italy’s with the UK at 2.6 percent fatality. The disease vector is continuing into Ireland and Scotland, where authorities have reported 214 and 153, respectively. The Scottish government is scrambling to double the capacity of their intensive care units to 380 beds.
Germany and France have desperately turned to domestic suppliers and surveying national stockpiles in anticipation of shortages. Germany has approximately 28,000 intensive care beds, of which 25,000 are fitted with ventilators. They have 25 critical care beds per 100,000 people. By comparison, Italy has half that capacity, the UK, a quarter. Britain’s health secretary Matt Hancock told the Financial Times that the National Health Service had around 5,000 ventilators but needed many times more.
These countries are in dire straits, but the conditions in the United States could become far worse as the coronavirus spreads through the population, given the poorer state of the public health infrastructure and the disorganized and profit-driven response of the authorities.
The White House reported Sunday that there are currently 3,400 cases (457 new cases) and 63 deaths. The millions of test kits that were promised have morphed into thousands that would sooner or later become available through the “public-private initiative.” Dr. Fauci was allowed to make a few understated comments concluding with “things would get worse,” but neither he nor other officials nor the media discussed the potential death toll.
There has been little coordination between the federal government, the 50 states and the various local authorities and school districts responsible for monitoring and reacting to the epidemic. The result has been a patchwork of responses, with all public schools shut down in a dozen states, but not in the others; bars and restaurants closed in some states but not in others; and governors banning gatherings of more than 100, more than 250, or more than 500, or imposing no restrictions.
The Centers for Disease Control issued a recommendation Sunday for a nationwide ban on gatherings of more than 50 people at one time. But the CDC added, “This recommendation does not apply to the day to day operation of organizations such as schools, institutes of higher learning, or businesses.” Given that most colleges are already shut, and most public schools will soon be, this is a green light for the continued operation of factories and other large workplaces, regardless of the impact on the health of the workers involved—a further indication of the primacy of corporate profits over public health.