Nearly 10,000 Americans were identified as positive for coronavirus Sunday, the biggest one-day increase in the global epidemic, and more than 100 people died, the worst day of mass casualties in the United States since the 9/11 attacks.
The US figures are alarming, with a record 9,418 new cases in one day. Of the 42,964 cases, the state of New York has 20,875 cases, registering 5,085 new cases yesterday. As of Monday, the US toll trailed behind only Italy, with 63,027 (and more than 6,000 deaths) and China, with 81,271 cases and more than 3,000 deaths, but few new cases since the spread of the epidemic was halted last month.
In a revealing statement made on Twitter, Tom Bossert, former homeland security adviser to President Trump, wrote, “Sadly, the numbers now suggest the US is poised to take the lead in the number of coronavirus cases. It’s reasonable to plan for the US to top the list of countries with the most cases in approximately one week.”
Bossert criticized the government’s inept response to the pandemic on ABC's “This Week,” stating that the US needed greater testing capacity mobilized earlier to prevent the whole country from shutting down. He warned that the health system in New York City would soon be overwhelmed.
This assessment was corroborated by the mayor of New York, Bill de Blasio, who indicated that if more ventilators weren't made available to the city’s 11 public hospitals, the mortality rate would begin climbing. “We can get through this week [emphasis added] with the equipment and supplies we have. That's the blunt reality. We will get to a point where people can't be saved who could have been saved.”
New York Governor Andrew M. Cuomo, visibly shaken by recent events, issued an emergency order yesterday requiring all hospitals to increase bed capacity by at least 50 percent. On Sunday, President Trump announced that he had approved Cuomo's request to issue a federal disaster declaration for the state, allowing the mobilization of the National Guard with federal financing.
The New York Times reported that more than 78,000 people have finally been tested in the state, accounting for one-quarter of all tests across the nation. The rate of testing in New York has reached 16,000 per day and has led to a huge increase in the number of people identified as infected with coronavirus.
A call to volunteer services has brought forward 30,000 retired doctors and health care professionals. There has been some headway in obtaining personal protective equipment, and the city is to receive 169,000 N95 masks. Though Queens has the highest number of cases of any borough, Staten Island has the highest rate of new infections, with 172 cases per 100,000 residents.
New Jersey has overtaken California as the second-worst state, with 2,844 cases, an increase of 930 in a single day. Other states with distressingly high totals include California, 2,065 (+310)), Washington, 1,996 (+203), Michigan, 1,328 (+293) and Louisiana, 1,172 (+335). Every state in the nation has taken some measures to impose social distancing, closure of nonessential businesses or stay-at-home orders.
Surgeon General Jerome Adams issued a grim prognosis Monday: “I want America to understand this week, it’s going to get bad. I think there are a lot of people that are doing the right things. I think unfortunately we're finding out a lot of people think this can't happen to them. Everyone needs to act as if they have the virus right now, test or no test. We need you to understand you could be spreading it to someone else or you could be getting it from someone else. Stay at home.”
These comments seem calculated to blame a skyrocketing death toll, which Adams clearly anticipates, on the behavior of the American people, particularly young people, rather than on the deliberate policies of the Trump administration of which the surgeon general is a part. (Adams is a right-wing figure, brought from Indiana by Vice Mike President Pence).
Adams was challenged on NBC’s "Today" show by host Savannah Guthrie, who pointed to the contradiction between his ominous forecast and Trump’s claims that “the cure is worse than the disease” and that restrictions like social distancing should be phased out quickly.
Citing Trump’s statement, Guthrie said, “It sounded like the president was at least considering ending these measures after the 15-day period; that sounds like what we're doing to stop it is worse than the virus itself. Where do you come down on that?”
Adams simply evaded the issue, claiming, “As the nation's doctor, I’m here to help America understand how we need to respond to this, and where I come down is that every single day counts. Every single second counts, and right now, there are not enough people out there taking this seriously.”
In other words, if people die, it’s not the fault of the Trump administration—although Trump’s policies have deliberately facilitated this horrific outcome.
According to Dr. Ashish Jha of the Harvard Global Health Institute, “In almost every way, our response has been far less effective than every other major country in the world. It's baffling. We have, in the CDC, arguably the best public health agency in the world. All of us thought that the CDC was going to—was prepared and was going to help fight this virus. The federal response has been a fiasco. We knew two months ago this pandemic was coming. Everybody knew. The entire public health community knew. The federal government knew that this pandemic was coming. And there has been one mistake after another.”
Health care workers are caught in the frontlines of this calamity. Without proper equipment and with an insufficient supply of protective gear, they place themselves at an ever increasing risk of contracting the infection, falling ill or becoming new vectors for the pandemic by infecting colleagues, patients and their families.
An Italian emergency room physician, Dr. Davide Bova, wrote ominously on conditions at his hospital on social media: “They are, and we are in pieces. We are getting sick. We are few, and we average 80 patients waiting to be admitted to the ER. Thursday night, I, alone, was in charge of 40 patients. It is inhuman for them, and for us, for their families and our families.”
China's National Health Commission reported that approximately 3,300 health care workers had been infected by early March. At least 22 had perished. Reports from Italy note that about 20 percent of health care workers have been infected and some have died. They are faced not only with personal health risks, but the physical exhaustion and mental anguish of deciding who will benefit from treatment and who must be denied ventilation, decisions applied equitably between their patients and afflicted colleagues.
Dr. Adam Levine, an emergency room physician and associate professor of emergency medicine at Brown University in Providence, Rhode Island, wrote: “Taking care of yourself also means that you must first protect your own health when you are tending to your patients. This means taking those extra few minutes, no matter the urgency of the situation, to be certain that you put on your protective equipment correctly, and that your team members have done the same. Be even more careful when you remove the equipment, so you don't contaminate yourself or others in the process.”
Using his experience in fieldwork during the 2014 Ebola epidemic, he counseled that US health care workers will be facing a situation with which they are not familiar—a resource-limited setting. They will have to come to terms about how to ration care as a form of duty to their patients; they have an obligation to be stewards of their limited resources. Specifically referencing ventilator shortages, he advised that physicians and hospitals should be prepared to prevent treatment biases that would introduce inequities in who will receive life-saving measures. These measures would have to be transparent and shared with patients, families and the general public.
It is criminal that health workers’ safety is not ensured through efforts to provide them with the necessary means to work safely. These also include provisions for rest, food and family support. Trump is offering ventilator support to the financial markets in the form of trillion-dollar bailouts, while now threatening to send workers back to work to resuscitate the rotting corpse of capitalism.