The novel coronavirus outbreak in the U.S. will last at least 18 months and “could include multiple waves of illness,” prompting “significant shortages” for consumers and overwhelming the healthcare system, a federal government contingency plan leaked to the media this week warned.
President Donald Trump’s anti-coronavirus plan, dated March 13 and delivered to policymakers, echoed the findings of a March 16 report by the U.K.’s Imperial College, which also found that the outbreak could “potentially” last “18 month or more” in the U.S. and strain the healthcare system “many times over.”
The Imperial College’s epidemiology report reportedly helped push the Trump administration to escalate its efforts to combat the deadly and highly contagious disease, the New York Times reported Tuesday, citing unnamed American officials.
Jeremy Young, an assistant professor at Utah’s Dixie State University, broke down the Imperial College team’s findings on Twitter.
We can now read the Imperial College report on COVID-19 that led to the extreme measures we've seen in the US this week. Read it; it's terrifying. I'll offer a summary in this thread; please correct me if I've gotten it wrong.https://t.co/AwE2cHIbeJ
— Jeremy C. Young (@jeremycyoung) March 17, 2020
While Trump’s anti-coronavirus plan does not provide any information on infection fatalities, the Imperial College team predicted that the more intensive and socially disruptive the intervention measures are, the fewer people will die.
The Imperial College team was able to make its predictions by entering coronavirus infection and death rates from China, South Korea, and Italy into epidemic modeling software and running simulations of what can happen in the United States.
Even with three months of a combination of social distancing of people over 70, the isolation of suspect cases, and having their families quarantined — described as the mitigation strategy — there would be “1.1-1.2 million” deaths in the United States, and the health system would be “overwhelmed many times over,” Imperial College found.
Mitigation would slow but not necessarily stop the spread of the virus, “reducing peak healthcare demand while protecting those most at risk of severe disease from infection,” the researchers explained in the report.
This mitigation strategy is what you've seen a lot of people talking about when they say we should "flatten the curve": try to slow the spread of the disease to the people most likely to die from it, to avoid overwhelming hospitals.
— Jeremy C. Young (@jeremycyoung) March 17, 2020
Reducing the case numbers to low levels or eliminating human-to-human transmission, described as the suppression strategy, would require social distancing of the entire population, combined with home isolation of cases and the quarantine of their family, as well as shutting down public gatherings and most work places in addition to school and university closures.
The intervention measures required for suppression would have to remain in place until a vaccine becomes available in 12-18 months or more.
During those 18 months, things are going to be very difficult and very scary. Our economy and society will be disrupted in profound ways. And if suppression actually works, it will feel like we're doing all this for nothing, because infection and death rates will remain low.
— Jeremy C. Young (@jeremycyoung) March 17, 2020
With the suppression strategy, fatalities would peak at a few thousand deaths, then go down. Imperial College warned that transmission would “quickly rebound if interventions are relaxed.”
Suppression works! The death rate in the US peaks 3 weeks from now at a few thousand deaths, then goes down. We hit but don't exceed the number of available ventilators. The nightmarish death tolls from the rest of the study disappear.
— Jeremy C. Young (@jeremycyoung) March 17, 2020
After the 1st suppression period ends in July, we could probably lift restrictions for a month, followed by 2 more months of suppression, in a repeating pattern without triggering an outbreak or overwhelming the ventilator supply. Staggering breaks by city could do a bit better.
— Jeremy C. Young (@jeremycyoung) March 17, 2020
If nothing is done to break chains of transmission, coronavirus-related fatalities will reach “2.2 million in the US, not accounting for the potential negative effects of health systems being overwhelmed on mortality,” the Imperial College report said.
About 80 percent of the population would also be infected by the virus absent any action, the report added.
Here's what would happen: 80% of Americans would get the disease. 0.9% of them would die. Between 4 and 8 percent of all Americans over the age of 70 would die. 2.2 million Americans would die from the virus itself.
— Jeremy C. Young (@jeremycyoung) March 17, 2020
Asked when can Americans expect their lives to go back to normal during a press conference Thursday, Trump did not provide a specific time frame.
“I hope very soon. We’ll see. This is uncharted territory,” he said.
Echoing the Imperial College report while briefing reporters alongside Trump, Dr. Deborah Birx, the coordinator of the White House Coronavirus Task Force, declared:
[Modeling studies show] that if you add these things [intervention measures] together, they have a bigger impact than separately. And so those are part of the decision-making. We had a whole group of modelers in yesterday. They’re compositing all the data together to look at this carefully because everyone has those same questions of what the impact [of the intervention measures] will be and what pieces could essentially be removed, and you still have the same level of impact in decreasing the spread of the virus.
The absolute key to this, though, is every single American looking at the President’s guidelines and taking it seriously.
Birx noted that state and local governments will ultimately decide how long the intervention measures will be in place.
Trump and Birx acknowledged that Americans are pulling together as a nation to combat the coronavirus and for the most part doing what they are supposed to be doing when it comes to following guidelines to hinder the spread of the virus.
The U.S. public may have to resign itself to over one million deaths (mitigation strategy) given that reducing the number of cases to the least amount possible (suppression strategy) may be unrealistic because of the detrimental impact 18 months or more of intervention measures will have on the economy.
Imperial College acknowledged that imposing non-pharmaceutical interventions (NPIs), such as social distancing and quarantines, for 18 months or more would be an unprecedented feat that would have a “profound” impact on society and the economy.
“We emphasize that is not at all certain that suppression will succeed long term; no public health intervention with such disruptive effects on society has been previously attempted for such a long duration of time. How populations and societies will respond remains unclear,” the report said.
Nevertheless, it concluded that “epidemic suppression is the only viable strategy at the current time.”
The U.S. healthcare system will be overwhelmed even if the United States takes the less restrictive route to stem the spread of the coronavirus.
Under the most optimistic mitigation strategy, the Imperial College noted, “The surge limits for both general ward and ICU [intensive care unit] beds would be exceeded by at least 8-fold.”
The Trump administration issued its 100-page plan on Friday, the same day the president declared a national emergency.
Consistent with the Imperial College report, the plan presented a grim prognosis for the spread of the disease and highlighted a response that would require action from agencies across the U.S. government and possibly employing special presidential powers to mobilize the private sector.
Trump has already announced that he would use the Defense Production Act of 1950 to address severe shortages of supplies needed for combating the coronavirus outbreak in the U.S.
The Cold War-era law forces the American industry to intensify the production of essential equipment and supplies — ventilators, respirators, and protective gear for healthcare workers.
Besides a vaccine, the U.S. is also working on developing other medicinal therapies to combat coronavirus symptoms that could take a few months to disseminate, Trump’s coronavirus task force indicated on Thursday.
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