Quicker lockdowns would have headed off the worst exponential growth in cities like New York and New Orleans, researchers say.
- May 21, 2020
ImageCredit…The New York Times
We now know that in early March, the pandemic was taking hold with a vengeance in the U.S. And without a vaccine, an effective therapy or widely available testing, the only way to fight it was by shutting down, staying home and keeping apart.
But from City Hall to the White House, many elected leaders hesitated to give the orders, with all the disruptions and hardships they would cause, until the mounting toll forced their hands.
Credit…Weiyi Cai/The New York Times
According to new estimates from Columbia University, if the U.S. had started social distancing measures one week earlier, about 36,000 fewer people would have died by early May. Make it two weeks, and about 54,000 lives — 83 percent — would have been saved.
Why? Because acting sooner would have headed off the worst exponential growth in cities like New York and New Orleans. The surge of severely ill patients who flooded hospitals in late March and April caught the virus in early to mid-March.
“That small moment in time, catching it in that growth phase, is incredibly critical in reducing the number of deaths,” said Jeffrey Shaman, an epidemiologist at Columbia and the leader of the research team.
That is why epidemiologists say that as states reopen, it’s vital to test widely, to monitor infections closely and to clamp down immediately on any new outbreaks. Waiting until people are visibly ill gives the virus too much time to spread.
The Columbia modelers’ estimates for the New York metropolitan area, the nation’s largest hot spot, were especially stark. The region recorded 21,800 coronavirus-related deaths by May 3. If it had shut down just a week earlier — on March 8, instead of in stages beginning March 15 — the toll would have been fewer than 4,300.
“Even slightly earlier action in New York could have been game-changing,” said Lauren Ancel Meyers, an epidemiologist at the University of Texas at Austin who was not involved in the research.
Not just the U.S.: A new study of blood donations shows that the virus was circulating widely in northern Italy in early February, at least two weeks before local cases were diagnosed there and regional lockdowns began. And there is evidence of the same in France, where a tissue sample taken from a patient on Dec. 27 recently tested positive for the coronavirus; the country did not lock down until March 17.
It may be the “second wave” everyone is worried about: New coronavirus cases have emerged in northeast China, prompting officials to impose many of the same draconian measures seen months ago in Wuhan, where the pandemic began.
The latest outbreak is concentrated in Jilin, a province of 27 million near the border with Russia and North Korea. This one is particularly worrisome because many of the patients have not traveled outside China. The numbers are not large yet — about 130 infections and two deaths have been reported so far — but experts warn that the situation could explode.
Thousands of people in Jilin have been quarantined, and tens of thousands are being tested. But the behavior of the virus in this part of China has complicated efforts to stamp it out: Symptoms are taking longer to appear than the usual one to two weeks, and people are carrying the virus longer, Chinese medical experts say.
As state health departments across the U.S. build contact tracing programs to try to contain outbreaks, they may want to emulate Paterson, a largely nonwhite working-class city in New Jersey.
Paterson’s approach is decidedly low-tech, relying on a few dozen employees who work the phones, calling anyone who may have come into contact with an infected individual and asking them to self-quarantine.
The tracers say it’s more an art than a science, gently persuading people to reveal intimate details of their lives. But it seems to work: The tracers have been able to successfully track about 90 percent of the city’s roughly 6,000 coronavirus cases.
Paterson had a lucky head start: It received a grant last year to train communicable-disease investigators. At the time, the main concern was a potential outbreak of a food-borne illness at one of the large catering halls in the city.
What are the symptoms of coronavirus?
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
How many people have lost their jobs due to coronavirus in the U.S.?
Over 38 million people have filed for unemployment since March. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
How can I protect myself while flying?
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Is ‘Covid toe’ a symptom of the disease?
There is an uptick in people reporting symptoms of chilblains, which are painful red or purple lesions that typically appear in the winter on fingers or toes. The lesions are emerging as yet another symptom of infection with the new coronavirus. Chilblains are caused by inflammation in small blood vessels in reaction to cold or damp conditions, but they are usually common in the coldest winter months. Federal health officials do not include toe lesions in the list of coronavirus symptoms, but some dermatologists are pushing for a change, saying so-called Covid toe should be sufficient grounds for testing.
How do I take my temperature?
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
Should I wear a mask?
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
What should I do if I feel sick?
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
How do I get tested?
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
How can I help?
Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.
Perry N. Halkitis, dean of the Rutgers School of Public Health, said it was impossible to know how much help contact tracing had been in containing the virus. But it “is one of the few tools that we actually have in the absence of a vaccine,” he said. And Paterson’s death rate has been lower than the state’s as a whole.
Stretch it out. Ease the aches and pains of working from home with simple exercises for your wrists, back, neck and arms.
Pick up a new hobby. Sales for how-to books have surged. Whatever D.I.Y. activity you’d like to explore — butchery, cheese-making, knitting — there is probably a title to guide you.
Visit the grandkids. One of the safer strategies is to reunite outdoors, with everyone, including children, wearing a mask. Some experts suggest keeping 10 to 12 feet apart if the grandparents are very elderly or have health issues.
The Department of Health and Human Services said it would provide up to $1.2 billion to the drug company AstraZeneca to develop a potential coronavirus vaccine. It’s the fourth and largest vaccine research agreement disclosed so far.
Coronavirus testing in the U.S. has been hampered by the fragmented health care system, which makes it difficult for hospitals to switch to new labs with spare capacity.
American nursing homes with significant numbers of black and Latino residents have been twice as likely to be hit by coronavirus outbreaks as nursing homes whose residents are predominantly white.
The Times’s Scratch column illustrates the new realities facing 14 public school teachers, who described the challenges of remote education in a pandemic.
I have an app that alerts me to when the International Space Station will be flying overhead at night. At each ping, I drop everything and head for the highest vantage point in my complex to watch it drift across the sky (or follow the path through my phone, if it’s cloudy).
— Holly Swenson, Winston-Salem, N.C.
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