1/16 A thread on how epidemiologists believe the coronavirus may play out, in best- and worst-case scenarios, drawn from my new column exploring virus mutation, weather effects and our actions: nyti.ms/3a5IvY5
2/16 “The best case is that the virus actually mutates and dies out,” says epidemiologist Larry Brilliant. In contrast to life in the movies, real viruses usually mutate to become less lethal.
3/16 #Covid19 might slow in the summer in the Northern Hemisphere because of warmer tempertures. But coronaviruses like SARS and MERS did not have clear seasonality, nor do two of the four coronaviruses that cause the common cold. We just don't know.
4/16 The coronavirus is not invincible: China, Singapore, Hong Kong, Taiwan, South Korea and to some extent Japan have shown that it can be controlled. Sadly, the US fumbled the early response and is not on South Korea’s trajectory, but on Italy’s -- eight days behind.
5/16 Unfortunately, the US has fewer doctors per capita than Italy, and fewer hospital beds. Even in the best of times, the US has shorter life expectancy than Italy.
6/16 One study showed that the coronavirus is doubling its number of cases more rapidly in the U.S. than in any country studied, including Italy and Iran.
7/16 One bit of encouragement: Washington State has done lots of testing, and the number of new positive tests there seems to have stabilized.
8/16 Many antivirals are in trials with coronavirus patients, with more drugs in the wings, and some may help with Covid and potentially even offer prophylaxis. No one knows, but they potentially could arrive before a vaccine.
9/16 The worst case scenario for the US from the master of epidemiology modeling, Dr. @neil_ferguson, is 2.2 million deaths. His best case is 1.1 million deaths – and that may be even scarier, considering it’s the optimal outcome.
10/16 In WWII, a single Ford plant produced B-24 bombers at a rate of one every 63 minutes. There’s nothing like the same urgency today toward #Covid_19 – so we have appalling shortages of protective gear for medical staff.
11/16 The CDC has put out official guidance for doctors so that they can make their own masks when supplies run out. In the richest country in the history of the world, spending $10k per capita on health care, we have almost no masks! This is unimaginable. And unforgivable.
12/16 One doctor in Seattle, forced to reuse N95 masks, told me that she and colleagues, just in case, are getting ready to die: “Wills, backup people to take care of kids, recording bedtime stories.”
13/16 After early missteps, China put in place tougher protective clothing protocols than the US (double gown, double gloves). Of 42,000 health workers sent to Wuhan, none is known to have been infected. In contrast, the US has pretty much abandoned front line health workers.
14/16 Another sign of US passivity: Dr. @PeterHotez, an eminent vaccine scientist, tells me he and a team have a candidate vaccine against Covid19 – but they haven't been able to arrange sufficient funding to put it in trials.
15/16 The US is taking some steps, such as passing a new law providing paid sick leave – but it guarantees sick leave to only one-fifth of American workers. Sigh. It's an example of the gaps in the US that undermine our response.
16/16 Whatever happens with this coronavirus, the Big One is coming. It may be this time, or it may be an avian flu years from now. But we must bolster public health and prepare for a lethal pandemic. Thank for reading; here’s my column behind this thread nyti.ms/3a5IvY5
