American life as we know it has changed drastically over the past week, and today President Trump asked all Americans to work from home if they can and to avoid gatherings of more than 10 people.
The NBA, NHL and PGA, college basketball and other US sports have all suspended play. Nearly 20 states have closed schools for the next several weeks. Washington state, Ohio and Illinois have shut down all restaurants and bars, and the CDC has now recommended a ban on gatherings of 50 people or more.
COVID-19 cases and deaths occurring in other countries have surpassed mainland China for the first time, and the WHO said on March 14 that Europe is the new epicenter of the pandemic. In China, the aggressive measures that the country imposed lock-down cities and restrict travel have helped dramatically decrease the daily confirmed cases. At its peak in mid-February, China was reporting thousands of new cases a day. Yesterday, only 16 new cases were added.
As cases accelerate in Europe, Spain and France have joined Italy in enforcing a nation-wide shutdown, closing schools and universities, bars and restaurants and non-essential stores. On Sunday, Italy reported a record high of 3,597 cases and 398 deaths in a 24 hour period – far outpacing China. However, in Italy’s northern region where the outbreak first began cases appear to have slowed there, reinforcing what we have already witnessed in China, that with protective social distancing measures- trends can reverse.
It is important to reemphasize why social distancing measures matter and why Americans should abide by them. Closures help to reduce the attraction of being out and about in public by limiting opportunities for people to get together, thereby limiting the opportunity for the virus to spread in a community. This is done to help reduce the spread and protect those that are most at risk of getting severely sick.
When discussing how COVID-19 is different than the flu or any other type of virus, Dr. Anthony Fauci, America’s top infectious disease expert and at the forefront of the government’s coronavirus response team, emphasized how quickly the disease spreads and the high morbidity/mortality rate among those in the high-risk category.
In one study using data from the CDC (image above) the Case Fatality Rate (CFR – the number of deaths divided by the number of cases) in China from the start of the disease until February 11 shows 6% CFR for persons aged 60 and older, a 4-7% increase over US 2018-2019 flu-related deaths in the same age group. However, these are very early studies and the dominator (disease circulation) is unknown, and the CFR could decrease as more cases and recoveries are reported. The takeaway is this – individuals aged 60+ should begin stringent social distancing measures immediately.
Dr. Fauci has suggested an aggressive 14-day national quarantine may be needed while acknowledging a worst-case scenario where hundreds of thousands could die.
Eric Ossmann, MD, FACEP, the founder and senior medical advisor for VIGILINT reinforces social distancing measures for all Americans:
“With the arrival of COVID-19 in the United States, our public health and acute care health systems will be severely tested. Broad and comprehensive social distancing is the essential strategy to limit the spread and severity of this disease. Communities that fully embrace this strategy will likely be able to attenuate the impact of COVID-19.”