Donald Trump delivered much-needed good news to the American people this week. Coronavirus, he told Fox Business, was “just going to disappear”.
The US president didn’t specify when this vanishing act would take place. One thing is certain, though: it’s not now.
The virus is spreading through a vast area of the American hinterland at a speed not seen since the pandemic began. Across the south and west, and even into California, which had been considered a shining light in its handling of Covid-19, alarm bells are ringing once again.
Hospitals are filling up, ICUs reaching capacity, protective gear falling short. It’s like April all over again, with the ominous difference that this time many Americans are fed up with lockdowns and, with Trump’s warm encouragement, spurning social distancing and masks.
It is a singularly perilous moment, with tens of thousands of lives at risk. Globally, too, trust in the US hangs in the balance as surveys show that Europe is asking what kind of world leader proves incapable of protecting its own people from a microbe.
The Guardian invited six of America’s top public health experts to address the crisis. How bad is the current threat? And were the White House committed to science and data, as opposed to disappearing tricks, what would it do right now to fend off the disaster?
Beth Cameron, former senior director for global health security and biodefense on the White House National Security Council, now vice-president at the Nuclear Threat Initiative
The situation is grave. Covid-19 is spreading uncontrolled, hospitalizations are rising in at least a dozen states, and – six months into the crisis – the United States has failed to muster a unified response. It’s crystal clear that Covid-19 won’t “just disappear”, as President Trump said this week – and the pandemic certainly won’t end if wishful thinking continues to be our federal response plan.
I have the opportunity to speak regularly with local leaders, public health professionals and scientists. Across the board – from mayors to tribal leaders – there’s a thirst for information, innovation, and decision-making tools. At a time when our country needs an orchestrated, coordinated, all-hands-on-deck response, there is simply no hand on the tiller.
At a time when our country needs a coordinated, all-hands-on-deck response, there is simply no hand on the tiller
What should the administration do? Immediately start daily briefings from experts at CDC and NIH to report progress on a core set of metrics and capabilities that must be in place across the country to suppress Covid-19 and reopen safely. Make racial disparities in Covid-19 response (and in healthcare and health security more broadly) a top priority. Organize a massive surge in community health workers and contact tracers. Reach young adults about the need to reduce spread and protect communities.
It’s also time that the White House launch a set of science and technology challenges to rally public and private sector leaders toward common goals, like urgently modernizing our public health data architecture.
And yes, the president should wear a mask.
Unfortunately, we can’t keep waiting for the administration. In the absence of federal leadership, I would like to see governors and mayors leave aside political and geographic differences and convene a virtual summit this summer to set an urgent course for a whole-of-country approach to suppress Covid-19. We need a shared strategy.
Tom Frieden, former director of the US Centers for Disease Control and Prevention (CDC) 2009-2017, current president and CEO of Resolve to Save Lives, an initiative of Vital Strategies
In the US today, the virus has the upper hand. We can expect weeks, even months, of increases if we don’t do much better. The fact is we are creating an enormous viral reservoir that will take a very long time to recede.
One of the most serious problems is the lack of a concerted federal response. You see that in the lack of consistent messaging, the failure to tackle supply issues from tests to protective equipment, the absence of uniform standards on what states should monitor and report publicly.
In short, there is no clear national strategy and no plan for controlling this virus.
Reduce the risk of spread, then box the virus in through strategic testing, isolation, and rapid contact tracing
We know what we need to do. First, reduce the risk of spread by applying the three Ws: wear a mask, wash your hands and watch your distance. Then box the virus in through strategic testing, effective isolation, and rapid contact tracing and supportive quarantine.
Having done those things, we need to hold ourselves accountable by tracking how quickly tests are reported, patients isolated, and contacts traced. Singapore, New Zealand, South Korea are all tracking those indicators. We are not.
The problem is that there is a strain of thought in the Trump administration that if we ignore the virus it is just going to go away. The truth is the opposite: ignore it and it will come back with greater force.
Within a matter of days we will record 140,000 US deaths from Covid-19. People ask whether those American lives were lost needlessly. One way to look at that is to compare our record with that of Germany, a nation that has a similarly decentralized federal system with lots of risk of spread.
Germany’s death rate is 109 per million population, according to Johns Hopkins, compared with 391 per million in the US. That means that more than two-thirds of the US deaths – 86,000 at least – would have been prevented if we had achieved Germany’s death rate.
Jennifer Nuzzo, senior scholar at the Johns Hopkins Center for Health Security
We are in a deeply disturbing moment where more than half of the states are heading in the wrong direction in terms of new cases. Critically, states reopened without capacity to test adequately and do contact tracing.
It didn’t have to be this way. In Europe there was swift and sustained action that, after a challenging time, kept cases from accelerating further. We basically decided to not do that in the US. We shut down, then grew bored of that and lifted the lockdowns without any sort of plan for what came next.
So here we are: we now have the largest epidemic in the world, which is currently accelerating at a rate we haven’t seen before.
This should be a profound wake-up call to the states that hoped they could out-talk the pandemic with rhetoric. They are now experiencing the consequences: the situation is out of control.
You can protect yourself even if your elected leaders refuse to do so
We still have the power to change the trajectory of the pandemic if we put our minds to it. You can protect yourself even if your elected leaders refuse to do so.
Places may reopen but you don’t have to go to them, especially if you or members of your family have underlying health conditions.
The tragedy is that people such as healthcare workers don’t have the luxury to stay at home and the more illness there is in the community, the more risk there is for them.
We also need to put in place targeted health interventions such as testing, tracing and isolating people. This will take effort and commitment from government, but that’s nothing compared with months of further lockdown.
I’d also like to see consistent and scientifically literate messaging from leaders about the virus. The president has said several times that the virus will just disappear.
Yanis Ben Amor, executive director of the Center for Sustainable Development and experienced researcher of infectious diseases
In the US, we are in an absolute mess.
Policy across states is disjointed, with some states requiring face masks and others just recommending them. People are obviously confused: they see the president not wearing a mask when visiting factories, the vice-president not wearing one even when visiting a hospital.
People think: “Why should it apply to me?”
The information being given to the American people isn’t allowing them to understand the situation. There’s huge confusion on CNN and Fox News over what the president and experts are saying, and then you have conspiracy theories on Facebook that masks will kill you.
This is America, land of the free. Just as people fought seat belts and some still don’t vaccinate their children, so there is resistance over masks.
The message should be simple – you want to go back to normal life? Wear a mask
The message should be simple – you want to go back to normal life? Wear a mask. You want your children to go to school and to be able to go to bars and not be unemployed? Wear a mask. You don’t want another lockdown? Wear a mask.
Uché Blackstock, urgent care physician and CEO of Advancing Health Equity
In a matter of just a few months, one in 1,500 black Americans have died from coronavirus. Every single American should be horrified. This pandemic has laid bare the appalling racial inequities that have left black Americans more likely to be infected, hospitalized and to die from Covid-19.
What we see in the magnitude of deaths in black communities is the legacy of slavery, Black Codes, the Jim Crow era combined with the current status quo in this country that has devalued black lives and black bodies. If it wasn’t clear before, now it is. Black communities were already sick from racism before coronavirus arrived here, and now they have become even sicker.
One in 1,500 Black Americans have died from coronavirus. Every single American should be horrified
The surge that is sweeping across the south and west of the US should make us very worried about further devastation to black communities. They could be hit especially hard given the poor public health infrastructure in their areas and the large number of people who lack medical insurance.
In order to mitigate further disaster, state and local governments must ramp up testing and contact tracing in black communities. Messaging will be critical to ensuring black Americans are aware of the symptoms of coronavirus and how it is transmitted.
Social services, including expanded health insurance coverage, will help keep black communities afloat for the time being. In the long term, the federal government must invest in black communities in the form of gainful employment, safe and adequate housing, home ownership opportunities and quality education.
Ultimately, the United States must reckon with the destructive force of racism embedded in its history and within every aspect of society. At this inflection point, the country has a chance to make a long overdue statement – that black lives really do matter.
Irwin Redlener, professor of clinical public health and director of the National Center for Disaster Preparedness at Columbia University
The United States is experiencing a surge in the sun belt and south that is all too predictable. There have been so many missteps that it’s not really that surprising that we now find ourselves in the middle of a crisis.
What ails the system is that we aren’t doing enough tests, we are inadequate in contact tracing and we have a random set of messages and guidelines coming from local and federal government. In such an environment, people make it up as they go along, and the end result is that a lot more people, especially younger people, get infected.
Messaging in particular from the president and vice-president has been inaccurate, dishonest and flawed. We could see from that so-called Trump rally in Tulsa, Oklahoma, that you don’t need someone wearing a Maga hat to know where they stand politically; all you need to do is see if they are wearing a mask and following public health advice.
Basic health protection has become the stuff of a cultural and political war.
In the absence of competent federal leadership, governors need to take control
There is no clear exit strategy from this, sad to say. If I were speaking to governors, my advice would be to stop any efforts to reopen immediately. Just stop.
The White House is living in a dreamland that everything is under control but you don’t have to follow that lead. Instead, give more power to the mayors, especially of the larger cities, to encourage mask-wearing and social distancing.
In the absence of competent federal leadership, governors need to take control themselves and impose more stringent guidelines. There’s a risk here: if more draconian measures should be needed I have very little confidence that people will comply with what many will see as a big reversal in their conditions.