Hospitals themselves are amplification points for the virus’s spread, as evidenced by the more than 1,700 confirmed cases of health-care workers stricken with the disease, including six deaths, the Chinese government reported on Friday. The most effective way we can respect the efforts of those who fell ill and the memory of those who have died is to protect their fellow health-care workers around the world and develop responses. China is a significant provider of personal protection equipment for the world, and the Chinese are running out themselves, which will leave the rest of the countries scrambling. A scary scenario indeed.
While public-health officials have not declared this outbreak a pandemic, we believe it is in the early stages of becoming just that: a worldwide epidemic. It has reached 24 other countries so far and is spreading like the influenza virus does each winter. Trying to stop influenza transmission is like trying to stop the wind. Nothing in our experience gives us hope we can halt an emerging worldwide epidemic spreading person-to-person like this coronavirus. It appears that on average, a case transmits to two people. After 10 doubling generations, which takes just 60 days total, that original infected individual has started a chain of more than 3,500 cases. Effective vaccines are many months, if not years, away.
Border closures, quarantines and airport screenings have, at best, slowed the disease, but they hardly stopped it. So what can governments and individuals do as the situation inexorably progresses?
If we are to have any real impact on this emerging crisis, we must safeguard the health-care workers who put their lives on the line treating patients. On Jan. 20, the Chinese National Health Commission revealed a covid-19 outbreak among 13 nurses and one physician, all related to the care of a single infected patient. An investigation published in the Journal of the American Medical Association shows that 40 of the first 138 patients diagnosed at Wuhan University Hospital were health-care workers, their infections related to caring for infected patients. Additionally, 17 patients treated for other conditions contracted the infection simply by breathing contaminated hospital air. Numerous Chinese physicians have spoken publicly over the past week on the major shortage of equipment necessary to protect workers and patients.
In a very real sense, what happens to our health-care workers will be the metric of how we respond to this unfolding crisis. If we don’t do all we can to protect them, they will quickly transition from providers to patients, further stressing already overburdened facilities. We are no more prepared to deal with the rapid increases in coronavirus patients needing hospitalization in the United States than in China. If doctors, nurses and first responders are faced with coming to work without such equipment as respirators, gloves, eye protection and disposable suits, will they? And if hospitals become places where coronavirus is spread more than contained, will the public panic?
It is no longer useful to debate how long and far this disease will spread. Public-health officials should stop trying to convince the public and political leaders we can contain this virus to China. One of the greatest hazards to the public in any crisis is misinformation from official sources.
Instead, we should build our next line of defense. As we experience one of the worst influenza seasons in years, the increased need for protective equipment has virtually exhausted supplies on hand at health-care facilities, which often don’t have the financial resources to store large inventories. Orders over the past several weeks of N95 respirators — the tight-fitting face masks necessary for protection against the virus — would take many years of manufacturing capacity to fulfill. World Health Organization officials report global demand for this kind equipment up to 100 times higher than normal and prices up to 20 times higher than just weeks ago.
We must immediately prioritize the use of those resources to health-care workers and first responders on a worldwide basis. Governments must support private-sector manufacturers in providing N95s and other equipment to front-line health-care providers and other essential workers. In terms of minimizing illness and death, this will be more important than any border closing, airport screening or quarantine. And it is no less than our front-line warriors deserve.