Letters to the Editor • Opinion
We already know how to prevent pandemics
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, responded March 12 to Rep. Debbie Wasserman Schultz (D-Fla.). (Video: Reuters)

As the country has been confronting the increasing threat of the novel coronavirus this week, top health officials have been testifying about it on Capitol Hill.

In hearings from Tuesday to Thursday, officials including Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, and Robert Redfield, the director of the Centers for Disease Control and Prevention, have taken lawmakers’ questions about the virus and the country’s ability to deal with it.

Because the hearings have been dense, we’ve distilled them into some key takeaways.

1. Testing is ‘a failing’

President Trump has sought to put a good face on the country’s capacity to test for the coronavirus, just as he has with just about everything about the spread of the pathogen. He said as recently as Thursday that “the testing has been going very smooth.”

Increasingly, though, his top health officials have told a different story. Redfield was confronted with complaints this week about the availability of testing, and he explained that there was a complicated process involved.

But Fauci was more direct Thursday, calling the limited availability of testing “a failing.”

“The system is not really geared to what we need right now — what you are asking for,” Fauci said. “It is a failing. I mean, let’s admit it.”

Fauci even conceded that the United States wasn’t doing as well as other countries. “The idea of anybody getting it easily the way people in other countries are doing it?” he said. “We’re not set up for that. Do I think we should be? Yes. But we’re not.”

Redfield added at Thursday’s hearing that the problem wasn’t so much with the number of tests — he said more than 75,000 have been sent out — as with other parts of the process.

“The public health labs actually have to have the people to do the test,” Redfield said. “And what is their capacity to do the test? They have to have the equipment to do the test. And what’s the capacity of the equipment they have? They have to have some of the early reagents that they need.”

Redfield concluded: “So there’s a whole system that we can see that there’s different limitations as we expand, expand, expand.”

2. Hospital capacity is a huge problem right now

To the above point, Redfield said Tuesday that slowing the spread of the coronavirus right now is especially important because hospitals do not have as much capacity while people also are coming down with the seasonal flu.

“Unfortunately, this virus is very similar in [the] sense it’s a respiratory virus,” Redfield said. “So, you know, if you look at hospital capacity right now. Much of it is full — up to 95, 96, 97 percent. So we really don’t have a lot of resilience in the capacity of our health system.”

Redfield noted in other testimony that the capacity to handle the spread is why the situation became so bad in Wuhan, the Chinese city where the coronavirus was first detected. And he noted that the challenge wasn’t just about having enough beds.

“They had 130 infection beds when they started; they had over 20,000 within about four weeks,” Redfield said. “But you know what they didn’t have? They didn’t have doctors and nurses and equipment to staff those 20,000 beds. Their health system fell apart, and that’s why the mortality was so high.”

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3. Don’t treat it like the flu

While Redfield noted that particular similarity to the flu, and certain people including Trump have sought to compare the coronavirus disease to the flu, Fauci warned Wednesday against assuming it’s too similar.

“I mean, people always say, well, the flu does this, the flu does that,” Fauci said. “The flu has a mortality of 0.1 percent. This has a mortality rate of 10 times that. That’s the reason I want to emphasize we have to stay ahead of the game in preventing this.”

Fauci added that a 1 percent mortality rate was on the low end of assumptions, if you grant that many people contract the coronavirus and are never formally logged as having it.

“I think if you count all the cases of minimally symptomatic, or asymptomatic infection, that probably brings the mortality rate down to somewhere around 1 percent,” Fauci said “which means it is 10 times more lethal than the seasonal flu. I think that’s something that people can get their arms around and understand.”

4. You probably can’t get this coronavirus twice

Fauci was asked Thursday whether people who have contracted the coronavirus — and even might not have known they had it because they thought they had the flu — might now be immune.

And while he’s often circumspect, he made clear that he thinks that is the case.

“We haven’t formally proved it, but it is strongly likely that that’s the case,” Fauci said. “Because if this acts like any other virus, once you recover, you won’t get reinfected.”

5. Warning against the 70 million-150 million estimate

While Fauci has contradicted Trump on a number of occasions, he also had some advice for the news media. He urged it to not play up the worst-case projections so much.

On Thursday, he was asked about the House attending physician’s finding that as many as 70 million to 150 million Americans could become infected.

“I think we really need to be careful with those kinds of predictions, because that’s based on a model. All models are as good as the assumptions that you put into the model,” Fauci said. “It’s unpredictable.”

He added: “I just want to make a point that I hope the public gets. When people do a model, they say, ‘This is the lower level, this is the higher level.’ And what the press picks up is the higher level, and they say, ‘You could have as many as …’

“Remember the model during the Ebola outbreak said you could have as many as a million. We didn’t have a million.”

6. Warm weather may indeed help, but don’t count on it

Trump has been hopeful that warmer weather once spring begins might help kill off the virus. Fauci and Redfield have indicated that that’s possible but have said that it should be something we hope for rather than something we count on.

“Many of us are hoping — not knowing, hoping — that this will follow the pattern of flu and other respiratory viruses,” Redfield said Tuesday. “That means the transmissibility in our environment might change.

“It is interesting that when I look at the cases around the world and I censor out all the export cases and I censor out all of the contacts of exports, and you look in the Southern Hemisphere [where it’s currently summer]. There’s very few cases in the Southern Hemisphere right now. I would — it’s a great possibility that it might change just like flu changes.”

Fauci added Wednesday when asked about Trump’s floating that theory: “The basis for any surmising that that might happen is based on what we see every year with influenza … and other non-novel coronaviruses,” which he said “often do that.”

He noted that the particular coronaviruses that do that, though, are the common-cold types.

“So for someone to at least consider that that might happen is reasonable,” Fauci said. “But — underline ‘but’ — we do not know what this virus is going to do. … We can’t proceed under that assumption. We have to assume it’s going to get worse and worse and worse.”

7. The private sector was too slow

Redfield offered some interesting comments Tuesday, in which he said he had hoped that the private sector would have been quicker to develop treatments for coronavirus.

“As a clinician like yourself,” he told a congressman who is a doctor, “I guess I anticipated that the private sector would have engaged and helped develop it for the clinical side. … I can tell you, having lived through the last eight weeks, I would have loved the private sector to be fully engaged eight weeks ago.”

He urged companies to develop as strong an interest in this as in other major medical problems.

“This is a medical condition that needs that innovation, that medical research,” he said. “The private sector’s got to get engaged — to develop the same passion that they have for cancer cures, that they do have for addiction cures.”

Coronavirus: What you need to know

Where do things stand? See the latest covid numbers in the U.S. and across the world. In the U.S., pandemic trends have shifted and now White people are more likely to die from covid than Black people.

The state of public health: Conservative and libertarian forces have defanged much of the nation’s public health system through legislation and litigation as the world staggers into the fourth year of covid.

Grief and the pandemic: A Washington Post reporter covered the coronavirus — and then endured the death of her mother from covid-19. She offers a window into grief and resilience.

Would we shut down again? What will the United States do the next time a deadly virus comes knocking on the door?

Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot. New federal data shows adults who received the updated shots cut their risk of being hospitalized with covid-19 by 50 percent. Here’s guidance on when you should get the omicron booster and how vaccine efficacy could be affected by your prior infections.

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