A Dose of Optimism, as the Pandemic Rages On

The months ahead will be difficult. But the medical cavalry is coming, and the rest of us know what we need to do.

Credit…Emiliano Ponzi

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By Donald G. McNeil Jr.

On March 16, back when White House news conferences were still deemed safe to attend, President Trump stood before reporters and announced that drastic nationwide restrictions — in schools, work places, our social lives — were needed to halt the coronavirus.

The guidelines, “15 Days to Slow the Spread,” were accompanied by a grim chart. Based on a prominent model by London’s Imperial College, the chart illustrated with a sinuous blue line how many Americans might die if nothing were done to protect the public’s health.

The line rose sharply as the estimated deaths went up, then drifted slowly down until finally, at the far right end of the graph, the number of new cases reached zero. Our national nightmare would end by October 2020 — that is, right about now. Along the way, if no action was taken, about 2.2 million Americans would die. Dr. Deborah Birx, one of Mr. Trump’s science advisers, referred to the graph as “the blue mountain of deaths.”

Clearly, the pandemic has not ended. So far some 215,000 Americans have lost their lives to the coronavirus, and reliable estimates suggest that the number could reach 400,000. Health experts agree that, with stronger leadership, the death toll would have been far lower.

Nonetheless, there is a collective accomplishment here worth acknowledging. In the Imperial College report, the authors underscored that their worst-case estimate would almost certainly not be realized, thanks to human nature: “It is highly likely that there would be significant spontaneous changes in population behavior even in the absence of government-mandated interventions.”

That prediction proved true, as millions of Americans agreed, however reluctantly, to accept the sacrifices involved in shutting down parts of the economy, keeping distance from one other and wearing masks.

In the day-to-day fights over reopening schools or bars, it is easy to forget that there was a time when the idea of canceling large public gatherings — the St. Patrick’s Day Parade, the N.C.A.A.’s March Madness basketball tournament — did not seem remotely necessary. That there was a time when leading health officials said that only sick people and hospital workers needed to wear masks.

Today, and despite the president’s own resistance, masks are widely accepted. Various polls show that the number of Americans who wear them, at least when entering stores, went from near zero in March to about 65 percent in early summer to 85 percent or even 90 percent in October. Seeing the president and many White House staffers stricken by the virus may convince yet more Americans to wear masks.

The slow but relentless acceptance of what epidemiologists call “non-pharmaceutical interventions” has made a huge difference in lives saved. The next step is pharmaceutical interventions.

Some are already modestly successful, such as the antiviral drug remdesivir and steroids like dexamethasone. But in the near distance are what Dr. William Schaffner, a preventive medicine specialist, has called “the cavalry” — vaccines and monoclonal antibodies. They are likely to be far more effective.

Since January, when I began covering the pandemic, I have been a consistently gloomy Cassandra, reporting on the catastrophe that experts saw coming: that the virus would go pandemic, that Americans were likely to die in large numbers, the national lockdown would last well beyond Easter and even past summer. No miracle cure was on the horizon; the record for developing a vaccine was four years.

Events have moved faster than I thought possible. I have become cautiously optimistic. Experts are saying, with genuine confidence, that the pandemic in the United States will be over far sooner than they expected, possibly by the middle of next year.

That is still some time off. Experts warn that this autumn and winter may be grim; indoor dining, in-classroom schooling, contact sports, jet travel and family holiday dinners may all drive up infections, hospitalizations and deaths. Cases are rising in most states, and some hospitals already face being overwhelmed.

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