This is what it will take for the US to contain COVID-19 by the end of 2020

Yesterday, during a forum presented jointly by the Harvard T.H. Chan School of Public Health and the New England Journal of Medicine, Dr. Anthony Fauci spoke candidly about the parameters informing the COVID-19 pandemic.

The veteran infectious disease expert was appointed to The White House Coronavirus Task Force back in January.

Although the initiative has made significant breakthroughs over the last five months, Fauci believes cases are higher than they ought to be compared to other impacted nations operating with much fewer resources.

He went on to suggest that mistrust toward scientific communities expressed by the American public may be to blame.

“The unseemly things that crisis brings out in the world. It brings out the best of people and the worst of people,” Fauci told Dr. Sanjay Gupta, who moderated the correspondence. “I wouldn’t have imagined in my wildest dreams that people would reject things that are purely public health principles.”

Nothing underscores what Gupta refers to as America’s “War on Science” better than the asymmetry between the US’s population size and its number of active SARS-CoV-2 cases.

Americans account for 4% of the global population and 25% of coronavirus carriers. There’s plenty of criticism to go around on this front, but politicization might be chief among them.

The novel coronavirus penetrated the US in the middle of primaries and ahead of a high-stakes general election. Both have played their part in obscuring well-advised health courses.

“It would be nice if everyone was singing from the same tune,” Fauci continued. “But look at the reality. We have a situation where we say open up in a measured prudent way. And you get some that do it fine but then you see the pictures of people at bars with no masks, not social distancing.”

In order to adequately monitor, prevent, contain, and mitigate the spread of the most sophisticated pathogen in recent memory, health systems, civilians and lawmakers have to react uniformly.

As it stands, our best efforts have seen case numbers plateau, but not decrease at a meaningful pace.

Younger demographics, who on balance develop mild forms of COVID-19, are propagating the highest infection rates. Vulnerable communities, namely the elderly, those with preexisting conditions and the immune-deficient, have the most to lose at the hands of this recklessness.

“As long as you have any member of society and demographic group, who’s not seriously trying to get to the endgame of suppressing this, it will continue to smolder and smolder and smolder,” Fauci added.

The longer we delay a reasoned choreographed response, the more forceful the ripples will be once this crisis is behind us. This is likely true of the economic and health consequences in equal measure.

An ensemble forecast published this morning by the US Centers for Disease Control and Prevention projects 181,031 COVID-19 deaths in the US before September.

As of the time of this writing, 4.83 million Americans have contracted the respiratory disease and nearly 160,000 have succumbed to it.

Moreover, after it was determined that workers were incorrectly listed as “employed but not at work,” in initial census reports published at the height of national outbreaks, unemployment rates were readjusted from the 16.1% recorded in April to 19.2% at the beginning of May.

Treasury Secretary, Steven Mnuchin contends that the actual number is closer to 25% though he expects it to increase dramatically before the pandemic has been contained.

Despite these figures, Dr. Fauci remains optimistic about the road to recovery.

As data sets increase, vaccinologists begin to hone in on sequences epicentral to viral clearance. Every infected person yields valuable insights into COVID-19’s erratic pathology.

In the short five months it took for the illness to climb the leading causes of death chart in the US, experts have learned so much about how it maneuvers.

We now know that SARS-CoV-2 is the most stable at 4°C. We know that coronavirus virions evidence an average diameter of 0.1 micrometers. We know that droplets of all sizes can travel 23 to 27 feet from their host after emission. We know that virions remain active while suspended in aerosols for roughly three hours and we know that a four-layer cotton muslin mask can reduce the contamination of all viral particles by 99%.

Virologists have also located the novel coronavirus’s incubation period somewhere between three and five days; carriers typically shed the most viral debris before the onset of symptoms.

Together, these findings have allowed drug manufacturers to expedite the development of targeted therapeutics and antigens without compromising the safety or ethics of immunization research.

Most insiders agree that the doses underway have been able to produce a comparable number of antibodies associated with natural infection, which is perhaps the most educative indicator of a trial’s success.

The next phase is being overseen by Active and Operation Warp Speed. Via a public-private partnership with the Federal Government, the organizations aim to operationalize trials as quickly as possible.

The two most promising developers, Moderna and Pfizer are looking to enroll 30,000 participants by the end of September.

“The whole point of these trials is to determine the efficacy and safety of the vaccine. Meaning if the vaccine, when we compare it to (the) placebo, results in lower incidents of COVID compared to the general public,” explained Dr. Hana El Sahly of The Baylor College of Medicine. “Generally speaking, the interest in participating in COVID trials has been robust, and I project clinical trials will not have problems.”

The process is reportedly going extremely well. In fact, Dr. Fauci is confident that effective COVID-19 vaccine doses will be ready by the end of the year.

“We are likely going to have maybe tens of millions of doses in the early part of [next] year. But as we get into 2021, the manufacturers tell us that they will have hundreds of millions and likely a billion doses by the end of 2021,” The NIAID director said in a media release.

Some drugmakers have said they may be able to deliver doses as early as October.

The World Health Organization is concurrently implementing strategies in accordance with COVID-19’s etiology. These include improved ventilation systems for establishments hosting dense crowds and supplies for Universities looking to welcome students back to campus.

In a study published earlier this week in the Journal of the American Medical Association’s Open Network, researchers from the Yale School of Public Health, Harvard Medical School, and Massachusetts General Hospital proposed testing students every two days to ease the return of the traditional college experience–which has value beyond economics.

In the meantime, burgeoning research on T-cell immunity might explain the 40% of hosts that do not exhibit symptoms characteristic of COVID-19:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

Communities exposed to commonly circulating coronaviruses in the past, maybe protected upon exposure to viruses that belong to its class–including SARS-CoV-2.

“You could have been exposed to coronaviruses and you can develop antibodies that will diminish over time but you would have t-cell memory that could likely cross-react with the current coronavirus,” Fauci explained.

Municipalities often appreciate our health crisis and our economic crisis as two distinct entities, when all of the data indexed above can just as easily help alleviate commercial immobility.

A recent study, published in The Lancet Public Health Journal that reviewed the countermeasures implemented to suppress local transmission within the city of Hong Kong between late January and March 31 corroborates as much.

In that time frame,  the city of 7.5 million people only endured 715 confirmed cases and four deaths. Meaning, the virus’s reproduction rate did not rise during the study’s eight-week period.

Although Hong Kong public officials did not initiate shelter in place mandates as rigid as ours, they employed effective surveillance techniques, and contact tracing for infections among incoming travelers as well as their own community.

They even enforced a 14-day quarantine on anyone entering from mainland China and placed travel curfews on work commuters and students. As a result, officials were able to at once suppress COVID-19’s exponential growth curve and steady the job market.

The hospitality industry (restaurants, hotels, bars, casinos, amusement parks, events, cruises, entertainment, and tourism-related services) are experiencing a sharp decline in the US. More discreetly to the tune of a 70% drop-off in revenue in affluent regions and a 30% drop in lower-class neighborhoods.

Even after shutdown mandates dissolve, Americans will be wary about spending money because of COVID-19 itself; not because of the restrictions the pandemic has placed on commerce.

Investing in the economic health of the US will only make sense when we have a better handle on reoccurring outbreaks.

A growing number of American multi-national companies have announced plans to keep full-time and contracted employees working remotely until 2021 at the very earliest to nudge this aspiration closer to reality.I

“For the first time in history, nearly every scientist in the world is focused on the same problem. This is starting to pay real dividends.”
commented Joseph Allen of Harvard T.H. Chan School of Public Health. “Progress is being made in treatments, testing, and vaccines, and there’s growing agreement about ways to curb the spread of infection.”

Back in 2005, America successfully contained the avian influenza outbreak before it reached pandemic status. An independent evaluation conducted by John Hopkins declared the US’s pre-pandemic response to be the best in the world.

If heartening developments like clinically cloned antibodies, the development of rapid, low-cost saliva COVID-19 tests, and the current telework movement are going to make a difference in our future, we have to restore relations between the public and academicians.

Electing recovery over superficial allegiances.