Declare national emergency, set curfew, bring the Army Corps of Engineers. Today.
[Update, 3/25/2020, 12:30pm EST]
Since publishing this story, the US confirmed cases surpassed 15,000 on Saturday, 3/21 (SR62), and are at more than 40,000 at end of day 3/24 (SR64), clearly happening faster than the worst case below, about to exceed the projected 100,000 cases by 3/29 and 1 million by 4/5.
We really, really need to support the social distancing, stay home, and go out and be in physical proximity with others only if critically necessary.
Please forward this message to anyone you know and care about. We need social distancing to succeed, or else there will be death on a scale previously unseen in this country.
Thank you.
[End of update]
For weeks now, it has been clear that the US cases of Coronavirus COVID-19 are following a sustained exponential growth. On March 11, I published this article warning that at the then consistent rate of doubling once per week, the US could have 1 million cases by July 2020.
Then, on March 15, I published this article, warning that the speed is accelerating, and we could be experiencing not a doubling of numbers per week, but an increase of 8x per week.
Unfortunately, the worst-case projections in that second article are coming true. That is, in that article, the worst case at 8x growth per week projected around 12,000 cases in the US by March 21 — see the table below copied from that article.
As of today, March 20, we have somewhere between 10,442 and 15,219 cases (per WHO SR60 or CDC daily report, respectively). We are clearly experiencing the worst projected case — social distancing is not working so far.
At the current rate, we will have 1 million COVID-19 infections in the US by the first or second week of April, and almost 10 million cases a week later.
At the current rate, we will have 1 million COVID-19 infections in the US by the first or second week of April, and almost 10 million cases a week later.
If these numbers seem impossible to comprehend and therefore appear unbelievable, just follow the daily CDC US Case Report and the WHO Situation Reports for the next few days. While I am trying hard to not be alarmist, the numbers paint a picture that is impossible to ignore.
To make matters worse, the CDC US Testing Report clearly shows that the CDC and public health labs do not have the capacity to administer more than 3,000 to 4,000 tests per day — at the time of writing, the day with the highest reported number of tests is March 12, with 4000 specimens tested. What this means is that the US actual cases will continue skyrocketing and we won’t even know it for lack of testing capacity.
The US hospitals will not be ready to handle the 1 million cases when we get there three weeks from today. Or six weeks from today, if the growth turns out to be slightly slower. In either case, the hospitals will be overwhelmed, the vast majority of cases will be turned back for lack of beds, equipment, and staff — many of whom will likely become infected.
Based on experience of other countries with higher infection counts, some 20 percent of the cases will need respirators. At 1 million cases, that number is 200,000 — much higher than the 60,000 to 100,000 respirators US hospitals currently have. What will happen with the people for which respirators are needed but not available? Will we let them simply die?
And what would happen in the weeks after we reach 1 million cases, when hospitals are overwhelmed and the spread continues to increase — whether at 8x per week, or just 2x per week? We could reach 10 million cases by end of April, and still only have the 60,000 to 100,000 respirators. How many people would die then, just from lack of respirators, let alone the lack of trained physicians, nurses, and other staff.
The only solution we have at this point is in two parts — part one is slowing down the rate of infections so we don’t get to millions of infections at any point of time. Part two is using the time we have to beef up our capacity as much as we can.
Slowing down the speed of infection is clearly not impacted by all the social distancing, closed schools, cancelled events, and companies shifting to work from home, however well-meaning and needed these measures may be.
In order to solve part one, and meaningfully slow down the rate of infection, we need to declare a national emergency, establish a curfew, and have it enforced by army and the police. This is not only the sole feasible option at this point, but also one that we will need to adopt either now, when the number of cases is still low and manageable, or in a not-too-distant future when the case have skyrocketed and the consequences are truly dire.
In order to solve part two, and beef up our medical capacity, we need to mobilize the Army Corps of Engineers to start building specialized hospitals for COVID-19. If they can build at least two dozen of specialized hospitals of a few hundred beds each, we will have a fighting chance. We also need to invoke emergency powers to order hundreds of thousands of new ventilator machines and other necessary equipment, and mobilize and train reserve medical personnel, including possibly bringing back retired medical professionals.
Our government should declare a state of national emergency, bring in the Army Corps of Engineers, and mobilize all available and potential resources.
Today.
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