Coronavirus: Can the U.S. quickly contain the epidemic without strong mitigation measures?

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With the most number of novel coronavirus cases in the world and nearly 75% more than China, can the U.S. contain community spread without any strong mitigation measures in the three hotspots of New York, New Jersey and Connecticut?

On March 27, with 85,486 people infected with novel coronavirus (SARS-CoV-2), the U.S surpassed mainland China to have most number of cases in the world. On March 30, the U.S has nearly 75% (1,43,527) more cases than China (82,198).

Even as Italy and Spain have reported large numbers, the daily increase in new cases has slowed down in Europe while sharply accelerating in America thus shifting the epicentre of the pandemic to the U.S.

Still no huge mitigation measures

However, unlike in China and a few other countries, America is yet to institute large mitigation measures like shutting down the three major hotspots – New York, New Jersey Connecticut. On Saturday, President Donald Trump backtracked on the possibility of imposing travel quarantine in the three hotspots after a pushback from the New York Governor. With over 53,000 cases as on March 29, New York has the most number of cases in the country. According to the Atlanta-based Centers for Disease Control and Prevention (CDC), residents in the three hotspots are now “urged” to refrain from non-essential travel for the next 14 days.

It is true that Singapore, Hong Kong and South Korea managed to contain the virus spread without having to undertake stringent mitigation measures like the one seen in China, Italy and even India. That is because these countries acted early and had enforced strong containment measures together with large-scale testing to prevent the spread of the virus, which is not the case with America.

Chalk and cheese

Though South Korea and the U.S. reported their first case on January 20, it was only by end February did the U.S. have a reliable test kit unlike South Korea, which had the tests by first week of February. While South Korea was testing in thousands each day after the wave of cases came up in a hospital and religious sect in the city of Daegu, the U.S. began large-scale testing only in early March. America thus remained largely oblivious to the looming threat from the virus spreading in the community. There were just about 100 tests done each day till end-February.

If the tests developed by the CDC were faulty, the testing criteria remained narrow and there was little surveillance for community spread. The public health emergency announced by FDA on January 31 did not make things easy for labs wanting to develop tests. Independent labs and hospitals could start testing people using tests developed by private players only by February 27. As on March 28, hardly 1,22,000 tests had been done in the country.

Dismissive attitude

Instead of decisive actions, Mr. Trump made the situation worse with his dismissive attitude to the threat posed by the virus. This despite knowing how the virus was crippling China’s healthcare system and was killing a few thousand people. If agencies such as CDC, which are known to act swiftly especially in the face of a pandemic, were found wanting this time, the government’s priorities too were misplaced.

The deadly combination is now playing out. But knowing how the U.S. can act, there is still hope that the epidemic would soon be brought under control. Tough mitigation measures need to be put in place soon for that. Will the President act?

Published in The Hindu on March 31, 2020