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LOOKING OVER OUR SHOULDER

Updated: Aug 28, 2020

April 4, 2020


Today we’re past the 1 million mark in confirmed cases worldwide, and that’s a horrible statistic. But what I can’t stop thinking about is what’s happening here in the US: 300,000+ cases as of today.


In South Korea, the number of infections is still only 10,284.


I know — “only.” But how we’d love to have those numbers here in the US! Instead we’re being told that we’re still nowhere near our peak. Whereas South Korea, it appears, has already passed theirs.


But why compare?


Because unlike China and Italy, two of the places that have been hardest hit by the pandemic, South Korea has been running along a remarkably similar course to ours. In fact, it’s been — or it should have been — almost identical.


South Korea discovered its first case of coronavirus on January 27. So did we. On that day there were only 4 known cases in South Korea. In the U.S., there were 5.


Today we’ve had more than 8,300 deaths. South Korea has had 191.


Like most Americans, I find this appalling, bewildering — and terrifying. We had the same amount of advance notice that South Korea had. We’re a developed nation just as they are, and we have resources that equal or surpass theirs. In fact, our resources are the envy of almost every country in the world. Yet we are nowhere near getting ahead of this.


In fact we’re scrambling far, far behind. And it’s becoming clearer that the price we will pay for our early response will be exorbitant.


So in the media, there’s been a lot of looking back to the beginning. Normally that’s what happens at the end of a cataclysmic event — in the middle, you don’t have time. You don’t have the perspective, either. I’m writing this to chronicle what’s happening day to day in an ordinary life. I can’t say, “This is how history will how it was when the corona virus came,” because there's no way of knowing yet.


So I’m chronicling here that on April 4, still just weeks into the thick of a catastrophe no one alive has ever experienced before, we keep going back to the beginning, again and again, almost obsessively.


The beginning — December, when corona arrived in China; January, when medical experts and world leaders knew it was coming; most definitely February, when new cases were turning up not because people were carrying it from foreign countries, but because community spread had begun within the US — was the time when we had the best chance to put up a defense. The contagion was in the world, and it would hit us hard, but at that point, we still could have hit back.


By many estimates, the 4 to 6 weeks or so between late January and early March were all but wasted. We developed a faulty test, then couldn’t get the next one approved. We started testing, but didn’t test enough people to put the measures into effect that China recommended, and South Korea was already using with a vengeance: discover who had the virus or had been exposed to it, isolate those people, discover and isolate everyone they had been in contact with over the last two weeks, and isolate those people, too. That sequence was impossible to follow when we didn’t know who had the virus, much less who they might have caught it from.


On February 4, the Director General of the World Health Organization, Tedros Adhanom Ghebreyesus, announced that the international community had “a window of opportunity” to control the novel virus that was already leaking out of China.


But even before that, there were clear warnings.

On January 28, a prescient op-ed, “Act Now to Prevent an American Epidemic,” appeared in the Wall Street Journal. It was written by Luciana Borio, one-time head of medical and biodefense preparedness at the National Security Council, and Scott Gottlieb, former director of the Food and Drug Administration. It stressed the need for early, aggressive testing. Borio reiterated to NPR on Jan. 30, “The most important and effective way to control epidemics is to identify patients who are infected, exposed to the virus, and isolate them.”


Even more disturbing, way back in 2014 President Obama warned of a “new strain of flu, like the Spanish Flu” that could arrive as soon as “five years from now, or a decade from now.” He urged us to “put in place an infrastructure, not just here but globally, that allows us to see it quickly, isolate it quickly, and respond quickly.”


I realize we can’t go back in time — not even to early this year, when White House officials attended meetings warning of the coming of COVI-19. (More than one Senator, fearing the impact of a pandemic on the stock market, opted to dump their own personal stocks rather than warn the public.) It’s now public record that Secretary of Health and Human Services Alex Azar repeatedly advised the President to take the threat seriously, but was dismissed by Trump as “alarmist” and belittled by a White House official who called Azar’s warnings “palace intrigue.”


No one wants to play the "woulda, shoulda” game right now, especially since every time we hear more about what happened back then our spirits fall a little lower. And really, we can’t afford to be dispirited now. We need all of our courage and positivity to face each day’s news report, and brace ourselves for whatever is coming next.

As of March 24, the US had still only conducted one test per 1,090 people. South Korea’s rate was about one in 170 people. That’s about 6 times more testing than we have done.


As of today, we’re still hearing constantly about shortages of tests, who can get one and who can’t. Celebrities can get them easier than regular people can, everyone says. I have not personally heard of anyone who has been able to get one. We see long, long lines outside of testing sites, and we get mixed messages: you can get one if you’ve been out of the country recently, or if you have been in close contact with someone who has the virus. But who knows who has it? Some people are asymptomatic. Some get it and recover, then wonder, was that corona or a cold? Most of the people who know they have it for sure are people in the hospital. But those are the really sick ones — the ones who would probably figure they have it even without a test.

Trump claimed in February that “Anybody that needs a test can get a test,” but that has never been true. And it’s looks like, in the United States, that never will be true. There has been a fair amount of conjecture everywhere about what use the tests are now that the virus is galloping merrily through the population. Yes, of course it’s still better to know. But maybe soon an antibody test will be more useful? That will tell us who has already battled the virus and won.

In the meantime, without accurate numbers of those infected, all of the scientific prediction models leaders are using to address the crisis can only be applied approximately. Unlike the Chinese, Italians and South Koreans, we are making it up as we go along.


Because we don’t know how many people have the virus, we can only guess when our hospitals will be inundated, and by roughly how many people. We can only shut down our states and cities and towns based on how many people have tested positive (a faulty strategy, but one very much in use) — but who knows what that number is? News and information programs bemoan the lack of testing on daily basis, probably an hourly one. How can we order supplies, build or convert facilities for patients, or make economic projections, or do much of anything that might help us, without testing data?


A lot of people believe Trump refused to test because he didn’t want to know the numbers — and he didn’t want us to know them, either. He talked about “keeping the numbers low” because he wanted to be able to say “We have only a few cases here.” A high number would attach to his legacy. It would drive down the stock market and the economy. It could lead to widespread panic. And it could prevent his re-election in November.


It’s a bitter irony that all of that will definitely or probably happen now, so being kept in the dark didn’t achieve his ends, and it definitely didn’t achieve ours. What we want is to fight and fight well. Yes, like the South Koreans. But like a bad general Trump is making losers out of us.




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