This link has been bookmarked by 242 people . It was first bookmarked on 25 Mar 2020, by Jason K.
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07 Jun 20
Whitney CoxA global pandemic of this scale was inevitable. In recent years, hundreds of health experts have written books, white papers, and op-eds warning of the possibility. Bill Gates has been telling anyone who would listen, including the 18 million viewers of his TED Talk. In 2018, I wrote a story for The Atlantic arguing that America was not ready for the pandemic that would eventually come. In October, the Johns Hopkins Center for Health Security war-gamed what might happen if a new coronavirus swept the globe. And then one did. Hypotheticals became reality. “What if?” became “Now what?”
So, now what? In the late hours of last Wednesday, which now feels like the distant past, I was talking about the pandemic with a pregnant friend who was days away from her due date. We realized that her child might be one of the first of a new cohort who are born into a society profoundly altered by COVID-19. We decided to call them Generation C.
As we’ll see, Gen C’s lives will be shaped by the choices made in the coming weeks, and by the losses we suffer as a result. But first, a brief reckoning. On the Global Health Security Index, a report card that grades every country on its pandemic preparedness, the United States has a score of 83.5—the world’s highest. Rich, strong, developed, America is supposed to be the readiest of nations. That illusion has been shattered. Despite months of advance warning as the virus spread in other countries, when America was finally tested by COVID-19, it failed. -
26 May 20
Dean HackerI wrote this two months ago, and have been thinking about it again given the rhetoric swirling around this long weekend.
https://t.co/woc4dxfi9r https://t.co/F6eJHVTp2M -
08 May 20
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03 May 20
Kathy GillAnd if you're thinking, "Pssssh, that's only 7000 words, I CRAVE MORE," don't worry, I got you. This one is a broad look at how the US got to where it is, the next options, and the possible aftermaths.
https://t.co/woc4dxfi9r -
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unasunoHow Will the Coronavirus End - The Atlantic via Instapaper https://ift.tt/3brnCXk
The U.S. may end up with the worst COVID-19 outbreak in the industrialized world. This is how it’s going to play out. Three months ago, no one knew that SARS-CoV-2 existed. via Pocket https://ift.tt/3brnCXk
via My Reading List: Read and UnreadPocket ifttt instapaper Pandemic How Will Coronavirus End - The Atlantic
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kevinwashington2The U.S. may end up with the worst COVID-19 outbreak in the industrialized world. This is how it’s going to play out. Three months ago, no one knew that SARS-CoV-2 existed. via Pocket https://ift.tt/3brnCXk
How Will the Coronavirus End - The Atlantic via Instapaper https://ift.tt/3brnCXk
How the Pandemic Will End via Instapaper https://ift.tt/3brnCXk
How the Pandemic Will End via Instapaper https://ift.tt/3cRkBQIPocket instapaper ifttt Coronavirus - Atlantic How the Pandemic Will End
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01 Apr 20
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Colin McNeil"One could also envisage a future in which America learns a different lesson. A communal spirit, ironically born through social distancing, causes people to turn outward, to neighbors both foreign and domestic. The election of November 2020 becomes a repudiation of “America first” politics. The nation pivots, as it did after World War II, from isolationism to international cooperation. Buoyed by steady investments and an influx of the brightest minds, the health-care workforce surges. Gen C kids write school essays about growing up to be epidemiologists. Public health becomes the centerpiece of foreign policy. The U.S. leads a new global partnership focused on solving challenges like pandemics and climate change."
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31 Mar 20
Shortman"The U.S. may end up with the worst COVID-19 outbreak in the industrialized world. This is how it’s going to play out."
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30 Mar 20
abc111More transmissible and fatal than seasonal influenza, the new coronavirus is also stealthier, spreading from one host to another for several days before triggering obvious symptoms. To contain such a pathogen, nations must develop a test and use it to identify infected people, isolate them, and trace those they’ve had contact with. That is what South Korea, Singapore, and Hong Kong did to tremendous effect. It is what the United States did not.
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The testing fiasco was the original sin of America’s pandemic failure, the single flaw that undermined every other countermeasure.
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Rudderless, blindsided, lethargic, and uncoordinated, America has mishandled the COVID-19 crisis to a substantially worse degree than what every health expert I’ve spoken with had feared. “Much worse,” said Ron Klain, who coordinated the U.S. response to the West African Ebola outbreak in 2014. “Beyond any expectations we had,” said Lauren Sauer, who works on disaster preparedness at Johns Hopkins Medicine. “As an American, I’m horrified,” said Seth Berkley, who heads Gavi, the Vaccine Alliance. “The U.S. may end up with the worst outbreak in the industrialized world.”
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29 Mar 20
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Alan Lew"It’s likely, then, that the new coronavirus will be a lingering part of American life for at least a year, if not much longer. If the current round of social-distancing measures works, the pandemic may ebb enough for things to return to a semblance of normalcy. Offices could fill and bars could bustle. Schools could reopen and friends could reunite. But as the status quo returns, so too will the virus. This doesn’t mean that society must be on continuous lockdown until 2022. But “we need to be prepared to do multiple periods of social distancing,” says Stephen Kissler of Harvard.
Much about the coming years, including the frequency, duration, and timing of social upheavals, depends on two properties of the virus, both of which are currently unknown. First: seasonality. Coronaviruses tend to be winter infections that wane or disappear in the summer. That may also be true for SARS-CoV-2, but seasonal variations might not sufficiently slow the virus when it has so many immunologically naive hosts to infect. “Much of the world is waiting anxiously to see what—if anything—the summer does to transmission in the Northern Hemisphere,” says Maia Majumder of Harvard Medical School and Boston Children’s Hospital.
Second: duration of immunity. When people are infected by the milder human coronaviruses that cause cold-like symptoms, they remain immune for less than a year. By contrast, the few who were infected by the original SARS virus, which was far more severe, stayed immune for much longer." -
28 Mar 20
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Gerry Solomon"The U.S. may end up with the worst COVID-19 outbreak in the industrialized world. This is how it’s going to play out"
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27 Mar 20
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Eric LanghorstHere’s a useful overview of the likely scenarios that the world will be facing in the coming months while managing this pandemic. So much depends on our ability to make good decisions going forward along with our ability to remain resilient. https://t.co/
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Áine MacDermot“Rudderless, blindsided, lethargic, and uncoordinated, America has mishandled the COVID-19 crisis to a substantially worse degree than what every health expert I’ve spoken with had feared.” https://t.co/aesebUfndO
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Marta PintoHere’s a useful overview of the likely scenarios that the world will be facing in the coming months while managing this pandemic. So much depends on our ability to make good decisions going forward along with our ability to remain resilient. https://t.co/
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pennmedicinenewsAn article from The Atlantic cites a recent analysis led by Ezekiel J. Emanuel, MD, chair of Medical Ethics and Health Policy, which estimated that even if social-distancing measures can reduce COVID-19 infection rates by 95 percent, 960,000 Americans will still need intensive care.
ezekiel_emanuel medical_ethics_and_health_policy The_Atlantic FY20 Q3 KD March 2020
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Charles GambrellThe U.S. may end up with the worst COVID-19 outbreak in the industrialized world. This is how it’s going to play out. Three months ago, no one knew that SARS-CoV-2 existed.
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26 Mar 20
Mela EckenfelsThis is a great read -> Will the Coronavirus End? - The Atlantic https://t.co/0BSXa5YSV0
But I think that while everyone saw the cracks in their particular area, few people saw all the pieces--or weighted them correctly. Which is why we had pre-pandemic indices that assessed the US as the most prepared of all nations. 3/
(From March: https:/ -
Calvino Rabeni"i"
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martineaupHere’s a useful overview of the likely scenarios that the world will be facing in the coming months while managing this pandemic. So much depends on our ability to make good decisions going forward along with our ability to remain resilient. https://t.co/
"To contain such a pathogen, nations must develop a test and use it to identify infected people, isolate them, and trace those they’ve had contact with. That is what South Korea, Singapore, and Hong Kong did to tremendous effect. It is what the US did not -
Jennifer CulpHere’s a useful overview of the likely scenarios that the world will be facing in the coming months while managing this pandemic. So much depends on our ability to make good decisions going forward along with our ability to remain resilient. https://t.co/
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Elizabeth TechmanHere’s a useful overview of the likely scenarios that the world will be facing in the coming months while managing this pandemic. So much depends on our ability to make good decisions going forward along with our ability to remain resilient. https://t.co/
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Sahana ChattopadhyayA must-read, clear-eyed, top-to-bottom look at coronavirus by @edyong209 that chronicles the failure that has been the American response. But it ends with possible embers of hope for the future. “Pandemics are democratizing experiences.” https://t.co/6OI0
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Jennifer BarnettHere’s a useful overview of the likely scenarios that the world will be facing in the coming months while managing this pandemic. So much depends on our ability to make good decisions going forward along with our ability to remain resilient. https://t.co/
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Klaus EckGanz toller Artikel #Coronakrise #Corona #CoronavirusPandemic
https://t.co/0iK8bv0dAW -
Stephen Thergesen“There are now only two groups of Americans. Group A includes everyone involved in the medical response, whether that’s treating patients, running tests, or manufacturing supplies. Group B includes everyone else, and their job is to buy Group A more time.
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Meg AllisonHere’s a useful overview of the likely scenarios that the world will be facing in the coming months while managing this pandemic. So much depends on our ability to make good decisions going forward along with our ability to remain resilient. https://t.co/
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Shelley FabrizioHere’s a useful overview of the likely scenarios that the world will be facing in the coming months while managing this pandemic. So much depends on our ability to make good decisions going forward along with our ability to remain resilient. https://t.co/
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Mary BernasHere’s a useful overview of the likely scenarios that the world will be facing in the coming months while managing this pandemic. So much depends on our ability to make good decisions going forward along with our ability to remain resilient. https://t.co/
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Sheri EdwardsAs a reminder, Atlantic has put its excellent COVID - 19 coverage in front of their paywall. This one is very informative and tempered. https://t.co/9yJ4ub5Pj8
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Lun EsexHere’s a useful overview of the likely scenarios that the world will be facing in the coming months while managing this pandemic. So much depends on our ability to make good decisions going forward along with our ability to remain resilient. https://t.co/
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Mike AgostinelliHere’s a useful overview of the likely scenarios that the world will be facing in the coming months while managing this pandemic. So much depends on our ability to make good decisions going forward along with our ability to remain resilient. https://t.co/
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Jorge BarbaHere’s a useful overview of the likely scenarios that the world will be facing in the coming months while managing this pandemic. So much depends on our ability to make good decisions going forward along with our ability to remain resilient. https://t.co/
1/ In March @edyong209 wrote about how a “rudderless, blindsided, lethargic, and uncoordinated” response could leave the U.S. with the worst COVID-19 outbreak in the industrialized world.
His story was @Pocket’s most read of 2020. https://t.co/azDvnmPDY9 -
Van Piercyquote "There are now only two groups of Americans. Group A includes everyone involved in the medical response. Group B includes everyone else, and their job is to buy Group A more time. Group B must now “flatten the curve” by physically isolating themselv
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Muzaffaruddin Alvivia All News on 'The Twitter Times: Muzaffar69/corpgov' https://bit.ly/2Mw5vpR
#CorpGov All News on 'The Twitter Times: Muzaffar69_corpgov'
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25 Mar 20
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Peggy George"The testing fiasco was the original sin of America’s pandemic failure, the single flaw that undermined every other countermeasure." Read @edyong209: https://t.co/aHHajW5tBd
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david stong"The U.S. may end up with the worst COVID-19 outbreak in the industrialized world. This is how it’s going to play out."
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A global pandemic of this scale was inevitable. In recent years, hundreds of health experts have written books, white papers, and op-eds warning of the possibility. Bill Gates has been telling anyone who would listen, including the 18 million viewers of his TED Talk.
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We realized that her child might be one of the first of a new cohort who are born into a society profoundly altered by COVID-19. We decided to call them Generation C.
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On the Global Health Security Index, a report card that grades every country on its pandemic preparedness, the United States has a score of 83.5—the world’s highest. Rich, strong, developed, America is supposed to be the readiest of nations. That illusion has been shattered. Despite months of advance warning as the virus spread in other countries, when America was finally tested by COVID-19, it failed.
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“No matter what, a virus [like SARS-CoV-2] was going to test the resilience of even the most well-equipped health systems,”
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To contain such a pathogen, nations must develop a test and use it to identify infected people, isolate them, and trace those they’ve had contact with. That is what South Korea, Singapore, and Hong Kong did to tremendous effect. It is what the United States did not.
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That a biomedical powerhouse like the U.S. should so thoroughly fail to create a very simple diagnostic test was, quite literally, unimaginable. “I’m not aware of any simulations that I or others have run where we [considered] a failure of testing,”
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The testing fiasco was the original sin of America’s pandemic failure, the single flaw that undermined every other countermeasure. If the country could have accurately tracked the spread of the virus, hospitals could have executed their pandemic plans, girding themselves by allocating treatment rooms, ordering extra supplies, tagging in personnel, or assigning specific facilities to deal with COVID-19 cases.
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None of that happened. Instead, a health-care system that already runs close to full capacity, and that was already challenged by a severe flu season, was suddenly faced with a virus that had been left to spread, untracked, through communities around the country.
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With little room to surge during a crisis, America’s health-care system operates on the assumption that unaffected states can help beleaguered ones in an emergency.
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That ethic works for localized disasters such as hurricanes or wildfires, but not for a pandemic that is now in all 50 states. Cooperation has given way to competition
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Partly, that’s because the White House is a ghost town of scientific expertise. A pandemic-preparedness office that was part of the National Security Council was dissolved in 2018. On January 28, Luciana Borio, who was part of that team, urged the government to “act now to prevent an American epidemic,” and specifically to work with the private sector to develop fast, easy diagnostic tests. But with the office shuttered, those warnings were published in The Wall Street Journal, rather than spoken into the president’s ear.
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Rudderless, blindsided, lethargic, and uncoordinated, America has mishandled the COVID-19 crisis to a substantially worse degree than what every health expert I’ve spoken with had feared. “Much worse,”
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“Beyond any expectations we had,” said Lauren Sauer, who works on disaster preparedness at Johns Hopkins Medicine. “As an American, I’m horrified,” said Seth Berkley, who heads Gavi, the Vaccine Alliance. “The U.S. may end up with the worst outbreak in the industrialized world.”
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it will be difficult—but not impossible—for the United States to catch up. To an extent, the near-term future is set because COVID-19 is a slow and long illness. People who were infected several days ago will only start showing symptoms now, even if they isolated themselves in the meantime. Some of those people will enter intensive-care units in early April
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The U.S. has fewer hospital beds per capita than Italy. A study released by a team at Imperial College London concluded that if the pandemic is left unchecked, those beds will all be full by late April. By the end of June, for every available critical-care bed, there will be roughly 15 COVID-19 patients in need of one. By the end of the summer, the pandemic will have directly killed 2.2 million Americans,
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The first and most important is to rapidly produce masks, gloves, and other personal protective equipment
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A “massive logistics and supply-chain operation [is] now needed across the country,” says Thomas Inglesby of Johns Hopkins Bloomberg School of Public Health. That can’t be managed by small and inexperienced teams scattered throughout the White House. The solution, he says, is to tag in the Defense Logistics Agency—a 26,000-person group that prepares the U.S. military for overseas operations and that has assisted in past public-health crises, including the 2014 Ebola outbreak.
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This agency can also coordinate the second pressing need: a massive rollout of COVID-19 tests.
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These measures will take time, during which the pandemic will either accelerate beyond the capacity of the health system or slow to containable levels. Its course—and the nation’s fate—now depends on the third need, which is social distancing.
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There are now only two groups of Americans. Group A includes everyone involved in the medical response, whether that’s treating patients, running tests, or manufacturing supplies. Group B includes everyone else, and their job is to buy Group A more time. Group B must now “flatten the curve” by physically isolating themselves from other people to cut off chains of transmission.
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Given the slow fuse of COVID-19, to forestall the future collapse of the health-care system, these seemingly drastic steps must be taken immediately, before they feel proportionate, and they must continue for several weeks.
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Persuading a country to voluntarily stay at home is not easy, and without clear guidelines from the White House, mayors, governors, and business owners have been forced to take their own steps.
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when the good of all hinges on the sacrifices of many, clear coordination matters—the fourth urgent need
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Pundits and business leaders have used similar rhetoric, arguing that high-risk people, such as the elderly, could be protected while lower-risk people are allowed to go back to work. Such thinking is seductive, but flawed. It overestimates our ability to assess a person’s risk, and to somehow wall off the ‘high-risk’ people from the rest of society. It underestimates how badly the virus can hit ‘low-risk’ groups, and how thoroughly hospitals will be overwhelmed if even just younger demographics are falling sick.
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A recent analysis from the University of Pennsylvania estimated that even if social-distancing measures can reduce infection rates by 95 percent, 960,000 Americans will still need intensive care.
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There are only about 180,000 ventilators in the U.S. and, more pertinently, only enough respiratory therapists and critical-care staff to safely look after 100,000 ventilated patients. Abandoning social distancing would be foolish. Abandoning it now, when tests and protective equipment are still scarce, would be catastrophic.
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If Trump stays the course, if Americans adhere to social distancing, if testing can be rolled out, and if enough masks can be produced, there is a chance that the country can still avert the worst predictions about COVID-19, and at least temporarily bring the pandemic under control. No one knows how long that will take, but it won’t be quick. “It could be anywhere from four to six weeks to up to three months,” Fauci said, “but I don’t have great confidence in that range.”
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there are three possible endgames: one that’s very unlikely, one that’s very dangerous, and one that’s very long.
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The first is that every nation manages to simultaneously bring the virus to heel, as with the original SARS in 2003. Given how widespread the coronavirus pandemic is, and how badly many countries are faring, the odds of worldwide synchronous control seem vanishingly small.
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The second is that the virus does what past flu pandemics have done: It burns through the world and leaves behind enough immune survivors that it eventually struggles to find viable hosts. This “herd immunity” scenario would be quick, and thus tempting
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it would also come at a terrible cost: SARS-CoV-2 is more transmissible and fatal than the flu, and it would likely leave behind many millions of corpses and a trail of devastated health systems.
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The third scenario is that the world plays a protracted game of whack-a-mole with the virus, stamping out outbreaks here and there until a vaccine can be produced. This is the best option, but also the longest and most complicated.
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there are no existing vaccines for coronaviruses—until now, these viruses seemed to cause diseases that were mild or rare—so researchers must start from scratch.
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The first steps have been impressively quick. Last Monday, a possible vaccine created by Moderna and the National Institutes of Health went into early clinical testing. That marks a 63-day gap between scientists sequencing the virus’s genes for the first time and doctors injecting a vaccine candidate into a person’s arm. “It’s overwhelmingly the world record,” Fauci said.
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The initial trial will simply tell researchers if the vaccine seems safe, and if it can actually mobilize the immune system. Researchers will then need to check that it actually prevents infection from SARS-CoV-2. They’ll need to do animal tests and large-scale trials to ensure that the vaccine doesn’t cause severe side effects. They’ll need to work out what dose is required, how many shots people need, if the vaccine works in elderly people, and if it requires other chemicals to boost its effectiveness.
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No matter which strategy is faster, Berkley and others estimate that it will take 12 to 18 months to develop a proven vaccine, and then longer still to make it, ship it, and inject it into people’s arms.
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as the status quo returns, so too will the virus. This doesn’t mean that society must be on continuous lockdown until 2022. But “we need to be prepared to do multiple periods of social distancing,” says Stephen Kissler of Harvard.
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First: seasonality. Coronaviruses tend to be winter infections that wane or disappear in the summer. That may also be true for SARS-CoV-2, but seasonal variations might not sufficiently slow the virus when it has so many immunologically naive hosts to infect.
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Second: duration of immunity. When people are infected by the milder human coronaviruses that cause cold-like symptoms, they remain immune for less than a year. By contrast, the few who were infected by the original SARS virus, which was far more severe, stayed immune for much longer.
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scientists will need to develop accurate serological tests, which look for the antibodies that confer immunity. They’ll also need to confirm that such antibodies actually stop people from catching or spreading the virus. If so, immune citizens can return to work, care for the vulnerable, and anchor the economy during bouts of social distancing.
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Testing kits can be widely distributed to catch the virus’s return as quickly as possible. There’s no reason that the U.S. should let SARS-CoV-2 catch it unawares again, and thus no reason that social-distancing measures need to be deployed as broadly and heavy-handedly as they now must be.
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“We can keep schools and businesses open as much as possible, closing them quickly when suppression fails, then opening them back up again once the infected are identified and isolated. Instead of playing defense, we could play more offense.”
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The vaccine may need to be updated as the virus changes, and people may need to get revaccinated on a regular basis, as they currently do for the flu. Models suggest that the virus might simmer around the world, triggering epidemics every few years or so. “But my hope and expectation is that the severity would decline, and there would be less societal upheaval,”
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After infections begin ebbing, a secondary pandemic of mental-health problems will follow.
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But “there is also the potential for a much better world after we get through this trauma,”
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Attitudes to health may also change for the better. The rise of HIV and AIDS “completely changed sexual behavior among young people who were coming into sexual maturity at the height of the epidemic,”
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Pandemics can also catalyze social change. People, businesses, and institutions have been remarkably quick to adopt or call for practices that they might once have dragged their heels on, including working from home, conference-calling to accommodate people with disabilities, proper sick leave, and flexible child-care arrangements.
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Perhaps the nation will learn that preparedness isn’t just about masks, vaccines, and tests, but also about fair labor policies and a stable and equal health-care system. Perhaps it will appreciate that health-care workers and public-health specialists compose America’s social immune system, and that this system has been suppressed.
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Aspects of America’s identity may need rethinking after COVID-19. Many of the country’s values have seemed to work against it during the pandemic. Its individualism, exceptionalism, and tendency to equate doing whatever you want with an act of resistance meant that when it came time to save lives and stay indoors, some people flocked to bars and clubs.
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Years of isolationist rhetoric had consequences too.
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“People believed the rhetoric that containment would work,” says Wendy Parmet, who studies law and public health at Northeastern University. “We keep them out, and we’ll be okay. When you have a body politic that buys into these ideas of isolationism and ethnonationalism, you’re especially vulnerable when a pandemic hits.”
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Pandemics are democratizing experiences. People whose privilege and power would normally shield them from a crisis are facing quarantines, testing positive, and losing loved ones. Senators are falling sick. The consequences of defunding public-health agencies, losing expertise, and stretching hospitals are no longer manifesting as angry opinion pieces, but as faltering lungs.
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After COVID-19, attention may shift to public health. Expect to see a spike in funding for virology and vaccinology, a surge in students applying to public-health programs, and more domestic production of medical supplies.
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The lessons that America draws from this experience are hard to predict, especially at a time when online algorithms and partisan broadcasters only serve news that aligns with their audience’s preconceptions.
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“The transitions after World War II or 9/11 were not about a bunch of new ideas,” he says. “The ideas are out there, but the debates will be more acute over the next few months because of the fluidity of the moment and willingness of the American public to accept big, massive changes.”
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One could easily conceive of a world in which most of the nation believes that America defeated COVID-19. Despite his many lapses, Trump’s approval rating has surged. Imagine that he succeeds in diverting blame for the crisis to China, casting it as the villain and America as the resilient hero.
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One could also envisage a future in which America learns a different lesson. A communal spirit, ironically born through social distancing, causes people to turn outward, to neighbors both foreign and domestic. The election of November 2020 becomes a repudiation of “America first” politics. The nation pivots, as it did after World War II, from isolationism to international cooperation
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The U.S. leads a new global partnership focused on solving challenges like pandemics and climate change.
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In 2030, SARS-CoV-3 emerges from nowhere, and is brought to heel within a month.
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