Four days ago, a stroll through the little grocery store nearest me showed everything normal. A day after that, the paper products had vanished from the shelves as neatly as if the place had been overrun by a convention of termites. Yesterday, the parking lot was full, but the shelves were bare, with the aisles patrolled by people just getting a grip on the idea that a bag of apples, a pound of ground beef, or a six-pack of Charmin was not guaranteed to be waiting for them. Several local stores, overrun by the sudden demand from frightened people, announced that they would be closed today for restocking—which only increased the panic buying at those stores that remained open.
This morning, Missouri joined neighboring states in closing restaurants and bars to dine-in service, as well as placing other restrictions on businesses to limit social contact. There haven’t been many good decisions coming out of Missouri’s Republican-dominated government in the last few years … but this was good decision. Even though the number of known cases in the state is still under a dozen, this is the time to take action.
It takes drastic action to break the exponential growth curve of an epidemic, especially with a disease as easily transmissible as COVID-19. Some countries, such as South Korea, stayed on top of the infection from the moment it entered their country. With extensive testing, dedicated follow-up on tracking down sources, and a hospital system that was already much better prepared to handle a sudden influx of patients, they never had to move away from a strategy of isolating the infected and working directly with cases—even when there were 8,000 of them.
But the failure to roll out testing in the United States and the continued stories of unbelievable, inexcusable actions in refusing to provide tests mean that South Korea’s methods are simply unavailable to the United States. You can’t improve what you don’t measure … and the United States simply refuses to measure at anywhere near the depth or width necessary to be helpful.
How effective can widespread testing be? As this story from Financial Times indicates: pretty damn effective. A single village was selected for an experiment in which every member of the 3,300-person community was tested. Those results were then used to isolate those who tested positive. The result: in an Italy where new cases were skyrocketing, the town at the center of this experience produced zero new infections. Zero. As the director-general of the World Health Organization said this week, “Our key message is: test, test, test.”
At the moment, the United States isn’t coming close to testing at a level sufficient to provide actionable information. So the only option is to attempt to mitigate through broad, public procedures. These procedures can work—but they do so at enormous cost to individuals and the economy. Plus, they are far less effective than the isolation of just the infected, which is allowed by large-scale testing.
You can use a pair of tweezers to select out those who are infected. Or you can smash your economy with a hammer, because you can’t get your act together. The United States is rolling out hammer after hammer. And the only good thing that can be said about it is that it’s better than nothing—even if it’s far, far less effective, more disruptive, and more costly in lives and dollars than simply testing the hell out of everyone.
At the time of writing, the United States had not only passed 6,000 cases, it had also just passed 100 deaths. Usually, I don’t include the current day on this chart, but on Tuesday, the 1,500 new cases are a painful increase over the previous days—and there are still a lot of hours remaining in the day.
For some time now, it’s been clear that the United States has been chasing Italy up the steep line of confirmed cases. But something interesting has happened in Italy over the past three days. The curve hasn’t flattened in the way that it did in South Korea, but it has flattened in a different sense—it’s become more a line than a curve, as Italy has posted nearly identical totals for four days in a row. What’s being measured here is the effectiveness of the broad mitigation strategy employed in Italy, and again, expect the United States to demonstrate a similar pattern. Where containment by testing and follow-up turned South Korea into a nation where the number of active cases is shrinking by the day, Italy shows what can be achieved by widespread, non-directed action. However … don’t be surprised if Italy’s numbers begin to genuinely fall in the next few days. The other issue with this kind of reaction is that it takes some time for the effect, so … keep a watch on Italy in the next week. It could be yet another signal about the future of the United States.
A big part of what’s happening in Italy is the same as what’s happening in the United States: statistics may be national, but people are not. It may take no more than a 100 cases in a community to more than swamp the available hospital beds, and 1,000 cases can place a strain even on the resources of a large city. To see how this works, try plugging some numbers into Penn State Medical School’s new simulator that lets you see what steps are most vital to the system, and how quickly things can fall apart.
That abrupt uptick in U.S. cases is visible even on the scale of European countries that have been a few days ahead. It’s unclear whether this new rate was fluke generated by testing on this day, or the new normal-abnormal.
Be careful out there. Plan before you go out. Don’t be a hoarder, but do consider getting a little more when possible in order to minimize the number of trips you make. There was a tweet earlier this week (which, unfortunately, I can’t find now to give proper credit) saying to treat your home like you’re on a Star Trek starship. Occasionally you make away missions to planets that may not be safe, and you should be sure to decontaminate when you return. But most of the time you’re just futzing with the tech and drinking tea … though you might have to hunt to find some Earl Grey out there.