NRPLUS MEMBER ARTICLE F rom coast to coast, Americans have put their lives on hold over the past eight weeks. We shut down “nonessential” businesses and placed the nation’s economy in an induced coma until unemployment reached levels on par with those of the Great Depression. We effectively ended the school year in mid March, when schools were closed and the inadequate substitute of “distance learning” was implemented. We delayed almost all “elective” medical care, including everything from joint replacements to treatments for non-life-threatening cancers to cataract surgeries. We have “socially distanced” from friends and relatives, canceled almost all events and travel, and, in some cases, barely left our homes.
That all sounds pretty bleak, and it most certainly is. But there’s good news, too. Those eight weeks of disruption bought us quite a lot in our fight with the coronavirus.
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1. With only a handful of exceptions, most of America’s hospitals did not get overwhelmed with a deluge of patients.
Thankfully, most hospitals across the country never came close their maximum capacity levels. The Army Corps of Engineers spent more than $660 million to turn 17 convention centers and other sites into emergency field hospitals. Nine of the 17 never saw any patients. The Javits Center in New York City treated 1,095, the TCF Center in Detroit treated 39, and the McCormick Center in Chicago treated 37. The hospital ship USNS Comfort treated a total of 182 patients over a three-and-a-half week period in New York City, while the USNS Mercy treated a total of 77 patients over a six-week period.
Certain hospitals in New York City, Detroit, and Prince George’s County, Maryland had stretches where patients had to be transferred to other hospitals to ensure space. Many hospitals in hard-hit cities and regions needed staffers to work at a relentless, breakneck pace, and they responded heroically. But we avoided the doomsday scenario seen in some cities in Italy and Spain, where the sick were denied care because there was no space for them in any hospital.
2. With each passing week, our ability to treat COVID-19 is improving.
There is no cure for the coronavirus, so the outbreak has forced American doctors and hospitals to try all kinds of measures — and they’re keeping track of which ones seem to be working the best. Many doctors have found that having patients lie on their stomachs or sides can generate higher blood-oxygen levels by reducing pressure on the lungs. After an enormous push to obtain and build massive numbers of ventilators, doctors are finding the machines less useful than they’d originally anticipated.
Meanwhile, research has continued apace into a handful of drugs that might mitigate the effects of COVID-19. Remdesivir, in particular, is being hailed as a “game changer” by some epidemiologists, and medical researchers are running six separate trials to determine whether it can be even more effective when combined with other medicines. Doctors in Hong Kong say they’re getting encouraging results from a three-drug cocktail of the HIV medicine lopinavir-ritonavir, the hepatitis drug ribavirin, and the multiple-sclerosis treatment interferon beta. We now know that the much-debated immunosuppressant drug hydroxychloroquine is probably going to be most useful in the 15 percent or so of coronavirus patients who go into a “cytokine storm,” during which the body’s immune system kicks into overdrive and starts attacking healthy cells in important organs.
In short, doctors know a lot more and have a better chance of saving those who get sick from the virus now than they did a few months ago.
3. Our testing capacity has been beefed up.
The number of tests conducted in the country each day has increased dramatically, from less than 100,000 in March to between 200,000 and 300,000 in May.
It is one thing to call for more testing; it takes time and the right materials to make more tests, and it takes lab manpower to conduct them. The Food and Drug Administration has granted 69 companies “emergency use authorizations” to produce tests, which has helped. Roche, the first commercial developer to receive such an authorization for a SARS-CoV-2 test, says it is now producing 15 million tests per month — or roughly 500,000 per day. Meanwhile, Quest Diagnostics, the nation’s largest lab-testing company, says it now “has the capability to perform approximately 50,000 of these diagnostic tests per day, or approximately 350,000 tests per week.”
In fact, one of the surprising problems in this pandemic has been unused testing capacity. A few hospitals, doctors’ offices, and labs are getting more tests than they can use.
4. We’ve bought time in the unprecedented global race to develop a vaccine.
By “flattening the curve,” we’ve managed to keep our hospital systems from being overwhelmed, saving lives and giving researchers the breathing room they need as they search for a vaccine.
There are more than 100 potential vaccines in development around the world. The White House developed “Operation Warp Speed,” which would pick a diverse set of vaccine candidates and pour virtually limitless resources into unprecedented comparative studies in animals, fast-tracked human trials, and manufacturing. Separately, several U.S. vaccine producers are contemplating doing joint trials to save time. The Oxford vaccine already appears to work in monkeys; now the question is whether it will work in human beings. Pfizer has already started human testing and hopes to scale it up dramatically by September.
The market-research firm MorningStar reviewed the work of a variety of pharmaceutical companies and concluded that our entire fight with the virus could look dramatically different by the end of the year:
While coronavirus vaccines have yet to produce clinical data, encouraging preclinical data, strong partnerships and funding, and rapid clinical progress all seem to indicate that use in high-risk populations could be possible by the end of 2020, with tens of millions of doses potentially available by that point. If just two of these vaccines succeed, we could have enough supply to protect high-risk populations in late 2020 and for broader vaccination as we enter 2021.
5. We’ve managed to avoid widespread shortages of personal protective equipment by ramping up production.
Hospitals will want to build up their own stockpiles of PPE — in New York, Governor Andrew Cuomo is requiring medical facilities to accrue a 90-day supply — but the worst shortages are over. Despite many valid complaints about the federal government’s not moving as fast as health-care professionals wanted, by April 20, it had delivered 55 million N95 respirators, 69 million surgical masks, 10.5 million surgical gowns, and 10,000 ventilators to hospitals.
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Americans will probably spend the rest of their days arguing about whether the nationwide shutdown was “worth it.” The cost in lost jobs, closed businesses, and depleted life savings is unparalleled and will probably take many years to fully recover from. Calls to suicide hotlines are increasing. Potentially preventable deaths from heart attacks and strokes may be rising, as people remain reluctant to go to the hospital because they’re scared to catch the virus. Children’s vaccinations are being put off. State and local budgets are wrecked. But our collective sacrifice has also generated much-needed advantages in the fight against this pandemic, and that’s worth noting, too.