{"id":9490,"date":"2020-03-23T02:56:30","date_gmt":"2020-03-23T09:56:30","guid":{"rendered":"https:\/\/worldcampaign.net\/?p=9490"},"modified":"2020-03-23T02:56:30","modified_gmt":"2020-03-23T09:56:30","slug":"the-best-case-outcome-for-the-coronavirus-and-the-worst-the-new-york-times","status":"publish","type":"post","link":"https:\/\/worldcampaign.net\/?p=9490","title":{"rendered":"&#8220;\u201cThe Best-Case Outcome for the Coronavirus, and the Worst\u201d, The New York Times"},"content":{"rendered":"<p>By <span class=\"css-1baulvz last-byline\">Nicholas Kristof,\u00a0<\/span>Opinion Columnist, Sunday Review, March 22, 2020<\/p>\n<p><em>Will we endure 2.2 million deaths? Or will we manage to turn things around?<\/em><\/p>\n<p class=\"css-exrw3m evys1bk0\"><strong class=\"css-8qgvsz ebyp5n10\">Here\u2019s the grimmest version of life a year from now:<\/strong><em class=\"css-2fg4z9 e1gzwzxm0\"> More than two million Americans have died from the new coronavirus, almost all mourned without funerals. Countless others have died because hospitals are too overwhelmed to deal adequately with heart attacks, asthma and diabetic crises. The economy has cratered into a depression, for fiscal and monetary policy are ineffective when people fear going out, businesses are closed and tens of millions of people are unemployed. A vaccine still seems far off, immunity among those who have recovered proves fleeting and the coronavirus has joined the seasonal flu as a recurring peril.<\/em><\/p>\n<p class=\"css-exrw3m evys1bk0\"><strong class=\"css-8qgvsz ebyp5n10\">Yet here\u2019s an alternative scenario for March 2021:<\/strong> <em class=\"css-2fg4z9 e1gzwzxm0\">Life largely returned to normal by the late summer of 2020, and the economy has rebounded strongly. The United States used a sharp, short shock in the spring of 2020 to break the cycle of transmission; warm weather then reduced new infections and provided a summer respite for the Northern Hemisphere. By the second wave in the fall, mutations had attenuated the coronavirus, many people were immune and drugs were shown effective in treating it and even in reducing infection. Thousands of Americans died, mostly octogenarians and nonagenarians and some with respiratory conditions, but by February 2021, vaccinations were introduced worldwide and the virus was conquered.<\/em><\/p>\n<div class=\"css-bsn42l\"><picture><img decoding=\"async\" class=\"css-11cwn6f\" src=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof1\/merlin_170643480_ea88f681-763c-44af-a43f-1f2d9732fb13-articleLarge.jpg?quality=75&amp;auto=webp&amp;disable=upscale\" sizes=\"((min-width: 600px) and (max-width: 1004px)) 84vw, (min-width: 1005px) 80vw, 100vw\" srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof1\/merlin_170643480_ea88f681-763c-44af-a43f-1f2d9732fb13-articleLarge.jpg?quality=90&amp;auto=webp 600w, https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof1\/merlin_170643480_ea88f681-763c-44af-a43f-1f2d9732fb13-jumbo.jpg?quality=90&amp;auto=webp 1024w, https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof1\/merlin_170643480_ea88f681-763c-44af-a43f-1f2d9732fb13-superJumbo.jpg?quality=90&amp;auto=webp 2048w\" alt=\"Medical personnel waited Tuesday for the next patient at a Seattle drive-through coronavirus testing station.\" \/><\/picture><\/div>\n<p class=\"css-exrw3m evys1bk0\"><span style=\"font-size: 8pt;\"><span class=\"css-16f3y1r e13ogyst0\">Medical personnel waited Tuesday for the next patient at a Seattle drive-through coronavirus testing station.<\/span><span class=\"emkp2hg2 css-1fxp258 e1z0qqy90\"><span class=\"css-1ly73wi e1tej78p0\">Credit&#8230;<\/span>Elaine Thompson\/Associated Press<\/span><\/span><\/p>\n<h2 id=\"link-2aacbf11\" class=\"css-lsf2nb eoo0vm40\">The Best Case<\/h2>\n<p class=\"css-exrw3m evys1bk0\">I\u2019ve been speaking to epidemiologists about their best- and worst-case scenarios to gauge what may lie ahead and see how we can tilt the balance. Let me start with the best case, since we could all use a dose of hope \u2014 which may even be therapeutic \u2014 before presenting a bleaker prognosis.<\/p>\n<p class=\"css-exrw3m evys1bk0\">\u201cThe best case is that the virus mutates and actually dies out,\u201d said Dr. Larry Brilliant, an epidemiologist who as a young doctor was part of the fight to eradicate smallpox. Brilliant was a consultant for the movie \u201cContagion,\u201d in which a virus evolved to become more deadly, but that\u2019s the exception. \u201cOnly in movies do viruses seem to become worse,\u201d he explained.<\/p>\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-exrw3m evys1bk0\">Two other lethal coronaviruses, SARS and MERS, both petered out, and that is possible here. \u201cMy hope is that Covid-19 will not survive,\u201d said Dr. Charles G. Prober, a professor at Stanford Medical School.<\/p>\n<p class=\"css-exrw3m evys1bk0\">Several countries have shown that decisive action can turn the tide on Covid-19, at least for a time. China, astonishingly, on Thursday <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.nytimes.com\/2020\/03\/18\/world\/asia\/china-coronavirus-zero-infections.html\">reported<\/a> not a single new case of domestic transmission. While China is still vulnerable to a second wave, it has apparently shown that the virus can be squelched.<\/p>\n<p class=\"css-exrw3m evys1bk0\">The West isn\u2019t going to copy the coercive tactics of China, but Singapore, Taiwan, South Korea and Hong Kong have also demonstrated that, at least temporarily, the virus can be controlled.<\/p>\n<p class=\"css-exrw3m evys1bk0\"><picture><source srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof2\/merlin_170713998_77d3a78b-8dcf-4f8e-9d52-788ee0fa5a60-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=600\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 3),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 3),(max-width: 599px) and (min-resolution: 3dppx),(max-width: 599px) and (min-resolution: 288dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof2\/merlin_170713998_77d3a78b-8dcf-4f8e-9d52-788ee0fa5a60-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1200\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 2),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 2),(max-width: 599px) and (min-resolution: 2dppx),(max-width: 599px) and (min-resolution: 192dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof2\/merlin_170713998_77d3a78b-8dcf-4f8e-9d52-788ee0fa5a60-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1800\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 1),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 1),(max-width: 599px) and (min-resolution: 1dppx),(max-width: 599px) and (min-resolution: 96dpi)\" \/><img decoding=\"async\" class=\"css-1m50asq\" src=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof2\/merlin_170713998_77d3a78b-8dcf-4f8e-9d52-788ee0fa5a60-articleLarge.jpg?quality=75&amp;auto=webp&amp;disable=upscale\" sizes=\"((min-width: 600px) and (max-width: 1004px)) 84vw, (min-width: 1005px) 80vw, 100vw\" srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof2\/merlin_170713998_77d3a78b-8dcf-4f8e-9d52-788ee0fa5a60-articleLarge.jpg?quality=90&amp;auto=webp 600w, https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof2\/merlin_170713998_77d3a78b-8dcf-4f8e-9d52-788ee0fa5a60-jumbo.jpg?quality=90&amp;auto=webp 1024w, https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof2\/merlin_170713998_77d3a78b-8dcf-4f8e-9d52-788ee0fa5a60-superJumbo.jpg?quality=90&amp;auto=webp 2048w\" alt=\"Travelers being screened for fever Thursday at an arrival hall at Changi Airport in Singapore.\" \/><\/picture><\/p>\n<\/div>\n<\/div>\n<div class=\"css-79elbk\" data-testid=\"photoviewer-wrapper\">\n<div class=\"css-1a48zt4 ehw59r15\" data-testid=\"photoviewer-children\">\n<figure class=\"css-1ef8w8q e1g7ppur0\"><figcaption class=\"css-18crmh6 e1xdpqjp0\"><span style=\"font-size: 8pt;\"><span class=\"css-16f3y1r e13ogyst0\">Travelers being screened for fever Thursday at an arrival hall at Changi Airport in Singapore.<\/span><span class=\"css-cnj6d5 e1z0qqy90\"><span class=\"css-1ly73wi e1tej78p0\">Credit&#8230;<\/span>How Hwee Young\/EPA, via Shutterstock<\/span><\/span><\/figcaption><\/figure>\n<\/div>\n<\/div>\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-exrw3m evys1bk0\">Singapore and the other successful Asian models responded with the standard epidemiological tool kit: vigilance and rapid response, testing, isolating the sick, tracing contacts, quarantining those exposed, ensuring social distancing and providing reliable information. They did not shut down their entire countries, and Singapore managed to keep its schools open throughout.<\/p>\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-exrw3m evys1bk0\">\u201cSingapore is a best-case scenario,\u201d said Dr. Tom Frieden, a former director of the Centers for Disease Control and Prevention. He said that there was some possibility that with social distancing and limits on gatherings, the United States could knock down the numbers of infections and begin to adopt Singapore-style strategies to reduce new infections.<\/p>\n<p class=\"css-exrw3m evys1bk0\">\u201cThe most important lesson is that the virus can be contained if people are responsible and adhere to certain simple principles,\u201d said Dr. Christopher Willis, a physician in Singapore. \u201cStay calm. For most people it\u2019s like the common cold.\u201d<\/p>\n<p class=\"css-exrw3m evys1bk0\">Dr. Tom Inglesby, an expert on pandemics at the Johns Hopkins Bloomberg School of Public Health, said, \u201cThe fact that Singapore, Hong Kong, Taiwan, South Korea and China \u2014 and <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.japantimes.co.jp\/news\/2020\/03\/18\/national\/science-health\/japan-coronavirus-peak-infections\/#.XnQXdZNKhTZ\" target=\"_blank\" rel=\"noopener noreferrer\">to some extent Japan<\/a> \u2014 have all flattened their curves despite having the initial onslaught of cases should give us some hope that we can sort out what they\u2019re doing well and emulate it.\u201d<\/p>\n<p class=\"css-exrw3m evys1bk0\">One encouraging sign is that in Washington State, which had an early outbreak, the number of positive tests <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/depts.washington.edu\/uwviro\/\" target=\"_blank\" rel=\"noopener noreferrer\">appears stable<\/a>.<\/p>\n<\/div>\n<\/div>\n<div class=\"css-79elbk\" data-testid=\"photoviewer-wrapper\">\n<div class=\"css-1kb3goj ehw59r12\">\n<div class=\"css-tux0zj ehw59r13\" data-testid=\"photoviewer-overlay\">\n<div class=\"css-ooeope ehw59r11\" data-testid=\"photoviewer-captionblock\">\n<div class=\"css-8h527k\">\n<div data-testid=\"lazyimage-container\">\n<div class=\"css-79elbk\" data-testid=\"photoviewer-wrapper\">\n<div class=\"css-1a48zt4 ehw59r15\" data-testid=\"photoviewer-children\">\n<figure class=\"css-1ef8w8q e1g7ppur0\">\n<div class=\"css-1xdhyk6 erfvjey0\">\n<div class=\"css-8h527k\">\n<div data-testid=\"lazyimage-container\"><picture class=\"css-1j5kxti\"><img decoding=\"async\" class=\"css-1m50asq\" src=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof3\/merlin_170659551_9640c1da-b6f5-4c1f-b124-aa63fccf1f8a-articleLarge.jpg?quality=75&amp;auto=webp&amp;disable=upscale\" sizes=\"((min-width: 600px) and (max-width: 1004px)) 84vw, (min-width: 1005px) 80vw, 100vw\" srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof3\/merlin_170659551_9640c1da-b6f5-4c1f-b124-aa63fccf1f8a-articleLarge.jpg?quality=90&amp;auto=webp 600w, https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof3\/merlin_170659551_9640c1da-b6f5-4c1f-b124-aa63fccf1f8a-jumbo.jpg?quality=90&amp;auto=webp 1024w, https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof3\/merlin_170659551_9640c1da-b6f5-4c1f-b124-aa63fccf1f8a-superJumbo.jpg?quality=90&amp;auto=webp 2048w\" alt=\"Lines on the ground help customers stay six feet apart at Dick\u2019s Drive-In in Seattle.\" \/><\/picture><\/div>\n<\/div>\n<\/div><figcaption class=\"css-18crmh6 e1xdpqjp0\"><span style=\"font-size: 8pt;\"><span class=\"css-16f3y1r e13ogyst0\">Lines on the ground help customers stay six feet apart at Dick\u2019s Drive-In in Seattle.<\/span><span class=\"css-cnj6d5 e1z0qqy90\"><span class=\"css-1ly73wi e1tej78p0\">Credit&#8230;<\/span>Brian Snyder\/Reuters<\/span><\/span><\/figcaption><\/figure>\n<\/div>\n<\/div>\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-exrw3m evys1bk0\">The weather may also help us. Some respiratory viruses decline in summer from a combination of higher temperatures and people not being huddled together, so it is possible that Northern Hemisphere nations will enjoy a summer break before a second wave in the fall. That\u2019s what happened during the 1918 Spanish flu pandemic: It hit in the spring of 1918, went away but returned worse than ever in the fall.<\/p>\n<p class=\"css-exrw3m evys1bk0\">Of the four coronaviruses that cause the common cold, two diminish in warm weather, while <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S1386653218300325?via%3Dihub\" target=\"_blank\" rel=\"noopener noreferrer\">two are more variable<\/a>. SARS and MERS did not have clear seasonal variations, and even seasonal flu is transmitted in the summer, although less than in winter. So while experts hope that hot weather will shortly bring a reprieve from the coronavirus \u2014 the flu is already on the retreat \u2014 there\u2019s no solid evidence.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\"><\/aside>\n<\/div>\n<div id=\"story-ad-3-wrapper\" class=\"css-1r07izm\">\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-exrw3m evys1bk0\">One reason for measured optimism is the prospect that antiviral medicines will beat the coronavirus; some are already in clinical trials. Scientists have hopes for remdesivir, originally developed for Ebola; chloroquine, an old anti-malaria drug; and some anti-H.I.V. and immune-boosting drugs. Many other drugs are also lined up for trials.<\/p>\n<p class=\"css-exrw3m evys1bk0\">Even without proven treatment, the coronavirus may be less lethal than was originally feared, so long as health care systems are not overwhelmed. In South Korea and in China outside Hubei Province, about <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/wwwnc.cdc.gov\/eid\/article\/26\/6\/20-0320_article\" target=\"_blank\" rel=\"noopener noreferrer\">0.8 percent<\/a> of those known to be infected died, and the rate was 0.6 percent on a cruise ship.<\/p>\n<p class=\"css-exrw3m evys1bk0\">That\u2019s still roughly six times the rate of seasonal flu, about 0.1 percent, but Dr. John Ioannidis of Stanford University <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.statnews.com\/2020\/03\/17\/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data\/\" target=\"_blank\" rel=\"noopener noreferrer\">argues<\/a> that the fatality rate may end up even lower. He warns that we are engaging in hugely disruptive interventions without firm evidence of the threat that the virus poses. Singapore has had more than 200 confirmed cases of the virus and not a single death.<\/p>\n<p class=\"css-exrw3m evys1bk0\">About four out of five people known to have had the virus had only mild symptoms, and even among those older than 90 in Italy, <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/myemail.constantcontact.com\/COVID-19-Updates---March-17.html?soid=1107826135286&amp;aid=UZamM7u0cpw\" target=\"_blank\" rel=\"noopener noreferrer\">78 percent survived<\/a>. Two-thirds of those who died in Italy had pre-existing medical conditions and were also elderly; Dr. David L. Katz, the former director of the Prevention Research Center at Yale University, notes that many might have died soon of other causes even if the coronavirus had not struck.<\/p>\n<p class=\"css-exrw3m evys1bk0\">That said, a new C.D.C. study <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.nytimes.com\/2020\/03\/18\/health\/coronavirus-young-people.html\">finds<\/a> that of coronavirus cases in the United States requiring admission to the intensive care unit, nearly half involved patients under age 65; there is also concern about lasting lung damage among survivors.<\/p>\n<p class=\"css-exrw3m evys1bk0\">Putting it all together, Dr. Tara C. Smith, an epidemiologist at Kent State University, said: \u201cI\u2019m not pessimistic. I think this can work.\u201d She thinks it will take eight weeks of social distancing to have a chance to slow the virus, and success will depend on people changing behaviors and on hospitals not being overrun. \u201cIf warm weather helps, if we can get these drugs, if we can get companies to produce more ventilators, we have a window to tamp this down,\u201d Smith said.<\/p>\n<p class=\"css-exrw3m evys1bk0\">So that\u2019s the best case, and it\u2019s plausible. If you want to feel upbeat, stop reading here.<\/p>\n<h2 id=\"link-2da921ce\" class=\"css-lsf2nb eoo0vm40\">The Worst Case<\/h2>\n<p class=\"css-exrw3m evys1bk0\">Now we get to the other end of the range of possibilities. Dr. Neil M. Ferguson, a British epidemiologist who is regarded as one of the best disease modelers in the world, produced a sophisticated model with a worst case of 2.2 million deaths in the United States.<\/p>\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-exrw3m evys1bk0\">I asked Ferguson for his best case. \u201cAbout 1.1 million deaths,\u201d he said.<\/p>\n<p class=\"css-exrw3m evys1bk0\">When that\u2019s a best-case scenario, it\u2019s difficult to feel optimistic.<\/p>\n<p class=\"css-exrw3m evys1bk0\">Ferguson questions whether South Korea and other countries can sustain their success for 18 months until a vaccine is ready, even as new cases are constantly being imported. Indeed, a burst of new cases has been reported in recent days in Singapore, Hong Kong and Taiwan.<\/p>\n<p class=\"css-exrw3m evys1bk0\">As for the hope that the United States can emulate Singapore or South Korea, that may be a leap.<\/p>\n<p class=\"css-exrw3m evys1bk0\">America and South Korea <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.reuters.com\/article\/us-health-coronavirus-testing-specialrep\/special-report-how-korea-trounced-u-s-in-race-to-test-people-for-coronavirus-idUSKBN2153BW?utm\" target=\"_blank\" rel=\"noopener noreferrer\">reported<\/a> their first Covid-19 cases on the same day, but South Korea took the epidemic seriously, promptly created an effective test, used it widely and has seen cases go down more than 90 percent from the peak. In contrast, the United States badly bungled testing, and President Trump repeatedly dismissed the coronavirus, saying it was \u201ctotally under control\u201d and \u201cwill disappear,\u201d and insisting he wasn\u2019t \u201cconcerned at all.\u201d The United States has still done only a bit more than <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/ourworldindata.org\/grapher\/covid19-tests-per-million-people\" target=\"_blank\" rel=\"noopener noreferrer\">10 percent<\/a> as many tests per capita as Canada, Austria and Denmark.<\/p>\n<p class=\"css-exrw3m evys1bk0\"><picture class=\"css-1j5kxti\"><source srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof6\/merlin_170694918_a66396c2-6510-4c3d-ba67-afa49059482f-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=600\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 3),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 3),(max-width: 599px) and (min-resolution: 3dppx),(max-width: 599px) and (min-resolution: 288dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof6\/merlin_170694918_a66396c2-6510-4c3d-ba67-afa49059482f-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1200\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 2),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 2),(max-width: 599px) and (min-resolution: 2dppx),(max-width: 599px) and (min-resolution: 192dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof6\/merlin_170694918_a66396c2-6510-4c3d-ba67-afa49059482f-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1800\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 1),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 1),(max-width: 599px) and (min-resolution: 1dppx),(max-width: 599px) and (min-resolution: 96dpi)\" \/><img decoding=\"async\" class=\"css-1m50asq\" src=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof6\/merlin_170694918_a66396c2-6510-4c3d-ba67-afa49059482f-articleLarge.jpg?quality=75&amp;auto=webp&amp;disable=upscale\" sizes=\"((min-width: 600px) and (max-width: 1004px)) 84vw, (min-width: 1005px) 80vw, 100vw\" srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof6\/merlin_170694918_a66396c2-6510-4c3d-ba67-afa49059482f-articleLarge.jpg?quality=90&amp;auto=webp 600w, https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof6\/merlin_170694918_a66396c2-6510-4c3d-ba67-afa49059482f-jumbo.jpg?quality=90&amp;auto=webp 1024w, https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof6\/merlin_170694918_a66396c2-6510-4c3d-ba67-afa49059482f-superJumbo.jpg?quality=90&amp;auto=webp 2048w\" alt=\"Police officers in Milan performing checks at Piazza Duomo on Wednesday.\" \/><\/picture><\/p>\n<\/div>\n<\/div>\n<div class=\"css-79elbk\" data-testid=\"photoviewer-wrapper\">\n<div class=\"css-1a48zt4 ehw59r15\" data-testid=\"photoviewer-children\">\n<figure class=\"css-1ef8w8q e1g7ppur0\">\n<div class=\"css-1xdhyk6 erfvjey0\"><\/div><figcaption class=\"css-18crmh6 e1xdpqjp0\"><span style=\"font-size: 8pt;\"><span class=\"css-16f3y1r e13ogyst0\">Police officers in Milan performing checks at Piazza Duomo on Wednesday.<\/span><span class=\"css-cnj6d5 e1z0qqy90\"><span class=\"css-1ly73wi e1tej78p0\">Credit&#8230;<\/span>Marco Ottico\/EPA, via Shutterstock<\/span><\/span><\/figcaption><\/figure>\n<\/div>\n<\/div>\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-exrw3m evys1bk0\">By some counts, the United States is just <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.theatlantic.com\/ideas\/archive\/2020\/03\/interview-francis-collins-nih\/608221\/\" target=\"_blank\" rel=\"noopener noreferrer\">eight days<\/a> behind Italy on a similar trajectory, and it\u2019s difficult to see how America can pirouette from the path of Italy to that of South Korea. The United States may already have 100,000 infected citizens \u2014 nobody knows. That\u2019s too many to trace. Indeed, one can argue that the U.S. is not only on the same path as Italy but is also less prepared, for America has <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.oecd-ilibrary.org\/docserver\/health_glance-2017-52-en.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">fewer doctors<\/a> and hospital beds per capita than Italy does \u2014 and a <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/data.oecd.org\/healthstat\/life-expectancy-at-birth.htm\" target=\"_blank\" rel=\"noopener noreferrer\">shorter life expectancy<\/a> even in the best of times.<\/p>\n<p class=\"css-exrw3m evys1bk0\">Mitre, a nonprofit that does work on health care, <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.mitre.org\/sites\/default\/files\/publications\/COVID-19_MITRE_Action_Paper_March-2020.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">calculated<\/a> that coronavirus cases are doubling more quickly in the United States than in any other country it examined, including Italy and Iran.<\/p>\n<p class=\"css-exrw3m evys1bk0\">The nightmare is a surge that overwhelms the hospital system. A Times colleague, Stuart A. Thompson, and I worked with two epidemiologists to develop <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.nytimes.com\/interactive\/2020\/03\/13\/opinion\/coronavirus-trump-response.html\">an interactive model<\/a> of the virus that suggested that up to 366,000 I.C.U. beds might be needed in the United States for coronavirus patients at one time, more than 10 times the number available. A <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.nytimes.com\/interactive\/2020\/03\/17\/upshot\/hospital-bed-shortages-coronavirus.html\">Harvard study <\/a>reached a similar conclusion.<\/p>\n<\/div>\n<\/div>\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-exrw3m evys1bk0\">This is an interval of quiet when the United States should be urgently ramping up investment in vaccines and therapies, addressing the severe shortages of medical supplies and equipment, and giving retired physicians and military medics legal authority to practice in a crisis. During World War II, the Ford Motor Company turned out one B-24 bomber <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.thehenryford.org\/collections-and-research\/digital-collections\/expert-sets\/101765\/\" target=\"_blank\" rel=\"noopener noreferrer\">every 63 minutes<\/a>; today, we should be <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/medium.com\/frontier-technology-livestreaming\/frontier-tech-4-covid-action-emerging-market-ventilation-systems-9c818cb46189\" target=\"_blank\" rel=\"noopener noreferrer\">rushing out ventilators<\/a> and face masks, but there\u2019s nothing like the same sense of urgency.<\/p>\n<p class=\"css-exrw3m evys1bk0\">Peter Hotez, an eminent vaccine scientist at Baylor College of Medicine, told me that he and his colleagues have a candidate vaccine for the coronavirus but still haven\u2019t been able to line up sufficient funding for clinical trials.<\/p>\n<div class=\"css-8h527k\">\n<div data-testid=\"lazyimage-container\"><picture class=\"css-1j5kxti\"><source srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof4\/20Kristof4-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=600\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 3),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 3),(max-width: 599px) and (min-resolution: 3dppx),(max-width: 599px) and (min-resolution: 288dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof4\/20Kristof4-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1200\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 2),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 2),(max-width: 599px) and (min-resolution: 2dppx),(max-width: 599px) and (min-resolution: 192dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof4\/20Kristof4-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1800\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 1),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 1),(max-width: 599px) and (min-resolution: 1dppx),(max-width: 599px) and (min-resolution: 96dpi)\" \/><img decoding=\"async\" class=\"css-1m50asq\" src=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof4\/20Kristof4-articleLarge.jpg?quality=75&amp;auto=webp&amp;disable=upscale\" sizes=\"((min-width: 600px) and (max-width: 1004px)) 84vw, (min-width: 1005px) 80vw, 100vw\" srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof4\/20Kristof4-articleLarge.jpg?quality=90&amp;auto=webp 600w, https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof4\/20Kristof4-jumbo.jpg?quality=90&amp;auto=webp 794w, https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof4\/20Kristof4-superJumbo.jpg?quality=90&amp;auto=webp 1587w\" alt=\"A store in New York City indicating protective gear in supply on Wednesday.\" \/><\/picture><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"css-79elbk\" data-testid=\"photoviewer-wrapper\">\n<div class=\"css-1a48zt4 ehw59r15\" data-testid=\"photoviewer-children\">\n<figure class=\"css-t9vhop e1g7ppur0\"><figcaption class=\"css-18crmh6 e1xdpqjp0\"><span style=\"font-size: 8pt;\"><span class=\"css-16f3y1r e13ogyst0\">A store in New York City indicating protective gear in supply on Wednesday.<\/span><span class=\"css-cnj6d5 e1z0qqy90\"><span class=\"css-1ly73wi e1tej78p0\">Credit&#8230;<\/span>Bill Tompkins\/Getty Images<\/span><\/span><\/figcaption><\/figure>\n<\/div>\n<\/div>\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\"><\/div>\n<\/div>\n<\/div>\n<p class=\"css-exrw3m evys1bk0\">Already there are stunning unmet needs for personal protective equipment. After initial missteps in Wuhan, where the coronavirus was first discovered, China adopted protocols for protective gear that are more rigorous than those in the United States, involving N95 masks and face shields, double gowns, gloves and shoe covers, plus special areas to remove protective clothing \u2014 and all this worked. Not one of the 42,000 health workers sent to Wuhan <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/drive.google.com\/file\/d\/14tGJF9tdv4osPhY1-fswLcSlWZJ9zx45\/view\" target=\"_blank\" rel=\"noopener noreferrer\">is known<\/a> to have become infected with the coronavirus. The United States isn\u2019t protecting health workers with the same determination; it seems to be betraying them.<\/p>\n<p class=\"css-exrw3m evys1bk0\">Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University, said he had received a phone call from a major Florida hospital that had run out of masks. A doctor wanted to know: Could cloth be used to construct makeshift masks?<\/p>\n<p class=\"css-exrw3m evys1bk0\">The answer: not very well, but it\u2019s better than nothing. The need is so acute that the C.D.C. has posted <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/ppe-strategy\/face-masks.html\" target=\"_blank\" rel=\"noopener noreferrer\">official guidance<\/a> advising that doctors and nurses \u201cmight use homemade masks (e.g., bandanna, scarf) for care of patients with Covid-19 as a last resort.\u201d<\/p>\n<p class=\"css-exrw3m evys1bk0\">\u201cIf people think that a hospital crisis is coming, it\u2019s important to know that it\u2019s already here,\u201d Redlener said. \u201cIt\u2019s affecting front-line health workers, who are probably the highest risk group. These are like combat troops on the front lines of a war.\u201d<\/p>\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-exrw3m evys1bk0\">In Italy, <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.aljazeera.com\/news\/2020\/03\/rising-number-medical-staff-infected-coronavirus-italy-200318183939314.html\" target=\"_blank\" rel=\"noopener noreferrer\">8.3 percent<\/a> of coronavirus cases involve health workers. A doctor in the Seattle area who is forced to reuse N95 masks told me that she and her colleagues fear that the lack of supplies will be deadly.<\/p>\n<p class=\"css-exrw3m evys1bk0\">\u201cWe are all making dying contingency plans at this point just in case,\u201d she said. \u201cWills, backup people to take care of kids, recording bedtime stories.\u201d<\/p>\n<p class=\"css-exrw3m evys1bk0\">In the worst-case scenario, will social services collapse in some areas? Will order fray? Gun sales are increasing, because some people expect chaos and crime.<\/p>\n<p class=\"css-exrw3m evys1bk0\">The United States is in a weaker position than some other countries to confront the virus because it is the only advanced country that doesn\u2019t have universal health coverage, and the only one that does not guarantee paid sick leave. With chronic diseases, the burden of these gaps is felt primarily by the poor; with infectious diseases, the burden will be shared by all Americans.<\/p>\n<\/div>\n<\/div>\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<h2 id=\"link-5c83594d\" class=\"css-lsf2nb eoo0vm40\">It\u2019s Up to Us<\/h2>\n<p class=\"css-exrw3m evys1bk0\">So where is the United States headed? Will we endure the worst case, with 2.2 million deaths? Or will we manage to turn things around, with help from summer?<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\"><\/aside>\n<\/div>\n<div class=\"css-79elbk\" data-testid=\"photoviewer-wrapper\">\n<div class=\"css-z3e15g\" data-testid=\"photoviewer-wrapper-hidden\">\n<div class=\"css-8h527k\">\n<div data-testid=\"lazyimage-container\"><picture class=\"css-1j5kxti\"><source srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof5\/20Kristof5-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=600\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 3),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 3),(max-width: 599px) and (min-resolution: 3dppx),(max-width: 599px) and (min-resolution: 288dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof5\/20Kristof5-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1200\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 2),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 2),(max-width: 599px) and (min-resolution: 2dppx),(max-width: 599px) and (min-resolution: 192dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof5\/20Kristof5-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1800\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 1),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 1),(max-width: 599px) and (min-resolution: 1dppx),(max-width: 599px) and (min-resolution: 96dpi)\" \/><img decoding=\"async\" class=\"css-1m50asq\" src=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof5\/20Kristof5-articleLarge.jpg?quality=75&amp;auto=webp&amp;disable=upscale\" sizes=\"((min-width: 600px) and (max-width: 1004px)) 84vw, (min-width: 1005px) 80vw, 100vw\" srcset=\"https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof5\/20Kristof5-articleLarge.jpg?quality=90&amp;auto=webp 600w, https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof5\/20Kristof5-jumbo.jpg?quality=90&amp;auto=webp 1024w, https:\/\/static01.nyt.com\/images\/2020\/03\/20\/opinion\/sunday\/20Kristof5\/20Kristof5-superJumbo.jpg?quality=90&amp;auto=webp 2048w\" alt=\"A road sign in San Francisco.\" \/><\/picture><\/div>\n<\/div>\n<\/div>\n<div class=\"css-1a48zt4 ehw59r15\" data-testid=\"photoviewer-children\">\n<figure class=\"css-1ef8w8q e1g7ppur0\"><figcaption class=\"css-18crmh6 e1xdpqjp0\"><span class=\"css-16f3y1r e13ogyst0\">A road sign in San Francisco.<\/span><span class=\"css-cnj6d5 e1z0qqy90\"><span class=\"css-1ly73wi e1tej78p0\">Credit&#8230;<\/span>John G. Mabanglo\/EPA, via Shutterstock<\/span><\/figcaption><\/figure>\n<\/div>\n<\/div>\n<div class=\"css-53u6y8\"><\/div>\n<\/div>\n<\/div>\n<p class=\"css-exrw3m evys1bk0\">No one knows, so the optimal path forward is to hope for the best while preparing for the worst. Dr. Brilliant, whom I quoted above as hoping that the virus mutates and dies out, also warns that the coronavirus may \u201ccause global disruption on a scale we have not seen from any epidemic in more than 100 years.\u201d<\/p>\n<div class=\"css-53u6y8\">\n<p class=\"css-exrw3m evys1bk0\">Outcomes depend in part on us \u2014 and my conversations with experts leave me concerned that we still are not doing enough.<\/p>\n<p class=\"css-exrw3m evys1bk0\">\u201cIf anything, we\u2019re still underreacting,\u201d said Dr. Chaz Langelier, an expert on respiratory infections at the University of California at San Francisco. \u201cIn the last week, in terms of public health response and testing, we\u2019ve maybe gotten to the pace we should have been at a month ago.\u201d<\/p>\n<p class=\"css-exrw3m evys1bk0\">This crisis should be a wake-up call to address long-term vulnerabilities. That means providing universal health coverage and paid sick leave \u2014 and if you think that the coronavirus legislation Trump signed on Wednesday achieves that, think again. It guarantees sick leave to <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.nytimes.com\/2020\/03\/14\/opinion\/coronavirus-pelosi-sick-leave.html\">only about one-fifth<\/a> of private-sector workers. It\u2019s a symbol of the inadequacy of America\u2019s preparedness.<\/p>\n<p class=\"css-exrw3m evys1bk0\">More broadly, the United States must remedy its health priorities: We pour resources into clinical medicine but neglect public health. What\u2019s the difference? If you get lung cancer, surgeons operate to save your life, but public health professionals keep you from smoking in the first place. If you get the coronavirus, a doctor will treat you; public health aims to keep the pandemic from getting near you. The United States has a decentralized and spotty public health system, and it has endured painful budget cuts, yet historically public health has saved more lives than clinical medicine.<\/p>\n<p class=\"css-exrw3m evys1bk0\">We may dodge a bullet this time, but experts have been <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.wsj.com\/articles\/SB124121965740478983\" target=\"_blank\" rel=\"noopener noreferrer\">warning <\/a>for decades that a killer pandemic will come; typically, they expected an avian flu like the 1918 pandemic rather than a coronavirus. Singapore and South Korea did well this time partly because they had been frightened by SARS and MERS and were vigilant; if we, too, can be scared enough to invest in public health and fix our health care system, then something good can come from this crisis \u2014 and in the long run, that may save lives.<\/p>\n<p class=\"css-exrw3m evys1bk0\">The Big One is approaching, whether now or later, whether we\u2019re prepared or not. Dr. Ferguson, the infectious disease modeler who predicted deaths in the United States might reach 2.2 million, <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/twitter.com\/neil_ferguson\/status\/1240171876695117824\" target=\"_blank\" rel=\"noopener noreferrer\">came down<\/a> with a cough and fever a few days ago. He <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/twitter.com\/neil_ferguson\/status\/1240696926183415811\" target=\"_blank\" rel=\"noopener noreferrer\">tested positive<\/a> for the coronavirus.<\/p>\n<p class=\"css-exrw3m evys1bk0\"><em>Nicholas Kristof has been a columnist for The Times since 2001. He has won two Pulitzer Prizes, for his coverage of China and of the genocide in Darfur.<\/em><\/p>\n<p class=\"css-exrw3m evys1bk0\"><a href=\"https:\/\/www.nytimes.com\/2020\/03\/20\/opinion\/coronavirus-outcomes.html\">The New York Times<\/a><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>By Nicholas Kristof,\u00a0Opinion Columnist, Sunday Review, March 22, 2020 Will we endure 2.2 million deaths? Or will we manage to turn things around? Here\u2019s the grimmest version of life a year from now: More than two million Americans have died from the new coronavirus, almost all mourned without funerals. Countless others have died because hospitals [&hellip;]<\/p>\n","protected":false},"author":1001004,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[53],"tags":[],"_links":{"self":[{"href":"https:\/\/worldcampaign.net\/index.php?rest_route=\/wp\/v2\/posts\/9490"}],"collection":[{"href":"https:\/\/worldcampaign.net\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/worldcampaign.net\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/worldcampaign.net\/index.php?rest_route=\/wp\/v2\/users\/1001004"}],"replies":[{"embeddable":true,"href":"https:\/\/worldcampaign.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=9490"}],"version-history":[{"count":1,"href":"https:\/\/worldcampaign.net\/index.php?rest_route=\/wp\/v2\/posts\/9490\/revisions"}],"predecessor-version":[{"id":9491,"href":"https:\/\/worldcampaign.net\/index.php?rest_route=\/wp\/v2\/posts\/9490\/revisions\/9491"}],"wp:attachment":[{"href":"https:\/\/worldcampaign.net\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=9490"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/worldcampaign.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=9490"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/worldcampaign.net\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=9490"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}