Lockdown delays cost of at least 36,000 lives, data says

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If the United States had started imposing social distancing measures a week earlier than in March, about 36,000 fewer people would have died in the coronavirus epidemic, according to new estimates from University disease modellers. Columbia.

And if the country had started closing cities and limiting social contact on March 1, two weeks earlier than most people started staying at home, the vast majority of the country’s deaths – about 83% – would have been avoided, the researchers said.

In this scenario, around 54,000 fewer people would have died in early May.

The enormous cost of waiting to act reflects the ruthless dynamics of the epidemic that swept through American cities in early March. Even small timing differences would have prevented the worst exponential growth that, in April, had engulfed New York, New Orleans and other major cities, the researchers said.

“It is a big, big difference. This little moment in time, catching it in this growth phase, is incredibly critical in reducing the number of deaths, “said Jeffrey Shaman, Columbia epidemiologist and head of the research team.

The results are based on the modeling of infectious diseases which assesses how the reduction of contact between people from mid-March has slowed the transmission of the virus. Dr. Shaman’s team modeled what would have happened if these same changes had occurred a week or two earlier and estimated the spread of infections and deaths until May 3.

The results show that as states reopen, epidemics can easily get out of control unless authorities closely monitor infections and immediately suppress new outbreaks. And they show that every day that the authorities waited to impose restrictions at the beginning of March was very expensive.

After Italy and South Korea began to react aggressively to the virus, President Trump resisted the cancellation of election rallies or the need to stay home or avoid the crowds. The risk of the virus for most Americans was very low, he said.

“Nothing is closed, life and the economy go on,” said Trump. tweeted March 9, suggesting that the flu was worse than the coronavirus. “At the moment, there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about it! ”

The White House did not respond to a request for comment, but Trump repeatedly cited travel restrictions from China in January and from Europe in mid-March as actions that stopped the spread of the virus.

On March 16, Trump urged Americans to limit travel, avoid groups, and stay out of school. Bill de Blasio, mayor of New York, closed city schools on March 15, and Governor Andrew M. Cuomo issued a stay order that came into effect on March 22. Personal behavior changes across the country in mid March slowed the epidemic, a number of researchers have discovered the disease.

But in cities where the virus arrived early and spread quickly, these actions were too late to avoid a calamity.

In New York City alone, 21,800 people died on May 3. Less than 4,300 would have died by then if nationwide controls and measures had been put in place a week earlier, March 8, the researchers said.

All the models are only estimates and it is impossible to know with certainty the exact number of people who would have died. But Lauren Ancel Meyers, an epidemiologist from the University of Texas at Austin who was not involved in the research, said it “convincingly proves that even slightly earlier action in New York could have changed the situation. “

“This implies that if interventions had taken place two weeks earlier, many deaths and cases of Covid-19 would have been prevented in early May, not only in New York, but across the United States,” said Dr. Meyers.

The fate of specific people cannot be captured by a computer model. But there is a name, a story and a city for each infected person who then showed symptoms and died in March and early April. Across the country, people distinct from this study wondered what could have been.

Rushia Stephens, a music teacher who became a county court technician in an Atlanta suburb, collapsed on the floor of her room, unable to breathe, and died on March 19. Adolph Mendez, a businessman in New Braunfels, Texas, was confined to his own bedroom because his terrified family cared for him until his death on March 26. Richard Walts, a retired Oklahoma firefighter, was transported to hospital by ambulance and died two weeks later, on April 3.

Mendez’s widow, Angela Mendez, said she still couldn’t say for sure whether action should have been taken sooner. It didn’t matter anymore, not for her husband.

“They probably could have had a better way sooner not to let this pandemic go that far,” she said. “But they didn’t do it. “

Formal social removal measures only work if people follow them. Although the measures have received widespread support among Americans, the results are based on the assumption that millions of people would have been ready to change their behavior sooner.

People tend to take restrictions much more seriously when the devastation of a disease is visible, said Natalie Dean, an assistant professor of biostatistics at the University of Florida, who specializes in emerging infectious diseases. But by early March, there had been few deaths and infections were spreading quietly among the population.

“If things really take off, people are likely to restrict more,” said Dr. Dean. “Do people need to hear sirens to stay at home? “

Dr. Shaman’s team estimated the effect of easing all control measures across the country. The model reveals that due to the time lag between when infections occur and symptoms begin to appear, without extensive testing and prompt action, many more infections will occur, resulting in more deaths – up to tens of thousands Across the country.

The timing and circumstances of those infected in March raise haunting questions.

It was a Friday evening in mid-March when Devin Taquino started to feel sick. Neither he nor his wife thought of the coronavirus at all. There were already over 200 cases in the state at the time, but most of these cases were in the eastern part of the state, not in the small town of Donora, south of Pittsburgh.

In addition, Mr. Taquino did not fit the profile: he was only 47 years old with no underlying conditions and his main symptom – diarrhea – was not something widely associated with the disease. He planned to work an additional shift on Saturday morning in a call center half an hour away, but he called sick. Offices across the region were asking people not to enter, but Mr. Taquino had not taken this action.

He worked Monday, but Tuesday came home from work sick, passed out in bed, and did not wake up for 16 hours. The next morning, his wife, Rebecca Taquino, 42, woke him up and told him to get tested. She didn’t think he had the virus, but she thought it was the smart thing to do.

Without primary care doctors, they went to a nearby emergency care clinic, where they learned that his oxygen level in the blood was very low. People at the clinic offered to call an ambulance, but fearful of the cost and still skeptical of the severity of the problem, the Taquinos chose to go to the emergency room.

At the hospital, he received an x-ray and was diagnosed with pneumonia. He stayed, kept in an isolation unit just in case, and she went home. The next evening, March 26, he called her with two developments. One: his work sent an email with the news that someone at the call center, where the workstations were sitting about a foot apart, tested positive for the virus. The other news was that he had tested positive.

There were many things that Ms. Taquino thought about in the weeks following this phone call, including the long days during which she never left home and her husband’s situation got even worse. aggravated.

Should the call center have sent employees home sooner? As of Friday, when she called the center to report her condition, the center was already empty: the workers had been sent home. Did they act too late?

“I sort of threw this one back and forth,” she said. “I really want to blame them, I really mean it. “

Could she know definitively where he got it? It was hard to say for sure. Still, given that email on the day of his diagnosis, it seemed by far the most likely possibility that he got it at work.

After three weeks of agony, Mr. Taquino died on April 10. You never know if he was among the thousands of people who would be alive if social distancing measures had been put in place a week earlier.

Taquino said the officials should have known.

“If it spreads so quickly, you should know that it would have arrived here,” said Taquino. “They should have implemented programs. I think it was a huge gap in our country. There was no way to think that we were going to be spared. “

Campbell Robertson reported on Pittsburgh.



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