Skolnik: In An Outbreak, Delays Kill

By RICHARD SKOLNIK
Los Alamos

As our governor has correctly and repeatedly said, the US federal government is still failing to address COVID-19 with sufficient urgency. In an outbreak, every day of delay leads to cases and deaths that should never occur. In due course, history will correctly attribute many of these deaths to government indifference, delays, and incompetence.

In states like New Mexico, more people filed for unemployment last week than at any time in history, including the great depression. Jobless claims for the US as a whole rose from 70,000 to over 280,000, as COVID-19 began to affect the economy. Unemployment did not rise because of a “financial crisis,” as in 2008. They did so because of a virus, for which the US should have been prepared but isn’t. 

Financial assistance can be helpful to many Americans. However, it will not be sufficient to right the economic ship. Only stopping the outbreak can do that. People are not going to go out (we hope), until they feel it is safe to do so.

Every public health professional and many others knew an event like this was coming. After inexcusable delays by the Chinese, the US did have advance warning of this virus. Yet, the US is still failing to provide the tests, masks, ventilators, and Personal Protective Equipment needed to address the epidemic in a timely way. Koreans get test results in a day by text message. We have family and friends in Georgia and Ohio who recently waited two weeks for their results. Church groups sewing masks is a gracious gesture. However, those masks can never meet acceptable standards of protection for our healthcare workers or their patients. In Singapore and Korea any government official associated with such failures would have resigned out of shame.

Some people want to “medicalize” the handling of the outbreak. They want us to believe that hydroxychloroquine and other medicines will “save us”. This is a political approach, not a scientific one. As Dr. Fauci has said, there is not yet any scientific basis for using the drugs that are being touted as “cures”. Urgent research on drugs and vaccines IS needed. However, this must not detract in the short and medium term from the need to urgently implement critical public health and clinical measures, which we started too late and for which there are still insufficient resources. 

NM in many ways is among the leading states in the quality of its response to the outbreak. Yet, COVID-19 is an existential issue for all of us. Our healthcare sector needs to get – tomorrow – not in two months, the equipment and materials needed to know who is infected and then move public health and medical approaches forward on that basis. Yet, the federal government continues to refuse to utilize the full powers of the Defense Production Act to speed its late and inadequate response.

As I write, clinicians I know are refining guidelines on triage in ICUs – who should live and who should die. Physicians in New York are calling what they are dealing with “an apocalypse”. Nothing could further highlight the urgency of this matter, our unpreparedness to address it, and the unacceptable pace at which the national government continues to move on it. 

Editor’s note: Richard Skolnik is the former regional director for health for South Asia at the World Bank. He was the director of an AIDS treatment program for Harvard and taught Global Health at the George Washington University and Yale. He is the author of Global Health 101 and the instructor for Yale/Coursera’s Essentials of Global Health.

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