In a prime time speech to the nation last night, President Donald Trump outlined some steps his administration is taking to address the coronavirus. A lot of his speech focused on the economic fallout from the spreading epidemic. Let's set aside those fiscal items here, and instead concentrate on the measures that aim to deal directly with the disease.
The most headline-grabbing item was his restrictions on travel from Europe for the next 30 days. (The spread of the new coronavirus is accelerating in most of Europe, with about 23,000 cases now, half of which are in Italy.) The new ban mirrors the limits his administration put on travel from China in January.
In his speech, the president claimed that by "taking early, intense action, we have seen fewer cases of the virus in the United States than are now present in Europe." A March 6 study in the journal Science did calculate that the ban led to 77 percent fewer cases imported from mainland China than would have been expected. At the time that the administration imposed the rules, many infectious disease experts concurred that the travel restrictions would likely help slow the spread of the virus into the U.S.
The Science study also noted that while the "travel ban was initially effective at reducing international case importations, the number of cases observed outside Mainland China will resume its growth after 2–3 weeks from cases that originated elsewhere." Slowing is not stopping. The idea behind the travel ban was to buy time for public health workers to roll out a robust program of testing, aimed at quickly diagnosing and isolating new cases to prevent community transmission of the disease. Unfortunately, due to a bureaucratic snafu, that extra time was wasted.
The president asserted that "testing and testing capabilities are expanding rapidly," but the plain fact is that the U.S. lags substantially behind many other nations in testing for the virus. Indeed, bureaucratic barriers are still hindering the rapid deployment of coronavirus diagnostic tests developed by private companies and academic laboratories. Now there is evidence that the coronavirus epidemic may be accelerating here.
"Smart action today will prevent the spread of the virus tomorrow," declared the president. He urged Americans to follow his administration's guidance with respect to school closures, social distancing and limiting large gatherings.
Trump correctly pointed out that for "the vast majority of Americans, the risk is very, very low. Young and healthy people can expect to recover fully and quickly if they should get the virus." Research shows that the death rate for folks under age 40 is about 1 in 500. The greater risk, as he noted, "is for elderly population with underlying health conditions." A study out of China, for example, reported that the fatality rate for folks ages 60 to 69 is 3.6 percent. The rate increases to 8 percent for patients in their seventies, 15 percent for those over age 80. "The elderly population must be very, very careful," warned the 73-year-old president. "In general, older Americans should also avoid non-essential travel in crowded areas."
The president also gave the now standard but always good advice for people to practice good hygiene by frequently washing their hands; to avoid infection by not touching their faces; and to stay home if they are not feeling well.
"We've seen dramatically fewer cases of the virus in the United States than are now present in Europe," stated the president. That's true. But how much longer will that last?
To get some idea of how the epidemic here might evolve, let's contrast how it is currently playing out in Italy and South Korea.
Italian public health authorities reported detecting the first 16 cases of local coronavirus transmission on February 21. By February 29, the outbreak had risen to more than 1,000 cases and the death toll stood at 29. Not even four weeks later, the country is reporting nearly 12,500 cases and almost 900 deaths.
In South Korea, the first community transmission of the virus was confirmed on February 19. By February 26, the number of confirmed cases had climbed to 1,261 and killed 12. At the time, the daily of rate of increase in cases reached 40 percent. To counteract the epidemic, the country's public health authorities engaged in a massive testing campaign featuring drive-by testing sites. As of yesterday, the number of cases had risen to nearly 7,900, with 66 deaths. But the daily rate of increase had slowed to just 1.5 percent. That slowdown is largely the result of the widespread testing, which let infected citizens know they should isolate themselves and helped public health workers track and monitor their contacts.
On February 28, four people in California, Oregon, and Washington state were suspected of having been infected through community transmission. As of Wednesday, 1,311 cases have been diagnosed in the U.S. and 38 people have already succumbed to the disease. In just a couple of weeks, we will know which way the epidemic is trending in this country—more like Italy, or more like South Korea.