The Way Forward

For various reasons, the United States greatly underestimated the true gravity of the Covid-19 pandemic.  Many reports indicate that our current administration failed us by not sending a clear message with respect to the severity of the disease.  Instead, the U.S exported personal protective equipment (PPE), which our health care workers desperately need, to China and other countries as late as last week.  

As a result of failing to take Covid-19 seriously, the U.S. is now playing catch-up.  We are behind, putting band-aids on an already fractured healthcare system, and placing our soldiers – our medical professionals, first responders, and the alike – in a battle with an enemy that has the insurmountable advantage of time.   Currently, New York City is paying the price, and Governor Cuomo reminds us daily of the grave need for increasing hospital capacity, acquiring additional ventilators, and extra personnel. 

In the meantime, if you are not an essential worker, you have been asked to stay home, practice social distancing, and slow the spread.  This hopefully will give our hospitals time to catch-up to mitigate American deaths.  The White House is now projecting – based on the assumption that all citizens abide by stay at home orders – that we will lose 100,000 to 240,000 Americans in the course of months.  (There are currently more than ten states that have not issued stay at home orders). 

So while a large majority of Americans are socially distancing, we haven’t been given very consistent, helpful information regarding prevention – other than washing our hands and not touching our faces.  That seems rather over simplistic during a pandemic.  

Other countries use masks whenever they leave their house or in their home, if they are ill, as a means of protecting their family members from potential exposure.   In the U.S., on the other hand, we have not been encouraged to wear masks.  It is unclear the basis for this: is it because masks are ineffective or because we have such a limited supply of PPE that we have been dissuaded from purchasing them at the peril of the health care workers?

This pandemic has highlighted the many flaws of our healthcare system and even our nation.  After a week of social distancing, multi-million dollar companies are asking for bailouts.  Our richest CEOs are still failing to provide their employees – the ones delivering the goods as essential business vendors – paid sick leave.    And our main suppliers of PPE are coming from other countries.  Our heroes – the medical professionals who are putting themselves and their families at risk (or not seeing them all together) - need us to look forward for them, since they are too busy playing defense. 

Research indicates that we won’t have a vaccine until potentially the fall of 2021 – eighteen months from now. An article in the Atlantic by Ed Yong predicts that this pandemic will not end until we get a vaccine or a significant portion of the population develops immunity by surviving Covid-19 exposure.  Are we really okay with those alternatives:  social distancing for a year and a half until a vaccine is discovered or contracting a fatal disease hoping to survive it? 

If that’s the case, travel restrictions – both abroad and domestically - should remain in place until we find a vaccine.  Otherwise, every time we extinguish a Covid-19 fire in one city (i.e. the apex ends), a traveler from another city in the midst of an outbreak could stoke the embers and ignite the blaze all over again. 

So if we are allowed to travel, even domestically, all travelers must be subjected to a 14-day quarantine or show some kind of proof of immunity, i.e. serological test indicating that the individual has resolved a Covid-19 infection, has some immunity to the disease, and won’t reignite the flames.  

Non-essential businesses that have already furloughed or laid-off employees need to be prepared to pivot as they won’t be able to survive being closed for eighteen months.  Or, as Dr. David L. Katz has suggested in his New York Times article, Is our fight against coronavirus worse than the disease?, we might be able to allow younger employees or those with Covid-19 immunity to re-enter the workforce. But there might be potential legal ramifications of limiting our workforce by age.   In addition, grandparents play an integral role in childcare for many parents.  So this approach might not protect our most vulnerable population after all. 

K-12 kids may not go back to school this academic year.  If this is supposed to go on another 18 months, should we send them back in the fall at all – only to potentially pull them out all over again and create more disruption for them?  Or would it be better to start implementing real plans to teach them remotely for the entirety of the year?  Should we create a new normal for them to avoid more disruptions?  

As far as personal protective equipment goes, the U.S. needs to be its number one supplier.  We cannot rely on other countries to supply our armor. This goes for prescriptions and our drug research and development as well.  It is time that we choose what is best for our citizens over our bottom-line. Just because something can be made cheaper by outsourcing does not mean we should do it – especially at the expense of an American life.   It has proven unsafe for Americans to rely on another country when we are at war with a contagion and by all accounts, this won’t be our last pandemic.  It is also time to research whether sustainable and reusable PPE is a viable alternative to our current equipment.  Is there a way to make something that can be sterilized like surgical instruments – at least as a backup – so that our soldiers are never forced to use bandanas as a makeshift form of armor? 

Finally, the goal here is getting a vaccine.  So we must look forward and implement a countrywide vaccination program that is equitable to all, not just the wealthy.  We must take into account the limitations our current health care system faces with respect to those individuals lacking the insurance coverage they deserve.  The vaccine must be free and everyone must have access to a healthcare provider.  But what measures are being put into place now to ensure this will happen?    

Again, this pandemic has left us with so many questions.  But it has also left us with so many opportunities.  Many of us have some extra time on our hands so it’s time to work together to fix these challenges before they actually arise.  No more catch-up and no more band-aids.