A surge in COVID-19 cases in some U.S. states has important lessons for Canada as lockdown measures continue to lift across the country.
Nearly two months ago, a health-care adviser to two U.S. presidents burst out in frustration when asked whether Americans would see a quick spike in new COVID-19 cases as states reopened.
Zeke Emanuel, who served in the Obama White House and has informally advised President Donald Trump, expressed exasperation that people kept looking for an immediate effect.
Launching into a sermon about the mathematical realities of exponential growth rates, Emanuel said the disastrous consequences of reopening too early would only emerge around early summer.
“Two months, not two weeks,” Emanuel said in early May. “That’s likely when you’ll see the effects of what we’re doing today. … That’s when people will recognize, ‘Wow, now we’ve got 1,000 cases today, 3,000 cases tomorrow, 6,000 the next day.'”
He predicted the country would awaken to the disaster around mid-July.
It’s happening ahead of schedule.
The U.S. has surpassed 127,000 deaths and case counts are rising rapidly in numerous states, mainly in the south. An alarming surge has forced Texas to pause its reopening plans. Hospitalizations have hit record highs in Arizona and in California.
Florida has backpedaled on its reopening bullishness. A governor who recently accused the media of fear-mongering over COVID-19 — wagging his finger at reporters over what he characterized as “black helicopter” conspiracy theories — was forced to announce Friday that bars would close again as Florida experienced an astronomical spike in positive tests.
“This is what happens when you reduce social distancing measures and you have community transmission ongoing and those two things collide and it just spreads,” said Jason Kindrachuk, an assistant professor of viral pathogenesis at the University of Manitoba in Winnipeg and Canada Research Chair of emerging viruses.
Kindrachuk said that Canadians would be well-advised to take lessons from the American response to the pandemic.
“We can take that information and posit here in Canada that as we reduce social distancing, especially in regions that are more population-dense, we’re likely going to see a resurgence in cases, because ultimately the virus is still in our communities and it’s still able to spread.”
U.S. South hard-hit
On Friday, the troubling trendline in the U.S. prompted the White House to resume its previously suspended coronavirus press conferences. Vice-President Mike Pence maintained the country is largely better off than a few weeks ago, but said 16 states have rising case totals and, more worryingly, a rising percentage of positive test rates.
While this virus is an evolving phenomenon, rendering any broad conclusions risky, here’s what we know about the places in the U.S. experiencing outbreaks: they’re mostly in the south; mostly in states that reopened early and aggressively and resisted the widespread use of masks; and mostly run by Republicans, unlike an earlier wave that primarily struck northern, Democrat-led states.
The rapid increase in cases and hospitalizations is due to the push to reopen states without first establishing proper systems of tracking and treating cases, said Dr. Amesh Adalja, an infectious disease physician and senior scholar at the Johns Hopkins Center for Health Security.
“It’s never been a question whether or not we would get more cases when people started to socially interact,” he said. “The question always was, could we keep those cases occurring at a pace that was manageable?”
Adalja said, “clearly in those states that are under stress right now, there hadn’t been enough preparation for these cases.”
He said states facing a strain on their health-care systems squandered opportunities during lockdowns to expand their capacity and prepare for a spike in cases.
“From the very beginning, this outbreak has really been mismanaged in terms of what the government response should have been,” he said. “People thought that they could get away with going back to the norm – not realizing the virus was still there.”
Adalja said some parts of the U.S. that were spared large outbreaks of COVID-19 early in the pandemic wrongly assumed they wouldn’t be hit hard after lifting lockdown measures — or that they could adequately handle the number of new cases.
He said that’s the main takeaway for Canada as provinces hit hard by COVID-19, like Ontario and Quebec, move to lift lockdown measures.
“What you can learn is that the virus hasn’t disappeared, that social interaction is going to drive new cases,” Adalja said. “The key thing is: Can you handle those new cases?”
U.S. testing more, finding more cases
The initial debacle over the lack of testing in the U.S. is well-documented, as are Trump’s boasts about the amount of testing and his later suggestions that the government should reduce tests, because they only reveal more positive ca