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“The main measures arrived very late”

by drbyos

The Cross: The number of people who tested positive for coronavirus in the United States has seen a sudden increase over the past week. Are American hospitals ready to cope?

Christopher Murray: Even though there are cases today in the 50 federal states, the impact of the epidemic varies widely from one to the next. Some, very little affected, will be able to cope with the epidemic peak. Others, such as New York State and Louisiana, are already saturated. American hospitals are anticipating the wave, but it is very difficult to suddenly increase the number of respirators and beds available.

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So they are multiplying their efforts, and are already taking measures, for example by stopping non-urgent interventions, by installing beds in the corridors of hospitals or gymnasiums, by maximizing the presence of nursing staff, with work rotations, by using external personnel … It’s a race against the clock, when we know that the peak will arrive in three weeks.

According to your study, 41 out of 50 federal states will run out of available intensive care beds by the beginning of April. In view of what happened in China, then in Italy, why did the United States not better anticipate the arrival of the epidemic?

C. M .: I think that the possibility of such an epidemic in the United States had not really been considered by the government. It was only when Italy began to be severely affected that the Americans suddenly became concerned and action began to be taken. But it was mid-March. The main measurements only arrived last week, it was already very late.

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However, we show this in our study, and we are convinced that only social distancing can have a positive effect on the slowdown of the epidemic. For Wuhan, for example, this is the only explanation. Our model also incorporates the speed at which containment measures are taken. From what we have seen, it is the only viable solution to date. If these measures are not followed, the health consequences will be much more serious.

In general, it is estimated that epidemics continue to increase for four weeks after the onset of social distancing. For the United States, the curves are rather predictable: we can expect that the number of cases will continue to rise sharply to bring us to a peak of the epidemic in mid-April.

The obesity rate is around 40% in the United States. Was the general health of the country perhaps an important determinant in the resistance of Americans to the disease?

C. M .: Many factors appear to be aggravating for illness, smoking or suffering from diabetes, for example. But above all, it should be remembered that these factors increase with age. In Italy, even more than in China, it has been found that age appears to be the most important determinant. It plays a crucial role in the body’s ability to fight disease.

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Knowing this, differentiating comorbidity from age as the main factor in the aggravation of the patient is very difficult, especially at this stage. It is still too early, and there is not yet enough data to draw any real conclusions. We are also still trying to explain why the death rate is higher in Italy than in China.

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