A Grim Coronavirus Milestone: 150,000 American Deaths

The 150,000-death milestone was reached on Wednesday, July 29, exactly five months after the first official death was recorded in King County, Washington. Two leading academic organizations have each released plans to "reset" the course the United States is leading in response to the pandemic to reduce future mortality.

“If the nation does not change its course — and soon — deaths in the United States could well be in the multiples of hundreds of thousands," warned David J. Skorton, a cardiologist and president and chief executive of the Association of American Medical Colleges. His organization has published a course correction, which they call a road map, as has the Johns Hopkins Center for Health Security (see header below).

"America needs to change course, and quickly," Skorton wrote in a Washington Post op-ed on July 29. "We should regard our failures as lessons learned — and apply those lessons right away, across the board."

"The Way Forward on COVID-19: A Road Map to Reset the Nation’s Approach to the Pandemic calls on federal and state governments, businesses, academic medicine, and local communities to work together to implement a set of 11 evidence-based, short- and long-term actions to address critical testing and supply issues, mitigate the spread of the virus, and ameliorate the health disparities that have further exacerbated the pandemic for vulnerable populations, among other actions," writes Gabrielle Redford for the Association of American Medical Colleges (AAMC) News. 

Based on AAMC experts’ understanding of the pandemic as doctors, scientists, and medical educators, the road map includes such immediate actions as ramping up production of testing reagents and tubes, personal protective equipment, and critical medications; increasing the availability of and turnaround time for testing; and establishing national standards for face coverings, stay-at-home orders, and reopening protocols. 

The action that caught my eye was the last one: "4. Establish and enforce national criteria for local stay-at-home orders and reopening protocols." Unlike other groups calling for "start-overs" by states, or better yet, on a national level, AAMC is open to doing it locally.

The nation's first shutdown was done on a regional basis in the Bay Area on March 17. It was successful, leading the way for California and most other states to follow. It was the reopenings, particularly after Memorial Day, where things went dramatically wrong that led to the current resurgence in the South and West that is now spreading north.

However, as Planetizen readers may know, two neighboring, overwhelmingly Latinx counties in South Texas, Hidalgo and Starr, issued stay-at-home orders last week, but due to a gubernatorial executive order, they have no power to enforce them.

Johns Hopkins experts call for "reset"

"The United States needs to restart its response with policy actions at the federal, state and local levels to get control of the pandemic, scholars at the Johns Hopkins University Center for Health Security said in a report," write Jason Hanna, Madeline Holcombe and Shelby Lin Erdman for CNN on July 29, 2020 (source article).

The report [“Resetting Our Response: Changes needed in the U.S. approach to COVID-19”] includes 10 recommendations that include universal mask mandates, federal leadership to improve testing and, in places where rates of transmission are worsening, stay-at-home orders.

For county-specific information on rates of transmission, see Harvard Global Health Institute's COVID Risk Level map (posted here). Orange-colored counties, where case incidence is above 10 but less than 25 per 100,000 people, stay-at-home orders and/or test and trace rigorous programs are advised. Red-colored counties, where case incidence exceeds 25 per 100k, stay-at-home orders are necessary.

"The coronavirus pandemic is the most serious epidemic threat to the United States in a century," concludes the report.

The United States has reached a critical point in the outbreak trajectory, and serious consideration needs to be given to ways in which the response can be improved. The time is now to move forward to reduce transmission and save lives. 

How many more lives will be lost?

The point of both reports – which are, in fact, plans for resetting our response to the coronavirus, is to reduce mortality. Barring a dramatic response correction, Michael T. Osterholm of the University of Minnesota has long suggested that as many as 800,000 deaths could occurr, the possible toll resulting from infecting 60 to 70 percent of the population. More recently, he was joined by pandemics preparedness expert, Dr. Irwin Redlener of the Earth Institute at Columbia University.

"If someone had suggested five months ago that we would be seeing more than 3 million cases and 135,000 COVID-19 deaths in the U.S. by mid-July, I wouldn’t have believed it," Redlener wrote on July 17 for the Daily Beast.

But now it’s distinctly possible that, five months from now, half of all Americans could have been infected with SARS-CoV-2, and more than 800,000 Americans may die in this extraordinary outbreak. That is what many of our most prominent public-health experts now expect. 

Related in Planetizen:

• Campaign Launched to Halt State Reopenings and Start Over, July 30, 2020
• Do You Know Your COVID-19 Colors? July 29, 2020
• A Missing Conversation: Medical Centers and the Built Environment, May 25, 2016