As U.S. Sees COVID-19 Infections Spike, Some Worry About 'Grave Errors'

With total known infections in the U.S. at 85,  at least two deaths, and a scramble to contain possible community outbreaks, two experts fear public health is taking a back seat to politics.
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In the beginning, the few reports of a newly discovered virus seemed inconsequential and distant. The coronavirus was causing pneumonia in scores of people, but those patients were in a faraway province of China, Hubei, that most outside that nation had never heard of.

“There is no evidence that the new virus is readily spread by humans, which would make it particularly dangerous, and it has not been tied to any deaths” stated an article dated Jan. 8 in the New York Times.

But soon after, as new information emerged, both those assertions would prove untrue. The virus was contagious among humans and it’s deadly. Next would come image after horrifying image of frantic crowds inside hospitals in the city of Wuhan. A map tracking infections around China and beyond would light up in foreboding red dots. 

Then, Li Wenliang, the ophthalmologist who was reprimanded by Chinese authorities for trying to alarm others of the rapidly spreading coronavirus, would die of COVID-19. Other citizen journalists reportedly disappeared. Early assumptions that the Chinese government had been acting quickly and transparently to contain the disease – learning lessons from the SARS outbreak – were soon thrown into question.

“Communications by the Hubei provincial government and Chinese national government were not transparent in December and the first three weeks of January, resulting in squandered opportunities to contain the outbreak when it still was easily containable in Hubei and China,” said Prof. Richard H. Ebright, the laboratory director at the Waksman Institute of Microbiology and a professor of chemistry and chemical biology at Rutgers University, in an email to TheStreet.

Now Ebright – a highly accomplished scientist who was elected as an Infectious Diseases Society of America fellow in 2011 – is growing concerned that the U.S. has made a series of missteps and continues to do so in its handling of the outbreak here.

Ebright, who has been known to be outspoken on a number of issues in the past, charges the U.S. government with also lacking transparency – after giving repeated assurances that citizens here face minimal risk of infection and President Donald Trump claiming the virus would be gone in April and equating some cases of COVID-19 with the “sniffles.”

This, he said, has resulted in “squandered opportunities to contain the outbreak when it still was easily containable in the U.S.”

The appointment of Vice President Mike Pence -- someone without expertise in medicine -- to oversee the U.S. response to COVID-19, said Ebright, is a “grave error.”

Another expert, Dr. David N. Fisman, a professor of epidemiology at the University of Toronto, is equally uneasy over the appointment.

“This almost always ends badly,” said Dr. Fisman in an email to TheStreet. “Politics and disease control don’t mix. This will blow up on them.”

Dr. Fisman said Canada made a similar mistake during the SARS outbreak there that contributed to a “second wave” of the disease. “Changed case definition to please politicians and make it go away,” he said. “Let’s see how it plays out. There’s a reason CDC has historically been arm's length.”

Taking aim at Pence’s appointment, Dr. Fisman said, “You have the most competent public health workforce in the world in the U.S.A. This is the time for politicians to get out of their way.”

But while Dr. Fisman hesitates to criticize past responses because of the unknowns of the virus when it was first discovered, Ebright is highly critical of the U.S.’ sluggishness on acting to prevent local outbreaks here.

“The appalling testing throughput in the U.S. in the last month is the direct result of the lack of transparency – and resulting lack of urgency – by the U.S. government in the last month,” said Ebright.

Despite witnessing countries such as Singapore and Japan uncover infections of people with no travel to China or known contact with other patients nearly a month ago, U.S. officials seemed to express little concern of such infections occurring here -- until late last week and over the weekend when such cases were discovered. 

Ebright questions why the U.S. had performed so few tests to date when compared with other nations outside of China, such as the U.K., South Korea, Taiwan, Japan, Singapore, Thailand, and even Vietnam.

That lack of urgency and testing is now resulting in a feeling of emergency: Just over the weekend several people in the U.S. have been diagnosed with COVID-19 with no known contacts with other patients or travel to China and one has died. 

This is a bad sign because many more infectious people most certainly are around the country.

Outbreaks that start with deaths, said Dr. Fisman, are “old” outbreaks. Dr. Fisman was speaking before the first U.S. death was announced in Washington, but after the first infection of unknown cause was found late last week in California. The disease takes a long time to progress from infection and incubation to showing symptoms severe enough to warrant hospitalization, he noted. From the start of symptoms to death can take up to eight weeks, according to the World Health Organization. Cases can take up to six weeks until recovery, too. Given the time that has passed since the first infection of these new U.S. patients were discovered, said Dr. Fisman, means there are now likely “lots of cases." 

As of Sunday night, the U.S. had 85 known infections including new ones in Chicago, New York and Rhode Island, with only seven recoveries. Globally total known infections is approaching 87,500. 

But not everyone is quick to criticize the U.S. response. One such person is  Dr. Henry I. Miller, who for many years worked at the Food and Drug Administration, including as an assistant to the commissioner for biotechnology, and currently is a senior fellow at the Pacific Research Institute, which is described as a “free-market think tank.”

Dr. Miller noted mid-last week that “if it bleeds, it leads” tendencies of the media may have contributed to some fear over the virus, and stressed that the flu was a more immediate danger to most Americans. 

Dr. Miller stressed commonsense preparedness among people -- and vigorous hand washing -- were important, as are the efforts nationally to contain the disease and pursue possible drug treatments aggressively, especially the trials of already-approved anti-viral drugs. 

"And in spite of the political squabbling over how much new funding is enough, that’s not really an issue," said Dr. Miller in an email to TheStreet. There’s "plenty" of emergency discretionary money at Health and Human Services and the Department of Defense.

Trump also praised the U.S. response over the weekend, saying, "We moved very early, which turned out to be a big life-safer. We ask the media and politicians not to do anything to incite panic, because there is no need to panic."

Last week, the president tried to reassure Americans that the was little to worry about: "Sometimes they just get the sniffles, sometimes they just get something where they’re not feeling quite right. And sometimes they feel really bad."

But adding to the anxiety of the outbreak, the World Health Organization most recently said the idea the fatality rate is lower than the statistics say is unlikely. Before, many had hoped that the mortality rate would turnout to be lower than 1%. But it appears from data coming out of China that one in five people will develop severe illness, and three in 50 will become critically ill. In Hubei, where the most cases have appeared – ostensibly because that area had the longest exposure time – between 2% and 4% died. Even the low end of that mortality rate far surpasses that of the common flu that Americans are used to getting. More disturbing, data from the WHO appears to show even a small number of the mild and moderate cases end in death.

Source: WHO.

Source: WHO.

Now, as the first death from the coronavirus occurred over the weekend inside the U.S. and patients with no known reason to have been infected are popping up, the government appears to be responding with high urgency, with efforts to allow for widespread testing.

“Well, there will be more cases. There’s no question,” Pence said in an interview Sunday morning with NBC News’ “Meet the Press” with Chuck Todd. “But it's not my confidence. It is the confidence of all of our health experts who are widely regarded as the best in the world that it's important that people in this country understand that while there are 46 Americans that we brought home from China and 22 Americans, now sadly with one loss of life, that the vast majority of, of those people and the vast majority of any American that would contract a coronavirus will, will be treated, they will recover...”

But when asked about the U.S.’ preparedness by late last week for dealing with a potential pandemic, Ebright was not optimistic.

“Nations like the U.S. that received hundreds of travelers from Hubei before lockdown – numbers that correspond to just to 0.01% of the millions that China outside Hubei received – should be able to contain resulting secondary outbreaks,” said Ebright. “But only if they try. And, prior to Thursday, the U.S. had not even started trying.”

This story has updated the number of cases known in the U.S. Some typos have been corrected in this story. Also, the line "Ebright, who has been known to make some controversial statements in the past" has been changed with links. To reach the reporter, email here.