The good news: The United States has an opportunity to fight back Covid-19 before it gets much worse.
The bad news: this window closes quickly. And the country seems unwilling or unable to seize the moment.
Winter is coming. Winter means cold and flu season, which certainly complicates the task of finding out who has Covid-19 and who has a less threatening respiratory infection. It also means that cherished outdoor freedoms that connect us to life before Covid – pop-up restaurant terraces, picnics in parks, trips to the beach – will soon be inaccessible, at least in the northern parts of the country.
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If Americans don't use the dwindling weeks leading up to the onset of "indoor weather" to contain transmission in the country, this winter could be Dickensian bleak, according to public health experts.
"I think November, December, January and February will be tough months in this country without a vaccine," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
It is of course possible that some vaccines could be approved by then thanks to historically faster scientific work. However, there is little hope that large numbers of Americans will be vaccinated in time to foresee the gritty winter of Osterholm and others.
Human coronaviruses, the distant cold-causing cousins of the virus that causes Covid-19, circulate year-round. This is usually the off-season for broadcasting. But this summer of America's failed Covid-19 response, the SARS-CoV-2 virus is rife across the country, and pandemic-weary Americans seem more interested in resuming the pre-Covid lifestyle than the virus has gotten this far How it suppresses schools can reopen and stay open, and restaurants, cinemas, and gyms can function with some restrictions.
"We shouldn't seek broadcast before we open schools and put children at risk – children and teachers and their carers. So if that means no gym, no movie theaters, so be it," said Caroline Buckee. assistant director of the Center for Communicable Disease Dynamics at Harvard & # 39; s TH Chan School of Public Health.
"We seem to prefer recreational activities to child safety in a month's time. And I can't understand that tradeoff."
While many countries have succeeded in suppressing the spread of SARS-CoV-2, the United States has failed miserably. Countries in Europe and Asia are worried about a second wave. This is where the first wave is raging, affecting both rural and urban parts of the country. Although there has been a slight decrease in cases in recent weeks, more than 50,000 Americans are diagnosed with Covid-19 each day. And these are just the confirmed cases.
To put that in perspective, the US is collecting more cases in a week at this rate than the UK has accumulated since the pandemic began.
Public health officials had hoped that with the warm summer temperatures and the increased tendency of people to engage in outdoor recreational activities this year, transmission of the virus would decrease. Experts believe that people are less likely to spread the virus outdoors, especially if they wear face covering and keep a safe distance.
But in some places people have tossed Covid warnings to the wind in breach of public health regulations. Kristen Ehresmann, director of epidemiology, infectious disease prevention and control at the Minnesota Department of Health, points out a major three-day rodeo recently held in her state. The organizers knew they should limit the number of participants to 250, but refused. Thousands were there. In Sturgis, S.D., an estimated quarter of a million motorcyclists were expected to come to town this past weekend to host an annual rally that lasts 10 days.
Even on a smaller scale, health officials know that some people are giving up their vigilance. Others never embraced the need to prevent the virus from spreading. Ehresmann's father was recently invited to visit some friends; He left, she said, but wore his mask and poked his elbow instead of shaking the offered hands. "And people kind of acted like … & # 39; Oh, you drank this Kool-Aid & # 39; instead of & # 39; We all have to do this. & # 39;"
Ehresmann and others in the public health arena are baffled by the phenomenon of people refusing to acknowledge the risk associated with the virus.
"Just this idea of 'I just don't want to believe it, so it won't be true' – honestly I haven't really looked into it before because it's diseases," she said.
Buckee, the Harvard expert, wonders if the magical thinking that seems to have infected parts of the country is due to the fact that many of the deceased were older. For many Americans, she said, the disease hasn't touched their lives – but who have restricted mobility and other responses.
"I think if children died it would be … a very different situation, really," she said.
Epidemiologist Michael Mina desperate that an important chance to get the virus under control is being lost as Americans ignore the realities of the pandemic in an attempt to resume life before Covid.
"We continue to miss out on every opportunity we get with this epidemic to get it under control," said Mina, assistant professor at the TH Chan School of Public Health at Harvard and assistant medical director of clinical microbiology at Brigham and Women & # 39; s Hospital in Boston.
"The best time to quell a pandemic is when environmental characteristics are slowing transmission. This really is your only opportunity in the year to take advantage of that extra support and get transmission under control," he said with audible frustration.
To roll back the transmission, people would have to continue to make sacrifices and accept that life after Covid cannot go on as usual until so many people remain susceptible to the virus. Instead, people are lightly shedding the shackles of coronavirus suppression efforts, seeming to believe that a couple of weeks of spring sacrifice was a one-off solution.
Osterholm has been warning for months that people are being misled about how long the restrictions on daily life should last. He now believes the time has come for another lockdown. "What we did before and more," he said.
The country has gotten into a dangerous pattern, Osterholm said, where a spike in cases in one place creates temporary reluctance from people who eventually become alerted enough to take precautionary measures. But once the cases plateau or decrease a bit, victory over the virus is declared and people think it is safe to resume normal life.
"It's like an all-or-nothing phenomenon, isn't it?" said Anthony Fauci, director of the National Institute for Allergies and Infectious Diseases. "You're all locked up, or you get so discouraged being locked up that you decide to be in crowded bars. You can have masked-free indoor parties. You can do any of the things that get you in trouble."
Osterholm said that with the resumption of the K-12 school year in some parts of the country or its start – along with universities – in a few weeks the broadcast will begin and cases will rise again. He predicted that the next peaks "will far surpass the peak just experienced. Winter will only intensify this. Indoor air," he said.
Buckee believes further shutdowns are inevitable unless the land changes its trajectory. "I can't imagine that we will have restaurants and bars in winter, to be honest. We will revive. Everything will be closed again."
Fauci advocates rolling back the reopening measures with a strong messaging component designed to explain to people why shutting down the broadcast pays off later. Young people in particular need to understand that transmission under 20s, even if statistically less likely to die from Covid-19, will ultimately lead to infections in their parents and grandparents who are at higher risk of serious infections and fatal consequences. (Young people can also develop long-term health problems due to the virus.)
"It's not you alone in a vacuum," said Fauci. "They're spreading it to the people who are going to end up in the hospital."
Everyone must work together to bring cases to manageable levels if the country is to avoid "a catastrophic winter," he said.
"I think we can get better control of it between now and mid to late fall when we get influenza, or we get whatever we get in fall and winter. I'm not giving up," he told Fauci.
But without an all-out effort, "the cases will not fall," he warned. "You are not. You just are not."