“This is the greatest public health crisis in a century,” said Centers for Disease Control Director Robert Redfield bluntly on Thursday.
In fact, Redfield sees the coming flu season in Dickensian terms.
“It’s dependent on how the American people choose to respond. It’s really the worst of times or the best of times, depending on the American public,” he said, paraphrasing the opening of Charles Dickens’s classic A Tale of Two Cities.
The current pandemic, paired with the oncoming flu season, could create the “worst fall, from a public health perspective, we’ve ever had,” said the CDC director in an interview with WebMD.
On which side of the scale will the U.S. fall? Redfield said that depends on how consistently Americans wear face masks, stay 6 feet away from each other, wash their hands and avoid crowded gatherings.
“I’m not asking some of America to do it — we all have to do it,” said Redfield. Somewhere between 95 to 99 percent of Americans will have to follow the guidelines for the U.S. to escape disaster, he said.
The scenario that health experts warn of is the flu season piling on top of an already widespread and active pandemic, overwhelming hospitals and resulting in far more deaths as people were unable to get treatment.
One person who is not hopeful about the country’s ability to escape a disastrous fall is the country’s top infectious disease expert, Dr. Anthony Fauci.
“When you look at other parts of the country,” said Fauci of regions that have not yet experienced big spikes, “this is the thing that’s disturbing to me: We’re starting to see the inkling of the upticks in the percent of the tests that are positive.”
That, as the country reported 1,500 COVID deaths in one day for the first time since May.
“We know now, from sad past experience, that that’s a predictor that you’re going to have more surges,” Fauci said during a panel discussion held by National Geographic.
“Bottom line is,” he said, “I’m not pleased with how things are going.”
So how many Americans are wearing masks? Are we anywhere near 90 percent compliance?
A Gallup Poll released exactly one month ago found that 44 percent of U.S. adults say they “always” wear a mask when outside their homes, and 28 percent say they do so “very often.” At the same time, three in 10 report doing so less often, including 11 percent “sometimes,” 4 percent “rarely” and 14 percent “never.”
According to Johns Hopkins, the U.S. on Thursday saw 55,910 new cases and 1,499 new deaths from the virus. Given the lack of testing and contact tracing, it’s likely those numbers are an undercount.
A recent analysis by the New York Times that looked at deaths above the average across the country found very clear spikes of additional deaths that followed the spread of the virus. By the Times’ count, at least 200,000 more people than usual have died in the country since March. That’s with many Americans locked inside, not going to work and only making trips out for groceries.
So what does the “worst fall, from a public health perspective, we’ve ever had,” look like?
The 1918 “Spanish” flu pandemic was the deadliest pandemic in history. One-third of the world’s population was infected. The virus killed an estimated 50 million people worldwide, including an estimated 675,000 people in the United States. That was at a time when the U.S. population (in 1917, pre-outbreak) was 103 million.
The country’s population in 2019 was more than 3 times that, at 328 million. The current epidemic has already taken 165,000 American lives.
The lead author of a new study published Thursday in the medical journal JAMA Network Open, Dr. Jeremy Faust, says COVID-19 “has 1918 potential.” Faust is a physician at Brigham and Women’s Hospital and an instructor at Harvard Medical School.
“If insufficiently treated, SARS-CoV-2 [the virus that causes COVID-19] infection may have comparable or greater mortality than 1918 H1N1 influenza virus infection,” according to the study.
During the “Spanish” flu pandemic, the greatest loss of lives happened in just 6 weeks between mid-November and the end of December. One-third of the virus deaths in America occurred during that period.
It is very possible the worst of times may be yet to come.