Return of the Coronavirus
To: Dr. Robert Redfield
U.S. Centers for Disease Control and Prevention
1600 Clifton Road
Atlanta, GA 30329
Dear Dr. Redfield:
This letter is addressed to you because medical experts, not politicians, should be in charge of this country’s response to a pandemic. Most of us are working at home or in self-quarantine. Self-quarantine might give many of us a chance to catch up on our reading; years of these Open Letters are available in the TCB Online Archives (you may prefer the flu). But even at this early stage, two questions emerge.
First, what are the lessons learned from prior pandemics?
One of the most famous pandemics is the so-called Spanish flu of 1918—misnamed because wartime censorship only allowed medical news about neutral Spain. My own grandfather almost died from this flu, and President Trump’s paternal grandfather did. Tens of millions worldwide succumbed.
In October 2009, President Barack Obama declared the swine flu a national emergency. By that time, the preparation of a seasonal influenza vaccine had become routine, but problems had slowed the vaccine production. We should have learned then that governmental monitoring of vaccine production (and possible subsidization) should become part of our regular public health agenda. Additionally, because most of the dangerous viruses that have pandemic potential have an animal origin, as in the case of the swine flu, closer monitoring of viruses circulating in animal populations should have been mandated.
Ebola was a headline-grabbing public health menace in the fall of 2014. The Ebola virus originated in West Africa and had a very high mortality rate. Several governors, including the governors of New York, New Jersey, and Illinois, authorized mandatory quarantine or monitoring for people entering their states from West African countries. U.S. Army Chief of Staff Gen. Ray Odierno ordered a 21-day quarantine of all soldiers returning from West Africa during this same period. But the key point was that the national government continued to update the American public on an almost daily basis, emphasizing how very few people were actually infected. A Wikipedia search discloses the names of every single patient who contracted Ebola and was treated in the United States (fewer than 20). No one both contracted Ebola and died from it in the United States. What could have become a politically inspired panic was averted by complete and transparent updates to the American public. President Obama even hugged one of the nurses who had been cured of Ebola, in an effort to calm public fears.
The second question: How do we prepare for the next viral pandemic?
As we have seen, there does not appear to be a documented and continuously updated set of successful responses to these pandemics. One should be started. Clearly, quarantine efforts should be evaluated to see which are the most effective. During the current pandemic, New York has called out the National Guard to help establish a one-mile containment zone around the city of New Rochelle, site of a coronavirus outbreak. The effectiveness of these types of quarantine efforts should be carefully calculated for our future use.
There are numerous innovative day-to-day responses to this pandemic that should be categorized and tested for effectiveness. For awhile, before test availability became constrained, local health systems would administer the test while the patient stayed in the car. This approach obviously cuts down exposure in an overcrowded ER and patient waiting rooms.
We also need innovative solutions to sanitizing all public transportation. Who pays?
And of course, vaccines. Why is it that no vaccine work was being done on this coronavirus strain—particularly when it was first isolated in December? For that matter, why isn’t there a worldwide, or at least U.S., effort to develop vaccine responses to the emergence of novel viruses? Genetic engineering technology has advanced a great deal in the past 10 years and is accelerating into the future. Our government can spend $28 billion to give to farmers who are victims of our trade policies, $80 billion to bail out our auto companies, and $400 billion to bail out the banks following the Great Recession. An equivalent amount of resources spent to attack the issue of mutating viruses with potential to infect humans should be a priority.
It is frustrating to feel one is a victim or potential victim of a calamity that, with foresight, could have been averted. In the meantime, we should do a better job of recording what works, how well it works, and how clearly we can communicate that to our fellow citizens. Viruses are always among us. We should be better prepared.
Vance K. Opperman
Prepared to self-quarantine with back issues of TCB
Vance K. Opperman
is owner and CEO of MSP
Communications, which publishes
Twin Cities Business.