Will we lean forward? Or wait until New York hospitals are overwhelmed?
Two days ago, on 3/17, I wrote about the infection patterns for COVID-19, and pointed out that any or all of our three outbreak epicenters could follow the same path of explosive exponential growth as Italy. What a difference a couple of days makes.
The chart above shows the growth of confirmed cases in New York and New Jersey. I’ve lumped the two states together as one because the majority of the cases in New Jersey are in the northeast area of the state near New York City. Put together, their 2,644 new cases just a bit less than the total number of cases in the country just 5 days ago on 3/14. There are more new cases in the New York City metro areas today than new cases in the rest of the country combined.
Yesterday, during remarks of the Coronavirus Task Force, the President and the Secretary of Defense Spoke about the Mercy and the Comfort, US hospital ships, preparing for deployment. Secretary Esper also mentioned that a variety of mobile military medical assets were available to be deployed. The Secretary of the Veterans Administration, Robert Wilkie, explained that part of the VA’s job is to assist in pandemics.
It is time to get those assets moving, at least some of them. According to Governor Cuomo, New York only has about 3K ICU beds that are already 80% full, and predicts that they could need tens of thousands more. He’s asked the President to have the Army Corps of Engineers construct hospitals. That might not be exactly what the Corps of Engineers is equipped to do on short notice, but between FEMA and the uniformed services there are plenty mechanisms to respond rapidly.
What we can’t do is wait and see. I see two possible arguments against reacting now.
First, politicians might fear creating panic. But New Yorkers (and New Jerseyans) are hardy people. They shrugged off 9/11. They are not going to freak out seeing some hospitals get set up any more than they are probably freaking out compulsively watching Worldometer.
Next, some might believe it’s too early. We don’t know what’s going to happen. This is true. We don’t know whether the mortality rate will be .1% or 1% or higher. We don’t know whether the true hospitalization rates will be 5% or 15% among symptomatic patients. But even the best case scenario seems to indicate that New York and New Jersey hospitals will be overwhelmed. The trends don’t really tell us where our suppression measures are going to be enough and where we will need resources next. They do tell us that New York and New Jersey will need help first.
If we jump too soon, the worst that could happen is that we don’t need those beds and we spent a lot of money for no reason. No big deal when the economy is going to shrink 14% this year anyway. The federal government might even reap some good press. “Look, they over-prepared! Glad they weren’t needed!”
More likely, we will keep medical personnel and equipment ‘ready’ to be deployed when needed. But as a student of government, I worry that we won’t recognize that they are needed until the day we run out of ICU beds. At that point, it will take another day or two to get expeditionary beds to New York, get them set up, get patients transferred start treatment. We probably won’t send enough at first either.
America can’t afford an unforced error. The day that we have a patient that needs a ventilator, a nurse, or even a cot to lay on and we don’t have one in place is the day we fail. We’ll look back in a few years and see that it was obvious that cases in New York were careening out of control. We’ll wonder why we didn’t have more beds ready.
Some good news…
The chart at the top of the story also shows the latest in Washington and California. Even as New York has explosive growth in infection, the rate of growth at the other two early epicenters MAY be slowing down. It is possible that they will still hit exponential growth, but it could be that suppression measures in those areas are helping.
That said, Chicago/Milwaukee and New Orleans could be heating up. Detroit area cases look to have tripled in about the last day. This could be because of increased testing, but that just means there are likely more cases out there.