Since the first patient detected at the end of January on American soil, with more than 100,000 people affected on Friday, the country has won the sad title of country of the world with the most officially recorded cases of coronavirus.

Since the first patient detected at the end of January on American soil, with more than 100,000 people affected on Friday, the country has won the sad title of country of the world with the most officially recorded cases of coronavirus.

(.) – About 1,600 people died on Friday evening of the disease in the United States, but for the moment the death rate there remains much lower than in several European countries. How did this great country get there? And what to expect for the future? According to public health experts, the peak of the epidemic is not yet reached in the United States, but several reasons explain that the number of cases of the Covid-19 disease has already exploded there. At the very beginning of the epidemic, President Donald Trump was accused of downplaying its severity, claiming that local spread of the virus was not “inevitable”, going against the advice of health officials.

As the disease settled, first in the states of Washington and California in the West, the country was unable to effectively trace the people who had been in contact with the patients detected, due to lack of tests widely available. The government initially refused to lift restrictions that would have allowed states to develop their own tests.

The big boulevards of central Los Angeles are completely deserted

Photo: .

The first available were sent to the headquarters of the Centers for Disease Control and Prevention (CDC) in Atlanta. The CDC then sent defective tests to states, adding to the delay. It was not until February 29, the date of the first death in the United States, and more than a month after the first reported case, that the government lifted the restrictions. The private sector then also entered the dance.

“If we had been able to trace the contacts that the infected people had, we could perhaps have found many more cases quickly, and isolated the places of high spread”, explains doctor Gabor Kelen, director of the medical department of emergency at Johns Hopkins University. US officials have sought to defend themselves, repeating that tests developed by South Korea – seen as an example in terms of mass detection strategy – sometimes produce false positive results. But it doesn’t matter, according to Gabor Kelen. “One thing that I teach my interns: something is better than nothing, the sooner the better (…), the better is the enemy of good”.

Highest concentration of # COVID19 cases are in areas where we have lowest density of SNF beds … @ kejoynt @DavidCGrabowski https://t.co/h9osBOaIJO pic.twitter.com/w9e9VCFDRB

– Thomas Tsai (@Thomasctsai)
   March 25, 2020

New York State has emerged as the epicenter of the epidemic in the United States, with nearly 45,000 cases and more than 500 dead Friday, numbers that are changing rapidly. Next are the neighboring states of New Jersey, California, Washington, Michigan and Illinois, with concentrations in large cities, such as New York. States without increased spread at this time, however, should not draw too hasty conclusions, according to Dr. Thomas Tsai, professor of public health at Harvard.

“The United States is not a monolith, there are 50 states with different responses from local governors and public health departments,” he said. “I think what we really need is a coordinated national effort,” he added, warning that by continuing with “a patchwork response”, certain regions could in turn be affected. . As of Friday afternoon, more than 60% of the U.S. population was called upon to remain strictly confined – meaning that about 30% of the country’s roughly 330 million residents were not.

And now?

Glimmer of hope: the national mortality rate, based on the number of confirmed cases, has remained relatively low for the moment, at 1.5%, compared with 7.7% in Spain and 10% in Italy. Will this trend continue? Experts are divided on the issue. “The case fatality rate is not reassuring,” said David Fisman, an epidemiologist at the University of Toronto. “It will increase because people take time to die. My forecast is that the United States is on the brink of an absolutely disastrous epidemic, ”he said.

Only point of agreement: social distancing measures are necessary, in order to continue to “flatten the curve”, that is to say to slow down the number and the speed at which new people are infected, so that hospitals are as little overwhelmed as possible, which is already the case in New York. Scientifically, the virus could mutate to a less virulent form over time, according to Gabor Kelen, and heat and humidity could also slow the spread.

The University of Washington medical school predicts a peak in the epidemic around mid-April, with death toll stagnating around 80,000 as of June, following current trajectory. According to their model, this number evolves from 38,000 dead minimum, to 162,000 maximum. In comparison, the flu killed 34,000 people in the United States during the epidemic in 2018-2019.

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