Ближайшие месяцы пандемии могут стать катастрофой, но у США еще есть время подготовиться – считает Джеймс Хэмблин, доктор медицины и штатный корреспондент The Atlantic
James Hamblin, The Atlantic
On Аpril 13, Robert Redfield, the director of the U.S. Centers for Disease Control and Prevention, appeared on the Today show and assured viewers that the worst was nearly behind us. It had been a month since the last gathering of fans in an NBA arena; a month since the fateful week when Americans began panic-buying bottled water and canned beans. The segment’s host, Savannah Guthrie, was broadcasting from home in upstate New York. With the light of a makeshift camera reflecting in her glasses, she asked Redfield to address reports that we could be facing another three weeks of social distancing. “We are nearing the peak right now,” Redfield told her. “Clearly we are stabilizing in terms of the state of this outbreak.”
By July, the number of daily cases had doubled. The death total had shot past 100,000. As Redfield looked ahead, his tone became more ominous. The fall and the winter, he said in an interview with the Journal of the American Medical Association, “are going to be probably one of the most difficult times that we’ve experienced in American public health.”
It is now widely accepted among experts that the United States is primed for a surge in cases at a uniquely perilous moment in our national history. “As we approach the fall and winter months, it is important that we get the baseline level of daily infections much lower than they are right now,” Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, told me by email. For the past few weeks, the country has been averaging about 40,000 new infections a day. Fauci said that “we must, over the next few weeks, get that baseline of infections down to 10,000 per day, or even much less if we want to maintain control of this outbreak.”
This may be the most salient warning he has issued at any point in the pandemic. Cutting an infection rate as high as ours by 75 percent in a matter of weeks would almost certainly require widespread lockdowns in which nearly everyone shelters in place, as happened in China in January. That will not happen in the United States. Donald Trump has been campaigning for reelection on just the opposite message. He has promised that normalcy and American greatness are just around the corner. He has touted dubious treatments and said at least 34 times that the virus will disappear. This disinformation is nearing a crescendo now that the election looms: Trump has been teasing a vaccine that could be available within weeks.
The cold reality is that we should plan for a winter in which vaccination is not part of our lives. Three vaccine candidates are currently in Phase 3 clinical trials in the U.S., and the trials’ results may arrive as early as November. But even if they do—and even if they look perfect—it would not mean that a vaccine would be widely available. On Wednesday, Redfield said in a congressional hearing that a vaccine was unlikely to be widely available until summer of next year, if not later. Fauci may be even less optimistic. He told my colleague Peter Nicholas that if the clinical trials go well, it could mean a few million doses could be available by early 2021. By the time we got to 50 million to 100 million doses, he estimated, “you’re going to be well into 2021.” If each person needs two doses, as many experts expect, that would be enough to vaccinate roughly 11 percent of the population.
The virus is here to stay. At best, it would fade away gradually, but that would happen after, not before, the winter. The sooner we can accept this, the more we can focus on minimizing the losses of the bleak and grisly coming months. Some of our fate is now inevitable, but much is not. There are still basic things we can do to survive.
Some of the physical elements of winter weather make viruses more difficult to escape. The coronaviruses that cause the common cold reliably peak in winter months, as do influenza viruses. There is some mystery as to why. It seems partly due to the air: Viruses travel differently in air of different temperatures and humidity levels. In typical summer weather, the microscopic liquid particles that shoot out of our mouths don’t travel as efficiently as they do in dry winter air.
Cold weather also drives us inside, where air recirculates. “As things get colder, activities and people will start moving indoors, and unfortunately that’s going to increase transmission risk, and the risk of super-spreading events,” Tom Inglesby, the director of the Center for Health Security at Johns Hopkins, told me. The public-health directives that have allowed many businesses to reopen in recent months—by opening windows and doing as much as possible outdoors—will no longer be feasible in regions where temperatures plunge as the days grow short.