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Today marks one year since the announcement of the first patient with Covid-19 in the United States. This happened in Washington state, where a man in his 30s who had just returned from his visit to Wuhan, China, began to experience symptoms and quickly sought help at a clinic.
Unlike movies or television, where a sick patient staggers into a waiting room at a hospital infecting everyone nearby, doctors and public health experts in Washington state were prepared: They watched carefully what was happening in China and were organizing exercises. to practice what to do when – not if – an infected patient arrives at their doorstep. This patient was tested, hospitalized and isolated, found in contact, treated and finally released. Even though this person became the first patient identified, he was almost certainly not THE first case in the country.
Over the past year, one patient has grown exponentially to 24 million confirmed cases in the United States alone – a number that is surely just the tip of the iceberg, the cases we know of.
The nature of the “ novel ”
All these firsts make me think about the meaning of the word “novel”. When was the last time that we, as adults and as a society, really first experienced something, or were we in a situation we had no context for?
When we hear about a novel – or new – whatever it is, one of the first things we as humans start to do is contextualize or look for similar examples among the things we do. know. We try to understand the outlines of this new entity by comparing it to what we have already stored in our memories and experiences. We are looking for patterns, similarities, overlaps.
It’s human nature. But, too often, this kind of thinking gets in the way.
When this new coronavirus, called SARS-CoV-2, emerged, many scientists, public health officials, and doctors – including myself – turned to other deadly coronaviruses, such as SARS and MERS , to find clues to predict how he would behave. We also tried to compare it to the seasonal influenza virus and past influenza pandemics, such as that caused by the H1N1 subtype, which sparked the 2009 and 1918 pandemics.
I remember diving my head into it all, taking all the information I could: reading research papers and unpublished pre-evidence; talking to colleagues in China, South Korea, Japan and at my hospital; chatting with experts like Dr Anthony Fauci and global health expert Peter Daszak, whose research has been essential to understanding the origin and impact of emerging diseases. And I remember everyone had a theory about one aspect of this new coronavirus – even my mom had a theory.
In the early days, we thought that human-to-human transmissibility was unlikely, that masks weren’t particularly useful, maybe not more deadly than the flu, that people couldn’t spread it in such a way. asymptomatic or by air. Maybe we were hoping that these things were true and that the pandemic wouldn’t be as devastating as it was.
But we were wrong. We quickly learned that SARS-CoV-2 was much more deadly than the flu and much more easily transmitted than one of its close cousins, SARS and MERS. We have accepted the sobering reality that aerosol particles and asymptomatic carriers are important factors in its relentless spread.
The point is, I don’t think anyone would have predicted – or wanted to predict – that we would be facing a global pandemic of this magnitude a year later. We didn’t want to face such a bleak future.
Even the way former President Donald Trump let me know he didn’t want to panic the American public probably contributed to the problem. But being honest and straightforward, and telling people the truth, can be difficult. I take care of this as a doctor all the time. Traumatic brain injury after a car accident on the way to work. This headache: the early sign of a brain tumor. I’ve learned that presenting a problem alongside a plan doesn’t ease the shock of terrible news, but it can help alleviate panic, which really doesn’t help. It is also much more likely that people will take the problem seriously, rather than simply feeling helpless, which can lead to disbelief and ignoring the problem altogether.
If I had known in January of last year that we would still be living this life of containment at Covid and that I would continue to conduct interviews from my basement until a vaccine was developed, well in any way, that would have been a very difficult pill to swallow. But in one way at least it would have been easier: There would be a timeline, a timeline, on how things should progress – and a tangible end. The certainty of a countdown to zero, as opposed to the inherent ambiguity of counting for what feels like an eternity. We are not as good at counting as we are at counting backwards. As painful as the countdown is, we still have the anticipation of an end date.
Thinking about the pandemic
Birthdays are also the time to reflect, to look back on this experience and to assess what we have good versus what we have bad.
We have done some great things well: we have made remarkable advances in science and medicine, such as developing protocols and therapies – both reoriented and new – for people who have fallen ill. Above all, we have managed to develop several vaccine candidates and even cleared two at an astonishing speed.
But we also had too many problems – most importantly and tragically the basics of public health, things that are a lot easier to do but not so flashy: wearing a mask and staying physically away from those who are not in our area. House. We’ve eschewed the inexpensive mask that slips on easily, while embracing the breakthrough billion dollar vaccine that requires Herculean effort to develop and distribute.
The truth is, especially for many of us in the developed world, we want science to save us – but it cannot save us from ourselves; our own human nature. And our human nature is not good at handling what it cannot see.
The other day someone asked me what a big breakthrough I would like to see for a future pandemic. Besides the obvious ones – avoiding a future pandemic, developing an effective vaccine, having access to effective drugs, gathering reliable data – here is a crazy idea that I would love very much: a fluorescent dye that gives the virus a little color. So if someone is infected, you can see a little plume of shiny green particles coming out of their nose and mouth. Not to scare people or disgust them, but because we are so much better at dealing with things that we can tangibly identify than an invisible threat. Trying to make people believe in what they cannot see, trying to prove a negative (for example, reliably conveying all deaths averted by wearing a mask) has always been the challenge of all preventive medicine.
On another side
Looking to the future, I am optimistic, medically speaking. I believe that once most of us are vaccinated, SARS-CoV-2 will become like other circulating coronaviruses, an annual nuisance but not an existential threat.
The image of the United States as a leader in public health, however, has been tarnished by the events of the past year and its failure to control the pandemic at home. It’s a fact, and we can’t turn the statistics to our advantage: we have 4% of the world’s population but 25% of known Covid infections and 20% of deaths. Can the United States Centers for Disease Control and Prevention, the country’s premier public health agency, regain some of its lost prestige at home and abroad? I believe that with hard work and time it is possible.
But beyond that, the country will be marked psychologically and emotionally for a long time, especially people who have lost family members to Covid-19, health workers who have fought relentlessly – sometimes in the face of disbelief or worse – to care for the sick, children of all ages who have lost a year of school and struggled to catch up, families who have lost income due to layoffs or have suffered other economic disasters, owners who have had to close their businesses. The list goes on.
I have no doubt that we will get away with it. And I hope there will be lessons learned, but most importantly, lessons learned – because those who forget history are doomed to repeat it, and the price we have paid as a society during this pandemic is too much. high to make it happen again. This past year has certainly taught us that.
Andrea Kane of CNN Health contributed to this report.
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