You have weight loss and stomach pains for more than a week. Worried that you might be sick, you go to the doctor to find out what could be causing it. Instead of asking questions, examining, and running tests, the doctor jumps to the best-case scenario — it’s just some indigestion and it will go away. You are sent home without any advice about what to do or what to watch for.
Sounds crazy, right? Had I treated patients that way in my 25 years of medical practice, I would certainly have been sued for malpractice and maybe even lost my medical license.
Unfortunately, this, in a nutshell, is the current federal response to the coronavirus crisis: pinning hopes on a best-case scenario against evidence to the contrary.
With more than 20,000 new cases and more than 700 new deaths each day from COVID-19, some of our most powerful national leaders are touting a highly uncertain best-case scenario — the discovery of vaccines or medications — while willfully ignoring the pandemic-controlling options in front of us.
Like an overly optimistic doctor, some policymakers are banking on a future vaccine that, at best, may arrive in 2021 while people are sick and dying now and the economy continues to be hobbled with an unclear path forward to stability.
The tragedy is that there is a playbook that can reduce the number of cases and deaths right now — a national program to test, trace and isolate people who are infected. Increasing evidence shows that this coronavirus can be beaten back if everyone follows simple rules while in public: wearing masks, staying at least six feet away from others and avoiding indoor crowds.
Other countries, like Germany, which locked down for eight weeks and brought new cases down from more than 6,000 per day to around 500 a day, have followed this playbook. By employing these basic public health practices, they have enabled their economies to restart safely.
If we want the same results here, our leaders have to focus on what we know is possible right now. They need to consider that a quickly available, highly effective vaccine could be just a mirage on the horizon. That any new treatment could be insufficient. That this disease, now established nearly everywhere in this country, could keep spreading and causing deadly outbreaks for years.
Refusing to acknowledge and plan for these events and clinging to the rosiest outcome increases the likelihood we will end up in a worst-case scenario — one where ongoing infections and outbreaks continue to pose deadly risks; fear of infection makes consumers unwilling to return to shopping and traveling; and infections and deaths overload our hospitals and mortuaries. Aside from the terrible danger to American lives, the continuing costs for private insurers and the government in treating COVID-19 patients would be enormous.
It is not too late for us to avoid the worst-case scenario by facing it now. We need a far more comprehensive program of state-based testing and contact tracing that is well-supported by federal government. Congress already has legislation that deals with testing and contact-tracing programs. Federal agencies like the Centers for Disease Control and Prevention and the Department of Health and Human Services should work together to assist states in collecting, analyzing and reporting data. The CDC’s Epidemic Intelligence Service officers have the knowledge and experience to make this happen.
We can’t sit around waiting for vaccines and treatments. They are only part of a whole package of steps to save ourselves and our economy. Our window of opportunity is closing. In nearly half of the states, new cases are rising rather than declining. If COVID-19 cases surge above the current level of 20,000 per day, it will be even more difficult and more costly to bring the disease under control and get the economy running. We can work toward a vaccine and a cure even while we take steps to drive new cases and deaths down as New York and New Jersey have done.
When my patients sought care, they also came looking for hope. Even in the most dire health crises, I could offer that. Not because I focused on the best-case scenario, but because they knew I was also planning for the worst outcome, leaving no stone unturned to help them get better.
The American public deserves the same professional commitment from all of our leaders. Action now will minimize the risks to the public and also minimize the economic pain while scientists develop the medications and vaccines that will help keep all of us healthy.
Eric Schneider is a physician and senior vice president for policy and research at the Commonwealth Fund.