Editor’s note: John Walters is a political columnist for VTDigger.
At a Monday press conference, Gov. Phil Scott said he would soon be instituting further restrictions on public movement — but “I would not describe it as ‘shelter in place,’” Scott said. “What we’re going to advocate is just what we’ve done thus far. It’ll probably take another step.”
Sorry, that’s not enough. If Scott doesn’t impose a full shelter in place order right now, he risks a pandemic that will overload our hospitals and trigger rationing of care among the most seriously ill.
And be prepared for that order to be in place for a substantial period of time. Months, not weeks.
You’ve seen the charts that show the U.S. is almost precisely following Italy’s trajectory, only we’re roughly two weeks behind. Italy has already resorted to some stunningly cruel triage. As of Monday, Italy had reported 64,000 known cases and more than 6,000 deaths. The rate of new cases and fatalities has begun to slow a bit, but is still on a sharp upward trajectory. According to a doctor in Parma, hospitals there are no longer allowing the use of respirators on COVID-19 patients over the age of 60.
Based on current trends Vermont’s health care system will likely be overwhelmed in the next few months if no further steps are taken, and demand would skyrocket thereafter. Rationing of respirators would be inevitable.
As Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Vox.com, “When you’re dealing with an emerging infectious diseases outbreak, you are always behind where you think you are.”
When Gov. Scott announced a state of emergency on March 13, he said, “In China and Italy, efforts to slow the spread were not quick enough.” He vowed to take action to keep us from following that same course.
There’s no evidence to support the notion that he has succeeded. He’s taken a number of steps in sequence: Closing the schools, then bars and restaurants, then most child care centers; limiting nonessential public gatherings to 50 and later to 10; and ordering businesses and nonprofits to institute work-at-home procedures “to the maximum extent possible.” On Monday, as he continued to delay further measures, he characterized his approach as deliberate. “I want to give people time to prepare,” he said. “I’ve taken a really measured approach to this crisis.”
And that’s the problem. When a measured approach is needed, Phil Scott gives you a measured approach. When urgent action is required, Phil Scott gives you a measured approach. As Vox.com reported, Italy actually took substantial, painful steps to try to contain the virus — but it failed.
“Italy has been devastated by the virus because the action it took was just a little too moderate, a little too restrained, and a little too slow,” wrote vox.com reporters Kelsey Piper and Christina Animashaun.
Estimates of COVID-19’s potential impact vary widely, because this is our first experience with the virus. The University of Nebraska’s Dr. James Lawler, director of International Programs and Innovation at the Global Center for Health Security, projected close to 190,000 total cases in Vermont based on a 30% infection rate. The bulk of those cases would be mild at worst, but thousands would become seriously ill — he projects roughly 9,400 would require hospitalization in Vermont, with 3,800 requiring intensive care. Based on a fatality rate of 0.5% for all cases, about 940 Vermonters would die. Fatality rates have been 2-3% or more in other countries; you do the math.
What will it take to prevent hospital overload and unnecessary loss of lives? Dr. Fauci told NBC it will take at least “several weeks” of social isolation and staying at home. And the sooner we act, the more effective those measures will be.
But wait, it gets worse.
There’s increasing evidence that when social isolation measures are relaxed, the virus can come roaring back. CNN reported Monday that Hong Kong, thought to be a COVID-19 success story, is seeing a resurgence in cases after easing restrictions.
A report from the Imperial College London sees the same trend on a global scale. “It is likely such measures – most notably, large scale social distancing – will need to be in place for many months, perhaps until a vaccine becomes available,” the report concluded. That may be 12 to 18 months from now.
“The world is facing the most serious public health crisis in generations,” wrote Professor Neil Ferguson, head of the College’s MRC Centre for Global Infection Disease Analysis.
That would include the AIDS epidemic, for those keeping score.
This is not a time for half measures.
“You don’t want to be complacent. You always want to be ahead of the curve,” Dr. Fauci said on “Meet the Press” on March 15. “I like to be criticized [as], ‘Oh you’re being too overactive’ — that’s good for me.”
That’s because the other scenario — we underreact and suffer catastrophic consequences — is something we never want to face. Neither should the governor. This may be the defining moment of his administration. He needs to face up to the generational challenge directly in front of him.
CORRECTION: Due to an editing error, the fatality rate, which is 0.5% was one decimal point off.
