The scourge of COVID-19 continues in the USA.  Our country continues to lead the world in cases, 1.3 million, and in deaths, approximately 76,000. Research is continuing aimed at finding medications for treatment as well as vaccines.  The USA accounts for 32% of the total COVID-19 deaths worldwide. Optimistic projections for a vaccine availability remain during 2021.  The medical community continues to learn about this disease. There is, yet to be peer-reviewed, research that hypothesizes the mutation of this SARS-CoV-2 virus (scientific name for the COVID-19 virus) to different strains. The researchers theorize that the strain on the US west coast came directly from China and is different, and less contagious, than the one that came from China, through Europe, then to the east coast of the US.  This concept is still being debated at this point.  Another alarming occurrence is the diagnosis of a severe multisystem inflammatory response (Kawasaki Disease) that is being seen with increasing frequency in children with COVID-19 infection.  This too is being studied further.  The major point here is that children are not immune to this infection and this COVID-19 affects all age groups.

Despite a different locale in the US reaching its peak number of COVID-19 deaths daily, states continue to open.  They are nearly uniformly violating the minimal guidelines set forth by the Coronavirus Taskforce. Even those guidelines were put forth with the acceptance of the deaths that will occur as the social distancing is abandoned. The Washington University (IHME model) which the taskforce has relied upon, alluded to a twofold increase in daily deaths by the end of June.

Let us explore which Americans are most susceptible to succumb from COVID-19.  African American make up 13% of the US population but are 30-34% of the deaths. Black folks who live in majority black counties have three times the infection rate and six times the mortality rate compared to majority-white counties. Americans over age 65 make up 80% of the deaths. Several weeks ago, the media and government officials gave fleeting lip service to the health disparities which are part of the fabric of America. Our government has moved on to demonstrating that the economy is a more significant consideration.  It is ironic that this preexisting focus on economic prosperity over health, actually contributes to the disparities which are being magnified by COVID-19.

So, one must ask why are they so willing to accept the possible death of up to 3,000 Americans a day (CDC draft report)? Is it because the people who are dying are not those in power? We continue to believe that the sacrifice of lives at the altar of livelihood is a false choice.  Our country needs a federal response to coordinate proper social distancing, robust testing, contact tracing, isolation, and treatment as well as research for a cure and/or vaccination. Disaster response has traditionally been locally executed, managed by the state, and supported by the federal government.  The federal government needs to step up to the plate and do its part.  The Defense Production Act needs to be used to assure that adequate testing materials and PPE is available for the public. Curiously, the President was not reluctant to use the Act to mandate that meat production facilities stay open, even though COVID-19 is rampant at many meat processing facilities.

Citizens will have confidence to return to work, go out and spend money when they feel safe. That will not happen until we can see that mechanisms are in place to protect us. The current haphazard “re-opening’, from state to state, lacks federal coordination and support. It is being perceived as valuing the economy over lives.  It is often said that “perception is reality”.

Clyde E. Henderson, MD                                                                                                                                                             Treasurer, Cincinnati Medical Association