The virus is winning

Iqbal Chaudhry, center, mourns his brother, Aurangzabe Iqbal, who spent a week in the hospital on a ventilator before he died from COVID-19, outside Al-Rayaan Muslim Funeral Services in Brook

When Michael T. Osterholm, a prominent epidemiologist, heard that the White House coronavirus task force was "ramping up" its work this month, he was elated. Maybe now the United States would finally tackle the virus with the seriousness needed.

Then he realised that he had misheard. The task force wasn't "ramping up" but "wrapping up."

"I was in shock," said Osterholm, a professor at the University of Minnesota. "We're just in the second inning."

The White House plan to disband the task force is in characteristic disarray, with President Donald Trump reversing course Wednesday and saying that the task force would continue but change its focus. The confusion perfectly reflects the incoherence of the US "strategy" toward COVID-19.

Vice President Mike Pence had earlier said that the disbanding of the task force was possible because of "the tremendous progress we've made" against the virus.

Hmm. It's actually the virus that has made tremendous progress, eclipsing heart disease to become the No. 1 cause of death in the United States. In less than two months, we have lost more Americans to the coronavirus than in the Vietnam, Persian Gulf, Afghanistan and Iraq wars combined.

While Spain and Italy have emerged from their COVID-19 outbreaks and enjoyed significant falls in new infections, that has not happened in the United States. For five weeks, new daily infections in the United States have been stuck roughly in the 25,000 to 30,000 range, declining only a bit.

Even the small decline in new cases in the United States is misleading, for it's simply a result of great progress in the New York City metropolitan area. Exclude New York, and new cases in the United States are still increasing.

About half of states are easing some restrictions this week. But to manage the reopening safely, we need massive levels of testing and contact tracing — and one more sign of how we have bungled our COVID-19 response is that while testing has, very belatedly, increased significantly, on most days the United States is still testing fewer people per capita than Britain, Iceland and Portugal.

Trump announced back on March 6 that "anybody that wants a test can get a test"; this is still not true.

Nor have we compensated for testing kit shortages by embracing widespread testing of sewage to look for the virus in wastewater, as the Netherlands has done. Even in impoverished Pakistan, sewage testing has been widely used to monitor polio virus outbreaks, so the United States should be able to use sewage testing for surveillance of the coronavirus and early identification of hot spots.

While the United States has poured $3 trillion into relief from the effects of COVID-19 — money that will run out soon and that hasn't prevented young children in 1 in 6 households from not having enough to eat — the nation hasn't invested nearly enough in science and in the scientific tools, like testing, vaccines, therapies and research, to combat it.

"We're significantly hampered by lack of funding," said Anne Rimoin, an epidemiologist at UCLA who studies transmission of the coronavirus by people who are asymptomatic.

Bravo to those local leaders who acted early and saved many lives — I'm thinking of Govs. Jay Inslee of Washington, Gavin Newsom of California and Mike DeWine of Ohio — but governors are now in an impossible situation.

It makes sense to experiment with reopening in areas with fewer infections (perhaps using randomised controlled trials to gain a better understanding of what is safe), and epidemiologists note that there's a particularly good case to be made for reopening parks and beaches if social distancing is practised. But we still don't have the testing and contact tracing to be confident that we can get the easing right or to clamp down quickly when we get it wrong.

And Trump and Pence still seem oblivious.

"By Memorial Day weekend we will largely have this coronavirus epidemic behind us," Pence told Fox News only two weeks ago. That magical thinking seems to be shared by many politicians and investors alike.

Let's be very clear: There's huge uncertainty, so we need great humility in looking ahead, but most epidemiologists anticipate a long, wrenching struggle against the virus.

"If we have a big wave in the fall, it'll make everything we've had so far seem not all that serious," said Osterholm, whose infectious disease institute recently issued an excellent and sobering report about the road ahead. "But that's the reality of this. I tell people my job isn't to scare you out of your wits; it's to scare you into your wits."

A new Columbia University study suggests that we may face a rebound in deaths by late this month because of the easing of restrictions, just as a model used by the Trump administration shows deaths increasing to 3,000 daily by June 1.

"This is here to stay, in all likelihood, until we have a vaccine, and a vaccine could be a year or two away," said Tom Frieden, former director of the Centers for Disease Control and Prevention. "Or it could be never."

©2020 The New York Times Company