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US coronavirus outlook: The virus pervades urban and suburban areas


US coronavirus outlook: The virus pervades urban and suburban areas

Since the beginning of February coronavirus has been spreading astonishingly throughout the United States. The governments at the federal as well as in the states level were at first unprepared and consequently a large number of people got infected and remained undiagnosed. Only the seriously ill people moved to the hospital but a vast number could not access the health care facilities. As the state governments began gearing up the hospitals and clinics the influx of infected people mounted. The hospitals became overwhelmed. Stocks of masks, gloves, personal protective equipment and beds fell utterly short of the requirement. The state governments sought urgent supply from the Federal Emergency Management Agency (FEMA), which had limited stockpiles, dispatched a limited quantity. A cacophonous situation unfolded and the pandemic engulfed more and more cities and habitations in the country. People became panicked and bewildered.

Ventilators which turned out to be a life-saving contraption for severely sick patients were needed in increasing numbers, but FEMA did not replenish its stockpiles since 2008 flue. Governor of New York made an urgent appeal for 30,000 ventilators but FEMA could supply no more than 4,000 units. Governors of California, Michigan and Washington were also asking for ventilators. The device supports severely ill patients whose lungs were functioning at reduced capacity.

A coronavirus survivor wrote in the Washington Post that she spent six days with ventilator serving as lungs. She doesn't remember anything from this period. "I have since learned that some patients had nightmares while on ventilators, so I view myself as very fortunate." Eventually the doctors took her off the ventilators and tested whether she could breathe on her own. They extubated her and it was successful; with the aid of supplemental oxygen, she could breathe independently again. She wrote, "It is an outrage that a country as rich as the United States had to debate the shortage of ventilators when the device appeared crucial to the survival of patients. Luckily the situation got eased partly because of ventilators being sent from places of low need to places of high need." She pleaded that "we need to make sure that every patient who needed a ventilator can get one so that as many of them as possible can survive." But at the same time she raised an alarm that "in the New York hospital where she was undergoing treatment, 80 per cent or more coronavirus patients who end up on ventilators have died."

In mid-March, President Trump had applied the Defence Act and instructed General Motors to manufacture ventilators. According to latest report, GM will make 30,000 ventilators by June at a cost of $491 million. In the meantime, as the rate of hospitalisation in California eased, the Governor transferred the surplus ventilators to New York. The New York Governor, with the help of the army, converted a convention centre into a Field Hospital with 3,000 bed capacity and the Naval ship Comfort with 1,000-bed capacity came into service. Equipped with additional facility the hospitals in New York are now able to serve more patients with less stress on the staff.

The overall situation hasn't made significant improvement. Though the influx of patients has declined in California and Washington State, new areas with higher infection rate are being reported. New Jersey, Philadelphia and Baltimore from Mary Land have recorded influx of patients with coronavirus symptoms. Now all 50 states have come under "state of emergency" and lockdown has been intensified.

Notwithstanding augmented health care facilities and increased supplies of medical items and equipment, the influx of infected persons and death toll continue to mount. Till April 14, over half a million people have shown positive symptoms of infection in the country and more than 24,000 people have succumbed to infection. On March 31, the White House estimated that even with social distancing in place, between 100,000 and 240,000 Americans would die of Covid-19. Now the estimate has been revised downward. According to the Washington University, the death toll would be around 61,000, that is at par with the number of people died of the flue in 2019-2020 season.

New York, the epicentre of the pandemic, shares about 45 per cent of total casualties in the United States. Governor Andrew Cuomo announced recently that despite the arrival of newly infected patients at the hospitals he observed flattening of the curve, but the death rate remains on upward trend. Should there be no reversal of the situation he expressed optimism that death rate would soon decline.

Meanwhile, South Korea has sent an air shipment of 600,000 kits to the US this week. China sent a plane load of medical items earlier in the week.

A debate has now set on motion how soon the shutdown could be relaxed, and people could return to work. Trump himself favours a gradual rolling back of the shutdown with effect from the beginning of May. Dr. Anthony Fauci, the Director of National Institute of Allergy and Infectious Diseases, said that return to normalcy will not happen all at once. Regarding rolling back the shutdown on May 01, he said "we are not there yet". In the Task Force led by Vice President Pence, there is disagreement on how soon the shutdown should end. Meanwhile, the Governors of the North East Coast and Governors of the West Coast have established their respective regional task force to plan and advise "when and how to roll back the shutdown" taking into account the prevailing ground situation. Trump retorted that as president, he has the authority to make the decision. The Governors vowed not to comply with the unilateral decision of Trump. They are concerned that a premature withdrawal of shutdown might provoke a second wave of the virus, they can hardly afford.

Trump has now turned his wrath on the World Health Organisation (WHO) for its alleged "China-centric policy". Trump has accused WHO for endorsing Chinese handling of the pandemic when it under-reported the death toll. Trump felt that had China divulged the ferocity of the pandemic at the earliest stage, many countries including the US could have activated preventive mechanism and contained the spread of the disease.

Trump's threat of defunding WHO during this unprecedented global health crisis will be tantamount to pouring gasoline on the fire. Trump administration should not lose sight of WHO's many achievements in the past including its robust response on the containment of HIV/AIDS, eradication of polio, malaria eradication programme and Ebola crisis in Congo before it takes a hasty decision to defund WHO.

The Covid-19 pandemic should come as a reminder to Trump and his advisors that a crisis of international magnitude cannot be effectively addressed by unilateral action or acting in sequestration. Coronavirus has pervaded at an astonishing speed and in less than a month's time about 200 countries fell prey to this pandemic. The United States, the richest country in the world, even after two months of the outbreak of the pandemic, could not provide adequate ventilators to the hospitals. The front line "care givers" were constrained to use same masks and gloves multiple times because the hospitals didn't have enough in the stock. The doctors had treated the patients without personal protective equipment (PPE) and exposed themselves to the virus. Consequently, many medical staff including doctors fell ill and died.

The situation in European countries has been tragic. Italy, Spain and United Kingdom (UK) are still struggling to contain the virus. It is unclear how African countries are coping with the pandemic. Globally over 1.9 million people have been infected and more than 121,000 people died.

Despite being severely affected South Korea and Japan dispatched shipments of medical kits and items to many countries in Africa and Asia. China sent medical supplies to 45 countries. Germany provided medical supplies to Italy and Spain.

This unprecedented human tragedy underscores the fact that a comprehensive, robust and multinational effort, coordinated by multinational organisation, remains the best mechanism to contain a catastrophe that transcends geographical boundaries. The United Nations (UN) was created not only to prevent wars and conflicts but to address humanitarian crisis as well. Regrettably, the Trump administration opted unilateralism, withdrew from several multinational organisations including UNRWA (United Nations Relief and Works Agency for Palestine Refugees in the Near East), UNESCO (United Nations Educational, Scientific and Cultural Organization, Paris Agreement on Global Warming and Trans-Pacific Partnership Agreement. The United States has isolated itself from the international community, abdicated global leadership and turned miserably inward-looking - and it has become incapable of addressing a crisis on its own soil.

 

Abdur Rahman Chowdhury is a former official of the United Nations.

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