Pubblicato in: Medicina e Biologia, Stati Uniti, Trump

USA. Virus. Senza interventi si prospetterebbe almeno un milione di morti.

Giuseppe Sandro Mela.

2020-03-20.

Washington. White House. 001

Coronavirus, Trump dichiara emergenza nazionale

«Il presidente americano Donald Trump ha dichiarato un’emergenza nazionale di fronte all’emergenza coronavirus. Un passo, ha detto, che permetterà di mobilitare risorse per 50 miliardi. I 50 stati dovranno aprire centri per affrontare la crisi e approntare piani per l’emergenza.

Trump ha inoltre detto di aspettarsi che “già la settimana prossima saranno disponibili mezzo milione in più di test” per il corononavirus. “Ciò porterà probabilmente a 1,4 milioni di test la settimana prossima e cinque milioni in un mese”, ha aggiunto. Il presidente ha spiegato che la proclamazione dell’emergenza nazionale permetterà al segretario alla Salute di sospendere una serie di leggi e regolamenti, in modo da concedere più flessibilità agli operatori sanitari nella lotta contro la diffusione del coronavirus.»

Il cuore del provvedimento è racchiuso nell’ultima frase:

«la proclamazione dell’emergenza nazionale permetterà al segretario alla Salute di sospendere una serie di leggi e regolamenti, in modo da concedere più flessibilità agli operatori sanitari».

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A febbraio si è svolta una riunione tra membri dei Cdc (Centers for Disease Control and Prevention) ed esperti di tutto il mondo sulla diffusione del virus negli Stati Uniti. Uno degli esperti, Matthew Biggerstaff, ha illustrato 4 scenari possibili basati sulle caratteristiche del virus, sulla rapidità di diffusione e sulla gravità della malattia.

«Tra 160 e 214 milioni di persone potrebbero essere infettate negli Stati Uniti nel corso dell’epidemia, secondo una proiezione. L’epidemia potrebbe durare mesi o anche più di un anno, con contagi concentrati in periodi più breve, scaglionati nel corso del tempo in comunità differenti. Potrebbero morire da 200.000 a 1,7 milioni di persone»

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«Statistical models meant to project the potential reach of the coronavirus and the COVID-19 disease suggest more than a million Americans could die if the nation does not take swift action to stop its spread as quickly as possible»

«At least three different models built by epidemiology experts suggest that millions of Americans will contract the coronavirus, even in optimistic projections, based on what they know of its spread in China and the United States so far»

«One model from the Centers for Disease Control and Prevention (CDC) suggested that between 160 million and 210 million Americans could contract the disease over as long as a year. Based on mortality data and current hospital capacity, the number of deaths under the CDC’s scenarios ranged from 200,000 to as many as 1.7 million»

«It found as many as 21 million people might need hospitalization, a daunting figure in a nation with just about 925,000 hospital beds»

«Another model built by experts at Resolve to Save Lives, a global health nonprofit, and the Council on Foreign Relations found the number of potential deaths could range from as few as 163,500, if the virus is no more deadly than seasonal influenza, to more than 1.6 million if the virus carries a mortality rate of just 1 percent»

«Modeling is to inform planning so that the worst-case scenarios are much less likely to occur»

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Di fronte ad emergenze di questo livello sarebbe sempre opportuno considerare anche le peggiori evenienze, facendo il possibile perché non si concretizzino.

Circa gli Stati Uniti sarebbe però da ricordare come il governo federale abbia molte competenze, ma, essendo un federazione, altrettante spettano ai singoli stati.

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The New York Times. Worst-Case Estimates for U.S. Coronavirus Deaths

Projections based on C.D.C. scenarios show a potentially vast toll. But those numbers don’t account for interventions now underway.

«Officials at the U.S. Centers for Disease Control and Prevention and epidemic experts from universities around the world conferred last month about what might happen if the new coronavirus gained a foothold in the United States. How many people might die? How many would be infected and need hospitalization?»

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U.S. Centers for Disease Control and Prevention. Updated Guidance on Evaluating and Testing Persons for Coronavirus Disease 2019 (COVID-19)

«The Centers for Disease Control and Prevention (CDC) continues to closely monitor and respond to the COVID-19 outbreak caused by the novel coronavirus, SARS-CoV-2.

This CDC Health Alert Network (HAN) Update highlights guidance and recommendations for evaluating and identifying patients who should be tested for COVID-19 that were shared on March 4, 2020, on the CDC COVID-19 website at https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html. It supersedes the guidance and recommendations provided in CDC’s HAN 428 distributed on February 28, 2020. ….»

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Worst-case coronavirus models show massive US toll.

Statistical models meant to project the potential reach of the coronavirus and the COVID-19 disease suggest more than a million Americans could die if the nation does not take swift action to stop its spread as quickly as possible.

At least three different models built by epidemiology experts suggest that millions of Americans will contract the coronavirus, even in optimistic projections, based on what they know of its spread in China and the United States so far. 

One model from the Centers for Disease Control and Prevention (CDC) suggested that between 160 million and 210 million Americans could contract the disease over as long as a year. Based on mortality data and current hospital capacity, the number of deaths under the CDC’s scenarios ranged from 200,000 to as many as 1.7 million. 

It found as many as 21 million people might need hospitalization, a daunting figure in a nation with just about 925,000 hospital beds.

The CDC’s model was described to The Hill by an expert who watched the presentation. The New York Times first reported its existence.

“CDC is working with federal partners on modeling efforts to estimate how many COVID-19 illnesses, hospitalizations and deaths might occur under various hypothetical scenarios and what the economic impact of COVID-19 might be on the United States. This type of modeling work is commonly used as a planning tool during outbreaks and can help inform the public health response, as well as other policies (e.g. economic policies) to mitigate the potential impact on the United States,” a CDC spokesman said in a statement.

The spokesman said the modeling can help health systems plan for a surge in patients and help the CDC plan to distribute medical experts and equipment. It also helps show local governments when mitigation steps like school closures are wise.

Another model built by experts at Resolve to Save Lives, a global health nonprofit, and the Council on Foreign Relations found the number of potential deaths could range from as few as 163,500, if the virus is no more deadly than seasonal influenza, to more than 1.6 million if the virus carries a mortality rate of just 1 percent.

Those figures are based on estimates that half of Americans will contract the virus.

Globally, the numbers are even more staggering. Five researchers at Harvard’s T.H. Chan School of Public Health estimated that between 20 percent and 60 percent of everyone on earth — or between 1.4 billion and 4.2 billion people — could eventually contract the disease.

If the virus only kills 1 percent of those who contract it, somewhere between 14 million and 42 million people are at risk. In countries like Iran and Italy, where health systems are overrun, the mortality rate can be much higher. 

The models are meant to project how a virus spreads around the world, including assumptions for both best- and worst-case scenarios. Those worst-case scenarios assume societies take no action against the virus — and in some cases the eye-popping numbers can spur a community to action, said Tom Frieden, the former director of the Centers for Disease Control and Prevention who now runs Resolve to Save Lives.

“Modeling is to inform planning so that the worst-case scenarios are much less likely to occur,” he said in an email. “The range of estimates is huge. We need much more information, fast, to understand how to limit the harms.”

The CDC warned that new data was still coming in, and that assumptions about the virus — how readily it spreads, how deadly it might be — continue to evolve.

“This is a rapidly evolving situation and information is changing quickly. Estimates based on data from other countries might not be applicable to the United States and it is unclear how the COVID-19 situation will play out in this country,” the agency spokesman said.

Governments across the world have taken a range of actions meant to hew closer to best-case outcomes, ranging from China’s harsh crackdowns and enforced quarantines to South Korea’s vast army of testers who screen motorists at drive-through stations. 

In the United States, where the federal government has been slower to act, state governments have moved to squelch outbreaks in their backyards. Mobile testing stations have opened in Minnesota and Colorado. Large gatherings have been prohibited in Washington, New York, Oregon and elsewhere. Several states have won approval from the Food and Drug Administration to begin testing patients for the virus, and New York has even rolled out its own plan to make tens of thousands of gallons of hand sanitizer every day.