This piece was posted at the UC Santa Cruz website. Author Dan Simon reported on his conversation with Laurie Garrett—expert on epidemics (and a UC Santa Cruz alumna).
Laurie Garrett was in China during the SARS epidemic, and won a Pulitzer Prize for chronicling the Ebola virus outbreak in Zaire. So she speaks with authority and experience when she says that the coronavirus is “different from anything we have ever seen before.”
Garrett is a leading expert on global health, with a particular focus on newly emerging and reemerging diseases and their effects on foreign policy and national security. She has been watching the coronavirus outbreak closely and speaking with news media including MSNBC to impart knowledge and combat the spread of misinformation.
The novel coronavirus “has something in common with SARS (Severe Acute Respiratory Syndrome), MERS (Middle East Respiratory Syndrome), and the common cold, but with a lot of nuances that we haven’t seen before,” said Garrett. “It is possible for people to seem completely cured and a couple of weeks later be dying of the disease.”
COVID-19, or coronavirus disease 2019, is comparatively less deadly than either SARS or MERS, Garrett said.
“It is not ultra-ultra-lethal, so we need a better understanding of what makes COVID-19 dangerous, putting people in intensive hospital care for two or three weeks. Roughly a quarter of all cases seem to go severe, and require long-term hospitalization, and yet the death rate is comparatively low.”
Community Response to a Global Health Crisis
To deal with such a contagious viral infection, which can now be found across the globe in every continent except for Antarctica, requires creative thinking and careful coordination, at the national as well as the local level.
To illustrate this idea, she gave an example of attending a co-op board meeting for a 27-floor apartment building in New York City. She suggested that the building could take a detailed census of its most vulnerable residents.
“Who in our building is elderly and might need assistance? Who are all those single moms with three kids? Who has recently suffered an injury and needs help?” she said. “We should have some system in place to look in on them, to get extra groceries for them if we get into a lockdown situation in this part of New York City.”
She said similar efforts can take place in communities all over the nation…
“Everyone defines community differently, right?” she said. “It might be your church, or Merrill College, or it might be all the people who love to go dancing out on the Santa Cruz Wharf. Whatever your community is, you have the opportunity to take leadership right now. This is the chance to say, ‘Here are the things we’re doing as a community that might be risky right now, and here is how we change our behavior, and here are the people who might need a little extra help.’”
Garrett has been outspoken about the Trump administration’s handling of the outbreak, as well as its earlier decision to disband programs that were instituted during the Obama administration to assess and respond to epidemics. She wrote an opinion piece for foreignpolicy.com detailing the “overt lies and cover-ups” from the Chinese government in its initial response to the outbreak. As a guest on Democracy Now, she said that if she could “wave a magic wand,” she would have had testing in January for every patient inside intensive care wards who was diagnosed with “some mysterious viral pneumonia” that was not flu or bacterial in origin.
“I’m not just saying this in hindsight,” she said. “I was saying this back in January.”
But she said that communities, at least, could institute a thoughtful and carefully coordinated response to the crisis. She urged local governments to set up coronavirus hotlines—one for anyone worried that they had the virus and needing special assistance and another for volunteers wanting to help out. Such centralized hotlines will be extremely important “if this really keeps going and we end up with a China-scale or South Korea–scale epidemic on our hands. If this happens, there will come a moment when chains of supply become a real issue, as more and more truck drivers take ill and go into quarantine.”
If this happens, getting fruits and vegetables grown in Santa Cruz County to grocery stores will be a pressing issue.
“This could conceivably be handled by a well-orchestrated volunteer situation,” said Garrett.
Future Outcomes and Best-/Worst-Case Scenarios
While Garrett had detailed advice about mutual aid in communities, she was less than optimistic regarding the future of the epidemic.
“We’ll see what happens with trying to come up with a vaccine,” she said. To pull off such a feat, “we would have to perform a miracle that we have never previously performed, meaning manufacturing enough safely and affordably so the world could be vaccinated, including the most remote parts of Chad or communities in the high Tibetan plateaus.”
But such an effort would make the eradication of smallpox “seem like small potatoes” in comparison. If there is sufficient vaccine, it could be possible to swoop into communities, vaccinate everyone, and stop this from returning as a future pandemic, she said.
But a more likely scenario is a long-term problem, she said. The virus is already in both hemispheres. It has emerged in South Africa, New Zealand, Argentina, Uruguay, Paraguay, and Chile.
“We could see it go somewhat like a recurring influenza that peters out in the summer in the northern hemisphere but comes in hard at the same time in the southern hemisphere, then reverses, year in and year out, and becomes a routine additional burden as a cause of morbidity and mortality for humanity for decades,” she said.
“Right now, I’d say the track record on the other two prominent coronaviruses is a bad omen,” she said, referring to SARS and MERS. SARS appeared in 2013, and MERS appeared in 2003, “and we don’t have a SARS vaccine, and we don’t have a MERS vaccine.”
She is especially worried about the spread of the virus in places that have large concentrations of people living closely together without proper medical care, including refugee camps in the Middle East, and the Rohingya camps in Bangladesh.
“We could see widespread transmission go on for quite a while before it is even noticed by medical providers, and of course these places don’t have hospitals or state-of-the-art medicine,” said Garrett.
She also worries about situations closer to home, including homeless encampments, whose populations will be especially vulnerable.
Working together and combating misinformation
In the face of such a contagious virus, she said that communities should also do their best to fight against false information.
“We are clearly racing to keep ahead of—or keep up with—the liars and conspiracy theories,” she said. “It is really out of control.”
She is especially concerned with “trolls” who downplay the severity of the coronavirus and the need to prepare communities. Garrett is also doing her best to disseminate her list of “10 simple precautions” to stop the spread of the coronavirus.
She also urged communities to start brainstorming about volunteer efforts and leadership roles right now instead of waiting for the situation to get any worse. It is time to pose such questions as: where is your extended family, who are your neighbors, whom may you call upon, and who can call upon you for assistance?
“A lot of this thinking has to happen now,” she said. “People have to do this before they are around others who are sick.”