Indian-American infectious disease specialists raised alarm over COVID-19 resurgence

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Keeping an eye on the ‘COVID-19 Dashboard’ provided by Johns Hopkins University, is in itself a moving experience as numbers keep changing globally as well as in the United States not always in a downward trajectory.

The current number of confirmed cases in the U.S. is 2,003,930 on June 11 at noon. It won’t be the same an hour later as testing for COVID-19 ramps up, and analysts see rising numbers. But it is the fatalities that  shake one. The current number stands at 113,038, as of noon on June 11, higher by far than any country, including India.  By June 12 morning the number of cases in the U.S. had risen to 2,023,690 and the fatalities to 113,820.

Indian-American infectious disease experts are sounding the alarm and have for some time, been cautioning against early re-openings. Now their warnings are more emphatic.

Dr. Ashish Jha, director of Harvard University’s Global Health Institute, rang the alarm bell in a June 10, 2020, CNN interview where he said he expects deaths in the U.S. to rise by another 100,000 by fall if stiff restrictions are not imposed or implemented, a bleak forecast that should impel states to act.

Instead they are busy with developing phased re-opening of stores, malls, restaurants, even hair salons, and looking ahead to schools reopening in September. Jha said protests around the country are going to fuel more cases. The key was to wear masks and while most who were in the protest marches were doing so several were not, he noted, adding that incoming data showed how critical masks were.

At least half the states in the U.S. are showing a rise in cases. According to an Associated Press analysis, as of June 12, 2020, there were 21 states where “the rolling seven-day average of new cases per capita was higher than the average seven days earlier.”

“Even if we don’t have increasing cases, even if we keep things flat, it’s reasonable to expect that we’re going to hit 200,000 deaths sometime during the month of September,” Jha said. “And that’s just through September. The pandemic won’t be over in September,” he warned.

The deaths, Jha said, are preventable by speeding up testing and contact tracing, observing social distancing and using masks routinely.

Dr. Pooja Shah, infectious disease specialist in Edison, N.J., also advises a high level of caution and is hesitant to predict the results of recent protests around the country.

“We in New Jersey are over the peak and seeing a decrease in cases,” she said. “But other states are having surges. And it doesn’t mean we might not have a surge again.”

“There is still so much that is unknown about this virus, and so much research to be done, not just into the disease, but into developing a vaccine,” Dr. Shah said. As an infectious disease specialist who has been on the frontline treating COVID-19 patients, Dr. Shah says the protests concern her because they could lead to community spread. “I am not saying don’t do what you want to do, but do it with the protections, and be diligent about it. Wear the mask, do the social distancing even if its outdoor, and wash your hands. This virus is still around.”

In addition, “Testing is not a hundred percent. There are a lot of false negatives, and antibody testing is uncertain,” Dr. Shah said. “What I say about this virus today, may  not hold true tomorrow,” she added. “We still have cases coming in. They may be less but that doesn’t mean anything. I’m still on high alert.”

Speaking to Judy Woodruff on PBS News Hour June 10, Jha said, “What I have always argued for is we needed to bring the virus levels down, we need to build in a testing infrastructure, and then open up more safely, so that we could have an economy and save lives. We’re sort of managing to do neither.”

On Twitter, Jha went on the explain that the solution was not indefinite lockdown. “It was to build a testing/tracing infrastructure that would bring virus levels down. And helped us open up safely (sic). It’s not too late to build this. We have to at least try,”

“Now we’ve come to the conclusion that this virus is not going to be contained. So every country, every location, really needs to be able to prepare to diagnose and treat those cases,” Dr. Amesh Adalja, infectious disease expert at Johns Hopkins, said during an interview on CNN June 11, echoing the views of Dr. Jha.

The cornerstone for achieving that, Adalja said, is being able to get hospitals prepared to deal with “the surge” of patients. That includes diagnostic testing, which he said, was one of the biggest shortcomings in the U.S. approach to Covid-19. “We are woefully behind in being able to diagnose these cases, especially the mild cases.. .”

Even the newest Centers for Disease Control criteria for getting a test  “doesn’t really allow people to be tested unless they have symptoms of lower respiratory tract infections and pneumonia. Not the runny nose, not the sore throats,” Jha said.

He expressed a sense of urgency about the need to understand the extent of community spread going on. While most of those cases are going to be mild, Adalja contended, “We don’t want to miss them and surprise the American public when all of a suddenly we have community spread and it seems to have come from nowhere. Because it’s going on right now,” he warned. Test kits should be available to all doctors and clinics, and emergency departments. “We need doctors to be able to order this freely without having to go through any kind of bureaucracy,” Adalja emphasized.

According to a Reuters analysis, New Mexico, Utah and Arizona each saw number of cases rise by 40% for the week ending June 7, and Florida and Arkansas are other hot spots.

Though analysts are warning of another spike around the corner with the massive protests which continue even two weeks after Floyd’s death May 25,  Vice President Mike Pence said there was no evidence of an increase in new cases between then and now. “Many people at protests were wearing masks and engaging in some social distancing,” he said.

But as Dr. Jha went into one of his myriad interviews on media he sent out this plea on Twitter, “The pandemic is still here. Between 800 and 1,000 people are dying a day. We can’t become immune to this. We can’t.”