COVID-19's learning curve is deadlier and more difficult than anyone guessed

COVID-19's learning curve is deadlier and more difficult than anyone guessed
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I warned my TV viewers on Jan. 27 about a virus that had originated in Wuhan, China, and spread to several other countries, with five reported cases in the United States at that time. "I've been studying contagions for a really long time, and I've never seen anything like this," I said. 

At the time, the Chinese government was reporting that at least 106 deaths had been attributed to the coronavirus, with more than 4,500 confirmed cases in the country. The U.S. State Department urged Americans to reconsider traveling to Wuhan and ordered all non-emergency U.S. personnel and their families to leave China immediately. I called China's delay in imposing quarantines and travel restrictions "reckless and really, really scary," and indicated that I felt the actual number of cases in China was far greater than was being reported. I also brought into question the role of the World Health Organization (WHO) in obscuring the truth about the emerging pandemic and irresponsibly calling it a regional problem only.

In late February, I traveled to Washington's Dulles Airport where acting Deputy Secretary of Homeland Security Ken Cuccinelli told me in an interview that it was very difficult to properly screen incoming travelers who originated in China, despite the ongoing travel restrictions put in place by President TrumpDonald John TrumpBiden says voters should choose who nominates Supreme Court justice Trump, Biden will not shake hands at first debate due to COVID-19 Pelosi: Trump Supreme Court pick 'threatens' Affordable Care Act MORE on Jan. 31, because travelers could obscure their point of origin when they entered the U.S. from secondary destinations. A Customs and Border Protection agent on the front lines there told me that he believed many travelers who weren't feeling well or had come from Wuhan originally hid that information and, if they had a fever, might take a Tylenol to bring down their temperature and avoid detection.

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From Dulles, I flew to the National Quarantine Center at Nebraska Medical Center, where the doctors and nurses taking care of COVID-19 patients from the Diamond Princess cruise ship taught me how easily transmissible the virus was and that it was likely spreading already throughout our communities, at a time when the Centers for Disease Control and Prevention (CDC) was still talking in terms of isolated clusters and attempting to contact-trace these clusters with frequently flawed PCR test kits. 

It is easy to finger-point now in retrospect and to assign blame, since we were learning about the virus even as it was infecting us. Yet, at the same time, it is clear to me that the CDC was underestimating COVID-19 and doing too little to "control" or "prevent" it from spreading.

Part of the problem was that the CDC was unable to get permission from the Chinese government to put "boots on the ground" there to further our understanding of the disease. Both Dr. Robert Redfield, the head of the CDC, and Dr. Anthony FauciAnthony FauciTillis appears to reinforce question about COVID-19 death toll Overnight Health Care: Trump signs largely symbolic pre-existing conditions order amid lawsuit | White House puts off action on surprise medical bills | Rising coronavirus cases spark fears of harsh winter NY health officials to review any vaccine approved by Trump MORE, director of the National Institute of Allergy and Infectious Diseases, told me in interviews that they relied on their good relationships with Chinese scientists to understand the virus. Unfortunately, this information proved to be unreliable and, in some cases, inaccurate. Meanwhile, China restricted internal travel but continued to allow international travel, including to Europe, where the virus soon spread.

Not only did we learn too late that you could easily acquire this virus from asymptomatic carriers and patients right before they developed symptoms — the rationale for increased mask use — but we also had to learn, on very ill patients in New York City, that this was not always a mild condition in 85 percent of patients with just 15 percent developing pneumonia and affecting only the lungs, as China had informed us. As we sadly discovered, it was a multi-organ inflammatory disease that often caused blood-clotting and vasculitis.

Once we knew the truth about COVID-19 and how easily it spread, the paradigm changed. Masking our faces, maintaining social distancing and disinfecting surfaces became more important. It also became clear how important travel bans would be in advance of the virus taking root since once such a transmissible virus was in your community, it would continue to spread despite lockdowns. New Zealand understood this better than perhaps any other country and instituted an almost total travel ban that has kept the case numbers there close to zero for months.

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Here in the U.S. and many other countries, lockdowns have had a tremendous economic, physical and emotional cost, as routine medical care has been delayed, jobs have been lost, and depression or suicidal thoughts have soared, especially among younger people who are out of work or out of school, living in a state of relative isolation.

As we begin the autumn months, we remain in a dark place in America, with many of our restaurants, theaters, schools and workplaces still closed, awaiting the promise of a vaccine and with only physical distancing or masking and personal hygiene to protect us. There are many COVID-19 treatments in the pipeline, but there is nothing for prevention or early treatment that we can all agree on. 

The reality is that almost everyone involved in our local, state and national responses to date — regardless of a political party, regardless of medical, scientific, sociological, economic or other technical expertise — were, in effect, shooting at a moving target and making determinations based on evolving science. Most were simply doing their best to devise solutions. All were dealing with something that had never been encountered before, a pandemic whose enormous ramifications and long-term, culture-altering consequences still remain largely unknown.

Until we have those preventions and cures in hand, we need to stop all the finger-pointing and ridiculing, to replace all the dogma and self-righteousness with kindness and respect, with courage instead of fear.  But, of course, given human nature, that won't be so easy for such a politically divided nation in the midst of a presidential election.

Marc Siegel, M.D., is a clinical professor of medicine and medical director of "Doctor Radio" at NYU Langone Health. He is a Fox News medical contributor and the author of six books, including "COVID: The Politics of Fear and the Power of Science," to be published this month.