We Should Have Known Better. The American COVID-19 Failure.




The New Yorker May 11, 2020 pp16-22

ANNALS OF MEDICINE “THE WARNINGS” “Why we should have known to prepare for COVID-19” by David Quammen. “This is about lack of imagination” said Ali Khan, formerly of the CDC.

See “The Next PANDEMIC on the frontlines against humankind’s gravest dangers” Ali S. Khan with William Patrick. Released May 24, 2016 Public Affairs.

When asked by David Quammen “Which of the diseases is your favorite?” …”for my money, SARS was the one.” “Because it was so contagious, and so lethal”. “And we were very lucky to stop it”. “SARS was the bullet that went whistling past humanity’s ear.”

Asked about COVID-19 (AKA SARS-CoV-2), “What went so disastrously wrong?” “This is about lack of imagination” he said. Elaborating. “Failure to appreciate the SARS and MERS warnings, both delivered by coronaviruses; and the loss of capacity at high government levels, within recent years, to understand the gravity and immediacy of pandemic threats”.

According to Beth Cameron, a former head of the Directorate for Global Health Security and Biodefense on the National Security Council staff, our failure it tied to a lack of “the smoke alarm”. You can’t stop outbreaks. “But you can stop outbreaks from becoming epidemics or pandemics”. “After John Bolton became the national-security advisor, it [Global Health Security and Biodefense on the NSC] was dissolved. Institutional memory lost America was ineffective in recognizing the risk and marshalling the plans on the Federal Government’s “Shelf” to stop the ensuring onslaught. South Korea which experienced MERS (MERS-CoV) in 2015 and Singapore which experienced SARS in 2003 had plenty of intact memory and quickly acted to aggressively limit the spread of SARS-CoV-2 or COVID-19. In essence, all America had to do was follow their actions. A matter of listening, comprehending and leading.

This is a great story about Khan’s experience chasing Zoonotic diseases (those that move from animals to humans) around the globe only to eventually have it come to him in Nebraska where he serves as the Dean of the College of Public Health at the University of Nebraska Medical Center in Omaha. The piece highlights viral epidemiology in a digestible way highlighting the importance of “superspreaders” in COVID-19.

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