Watching surging states struggle is like déjà vu

In Connecticut, we saw the COVID-19 tidal wave approaching from New York. We prepared. And then the patients came, at first like the drizzle before the hurricane that followed. As an infectious diseases specialist, I took care of our first COVID-19 patient in the ICU, intubated and in prone position. We tried multiple therapies, but my patient and his spouse, both in the ICU, died.

At Yale New Haven Health, we cared for over 3,700 COVID patients, discharging over 3,100. For months, I treated patients, educated hundreds of doctors, and feared for the lives of my friends and family. Finally, we could breathe again, of course, behind masks. We had weathered the storm. As of Friday, Connecticut has 66 COVID patients hospitalized.

Now, health care workers in other parts of America are in the same emotional despair. They’re at a breaking point, hospitals filled to the rim. It feels like déjà vu. This was avoidable. So far, over 3 million Americans have contracted COVID-19 and over 136,000 have died. Prioritizing a full reopening of the economy, including crowded indoor establishments, has inadvertently fueled the death care industry.

By following scientific principles while opening the local economy in a phased approach, we can control this pandemic nationwide and get back to a new “normal” life. But the virus will force state closures again where COVID-19 is rampant.

When the pandemic first hit the tri-state area, Govs. Cuomo, Lamont and Murphy worked together to prevent spread of COVID-19. Citizens of New York, Connecticut and New Jersey drove down the actual reproductive rate, or Rt, meaning the average number of people who get infected from one person carrying the virus. Hospitalizations and deaths have stabilized. These states did not have identical reopening plans, but all three continue to work together, most recently on instituting 14-day quarantine orders for travelers from states with high coronavirus rates. As a result, our people are safely enjoying some semblance of summer.

Rt below 1.0 means the rate of transmission of COVID-19 is low. When Rt is above 1.0, COVID spreads quickly. Rt in Connecticut was well below 1.0 for 47 days before we reopened. Since Connecticut has reopened, Rt has risen, but it has stayed below 1.0. In Arizona, Rt was above 1.0 and rising when they reopened. In Florida and Texas, Rt was just below 1.0, increasing, and rose further after reopening. It’s no surprise that COVID spread like wildfire.

With a low Rt, Connecticut schools now have the ability to plan for in-school instruction this fall. With a raging pandemic, in many corners of America a safe transition back to in-person learning seems impossible. Some summer schools tried to open, but were forced to close as the virus raged on. All the ground gained with stay-athome orders was lost with early state reopenings. That experiment failed. Heat and humidity did not kill the virus this summer. In many parts of the country, the virus is winning. States in the greater New York area played the long game, taking early economic hits that have helped health, the economy and education in the long run.

The lockdown in Wuhan, China, drove Rt down from almost 4.0 to 0.3. Six months into this pandemic, we know what works — early recognition of coronavirus circulation, timely lockdown, masks and distancing, widespread testing, contact tracing, economic stimulus, and consistent public messaging. Our six-month experiment across the world reveals who has done well and who hasn’t.

It is painful as a doctor and as an American to watch patients and hospital workers around the country suffering. I worked for two months straight, hoping to save people in Connecticut, only to now see the tsunami of cases, hospitalizations, and deaths around us. A vaccine will not be a panacea. We cannot mass produce health care workers. We are buying time until we have more effective therapies. My prescription is simple: drive down Rt, then open slowly.

We can still save lives. We were able to control the pandemic right here in our little corner of America. The rest of the country and world can, too.