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How will the epidemic evolve in the United States and what measures would need to be taken in the coming months to contain infections? A team ofUniversity of Washington (Institute for Health Metrics and Evaluation, IHME), with a study that was published in the journal Natural medicine. The authors analyzed data on infections and deaths from February 1 to September 21 to develop a model of possible future scenarios, based on the restrictions (non-pharmaceutical interventions) that can be implemented from now until the end of February. The model takes into account four categories – subjects susceptible to infection, exposed to the virus, infected and cured – and some variables (seasonality of pneumonia, mobility of people, number of swabs performed and use of masks). Currently, US guidelines provide for the use of social distancing measures when the threshold of 8 daily deaths per million inhabitants: maintaining these criteria, according to the study authors, deaths from Covid in the next 4 months could exceed 500 thousand (only in the United States).
Universal use of the mask
One measure that could be implemented immediately, the researchers continue, the universal use of the mask (95% of the population should use it.), which could curb the violence of new epidemic waves and save 130,000 lives by the end of February (95,000 if 85% of the population wears the mask). Since January, the coronavirus has spread to every state in the United States, causing more 8 million infections and 220 thousand deaths. Impressive numbers: this is why, say the study authors, in the absence (for now) of truly effective vaccines and drugs against Sars-CoV-2, non-pharmaceutical interventions are needed the only possible weapons to stop the pandemic. The US government has reacted with various measures, depending on the severity in the different areas of the country: use of masks, social distancing, school closures, prohibition of public meetings, partial or total closure of non-essential commercial activities, invitation to stay at home. .
Five possible scenarios
Researchers from the Institute for Health Metrics and Evaluation particularly insist on the use of the mask, which according to a recent review reduces the risk of respiratory infections (overall) by 40%. A figure clearly unknown to many: at the end of September, according to a survey, only 49% of the American population wore masks. Taking into account all the variables described, the authors described five possible scenarios that could occur in the coming months. First scenario: restrictions are gradually removed to increase population mobility and social contacts. The second hypothesis is to restore some restrictions for 6 weeks, after exceeding the threshold of 8 daily deaths per million inhabitants. The third scenario related to the universal use of the mask in public (95% of the population), associated with distancing rules. The last two scenarios are “softer”: the first contemplates distancing measures and the use of masks by 85% of the population; the second is related to the universal use of masks, in the absence of other non-pharmaceutical interventions.
A million dead?
The Covid epidemic progressed unevenly across US states and roughly one sixth of the deaths occurred in New York alone. The states of Washington and California agreed to their first restrictions in March, banning gatherings of 250 or more people, and within days all 50 states began a combination of social distancing measures. According to the study authors, in the first scenario (gradual relaxation of distancing measures), deaths in the US could reach more than a million by February 28 and a third will occur in just three states: California, Florida and Pennsylvania. Infections could reach a staggering 153 million. In the second hypothesis (partial closures and restrictions to exceed 8 daily deaths per million inhabitants), a budget of approximately 511 thousand deaths at the end of February (more than 541 thousand deaths less than in the first scenario). The infections would be 80 million less than in hypothesis number one (or 73 million). In the third scenario (universal use of the mask in public and rules of distancing when the critical threshold of daily deaths is exceeded) the total number of deaths would drop to 380 thousand and total infections would be “only” 55 million. The fourth hypothesis (measures of spacing and use of the mask at 85%), according to the authors, is effective in saving lives even if it is less than the third. But especially the last scenario to reserve surprises: universal use of the mask in public places It would guarantee a decrease in infections and deaths, even in the absence of social distancing measures or partial closures.
Save lives, save the economy
We have outlined possible future scenarios for the course of the epidemic in the United States to stimulate a discussion about what actions can be taken and imagine the health, economic and political influences these decisions will have during the rest of the winter, the study authors explain. In all scenarios, the United States is likely to face a long challenge from now until the end of winter, with the most populous states at risk from the number of infections, deaths and patients requiring intensive care. The implementation of social distancing measures As soon as individual states reach the threshold of 8 deaths per million inhabitants per day, the situation could improve significantly; the achievement of a almost universal use of masks (95%) could delay or, in some states, avoid reaching this threshold and could save most lives, minimize damage to the economy. In countries where the use of the mask has been widely adopted, such as Singapore, South Korea, Hong Kong, Japan and Iceland, the transmission of infections decreased and, in some cases, stopped.
October 24, 2020 (change October 24, 2020 | 7:59 PM)
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