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Coming Weeks Critical in Battle Against COVID-19

COVID-19 Insights March 24, 2020
COVID-19 Insights March 24, 2020
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Coming Weeks Critical in Battle Against COVID-19

The coming weeks will be key to providing a picture of where North America is in containing the COVID-19 outbreak, and whether the measures in place to track and contain the spread of the disease are the right ones or should be amended, Dr. John Whyte, Chief Medical Officer for WebMD, told a BMO Capital Markets conference call this week.

On March 16, US President Donald Trump announced a 15-day period to slow the spread of disease, including social distancing, the cancellation of events, avoiding crowds of 10 to 25 people and practising good hygiene.

“I think one of the biggest changes that we're going to see in another week or so, where we start to have more data about how we're doing in the mitigation strategy, is how we stratify risk so that we can address the overall challenges of social distancing,” Dr. Whyte said.

“In the last day or two we have been hearing more and more about risk-based stratification, in terms of mitigation strategy. So what we are starting to think more about is whether locking down and closing schools is potentially causing more risk as kids are staying with elderly parents or grandparents,” Dr. Whyte, who prior to WebMd served as the Director of Professional Affairs and Stakeholder Engagement at the Center for Drug Evaluation and Research at the USFDA, said on the call with BMO Capital Markets experts to discuss the impact of the coronavirus on global markets.

Testing and Cases

Testing in the U.S. has ramped up in recent days, Dr. Whyte said, with a total of 254,000 tests now done nationwide as of Monday, compared to some 20,000-30,000 done up until last week. The increase was due largely to the inclusion of the private sector and it will likely rise further if home, self-test kits become available.

“We are going to see a steep rise in new cases because we are testing about 10,000 people a day minimum,” he said. “But that is expected. It doesn’t mean the situation is getting worse, it means that we are finding new cases because we know there is community spread.”

While the numbers are changing daily, at the time of the call, there had been 351,731 cases of the virus reported globally, with 15,374 deaths. The US has reported 414 deaths due to the virus, from a total of 34,400 cases, and 60 percent of those cases have been in the states of California, New York and Washington.

Flattening the Curve

As authorities battle to flatten the curve of the outbreak, the priority will be to protect the ability of the healthcare system to treat those affected by slowing the spread of the virus through social distancing measures.

“What we're trying to do in flattening that curve is trying to delay the number of cases as well as reduce the number of cases,” said Dr. Whyte.

He warned against comparing the contagion curves of different countries, especially that of Italy.

“The Italian population is very different from the US population,” he said. “The reason why is that because the Italian population is older, they have significant more comorbidity - 99 percent of the deaths in Italy have been in people with one or more comorbidities - they have a higher smoking rate and a higher obesity rate, and they started their mitigation strategies much later on.”

“We are doing all the right things,” he said, underscoring that effective public health strategies are being employed in terms of social distancing, good hygiene, protecting surge capacity and thinking about therapeutic interventions while starting vaccine development.

Key Data points - What to look for?

So what are the key data points Dr. Whyte and health authorities are looking for?

“I would definitely want to see the number of deaths, but I also want to see the number of cases that are presenting to the ER, and being admitted to the hospital, because that's going to tell me a little bit about surge capacity,” he said.

He predicted that by March 31 – the day President Trump set to evaluate progress in slowing the disease - experts will know how well mitigation strategies are working, and where the death toll – a critically important marker – stands.

“And then the next (will be) to see if there are services that we can reopen in the economy that do not increase risk of spread. I think that's what we're going to start thinking about. I don't think it's going to happen on March 31, but perhaps it could start several weeks later,” he said.

“Maybe in two or three weeks we will be able to have that conversation.” 

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