Columbia University Study Finds Trump Delay in Social Distancing Cost Tens of Thousands of Lives

Interview with Dr. James G. Kahn, emeritus professor, Philip R. Lee Institute for Health Policy Studies at the University of California, San Francisco, conducted by Scott Harris

As the U.S. neared 100,000 deaths from the COVID-19 coronavirus pandemic, President Donald Trump appeared oblivious to the loss and grief that has shaken the country. As he played golf during the Memorial Day weekend, his tweets focused on claims that he received “great reviews,” for his handling of the crisis and attacks on political opponents – which included a threat to move the Republican National Convention from North Carolina, if the Democratic governor didn’t loosen social distancing restrictions in time for the August gathering.

But while Trump takes no responsibility for his administration’s mishandling of the pandemic, a new Columbia University study found that the president’s inaction in the early days of the pandemic is linked to the preventable deaths of tens of thousands of Americans. The study found that if the U.S. had imposed social distancing one week earlier than it did in March, some 36,000 fewer people would have died. If the lockdown had been put in place two weeks earlier about 54,000 fewer people would have died by early May.

Between The Lines’ Scott Harris spoke with Dr. James G. Kahn, emeritus professor at the Philip R. Lee Institute for Health Policy Studies, at the Department of Epidemiology and Biostatistics at the University of California, San Francisco, who discusses the Columbia study, and the challenges ahead in battling the COVID-19 pandemic.

DR. JAMES KAHN: Our government was very slow to recognize the severity despite clear warnings both in the news from China and in the statements from the World Health Organization.We failed to immediately implement testing. There were tests available. We could have started to really carefully track what was happening with the pandemic and respond more quickly. And as a consequence, I think all of the kinds of actions that we could take were delayed. Most importantly, the most effective thing we could’ve done, which is shelter in place, was potentially delayed by a week or more. And this study uses some of the standard methods in epidemic modeling to look at what would have been different if we’d gone to shelter in place a bit earlier. They looked at the patterns of new infections given what we actually did and then they created what they call the counterfactual, where they say, Well, what if we implemented shelter in place a week earlier or potentially two weeks earlier and had seen the same change in the pattern of transmissions of the virus – but earlier? And because the virus hadn’t taken hold as much a week earlier and two weeks earlier, they found actually quite stunning estimates of the potential savings in lives and of course, in infections as well.

SCOTT HARRIS: From almost the very beginning of this pandemic, there has been a call by public health officials and even some in our own government who talked about the priority widespread testing should have around the country and testing has been in short supply for much of the last eight weeks. What can you tell us now about the continued importance of testing and how easy it is for a person right now to gain access to testing — either if they have symptoms or they have loved ones who may have tested positive and are in danger themselves or folks who may have no symptoms at all, which is part of the disease. You have people who are asymptomatic and still want to go get a test just to make sure.

DR. JAMES KAHN: Well, the good news is there’s a lot more testing now than there was a few weeks ago. A lot of companies who already who are already making tests or labs that redirected their efforts to developing tests have come forward to make testing much more available than it was. And that testing is being used both in clinical situations such as you described, but also for community surveillance of disease, which is really important.

I think it’s hard to generalize because there is variation from state to state, from city to city, even from clinical setting to clinical setting. I have a colleague who is an emergency doctor who works in a hospital about 20 miles from here who mentioned to me a week ago, [who] sort of took a sigh and took a big breath and said, “Finally we have all the tests we need.” But it’s because there’s no federal assistance in assuring the availability of tests, you get this sort of scattershot pattern of lots of tests available in this county, but not so much in some other county. And I think that’s really unfortunate. The federal government has the power to compel companies to produce products for the government at a fair price. It’s under the Defense Procurement Act and it’s used all the time, every day for the military.

So the mechanisms are in place and the federal government could easily have said very early on, we need this many millions of tests. You need to produce them in the next two weeks and this is what we’re going to pay you. And we guarantee payments so you won’t lose money. But they’ll be at a fair price. And, the government declined to do that. It’s completely incomprehensible to me that this mechanism in place – which could have been applied to fight the virus – instead was not. And in terms of holding the government accountable, I think that’s going to be one of the items at the top of the list.

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