The US health system is struggling to come to grips with COVID-19. Now, it’s reporting the highest fatality rate in the world.

Tainted test kits. Censored scientists. Mixed messages. The US health system is struggling to come to grips with COVID-19. Now, it’s reporting the highest fatality rate in the world.

United States medical workers are up in arms.

They’re angry.

They know the world has had two months warning of a highly contagious new virus. By all accounts, it’s a nasty one. It’s certainly more deadly than flu.

They believe it has been “circulating unchecked” within the US for weeks.

But there are almost no test kits to prove it.

Instead, they’re seeing critical care patients seemingly emerge from nowhere.

Now they’re getting infected themselves.

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A sick Californian nurse made a desperate appeal for help.

She says the federal Centres for Disease Control had been unwilling, or unable, to test her for COVID-19. Her patients may have infected her. She may have infected others.

She had volunteered to help.

“I did this because I had all the recommended protective gear and training from my employer,” she wrote in an open letter. “I did this assuming that if something happened to me, of course, I too would be cared for.”

She was wrong.

The protective gear did not work. She is sick. But she’s not getting any treatment.

“I’m awaiting ‘permission’ from the federal government to allow for my testing, even after my physician and county health professional ordered it. I am a registered nurse, and I need to know if I am positive before going back to caring for patients.”

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PATIENT ONE

The first recorded case of COVID-19 in the US was in Washington state. A month ago, a 35-year-old-man from Snohomish County suffered what appeared to be a setback while suffering from flu.

“He was day nine in his course, and he actually started going downhill, started getting worse,” chief clinical officer Compton-Phillips told CNBC.

After being given an experimental antiviral treatment, the patient recovered. He’s since been released from hospital.

But the virus he was carrying won’t go away.

As for staff coming and going day-by-day, we’re simply told they’re following infection control protocol. “We’ve learned that the virus is volatile, unpredictable.” Patients have gone from showing no symptoms to being rushed to the hospital in an hour #KOMONews — Cole Miller (@ColeMillerTV) March 7, 2020

Compton-Philips says doctors and nurses feel powerless watching this outbreak unfold before them in real-time. “This is coming. It’s not if, it’s when. And we better get ready now,” she said.

Elsewhere in Washington state, a worst-case scenario is infolding.

A “cluster” of infections has been found in a Seattle Life Care Centre nursing facility. About 50 of its patients and staff are sick. They’re still waiting for tests to confirm it is COVID-19.

That’s the problem.

As of yesterday, the US had only identified some 300 cases. Only eight have so far recovered, and 17 have died.

The resulting death rate of 5.9 per cent is the world’s highest. But that is a statistical aberration: the numbers are simply incomplete.

Epidemiologists know the actual number of sufferers is likely to already be in the tens of thousands. They just can’t prove it.

That’s because the test kits tailored to identify this specific virus are unavailable. And the government-run CDC has been imposing strange conditions upon its distribution and use.

GERM WARFARE

Notorious germophobe President Donald Trump is proud of his COVID-19 response.

“I like this stuff. I really get it,” he said during a tour of a CDC facility yesterday. “People are really surprised I understand this stuff. Every one of these doctors said, ‘How do you know so much about this?’ Maybe I have a natural ability.”

Yesterday, Mr Trump was visiting his new CDC appointee, director Robert Redfield.

The 68-year-old retired US Army colonel has a patchy track record. His belief HIV was God’s retribution on gays produced some highly controversial military policies during the 1980s.

But Mr Trump has every confidence Dr Redfield is on top of COVID-19.

“We have very low numbers compared to major countries throughout the world. Our numbers are lower than just about anybody,” Mr Trump said yesterday.

President Trump: "If it were up to me, I would be inclined to say leave everybody on the ship." pic.twitter.com/bceq7GubAw — The Hill (@thehill) March 7, 2020

His strategy is all about stopping the virus at the borders. “The risk to the American public is low,” he said a week ago. “ We have an aggressive containment strategy that really has worked up to this time.”

The ‘proof’ of this, he said, was in the low number of cases found within the homeland.

It turns out the cases were there. They just weren’t being reported.

A doctor in Victoria, Australia has tested positive to #SARSCoV2. He appears to have been infected in the US and travelled to Denver, Vale, SF & LA.



Not only are travel bans ineffective, especially as we see widespread transmission, they can give a false sense of safety. https://t.co/aWojiDut7k — Dr Alexandra Phelan (@alexandraphelan) March 7, 2020

Now New York has had to order 2500 residents to self-quarantine. And it’s just declared a state of emergency.

“There’s something wrong here that the federal government is missing and they must fix it,” New York Mayor Bill de Blasio said. “The fact that the federal government cannot get tests out there is extraordinarily problematic.”

But White House presidential advisor Kellyanne Conway is sticking to the White House script: yesterday she told reporters: “It is being contained. Do you not think it’s being contained?”

Redfield agrees: “This nation should not give up on containment,” he told Trump during the CDC tour.

UNSEEN, UNSTOPPABLE

“The National CDC would not initiate testing,” the Californian nurse wrote. “They said they would not test me because if I were wearing the recommended protective equipment, then I wouldn’t have the coronavirus … What a ridiculous and uneducated response from the department that is in charge of our health in this country.”

The CDC is facing intense scrutiny.

The production of US COVID-19 testing kits was botched. The production facility was contaminated. A large batch of the vital kits was found not to be properly functional.

So they had to be recalled.

Instead, local doctors have had to ship samples to the one CDC laboratory capable of testing for the disease. The Atlanta facility was soon swamped.

Exactly how many US citizens have been tested is unknown. The CDC has strangely ceased reporting such vital statistics after Vice President Pence took over as the health agency’s public face.

Earlier this week he promised “roughly 1.5 million tests” would be available by the end of this week. On Friday, he rolled that promise back: “We don’t have enough tests today to meet what we anticipate the demand going forward,” he said.

"This is the most frightening disease I've ever encountered in my career."



Richard Hatchett, the doctor leading efforts to find a vaccine for coronavirus, says it is much more lethal than normal flu. pic.twitter.com/1tjJ2ed0Hq — Channel 4 News (@Channel4News) March 6, 2020

But a survey of regional health officials by The Atlantic reveals a total of only 1900 suspected cases tested.

This is against the tens of thousands that need such testing - every day.

Meanwhile, the virus had already jumped ship.

It’s circulating within the communities of California, Washington state, New York and North Carolina. And that list is set to explode.

“I think it’s one of the reasons we’re seeing these hot spots pop up around the country is because we simply didn’t know this had already hit our shores,” Compton-Philips told CNBC. “I do think that this virus has been circulating now for several weeks in the US ... Until now, it’s been circulating unchecked.”

California is reportedly monitoring some 8400 people for the virus. But it can’t test them.

New York has ordered some 2500 people to self-quarantine. Limited testing has revealed 22 of them are COVID-19 positive.

The upshot: Nobody has a clear idea of how far the virus has penetrated US society.

CAUGHT OFF GUARD

Markets have collapsed. US Congress is up in arms.

On Friday, President Trump signed a $US8.3 billion emergency aid bill. Congress had upped the figure. The president had asked for $US2.5 billion.

It’s being distributed among the states, to medicare and research institutions. A substantial sum is destined for small businesses suffering economic impacts.

It’s set to get worse.

The famous Texas tech conference SXSW was cancelled last night. It joins a host of similar cancellations. Many more will follow.

An Ipsos poll found 37 per cent of US citizens feel the COVID-19 threat is severe. That’s a jump from 28 per cent a fortnight ago.

It’s set to get worse.

Hello, I'm a biologist and scientific illustrator. Thanks for highlighting the importance of graphics for scientific communication. Here's my take on this schematic. Feedback welcome. Feel free to use and share. pic.twitter.com/B1CsAbzk5R — Thomas Splettstößer🔬 (@splette) March 7, 2020

The lack of testing means US public and private health facilities are unaware of the extent of the problem.

Media reports reveal hospitals that have yet to activate strict isolation protocols for sufferers with COVID-19 symptoms. Others have been ordered by state officials to relax quarantine rules because of their inconvenience. Some have simply mistakenly released infected patients.

Now, doctors and nurses on the front line are appealing for action.

“We’re going to need millions and millions and millions of tests. That’s what I feel, and that’s what many of my colleagues feel,” says the head of the National Institute of Allergy and Infectious Diseases Dr Anthony Fauci.

POLITICAL TEST

“As a nurse, I’m very concerned that not enough is being done to stop the spread of the coronavirus,” the Californian nurse’s statement reads.

It’s a sentiment echoed by the World Health Organisation.

“This is a reality check for every government on the planet: Wake up. Get ready. This virus may be on its way and you need to be ready. You have a duty to your citizens. You have a duty to the world to be ready.”

Just so you get a feel of how well #nCoV2019 (#SARSCoV2) is spreading, here’s the official figures lifted (and most of these are from countries with good surveillance; real numbers will be much higher in all territories) from #WHO situation report:

Quite steep exponential growth. pic.twitter.com/vw6l5C0B6a — Jonathan Ball (@JonathanKBall) March 7, 2020

Those are the stark words of the WHO’s health emergencies program head, Dr Mike Ryan.

“Shortages are leaving doctors, nurses and other front-line workers dangerously ill-equipped to care for COVID-19 patients, due to limited access to supplies such as gloves, medical masks, respirators, goggles, face shields, gowns, and aprons,” a WHO statement reads.

Taking swabs for #COVIDー19 testing does present a risk for the person taking them, which is why @G_RegevYochay set up this outside the @SHEBA_ ER. The person taking the swab has no direct contact with the patient. This is what preparations look like pic.twitter.com/DViwZVm0ll — Bill Hanage (@BillHanage) March 7, 2020

The wheels of industry within the US are finally gearing up for a response.

The CDC says a production run of new test kits will soon be rolled out. Rules keeping them from local doctors and regional hospitals will be relaxed.

Two private labs are also gearing up to test samples. They’re supposed to be online sometime next week.

“Our goal is to have every state and local health department online, doing their own testing,” the director of the CDC’s National Center for Immunization and Respiratory Diseases said.

But the COVID-19 horse has already bolted.

“We knew from the onset that it’s not the type of virus that is amenable to containment,” former White House National Security Council biodefence advisor Luciana Borio told Time. It’s possible that the time that it bought us wasn’t used in the best possible manner to help us get ahead of the curve in terms of preparing the homeland for the eventual epidemic.”

US WHO emergency committee member Jeremy Konyndyk was blunter in his assessment.

“If you buy time, you need to use that time to prepare. It’s insane to me that they’re still harping on containment and travel controls and keeping the disease out when that is not going to be the driver of transmission at this point.”

Jamie Seidel is a freelance writer. Continue the conversation @JamieSeidel