Northwestern Buffett facilitates Q&A session on blunting the impact of COVID-19 with infectious disease expert, Dr. Robert Murphy

The novel coronavirus (COVID-19) is much more than a viral infection, with a mortality rate at least five times greater than influenza. Reverberations include stressing our health care system to the point of partial collapse and a kind of global social isolation never before experienced. In a webinar hosted this week by Northwestern’s Roberta Buffett Institute for Global Affairs, Northwestern Medicine infectious disease expert and executive director of Northwestern’s Institute for Global Health, Dr. Robert Murphy, spoke about these issues and how we can blunt the impact of COVID-19 before it’s too late. Here are four key takeaways from the discussion:

We can learn important lessons from South Korea. Cases of COVID-19 in South Korea have leveled off, which Dr. Murphy attributed to the country’s experiences with MERS and SARS, as well as a simple, yet effective strategy: “Test, test, test.” Dr. Murphy noted South Korea ranks highest in terms of tests performed by country and per million people, running about 15,000 tests day. “The hallmark of the South Korean model is very different from what we’re doing here,” he said.  “The U.S. is not set up with a strong, central public health organization. Most public health interventions are relegated to states.”
 

Dr. Murphy went on to talk about the implications of a decentralized approach to combating COVID-19: “If we leave it up to just the states to enact interventions, we’re looking at 12 to 24 months to flatten the curve,” he said. “If we all get on the same page, we could start seeing a decline [of COVID-19 cases] in the early to mid summer. We really do not have a central plan and, if that continues, we’re going to be in big trouble.” When asked about the role international organizations could play in coordinating efforts to combat COVID-19, Dr. Murphy expressed that, “yes, that would be the best thing, but what international authority do we have? The World Health Organization and United Nations could make recommendations, but without teeth. The teeth are going to be at the national level.”

Now is the time for collaboration, not nationalism. “COVID-19’s spread in the United States has been compounded by the fact that, at the beginning of this thing, the U.S. opted not to import the World Health Organization approved tests from Asia and Europe and insisted on making its own tests,” Murphy said. “The tests that were made were sent to the states and didn’t work. We wasted an entire month and we haven’t been able to catch up yet. The doubling rate of this infection is 3-7 days, depending on where you are.”

“It’s basically a war without a general. We need all these pieces to be working together. Our governors are working hard but don’t have the ability to martial the industrial forces that a president would have,” he added, noting that now is the time to leverage the Defense Production Act of 1950 and direct companies to produce more ventilators, personal protective equipment, swabs for testing, and other critical supplies.
 

1918 can clue us into the way forward with COVID-19. “Social distancing is nothing new,” Dr. Murphy noted, citing the Spanish Flu of 1918 that the city of Philadelphia downplayed and St. Louis took more seriously. St. Louis closed bars and other gathering places early in the pandemic, while Philadelphia continued with life as usual—even hosting a parade—and saw a devastating mortality rate. Just 72 hours after the parade, all 31 of Philadelphia’s hospitals were full and 2,600 people were dead. Murphy said this should serve as a dire warning to those advocating for an early end to social distancing or not heeding social distancing recommendations: “If we did nothing about COVID-19, about half of the U.S. population would get infected, which would make coronavirus the leading cause of death in the United States with just under a million deaths. That’s where we could go if we did nothing,” he said. In a similar vein, Northwestern University economist Martin Eichenbaum’s research finds shutdown measures could save 600,000 lives in the U.S. if they continue to gain traction.

“It’s all doable!”  Dr. Murphy closed the discussion on a hopeful note, outlining what he believes is our best way forward: 1) Keep schools and universities closed, 2) ramp up testing—and test health care workers, putting those with immunity to COVID-19 on the front lines, 3) ramp up production of hospital supplies and capacity, using the Defense Production Act if necessary, 4) invest in massive vaccine and antiviral drug development initiatives, 5) support the unemployed with funding and health insurance and, 6) vigilantly enforce public health policies like social distancing.

“The more forcefully we act now, the shorter the problem,” he said. “South Korea, Japan, Hong Kong, Taiwan, and Singapore have all been able to suppress the infection rate through a ‘dull roar’ and that should be the goal we have now.” However, collective action and self-discipline matter, he added:  “Italy has shelter in place and quarantine mandates and then a group of people will get together for a giant dinner and the whole thing starts all over again,” he said. “If the whole country doesn’t act the same, attempts to flatten the curve are not going to work…we have to be vigilant. It’s the moving around of people that can reignite the epidemic in places it has begun to recede.”