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By Sertse Desta

Now the US contributes over a third of confirmed cases and a quarter of deaths of the world COVID19 data. Most nations that were highly hit by the virus seem now controlling it. The European economic power, Germany, has brought the total active cases from ~73,000 down to ~42,000 with a total recovery of ~110,000 death of only less than 6 thousand.  Although the world economic power US allocated huge money and resources and has been under lockdown for over a month, both new cases and deaths haven’t yet shown a waning.  The country recorded the highest daily new cases just yesterday, amounting to ~39,000. New York, the world epicenter with approximately 300 thousand cases and 22 thousand deaths (Today, April 25, 2020, around 8 pm) is still counting a third of both the nationwide new cases and deaths per day. Why is the US unable to be successful in fighting this virus? Different people say different things. Let me list some and discuss each further.

President Trump: The President obviously didn’t act properly at the beginning, although he closed travel from China very early. He undermined the incidence and couldn’t give appropriate attention. However, since the time he realized the seriousness of the problem, he has been very aggressive and has been working very hard. However, he couldn’t get enough supports and collaboration from the states as well as the public. For example, he availed most critically necessary resources in excess, including a new Hospital and military ship of total 3500 beds for the epicenter New York. He also mobilized the military for assistance.  Unfortunately, the New Yorkers did not seem to help themselves at least by complying with the guidelines. Until recently, after a nationwide lockdown, New Yorkers were walking in crowded streets and parks freely with no protection. We even have seen big crowd funeral events.  Trump sometimes behaves at odds that expose himself and confuse the public. It was shocking to hear from Trump the idea of injecting disinfectant into humans. This was really terrible. Whatsoever he is eager to see the US free of the virus; it is so embarrassing to hear injection of disinfectant through human veins from the US president. Yet, his effort and determination to bring down what he mentioned ‘hidden enemy’ is so huge. His efforts need to be appreciated while correcting even challenging when he goes wrong.

State/local leaders: Some states seem right in their actions, but others looked even totally unaware of what was going on until recently, let alone helping their public awareness. It was only two weeks and so that we heard a state governor publicly saying he was not aware that asymptomatic people could transfer the virus.   Some others seem to talk much but do little. For example, I hardly understand what the New York governor Cuomo and county leaders in the state have been doing. Indeed, Cuomo worked well in requesting necessary resources and equipment’s from the federal government. But I could not understand why he and the county leaders in the state couldn’t do on awarenessto of their people about what is going in their surroundings and take measures so that people should comply with guidelines. After a month and more, we still see numbers rising, although the federal government support has been so tremendous. That seems to be mainly the problem with the local leaders.

Test: Testing might be somehow limited considering the outbreak. But it is clear that the US has tested more tests than any other country. It has already tested over 3million tests. Having more tests is good, but the number of tests in the US seems to be quite reasonable to get insight into the level of the problem. What seems lacking instead is that to strictly complying with the guidelines during the lockdown. Had there been a strict obeyance to the rules and regulations from the first day of the lockdown, they could have effectively reduced the number and would have shortened the lockdown.  Unfortunately, in some states like New York, things seem even just fresh.

Media: US media have had no help; if not, they even have aggravated the outbreak. Big media daily talk about Trump. Most of them against some in support. They have had little space to transfer critical information to the public.  The Trump disinfectant injection idea was like a big opportunity to attack Trump for media working hard to let him see failed. Though it is unexpected from a mature person, let alone from US president, it can also partially be understandable; he seemed to suggest whatever that halt the virus. Since he has been worried about the situation too much, he wants a miraculous solution. The media mostly follow his lips seeking any wrong word he may speak. That is not good!  Earlier, Trump publicly suggested his “game-changer” Chloroquine or derivatives for COVID19 treatment. Nearly all media have been working hard to defy the use of Chloroquine and its derivatives for COVID19 treatment. But they hardly mention their source of information for what they are talking about. Scientific reports have, however, been consistent with what Trump suggested. Of course, Trump got that information from scientists may be from one of his advisors.

Anyone who reads most of the scientific articles (eg. (Colson et al. 2020; Gao et al. 2020) feels that these drugs really are “game-changer”.  What Trump said was not out of the blue. Media didn’t mention any of such scientific reports, but they used unverified sources like from Nigeria, Brazil, and the US itself just to attack Trump. Early on, the media used Trump’s rally word ‘Hoax’ inaccurately as if he said corona was ‘hoax’ though he already had established taskforce and also had banned travels from some countries. He clearly meant how democrats were (still are) using this challenge for political profits.   The other thing is that journalists don’t seem professionally behaving. The way they ask at briefings and elsewhere does not look good. They even don’t wait for their turn. It seems everyone in the room is asking his/her question at a time. It looks more like in a bar than in a meeting room. That is awful!

Political condition: The tension between Republicans and Democrats is the other problem in the US COVID19 control effort. The President doesn’t want to acknowledge democrats in the senate and house even when they are supportive. Obviously, the previous impeachment and other itchy things since Trump came to power have contributed a lot to deepen the rift between the President (also Republicans) and democrats.  We also see the carryover effect of pre corona situations during this pandemic that diluted coordinated efforts.

Science: Some of the confusions might have been avoided by clear scientific evidence. For example, what scientific team of the taskforce telling about the use of mask and chloroquine seem confusing. Masks have now become mandatory in some states, particularly in shopping and other essential working areas.  Earlier, advisors undermined the importance of masks. They still flimsily explain their importance. They say, “use a mask to protect others, not yourself.”  Yet, one can understand by common sense how a mask can protect the person wearing the mask as well. It is clear face masks can’t fully protect, but they can reduce the risk of getting the virus while at the same time, protecting others too. The other problem with this kind of message is that people are usually selfish, so if the mask does not protect themselves, many don’t want to wear a mask simply to protect others. The other confusion is on the use of Chloroquine and its derivatives for COVID19 treatment.   It was clear the President didn’t mention these drugs as if they were “game-changer” with out getting some kind of advise from professionals. He got the information from some scientists. Some papers even mentioned these drugs nearly in the same word as the President mentioned: “game-changer” (Colson et al. 2020; Gao et al. 2020). These drugs seem on shelves of all hospitals treating COVID19. Perhaps the success of some countries is connected to the use of these drugs.  The US Food and Drug Administration (FDA) have given the green light to use these drugs as COVID19 treatment, but it recently cautioned to be used only in hospitals by professional health care workers.  It seems that the drugs are helping the fight against the virus. Research results, however, are scantily and without clear evidences. The drugs showed successful results in vitro (Wang et al. 2020).   The in vivo research result from French researchers (Gautret et al. 2020) was blamed for its poor experimental design (Molina et al. 2020). But, other reports based on a randomized experiment with reasonable number of patients showed the significant effect of chloroquine and hydroxychloroquine (Chen et al. 2020). There were other large-scale clinical trials promised from the US. We have not yet heard the result of any of those.  Even it would be possible to understand the effects of these drugs by collecting and analyzing from existing patients who took the treatment and those who did not without going into a designed experiment. For some reason, this issue has remained vague. I don’t know why?

May The Almighty God have mercy on us and the entire world! Amen!

ቅዱስ እግዚአብሔር ምህረቱን ለዓለም ሁሉ ይላክኢትዮጵያንና ሕዝቧን ይጠብቅአሜን!

Thank you!

 

Chen Z, Hu J, Zhang Z, Jiang S, Han S, Yan D, Zhuang R, Hu B, Zhang Z (2020) Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial. MedRxiv

Colson P, Rolain J-M, Lagier J-C, Brouqui P, Raoult D (2020) Chloroquine and hydroxychloroquine as available weapons to fight COVID-19. Int J Antimicrob Agents 105932

Gao J, Tian Z, Yang X (2020) Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Bioscience trends

Gautret P, Lagier J-C, Parola P, Meddeb L, Mailhe M, Doudier B, Courjon J, Giordanengo V, Vieira VE, Dupont HT (2020) Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. International journal of antimicrobial agents:105949

Molina JM, Delaugerre C, Goff J, Mela-Lima B, Ponscarme D, Goldwirt L, de Castro N (2020) No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection. Med Mal Infect:30085-30088

Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M, Shi Z, Hu Z, Zhong W, Xiao G (2020) Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell research 30:269-271

 

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