“April,” T.S. Eliot said in “The Waste Land,” is “the cruelest month.” But not now, not in America, not with COVID-19. Hospitals already struggling near capacity are in the midst of the post-Thanksgiving surge in admissions. According to Dr. Anthony Fauci, that has hit right before “the Christmas, Hanukkah potential surge.” This surge upon surge could mean “a really dark time” for America, he said, making January the cruelest month. But science and experience tell us that decisive, targeted action, like Gov. Tom Wolf has taken in Pennsylvania, can still mitigate the impact in January and beyond.
With record-high cases and deaths across the country, Pennsylvania is no exception. Recently, Pennsylvania set records for new cases (over 10,100) and deaths (270) in a single day. With test positivity rates near 16%, Pennsylvania’s total case count is now over 570,000, and Pennsylvania recently joined New York, Texas, California, Florida, New Jersey and Illinois in reaching more than 12,000 total deaths (currently over 14,000).
These record-breaking numbers mean governors across the nation are now having to weigh the benefits of mitigation measures that save lives against the social and economic costs that imperil livelihoods, businesses and food security. Two weeks ago, Mr. Wolf took decisive action to put in place new evidence-based measures through Jan. 4 that seek to strike a balance between these competing demands.
This three-week pause includes banning indoor dining at bars and restaurants; closing entertainment venues such as casinos, theaters, and bowling alleys; restricting retail activity and businesses to 50% capacity; limiting indoor gatherings to not more than 10 people; requiring mask-wearing indoors and outdoors away from the home; and urging citizens to curtail nonessential travel. These measures can disrupt transmission, stopping the spread and flattening the curve. Lives will be saved.
Mr. Wolf has tried to mitigate the costs of these actions. By allowing limited gatherings as long as people are practicing strict public health measures, such as mask wearing, social distancing and ventilation, Mr. Wolf is acknowledging Pennsylvanians’ desire to be with their closest loved ones during this season. To cushion the blow for businesses already struggling in the absence of new federal stimulus funding, he has been providing state grant support for businesses when closures are mandated by public health needs.
While these measures may still seem too restrictive, the alternative is untenable. If infections overwhelm our hospitals, insufficient staff, beds and equipment will make it impossible to treat severely ill COVID-19 patients at the standard of care. An unchecked surge in COVID-19 cases could also result in hospitals needing to cancel elective procedures for such things as cancer and heart disease.
In short, many more people will likely die both directly from COVID-19 and from a lack of access to other needed care if we allow COVID-19 to overwhelm our hospitals. If that happens, governors will have no choice but to issue stay-at-home orders. Taking targeted, chiseled, data-driven steps now, as Mr. Wolf has done, can avoid drastic shutdowns later.
But with surging cases across the country, it’s not enough to take these steps on a piecemeal basis, state by state. Mr. Wolf has recognized that COVID-19 does not respect state borders and that viral spread in one state threatens all states. He recently joined a bipartisan assembly of governors representing 1 in 3 Americans in supporting an evidence-based Call to Action to Defeat COVID-19. This is the first time since the crisis began that governors have come together across state and party lines to support a common approach to combating COVID-19.
The recommendations in the Call to Action are comprehensive and were developed by the COVID Collaborative, which has brought together leading experts and institutions across health, education and the economy to turn the tide on the pandemic. As a result, the Call to Action integrates the best science and practices on how to tackle the crisis, reflecting a public health consensus that transcends politics.
The steps Mr. Wolf has taken to combat the winter surge are grounded in that public health consensus. Difficult times require tough measures. They also require compassion, which Mr. Wolf has shown through his support for families and businesses. Vaccines hold the promise of ending this pandemic but will take time to distribute. Until then, it is measures like those that Mr. Wolf has taken that can help us emerge from COVID-19’s dark winter into a bright spring — a spring in which April could be one of the most hopeful months of all.
Dr. Monica Gandhi is professor of medicine and associate division chief of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF/San Francisco General Hospital. Gary Edson is president of the COVID Collaborative.
First Published: December 24, 2020, 5:00 a.m.
