In this Commentary, we compare the responses of both democratic republics and demonstrate that the immediate and nationally coordinated public health strategies employed by South Korea effectively contained and mitigated their epidemic.
In contrast, the US government mounted a delayed and fragmented response, becoming and remaining the worldwide epicenter of the pandemic.
Further, by the end of February, South Korea had the most COVID-19 patients of any country outside China. Today, South Korea has experienced 14,269 cases and 300 deaths. At present, the US, accounts for 4.4 million) as well as deaths (>150 thousand). After adjustment for the 6.5 fold difference in populations, the US has 47X the number of cases and 79X the number of deaths.
. The time period for these mitigation efforts extended far beyond the flattening of the curve.
Not surprisingly, in a recent survey, > 2/3 of Americans who express support for the Democratic candidate for President stated that they will wear masks when not socially distancing in comparison with
In addition, the US government has removed the CDC from its decade’s long functions of receiving and providing analyses of surveillance data on COVID-19. This continued politicization of the US CDC is producing further harm to its longstanding reputation and role as the model for disease control and prevention activities throughout the world.
If one believes that “those who do not understand the lessons of history are doomed to repeat them” then the US is in a downward spiral reminiscent of the tragedies of the Spanish Flu over 100 years ago. From September 17, 1918 until 1920, under a Democratic administration, about 42.9 million Americans developed the Spanish flu, of which 675,000 died. In that pandemic, whose epicenter originated and remained in Europe, the US accounted for >9% of cases and >1.5% of deaths.
We strongly concur with all responsible health professionals that there is an urgent need for a unified national approach to implementation of effective public health mitigation strategies including social distancing, masking, avoidance of crowds, as well as frequent hand and face washing. These simple measures are likely to be at least as effective as any safe vaccine that may be developed and approved for widespread use by the general public. While the public health strategies of containment and mitigation were effectively implemented in a nationally coordinated effort in South Korea, the current trajectories in the US may no longer be materially alterable by anything less than a coordinated national shutdown of sufficient duration which was not achieved previously. Without these efforts it is plausible, if not likely, that the exponential growth of the virus will continue as reflected by the markedly decreasing number of days to achieve each million case in the US from 97 to 44 to 28 to 15 days. Last but not least, the failure to mitigate COVID-19 in the US will paralyze the healthcare delivery system and decrease the ability to provide lifesaving measures for patients with COVID-19 or other serious conditions. Thus, it is now imperative that the US abandon “pandemic politics” and focus on effective public health strategies.
We are indebted to Peter Grossman for his advice.
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All authors had access to the data and a role in writing the manuscript.
Funding sources: None
Conflicts of Interest: Dr. Solano and Professors Maki, Adirim and Shih have no disclosures. Professor Hennekens reports that he serves as an independent scientist in an advisory role to investigators and sponsors as Chair of data monitoring committees for Amgen, British Heart Foundation, Cadila, Canadian Institutes of Health Research, DalCor, and Regeneron; to the Collaborative Institutional Training Initiative (CITI), legal counsel for Pfizer, the United States Food and Drug Administration, and UpToDate; receives royalties for authorship or editorship of 3 textbooks and as co-inventor on patents for inflammatory markers and cardiovascular disease that are held by Brigham and Women’s Hospital; has an investment management relationship with the West-Bacon Group within SunTrust Investment Services, which has discretionary investment authority; does not own any common or preferred stock in any pharmaceutical or medical device company.
© 2020 Published by Elsevier Inc.