The rapid spread of coronavirus in the southern hemisphere suggests it is likely to flare up again in the US this autumn and winter, raising the possibility of a second round of lockdowns this year, the head of the nation’s public health body has told the Financial Times.
Robert Redfield, director of the Centers for Disease Control and Prevention, or CDC, warned the US would have to increase its disease-tracking capabilities rapidly in the next few months to avoid another public health crisis as seasonal flu coincides with a second wave of Covid-19.
“We’ve seen evidence that the concerns it would go south in the southern hemisphere like flu [are coming true], and you’re seeing what’s happening in Brazil now,” Dr Redfield said. “And then when the southern hemisphere is over I suspect it will reground itself in the north.”
The warning from the CDC chief comes despite repeated efforts by President Donald Trump to convince Americans the worst of the pandemic is over, arguing the country was “transitioning to greatness”.
It also comes amid mounting tensions between the CDC and the White House, which has accused the world’s pre-eminent disease-fighting agency of mishandling the early stages of the outbreak.
Dr Redfield acknowledged the US was caught on the back foot when the virus hit, but attributed the failure to deficiencies in the nation’s public health efforts that predate Mr Trump’s arrival in the White House.
“This simple respiratory viral pathogen has really brought my nation to its knees, and the reality is, it’s no one particular person’s fault,” Dr Redfield said. “This nation has been unprepared for that for decades.”
Asked whether he could guarantee the US would not have to go back into lockdown this winter, when public health officials expect colder weather could exacerbate the spread of the disease, he replied: “I can’t guarantee; that’s kind of getting into the opinion mode, we have to be data driven. What I can say is that we are committed to using the time that we have now to get this nation as overprepared as possible.”
He added: “If we have a [flu] season like we had the year I became CDC director  — almost 80,000 people died — it’s going to put a lot of stress independently by itself on our health system . . . and then you add on coronavirus and you can see the stress on the health system.”
The CDC has been criticised for its response in the early days of the outbreak. Over the weekend Peter Navarro, a senior White House adviser, accused the organisation of “letting the country down” with testing kit failures earlier this year.
Dr Redfield blamed the high US death rate on two factors: a lack of funding for public health organisations such as the one he runs; and high levels of underlying health conditions such as obesity and diabetes.
“What this outbreak has shown is that the underlying occurrence of some key co-morbidities in the American public is greater than it should be,” he said. “We need to work to try to develop programmes that help improve the public health of America.”
He added that avoiding a similar public health disaster in the future would involve “doubling or tripling” investment in the US public health system. The CDC currently has a discretionary budget of about $7.8bn. Its funding fell about 10 per cent in real terms between 2010 and 2019, according to Trust for America’s Health, which carries out research into US public health policy.
Meanwhile, the CDC has also found itself at the centre of the tussle over how quickly states should reopen. Dr Redfield said he did not object to several states reopening faster than his organisation’s guidelines recommended, but he urged Americans to continue social distancing as much as possible.
“I think it’s important to rebuild the confidence of the American public that there is a path that they can go out safely but we want them to maintain social distancing.”
And Dr Redfield sent a warning to airlines that have been filling planes to capacity, saying they would have to enforce stricter social distancing to reduce the risk of Americans contracting the virus.
“If the airlines are really not going to put anybody on either side of you, great,” he said. “But if you’re going to be in the middle seat packed in between two people, that’s probably not the best place to be.”
Dr Redfield suggested, however, that the CDC could relax guidance stipulating people should keep a distance of six feet between themselves and someone else if it turns out that wearing a mask offers some protection.
“It may turn out that in the presence of using masking that social distancing may be modulated,” he said, although he cautioned that the CDC does not “have the data yet”.
Dr Redfield said that as states begin to reopen, the US would need a massive increase in its ability to identify and isolate clusters of cases. “We’re committed to stay in the containment mode, where we have to get . . . every single case and cluster, a family cluster, workplace cluster, nursing home cluster, and we’ve got to shut them down.”
But he admitted his organisation was finding it difficult to obtain the kind of immediate case data needed to manage such a system. “Sometimes that data is not collected in electronic form. Then that data needs to be centralised and sent to the states, and once it’s with the states, sent to CDC. The truth is regularly the data is delayed and it’s incomplete.”
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