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An Infectious Disease Doctor Explains Why Coronavirus Cases Are Skyrocketing

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Dr. Mark Kortepeter, who’s been involved in combating multiple epidemics, explains why Covid-19 cases are on the rise in the United States.


After months of maintaining a plateau, new Covid-19 cases in the United States are skyrocketing in certain states: Texas, California, Arizona, and Florida, to name a few. Put simply, we are losing the war with the SARS-CoV-2 virus.

What is going on?

During an interview for a Reuters article back on February 11, 2020, before we had any Covid-19 cases in the United States, I said, that the infections that had occurred thus far pointed to an “agent that is highly transmissible,” in enclosed environments, and that “the virus is unforgiving and there is no room for error in use of personal protective equipment and hand hygiene.”

The viral “enemy” and basics of viral transmission have not changed since then and increases in new cases of infection are not surprising. The states that have either ignored the problem or have had more aggressive re-opening timelines are now paying the price and are having to walk back on their prior openings. The states in the northeast that were hammered during the first wave are being a bit more cautious and seeing declining or stable numbers of cases.

The study of infectious disease epidemiology is not rocket science. We may not be able to name with pinpoint precision how many cases or deaths will occur on a given day, but we can identify and predict trends. People, states, and governments ignore basic principles of infection spread at their peril. Although the numbers of deaths have been declining across the U.S., as the cases surge, it will not be surprising if an increase in deaths soon follows. Hoping that this problem will go away is not a plan.

If you are driving down the highway and a car in front of you stops, you will put your foot on the brakes. If you let up on the brakes too soon, you will crash. This is what has been occurring across the country. As businesses re-open, they have let up on the brakes. If it occurs too quickly, a “crash” is inevitable.

Consider the SARS-CoV-2 virus like an alien from outer space that is trying to take over your body, like in the movie “Invasion of the Body Snatchers.” A virus has only one purpose: to reproduce. It is programmed to hijack your cells to crank out offspring, which then infect others. It does not discriminate in who it infects – it doesn’t care what political party you belong to, what race you are, where you live, where you went to school, what religious beliefs you have, who your parents are, or what language you speak. If you let up on the brakes, the virus will take advantage of any opening you give it.

I have previously discussed the key ingredients for any outbreak. One of those is human nature. We give the virus opportunities to spread during interactions with other people. If you gather with others, whether for a political rally, a protest, a drink at the local bar, a beach party with friends, in a nursing home, or in a meat packing plant, the virus will exploit any vulnerabilities.

The only real control we have is our own personal behavior to prevent the virus from getting inside our bodies. Once it is inside, we yield to the will of the virus and its pitched battle with our immune systems. We lose control and become the virus’s vessel to reproduce itself.

This doesn’t happen only with the SARS-CoV-2 virus and COVID-19. We see this over and over with other infectious diseases – once public health measures are relaxed, the pathogen takes advantage of the opening. We see this with measles regularly when vaccination rates drop. Infections follow public health breakdown in the wake of war.

Getting through this pandemic and reducing spread relies on some basic principles:

1) There is no such thing as a “safe” or “unsafe” activity.

2) Consider instead that every activity you do will have more or less risk to you. Assess the risk of any activity before you do it and decide whether or not it is in your best interest to engage in that activity, and whether there are things you can do to reduce the risk

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High risk activities involve being around others. Risk increases when engaging in indoor activities, and the more people, the more time, and the more crowded an area translates to more risk. Not wearing a mask is riskier than wearing one.

Lower risk activities involve being by yourself, being outdoors, social distancing, and limiting the number of people with whom you have direct contact. Wear a mask when you can’t avoid being in close proximity to others.

Sadly, by ignoring the problem, the chance of our getting back to “normal” gets further and further away, and the outcomes we are trying to avoid (economic damage, illnesses and deaths, limited travel, loss of psychological well-being and social interactions), will continue longer than necessary. We are already seeing the consequences of rising cases in the inability of Americans to travel to Europe. This will only get worse until we get this virus under control, which will require us to attack the problem proactively, not continue to play catch up. The virus will win.

Plain and simple: those who don’t know history or who ignore history are doomed to repeat it. Everyone can do their part to make a difference by acknowledging their risk and taking measures to reduce that risk.

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