Pandemic Is Overwhelming U.S. Public Health Capacity In Many States. What Now?

When the coronavirus pandemic began, public health experts had high hopes for the United States. After all, the U.S. literally invented the tactics that have been used for decades to quash outbreaks around the world: Quickly identify everyone who gets infected. Track down everyone exposed to the virus. Test everyone. Isolate the sick and quarantine the exposed to stop the virus from spreading.

The hope was that a wealthy country like the United States would deploy those tried-and-true measures to rapidly contain the virus — like quickly dousing every ember from a campfire to keep it from erupting into a forest fire.

Today, that hope has been extinguished — not the fire. A return to more restrictive shutdowns of businesses and public gatherings is likely necessary in many places, public health leaders say, to bring the number of cases low enough that "test, trace and isolate" can be used to douse epidemic embers.

"Right now we are experiencing a national forest fire of COVID that is readily consuming any human wood that's available to burn," says
Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Testing, contact tracing and isolation are the tactics being used successfully to crush outbreaks in countries such as South Korea and Germany. But those places never had the level of case surges that many U.S. states are now experiencing.

"When you have something like this happening, there's no way that traditional testing and tracing is going to have any meaningful impact," Osterholm says. "I liken it to trying to plant your petunias in the middle of a Category 5 hurricane."...