COVID-19 is no avoidable catastrophe

Pandemics imply catastrophe by their very nature, and Alaska knows that from history. The second wave of the 1918 H1N1 influenza pandemic devastated our state, especially on the Seward Peninsula, in November of that year.

Maybe in a perfect world, all nations would respond quickly and effectively to the threat of a highly transmissible novel virus at their doorstep, but I believe that in the case of COVID-19, it is a little more complicated. I’m not sure if there was any other way for this “virus from hell” — highly contagious and deadly — to play out on the world stage once silent transmission was established and then accelerated.

Hindsight is 20-20, and we can all point to what might have been done better. There is plenty of blame to go around when we look at our situation now and the destruction at hand. A sensible person might wonder at our collective response around the world to this pandemic.

How were tens of thousands of citizens of Wuhan, China allowed to travel internationally during their initial COVID-19 outbreak — yet banned from local travel throughout China?

How did the normally adept health care system in Italy become so overwhelmed that age became a disqualifier for intensive hospital treatment?

Why, only beginning this month, were New York City subway cars being disinfected daily?

Taiwan had an expert team on the ground in Wuhan on Jan. 14 and documented human-to-human transmission but nobody, especially the World Health Organization, listened. Even if we had, could the U.S. really have kept COVID-19 out and, more importantly, would there have been a public appetite for harsh public health measures necessary to accomplish this, with only a handful of cases diagnosed in the U.S. during the first few months of 2020? I don’t think so. The much-lauded South Korea response, including use of high technology surveillance, would not have been accepted in the U.S., especially with so few cases.

At this point, I am elated that in Alaska and the U.S., in large part due to the federal mobilization of resources coordinated by the White House Coronavirus Task Force, our health care system has held up to this “perfect storm” of a highly contagious and relatively deadly novel virus in part spread by those without symptoms —making it unusually difficult to control by standard public health measures. This was accomplished by a national mitigation effort — including social distancing — that began in mid-March, after it became apparent that over a million Americans could perish without it. This was a shared goal by all Americans and it was accomplished. Everyone who needed medical care was able to get it. Also, our president deserves credit for his prescient decision Jan. 31, even during an impeachment trial, declaring a national emergency and banning all travel from China a day after the Centers for Disease Control confirmed human-to-human transmission on U.S. soil. He was widely criticized at the time, both nationally and internationally, for this action, but it was the right thing to do.

The U.S. has unfairly been compared to smaller nations such as Taiwan and South Korea, which have rightly been praised for quickly containing their early COVID-19 outbreaks. They have used to their advantage a shared societal trauma from their recent experience battling other coronaviruses such as SARS, and specifically MERS for South Korea, which had frequent and aggressive testing rehearsed with strict public health laws in place ready for a rapid response. As a society, they had already agreed upon drastic curtailment of personal freedom for this situation. In the U.S., not so much.

In Alaska, Gov. Mike Dunleavy needs to be applauded for his deliberate and practical approach to COVID-19, to the point where our state is a leader in responding to this pandemic. So far it has not been the catastrophe we had feared and that is good. Locally, in the Bethel area, during the 1918 pandemic, five cases were recorded. Thus far, we have bested that.

Ron Bowerman, M.D., M.P.H., is a family medicine physician with public health training who came to Alaska in 1991, working in what was then Barrow as a physician and epidemiologist for the North Slope Borough. He recently retired and lives in Bethel after many years with the Yukon-Kuskokwim Health Corp. Additionally, he served for a number of years in Taiwan and Papua New Guinea.

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