As New York, California and other states begin to see their numbers of new COVID-19 cases level off or even slip, it might appear as if we’re nearing the end of the pandemic.
President Donald Trump and some governors have pointed to the slowdown as an indication that the day has come for reopening the country.
“Our experts say the curve has flattened and the peak in new cases is behind us,” Trump said April 16 in announcing the administration’s guidance to states about how to begin easing social distancing measures and stay-at home orders.
But with the national toll of coronavirus deaths climbing each day and an ongoing scarcity of testing, health experts warn that the country is nowhere near “that day.” Indeed, a study released this week by Harvard scientists suggests that without an effective treatment or vaccine, social distancing measures may have to stay in place into 2022.
Kaiser Health News spoke to several disease detectives about what reaching the peak level of cases means and under what conditions people can go back to work and school without fear of getting infected. Here’s what they said:
It’s hard to see the peak
Health experts say not to expect a single peak day — when new cases reach their highest level — to determine when the tide has turned. As with any disease, the numbers need to decline for at least a week to discern any real trend. Some health experts say two weeks because that would give a better view of how widely the disease is still spreading. It typically takes people that long to show signs of infection after being exposed to the virus.
But getting a true reading of the number of cases of COVID-19, the disease caused by the coronavirus, is tricky because of the lack of testing in many places, particularly among people under age 65 and those without symptoms.
Another factor is that states and counties will hit peaks at different times based on how quickly they instituted stay-at-home orders or other social distancing rules.
“We are a story of multiple epidemics, and the experience in the Northeast is quite different than on the West Coast,” said Esther Chernak, director of the Center for Public Health Readiness and Communication at Drexel University in Philadelphia.
Also making it hard to determine the peak is the success in some areas of “flattening the curve” of new cases. The widespread efforts at social distancing were designed to help avoid a dramatic spike in the number of people contracting the virus. But that can result instead in a flat rate that may remain high for weeks.
“The flatter the curve, the harder to identify the peak,” said William Miller, a professor of epidemiology at Ohio State University.
The peak does not mean the pandemic is nearly over
Lowering the number of new cases is important, but it doesn’t mean the virus is disappearing. It suggests instead that social distancing has slowed the spread of the disease and elongated the course of the pandemic, said Pia MacDonald, an infectious disease expert at RTI International, a nonprofit research institute in North Carolina. The “flatten the curve” strategy was designed to help lessen the surge of patients so the health care system would have more time to build capacity, discover better treatments and eventually come up with a vaccine.
Getting past peak is important, Chernak said, but only if it leads to a relatively low number of new cases.
“This absolutely does not mean the pandemic is nearing an end,” MacDonald said. “Once you get past the peak, it’s not over until it’s over. It’s just the starting time for the rest of the response.”
