Scientists say America is about to face its 'worst public health event' ever

That might sound a bit melodramatic — but public health experts Salon spoke with agreed with her stark assessment.

During an appearance on NBC's "Meet the Press" on Sunday, Birx addressed the fact that US hospitals are struggling to keep up with the influx of patients caused by the coronavirus pandemic and anticipated that things are going to get worse.

"This is not just the worst public health event. This is the worst event that this country will face, not just from a public health side," Birx told NBC. She later added, "This fall/winter surge is combining everything that we saw in the spring with everything we saw in the summer — plus the fall surge going into a winter surge. I think that's why Dr. Redfield made this absolute appeal to the American people." This was in reference to a comment last week by Centers for Disease Control and Prevention Director Dr. Robert Redfield, who said that the upcoming months will be "the most difficult time in the public health history of this nation."

The experts who talked to Salon agreed with that analysis.

"Certainly the 1918 influenza pandemic most closely approximates the current pandemic in its mortality, infectiousness, involvement of a broad swath of American society, and coordinated public health responses," Dr. Deborah Doroshow, an assistant professor of medicine at the Icahn School of Medicine at Mount Sinai and adjunct assistant professor of the history of Medicine at Yale University, wrote to Salon. "In 1918, germ theory was really taking hold among the American public (although it had been accepted by scientists and physicians for several decades) and similar arguments about masking and 'freedom' were not uncommon."

She added that, although the 1918 influenza pandemic is the closest equivalent to the American experience with the coronavirus pandemic in 2020, "other public health events have proven devastating to particular groups of Americans." These included the way that smallpox and other infectious diseases that decimated the population of Native American and Alaska Natives, and the systemic public health issues that stem from racism.

Experts who spoke to Salon also emphasized that the public health crisis is not some distant future event; it is already upon us.

"They [hospitals] are overwhelmed already," Dr. Alfred Sommer, dean emeritus and professor of epidemiology at Johns Hopkins Bloomberg School of Public Health, wrote to Salon. "Many are not just near the breaking point in physical capacity, but what is too often overlooked, their staff are exhausted, physically and emotionally, with no let-up in sight."

Dr. Georges Benjamin, executive director of the American Public Health Association, echoed that view.

"Respiratory disease always get worse in the fall and winter," Benjamin wrote to Salon. "So this natural increase plus the lack of aggressive use of masks, social distancing and closures of large events will make this outbreak worse. Influenza during this time will also make it worse unless people get their flu shots."

Sommer explained that the surge in COVID-19 cases can also be attributed to people disregarding important public health guidelines.

"We just came off Thanksgiving when far too many people travelled and congregated, spreading this highly infectious disease; and Christmas is coming up, when even more people who are infectious will be congregating with family and friends and spreading it further," Sommer wrote to Salon.

Sommer emphasized the "exponential" spread pattern for infectious disease. "[One] case (for [COVID-19]) produces [four] cases; the next iteration is then 16 cases, then 32, etc."

Sommer also noted that winter is helpful to the virus' need to spread, as people are "getting closer together indoors," while dry air "helps to 'preserve' the virus in the air and surfaces longer."

Sommer lamented that so many Americans shirk public health advice, such as mask-wearing and avoiding congregating in groups. "It is a great lesson to the rest of the world at how bizarre our 'wild west' mentality can go against everyone's best interest," Sommer added.

"We are seeing new and ominous records being set as the [COVID-19] pandemic surges throughout the US," Dr. Russell Medford, chairman of the Center for Global Health Innovation and Global Health Crisis Coordination Center, wrote to Salon. "Over 100,000 Covid-19 patients are now hospitalized in the US with over 20,000 patients in the intensive care units for the first time since the pandemic began. This is nearly double the record highs in hospitalizations we saw in the springtime in the northeastern states and in the summer in the Sun Belt."

He added, "Today, hospital systems throughout the US are facing critical shortages not just in beds and space but, due to the incessant demand since the beginning of the pandemic, in the availability of trained healthcare workers (nurses, technicians, doctors) to care for these patients. Unfortunately, over the next eight to 12 weeks, we will likely see an intensification of these trends."

"The consequences of an overwhelmed hospital system to the health of the individual with COVID, or with any other serious medical condition requiring hospital care, are dire," he emphasized.