Robert Pearl, M.D., says focus must be on slowing coronavirus or U.S. will be like Italy

The U.S. missed its chance to contain the coronavirus and must now not let up on efforts to slow the spread of the virus, says prominent doctor Robert Pearl, M.D.

Pearl, a plastic and reconstructive surgeon and medical and business school professor at Stanford University, outlined what he called seven “dangerous myths” about the coronavirus that the U.S. must address in an opinion piece in Forbes.

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It’s a matter of saving lives, Pearl said in an email to FierceHealthcare. Pearl, the former CEO of the Permanente Medical Group, the largest medical group in the nation, and former president of the Mid-Atlantic Permanente Medical Group, is a member of FierceHealthcare's Editorial Advisory Council. 

“We missed the opportunity to contain the virus two months ago, and now all we can do to protect the health of people is to slow the spread. If we fail, we may end up like the doctors in Italy having to choose which people, who otherwise might live, will die since there aren't enough ventilators,” Pearl said.

Hard hit by the coronavirus, in just weeks the virus overloaded hospitals in northern Italy, with doctors forced to decide not to treat the very old, sending patients with coronavirus-caused pneumonia home and overwhelming medical staff. Italy currently has the largest number of coronavirus cases in Europe, as well as outside China.

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In the U.S. President Donald Trump has said he wants to restart the economy and normal life in America by Easter. However, Anthony Fauci, M.D., the nation's top infectious disease expert, Wednesday cautioned about relaxing public health measures. "You don't make the timeline, the virus makes the timeline,” Fauci told CNN.

Pearl agrees. Since there is a lag in exposure to the virus and when actual symptoms occur, Pearl says he thinks the coronavirus outbreak is worse than currently reported. “The numbers you see on news channels currently on the incidence, hospitalization rate and death totals all reflect what happened two to three weeks ago. The real numbers—assuming a three-day doubling time—are somewhere between 16 and 64 times higher,” he said.

Americans need to respond to the facts about coronavirus, Pearl said in the Forbes column.

“Avoiding many of the worst consequences and doomsday predictions will depend, in part, on the ability of Americans to act according to the facts,” he wrote.

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The opportunity to contain the virus in the U.S. is long gone, Pearl wrote.

Infected individuals now likely number in the hundreds of thousands, he said, with the only approach left to slow the spread of the disease and reduce the total number of people infected at any one time.

This “curve-flattening approach” can help ensure there are enough hospital beds, respirators and healthcare professionals available for coronavirus patients who develop pneumonia, he said.

The country needs to prolong actions such as social distancing, school and restaurant closures. ‘It’s our nation’s best hope for saving lives,” he said.

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And it’s not factual that people don’t need to be tested unless they’re very sick, he said.

“Without knowing the exact percentage of infected people who will require inpatient treatment, hospitals can’t project staffing or prepare to meet the needs of patients with non-emergent problems.” 

It’s wrong to compare coronavirus to seasonal influenza and it’s time that people recognize that social distancing applies to the young and healthy, who can easily transmit the virus to vulnerable populations, Pearl said.

Not all doctors and nurses are being adequately projected from COVID-19, he wrote. “For about the cost of running an ICU for one day, every hospital in the country could have purchased and stockpiled an ample supply of masks. They didn’t, and now many physicians and nurses must work at an unnecessarily heightened risk,” he said. 

Promises of a future vaccine won’t help with the current health threat, as development is likely 12 to 18 months away, Pearl said, though it could be available in time for the country to face another round of the virus in 2021.