The US is in the throes of the coronavirus outbreak. Since February 29, 41 Americans have died. The virus has spread to 1,700 across 47 states and Washington, DC; more than half of US states have declared a state of emergency.
According to a panel of infectious-disease experts at the University of California, San Francisco (UCSF), the outbreak on US soil is only going to get worse. The panelists predicted that between 40 and 70% of Americans would become infected with the virus in the next 12 to 18 months, a Bay Area internist in attendance, Jordan Shlain, reported on Thursday.
After surpassing that threshold of infections, you can start to get herd immunity, the panelists added, according to Shlain.
Shlain used that prediction, and an assumed 1% mortality rate from the coronavirus, to work out an estimate of American deaths in the next year and a half - concluding that about 1.5 million Americans may die.
"The panelists did not disagree with our estimate," Shlain wrote on his LinkedIn. "This compares to seasonal flu's average of 50,000 Americans [dying] per year."
This assumes no drug is found effective and made available, he added.
One member of the panel, Joshua Batson, wrote on Twitter that Shlain's "inaccurate notes were not reviewed, endorsed," and missing significant context.
"In particular, the large % infected is not a forgone conclusion; coordinated action can now help," Batson wrote. He did not respond to Business Insider's request for comment.
The UCSF panelists' predictions, as reported by Shlain, mirror those of other experts.
Harvard epidemiologist Marc Lipsitch told the "Deep Background" podcast on February 28 that the coronavirus could affect between 40 and 70% of the world's adult population - about 3 billion people. Lipsitch said "40% of adults getting infected" didn't mean 3 billion people would get severely ill or die. But it would mean that some proportion of them would have symptoms, and about 1 to 2% would die.
Four disease scenarios, modeled in February by experts at the US Centers for Disease Control and Prevention (CDC), suggested between 160 million and 214 million people in the US could get infected within a year. Between 200,000 and 1.7 million Americans could die, according to a New York Times report.
In a February webinar presentation hosted by the American Hospital Association, national healthcare experts across the US estimated as many as 96 million people could be infected in the US, and 480,000 Americans could die.
The coronavirus outbreak, which the World Health Organization labeled a pandemic on Wednesday, has spread to more than 111 countries.
The UCSF panelists said that trying to contain the virus in the US "is basically futile." Containment refers to the process of tracking a disease's spread within a community and then isolating and quarantining patients or those exposed to the disease to prevent further infections.
"Our containment efforts won't reduce the number who get infected in the US," they added.
With that in mind, they suggested "anyone over 60 stay at home unless it's critical."
"We at UCSF are moving our 'at-risk' parents back from nursing homes, etc. to their own homes" and not letting them out of the house, Shlain reported the panelists said.
Last week, the CDC tried to suggest that anyone over 60 not travel on commercial airlines but was overruled by White House officials, The Associated Press reported. On Monday, the CDC urged people at "highest risk" to stock up on groceries and medications so they can avoid venturing out, adding that the risk begins to go up at age 60 but people over 80 are at highest risk.
Shlain said panelists recommended avoiding crowded places like movie theaters and concerts, practicing basic hygiene like handwashing, avoiding face touching, and cleaning surfaces with common antibacterial agents. There's no consensus on how long the virus lasts on surfaces, the panelists said, but their best guess is four to 20 hours, or even days.
Like the CDC, the panelists recommended stockpiling critical medications but recognized that may be difficult since many pharmaceutical supply chains run through China.
They also urged people to get the flu shot in the fall (though it's not too late now). While the shot won't prevent COVID-19, it "reduces your chance of being weakened, which makes COVID-19 more dangerous," Shlain reported a panelist said.
If someone is under 70 without underlying health problems gets sick, they should stay home and "socially isolate" since hospitals can't do much. People 70 and older, or those with heart or lung issues, should go to the ER if they get sick - and recognize that doctors can't cure them but that they can give them IVs and oxygen to help their bodies fight the disease.
High-risk people with the illness can also try to enroll in a clinical trial for the drug remdesivir, which is taking place in San Francisco and China.
The only way to determine if a person has COVID-19 is a polymerase-chain-reaction (PCR) test, but the kits for them take "time, space, and equipment" to create and certify. Plus, they're sometimes imperfect.
What's more, hospitals are already at capacity, and school closures mean some of their hospital-employee parents can't work.
"Public Health systems are prepared to deal with short-term outbreaks that last for weeks, like an outbreak of meningitis," a panelist said, according to Shlain. "They do not have the capacity to sustain for outbreaks that last for months. Other solutions will have to be found."
Looking to China for what those solutions might be isn't so comforting: Wuhan has 4.3 beds per thousand people, compared to the US's 2.8 beds per thousand. Plus, many other aspects of the country's response, like their testing capacity, contact tracing, and quarantining efforts demonstrate how the rest of the world is "simply not ready" to tackle the pandemic, WHO's Dr. Bruce Aylward told reporters last month.
"Are we in the twilight of a century of medicine's great triumph over infectious disease?" UCSF a panelist asked. "We've been in a back and forth battle against viruses for a million years."
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