‘It did not need to be nearly this bad’: A million people have died from Covid-19 across the world. - The New York Times

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In the 10 months since a mysterious pneumonia began striking residents of Wuhan, China, Covid-19 has killed more than one million people worldwide as of Monday — an agonizing toll compiled from official counts, yet one that far understates how many have really died.

The coronavirus may already have overtaken tuberculosis and hepatitis as the world’s deadliest infectious disease. And unlike all the other contenders, it is still growing fast.

Like nothing seen in more than a century, the virus has infiltrated every populated patch of the globe, sowing terror and poverty, infecting millions of people in some nations and paralyzing entire economies.

But as attention focuses on the devastation caused by halting a large part of the world’s commercial, educational and social life, it is all too easy to lose sight of the most direct human cost.

More than a million people — parents, children, siblings, friends, neighbors, colleagues, teachers, classmates — all gone, suddenly, prematurely. More than 200,000 in the United States, which has the largest total number of coronavirus deaths in the world, followed by Brazil, with over 140,000.

Dr. Michael Ryan, the head of the World Health Organization’s emergencies program, said on Monday that the actual numbers were probably higher.

“When you count anything, you never count it perfectly,” he said at a news conference in Geneva. “But I can assure you that the current numbers are likely an underestimate of the true toll of Covid.”

Those who survive Covid-19, the disease caused by the virus, are laid low for weeks or even months before recovering, and many have lingering ill effects of varying severity and duration.

Yet much of the suffering could have been avoided.

“This is a very serious global event, and a lot of people were going to get sick and many of them were going to die, but it did not need to be nearly this bad,” said Tom Inglesby, the director of the Johns Hopkins Center for Health Security.

At the height of the first wave, places like China, Germany, South Korea and New Zealand showed that it was possible to slow the pandemic enough to limit infections and deaths while still reopening businesses and schools.

But that requires a combination of elements that may be beyond the reach of poorer countries — and that even ones like the United States have not been able to muster: wide-scale testing, contact tracing, quarantining, social distancing, mask wearing, providing protective gear, developing a clear and consistent strategy, and being willing to shut things down in a hurry when trouble arises.

Time and again, experts say, governments reacted too slowly, waiting until their own countries or regions were under siege, either dismissing the threat or seeing it as China’s problem, or Italy’s, or New York’s.

Thomas R. Frieden, a former head of the U.S. Centers for Disease Control and Prevention, said that a major failing had been in governments’ communication with the public, nowhere more so than in the United States.

“You have standard principles of risk communication: Be first, be right, be credible, be empathetic,” he said. “If you tried to violate those principles more than the Trump administration has, I don’t think you could.”

The world now knows how to bend the curve of the pandemic — not to eliminate risk, but to keep it to a manageable level — and there have been surprises along the way.

Masks turned out to be more helpful than Western experts initially predicted. Social distancing on an unheard-of scale has been more feasible and effective than anticipated. The difference in danger between an outdoor gathering and an indoor one is greater than expected.

And, crucially, people are most contagious when they first show symptoms or even earlier, not days or weeks later, when they are sickest — a reversal of the usual pattern with infectious diseases. That makes preventive measures like wearing masks and swift responses like isolating and testing people for possible exposure much more important. If you wait until the problem is evident, you’ve waited too long.

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‘It did not need to be nearly this bad’: A million people have died from Covid-19 across the world. - The New York Times
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