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Donald G. McNeil Jr. has been covering epidemics for nearly two decades. Times Insider first interviewed him a little over a month ago, when there were 13 confirmed cases of the coronavirus in the United States. Now, more than 7,000 cases have been reported in the U.S. as of Wednesday, and all 50 states are racing to stymie the spread of infection. Mr. McNeil has been reporting on experts’ recommendations for what to do next. He took a break from that to answer a few questions.
What do we know about clusters?
If you get the disease, you are most likely — 75 percent to 80 percent likely — to transmit it to people who are in your household, in your family or people who are in close contact with you at all times. A family in New Rochelle, N.Y., is probably where every single case in New York City came from right now.
The entire outbreak in Seattle leads back to one person. We know that from genetic testing. When it’s all over, you can look at the situation and see what looked like a blanket over the whole city was actually a whole bunch of clusters.
You’ve said this is a crisis but it’s not unstoppable. How do we stop it?
We need to shut down all travel, as experts have said. And then we really aggressively tackle the clusters. People have got to stop shaking hands; people have got to stop going to bars and restaurants. New clusters are appearing every day.
It’s basically urgent that America imitates what China did. China had a massive outbreak in Wuhan, spreading all over the country, and they’ve almost stopped it. We can shut off the roads, flights, buses and trains. I don’t think we’ll ever succeed at doing exactly what China did. It’s going to cause massive social disruption because Americans don’t like being told what to do.
In places like China, Singapore and Taiwan, they’ve gone through the SARS epidemic — they know how scary it is.
Is that what some countries are missing? This sense of collective action and selflessness?
That is absolutely what many Americans are missing — that it’s not about you right now. My parents were in the World War II generation and there was more of a sense of, “Hey, we did something amazing; we ramped up this gigantic societal effort.” It was this sense of we’re all in this together.
We’ve got to realize that we’re all in this together and save each other’s lives. That has not penetrated yet and it needs to penetrate because we all have to cooperate.
The sad thing is, most people — this has been true in every epidemic I’ve covered, whether it’s Zika in Puerto Rico or AIDS in South Africa — don’t believe in the disease until they see someone get sick and die from it, someone they know. And it’s too bad. It’s, “Oh, that’s happening to those people over there, that’s happening in China, that’s not going to happen to us.”
I imagine that after decades of covering epidemics, you understood the severity of this coronavirus early on. Tell me about when this became serious for you.
I remember vividly. I went on a trout-fishing trip to Argentina in January, not thinking this was terribly serious: It sounds like an animal disease and it’s going to kill a limited number of people. By the time I came back, China admitted there was sustained human-to-human transmission. I started watching the case counts double and doing the math in my head, and I realized, “Oh my God, this is going pandemic.”
When was the moment you realized that?
It was late January. I was on the subway, going from work to my girlfriend’s house, just sort of thinking about the numbers and realizing, “Wait a minute, that doubling rate is so fast, there’s no way this isn’t going to become a pandemic.” I started writing on a piece of notebook paper trying to see if I was crazy — and then looked up the 1918 pandemic and realized that was the closest model to this.
What should we know about “sheltering in place?”
It’s very, very inconvenient. It destroys your vacation plans. My niece’s wedding is off. People are heartbroken over this, but it beats being dead, or having somebody you love being dead. It beats the alternative.
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