By BRIAN A. HOWEY

INDIANAPOLIS  – Hoosiers are facing their greatest physical and economic threat since the Great Depression and on the most crucial aspect of this crisis – the availability of coronavirus testing that would allow health and policy executives to learn of the extent of the spread and contact trace those in a cluster – we are flying blind.

As of Thursday, only a mere 1380 out of 6.85 million Hoosiers have been tested. While there have been 56 confirmed cases (including 19 in Indianapolis) and two deaths, Bill Joy, the computer scientist who co-founded Sun Microsystems, told New York Times columnist Thomas Friedman, “The last few weeks were actually pretty unsurprising and predictable in how the pandemic spread. But we’ve now reached a point where all of our interlocking systems, each with their own feedback loops, are all shutting down in unpredictable ways. This will inevitably lead to some random and chaotic consequences, like health care workers not having child care.”

Joy described the power of exponentials: “The virus is like a loan shark who charges 25% a day interest. We borrowed $1 (the first coronavirus to appear here). We then fiddled for 40 days. Now we owe $7,500. If we wait three more weeks to pay, we’ll owe almost $1 million.”

Last Friday, Dr. Box, Indiana’s health commissioner, said modeling showed that up to 60,000 Hoosiers may be carrying the highly contagious virus. If these unknowing carriers transmit it to 2.5 people, as pandemic models suggest, another 150,000 people can be exposed, and they become spreaders. “People ask me a lot of times, ‘Well, how many negatives have you had?’ Well, unfortunately I don’t have that knowledge,” Dr. Box said.

Dr. Woody Myers, the presumptive Democratic gubernatorial nominee and past state health commissioner, said Wednesday that testing should be the “top priority” at this stage of the pandemic. “Without testing, we don’t know where the patients are, where the clusters are,” Myers said.

“Stealth” coronavirus cases are fueling the pandemic, with a staggering 86% of people infected walking around undetected, according to a study Monday in the journal Science. “It’s the undocumented infections which are driving the spread of the outbreak,” said co-author Jeffrey Shaman of Columbia University Mailman School, according to GeekWire.

That’s why when Gov. Eric Holcomb announced the state’s first death on Monday, he ominously said, “This is the beginning. This is real.” He and Dr. Box will give an update at 1 p.m. today in the Statehouse south atrium. You can watch the livestreaming by clicking here.

Since Monday, Holcomb has ordered all bars and restaurants closed; limited public gatherings to a maximum of 50 people; and activation of the National Guard to help with logistics and, if needed, establish MASH units. More than 270 school districts have closed, as have most of the colleges and universities. The NCAA’s March Madness has been cancelled, as have the ISHAA tournaments.

If the Indianapolis 500 is cancelled (at this writing it’s still on for May, but like the Kentucky Derby likely to be postponed), that would be a devastating economic hit on the state. The Indiana Business Resource Center commissioned a study in 2000 that estimated the economic impact was $331 million. Adjusted for inflation in 2010, it was estimated to be $431.1 million. It will almost certainly crest the $500 million figure this year.

Holcomb faces a similar scenario as Gov. Mitch Daniels did in 2008, when the Great Recession almost sacked the domestic auto industry and Indiana’s extensive network of auto supply firms. Holcomb’s second term, should he defeat Dr. Myers in November, is likely to be in stark economic contrast to his first term, which was marked by record investments and low jobless rates (it was 3.1% in January).

Treasury Sec. Steve Mnuchin warned Republican senators at their weekly Tuesday luncheon that unemployment could reach 20%, levels seen in places like Elkhart, Kokomo and Anderson during the 2008-09 Great Recession.

At least 60 American health care workers have tested positive for the virus with just 4,226 cases reported by the Centers for Disease Control and Prevention on Wednesday. Of those cases, 229 were travel-related, 245 came via close contact, and 3,752 are under investigation. According to the Harvard Global Health Institute, if 60% of the U.S. population contracts the virus, the nation would need seven times the number of available hospital beds. That has prompted calls for additional beds to be created in now-vacant college dorms and private surgery centers.

The United States is expected to lose 4.6 million travel-related jobs this year as the coronavirus outbreak levies an $809 billion blow to the economy, according to the U.S. Travel Association.

An internal report from the Department of Health and Human Services obtained by the New York Times concluded that the “pandemic will last 18 months or longer and could include multiple waves of illness.”

Without widespread testing, Indiana and the U.S. has been faced with literally shutting down the economy, as opposed to South Korea, which tested and isolated those infected without broader shutdown.

The Trump administration is working on a $1 trillion rescue package that could include two $2,000 checks to be mailed to most Americans, one within two weeks and a second in May, and $50 billion for the American airline industry. Last Sunday the Federal Reserve cut interest rates to zero. With budget deficits already more than $1 trillion, and national debt more than $22 trillion, the American quiver is quickly running out of arrows. What happens if “social distancing” lasts six to 18 months, as opposed to six weeks?

Vice President Mike Pence, who heads the federal coronavirus task force, said on Tuesday, “Every American can be confident that we’re going to do whatever it takes to keep the American people safe and when we defeat the coronavirus in the United States, the economy will come roaring back. All of our health experts agree, you do not need the results of coronavirus testing to know what you should do. Every American in every community should be following President Trump’s guidelines.”

As for President Trump, he told the nation on Tuesday, “This is a pandemic. I felt it was a pandemic long before it was called a pandemic.”

On Jan. 22, he told CNBC when asked about a pandemic, “We have it totally under control. It’s one person coming in from China, and we have it under control. It’s going to be just fine.” On Feb. 27, at a White House meeting: “It’s going to disappear. One day – it’s like a miracle – it will disappear.” On March 7, standing next to President Jair Bolsonaro of Brazil at Mar-a-Lago, he was asked if he was concerned. “No, I’m not concerned at all. No, I’m not. No, we’ve done a great job.”

The president, who at the 2016 Republican National Convention declared, “I alone can fix it,” was asked last Friday about the lack of testing. “I don’t take responsibility at all,” he said. The “responsibility” in the wake of its glaring absence from Washington has essentially been shouldered by both Republican and Democratic governors, sports league commissioners, and mayors.

Beth Cameron, who headed the National Security Council’s pandemic response team, observed in a Washington Post op-ed, “When President Trump took office in 2017, the White House’s National Security Council Directorate for Global Health Security and Biodefense survived the transition intact. Its mission was the same as when I was asked to lead the office, established after the Ebola epidemic of 2014: To do everything possible within the vast powers and resources of the U.S. government to prepare for the next disease outbreak and prevent it from becoming an epidemic or pandemic. One year later, I was mystified when the White House dissolved the office, leaving the country less prepared for pandemics like COVID-19.

The U.S. government’s slow and inadequate response to the new coronavirus underscores the need for organized, accountable leadership to prepare for and respond to pandemic threats. In a health security crisis, speed is essential. When this new coronavirus emerged, there was no clear White House-led structure to oversee our response, and we lost valuable time.”
 
Ron Klain, the Indianapolis native who headed President Obama’s Ebola task force in 2014-15, said on CNN Wednesday, “As bad as this is, something worse is yet to come. The virus will be more patient than we are.”

Status of testing

ISDH Communications Director Jennifer O’Malley told HPI on Wednesday that “the ISDH lab is testing seven days a week, with results typically available within 24 hours. LabCorp is also performing tests in the state. All options for expanding testing are being explored. ISDH received additional testing materials from the CDC last week and again this week.

“Despite the additional supplies, ISDH, like other states, still has finite resources for testing because we receive our materials from the CDC,” O’Malley continued. “We are prioritizing high-risk individuals and healthcare workers, but individuals who do not meet those criteria can pursue testing through a private lab with their healthcare provider. Private labs have been asked to report their results to ISDH, and all information received is included in the count. However, there may be some lag time while private lab results are in transit to ISDH.”

On Wednesday, Eli Lilly & Company announced it will use its labs to test for the virus, adding to the state’s testing capabilities and making testing available for more people. Lilly is also piloting drive-through testing. “This partnership between the Indiana State Department of Health and Eli Lilly and Company will be transformational in our efforts to accelerate testing for COVID-19,” Gov. Holcomb said. “We are grateful for Lilly’s dedication to the health and safety of Hoosiers as we continue to put all of our focus into slowing the spread.”

Pence counting on personal hygiene

Vice President Pence told National Public Radio’s Steve Inskeep on Wednesday, “It really is all about trying to focus on two things. No. 1 is we really believe if every American will take strong steps now over the next 15 days, that we can significantly impact the spread of the coronavirus in the United States. And also, as every American puts these common sense personal habits and hygiene into practice, we’re going to protect the most vulnerable among us.”

Inskeep pressed Pence on the pandemic modeling he has seen: How many people are on their way to being sick, for example? How serious will the damage to the economy will be if nothing is done? What are your assumptions about how bad this is?

PENCE: Well, we got modeling in in the last several days, and that’s what precipitated the president’s decision. But let me say – and Dr. Tony Fauci and Dr. Deborah Birx, two of the leading experts in the world on infectious disease, tell us – is that we are still at that point in the spread of the coronavirus in the United States where strong action, common sense, personal hygiene and what they call social distancing for now among every American can significantly reduce the spread of the virus in our country.

INSKEEP: But is that taking it from catastrophe to still a disaster, or what is on the horizon here?

PENCE: Well, look. There will be many thousands of Americans that contract the coronavirus. We know that. And as we expand testing, those numbers are going to be more evident to the American public every day. But what your listeners should know is that most Americans who contract the coronavirus will either have mild to serious flu-like symptoms and completely recover. Many will have no symptoms at all.”

Surgeon General Jerome Adams acknowledged on NBC’s “Today Show” Wednesday that the Trump administration’s recommendation that Americans practice preventive measures for 15 days is “likely not going to be enough” time to successfully halt the spread of the coronavirus pandemic in the United States. Fifteen days is likely not going to be enough to get us all the way through. But we really need to lean into it now so that we can bend the curve in the next 15 days, and at that point we’ll reassess.” 

Epilogue

On Monday, Gov. Holcomb said, “For those of you who think we are over-reacting, I can assure you we are not. Indiana is under a state of emergency. We will win this war with COVID-19. Make no mistake about it, collectively the actions we are taking today will have a positive impact 30, 60, 90 days later.”

While he didn’t speak, Indiana National Guard Brig. Gen. R. Dale Lyles was present at the Statehouse press conference when Holcomb said the state had “contingency plans” to deal with a flood of cases that some fear will swamp the medical system: “We will respond to facts on the ground,” Holcomb said. “We want to stay as ahead of the game as we can. Every tool, every resource is on the table. We’re trying to slow the curve so it doesn’t last as long. We have resources around the state to deal with a surge.”

David Lauter of the Los Angeles Times reported: “The coronavirus pandemic has confronted governments around the globe with the ultimate bad choice: Wreck your economy or lose millions of lives. While some initially hesitated, leaders and legislators in the United States and worldwide increasingly have decided they have to accept the severe economic pain.”

“Everything else will come back,” President Trump said Tuesday even as the economic downturn and global turmoil deepened. “Lives won’t come back.”