NIH Director: ‘We’re on an Exponential Curve’

“There are estimates that if nothing goes right and if we fail to flatten the curve and if health systems are overwhelmed, we might see the deaths of as many as a million and a half people in the United States.”

That’s what Francis Collins, the director of the National Institutes of Health, told me on Saturday. Collins is one of the most widely respected physician-geneticists in the world, who is deeply involved in containing the coronavirus pandemic. (Anthony Fauci, arguably the world’s leading infectious-disease specialist, works for Collins at the NIH and is a close friend.)

Collins was not offering a prediction, but a realistic worst-case scenario of what awaits America in the next eight weeks or so unless, in his words, we embrace “the more extreme version” of social distancing.

[Read: The dos and dont’s of social distancing]

“If you look at the rates of new cases that are being diagnosed, we’re on an exponential curve,” Collins told me. “That curve, some would say, places us only about eight days behind Italy. If that’s true, we have only a very short period of time before this becomes an obvious national crisis with many people presenting with serious illness and hospitals quickly becoming very stressed with the ability to handle all of these sick people, especially older people who are at higher risk and who may need not just a hospital bed but even a ventilator.”

I asked Collins whether that means we seem to be tracking with what happened in Italy.

“Right,” Collins told me. “If you look at the curve of new cases being diagnosed over the course of the last month, just look at the curve of what happened in Italy, and then look at our curve in the U.S., and you say if you go back eight days from today, they had about the same number of cases that we have today—that is, slightly over 2,000. And then if we follow that same track, then eight days from [March 22], we would be having the same kind of incredible crisis that they are facing.” (The New York Times described the catastrophe befalling Italy: “The coronavirus epidemic raging through Italy has already left streets empty and shops shuttered as 60 million Italians are essentially under house arrest. There are the exhausted doctors and nurses toiling day and night to keep people alive. There are children hanging drawings of rainbows from their windows and families singing from their balconies. But the ultimate metric of pandemics and plagues is the bodies they leave behind. In Italy, with the oldest population in Europe, the toll has been heavy, with more than 2,100 deaths, the most outside of China. On Monday alone, more than 300 people died.”)

Collins added this important qualifier: “Now we have a chance to change that, by applying now the most draconian measures on social distancing to try to limit the spread of coronavirus from person to person. But we will not succeed at changing the course from that exponential curve unless there is full national engagement in those commitments to try to reduce spread. I think we’re getting there; certainly in the last few days there seems to be a lot of waking up to just how serious the threat is, but that’s obviously not universal across this large and complicated country.”

[Read: The pandemic could change how Americans view the government]

Since our interview, we’re seeing what “waking up” means : Ohio is postponing its presidential primary and ordering restaurants and bars