EDITORIAL 1 www.journals.viamedica.pl Address for correspondence: Harpreet Singh, Sutter Gould Medical Foundation, Stockton, United States; e-mail: harpreet91@gmail.com DOI: 10.5603/ARM.a2020.0099 Received: 14.05.2020 Copyright © 2020 PTChP ISSN 2451–4934 Harpreet Singh, Tarun Popli 1 Sutter Gould Medical Foundation, Stockton, United States 2 New York Medical College, New York, United States Stopping the SARS-CoV-2 surge in the USA-CDC recommendations and ground realities Introduction As of May 10, 2020, the United States of Ame- rica (USA) has 1,367,079 cases of SARS-CoV-2 and 80,773 deaths associated with the disease. New York alone has more than 333,000 cases and near- ly 21,271 deaths. We are having about 20,000 new cases every day and the deaths are exceeding 1000 a day. There is overwhelming evidence that the most effective way of controlling the virus from spreading is restricting movement to prevent human to human exposure. As a result, economies were put on a lockdown worldwide. In the USA, lockdown began in California on March 19 th , 2020, with stay home orders, allowing only for essential jobs, errands, and some exercise outside. Other states followed soon. Opening the economy seems necessary. Loc- kdown was at least partially successful, but as expected, the economy slowed and jobs were lost. The latest job report per the US labor department showed 26 million Americans have been laid off and fled for unemployment benefts. The US unemployment now stands at 14.7% meaning 1 out of every 6 is jobless. This issue is the toll of the SARS-CoV-2 on the largest economy of the world. Most states now are looking toward the opening. Most of the “shelter in place” orders expire in May and some states like Georgia have already opened its businesses. Dangers involved with the reopening Re-opening will pose challenges. The biggest risk we face is a surge in the immediate cases of new infections. The second wave of infection in the fall has also been predicted. Prediction models have increased the United States deaths to 130,000 by early August this year given the re- opening and relaxation of social distancing guide- lines. The surge can overburden the healthcare system. If we were to see a second wave similar to the frst, our present health care system will stretch again and mortality will increase directly due to SARS COV-2 and related conditions such as heart attacks and stroke. In order to reduce mortality and health care utilization, it is impor- tant to identify and secure the most vulnerable and protectable. The older and the frail are at particular risk of contracting the disease and losing their lives. Lessons learned until now about the most impacted group As per the Center for Disease Control and Prevention’s (CDC) latest data set, among the dead from SARS-COV-2 in the USA, 80% were 65 years or older and that has not changed since March 18 th , 2020. As per CDC, on May 8 th , 2020, the ho- spitalization rate was highest in people 65 years or older in age at 162.2 per 100,000 as compared to that rate in people 50–64 years of age was 79.0 per 100,000. The cumulative hospitalization rate was 50.3 per 100,000 [1]. It is logical to conclude that the group facing maximum mortality will also need more intensive care support. The CDC also studied the number of people above 65 years of age requiring intensive care shown and found it to be 53% in that age group [2]. Patients older