Some Context for You C19 Freakout

Here are couple of pieces of context to balance a lot of the flailing going around the internet.  This is not meant to discourage people from current attempts to flatten the curve, but I’m putting it here because I think that a lot of the discussion around Social Distancing has been remarkably binary.

  • Flattening the Curve (we’ll call it FTC) has ZERO guarantee of actually stopping your loved one from getting COVID-19.  It means potentially better care for them when they do get it, but this is a virus with a long shelf life and a high percentage of asymptomatic carriers.  Unless you plan to lock grandma in a bubble for the rest of her life, she will eventually come into contact with this virus.
    • The point of FTC is so that hospitals which have severely limited bed and equipment quantities can hypothetically keep up with demand.  A lot of the estimates I’ve seen about capacity imply that even stopping curve growth now, we’re going to see massive over-demand in coming weeks.
    • Once you get COVID-19, whether you need a ventilator or not  IS NOT IMPACTED BY FLATTENING THE CURVE.  The ONLY thing FTC does is get you a higher odds of landing one.
  • We don’t know where we are on the curve.  Due to an incredibly poor initial managing of the Coronavirus situation in the US, we are roughly 2 months behind where we should be in terms of testing.  Due to CDC guidelines, the only patients reliably getting tested have been in ICU-admission level respiratory distress, and it’s unclear what percentage of COVID-19 cases that is (aside from a very small one).  12% of those who tested positive in China didn’t even have a fever, and an it’s estimated that 60% of cases were originally missed in the early days in Wuhan because they were either asymptomatic (no symptoms at all) or their symptoms were so mild they didn’t qualify for screening.  Numbers in New York and Washington are higher in part because they’re testing more people – we have no real way of knowing how high current infection rates are in most of the country.  As of right now, the US is reporting over 42,000 cases.  If that’s still as aggressively under-tested as it has been, that means that there are probably closer to 400,000 cases in the US at present time.  That’s sounds like a long way up the curve to me…
  • FLATTENING THE CURVE MEANS EXTENDING THE OUTBREAK. NOT ENDING IT IMMEDIATELY.
    • I have run into a whole bunch of angry shouting on FB about how parents in parks are causing this to be a 12 month situation instead of a 3 month.  The reality is exactly the opposite.  FTC is an attempt to press pause on exponential growth, slowing it down to a 1 to 1 continuing infection rate and keeping the number of people infected at a given time FLAT.
  • Vaccine? What Vaccine?  Despite the claims of various private bioengineering firms, there’s no guarantee that an effective vaccine or treatment is actually in the works.  A few options are nearing/in first wave clinical trials, but that’s a year to market under the best circumstances.  If the virus behind C19 mutates too often, the best option will be a yearly adjusted guestimate vaccine similar to what people currently can get for the flu.
  • Flattening the Curve Comes with Costs. And not just the financial ones.  These are just starting to become apparent, but here are a few:
    • Blood Supplies are drying up.  With bans on public gatherings, medical facilities restricted to essential visits only (no vaccinations right now, kids!), and hospitals pushing people only to come in for a true emergency, nobody’s donating blood.  This is going to have a profound – often life threatening – impact across the country.
    • Closing schools means limited (or non-existent) access to NSLP school lunches for nearly 30 million students.
    • Everyone’s heard the recent stories about hospital staff running out of PPE (Personal Protective Equipment).  If we quadruple the length of the crisis phase of the outbreak, those shortages are going to become a lot uglier and healthcare workers will be in compromised situations for longer as supplies continue to dribble in.  If extended far enough, broader PPE supplies should become more available again.

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