COVID-19 Day 48: Feeling Dumb About Reopening

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The following is an attempt to work through in my own head what I know of the current state of COVID-19 and weigh the conflicting needs to stay safe and to restart our economy before it’s too late. After spending a month boning up on biology and history, I still feel dumb about where we should go from here. No great insights or clever solutions. Sorry.

What many politicians and economists have asked since the National Emergency was announced on March 13, was “Is it worth it?” Few of us questioned the need for business shutdowns and stay-at-home orders at the time. But what we didn’t know (and weren’t being told) was how long would these measures would be necessary. At first our expectations were set in 14-day timeframes. But after 45 days and the goal-post getting moved, again and again, the question of whether the shutdown a valid one.

The shutdowns were our only viable strategy at the time due to a severe lack of information about the speed and spread of the virus infections. Due to internal bungling at the FDA, and international politics, PCR tests for COVID-19 weren’t widely available when the first communal infections were detected in early March. Lacking an effective medical treatment for COVID-19 or available tests, meant it was impossible to identify and quarantine the sick before they could infect others.

Shutting down entire states seemed to be the only option on the table at the time. We had to slow down new infections to not overwhelm medical systems as had happened in Wuhan, China, and Lombardi, Italy. And while it is now known that for the general public, a COVID-19 infection is only a little more deadly than the seasonal flu, we thought it was much more lethal based on the info from China. And we do know it spreads far more easily via asymptomatic and presymptomatic spread.

Those who push for reopening earlier compare COVID-19 deaths to flu deaths. Looking at the numbers, as of this writing, almost 60,000 people have died of COVID-19. That’s nearly the same number of people that died (61,000) in all 5 months of the 2 017–2018 flu season. 60,000 is about 0.002% of the population.

Some have questioned the accuracy of COVID-19 death counts due to financial incentives biasing the data or for political motives. But a broader look at “normal” death counts over the last 5 years for each state show a clear increase over the average which can’t be attributed to other causes such as the flu or pneumonia. These “extra deaths” show that something killed all these people in NYC and other hard-hit COVID-19 states. Unless you believe these bodies in morgues and funeral homes are simulated doppelgangers, Occam’s Razor suggests it’s COVID-19.

A handful of nations like Sweeden have argued that COVID-19 deaths were not worse than the deaths and deprivations from a damaged economy. Sweeden has experienced more deaths than its Scandinavian neighbors, who chose shutdown strategies, but not as many as experts predicted. Countries in the developing world that lack resources and technology are relying on herd immunity as well, because they have no other option.

Herd immunity is a solution for a pandemic, when enough of the population has recovered from a virus and gained immunity, to make it unlikely for an infected individual to infect a new host. Immune people ‘in the herd’ are essentially functioning as a means of distancing infectious people from non-immune people and each-other.

But a herd immunity strategy wouldn’t really reduce the overall number of deaths that COVID-19 could cause before a pandemic exhausted itself, especially among the elderly and those with pre-existing conditions. It just compresses the deaths and pandemic into a shorter timeframe.

What shutdown strategies do, is buy time. This forestalls deaths and spaces them out over a longer time period. If you can isolate a large enough portion of the population and you can guarantee no pockets of contagion exist after it has burned through its available pool of people, then not only is the pandemic over but its effectively extinct. This is what happened with the Black Death that killed over 25% of Europes population in the 15th Century and untold millions in the world. The plague never reached North and South America. But these New World peoples would later be decimated by smallpox due to their isolation.

Unfortunately, we don’t know where this virus came from. Whether from a bat in a cave in Southern China, a pangolin in a farmers market, or a lab accident, the fact remains that a source of the virus remains out there. It could reinfect somebody somewhere, sometime, and come back for all us spared the last time. So we can’t stay isolated forever. And restructuring out lives around shutting down on a moment’s notice from now-on seems unlikely.

The other way to deal with a pandemic is to find a treatment. This is how we currently manage with other communicable diseases such as AIDS, malaria, and hepatitis. There are over 70 other drugs and therapies going through FDA approved clinical trials but currently we have no proven drug treatment that shortens the length of the viral infection or reduces the number of deaths. Clinical trials for Chloroquine and Hydroxychloroquine have shown it works at reducing symptoms in mild-to-serious cases but so far ineffective for reducing the chance of death for serious cases of COVID-19.

The ideal solution to a pandemic an effective vaccine to grants people immunity without the illness. Dr. Fauci and other scientists think a vaccine could be 12–18 months away. And that’s a best-case scenario where the vaccine is safe (no dangerous side-effects) but there’s no guarantee that it will be effective until the testing is complete. It took 5 years of intense, multi-national research, with questionable ethics violations to develop an Ebola vaccine. They’ve been researching a vaccine for SARS1 for over 15 years but they still haven’t succeeded. But that does mean we have a head-start on our needed vaccine for SARS2 (the virus that causes COVID-19).

Shutdown strategies were designed to buy us time for scientists to develop a vaccine or an effective treatment. Currently we have neither. And we can’t remain shut down for another 12–18 months for one even if we were 100% sure it would be developed.

After only a month, we’re already seeing cracks form in our food and supply chain causing shortages of eggs, milk, and other necessities. We’ll see people losing businesses, livelihoods and places to live. Desperate and disgruntled people have started to protest and form groups agitating against the shutdowns and regulations that over-reach or seem irrational like arresting people for sitting outdoors.

Civil disobedience can lead to more infections and it can lead to civil unrest and open rebellion. If the economy collapses due to shutdowns, we could see Venezuela-level food shortages and riots. Desperate and destabilized countries are more likely to resort to violence or go to war.

We’re going to have to go back to work to avoid more death and disaster than the pandemic itself. The question our state’s governors are grappling with now is how to do this while continuing to slow the infection spread and its inevitable death count.

We just spent over $2 trillion to buy time to figure out where we go from here. We didn’t do so great a 100 years ago during the 1918 Spanish Flu. 675,000 Americans lost their lives before we achieved herd immunity. It’s not likely this pandemic will be as deadly, but let’s not try to beat that record.



SOURCES

https://www.cdc.gov/flu/about/burden-averted/2017-2018.htm

https://medium.com/@tomdelmundo/covid-19-was-an-accident-ce801d81f6ed

https://www.medrxiv.org/content/10.1101/2020.03.22.20040758v3

https://www.livescience.com/coronavirus-covid-19-vaccine-timeline.html

https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html

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