EITHER...
OR...
If the first scenario happens, we'll have to deal with it. We cannot stay locked-down forever, no matter what some extremists want.
If the second scenario happens, then we'll know that all of these emergency quarantine, isolation, social-distancing and "Safer At Home" policies were bullshit.
In the Comments section of my previous post (viewable below), my friend Ed worried that his state (Iowa) will become a "guinea pig" because the rates of infection and hospital visits are still increasing to record highs as their governor relaxes restrictions. Ed says, "Yes, most of those numbers setting our record highs are in areas that aren't being relaxed just yet."
Me, I keep an open mind and look strictly at the numbers. Some of them are known, and some of them we're forced to make an educated guess at - like the *actual* number of people who've been infected by the virus. We know from studies in other states that somewhere between 25X and 80X more people have the coronavirus antibodies than have actually been tested and come back positive.
So Ed, if Iowa has 6,843 confirmed cases, the *actual* number of cases could range anywhere from 171,075 to 547,440. Quite a range! It really screws things up when you're trying to calculate a case-mortality rate, and of course when you're trying to figure out what percentage of the population has already been infected.
Let's use a conservative multiplier such as 40X, and focus on Black Hawk County, which is 50 miles NW of Cedar Rapids and has a population of 132,400 people. Black Hawk County has 43,280 infections, or 33% of its population. That's high, considering the rest of Iowa is down around just under 9% (using the same 40X multiplier). By comparison, New York City is up around 40% of the population infected.
Remember, we *cannot* stop the spread of the disease; we can only slow it..."flatten the curve" so to speak. (Maybe.) On the other hand, we cannot stay in lockdown forever. My mortgage, car payment and insurance payments have not been put on hold.
If you believe in your heart that the isolation, quarantine and social-distancing techniques *absolutely* slowed the spread of the virus, then you should expect that the number of infected people *WILL* go up once we start getting out and about again. Nothing we can do about that, really. It's going to happen.
There is a part of me that believes (hopes?) that the rates of infection and death will not go up markedly...that the numbers will continue to slowly rise AS THEY'VE BEEN DOING in most places - like the county where I live.
The numbers of infections and deaths will rise until we reach "herd immunity," which may give some protection against getting the virus again when it resurfaces in the Fall. Or not. People get the flu more than once a year, so I wouldn't bet my life that having COVID19 once would give me any immunity from getting it again.
Also in the Comments section of my last post, Kelly mentions talking to her brother about Sweden, a country that put minimal social-distancing policies in place.
Kelly says, "When I posed the Sweden scenario...to my doctor brother, he said there was no way to predict how it would have played out in our demographic. It would have probably overwhelmed the healthcare system even more."
That's such a typical cop-out. "Yeah well...that wouldn't be the case HERE!" Oh no? Why not? Why make the assumption that our healthcare system would have been overwhelmed?
Kelly, if you talk to your brother again about Sweden, all you need to do is look at New York State. Governor Cuomo was sounding the alarm that he needed "30,000 to 40,000" ventilators. He ended up needing only a small fraction of that. *NONE* of his hospitals got overwhelmed...nobody who needed a ventilator was denied a ventilator.
It is likely that even if New York State had done *nothing*, their health care system would not have been overwhelmed. After all, the federal government built extra hospitals and even sent a big hospital ship up to New York to handle any overload (which packed up and set sail yesterday back to its homeport). Thankfully, none of those extra capabilities was needed.
So New York was prepared. And remember, best estimates are that 39% of all New Yorkers have already become infected in that petri dish they call The Big Apple. (Glad I don't live there anymore!)
Point being, I doubt that any other city's health care system would have been overwhelmed either. I keep droning on about my county here in Florida, but with 315,000 people we *still* have had only 11 deaths. We never even came close to running out of hospital beds, ICU beds, or ventilators. Not even close.
Let's say worse comes to worst and, ohhh, 70% of our population - which would be 220,500 people - gets infected. If the current case-mortality rate of 0.04% holds, then we could see 96 deaths.
I'm sure that all the hospitals we have in this area can easily handle that load, because: 1) We've already had eleven deaths, so it'll probably only be 85 more; 2) The deaths won't all happen at once, and 3) If a person is going to die from coronavirus, it happens pretty quickly. At this point there is no reason to think that the case-mortality rate will change very much. In fact, it may go down a bit since the most vulnerable people have already succumbed to the disease.
The computer models the government was using for COVID19 in the beginning were horribly flawed and waaaaaay pessimistic (perhaps deliberately?). They modified them as the real data came in, but by that time non-government geeks...regular people like you and me had already made up our minds as to the severity of the virus and how many people might die if we all didn't hunker down and hide away in our houses like the frightened pigs with the big, bad wolf at the door. Or whatever that fairy tale was.
Personally, I don't think that getting back to "normal" is going to be a bad or cataclysmic thing. Yes, more people will get infected, and more people will die, but that's going to happen anyway. There was never any hope of lowering the death rate to zero.
But maybe I'm wrong. We shall see.
8 comments:
I must point out that your example of Black Hawk county in my state has some flaws. The biggest one is that 90% of those infected in that county worked at the same place of employment, a meat packing plant, and every single employee was tested, almost all didn't meet state testing guidelines. I think that probably skews the 40X factor significantly down since most of those who tested positive at the plant were asymptomatic and would never have been tested in the rest of the state where different rules are followed, namely one has to have some sort of symptom and a known contact. Thus I would suspect that they are much closer to a single digit factor which would bring it on par with other parts of the state.
The second problem I have is that comparing where I live and places like New York City might as well be comparing an orange to a Lamborghini, especially when concerning the ability of the area hospitals to deal with a pandemic should things get worse. Our regional hospital has one ventilator and one backup so say a total of two assuming they both work. Assuming just the city where it is located, population 25,000 gets slammed with Covid-19 and 40% of the population gets infected like New York City, that is 10,000 people that test positive (we are now at a whopping 15 people). Assume 1% of those will need a ventilator that means 100 ventilators or 50X more than what we have. This isn't even considering that our regional hospital serves people from 10 counties making the numbers probably another 4X worse than what I just figured. Yes many urban places in our state and others may have the ability to ride out these larger numbers but we simply do not. I don't know what we have now but when this thing was in its infancy, our state had only 280 ventilators total for a population of 3.15 million people. 40% getting infected of that is 1.26 million and 1% of those needing a ventilator would be 12,620 or 45X more than what we have. If we guess wrong or make the wrong assumptions with the 2 to 3 week lead time of this disease, it could be disastrous and we could be making life and death choices of who gets ventilators for a month before we could correct our assumptions/policies.
I'm in agreement that we eventually have to let this disease work its course through the population. But when our daily death totals and new hospitalizations set the record for something like the fourth day in a row, I'm not sure now is the time. I would rather error on the side of caution.
Oh, I think my brother was just placating me since I was wondering if we shouldn't have just gone the route of Sweden. He's always told me we need a periodic pandemic to take care of over-population (I'm saying that with tongue in cheek... we're a dark humor kind of family).
In reality, there's no point in "shoulda, coulda, woulda". Speculation is pointless. (tell that to the 24/7 news media) I am sick of seeing Cuomo's face on the TV. You'd think the entire universe revolved around NY.
*sigh*
Ed, I hear what you are saying. Playing with numbers can be tricky and frustrating. What you say is true about Black Hawk County. But the county has 132,408 residents, and only 2,800 people work at Tyson in Waterloo. Officials are saying that 90% of the county's 1,140 confirmed cases are connected with the plant - so, like 1,000. But there are sure enough *plenty* of other asymptomatic people in Black Hawk County who don't work at Tyson. We will have to keep our fingers crossed that those Tyson workers are young and healthy and don't have the associated health problems that are so gravely serious for people who do.
So let's revise downward! Maybe the total number of people who have coronavirus in Black Hawk County is not 40X but only 10X the number of confirmed-cases? That would be 11,400 "actual" cases (1,140 X 10), which works out to be 8.6% of the county, which lines up with many other areas. If we use that number, then the disease mortality rate becomes 0.11% - *one-tenth* of one percent.
It is true that the death rate lags behind the infection rate by some interval which is hard to pin down but is probably around two weeks. So the disease mortality rate may go up...a bit. I doubt it's going to spike up ten times from .11% to 1.0%. In fact, all across the country, the death rate has stayed consistently between .2% and .4%. But I mean, anything could happen.
So if 40% of Black Hawk County residents become infected with coronavirus, that would be roughly 53,000 people. If 0.11% of them eventually die, that would be 59 people. But if .4% die, that's 212 people! That's scary. Would they all need ventilators? Would they all need ventilators at the same time? If so, one would hope that ventilators would be available from other nearby hospitals and/or the stockpile maintained by the federal government.
This is why it is so important for the elderly, and for those among us who have existing health issues (especially respiratory) to stay the hell away from people for a while. If I were in that category, I wouldn't leave my house!
Kelly, I had a guy who works at a hospital get in my Uber recently. In talking about the coronavirus, he suggested that the Chinese released the virus deliberately to "thin out" the sick/elderly in their country - the ones who were the biggest drains on their health care system. It's a horrific idea - perhaps too horrific to even consider.
But is it? I don't put *anything* past China.
I have a friend, and he and I were talking about the overall death rate of this coronavirus. Specifically, we were wondering if it would stay the same or change? He suggested that it might actually go down. Why? Because all of the people who were most vulnerable have already succumbed to the disease in this first-round. A morbid though, but perhaps he's right? Survival of the fittest?
If we look at the raw numbers, Sweden looks terrible. 21,500 confirmed-cases and 2,163 deaths? Wow. That's a case-mortality rate of over 12%. But we know that's not right. More Swedes have contracted the virus than have tested positive for it. How many more? I dunno...let's use 25%? That would make their "actual" number of cases 538,000, bringing their case-mortality rate down to 0.5%. That's still pretty high. But Sweden's per capita death rate (deaths divided by population) is only 0.03% which is actually a little lower than both Spain and Italy! Strange.
I agree with you about Governor Cuomo. He has stated that he will not run for president, but it sure seems like he doing just that. He seems to be a calming, "let's not panic" influence on his state, something that President Trump has ironically been criticized for.
Personally, I think both he (Cuomo) and his butt-buddy mayor of NYC, Bill Di Blasio have really screwed up the response to the coronavirus up there. Not shutting down the subways was a HUGE mistake. One could ask what the alternative might have been? Uber Pool? I don't know. But you cannot tell me that one of the big reasons NYC has seen such a spread of the virus *isn't* because of the jam-packed subway trains.
Or...maybe that "going forward" (as everyone likes to say these days)...going forward, we're just going to have to accept that if you *choose* to live in such a densely-populated place as NYC, you are putting yourself and your family at a very big risk if and when another pandemic breaks out - and there won't be much anybody but God can do about it. I have an older brother who lives *in* Manhattan. The fact that he has not gotten COVID19 yet is a friggin' miracle.
Another aside about our state which I'm not sure how far was publicized but as little as two weeks ago before the meat packing plants business anyway, 48% of all positive cases in our state were in elder car facilities. Seeing I have a close family member in one of them, it makes me sit up a bit reading that number. The worst part is that there really is no earthly way we can protect those folks. Despite having locked the doors to visting friends and relatives, they are entirely dependent on younger people who come and go on shifts and will be mingling with those of us coming out of the strict lock down measures. Like you said earlier, we have to either lock the entire country down until a vaccine is found which isn't feasible or we just delay the inevitable that it will get to the facility where my grandmother is staying and roll the dice as to whether it will kill her or let her live another day with little or no symptoms.
On an aside to my aside, I had to go to the home improvement store to get some supplies for my project. During the stricter measures, 20 cars was a busy day for them. Today, with the new relaxation of rules, there were probably close to 150 cars in the parking lot. I think that answers my question as to whether or not people will decide to hunker down for awhile longer like myself or go back to business as usual.
Ed, this is, aaaahhh, awkward to point out, but if *you* were at the Home Depot with all the other guys (presumably guys), then you weren't exactly "hunkering down," know what I mean? Yours was one of the 150 cars in the parking lot, is all I'm saying.
But to your point about the elderly... We've known from the beginning that COVID19 targets the elderly. And as you point out, the staff at nursing homes could absolutely have the virus, not even know it and transmit it to the residents. So what do we do? Walmart is taking the temperature of every employee as he/she shows up for work. Anyone with a temp of 100 degrees or more is sent home for 14 days. (I'm just shocked that they use rectal thermometers! Sure kept me from applying for a part-time position.) Perhaps nursing homes and senior care facilities should be doing the same thing (using those newfangled digital thermometers hopefully)? At every least, every employee should be wearing fresh PPE any time they interact with a patient. However, that maybe be difficult or next-to-impossible to implement 100% of the time. It's a tough situation, for sure.
And this points out the horribly tragic consequences of a pandemic caused by a new virus for which we have no vaccine. Even here in the year 2020, we're fairly powerless to fight it. This is one for the history books.
I see your point but that was my second trip there in the last six weeks and it was for necessary supplies needed to keep me working. It was obvious most of the others around me (mostly ladies actually) were just getting out of the house and stretching their legs. While I was all by myself in the back corner getting gas pipe, they were in the home goods section of the store having mini reunions. I skirted around them in side aisles and got checked out without coming within probably 20 feet of anybody but the cashier. The cashier and I were the only two I saw wearing masks and after loading my pipe into the car, I lubed my hand well with hand sanitizer before getting in and removing my mask.
Currently, our city facebook page is descending into hysteria. We got more positive cases in the last 24 hours than we have in the previous six weeks combined. People were cussing out others for being out and about on the first day of "freedom". I don't think anyone understood though that all those diagnosed caught it more than a week ago.
I forgot to mention, probably a month ago I saw a very excellent youtube video about highly mutating RNA viruses which the Covid-19 virus is. He said that it is quite common for their mutations to essentially burn themselves out so they aren't as lethal or even noticeable in terms of visible symptoms. All this is to say that it wouldn't surprise me if it isn't as lethal now as it was in China or even Italy. Such is the nature of the beast in regards to highly mutating RNA viruses.
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