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rustyhyde · 4 years

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Tough Decisions Ahead

I like to think of myself as reasonably rational, intelligent, and compassionate being. I trust and care for my family, friends and neighbors. Community is important to me. I’m also risk adverse and a long-term planner. I am by any definition, a mere cog of society.

I’m at heart a data driven guy that loves hard facts and numbers. I work numbers and facts into my own planning. The problem with the Corona virus is that there aren’t any solid verified and validated numbers or facts. I suspect this is par for the course for a pandemic caused by a novel virus. In the mountains of conflicting information, whom do I believe? From information theory, its all of them. What I mean to say is, believe the aggregate of the information, being that the real number or fact is somewhere in the middle. As an , some medical authorities say the mortality rate is 0.66 percent. Others say 5.5 percent. The bulk of the numbers hover around 2-3%. I’m inclined to believe that middle number. Of course, that number is an overall mortality number for an entire population. Old people are at higher risk, younger people, not so much. Murphy’s law says that no matter the risk categories, I will always be in the high risk one.

From the mountain of dubious data, what questions would I like an answer to? They are in no specific order:

1. What is the infection rate?

2. What is the mortality rate?

3. What are the most common symptoms? FYI: Hard to believe an actual MD said a possible symptom is developing color blindness? Really? - If you are licensed- you should have your license revoked.

4. Who’s most at risk?

5. What are the treatments?

6. What do we need to do?

7. What is our national collective strategy to combat this pandemic?

Before I continue with my rant, I’d like to say that pointing fingers and saying woulda, coulda, shoulda will not help resolve this issue. Now, back to my rant.

From the disparate data, three battle plans are emerging. One plan is advocated by the health care professionals, one plan advocated by economists, and one plan advocated by the civil political leadership. All the plans have pros and cons. I’ll try to describe them with my limited amount of knowledge and weigh in on the pros and cons.

Plan A as advocated by the health are professionals. This is the complete shutdown of all physical interactions, the social distancing plan if you will. The oversimplistic description is that one can’t spread or contract the virus if one does not come into contact with other people. You effectively drive the infection rate to zero, or near zero. Note, this plan is different than a quarantine. Inside a quarantine, people are allowed to interact, thus everyone in the quarantine will be exposed to the virus. The problem with a quarantine is that they are not leak-proof. Someone will get out and infect others. So, social distancing means don’t come into contact with anyone else. To make this work some/most think this plan has to run through to al least the end of the summer (five more months). What are the pros and cons of this approach?

Pros

- Effective. No contact means no infection.

- Ideally, it is simple to implement in that it doesn’t require tools, equipment, or drugs.

- Least amount of people to die.

Cons

- Not practical to implement. Doctors must interact with patients. Power company employees have to keep the power running, grocery stores still have to operate. Unfortunately, the United States is not “Little House on the Prairie” where most people are isolated and can go long periods without social interaction.

- We’re not equipped for sudden and long-term isolation. How many people have food and water to last even one month?

- Economic reality. I don’t know about you, but most of my extended family live paycheck to paycheck. I’d predict most can get by for a month without working but after that, they will go out and do what they have to do to feed their families.

- Time line too long. After five months of total social isolation, the economy will ground to a halt and the resultant disaster will be greater that the pandemic. I’ll use us as a personal example. My boss is a compassionate person. She will hold on to employees for as long as possible. She cares for them deeply. But at some point, well before five months, without work, she will have to lay off everyone. This means no paycheck, no insurance, no nothing. That’s ten people. Those ten can’t pay bills or rent, or insurance. Now multiply that by millions of companies. Who’s going to pay for their healthcare? Without insurance who is going to pay the healthcare providers. Who’s going to keep the hospitals open without revenue? More will die from the economy disaster that the pandemic. Ultimately the social distancing plan would be a bust simple because people will run out of money for necessities and do what they must do to survive, i.e. go out and socially interact.

Plan B as advocated by the economists. This the rapid development of herd immunity. The idea being that they want the virus to run through the community as quickly as possible so that the numbers of infected and recovered people rise to a level that effectively gives the community a herd immunity. The point being that if enough people have and survived this virus, then the virus will die away because of the lack of hosts or the ability to effectively spread to non-infeccted hosts. Most economist think and health professionals believe this would take a month to six weeks. What are the pros and cons?

Pros

- At a mortality rate of around 2-3% and the short duration of the event would mean society as a whole would regain its footing by summer.

- As some scientist have suggested, the virus unlike others is genetically stable and once infected, most would people have lifelong immunity.

- This isn’t a pro per se, but Sweden is leading the charge with this approach. Curious how this will work out.

Cons

- A LOT OF PEOPLE WILL DIE. If 200 Million people in America get infected at least 5 million will dies. Most likely more, because they would be a certain percent that would have survived if they had life support.

- Social unwinding. I’m pretty sure we’ll see some horrific acts by people trying to survive and trying to save a loved one. It would not be pretty. I’m not sure we can protect those who need protection in the short-term anarchy.

- Healthcare system taking a big hit. It would years for the system to recover. Supplies would be exhausted, healthcare professionals leaving the profession. Hospitals close.

Plan C as advocated by the political leadership. This plan is hard to decipher but I think it is this. They take a little from plan A and mix it with plan B so that they can buy time (a month to six weeks). What do they hope to accomplish with this additional time? I think it is multi-layered. One, buy time to find a prophylactic treatment for the virus. They know there isn’t a cure, but maybe find something that can greatly reduce the hospitalization rate and be deployed in days or weeks. Apparently, there are several anti-virals that show promise and are already approved for human use by the FDA. Two, develop a deployable vaccine for emergency use within a month or two. I think we’ve all heard the steady drumbeat that it takes at a minimum of 18 months to develop and deploy a traditional vaccine. However, researchers have several novel vaccines in the works. They include genetic and rNA based vaccines. Both are quickly deployable and have little risk to people getting the vaccination. The million-dollar question is if they are effective. At least three candidates are in human trials now. We’ll have to wait and see. Three, test for the virus like hell, find the all the infected, and isolate them and their close contacts. This approach is working for Japan and Korea. We appear not to have the social discipline or capabilities to do that. Four, shore up our healthcare system to be able to withstand or at least blunt the onslaught of mass casualties. What are the pros and cons of plan C?

Pros

- We’re leveraging the ability and resources of all the smart people in the USA to find a workable solution within a month.

- Exploiting capitalism with vested interests. Its time for researchers and big pharma to now walk the walk. The first one with a viable treatment or vaccine wins the race and all the economic spoils that come with this. Money is an amazing motivator.

- Short timeline. If it works, we don’t suffer social or economic ruin.

Cons

- High risk approach. If we don’t find a workable solution in a month to six weeks, we’ve let the genie out of the bottle and it will be too late for plan A and plan B will be the default and with it comes all of plan B’s cons.

Optimism

What will work? Only time can be the judge of that. Contrary to popular belief, I’m an optimist. We as a species are resilient. I love and trust my fellow man. This pandemic is just another disaster in a long line of disasters we’ve had to endure. It just so happens to be our turn to be in the barrel. We may not be the greatest generation, but we’ll not only survive, but flourish. In these times I like to think what Teddy Roosevelt thought on being American: "Much has been given us, and much will rightfully be expected from us. We have duties to others and duties to ourselves; and we can shirk neither. We have become a great nation, forced by the fact of its greatness into relations with the other nations of the earth, and we must behave as be seen as a people with such responsibilities."

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