COVID-19 has killed a lot of people in the last couple of
months, it is killing people right now, and will kill more people in the months
ahead. It is an invisible enemy. We have two choices: we can follow the advice
of the experts or we can ignore them. If we follow scientific advice, fewer
people will die in the US.
Twenty plus governors chose to ignore the advice of
scientists, and continue to put their citizens at high risk. Some governors
acted quickly by shutting down their state. New York City put out the warning
early, and it still is suffering hundreds of deaths each day. It is hard to
comment on this epidemic without getting a bit wonky. Tolerance appreciated.
We know for sure that the virus spreads from one person to
another because of coughing, sneezing, or just breathing. The most effective
way to keep the virus from spreading is to keep people away from each other. Duh!
And yet, some governors and the national government’s strategy seems to be: “Let’s see how it plays out.”
The Governor of Florida refused to issue shelter-in-place
orders for the entire state until April 1st, when the warnings have been out
there since at least early January. His new order exempts religious services from
the stay at home order. In New Rochelle, NY the onslaught of cases was traced directly
to one infected person who attended synagogue one night. Nearly a third of the
cases in Sacramento County, CA are from members of one church. While it
canceled church services, it encouraged small group meetings in parishioners'
homes. On April 2nd, the Governor of Georgia announced that he was
closing down the state because he just learned, the day before, that the virus could
spread from one person to another. The Governor of Mississippi says his state
is not China and he will not close it down like a communist country. Devin
Nunes, a reactionary member of congress from California, went on Fox News to
state that closing schools, restaurants, and bars was ridiculous and that we
should get people back to work, and kids back in the classroom. Who are these
people?
President Trump
extended the call for social distancing until the end of April. He took the
recommendations of the scientist who advise him. Their advice is based on their
years of experience and the predictions of various statistical models at their
disposal. Obviously, the CDC and other governmental agencies and the military
have great modeling expertise. But the most frequently mentioned model was
developed by the University of Washington’s Institute for Health Metrics and
Evaluation (IHME)[i].
The model assumes that if every state in the Union enforces a strict shelter in
place rule, closes all restaurants and bars, and closes all non-essential
businesses, it will reduce the death toll. That is if we did everything
perfectly. We haven’t!
Because the Governor of Florida didn’t close all non-essential
businesses, order restaurants, and bars closed, close the beaches, or enforce a state-wide
shelter in place rule, the model predicts that the number of cases and deaths
will peak on May 3rd. It predicts that the state will be short 2,000
ventilators, nearly 1,000 ICU beds, and it points toward 179 deaths on that one
day, and 7,000 souls lost by August 4, 2020. Mississippi is projected to have
40 deaths on April 22nd, and over a thousand deaths by August 4th.
Georgia cases are predicted to peak on April 25th when the state
will be short 1,224 ventilators, 900 ICU beds, and will have 96 deaths that
day. It predicts 3,232 deaths by August 4, 2020. The best news we can hope for
is that the model is inaccurate on the high side.
Another way to look at it is that Florida will have one
death for every 3,000 people in the state, Mississippi with have one death for
every 2,987 people. Georgia will have one death for every 1,234 people. California,
which shut down early, will have one death per 7,750 people in the state.
States that took early action should be more successful flattening the curve of
virus cases and deaths.
This epidemic lays bare the underbelly of an inadequate
national healthcare system and congers up discussions about the role of
government at the national and state levels. Difficult as it may be to imagine,
it is not a time for political finger-pointing or blame gaming. That can wait a
few months.
The virus hit Wuhan, China with a bang last year. After
some fits and starts, the government shut down the city of twenty million
people. The US Army, the CDC, NIH, and other medical groups warned that the
epidemic was coming. They were basically ignored for months. Most immunologists
tell us that when a coronavirus hits, it needs to be dealt with quickly and
with a shock and awe strategy at the outset, not months down the road. We didn’t
go into immediate shutdown and the virus spread. The President took some
important first steps, such as closing the borders to people from China, and
then many parts of Europe. But there still is no national strategy to fight the
spread of the virus. If there was ever a time when we needed a countrywide strategy,
it is now.
While people are sick, hospitalized, and dying, what are
the rest of us to do? If we ignore the science we put ourselves in jeopardy. If
we follow the science, we shelter in place. What does that mean? The CDC has
posted its recommendations. CNN has an informative site on how to
coronavirus-proof your home. [ii]
If you are over 70 years old, stay in your house, period.
Everyone else should stay at home as well if they are not required to be at work.
It is suggested that every house has a disinfecting station outside or in the
garage. We use the garage. Anything coming into the house is first wiped down
with a Lysol sheet. If it a box from Amazon, it is sprayed with Lysol. Each
package of food is wiped down before being taken inside. If you have to go
shopping for food or other items, designate one person to be the shopper. It
reduces the opportunity for the virus to infect the second person. If you must
go outside the house, wear plastic gloves and wipe the handles of the shopping
cart. Wipe your credit card or ATM card after each use. Wipe down the inside of
the car after you use it. Try to shop at stores that will take an online order
and put it in the trunk of your car so that you don’t come in contact with
people. Don’t let anyone in your house that doesn’t live there, even your kids
and never your grandkids. The list of suggestions goes on. It feels like
overload. It is the minimum we should be doing, according to the CDC. Dr. Fauci
said that if at the end of the next two or three months we think that they
asked us to do too much, and we are still alive, their request was just about
right.
The clubhouse in our development is closed, the pool is
closed, the gym is closed, the library is closed, the game room is closed, all the meetings are canceled. The local Senior Center is closed for another month or
two, at least. All schools are closed for the rest of the year. All the local
parks are closed as well as all the equipment in them. All of the state parks
are closed as well as the parking lots. The beaches are closed. The streets are
pretty much empty. Doctors and other healthcare workers are available by
phone, email, or Zoom. It goes on and looks like it might last another couple
of months.
We can talk about economics later. We can talk about
the response at the county, state, and national level later. We can talk about
job loss later, We can talk about the six million people who lost their health
insurance in the last two weeks. Right now, our primary job is to not be one of
the 240,000 potential deaths between now and August.
