Category Archives: Later, on health

Is All This Really Happening?

As April began, more than 277,000 people had tested positive for the coronavirus and 6,600 people had died from COVID-19 in the United States. Worldwide, deaths now exceeded 57,000.

It was estimated that 80 percent of the people infected with the virus would recover without needing special treatment, but the other 20 percent would become seriously ill and many would require hospitalization. Too many would die a horrible death. Unable to breathe on their own, they would be put into an induced coma, intubated and hooked to a ventilator, with the weak hope that their ravaged bodies would still be strong enough to fight off the virus.

As an “older person” (over 65), I was at higher risk of severe illness if the virus were to get to me. The last place in the world I wanted to be was in a hospital. Fortunately, I did not have any of the underlying medical conditions that would make a person even more vulnerable to life-threatening illness. Still, it was unnerving to be an older person–a cohort that some whippersnappers called “elderly.” Good God.

Our best defense was to hide from the virus: stay home, stay safe. When it was necessary to go out, we were told to practice “social distancing”—keeping at least 6 feet away from other people. We were advised to wash our hands a lot. Our hands could betray us by straying to our face, mouth and nose, possibly transporting a little gang of coronaviri to our respiratory tract where it would soon grow into a larger gang and quickly into an army.

Whether we should wear home-made cloth facemasks was a hot topic. The answer was complicated. The mask would not protect the wearer from the tiny virus itself, which could penetrate most fabric face coverings. But a mask would filter moisture droplets exhaled by the wearer, droplets that could carry the virus to another person. You could be symptom-free and yet have the virus and potentially spread it to others. Wearing a mask was less about self-protection and more about showing care for other people.

Because the country was not prepared for a pandemic, masks that could block the virus (N-95 masks) were in short supply, and available N-95 masks were rightly being reserved for hospital personnel, who were risking their lives to treat COVID-19 patients.

We did all of the things that we were advised to do. In the past month, I had left the house only to go to the grocery store (once a week) or to take walks (daily). I felt that maintaining my health and strength was my last best defense against the virus, and daily walks were part of that health-maintenance regimen. I rarely encountered other humans on my walks, and I was careful to social distance from them.

My isolation at home was not total. I was blessed to share the solitude with my wife. We were thankful for each other’s company, and spending time away from other people was not a big change in our life-style. And yet, isolation was more difficult than it looked. On the surface, physical isolation was not difficult. Our home was our refuge, but I felt besieged. I could not psychologically isolate.

I could not make it through a day without knowing the latest coronavirus news. What the virus had done to the world was frightening. When the pandemic would end was unknowable, and the end would not come any time soon. I knew that it was months away. Estimates were that it would be at least a year before an effective vaccine would be available.

The Institute for Health Metrics and Evaluation at the University of Washington estimated that the “end” of the “current wave” of the pandemic in the United States would come in early June, defining the “end” as the soonest that carnage from COVID-19 would drop below 10 deaths per day. Meanwhile, we would reach the peak of the wave (3,130 deaths in a day) on April 16.

The IHME projections assumed that everyone would maintain recommended social distancing and other precautions against spreading the virus. And there could be a second wave ahead: “By end the of the first wave of the epidemic, an estimated 97% of the population of the United States will still be susceptible to the disease, so avoiding reintroduction of COVID-19 through mass screening, contact tracing, and quarantine will be essential to avoid a second wave.”

The IHME estimated that 81,800 people, possibly many more, would die in the US by the end of the current wave.

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The Trump Coronavirus Fake-out

The “president” has taken the nation on a long down-escalator ride to reverse the progress of the last seventy years—the post-World War II era, roughly speaking—dismantling, for example, progress in civil rights, progress in environmental protection, and progress in foreign alliances and diplomacy. 

Then, along came the coronavirus. After complaining that the media were hyping the coronavirus threat—another “hoax” to make him look bad—he ordered travel restrictions on January 31, including banning foreigners from entering the US if they had recently traveled in China.

Aside from the travel restrictions, Trump took no action to prepare for a coronavirus outbreak in the US. Instead, he continued to downplay the threat, repeatedly saying it was “totally under control.” On February 26, he said there were only 15 people infected in the US and they were all getting better: “within a couple of days” it would be “down close to zero.” The next day he said: “It’s going to disappear. One day—it’s like a miracle—it will disappear.”

The president objected to allowing the passengers on the cruise ship Grand Princess to come ashore in San Francisco because that would raise the number of people in the US infected with the virus: “I like the numbers being where they are. I don’t need to have the numbers double because of one ship that wasn’t our fault.”

On March 11, the World Health Organization declared the coronavirus had become a pandemic. There were more than 118,000 cases in 114 countries, and 4,291 people had died from the disease, “COVID-19.”

The US lagged behind other countries in testing for the novel coronavirus. As of March 20, the US had performed about 300 tests per million population, far below the rates of testing in other countries. In the same time-frame, for example, South Korea had performed over 6,000 tests per million, Australia more than 4,000, Italy more than 3,000, Germany more than 2,000 and the UK more than 900 [data from the website Our World in Data].

A new vocabulary developed to describe our plight. We were advised to “shelter in place,” to practice “social distancing” and to “self-quarantine.” No one could say how long these measures would be in place. There was no vaccine and there were no anti-viral drugs known to be effective in treating COVID-19. Development and testing of a vaccine was expected to take 12 to 18 months.

On March 13, the Dow Jones Industrial average closed at 23,185.62 after a record high closing of 29,551.42 set on February 12. Ten days later, on March 23, it closed at 18,591.93, down by 20 percent.

The loss of shareholder wealth can largely be attributed to the coronavirus and public health measures that were put in place to “flatten the curve” (reduce the rate of infection). Advice to avoid public gatherings of ten or more people, to practice “social distancing” (keeping at least six feet away from other people), and to stay at home unless going somewhere was absolutely necessary, resulted in an abrupt drop in consumer spending with no end in sight. Stock values plummeted as investor uncertainty prevailed, but only by flattening the curve could we hope to keep hospitals from being overwhelmed with critically ill COVID-19 patients.

After Senate approval of a $2 trillion spending bill (including a $500 billion loan fund for big businesses), the Dow spiked on March 26 to close at 22,552.17, but the market was likely to remain volatile in the months ahead as the virus continued to ravage economies worldwide.

It was nearly impossible to take it all in. It was disruption on a global scale, something that we had not experienced before in my lifetime. In an odd way, our voluntary isolation brought us closer as a human family as people around the world on every continent faced the same risk of infection from the same microscopic lethal army. There was no effective weapon anywhere in the world to combat the virus. For now, the only effective strategy was to isolate ourselves. We could reduce the risk by denying the human hosts that the virus depended on to propagate and spread.

On March 16, the Trump administration announced a 15-day plan to address the spread of the virus, including advising “older persons” and people with underlying health conditions to stay home and away from others. The administration advised everyone to avoid gatherings in groups of more than ten and to avoid discretionary travel, restaurants, bars, and visits to relatives in nursing homes.

Just 7 days later, in a midnight “tweet” on March 23, the president declared: “we cannot let the cure be worse than the problem itself.” Later that week, he told Fox News: “I think Easter Sunday [April 12] and you’ll have packed churches all over our country, I think it would be a beautiful time. And it’s just about the timeline I think is right.”

Of course, it was too early to know whether the administration’s earlier social distancing guidance was having the desired effect of slowing the spread of the virus. The incubation period of the virus (the period between becoming infected with the virus and the onset of symptoms of COVID-19) could range from 2 to 14 days, according to the CDC. The reported number of COVID-19 cases in the US had grown tenfold from 4,226 on March 16 (when the guidelines were announced) to 44,183 on March 23 (Trump’s tweet-date).

Whether the cure is worse than the problem depends entirely on what you perceive “the problem” to be. The president, it seemed, had concluded that COVID-19 was no worse than seasonal flu: “we’ve never closed down the country for the flu.” If you think it’s no worse than the flu, then maybe you can believe that it would be “beautiful” to pack churches for Easter with coronavirus spreaders.

The coronavirus was not the flu. A presidential proclamation would not make it so. True to form when confronted by facts incongruent with his imaginary world, the president tried to rebrand the coronavirus as fake news. The problem could not be worse than the cure. He would bamboozle his base but he would not be able to fake out the virus.

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