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COVID-19: Revising my Optimism Somewhat

Thank you to knowledgeable readers, particularly medical doctors, who have given me sound perspective over the past few days—much appreciated!

Looks like I will be living in my van for at least 2 more weeks and maybe another month! I have zero risk of infection except when getting supplies every 10 days or so.

Asking around, and ready to be proven wrong by facts, I nonetheless retain my optimism that in ~2 weeks (by mid April) medical professionals will have at least some hints at where we might go from here in terms of drugs to treat COVID-19, as well as faster and hopefully more accurate diagnosis, along with improved triage and initial treatments.

The triple-drug treatment involving hydroxychloroquine might be a dud, might be premature optimism. Apparently there are more than a dozen protocols being tested with many different treatments. Of those, if only one of those treatments works well (and is widely available), we are in much better shape. Two weeks should tell us something, given the rapid progression of the disease.

One big problem I see in managing the whole thing is that apparently we do not have a test for infected/recovered/virus eliminated from the system people, which would require some kind of antibody test. So we do not know who is “safe” and we do not even know for sure if re-infection is possible. Not good.

While people are dying from COVID-19, having everyone isolate for months will be a disaster with repercussions for years to come and cause deaths by various other mechanisms. I hope the experts can figure out the tipping point between more versus less harm as infections rise. If there is immunity, I wonder if the requirement to wear a visible “I recovered” badge might be socially useful for getting things functioning again.

A light at the end of the tunnel is badly needed. And it doesn’t matter much whether the optimism is unfounded for 'A', should 'B' comes along instead and prove-out as a solution.

Various thoughts

  • I have myself and my wife and my parents all in the 'kill zone' and so a lot on the line. I know people that if lost would shake me badly. So do you all. I’m doing my best to talk about this whole thing in my own way, so I hope that “mind reading” my thoughts and intentions will be suspended among my readers, and my good intentions taken as default. I will be wrong about some (maybe many) things, but my heart is in the right place.
  • Would it make sense on a strictly volunteer basis for young low-risk people to volunteer to travel to special tent-city “infection camps” of 10K people or so in isolated areas to gain immunity for ~1 month and thus get them recovered and non-infectious and then back to work (wear a special badge of honor?) quickly so as to protect the rest of the country from transmission vectors and to have able-bodied workers? Terrible idea? Probably, but I don’t know but I wonder if such ideas are at least considered by experts.
  • Public policy is incoherent with respect to those most at risk. It might be time for those at high risk to be handled specially: strict limitations on movement and exposure along with special services like home delivery of all necessities so that those at risk need not expose themselves. Good idea or bad? Not for me to say, but I do know that we cannot afford to have too many at risk people get seriously ill, or the entire care system will collapse. If you are at low risk, see what you can do to help your neighbors who might need help, such as getting groceries or medications or whatever, all with appropriate protective gear of course. I don’t understand why the government is not directly forming such groups, or some private company, like Apple or Google or whatever.
  • As an entirely apolitical question: it good or bad for a President (any President, set aside politics!) to offer unfounded optimism, e.g., “encouraging results” that remain entirely unproven? Is it better to remain non-committal or even to express alarm/negativity? Or just shut up and let doctors communicate, most likely in terms most people cannot understand? I tend to be in the camp that optimism is better, even if it doesn’t pan out with 'A', and 'B' arrives to the rescue instead. I don’t know what is best, but I doubt that anyone else knows either. I do know that mass panic and social breakdown are huge risks if people come to believe that all that is left is save-yourself mentality. It is critical that the national psychology be strengthened, as in “we are all in this as a team and there is hope”—that’s what I expect from our leaders at every level. The opportunity for shared purpose is massive, all-important, and could end up being tremendously constructive.

I’m considering stopping these posts on COVID-19—I have to ask myself if they are helping anyone or just one more voice in the wind. While nearly all readers have been supportive, there are some not so nice emails each day (usually only one), but that’s one more than I want in my day.

Jan-Dieter S writes:

Please do not give in to them bloody ninnies.

Thanks to you, and to your early alerts, my family was able to acquire the small amount of N95 and N100 masks we needed, just in time. Not only that, you alerted us to the difficulties of dealing with the bloody China virus. You do have your heart in the right place, absolutely no doubt about it.

These are indeed very trying times; the political apparatus (the DC swamp) is not going to give up without a (very dirty) fight.

This is the ONE battle we MUST win. Hang in there. As an aside - the one number (or metric) we should be looking for, can be derived from published data (like what Johns Hopkins publishes): There will be a point in time when the total number of virus related deaths (normalized per 100k population, or whatever) will indeed level off (i.e., have a negative first derivative) - on a state-by-state basis, and also nationally, at some point in time.

Unfortunately, nobody seems to be publishing time series right now (not sure why), even though those would reveal when we do reach that tipping point. If and when we get there, we know that we have either reached herd immunity, or the medications that we have come up with in the meantime are getting serious traction. This IS the one important turning point that we are looking for. And if and when we reach it, hold on to your breaches: At that time, the U.S. stock market will come roaring back, faster and stronger than what we have seen before, ever.

DIGLOYD: the lies about masks not being useful for the public continue to this day (the WHO is to be condemned for this). But I urge people not to hoard masks as they are indeed in very short supply (not that it is possible to even find N95 or N100 masks these days).

The virus has to be transferred somehow. It’s not magic. Surely that is by contact e.g. hands touching things, then hands to face, along with airborne transmission. I’d bet that 99% of transmission is by such means.

If everyone wore a mask and gloves in all places where people interact, I’d bet that the rate of infection would drop precipitously. So why are we not requiring gloves and masks for EVERYONE in ALL places that people share/visit?

It does NOT take a doctor to understand that a cough or sneeze blocked by even a handkerchief keeps huge numbers of particles from entering the surrouding air. It does NOT take a doctor to understand that an infected person touching a surface contaminates it. It does NOT take a doctor to understand that wearing a mask means that face touching is greatly reduced (mask blocks it). Or that hands, gloved or ungloved, are far likely to carry the virus and that gloves can be changed a dozen times day. When I went shopping for supplies, I used new gloves at the grocery store, new ones at the gas station, etc. The risk for me acquiring or contaminating a surface are thus greatly reduced.

I’d bet that even a poor quality mask (e.g., a surgical mask) would block nearly all airborne transmission, because coughing and sneezing would block droplets from getting anywhere.

Tipping point: I fear that because of the lack of basic precautions (masks, gloves) that at least in the USA we haver a long way to go before this is reached.


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