A Sunday Evening COVID-19 Update
I’m trying not to spam anyone or make anyone panic or overwhelm people. But there is so much information floating out there right now that I want to keep my readers up to date with the most timely and factual information. I also want to make sure everyone gets this and not just subscribers. But, remember that I’m now limiting daily emails to just subscribers. So if you want all the deep dives, information, special podcasts, etc., click the subscribe button.
The US infection of confirmed cases has crossed 3,000 cases and stands (at this writing) at 3,244 and 62 people have died. Just as a snapshot, I’m in Georgia and last week we had 1 case. Now we have over 100. Just yesterday there were only 70 cases and the day before that there were 40. That gives you a sense of how this is rapidly increasing in spread. Also, more testing is happening so we should see the numbers going up considerably.
In Europe, way more people under the age of 60 are being hospitalized than anyone expected. It is very clear now that China did lie. While the virus is more deadly for those over 60, it is having effects on young healthy people.
That Flu Bump
In major urban areas like New York and Los Angeles, hospitals are seeing a spike in flu-like symptoms among those testing negative for the flu.
The data is now sufficient to conclude the virus is spreading in communities and we are only just now getting out enough test kits to test for it.
Honestly, at the point, the media obsession with test kits is just to get numbers. We are past the point at which anyone needs to be tested. Given the spread rate, if you are having flu-like symptoms and do not have the flu, there are very good odds that you have contracted COVID-19.
Ibuprofen
While a bit hesitant to pass this along, there is growing evidence that ibuprofen as a fever reducer may actually make a COVID-19 infection worse. The French Health Minister put out a tweet that cortisone and ibuprofen are doing more harm than good. A Bulgarian media outlet claims the tweet was fake, but France stands behind it.
The medical journal Lancet is reporting similarly that the anti-inflammatory effects of ibuprofen and cortisone may negatively impact recovery. Tylenol is best, but monitor its use to avoid liver damage.
That H1N1 Comparison
A lot of people are talking about that comparison. 68 million people got it. But it had a mortality rate of less than .3%. Also, it was similar enough to seasonal flu that most infected people had bodies that could create an immune response.
COVID-19 is new and no one on planet earth has an immune response. Also, 68 million got H1N1 over an entire year. We’re at 3000 cases of COVID-19 and just yesterday we were at 1,700 cases. If it doubles daily as some epidemiologists worry, we’re just over a week or so away from more than a million people getting it. With a 1% mortality rate, COVID-19 will kill more people while infecting fewer people than H1N1.
But there’s hope
People’s behavior is changing. Governors are ordering businesses to shutter to keep people away from crowds. As people socially distance, they slow the spread of the virus. Here is a great, great resource from the Washington Post explaining it.
Bottom Line
The government wants you to stay home not to stop the spread of the virus, but to slow the spread of the virus. This is about “flattening the curve.” At the present rate of infection — a doubling of the virus every 24 hours — we do not have enough hospital space for those we know will need it. We need to slow the transmission rate so people can recover as new people get infected.
In Italy, roughly 50% of patients need hospitalization. In most places, it is 10% need hospitalization. At the present rate of infection, the United States will be out of hospital capacity in the new few weeks if people do not change their behavior.
It is worth noting that the data from Italy is horrifying and even in other European countries hospitals are already being overwhelmed because they did not take rapid efforts to flatten the curve of infection rates.
I realize some of you are reading this and thinking it is not that bad, or you have a relative who works in a hospital with no cases, or we cannot believe anything we hear. I get that. But get this — the CDC has accurately modeled the spread of the virus and has not yet been wrong. The difference between you taking one for the team and staying home versus you ignoring the advice and hanging out in crowds is the difference between a few hundred dead and a few hundred thousand dead.
Just because it has not impacted you and your community yet does not mean it won’t. It doesn’t mean it will either. But the experts who have been modeling this have been spot on so far. So hunker down for the next couple of weeks and get to know your family better.
This is a sobering piece. We have been in Honolulu since Feb 24, having come here to help our daughter, her husband who is a Special Operations officer and our three grandkids prepare for their next move to Australia where they will be stationed in Canberra. They don’t live on post but up in one of the neighborhoods overlooking Pearl Harbor, and pretty much the week after we began to be concerned about crowds of tourists, given that Hawaii is the gateway to and from Asia to the East and the Western front door of the US. Here you realize very quickly that basic supplies can disappear fast and none will be coming in on a regular basis after a point. Not everyone can leave but our son in law has ordered us all off the island and back to the mainland where health care, a reasonable supply chain and isolation on our farm in northeast Georgia are available to us. So we are leaving tomorrow and will be home Tuesday morning and happy to be back. Preparation is key and denial of the potential for hardship is foolish. Healthy at the moment a hoping to stay that way.
Based on the WP simulation, the best strategy is probably to maximum social distancing along with quarantines of regions with high infection rates, as they are not mutually exclusive. China stopped its exponential rise with its quarantine at around 80K patients - and the simulation shows similar results. South Korea stopped its exponential rise by large scale testing allowing separation of infected patients, which is like quarantining. A combination of these strategies is what is most likely to lower the peak to its minimal level.
One area of disagreement I have with Erick is that both Italy and the US have an average death age of 81 years (as of about a week ago) and that is the main risk age for the virus. Corona is certainly not a disease that infects only the elderly, but it is far more severe for elderly patients and those with weakened immune systems. That is why a large number of US deaths are from a single place, a Washington-state nursing home, and a large percentage of both staff and patients become infected.