 |
| An old photo looking back at NYC, from a train headed north. My heart goes out to you, New York. Every storm runs out of rain. |
***Post
updated 4 April 2020
***Disclaimer:
I am neither a Physician nor an Epidemiologist, but I am a scientist and I can
read.
Like many of you, I wake up each
morning and ask, “How did we get here?” Things seemed to change overnight,
and yet they didn’t. There were plenty of people trying to sound the alarm, but
again people have refused to listen to science, and instead trusted their
leadership, and outside a few bright spots in this – folks like Massachusetts
Governor Charlie Baker, Boston Mayor Marty Walsh, New York Governor Andrew Cuomo, LTG Todd T. Semonite, and Dr. Anthony Fauci – there has been a failure of leadership at practically
every level, and a delay in taking action.
***
There
are a couple of really good articles that detail the timeline:
Abutaleb,
Yasmeen, Josh Dawsey, Ellen Nakashima, and Greg Miller. 2020. The U.S. was
beset by denial and dysfunction as the coronavirus raged. The Washington Post.
4 April 2020.
Schumaker,
Erin. 2020. Timeline: How coronavirus got started. ABC News. 25 March 2020.
***
All through January and February,
there were the continued reports out of China, and the extreme efforts taken
there to try to contain the virus. But, as early as 31 January, the first two
cases had been confirmed in Rome. And by 1 February, the Diamond Princess
cruise ship reported its first confirmed case, which would lead to the
multi-week saga of the quarantined passengers on the ship docked in Yokohama,
Japan. It had gotten out.
16
February 2020. The US
Embassy announced they would bring home the US citizens onboard the ship for
treatment and quarantine.
25
February 2020. In a
press conference, Dr. Anne Schuchet from the CDC said:
“Current global circumstances suggest
it’s likely that this virus will cause a pandemic. It’s not so much a question
of if this will happen anymore, but rather more a question of exactly when this
will happen, and how many people in this country will become infected, and how
many of those will develop severe or more complicated disease.”
Alex Azar, Secretary of Human Health
Services stated:
“Abroad, this is spreading quite
rapidly. In the United States, thanks to the President and this team’s
aggressive containment efforts, this disease as Dr. Schuchet said, is contained. As we’ve always said, we
expect to see more cases.”
By this time, Italy had recorded 10
deaths and a total of 322 cases, and Iran had experienced a second cluster.
26
February 2020. First
case of locally transmitted COVID-19 in California, unrelated to foreign
travel (Schumaker, 2020).
28
February 2020. President
Donald Trump, speaking at a campaign rally in South Carolina, called the
Democrats’ criticism of his coronavirus response their “new hoax.”
True, the wording in his speech is
ambiguous, and it’s not clear whether President Trump was saying that the
coronavirus itself was a hoax, or the fact that Democrats were talking about it
in their speeches and “politicizing” it. Either way, the problem is that words
matter. President Trump’s blatant disregard for the potential hazard had a
grave trickle-down effect in Government. For a president who values loyalty
above all else, everyone knows that disagreement is not an option, if one wants
to stay in the game.
President Trump’s early dismissal and
false reassurances that the coronavirus was contained and would go away set the
wheels in motion allowing continued spread, in the absence of rigorous testing,
which was not available, and delayed action across the country at all levels of
Government.
For example, New Orleans Mayor LaToya Cantrell said they never
considered canceling Mardi Gras because the message from the Federal Government
was that the virus was contained, and there was no warning otherwise (Finch,
2020; Montgomery, Cha, and Webster, 2020). New Orleans has become a new hot
spot due to revelers unwittingly spreading the virus there. Mardi Gras (Fat
Tuesday) was on February 25th.
Later that same week, in a similar
way, Biogen proceeded with its conference in Boston 26-27 February, leading to
a cluster of cases in the Boston area that grew from three cases to nearly 100,
and likely continues to spread.
The following series of video shows the
progression of President Trump’s messaging, saying that it would go away, “like
a miracle,” and that everything was well under control.
6
March 2020. President
Trump visited the CDC and said that “anybody that needs a test can have a test,”
and Alex Azar promised “up to 4 million test kits available in the United
States by the end of next week.” It’s the end of March, and we’re still
waiting.
11
March 2020. WHO
declared a global pandemic. That night, President Trump made an Address to the
Nation, and appeared to finally grasp the severity of the situation.
12
March 2020. US
declared a National State of Emergency.
What changed? A lot of people theorize
that someone finally got President Trump’s ear, and showed him the predictions scientists
were making about fatalities and number of patients requiring advanced care,
such as ventilators.
16
March 2020. The
Imperial College Report was published (Booth, 2020; Ferguson, et al., 2020). Authored
by Neil Ferguson’s group, the report predicts death rates, based on modeling
the effects of mitigation, virus transmission, and severity of cases. In some
ways it’s not so different from modeling the flow of groundwater through a
porous media, such as a sandy aquifer. In this case, the model requires
knowledge of the virus properties, and how the population helps or hinders its
transmission. By social distancing, we can be more like clay, and less like
sand and gravel, and slow the flow.
Here’s a link to the report, and you
can read it for yourself.
It is painfully ironic that Neil
Ferguson himself recently contracted the virus, and I wish him well as this
crisis now hits close to home for him.
I am also grateful to all the
healthcare workers and all those on the front lines – grocery store and
restaurant workers, pharmacies and delivery persons – for taking care of us,
while we stay home.
***The
President presented predictions on possible number of fatalities this past week
on 31 March 2020, as if it were new news, but the math has been out there
literally for months. The numbers out of China showed a fatality rate of about
2 to 4 percent of diagnosed cases. And we’ve been told that we can expect that
eventually 40 to 70 percent of the Earth’s population will eventually contract
the virus. So, let’s say the US population is 327 million, and to make the math
easy, let’s just call it 300 million, and let’s say one third of the population
gets infected, i.e., 100 million people. Eighty percent will have mild symptoms
or no symptoms at all, and will probably not even be tested. The other 20 percent
will have more severe symptoms, and these cases probably account for the bulk of
the diagnosed cases in the US right now (test positive). For these 20 million cases,
even with a one percent mortality rate, this would result in 200,000 deaths. If
two thirds of the population gets it, just double this number. If the virus is more
lethal, the numbers could double or even triple. These are just back-of-the-envelope
calculations that people were doing even way before the Imperial College report
came out.
***
The numbers continue to climb. The US
has over 100,000 confirmed cases, and 2,000 deaths. Massachusetts has over
4,000 cases, and 44 deaths, when it suffered its first death only one week ago.
The true number of cases is likely at least twice that, if not tenfold, given
the limited testing. For every confirmed case, there are probably at least a
half dozen or more cases where people had mild symptoms or no symptoms at all.
Which is why for now we have to act as
if any one of us might have it.
***
A
week later (4 April 2020) and the US is approaching 300,000 cases, and over 7,000
deaths.
***
It must be hard for places in the
Midwest and elsewhere that are a week or two behind us. New York City is a week
or two ahead of us, and offers a chilling preview of what might be to come.
There is hope.
People who have already had the virus
might have immunity, we’re told. Imagine what you could do, if you had
immunity. We could go where others dare not tread. In addition to increasing
testing to determine who has the virus, it may be equally if not more important
to test to determine who has immunity. Ironically, as I was scratching this
very thought out, pencil on paper, the CBS
News Sunday Morning show aired a segment by Dr. John LaPook this morning,
suggesting the very same thing.
Because, eventually there will be a
vaccine, and eventually the virus will run out of new victims, just as every
storm runs out of rain.
Song
for the day: “Every Storm (Runs Out of Rain),” by Gary Allen.
#MoreTestingLessSpreading
***
A
big THANK YOU to Governor Charlie Baker and Robert Kraft, for using the Patriots
plane to fly over a million N95 masks back from China in an extraordinary humanitarian mission. THANK
YOU!!!
***
References
Booth, William. 2020. A chilling
scientific paper helped upend US and UK coronavirus strategies. The Washington Post. 17 March 2020.
Ferguson, Neil, et al. 2020. Impact of non-pharmaceutical interventions
(NPIs) to reduce COVID-19 mortality and healthcare demand. Imperial College
COVID-19 Response Team. 16 March 2020.
Finch, Chris. 2020. Video: New Orleans
Mayor Cantrell says city saw no reason to cancel Mardi Gras, needs medical
supplies. Fox8. 28 March 2020.
LaPook, Jonathan. 2020. Dr. Jon LaPook
on the value of antibody tests for past coronavirus infection. CBS News Sunday Morning. 29 March 2020.
Montgomery, David, Ariana Eunjung Cha,
and Richard A. Webster. 2020. ‘We were not given a warning’: New Orleans Mayor
says federal inaction informed Mardi Gras decision ahead of covid-19 outbreak. The Washington Post. 26 March 2020.
Schumaker, Erin. 2020. Timeline: How coronavirus
got started. ABC News. 25 March 2020.
©
2020 Rosemary A. Schmidt
Rose
Schmidt is the author of “Go Forward, Support! The Rugby of Life” (Gainline
Press 2004). The views expressed herein are solely those of the author, and do
not reflect the views of any other agency or organization. Use of individual
quotes with proper citation and attribution, within the limits of fair use, is
permitted. If you would like to request permission to use or reprint any of the
content on the site, please contact me. Twitter: Rosebud@GainlineRS
Mission
Statement: To Educate, Inform, Entertain, Inspire, and Open Minds.
(E.I.E.I.O.M.)
No comments:
Post a Comment