There seem to be two groups when it comes to Covid19. Group A thinks it’s no big deal. That the country is overreacting to a virus that is like a regular flu for 85% of the population. The death rate is between 1% and 2%, which doesn’t seem that bad if we don’t investigate it further. And besides, not that many people have Corona Virus. Group B is the opposite. They believe that we need three months of toilet paper, food, and water and need to hunker down with no contact with another human for that entire time.
Up until yesterday morning, I leaned towards Group A. I thought that the most at risk should self-isolate but the rest of us could go about our regular business. We went to small social gatherings over the weekend. We were dumb. Many medical professionals I know were leaning towards Group A, so certainly I was right. Then I focused on the numbers. Last night I researched the numbers and decided I am actually in Group B now.
I spent most of the day yesterday moving Taryn out of her dorm. It was a busy place. We hand sanitized and washed our hands, but it felt wrong to be around that many people. That led me to search out numbers based research. I like numbers. Numbers are unbiased and generally don’t lie. And many medical professionals are not numbers people, which is why some have been leaning towards group A. Truthfully, my medical friends are split roughly the same as my non-medical friends. It’s just that more people ask the opinion of my medical friends. And right now, it’s a numbers thing. You would be better off asking my math friends than my medical friends.
The current estimate is that the number of cases doubles every three to six days. That’s a wide variation. The six day model stretches the peak of the curve (the most cases) out about two months. The three day model is half that and much more grim. Everyone that I know in both groups has agreed that testing is vastly underutilized and there are actually many times the reported number of cases in the US. I personally know of two individuals that should be tested but can’t seem to get tested due to limited availability of testing. One is my friend’s elderly mom who is currently battling pneumonia. While she doesn’t live in a retirement community, she lives in a condo that has many elderly residents. Maybe we should know why she has pneumonia so we can reduce exposure in that environment. The other is a son of a medical professional. He has been sick for a while, but has tested negative for influenza A and B as well as strep. His mom wants him tested. She works in cardiac care at a local hospital. Perhaps we would want to know why this boy is so sick.
We need to look at the right numbers. We need to focus on the 15% that require hospitalization. The US may reduce that percentage due to better air quality and fewer smokers than other countries, but by how much? My research is limited, but I try to find credible sources that are willing to attach their name to the article. Using the model where the number of cases doubles every three days and 15% require hospitalization, our hospitals will be working at capacity in roughly two weeks. In four weeks, they will be working out of tents in the parking lot because the hospital is full. Maybe we have avoided that model by closing schools. But if we don’t start enforcing stricter self-controls on distancing ourselves from others, we are only stretching out the inevitable because we are still in contact with far too many people. Here is the basic breakdown if it doubles every three days:
There are 10 three day periods in a month. So that means that it will double 10 times, so the multiplier is 2x2x2x2x2x2x2x2x2x2 or 2^10 (which is 2 to the 10th power), which is 1024. In this model, that is the 1 month multiplier. If I were to estimate that there are 5 current cases in my area (Say Valparaiso – I personally believe this is conservative), then in a month, there will be 5 x 1024, which is 5,120. If I conservatively estimate that 10% need hospitalization, that is 512 people. The Italy model has 15% needing hospitalization, but that may be high for the US. So, in the next month, there will be 512 individuals needing hospitalization in Valparaiso (not including the surrounding communities). The TOTAL beds available at the two hospitals that service Valparaiso is 452. Hospitals run at around 65% occupancy rates in the US, which means that there are only 158 hospital beds available on any given day. I understand that the 512 will be over a month, but the peak will be at the end of the month. So, on a conservative hospitalization estimate, we can’t do it. I haven’t even addressed the number requiring ventilators, since I don’t have the number of ventilators available in our area. If it doubles in six days instead of three, this model spreads out over two months, which is better for us, but still not great.
Another problem with the beds being full is that they are not available for other emergencies. If your family is in a life threatening car accident, there may not be a hospital able to handle your injuries. In addition, medical staff will be stretched thin, working long days. And medical staff will get sick, requiring long absences. This is what is playing out in Italy.
The best way to mitigate the numbers is to utilize social distancing. That will slow the spread and enable hospitals to handle the load. Closing schools is a great start. I think that one decision will already have an effect on the numbers. But we must limit non-essential movement and interaction.
I must present the alternative model that Travis mentioned to me this morning. He said that maybe it has been around much longer and far more people have had it and are now immune. Then the numbers plane out and the curve is automatically lower. I want to believe this, but I have a hard time accepting that we are ahead of Italy, when this started in China. I think that the numbers of cases with pneumonia in hospitals would have hit the news sooner.
So, there is my boring blog for today. I am sorry it is so late, but it took longer to write. I had to say why I changed my mind, because to me, I need more of you to change your mind to avoid overrunning our hospitals. I didn’t address the limited availability of proper masks for hospital staff, or limited supplies in general, because that all presumes that my numbers are correct. I guess we will know which way this is going in a few weeks. The numbers will climb just because testing will be more available. We will just need to see if we have slowed the spread. I hope Travis is right. I have never wanted to be wrong more in my life. I know numbers don’t lie, but the underlying assumptions can be wrong…and I hope they are. Next week, I return to normal programming.
Thank you for your thoughts Joanne, and your research. I agree with you…we all need to do our part to stop this from getting to the point of prediction or worse with all the unknowns. If this is all we can do, then we are not helpless.
Thanks for your insight, Jo. I think for most of us, it just doesn’t seem real yet because it just hasn’t hit close to home. We see it on the news…but that’s about it. I fear that is all about to change soon. Stay healthy. Stay safe!