Day 2 California Emergency: It’s not like the flu.

Yesterday the Governor of California declared a state of emergency. This is a good thing. It is not clear how long the virus has been circulating in Northern and Southern California but its been at least several weeks.There will be lots more cases here in the coming days.

This is not like the Flu! Here are 4 important facts. 

1) COVID-19 has a much higher fatality rate then the flu.

Just like the flu it affects older people more but this affects older people a lot more.  Normally the flu doesn’t kill people in their 20s, 30s and 40s and this has. 

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More people get more sick and require more hospitalizations than the flu.

With COVID-19, 20% of patients get very sick and may require hospitalization and 10% patients need acute care with respirators in an intensive care unit, ICU etc. (data from Italy)

2) COVID-19 is spreading very very fast. 

Because this disease is novel – no one has immunity. So everyone who comes in contact with it gets infected.  Below are growth curves of people diagnosed. We can have a massive spike in the number of people infected if we don’t take measures to reduce transmission. 

Keep in mind that because people can transmit it without symptoms or only mild symptoms they likely won’t stay at home and as they go about their lives, they unknowingly are infecting others. 

The incubation period is 14-21 or 27 days. So the number of actually infected people is at least 20 days behind.  This is in contrast to the flu being spread out over a whole season. Like the flu, the number of people who need care in a hospital is higher in the winter than the summer but unlike the flu, COVID-19 has a giant spike of all the cases happening all at once in November.

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Here is a study of the projected curves for the spread of the virus in England and Wales. 

From the study’s abstract: We predict that a CoVID-19 outbreak will peak 126 to 147 days (~4 months) after the start of person-to-person transmission in England and Wales in the absence of controls, assuming biological parameters remain unchanged. Therefore, if person-to-person transmission persists from February, we predict the epidemic peak would occur in June. 

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The US and other countries have these kind of projections/calculations the American public and business leaders need to see the projections if there are no large scale public health interventions. 

3.  If  COVID-19 makes some of the people who get it very sick. If continues to spread at this rapid rate,  it will overwhelm our US healthcare systems.

Collectively, WE must act now to “flatten the curve”  by pressing down firmly on it with Social Distancing measures. As this graph from The Economist illustrates.image.png

We literally don’t have enough respirators to save people unless we slow he spread of COVID-19  down.

Bonus problem right now we don’t have enough PPE for our healthcare workers – if they all get sick…we don’t have anyone to care for the sick people.

4) Overwhelming the healthcare system can cause social breakdown.

If all the people get sick with this virus and have to be “away from work” to protect everyone else then we will have really big problems. Including social break down.

Yes putting the breaks on the economic activity that involves people interacting with people is a huge deal.… However a massive social breakdown is a bigger deal if we don’t act now when we have the time  to do so in measured, evidence-based ways.  

“Don’t panic” doesn’t mean don’t act with calm urgency.

Yes it is a big deal to think about this much slow down…and we also have to act to support people who are working paycheck to paycheck in the service industries and all the places that will be affected by a massive economic slowdown for the next 6 months to a year but we still will have a functioning society.

Conclusion: We have to slow the spread of COVID-19 down in the United States NOW. 

We have to protect the vulnerable and to support the healthcare system not being completely overwhelmed by sick people causing social break down.

We have to work together to flatten the growth curve of COVID-19. We need a plan.

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