Thursday, March 12, 2020

Coronavirus: good news and bad news

Here are two useful articles on the coronavirus:

  1. "9 charts that explain the coronavirus pandemic"
  2. "Coronavirus: Why You Must Act Now"

Bad news

So bad news first:

  1. Epidemiologists are predicting a best-case scenario for the coronavirus would be around 0.5% fatality rate, while a worst-case scenario would be around a 3%-5% fatality rate. (I'm no epidemiologist, but from reading what they say it sounds to me that case fatality rates are based on those who develop symptoms.)

    For comparison, the seasonal flu fatality rate is 0.1%, while the Spanish flu fatality rate was 3%-5%.

    Now, in a population of 330 million people, a 0.5% fatality rate is 1.65 million deaths, while a 5% fatality rate would be 16.5 million deaths.

    In short, if the epidemiologists are to be believed: even on a best-case scenario, we're still looking at 1.65 million dead.

    (Of course, all this is based on certain mathematical or statistical assumptions, which could be debatable.)

  2. Many physicians, virologists, and other experts believe this strain of the coronavirus could be a permanent fixture in life (e.g. here). Like the seasonal flu. But obviously worse.

Good news

That's the bad news. Some good news. Or at least hopeful news:

  1. Mitigation measures (e.g. hand-washing, social distancing) could slow and dampen the virus' impact. If this happens on a widespread scale, then it could result in significantly less deaths than the experts are predicting. Hence, if we hope to prove the experts wrong, then people should enact reasonable mitigation measures.
  2. Some (not all) experts think the summer months could slow the coronavirus. If so, then the summer months would prove a backstop for the coronavirus' transmission and spread. However, that's still debatable. We won't really know until summer comes. And it wouldn't apply to the southern hemisphere where it would be winter.
  3. A vaccine for the general public is a year off (minimum), but the majority of experts seem quite confident that there will be a successful vaccine against the coronavirus.
  4. Whatever happens, people can use all the knowledge and experience gained in this coronavirus pandemic to avert future pandemics. That may be one reason why nations like South Korea and Hong Kong have evidently been dealing with the coronavirus better than other nations like Italy: they've had to deal with national epidemics in their recent past.

    In any case, a possible way forward is what Michael Osterholm argues in his book Deadliest Enemy: Our War Against Killer Germs. Specifically the last chapter "Battle Plan for Survival". Here's an excerpt, and keep in mind the book was published in 2017, well before our pandemic:

    To review, our greatest threats are:

    1. Pathogens of pandemic potential, which essentially means influenza and the downstream effects of antimicrobial resistance.

    2. Pathogens of critical regional importance, which include Ebola, coronaviruses like SARS and MERS, other viruses such as Lassa and Nipah, and Aedes-transmitted diseases such as dengue, yellow fever, and Zika.

    3. Bioterrorism and dual-use research of concern (DURC), and gain-of-function research of concern (GOFRC).

    4. Endemic diseases that continue to have a major impact on the world’s health, particularly among emerging nations, including malaria, tuberculosis, AIDS, viral hepatitis, childhood diarrheal diseases, and bacterial pneumonia.

    Priority 1: Create a Manhattan Project–like program to secure a game-changing influenza vaccine and vaccinate the world.

    By the way, Osterholm was recently on Joe Rogan. Thanks to Coram Deo for pointing that out to me.

2 comments:

  1. I've been sharing Osterholm's interview on the "Joe Rogan Experience" with family, friends and colleagues as well as referencing CIDRAP recently.

    On balance I think he's among the more credible sources I've come across. I'm not in the healthcare industry but in my professional life I do occupy a space that deals extensively with risk management/mitigation so this emerging crisis and the resulting domino effect it's causing has a direct effect on my work. This makes reliable predictions and models important to me beyond reasons connected to my own personal curiosity and self-concern.

    Not to mention many people I know are simply afraid and it's good to have reasonable experts to refer folks to.

    I appreciate the work you've been doing in particular here, Hawk, compiling many valuable resources and writing encouraging posts in an effort to prevent panic. It's a yeoman's work.

    If it wouldn't be a huge ask I think it would be very helpful if the T-blogue editors could create a single post referencing all the coronavirus/COVID-19 posts thus far as a one-stop shop reference point.

    This has been done in the past for topics like Christmas, the ethics of lying, etc. Just a suggestion.

    In Christ,
    CD

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    Replies
    1. Thanks so much for the kind words, CD! :) I seriously appreciate it very much.

      I've been trying (in my fumbling way) to steer a middle road between "this will all blow over soon" and "the end of the world is at hand". I think these are the loudest voices, but who wants to listen to "voices of moderation" (as a friend put it)? Meanwhile I could both agree and disagree with both sides to various degrees, which might make both sides think I'm prevaricating, when in reality I'm simply trying to take the parts I find sensible and leave aside the parts I don't.

      Oh yeah, thanks for letting me know about Osterholm! From what I can tell, he's a superstar in the field. He's been at it for decades. It seems everyone involved in infectious disease, epidemiology, biosecurity, and so on knows his work. For example, Peter Hotez at Baylor University is a pediatrician and virologist. He's involved in tropical diseases and developing vaccinations (and by the way he did one of the best interviews I've ever heard on the anti-vaccination movement, also on Joe Rogan, though I felt Rogan gave Hotez a real hard time throughout much of the interview). Sorry, I'm rambling, but I believe Hotez and Osterholm respect and admire one another quite a bit. Same with Amesh Adalja. Adalja has recommended Osterholm's work in the past. And I've known about Adalja before the pandemic (and even communicated with him). Adalja is someone else I've found generally reasonable throughout the pandemic.

      Anyway, as you know, but just in case others who might not, I did a post titled "Which medical experts do I follow?" where people can go to see which experts I'm relying on for a lot of this information (since for all they know I'm just some random dude on the internet).

      That's a good idea about making a compilation. I guess I just have to take the time to do that. For now I think people can simply click on the "Coronavirus" label and all the posts we've done on the topic should be available. I guess it's not as nice as having it all in one post, but hopefully it should be suffice for the time being.

      Thanks again, CD! And may the Lord bless you and keep you and yours in all this.

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