It started (we think) in filthy conditions, in a marketplace in Wuhan, China, where non-domesticated animals are caged live in squalid conditions and sold for food. It seems to have initially spread in those conditions.
So the virus itself is not the only factor affecting the spread of the virus. We’ve seen similar instances.
The Bubonic Plague bacteria was spread by fleas, which infected rats. Getting rid of the Plague included getting rid of rats and fleas.
Similarly, Polio was spread through contact with feces or when an infected person sneezed or coughed. Yes, we developed a vaccine for it, but around that same time, modern plumbing and sewage treatment helped with basic sanitation, and Polio has fallen off the grid as a serious concern.
In the same way, Coronavirus is spread by “non-viral” conditions. People with the virus cough and spread it. But Coronavirus is not a super-bug. It is a stupid bug. It has certain properties (which we know) can be significantly reduced and even eliminated in any environment by washing (hands, faces, things in your home) with simple soapy water, or simply by staying away from it and letting it die.
Sometimes this isn’t always possible. But doing so is a goal. And we now are in the midst of a major effort to remind people again to stay away from people who may have a spreadable form of the disease, and to wash their hands, wash surfaces that have been exposed to the virus.
Yes, “draconian” measures enabled places like China and South Korea to significantly interrupt the spread of the virus. But simpler measures such as these will likely be effective as well.
President Trump is betting that the Coronavirus is a stupid virus, and that 15 days-worth of attention to “social separation” and better hygiene will greatly facilitate the “flattening of the curve”.
That’s not the only response, however. The response we’re seeing is both massive and multi-faceted.
Trump as CEO is clearly in “git ‘er done” mode. For example, he has also called in Navy hospital ships to New York City and Los Angeles to ease burdens on medical facilities there. There are other (multi-faceted) military responses as well.
There is also an effort to enlist private enterprise as a counter measure to existing government (bureaucratic) ineptitude. The much-publicized failure in “testing” is a result of the fact that no one in the government has had the foresight to just go off and create and stockpile millions of this specific variety of test. Or N95 masks. Or respirators.
Trump as CEO probably had the issue of testing brought up, and he at first listened to his designated advisors on that, the CDC. “Yes, Mr. President, we can take care of that”, they would have said. The problem was, they weren’t prepared to do it. That process took some (valuable) time.
So Trump’s response has been to bring in a massive and muti-faceted corporate / public “partnership”, which included people who CAN do that. Large and small organizations alike have been enlisted to try to produce massive numbers of tests. Organizations that can enable quick and “drive-thru” testing at a retail level (Walmart, Target, CVS, etc.). And quick analysis and results through commercial testing labs like Roche and LabCorp. Along with a central source for compiling testing results.
Masks and respirators are now being mass-produced by major corporations like 3M and distributed by ThermoFisher, which is a large scientific catalog/distribution company. They have the ability to move to a “war-time” footing, in a way that is similar to the US’s production of bombers and bombs, tanks, ships, and other weaponry during World War II.
He’s also given the states license (by removing FDA regulations, which maybe involved congress) to turn States into “50 laboratories” of experimentation to create their own responses to their own individual needs. Each state can find its own version of Walmart and 3M and Thermofisher to facilitate their own testing and other responses to the spread of the virus.
Trump has mobilized huge numbers of different people and organizations to do lots of different things. At a federal level, he has removed obstacles such as FDA regulations, to enable the testing and public trials of existing drugs to treat the disease.
At a public level, we are asked to observe “social separation”, not to hoard, but to observe sound hygiene principles everywhere.
Out of this, some will be more successful than others. But we will learn what works and what doesn’t. Trump has been saying, he wants this process to be repeatable and scalable going forward. So if anything like this happens again, we as a country will have a ready pattern for mobilization.
We know the terms: “scalable”; “repeatable”.
And none of this is even beginning to speak to the financial responses.
Trump is in every way showing his trust in “the American people”. He is betting his presidency on the fact that Americans will catch on to the right ways to respond to a stupid virus. He is betting that Americans, by and large, won’t be stupid people. As more and more people recover (even those who are asymptomatic), more and more people will have immunity to the spread of the virus.
Hawk below has already cited a medical expert suggesting that we might find the fatality rate is “much lower than we have been fearing”.
And President Trump is predicting that, if that’s the case, things will get back to normal sooner rather than later.
I think I agree with your general point. Also, I'm very glad to see you describe what private industry is capable of doing (it's something I've mentioned and hoped for in a couple of my past posts too). And I certainly agree the federal govt can't do it on its own without the help of private industry. As I've mentioned in the past, everyday Americans are the bedrock in our response.
ReplyDeleteAll that said, I just wanted to make a few friendly corrections:
"Coronavirus is not a super-bug. It is a stupid bug."
I mean, the name for our current coronavirus is SARS-2 because it's quite similar to the first SARS. The first SARS in 2002-2003 wasn't exactly a lightweight contender. It had an approximately 10% case fatality rate. That's two to three times worse than the Spanish flu in 1918 which it's estimated had a fatality rate around 3%-5%. Thankfully the first SARS had a lower transmission rate so it didn't spread as far and wide. However we don't really know where this SARS-2 virus will end up.
"Yes, “draconian” measures enabled places like China and South Korea to significantly interrupt the spread of the virus"
I don't think I'd lump South Korea's measures in with China's measures. China is certainly draconian. However I wouldn't necessarily call South Korea's measures draconian, even though some of what South Korea has done doesn't exactly sit well with me as an American.
"The much-publicized failure in “testing” is a result of the fact that no one in the government has had the foresight to just go off and create and stockpile millions of this specific variety of test. Or N95 masks. Or respirators."
Actually, there is a Strategic National Stockpile that houses around $7-$8 billion worth of medical supplies. It has significant problems, and there probably aren't enough medical supplies overall, but it does exist.
"Trump as CEO probably had the issue of testing brought up, and he at first listened to his designated advisors on that, the CDC. “Yes, Mr. President, we can take care of that”, they would have said. The problem was, they weren’t prepared to do it. That process took some (valuable) time."
Not that I care for the CDC all that much, but I think what you say is a bit speculative.
"Hawk below has already cited a medical expert suggesting that we might find the fatality rate is “much lower than we have been fearing”."
It's true that's what Nicholas Christakis said, but even Christakis doesn't think it's a certainty. Just wanted to be clear about that.
"Coronavirus is not a super-bug. It is a stupid bug". "I mean, the name for our current coronavirus is SARS-2 because it's quite similar to the first SARS"
DeleteI say "stupid" as in, say, "dumb terminal". It has some basic functionality, but it's largely dependent on what happens to it, how it gets moved around, where it lands.
I think I read that the "official" WHO name is COVID-19. People commonly know it as "coronavirus", so I don't see why the distinction needs to be made here.
The first SARS in 2002-2003 wasn't exactly a lightweight contender. It had an approximately 10% case fatality rate.
This probably needs to be qualified somewhat now that we know that it no longer has that same fatality rate. For example, we learned early on that Chloroquine is a potent inhibitor of SARS infection and spread. And they knew this was the case back in the day, which makes it much more lightweight now (and infrequently seen).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/
I don't think I'd lump South Korea's measures in with China's measures.
Patrick Buchanan, in his column yesterday, used the word "draconian" when discussing the efforts among Asian countries, including South Korea, "in containing the virus". Perhaps you didn't see it:
https://buchanan.org/blog/are-americans-all-in-for-a-long-coronavirus-war-138334
Actually, there is a Strategic National Stockpile that houses around $7-$8 billion worth of medical supplies. It has significant problems.
Aside from their other significant problems, have they stocked large numbers of Covid-19 (SARS-2) tests? Or N95 masks? Or respirators? My point is that they were not and could not have been precisely prepared for this.
Not that I care for the CDC all that much, but I think what you say is a bit speculative.
That's why I said "probably". Kimberly Strassel mentioned this in her WSJ piece that I quoted above. "But the single biggest mistake so far came from the government. The feds maintained exclusive control over early test development—and blew it. The Centers for Disease Control and Prevention’s failure delayed an effective U.S. response, and the private sector is now riding to the rescue."
Now, how would a federal government agency, with "exclusive control over early test development", possibly have "blew it"? My fictional conversation gives them the benefit of the doubt. At least they thought they could have handled it, and during their "exclusive control" period, there is no doubt that they were able to do what they, in fact, had "exclusive control" over.
https://triablogue.blogspot.com/2020/03/heres-lesson-of-virus-so-far-relying.html
It's true that's what Nicholas Christakis said, but even Christakis doesn't think it's a certainty.
That's why I said "might".
"I say "stupid" as in, say, "dumb terminal". It has some basic functionality, but it's largely dependent on what happens to it, how it gets moved around, where it lands."
DeleteAs far as that goes, I wouldn't call what a virus (including the coronavirus) does "basic" in any way. Nor would I describe it as "largely dependent on what happens to it". Maybe "basic" and "dependent" relative to other lifeforms (and I wouldn't necessarily call a virus non-life even though I know that's popular to say), but on its own a virus is quite a sophisticated critter. We could talk to the Intelligent Design guys about all this. :)
"I think I read that the "official" WHO name is COVID-19. People commonly know it as "coronavirus", so I don't see why the distinction needs to be made here."
1. Coronavirus is just the popular designation for this virus.
2. However, technically speaking, coronavirus is a large family of viruses. There are many different coronaviruses out there. Some cause the common cold. But others are more serious.
3. Prior to our current coronavirus, the most concerning coronaviruses were the first SARS coronavirus and the MERS coronavirus. Both caused epidemics. SARS had a 10% fatality rate, give or take, while MERS had a 35% fatality rate, give or take.
4. Our current coronavirus is very similar to the first SARS coronavirus. Hence our coronavirus is called the SARS-2 coronavirus.
5. If you want to be more specific, the official name for our coronavirus is SARS-CoV-2 while the disease is called COVID-19. It's the same distinction between HIV and AIDS. HIV is the virus, while AIDS is the disease caused by the virus. SARS-CoV-2 stands for Severe Acute Respiratory Syndrome Coronavirus 2.
6. And it's not the WHO which officially names viruses. Rather it's the International Committee on Taxonomy of Viruses (ICTV). The WHO uses the name ICTV designates. I personally don't care about all these various nomenclatures and naming conventions, but I mention it in case others do.
"This probably needs to be qualified somewhat now that we know that it no longer has that same fatality rate. For example, we learned early on that Chloroquine is a potent inhibitor of SARS infection and spread. And they knew this was the case back in the day, which makes it much more lightweight now (and infrequently seen). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/"
Hm, I take it you didn't read the paper? Not even the abstract? Just the title? Because the paper is talking about inhibition "in cell culture". That's hardly the same as in a living person. That's precisely why there are clinical trials to test for the efficacy of certain drugs.
"Patrick Buchanan, in his column yesterday, used the word "draconian" when discussing the efforts among Asian countries, including South Korea, "in containing the virus". Perhaps you didn't see it:"
True, I didn't see it, but I also don't accept it just because Patrick Buchanan says so! :)
"Aside from their other significant problems, have they stocked large numbers of Covid-19 (SARS-2) tests? Or N95 masks? Or respirators? My point is that they were not and could not have been precisely prepared for this."
Yes, the U.S. stockpiles include N95 masks, respirators, and much more. Obviously they don't include the tests since this is a new virus. However, as I already mentioned, there are problems with the stockpiles and the stockpiles likely don't have enough medical supplies overall.
"My fictional conversation gives them the benefit of the doubt."
The problem is neither of us were privy to what went on behind the scenes.
Again, despite these replies, I generally agree with what I think you're saying.
DeleteAlso, I do hope SARS-CoV-2/COVID-19 ends up with a far lower fatality rate than expected. I'm sure most people hope so. Heck, even Anthony Fauci has said the virus may have a fatality rate as low as 0.1% (like the seasonal flu), but at other times he has mentioned over 1%. Not to mention I've pointed out the limitations of mathematical or epidemiological models in making such predictions. And much depends on what we do too. We can avoid (say) Italy's fate if we do the right things.
I agree with most of what you wrote.
ReplyDeleteHowever, I think this statement has not been confirmed by health experts: "It has certain properties (which we know) can be significantly reduced and even eliminated in any environment by washing (hands, faces, things in your home) with simple soapy water, or simply by staying away from it and letting it die."
There does seem to be a possibility that this virus can "aerosolize" - meaning it hovers around like a fog for hours or even longer. That was the case with the measles virus. You can get it from someone in the same elevator, even if you touch nothing in they're not coughing.
That is a huge difference in terms of transmission mechanism. If it weren't true, I'm not sure I'd see a need for all of the forced shut downs that we're now seeing. But, at this stage in the game, I'm not sure anyone really knows.
You might be interested in the following paper which was published only a couple of days ago in the NEJM which is one of the top medical journals in the world:
Deletehttps://www.nejm.org/doi/10.1056/NEJMc2004973
If I'm reading that correctly, the virus can remain viable in the air for about three hours after someone with the virus coughs (but not necessarily if they're just respirating normally).
DeleteNot as bad as the measles, but still ... it means avoiding contamination is almost impossible in a densely populated city like New York.
Yeah, the paper says the coronavirus (SARS-CoV-2) can stay in the air (aerosol) for as long as 3 hours. (Not to mention other surfaces like 2-3 days on plastic and stainless steel! Fomites.)
DeleteHowever, perhaps some good news? Just because it can hang in the air for that long doesn't necessarily mean a person will get infected. The main thing is it's uncertain how large of a viral load one needs to be infected with coronavirus in the air via our mucous membranes (e.g. eyes, nose, mouth).