Flatten the curve for COVID19
Like many of you, I have been watching the unfolding of the COVID19 pandemic. Up until last week, I didn’t really understand the problem. In fact, I was annoyed at the Iowa Board of Regents for canceling my trip to Germany for what seemed like “just another flu”. But now (I think) I understand the severity of the problem. So I thought I would share my perspective in case you are also thinking “what’s the big deal?”
Not just the flu
The big deal is that this is a novel coronavirus which means that we have little to no immunity to it. In addition, current best estimates are that the disease is more deadly than the flu with a fatality rate of 0.5%-4% compared to 0.1% for flu (that’s 5-40 times more deadly). So it is not “just like the flu” because we have no immunity (or vaccine) and it is more deadly.
Healthcare system overload
More problematic than this is the need for hospitalization for those with symptoms severe enough to need treatment. In Italy, about 10% of cases need ICU care for 3-6 weeks. (Reports out of Italy and Korea make the effects of this outbreak sound like a war zone.) No medical establishment has the capacity to handle this many cases simultaneously. THIS IS THE ISSUE!!
Mary Greely Medical Center in Ames
In Ames, which has a population of 65,000, our hospital, Mary Greeley Medical Center, has ~220 beds. If these numbers are similar for Ames and everybody was sick at the same time, we would need 6,500 beds for ICU patients or about 30 times as many beds as we have total. Even if these estimates are off by an order of magnitude or two, we don’t currently have the capacity to care for these individuals let alone the other individuals who need hospitalization.
Impact on healthcare workers
Just like us, healthcare workers have no immunity. Personal protective equipment is all on backorder. So, it will be likely that doctors, nurses, and other hospital staff will become infected and therefore unable to treat those who are sick for a couple of weeks.
This overburdening of the healthcare system will be bad for those who have COVID19, but it will also be bad for anybody who needs to use the healthcare system for other reasons during that time, e.g. heart attacks, broken bones, giving birth, etc.
Flatten the curve
So, what we need to do is #flattenthecurve.
This means we need to stretch the outbreak into a much longer time frame so that healthcare can keep up. We need to reduce transmissions through a number of means including social distancing. I’m betting that Iowa State University will move to online instruction for the remainder of the semester, as Harvard has done.
Reconsider spring break travel plans. My parents and sister and her family have cancelled their trip to visit us in a week and a half and my daughter was extremely disappointed that her grandparents and cousins were no longer coming to visit, but that is the situation we are in.
Wash hands, no hand shaking, etc.
There are a whole bunch of other common sense disease prevention strategies as well.
US compared to the rest of the world
There are reasons to be optimistic and reasons to be pessimistic about what will happen in the US compared to the rest of the world. On the positive side, our age distribution has fewer older individuals than Italy and our population is generally more spread apart than in South Korea. On the negative side, our national government has done virtually nothing to stop transmission from abroad, is not , and has overly restrictive requirements for testing (generally you need to have been in contact with a confirmed (!) COVID19 case or in China/Italy/Iran/South Korea/Japan).
Washington state outbreak
University of Washington developed their own test and 5-7% of individuals are testing are positive. Many of those tested would not have qualified for the CDC’s test.
So likely coronavirus is already here (both where I am and where you are), but we aren’t testing so we don’t know. Also on the negative side, it seems doubtful we (as a country) have the will to institute containment measures like those instituted in China and Italy.
COVID19 is worse than the flu because we have no immunity, it is 5-40 times more deadly, and will quickly overburden our healthcare system due to the need to treat patients with symptoms severe enough to be hospitalized.
If you want to read more, the best single source for information that I’ve found is https://www.flattenthecurve.com/.
I hope you will do your part to #flattenthecurve.
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