Childers: “Wait two weeks” is a more destructive virus than COVID
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BY JEFF CHILDERS
“[T]he only thing we have to fear is… fear itself[.]” – Franklin D. Roosevelt, 1933
Ever since COVID-19 arrived on the scene in March, conventional wisdom has said that even though things don’t look so bad just now, “wait two weeks” and—you’ll see—things are going to be a lot worse. Two weeks is the estimated time between onset of SARS-CoV-2 symptoms and death. The idea has been—at nearly every point in the pandemic—that we simply can’t afford to stop and consider any good Covid-19 news, because some really awful news could be right around the corner. The corner is always exactly two weeks—apparently—from any particular point.
The “wait two weeks” virus has infected lay people, experts, doctors, pundits, celebrities, and worst of all, our elected officials. But if you look at the Covid-19 experience here in Alachua County in three ways—in terms of our worries, our cases, and our local deaths—you will see that, no matter which way you look at it, there is excellent reason to be optimistic—maybe VERY optimistic—about Covid-19.
PART I. OUR SHRINKING WORRIES
Time flies. It flies even faster in a pandemic. The headlines you see today reflecting our worries about the virus are nothing like what we were worried about only three months ago in late March. Our worries now are much less frightening. The evolution of our concerns is good news, in and of itself. The sum of our previous fears dwarfs any reality of what has actually happened. Maybe we should stop planning for the worst?
Let me be clear: this article is not intended to criticize anyone, advocate any conspiracy theories, or suggest in any way that anyone has acted in bad faith. If anything, I criticize a devilish mind-virus of worry that seems to have infected us, here in the U.S. in particular.
You will recall, I’m sure, that in late March and early April, the headlines reflected the terror of catastrophically running out of PPE, whereby even healthcare workers wouldn’t be able to get basic protective wear. If healthcare workers couldn’t get masks, gloves, and body shields, wait two weeks and they would all get sick. And then nobody would be able to care for a giant flood of Covid patients. Our entire hospital system would collapse into a germy whirlpool, taking civilization down with it.
The fear of a PPE shortage led fearful policymakers and anxious medical experts into one of their most birdbrained mistakes of all: in order to conserve the best gear for our medical providers, they told us all—repeatedly—that masks wouldn’t do any good. Later they revealed that the opposite was true, plus you could have used basically any old rag you want for a mask and been nearly just as well-protected.
If you think about it, this tiny lie—that masks wouldn’t work—was an astounding blunder. If the experts are correct now—if masks do prevent the spread of the virus—then the experts could have stopped this thing in its tracks in late March by simply telling us to cut up a few t-shirts.
So anyway, as it turned out, here in Alachua County we never ran out of PPE. Not even close. To my knowledge, nobody anywhere ever catastrophically ran out of PPE. Instead the opposite happened, and you can now buy a 50-pack of masks at the Kangaroo.
Once it became clear that we didn’t have to worry about PPE, we started worrying about ventilators. Terrified newspaper reporters told us every day how many ventilators we had, how many ventilators we didn’t have, how many ventilators were “missing” from the national ventilator stockpile (which I hadn’t known existed), how many do-it-yourselfers were building ventilators in garages, and how many ventilators Governor Cuomo was sure that he would need any minute now.
The ventilator situation was so bad that President Trump even had to invoke extraordinary wartime powers to force companies like GM to start making ventilators instead of cars. We watched any number of Rose Garden pressers where corporate executives breathlessly reported on their efforts to manufacture PPE and ventilators as fast as their companies could, in order to meet the anticipated need.
Anyway, the opposite happened again: we did NOT need all that PPE and those ventilators, and before you knew it, we were drowning in them. All the governors reported that anyone who needed a ventilator got one. Another horrible possibility averted by American ingenuity and knowhow, or something. Plus, it looks like ventilators kind of aren’t such a hot idea anyways, so never mind.
We worried that the hospitals were “two weeks” away from being overrun, like in some kind of communist dystopia. The media fixated on terrifying pictures of body bags and bloody gurneys stashed in hospital hallways. So we banned elective procedures. But as it turned out, hospitals weren’t overrun like we had worried—instead the opposite happened—and a lot of hospitals were forced to close down and lay off medical staff.
After that, we started worrying about tests. The problem was, we just didn’t have enough of them. Not nearly enough. BIG problem. And the tests that we did have weren’t nearly fast enough. We needed more testing, faster, pronto. Alarmed reporters and tremulous media personalities spent reams and hours obsessing about the terrible fate awaiting us “in two weeks,” absent millions of tests delivered yesterday. It was going to be bad. Very bad.
Well, here in Alachua County we somehow survived the test crisis and instead of running out of tests, the opposite happened, and now we are swimming in tests. The local Department of Health has reported that at times they run out of people who even want to be tested. There’s probably at least six different ways to get tested whenever you want to, as many times as you want to, for free if you want to. Knock yourself out.
The test thing fizzled out, but the worrying still wasn’t over. We had to find something new to worry about. Cue the models. We became obsessed with “models.” A “model” is just a guess, dressed up in fancy science-ey sounding lingo. Relying on these models—guesses—we ordered everybody to do all kinds of bizarre, counterintuitive things because—even with lockdowns and social distancing—millions would die. MILLIONS. Starting two weeks from now.
And, as time went by, the opposite of everything the models guessed would happen happened, and eventually they slunk back to whatever university skunkworks they came from and we stopped worrying about them, leaving a vacuum of worry. You know how nature feels about vacuums.
Now what are we worried about? Asymptomatic cases. Why? Because something bad could happen if too many people catch Covid and don’t have any serious symptoms. What could happen? Our very old and very sick folks might get infected by someone whose case was so mild that they didn’t even notice they were sick. Just wait two weeks. But what does the data show? FALLING hospitalizations and deaths. So why are we so worried about a thing that might happen, but appears at present to be even more likely to not happen? Why are we so obsessed with finding something else to worry about when we can plainly see that our previous worries were overwrought?
Maybe, as a country, we should consider stopping worrying so much and stop fantasizing that everything is going to get terrible in two more weeks. What if we just focused on the actual problems before us instead of worrying so much about future things that might happen?
But there’s a brighter side to all this over-worrying. Here’s the great news: Over the last three months, the focus of our worry has successively shifted from some pretty realistic immediate threats (e.g., lack of PPE and ICU beds) to amorphous maybe/maybe-not possible futures that are not indicated by the data. In other words, things have progressed so well that—as much as we want to worry—we are having a hard time coming up with anything “real” to worry about.
Anyway, since we are presently worried about asymptomatic cases, let’s look at that issue next.
Here in Alachua County, do we have too many asymptomatic cases? Too few? Just right?
The question is tongue-in-cheek, but there’s a real question in there. Is even ONE case of Covid-19 too many? If you think one case is too many, you are headed toward a world of disappointment and obsessive-compulsive insanity. Humans are nowhere close to having control over the microscopic bacteria or the sub-microscopic virus. You may have heard that we live in a “sea of bacteria.”
And, as the New York Times reported on April 13, 2018, “Trillions Upon Trillions of Viruses Fall From the Sky Each Day.” Trillions. From the SKY. Every day. How exactly do you think you are going to get ahold of that, my friend?
As of July 4, 2020, Alachua County had 1,506 reported positive cases of Covid-19. That represents about one-half of one percent of the population of the county. In other words, as far as we know, 99.5% of the county is not infected. Fewer than a hundred of those cases have been serious cases requiring in-patient treatment. So the portion of the county not having had a serious case of Covid is 99.9%. That’s not really a whole lot of Covid cases, when you think about it.
Maybe you worry: At a 10% positive rate, eventually, once we test everybody, 27,000 people will have caught Covid-19 here, at one point or another. You know what’s interesting about the number 27,000? That’s the approximate number of people who had the flu in Alachua County in 2018. But, assuming 8% of those who get Covid have a serious case needing hospital care, you still have 99% of the County who will never have a serious case of the disease.
As long as I live, I’ll never forget when, on March 23, 2020, Alachua County Commissioner Ken Cornell said that he had been crunching the numbers and it looked to him like cases were “doubling every two days.” That alarmed me considerably. At that rate, the entire county—270,000 souls—would be infected in a few short weeks. So that same day I started tracking and typing up my daily posts. You know what I quickly figured out? We were nowhere close to doubling. At all. Never have been. Cornell’s math was based on the very early weeks, when we went from 1 to 2, 4, and 8 cases, and the rest is history.
Even now, with daily positive case reports in Alachua County running nearly ten times what they were back during the “peak,” we are still nowhere close to doubling in any kind of statistically significant way. No exponential growth. Three months in, and we’re only at one half of one percent of the county infected, including all the asymptomatics.
We really shouldn’t be all that worried about mild Covid-19, which is what the current positives represent in the great majority. We probably should even report how many are actually sick vs. how many are asymptomatic. The closest thing we have to that is hospitalizations (serious cases) versus “positives.” And serious cases are increasing, if you can call it that, at a microscopic rate.
Maybe you worry: Covid is so much deadlier than influenza. First, we don’t know that yet. We DO know that the projected death rate keeps falling, being miniaturized and shrunken, just like everything else about this virus has shrunk since we first found out about it.
But second—and this is a critical, critical point—this is our first year with Covid. How do you think humans did with influenza the first time they came across it? Or, since Covid is a form of the common cold, how well did we do the first year we came across that pestilent nuisance? Let’s look at the deaths situation.
Every single individual death is a tragedy to someone. When discussing deaths in groups—as statistics—we should be mindful to be empathetic toward friends and families who are missing their loved ones.
Nobody has died in Alachua County under age 60. Nobody has died in Alachua County that was not already “medically frail.” In other words, the folks who died could easily have died from flu or a cold instead of Covid. Nobody in our county has died who would have simply fended off a cold or flu. Old age isn’t enough. We’ve yet to see any reasonably healthy elderly person succumb to Covid here. The people who have succumbed to the disease here in our county already knew that they were at great risk of dying, not just from Covid, but from any opportunistic infection of any kind.
Did you remember that, even today, the common cold is a killer? Especially in nursing homes? And there is NO vaccine for the common cold —another coronavirus—and there’s no vaccine in sight. We even have an ironic saying, “… and they can’t even cure the common cold.”
Whether you count the Parklands nursing home fatalities or not, Alachua County is not even close to reaching the twenty-seven (27) flu fatality high-water mark we saw here in 2018. If deaths have slowed—and it appears that they have—Covid may never reach the influenza mortality levels from 2018.
And as we speak, an unprecedented worldwide effort to develop treatment protocols and pharmacological tools to deal with Covid is underway. It would have happened anyway, more slowly, but there has been nothing like the velocity of this particular effort in human history. About any problem. Folks, we are only three months in, and we are already seeing significant results. Three months is nothing in terms of medical studies. But nearly every day, we learn something new about how the virus works, leading to improvements like maybe don’t put people on ventilators so fast, and don’t give diabetic people so much insulin. What do you think the medical approach to Covid will look like twelve months from now? You think it might be a little different, maybe better?
So think about the Covid fatality rate this way: however the year finishes out, it will only be the Year One fatality rate. Next year we’ll have a much different—better—Year Two fatality rate. If Year One’s rate ends up anywhere close to flu—which looks very possible—Year Two will *certainly* beat the flu. And Year Three will be even better than that, and so on.
You want an example? Just imagine how things could have been different had we been already prepared to protect nursing home residents. What if places like New York had known not to send infected residents BACK to their nursing homes? Just that one single bit of knowledge would have reduced total deaths by a substantial amount. That won’t happen next year, or even in the fall, for that matter.
So improvements in medical treatments are part of the reason deaths are slowing. We are getting better incrementally, day by day, at treating this brand-new disease and identifying and protecting medically vulnerable folks. But there is a larger force at work that is even more likely to be the cause of slowing death rates from Covid. One which we have no control over—Farr’s Law.
In the mid-1800s, William Farr pioneered epidemiology. Famously, he discovered that the “bell-shaped curve” applied to epidemics. He discovered that death rates spike as the virus first claims the “low-hanging fruit” of the most medically-susceptible and least-immune victims. Eventually though—fairly quickly—the virus runs out of easy pickings, and the death rate tapers off again. This has been so consistently true over time that it is referred to, not as “Farr’s theory,” but as Farr’s Law.
There is no reason to think, and no evidence to believe, that Farr’s Law applies differently to Covid than to every other epidemic on record. It is easily possible that Covid has already claimed its “low hanging fruit” and it is getting more and more difficult for the virus to infect new vulnerable cases. What we see in the data is entirely consistent with Farr’s Law. That’s great news.
So, consider recovering from the “wait two weeks” virus. Try focusing on the present, and let the good news be what it is. If the situation turns, we can handle it, but in the meantime we can add some joy back into our lives. Next year will almost certainly be better, and the year after that better still. Be optimistic! The future looks bright.
Wow. That was excellent. Many thanks to Jeff Childers for writing and sharing that.
Will we be forced to wear masks if we’re healthy forever or just until this November?