The Kabuki theater reveal is nearly here. The poorly orchestrated government response to COVID-19 is being forced to throw off the kimono.  We have watched the ratcheting up of the warnings for several weeks now and the step by step escalation of responses.  It is just the way of it I guess.  The government knew this information in late January. We wait too long for proof and consensus before we will take a difficult step.

The first thing to understand is the epidemiological facts about the virus. The big number is we should plan for a health crisis about 10 times as big as the flu.  The knee jerk announcements you are seeing today are in recognition of the risk.

What does a disease 10 times as great as the flu really mean.  A look at what we are seeing around the world is a guide from which we can draw some conclusions.

When you look at what we see around the world you get a lot of different views of the hazard of COVID.  South Korea probably gives us a reasonable number for a well-managed process at 0.6%.  Not too bad if you don’t think about it.  However, we know the flu kills around 20,000 a year with a mortality of 0.095% people a year so COVID is somewhere between 6 and 20 times as deadly.  It is also about twice as infectious.

When we look at it broadly the question we want to think about is whether our system can respond to this huge pulse of disease.

You might remember the earlier estimate of 96,000,000 total patients.  That suggests that we will need ICU beds for 4,500,000 people over the next several months.  Since we have around 100,000 of those beds available the problem is pretty stark.

From the perspective of patients who already are dealing with serious illness, the prospect of our hospitals being overwhelmed by COVID patients is a grim one.  We wonder how they will triage our needs against this new threat.  There is an inevitable conflict in the demand for medical services and support for patients like those served by the Foundation may not be very effective as the staff buckles under the stress. 

It is important to understand that this is a new virus and we have no immunity so it will sweep through the community.  What we hope all of our efforts can accomplish is to slow down the infection rate so that the needs stay below the maximum capacity of the medical systems we rely on.  Until we have a vaccine and/or real treatment we are not going to stop this disease.

We are behind the curve on this but if everyone gets it and practices good personal hygiene we made keep it from becoming a disaster.

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