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Growth Study, Gary Sim 2009

THOUGHTS ON COVID-19

UPDATED MARCH 30 2020

Since I wrote my opinion piece on global warming, things in the world have taken a turn for the worse. The new COVID-19 sickness is creating chaos, and the "house of cards" that is globalization is quickly starting to fall apart.

One bit of good news is that pollution is down in China, a result of most of the factories having been closed there for the past two months. However, the number of container ships crossing the Pacific is down by more than half. Governments are closing their borders all over the world. Airlines are suffering large numbers of cancellations, and are starting to go out of business. The cruise ship industry has just been virtually terminated, and almost all professional sporting events are being cancelled. The stock market is in chaos, going up and down with every presidential tweet. The wheels are wobbling and about to fall off, and this crash is going to be ugly.

Unless the virus mutates and becomes more lethal, it appears most folks will survive this pandemic (by itself, that is). Lots of numbers are being tossed around about mortality rates, but Italy is leading in reported deaths per confirmed infections with a 7% or 8% mortality rate. That is seven or eight people out of one hundred who contract the disease will die. They are mostly older people with pre-existing medical conditions such as asthma or a compromised immune system. The mortality rate in that specific group of people is over 50%, it's just softened into a slightly less frightening number by the national average.

Italy has been suffering more deaths than any other country, with the exception so far of Spain, with mortalities ranging from 400 to more than 900 per day. In comparison, the average number of deaths in Italy is around 1,750 per day, every day.

What percentage of any population will be infected by this virus, and what are the age demographics in any population? No country has agreed on an overall infection number, with current estimates ranging from 50% to 80% of the population becoming sick.

Comparing this virus to pneumonia, the CDC website notes that approximately 50,000 Americans die every year from pneumonia, or about 960 deaths per week. As of March 14, the US had 41 reported deaths from COVID-19. However, by March 30 the US had over 144,000 sick and 2,575 dead. In the past two weeks, COVID-19 mortalities have surpassed those of pneumonia by more than half.

Questions that I've been trying to find the answers for:

0. What is a fomite?
    a. A surface or object from which the virus can be contacted.
       (table, counter, door knob, coffee mug, elevator button, ABM keypad, etc.)

1. How does the virus get into me?
    a. from inhaled droplets shed by an infected person
    b. onto skin from droplets or a fomite
       (can you be infected if it just gets onto your skin?)
       (does it need to be transferred from skin to face or mucous membranes?)
       (does the virus need to get into the respiratory system?)
    d. ingested (from droplets in food or drink)
       (will you be infected if it gets into your digestive system?)
       (does the virus need to get into the respiratory system?)

2. How long is the virus viable on its own after it is "shed" by a sick person?
    a. Droplets: no accurate data currently available.
       Estimates run 1 to 3 hours, or longer
    b. Fomites: no accurate data currently available.
       Estimates run from 1 to 10 days
       Textured surfaces may dry out virus or make it stick
       Smooth surfaces allow longer viable period
       Smooth surfaces are easily cleaned

3. How soon after I get the virus can I infect other people?
    a. Current estimates start at 2 days.
    b. You can be infectious before you have symptoms.

4. For how long after I get the virus can I infect other people?
    a. Accurate data not available.
    b. Assume that you are infectious for as long as you are sick.

5. How soon after I get the virus will I have obvious symptoms?
    a. Current estimates are from 1 to 14 days, average time is 5 to 6 days
    b. Some people show almost no symptoms.

6. How long will I be sick?
    a. On average, onset to clinical recovery is about 2 weeks for mild cases (WHO)
    b. For severe and critical cases onset to recovery is 3 to 6 weeks (WHO)

7. What are the symptoms of a mild case of COVID-19?
    a. Fever, dry cough, fatigue, sputum, shortness of breath, muscle pain,
       joint pain, sore throat, headache, chills, nausea, vomiting, nasal congestion

8. What are the symptoms of a severe or critical case?
    a. Severe pneumonia, respiratory failure, septic shock, multiple organ failure, death.
    b. About a quarter of severe and critical cases require mechanical ventilation (WHO)
    c. The time from symptom onset to death ranges from 2 to 8 weeks (WHO)

9. When I recover, can I get it again?
    a. Current thinking is "yes" (like a cold or flu).

10. When I recover, can I still infect other people?
    a. Accurate data not available.

11. Is there any correlation between the patient's age and likelihood of death?
    a. Yes. Older patients are at much higher risk.
    b. Children are at much less risk.

Countries such as Canada are at a 1% or 2% reported mortality rate. Even "one digit numbers" like this will be enough to virtually crash the medical system. In Canada, even a 1% mortality rate would result in about a third of a million deaths (if everybody in Canada was infected), and twice as many people critically ill. A million ICU beds, a million ICU teams, a million sets of ICU supplies. Oxygen has so far proven to be the best treatment, and millions of machines will be needed. We don't have those ICU beds, we don't have the machines.

The US President recently told another lie, that "every American will be tested." News reports state that this resulted in a surge of people going to the hospital to get tested, when there was no chance that they actually would be tested. According to a current report from the Centre for Disease Control in the US, there were only 75,000 test kits currently available in the States at that time. They could barely test all of the US billionaires with those. Luckily, I seen that a Chinese billionaire is donating hundreds of thousands of masks and test kits to the USA, as well as to a number of other countries around the world.

The entire system is now built around "just in time" delivery, and that means that we don't build hospital beds before they are needed. We don't stock up on oxygen or other medical supplies unless necessary. A surge in demand like the one now upon us will be extremely hard to properly support, in particular because the vast majority of basic supplies and raw materials come from China. As is now happening in Italy, hospitals will be overwhelmed, and the medical system - while it exists - will have to switch to a "triage" mode - save the people who can be saved. Don't expend resources on those who can't be saved. At some point there will be probably need to be a change in government thinking about assisted death, simply by necessity.

One well-thought through article that I read on-line noted that in times like this, the people have always risen to the challenge. I would like to think that will be true again.


Adventures of Noman, Gary Sim 2019



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