Monday, November 2, 2020

Why Now? [25 March 2020]

 



Cuomo: “My mother is not expendable. And your mother is not expendable. And our brothers and sisters are not expendable. We’re not going to accept a premise that human life is disposable. We’re not going to put a dollar figure on human life.”
Typical response: “61,000 lives were apparently disposable to the infectious flu season in 2017 -2018....Why now ? ...... asking for a friend”
Well, hell-- since it's for a friend. Let me see if I can break it down for you. In an ordinary flu season (the fair to middling kind), the number of days from infection to being symptomatic takes from 1-4 days, and you're contagious from about 24 hours prior to showing symptoms to about 4 days afterward. For SARS-CoV-2 (the current novel coronavirus taking up the news), it takes up to 10 days to begin showing symptoms, and people shed the virus pretty much from day 1, making it possible to infect people long before you even suspect you're sick (although thankfully and somewhat mysteriously, this happens less often than is expected). 13% of novel coronavirus infections occur when the vector is pre-symptomatic, whereas pre-symptomatic transmission of the flu is statistically negligible.
It's also possible that novel coronavirus may be transmitted in ways that the flu cannot be, such as through airborne transmission.
The mythical "average" patient with the flu spreads it to 1.3 others. The average novel coronavirus patient infects about 2.5 additional people.
The flu is actually comprised of several different strains of flu virus, most of which have been seriously studied for decades, are well known, and to which human beings have developed some level of immunity. Novel coronavirus is... well... novel. As in new. No human being has a natural immunity or antibodies, and the entire population of the world seems likely to be susceptible to it (i.e., there is no upper limit to the number of cases we might see other than the number of human beings on the planet).
In the US, in any given year, about 8% of the population contract the flu and show symptoms. An estimate that includes people who contract it but do not show symptoms tops out at around 20%. Most estimates of the potential infection rates in the US for novel coronavirus START at 20% and suspect it may reach as high as 80%
The flu GENERALLY isn't very serious. A person infected with it has about a 1%-2% chance of requiring hospitalization. The mortality rate of seasonal flu is relatively low-- about 0.1%. What we can surmise from the several hundred thousand observed cases of novel coronavirus is that about 20% of victims will require hospitalization, and the mortality rate of this virus (although dependent on how quickly a country's government gets in front of it) ranges anywhere from 1% to about 6%-- the WHO currently estimates its average at around 3.4%. A lot of that depends on whether or not a country's healthcare system becomes overwhelmed and how many people had it who remain undetected, but who didn’t die (a number we can’t actually know, at the moment).
What this all means is that you’re ten times as likely to need hospitalization for novel coronavirus than for the flu, and about 34 times more likely to die from it than from the flu. Those orders of magnitude differences in seriousness and mortality rate are proportional for more at risk populations, too. For the elderly, the mortality rate is a lot closer to 10% for novel coronavirus (and may even top 1% for the seasonal flu).
The average stay for someone who is hospitalized with the flu is 5-6 days. The average stay for someone who is hospitalized with the novel coronavirus is 11 days.
Just to recap the math, so far, ten times likelier to require hospitalizations which take twice as long as the flu to recover from and with a 34 times higher mortality rate.
We have good surveillance testing of flu outbreaks-- we see it coming in the population before the infection rates get really bad, especially for strains that seem more than usually severe, which is how we manage to create flu vaccines to address those which seem most likely to be problematic.
There IS no vaccine for novel coronavirus, as yet, and probably won't be one for at least a year.
These are all extremely serious problems which have medical experts EXTREMELY concerned about the potential for damage to the US population. If you want to cut to the chase, take the figure (61,000) sarcastically mentioned above (as though the US doesn't, every year, engage in widespread vaccinations against the flu) and multiply that number by 10 on the low side and 34 on the high side.
If novel coronavirus were NO MORE infectious than the flu (although it is roughly twice as infectious), and presuming we had a vaccine for it (which we don't) you'd be talking about a body count of 610,000 to 2,000,000.
If the worst case scenario developed by the CDC were to actually come to pass (80% of the population infected), we’d be looking at somewhere between 2.6 million and 9 million dead Americans.
THAT'S "why now."

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