COVID 19 Update: Help Us Help You!

I am a medical professional.  The numbers keep pouring in and are overwhelming, both scientific and economic.  It's easy to become fatalistic, give up and say, "what will be will be."  There is nothing I can do about it anyway.   I imagine if I feel that way, the average person out there must be feeling it even more.  The numbers, to be sure, are extremely sobering.  We are in the greatest fight to save our civilization as we know it since World War 2.  But, in the overwhelmingly bleak numbers, there is clear evidence that this fight is winnable, that the worst case scenario can be avoided.  It's up to us, individually and collectively.  If you follow the numbers nothing is surprising and the weapons to fight back clear.

For a quick review, Covid-19 is a respiratory virus transmitted from host-to-host through droplets dispersed in the air in a 6 foot radius around people who are infected.  It can also be transmitted through direct contact with hosts and with surfaces droplets have landed on as well as through fomites, or dormant viruses, on surfaces.  But the main route of transmission seems to be through airborne droplets.  Here are a few statistical facts:

1.  On average, each person infected with the virus transmits it to approximately 2-2.5 other people.  Incubation period is 5-6 days.  In every country and community where the virus has gained a foothold and left unchecked, the number of new cases has doubled every 6 days.  Every. Single. Time!

2.  China and South Korea demonstrated that this exponential growth in the number of cases can be blunted or reversed through aggressive testing and quarantining.

3.  In average risk populations, Case Fatality Ratios(CFR's) can be held at approximately 2% as long as the healthcare system is not overwhelmed(CFR's can be held lower than 2% in lower risk populations such as South Korea).  So far in the U.S., the healthcare system has mostly had capacity to treat all affected patients through supportive care and our CFR is holding at 2%.  

4.  In average risk populations, if the healthcare system is overwhelmed, CFR's rise to around 4%.  In Italy, a country with a high risk population AND an overwhelmed healthcare system, CFR's have ballooned to a horrifying 7-8%.  We cannot let the number of cases increase to the point of overwhelming the healthcare system!

These numbers are based on known, confirmed cases.  Real CFR's may be lower due to uncounted cases, but the above numbers have remained remarkably stable as the totals climb.  As us baseball fans know so well, the larger the sample, the more likely it won't regress.

So, what does this data tell us?  The bad news is this virus has the capacity to kill in numbers none of us have ever witnessed.  The good news is that aggressive preventive measures can limit the number of infections with the added benefit of allowing the healthcare system to save up to half of infected patients who would otherwise die.

This is why it is imperative that each and every one of us must practice social distancing, not just to stay disease free ourselves, but to "flatten the curve"(and eventually reverse it) and give us, your healthcare professionals, a fighting chance to save those who are not fortunate enough to escape infection.  Despite having no proven effective treatments for the virus itself, healthcare professionals can save lives through aggressive supportive care, but you need to give us a fighting chance.  To paraphrase the immortal Jerry Maguire, "We need you to help us, help you!"

For details of how to help us, visit the CDC website for best practices for social distancing.  You may also wish to review my prior post entitled Thoughts on Novel Coronavirus(COVID-19).  I have come to sum it all up in one simple principle:  Your probability of becoming infected is directly proportional to the number of people you come within 6 feet of.  Simple as that.  Every other recommendation is based on that fact.