Tuesday, March 17, 2020

Buckle Up - We May Have To Remain Shut Down For 18 Months Or Die By The Millions - According To New Brit Study

Image may contain: textImage result for brane space, stocks

When I first  read this report, released Monday by an epidemic modeling group at Imperial College London  I refused to believe it.  Ok, I had extreme difficulty in accepting it.  But the bottom line conclusion from one of its lead authors - Neil Ferguson - was that: the potential health impacts were comparable to the devastating 1918 influenza outbreak.  Also, and this is the kicker, would “kind of overwhelm health system capacity in any developed country, including the United States unless measures to reduce the spread of the virus were taken."

The study’s  30 authors simulated the role of public health measures aimed at reducing contact, including social distancing - such as evident in the U.S. now.  However, this is being projected to be for a few months at the most.  The study, instead, is advocating sequester until a viable vaccine is available - which may not be for another 18 months.  As Dr. Ferguson was quoted:

We don’t have a clear exit strategy.  We’re going to have to suppress this virus — frankly, indefinitely — until we have a vaccine.

That is some "serious shit" as comedian John  Oliver ('Last Week Tonight') would say.  But what is the alternative?  According to the study's authors:  without action by the government and individuals to slow the spread of coronavirus and suppress new cases, 2.2 million people in the United States could die.  In the words from the report, leading to that conclusion:

"We assume that 30% of those that are hospitalised will require critical care (invasive mechanical ventilation or ECMO) based on early reports from COVID-19 cases in the UK, China and Italy (Professor Nicholas Hart, personal communication). Based on expert clinical opinion, we assume that 50% of those in critical care will die and an age-dependent proportion of those that do not require critical care die"


"With 30% of hospitalised cases requiring critical care, we obtain an overall mean duration of hospitalisation of 10.4 days, slightly shorter than the duration from hospital admission to discharge observed for COVID-19 cases internationally."

Most disturbing in all the model's prognostications is the high R0, ("R nought") or reproduction number, of 2.4- 2.5.    This embodies the ease of transmissibility, or the infection rate per person.  By comparison the value for SARS (a variant of coronavirus) was 5.5. and for the Spanish flu, 1.8.   The authors do leave us with some minimal consolation - e.g. halving the projected fatalities- when they write:

"Even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US."

But  isn't this all exaggerated?  Not so. The Brit study is confirmed pretty well by an independent study by the CDC, using 4 scenarios developed by Prof. Ira Longini  (Center for Statistics and Quantitative Infectious Diseases) at University of  Florida. According to the span of scenario outcomes the U.S. could see from 200,000 to 1.7 million dead by the end of the pandemic.   This also means a critical patients load 5 to 10 times larger flooding our hospitals - of which only 10 % (of the current 975,000 beds) are already allocated to critical care.  

Could we see all patients treated? Unlikely, given the minimal additional capacity of our hospitals. Indeed,  I predict at least 4,500 supplemental and temporary medical facilities - at minimum- would be needed across the country.  These would most likely be put up  by the Army  Corps of Engineers, as Gov. Cuomo of New York has already requested.   The Germans are clearly able to do it, e.g.

This is something Trump could order right now so the nation is ready when the surge begins.  But the idiot asshole, who displayed a brief moment of sobriety last night, took to Twitter this a.m. and blasted Gov. Cuomo for his impertinence in demanding federal leadership. While also reverting to his standard xenophobia in calling it a "Chinese virus".  What will this Turd do next, suggest it was "created by Chinese bats in a lab"  like some of his paranoid asswit followers?  But it shows he has little comprehension of how weak his administration's response has been - not only in getting testing underway (weeks ago!) but having ample medical supplies including N-95 masks and ventilators. (That ought to have been ordered months ago, according to Dr. David Agus on CBS this morning). Instead the Dotard administration wasted weeks in labeling the outbreak a "hoax" and blaming Dems.  So they are responsible if this virus overwhelms the health care system with millions of patients because mitigation doesn't work.

To use the analogy of one VA Dept. of Public Health head: "If your stove has a fire you can probably put it out with a fire extinguisher, if your whole kitchen is ablaze, you can't".   This refers to not allowing the infection to overwhelm hospital capacity to treat patients.

Trump in a presser yesterday, after having been briefed on the British study, at least for the moment displayed a more sober demeanor and one heard no more happy talk.  (Even the FOX News bunch- according to a WaPo piece- have now gotten off their "hoax" hobbyhorse and are talking about a "crisis".)  Trump referred to the shutdown condition lasting through the summer - up to maybe August.  But even this is barely 5 1/2 months, and no vaccine will be ready at the end.  The British Imperial College study warns that to keep deaths down we will need to remain social distanced until that vaccine is ready and distributed.  They do warn people may not be able to adhere to strict quarantine standards, but maybe they will if their lives depend on it!

The other aspect is for such a lengthy shutdown, i.e. no one going out to work, to school, to theaters, to airports, to restaurants (all of ours in Colorado are already closed except for carry out)  a massive cash infusion will be needed to sustain those millions  shut in.  A Yale Epidemiology Professor (Gonsalves)  last night on 'All In' suggested what I also believe is needed: A $1,000 check per month per family affected.

Nonetheless, the nabobs at The Wall Street Journal are appalled at such a "giveaway" ('Virus Relief But New Business Burdens', March 16, p A16) and instead lean to Sen. Ron Johnson (R, WI) proposal of "applying for unemployment benefits"  Of course, this is nutso given our unemployment insurance system wasn't designed to provide support for what could be a year and a half absence from work.    The Journal editors' other solution of just extending sick days "as 76% of companies already allow" - also borders on foolishness.  How are you going to allow or enable an extension of sicks days for 18 months, far less 30 days? (The companies the Journal cites allow 3-7 days at most.)

Will such a stimulus infusion be mind boggling in terms of  the money needed? You bet!  But we've been through such extreme deficit spending before, as in the case of the national emergency known as World War II (Still have my mom's gov't issued ration cards from that era.)  The alternative, of letting people go out and still work while infected will see a condition in which there will not be enough body bags to dispose of the dead.  Mitch McConnell, you paying attention? 

How about the little dirtbag and Trump traitor enabler Devin Nunes, e.g.
The Fix

Should we put Devin in a  COVID-19 ward - with the other Reeptard skeptics- and let them catch it and see how much of a "hoax" it is?
French President Emmanuel Macron was correct last night when he said: "We are at war".  It is time all other global citizens recognize that and also that we may be facing a foe as ravenous and relentless as the H1N1 Spanish influenza virus that wiped out an estimated 1 percent of the then global population.

See also:

Testing positive: One D.C. woman’s week-long passage from perfect health into the grip of a ferocious virus





No comments: