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COVID-19 Update August 8, 2020 – The Most Important Number Now: 1 in 100,000

By Dr. Arthur Lavin

Glossary

  • Virus– a type of germ that consists solely of a bit of genetic material (DNA or RNA) wrapped in a protein coat.  The coat gets the genes into the target cell where the genes force the cell to make zillions of new viruses, and on it goes.
  • Coronavirus– a species name of a number of different viruses.  Called corona because its protein coat is studded with spike shapes that form a crown, halo, or corona of spikes
  • SARS-CoV-2– the specific name of the new coronavirus
  • COVID-19-the name of the illness that the new coronavirus is causing
  • Endemic– an illness always present in a region.  One could say strep throat is endemic in the US
  • Epidemic– a sudden burst of an illness that comes and goes over a limited time
  • Pandemic– an epidemic that bursts across the world not just one region
  • Spreadability– how contagious is the disease, how many people will end up infected
  • Symptoms- the experience of being ill, for example- fever, cough, headaches, loss of smell etc.
    • Asymptomatic– literally means “without symptoms”.  For COVID-19 it refers a person infected with the virus but has no and will have not symptoms
    • Presymptomatic– This is a person who was infected with SARS-CoV-2, and will feel sick, but hasn’t yet
  • Severity– what harm does the disease cause, in terms of  how sick you get and how many it will kill
  • Mask- a mask is a loose-fitting cloth or textile that covers the mouth and nose loosely.  A surgical mask is a mask used in surgery
  • Respirator-  for the purposes of the COVID-19 pandemic and other respiratory illnesses, a respirator is a mask that fits very snugly or tightly to the user’s face.  An N95 mask is a respirator.
  • Personal Protective Equipment (PPE)- PPE are any item that covers any part of the body with the design and intent of keeping viruses in the environment from infecting the wearer of the PPE. PPE’s include all masks (which includes respirators), face shields, eye shields, gloves, gowns.
  • Ventilator- a ventilator is a machine that can force a person unable to breathe to inhale and exhale and control both effectively.  They are sometimes called respirators, but during this pandemic the word respirator is now reserved for reference to a tightly fit mask.
  • Live Virus Swab– this is the swab which attempts to swipe live virus from one’s nose or throat to see if you are currently infected.
  • Antibody Test- (aka serology test) this is the blood test which looks for antibody to the SARS-CoV-2 virus to see if you have been infected in the past.

 

Stopping the American Pandemic:  1 in 100,000- the Key to Saving our Lives

As we report news on the progress of our nation in responding to this most dangerous epidemic, our attention gets drawn to so many items that demand our attention, but will not solve our essential problem.

The items that demand our attention include:

  • Opening Schools
  • Getting Back to Work
  • Visiting Family
  • Vaccine Development
  • The Course of this Peculiar and Very Dangerous Infection

But none of the items will ever solve our essential problem.

What is our essential problem?  That is easy to say- the nation has a deadly virus running loose, when it could be stopped.  As a result over 1,000 of us are dying every day, for no very good reason.

Just a couple of days ago, the very wise and knowledgeable Dr. Michael Osterholm and the President of the Federal Reserve Bank of Minneapolis.  Dr. Osterholm is the amazing expert on COVID-19 who joined us for an interview.  And the Fed of Minneapolis President is one of only 12 Federal Reserve Bank Presidents.   This is an amazing article, I urge all who have any interest in solving our essential problem to read it, it tells us the answer.

Here is the article:  https://www.nytimes.com/2020/08/07/opinion/coronavirus-lockdown-unemployment-death.html

This is one of those essays that deserves a close reading, and re-reading.   It lays it all out there, what must be done to stop this devastation, what will happen if we do not, how will we know if we have succeeded, and other key items.

I found there were two facts worth noting:

1 in 100,000

This is the key number that defines all efforts that matter today.   The authors report that if in the United States the daily count of new cases were to be dropped to 1 in 100,000, we could really control the spread of this virus.

Think what this means.  With full control of the spread of the virus, we can go back to work, to play, to school, without twisting ourselves into knots pretending we can do so without accelerating the number of us who will be killed by this virus.  Schools could open without threat of them closing a week later.  College students could go to college.  Everyone with a job could go to work.   And incredibly, almost no Americans would die from this virus on any given day.

In the United States, 1 in 100,000 translates into 3,500 new cases a day.  We haven’t had that few cases a day since mid-March, and are at about 60,000 a day right now.

The authors make clear the only path to achieve this essential goal, is to truly lockdown for 6 weeks.   A terrible reality.  But if we do not do this, then the acceleration of illness and death will create “a greater catastrophe.”

One interesting observation is that if the pandemic were to be halted, then all the millions of tests available would be plenty to find new outbreaks, and could provide much faster results with numbers of cases so drastically reduced.

Personally, I find the needless loss of 160,000 of our lives an outrageous catastrophe, but knowing we can keep that from happening again, and not doing it would indeed be “a greater catastrophe.”

Current Efforts Should Continue, but will Fail on their Own

The authors emphasize the solution needs to be twofold:

  1. Lockdown for 6 weeks, or really, until the national case rate is about 3,500 per day, not our current level which is about 20x that level.
  2. Current efforts, including masks, social distancing, handwashing, smaller crowds, simply will not stop the pandemic in the United States.

A Word on College

We have focused most of the school re-opening issue on K-12 schools, which makes sense as we seriously contemplate sending 55 million of our children into indoor rooms for several hours a day.  Again, our point on this issue is that the first question should not be how to re-open schools, but ho to stop the pandemic (the answer is above).

But not only K-12 schools are trying to open as the pandemic rages.  So are 15 million college students, yearning to be free.  Staring around now and in the next month, we will be witnessing the vast majority of these 15 million of our children going to college.  Colleges are trying all sorts of ideas, some virtual classes for large groups, dorm restrictions, etc.

The problem is the same as K-12.  Gathering any group of people, while the pandemic rages clearly risks a major flare of disease, harm, and even death.  The situation with college students seems to challenge all of us with a particularly sharp risk.

The experience in the American South and Southwest appears to be due to a very serious rise in COVID-19, a real and very dangerous epidemic, whose progress seems to have been ignited and sustained mainly by young adults, in the range of 15-25.   It is this group in the US, more than most, that is getting together now with quite a bit of abandon.  Getting together in homes, in parties, with documented spread of the virus.

I am imagining 15 million college students gathering on campuses across nearly every city and county.  And in many of these campuses, despite long lists of guidelines, these young adults will find a way to get together, and if they do, the virus will rise.

Again, the only answer that makes sense if for our nation to stop this pandemic here, and the path forward is now very clear, the number 1 in 100,000 is the target.

BOTTOM LINES

  1. The masterful Dr. Michael Osterholm has teamed up with one of only 12 Federal Reserve Bank Presidents in the nation to alert us to the essential challenge we all face in our country- to stop this pandemic and now.
  2. The only path to do so is to reduce new daily cases to 1 in 100,000 people, or about 3,500 new cases a day.
  3. The only path to achieve this goal is to do a lockdown, this time until case counts drop to the 3,500 a day.
  4. Once the pandemic is halted, and the spread of virus severely reduced, then outbreaks can be discovered and squashed.
  5. Do this, and the threat of the pandemic lifts.  We can do all we so dearly need to do- school, college, jobs, family visits.
  6. Don’t do this, and the damage to our lives and economy so far, will pale in comparison to what will happen.
  7. As we consider these realities, it is reasonable to consider the threat of 15 million college students gathering without such actual success in stopping the pandemic in America, like so many other nations have already done.

To your health,
Dr. Arthur Lavin

 

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