Archived Facebook Coronavirus Posts: Feb 14th

[I'm transitioning a bunch of Facebook posts I made on the Coronavirus to my blog.  This was from February 14th]

With multiple children who are at relatively high risk to a pneumonia-causing disease, I have been following news of the novel coronavirus disease (aka Covid-19 now) pretty closely. I now think it is pretty likely--maybe more likely than not--that Covid-19 will become a global pandemic that will reach to the United States.

At any rate, it is now very reasonable to start talking about common sense preparations people can do *in case* we do end up with a medical crisis on our shores.

I think the first thing to do is to understand what such a crisis would look like, *if* it did happen. So here's my attempt to pre-construct a worst-case scenario that is reasonable to consider:

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1. A certain threshold of number of infected people is crossed in your community. Most (85%) of these people are showing very mild or even no symptoms and spread the disease around before they know to contain themselves. The disease is now essentially anywhere and everywhere in your community. Let's say for the sake of argument that the disease infects 25% of the entire population within a relatively short time period.

2. In about 15% of cases, the Covid-19 causes serious problems, specifically pneumonia requiring hospital aid. This contingent consists primarily (but not entirely) of vulnerable people, specifically:
* the elderly
* immunocompromised
* diabetics
* people with Down Syndrome
* smokers or ex-smokers
* healthcare workers or anyone who has to spend a lot of time in hospitals.

Depending on the whose numbers are accurate here, maybe 1 or 2 percent of the total who fall sick will die, mostly from Acute Respiratory Distress Syndrome, or ARDS..

3. Suppose you live in a town of about 20,000 people. With the numbers above, about 5000 people will become infected and 750 will become seriously ill. Of these, about 50-100 will die even if they receive full care.

4. In a town of 20,000, the local hospital will not have anything near the resources to deal with 750 seriously ill people in a short period of time. The primary stressed resources will be personnel, hospital space, and ICU resources, particularly ventilators.

5. The likeliest consequence, I think, is that a distinction will have to be made between *seriously* ill people and *critically* ill people. People with "just" pneumonia will be told to stay at home, self-care and self-monitor, with occasional visits from over-worked health care workers for check-ups. Only the people at death's door are going to be admitted to the hospital for ICU treatment. This is what (we're pretty sure) has been happening in Wuhan.

6. There is some evidence that this state of affairs greatly increases the case fatality rate. That is, even with full hospital care the CFR might be 1%, *but* some estimates put the CFR in Wuhan at 18%. This difference *might* be because of the large number of people who are being left at home out of necessity.

7. Note that for this scenario I have chosen numbers that are very plausible and have put forward as the best guess actual proportions by people I consider pretty expert and knowledgeable. However, the numbers are not certain and it is quite possible that they could be worse in reality.

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So this is the plausible scenario that we might try to plan for. What can we actually do in such a scenario? Well, first I think we can all educate ourselves on how to avoid picking up viruses of this sort as much as possible--learn all of the hygiene rules and be able to self-isolate as much as possible.

Second, I think we should learn the symptoms of ARDS, especially those of us with vulnerable family members. I have two links for this: an excellent YouTube video on ARDS (https://www.youtube.com/watch?v=okg7uq_HrhQ) which includes some information on recent research on how to improve survival rates from ARDS. And also here is a symptom run-down of ARDS from healthline: https://www.healthline.com/…/acute-respiratory-distress-syn….