Don Rogers: The curve to flatten
The Centers for Disease Control put its worst-case scenario at 1.7 million COVID-19 deaths in America. That caught my eye for the magnitude, certainly, but also because I’d landed on the same number through far less scientific means.
Thing is, no one knows. Not the infectious disease researchers, public health officials, doctors, you, me. Of course we tip to the experts and plan according to their recommendations, and they will gauge the pandemic more starkly than not, as they should.
So it is more and more communities are sheltering in place, and almost everywhere the kids will stay out of school, events cancel and restaurants close, which only makes sense.
How many people are actually catching the disease remains a mystery even in countries where there is more testing, like South Korea, which has tested about half of a percent of its population and may stop short of 10,000 confirmed cases as the disease wanes there.
Deaths, though. You can count the deaths from COVID-19 with much more certainty.
If so, the current trajectory doesn’t support the worst case. China, the most populous country on Earth and where the disease began, looks like it may not reach 3,500 deaths — 3,000 of them at the epicenter in Wuhan, a dense city of 11 million, more people than the Bay Area’s 7.8 million souls.
New cases and deaths in Wuhan and the rest of China have decreased to a trickle for a month now, and 70,000 of the 80,000 confirmed cases there are listed as recovered.
Our Wuhan, of course, is Seattle, with about 4 million people, where about half of the U.S. deaths have occurred so far, most in nursing homes.
Italy, Iran and South Korea are farther along in the cycle and so bear careful watching for clues. New cases in South Korea, at least, have been waning since March 5, while Italy continues sky rocketing and Iran, more opaque, appears to track with Italy and other European countries.
From what I’m seeing so far, the CDC’s worst case projections showing 50-60% of the world catching COVID-19 — about as prevalent as a cold — are at odds with what has happened at ground zero, where the outbreak appears to have abated and citizens have returned to work. If this holds, we’re talking 0.6% confirmed cases to an unknown percentage of the population actually infected at the peak. Remember that the higher the actual transmission, the lower the actual mortality rate of the disease.
Italy looks like the best model as a democratic country where the disease is spiking and precautions came late. The rate of identified coronavirus infections there is about a 10th of Wuhan’s, so far, in a country of 60 million people. Even so, the sick have overwhelmed hospitals in northern Italy.
Hospitals there, as here, are not set up for infectious outbreaks. We should have identified other public buildings for triage by now, and probably enlisted the military, which does at least have medical resources and expertise for battlefield conditions, if not at the scale of this.
Also, the United States has the ability to pump out ventilators, but hospitals have been slow to order them because of the expense. The government could handle this issue, as well, with a bit of foresight. We are not actually helpless. This shortage has more to do with economics and politics than capacity.
Meantime, COVID-19 confirmations continue spiking here, especially with testing becoming more available, and so fear will grow exponentially. This is not a bad thing in that the more scared we are, the less we’ll go out and spread the disease, all the better for flattening the curve.
What is that? Well, it comes from the Spanish flu pandemic in 1918-19. St. Louis prepared — arguably over prepared — at the first known case of that pandemic in town, closing public facilities and schools, and banning gatherings of 20 or more people. At the same time, Philadelphia took no precautions and carried on with a big parade. Some 4,500 people subsequently died of the Spanish flu there, while St. Louis suffered half the deaths. St. Louis flattened the curve in an effort to soften the spike and strain on medical facilities. It worked.
China did this however belatedly in Wuhan. Seattle might have lost its best chance in being first in the United States while the virus had more time to run amok before it was recognized.
The CDC and others have plotted out worst-case scenarios, and our political leaders — at last, some would say — are acting on those. There are better-case scenarios, too, although from this side of the curve we can only wait and see how this all actually plays out.
Today, as confirmed new cases soar, the death toll in our country has swept up to 175 people as I write. That much, at least, we do know. A hard count indeed.
Don Rogers is the publisher of the Sierra Sun and The Union, based in Grass Valley. He can be reached at firstname.lastname@example.org or 530-477-4299.
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