Day 43: April Won’t Be The Cruelest Month

Day 43. I hoped to not get this high. If we hit triple digits…well, that will be a in world I don’t think we will be able to fully understand.

I am still working, as is Tammy. I’m at the dining room table, she works in a hospital lab. Neither of us is sick, that we know of, and that is likely to continue to be the case. Of course, we could both be asymptomatic. But then, so could everyone. It’s a crap-shoot. Illinois is mandating masks as of Friday, the 1st of May. I have a Mission headwrap thing that I am using as a mask, and a balaclava on route from Under Armour. I know those are not the best choices, but it is what it is. They work well enough for now, and since I am not sick, and the mask isn’t to keep me from becoming sick, that’s all it needs.

Ideally, something similar, but with multiple layers would be available. That just isn’t the case these days. Oh, the useless ‘dust mask’ with side vents is all over the socials. While that is exactly the concept I am looking for, the side vents…which open to allow you to exhale…make it less than useless. Remember, the mask is to prevent you from spreading the virus, not to keep you from getting it.

Of course, the busybodies insist on making people as paranoid as possible about these things. While it is true that a three layer mask of differing cloth types is best, any mask helps. And posting articles about improper fit is just feeding the fear – these aren’t respirators, they don’t need a skin seal. Seriously. That kind of seal is needed for N95, and nothing else. Stop working to undermine people’s sense of safety already.

Honestly, if the media as we know it survives this, I’ll be shocked. As a collective, they have failed at every level, and are increasingly being exposed as little more than low-level PR flacks. Honestly, a purge of their ranks would not be unwarranted. The myth of the intrepid reporter crusading for truth is as dead as the crusaders themselves. Sadly, they did this to themselves, and there is literally no one else to blame.

But enough about that. Let’s look again at what might be next.

Reopening Things

This is the hot topic of the week. Some states are beginning to ease restrictions on activities. In essence, they are the canaries in the coal mines for how a post-restriction US might look. Some states seem to be throwing open the doors, so to speak, while others are taking it slowly. Personally, I like the approach being used in Texas.

First, on May 1st, retail stores, restaurants, movie theaters, and malls can reopen. But they will only be allowed to operate at 25% capacity. Museums and libraries will also be allowed to open at 25% capacity, but hands-on exhibits must remain closed. If there is no flare-up in cases, then on May 18th, at the earliest, businesses to expand their occupancy to 50%. If there is an increase in cases, then Texas will revert to the 25% cap. There is no information on full capacity reopening. There are also rules about who can be at work, and so on. Lastly, this isn’t a forced reopening – if you feel that remaining closed is best, then you can continue to do so.

I think that is the most sane way to handle this. As we have seen, the collateral damage has been pretty heavy, and that isn’t counting the medical cost.

The Medical Cost?

Yeah…you would think that in a pandemic, the strongest industry would be health care. You would be wrong. The Mayo clinic is facing a reported $3 billion loss, and furloughing or laying off (reports vary on phrasing) some 30,000 employees – 42% of their workforce. And they aren’t the only ones. With the orders in several states to restrict or cancel all elective procedures, hospitals are struggling. See, the term ‘elective’ is misleading. Elective doesn’t mean ‘by choice’, like a facelift. Elective means ‘not required to save your life right now’. So, having a gall bladder out is elective. Having biopsies – including for breast cancer – is elective. And those just stopped. And with them, the bulk of most hospital’s income.

Of course it gets worse. The American Academy of Pediatrics reports that only 20% of four month olds are fully immunized. Parents are refusing to take kids to the doctor in fear of COVID-19. What that means in terms of the health of these kids is that they become unprotected against lethal, avoidable, diseases. A local pediatrician states “There will absolutely be far more infants and young children who die as a result of that than from the pandemic.” This, of course, is just the icing on the horrible cake. We are seeing delays in literally every medical procedure. From the aforementioned facelifts to appendectomies. Which are, in case you weren’t aware, is not elective.

Reopening The Wrong Way, Part 1: Vaccines

The wrong way to do this…now that’s not how we talk about it most of the time. There are two main ways to do this wrong. First is to wait for a vaccine. Keeping things in pause that long would destroy most people’s sanity, and most business and state’s ability to pay the bills. Vaccines take time. 14 months, minimum. Then time to produce and distribute. And that is assuming they are an option at all (see the common cold…). So, call that 18 months. Or, about this time, 2021.

Can you imagine? 18 months. No haircuts, no dates, no movies, no social activity. Of any kind. Worse, people will, in all likelihood, keep avoiding doctors, and that will result in avoidable deaths. Waiting on a vaccine is social suicide.

Reopening The Wrong Way, Part 2: Herd Immunity

If waiting on a vaccine is social suicide, then waiting on herd immunity is actually worse. It’s literal suicide. At least for a huge swath of the population.

In an nutshell, herd immunity is the status achieved when a sufficient amount of the population has antibodies to a disease, preventing it from spreading. Antibodies come from two places – recovery from an illness and vaccines. Since we are not talking about vaccination, we’ll discuss the ‘recovery’ aspect. First, herd immunity won’t keep you from getting sick if exposed, it merely lessens the chance of exposure. No more, no less. The ‘herd’ part acts as a buffer – so if you are infected, but most of the people you know are immune, then you have no one to spread it to. Simple!

And it is. When it works. As I mentioned above, there is no proof COVID-19 antibodies confer future immunity. Other corona-type viruses do, so there is a logical expectation that this will, but we haven’t gotten to the point where that can be reliably demonstrated just yet.

Further, herd immunity has a threshold of the population to meet. The herd immunity threshold (HIT) varies by disease – for the flu, it is around 33% – 44%. For things like pertussis (see missed infant vaccinations above), it’s 92% – 94%. The current estimates for COVID-19 range from 29% – 74%. For the next bit, I will use the average of 66%.

66%. That is the average population amount of recovered COVID-19 patients to achieve HIT. Look at the case fatality rates below. The average CFT for the three states I have been following is 5.37%. Still using only these states, the total population is 38,857,601. 66% of that population is 25,646,016. 5.37% of that number is 1,377,191. Or, in just these three states, to achieve herd immunity, you would need to have 25,646,016 people infected, of those, 1,377,191 would die.

1,377,191 deaths. That’s Indianapolis and all of the rest of Marion County wiped out. More than one and a half times.

The US as a whole, using today‘s CDC data, has a case fatality rate of 5.82%. In the US, achieving herd immunity would require 12,777,333 deaths, based on these numbers.

It is vital to note that COVID-19 is a very regional disease – Idaho is not New York. However, the estimate above is based on the CFR of the US as a whole, so while it’s likely inaccurate, it’s at least based on what the nation, as a whole, looks like.

Final Thought

It’s day 43 – and we are still in a holding pattern. We need to have serious discussions about how we move forward, and that means talking about reopening our nation. The consequences to continuing to hold are dire – but so too is reopening poorly. There is no way to win this thing, exactly, only minimize the loss. We need to hold our elected officials to the proverbial fire on this issue – discuss the plan to reopen. Eventually that window will close, and people will just reopen it themselves. At a staggering cost.

Just a reminder about the ‘Day xx’ in those section headers. That is day 43 for my experience & blog. Not the actual day for the infection tally in the listed states. Just to clear up any confusion.