Where we are at right now from a Public Health perspective is it is an ill conceived notion that this is no different from seasonal influenza.

Seasonal Influenza spread is limited each year by the fact that (1) we have a vaccine against it, and (2) even though the antigens mutate each season there is still a certain amount of herd immunity that mitigates both the spread and the severity.

We have anywhere from 20,000 to 80,000 deaths from influenza each year. There would be more deaths except for the fact that when influenza sufferers develop pneumonia, they are put on ventilators in an ICU and pulled through the crisis. Take note of the fact that each flu season finds both emergency rooms and ICU resources somewhat overwhelmed by the number of infections.

The Corona virus. New virus. No herd immunity and no vaccine available for about a year. I was musing how our very definition of an epidemic alerts us to a problem well in advance of it arriving. An epidemic is when the number of cases is more than one standard deviation over the average. If you had zero cases before now, then a handful of cases is by definition an epidemic. That seems crazy unless you understand the math of an epidemic in a completely un immunized population.

I used to ask a question in an Epidemiology class that I taught. Would you sign a contract with me, for me to work for you for one month, with my starting pay at one cent a day, and the stipulation that you had to double my pay each day for a month? On day fifteen, my pay still looks pretty reasonable at $163.84. On day 20, it’s already looking less reasonable at $5,242.88. By day 30 I’m earning a whopping $5,368,709.12. This is the way a completely unmitigated infection moves exponentially through a population.

There have been descriptions of how the Italians went from preparation to crisis in their response to this virus. They completely cleared all departments of a hospital of cases that absolutely did not need to be there. Day one, the hospital was a virtual ghost town. Then a small population that grew to challenging, then became overwhelming. They became so overwhelmed that people over 65 or with underlying conditions were triaged out of the process and did not have resources wasted on them. That is the reality.

Don’t let anyone convince you that this is no different than the seasonal flu. It’s not, by a long shot.

Keith
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