From Martha Kennedy, Interesting Graphic from a Historical Pandemic

I guess this means, “Hooray for the internet!”

Every group I’m familiar with has been canceling all their F2F activities. The Pacific Crest Trail Association is no longer having meetings or doing trail work. The schools are shut down and God only knows what all those two-income families are going to do with their kids. They’ve also shut down the local colleges. (And right after I’d gotten a figure modeling job there!)

The Nature Center where I’m a docent is a ghost town. All nonessential functions in Santa Clarita are shut down. Almost every theater is closed, and classes are shut down for the duration, so progress on my skit is at a standstill. A few movie houses are open to smaller capacity so that customers can sit several seats apart.

Even the NBA has shut down. The live entertainment industry is going to crash and burn.

Grocery store shelves are barren. People are hunkering down. I could actually start to enjoy this. It is a great time to hit the trails. No viruses out there. My social anxiety levels are approaching zero.

Welcome to Walmart

Voluntary social distancing is the only practical way to slow the spread of the coronavirus. We do not live in a dictatorship. The government cannot force millions of people to stay at home. It cannot force you to test yourself daily with a phone app. It cannot whisk off ill people to a detention center. Even if it tried, there aren’t enough soldiers to enforce it.

While isolation slows the spread, it does not necessarily reduce the number of infected. It may just stretch the term of the epidemic out so that at any given time there are fewer ill people. But that is a good thing. Hospitals do not become as overcrowded. The caseloads of medical professionals do no become so overloaded. Industry can continue to run at reduced capacity. Over time we get better at managing the symptoms and every day offers a chance for a breakthrough.

A short and intense epidemic overwhelms the system’s capacity and everyone is sick and recovers (or not) before any progress is made.

A fair percentage of people who were infected but have since tested negative for the virus are relapsing.  Combine that with the number of people who are infected but asymptomatic and it could be a long time before we are confident it has passed.

We just don’t know enough yet. If anyone needs to be hated on for this it is the government of China. We still do not have the full story (and probably never will) but they sat on this and denied anything was going on for at least a month. The doctors who

Cytokine storm. Your own immune system goes crazy and attacks your own body.

reported this new disease were forced to keep it quiet and nothing was done because the officials were more afraid of bad PR than of the epidemic. That’s a month of uncontrolled spread, a month of lost research into vaccines and treatments, and a month of lost time to prepare for impact.

The virus can kill by destroying lung cells. Victims with a severe case need to stay on respirators until the body can do some repairs.  Because the demand for respirators and extracorporeal membrane oxygenators can exceed supply, flattening the curve becomes even more important or triage becomes an ugly possibility.

In some people, it causes what is called a”cytokine storm”. Your body’s immune system overreacts to the point it destroys itself through multiple organ failure.  It is not the only virus to do this, so we don’t have to start from scratch. We’ve had good luck in treating this through the use of drugs used for autoimmune diseases, notably Tocilizumab, an IL-6 pathway blocker used for rheumatoid arthritis. Roche has permission now to start producing the drug on a mass scale.

COVID-19 underlying illness.
A different way of slicing the numbers. If you have no underlying health issues you are comparatively safe.  I am fortunate according to this chart.

You hear a lot of nasty numbers bandied about. The WHO estimate of 3.4% mortality is the most common. The media runs with it but doesn’t explain what the numbers mean.

OTOH, South Korea has a .6% mortality rate. They seem to be well prepared and responding as aggressively as a liberal democracy could be expected to. Their massive testing effort also turns up asymptomatic cases. By reporting many more minor cases, the fatal cases become a far smaller percentage of the whole.

Why are South Korea’s COVID-19 Death Rates So Low?

I shudder to imagine what is happening across the border to the North.

The earliest phase of a modern epidemic always has the highest mortality. People are getting sick and doctors don’t have a clue. Once we realize what is going on, protocols for medical care are developed. We learn how the virus kills, how to slow the spread and where to put resources. Drug therapies are developed.  Spooling up to fight a pandemic takes time. That is why social disconnection to slow the spread is so very important.

We are also discovering that most cases of COVID-19 are asymptomatic. You will never know you have it, in most countries will never be tested, and will never end up in the data books.

A total of 81% of cases in a Journal of the American Medical Association study were

COVID-19 by age
As pointed out, these numbers are artificially high. They will drop as we get better at detection and treatment. Even so, if you are both young and healthy you have little to fear for yourself. Grandma is a different matter.

classified as mild, cases that are so minor as to be dismissed as a cold or light flu. The perceived mortality rate is affected by how widely testing happens.

Also, the mortality by age chart shows us that the mortality rate is dependent on age.  Folks like me get the short end of the stick while those in their 80s are in desperate straits.

Any kind of chronic medical issue compounds mortality your risk. Almost everyone under 50 who has died had diabetes or heart disease or liver disease or some other seriously debilitation medical condition. (Everyone over 80 has a seriously debilitating condition called old age.)

OTOH, the saving grace is that younger children have a virtually zero mortality rate. I’ll take that trade-off if I must.

So stay at home. Limit your contact with other people. Keep your distance when you must and avoid touching. Wearing a mask by itself will not prevent your own infection but it will keep you from infecting others. A painter’s mask or even a bandanna isn’t as good as a fancy N-95 mask but is far better than nothing.

To protect yourself completely in a social situation, you’d also need goggles (in case of a nearby sneeze) and to keep from touching your face unless you have just washed your hands. It doesn’t need to be alcohol wipes or hand sanitizer. Soap and warm water is just fine. Heck, wash everything after close contact with another person.

Wipe down surfaces that others have been in contact with a disinfectant. Chlorox, Lysol, Spic and Span, any of the household disinfectants will do. (Hard liquor would work in a pinch. You’d want a very high alcohol content, 120 proof is best. Not vodka and not pure alcohol.) Or wear gloves and either toss them or launder them.

Of course, everyone else you live with has to do the same thing else you are delaying your own infection instead of preventing it. (This is still preferable to landing in the first wave.) Few are prepared to button up completely in a home/bunker for the months this is going to take. It makes life in a rural area look really attractive. (And maybe those obsessed survivalist types understand something the rest of us have forgotten.)

I view coronavirus exposure as being as inevitable as waves on the sea.  You learn to hold your breath when you need to or you get in trouble.

COVID-19 prevention