Like most of the rest of the world, I have been following the news of the coronavirus closely for the last couple months. Having two daughters from China, I was particularly struck by reports of this new virus killing people and shutting down cities in that country that will always have a piece of my heart.
And then it spread – and now it is here in the States. And each of us is faced with the question – what should we do now? Even if we could trust the leaders of our country (and the evidence is clear that we cannot), each of us is responsible for ourselves, and, in a broader sense, we are all bound together as a society, and we share responsibility for what happens to us all. We are all responsible for making wise choices, but when there is no clear, competent leadership, we have an even greater individual responsibility.
Initial data indicates that without intervention, each person infected with the coronavirus transmits it to somewhere between 2 and 3 other people. The World Health Organization (WHO) states that its incubation period is probably between 1 and 14 days – meaning that people can transmit the virus to others for up to two weeks before they develop symptoms themselves. And they also state that, “older persons and persons with pre-existing medical conditions (such as high blood pressure, heart disease, lung disease, cancer or diabetes) appear to develop serious illness more often than others.”
Its mortality rate, right now, seems to be around 3-4%. But, beyond that, we can see significant issues. For instance, “Around 20% of cases require hospitalization, 5% of cases require the Intensive Care Unit (ICU), and around 2.5% require very intensive help, with items such as ventilators or ECMO (extra-corporeal oxygenation).” Our hospital systems in America simply do not have the capacity to provide ICU care to the numbers of people who may need it. The same article states, “A few years ago, the US had a total of 250 ECMO machines…So if you suddenly have 100,000 people infected…Around 20,000 will require hospitalization, 5,000 will need the ICU, and 1,000 will need machines that we don’t have enough of today. And that’s just with 100,000 cases.”
As of yesterday, there were about 3,500 people who tested positive for the coronavirus in the States. However, one of our earliest failures in fighting this disease has been in testing. A Johns Hopkins physician was quoted last week (back when the official tally of cases was 1,600) as saying, “Don’t believe the numbers when you see, even on our Johns Hopkins website, that 1,600 Americans have the virus…No, that means 1,600 got the test, tested positive. There are probably 25 to 50 people who have the virus for every one person who is confirmed…I think we have between 50,000 and half a million cases right now walking around in the United States.” This article explains in great detail how we can estimate case numbers and project into the future.
There are no confirmed cases of the coronavirus in the city or county in which we live. But what does that mean? It certainly does not mean there are no cases. It means that there may be cases…but we don’t know it yet. And quite probably, those people who have the virus don’t know it yet either.
So what do we do?
I believe we need to start acting like there are cases here. And, as many are advocating, we need to do everything we can to flatten the curve. If everyone gets sick at once, our healthcare system (our hospitals, our ICUs, our ventilators, our ECMO machines, our doctors, our nurses) will be overwhelmed. This is already happening in Italy. They are having to make decisions about who to treat – who will live and who will likely die. No one wants that to happen here.
And there is something each and every one of us can do to work to prevent it. This brief Washington Post article with simulations does an amazing job explaining and showing why social distancing works. Please check it out. Look at what happens when everyone moves around normally. Look what happens when only one in four people continue to move around. And then look to see what the results are with only one in eight people moving around. The difference is dramatic.
Some people cannot stay home. Doctors and nurses, of course, cannot. My 66-year-old mother who is a Wisconsin county’s Director of Emergency Management cannot. We all need to eat, and those who work at grocery stores will continue to work. Many people have no savings and will be required by their employers to continue to come in to work. However, there are a great many of us who have tremendous privilege, who are able to stay at home. It would be impossible to get any of our cities to a point where everyone stays home 100% of the time – but can we get to a point where only one in eight of us are moving around regularly, or even one in four? Can we slow the spread of the coronavirus enough that we will truly flatten the curve, so that our healthcare systems and our doctors and nurses and other hospital staff members are not pushed beyond their capacities?
I hope so. Lives depend on it. You may be young and healthy, and likely you would be fine, even if you contract the virus (though there are no guarantees). But that is not true for everyone. The mortality rate for those over 80 is around 14%. China’s CDC indicates that the mortality rate, “was 10.5% for those with cardiovascular disease, 7.3% for those with diabetes, 6.3% for people with chronic respiratory diseases such as COPD, 6.0% for people with hypertension, and 5.6% for those with cancer.”
Within my little family, risks are high. I have exercise-induced asthma, which may (but also may not) be an additional risk factor. But for two members out of our family of six, their underlying medical conditions could make the coronavirus extremely dangerous for them. While we often think of osteogenesis imperfecta as primarily related to bones, it is actually a collagen disorder and therefore affects every system of the body. The OI Foundation reports that, “Respiratory complications are a leading cause of death for children and adults who have OI.” The coronavirus could be devastating for FangFang. Additionally and probably even more concerning, last year Matt was diagnosed with interstitial lung disease. His lung function is already so compromised that the prospect of him also facing a virus that attacks the lungs is terrifying. Most people who contract the coronavirus will be fine; would Matt and FangFang? It is less clear.
So what are we doing?
We are staying home. We are practicing extreme social distancing. We are canceling everything. I went grocery shopping on Saturday morning, and that will be our last grocery shopping trip for weeks, at minimum. We are not running errands. Mizzou has transitioned all in-person courses to be taught online, so Matt is able to teach from home. If he has to go in to campus for meetings or any other reason, he will, but he will do all he can from home. We are not attending church worship gatherings. Our kids are staying home from their homeschool enrichment group. Swim practice has been canceled through the end of March. We will not be doing horseback riding lessons. We will not go to the library or to the gym. We have canceled a spring break trip Matt was scheduled to take – unnecessary travel with thousands of other people through airports and on airplanes seems unwise at this time. We have rescheduled all non-urgent medical appointments. We are not visiting friends, and we are canceling visits from those who had planned to come to our home.
Would you consider doing the same? Will you help to flatten the curve? Will you do your part in reducing the risk to vulnerable populations, like the elderly – and like Matt and FangFang? Will you do what you can to protect our health care system and medical professionals? Some people cannot stay home – but if you can, would you please do so?
Maybe it will seem like an overreaction. But what if it doesn’t? What if we are facing an unprecedented pandemic? What if you could save lives with your decisions, by simply staying at home with your family? Would you do that?