31 March 2020

On how to deal with the Coronavirus Epidemic

I keep saying this, but I am going to keep on saying it, in hopes that it will influence a few people and that others saying similar things will create a critical mass to actually do something.


There is only one way ONE WAY before there is an effective antiviral treatment or vaccine, to prevent millions of cases, hundreds of thousands of deaths, and continued virtual cessation of the economy. And that is to drive the R0 ("R naught") for our country down to or below 1. (R0 < 1). If you don't understand what R0 is, it's pretty simple. It's the rate of infection of others by each infected person. If each person contracting the virus infects fewer than one other person, in relatively short order, the rate of new infections drops to zero. It's Epidemiology 101.

No amount of "social distancing" or other half measures that fail to achieve this will actually stop the epidemic. Any easing up will just cause it to return later.

Our Federal government botched the response early on. That's just a fact, and there's no point in arguing about it. But what is actually worse is that our governments, even our state governments, are STILL not doing what is necessary.

This is a war. We have seen what it is doing to our economy, our way of life, everything. We have to respond to it the way our country responded to Pearl Harbor. Full mobilization. Temporary extraordinary measures. Compulsion that we're not used to in this country, but it's necessary. If you read about what has been done in China, Singapore, Japan, Taiwan, and Hong Kong, you realize that suggestions and half measures are not enough. We must mobilize as if we were in a major war, because WE ARE.

There is no way to get R0 below one other than the following: TEST at least 65% of the adult population while maintaining "Stay at Home" nationwide. TEST everyone who is asymptomatic and tests negative again with an antibody test to determine if they are exposed asymptomatic immune. Such people are very much needed to help in the fight. It may even be necessary to draft some of them into service.

The reason for the 65% figure is that this is the threshold where, if that percentage of the population is immune, or isolated, or recovered, or known negative, then the virus will begin to disappear. This happens naturally, but only after a devastating catastrophe that we MUST prevent.

Those who test positive but are asymptomatic must be STRICTLY quarantined for at least 14 days. Everyone who tests positive and is ill needs to be given treatment in ISOLATION.

There needs to be a worldwide effort, but right now a major national effort, to produce a cheap, disposable, and eminently mass producible test with at least 99% reliability. This should be the challenge. The first company to succeed should get, not a patent, but a direct reward payment from the US treasury of $1 billion. The powers invoked (finally) by Trump to force manufacture of war materiel should be used to ramp up mass production of PPE, test materials, field hospitals, and major isolation installations to treat the sick without continuing to spread the virus in the population. Thousands of people with ancillary medical training and skills should be brought in from the serum immune population to help with this effort.  

In the meantime, EVERY conceivable effort must be promoted and funded to develop effective antivirals and vaccines, because that is what will finally end this and allow international exchange and travel to resume.

If our nation finally realizes that this REALLY is the equivalent of a World War event, this kind of response can work. There will have to be massive relief efforts in conjunction with it, and a total commitment of the citizenry to cooperate and make it work.

This is our challenge.


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