Is Our Current Approach to Coronavirus the Quickest Way to Cure the Problem?
 

I know there are many threads on the coronavirus problem, but please allow me to start one to discuss just one specific aspect of this. I recently read in another thread here a comment to the effect that if we will just stick rigorously to our social distancing practices and practice good handwashing and the like, that we will be over this problem quicker.

While that may sound logical and correct, I don't believe that it is. In fact, if you will recall, the whole idea behind shutting things down and maintaining social distancing was to drag this process out for many months so as not to have too many cases at one time which would overwhelm our hospital resources. In other words, we wanted to "flatten" the curve, not have a short, sharp, high curve.

The quickest way to be rid of the CV problem would be to make no changes in our everyday habits, let people catch the virus, and then have about 99+% of them recover and thereby build herd immunity rather quickly. The problem with this approach is that fatalities would likely be higher in the near term because the number of seriously ill patients would overwhelm our hospital system.

So, the powers that be chose the approach that would drag this situation out for a much longer period of time. While this approach would likely be easier to handle from a healthcare perspective, it will undoubtedly extend the time that we are dealing with the disease to a much, much longer period of time.

The drawback to this approach is that the disease doesn't really go away, it just spreads at a much slower rate and therefore takes a much longer period of time for our country to build a sizeable herd immunity. If we were able to go about our ordinary lives while slowing down the spread of the virus, that would be great, but unfortunately we can't.

So, I don't mean to be the bearer of bad news, but I'm concerned that this "social distancing" and shutting down of all non-essential businesses may be with us a LOT longer than many people think. In fact, the better we are at self distancing, the longer the situation will likely last.

So it appears that we either stay the course for many months or resume life as usual in a few weeks and see a rapid return of many sick people. The only bright light that I can see in the "slow" approach that was chosen is that it may buy us some time in the hopes that a cure may be found quickly. I certainly hope so.

There is one other alternative, but it's not popular in many circles... and that is to isolate the most vulnerable (the aged, the immune compromised, etc) in their own homes and let the rest of the country go back to work. Personally, that's the approach that I think should have been taken from the start, but many people think otherwise.

I hope everyone stays well. I just wanted to present the choices as I see them.

Thanks

Good article, but I don't think it said anything substantially different from what I said. In a nutshell, it said there are 3 ways of stopping the disease. One of those ways is to have an effective vaccine which could be a year or more from now.

The other two ways could be called the fast track method and the slow track method. In either of these two methods, it takes a certain number of the population (say 60%) to become infected and to build immunity in order to provide herd immunity to the rest of the population. The only substantial difference between the two methods is how long it takes to get to 60%.

We've apparently chosen to take the slow method.

I think you've summarized it exactly as it is. This is not sustainable from a societal perspective and we've yet to hear a cogent alternative. My fear is our government doesn't have a plan and is making it up as we progress.

Regardless, your assessment is on point.

Yes. You are correct. I attached the article because it reinforced your points. I am married to a retired physician and I gain my medical perspectives based on her expertise. We have discussed this virus issue daily. And based on those discussions, I believe that herd immunity will end this pandemic in the end. According to current testing, the US has over 350,000 active cases now. And if as the experts claim approximately 80% of citizens can have the virus with little to no issues, the number of active cases might be much greater. So, herd immunity is already taking place isolation or not. A vaccine will come at some point but it will only prevent a possible yearly return of the virus and only if people get the vaccine.

Coronavirus Dashboard

Just make sure to write your obit before locking yourself in a school gym with all your pals who are willing to sacrifice themselves for the sake of humanity.

I for one would prefer not to get sick in the first place, than to get sick and risk death while hoping to recover and become immune.

Seeing there are only 3 choices, two really. The vaccine is at least a year away. Either let everything go back to normal and deal with an overwhelmed hospital system: not only COVID 19 but heart attack, stokes, annurym, etc. Many more people will probably die and many of them would have had a better chance for survival. Many of those people are likely to be older and/or have other health issues.

I think the idea of "flattening the curve" while not perfect makes more sense. The hospital system is not overwhelmed leaving more people alive until a vaccine could be found. A better approach would be a nation side shutdown until the end of May. During that time massive testing to see what areas could be brought back online.

I'm selfish in that if there is anything to lessen the chance of my Dad getting this; that and my son and daughter in law being saved than I am fine with that. Am I bored? Yes. Am I frustrated? Yes.

There is no easy answer.

One more factor is is give time to develop a thearaputic that at least decreases the severity of the disease.

Four simulations of different degrees of social distancing.

https://www.washingtonpost.com/graph...ona-simulator/

I see the point of the herd immunity, but there are some very real problems with that approach. The small percentage of people that would die are not spread out evenly between the entire population. It is an easy and shellfish argument if you are in your 20's and healthy, but a very different and dangerous argument if you fall into one of the statistical groups that has a much higher expected mortality rate than the general population. Also, the virus could prove to be both seasonal and able to mutate and come back in another form that immunity may not block. Another important issue is that many people that survive this horrible virus my in fact now have immunity, along with permanently damage to their lungs and/or other vital organs. I would rather be cautious and try not to get infected until a vaccination is readily available.

There were many wild estimates by the experts in the very early stages of this CV situation, but more recent data suggest that these estimates were likely off by several orders of magnitude.

Besides, whatever number of cases it takes to achieve herd immunity doesn't change to any significant degree whether we choose the fast track route or the slow track route. It's kind of like the guy said on the old motor oil commercial on TV... "You can pay me now or you can pay me later."

No one would be "sacrificed" under the Protect the Vulnerable plan. In fact, a vulnerable person would likely be safer from exposure if he/she remained isolated in their home for several weeks while the government paid to have groceries, medicine, and all other necessities delivered to them in sanitary packages. The cost of that would be a drop in the bucket compared to what all these stimulus bills are costing us. Plus, we wouldn't have to shut our economy down.

If a vulnerable person chose not to stay isolated at home for 6 weeks or so while the virus ran its course among the general population, then the risk of venturing out would be on them.

Where is the more recent data for an order of magnitude (10 times) less? Please provide a reference as I'd like to see that. Dr Birx gave a 2.2M number just last week so I'd like to know who disputes that and what their credentials are (certainly not as good as Dr Birx who is the most reputable person in that field)

The choice is between being able to treat people in hospitals, and being overwhelmed and letting people die who ordinarily would have had a good chance of surviving. Flatten the curve and we can save many more lives. It's a fallacy to believe that the economy would continue as normal as people were dying around us.

There are lessons to be learned from the 1918-1920 epidemic. This is probably going to last a while unless we are fortunate and develop a vaccine quickly. Anything we do to buy time is helpful. Data will also help.

The TV commercial was a bad analogy. The choice is get it now with limited medical resources and little data, or later with ample medical care and plenty of data. I'd chose the later in a heartbeat and I'm not in the "vulnerable" risk group.

Folks - EVERYONE is vulnerable. This is not just an old persons disease, or one which only impacts people with compromised systems. Young people are also getting it and dying from it although at a lesser rate. And for those that survive, many of them have damaged lungs or hearts which could affect them later on in life.

Boris Johnson - a youthful 55 - got the virus and look at how he is faring. The UK originally had a let it rip strategy, but it didn't take long for them to see that it was going to be a disaster.

We all need to take it seriously. You don't want to mess around with this.

I like to listen to the experts ... Dr Fauci and Dr Birx, plus Bill Gates - all seem to be in agreement that the path we're on is the right one (just wish we could successfully implement it nationwide).

I think over time we will get more data which will enable us to make better decisions. And let us hope it doesn't last 2 years which is what happened in 1918-1920.

We have to support our hospital staff right now. They are the soldiers in this war and are the real heroes. I am in awe of what they are dealing with - many of them are dying as a result. They want us to stay home, so let's support our "troops" as they fight this war.

I bet if this virus was knocking over the millenials, and not the oldies, 'Herd Immunity' would be the last option on the table!

Interesting thoughts, however, going about our daily life would probably cause the loss of many more lives. What needs to be done is TESTING........everyone. Sound impossible? So was putting a man on the moon, but it was done. We're talking about a disease that has the ability to wipe out the human race.......gee, don't you think we could care about that and do what it takes to get it under control and gone.

Self test
 

I believe testing is the answer as well. For now a daily temperature check may be the thing to do. Get up brush your teeth, take your temperature, if normal go about your day. If your temperature is elevated isolate or see a doctor for further tests. Electronic thermometers are quick and easy. 5 seconds and you have a result.

I guess those folks in Louisiana didn't get the message? I have no words for these people. Such utter fools.......

Over 1,200 people attend Louisiana church service, defying coronavirus ban - CBS News

Taking your temperature will not stop those who are asymptomatic from going about their day. Keep in mind also.....those people who become symptomatic may shed virus for up to two days prior to becoming symptomatic. Sorry, no link for that info but I have heard this on the news several times.

I think there are other tools that are being worked in such as therapeutics and vaccines. When we have all of ammo in place, it will be a much easier fight.

The problem with your approach is simple .... too many will die. That doesn't seem to factor into your thinking. But how about this ... we allow the medical community to come up with medications that will keep the virus from going from the nasopharynx area into the lungs. Make sense?

Once we have a way to keep the symptoms within reason ... then sure ... expose people who are not immunocompromised as you suggest.

Exposing them when many will die ... doesn't make sense unless your actual goal is to decrease federal government entitlement spending.

Your percentages are wrong, your theory of transmission is wrong, your idea about curve flattening in totally stupid. If left un-checked this virus would infect millions in the US alone and kill 100000 to 250000 people. Granted, a large percentage of them would be elderly. So from your point of view its okay to wipe The Villages and one or two other communities off the map.
You could drop an atomic bomb on a major city and probably not kill that many people. I assume that would be an acceptable solution to some problem in your underdeveloped mind.

Where is the economic hardship in the villages? Afraid y'all might have to help your kids?

Hopefully our kids are capable of helping themselves.

I've been pro herd immunity for quickly dealing with this virus, but reading a few of you talk about the damage to lungs, heart and other parts of the body that would be the result experienced by many survivors, I've had to rethink this approach. Thank you for sharing your thoughts, it's so beneficial to keep updating one's mentality.

Wrong any guesses are just that Guesses! Common sense says: STAY AWAY FROM PEOPLE THAT ARE SICK.

And all number’s you see of projections are just guesses, it could be less, or a lot more, nobody knows!

Two thoughts:
If you want to follow a country that did not practice "stay-at-home", follow Sweden. This may provide a limited amount of information about the non-isolation approach. It won't be perfect since Sweden has a more homogeneous culture (mores', beliefs system, values...) and would not reflect a very diverse cultures that we have in the USA and other countries across the world.

Then look at the Avian Flu (H2N2) data from the 1957-58 time period in the USA. "The estimated number of deaths was 1.1 million worldwide and 116,000 in the United States" (source: CDC). You can also read about other pandemics (1968 H3N2; 2009 H1N1) as well as the 1918 Influenza pandemic.

Hopefully, we can learn from these lessons and prepare for the next pandemic as we are a more global society now than ever before.

Not everybody lives in premium 500K or more housing in the villages. Yes, some people are struggling in villages just like outside the bubble. I have word I use for comments like this but will reframe from using it in this site.

Alternative Approach
 

So like the Lt. Gov of Texas you believe in Social Darwinism?

For older people, your way sounds suicidal to me. I’m guessing either depression or you’re not in the vulnerable group.

There is a reason why every educated country did not follow the thinning of the herd route through “herd immunity”.

Genocide, comes to mind.

Exactly

Why hasn't anyone suggested everyone wear something over their face? If the virus enters thru the nose or mouth doesn't it make sense if everyone was covered when they left the house this thing would be gone in a short period of time?

There was no vaccine for the 1918 epidemic. It just eventually burned itself out and went away.

I’ve read a report by a doctor in New Orleans that says that about 80% of the people out on respirators there die on them. Only about 20% get well enough to breathe on their own again, and some of them will have brain damage. (Before people are put onto respirators, they are given anesthesia and their muscles are relaxed so they don’t fight the endotracheal tube, and they are kept that way for the duration, so if they die on the respirator, they don’t even know it.) The ones most likely to die are those with pre-existing conditions. If we had the guts, we could make it nation-wide policy that those with pre-existent conditions who need a respirator get only palliative care in a special unit (like a gymnasium). Then there would be no shortage of respirators for those who might survive, and a much larger percentage of those put on a respirator would survive it.

Sorry to be morbid.

I don’t disagree with your post. The social distancing was always intended to not overwhelm our limited medical resources and facilities. There was no mention that flattening the curve would drastically reduce the death count. However, that’ll never be proven. The measures taken now will provide the needed time to develop both a vaccine and cure. Hopefully, both will be available or the cycle starts again.

Of course our govt doesnt have a plan...Niether does the rest of the world. No one alive today has ever seen a worldwide pandemic like this. The last one was in 1918.

I live in south east Asia for part of the winter, almost everybody wears a mask because of air pollution. But it also was a way for countries like Korea, Singapore, Taiwan to stop the virus. Maybe we TV could learn from them, they live longer than us and are certainly a lot slimmer than the cart riding TV person

This idea has been tried.
 

During the Great Flu of 1918, there was no such thing as social distancing or even a vaccine. So, the disease was free to infect virtually everyone in the world and everyone got sick. The result was the death of 50 million people which amounted to 1/5 of the population. Today that statistic would translate to 1,400,000,000 (1.4 Billion) deaths. Do I hear any volunteers?

I find the original post has several flaws, including lack of secondary and tertiary effects analysis, theoretical assumptions which may not prove out in reality, and reactive only vs proactive behavior with a lack of responsibility to the outcome.

The first theoretical assumption I challenge is that “herd immunity” only results from unrestrained R0, or infection rate. “Herd immunity” can also be gained over time with a lower R0 as the total population infected rate converges to the same percentage, just to a different future date.

The second omission I challenge is the lack of secondary effect on the current healthcare system design. An unrestrained R0 can overwhelm a healthcare system, in more than one way: financially and staffing. Very similar to a bank run, the system can collapse and create extreme chaos for more than the infected, but for the healthy as well as standard healthcare evaporates. In that scenario, current curable or manageable illnesses turn deadly, as maintenance care is no longer available and the indirect death rate rises as well.

Third, studying human behavior and having a wife work along side doctors in the medical field, I find that most of the medical field in hospitals and primary care are in a reactive situation only. They react to what walks in the door, they have prescribed methods to deal in their situation in front of them. And like a teacher, they are the expert but have little control over what comes in, and some control over the outcome. But once out the door, they have much less control on the eventual outcome. This reactive position struggles with strategy and proactive behaviors. In my field of finance, I try to quantify risk, a concept of uncertainty, and be proactive to minimize the risk across the organization. That’s where my wife works, dealing with data, the risk and the outcomes to the total organization. Most, not all, primary care or emergency room doctor lacks that perspective, the strategic long term perspective of the entire organization, and the secondary and tierary effects which risks must be mitigated. I see the same blind spot in other people and professions.

Finally, I see and hear the differences with “older” doctors to whom I have had appointments, who have tough time with data analytics, with large systems, which collects more data for better outcome analysis, and don’t understand the trade off between time and cost to clean data, and the improvement in outcome, to the point that I hear about doctors who shun medical systems in favor of a blackboard with a single number. Again, from personal experience watching and studying questions of process or strategy, outcome or process, reactive versus proactive risk behavioral adjustment.

In my risk analysis, the choice before us is one of balance between economic damage, human damage, and healthcare system damage. As society progresses with medical advances, there is more emphasis on the value of life, and minimizing human damage. Having just bought a retirement home and a year or two away from retirement and joining the villages life, I am doing everything I can to survive to be able to enjoy the outdoor and active lifestyle I enjoy. Wanting to risk that with an outcome I can’t control, not sure I agree with the assumption of “herd” immunity by unrestrained R0 versus a constrained R0 which will give the healthcare industry time to prepare for a scenario that is rarely seen.

A comparison could be made between corona virus and H1N1 virus, in which little proactive behavior was initiated with H1N1 and the death rate will probably be higher with H1N1 (a prediction which is not yet proven nor disproven). The economic damage will be much higher, but again temporary, and recoverable in the medium term. There are ways to recover from temporary economic dislocations, not so with healthcare dislocations. Doctors, nurses take years to educate and prepare.

We have not read the MIT article, but we have had lots of discussions after being well prepared as I saw this coming in January. I asked a life long nurse with 10 letters after her name, about the virus in January. She said she wasn’t worried. Now both she and her husband have it, and we are hoping they survive. The person they got it from is on a ventilator.

Sportsguy and CoachK

They wear masks cause the live in over populated ____ hole. They are slimmer cause they have little to eat after they ravaged land and sea. Riding around is carts HAS NOTHING to do with it. Majority of population NOT part of the elite like you, they are surviving. But, you probably live in the 1% area right?

The government of any country are not the saviors, they are the taker’s