Sunday, March 29, 2020

"Flattening The Curve" vs. "Business As Usual"

      If you're a member of the "Oh, it's no worse than a bad flu season" set, you might as well leave now, and take a look at the video coming out of Italy and NYC on your way: this thing hits hard and fast, compressing a flu season's worth of deaths and cases requiring hospital support into a few weeks.  Too many, too quickly for hospitals to cope.  Health-care workers are falling ill at a much higher rate than the population at large: they have to get universal precautions right every time, while the virus only needs to get a solid toehold once.

     The thing that social isolation and stay-home orders sets out to accomplish is not quite like a classic quarantine order used to contain something like measles, where quarantine and contact tracing can stop an outbreak in its tracks.  COVID-19 appears to be infectious for a couple of weeks before symptoms appear.  By the time you know you're sick, you've already been spreading it.  The best we can hope for is to slow it down.

     Slowing it down will save lives.  It will save many more lives indirectly than directly: The goal is to keep from smashing our healthcare system so flat that it takes years to recover, and does a much worse job coping with the surge and its aftermath.

     Nobody seems to understand that facilities and personnel are not going to bounce right back from an Italy-type caseload. Few people grasp that every patient in a hospital suffers when it is overloaded by a surge of COVID-19 patients.  A lot of people will die of a lot of things while we learn this lesson.

     In Marion County, Indiana, my county, we've got 676 known cases as of midnight.  That's about fifteen to twenty times as many as a week ago.  We're two or three weeks away from the peak if present projections hold.

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