Thursday, March 12, 2020

a pandemic is inconvenient - and we are not used to that

If there is one thing I've been saying once it was clear that the virus situation in Wuhan was something extraordinary, it's "It's going to be inconvenient for many people. I mean, people complain about one snow storm stopping their plans. This is going to be more for longer time".

What I meant was that a lot of people didn't, and still don't, understand the basic concept of a pandemic. We have built a world where a lot of us think we have control. We decide. And if we want to do something, we do. (Of course there are a lot of people who don't have these choices. A lot of choices open up when you get from poor to middle class. Or higher.)

In reality though, the only way to stop a pandemic is to stop the spread of the infectious agent. In this case, Covid19, it's a virus that spreads mostly people to people, but also can't be ruled out as fomites (virus gets to a surface, you touch surface with hand, then touch hand to face/mouth, you might be infected).

So, now that WHO has declared a pandemic, a lot of countries will and have already done these curtailing measures. Most of these will be annoying for you in your everyday life. And it will be so for a while - most start with "for the next 2 weeks or 30 days". A lot of them will probably be longer. And it will affect a lot of businesses, family income and infrastructure.

It's important to remember, this is much better than the alternative - which would be a more chaotic, panicked world where people would be more hurt and dead.

What can you do to make this situation better?

Well, first of all - don't disregard the severity of the situation. Exponential growth is difficult to understand. When I started learning epidemiology and microbiology we had examples with peas and then one with a pond of water lilies (think Monet or Manet paintings).

In a pond grows water lilies. Every water lily gives rise to another water lily the next day. At day 48 the pond is full with water lilies. When is the pond half full?*

On top of this is - at least in the USA - a underreporting of cases since there is a lag in confirmed tested cases. That means that the confirmed cases is not the amount of people who are infected.

And to underscore the point with curtailing measures. It's not because we think the majority of people in society will die. It is because people who are in risk groups have NO OTHER way to protect themselves but for all of us to decrease the amount of people who walk around spreading the virus. There is no vaccine, no specific treatment and no immunity.

And the risk groups right now are pretty broad; older people (definitely over 70), immunosuppressed people (any former cancer and transplant patient), pre-existing conditions like diabetes, high blood pressure, obesity...

So please, let's repeat this to all of us who will get annoyed, bored, scared and inconvenienced in the weeks/months to come. It's because this is the better way than the alternative. It's not because it is fun and games. There will be no concerts, no sports events, no conferences, less/no travel and no vacations.

Staying at home doesn't mean play parties or drink parties. It means distancing yourself and your family to avoid spreading virus. It means, calling your grandmom on the phone or via skype, and not going to visit with your cute little child. School closings means that you can't put your child in after school activities since they are not supposed to be in a big group. And it means not going to a game of hockey to avoid thinking about this pandemic and worrying. Nope. It's you, at home, trying to keep hope that this to will pass and the world will learn, while washing your hands and avoiding touching your face.

Also, it will be imperative NOT to burden the (hospital and health care) system unnecessary. Most likely there will be longer wait times for everything and staff will either be fewer or they will be overworked. So please keep that in mind.

Food banks will need money and food for the poor who will lose income and jobs. And for the children who don't get their subsidized school lunch.

Overall, it's going to be rough before it gets better. And we will need to overcome it together.

*the pond is half full with water lilies at day 47. It's very hard to grasp since it means "it grow so fast over night" but in reality it was same as always, one per one 1:1 spread. which in covid19 would be 1:2 or 1:3 plus the super spreaders who have been shown to infect as many as 1:100. pond fills very quickly.