Nations that moved quickly to contain Covid-19, even when their societal protections were “weak,” had one eighth (https://www.bloomberg.com/graphics/2020-swift-covid-19-lockdowns-more-effective/?srnd=premium&sref=lWBkwdXC) the number of deaths of countries compared to those who moved slowly. That includes Japan, whose model of rolling partial lockdowns, social distancing plus infrequent testing has been scorned by the nation and may lead to the end of Prime Minister’s Abe Shinzo’s regime. Without severe lockdowns, Japan’s deaths per million run 7 per million. The U.S. as of today is 360 and rising, from the virus’s first wave.
Why? This sneaky, baffling virus spreads exponentially. It spreads through superspreaders, with 10-20% of those infected infecting the next 80% (https://regenerationhealthnews.com/sleep/covid-19-and-kappa/.)
How do you control it? Through quick response. Cut it off fast and you cut it off. Vietnam claims no deaths. You actively trace, track,and quarantine. Catch a point outbreak quickly and far fewer become, especially when superspreaders provoke the majority of cases. You prevent second, third, fourth waves.
Are we doing this in the U.S.? With a few local exceptions, no.
In a nation where people travel all over the place, are we nationally coordinating our response? No.
So you’re stuck. Until there is a national focus on prevention and protection, you have to protect yourself. Here are a few ways that should help.
Think Like the Virus
In a previous post already censored by one national publication (https://regenerationhealthnews.com/sleep/interview-with-the-virus/,) I asked people to “think” like the virus. What are its evolutionary imperatives?
To spread quickly, across species, and develop means, often through mutation, to blunt immune responses and keep its own species alive.
Sars-Covs-2 spreads mainly through respiratory droplets. Breathing alone may do it, but in worse order talking, talking loudly, coughing, and then sneezing increase its infectiousness. Not sure about singing, but it’s probably between talking loud and coughing in its ability to propagate the virus.
So you want to be thinking about infectious dose – how many viral particles hit you. It seems 500-1000 particles may be enough to infect. Yet with most viruses, more is worse. A cough probably puts out tens of thousands of particles, or more. That may be why so many medical personnel succumbed during the height of urban epidemics (https://regenerationhealthnews.com/sleep/coronavirus-public-health-blog-3-29-20-hot-to-not-get-sick-the-issue-of-viral-load/.)
How to protect yourself? Think Three Cs- Closed places, crowded spaces, close contact. Recognize that exposure is magnified by time. An hour in a tight, poorly ventilated public washroom is far worse than 60 seconds. Avoid the 3-Cs as much as possible and you protect yourself, and everyone else.
My pandemic is your pandemic. Keeping yourself from infection keeps others from illness. Save yourself and you save others. So far, the Swedish model of “herd immunity” is a bust. The death rate in Sweden is about 11 times higher than Norway, which has stricter rules, and the number of Swedes infected nationally is vastly less than what’s required for herd immunity to work.
Know Your Own Risk
Every move in life involves risk. Walking risks being run over by avid drivers who think right-hand turns turn pedestrians invisible. Water supplies may not be completely safe, and not just in Flint.
We navigate these risks all the time. With Sars-Cov-2, the negotiations are harder, more uncertain, and more widespread.
So consider three levels of risk, medical, personal, and local:
Are you older?
Do you have hypertension or any heart disease?
Are you diabetic?
Are you obese?
Do you have immune deficits?
That’s the start of a rather long list. African-Americans and Hispanics are at more risk of fatality from the virus. You can look to many different comparative metrics; one you can try was devised by Darria Long and David Katz (https://medium.com/@drdarrialonganddrdavidkatz/as-cities-move-toward-reopening-how-to-manage-risks-1834a264f9d.) The really increased risks of death and severe illness seem to involve age and heart disease.
In Wuhan, 75-80% of the population appeared to get infected via family members. My pandemic is your pandemic. Who you see and live with changes your risk. Are you working in a place where you can’t control the 3-Cs? Lots of emergency medical workers have tried to isolate themselves from their families. One New York ER doctor in NY is having great difficulty dealing with the death of his co-habiting father and mother-in-law. Are you living with kids who don’t perform social distancing? Or does your live-in niece work as a server at say, Olive Garden, where one of my patients heard a patron shout “If you take off your mask I’ll give you a tip, if you keep it on you get nothing.”
Assessing your personal risk leads to difficult social conversations. To protect those you love, have them.
Most nations that have controlled Covid-19 effectively can track local outbreaks and quarantine effectively. Move fast and you stop exponential growth.
The United States’ response represents many local states of delirious confusion.
Some places really want to know what’s going on. They perform random population screens. They actively check high-risk situations like care homes and food markets with more testing. They hire tracers and trackers.
Others believe that if you don’t count things, they never happen. Recently the president declared America’s increase in cases was due to increased testing, and that without it, we’d have few cases; perhaps not any. This position has become a presidential “talking point” propagated throughout the country.
Meanwhile, in America there are 20,000 new cases and 1,000 deaths per day.
So local quantification of risk is a crazy quilt. Some places test avidly, others don’t. Death statistics, a harder endpoint than cases, are variously massaged.
Still, if you’re thinking of having a large family gathering, it pays to look at your local health department Covid-19 statistics. Are they flat? Going up fast? Is the local hospital seeing more hospitalized cases or less? Is the local percentage of positive cases of those tested for Covid-19 less than five percent, or better, less than 2%?
Knowing your local risk can involve little or a lot of study; noting the local case variation weekly is probably a good idea.
Lacking a nationally coordinated strategy, Americans are on their own. You have to assess your medical, personal, and local risks, and act within your own risk tolerance.
But following the three Cs will help. Recognizing everyone is in this together helps a lot more. Unity, not ignorance, is strength.
The virus recognizes we are a social species. The social acts of talking and singing spread it.
Responding to it intelligently can control, even potentially eradicate it. The words of British Columbia’s public health chief – be kind, be calm, be safe, echo well.
But you still have to protect yourself.