Episode 082
Episode 082: Coronavirus and How We're Handling It
Dominating the news today is the pandemic coronavirus or COVID 19. The viral infection that was believed to start in Wuhan, China near the end of 2019 has now spread over most of the globe. It is unique in that its hosts are often asymptomatic but infectious for days making its spread so effective. It also seems to have the potential to be somewhat lethal especially in the elderly, immunocompromised, and those with preexisting heart disease. What is still unknown are the long lasting effects of those who survive the initial infection.
The response to contain coronavirus by countries has differed greatly with some imposing almost draconian shut downs to those who have had measured responses. We have seen some health care systems get overwhelmed like Italy's which concerns other countries in the West about their hospitals too.
Unfortunately, there is not a whole lot that can be done in most countries to contain the disease. Had the infection been stopped early perhaps the rest of the world would have been spared. However, the nature of the infection and the asymptomatic presentation by many led it to spread quickly and widely before anyone had a good feel for the danger. This means we are now in a place where we have to acquire herd immunity to protect ourselves.
Herd immunity (having enough people immune to the disease so that it can't spread effectively) can only be acquired in one of two ways: immunization or overcoming the illness. Since it is too soon to have a vaccine developed we are left with only the option of having enough people acquire the viral infection and develop their own immunity. With the lethality of the infection for those who are susceptible - this poses the risk of flooding the hospitals all at once leaving people without proper medical care (ventilators, etc.).
What does all this mean? It means we have to get our population infected but not fast and all at once. A slow burn that will keep the hospitals busy but not too busy. If you shut things down too soon, you run the risk of having a vulnerable population as soon as you open up activities like gatherings and dining out. If you wait too late, you run the risk of crashing your system today. The right answer is probably unknowable but important to keep in mind.
On top of these considerations is the fact that draconian closures of businesses affects the economy and the ability of people to earn money and support themselves. A real possibility is that we will now be forced to keep this prolonged closure of businesses to prevent a spike. The cost to jobs and social stability will be immense and lead to unpredictable social pressures on politicians. It is indeed a dangerous tightrope we walk.
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show notes
Life, Liberty, & the Pursuit of Snarkiness: The show that I appeared on with Aaron Pomerantz.
Pomerantz on Twitter: @libertysnark
Flattening the curve: A good resource on what flattening the curve means and how you do it.
Episode 080: My previous appearance on Life, Liberty, & the Pursuit of Snarkiness.
Made Simply Web Site Creations: This is the great, affordable website service that built my wife's podcast site. I cannot recommend this company more to someone looking for creating a website.
Always Andy's Mom: Home of my wife, Marcy's, podcast for parents grieving or those looking to help them.
YouTube for Paradocs: Here you can watch the video of my late son singing his solo on the Paradocs YouTube page.
Patreon - Become a show supporter today and visit my Patreon page for extra bonus material. Every dollar raised goes towards the production and promotion of the show.
  
Hi Eric- I enjoyed this podcast (as I enjoy most of yours!). Couple questions or observations: I’m interested in looking into how tariffs on China really hinder American health care. Your feeling that that had a lot to do with our initial response to Covid or to the limits in PPE – not sure that’s true. Was China in a position to suddenly ship massive quantities of PPE to US in the midst of their own health crisis? And is it in our country’s best interest to be so heavily dependent on any one other country for critical health care needs? That would seem to leave us vulnerable in normal circumstances. Our dependence on China for pharmaceuticals/drugs frequently causes problems – we have had numerous recalls of so many meds past few years. Causes problems in outpatient sector. Much of what has gone on in our US health care system during the crisis is in having to switch from practicing our usual standard of care – one-on-one patient care under the highest levels of strict monitoring, to suddenly function within a pandemic! That was just not going to be an easy transition! As someone practicing primary care in WA state, we were the first area affected. We suddenly had to approach all outpatients with URI symptoms with significant PPE; it was changed new for each patient. That works under normal circumstances, but will just NOT work during a pandemic. A pandemic is not “business as usual” in any sense. This was always going to be a rather painful transition. BUT, I see us adjusting over these last few weeks. Knowing more about Covid; learning from other countries and other areas in US. Being more conservative with PPE. Learning how to change clinic flow. Much of what we’ve encountered was always going to happen as our US healthcare was never geared for this. But obviously many things are being forced to change. I think a new system will be put into place. S Korea had same issue. They responded poorly to 2015 MERS outbreak and restructured their health care public health response apparatus. They seem to have done extraordinarily well in this current one. I would foresee US following that path.At this point, I have seen adjustments locally, we’re ramping up testing, we’re expanding capacity. Again, have enjoyed your podcasts. Have learned a lot! Keep it up. Best regards, Lisa
Lisa,
Thanks for the comment (and so sorry with the delay replying). I agree that much of what we are seeing is a result of the US not ever having faced something like this. Our population doesn’t know how to behave (wearing masks, social distancing, hand washing, etc.) and the health care sector did not adequately prepare or have plans in place for a time of shortages. I expect at least the actions and behaviors of the populace and health care workers will change and adapt appropriately.
I do think that the supply chain issues are deeper than ‘we get everything from China’ and I tried to address that in episode 083. Our hyper-regulated health care industry makes it very difficult to respond in a timely fashion to any sort of problem that moves quickly. There is no shortage of industrial players who could have started producing masks, gowns or face shields two months ago except that the regulatory burden is so high that there is no way to produce things fast enough to be of any use before the demand is gone. There has been a recognized shortage for months yet no one either domestically or internationally could fulfill that void causing the problems we are seeing today.
Thanks,
Eric
Thanks for reply, Eric. I totally agree with your assessment. Our system was complex, restricted, convoluted. I do feel hopeful that our country will continue to update systems and procedures so that we’ll be in much better position come the next cycle of this in the fall, but it is painful these weeks now as we move into crisis. I’m inspired by the signs of American ingenuity, courage, caring – hopefully the will to get this done. Stay safe and thank you for your info.