This is really serious. I’ve been paying close attention to the coronavirus news for a while now, and I’m struck by how many people still think this is media hype and overreaction or even a hoax. It’s not “just the flu” and, while panic is never helpful, concern and action are definitely warranted. This is a pandemic and, in all likelihood, it is going to reach your community.
Here’s why it’s concerning – even if it doesn’t seem like “that many people” or you are young and healthy and not in the most at risk demographic.
Infectious diseases spread with something called exponential growth. For example, if each sick person infects two other people, 1 person will spread it to 2 people. Those 2 people then spread it to 4 people (2 each). Those 4 people then spread it to 8 people (2 each again). Those 8 people then spread it to 16, then 32, then 64, and so on (…128, then 256, then 512, then 1024, then 2048, then 4096, then 8192, then 16,384, then 32,768, then 65,536, then 131,072, then 262,144, then 524,288, and then you’re over a million people.) It’s not always that 1 person infects 2 people. It could be better (they only spread it to 1.2 people) or worse (they spread it to 50 people). The point, though, is that the rate of infection increases as more people get sick.
The numbers look really low for quite a long time and it might seem like “no big deal,” but then it ramps really fast and keeps increasing faster and faster. We end up in a situation that catches some people by surprise. We’re seeing the start of the ramp in the United States. There are about 1500* confirmed cases and the numbers are going to climb more and more rapidly. Some people think that this is still a small enough number that action towards canceling events or minimizing interaction is “overreacting.” Others would point out that we aren’t reacting enough. We can reasonably predict that the numbers are going to continue to climb – and then keep climbing faster and faster. (*Note: the actual number of cases is likely much much higher. All reports suggest that the US is woefully under-testing right now.)
Source: https://www.worldometers.info/coronavirus/country/us/ (as of 3-12-20)
Now, it won’t continue to climb faster and grow exponentially forever. We would run out of people on the planet at some point. Once enough people have been infected, the growth will start to slow naturally because people that are sick won’t encounter other people that haven’t already been sick. (This is herd immunity.) We can also impact the exponential growth if we take actions to decrease the interactions between people. For example, if a sick person is not interacting with others, they won’t infect others or it will take longer to infect other people. If healthy people are avoiding crowds, they are less likely to get sick and continue the spread. This will slow the growth. The numbers reported from China would suggest that growth has slowed there (but not before increasing to much higher levels than we are currently seeing in the US) – mostly likely from the significant measures taken to decrease the interactions and chance of spreading infection.
Source: https://www.worldometers.info/coronavirus/country/china/ (accessed 3-12-20)
It’s important to note, though, that any measure taken to minimize interaction will have a lag time between when the action is taken and when the impact is seen. Italy has the entire country in quarantine right now, but they are still seeing cases grow exponentially. This is most likely because there is a 5-14 day incubation period. A lot of people were exposed before the quarantine took effect and they don’t even know that they are sick yet. Infections are going to continue to increase even after the measures are taken to minimize interactions and slow the spread.
Source: https://www.worldometers.info/coronavirus/country/italy/ (accessed 3-12-20)
A lot of infections and diseases have the potential to spread exponentially like this, but there are a couple of reasons why this one is different. It’s not “just like the flu.”
- This is a brand new virus and no one has immunity to it yet. With influenza, some of the population has already had it or has been vaccinated. This is not the case with coronavirus. No one is protected from this virus yet, and infection is spreading faster through our communities.
- It’s also requiring more medical attention than influenza. Most people that get influenza are able to recover at home without medical intervention. Reports from other countries are that approximately 20% of people that get coronavirus require hospitalization.
This second reason is one of the big concerns right now. If a lot of people are getting really sick all at the same time, we will run out of hospital beds and ventilators and medical supplies to meet their needs.This is not just hypothetical, it is currently happening in Italy. The health care system in Italy (that is still seeing exponential growth) is at capacity. Patients that should be in the ICU are in hallways. Heart surgeries are being postponed to make room for coronavirus patients. There are heartbreaking accounts from medical professionals in Italy that suggest there will be patients that may have recovered with proper care that will likely die because there isn’t a ventilator for them. And, people are still getting sick. This is going to get worse.
In the US, some may have the impression that we’re not there yet or it’s too soon to take measures like canceling events and limiting interactions and travel. The reality, though, is that it will be too late if we wait until it seems like we are there. We have more confirmed cases now than Italy did 2 weeks ago. We know that it is going to get much worse and we know that any actions we take to slow the spread will have a lag time. It is time. You might also think that it’s no big deal if you are young and otherwise healthy because data would suggest that you will recover. That’s probably true, but you could still contribute to spreading this to more at risk members of the community. We should do our part to reduce and slow the spread.
Slowing the spread is what some people are referring to as “flattening the curve.” A lot of people will still get sick, but we will have a better chance of caring for them if they are not all sick at the same time. This will reduce the burden on our health care system and save lives. If we can’t slow the spread, we risk having medical needs that exceed the capacity of our healthcare system. This is true in terms of hospital beds, ventilators, saline bags, masks for health care workers, and everything else. It is also true for anyone that needs medical care for anything. This burden on the medical system would impact anyone that needs medical care, whether coronavirus or car accident or heart disease or babies with RSV.
Interacting with each other in person less is a good way to slow the spread. If you are sick, avoid spreading your germs. If you are healthy, avoid crowds where people are bound to have germs that you could pick up. Stay home when you can. Work from home if you are able. Cancel conferences and work travel. Skip the concert this weekend. Stock up on groceries to minimize how many errands you need to run. Wash your hands. If enough of us are doing this, it’s possible that we can impact the exponential growth enough that skeptics will say it was all unnecessary an overreaction – even if it was the cause.
Please note that I am not a medical doctor or an infectious disease expert. Please seek out and follow the advice of those that are.