COVID-19: Who Exactly Are You Fighting For?

I wish that I could ignore it, but anti-preparedness messaging about COVID-19 that suggests we shouldn’t practice social distancing or cancel large gatherings during this pandemic has been bothering me a lot. The impression that I get from people pushing this content is that they have bought into an ideologically aligned narrative and are excited to share all new content they come across that supports it. This content often carries anti-science undertones but then provides incredibly shallow analysis about mortality rates. It also likes to compare existing numbers of influenza deaths with extremely incomplete data about COVID-19, ignoring crucial differences between the two illnesses. If you think that a foot doctor with a blog is more reliable source for information about epidemiology, virology, and data-science than the experts in the WHO and countless academic and governmental institutions, you should maybe stop for a moment and think about what values you are promoting when you say “It’s just a flu”. Who exactly are you fighting for, and what are you fighting against?

One quick point of clarification, if you haven’t already heard it: The primary threat we’re facing isn’t the mortality rate of COVID-19. It is the capacity for a sudden increase in severe cases (a significant percentage of overall contractions) to overwhelm the carrying capacity of a local healthcare system. When it reaches a certain threshold, hospitals are forced to change protocols, in the worst cases (such as is happening in Italy already) performing battlefield triage – not treating those who aren’t expected to survive (such as those over a certain age or with preexisting conditions). When that happens, mortality spikes not just for COVID-19, but for other serious ailments as well. Necessary supplies become unavailable. Never mind the impact to economies, livelihoods, etc.

Lastly- The range of potential outcomes in an emerging incident of this complexity is very wide. There is plenty of room for skepticism in projections and forecasts, just like in weather patterns. It is definitely possible that things won’t be as apocalyptic as many fear, and you will have an opportunity to call me paranoid. I hope that’s fun for you, and I hope it turns out that way.

But responsible response, in a case like this, will look excessive in retrospect IF WE DID IT CORRECTLY. THAT WOULD BE A SIGN WE DID ENOUGH. 

When worst-case scenarios are likely enough, and have the potential impact that they do in this case, the responsible response is to reduce our exposure to the worst possible outcomes. In this case, that means flattening the transmission curve- slowing the rate of transmission, not to prevent 20-60% of the world’s population from getting it (probably no hope of making that happen), but preventing it from happening so suddenly that healthcare systems collapse and mortality rates explode for everything that requires treatment.

Here are a few resources which I found particularly enlightening:

https://www.fast.ai/2020/03/09/coronavirus/

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