Is It Really Worth All the Fuss?

There are currently 12 confirmed COVID 19 cases in Kent County.

There are ONLY 12 confirmed COVID 19 cases in Kent County.  And yet we have shut down everything. Restaurants closed. People being laid off. The streets quiet. All of us obsessively washing our hands and filled with anxiety.

Did we act too early?  Couldn’t we have waited until it really hit here hard? I mean, shouldn’t we have waited until we had a big portion of our city sick and reports of lots of deaths? These changes have been extreme. Shouldn’t we have waited until the extent of the people who were ill and dying was that extreme?

I obsessively check the statistics each night. It is an odd and somewhat morbid thing. Of course, I don’t want the numbers to climb. I don’t want people to be ill and certainly don’t want people to die. I don’t want our ICU to become overwhelmed. I don’t want to hear about our teams having to make extreme choices of who gets treated and who doesn’t. I don’t want to hear about not having enough ventilators, or isolation masks, or anything. I want it to remain at only 12 cases. 

But a part of me is anxious to see the numbers rise. Part of me wants to see that all of this upset of our routines and our economy and our society is worth it. Part of me wants to have the numbers jump in our area and then confirm inside of me that this is all worth it. “See. It IS really bad. I am SO GLAD that we acted. I am SO GLAD that we are doing everything we can to control this and counter this monster.”

That is the strange circumstance in which most of us find ourselves. Don’t get me wrong, 12,955 deaths around the world is bad. But in the 2018-2019 influenza season in the United States, the CDC estimates that 34,200 people died of the flu. In the grand scheme of things, it seems that we are accustomed to a LOT of deaths from influenza and it doesn’t seem to phase us too much. We don’t stop our entire culture and destroy our economy each year for the sake of the 34,000 who die. What is so different here? 

That is the basis of the emotional disconnect. 

I am not challenging the decisions have been made. I am not going to say that this is a big socialist conspiracy to deprive of us of our liberties. I am not going to say that this is some colossal election year trick or manipulation. I know that those things are not true. 

But what I am saying is that it is okay to acknowledge the question. Asking the hard question is the first step to a better understanding of what is going on. It is important that we go through this process so that we can go from head knowledge to knowledge that makes sense to us. We need to really understand. We need this so that we have the strength we need to face the challenges ahead of us.

I looked at a picture of my grandfather as a young man. He is standing with his brothers. His mother is seated with her boys around her. My mother captioned the picture, “Alonzo died on 3/24/1919. Mary was left to raise 5 sons.”  

My grandfather’s family was traumatized by the Spanish flu epidemic (the 1^st major H1N1 outbreak). At the age of 11 he saw his family become ill and his father die. Overnight he had to take responsibility for running the family farm. I cannot imagine that. 

In 2019 the CDC collected a series of stories to remember what happened in that epidemic. The stories are riveting.^[1]One person told how she was baptized at the same time as her father’s funeral because then the minister only had to come to the house once. No one else was allowed to attend. Another tells of how the leaders pulled a wagon down the street each day. Families would bring out their dead relatives and load them on the wagon to be taken away (without caskets). Outrageous. Awful.

One morning this week I found myself looking up numbers about that time. I was hoping it might help me understand what is going on now. What I learned was that in that epidemic, 500 million people contracted the flu. Around the world there were 50 million deaths. In the US there were 29 million cases (about 28% of the population). Somewhere between 500,000 to 675,000 persons died. That is enormous. By comparison, in all the years of World War 2, the US lost 235,000 in battle. The Spanish flu was horrible. It shook the world.

To get control of and end the epidemic the authorities implemented “mitigation” strategies. This included efforts to slow the spread and protect at risk individuals.  The strategies worked and eventually the epidemic ended. 

With the H1N1 outbreak of 2009, these same strategies were implemented. This resulted in 60.8 million cases with about 12,469 deaths. With modern healthcare and mitigation, the strategies appeared to work.

What is so different with COVID 19? Why is this such a big deal that leaders in both political parties are willing to throw our country into chaos?

My best way of explaining this is to reference the Imperial College report.  Who is the Imperial College? They are a team of 50 scientists with close ties to the World Health Organization.^[2] They really are the “gurus” of public health policy. They are the ones that everyone trusts. They are considered the “gold standard”. What they say usually becomes public policy.

Early on, they were recommending the same “mitigation” strategies and talking about how “herd immunity” would be the best approach for the novel coronavirus. But then they saw what happened with the disease when it spread outside of China (where strict suppression was implemented). They did a detailed analysis. They came up with some scary predictions.  

Like 2.2 million deaths in the US if we just let the disease run its course.

If we do what we did with H1N1 in 2009 (mitigation) we should expect 1.1 to 1.2 million deaths.^[3]  Also we should expect that we will have such a terrific spread of the disease that we will overwhelm the US healthcare system. They predict that we will exceed the ICU and ventilator capacity in the US by 8-fold. We will literally have people dying without the ability to care for them.

They ran the figures again if we implement the strict suppression strategies that were put in place in China. If we do this, they anticipate that we might be overwhelmed at first but then over the course of a few weeks we could slow the spread down to a pace where the healthcare system would have more of a chance to keep up. Even with this they recommend that we take drastic actions to increase capacity. This includes cancelling all elective procedures and finding ways to increase ICU capacity. 

Is this real?

In short: yes. 

It is real enough to scare Boris Johnson and Donald Trump into doing things that none of us ever thought we would see. 

It is real enough that we are daily hearing horror stories out of Italy, and now New York and Washington State and California.

This disease is unlike anything we have ever had to deal with. If you get COVID-19, you are 21 times more likely to die than if you get influenza. It is real and it is that bad.

The thing is the only way to manage this is to act aggressively and act early to prevent the spread. We just don’t have anything else we can do. I just hope we have acted soon enough.

Only 12 cases in Kent County. That should make us happy that so far there have only been 12.  I sincerely hope that we are so ahead with “suppression” in West Michigan that we won’t have to live through the horror that is currently happening elsewhere.  

Not able to go to a movie or go out to eat at a restaurant? Not able to go to church? Not able to get together with friends? Obsessively washing my hands?

I am ok with that. 

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^[1] You can read the Spanish flu stories here: https://www.cdc.gov/publications/panflu/stories/index.html

^[2] [2] https://www.nytimes.com/2020/03/17/world/europe/coronavirus-imperial-college-johnson.html

^[3] https://ftalphaville.ft.com/2020/03/17/1584439125000/That-Imperial-coronavirus-report–in-detail-/