Plague journal

Now wash your hands

It turns out that malignant narcissists tend not to make good policy decisions.

In late January, Secretary of Health and Human Services Alex Azar went to Trump with the news that a new coronavirus was spreading, and that it was serious. Trump didn’t want a program of testing for the virus, though; he thought that increased infection numbers might harm his chance of re-election. Researchers in Seattle were ordered not to test people. Earlier this month, Trump wanted to keep passengers on an infected cruise ship so that infection numbers wouldn’t officially increase.

The World Health Organization had a working test, but in typical style the US decided it was going to ignore the rest of the world and develop its own test. Weeks later, it still didn’t have a working test.

So now it’s the middle of March, and we still have no real idea how many people in the US have the SARS-CoV-2 virus. We’ve done somewhere around 5,000 to 8,000 tests in total, whereas South Korea has been doing 10,000 per day.

It doesn’t help that Trump fired the entire US pandemic response team in 2018, eliminated the seat on the National Security Council, and cut funding by 80% that the CDC had been using to help fight pandemic outbreaks in China. Even now, they are planning further cuts to CDC budgets. Why? We don’t know, because discussions on pandemic response are considered classified information. We’re just expected to trust the administration.

It also doesn’t help that Trump’s trade war with China means that many essential medical supplies have had additional taxes imposed on them this year. Those tariffs are now being reduced, but any price reductions will likely be reversed by the imposition of new rules requiring that the government buy only American-made supplies. (Alex Azar was formerly a senior executive at US pharmaceutical company Eli Lilly, fancy that!)

Trump overruled CDC officials who wanted to advise senior citizens to avoid plane travel. Meanwhile, Trump himself has been flying around the world, shaking hands and having dinner with people exposed to SARS-CoV-2. Days after that, he literally shook everyone’s hands at the coronavirus press briefing.

You might think that he has secured his place as the most irresponsible idiot of 2020, but this week Boris Johnson decided to join the contest.

About a week ago I idly wondered if the galaxy brain antivaxxers who take their children to chickenpox parties would start trying to organize coronavirus parties. Well, imagine my surprise when the UK government announced that laughably stupid idea as their strategy.

It’s simple enough: don’t close schools, don’t shut down mass gatherings, only have people self-isolate for 7 days, and try and get 60-80% of the population infected. Hopefully the people who get COVID-19 once will develop immunity, and the disease will then gradually die out. Yes, around 300,000 people will die, mostly old and sick people, but apparently that’s an acceptable success metric now.

So-called “experts” have pointed out a few flaws with Boris’s brave strategy, though. For starters, a very recent study in The Lancet suggests that the long term COVID-19 mortality rate might be around 5.7%. That would mean 2.25 million dead, rather than a mere 300,000. There’s also recent news that some people who survived COVID-19 once have recently tested positive a second time. That would suggest that SARS-CoV-2 is more like smallpox, polio, chickenpox or flu, where no amount of exposure results in herd immunity. Even Tory rhyming slang Jeremy Hunt thinks the idea is “concerning”. Still, if we’ve learned one thing from Brexit, it’s that Boris won’t abandon a plan just because experts tell him it’s a terrible idea. Good luck, England!

So because the Trump administration have botched the response to COVID-19 so badly, we have very little idea how many people in the US are infected right now. Estimates of the fatality rate for infection vary widely as well, from as low as 0.16% in some areas, up to (say) 5.7%, with a consensus at the moment of around 1%, and the chances of death rising rapidly after age 50. This makes it very hard to estimate exactly how many people will die. It’s safe to say that Trump’s February 26th estimate of close to zero cases is inaccurate, however.

Absolute best case scenario? It’s about twice as bad as the flu, and around 60,000 die this year. Worst case scenario? 80% infected and 5.7% death rate is 15 million dead. Those are some huge error bars.

The real magic number, though, is around 1 million. That’s the number of hospital beds there are in the US. We know that 10-20% of COVID-19 sufferers require hospitalization. Let’s be optimistic and assume that it’s actually 10%, and that every hospital bed is currently empty. A little simple math then tells us that if we go much above 3% of the population infected and symptomatic at any given time, hospital beds are going to run out. (3% × 10% × 327m is about 1m.)

I don’t know about you, but I am really confident that we’re going to go above 3% infected and symptomatic at some point. And remember, that’s the wildly optimistic scenario. In reality, we may have a million beds, but we only have 160,000 ventilators.

That’s why all the experts have been talking about slowing the rate of infection through self-isolation and social distancing. We really, really need to slow the rate of spread, so that what passes for a healthcare system in the US can deal with the ongoing cases. Or as The Onion put it: “Health Experts Worry Coronavirus Will Overwhelm America’s GoFundMe System”.

I’m doing my part. Recently I’ve been socially distancing myself by telling everyone what a terrible Presidential candidate Joe Biden is, but in truth distancing has been a lifelong habit; as a young child my parents would have to force me to go out and interact with other kids.

I’ve also been a compulsive hand-washer for decades. I can’t tolerate any kind of dirt or grime on my hands, particularly if it’s sticky. As my mother once pointed out to a girlfriend, “You watch, the first thing he does when he gets home is wash his hands.” So as far as current strategies go, I think I’ve got this.

We stocked up on groceries the week before everyone started panic buying. We went to get a few more items on Thursday, and they were totally out of toilet paper. This, of course, makes no sense. COVID-19 is a respiratory illness, not dysentery; if you get it, you’re going to be coughing a lot, not shitting yourself to death. But apparently one local supermarket shelf stacker got attacked when he went to put toilet paper out, and now they have police supervising restocking.

There was also a great shortage of pasta sauce and pasta, and a shortage of chili-making ingredients, it being Texas and all. No canned beans in the regular aisle, but apparently people didn’t think to go to the Mexican food section and buy Goya branded foods.

Still, no matter how annoying things are right now, it seems pretty clear to me that they’re going to get a whole lot worse. I’m reluctant to speculate what the world is going to look like in a month’s time, let alone this summer. I don’t think apocalypse, but we might see FEMA camps offering palliative care to large numbers of sufferers.

Some have suggested that the reckless response to the virus and the resulting likely disaster might be what brings down Trump. I wish I could be confident in that. Right now FOX News is still pushing the idea that it’s all mass hysteria, a conspiracy to try to harm Trump, no worse than flu. They even advised viewers that it was a great time to fly, in spite of their own corporation banning non-essential travel. Still, I’ve a feeling that Trump and FOX News will ultimately lead to tens of thousands of unnecessary deaths — but that the families of the deceased will gladly vote for Trump again. Still, he’s been exposed to the virus multiple times, and it’s particularly deadly for people over 70 with major health issues, so thoughts and prayers, eh?