Showing posts with label pandemic. Show all posts
Showing posts with label pandemic. Show all posts

Thursday, April 16, 2020

Learning to get along with COVID-19 (and possibly take a selfie with it)

Everything I'm seeing tells me that we've painted ourselves into a corner on COVID-19.

To encourage people to take the short-term lockdown seriously, a significant number of people have been put into a panic about the virus. To be sure, it is to be taken seriously, but perhaps not this seriously as long as you are following the rules of social distancing.

The people who are dying in Canada from COVID-19 are dying during a lockdown with many precautions in place, and with full access to ICUs and ventilators. They are not dying because of unavailable critical care. There is no shortage of ICUs and ventilators because of actions taken so far to divert resources to deal with the epidemic - in fact there is a significant excess.

This is good news, but it's only good news for a short period of time. At some point, it begins to look like a misallocation of resources during a time of economic collapse.

So, once we are confident in our ability to consistently help those that can be helped, excess resources need to be reallocated where they will be more likely to save lives. Such as resuming cancer consultations, pre-emptive surgeries, and similar things that have been put deprioritized and put on hold. Putting people back to work is also effective medicine where the unemployed condition involves over-eating, alcohol or drug abuse, depression, and other grotty things that fall under the banner of "idle hands syndrome".

Without a vaccine and/or some other anti-viral therapy that is discovered to improve survival rates, that percentage of susceptible people would still die with or without a lockdown. But without a lockdown, or with a relaxed lockdown, it's now going to be seen by some as the government's fault to some extent if lockdowns are relaxed and people suffer, as they inevitably will.

Unless seasonal weather changes things. Hopefully, but hopefully not - because, if true, then come June it becomes the southern hemisphere's turn to deal with this.

We don't know if you become immune after you've caught it once, and if we suspect that you are then we don't know for how long... but hopes pinned on a vaccine are high.

We don't have the means to know broadly whether someone has already caught it and acquired some immunity.

But, it sounds like mutation of this particular type of virus is a red herring as far as vaccination goes.

Like many others, I can see a way that life gradually returns to normal by gradual easing of the lockdown. I don't know how businesses that were marginally surviving at full capacity would survive at half-capacity. Live events and restaurants that normally need to fill 90% of seats may not survive filling 50% of seats. Airlines won't. Transit won't. But it's better than nothing and perhaps government programs can compensate in part where they are currently compensating in full, which is still a net benefit. At some point it has to end in full because we can't afford to do otherwise, and this is independent of whether or not there is a vaccine.

Even with all sensible measures in place, this doesn't stop a certain % of susceptible people from meeting an early death as restrictions are relaxed, nor does it help governments that have taken full responsibility for the lockdown absolve themselves in the public eye of responsibility for outcomes.

To be clear, I would not hold the government responsible because (a) I don't see any of this as the government's fault and (b) I see relaxing the lockdown as soon as possible as an absolute necessity and accept that mistakes will be made. If that's evil then it is a necessary evil. But that's just me and people that think like me. Click-bait media (most mainstream media) would hold them accountable; political opponents would; and undoubtedly would reddit. Even if those factions didn't believe the government was responsible in their heart, they would still blame and provide encouragement to those looking for a scapegoat.

Here's one communication point that would set the stage: start emphasizing now that the goal is not to prevent everyone from being afflicted by COVID-19, but to ensure that we have all necessary resources available to assist when someone does catch it and needs attention. That has always been the goal, but it is not at all clear.

Proof? Grocery workers, transit workers, and nurses refusing work or agitating over work that they believe mean "it's only a matter of time" until they acquire COVID-19. Well, it's only a matter of time until all of us catch it.

The concern about kids catching this ("...and she has 2 kids at home!") seems particularly misplaced. I'm sure someone has a link they can send me of one child that has died from it. That is beside the point, but it's also part of the irrational hysteria that cohabits with the rational hysteria around COVID-19.

The people I have most affinity toward during these times are those special epidemiologists who say that we can't just be listening to medical professionals on this issue. These people are out there. Medical professionals are not elected and have no accountability to keep society functioning. Nor do the media. Scientists go where their scientific specialty leads them and the media are starved for revenue, with attention being a proxy for revenue. Both have had an overweight say in public policy on this issue until now. Medical professionals very clearly have valuable advice to impart, but we also need the equivalent of "engineers" that are going to put that scientific knowledge to effective use (and I mean real engineers - not software ones).

And with the production pipeline shut down this year, there will be very few new Hollywood movies next year.

Dark skies ahead, but hopefully warmer weather.

Thursday, March 19, 2020

Have some self-control: COVID-19 subsidies are for the people that really, really need them

In semi-lockdown like most other people due to COVID-19, I'm a bit disappointed to see people who can well-afford to maintain their lifestyle for the time being trying to apply pressure via social media or elsewhere to get free benefits such as cheaper electricity, increased Internet caps, and other similar things.

Some of these people are even people I know to be on fixed-income. Times like these are when fixed-income is a blessing rather than a curse. Imagine that: someone else is responsible for making sure you get paid when they themselves may be losing!

The impact to the economy of this lockdown will be incredible. I would not be surprised to see a "pandemic tax" come out of this, and for good reason. Subsidies are for the people who will suffer extreme hardship.

The role of anyone who can still afford to pay their bills for the time being is to continue to pay them as promised for the services they chose, and be glad that they are in a position to do that.

And why not donate any money you are saving from driving less, taking fewer transit trips to work, or buying fewer coffees or take-out meals to a local charity that will help people in your community who will soon begin to struggle?

Thursday, March 12, 2020

The post on COVID-19 that nobody asked for

The last thing anyone needs is another post on this topic. But, at this point it is therapeutic for me to try and connect and resolve the many conflicting pieces of information I've absorbed from the five sources of quality news that I pay for, together with the highly interesting and insane cross-section of information gleaned from free clickbait sources and back-alley slums of ill-repute like reddit.

Plus, it'll be interesting to look back and see how wrong or naive I was in retrospect.

What have I learned about COVID-19?
The fact that I've learned it doesn't mean it's true, but this is where I think it is at:
  • When the virus first appeared in China, efforts were focused on quarantine and elimination of the virus.
  • Most people who get the virus are no worse off than if they'd got a cold or the flu. Some people have an extremely serious infection that requires mechanical ventilation and intensive care facilities.
  • Mechanical ventilators and intensive care facilities are in short supply around the world. This is reasonable.
  • Global efforts are no longer focused toward elimination of the virus, but instead on controlling its inevitable spread so that it doesn't overwhelm healthcare resources such as available ventilators and intensive care units.
  • If healthcare resources are overwhelmed, triage will determine who will live and who will die. More people will die than would die if resources were unoccupied. The deceased may include among them people who did not have COVID-19 but had another serious accident or illness at the wrong time - for example, a severe case of regular influenza or an unrelated heart attack that required intensive care facilities.
  • Healthcare systems have generally have not been good custodians of the supply chain. Important tools in the pandemic toolkit such as masks and other protective equipment have not been stockpiled. Further, many are produced in China along with certain important medications and these supplies are now quarantined along with a large chunk of the Chinese population.
  • With all of the above in mind, reducing the opportunity for all types of illness, injury, and accident while COVID-19 is a clear and present risk makes sense, and to me this is why shutting down events and travel makes sense. If you have a serious car accident travelling to an event when COVID-19 is in full swing, you may be out of luck.

What I don't understand: why not inverse quarantine?
I don't fully understand why we are roping everyone into the cancellations and restrictions that are now becoming widespread. There is a clear profile of the type of person that is vulnerable and they are in the minority: older people with existing health conditions. These are the people who have the most self-interest in protecting themselves, and they are also the reason that everyone else should be trying to avoid catching the virus - not so much for themselves as for someone who is vulnerable that they may pass it on to.

Why wouldn't we get in touch with the most vulnerable people, have those people quarantine themselves with supports to ensure they have what they need for the duration, and let it blow through everyone else as quickly as possible - the vast, vast majority of whom will not suffer greatly though may be contagious for 2 weeks? Perhaps it is too large of an effort to orchestrate reliably and quickly, but it seems that most people are hyper-aware of this issue so the communication would surely not be a problem. If there is a vulnerable person that does not know that they are at risk from this virus by now, I would be extremely surprised.

I can't help think, in the back of my mind, that this has largely become one big exercise to see how quickly and deeply governments can bring people under control should a more serious emergency or outbreak warrant it in future. How often does this opportunity come along with commensurate public support? The largest social experiment ever conducted - so much will be learned from this.

Ontario schools closed for 3 weeks - where do the kids of healthcare workers go?
March Break - an annual week off school in March - was to begin next week. It happens every year and parents plan around it. Parents have now been told that schools will be closed for an additional 2 weeks after March Break to reduce the chances of propagating COVID-19. Fair enough, but I can't help wonder what this does to healthcare workers with children not old enough to stay home alone. A great government support would be to do everything it can to provide free, priority daycare for children of healthcare workers. If this virus kicks off, the last thing you will want is healthcare workers torn and stressed between home and work-life issues.

The logic of closing down schools for 2 weeks after March Break appears to be that children returning from March Break travel to locations where the virus is more prevalent than in Canada will not have a chance to spread the virus among their classmates on their return. After 2 weeks, it'll be clear who does and does not carry the virus but immediately after March Break it will not.

Donald Trump and US Election 2020
It seems to go without saying that Donald Trump's prospects of re-election look worse at the moment than they did at the beginning of the year. I'm not sure they were ever that great - he won in 2016 by an extremely slim margin and lost the popular vote. It's hard to imagine that he has brought more people onto his side in the last 4 years, but there's no accounting for public affinity for an opponent who is older, appears confused a lot of the time, and will not bring out the youth vote... and that is what you have in Joe Biden.

If you look at the core of this COVID-19 issue and the havoc it has wrought in general to the economy and healthcare system so far, you see a fundamental issue of over-dependence on China both in the supply chains of every day products and in medical supplies that are critical to the health of the country. It really does seem feasible at this point that even the US military may not be able to function completely without the Chinese supply chain being intact, which seems unimaginable.

So, all I want to say here is that Donald Trump has made reducing dependency on China a central and highly-visible part of his presidency for the duration. He has been attacked from all angles for doing it, and primarily by his opponents (some of whom had a direct hand in implementing the over-dependencies). There is political gold to be mined for Donald Trump if done in the right way and at the right time, though I'd still have doubts in his ability to sway such a polarized population.

Donald Trump and the ban of EU travel
It was wrong to impose such restrictions without letting his counterparts know it was coming. But the immediate cries of "this won't work!" were really strange. China did it, and was praised for it. Granted, the US will not be able to be so draconian and complete in their shutdown. But how do the EU naysayers know that it won't work, and what position are they in to say so with all of their most prominent countries grappling with this virus more severely than is the US?

The US has some unique healthcare struggles with such an apparent lack of integration or common goal of public good within its fragmented healthcare system, and I have to wonder whether border restrictions may really be the best (if not the perfect) approach for that type of system.

Over-reaction and stockpiling
I went to the supermarket on the evening of March 12th to pick up a few things, but none of them were must-haves. It was worse than the height of Christmas. All aisles packed with shoppers and shopping carts going queued around the perimeter of the store waiting to be checked out. I've never seen anything like it, and I can't imagine what could be so urgent for so many people! I left.

I went back the following morning at 7:00am. Not as bad as March 12th but definitely abnormal - more on the scale of a busy Saturday afternoon, though with very few checkouts open.

India
I am absolutely amazed that this virus hasn't kicked off in India yet. but here you have it - as of today, only 73 cases and 1 death in an extremely crowded country of 1.3 billion people.

But life goes on...
For the most part, people I interact with on a daily basis are going about their day and getting things done. There's such a sharp contrast between portrayals in the media of absolute chaos at every turn and the calmness of every day life.