The COVID-19 Lottery

 

The strangest aspects of the novel coronavirus are the profound differences experienced by those infected by the disease. The double-edged sword includes the benefit that 40% of those infected show no easily discernable symptoms. Not those with a “pre-serious infection” lack of symptoms; that’s another category altogether. Those who never show symptoms. The lack of serious symptoms is a serious plus for those who have side-stepped the debilitating and frequently fatal consequences of the disease that saturate the headlines. Most younger children fit into this category, although we are clearly uncertain as to potential longer term serious and perhaps permanent negative health issues down the line.

On the other blade of that sword: There are negatives to walking away with an infection but showing no obvious immediate impairments. First, the growth of a myth that COVID-19 is only a concern for the obviously vulnerable (almost half of all Americans, by the way; see below). “Don’t take away my choice,” is the cry. So, they say, we really should let the pandemic run its course and just reopen the economy. This mythology is precisely what seems to motivate teens and young adults to ignore bans on social gatherings, distancing generally and wearing of masks. They are somewhat less vulnerable – but unfortunately not all of them (and often discover the hard way who gets hit hard).

The 18-49 demographic is currently experiencing the greatest explosion of infections… with severe symptoms. Second, and much more importantly, all those asymptomatic infected individuals are active carriers of the disease… fully capable of spreading the virus.  As long as these selfish practices are widely practiced, the coronavirus will just continue and probably grow.

This second characteristic is the source of so much angst and political turmoil. The arguments that since young children are less likely to experience severe or fatal infection consequences, depriving them of in-person education is far more dangerous and disruptive than opening schools.

That these children can still be very active carriers, bringing the disease home with them to infect older siblings, parents, grandparents, etc. is simply ignored, even though it is very real. That there are likely longer term issues that children could experience, coupled with an explosive rise in MIS-C (multisystem inflammatory syndrome in children with severe and permanent neurological damage) and Kawasaki disease (which can result in organ failure and death) that are often part of the COVID-19 infection experience in such young people. We are watching as primary, secondary and colleges open up, the number of new cases in those venues is rising and forcing closures and increasing isolation procedures. Opening up is a nice theory, but in practice, so far, it just isn’t working.

Speaking of vulnerability, even setting blood type aside (a person with type A blood is 35% more susceptible than someone with another blood type), 45% of all Americans have vulnerability indicators that make them susceptible to the worst consequences of the disease should they be infected. Age, particularly those experiencing age-related disease or frailty, is the most obvious risk. Those in their sixties and older have generated the bulk of the COVID-19 fatalities. Any chronic immune or respiratory impairments, obesity, cardiac issues, and diabetes are just part of a long list of COVID-19-risk ailments.

Although a saliva test developed by Yale University along with the NBA, which is easy to administer and provides rapid results, shows promising results, the United States is millions and millions short of viable tests and faces thoroughly unacceptable waiting periods for results. Unlike most other nations that faced serious infection rates, the United States still has no national playbook to contain the disease. A medical pandemic has become a political event pitting economy-first conservatives against life-is-precious residents. Even as the federal government has the absolute ability to provide enough economic flow to sustain serious containment efforts, Republicans have dug in their heels against releasing such financial aid in order to force even the vulnerable to get back to work to restore the economy.

That the United States, allowing individual states to go their own way even as Americans travel back and forth between and among states (in spite of purported attempts to impose interstate travel restrictions and quarantines), has all but assured that the virus is nowhere near containment. We are in the middle of a first wave outbreak explosion, and the probability of a massively corrosive second wave now seems inevitable.

“A top CDC official has warned that the US must brace for the ‘worst fall’ ever in the history of public health disasters if Americans don’t follow coronavirus guidelines… ‘For your country right now and for the war that we’re in against COVID, I’m asking you to do four simple things: wear a mask, social distance, wash your hands and be smart about crowds,’ Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, told WebMD.

“‘I’m not asking some of America to do it. We all gotta do it.’… If people fail to follow those tips, next season could be ‘the worst fall, from a public health perspective, we’ve ever had,’ he said… Redfield’s powerful plea came as COVID-19 fatality numbers soared to more than 166,000 nationwide, with 1,499 deaths reported on Wednesday [8/12] alone — the most in a single day since May, according to Johns Hopkins University data.” New York Post, August 13^th. Do those who have experienced an infection and recovered have permanent immunity?  So far, all we know is that the immunity extends at least 90 days. Maybe more. We just do not know.

And if you think we are on a path towards an inevitable “herd immunity” no matter what, see my August 12^th Have You Herd of Immunity? and my June 13th Are We Just Going to Learn to Live with Massive Death Tolls? blogs to correct that assumption. While we may develop an effective vaccine (politicians cannot guarantee anything), which has almost a zero chance of widespread deployment until next year if is satisfactorily tested and mass produced in time, it will still take a long time for the overall containment to occur… and a much longer period for the economy to recover from this devastating pandemic. That a large segment of the population is indicating it may simply not get the vaccine even if available should be troubling to us all.

If we keep trying to force the economy to full opening, to get our children into schools without proper COVID-19 containment, the pandemic will escalate to even greater numbers and toxicity… taking the economic further down with it. And the next drop of the economy could be so much worse than the financial disaster we have experienced to date. Anything that we do to force people out of safe venues, like requiring older people to vote in person by shutting down the US Postal Service, will only make a bad situation incredibly worse.

            I’m Peter Dekom, if you need proof of our failed COVID-19 policies, just compare our infection, hospitalization, ICU-usage and mortality statistics with the results in the rest of the developed world.