Is It COVIDpendency?

Is It COVIDpendency?

I know codependency. My dad was a smoker, an alcoholic, and a compulsive gambler. I spent decades of my life using data, logic, and emotion in a smorgasbord of thoughtfully and lovingly conceived schemes to convince him to quit. He never did. His death was an avoidable and foreseeable end result of his drinking and gambling.

At times, I’ve seen parallels between those efforts with my dad and my efforts to convince others to believe that COVID exists, to use masks, to get vaccinated, and to take the disease seriously. At other times, I think that COVID doesn’t really fit the model of codependency, because with COVID, the behavior of others – even strangers – impacts my life and the lives of people I love in significant ways. Regardless of whether I detach from the no-vaxxers, their collective actions will result in more mask mandates, possible lockdowns, and a more rapid decline in the current vaccine’s effectiveness.

Last night, my son told me that he had just read a news story about a new variant that may be vaccine-resistant. He asked if I really thought that he would be able to go back to school in person in September – he misses learning in a classroom with his friends. I had to tell him that I didn’t know, that my guess was that school would be in-person for at least a month or two – probably longer – before a vaccine-resistant COVID variant emerges and causes a change in policy. He expressed frustration that people who refuse to get vaccinated are making such a variant more likely. I told him that I agreed with his statement, but wanted to know his reasoning behind it. He said that the more people who don’t get the vaccine, the more of the virus that is out reproducing in the community, and the more chances that it has to produce a mutation that the vaccine can’t stop. Basic statistical math. He’s 14. He gets it.

The enraging and crazy-making irony, of course, is that the people whining the loudest about measures needed to stop COVID are the same ones prolonging COVID and making more of those measures necessary. In the US, we have a widely available, free, effective vaccine. 99.5% of those dying in American hospitals now are the unvaccinated. We even have the absurdity of $100 gift cards as incentives to get vaccinated. If embraced by the entire population, the vaccine could have gotten us to herd immunity. Instead, new COVID cases are spiking in nearly every state, with Louisiana now having almost as many hospitalizations as its deadliest spike in the dark days of mid-April 2020. It’s enough to make one want to shake some people by the collar and ask what the hell is wrong with them.

And it’s especially hard to simply detach, knowing that people will die as a result of those who choose not to get vaccinated. But an impact on others is not inconsistent with other forms of codependency. My dad’s drinking could have killed others (or me) when he drove drunk. His gambling had a huge impact on us when our house was lost to foreclosure. And I still don’t know if I’ll see the impact on my own pulmonary health from 18 years of inhaling second-hand smoke.

Still, rather than living with an alcoholic, the current situation seems more like trying to get to a hospital to treat a health emergency but being stuck in traffic on the freeway. Is it codependent to be pissed at the people who are slowing down to gawk at a stalled car by the side of the highway, or is it reasonable frustration with stupid behavior that is threatening your life?

In the end, I have to separate my own COVIDpendency into two pieces. The first is the real and clearly foreseeable threat that the actions of others pose to my physical wellbeing and that of people I love. The behavior of a percentage of the population, if unchanged, will very possibly result in my son having to learn from home again rather than at school. It will result in the need for more vaccinations as the current one is eventually rendered ineffective by a new variant. It will result in needless deaths – some possibly being people I care about. It will result in people I know and many more that I don’t know losing loved ones, and people being stuck with massive medical bills that didn’t have to happen. It will likely result in another period of my having to limit my trips outside the home. It will likely result in struggling businesses having to shut down for good, rather than being able to get back on their feet, due to a needless next surge of a deadly pandemic. These are all things that I have little to no control over. After a year and a half in a world shaped by COVID and a political climate shaped by Trump, I have to admit that I am powerless to change the behavior of those who could get us to herd immunity. They are going to do what they are going to do.

The other piece of my COVIDpendency, however, is one that I do have control over: the effect of all this on my own mental wellbeing. I can choose to stop wasting energy trying to change minds that will not be changed, and instead work on changing myself. I can choose to distance myself from the COVID deniers, no-vaxxers, and conspiracy theorists in my life, because my love for them as individuals also causes me stress and frustration. Contrary to what my ego has been telling me, my presence in their lives is also not something that will eventually cause them to rethink anything. As a friend once said in a different situation, stop trying to teach a pig to play the violin: it wastes your time and annoys the pig. Sad as it makes me, I can and will choose to let go of them with love. I can save that energy, and in the process have more of myself to give to those who are not causing me stress and frustration. I can help people who are behaving responsibly to better navigate the real world consequences left for us by those whom I am letting go. Not the most inspiring message, but I think it’s a pragmatic one under the circumstances.

– rob rünt

Why Social Distancing Doesn’t Seem to be Working

Why Social Distancing Doesn’t Seem to be Working

Why Social Distancing Doesn’t Seem to be Working

Short answer: it is.

On Monday, March 23, 2020, President Trump tweeted:

Tweet

The tweet appeared to indicate impatience with the effectiveness of social distancing. The President elaborated in his press conference that he was eager to see Americans get back to work, and was looking into ways to make that happen immediately after the 15 days of social distancing. His message contradicted nearly every medical expert in the country, many of whom believe that we may need to continue this for 8 weeks or even longer.

Because hundreds of thousands of people apparently agreed with the President’s tweet, it seems important to explain why our “new normal” of self-isolation is unlikely to show any noticeable effect during the rest of March, and why, as we watch the numbers go up dramatically and hear more and more tragic stories of hospital workers pushed beyond their limits, social distancing is nonetheless working and essential.

To understand this, we need to understand how this virus works. The current medical thinking is that coronavirus is spread by touching infected surfaces and then touching the mouth, eyes or nose. However, it is also spread by breathing exhaled microdroplets from an infected person. That is why it is so important to keep a distance of 6′ from others and assume that anyone could be infected.

Coronavirus has a median incubation period (you’ve caught it, show no symptoms, and are contagious) of 5.1 days. Some cases have a longer incubation period – up to 15.6 days. During that time, it is estimated that an infected person will spread the virus to 2-3 people. During their incubation periods, those people will also spread the virus to 2-3 people, and so on. Once each person begins to show symptoms, they will not immediately be added to the government statistics of “confirmed cases.” Most will wait for several days trying to decide if it is worth getting tested, especially given the limited number of tests that we have available in the United States. Those who get tested will likely have a 2-3 day wait before their test results come in, at which point, they will be added to the government statistics if they are infected.

This delay in data is why the President’s main adviser on this pandemic, Dr. Fauci, says that “if you think you’re in line with the outbreak, you’re already 3 weeks behind.” The effects of our lax attitude toward the virus will still be with us in 2-3 weeks, and similarly the effects of our actions to contain the virus will only begin to show up in 2 weeks at the earliest.

On March 16, the President released his plan for “15 Days to Slow the Spread.” While the plan is far less strict than it needs to be, it is America’s first real effort to contain the spread of the virus. Its effects will likely not become visible until April. In the meantime, the graph below shows what the rest of March is likely to look like in America, based on a spread rate of 32% per day, 20% of cases requiring hospitalization, a 35% increase in deaths per day, and 45,000 ventilators nationwide.

Chart
(Data recorded at 6pm ET each day from ncov2019.live/data)

This is possibly the worst situation for America to have an impulsive President whose life experience has been guided by easy solutions and instant gratification, and whose closest aides charitably describe his personality as “childlike.” The consequences of ending social distancing early would be severe and crippling for our country. Hopefully our governors will have more sense than the President and will increase, rather than decrease, measures to contain the spread.

There is good news and bad news for April if social distancing remains in effect. The good news is that the rate of spread will likely begin to slow in early April. Italy has finally had its first day of single-digit increases in the number of people needing hospitalization.

The bad news is that America’s hospital system will have already become overwhelmed by then. Particularly critical in this dynamic is the shortage of N95 masks that our hospital workers have experienced thus far. Nurses have been told to reuse masks, create their own masks, use bandanas, etc. As a result, they have been inadequately protected from the virus, and while masks finally seem to have begun to be made available, it may be too late for some of our nurses. This means that not only is their own health now at risk, but also that these nurses will be unable to continue working as they recover or need treatment themselves – all at a time when our hospitals are being pushed beyond their capacity.

The best thing that Americans can do to limit the spread of this virus and eventually get it under control is to continue social distancing measures and ideally to take precautions that are one or two steps more extreme than we think are reasonable at the moment.

We should also note that as China began practicing social distancing, they saw the virus begin to take hold in family clusters. If one person in the family had become infected before their confinement or while out getting supplies, they would spread the virus to other family members. If someone in the home shows symptoms (fever, dry cough), they need to be isolated in a room away from other family members, one family member needs to be assigned to care for them, and that caregiver needs to have limited exposure, wear whatever protective gear that they can when providing care, and take measures to sanitize themselves and exposed objects immediately after each incident of providing care.

China’s eventual solution involved many extreme steps, including taking people’s temperature at the entrances to public places like grocery stores, isolating the infected in stadiums and sectioned-off hospital wings until they recovered or died, and other steps that were even more severe. For our President to look at that and think that America’s trajectory will magically be different from China or Italy if we end social distancing after 15 days and “get back to work” is folly. If the projection above is accurate, by March 26, America will have far surpassed the total number of cases that China has had during the entire outbreak.

– rob rünt

30 Days in the Life of Coronavirus

30 Days in the Life of Coronavirus

30 Days in the Life of Coronavirus

The other day, I posted info on Facebook about how to avoid spreading coronavirus. A friend asserted that this was all just politically driven hysteria, and pointed out that during Obama’s Presidency, H1N1 killed over 12,000 Americans in a single year. The day that he wrote that, the American death toll from coronavirus was in the 40s.

While I countered that the coronavirus is highly contagious, I was still bothered by the stark contrast in the numbers, and began to wonder if perhaps my friend had a point about things being blown out of proportion.

To test the theory, I looked at the numbers and put together a model based on those numbers. What I found was alarming, and yet quickly appeared to underestimate the scope of what is coming. It should be a wakeup call to every American about the need to practice social distancing and all other CDC recommendations NOW.

The issue is not so much the number of people who will die, although the number is likely to be large. But the greater issue is the strain that will soon be placed on our country’s medical system. Due to inadequate measures taken thus far by our government and our fellow citizens, America may well be in for a crisis far eclipsing that of Italy. If you are not familiar with what is happening there, you need to be. There is little time left for us to avoid such a catastrophe. We need to dramatically alter what we are doing NOW.

To create the model, I relied on a few basic facts:

  • On 3/11, the number of confirmed cases in the U.S. was 1,267
  • On 3/14, the number of confirmed cases in the U..S. was 2,657
  • That equates to a daily increase of 28%
  • The death toll on 3/14 was 50 which would imply an approximate death rate of 1.88%
  • A study by the Center for Infectious Disease Research and Policy (CIDRAP) determined that the maximum incubation period for the virus (no symptoms, but contagious) is 15.6 days
  • CIDRAP’s study determined that the median incubation period for the virus (no symptoms, but contagious) is 5.1 days
  • The CDC estimates that hospitalization will be needed for 20% of cases
  • Much of that hospitalization will require ventilators
  • America has approximately 45,000 intensive care units (ICUs) with ventilators

Below is the model, which assumes no significant change in behavior by Americans and no cure or vaccine available within the next month:

CoronavirusChart

Today was the first day of new data to compare with the model. As of this writing on 3/15, the number of cases in America is 3,552, and the number of deaths is 65 – both higher numbers than predicted in the model above.

The model is also graphed as the main image for this article, but is, of course, cut off at the top. Below is the full graph. The fact that it stops at April 12 was an arbitrary decision on my part to limit the data to 30 days: in reality, of course, the disease may continue to spread beyond that.

CoronavirusGraph-02

To summarize, the difference between H1N1 and coronavirus in terms of spread is that, without drastic measures, it is likely to kill more Americans by April 6 than H1N1 killed in an entire year. The calls for social distancing (6′), hand washing, avoiding touching the face, avoiding crowds, etc. are not hysterical hype, but rather are crucial and sensible measures that we all must take NOW.

The purpose of this piece is to raise public awareness in hopes of changing public behavior in time to prevent crippling or even collapsing our nation’s hospital system. We have little time left.

Sources:

Ncov2019.live/data

U.S. Center for Disease Control

Center for Infectious Disease Research and Policy

Politifact

Vox

 

–  rob rünt

Gratitude.

Gratitude.

As the coronavirus continues to spread through our country, I want to express my deepest gratitude to all the people who will likely still need to work even when everyone else goes on lockdown:

  • Doctors, Nurses and Paramedics, all of whom have been, are currently, and will continue to be on the front lines treating those hit hardest and risking exposure to the virus themselves. They will be the ones dealing with the worst of what this brings us. I pray that they do not have to experience the kind of overwhelming tidal wave of patients that medical professionals in Italy and Iran are currently dealing with, but our country’s belated response indicates that our medical workers may be in for an extremely rough time.
  • Pharmacy Workers, who will still need to provide medications, not just to those with the virus, but to people with all other conditions that occur every day – including chronic conditions like diabetes, heart disease, HIV, and mental illness.
  • 911 Operators, who will still need to process and route our emergency calls.
  • Firefighters, who will still have to put out fires, help people having heart attacks and other medical crises, and will likely be called out to help some of the 20% of people who experience severe symptoms from the virus.
  • Police, who will still be called to address criminal activity, domestic disputes, and other situations that will continue to some degree regardless of what else is going on in our country.
  • Grocery Store Employees, who will still need to provide vital food and other goods to the public.
  • Truckers, who will still need to transport food, gasoline, medical supplies, and other goods across the country.
  • Dock Workers, who will still need to receive food, medical supplies, and other goods at our ports.
  • Gas Station Workers, who will still need to provide gasoline.
  • Trash Collectors, who will still need to collect our garbage, which never ends.
  • Utility Workers, who will still need to ensure continued electricity, natural gas, water, and phone service.
  • Postal Workers, who will still need to facilitate communications and the delivery of life essentials like Social Security checks.

These people, and many whom I’ve probably left out, are my heroes during this time, because while their contributions are often simply assumed to always be there, it is because of them always being there that they will be the people most vital to keeping our country running.

I am also grateful for the Americans who are voluntarily taking steps now to lessen the coming impact of the virus on our country:

  • People who are following the CDC guidelines to limit spread of the virus: their efforts now will reduce the stress on our medical system in the coming weeks.
  • People who are taking the time to seek out credible sources to learn about the virus and how it is spread.
  • Employers who provide paid sick leave so that their workers don’t feel pressure to come to work sick.
  • Employers who acknowledge the reality that people can have this virus with no symptoms for well over a week and still be contagious, and employers who are therefore allowing their employees to work from home when possible to reduce transmission.
  • Employees who stay home from work when they are sick, thereby keeping their coworkers from getting whatever they have
  • Landlords who are willing to be flexible with tenants who may miss one or more paychecks and therefore may not be able to pay their rent: these landlords’ compassion will reduce the degree to which homelessness ends up a side impact of this virus.
  • Bankers who are willing to be flexible with mortgage payments, and who can therefore have a similarly positive impact on our country.
  • School districts that are closing down and finding alternative ways to continue teaching kids at home.
  • Teachers who stay home when they are sick, and whose jobs may currently require them to be around sick kids all day.
  • Parents who keep their kids home when they are sick.

These people also deserve recognition for helping keep this virus as manageable as possible. Thank you.

– rob rünt