This is a very difficult post to write. While I am not aware of any underlying conditions that raise the risks for me personally, I have siblings who do. They must do everything they can to prevent exposure to the virus. As of this writing, many areas of the country are designated as "hotspots" due to increased numbers of reported or identified cases. This metric, newly identified cases, continues to be the barometer for how we are succeeding or failing with the virus. As I indicated in my first installment, I find this measure to be flawed and misleading. This past week, the CDC announced its belief that in the United States, there were likely twenty million cases, rather than the reported two million. If correct, then we need to adjust the daily report of new cases by a factor of ten. For example, if South Carolina identifies 750 new cases in a day, the real number is actually 7,500. Why the discrepancy and what does it mean? The CDC believes that the vast number of cases are either asymptomatic or so mildly symptomatic as to not trigger testing. But aren't we being told that the virus is deadly and that we must social distance and wear masks to avoid catastrophe? I believe we are being told that but the numbers speak otherwise. If the death rate is based on identified cases, rather than actual cases, it is ten times higher than it actually is. Hospitalizations are not and that's one reason why I think number of hospitalizations is a better measure. But the rate of hospitalizations is linked to actual cases and needs to be reported as such.
Though admittedly not my primary area of healthcare expertise, public health and its experts seem to me as lost as everyone else. The coronavirus is just not like other pandemics. It is not as lethal and so it is not self-limiting. It is also highly contagious and therefore not preventable. In the beginning, we used to hear the term, mitigation. We did not hear the term, prevention. Mitigation means slowing the spread of the virus. Prevention means stopping it. There is no stopping the coronavirus. Failing a vaccine, sooner or later everyone will become infected. We are really discussing the rate, how quickly or slowly, that process will take. I think the experts know that but they won't admit it to the public. Instead they feed the belief that with enough restriction, we can stop it dead in its tracks. An Israeli researcher looked at the pattern of spread of the virus across all countries. What he found was that there were differences in the rate of spread but not the end result. Herd immunity is supposed to be achieved at around 70%. If there are a reported 2.5 million cases, then there are really 25 million. Though a big number, we have a long way to go.
We accept risk as the price of everyday living. We get on an airplane knowing that sometimes they crash. We drive in cars, aware that accidents happen daily and often completely out of our control. I read once that more children drown in swimming pools than are killed in auto accidents. Nevertheless, we still build swimming pools. The coronavirus is deadly for some, probably less than one per cent. What do we know about that one per cent. They are old, they are predominantly male and they have known pre-existing conditions: obesity, diabetes, high blood pressure, pulmonary problems. It makes undeniable sense to target those who are most vulnerable for prevention. It makes just as much sense, at least to me, to mitigate the spread of infection for the other 95+% who do not require intensive treatment. When much of the South began opening up, I said now we're going to see what would have happened if we hadn't shut down. The Northeast is beginning Phase 3. I think we'll see spikes in new cases, just as we have seen in the South and the West. Unless the healthcare system is overwhelmed, it will be the predictable and acceptable price of mitigation.
We like to see things in "either-or" terms. We want clarity; we love certainty. We want somebody to be right and somebody to be wrong. It just isn't that way in real life.