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Stop with the fatalism: Don’t flatten it, Crush The Curve on Coronavirus

There is a third way — Why are we so fatalistic?

It’s not a choice between Let It Rip and the slow bleed of “Flatten the Curve”. It’s not a choice of health versus money. The third option no one is mentioning is to Crush The Curve: we go hard, fast, and do a major short sharp quarantine. It’s not radical, it’s just textbook epidemiology, it saves more lives and it saves the economy too.

SlowMo, Boris and Trump are still two weeks behind the virus. It’s time to get the Third Option on the table.

Flattening the Curve is a fatalistic slow bleed that must last months. It rescues us from the demolition derby that the Let It Rip disaster is cursing on Italian hospitals, but it’s deadly for the economy. All leaders who are keeping schools open while turning student dorms into triage units are locked into this limited thinking. It’s the Influenza-plan rejigged.

There is another way  — (as I’ve been saying) — we stop dithering and acting two-weeks-late, and jump ahead of this inanimate code. We aim for extinction — hunt every infection down, keep most people at home, reduce the spread, then finish by following every contact, track and trace. It’s not that big a deal. When we said “close the borders” people said it was unthinkable, but they’re closed now. Somehow life goes on without the trip to Bali, and the dinner at the Hyatt. The slow-bleed keeps people going to work and dinner parties, and keeps the kids in school, but we walk the tightrope of Hospital Doom with an exponential foe — people dying drip, drip, drop all the way.

Crush the Curve instead, enough with the fatalism, Graph. Flatten the Curve.

Crush the Curve instead, enough with the fatalism

We’ve already given up sport, holidays and big parties — it’s not the end of the world to just call a halt to work and school and stay home for a few weeks. I predict we’ll end up there anyway, so the sooner the better. As long as people have food, it’s not exactly “survival camp” struggle to stay home  for a few weeks. Regions can still trade with care. We drop the containers at the border, swap cabs and use local drivers. Planes with cargo can be quarantined or cleaned. We do food deliveries, so no one goes hungry. We test those delivery guys, and the packer girls. We guard the supply chain people — the farmers, health workers, and all essential services.

We live without lawyers and accountants for a few weeks, and look after the supply chain people. We expect the delivery team to be as isolated as possible (apart from the delivery rounds), and tested often, so we pay them more temporarily. The last thing we want are deliveries of coronavirus. (Like in Italy).

In this future we build holiday homes, not hospitals.

The secret is strict walls. We stop feeding the virus fresh bodies and simply outwait the code. Its big weakness is that it can’t repair from daily wear and tear. Heat will break the bonds. So will UV. Sooner or later (nine days?) we don’t have to do anything and the code disintegrates. One snip and it’s powerless.

The great thing about this is certainty and speed

Do it once and do it well, then maintain the barrier around the Virus Zone as it shrinks bit by bit.

Imagine nations split into mosaics of small regions and we clean one at a time and build from there. As each small region is cleared of the virus it can be opened to other clean regions, then clean states join clean states, and finally clean nations connect. This quarantine is only as good as its walls, but it can be done. And it can be maintained and it will keep airlines, events and restaurants alive. Footy games too.

Schools have to go skeleton minimalist (briefly) — all kids who can stay home should stay home. South Korea had emergency classes for children of essential workers and kept class sizes to 10. After the state is clean, schools can run normally again. In the six month Slow-Bleed-Plan schools will have no certainty that they won’t be shut down due to infection any day. Flights can’t be restored quickly, and businesses go bust.

How realistic is it to aim for extinction?

This is not 1918. We don’t have to give up before we even start.

Thousands of medical researchers are working on this from scores of different angles. There are plenty of interventions in the pipeline to improve the odds.

It will take a special kind of determination. It will take thousands of tests and discipline, but we won’t have to keep it up for six months. Keeping the virus out would have been a snap a few weeks ago, but now we need to over reach to aim for zero. Instead of slowly sliding belatedly into greater and greater restrictions, just do them all now temporarily. Make it top priority to get the Ro under 1 and keep it there. Declare a war on this virus.

As a side benefit, even if we don’t achieve extinction we stop more countries losing control. And we discover what makes this virus tick and which restrictions matter the most. Crushing it now buys us time to find ways to improve the odds. Being defeatist now just makes it harder to use the new tools when they come. And they will come, we know the code.

Any antivirals  (chloroquine, anti-HIV drugs) can be used as preventatives on the contacts to ring-fence the virus.  New biotech solutions with potential to make this easier include mass production of monoclonal antibodies, or small copies of the infectious spike protein or stem cell treatments and RNAi. We declare war on this virus. We study it to the nth, do gene assays, figure out which people are most at risk of infection or at risk of being carriers or at risk of getting the severe disease.

But we don’t need hi-tech, we need a clear mission, and some time…

States with the fewest infections have the best chance to lead the way — New Zealand, Tasmania, Hong Kong. West Australia. Russia, Macao, Taiwan. India?

After the curve is crushed, freedom is mostly fixed fast

Inside the No-corona-state everyone has all the freedom that they usually have, they just can’t leave and come straight back without a two week quarantine. But restaurants, schools, clubs and pubs are all back on again.

The proviso is that that walls must stay strong. A No-corona state can only afford open travel with other proven No-corona nations. All arrivals from the virus zone will have to be quarantined and not with polite requests but mandatory checks and carefully enforced. But every nation will want to be on the clean list — there is a big incentive to get there and maintain it, and to be honest. Countries caught hiding infections will be dropped like hot potatoes, and lose the right to get back on the list quickly. Poor nations will need help but big clean nations will have healthy economies, and they can assist.

There is better future

Until there is a vaccine or a serious treatment we live with constant vigilance looking for an outbreak. But when it happens, we know what to do. Short, sharp and fast. Obviously we test, test, test, and then test again.

 

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Coronavirus Background: ☀ The Demographics: the young are spared, but the severity increases with age, and slightly more for men than women. ☀ The Ro is 2 – 3 and exponential curves are steep. How Coronavirus kills: why the number of ICU units matters so much. ☀ Illness progression: Dry coughs and Fevers, Aches. In 15% of people, by day 5 breathing trouble starts. In 3% (?) by day 8 they may need an ICU (intensive care unit). ☀ The good case of Singapore but the ominous calculations of how fast the ICU beds may run out. ☀ The story of how American Samoa avoided Flu Deaths with quarantine in 1918. ☀

Economics: ☀ The huge impact on the Chinese economy, the awful case of Iran.☀

Beware UN advice:Ethiopian WHO chief was part of China’s debt trap diplomacy ☀

Stats and Data: John Hopkins Live Map Worldometer

 

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