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We Can Hammer Coronavirus in weeks instead we Rush to War Unarmoured

Posted By Jo Nova On March 29, 2020 @ 6:26 pm In Global Warming,Microbiology | Comments Disabled

If you only read one serious page about how to deal with this crisis read Coronavirus: The Hammer and the Dance. The countries that “get this” approach will be the first to recover.

It’s all the things I’ve been suggesting but done on big scale with an expert team.

What I call the Slow Bleed is officially known as Mitigation. It’s the 6 month Flu strategy that kills people and the economy.

When I said Crush the Curve, they call it The Hammer, the hardest form of suppression. The Dance is the delicate recovery process until we get a vaccine, a treatment or a nicer mutant version of the virus.

Hammer and Dance with coronavirus

1. Hammer and Dance — there is a better plan   (click to enlarge)

 

Eventually we’ll all get to the Hammer Crush approach because the alternative is so horrible.

Even Imperial College concludes that slow “Mitigation” is just not viable: in the UK the demand for ICU beds would exceed capacity 8-fold, and there would be something like a quarter of a million UK deaths, and over a million in the US. They conclude that epidemic suppression is the only strategy, yet their predictions on that are dire. Their March 16 report has a chilling dystopian graph that hammers the infection then bounces up and down through cycles of suppression and release. But it ignores the key advantages of buying us time. We are not doomed to repeat each infection cycle. Right now we are unprepared, unarmoured, but some are headed into battle already — there aren’t enough beds, ventilators, specialists, drugs, masks, results, trials, or anything but guesses and hints. A two month pause would help so much more. Even a two week pause would.

Stanford Engineer Tomas Pueyo and a “group of normal citizens” which includes epidemiologists and experts have spelled it out in detail. It’s already been translated into 30 languages, and almost 35,000 people have signed their Petition to the Whitehouse.

At the moment Spain, Italy are facing the fight of their lives, but some of the rest of the West are almost giving up without a fight.

The red line in the graph below is not an error

The red line marks the size of the ICU capacity. This is the size of the challenge we face and it’s why there is no other realistic choice. Would we like to have a hospital system, or would we rather stone age luck?

ICE Beds, capacity, Coronavirus

2. Hospitals will be overwhelmed  (click to enlarge)

Their summary:

When you’re done reading the article, this is what you’ll take away:

  • Our healthcare system is already collapsing.
  • Countries have two options: either they fight it hard now, or they will suffer a massive epidemic.
  • If they choose the epidemic, hundreds of thousands will die. In some countries, millions.
  • And that might not even eliminate further waves of infections.
  • If we fight hard now, we will curb the deaths.
  • We will relieve our healthcare system.
  • We will prepare better.
  • We will learn.
  • The world has never learned as fast about anything, ever.
  • And we need it, because we know so little about this virus.
  • All of this will achieve something critical: Buy Us Time.
  • If we choose to fight hard, the fight will be sudden, then gradual.
  • We will be locked in for weeks, not months.
  • Then, we will get more and more freedoms back.
  • It might not be back to normal immediately.
  • But it will be close, and eventually back to normal.
  • And we can do all that while considering the rest of the economy too.

Ok, let’s do this.

Spain, Germany, France and the US all have more cases than Italy when it ordered the lockdown.

Collateral damage could mean 1.5m more deaths in the US

There are 4 million admissions to the ICU in the US every year, and 500k (~13%) of them die. Without ICU beds, that share would likely go much closer to 80%. Even if only 50% died, in a year-long epidemic you go from 500k deaths a year to 2M, so you’re adding 1.5M deaths, just with collateral damage.

The case for South Korea

Because it was started so fast, the hard part was done in three weeks, and it wasn’t as hard as it will be in slower countries.

South Korea, infection control, Coronavirus, daily new cases, graph.

3. South Korea, case-load managed and is now doing the dance to keep it under control.   (click to enlarge)

Feeding this virus comes with a risk

The more mutations there are the more versions of this virus we get:

Not only that, but the best way for this virus to mutate is to have millions of opportunities to do so, which is exactly what a mitigation strategy would provide: hundreds of millions of people infected.

Under a suppression strategy, after the first wave is done, the death toll is in the thousands, and not in the millions.

It’s a no brainer, but

Suppression would get us:

  • Fewer total cases of Coronavirus
  • Immediate relief for the healthcare system and the humans who run it
  • Reduction in fatality rate
  • Reduction in collateral damage
  • Ability for infected, isolated and quarantined healthcare workers to get better and back to work. In Italy, healthcare workers represent 8% of all contagions.
The Imperial College graph from mid March shows just how far beyond our hospital capacity we are even with quite serious measures to slow the spread.
Imprisoning the over 70s and closing schools still won’t save us from the Hospital Bed Bomb. That’s why we need to do more, go hard, go fast and wage War from our strongest advantage point — time. Without fresh bodies the virus doesn’t survive longer than a couple of weeks at room temperature. And the hotter it is, the shorter the viral “lifespan”.
ICE Beds, capacity, Coronavirus

4. Imperial College estimates of the effect of various forms of mitigation.  (click to enlarge)

My favourite quote:

What if it turned out that in two months we discovered a treatment for the coronavirus? How stupid would we look if we already had millions of deaths following a mitigation strategy?

The speed of medical research is unprecedented. Labs all over the world are onto this, and because of the huge cost — there is a huge incentive to solve this. Note that the most promising avenues are in mass testing approaches and anti-virals or anti-inflammatory lines.  Vaccine research can not be sped up to the same extent.  There are inevitable bottlenecks in testing and waiting for humans to react and in being sure that all risks are being checked. Testing of other approaches is much faster.

We have The Code. We understand the biological alphabet. We will find a way to treat or neutralize this virus. It’s just a question of when.

South Korea, infection control, Coronavirus, daily new cases, graph.

5. The escalation of medical knowledge    (click to enlarge)

This is no time to just give up

On one side, countries can go the mitigation route: create a massive epidemic, overwhelm the healthcare system, drive the death of millions of people, and release new mutations of this virus in the wild.

On the other, countries can fight. They can lock down for a few weeks to buy us time, create an educated action plan, and control this virus until we have a vaccine.

If you agree with this article and want the US Government to take action, please sign the White House petition to implement a Hammer-and-Dance Suppression strategy.

Here’s the latest mutation map. Many of these changes are just “decoration” — they don’t necessarily change the virus in a meaningful way, but they do mark the “heritage” of each subgroup of viruses.

Evolution is at work in the virus world. We know the virus will mutate to become more infectious, but we don’t know whether it will be more or less deadly.

ICE Beds, capacity, Coronavirus

6. The branching chains of Coronavirus around the world.  (click to enlarge)

Buy Us Time to Fight the Coronavirus and Save Millions of Lives with a Hammer-and-Dance Suppression…

Our healthcare system is collapsing. It will only get worse. Mitigation-”flattening the curve”-isn’t enough. We must…

 Compare these two scenarios

ICE Beds, capacity, Coronavirus

7. Mitigation — The Slow Bleed   (click to enlarge)

Don’t miss that the whole scale changes here

This is not just a bit better, it’s an order of magnitude (or three) better.

Every day we delay starting the hammer means more total deaths and many more days on the other side before the hammer ends and the dance begins. Exponential curves are so unforgiving when they are rising, but they can collapse just as fast on the downside. The further we drag the Ro (rate of infection) down, the faster we bring new cases down.

The payoffs from making Ro close to zero are astronomical at this point. We ought be prepared to throw everything at hammering this flat.

ICE Beds, capacity, Coronavirus

8. The Hammer and Dance (click to enlarge)

This is the group to follow, to share, to discuss:

This article has been the result of a herculean effort by a group of normal citizens working around the clock to find all the relevant research available to structure it into one piece, in case it can help others process all the information that is out there about the coronavirus.

See all the endorsements from Professors, experts and commentators, if you are interested in that sort of thing. Doesn’t show they are right, just that they are not crazy.

On Modelling: It’s still wrong. These are estimated projections, based on assumptions and incomplete information. But data from nations all over the world already shows the trends and patterns are correct. The nations that got on top of things fast are already doing the dance — like  South Korea and Taiwan. The nations that tried the slow bleed reactive approach have had catastrophic outcomes (if not in actual total death –  its been measured in disruption and pain, and we have not even tried to count the collateral losses).

And all the nations that tried mitigating get overwhelmed and end up doing the hammer anyway. It’s inevitable so do it now. It’ll never be faster or more effective than starting today.

There’s a lot more detail at the original — read it all there. Hammer and the Dance

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