I had a sobering half-hour phone conversation today with my brother Suleman, a hospitalist at Valley Hospital in Ridgewood, New Jersey. Ridgewood lies just a few miles northwest of the current epicenter of coronavirus cases in New Jersey, Teaneck. My own county, Hunterdon, has just seen its first case.
I asked Suleman two questions: first, whether we’re taking the coronavirus outbreak seriously enough in the United States, and second, whether we’re headed for an Italy-like scenario here. His answer to the first question: a categorical “no.” His answer to the second question: a cagey half-yes whose optimistic half sounded more like wishful thinking than a realistic estimate. My heart sank a bit when I clarified my question to him.
Irfan: So what are the odds of a catastrophic outcome?
Suleman: Catastrophic? By definition relatively low.
Irfan: So things will be a lot different here than they were in Italy, then.
Suleman: Oh–you’re taking Italy as your baseline for “catastrophic.” No, I wouldn’t call those odds all that low. That could definitely happen here. We’ve done about as little as Italy, and with less excuse.
What he said was that nothing differentiates our level of preparedness for coronavirus from the Italian response except for the fact that we have greater resources for dealing with what will inevitably be an overwhelming demand for medical services within 7-10 days. But the demand will likely be so overwhelming that our greater resources won’t entirely compensate for it. We will at that point have to face choices of the sorts the Italians have faced. If we think of responses to the coronavirus on a spectrum, with South Korea or Taiwan at the successful end, and Italy at the disastrous end, we’re looking at something between those extremes, but closer to Italy than to South Korea or Taiwan. That’s the optimistic view. The truth is, we don’t know.
This is where Italy was dithering two weeks ago. At the time, the WHO “did not consider asymptomatic transmission a significant factor in the outbreak.” It is a significant factor. The basic problem is that the disease has an incubation period of two weeks during which carriers may be asymptomatic but can transmit. (The same mistake, of disregarding asymptomatic transmission, was made decades ago regarding herpes simplex 2.)
I get that you may not be willing to accept the say-so of some random physician who happens to be the brother of the guy who runs the Policy of Truth blog. If you want a more mainstream source, I’d suggest reading this article in ROI, a New Jersey-based business journal–an interview with Mike Maron, the CEO of Holy Name Hospital in Teaneck, New Jersey. The basic takeaway: government information sources are way behind the curve, and most Americans are underestimating the severity of what’s to come.
“I can fall back on my cholera experiences in Haiti, which was devastating, considering the lack of basic medical supplies after the earthquake — and then the other things that came here, everything from MERS and SARS, and even when we ramped up for Ebola — this is unprecedented,” he said.
“I can tell you, it’s real.”
There are lots of other useful nuggets of information there, all variations on a couple of themes–the need for accurate local knowledge, and the need to engage in rigorous, systematic social distancing. (I happen to think that the advice offered in the article just linked-to is problematically understated, but it conveys the basic concept.)
To put the point in Randian terms, from Atlas Shrugged: what we have here is Nature’s version of the Taggart Transcontinental disaster in the making–operating simultaneously in slow and in fast motion. I’ll try to blog as much of it as I can. With classes moved online as of Monday, God knows I’m not going anywhere.
A post I wrote on my Phil 250 class blog back a few days ago, which has so far fallen on deaf ears. My Phil 250 sections contain about 65 students. Since March 12, the post has gotten 5 hits.