CommentsGELFAND’S WORLD--Interesting times indeed. I’d like to start with a modest editorial in support of all the crazy things that our state and local government are doing.
This includes closing public schools, mass sports events, and colleges. The restrictions on restaurants and bars seem to have been changing from one hour to the next, but it makes sense to develop and maintain some common sense limitations. But to figure out what is (and is not) common sense, we are going to require a little bit of explanation as to some of the technicalities. Let’s try to do so in an understandable way, meaning that I will avoid using terms from differential calculus.
I’ll start with a bit of irony here. When I first started doing an internet column for American Reporter, one of my first gripes was the common misuse of the term “growing exponentially.” I tried to explain (back in 2003) that the term “growing exponentially” is a term from math and science that does not necessarily mean that something is growing fast. Quite the contrary. And most of those issues that were claimed to be “growing exponentially” were not, in fact, growing exponentially.
But over the past few weeks and probably for the next couple of months, the Corona Virus epidemic has been and will continue to be growing exponentially.
(Note: For those of you who are familiar with computer terminology, there is an easy way to understand exponential growth. I have included it as an addendum at the bottom of this column.)
In the beginning, that meant that we saw increases from one to two to four cases. That doesn’t seem like very fast growth. But imagine the number of cases increasing from two-thousand to four-thousand to eight-thousand over the same interval of about a week.
That’s what’s meant by exponential growth –- the number of cases increases proportionately over each successive time interval. What we have been seeing in a number of European countries, South Korea, and the United States, is exactly that pattern, and the time that it takes for the number of cases to double is about two and a half days.
That’s pretty scary.
There’s one more issue that is the scariest of all, and it is what justifies these otherwise-radical measures. The thing about exponential growth of this order is that left unchecked, the number of cases could be a hundred thousand or even twice that number within a few more weeks. We can’t put up hospitals or build ventilators or train respiratory therapists at a rate sufficient to deal properly with this rate of growth. Unless we can interfere with the spread of the infections, the medical system will be overwhelmed.
Public health officials have done the math, and they have explained the approach. If (let’s say) our medical system could treat as many as 50,000 of the most severe cases in an effective manner, then the proper strategy is to slow down the number of new cases so that we never go past that limiting number of treatable cases. They refer to this process as flattening the curve. On the other hand, if we were to do nothing, then we would reach 50,000 cases in about 5 doubling times, which could be as little as 2 weeks.
Now do you see why the authorities are pulling out all the stops? Exponential growth with a doubling time of less than a week is a daunting challenge.
Right now, the only effective prevention is to keep healthy people from being exposed to people who are contagious for the Corona virus. Unfortunately, knowing who is contagious is not all that clear at the moment. We can (given the test kits) identify who has an active case, but we don’t have the kits or the technicians or the lab equipment to test everybody in the country in the coming week or two. So we have to go on the assumption that any person could be a carrier unless we show them to be otherwise.
Experts in the field understand that we can’t put the entire country under house arrest, but we can advise people to keep their distance from strangers. That’s what it’s about when they tell restaurants to limit customers to half their capacity, or even limit service to carry out. They are trying to keep you from spending a lot of time up close and personal with a bunch of people you’ve never met before. Whether it’s safe to be three feet from other people, or even six feet, is not anything I am sure about, but it would appear to be safer than the denser atmosphere of the club scene.
So I’m unhappily endorsing the restrictions that the local authorities are imposing, at least for now. Let’s get a better look at what the numbers are (and the growth rate) after we get the new test kits in operation. It will take at least two or three weeks to get an accurate picture of what the situation (and therefore the immediate risk) happens to be. If we find that the growth curve of new cases has flattened out over the next couple of weeks (which will take three weeks to find out), then we as a society can gradually taper off from the worst restrictions.
A harsher scenario would go something like this: Suppose people who get exposed take five or six days to show symptoms, but are giving off infectious virus particles on their second or third or fourth day. Those people will figure out to stay at home when they start to run fevers and coughs, but in the meantime, they will have exposed people they came in contact with on days 2 through 5. This may be what we have been seeing all along, or maybe not.
The key data points will be the number of new cases that are showing up four and five weeks from now, after our society has adopted all the preventive measures and they have had a couple of weeks to percolate through the system.
It almost seems like sarcasm
For 3 years, we have been developing a neighborhood council emergency preparedness group in the hopes of (a) teaching the population some survival skills including saving up water, food, and required pharmaceuticals and (b) being able to function as immediate responders in the event of a natural disaster.
Two things are going on that strike me as highly ironic:
First, the city has forbidden our neighborhood council committees – including our Neighborhood Council Emergency Preparedness Alliance – from meeting. This is one of the first full-scale natural disasters we will face, and we are forbidden to even consider taking action.
Second, the people of this community are doing exactly what we have been advising for earthquake preparation, in that they are amassing food and water. The problem is that they are doing it all at once instead of over a few month’s time, as would have been preferable.
One major difference between the epidemic and an earthquake is that there is no water shortage right now. Good, clean water comes out of the pipes. That would probably not be the case in the event of a major earthquake because it would shatter the water mains. The other little qualm we have about this current hoarding mania is that in the event of a big earthquake, we would probably lose electric power, so collecting lots of frozen food would be counterproductive. For the earthquake aftermath, canned food and boxes of oatmeal or rice or potatoes is going to be what is useful.
Are we overreacting?
This is the most common question, and one that most of us have considered. At the moment, there are only a couple of thousand cases in the entire country, and only a few dozen people have died as a result. This does not begin to compare with seasonal influenza, not to mention heart disease, colon cancer, or even the more serious forms of skin cancer. Moreover, the death toll has been largely limited to a few of our nation’s oldest people. If the numbers were to remain pretty much unchanged, then this virus wouldn’t compete with the flu.
But although we know a lot about the flu, we don’t know much about the Corona virus except its ominous growth curve. If the Corona virus incidence increases at its present exponential growth even for one additional month, it will be a massive public sickness crisis indeed. That month would signify perhaps 12 doubling times, resulting in a case load of as many as 8 million people. You can see why the authorities (those with half a brain) are so scared.
How to protect yourselves
Obviously, the most effective way is to isolate yourself from other people who could give it to you. Luckily for us, this virus isn’t as infectious as the measles. You could probably avoid catching it if you are obsessive enough.
The next way is to hope for a vaccine. If it is possible for one to be made, then we can hope that it comes out within the year, but there is no guarantee. Apparently, there are several strains of this virus, so it will take some tinkering to get to the right place.
By the way, imagine what the world would be like if the anti-vaccine people had their way. Things would be just like this, every year. Shall we go back to losing four or five hundred children every year from the measles?
Where it all ends
There are three ways that this ends. The first way is that a large fraction of the people get the disease and eventually develop immunity. We can hope that most of us would have mild cases and get over it. At that point, if you are one of the few who is lucky enough to have avoided the Corona virus, you won’t be at nearly the original risk because most of the people you will encounter will not be spreading the virus -- they are already immune. This is the condition called herd immunity. It is what we try to accomplish by mass vaccination.
The second possibility is that we get a vaccine pretty quickly and start to inoculate everybody who is likely to come in contact with a sick person.
The last possibility is that the methods we are already trying – reducing personal contact by banning large gatherings, closing schools, and avoiding basketball stadiums – will actually work. Even if it just works long enough to develop some anti-viral agent or a vaccine, that would be enough.
National politics
We shall obviously have more to say about this as the weeks go by. The president, in his usual way, blustered, flip-flopped, blamed everyone else but himself, and eventually got forced into letting a few people with clearer heads start developing plans.
It has not gone unnoticed that the Trump White House abolished its own office dedicated to combatting pandemics, and that was back in 2018. To this president, ignorance is clearly the norm. The problem comes when you mix that level of ignorance with blustering dishonesty, and thereby stall the advent of a useful program until things start to get out of hand.
Addendum
Computer folks get used to describing things in terms of bits and bytes. One bit is just a single digit which can be a zero or a one. This is the beginning of what is called binary arithmetic. If you put a zero in front of the one, you get the binary form for two, if you put another zero in front, you get the binary form for four. Thus these binary numbers:
1
10
100
They are, in our usual decimal form, 1, 2, and 4.
So that’s pretty much all it takes. Each time you add a zero to a binary number, you multiply by two.
And if you add that zero every two and a half days, you have a pretty good model for what has been happening in the current epidemic. The number of cases double, then double again, then double again. Each seven and a half days on the average, we go through 3 doublings. In terms of binary arithmetic, we just keep extending that number by adding a zero three times a week.
If we want to do the same calculation using our usual decimal arithmetic, then just add a zero to the number of cases every ten days or so:
2000, 20,000, 200,000 and so on until the virus runs out of people to infect.
(Bob Gelfand writes on science, culture, and politics for CityWatch. He can be reached at [email protected])
-cw
