Coronavirus: What we need to do today

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This is serious. We may need to take some fairly extreme measures today, to avoid or reduce a disaster caused by the coronavirus.

The bottom line? In most countries affected by the coronavirus, most of us may need to stay at home if possible, at least for the next few weeks.

Work remotely if you can. Cancel all meetings. Cancel everything that is not necessary. And start today. Every day we wait could worsen the epidemic by 40%.

While younger and healthy people are likely to be OK even if infected, we need to do this if we are to protect the lives of people who are at risk – older people and people with pre-existing health issues.

A panic or necessary measures?

Country after country – including Italy, Spain and France – are now shutting down, telling people to stay in their homes, closing schools, closing all non-essential stores, closing restaurants, cancelling all gatherings of people, and closing their borders.

A week or two ago I don’t think many people could imagine this happening. It’s more than a bit apocalyptic.

Is it a panic? I don’t think so. I think these measures – while extreme – may be the responsible thing for our leaders to implement. These measures may be necessary to protect vulnerable people in our communities, at least for the next few weeks.

While young and healthy people are likely to be OK even if they get the coronavirus, for older people and people with pre-existing conditions it can be deadly. Several percent of people over 60 who need medical attention could die, and for people over 80 years of age the death rate might be as high as 15%.

Without extreme measures now, our healthcare systems are at risk of being completely overwhelmed within days or weeks. We might be unable to help a tsunami of sick people urgently needing lifesaving healthcare, like oxygen and intensive care.

Our doctors may have to decide who gets intensive care and who does not, and decide who lives and who dies.

According to reports, this is already the case in northern Italy. And this is an exponentially spreading disease. This means that within a week or two the same thing could happen in your city.

A once-in-a-century epidemic?

I’m usually not all that worried about new viruses or diseases. When the H1N1 flu was around back in 2009, and there was media panic all around, I wrote about how comparatively small the risk appeared to be – overall significantly smaller than with the seasonal flu.

However, unfortunately, this time it’s different. The coronavirus is not a minor flu. It’s far worse than the seasonal flu. It might be the most dangerous virus facing humanity since the 1918 Spanish flu. It could be a once-in-a-century epidemic.

Just look at what’s been happening. China had to build new hospitals – in days! – to handle the epidemic where it originated. Healthcare in wealthy and developed northern Italy is already overwhelmed and close to failing, unable to offer intensive care to all that need it. Iran is apparently digging mass graves for victims.

This does not happen with the seasonal flu. The coronavirus is not like the flu.

According to the best estimates, the coronavirus may be close to ten times more deadly than a regular flu. Furthermore, it spreads faster as there is no pre-existing immunity in the population to this new virus. Because of this, somewhere around half the population could end up being infected this year.

While the flu might kill 0.1% of those infected, the current number of dead out of known cases is currently 3.7%. Fortunately, this number is likely a major overestimation, as many or most mild cases are not known. On the other hand, some known cases will still die, pulling the number up a bit.

The true number of deaths may end up being around 1% of infected people, hopefully a bit lower, and with mainly older people dying.

Crucially, this is if our healthcare system can cope with the disease. But if our healthcare system can’t, if severely sick people can’t get intensive care, several percent of those infected are likely to die, perhaps up to 3 or 4%.

In the worst-case scenario, with half the population infected this year and the healthcare system completely overwhelmed, it’s possible that around 2 percent of infected people could die. That’s 1 percent of the entire population.

This could mean, worst case, several million dead in the United States (similar figures have been mentioned by experts), and 50 million people or more dead worldwide.

That’s on par with the Spanish flu of one hundred years ago.

This disease can be stopped

Fortunately, the numbers above are not a prediction of what will happen, just what could happen. The future depends on what we do today. What happens is still to a large extent within our control.

Importantly, China and South Korea have already demonstrated that this epidemic can be slowed down, or even possibly stopped, if we take extreme measures starting as soon as possible.

It’s possible to slow or stop this disease, but it requires decisive action in all severely affected countries.

What to do now

First of all, we need to stop the spread of this disease. This requires more than just washing our hands and not touching our faces – though that’s necessary, too. It also requires keeping away from other people as much as we can. It requires social distancing.

This means closing everything and cancelling everything that is not necessary, at least for the next few weeks. No schools, no conferences, no meetings, no movie theaters, no restaurants, no pubs. Start today. Every day we wait could worsen the epidemic by 40%.

This is what many governments are now requiring. I believe this is wise and that anyone who can should do their best to follow these guidelines.

Even if you personally feel young and healthy enough to be safe, your responsible actions in the next few weeks can save someone else’s life – possibly your parents’ or grandparents’ lives, or your friends’ parents’ lives.

Basically this means just going to work and only going to the store for necessary supplies, like food or medicine. No handshakes with anyone.

If possible, even work remotely. At Diet Doctor, we’ve closed down our office, and the company is now 100% remote, with everyone working from home. I believe every company that can do this should do it, at least for the next few weeks.

If you get cold or flu symptoms (e.g. a fever and coughing) and you feel relatively OK, isolate at home. Don’t go outside until a day or two after the symptoms disappear.

Try to prepare for this, make sure you have the food and the supplies you need in advance. For most people, the coronavirus will likely only result in relatively mild symptoms similar to a regular cold or flu, and you’ll likely recover just fine without any medical assistance.

Of course, should you start feeling really bad or if you get cold or flu symptoms and you’re at risk of serious disease due to age or pre-existing conditions, contact healthcare services. Call them.

It could be worse, and it will pass

While all this social distancing may sound bad, it’s going to pass. We’ll get through this, and it could be far worse.

The main thing now is that we can and must prevent people from dying unnecessarily. As long as we can achieve that goal, the rest matters less.

People have endured worse things than having to work from home and watch TV instead of going out in the evenings, and not seeing their friends or family for weeks, while possibly taking a significant financial hit. While this is bad, worse things can and do happen.

People have endured catastrophic wars, famines and truly lethal epidemics like the Black Death of the 14th century where half of Europe’s population was wiped out, taking 200 years to recover.

In comparison, having to endure social distancing for a few weeks or months, to protect others, is still a relatively modest inconvenience.

A few weeks or months from now, things may start to return to mostly normal again. This is provided we do the responsible things now to slow down or stop this disease, though we’ll still have to be careful for some time. Our healthcare system will have to become great at quickly testing everyone at risk and isolating and treating cases, to keep the disease under control.

Hopefully we’ll find antiviral drugs that can help treat severely sick patients relatively soon, reducing mortality and speeding up recovery.

Within a year or so, as we get a vaccine for the coronavirus, we’ll hopefully be able to return to living just like before.

Let’s just make sure that once we get there, we can be proud of how we came together to face this crisis and rise to the occasion. Let’s do the right thing to protect people’s lives and prevent a widespread disaster.

Social distancing, starting today.

/ Andreas Eenfeldt, MD

Recommended reading

Medium: Coronavirus: Why you must act now