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Friday, March 27, 2020

Wuhan Virus - Testing Stigma and Virus Spread

Today I've got two topics to discuss (and zero readers (:-).  The first is a national level testing stigma.  Everyone around the world watches the number of cases in each country.  You can test and accurately report deaths, or you can not test and inaccurately report deaths.  When you don't test, you don't get Wuhan virus deaths reported to WHO and they don't get into the Johns Hopkins COVID19 map.

So the US did its usual world-leading effective testing regime.  One that the press inadvertently forced by continually claiming we weren't testing adequately.  So we now show more cases than any country in the world, including China.  Our death rate is of course lower than countries with limited testing but honest reporting of deaths.  Who knows what the situation is actually around the world.

The increasing number of positives in the US is going to limit travel for our people if the rest of the world 'effectively' shows virus die out.  But that doesn't matter since they don't seem to be limiting shipment of goods.  What will be bad is if the rest of the world stops testing and accurately reporting and we allow them to travel here again.  But then again, they will probably be afraid to travel here.  Maybe its a wash.

More importantly, how is the virus spreading?  I suspected all along that China stopped accurately reporting cases. It makes them look good and it removes any stigma from their people and goods.  What is the benefit of accurately reporting a spreading contagion?

But there is also the chance that China did actually stop the spread.  They took some drastic measures separating out the sick (forced quarantine), locking people down in their apartments, allowing only food delivery (not take out or drive thru), and preventing entry and exit of people from virus breakout areas.  I do not know how they got food and fuel into those regions.  But if they did careful testing and protection of truckers, they would have had a pretty good way to stop virus breakouts from leaking to nearby regions.

Contrast that with the US.  Only in the big cities do people live in large apartment complexes, and that is usually just a small percentage of the population.  Groceries do not have the capability to deliver to their customers.  China did it by requiring large orders where people grouped together to place orders.  US mayors could have done something to work out voluntary delivery assistance (for pay), but they couldn't mandate it.  Instead in US cities, we all mingle in a few large groceries trying to stock up for 'worse to come' where we enhance the spread of the virus by crowding and a stigma against using masks.

Likewise, when someone gets sick in the US, they aren't visited by HAZMAT dressed police or military that drag them to a communal quarantine area.  Instead, they continue living with their family or friends with the serious chance of virus spread.

Perhaps worst of all, there is no limit on travel into or out of breakout areas.  I think NY tried that with the Westchester breakout with a national guard cordon around a one mile radius.  But NY now has about half our national cases.  Their limited trial didn't do them much good.

But take Texas, and our local experience as an example.  We have a Super Walmart and a super HEB within 15 minutes of us in our county.  Their shelves continue to be empty of any kind of disinfectant supplies.  30 minutes away, in Bexar Country (San Antonio) where they have a shelter-in-place order, is our closest Sams Club.  We heard that yesterday they were allowing old folks early access.  We went and stood in a tight line outside for 15 minutes, then shopped in an overly crowded store.  They did have Clorox and Clorox wipes, the first we've seen since the pandemic started.  But if anyone had the virus, there was a good chance it was spread.

My point is that even locals are going to shop a little farther from home to find goods they consider essential.  No locked down city, the way the US does it, is going to stop the slow spread of the virus outside its borders.  And there is nothing stopping a person in a breakout (locked down) area from traveling out into the 'country side.'  If they have the means to do so, they are going to try and reduce their risk of the virus.

So in the US, unless something drastic changes, and I think it may be too late for that, the virus is going to spread outward from each breakout area.  New breakout areas will form.  It will move from the large cities to the smaller ones to the towns throughout the country.

The spread may not be fast, but it is going to happen.  I guess it might disappear for summer weather.  But if not, you are going to see waves spreading out from the big cities and hot spots.  Each wave will have it's own 8 week curve.  And like waves, they can go both ways.  This will not be an 8 week hunker down and it's over.

There are three things that may mitigate the pandemic in the US:  (1) therapeutic drug cocktails like hydro chloroquine and antibiotics may be effective enough to stop people from dying and slow down the spread and allowing the young and healthy to go back to work, (2) summer weather may nearly stop the spread as it does with the flu, and (3) social distancing and self-isolation may slow the spread enough that relatively few elderly and medically-at-risk persons will get sick, at least outside big urban centers.

There is a fourth measure that may help the situation.  If the feds can convince people that the death rate is not much worse than the flu, they have a chance at heading off draconian measures.  Just keep the elderly and sick protected.  Unfortunately, I don't think the media will allow that to happen.  It might help Trump.

Like the President said, I think the economy needs to get back to work.  But if the death rate keeps going up drastically, the US is going to need to rethink its approach.

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