Thoughts on COVID-19.

As a rule I do not provide trigger warnings but given the sensitive nature of this topic and the potential levels of fear and panic involved I am going to ask that you not read this post if you suffer from high levels of stress or anxiety or are not familiar with the facts of the matter.

I will also ask that you visit these two websites FIRST.

CDC coronavirus page
World Health Organization COVID-19 page

That said, panic is never a useful emotion and hoarding and other behaviors will lead to more deaths in those who are trying to help you. The USA already is suffering a shortage of doctors and nurses so please do not steal much needed supplies from those who are left.

Remember also that self-care and self-isolation are your best protections from this disease.

After that:::

keep informed

consider staying away from large crowds and group gatherings

do not touch your face – yes, this is very very hard…but try, yes?

wash your hands and face, regularly

trim and wash facial hair

wear a mask/glove if you are ill, immunocompromised, or in contact with infected persons

if you think you are infected, call or email your doctor before going to an ER or clinic. Telemedicine works.

remember this is cold and flu season and allergy season is on the way – a cough does not equal coronavirus in the majority of cases so be calm. Only seek care if symptoms worsen. It is recommended you give yourself two weeks on this one.

It is also important to use common sense in this emerging situation. Coronavirus is not a world ender and this is not a Stephen King novel despite the various irresponsible Captain Tripps comments I keep seeing in the horror fan forums.

But it’s not just going to go away either. It is a good idea to prepare for significant impacts and to do so as soon as possible.

There are multiple scenarios here. The best case was outlined by Neil deGrasse Tyson on Stephen Colbert.

We all listen to the scientists and behave like rational beings and don’t hoard, panic, price gouge or go insane and this illness just takes a small portion of us and leaves the rest of us alone.

The worst case scenario is that we all succumb to the panic weasel and more people die than should.

Being a cynic, med student, and historian, I think we will fall in the middle due to cascade effects…some of which are already being seen.

So cascade effects – first described after the Black Death interestingly enough. It led to the dark ages remember? And then the effects were described again for the Spanish Flu.

With COVID- 19, I think we will start seeing mass level deaths, starting in the medical triage tiers which is where most pandemics start probably within the next few months. A 2% mortality rate (which seems low to me) would mean the deaths of about six million people (thank you Google) with higher rate of death in medical staff, the young, the old, and the immunocompromised. It will also spread faster in communal societies, cube farms, nursing homes, schools, etc.

Given that the US is also in the midst of a doctor/nurse shortage and the healthcare system at large is failing; also that moving resources around would also become more difficult I think the secondary effects would also lead to a high number of what are known as corollary or cascade deaths – deaths due to lack of resources – medical care being the first to be affected.

As an example here let’s return to the Spanish Flu in the early 1900s. That particular flu led to all sorts of fun stuff, but one of the first medical after affects was that encephalitis lethargica “sleeping sickness” went from being relatively rare to surging to it’s highest peak historically speaking. A lack of doctors and nurses, paramedics and other caregivers meant that encephalitis lethargica went undiagnosed in early stages and untreated in later ones, not that there was much that could be done for victims at the time. Link for more details here:

https://en.wikipedia.org/wiki/Encephalitis_lethargica and you can try out Oliver Sack’s book Awakenings as well.

That second wave of illness killed a lot more people, including more medical professionals, but it had another cascade effect as well.

Those who survived EL often developed various “mental health issues” latter – although the are now know to be more along the lines as acquired brain injuries. Long term swelling of the brain and high fevers cause a set of side effects that range from complete inability to function to what the twentieth century doctors termed “neuroasthesias” – panic attacks, nightmares, anxiety disorders, memory problems, and more. Often those survivors were hospitalized or institutionalized for years or even decades to come – with post EL dementias, Parkinsonisms, and other neurological damage so they could not work or provide for their families.

Lengthy aside : I have suffered encephalitis twice, and was comatose due to it once, and can attest to the lingering side effects. There is evidence that the hippocampal and amygdala damage I suffered during those episodes contributed significantly to my neurological ill health, and may have seriously speeded up the symptoms.

Link here: https://www.symptoma.com/en/info/post-encephalitic-syndrome

This in turn led first to a labor shortage and then to a resource shortage in goods and services which led to more poverty and more ill health.

There are epidemiologists and biologists who go so far as to say the Great Depression and other economic collapses world wide were late stage side effects of the Spanish flu. Oh, and fun fact here, keeping in mind that correlation does not necessarily equal causation, Hitler was an EL patient and spent some time in a sanitarium recovering from the postdromal syndromes.

Think of this as a waveform, the flu was the tsunami, EL was large waves, and the effects of EL in the living was a smaller wave still, and then there labor shortages were ripples that happened in the wrong place leading to a different kind of tsunami.

I already noted that coronavirus is also a slow burn so that in all probability the cases are seriously under-reported.

It is also a disease that weakens the immune system so there is a very good chance that a secondary illness will follow on it’s heels – probably measles or influenza in some form.

And in an already overwhelmed hospital system that could only add to the issues. People with other usually nonfatal illnesses could die simply from lack of care. Even something like a head injury, heart attack, or blood infections.

Now consider this as well. In the 1900s, there was both far less specialization and a greater base of people who actually knew how to do things. Today the majority of people rely on their TVs, laptops, or cell phones for information. Which adds a new dimension to the problem, and one the Chinese have already figured out.

Traditionally most tech workers work in cube farms or communal buildings, and so they tend to get sick and stay sick with whatever bug is making the rounds. Add in long hours and poor diets, both common in such environments, and you end up with your communications grid being built on a bunch of immunocompromised specialists. So China is already going to great lengths to separate out it’s tech people by moving them into larger spaces and more offices rather than bunched up into hives.

They know that if they suffer a cyberfail on top of a viral fail, if you’ll pardon me the pun in passing, what happened to the Western world after the Spanish flu would be less than a pixel on the screen by comparison.

And here in the States, our cyber security is even worse. We not only have our tech infrastructure in the hands of a few highly trained people but we also don’t pay them a living wage, don’t give them insurance, and forbid them sick leave.

So on a scale from one being a walk in the park to ten being the end of the human race, I’d say that coronavirus is poised to be at least a solid six unless we get very lucky indeed.

I figure we could easily lose a fifth to a third of the population to the virus and it’s cascade effects. I sincerely hope that I am wrong.

So the plan?

Trust in God but keep my powder dry.

Covid-19 made landfall in my home state today. 2 cases, both isolated. Since I am immunocompromised and my life partner works in hospitals, I will start wearing my mask on the rare occasions when I go out.

I will grocery shop online – something you healthy folks DO NOT need to do but can do if desired.

But I will NOT be panicking. I shall not go out and hoard weird things like toilet paper, alcohol or bleach. I will not buy super expensive masks nor tell others to do so.

I will face my fear and wash my hands.

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