Hope despite COVID-19

When the Corona Virus struck we all assumed things would get better after two weeks. But four weeks passed and everything was worse. Week after week reality is more nightmarish. I am an MD physician, and an epidemiologist by training. In my latest YouTube video I give a blunt, unvarnished report of how I am reckoning with my future. I am 76 years old, I have hypertension and mild heart disease, so my risks of getting and dying from COVID-19 are increased over the average person.

In 1918 a virus living in birds jumped from that species into humans and there was a pandemic that killed 25 million people worldwide. We don’t know the number of people who died if 100 people were infected, but it is reasonable to assume it was 1 percent or more.

In 2019 a virus living in some other species of animal, probably bats, jumped from that species into humans, and there was a pandemic similar to 1918. Many people today say the death rate of 1 percent is no worse than the ordinary seasonal flu. But what they fail to recognize is that is not THE problem. The problem is that if you blink your eyes the number of infected people doubles.

You need to know about “exponential growth.” According to legend a man owed some money to a king. The king said he would ask to be repaid in rice. He set down a checker board, and said that the man should put one grain of rice on the first square, two grains of rice on the second square, four on the third square, and so on, doubling the number of grains of rice every time he moved to the next square. The man said that sounded fair and he thanked the king for such mercy.

What is wrong with this repayment scheme?

The problem is that before the man got to the last of 64 squares, he was required to put down 9 billion billion grains of rice. That is more rice than have ever been grown on earth in all of history. That is what “exponential growth” means. A virus that grows like the grains of rice on that checkers board would have infected every person on earth in just over half a checker board.

If a virus had infected the eight billion people who live on earth and one percent of them died, that would be eighty million deaths. Since about sixty million people on earth die per year in a normal year, that would be a bad year.

The problem we are facing is not the 1 percent death rate. The main problem is the “surge.” That means the tidal wave of so many millions of people getting sick at the same time. If you get the virus, about three weeks later you might need hospitalization, and soon thereafter intubation and placement on a ventilator.

If 85 percent of these infections are sufficiently mild that no hospitalization is needed, that is good. The problem is with those who get very ill and need to be in a hospital lest they die. But there are only so many beds, only so many ventilators, and it is not enough to deal with a surge.

What happens if more people need to be hospitalized than the hospitals can treat? Well, it’s bad. We saw that in Italy. The hospitals in Italy were forced to say that if a surge of patients needed to be admitted or else they would die, it was necessary to make a life and death decision at the front door. They decided that the only fair way to make that decision was to turn away everyone over the age of sixty.

As someone over the age of sixty, I think that is a terrible situation, but I think it is the most ethical way to make such a horrible decision as to who would and would not get the scarce resources.

It is a good idea to avoid getting into that situation. In order to avoid overwhelming the hospitals, it is essential to reduce the rate of exponential growth. That means moving from one square on the checker board every day, to the next (i.e. doubling) every two or three days. That is currently happening in New York State.

The man who was repaying the king in grains of rice on a checker board would be much better off if he stopped after ten squares which required him to put down a thousand grains of rice, than if he stopped after eleven squares, which required him to put down two thousand grains, or twelve squares which required four thousand squares.

When your enemy is doubling every day or two, you have to make a decision rapidly. Currently the only proven way to stop the doubling of COVID-19 is to lock ourselves down into extreme social isolation immediately. My wife and I have done that.

My own goal in extreme social isolation is to stay inside until the surge passes and the hospitals recover their ability to treat sick people. I figure that sooner or later I’m going to get COVID-19, and then I will spin the dice and discover whether I survive or not.

Given the risk factors I have, I plan to stay isolated until September 2020. That is an intolerable amount of time. The question is, which evil is worse. My judgment for myself is that isolation until September is a horrible idea, but better than the alternatives.

I am not going to waste your valuable time talking about economics, which is not my area of expertise.

So my wife and I have put our affairs in order. We have a will, and more important, we have a legal document appointing a health care decision maker. If I were unconscious and unable to make decisions, there are circumstances under which I would prefer to preserve my dignity and die. If I am unconscious, my wife has the right to make life and death decisions, and I want her to do so.

Times like these force me to make peace with death. Making peace with death and making peace with life are two sides of the same thing. My religion has helped me. If you read the history of plagues and massive amounts of death in the past, religion helped a lot of people. Some viewers prefer the word “spirituality,” which is an equally good word. Another way of saying it is, “What is life really all about?” Ironically the nurses and doctors who are risking their lives to treat this illness, are one model for what life is all about.