Covid-19: Preface & Chapter 1

The rest of the book seems to be about prior pandemics and how to stop the next one but starts off with what was known about Covid-19 as of June.

Science didn’t actually fail us. The ability of governments to act on it, together, did. (page xiii)

The comforting myth that viruses become more benign as they adapt to us is simply not true. It all depends on what works for the virus, and it can go either way. (page xv)

What we need to remember, though, is that we will have another pandemic. And it could be worse. (page xviii)

ProMED – the PROgram for Monitoring Emerging Diseases of the International Society for Infectious Disease, a scientists’ organization, formally called ProMED-Mail – is the world’s leading online reporting system for new, or “emerging infectious disease. (page 2)

A respiratory infection – be it virus, bacteria, or fungi – may invade your nose, throat, or the deeper, bronchial air passages and give you a cold or a bad cough. But if it gets into the alveoli, that’s pneumonia, and it can kill you. (page 4)

The European Centre for Disease Prevention and Control estimates it takes a hundred person-hours to track one case’s contacts. If you can break all the chains of infection from every case, the disease can be contained.  But you have to start early, before there are too many cases to track. If a disease is spreading generally – “int he community” – it becomes impossible: not only are there probably too many cases, but people might have no idea who they caught the virus from. That person could still be out there, spreading the virus, no matter how many know contacts of that case you quarantine. (page 12)

The variable that matters – and about the only piece of epidemiology jargon you really need to know to get all this is RO, the basic reproductive number. This is the number of people each infected person passes the virus on to, on average, at the start, when everyone is susceptible. And we all were susceptible to start with, as this was a virus no one had encountered before. That value for Covid-19 was originally calculated at between 2 and 3, making it more communicable than most se4asonal flu, although later calculations found it might sometimes be higher for occasional people who seem to spread it massively, called super-spreaders. Rosalind Eggo at the London School of Hygiene and Tropical Medicine and her team calculate that for a virus with a basic RO like that, contact tracing and isolation work if there is little or no transmission before the virus causes symptoms. Otherwise an infected person will have too many untraceable contacts, because the contact occu8rred before they knew they were sick. And even if you find those contacts, they will have had more time for their own infections to incubate and may already have spread it before you can quarantine them. Covid-19 spreads as much as a day or two before you get sick. The many cases with very mild symptoms, or none at all, also pose problems for containment. It’s as if a virus with a high enough RO is just too slippery to pin down easily. So the answer is to reduce the number of people infected by each person with the virus. That’s what mitigation does: with less person-to-person contact, fewer people catch the virus from any given case so you have to quarantine fewer people to break transmission. If a virus has an RO around 2.5, Eggo and team figure you need to reduce contacts by around 60 percent to get the R value down to 1, the level at which the epidemic stops growing. (pages 26-7)

A preference for secrecy and stability won out over the scientists’ epidemic models at the typical crisis point in public health: when you need strong action even though it doesn’t look to observers – or politicians facing the year’s biggest holiday – like much is wrong. (page 28)

The virus had already gotten a head start in Italy, the UK, the US, and elsewhere by the time a serious response was launched. In late March, no Chinese province outside Hubei had officially reported more than 1,500 confirmed cases, but 15 US states had – and most Chinese provinces have more people. (page 31)

Wuhan had its Guinness-record potluck. But on March 7th, as the pandemic took hold in France – and we all knew the virus was contagious – more than 35,000 people dressed as Smurfs gathered in Landerneau, France. The next day, France banned gatherings over 1,000 people. (page 33)
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And ideology trumped public health in many places. A US administration focused on threats from foreigners rushed to close borders – after the virus had already arrived int eh US and despite science and experience showing this does little to stop viruses. (page 34)

4 responses to this post.

  1. Posted by dentss dunnigan on September 26, 2020 at 5:24 pm

    First

    Reply

    • TL, that’s so very funny, I thought this guy looked like the typical D voter, crazy looking, blue hair and then some 🙂 🙂

      I guess it’s all perspective huh?

      Reply

      • Posted by Tough Love on September 27, 2020 at 9:41 am

        I guess so. to me he looked like the quintessential middle age White dumb as shit male, a perfect description of the majority of Trump supporters ….. even though those who have worked with him know that he doesn’t give a crap about them.

        Lol ……….. yeah, like he’s going to bring back manufacturing to middle America. What a bunch of fools.

        Reply

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