[PLUG-TALK] Covid-19 mortality rates

[Keith Lofstrom]

On Wed, Mar 11, 2020 at 02:13:13PM -0700, Rich Shepard wrote:
> The apparent panic about the coronavirus, covid-19, made me curious about
> its mortality rate. Turns out to be very low:
> <https://www.worldometers.info/coronavirus/coronavirus-death-rate/?ref=hvper.com>

The *AVERAGE* mortality rate is "low".  The mortality rate
is considerably higher for those of us above 60, or with
pre-existing medical conditions.  That differential is
the reason to take extra precautions, for any age group.

Oversimplifying WAG: If the vulnerable groups are 20% of
the population, and half of the "average" 3% mortality
rate is in those groups, then the mortality rate for the
vulnerable groups is 7.5%.  However you slice it, if
everyone is exposed (somehow), that is almost 10 million
deaths in the US alone.

There are less than 1 million hospital beds in the US.
There are about 600,000 oxygen concentrator equivalents.
Almost all are in use for pre-existing conditions.  Who
do we push out of the lifeboat?

Healthy children acquire COVID-19 without any symptoms,
then spread it to each other and the adults around them.
If schools are closed, children won't spread the virus
there, but still can spread it at the playground and other
public areas.  If they aren't in school, and their parents
must work, then older relatives may help out - and may get
a fatal disease from the asymptomatic children.  How's
THAT for giving a child lifelong guilt?

COVID-19 is not as lethal as SARS-2002 or MERS, but it
spreads much more rapidly.  It is an RNA virus, so it
mutates rapidly.  If COVID-19 infects millions of people
worldwide, even without symptoms in most, there may soon
be hundreds of variants (three identified so far), some
of which will be difficult to detect, and some will be
more lethal.

Very bad threats (like Ebola) kill too fast to spread
fast; the most "successful" pathogens produce the most
virus particles that can reach other people.  COVID-19
is near the "sweet spot", and can evolve closer.

So - no vaccine, no widespread testing, few beds, few
staff, few machines, against a threat that can become
more lethal.  This is not time to panic, but it is time
to PREPARE, and time to minimize the opportunities to
spread.  MAXIMIZE the growth of treatment resources so
that the exponential nature of this problem will be
slightly less overwhelming in the coming months.

Given the status quo, and the nature of the threat, all
of us can expect to be exposed to COVID-19 at some point. 
The increase of IDENTIFIED cases in the US has increased
35% PER DAY over the last WEEK (from 175 to 1440). 
I hope most of that is due to more complete testing than
to natural increase. 

But even if the natural increase is actually a "mere"
10% per day, then the growth from 1440 to 480 thousand
will take two months.  The growth from 480 thousand to
160 million will take two more months.  EVERYONE in ONE
more week.  MORBID's law.

480 thousand (mostly asymptomatic) COVID-19 carriers
we can probably prepare for, if we drop everything else
and focus on that.  There's no way we can prepare for
160 million in four months.

So - the best option is to SLOW DOWN THE GROWTH RATE.
**DRASTICALLY**, so a large but not gigantic investment
will have time to pay off in, say, six months. 

An overabundance of caution and vast expansion of research
and preparedness might seem a huge waste of resources a
decade from now.  Better that than NO "decade from now",
for us sheltered retail-vorous urban dwellers.  

So - bring out the BIG HAMMER - but not Stalin.  Stimulate
our flagging economy with MASSIVE resource allocation to
medical capability.  I prefer a Medical-Industrial complex
to a Military-Industrial complex.  Express your preferences
to your pension fund manager, not just your congressperson.

------

I GREATLY prefer and OPEN SOURCE Medical-Industrial complex.
We can make complex software - let's learn to make complex
molecules.  Make our own tests.  Make our own disabled-virus
vaccines.  Perhaps gene-engineer an algae that expresses the
COVID-19 capsid proteins on its cell wall, grow it in jars
in our kitchens by the kilogram, and share it with friends.

Outrace the patent-producing monopoly labs.  SHARE.

We have already developed the communities and the worldwide
sharing techniques to implement this.  Time to learn some
molecular biology, and share that with each other, the way
we share software and coding techniques.  Much of modern
molecular biology is Linux/Unix Big Data computing.

Suggested reading: "Cell Biology By the Numbers" by
Ron Milo and Rob Phillips.  Download a free draft 
version here:

https://www.dropbox.com/s/gvpleqtcv8scro4/cellBiologyByTheNumbersJuly2015.pdf?dl=1

Also visit https://bionumbers.hms.harvard.edu/KeyNumbers.aspx

------

But please, be cautious, learn good health habits, and stay
healthy so you can learn and contribute.  We can CHOOSE to
be smarter than a damned virus, but we *MUST* CHOOSE.

Keith

-- 
Keith Lofstrom          keithl at keithl.com