On Coronavirus, Reason To Hope
Reader Ryan Booth writes:
Rod, I was one of those screaming at our public officials to shut stuff down. I was extremely frustrated by President Trump’s brushing off of our problem for a long time. I asked my Facebook friends if anyone wanted to help with a recall petition of Governor Edwards, after he took very mild steps against COVID-19 instead of the necessary firmer ones. I bristled with a mixture of horror and astonishment as New Orleans Mayor LaToya Cantrell allowed bars to pack people in last weekend to celebrate St. Patrick’s Day. I argued with friends on Facebook who insisted to me that “this is just a cold” and told me that I was irrational and needlessly spreading fear and panic.
So I have consistently supported strong steps to contain this virus, but I have now become very optimistic that the tide is about to turn, and I want to share why.
Testing is about to expand exponentially.
We’ve been steadily growing our testing ability since the outbreak began. America tested 44,176 people today, and every day sees a big increase. Yesterday, we tested 34,654 and it was 27,372 the day before that. A week ago, it was 4,124.
But these increases are small compared to what’s in the pipeline. This week we saw FDA approval of new testing systems from Roche and from Abbott labs that run tests ten times faster than current methods. To give you an idea of what this means, Roche brags that their Cobas 8800 machine can process over 3000 tests per day. Until today, Louisiana hadn’t had a total of 3000 people tested. Roche is now making and shipping 400,000 test kits per week in the US, while Abbott is making a million of their test kits each week. Those systems will be coming online this coming week.
Today, we got even more good news, with Cepheid getting FDA approval for their new test, which will detect the virus in 45 minutes and can be used in over 5000 Cepheid machines already in US hospitals. This will allow hospitals to test all their staff and every incoming patient on a consistent basis, so that we can keep our doctors and nurses safe and our hospitals don’t spread the disease. Those testing kits are getting shipped out this coming week.
And there are more companies in the process of getting approval. In two weeks, we should be able to test 150,000 – 200,000 Americans daily, and that means that we don’t all need to stay home anymore.
Let me explain how this works.
Suppose that Boudreaux, who works for the state of Louisiana, wakes up and has a fever. Right now, it’s not easy for him to get tested – and if he could get tested, he wouldn’t get his results for days. Let’s say that Boudreaux is a good citizen and stays home at this point. That’s great, except that Boudreaux went to work yesterday and exposed his coworker Pierre, and he also got his hair cut and exposed his barber, T-Boy. His wife Marie doesn’t isolate from him, because she thinks that Boudreaux is just lazy and doesn’t want to work, so she is also exposed. Unless Boudreaux gets sick enough that he needs to go to the hospital, he’s not going to be tested, and Pierre, T-Boy, and Marie might all get the virus and – and this is key – then spread it themselves.
That’s been our situation, and the only solution that we’ve had was to keep Boudreaux at home in the first place. That’s why the state is keeping non-essential workers at home. That’s why many places are forcing barbershops to close. So, now, our governmental restrictions keep T-Boy and Pierre from getting infected, though Marie is still at risk.
Now, imagine our original situation with easy, high-speed testing. Boudreaux wakes up with a fever, he goes to the drive-thru testing site and is notified about four hours later that he is positive. Now, everyone in his family and workplace immediately gets tested, as does T-Boy – and the virus does not spread beyond them.
The ability to test everyone who needs to be tested is how South Korea and Singapore have been able to control their outbreaks without significant societal restrictions. Their schools, restaurants, etc. are all open. And their economies are not wrecked. Again, we’ll be at that point in less than two weeks.
Evidence strongly suggests that COVID-19 is seasonal.
A recent Chinese study compared transmission rates for all 100 Chinese cities outside of Wuhan that had at least 40 cases before their national lockdown, to see if the virus spread more slowly in warmer, more humid parts of China. Their conclusion:
“High temperature and high relative humidity significantly reduce the transmission of COVID-19, respectively, even after controlling for population density and GDP per capita of cities … This result is consistent with the fact that the high temperature and high humidity significantly reduce the transmission of influenza. It indicates that the arrival of summer and rainy season in the northern hemisphere can effectively reduce the transmission of the COVID-19.”
That study, as an example, predicted a R value of 1.3 in Tokyo for the Olympics — with zero intervention! (For those of you who don’t know what that means, it means that instead of spreading the disease to about 2.6 people, which is what happens now, the average person would only infect half as many people.) If this study were correct, it would mean that, with some control measures, it would be easy to keep COVID-19 from spreading during the Olympics.
Besides this study, we have the basic observation that the world’s serious outbreaks have occurred in cold, dry weather. Jakarta and Milan both had nonstop flights to Wuhan during Wuhan’s outbreak, but Italy has suffered a horrific crisis and Indonesia has not. Scientists believe that this is because COVID-19 is mainly transmitted by coughing, and the microdroplets emitted when someone coughs travel about twice as far in cold, dry air. Additionally, the water vapor present in humid air interacts with those microdroplets to stop them.
If COVID-19 is indeed a seasonal disease, then we should be able to almost eliminate it this summer, to the point that there will be zero restrictions on ordinary life. Sports leagues can fill stadiums with fans and political conventions can meet, and we won’t have to worry that we’re fanning a new outbreak.
Improved treatment will improve COVID-19 patient outcomes.
If you have watched President Trump on TV or follow him on twitter, then you know that he is hopeful about the promise of chloroquine (and its close relative hydroxychloroquine).
President Trump has perhaps overpromised what chloroquine can do, as the evidence of its benefit is still rather thin. But, if it has any benefit at all, it’s a game-changer in terms of our ICUs. If chloroquine works, it works by lowering the amount of virus in the body. When you combine this with earlier testing, there’s a tremendous advantage. The people who end up in the ICU don’t get there until they’ve been sick for a week or so, as the virus grows in their body and then inflames the alveoli in the lungs, leading to shortness of breath. If chloroquine works, an at-risk patient would be given it right after testing positive, and hopefully, the viral load in their body never gets high enough for the patient to develop severe shortness of breath, and he stays out of the ICU.
A drug like chloroquine doesn’t have to be extremely effective in order to have a huge benefit on our ICU density. A small effect could have a big impact. And if chloroquine turns out not to work, there are other promising drugs such as Remdesivir, though chloroquine has the advantage of being cheap and easy to produce.
Is the situation going to get worse in the US? Yes. Is the end in sight? I believe that it is. I write this to encourage each of you to hold on. If we can stay and home, enduring the claustrophobia, the family bickering, and the often severe economic consequences, we can beat this virus.
I miss my church. A streamed service tomorrow is not a true substitute for the togetherness in Christ that I need more than ever at this time. And my business is suffering. I think that I can make it another month, but I don’t know about longer than that. I expect that our nation’s psychiatrists and therapists are swamped right now, as stress and depression skyrocket.
But there is a light at the end of the tunnel.