As I live in Australia I can write about the response of the Australian government to the Coronavirus, although the response by other governments has been very similar and the proposed alternative way of dealing with this virus is applicable to most countries.
The way of dealing with the Coronavirus has been to prevent its spread. People who have symptoms must be tested and isolate themselves for around 14 days, which is the estimated incubation period (although this is by no means certain). This is sold to the public as a way of preventing the spread of the disease. In fact, no one who understands the situation really believes that a pandemic can be prevented, only delayed. The idea of delaying the spread of the disease is to spread the pressure on health resources over a longer period.
Most people who get the disease will have mild symptoms, no worse than a cold. According to this site the number of people who will have serious or critical symptoms are around 12% (as of mid March 2020, the number varies and appears to be going down). The death rate is difficult to estimate but if we look on a country by country basis and divide the total deaths by the total cases we get from less than 1% to around 6%. This depends on the number of cases, how recent the virus has been in that country and the health resources of the country.
So instead of attempting to prevent the spread of the diseases, maybe we should simply put processes in place to deal with the disease.
- Don’t attempt to prevent the spread of the disease. Allow the mingling of people as usual in shopping centres, schools, etc.
- Clear hospitals of all non-essential cases.
- Commandeer some hotels to be used as back up to hospitals,
- Train people in health-related areas on how to deal with Coronavirus patients
- Set up a pool of trained people who can do house calls, to keep hospital visits to a minimum
The aim is to let those who have mild symptoms to go about their lives as usual and deal with those who have severe symptoms. People in high risk groups can be admitted to hospital as soon as they show symptoms. The intention is that if the 12% with severe symptoms can be dealt with in a timely manner then the death rate can be kept down to an absolute minimum.
The advantages to this are many:
- The economic effect of the virus will be reduced substantially
- Trained people and other resources that are used at the moment to test for the virus will be freed up to deal with people who are ill
- By setting up a team of people to deal with the virus the government will be able to deal with any future pandemics in a timely way
- Also, this infrastructure once set up will be useful even when the virus has dissipated
This will also require research. There are many unknowns. For instance the incubation period is still uncertain; there is evidence that there are at least two viruses (which has implications for a vaccine); we don’t know why some people respond more intensely than others. Putting all the health resources behind dealing with the pandemic, and dealing with large numbers of cases, will enable answers to be found to these questions.
The main problem is that would take a strong and determined government. The kick-back from the media and certain groups is predictable. One could imagine that when the first (inevitable) deaths are reported, some media outlets will blame the government. A government would have to enact emergency powers to put this in place.
Update mid March 2020:
The percent serious or critical is dropping over time and currently sits at around 8%. The death rates in Italy and Iran (two of the worst affected at the moment) are increasing. I would suggest that the reason the death rate is increasing is that they these countries are not managing the critically affected.
The death rate is from COVID-19 is completely dependent on how you handle the serious and critically ill patients
The outbreak must be handled as a war. The UK recently announced measures that go someway towards this, but by using essential resources to test for the virus, and by removing staff when they are infected, they are fighting the battle one handed. By crippling the economy they are tying the other hand.
Many people have pointed out that the hospital resources don’t exist to handle the numbers that would be needed. This misses the point. A hospital ICU is equiped to deal with a wide range of situations. Similarly, nurses and doctors are trained to deal with all types of ailments. What is needed in a limited range of equipment, drugs and training: incubators, certain drugs and the skill set of how to deal with people if they get to the critical stage.
Most serious cases can be dealt with at home with visits by trained staff. In Italy many of these people are abandoned which is why their death rate is so high.
The Prime Minister of Canada has self incubated for two weeks whist dealing with a war-type emergency. He probably won’t get more than the relatively mild symptoms. He should be out dealing with the emergency.
By Philip Braham on .