Adonis Diaries

Archive for July 22nd, 2020

There are two problems with this question.

  1. It neglects the law of large numbers; and
  2. It assumes that one of two things happen: you die or you’re 100% fine.

The US has a population of 328,200,000. If 1% of the population dies, that’s 3,282,000 people dead.

Three million people dead would monkey wrench the economy no matter what.

That more than doubles the number of annual deaths all at once.

The second bit is people keep talking about deaths.

Deaths, deaths, deaths. Only one percent die! Just one percent! One is a small number! No big deal, right?

What about the people who survive the affliction?

For every one person who dies:

  • 19 more require hospitalization.
  • 18 of those will have permanent heart damage for the rest of their lives.
  • 10 will have permanent lung damage.
  • 3 will have strokes.
  • 2 will have neurological damage that leads to chronic weakness and loss of coordination.
  • 2 will have neurological damage that leads to loss of cognitive function.

So now all of a sudden, that “but it’s only 1% fatal!” becomes:

  • 3,282,000 people dead.
  • 62,358,000 hospitalized.
  • 59,076,000 people with permanent heart damage.
  • 32,820,000 people with permanent lung damage.
  • 9,846,000 people with strokes.
  • 6,564,000 people with muscle weakness.
  • 6,564,000 people with loss of cognitive function.

That’s the thing that the folks who keep going on about “only 1% dead, what’s the big deal?” don’t get.

The choice is not “ruin the economy to save 1%.”

If we reopen the economy, it will be destroyed anyway. The US economy cannot survive everyone getting COVID-19.

Edited to add:

Wow, this answer has really blown up. Many people are asking about the sources, so here’s the basic rundown:

This model assumes that the question’s hypothetical is correct and the fatality rate is 1%.

It also assumes for the sake of argument 100% infection.

(In reality, neither of these is a perfect match to reality. The infection rate will never hit 100%, but the fatality rate in a widespread infection is likely to be greater than 1%, because health care services will be overwhelmed.)

The statistics I used in this answer were compiled from a number of different sources.

I spent quite a bit of time writing the answer. Unfortunately, I don’t have my search history in front of me, so I’ll attempt to re-compile them.

Some of the sources include:

What we know (so far) about the long-term health effects of Covid-19

Physicians have also reported an increase in inflammation of and damage to the heart muscle in Covid-19 patients. One study published in March found that out of 416 hospitalized Covid-19 patients, 19% showed signs of heart damage.

Another study from Wuhan published in January found 12% of Covid-19 patients showed signs of cardiovascular damage. Other studies have since found evidence of myocarditis, inflammation of the heart muscle that can cause scarring, and heart failure in Covid-19 patients.

Now, physicians warn that Covid-19 survivors may experience long-lasting cardiac damage and cardiovascular problems, which could increase their risk for heart attack and stroke. Doctors also warn Covid-19 could worsen existing heart problems.

What We Know About the Long-Term Effects of COVID-19

“Some of the data that we’re getting now from the China studies, one study that was just published in JAMA Neurology showed that 36.4% of patients had neurologic issues,” said Dr. Sheri Dewan, neurosurgeon at Northwestern Medicine Central DuPage Hospital in Winfield, Illinois. “One of the review articles that came out at the end of February discussed the possibility of virus traveling into the olfactory neurons, through the olfactory bulb, and into the brain.”

Lifelong Lung Damage: A Serious COVID-19 Complication?

“Holes in the lung likely refers to an entity that has been dubbed ‘post-COVID fibrosis,’ otherwise known as post-ARDS [acute respiratory distress syndrome] fibrosis,” said Dr. Lori Shah, transplant pulmonologist at New York-Presbyterian/Columbia University Irving Medical Center.

ARDS occurs when fluid builds up in tiny air sacs in the lungs called alveoli. This reduces oxygen in the bloodstream and deprives the organs of oxygen which can lead to organ failure.

Post-COVID fibrosis, according to Shah, is defined as lung damage that’s irreversible and can result in severe functional limitations from patients, such as cough, shortness of breath, and need for oxygen. […]

According to The Lancet, in a piece titled, “Pulmonary fibrosis secondary to COVID-19: A call to arms?,” the first series of hospitalized patients in Wuhan, China showed that 26% required intensive care and 61% of that subset developed ARDS.

What we know (so far) about the long-term health effects of Covid-19

Physicians report that patients hospitalized for Covid-19 are experiencing high rates of blood clots that can cause strokes, heart attacks, lung blockages, and other complications, Parshley reports.

For instance, physicians are seeing an uptick in strokes among young patients with Covid-19.

The blood clots also can travel to other organs, leading to ongoing health problems.

For instance, pulmonary embolisms, which occur when the clots block circulation to the lungs, can cause ongoing “functional limitations,” like fatigue, shortness of breath, heart palpitations, and discomfort when performing physical activity, Parshley reports.

Similarly, blood clots in the kidneys can cause renal failure, which can cause life-long complications.

Heart damage

Physicians have also reported an increase in inflammation of and damage to the heart muscle in Covid-19 patients. One study published in March found that out of 416 hospitalized Covid-19 patients, 19% showed signs of heart damage.

Another study from Wuhan published in January found 12% of Covid-19 patients showed signs of cardiovascular damage. Other studies have since found evidence of myocarditis, inflammation of the heart muscle that can cause scarring, and heart failure in Covid-19 patients.

Now, physicians warn that Covid-19 survivors may experience long-lasting cardiac damage and cardiovascular problems, which could increase their risk for heart attack and stroke. Doctors also warn Covid-19 could worsen existing heart problems.

The numbers in this answer were made from extrapolations about percentages of COVID-19 long-term effects reported in a range of studies on Google Scholar, assuming a hypothetical 100% US infection rate and a 1% fatality rate.

Of course, in reality, a high infection rate would cause the mortality and comorbidity rates to skyrocket, so if anything, these numbers are conservative.

Wear your damn masks, people.

An Urban Detour in architecture?

Note: Re-edit of “An Urban Detour” by Rania Sassine (Book Review). March 28, 2009

Rania Sassine is a young Lebanese architect. The tiny book “Viree Citadines” is her first and written in French.

Rania is attempting to describe 24 imagined villages that might add variety to the landscape.

The fictional villages are divided into two categories:

The village-objects that resemble objects such as necklace, cone, spinning top, turning wheel, hoop, drawer, geological fault and

The village-adjectives such as magnetic, cloud, artist, show-biz, retirees, fairy tales, remembrance or souvenir,  and on.

I can imagine that the publisher is a close relative of Rania and encouraged her to give him the nod. We thus have got shapes, forms, and unlimited imaginations to dream of new dwelling quarters and communities.

What I will describe are my imagined villages on the main themes because it is a God sent opportunity to refresh my youthful dreams.

If you like to discover Rania’s imagined villages then you read her manuscript.

Imagine a Real Estates developer who acquired a hill.

At the top of the hill he builds a humongous tree-like edifice and from this tree flows a necklace of residences.

There are unlimited variations on the forms, pearls, color, and arrangement of the pearls or stones.

You could have a series of spherical houses or pine-like cones or other gems’ forms and shapes.

Imagine that the developer adds two mounds within the necklace, adjacent and in the shape of apples or pears for public gathering and a commercial center.  The houses could be detachable so that every spring a new look for the necklace is exhibited.

Imagine a flat terrain covered with glass-like materials for tanning and ice skating and the residences are underground.

When it rains or when it thunders or when the sun is blazing then you open a trap and descend a staircase to your house or to the common gathering theater or commercial center. A labyrinth of underground pathways should take you home.

Imagine that the houses in the town are bubbles that are transparent, colorful, and can be navigated to certain altitude.

The well to do can afford large bubbles with complex navigation consoles but the movement of these bubbles is restricted to an area and an altitude.

It would be advisable that clusters of bubbles be attached to one another through flexible tube-like bridges that never tangle up so that people can visit neighbors up in the air.

The elderly are reserved a ring-like bubble houses close to a cushioned ground.  The whole exercise is to never land, which required complex administrative and maintenance jobs.

Imagine a town in the shape of spinning top; it intersects with the ground in a single point and rotate around a seesaw axe.  Would you like this town to spin? Who might reside in it?

Imagine a town built in permanent clouds; an atmosphere of fiber between gas and liquid.

When you enter you have the sensation that thousands hands are touching you and palming you, where you cannot see anything but can hear sounds and music constantly.   Who might reside there and what could be its function and purpose?

Imagine a town reserved for characters in fairy tales, or simply tales, decked in the corresponding characters.  What could be its shape and what could it produce to stay financially stable?

Imagine a town where it rains constantly 24 hours and every day.  The clouds are made to converge to this town and deliver their bounty.  The town is built to store rain water and distribute it equitably to the rest of the world.  Who would like to work there and how workers could survive?

Imagine a town built as drawers with translational motions. What could be its purpose and who might reside there?

Imagine a town in the shape of hoops.  It gravitates around an antenna of photons linking earth to moon.  It can move upwards fast and follow the rotation of the sun 24 hours or decide not to see the sun for 24 hours. What could be its purpose and how could it generate profit?

Imagine a town in a hole, drilled for miles underground in the South Pole.  How could you design it and what could be its purpose?

Imagine a town in the form of a wheel, with a few concentric circles and the possibility to rotate at different angles. What could be its purpose and who would reside there?

This is starting to be a fun exercise.

Could you imagine other kinds of specialized towns in shape and purposes?

A few “leaders” are Not about to take Covid-19 pandemics with a high level of seriousness

As COVID-19 surges in the US, are we all willing to take it seriously?: Opinion

We can control the path of this deadly, destructive virus.

In the United States we’ve learned that collective and individual action can slow the spread of COVID-19.

The progress seen in New York — which recently reported zero deaths on a given day — proves we can control the path of this deadly, destructive virus.

Despite these pockets of incremental progress, we’ve also learned that dealing with COVID-19 is a marathon, not a sprint, and that we, as a country,  are falling short of what’s needed to slow the spread of the virus and safely inch back to normal.

Initial shelter-in-place orders helped temporarily slow the spread, but upended our lives, closing schools and workplaces across the country.

Shelter-in-place allowed the health care system to prepare for a surge and was meant to buy precious time to develop and implement an effective contact tracing strategy as well as build a high-volume testing capacity that could have helped limit the virus’ spread.

Most of that, sadly, did not happen.

With the virus surging at ever-higher levels, we are on the brink of blanket restrictions that protect our health but also harm our economies and our psyches.

With nearly 140,000 people in this country dead from COVID-19, and potentially hundreds of thousands more suffering the long-term health impact of this still-baffling disease, can we all finally agree to make the investments needed for America to vigorously respond to this pandemic?

Build the public health infrastructure now

We have to develop a robust public health workforce that will allow us to contain the spread of COVID-19.

Other countries, including New Zealand and Taiwan that have beaten the virus or slowed its spread, already had the teams and infrastructure in place from their responses to past epidemic diseases.

In the U.S., decades of disinvestment created a frayed and disjointed infrastructure that didn’t stand a chance against COVID-19.

The cost to create the public health workforce of high-volume testers, contact tracers, support systems to enable isolation, coordinated lab facilities and vaccinators is unavoidably huge and dwarfed by the economic fallout of a prolonged pandemic that will occur if we do not invest in these solutions now.

Do the advance work

This critical infrastructure is needed right now to stop the spread.

And when a vaccine is developed, it will be needed even more to assist with distribution, administration and further containment.

We are already hearing rumblings about limitations of distributing a vaccine. Will there be enough glass vials to accommodate the billions of doses needed globally, or will they fall short the way testing swabs are today?

Additionally, an effective vaccine does Not guarantee eradication of COVID-19.

Research is now showing that antibody-based immunity may only last for a few months after recovery for some people, leaving victims potentially vulnerable to reinfection.

We must imagine that any vaccine could require periodic booster doses.

What would that look like in the U.S. for a population of 330 million people? We may need to create permanent COVID-19 centers where Americans can receive these frequent injections.

These are the types of issues we need to think about now, so we can get ahead of problems instead of continuing to play catch-up, with devastating consequences.

Communicate honestly

Perhaps the greatest travesty of this pandemic has been the mistrust and skepticism toward the scientific and public health communities sown through politicization and misinformation about the novel coronavirus.

The facts are simple: this disease does not discriminate based on political party, or whether you believe in it. Testing is essential to uncover cases and does not “create” new ones.

For the greater good, we must not only back down from the rhetoric, we have to redirect tremendous resources into communicating to the public the truth about the virus and the effective, proven steps everyone can take to reduce its spread.

Public health campaigns work. According to the Centers for Disease Control and Prevention, more than 1.8 million smokers attempted to quit smoking because of its nine-weeks long 2014 “Tips From Former Smokers” campaign.

With the viral nature of today’s mass communication channels we can save lives if we can first undo the harm that misinformation has already caused and replace those messages with ones that will save lives.

Think about the power of the ALS ice bucket challenge. Now the message to get out is about wearing masks.

Physical distancing. Washing hands. Staying home if you’re ill. These steps are all slightly inconvenient but simple to execute and hugely effective — if we can convince people to do them.

We should not fool ourselves that COVID-19 may be the last pandemic in our lifetimes.

A functioning society, for the foreseeable future, will necessarily include the public health professionals who can identify, isolate and mitigate this virus and potentially others.

No level of normal will be possible without that vital change.

Dr. Jay Bhatt is a practicing internist, an Aspen Health Innovators Fellow, and an ABC News contributor.

Dr. Bechara Choucair is a physician and chief health officer at Kaiser Permanente. His book, “Precision Community Health: Four Innovations for Well-being,” was published in May.

MORE: How New York has been able to keep coronavirus at bay while other states see surges

MORE: COVID-19 antibodies may fade in as little as 2 months, study says




July 2020

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