I watched that video.
I agree with most of what was said.
Forgive me as I'm organizing my thoughts as I write this.
This is a new virus, so we have been flying blind with very incomplete data, which is no ones fault.
Tests are complicated and not at all easy to produce quickly on high demand.
A PCR test to identify current any new infections is crucial and it needs to be accurate and identify nearly all cases without many false positives. Producing these everywhere has been a huge challenge making modelling very difficult.
The ELISA antibody tests is just coming on stream as we now only have enough people who have been exposed to make this testing worthwhile. Accuracy has more leeway here as a few false positives and negatives are of less consequence. They mainly have to be good enough to let vital workers return to their duties and above all get accurate mapping of the outbreak now and as it unfolds.
Again producing the ELISA test in quantity is a huge challenge. This is true of laboratory reagents, As I understand it Mayo with the U of M have developed two tests to help mitigate the reagent bottle neck. I think for now these tests will be confined to Minnesota. The Federal government seems to be of the view this should be left to each state. This is not appropriate as states vary enormously in their ability develop and to acquire this difficult technology.
China has been doing antibody tests but the results are questionable. The UK in particular and also Holland have received vast numbers of these test from China that are useless.
In the US these tests are just starting up, but will make public health measures more targeted and precise.
What is happening in the UK is less clear. This is because a top secret military institution appears to be playing a pivotal role. This means cards are being held close to the chest, with limited public information. However it seems likely Porton Down have had an antibody test for some time. As I understand it they are making a detailed map of the UK, dividing it into regions where 800 test a done in each region. This should give a good map there.
Now in this video there was too much emphasis I think on crude mortality. What is of more importance from a public health point of view is the rate of hospitalization of those infected and even more important those that need care in an ICU. The reason I say that is because this is an area where this infection differs from flu. We have never had an outbreak of any infectious disease that seems to have the incidence of the need for ventilators, CPAP, dialysis and ECMO along such multi system involvement. In the flu epidemics even in the bad years we never had more than a handful of cases going on life support, even in a bad year in Grand Forks. These were not mainly due to the virus itself, but due to a secondary staph pneumonia, that we had antibiotics for. On the other hand this virus causes a novel lung injury that is hard to manage.
This really goes to the crux of the current state of the outbreak. In modern society seriously ill patients expect to be able to get into hospital. Right now in Moscow queues for ambulances to get patients into hospital are nine hours long. Further, except for the very aged, people expect life support measures to be available. In order to provide that you have to limit case occurrence over time or you run out of facilities and staff. Remember every patient on life support takes the continuous attendance of one or more staff members 24/7. So that does justify the measures that have been taken.
So logically what does this mean. This YouTube presentation shows that about 3% of the population of Santa Clara county have been exposed to Covid 19 and have antibodies. Really this is far from the 70% required for herd immunity.
This given what I said above is actually terrible news, given what we have seen when this virus runs riot unchecked in a community. The medical infra structure can not cope.
So all this explains what we now see in communities that are passed peak and starting to loosen restriction. Germany, Italy, Spain, Japan, and now South Korea.
So if we are going to take the view that we now let this rip, then he has to understood that medical staff can not be overwhelmed and people will have to die awful deaths at home without medical attention. I'm not sure society is ready for that.
So the only logical way out is a massive moon shot drive on two fronts. I agree the world will live with this virus for ever now. So that means I think there will be severe disruption until we have a treatment that is as easy as antibiotics for step throat and an effective vaccine.
These have to be developed with the utmost urgency and no expense spared.
Lastly we need a lot more public education, and also education of policy makers. Public health policies must be driven not by the state of play now in any given location, but to look at the horizon and make policy based on the most reliable about what the state of play will be. As more is known this should get ever more accurate over time. I also point out that we absolutely must not remain dependent on, especially China and other Asian countries for so much of the manufactured goods we require. It is ridiculous that we are so dependent on these regions for surgical gowns, ventilators, laboratory reagents medicines and just about everything. This has to change fast. This is a massive root cause of so much of our supply and organizational problems here and in Europe. Cutting these ties will be a big part of getting our populations back to work and productive in short order after we have this virus under control.
