Covid-19 is unequivocally more widespread than you have been told.

The true incidence of Covid-19 in MA, (where I am a local expert) and nationwide is woefully under-reported. This is due to the fact that until a government lab tests a case as positive, it is not reported on the otherwise excellent websites such as Johns Hopkins University’s COVID-19 case counts by country and county.

I have spoken to many MA radiologists who have diagnosed patients with Covid-19 pneumonia, yet the state numbers will not include their patient. These patients’ state laboratory test results are not yet available (as there have not been enough test kits and the lab takes more than 48 hours to turn around results due to high volume).

Experience has taught us that for every hospitalized patient we know about, there are four more in the community who are not reported in the numbers.

Between you and I, one of us is likely to contract Covid-19 within the next 12 months:

While no one knows for sure, it is possible, even probable, based on the evidence to date that most of us will likely contract Covid-19, despite our best efforts. The Prime Minister of Germany, Angela Merkel recently warned that 70% of German citizens might contract Covid-19. Harvard epidemiologist Marc Lipsitch suggested between 40% and 70% of the world’s population will likely contract Covid-19. It is however critical that we delay that eventuality as discussed below.

When we get sick this will be the result:

Based on the experience in Asia and Europe for roughly 80% of us, the symptoms will range from a mild cold to a bad case of the flu, all of which can be treated in the privacy and comfort of our own homes. However, for those of us over 60 years old, and those of us with chronic diseases such as emphysema, diabetes or high blood pressure, we may need hospitalization or even treatment in an intensive care unit (ICU). Covid-19 will kill some of us, most commonly (but not exclusively) those who will die will be older, frailer and sicker patients to begin with.

It has been reported in China that for those patients younger than 30 years of age, the death rate was 0%. The news was worse for older patients. The death rate was reported to be 7.2 percent for patients over 79 years of age. According to that report, slightly less than 1% of all Covid-19 patients with the virus died there. The only good news is that this means over 99% survived.

The math is brutal: If millions of patients required intensive care at the same time, there simply isn’t enough care to go around:

Dr. Anthony Fauci testified before congress that the mortality rate for Covid-19 may be 1%. Hence without drastic measures, Covid-19 may kill 1 million Americans.

For patients with severe Covid-19, hospital care or ICU care can be lifesaving. There are roughly 328 Million residents living in the USA. If only 50% of us contract Covid-19, 164 million patients will fall ill. If 20% of these patients require hospitalization, 32.8 million patients would require a hospital bed. Yet there are less than 1 million hospital beds in America (924,100 hospital bed in the USA). There are only 160,000 ventilators to help patients with pneumonia breath. We have less than 100,000 ICU beds.

You Can Save a Life (Maybe Your Own)

Therefore we must slow the rate of progression of this potentially catastrophic, once in 100 years pandemic:

If the rate of spread of Covid-19 is slow enough, we can “flatten the curve.” 164 million Americans may still contract Covid-19, but if they do so slowly, over time, then there will be enough care to treat the sickest of us, as in the diagram below:

Source: “Flattening the Coronavirus Curve: One chart explains why slowing the spread of the infection is nearly as important as stopping it.”

What your community can do to slow the rage of spread:

Cancel all non-life-saving public meetings: This includes sporting events, classes, religious services, concerts, schools, libraries etc.”

As much as possible, workers should be encouraged to work remotely from home. Face to face meetings should be converted to phone calls, conference calls or webinars.

Business owners, community organizations and government should clean and disinfect frequently touched surfaces more often. They must also provide adequate supplies of hand hygiene supplies at multiple convenient locations.

By limiting the opportunity for the virus to spread, we are flattening the curve.

Reason for optimism:

During the Spanish Flu pandemic of 1918, an estimated 50 million people perished worldwide. That is more than the 40 million deaths due to WW1. However, pioneers of social distancing in 1918 proved we could flatten the curve. In 1918, the mayor of Philadelphia threw a parade to support the war effort. 200,000 people lined the streets to watch. Within three days, every hospital bed in Philadelphia was full of sick and dying flu patients. 4,500 Philadelphia residents died that week alone.

In contrast in St. Louis, a similar sized Midwestern city rigorously began practiced social distancing. Just two days after their first civilian influenza death, the mayor of St. Louis closed all churches, courtrooms, libraries, playgrounds and schools etc. They didn’t throw a parade; they banned all public groups of over 20 people. Their death rate was only half of that of Philadelphia.

Source: “This chart of the 1918 Spanish flu shows why social distancing works”

What you and I can do? Employ social distancing and rigorous hand hygiene:

Practice social distancing now:

· Support school closures and postponement of public meetings

· Telecommute

· Convert in person meeting to calls or webinars

· Cancel family get-togethers, parties, wedding ceremonies (you can still get married, but hold the public ceremony and reception a year from now, once the pandemic is behind us).

· Keep a two week supply of medications, groceries, and household items on hand, in case you are quarantined.

· Check in on neighborhood shut-ins by phone.

· Share your supplies if needed.

Practice pandemic hygiene:

· Don’t go to work (or out) when sick.

· If you need to see a physician, call ahead first.

· Cover coughs and sneezes with your elbow or a tissue, and throw the tissue in the trash.

· Wash hands often with soap and water for at least 20 seconds.

· Avoid touching your eyes, nose, and mouth.

· Get plenty of sleep.

· Exercise.

· Stay hydrated.

· Eat well.

· Don’t shake hands. (Don’t touch their sleeves instead; this is where they have been coughing.)

· A respectful bow while uttering “social distancing” sets a good example.

Be compassionate: Social distancing and a focus on hygiene will help flatten the curve.

The ICU bed you help save may someday be your own.