Wednesday, July 8, 2020

Staying Alive in a Time of COVID 19

Steps in Contact Tracing

Anyone who's been following the news and government actions, since this Pandemic became a real crisis sometime in March can be excused for being confused, if they were believing the things the President was saying. The virus is everywhere. It is spread by droplets, large and small. The scientists keep learning new things about how dangerous it is. People get it and don't know they got it. Others get severe pneumonia symptoms. Now we find out that it gets into the blood and causes a wide variety of symptoms, organ damage, symptoms similar to myalgia in some people, invisible lung damage in others, and death in too many people.

It initially spread on the East and West Coast. Much of the West Coast went into emergency mode right away, and they "flattened the curve", the East Coast was slow to react, and New York and New York City were nearly overwhelmed by cases. COVID 19 is the first out of control viral pandemic we've had in a long time. We have yearly pandemics of some flu's, but most of those could be prevented with vaccines and contact tracing. Little contact tracing is done for most flu's, because the combination of herd immunity and vaccines, keeps the numbers of severe cases manageable. So what is the problem with COVID 19? Let's look at some Jargon definitions.

Flattening the Curve

An epidemic is virulent when each infected person infects more than one additional person. When the rate at which an infection spreads is less than one additional person per infection, the epidemiologists (folks who study this stuff) call that flattening the curve. When an infection is spreading rapidly, some folks become "super spreaders". One person might infect infect 100s of others. Over a century ago a kitchen worker named Mary, was isolated and nicknamed "typhoid Mary" because she spread Typhoid to hundreds of people. This is a statistical thing. When a hundred people get infected by ten people, that would be a rate of infection of 100/10. The rate of infection is thus often a multiple. That means it grows "geometrically". 100 turns into 1000 turns into 10,000 which turns into 100,000. At the rate COVID-19 is currently spreading we went from 2 million cases to three million cases in 28 days. That is a geometric progression.

Contact Tracing: Discover, Test, Isolate, Trace Contacts, repeat.

The Typhoid Mary story illustrated the importance of contact tracing. In contact tracing public health people find out who someone may have came into contact with after they became infected and seek to find, test and isolate those people until they are cleared of infection, either by testing negative or being quarantined until they are no longer contagious. Poor Typhoid Mary was treated as a prisoner, possibly long after she was no longer contagious. But the principle is important.

Community Spread

We have what is known as "community spread." That means thousands of people who may or may not have COVID-19 symptoms, but are "shedding" (spreading) the virus and infecting others. When you don't know who has the disease and you can't stop it at borders or easily isolate those infected, that is known as community spread. In the case of the aforementioned flu cases, community spread is dangerous but not overwhelmingly so. Young people with strong immune systems get the flu, and make other young people sick. They also make elderly relatives and parents sick, and that is a problem because the flue kills elderly people and people with pre-existing conditions.

Wear a Mask! Get your shots!

That is why vaccines and masks help control the spread of the disease. Wearing masks, washing hands and practicing social isolation when one has the flu or a cold, is the polite thing to do if one doesn't want friends sick. In the case of some people, it is also a life-saver. We tended to look down on Asians for wearing masks when we had flu epidemics, but they were protecting parents, children and the elderly.
People who won't take vaccines due to slander and rumors about them being dangerous, not only risk their own children, they risk the elderly and their relatives.

This is even more dangerous for COVID 19 because it is even more dangerous than the regular flu.

Novel Virus

A Novel virus is a virus that just leaped from one animal or form, to a mutated form that infects humans. Sometimes pandemics flow from variants on older viruses. That would be the H1-N1 series of viruses as an example. The Spanish Flu that killed more than 750k Americans in 1918-1919 was an H1-N1 virus. Swine flu was a descendant of the Spanish Flu or one of its variants. Viruses constantly mutate. People have some immunity to some viruses, from exposure to their cousins and siblings. But a novel virus is one that few humans have been exposed to before. In the case of COVID-19, the scientists keep learning new things about it and few have any immunity to it. Worse, there are some viruses that humans never become completely immune from. A good example of that was HIV. A person who gets HIV eventually gets AIDS unless science figures out a way to either kill the virus, mitigate its effects, or provide artificial immunity. The administration is hopeful that a vaccine will be found fast. But there are no guarantees. COVID-19 is a novel virus, and nobody knows if a vaccine will even work, for sure.

Confidence, Surety Versus Faith

Faith is a good thing. But it means believing in the unknown. Confidence is a bit difference. It means quantifying ones faith in whether an assertion about reality is actually in fact true. Most random things have a 50/50 probability. If one is 80% confident a thing is true, one has evidence that that thing actually is true. Faith is for things you can't quantify or falsify. Confidence levels are for material things one can quantify or falsify. If I assert a confidence level of 80%, there is still a 20% likelihood the thing is false. Science lives on verification and validation. Unlike charlatans and magicians, they are quite willing to be wrong, even happy when a hypothesis is invalidated. With COVID 19 scientists are quite happy when someone gets it and recovers without much in the way of side effects or major life threatening ones. A Gambler might win at 1000:1 odds. But 999 out of 10000 times the gamble loses. If you get sick, please pray. But do the things that you can be confident will save the day so you don't. Protect yourself so you can live.

That is all for this post. I wrote this for GABIDDC, but it is universal!

If you want a comprehensive manuscript on cleaning and dealing with COVID 19 please read the GABIDDC manual:

https://www.gabiddc.org/workersguidehazards/

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