Pestilence and Pests: Covid-19

TL; DR: People in Slovenia are not taking covid-19 serious. But it is fucking serious so everyone should be responsible and do their part to stop and slow the spread of the new coronavirus. No excuses.

  • Follow your local health guidelines. They’re there to protect you.
  • Maintain social distance. Don’t touch people. Don’t shake hands. Don’t stay close to sneezing and coughing people. Don’t go into crowded places. Stay home, don’t travel.
  • Wash your hands with soap. Regularly. After you touch your face. After coming home. After sneezing or coughing.
  • Be hygienic. Don’t cough or sneeze on people. Use a tissue or the crook of your elbow. Then wash your hands. Don’t go visiting friends and festivals and family if you’re sick.
  • Don’t be a fucking self-centred asshole saying that “it’s just a little flu,” that “it’s harmless,” that it’s a “hoax,” that you “won’t get sick because it only kills old people.” Don’t mock people wearing masks or taking extra hygiene precautions. Don’t go hoarding toilet paper or soap or disinfectant. If you do that, you are a fucking self-centred asshole. All the precautionary measures are fucking basic hygiene. You should be doing them anyway. So fucking do them. You have no excuse.

Politicians and people pretending everything is peachy

It’s here in Slovenia now. Pestilence. Old foe.

It followed me from Seoul. On the 19th of February I travelled from Incheon airport to Venice Marco Polo airport and thence to Slovenia. The outbreak was gathering steam in Korea where the Shincheonji group’s thoughtful mass masses had amplified a single patient’s infection to thousands.

An inauspicious start. The flight was tense. I wore a mask, and had a backup packed. I soaped and avoided people as much as I could. Still, it was a tense feeling in that aluminum tube in the sky. When I returned I secluded myself for two weeks. No symptoms, thank the gods. Still, stressful, nervous.

Productive but nervous weeks. I watched the cases rise in Korea and the media talking about the problems of China’s authoritarian regime. Of Korean cults. I watched the cases taper of in Korea and keep rising in Italy.

Nothing in Slovenia, where the fallen-government simply affirmed that everything was fine.

I’d planned to stay by the seaside, drive down the coast, but then came 23rd February and it became clear to me that the disease was exploding in Italy. That’s right across the wide-open border here. The Croatian government introduced checks at the border. The Slovenian government said we’re prepared and fine and don’t need to do anything.

Ostriches with heads in their sand.

I stayed in the mountains and holed up, taking my temperature daily. Well, that never rose. But tourists, including doctors, took advantage of the bargains to be had in Italy as tourists fled. And brought the virus to Slovenia as well, including to a few key clinics. Yay!

And still, talking heads bobbled.

“Everything is fine. Everything is under control. It’s just like the flu. Wash your hands. Practice cough / sneezing hygiene. Stay indoors. Don’t use masks [because we’re out of masks and medical staff need them.]”

Let me be very clear. Coronavirus disease 2019 (covid-19) is deadly serious. We will be talking about it for a long time. Hopefully not in the same breath as the influenza pandemic of 1918–1920 (the Spanish Flu), but quite possibly.

The report of the WHO-China Joint Mission is chilling.

But the media here (or most everywhere else) didn’t report on it for days. I found the report via Reddit. Was this some attempt to avoid panic? Because it seems to have worked. In Slovenia it is still very popular to say, “it’s no worse than the flu.”

“Do you know how many people the flu kills every year?”

“This is nothing like the Spanish flu, this is just a Chinese knock-off.” Because, ‘haha’, the Chinese only make knock-offs, ‘haha’, imagine if they made an original disease (SARCASM).

“I think it’s a biological weapon.” Weirdly enough I’ve seen the same people say it’s some kind of biological weapon and also that it’s less serious than the flu.

These kind of opinions are, of course, complete horse shit.

I’m not a doctor or an epidemiologist, but you can be damn sure I listen to experts when they say this is serious. And, let’s be clear, every one of us in the godamned UN is contributing some money to the WHO, so these are our chosen experts. You might disagree with the details, but these are the people the states of the world have chosen, in our name, to keep us healthy. That’s a fact.

Why is covid-9 so serious?

So what is so serious? Let’s look at a few things things. Now, caveat, this is a brand new virus. It was only discovered in December. We know very little about it yet … but what we know is not comforting.

ZERO

That it’s a brand new virus means everyone is susceptible. All 7-and-counting billion humans on Earth. We’re all susceptible. This is not good.

FIRST

Basic reproduction number also r-nought or put simply how many other people does the average sick person infect. The WHO report’s estimate is an R0 of 2–2.5. Earlier estimates pegged it at 4–6, but let’s go with WHO’s numbers because they’re less scary. This means that the average sick person infects another 2–2.5 people. This is in the ballpark of the 1918 influenza pandemic (2–3). Normal influenza A (the common flu) has an R0 of 1.1 to 1.5 (according to the Lancet). This means covid-19 is much scarier than “just the flu.”

An R0 of 2 means that without some kind of community intervention (quarantine! self-isolation! containment!) each patient infects 2 other people. This is the best case estimate for covid-19. This is not good for us.

Then there’s the serial interval. The mean time it takes for an infected person to pass on the infection to others. Let’s take the Lancet’s best case estimate (lots of unknowns here) of 7.5 days. This is related to the doubling time (how long it takes for the number of cases in an epidemic to double), between 4 and 7 days (source: Lancet). This is not good for us.

This means fast exponential growth. Humans suck at understanding how scary exponential growth is, so here’s a video. Remember, Italy only had 200 cases on February 23rd, about 2 weeks ago. Now it has 7,000+ (and rising) and 366 deaths. And 16 million people locked down.

SECOND

Severity and disease progression. This is also scary.

First severity. According to the WHO report 13.8% of patients develop severe disease (they need to lie down and do nothing, they need medical help or things will be really, really bad for them) and 6.1% develop critical disease (without medical help they will probably die, and even with it they might die). So, about one in five (20%) of infected people will need medical care. About one in twenty will probably die without it. That is a lot of people. This is not good.

Next, disease progression. “The median time from onset to clinical recovery for mild
cases is approximately 2 weeks and is 3-6 weeks for patients with severe or critical disease.
Preliminary data suggests that the time period from onset to the development of severe
disease, including hypoxia, is 1 week. Among patients who have died, the time from
symptom onset to outcome ranges from 2-8 weeks.” (source: WHO report) This means the 20% of people who need medical care will be sick for 3–6 weeks. That’s 21 to 42 days. Let’s ballpark it at 30 days (optimistic). That’s a month. That is a long time. This is not good.

THIRD

Put 1 and 2 together. The disease spreads fast and seriously sick people stay sick for a long time. People stay sick four times as long as it takes for the number of sick people to double. This is not good.

It means that if we let covid-19 get out of control the health care system will be overwhelmed quickly.

What does an overwhelmed health care system mean?

  • Doctors and nurses get sick and die. This is bad in the short term and long term for obvious reasons.
  • Other diseases and injuries cannot be treated. This is bad.
  • Ambulance and emergency response times go down. Surviving a heart attack depends on getting care quickly. Care slowed down? Heart attacks kill again. This is bad.
  • And, of course, crude fatality rates aka. the number of dead people from covid-19 goes up.

FOURTH

Oh I haven’t even started on the crude fatality rates. Estimated at 3.8% … this is very very bad. This is not like the flu. The flu has a crude mortality rate of 0.1%. This is ballpark thirty times worse.

People think 3.8% isn’t much. It’s a lot. I make roleplaying games for a living. I play with dice and statistics all the time, and I can tell you: I don’t want to risk an imaginary character to a 3.8% chance of death. My mother is old enough to fall into a higher risk category with a 10% chance. That’s a lot. If it still doesn’t feel like a lot … hey, you know what, get together with four other friends. There’s five of you and you’ve got ten parents between you. Say they get sick. Pick one. That one’s dead. And death is serious.

But these are estimates based on China and its response. Korea’s has been much better and its fatality rate is much lower. Italy’s is worse, with a current fatality rate of 5% … and they’re starting to institute triage because they’re running out equipment (this just 2 weeks after they declare an emergency).

Still, let’s best-case estimate it at 3%. Look around your town. Say it has 100,000 people. If you let the disease infect everyone, that’s 3,000 dead people. That’s a lot. That’s a lot of parents and grandparents, especially. So it means that everyone knows someone who’s died. That’s the definition of a shared tragedy.

Now imagine it infects 4 billion humans (about 60% of the population). Let’s say it’s all best case and just 3% die and there’s no extra people dead from, you know, the health system being in trouble (hahaha). That’s 120 million dead. That is such a big number the human mind just rebels. Let me give you some fucking perspective. During World War 2 about 75–80 million people died (interestingly enough, that’s the equivalent of about 3% of the world’s population at the time). The world is littered with monuments remembering those dead.

WHAT DOES THIS MEAN?

  • This is fucking serious. This is the public health emergency epidemiologists have been warning about for years.
  • Every economy will take a beating. There’s no way about it.
  • We need to work together to globally beat back the virus and keep down infections long enough to develop a vaccine.
  • We’re going to see anti-virus measures in place for many months. This will not just disappear with warm weather. Airports will have temperature checks in place for more than a year. Sick people won’t be allowed to travel or fly. Quarantines and isolations will remain in place. Outbreaks will continue to happen. This will not mean things are useless or not working, just that the fight is a very long and hard one.

via GIPHY

SO WHAT DO WE DO?

  • Take it fucking seriously. Don’t be an asshole smirking it off as “just the flu.” Be responsible and think about the other people around you. You might be a low-risk category, but your parents and grandparents are not.
  • Don’t panic. Don’t go hoarding toilet paper, you don’t need 200 rolls. Don’t hoard soap, you don’t need 20 bars. Don’t go spreading conspiracy theories. Don’t be a racist fuckhead, it’s not a “Chinese” epidemic, it’s a human epidemic. This is a virus, not a magic ghost-monster bio-engineered in some lab.
  • Follow WHO public health policies as much as possible. Wash your hands frequently with ordinary soap. Maintain social distancing of at least 1 metre between yourself and anyone who’s sick. This means you stop shaking hands and kissing people and hugging. Don’t sneeze and cough on people (do I even have to say this?!). Don’t touch your face as much as possible. Do you know why this is advice? Because it works!
  • Mask. Wearing a mask isn’t useless, because it means when you cough and speak and sneeze your “droplets”, your precious bodily fluids, aren’t flying on other people and every surface around you. And neither are theirs. But here’s the thing: after you remove your mask, wash your damned hands. Because if the mask did it’s job, it’s now covered in … droplets. You know, the things that might have the covid-19 viruses you don’t want in your body because you have no immune response and they’re the things that could kill you or your friends and family.
  • Avoid public gatherings. Don’t go meet in clubs or cinemas or concerts. Especially avoid them if you are sick or have any symptoms. That’s just how it’s going to be for the next several months. Deal with it.
  • Don’t visit friends or family if you are sick or you have someone in your household who’s sick or someone in your office who’s sick. Like, this is a simple question of being a responsible, respectful person. You wouldn’t shit on someone’s rug. Don’t sneeze on their table. Don’t cough in their face. Just fucking don’t.

THIS IS NOT COMPLICATED, BUT IT IS HARD TO DO CONSISTENTLY.

Still, make the fucking effort. Be responsible and do your part to help control the spread of this virus. It’s not full-proof, but our efforts only have to be good enough to slow down the spread and then contain any outbreaks that pop up. Once we have a vaccine in place, next year or in early 2022, we’ll be able to put a lid on this disease.

Don’t panic. Don’t give up. Do your part.

Take care everyone.
—L.

P.S. — if someone reading this feels compelled to respond with some stupid remark about how it’s not so deadly, some stupid comment about how it’s only going to kill old people … yeah, they’re not going to get a response, just a delete.

P.P.S — This article shared without copyright restrictions.

P.P.P.S. — if you believe all this is pointless and stupid, please don’t visit me or my house for a few months. Thank you.

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