Wait - why is Jason talking about COVID-19? And why are these written like FaceBook posts? There’s a longer explanation here but the short version is that my day job for the past 15 years has been developing models of human health effects and medical response for chemical injuries and biological illnesses, including pandemics. I’ve been making these posts on FaceBook and I was asked to put them in a more shareable manner. I’m linking to the posts on the explanation page. These are the original, unedited posts. I’ll continue until I run out of things to say.
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Originally posted here on March 10th.
Hello, family and friends. Many of you all know that my day job is doing physiological health effects and medical response during mass casualty scenarios. Some of you don't know this and you're, like, "woah!" Also, I only post once a year so some of you are, like, "woah!" for very different reasons.
But, yes, that is what I do. My group is good at it! We started as three people 15 years ago and now we're around 60! We do a lot of work with a lot of agencies. I got a framed letter of kudos in my office on NORTHCOM stationary from 2008 about the work I did on estimating medical capacity to handle PanFlu. And that's why I'm making this rare post.
So more and more folks are asking me questions about how panicked they should be and my answer to them is, "Well...it's complicated." Because it is complicated! And it's honestly made more complicated by inconsistent and incorrect messaging that we're getting combined with the media trying to fill all 24 hours with COVID-19 coverage. No one is handling this well.
The main thing I'm telling folks is to have contingency plans, especially for the elderly and the immunocompromised, and to be prepared to start enacting them as early as this month. That doesn't mean start enacting them today, but just have a plan ready to go and be ready to implement it. Because right now we have a high case fatality rate for 70+ but here's the thing about CFRs - they are highly dependent on the level of care received. If we have early detection capacity, a vigilant and responsible population, and a strong healthcare system, that CFR can actually go down! As you lose any of these, the CFR will go up! And if you hit the critical point where we are in a resource-limited care paradigm (as in, we do not have enough of the critical resources required to treat people), that CFR is completely driven by the individual's response to the disease and all of the testing and population controls aren't going to do much.
We don't need to panic, but we also can't equate quarantining, hygiene, and maybe taking it easy for a month with panicking. It's just smart, population-wide measures to protect our more vulnerable sub-populations. Take this time to work on your cooking, make more phone calls, and catch-up on the movies you've missed. Listen to some albums you've never listened to. And monitor yourself for any respiratory symptoms and, if you have them, stay home, call an urgent care clinic, put on a mask if you have one and you have to go out, and isolate yourself for a couple of days. And DO NOT interact with the elderly or immunocompromised. Isolation means you are isolated - you have a room or a space and that is your space.
And yes I know this is not going to be easy advice for everyone, and impossible advice for a good portion of the population. The more you do your part to lower the exposed/infectious population, the more you're doing to protect the people who can't remove themselves from the susceptible population. That is the key - in a pandemic there is a susceptible (S) population, an exposed (E) population, an infectious (I) population, and a removed/recovered (R) population. The best way to stop a pandemic is to keep the Is away from the Ss. With some diseases, you also want to keep the Es away. This doesn't YET look to be one of those diseases. If you're showing symptoms, you could be an I and you should stay home. Isolate yourself. Call an urgent care clinic. That's it. If you have a known contact with someone then you're an E and you should self-quarantine if you can and be extra vigilant if you can't.
And honestly, don't let anyone tell you that this isn't a big deal. It is a big deal. It's not SARS, it's not MERS but it's also not the flu. Just be smart! And don't be afraid to ask questions! I don't have all of the answers but, you know, I can definitely handle the easy and medium ones.
Love you all! Stay safe.
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These are my opinions and thoughts and analyses - I am not representing any government agency or my company. More disclaimers on the main page.