KNOWLEDGE, PRUDENCE, AND COMPASSION IN A TIME OF FEAR

Whenever you find yourself in a crowd running for your life, it is always a good idea to take a moment to sneak a peak over your shoulder and take stock of exactly what you are running from.  Now, there can be some risk to that.  Someone might get the drop on you on that last jumbo pack of toilet paper or case of Purell, but you might gain some perspective that keeps you from running yourself into a wall or a heart attack.

So let’s look at what we are all running from today: the Covid-19 virus.  It’s a nasty new bug that is as easily transmittable as everyday influenza and considerably more lethal.  In fact, so far it seems to be about 20x more lethal than the flu, but even that is a little misleading because it seems that only a small number of individuals under the age of 30 even exhibit symptoms, likely skewing the denominator by assuming virtually zero infections among that demographic.  Even as stated, though, the fatality rate is still about 1/15 that of even the recently improved death rate associated with Ebola.  And in the case of Covid-19, 80% of those positively diagnosed experience symptoms that do not require medical attention.  Not so for Ebola; nobody rides that out with a few days of Netflix and some soup.

So we have something that is considerably closer to a regular flu in its impact upon the health of infected persons than it is to Ebola.  But a whole region of China, much of South Korea and Iran and most of Italy is in lockdown.  SportsNet is facing a spring filled with nothing but darts and poker as the NBA, NHL MLB, MLS and NLS have all shut down their operations.  Mass gatherings all over Europe and North America are cancelled, and we are confined to our homes except as necessary to keep essentials in stock.  Borders are closed to foreign travelers, and air travel has ground to a halt.  Public school are even one-upping the private schools by extending their March Breaks out to at least three weeks, and the reality is that the school year might well be over.  Financial markets and oil prices have plummeted, economic activity has ceased, and businesses are busily planning the implementation of their heretofore theoretical business continuity plans.  How do we square that circle?  Are we finally coming face to face with the prophesied End Times?

Nope.  We are just a knowledgeable, prudent and compassionate people.  Knowledgeable enough to understand in detail the math and manner of pandemic contagion.  Prudent enough to try to slow the inevitable spread of infection to ensure that those few who do require hospital treatment to manage the symptoms of Covid-19 can be accommodated within the stretched capacity of our health care systems.  Compassionate enough to try to keep the infection out of the communities of medically vulnerable people, including the elderly, for whom the risk of severe complication and death are materially higher than for regular flu.  And we have knowledgeably decided that some short-term disruption to the global economy and our everyday life is a price worth paying for our prudence and compassion.

We have not always been so prudent and compassionate.  Through much of modern human history, knowledge of pandemic control strategies has been spotty, and even when available, expedience has trumped (pun, as always, intended) prudence and compassion.  The Spanish Flu of 1918 infected 500 million people, 25% of the world’s population.  Global statistics on the fatality rate are much disputed ranging from as few as 17 million to as many as 100 million, meaning somewhere between 3% and 20% of those that were infected.  The fatality rates are far greater than even the worst projections for Covid-19.

What made the Spanish Flu particularly nasty was that the fatalities skewed not toward the usual vulnerable populations of the very young and the very old, but to the strongest and healthiest.  It seems that its worst effects were the stimulation of the healthiest immune systems into a lethal overreaction.  99% of Spanish Flu fatalities were younger than 65, and more than 50% were between the ages of 20 and 40.  Covid-19 appears to instead be most dangerous for our oldest citizens, who are more inclined and thus far easier to keep out of circulation in the broad population, and leaves the youngest almost unaffected.

But these are facts that were unknown to even the most learned of Western societies in 1918.  Europe was in the midst of its Great War, and a flu was not going disrupt the critical war effort.  In many soldiers, the infection was mild enough to weather it out in the trenches, where they did so in relative isolation to protect the remaining healthy troops.  The sickest were not more carefully quarantined, but were instead shipped off in crowded transports back to civilian hospitals in Britain and France.  The application of even the limited knowledge of viral transmission of the day and a smattering of prudence and compassion could have saved millions.  But there was a war to be won, and individual lives were far less precious than they are today.

Stop running.  Take a breath.  No one is telling us to run for our lives.  We are being asked to be just sufficiently knowledgeable, prudent and compassionate to allow even those few for whom this viral illness presents a serious risk to have the best chance of the same good outcome that the vast majority of us will have if we do indeed become infected.  We are not cowering in the face of Divine Retribution; we are engineering a triumph of Enlightenment.

Wash your hands.  Stay home.  Be knowledgeable, prudent, compassionate, and calm.

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