It’s too late?

I want to start with a sobering thought. It’s too late to contain this pandemic. I’m watching the news as slowly more and more states in the US issue versions of “shelter in place” or “stay at home” orders. But I think in most cases, it’s too late. The virus has probably already spread so much that self-isolation won’t be nearly as effective as it would have been had the states issued the same orders a week or two earlier. That said, it’s most likely still better than doing nothing.

Human beings at times are lousy with risk analysis. If a risk is immediate, we can react well, but the longer it stretches out or the further away it is, the harder it is to get people to react. Almost any climate scientist who has studied anthropogenic global warming has known for a decade or more we have a problem and we have a very quickly narrowing window for solving it, and the longer we wait, the harder it will become.

Yet too many of us put off the problem for another day.

So it is with the Covid-19 virus. “Oh we don’t have to lock down just yet, let’s wait another day.” And I’ll admit, sitting in the state that is the center of the virus outbreak here in the US, I’m tempted to say, “25,000 isn’t TOO bad, we can manage that.”  But that’s the lizard part of my brain reacting. It’s the emotional part. Then I kick in the rational part. If we use one of the numbers bandied about, doubling every 4 days, that means by this weekend, in New York State alone, it will be 50,000. By April 1st, 100,000. By the end of April, it could be the entire state.  Those numbers are hard to comprehend.

That said, I’m also hopeful. Modelling pandemics is pretty much pure math, but reality is more complex and often luck can play a huge factor. Let me try to explain.

First, we need to heed the words of experts like Dr. Fauci and others who are basing their remarks and recommendations on the inexorable exponential rise in expected infections. They are giving basically the worst case scenario if their recommendations are followed. And that’s proper. That’s really what you have to plan for.

Let me take a little side trip and mention a cave rescue in Vermont several years ago. By the time I had gotten the call to show up and to call out other rescues, the injured party had been in the cave for several hours. I didn’t know much about the extent of their injuries other than it was a fall and that it was in a Vermont cave, which almost certainly meant operating in tight quarters. I grabbed a box of Freihofer cookies, a lawn chair (my fellow cave rescuers will understand the reference), a contact list of other potential rescuers, and my son. While I drove, he’d read off a name and I’d say “yes call” or “Nope, next name.”  On the hour plus drive to the rescue we managed to contact at least two other people who could get there. (It turns out, as I surmised, several of the folks I wanted to call were members of the original caving party.)

Once there, my son and I were driven partway to the cave entrance and trudged the rest of the way. I talked with the folks on the scene to gather information and then dressed to go into the cave to gather first hand information. I still hadn’t gained too much information other than to know it was potentially shaping up to be a serious rescue. The person had been climbing a cable ladder when they fell and injured themselves. This meant, based on the information at hand, a worst case scenario of an evac through tight passages with the patient in a SKED stretcher.  I was playing the role of Dr. Fauci at that point, preparing for the worse based on the information I had.

Fortunately, literally at the moment I was about to enter the cave, one of the members of the original caving party crawled out and said, “he’s right behind me, he’ll be out in a minute or so.”  It turns out his injuries were fairly minor and with the members of his own caving party, he was able to get out of the cave under his own power.

I got back to Incident Command about an hour later and was informed, “oh, by the way, you’ve got at least 3 cavers who showed up to help. We held them at the bottom of the road. What should we tell them?”  My answer was simply, “Thanks and to go home.”

I relate this story not so much to talk about cave rescue specifically but to point out that even when planning for the worst, you may get a lucky break. But you can’t rely on them. Let me give an alternate scenario. Let’s say I had not called out the other rescuers and had gotten to the cave and crawled in, realized the situation was a worst case scenario, crawled back out and then initiated a call-out. It would have at that point probably meant at least an extra 90 minutes before the extra resources would have been on the scene. It would have meant the patient was exposed to hypothermic condition for another 90 minutes. It would have meant 90 more minutes of pain. It would have meant fewer brains working to solve the problem.

Getting back to Covid-19. Will we get lucky? I don’t know. I actually suspect we might. One “advantage” of an increasing population of sick people is we can better model it and we can also perform more drug trials. We may discover certain populations react differently to the disease than others and be able to incorporate that into the treatment plan. I don’t know. But I do know, we need to plan for the worst, and hope for a bit of luck. In the meantime, hunker down and let’s flatten the curve.

And if you’ve read this far and want to know how to make some pita bread, I’ll let you in on the two secrets I’ve learned: VERY hot oven (I typically bake mine at about 500-550F for 2 minutes on 1 side, and 1 minute on the other) and roll it out thinner than you might think.