COVID-19: A Perfect Storm

I have never written an essay like this. I have never experienced a time like this.

The U.S. Surgeon General just stated that “It is going to get really bad this week”. He was referring to the COVID-19 virus, also known as the coronavirus.

Spare me 5 minutes of your time, while I share some facts with you.

40% of all Americans cannot afford an emergency $400 bill, according to a Federal Reserve report issued in May 2019.

According to the Kaiser Family Foundation, there were 27.9 million uninsured nonelderly Americans in 2018.

According to the Prison Policy Initiative, there were 2.3 million Americans incarcerated in 2019.

According to the Housing and Urban Development ‘s Point in Time Count in 2016, there were 550,000 homeless people.

There are many Americans who aren’t taking COVID-19 seriously. The beaches in Florida and Delaware were still open this past weekend, and thousands of people congregated there.

There has been a profound lack of COVID-19 testing available. I do not know one person who has been tested yet.

This one is important. It took two months to go from 0 cases of COVID-19 to 100,000 cases. It took two more weeks to get to 200,000 cases. It took 4 days to get to 300,000 cases. It took one day to get to 400,000 cases. (With thanks to a Bloomberg article).

Now give me 5 minutes while I “connect the dots”.

This past weekend (March 21-22, 2020), the United States had two consecutive days with the highest number of new COVID-19 infections in the world. The U.S. now has the third highest number of active infections, (35,000), even though we had under 100 cases a month ago. The number of new cases continues to increase every day. As I write this, today will be the third day in a row where the U.S. has the highest number of new cases of any country in the world (and the next highest country isn’t close)

The actual number of cases in the U.S. is much higher. There is a profound shortage of tests and testing capability. I don’t know anyone who has been tested yet.

There is also a shortage of appropriate medical equipment needed to treat this disease. Some states have already run out of masks, gloves, gowns, and most importantly, ventilators. The shortage of masks, gloves and gowns threatens not only patients, but also healthcare providers. If your physician gets sick, you don’t have a physician anymore.

You have hopefully heard the expression “Flatten The Curve”. What that means is that in order to decrease the spread of this virus, everyone needs to minimize contact with each other, wash their hands frequently, stop non-essential activities, and practice Social Isolation.

The challenge with that strategy is (go back to the beginning of this essay), almost half of all Americans cannot afford to miss one paycheck. That means that Americans feel economic pressure to go to work, even if that means that that work endangers their lives. Someone who is living paycheck to paycheck cannot afford to stay home for three months.

Someone who is uninsured, homeless or incarcerated (this is 31 million people, or almost 10% of our country) is not going to seek medical treatment, and is probably not going to be able to self-quarantine.

And worst yet, there are a lot of Americans who don’t understand how bad this is going to be, and aren’t practicing any preventive actions at all. Yesterday, the President suggested that we all go back to work, to minimize the impact of this on the economy. I wonder how many people will die because of that advice.

The fivethirtyeight website ( published an article on March 20th, which included epidemiologist predictions for the number of new cases in the U.S. in the next week, and the total number of fatalities in the U.S. Epidemiologists do this stuff for a living. They understand disease spread and disease fatality.

They interviewed 18 epidemiologists. Four of them estimated at least 500,000 U.S. deaths, and one estimated 1 million U.S. deaths. One of them provided a worst-case estimate of 6 million U.S. deaths.

The United States has gone from one case on January 20, 2020 to over 40,000 cases today. The last three days, there have been over 5,000 new cases every day. This is not the flu. This virus is more contagious than the flu, and it is much more deadly than the flu.

If this virus spreads to even 10% of the American population (and that may be a conservative estimate), 35,000,000 Americans will catch it. This virus is predicted to have (approximately) a 3% fatality rate (although over 4% of infected patients have died, on the website I use for tracking).

Do this math: if 35,000,000 Americans catch COVID-19, and it has a 3% fatality rate, then over 1 million Americans will die from it.

These are catastrophic numbers. The United States does not have the capacity to treat 35,000,000 patients with the virus. (I would argue that we may not have the capacity to treat 1,000,000 patients, given the isolation and ventilation needs that these patients have).

I may be wrong about this. I may be making a mistake by thinking that these numbers are realistic. But I would rather be wrong about that, and laugh about my mistake later, than make a mistake about the gravity of this virus, and die from my mistake.

Someone I know is saying “you can flatten the curve, or it will flatten


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