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COVID-19 and All of Us

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a tiny sprout

This isn’t the usual brand ‘our response to COVID-19’ post. It’s not about Plato at all. It’s about all of us.

At times like this, even smart, well-informed people can operate under unrealistically optimistic models of what’s about to happen.

As is our way, we’re here to offer a science-and-reality-based ‘plan for the worst, hope for the best’ perspective. This is based on the information available as of 3.20.20, and, of course, the future remains unwritten.

Top line

We all have trouble envisioning catastrophe. Even if we can really picture a total disruption of life as we know it, we have a lot of trouble picturing those effects really reaching us personally.

This tendency leads people to select for optimistic information and to add a little extra-rosy fudge factor on top, resulting in some poor planning and bad decision-making. This is called optimism bias, and it stands between us and seeing the world as it is.

How seriously were you taking your bug-out bag a month ago? Does it seem that unnecessary now?

We’re not anti-optimism, and there’s a lot to be optimistic about (we saved that for the end), but when you plan, be pessimistic about what’s about to happen. Best case, you wasted some effort. Worst case, you’ll be in a position to help people who need it when the time comes.

It may seem premature, but think about who you want to be and what you want to do in the world we’ll have when we all begin again, maybe as late as next fall.

Use this time to plan or even start your journey towards being that person, and doing that thing.

This could take 18 months

Almost everybody we’ve talked to recently has said something that indicated they envisioned things going back to normal anywhere from two weeks to two months from now. That could only be based on wishful thinking.

What’s going to bring about a real end to this? Herd immunity — herd immunity through a widely-administered vaccine or through a sufficient quantity of the population contracting and recovering from the virus. The problem with the latter is that we don’t know that you become immune after recovering, or if you do, for how long.

So to be sure, this will end when there is a vaccine deployed widely. That’s likely to be 18 months in development before it goes into mass production, then who knows how long before it’s deployed widely.

Yes, but China implemented social distancing in Wuhan and they had zero transmissions yesterday. The lockdown in Wuhan and what we’re doing here have nothing to do with one another. They have brought to bear all the force and tracking capability of the world’s most sophisticated totalitarian surveillance state, we have this going on. It won’t be the same here, and they may be headed for more trouble…

Yes, but once we get it under control, it’ll be ok to come out, right? Until there’s a vaccine, even if we get transmissions under control, as soon as we all come outside, the infection rate will begin to grow exponentially again.

Yes, but there is a vaccine moon-shot going on now — it probably won’t take 18 months right? See optimism bias, above.

Given the best understanding we have now, it will not be safe to resume normal life until we have herd immunity.

Social distancing is meant to ‘flatten the curve’, not solve the problem.

‘Flattening the curve’

There’s been a lot of misunderstanding about this idea, so here it is in a nutshell:

We do not have enough hospital beds, ICU beds, medical staff, PPE, or ventilators to support the number of people who are about to need them. As is happening in Italy as you read this, so, too, will our US medical professionals be required to choose who among many patients gets lifesaving care and who must be allowed to die. Planning for this scenario is already underway in Washington state.

The goal with social distancing is to reduce the rate of transmission such that the number of concurrently sick people is closer to the number of people our medical system can save.

Regardless of how successful we are with that, many, many people will die. If you haven’t accepted that idea, do so now so you don’t have to confront it for the first time as it’s happening. Panic is bad for your immune system and for the people you love.

You are personally at risk

Yes, but people under 60 aren’t really in jeopardy anyway. This is wrong. Unless you’re under 10, you can die from this disease, especially if you’re unable to get the care you need because the system is swamped. Even if you don’t die, you could be left with permanent disability from your illness.

You could easily end up hospitalized, anyway. So far, 40% of people hospitalized with CV in the US have been between 20 and 54. Even if you’re entirely selfish, you don’t want to go to the hospital ever, much less right now. Don’t take a bed from someone who needs it.

You can bring it home anytime

Lots of our conversations have revealed that the people think that if they quarantine themselves, they’ll never get sick. Unfortunately, no quarantine is perfect, and every contact with the outside world is another chance to bring home the virus. Disinfect your groceries and watch out for surfaces everywhere you go.

If you’re young you’re likely to contract the illness asymptomatically, which means you could unknowingly bring home CV on a weekend visit and infect everyone in your household.

Fewer is more

For that reason, you should have as few people in your household unit as you can. Since intra-household transmission is likely, think of the infection risk for every individual within a given household as the sum of the risks to every individual if they were alone.

When — not if — the hospitals fill up, it may mean that infected individuals who do not need the most urgent care are sent home to recover. The more people you have in your shared living situation, the more you’re coming home to if that happens. If it’s possible, stay in the smallest groups you can. Yes, it’s lonelier.

Yes, but my prospective guests have been asymptomatic for two weeks. See above — your guests could very well be infected and asymptomatic now. Or they could have picked up the virus on their clothing on the way over to your house. Don’t have guests over.

Don’t be a selfish martyr

‘We’ve all gotta die sometime!’ is not a good reason to ignore warnings and likely contract the virus.

Unless you have a standing order to refuse emergency services, a DNR, living will, all that, such that you won’t even end up in an ambulance if you become seriously ill, you’re going to take a bed from someone who doesn’t share your cavalier attitude, and you’re going to risk an unprotected healthcare worker’s life with your infection.

If you tut-tutted at those kids partying on Miami beach the other day, realize that it’s not a huge leap from that to you granting yourself license to do something risky because you feel that the risk you’re taking is only to your own health. We’re a herd, and we’re in this together.

This is analogous to ignoring an evacuation warning before a storm because you think you’re not afraid to die or that it won’t be as bad as they say. You do something risky and get sick now, you’re that guy on his roof expecting an EMT to airlift him out after a hurricane. Don’t be that guy or gal.

What you can do

Pretty much a big bummer so far, right? It’s not all bad.

First of all, if it wasn’t clear before, stay home. Isolate. Just do it. This is the hard part, and it may be all you can do, but you can do that. Just do it.

Find someone to help. Odds are, though, that you can help someone near you. Do you have an elderly or at-risk neighbor? Offer to dead-drop groceries for them at their front door next time you’re going (and tell them to disinfect them before bringing them inside).

Don’t stress. Of course this is easier said than done, but take solace in knowing that by staying home, you’re doing your part. Exercise, cook, treatchoself, video chat nightly with friends, start new hobbies, and don’t give stress a part in your life. This isn’t your fault and it could end up having a huge silver lining (more below).

Support small businesses. If you can avoid it, don’t shop at Home Depot or big chains or even Amazon. If you can afford it, buy gift certificates from your local bars and restaurants to help them stay afloat, and if you can really afford it, don’t redeem them when the time comes. Take-out is safe if you’re careful with the outer container, and it’s a great way to help your favorite local businesses survive this.

Donate. Food banks, shelters, you name it, they’ll need help.

Dream of things with bigger impacts and share them, with specifics. Citizen inventions have made a difference during wartime before. Just because you’re not a doctor or a scientist doesn’t mean you can’t change the course of this thing.

Correct optimism bias. Be that person. Don’t let people plan for a week when you know it’s going to be longer. Do it in the way most likely to reach them, but help people plan for reality so they’re not caught unprepared later.

Open up. Don’t be afraid to tell others you’re afraid. Ask for help. Be vulnerable and be open about being vulnerable — it will help everyone else feel better about feeling the same way.

Sow seeds, literally and figuratively. Just a few days ago was the first day of Spring (a day early this year due to a technicality about leap days and such) — literally plant a ‘victory garden’ so come summer and fall (and winter if you jar or pickle) you can have a supply of fresh produce to supplement your pantry and reduce your shopping frequency or maybe share with neighbors. Plus, gardening is a soothing and rewarding activity.

Figuratively, sow seeds and stockpile plans for the future. The world will be different when we come out of this. It’s different already. The economy will be different. Priorities have changed. A lot of that will be for the better.

People are already far more concerned with one anothers’ well-being, even that of strangers. This is like the alien attack in Independence Day or Mars Attacks or Invasion of the Bodysnatchers — it’s going to bring us all together at a time we really need it.

The air is pristine in LA and soon it will be all over. We’re all getting loads of QT with the people in our households.

It may seem premature, but think about who you want to be and what you want to do in the world we’ll have when we all begin again, maybe as late as next fall.

Use this time to plan or even start your journey towards being that person, and doing that thing.

This is a (hopefully) once-in-a-lifetime opportunity to ‘hard reset’ our society, our economy, and our individual lives. Let’s not waste it worrying about the future we lost last month. Be honest — it wasn’t looking that great anyway.

Be good to each other,

Plato

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