Flattened curves and mandatory masks
WHETHER WE like it or not, we are fighting a losing war against the new coronavirus. But as any military strategist will tell you, the goal in fighting such a war is not to suffer too many losses or lose too many battles. Whatever the outcome, the Ministry of Health and Wellness and the Government of Jamaica will come out looking badly.
COVID-19 will cause significant deaths, and fighting the virus will cause untold hardships and economic disaster. It is a delicate balance that must be maintained in the approach to COVID-19. Without any vaccine or viable treatment on the horizon, there is only one option to prevent thousands of deaths. We must flatten the curve. It is this approach why we have lockdowns and the tan-a-yuhyaad approach. But what is this curve that we are talking about?
In any epidemic, there is an initial stage where there is a slow growth in the numbers of cases. Then as more people get infected and they expose more people to the virus, there is an explosion in new infections. The numbers take a shorter and shorter time to double as the number of carriers of the virus increases. This continues until there is a peak in the number of persons infected. At this point, the carriers of the virus encounter less persons who lack immunity to the virus because so many people have already contracted the disease and built up resistance to it. So at the beginning of the epidemic, one may transmit the virus to 10 people because none of the ten have any immunity.
HERD IMMUNITY
At the peak, maybe five out of that possible 10 people have contracted the disease already, so only five new persons can contract the virus versus the initial 10 at the start of the outbreak. The number of people who can get infected decreases, and the number of new infections therefore begins to fall.
Persons who were lucky not to get infected during the rapid rise in cases are safer, because less and less people are around them who can infect them. This is called herd immunity. When enough people in the herd or population contract the disease, the virus runs out of new people to infect. The number of cases dwindles until the virus dies out and the epidemic is over.
Our hospitals will admit and care for approximately 15 per cent of those infected with COVID-19. About six per cent of the infected will require care in the intensive care unit (ICU). What we have seen in other countries is that the number of people dying is initially small, until the ICUs get full and the hospitals cannot care for everyone. Those who cannot get a space in the ICU are left to die or get lucky.
If a large number of people get infected all at once, then it becomes 15 per cent of a large number that will need care in any instance. Many will not make it to the ICU and the death rates will skyrocket. We understand that for the epidemic to die out, a large number of persons must get infected to build up herd immunity. So, the ultimate goal must be to allow the epidemic to progress, but to space out the infections so there is no spike in ICU admissions and the associated increase in deaths. That is the idea of flattening the curve.
The less persons you are exposed to, the less the chance of you contracting the disease or spreading it to others. That is why we must limit our contact with others. With less persons being in close contact, the rate of spread of the virus falls, and we space out the infections so that we don’t get a large number all at once to fill the hospitals.
A DIFFERENT CURVE?
So why don’t we just lock down the country and stop the infection from spreading and be done with it?
My theory is that the Ministry of Health is looking at a different curve from the one we are being told to watch. The Government knows that locking down the country and restricting movement completely will be a death sentence for so many of the poor who can’t afford to stockpile food or have any means of earning to buy food and medicine.
While we are tempted to think about ourselves, we cannot ignore the hundreds of thousands of Jamaicans who go to work to earn a daily wage to buy enough food only for that day. There is no way they can be cared for during a lockdown. The civil unrest that would be caused would be unmanageable by security forces already stretched to the breaking point.
A lockdown, as perfect a solution as it may seem, is bitter medicine. The prime minister, haunted by the ghost of bitter medicine near a general election, will not come out and say it. But it is what it is.
The ministry is therefore left with a novel approach. Use a different curve rather than the number of COVID-19 infections. Whether they want to admit it or not, they are looking at the curve showing the number of admissions to hospital and the number of deaths.
As it is right now, despite the rapid increase in number of infections, there is still not a significant increase in the number of persons being admitted to hospitals with respiratory infections.
Meaning, more and more people are getting COVID-19, but there are not many people getting the severe form of COVID19. When more people begin to crowd the hospitals and more deaths are recorded, only then will the extreme measures be implemented.
It is this delay that will allow the younger persons, for example, call centre workers, to contract the disease and build up immunity while not burdening the hospitals.
DEATH CURVE
We are still in the early stages of this death curve, so it is really this curve that we are attempting to flatten. Of course, no government will come out and say not enough people have died for us to close down the country. That would be political suicide. We the citizens have to flatten the death curve by protecting the vulnerable members of the population that will cause a spike in deaths.
Quarantine our older persons and those with chronic diseases.
Extreme social distancing must be practised in their case.
If we won’t lock down, then slow the progress of the disease by making the wearing of face masks mandatory.
We cannot afford to half-step and guess at a time like this. Close down the call centres. Even if there is no conflict of interest between call centres and senior members of the Cabinet, ‘it stink out a road’ that this is the reason why they are being kept open, despite the surge in numbers being attributed to them.
The appearance of corruption, whether real or not, will not add anything to the fight against COVID-19 when you require the full cooperation of the public to fight the epidemic.
In the end, it is us the citizens who have the power to soften the losses in this war, not the Government. Let us, for once in our history, forget about the divisions of class, colour or political party and come together to flatten whatever curve is prioritised by the Government. Be it the number-of-infections curve or the death curve.
Come on, Jamaica! We love to cheer for our national teams, let us create a team for the world to cheer for!