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Oscar: Doc, what's ahead?
Me: An even bigger surge of COVID-19 pts arriving at hospitals.
Oscar: Sounds awful. Could a lot of people die?
Me: Yes, Oscar. Sorry to say it. The number of deaths is likely to climb dramatically.
Me: An even bigger surge of COVID-19 pts arriving at hospitals.
Oscar: Sounds awful. Could a lot of people die?
Me: Yes, Oscar. Sorry to say it. The number of deaths is likely to climb dramatically.
Oscar: Is this ever going to end?
Me: Yes. And the surge will peak and fall faster if we keep up physical distancing, & further intensify testing & tracing. Personal precautions also help.
Me: Yes. And the surge will peak and fall faster if we keep up physical distancing, & further intensify testing & tracing. Personal precautions also help.
Oscar: But what about the virus? Are we cooped up forever!?!
Me: Not if we do more testing/tracing, test widely for immunity, and act accordingly.
Me: Not if we do more testing/tracing, test widely for immunity, and act accordingly.
Oscar: But some models say this goes on and on!
Me: Well, if you construct a model based on current cases and a target level of pop'n immunity of x cases, you create a COVIDiotic tautology that punishes success.
Me: Well, if you construct a model based on current cases and a target level of pop'n immunity of x cases, you create a COVIDiotic tautology that punishes success.
Oscar: Why?
Me: Because there is definitely more background immunity than identified cases, and no one knows its level or how fast it's growing.
Oscar: And?
Me: So, if you don't factor that in, slowing the outbreak looks like it simply delays the needful climb to x cases.
Me: Because there is definitely more background immunity than identified cases, and no one knows its level or how fast it's growing.
Oscar: And?
Me: So, if you don't factor that in, slowing the outbreak looks like it simply delays the needful climb to x cases.
Oscar: Oh. Do people think like that?
Me: Yep. Saw someone attack @DFisman 's NYT model on that basis just last night.
Me: Yep. Saw someone attack @DFisman 's NYT model on that basis just last night.
Oscar: More please.
Me: Even the concept of a target level of so-called herd immunity is dubious. Growing background immunity dampens the spread, albeit in unpredictable ways.
Oscar: Epidemics can slow or stop unpredictably?
Me: Yes.
Me: Even the concept of a target level of so-called herd immunity is dubious. Growing background immunity dampens the spread, albeit in unpredictable ways.
Oscar: Epidemics can slow or stop unpredictably?
Me: Yes.
Oscar: So the models can be misleading?
Me: Yep. They're essential in the short- and medium-term. But the further out one goes, the more meaningless models become.
Me: Yep. They're essential in the short- and medium-term. But the further out one goes, the more meaningless models become.
Oscar: What about the people who say physical distancing slows the development of background immunity?
Me: They're right. But the alternative is a nightmarish and needless loss of life. Over-run ICUs, no proven drugs.
Me: They're right. But the alternative is a nightmarish and needless loss of life. Over-run ICUs, no proven drugs.
Oscar: So we need a controlled return to normalcy. Testing, tracing, fighting each flare-up, ideally w/ drugs that work to treat COVID-19.
Me: Right. And lots of immunity testing/certification.
Me: Right. And lots of immunity testing/certification.
Oscar: What about schools, colleges, universities?
Me: Kids and youth appear to get minimal clinical disease, But we do need to sort out how much transmission from them occurs to parents and grandparents.
Me: Kids and youth appear to get minimal clinical disease, But we do need to sort out how much transmission from them occurs to parents and grandparents.
Oscar: So lots more to do and learn, and a few very rough weeks ahead, but we will get through this, right?
Me: Yes, Oscar. This too will pass.
Me: Yes, Oscar. This too will pass.
