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I arose this weekend morning thinking I would be going to “wake-up” tennis clinic, held at 8:30 A.M. every Saturday at Sun Oaks. I’m well aware of the calls for social distancing to minimize the risk of infection by COVID-19, but my attitude has been somewhat cavalier. I’ve been practicing social distancing myself to a certain extent, but my wife is an Assistant Principal at a local junior high school, and my daughter (who lives under our roof) works with the public all day long as a Shasta County planner. In general, I’m going to get whatever they get, so my attitude has been somewhat fatalistic.
My oldest daughter delivers babies at the Kaiser hospital in Roseville, where the first COVID-19 fatality in Northern California occurred. The levels of social distancing and personal/household hygiene she’s been advocating have struck me as Katie being Katie, even though I respect her professional expertise immensely. But last night she re-posted a Facebook post by a statistician and software developer—the CEO of a company that consults to companies like Google and Starbucks (in other words, a high-powered no-bullshit analytics guy). I read his post this morning, and I’m not going to tennis clinic. Instead, I’m adapting his post (which he encouraged sharing) to make it far shorter and more applicable to our community.
I’ll start with two take-home messages.
1. It’s already too late for this essay—ideally, it would have posted a week ago.
2. Start social distancing now, and do it aggressively, to the greatest extent that your circumstances permit.
Issue #1: We live where we live.
This is Shasta County. We’re a conservative community, and skepticism about analytics and academics is the norm. We’re inclined to view what we’ve been advised to do in the face of the pandemic by “so-called experts” as over-reaction. We’ll believe it when we see it. “The flu kills more people than COVID-19!” Or, “This is just another way to undermine President Trump!” If you haven’t heard these types of sentiments voiced, you’re already social distancing sufficiently, and this essay probably isn’t for you (but please read on).
Issue #2: Our brains don’t work the right way.
The reason that extreme social distancing feels like an overreaction is that most people overweigh the currently reported cases (there aren’t that many!) and under-weigh the math of how the virus is spreading, and where we’ll be in 30 days. We tend to think linearly, not exponentially. It’s the same reason many people don’t start saving early for retirement or understand compound interest. We’ll do a quick math exercise later to underline this, and if you’re thinking this essay is already dragging on, I encourage you to skip to that math exercise—it makes the whole point.
Issue #3: Maybe you don’t care about at-risk people.
We’ve all heard that the elderly and those with pre-existing conditions are most vulnerable, and indeed, one of the insidious characteristics of COVID-19 is that many people who have it are asymptomatic or have very mild symptoms. These people are carriers—the COVID-19 equivalents of Typhoid Mary. This gives some young people a sense of complacency—I’ve encountered many comments on social media to that effect. If that’s your thinking, I strongly encourage you to look at the now-ubiquitous “flattening the curve” graph above and gain an understanding of why it’s important to slow the spread of the virus, even if it’s a given that most of us are eventually going to get it. Unless you’re absolutely callous about the fates of others, you owe it to people who may need hospitalization.
But know this, “me-first” people under 60: A generalization is not an absolute. One of the eye-openers for me regarding this pandemic was watching video reports from Italian hospitals. Two things were apparent:
- When hospitals get slammed and overwhelmed, it gets ugly—extremely ugly.
- What the hell? Quite a few of those people on respirators are in their 30s and 40s!
Bottom line: If not you, someone in your family or close to you is at risk. But maybe you.
Okay, here’s the math.
There has been one confirmed case of Covid-19 in Shasta County. According to many epidemiologists, we can assume there were actually 10 times that many infected people at the time that case was confirmed on March 8, six days ago. Fifty times that number if you believe Harvard Medical School’s epidemiologists—but to be conservative, let’s stick with 10x.
The number of infected people doubles every ~3 days as the infection spreads. So take that conservative 10 infections and multiply by 2. Then do it again nine more times, for 10 times in total. You’re doing it 10 times to simulate where we’ll be in a month. It’ll take you 30 seconds to do the calculation on your phone’s or computer’s calculator, but I’ll save you the time. 2 to the 10th power is 1,024. Multiply that by the assumed 10 infected people six days ago, and in 30 days ~10,240 local people will have contracted COVID-19. At an estimated 2% mortality rate, over 200 people will have died…in the first month.
And remember, assuming that the one confirmed case 6 days ago was really the first, there are likely 40-80 people spreading it around town today—right now. Ten times that if we assume the earlier 10x multiplier (400-800), and 50x that if we go with Harvard’s estimate (2,000-4,000).
Divide 10,240 infected people by the population of Redding (~92,000) and you have ~11%. That’s the approximate percentage of people that you know personally who will have been infected 30 days from now.
Now take 15% of the 10,240 total infected people—that gives you 1,536, an approximation of the serious cases that will require acute medical care locally. Mercy Medical Center has about 270 beds, Shasta Regional Medical Center about 225. Total beds: ~495. And realize, those beds are not sitting empty now, and many will be needed over the next 30 days for other serious issues. Heart attacks, emergency surgeries, births, and other medical procedures requiring hospital beds aren’t going to magically be put on hold.
Too many patients, insufficient numbers of hospital beds, and a shortage of ventilators—the most serious problem of all—if we don’t immediately ramp up the social distancing. Major social distancing.
Yeah, I know.
Again, we live in Shasta County, which I sometimes affectionately call “Shastanistan.” We’re surrounded by people who just ain’t buyin’ it. They’re not going to do the social distancing thing. Maybe your job makes it impossible. Maybe your boss will tell you to get your ass to work or you’re fired. Maybe you’re self-employed, and you’ll go broke if you avoid people. Some of the people you know will mock social distancing. If enough of us do the social distancing thing diligently enough over the next 30 days, maybe the local impact of the disease won’t be as severe as the numbers we calculated. If that happens, those same people who benefitted from your diligence are going to call the whole thing a hoax, and call you a chump. Be an adult and don’t worry about that. Do whatever you can—the OCD hand washing and all. This is serious.
Lastly, I’m fairly handy with these sorts of analyses, but I don’t profess to be an epidemiologist or communicable diseases expert. The last thing I want to do is spread misinformation—there’s enough of that going around. If any medical experts read this and detect flaws in the argument, please weigh in.
(I thank Jason Warner of Bend, OR for the inspiration for and bones of this essay.)