Tuesday, March 24, 2020

Reversing course

For several weeks we have been trying to slow the spread of covid-19. Since it can't be eliminated the only way forward was to slow its spread sufficiently that the heath care system would not be overwhelmed. Some argued that the economic toll of a country-wide lock-down, which appeared to have worked in arresting the spread of covid-19 in China, would be so severe as to cause as many deaths as the virus itself. That at least made the possibility of trading off lock-down against business as usual less about death vs financial well being as about how many deaths each route might cause.
But slowing down the spread, while not leading to large numbers of fatalities, would still leave those who are most vulnerable at some risk, albeit ever smaller and albeit without having to worry about being triaged out of an ICU bed.

Perhaps we have been going about this the wrong way. The best defense is a firewall of immune people. And since we have no way of artificially creating immunity (vaccination), the only sure way of developing the antibodies is to get sick. So we need everyone who is at low risk to get sick (and recover) as fast as possible, so that they form an insulating barrier between those who are contagious (an ever declining number) and those who are most vulnerable.

The risk, of course, is that some we thought were low risk turn out to need hospitalization and we could precipitate the crisis we are trying to avoid. But as we learn more, this might be not only the fastest and therefore economically prudent way out of the crisis, it might also be the safest for all of us.
   


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