Society is struggling on two fronts, both for social justice and at the same time to control a raging epidemic. The epidemic of COVID-19 may be with us for a long time — and those who try to minimize it are doing so by placing front-line workers and economically disadvantaged populations at risk.
I have been asked by many if I am on the side of the far right, whose narrative trivializes the dangers of this virus, or the far left, who advocate for a protracted closure of the economy and non-ending monetary payments to the entire nation. My answer is: If I had my way I would be on the side of the virus, since it is winning. We are divided.
We need to unify around sound leaders. And we need to suspend false narratives, both the belief that the virus is not dangerous, or the opening of the economy is not a priority. Both are untrue.
I have witnessed the narrative changing from “The virus is in China, it will not affect the United States,” to “The virus is just in the Northeast United States, Kentucky does not have to worry.” And finally, “It is in Kentucky; maybe Louisville will be hit hard, but other areas are safer, and we can do things differently there.” But now Bowling Green and Warren county have the second-highest number of cases in the state, only less than our most populous city, Louisville.
And then there is the false narrative that it is safe to let this virus run rampant through our entire population and eventually burn out, quoting the “scientific fact” of herd immunity. However, the virus is far too infectious for that, and the duration of immunity is uncertain at best.
In January, presidential adviser Peter Navarro compared the infectiousness of this disease to that of smallpox, which has an R0 (pronounced R naught) between 5 to 7. This means that one infected person will infect five to seven people. The R0 without any mitigation, such as social distancing, for the COVID-19 virus is estimated to be 5.7. At this level, more than 80 percent of the population would have to be immune before herd immunity would even start. A pathogen’s R0 must be below 1 for an epidemic to burn out.
The argument that this virus is similar to the flu is retorted by the makeshift morgues that were in New York and the horror stories told by health-care workers. We may never know the true toll. In almost all epidemics, governing institutions tend to minimize the size by using questionable statistical or counting arguments.
With a coronavirus, natural immunity may only last for one to two years, and recent studies out of Sweden and Los Angeles found a lower level of immunity in the community than expected. We have high hopes for a vaccine, and if all goes well it may be 12 to 18 months away.
However, vaccines often take a decade to develop, and already a second strain has developed that affects the virus attachment spike, which may well necessitate modifying vaccine production. We must ask, how many iterations of infections can a person and our society withstand? Not only from death, but from the lasting disability which can develop from damage to lungs, heart and other organs?
We are opening our economy, but we need to do so safely, and we need to learn to live with this virus. That means wearing masks in public and in stores, social distancing and protecting, not fighting others.
And do not point to Sweden to ignore public-health guidance. Even in Sweden, social distancing is encouraged with a ban on gatherings greater than 50 people, and government support is being provided for impacted cultural and sporting institutions. Tables in restaurants are six feet apart, nursing homes are closed to visitors, high schools and universities are closed, and people are encouraged to work from home. Travel has voluntary decreased in Stockholm by 75 percent. Over Easter, travel voluntarily decreased by 90 percent. In the United States, we could not get 90 percent of us to agree on anything.
While we fight for social justice, it is imperative that at the same time we need to slow the spread of this virus, so our technology and vaccine development can catch up. If we do not come together as a nation and confront this epidemic with a coherent unified voice and strategy, the human species may well have an R0 of less than 1.
Kevin Kavanagh is a retired physician from Somerset and chair of Health Watch USA.
