UPDATE ON THE PANDEMIC 3/31/2020
Many of you are struggling to remain optimistic during the coronavirus pandemic. Our staff has spoken to many who are afraid of the disease, afraid for the health of loved ones, afraid of shortages in stores and pharmacies and confused by the news they receive from the TV and the internet. Confirmed cases of COVID-19 disease are going up dramatically and deaths are climbing. This past weekend, Dr. Fauci announced that the US could see up to 200,000 deaths related to COVID-19. (The picture of this pandemic has changed significantly because of the situation in NY.)
I understand your fears, but I remain optimistic for many good reasons which I will explain below. Mostly, I know what American doctors, scientists, and businesses can do when mobilized. If you want to call the pandemic a war, I’m confident we will win that war. Stock market analysts have called coronavirus a Black Swan event akin to the financial crisis of 2008. (Technically, a Black Swan event is something unpredictable and very low probability- this pandemic was anticipated by many- a topic for a future newsletter). The large number of infected patients, the strain on medical care systems, the need for regional lockdowns to stop the spread of disease have had a devastating effect on countries around the world and the worldwide economy. Unfortunately, it’s hard to know how and when the crisis will end, but there are clues as to how that will happen.
Fortunately, we also have White Swan events and they are, by definition, both certain and predictable. With the pandemic, we should expect a series of White Swan events to help us recover. Some have already occurred, and some big ones will be here soon. Here is my personal list of White Swan events and there will likely be more:
Test kits- The US went from a shortage to millions of kits in a matter of weeks. We won’t even use most of them because the initial ones (results in one week) will largely be replaced by 15-minute tests that can be done in any doctor’s office, like a flu test. These are coming soon. GAME CHANGER. Personal protective equipment and ventilators- This, I expect, will be another shortage to a surplus scenario. Businesses are stepping up and we will have enough soon. If we handle distribution properly, we should be okay very quickly. An experimental treatment for the disease- Clinical trials are underway to determine the safety and efficacy of a series of drugs. Remdesivir and Hydroxychloroquine have both been in the news and are being used. Yes, some patients who are critically ill will receive treatments now, but researchers will know as soon as 4-8 weeks which treatments show efficacy.
Another promising strategy is to infuse the antibody-rich blood plasma of recovered individuals into hospitalized patients in order to prevent progression to respiratory failure and the need for a ventilator. STAY TUNED. Rapid antibody tests- Knowing if someone has antibodies to the virus will be helpful to inform the decision to reopen the economy. These tests exist today and hopefully will reach the medical system quickly, just as test kits did once mass production began. While we don’t know how long antibodies to coronavirus will be active, we expect those with antibodies to be resistant to re-infection for at least some period of time. Knowing within minutes whether a person is actively infected or immune will make a big difference. A VERY BIG DEAL Summary The US and World received a knockdown punch but not a knockout.
The disease began in China and subsequently Iran, Italy, Spain and France have been devastated. They will face a difficult time for months. Here, in NYC and surrounding states, the medical system is facing an equally tough challenge. I believe the public health advisories and restrictions should help us see declining cases in many areas over the next few weeks. We need to be patient and maintain our isolation measures. If you have significant pre-existing conditions- stay at home, arrange for food, medication, and supply delivery. It takes 3-4 weeks, even with severe restrictions to see a difference in disease spread. The coronavirus task force called for a 15-day plan and the restrictions have now been extended to April 30th. The situation in NY, NJ and CT may mean we need a longer period of restriction, at least in some regions. I believe it will be the White Swan events that get us out of this pandemic.
The combination of adequate supplies, sufficient respirators, rapid tests, rapid antibody tests, new treatments and one or two things I have not anticipated (but will certainly happen), will beat this thing. I believe we will avoid having our hospital systems overwhelmed (there will be exceptions) and I believe we will find effective treatments and eventually a vaccine.
America is capable. If we work together, with a common purpose, we will overcome COVID-19