My Coronavirus Lightbulb Moment: It's When, Not if
This is in one sense blindingly obvious and implicitly understood, but in another sense something I only properly consciously clocked today. This piece may seem callous and uncaring: I realise I am talking abstractly about that which refers to real people and real deaths, and my intellectualisation may seem a little distant from emotional reality.
Just in case you were in any doubt, these precautions we are all experiencing ([self-]isolation, shutting down of society) are not about us not getting coronavirus (CV). They are about when we get it. Yes, this is about flattening the curve to take the strain off our healthcare systems. But, implicitly within this, I guess I have always subconsciously thought that there was an intention to stop people getting CV, period.
In reality, of course, they "merely" don't want us all to get it at the same time, but to spread it out and delay cases until a vaccine comes about or a herd immunity is developed. But I guess we'll all be directly touched by CV at some point. This is not to stop us getting it, period, unless you personally remain in lockdown forever.
In other words, if you are in the vulnerable or extremely vulnerable categories, you will remain in these categories after the main period of this pandemic passes. You will have just as much chance of dying from this disease in six months time as you do now.
As my friend asked when I announced this elsewhere:
So where does that leave the vulnerable? Those with COPD? Will they have to remain isolated for the (approx) 18 months that it will take for a vaccine to become available? Because even with a flattened curve and a fully prepared health service those people will still die in droves.
I said: yup, I guess so. He replied:
Well that's depressing. It will certainly mean that my children won't see their grandparents this year.... [A]nd the longer we go on, the more that become immune, the greater the risk of complacency amongst the vulnerable as society returns to normal.
This appears broadly correct.
What we are doing is playing around with when people die in order to stop them dying as a result of hospital overcrowding. Those who would die from CV now in a hospital under capacity are just as likely die later if they were to get it in, say, six months, or a year. Either herd immunity or a vaccine are required for this these people (arguably including me) to feel somewhat safe going forward, where herd immunity is defined as:
...the resistance to the spread of a contagious disease within a population that results if a sufficiently high proportion of individuals are immune to the disease, especially through vaccination.
We can see that vaccination is still arguably a vital component of herd immunity.
The only mitigating factors that I can think of off the top of my head is whether the strain is more virulent now or the manner in which it is caught in high volume cases makes it more virulent somehow (?); and again, whether some kind of herd immunity can help inoculate vulnerable people over time. Furthermore, the more people having had the virus, then there is less chance of other people catching it if the pool of those with its and even without it is smaller. This last point may have a big impact, though it still depends on mutation rates and whether people gain proper immunity or can get it again.
This means that, as stated by my friend, when the worst of this "passes", the old and vulnerable amongst us will need to remain in isolation or social distancing for perhaps 18 months.
Underlying health conditions
Every single person, short of hospital complications, malpractice and so on, who dies from coronavirus has underlying health conditions (UHC). Sometimes it gets reported that x% of the deaths had UHC, the rest normal. This can be misleading: UHC are, for many people, unknown. You may know, for one reason or another, that you have a heart defect, or asthma, or whatever. Likewise, you may not. Your chance of dying from CV sits on a digital scale, but also on a longer continuum from definitely going to die given scenario A to just about dies (where if A was marginally changed you would not) down to definitely wouldn't die, and everywhere in between. So you will either die or not, but the amount you would have to change the scenario A in order not to die, or to die, would vary considerably (I hope my explanation makes sense!).
So there will be an awful lot of people who are in the vulnerable category who won't know it and who, when the worst "passes" won't know that they are in for a shock. You and I and our friends and family could be those people.
So when this thing gets over the peak and is back down around the foothills, if there is still no vaccine, things will likely be no safer. This virus is equally deadly to an individual (external issues aside) no matter what stage of the curve you meet it on.
Beware, my friends and interlocutors, beware. I'll try to be happier in the next piece...
Stay in touch! Like A Tippling Philosopher on Facebook:
A Tippling Philosopher
You can also buy me a cuppa. Please... It justifies me continuing to do this!