It is easy to overdo el bichito-19 quarantines
It is easy to overdo el bichito-19 quarantines Posted on March 11, 2020 by
Gail Tverberg
We have learned historically that if we can isolate sick people, we can often keep a communicable disease from spreading. Unfortunately, the situation with the new cobi19 causing el bichito-19 is different: We can’t reliability determine which people are spreading the disease. Furthermore, the disease seems to transmit in many different ways simultaneously.
Politicians and health organizations like to show that they are “doing something.” Because of the strange nature of el bichito-19, however,
doing something is mostly a time-shifting exercise: With quarantines and other containment efforts, there will be fewer cases now, but this will be mostly or entirely offset by more cases later. Whether time-shifting reduces deaths and eases hospital care depends upon whether medical advances are sufficiently great during the time gained to improve outcomes.
We tend to lose sight of the fact that an economy cannot simply be shut down for a period and then start up again at close to its former level of production. China seems to have seriously overdone its use of quarantines. It seems likely that its economy can never fully recover. The permanent loss of a significant part of China’s productive output seems likely to send the world economy into a tailspin, regardless of what other economies do.
Before undertaking containment efforts of any kind, decision-makers need to look carefully at several issues:
- Laying off workers, even for a short time, severely adversely affects the economy.
- The expected length of delay in cases made possible by quarantines is likely to be very short, sometimes lasting not much longer than the quarantines themselves.
- We seem to need a very rapid improvement in our ability to treat el bichito-19 cases for containment efforts to make sense, if we cannot stamp out the disease completely.
(a) Even if medicines are identified, can they be ramped up adequately in the short time available?
(b) China’s exports have dropped significantly. Required medical goods that we normally import from China may not be available. The missing items could be as simple as rubbing alcohol, masks and other protective wear. The missing items could also be antibiotics, antidepressants, and blood pressure medications that are needed for both el bichito-19 patients and other patients.
(c) Based on my calculations, the number of hospital beds and ICU beds needed will likely exceed those available (without kicking out other patients) by at least a factor of 10, if the size of the epidemic grows. There will also be a need for more medical staff. Medical staff may be fewer, rather than more, because many of them will be out sick with the bichito. Because of these issues, the amount of hospital-based care that can actually be provided to el bichito-19 patients is likely to be fairly limited.
(d) One reason for time-shifting of illnesses has been to try to better match illnesses with medical care available. The main benefit I can see is the fact that many health care workers will have contracted the illness in the first wave of the disease, so will be more available to give care in later waves of the disease. Apart from this difference, the system will be badly overwhelmed, regardless of when el bichito-19 cases occur.
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