Covid-19 Missive Three, March 14th

We are in a very painful but maybe still can-I-please-have-a-tiny-bit-of-hope stage of this epidemic.

Travel mattered before, but now it’s irrelevant – it doesn’t matter where you’ve been – it’s in your neighborhood or next door (so stop, for heaven’s sakes, saying “we don’t need to cancel basketball b/c there’s no cases here.”).

There were few tests, and strict criteria, but now there’s more tests, and less strict criteria, and gradually more testing centers.

The information you received last week is now out-of-date, so: call again.

It feels like chaos, but what it is is that the procedures we were using last week are now changed, based on the evolving science.

So far there are 138 cases in Massachusetts, up from 123 yesterday. Ten are hospitalized – a decent ratio for now. But a number of people are hospitalized with concerns for C-19 and their test results will come out in the next few days – expect a spike.

The Boston hospitals are working all-day-all-night to try to learn from the lessons in Italy and China and Iran. They are coming up with copy-cat ideas (drive-through testing like Korea) and innovative ideas (testing centers in HazMat facilities). They are thinking hard about protecting health care workers – not just protective equipment but actually limiting physician/nurse exposure with virtual visits, delaying all but crucial surgery, getting a CT and then getting results by phone, etc etc etc. We live in a miraculous medical megalopolis and some of the greatest minds (and funniest) are seriously working on these issues. We need to #savethedocsandnurses from the horrible deaths of health care workers we’ve seen in the other countries.

Here is my message for you, and it is an increasingly dim one:


To quote my darling Kerry Reynolds quoting someone else:

Here are the answers to your questions:
Do you take that trip? NO, you cancel
Do you go to swim lessons? NO, you cancel
Do you go to a playdate? NO, you cancel
Do you do anything with other people? NO
Do you go to that restaurant or bar: No, for the love of god and all your friends who are doctors and nurses and techs and security guards in the front lines: NO please for the love of god GET TAKE OUT for god’s sakes

You still have time to really STOP the spread (hopefully we do too which is why schools are closed, all non-medical non-critical personnel should working from home, and all events with more than two consenting adults should be cancelled). Another physician put the actual numbers on paper. The average number of people each individual person infects is 3. Here is the math:

1 - YOU
3 – Those you infect
9 - Those they infect
27 - Those they infect
81 - Those they infect
243 - Those they infect
729 - Those they infect
2,187 - Those they infect
6,561 - Those they infect
19,683 - Those they infect
59,046 - Those they infect
177,147 - Those they infect
531,441 - Those they infect

We are deeply deeply afraid we will be like Italy where hundreds of people die per day and they reportedly look at a person’s age to decide whether they get a ventilator. Please, please stay home and protect us all.