Good news and bad news

First, the bad news. Here is an epidemiological paper from Imperial College London that has been making the rounds. They base their conclusions on their models, which they claim are robust against modest changes in their assumptions. See also this profile of the principal author.

They say if we take sufficiently draconian measures to get the reproductive rate below 1, we have to do so nation-wide and for at least two months. And then after we relax those measures, we will have a nearly identical epidemic a few months later, because our population will still have almost no immunity. (They recommend paying close attention to what happens next in China and S. Korea.)

If we just “flatten the curve” with moderate measures, there will still be enough cases to overwhelm our health care system and result in hundreds of thousands of deaths.

The middle option is to institute draconian measures whenever a certain number of ICU beds fill up, and then relax them when those beds become free again. This would result in a series of manageable peaks, with draconian measures in place around half the time.

This is pretty much where we are until the summer or fall of 2021.

That is my interpretation, anyway. Read it for yourself.

The reason for this dire conclusion is the lack of any effective treatment or vaccine. New pharmaceuticals take time, first because you have to make sure they are safe and second because you have to ramp mass production. And that’s without even considering long-term side effects; e.g. what if remdesivir causes cancer?

Enter the good news.

HCQ is hydroxychrloroquine, aka. Plaquenil. It is an anti-malarial that has been around for more than 50 years, and early results both in the lab and in people suggest it is effective against COVID-19. It is impossible to overstate the importance if this is true.

Make no mistake; this is a serious drug with unpleasant side effects. But those side effects are largely temporary. Most importantly, we know what they are (even long term), we know their incidence, we know how to mitigate them, and we know all of the risk factors.

We will avoid disaster if we can prevent the ICUs from filling up. If there really is an existing, widely available drug that is even 70% effective, this whole thing is going to be over in a few weeks.

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