How Do We End a Pandemic?

When I read my morning paper on May 4^th, three articles jumped out at me:

As Trump Pushes to Reopen, Government Sees virus toll nearly doubling

WASHINGTON — As President Trump presses states to reopen their economies, his administration is privately projecting a steady rise in coronavirus infections and deaths over the next several weeks, reaching about 3,000 daily deaths on June 1 — nearly double the current level.

The projections, based on data collected by various agencies, including the Centers for Disease Control and Prevention, and laid out in an internal document obtained Monday by The New York Times, forecast about 200,000 new cases each day by the end of May, up from about 30,000 cases now. There are currently about 1,750 deaths per day, the data shows.

Here’s Cuomo’s Plan for Reopening New York

Net hospitalizations for cases of Covid-19, the disease caused by the virus, must either show a continuous 14-day decline or total no more than 15 new hospitalizations a day on average over three days. The latter would probably be a realistic goal only in less populated areas.

• 14-day decline in virus-related hospital deaths, or fewer than five a day, averaged over three days. New York City and many other parts of the state have reached that benchmark, but Long Island and the Hudson Valley have not.

• A three-day rate of new hospitalizations below two per 100,000 residents a day, something that was well beyond the grasp of New York City and its suburbs on Monday.

• A hospital-bed vacancy rate of at least 30 percent, which Mr. Cuomo has said is necessary to be prepared for possible new waves of the disease in the future. Most parts of New York have met the threshold, despite more than 9,600 coronavirus patients still being hospitalized.

• An availability rate of at least 30 percent for intensive care unit beds; 3,330 people remain in such units, often on ventilators, which are needed in severe cases of the disease.

• A weekly average of 30 virus tests per 1,000 residents a month. This category could be the most challenging one to meet in many rural or more remote areas, where testing, and thus positive results, has lagged far behind major cities, like New York, which already is surpassing this goal.

• Finally, the governor also wants at least 30 working contact tracers per 100,000 residents as part of a program led by Michael R. Bloomberg, the former New York City mayor, who has given $10.5 million for the effort. Mr. Cuomo has described the initiative as “a monumental undertaking,” requiring “an army” of tracers, some of whom will be public employees who have been redeployed.

Billions Could Live in Extreme Heat Zones Within Decades, Study Finds

As the climate continues to warm over the next half-century, up to one-third of the world’s population is likely to live in areas that are considered unsuitably hot for humans, scientists said Monday.

Currently fewer than 25 million people live in the world’s hottest areas, which are mostly in the Sahara region in Africa with mean annual temperatures above about 84 degrees Fahrenheit, or 29 Celsius. But the researchers said that by 2070 such extreme heat could encompass a much larger part of Africa, as well as parts of India, the Middle East, South America, Southeast Asia and Australia.

With the global population projected to rise to about 10 billion by 2070, that means as many as 3.5 billion people could inhabit those areas. Some of them could migrate to cooler areas, but that would bring economic and societal disruption with it.

The parts of the world that could become unsuitably hot “are precisely the areas that are growing the fastest,” said Timothy A. Kohler, an archaeologist at Washington State University and an author of the study, which was published in Proceedings of the National Academy of Sciences.

All three of these articles made me think of the 1918-1919 Spanish flu pandemic. One third of the world population (then below 2 billion) was infected. The flu left about 50 million dead, especially impacting European colonies that have since become independent developing countries. Within the US, about 650,000 people died.

Newspaper image from 1918 about the Spanish flu

The pandemic, which overlapped with the end of WW1, occurred only about one generation (25 years or so) after scientists first discovered viruses.

It is unnerving that—like the Spanish flu—climate change could decimate the world population. Pandemics have an end, though. Once the number of cases reaches a critical level, the virus begins to decline. Climate change is not self-terminating (at least not on a human time scale). With no intervention, Earth will become yet another planet not suitable for life.

The 1918 pandemic reached its peak at one third of the global population (approximately 600 million). Since it struck so soon after the discovery of viruses, we did not have any of the modern-day technologies that we have now. There were no vaccines or medicines; our bodies’ immune systems had to produce antibodies with no outside help.

The main tool available at the time was social distancing, which was applied wherever possible. In the current pandemic, the virus spread too quickly for us to use our acquired scientific knowledge to curb it. We are once again relying mostly on social distancing. Now, though, almost the entire world is mobilizing to develop the tools that will limit further the spread of the virus. The goal is to end the pandemic by developing herd immunity. Israel has coordinated one such scientific mobilization.

Meanwhile, Sweden is trying to force herd immunity by closing its borders and limiting its social distancing measures to older citizens. The experiment is still in progress but it is costing a lot of lives. Sweden has the highest number of cases and deaths among the Scandinavian countries.

We still have a way to go before the end of the pandemic. Infectious disease expert Michael Osterholm has said we are only in the 2^nd inning of a nine-inning game. Nor is everyone taking the necessary actions. Within the US, the federal government seems more preoccupied with the economy and the November elections than with how to end the pandemic with the minimum number of casualties.

With regards to both climate change and viral pandemics, we must strive for a balance between preserving the economy and preserving life. This should not mean that some people must sacrifice their lives to save the economy.