Reconciling the incompatible: numbers, humans, and COVID-19

It can become overwhelming as one looks at the images of coffins laid out in various venues, listens to exhausted health care professionals, and sees body bags being loaded onto vans while reading stories about the people who have been hospitalized and/or have died.

In this sea of information, it’s easy to forget that COVID-19 is one in a long history of pandemics. For the sake of brevity, here’s a mostly complete roundup of the last 100 years. The H1N1 pandemic of 1918/19 resulted in either 17 million, 50 million, or 100 million deaths depending on the source of information. The H2N2 pandemic of 1958/59 resulted in approximately 1.1. million deaths; the H3N2 pandemic of 1968/69 resulted in somewhere from 1 to 4 million deaths; and the H1N1pdm09 pandemic of 2009 resulted in roughly 150,000 -575,000 deaths. The HIV/AIDS global pandemic or epidemic, depending on the agency, is ongoing. The estimate for HIV/AIDS-related deaths in 2018 alone was between 500,000 – 1.1 million.

It’s now clear that the 2019/20 pandemic will take upwards of 350,000 lives and, quite possibly, many more lives before it has run its course.

On the face of it, the numbers for COVID-19 would not seem to occasion the current massive attempt at physical isolation which ranges across the globe and within entire countries. There is no record of any such previous, more or less global effort. In the past, physical isolation seems to have been practiced on a more localized level.

We are told the current ‘flattening the curve’ policy is an attempt to constrain the numbers so as to lighten the burden on the health care system, i.e. the primary focus being to lessen the number of people needing care at any one time and also lessening the number of deaths and hospitalizations.

It’s an idea that can be traced back in more recent times to the 1918/19 pandemic (and stretches back to at least the 17th century when as a student Isaac Newton was sent home from Cambridge to self-isolate from the Great Plague of London).

During the 1918/19 pandemic, Philadelphia and St. Louis, in the US had vastly different experiences. Ignoring advice from infectious disease experts, Philadelphia held a large public parade. Within two or three days, people sickened and, ultimately, 16,000 died in six months. By contrast, St. Louis adopted social and physical isolation measures suffering 2,000 deaths and flattening the curve. (That city too suffered greatly but more slowly.)

In 2019/20, many governments were slow to respond and many have been harshly criticized for their tardiness. Government leaders seem to have been following an older script, something more laissez-faire, something similar to the one we have followed with past pandemics.

We are breaking new ground by following a policy that is untested at this scale.

Viewed positively, the policy hints at a shift in how we view disease and death and hopes are that this heralds a more cohesive and integrated approach to all life on this planet. Viewed more negatively, it suggests an agenda of social control being enacted and promoted to varying degrees across the planet.

Regardless of your perspective, ‘flattening the curve’ seems to have been employed without any substantive consideration of collateral damages and unintended consequences.

We are beginning to understand some of the consequences. On April 5, 2020, UN Secretary-General Antonio Guterres expressed grave concern about a global surge in domestic violence. King’s College London and the Australian National University released a report on April 9, 2020 estimating that half a billion people around the world may be pushed into poverty because of these measures.

As well, access to water, which many of us take for granted, can be highly problematic. Homeless people, incarcerated people, indigenous peoples and others note that washing with water and soap, the recommended practice for killing the virus should it land on you, is not a simple matter for them.

More crises such as pandemics, climate change, as seen in extreme weather events and water shortages along with rising sea levels around the world, and economic downturns either singly or connected together in ways we have difficulty fully appreciating can be anticipated.

In addition to engaging experts as we navigate our way into the future, we can look to artists, writers, citizen scientists, elders, indigenous communities, rural and urban communities, politicians, philosophers, ethicists, religious leaders, and bureaucrats of all stripes for more insight into the potential for collateral and unintended consequences.

We have the tools – what remains is the will and the wit to use them. Brute force analysis has its uses but it’s also important to pay attention to the outliers. “We cannot solve our problems with the same thinking we used when we created them.” (Albert Einstein)

Sources:
Statistics for previous pandemics:
wiki/List_of_epidemics
mphonline.org/worst-pandemics-in-history
wiki/Spanish_flu
wiki/2002_SARS_outbreak
wiki/2009_swine_flu_pandemic
vancouversun.com/news (Online version does not include the sidebar with the statistics for the 1918/19, the 1957/58, 1967/68, and 2009 pandemics. His sources were the Imperial College of London, the CDC, and the Canadian Encyclopedia.)

2018 AIDS/HIV
who.int/gho/hiv/epidemic_status
avert.org/global-hiv-and-aids-statistics

Statistics supporting my projections:
Monday, April 27, 2020 the number of deaths was, roughly, 210,000 worldwide
worldometers.info/coronavirus
covid-19canada.com (References include Johns Hopkins University, the federal government of Canada, and the World Health Organization)

April 9, 2010 Report on poverty and COVID-19
Australian National University
King’s College London
United Nations University Working Paper