Note from Peter: Dealing with health issues that impact family structure is not my strong point either topically or mentally. The bulk of this newsletter is the product of one Melissa Taylor who is both my chief researcher and a mom. If the text reads empathetic, instructive, and unambiguous, that’s Melissa’s voice. If it is snark in the face of despair, that would be me.
I just shared a lovely meal with my family. We all brought our own food and chairs, sat outside, and maintained a constant 6ft bubble around everyone, especially my parents. It was hard with a toddler running around, wanting to hug his uncle and grandparents. But despite that, it was comforting. This family gathering would have made most people laugh in disbelief a few weeks ago. But now it’s the new normal until we’ve been free from exposure long enough to relax… a little bit. That’s about 14 days, though even that might not be long enough to be sure.
Coronavirus manages to play into our weaknesses in a big way. Our brains are bad at comprehending risk, understanding probability, anticipating and accepting big changes, or dealing with uncertainty. So if this crisis has hit you like a ton of bricks, you’re not alone. And don’t worry, those spring breakers in Miami? They’ll have their own…moment.
I’m sure you’ve guessed from our company name – Zeihan on Geopolitics – that we are not doctors. But making the world a bit more comprehensible is what we do, so we have turned our efforts to compiling the best information that we could find to help you understand the virus and protect yourself. I assure you this is purely selfish. If you all get sick, who will read our stuff?
There are three reasons you should stay home and try your damndest not to get coronavirus. The first is that we do not know enough about the virus. Yes, it’s been around for 3+ months, but in part because of the Chinese attitude towards information control and in part because of the nature of viral medicine our understanding is limited. We don’t know if there are long-term consequences to infection for those that recover, but there are indications coronavirus can leave patients with permanent lung damage. There could be other permanent damage. We won’t know until we have people who have survived it get fully checked out months after their recovery. That will take, well, months.
Second, you need to protect yourself and your family. Yes, about half of cases are so mild that they’re mistaken for a mild cold. But “mild” in the medical lexicon means something else: that you simply don’t need to go to the hospital. Another roughly 30% of the cases are that flavor of “mild”: people who experience the worst flu-like symptoms of their life.
The next level up, “severe” affects an estimated 15% of cases. These people end up in the hospital because they require supportive oxygen treatment and are hardly able to use the bathroom on their own. Are most of these “severe” cases older and/or suffering from pre-existing conditions like asthma? Absolutely. Are they all? Absolutely not.
Finally, about 5% of sufferers experience “critical” symptoms. They need a ventilator to breathe. That’s the fancy way of saying they need to be on life support. The largest study – one out of China – indicates half the people in this category didn’t make it (although keep in mind that it appears roughly half of all cases are so mild that they were never diagnosed with coronavirus in the first place, so it’s believed the true fatality rate is far closer to 1% of all cases than 2.5%... as long as hospitals are functioning).
Which brings us to the final reason you should take this seriously. Regardless of the country you consider, no hospital has enough ventilators. America has more critical care beds than anyone else (almost more than everyone else) and we only have 100,000. Those who recover successfully from the “critical” category need a week or so of intensive care.
That means if everyone lines up and gets sick in a very orderly process, and no one anywhere has a heart attack or stroke or gets in a car accident or gets stabbed or shot or otherwise needs critical care, it’ll take nearly three years to cycle through everyone who coronavirus puts into ICU. Even then, this pie-in-the-sky scenario only gives everyone precisely one week of treatment. For many that simply isn’t enough. But with hospitals overloaded, no one will be allowed to linger in those critical care beds.
We have a word for what happens when you have to choose who gets help. Who to save.
Triage.
The Italians and Iranians have been mournfully struggling with that for days. They now have guidelines for who gets any time in critical care and who is left to die.
In the worst-case scenario, four times as many Americans will die than during the whole of World War II, including the lives of doctors and nurses risking their lives for you and everyone you love. You can literally save lives by staying home and binging Netflix. So do it. Now.
Here are some other ways to save lives. Maybe even your own. Let’s start with personal protection based on our current understanding of the virus.
Keep Germs at Bay – Washing your hands is the absolute best thing you can do. Watch this short video on doing it properly. Coronavirus may live on cardboard for a day, plastics and metals upwards of three days. So don’t wear your shoes in your house, clean or quarantine anything coming into your home from outside for at least three days, and use normal alcohol (at least 60% alcohol), peroxide, or bleach based cleaners frequently on commonly touched surfaces. Yes, some of this is overkill. Here at ZoG we are all about viral overkill.
Masks – Donate them. Seriously. There are doctors and nurses going without and everyone knows someone in the field. Reach out to them. It’s not that masks offer no protection, its that unless you’re up in someone’s face – like a health professional – the chances of your mask helping you with anything is extremely low. Keep a small stash in case you get sick to protect your family members from your germs. When more supplies are available, wear a surgical mask everywhere, but not for you. Masks for the general public are more about not spreading illness before you become symptomatic, than protecting you as an individual.
Leaving the house – If you must go out, bring hand sanitizer or alcohol wipes. Wear your glasses. Put on your least serial killer-looking pair of gloves. Don’t shake hands. (Peter’s greeting preference is the Bruce Lee fist-in-palm bow, Melissa goes with the hand-guns *pew pew*.) Keep distance. Pretend the people you’re interacting with are the extended family members you only see at holidays that you’d rather not see at holidays. Six feet is good. Two meters (six and a half feet) is better. Open air is better than enclosed spaces. Keep your hands off of your eyes, nose and mouth. That’s just gross even if there isn’t an epidemic. Most major grocery stores these days have apps which enable you to order and even pay for food ahead of time. That way you just need to pick it up. Use them.
Health – The heathier you are, the better. Get the flu shot. Not because it will protect you from coronavirus, but because you do not want to have the flu and coronavirus at the same time. Coronavirus at its core is a respiratory condition, so get in shape. Run, hike, swim, whatever it is that helps you breathe deeper and easier.
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| This graphic is from Our World in Data, an excellent source of well researched, accessible data on coronavirus. |
What you should know
Symptoms – Symptoms usually appear in about 5 days after exposure, but it could be as many as 14 days (or maybe more. See “We don’t know enough.”). Some people never show symptoms but still spread the virus. This means that if you have been in a risky situation, you should stay away from people with compromised health for at least 14 days. If you develop symptoms, they will likely include fever and a dry cough. You may get extremely tired or have muscle pain. If you are short of breath, you have likely progressed from the “mild” to the “severe” category…overnight. It’s time to call your doctor, immediately.
If You Are Sick – Stay home, even if it’s clearly not coronavirus. Isolate yourself from your family to the extent possible. If you get coronavirus, that does not mean your immediate family already has coronavirus even though you’ve likely been contagious for a few days. They should take precautions from you. The CDC has advice for disinfecting your home
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A couple of things to not worry about Don’t horde food – The United States is the world’s largest food exporter by a ridiculous margin. Your grocery store has been preparing for this and warehouses are full even if workers are struggling to keep retail shelves stocked. Tech supply chains fall apart because it’s difficult to make an iPhone if you only have 99% of the parts. Food supply chains are the opposite. A taco without salsa may not be fabulous, but you can still eat it. And you only have to have one of the 500 types of salsa which typically make it to your store to enjoy it. (Melissa lives in Austin, so really not exaggerating about the 500.) You may have to come back another day (so don’t let your personal food stores get too low), but more food is incoming. And because food will continue to be prioritized, this should be true even if things get much worse before they get better. And for goodness sakes, don’t horde tap water. It is strictly monitored, safe, and there is no reason to think it’s going offline. Regulations and practices for producing bottled water are not nearly as rigorous and producing bottled water is far more labor intensive (i.e. people cough all over that stuff). Don’t horde gasoline – Heard of the shale revolution? The United States isn’t simply a net exporter of crude oil, it is the world’s largest exporter of refined product. Product like gasoline. Unlike manufacturing, oil production and refining and fuel transport are extremely low-employment activities. There’s zero reason to expect disruptions to any part of the system for at least the remainder of this calendar year. How long will this last? We would love to tell you, but we just don’t now. You should start settling in. Best case scenario estimates are a couple months. But that probably just means that about then we will relax…only to a few weeks later have to cope with a flare up in this or that city. There are any number of treatment regimes which show promise, but what we really need is a vaccine. At the soonest that will be October. And that’s very unlikely. My new book Disunited Nations: The Scramble for Power in an Ungoverned World published March 3. It is about the shape of a global Disorder when the Americans go home.
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