“I think it’s very hard to realize that we’re first in the first innings of this crisis,” said Michael Osterholm, who founded the University of Minnesota’s Center for Infectious Disease Research and Policy in 2005, while discussing COVID-19 at a recent online event organized by the Washington, D.C. New America think tank, which was founded in 1999. New America is made up of intellectually and ideologically independent policy experts and public intellectuals in a community of innovative problem-solvers, combining their core expertise in researching, reporting and analysis with new areas of coding, data science, and human-centered design to experiment and innovate nationally and globally.
“A quote keeps coming back to me from Sir Winston Churchill,” said Osterholm: ‘This is not the end. It is not even the beginning of the end, but it’s perhaps the end of the beginning.’ “I think that’s where we’re at right now. You might say we’re in the second inning of a nine-inning game.”(https://www.cnn.com/2020/04/21/opinions/bergen-osterholm-interview-two-opinion/index.html)
Neither comforting nor alarmist, but truly sobering. If Michael Osterholm is correct, we’re in this for the long game for the next 16 to 20 months, give or take, perhaps until the fall of 2021 or winter of 2022, by which time COVID-19 may have infected at least 60 to 70 per cent of the U.S, population and killed perhaps 800,000 people.
While more chemical reagents for increased testing, continued non-pharmaceutical public health measures for mitigating the risk and impact of COVID-19, such as social distancing, flattening the curve, peaks and waves, infectious disease modelling, how, when, and where to reopen the economy, knowing a true basic reproduction number (R0), availability of an adequate supply of Personal Protective Equipment (PPE), the importance of outliers, antivirals and vaccines, are all of relative interest and value, the central fact remains that COVID-19 has infected the world long before the proverbial barn door was or perhaps even could have been shut.
For a novel disease that probably emerged in Wuhan, China in late October or early November of last year, I’m not convinced there was ever a real window of time to shut that barn door even though the National Center for Medical Intelligence (NCMI) at Fort Detrick, Maryland warned as far back as last November that a contagion was sweeping through China’s Wuhan region, changing the patterns of life and business and posing a threat to the population. The report was the result of analysis of wire and computer intercepts, coupled with satellite images.The medical intelligence (MEDINT) cell within Canadian Forces Intelligence Command (CFINTCOM) gave a similar warning in January.
Canada’s COVID-19 experience will be different than the United States, as will Ohio’s from Michigan’s, and Manitoba’s from Ontario’s, but it is the fire this time for much of the world.
I wrote a piece Jan. 23 headlined, “The fire this time? Pandemic prose, and waiting and watching for the ‘big one’ (https://soundingsjohnbarker.wordpress.com/2020/01/23/the-fire-this-time-pandemic-prose-and-waiting-and-watching-for-the-big-one/) where I wondered, “How quickly we could we make a trip back to a modern-day equivalent to the Dark Ages of the 5th to 11th centuries?” I think the early evidence we have seen in the three months since then suggests not so very long, and that the best parallel in modern times will turn out to be the “Spanish Flu” influenza pandemic of 1918, which killed about 675,000 people in the United States, and perhaps somewhere between 50 and 100 million around the world.
While he didn’t come up with it, American humourist Mark Twain popularized the phrase, “There are three kinds of lies: lies, damned lies, and statistics.” After trying my mathematically-challenged best to understand even rudimentary infectious disease modelling over the last several months, I have no doubt Twain spoke the truth. The lies of statistical projection have infected my own writing at times. I am hardly immune from it.
The Institute for Health Metrics and Evaluation (IHME) is an independent population health research center at UW Medicine, part of the University of Washington, that provides rigorous and comparable measurement of the world’s most important health problems and evaluates the strategies used to address them (https://soundingsjohnbarker.wordpress.com/2020/04/12/hope-in-a-dangerous-time-projected-peak-in-daily-deaths-and-hospital-resource-use-reached-or-at-hand-for-u-s/). Yet their projections change constantly.
They projected 61,545 COVID-19 deaths in the United States by Aug. 4 several weeks ago. Their most recent projection April 22 predicted 67,641 deaths by Aug. 4. They projected 83,967 COVID-19 deaths on March 31, and then on April 5 they increased that projection to 93,531 deaths. Up, down, and all around, so who knows really, a point Osterholm has made.
It surely would be a most apropos time to hit a home run against COVID-19, with an effective antiviral or antivirals, old or new, or develop a prophylactic antigen vaccine or vaccines, but I wouldn’t count on it for 2020, which will be noted more for hindsight than foresight, although we do well to remember sometimes neither trumps nature.
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