The spotlight is largely on the Upper Midwest, Rocky Mountain States and college campuses right now. The media, of course, is trying to lather up another bout of frenzied hysteria. According to the panic racketeers, we are about to be swallowed, not by a wave, but a tsunami of cases lasting through the winter. Hubris means excessive pride or self-confidence, and as the Greeks used it, meant excessive pride or defiance in regard to the gods, which inevitably led to the hubriser’s downfall. The hubrisee always wins. I always keep the concept in mind. The response to the epidemic is a good example. A highly transmissible and not overly lethal pathogen has a remorseless, unrelenting and inexorable mission of its own. The notion that we can stop it is full of hubris. The virus god will have its way.
Here is the clearest current example of hubris. There is something called the Great Barrington Declaration, which I have posted about and encourage you to read and decide if you want to sign. The three authors are prominent scientists and physicians. They are being pilloried for supposedly encouraging population immunity. A counter “memo” has now gone up, claiming this is a heartless and horrible strategy. The estimable, but long past his sell-by date, Dr. Fauci has weighed in also calling it a bad idea. The only issue in my mind is whether the virus infects enough of us to slow transmission dramatically, which is all population immunity means, or we find a vaccine and help the virus get to that place.
This is not about a strategy choice. We don’t get to choose if we are going to seek population immunity or not. It is foolish to think we do. This virus is very transmissible, in ways we don’t fully understand. I said early on that all locations are going to end up pretty much in the same place, on an age and population health adjusted basis. The virus is going to infect a large number of people. It doesn’t care what we do. As I have also pointed out before, we are fortunate that this isn’t a very lethal pathogen. The rule of 90/10 is holding, in fact its starting to look better than that. 90% of people don’t even know they are infected. Of the remaining 10%, 90% have a mild or moderate illness, only 10% need hospitalization (although because of advance directives, not all will be hospitalized). Of that 10%, 90% will survive and 10% will die. Considering no vaccine, and that mortality is heavily skewed toward the frail elderly with only a few months to live at best, rather than the young who would lose decades of life, it isn’t something to panic about.
And our response is to do our best to destroy our society–our economies, our educational systems, our social life, the health of people suffering from diseases other than CV-19. We are literally causing far more damage than CV-19 is.
So back to the Upper Midwest and Rocky Mountain areas. We are clearly having a swell, the intensity of which is inversely related to intensity in the spring wave. There are lots of cases, more than the spring, but only because of testing. Testing at the same levels in the spring would have revealed many more cases than are occurring now. Hospitals aren’t going to be overrun. (Capacity looks tight only because for 30 years one of the main thrusts of health care policy has been to move people from very expensive inpatient to less expensive outpatient settings for care, so hospitals did what we wanted them to do, they dramatically cut inpatient capacity.) And there will not be a massive number of deaths.
So I hope we can all be a little rational and recognize the limits of human action. We don’t control everything, some things we just have to adjust and adapt as best we can. Humility, not hubris, should be the order of the day.