We are at a point where carping about what was or wasn’t done in the past is useless. We have to move forward in ways to savie lives and, at the same time, preventing a deep depression. Many solid ideas are floating around to help make this possible. This is our attempt to combine them into a workable program. 

Segregate and Protect the vulnerable. It would’ve been much better to have done this right from the beginning, but better late than never. Virtually all the at-risk are known to the medical community. Those with underlying conditions young and old have been treated by a doctor. Someone writes their prescriptions. Doctors need to immediately contact patients with instructions to self-quarantine. This should be accompanied by a letter identifying them as at-risk with a barcode, and directions to an online questionnaire to find each person’s ability to comply. Also, this should include a release to share the info with others at the end of the survey. This is needed to resolve medical confidentially issues in allowing others to asist. It would be best if these forms were quickly created at the federal level for speed and uniformity. It would help if there were public service announcements to make people aware of these forms and the need for a quickly filled out questionnaires. This will allow us to know who needs help and support. We can then center maximum efforts keeping them from being exposed. If they’re not exposed, they won’t need the ICU or to be put on ventilators because of Coronavirus. Remember, anyone needing intensive care is a failure to protect them from exposure. Nursing home residents still dying from Covid-19 shows us we haven’t even protected the most easily identifiable at-risk group. 

Extend Testing and Tests.  We need to know who is presently infected, who isn’t, and who has recovered. To identify the infected, we still need to quickly expand the quantity and speed of Covid 19 tests. Also, we need two other types of tests. The polymerase chain reaction test (PCR) presently used to determine the genetic signature of the live virus to identify those very recently infected. Now in development, a serology test studying the serum and other bodily fluids to identify antibodies formed in response to the infection. The knowledge of who is or isn’t infected and who has recovered will provide us with better tools. These can be used to keep the space between people having the disease and those in the greatest danger. Knowing who is immune can be a game-changer. Just having them available to care for the vulnerable would significantly improve safety. The tests will provide us the data to move forward.

What are we hearing? Hospitals are in danger of being overwhelmed, resulting in needless deaths. We are going to spend trillions of dollars to offset a near shutdown of our country. Who are the ones needing acute care threatening to swamp our medical facilities? As we pointed out in our last post, the vast majority are the elderly and those already compromised. This at-risk population is the one contributing by far the most to the death tolls. Common sense cried out; these were the ones to protect and segregate from the carriers. After all, this has been true in every epidemic experienced. Identifying those infected and putting distance between them and the most endangered is the first thing to do. In response to past epidemic experience, countries such as Singapore and South Korea moved immediately to widespread testing. They enlisted all public and private resources to make testing kits available as widely as possible. Blocking travel with infected areas was a given. President Trump acted with reasonable speed in shutting down travel with China buying precious time. The time that should’ve been used to test widely and protect and segregate the vulnerable. Instead of following countries such as South Korea and getting widespread help in producing and using test kits, our CDC and FDA refused help in favor of their own paltry number of test kits. Then theirs proved faulty. We slipped behind the testing curve. The CDC has offices all over the world, so they were well aware of what others were doing and experiencing. They just elected to go their own way and do inadequate testing.

It’s a good idea when faced with an attack to take stock of your arsenal to see what works. With this Coronavirus attack, we have to look to what has worked on virus-immune assaults in the past. There seems to be quite a list of possibilities. For instance, a 70 yr old malaria drug, Chloroquine, seems to show some promise. Sadly it was the French initially tested it, not the US. Again the CDC and FDA were slow off the mark.

Still, one would expect we would have robust procedures to alert and segregate the compromised and those close to them. They are the ones filling the ICUs. They are the ones most in danger of dying. Even today, we haven’t taken many of the most straightforward targeted measures to protect the most vulnerable. For instance, Honeywell and 3M are increasing the production of n95 masks by 1 1/2 million a day. Wouldn’t it make sense to make some of these available to 1-2 % most at risk? These could be used whenever they have to interact with others. Older people and others at high risk still need to eat and procure necessities. One would think they could get delivery and avoid contact, but this is spotty at best. Fresh produce, an immune enhancer, for delivery service has been overwhelmed by demand. Even “pick up and go” when available have extended lead times. A week seems a minor miracle. Many grocery stores have tried to accommodate seniors with special early shopping hours. Now we have a mass gathering of the vulnerable. Just one infected person could wreak havoc. How could this happen? An 86 year old acquaintance went to Costco for needed hearing aids and also went shopping at the local grocery. Maybe masks might’ve prevented a potential virus hot spot. Governor Cuomo of New York fears health care in his state will be swamped by a flood of the sick One of the best ways to prevent a flood is to build a dam in the narrows upriver. Once you have a torrent, you have a vastly more extensive problem. Our leaders have been thinking Macro when micro might’ve have given better results.

We’ve known almost from the time China admitted the contagion, only 15% of the US population would be at risk of severe complications from the Coronavirus. The rest will have, at worst, have the equivalent of a cold. Many, if not most, will hardly be affected. Importantly, those really at risk are, for the most part, easily identifiable. The medical community knows who is under cancer, diabetes, heart and kidney treatment, or anything else might compromise immune systems. We know exactly where all the nursing homes, assisted living, senior communities, and senior centers are located. Would it have been better to segregate and protect these communities, rather than disrupting the lives of the other 85% at an enormous cost? After all, the fear is our ICUs, and other medical facilities will be overwhelmed by a spike. The ones most likely needing hospital care are the at-risk group. A healthy 20-year-old isn’t going to tax the system. By making a massive targeted effort to slow down, the spread among the older and compromised population would’ve lessened a crunch and made it manageable.

Meanwhile, the rest go on as they would in a bad cold or flu season. It wouldn’t have been fun but might’ve been better than the total dislocation we’re experiencing. The virus would’ve spread rapidly throughout the younger and healthier population. However, the immunity that comes from once having it would also spread quickly, bringing an end to the epidemic. In this case, the old saying “time is money” is true to the tune of trillions. In this worldwide panic, it seems any cost-benefit analysis hasn’t even been considered.

Italy was slow to take action on movement to and from China, resulting in it being massively struck. Its single-payer health system fell behind and suffered the dreaded spike where it was overwhelmed, resulting in a high death count. Italy’s generally older population probably contributed, but that was a given. It will be interesting to see if the faster spread in that country leads to a swifter epidemic fade. If true, they might have a high death rate but a speedier return to normal. If this is the case, the idea of making every effort to protect the vulnerable while leaving the virus to run its course through the younger, generally healthy public was worthwhile. We didn’t do this. Older people are just now getting help with things such as food delivery and shopping priority at stores while they shelter in place. Segregating this population from the mass population requires reliable support these vulnerable groups are just now getting. While data from China and South Korea, among others, pointed out where the real mortal danger was. There was a bureaucratic failure of the CDC and the FDA to enlist all private government sources in widespread testing. This deprived us of knowing who needed to be kept away from the vulnerable and visa versa. Still, we knew enough to require protective garb for those serving nursing homes and assisted living and other identifiable at-risk people. Maybe an earlier bullet rather than a belated shotgun blast was the way to go. Unfortunately, this just isn’t in the bureaucratic DNA.

Amid all this turmoil, this remains an election year. The Democrats have concluded Bernie Sanders accomplished his task of moving the party to the far left. He and his election losing socialist label now can be safely dumped. Unfortunately, the only alternative they had left was good old Uncle Doofus, aka Joe Biden. Joe seemingly has a clear path to the nomination. It has been pointed out our prediction of a hung convention giving the nod to Michelle Obama is a dead letter. We beg to differ. No matter what closet they hide good old Joe in, he still has seven months to be Joe. Does anyone really think he can go that long without a significant gaff or worse a defining senior moment?

The Democrats didn’t get rid of Bernie only to nominate another undetectable. Joe has always been a walking gaffe machine. However, his ugly attack on a gun-owning voter just asking a pointed question appeared to indicate something else. It looked like the actions we’ve seen in older friends and loved ones. Angry uncalled for outbursts more often than not accompany the onset of some form of dementia. If we saw it that way, others also see it. Can the Democrats take that risk? Gov. Andrew Cuomo of New York apparently doesn’t think so. How else do you explain his almost endless daily coronavirus news conferences? No other Governor even comes close to his TV time. He is running for something, and unless he gets a quick sex change operation, it isn’t Vice-president. If he sees an opening due to a medical drop out(or push out) ending Joe’s run, party movers and shakers also see it. Joe leaves before the convention, leaving it wide open. In that case, Michelle is a much better spot than Andrew or anyone else. Place your bets.