Covid#1 – 20 March 2020

Though I’m not yet self-isolating (except in the accidental, involuntary sense) the bunker mentality that’s been spreading over the last week has taken its toll. Like many other people, I’ve developed an interest in epidemiology that’s grown almost as quickly as COVID-19 – and even if my learning curve hasn’t been quite as steep, theories of contagion are now exercising parts of my mind that, in happier days, were devoted to more superficial subjects like ISIS and Brexit.

In the absence of jolly things to do and avenues of original research to pursue, I’ve been ruminating on peculiar reactions to the pandemic among people I know. One Facebook friend of my acquaintance was telling anyone who’d listen a couple of weeks ago that coronavirus was a storm-in-a-teacup that would pass as uneventfully as the Millennium Bug; a couple of days ago, he shared a post from the solicitor’s firm where he works which advised ‘all individuals who do not have a will in place [to] consider making one as soon as possible.’ I thought about excluding him from this post’s audience, but then changed my mind. If you’re reading this and recognise yourself, hi!

Less distasteful, but also more common, is the sense of denial that still prevails in some quarters. Though attitudes are shifting fast, a few relatively young and probably healthy people still seem to see COVID-19 as an inconvenience, or at worst an unpleasant ordeal that’s better endured sooner than later. It’s a view I almost sympathise with, not least because I shared it until a few days ago. Quick recovery is obviously preferable to lingering uncertainty, and though no one’s yet sure how immune you become after getting over the disease, I’d hoped to end up in a better position to look after my 76-year-old mum and 82-year-old dad. Having just submerged myself in a few facts and figures though, I’ve flip-flopped – decisively – and though the reports I’ve been reading have had a fair amount of media coverage, I figured it’d do no harm (and perhaps some good) to spell out what they make obvious.

The most extensive survey of the Chinese outbreak so far published (an analysis of 1,099 hospitalised people) reported in early February that 60% of non-severe cases involved individuals aged between 15 to 49 – and among the 173 people whose condition was categorised as ‘severe’, the age spectrum was broad and its profile was surprising. Just 27% of them were older than 65, while 31% were aged between 50 and 64, and 41% were adults under the age of 50. The study’s been translated, and was published in February’s New England Journal of Medicine: https://is.gd/yrNaSf.

That isn’t a statistical aberration or an abstraction. China’s experience has been reflected in the pandemic’s westward spread – and one consequence in both the United States and Europe is that the patients who have been getting medical treatment are disproportionately young. That has serious implications for those patients themselves, of course, but it also affects everyone else.

According to a US Center for Disease Control report issued on 18 March (https://is.gd/Dp7ofo), 38% of 508 Americans known to have been hospitalised for coronavirus were aged between 20 and 54, and nearly half of the 121 admitted to intensive care units were adults under 65. A report on the Italian outbreak published yesterday (19 March) states that almost a quarter (24.7%) of nearly 28,000 coronavirus patients in that country are between 19 and 50 years old: https://is.gd/AeifTi. I haven’t found an equivalent figure for hospitalisations in France, but at least one official statement indicates that the position there is similar. Last week, the head of the national health agency said that more than half of the 300 patients being treated in intensive care units were people younger than 60: https://is.gd/iJfyJS.

Those numbers don’t mean that younger people are likely to suffer the very worst outcomes. Septuagenarians and octogenarians are still the people most likely to be hospitalised and to die. But, at the cost of emphasising what shouldn’t even need mentioning, people of any age ought to do everything possible to minimise risks of exposure to the disease and to slow its spread. Anyone who recklessly hopes for a quick bout of COVID-19 to instil future immunity is being selfish even if, by extraordinary luck, they transmit the virus no further. Since every adult has a real chance of requiring professional medical treatment, no one’s gambling with just their own chips in this pandemic. Anyone who ends up recovering in hospital will be using resources and a bed that someone else needs – and they might occupy space in an intensive care unit that another person is going to die without.

A pronouncement like that sounds melodramatic, but at a time when quite a few people still don’t get that social distancing includes them, the point’s worth labouring yet more. This country’s health workers are about to wade through some exceptionally deep shit: as well as the wave of infections that’s already overwhelming several British hospitals, alcohol abuse, depression and domestic violence are liable to skyrocket in coming months. Anything that lightens the burden is worth doing.

Chances are that anyone reading this post reached similar conclusions long before I did. But I thought it was still worth putting the rationale out there. Navigating through this is going to involve more than common sense; it’ll depend on people’s willingness to act in accordance with probability theory. Every avoided physical meeting and every gathering that’s postponed or shrunk over the next few weeks is likely to lessen hospital admissions and save lives.

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