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Quarantining everyone not sustainable, will not work

Larry BUEGE

Our current policy of quarantining everyone is not sustainable. It may flatten the curve, but it also lengthens the epidemic, which could persist for months. Individuals hoping the epidemic will dissipate in the spring need only look to Australia, which is enjoying summer. They have 456 cases and counting.

Our mom and pop motels, restaurants, and coffee shops cannot endure many months of closure. Students cannot advance with two-thirds of a year’s education. The White House is now suggesting a recession with unemployment as high as 20 percent. The virus kills, but recessions also kill. People must choose between food and medications. Suicides increase.

Turn on the TV and we are bombarded with corona virus statistics. Commentators constantly update us on how many people died and how many people are infected. These data do little to help us cope with the disease. There is no cure for the corona virus infection, but we do have a cure for the epidemic.

To understand how to cure the epidemic we must understand a seldom-mentioned statistic called R0 (pronounced R naught). The common flu has an average R0 of 1.3, which is the number of people infected by each person with the flu. This is a difficult statistic to quantify, but that does not stop epidemiologists from trying. Currently, they believe the corona virus has a R0 of about 2.0, which makes it much more contagious than the flu. Measles has a whopping R0 value of 12-18 in an unvaccinated community (please vaccinate your children).

We know a virus with an R0 above one will start a chain reaction and produce an epidemic. If the R0 is less than one, it will wither and die. In a normal flu cycle, the virus with a beginning R0 of 1.3 will increase the number of infected individuals. The infected people will get better or die (people do die with flu). Those that survive will be immune to the virus. With more and more people immune to the disease, it becomes harder to infect new individuals. The R0 drops below one, and the flu epidemic subsides.  

With such a high mortality rate, we cannot allow the corona virus to run its course. We must artificially lower the virus’ R0 value. China, South Korea, and Singapore have proven this is possible. All three countries have dwindling infection rates. In theory, this is easy to do. If everyone were to self-quarantine for two weeks following their first cough, the epidemic would be over in a few weeks. Unfortunately, we have workaholics with a mild cough who continue working. We also have people who do not eat if they do not work. They are the individuals who keep the epidemic going.

The R0 value for the corona virus could be lower in the UP than it is in Wayne County. We do not spend an hour on a crowded bus on our way to work. We don’t live in crowded apartment buildings. Planes arrive at K.I. Sawyer at a rate of one or two per day. At the Detroit airport they arrive at one or two per minute. Our rural community provides a distinct advantage.

As of this writing, we have yet to have a confirmed case in the U.P. With luck we never will. It is quite possible the medicine will be more harmful than the disease. We need a better solution.

If we are to avoid multiple bankruptcies and a severe recession, we must learn from nations that have controlled the virus. China, South Korea, and Singapore all have diminishing new infections. As I write Wuhan had one new case in a 24-hour period and Singapore had none. The one common denominator is each nation aggressively tests everyone with a fever or cough. (We only test the most severe cases.) If a case is found, all the contacts are hunted down and tested, with or without a fever.

Singapore is a more developed nation than the U.S. Their students ranked first place in math, science, and reading. The U.S. ranked about 20th in science and reading and even lower in math. Singapore has a high respect for education and closing their schools was unthinkable. They also did not wish to destroy their economy. Schools and businesses remained open. They have no need to worry about large gatherings when they know the infected patients and their contacts are in quarantine. We only know the location of the severely infected patients. Mildly infected patients are walking around undiagnosed, which is why we must quarantine all individuals including students to avoid infection.

We were slow to obtain testing kits. I don’t care why or who is to blame, but we must replace total quarantine with aggressive testing and contact follow up if we are to avoid a painful recession with multiple bankruptcies.

Editor’s note: Larry Buege is a retired physician’s assistant. He resides in Marquette.

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