A letter to everyone's parents about Coronavirus

Boy, what a great reason to write my first blog post in 8 months.

I have been traveling in Spain and just got back to America (current status:  self-quarantined for 14 days and/or forever) as we grapple with the reality of what is happening, and more importantly, what is going to happen.  Being in Recently In Europe (tm) and Extremely Online (tm), I've realized that my awareness of the coming impact of COVID-19 is different than a lot of Americans, and this morning while not-sleeping due to jet lag I realized that the people I needed to share this with the most were my parents.

Since then I've showed it to a few friends who were also in the position of worrying that their boomer-generation parents have yet to realize how acute the risk is to them, and someone joked that this is how I get back into blogging.  SO HERE YOU GO, JOHNNY.

Please feel free to send this to your older loved ones who you suspect are dangerously behind the information curve.  You might want to take out the references to Western Maine and "Colin" if you want to pretend it's coming from you ;)

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Hi Mom and Dad, hopefully everything in this email is not news to you, but I want to make sure we're on the same page about how serious this crisis is and what your plan is for getting through it.  Recently a lot of people have reached out to me expressing concern for me since I was in Europe, which makes me worried that Americans still think if they didn't travel overseas recently their risk level is low enough that they can still be out and about living a semi-normal life.

The thesis of this email is: I want to make sure you both realize that if either of you gets a bad case of coronavirus in the coming months, you will probably not be able to access ventilation support at a hospital due to your age -- you will be left to die.  And I don't want that to happen.

Furthermore, every day additional research points more and more toward asymptomatic transmission (i.e. getting it from people who don't appear to have any outward symptoms yet) being a main driver of the epidemic.  So if you're thinking "there aren't many cases in Maine" or "no one in town seems sick", that's not a safe line of reasoning.  The time to aggressively self-isolate in Maine is NOW.  (well actually, it was a week ago)

See https://www.cnn.com/2020/03/14/health/coronavirus-asymptomatic-spread/index.html for more info on how clear it's becoming that people are spreading it without showing any symptoms.

And here's a tweet from a friend about how fast cases are being discovered in Maine: https://twitter.com/iworedettos/status/1239532072877907969

So to reiterate, your community almost certainly has asymptomatic coronavirus cases in it already and they are spreading.  If you're waiting for it to "get to you" then it's going to be too late.

Now, to elaborate on the idea that a hospital would not treat you, which might seem insane right now.  But the rationing of healthcare is absolutely going to happen in this country and it's going to start very soon.  Here's an article from today:
https://www.washingtonpost.com/health/2020/03/15/coronavirus-rationing-us/

Note this particular paragraph with an age cutoff of 65 floated for access to a ventilator:

If this seems theoretical or distant, consider the situation in Italy 2 days ago:
https://www.independent.co.uk/news/health/coronavirus-italy-hospitals-doctor-lockdown-quarantine-intensive-care-a9401186.html

Since that article was written, Italy has set a new record each day for the death toll, with the last 24 hours seeing 368 deaths in the country:  https://www.aljazeera.com/news/2020/03/spain-france-tighten-curbs-coronavirus-fight-live-updates-200312054153018.html

It's safe to assume that the age and health cutoffs for patients they are even trying to save get lower every day, and it will keep lowering until the epidemic slows.  In Italy, even 6 days after the start of the lockdown, the rate is continuing to climb -- probably due to the amount of transmission that was already in progress when the lockdown started.  It's bad there, and it's going to get worst before it gets better.

Now, you might think that Italy is not the US and thus what is happening there will not happen here.  I wish that were true, but even with the paltry amount of coronavirus testing happening in the US right now, we are following the Italian infection curve, just a week or two behind:
https://twitter.com/Atul_Gawande/status/1237916584460640257
Note that the entire western world is following this curve, not just the US.  To think that we will not end up where Italy is at present, 2 weeks from now, requires believing that something substantially different will happen in our society that didn't happen there.

And the US only has 2.8 hospital beds per 1000 people, compared to 3.2 with Italy.  I'm not sure where Maine falls on the hospital beds per capita scale, but I'd be shocked if it's better than the country as a whole.  https://www.vox.com/science-and-health/2020/3/14/21179714/coronavirus-covid-19-hospital-beds-china

So to summarize:
1) Hospitals in the US will have to ration healthcare in the coming months and your age means you will likely not get treatment.
2) Asymptomatic transmission is a very real threat, so you can't rely on the absence of sick people in Bethel or Western Maine as an indicator of safety.  By the time it feels unsafe you will have been surrounded by carriers for days, if not weeks.
3) We aren't testing anyone who isn't showing severe symptoms, so the number of actual Covid-19 carriers in Maine is probably several orders of magnitude higher than the reported cases

What you should do:
1) Self-quarantine as aggressively as practical for the indefinite future.

Hopefully you have already considered everything before this email and are taking action.  I love you and I want you to be safe.

Colin