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Update III: Tuesday 3rd March 2020

Things are progressing in the US as expected right now, but my concern level is slightly higher. There is a tone change to my assessment.

It’s heartbreaking news out of Washington State, as the virus was introduced into an aged-care facility; some of our population’s most vulnerable. As testing ramps up in the US, which will take a few weeks, we are going to find more cases. Potentially, many hundreds. Most of the first cases you hear about are not going to have good endings, this is the way it works in an outbreak. We hear of the severe cases first, and then we get a handle of prevalence of the disease in the rest of the community. Over the past few days, index cases in ~20 states have popped up. Most of these people traveled to Europe, Asia, and the Middle East in the past few weeks and brought it back with them. Contact tracing, and self-isolation is taking place, to try to stop the spread of the virus into local communities.

There really are two situations in play right now: control and eradication or spread but mitigation.

China has demonstrated that control of the virus is possible, numbers of infected people in China have dropped consistently for over 2+ weeks. In order to get control over viral transmission they have had to enact pretty draconian actions that may not be possible elsewhere in the world. WHO is standing by their assessment that control and eradication is still possible. Supporting this, many countries around the world, still only have 1 or 2 cases, even weeks after their first case. With good surveillance, control is possible.

The other option is the continued community spread of the virus. If control is not possible through contact tracing, our options lie with mitigation. We must do things to slow transmission and spread out the infection curve: Hand-washing, minimize touching your face, social distancing, and staying home when sick. Practice these now. These behaviors are really hard to change.

Personally, I feel the window for control and eradication, especially in the US, is closing fast. Australia seems to have a better handle on things right now. We probably need to change our mindset and accept that this virus is here to stay. There is no need for panic, it will achieve nothing. As mentioned in an earlier post, preparedness is key. Don’t follow the Aussie example and buy out all the toilet paper…. We make that stuff locally so we are not going to run out. Pick up a few extra things with each shop, get your medicines in order, don’t forget your pets.

Two last points. Our front-line people will really need our help (doctors, nurses, first responders). Get your damn flu shot! don't choke up the hospitals with something preventable. And most importantly, call ahead to your Dr/ED and ask for advice on where to go and what to do if you, or a loved one, feel sick. We need to keep our healthcare workers and first responders protected, so they can continue to assist us.

Finally, you are the firewall for the most vulnerable in our community. This is a pathogen that infects everyone equally, but it is a pathogen that is very hard to fight off if you are older (>70 yo) and/or your health is compromised in some way. It is our behavior that will protect them. You don’t need an epidemic to model good hygiene… wash your damn hands!

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