My Latest Thinking on the Pandemic

I have been trying to learn as much as possible about Covid-19 and how to control its spread. This post is some of my latest thinking about this new disease. As more information and data is coming in, the medical community is learning more about this coronavirus. I am trying to make the best decision for our community regarding reopening campus for the 2020-2021 school year. I think we all see the need to try to come back to school, but I want to do so protecting the health of the community. I do not want to have an outbreak in our community.

Dr. Clayton Dalton an emergency resident at a couple of hospitals in Boston wrote an opinion piece in Scientific American yesterday, “So How Deadly Is Covid-19?” I was asking that same question a couple of weeks ago in a blog post. He reminds us that because most cases are asymptomatic, they are greatly underreported in the statistics, according to Food & Drug Administration Chief Scott Gottlieb by 10-20 times. The disease also had a big range of mortality rates, depending on where and when the outbreak took place. One worrying factor for school leaders is that this coronavirus appears to be much more contagious than normal strains of influenza.(CDC Study). On a positive note, the less exposure one has to the virus, the less severe are the symptoms.

But from my perspective as an emergency physician, precisely how deadly the virus is doesn’t matter right now, because the virus is deadly enough. I’ve stood on the front lines of the pandemic, and I know that this virus is no house cat. Every day for weeks, my colleagues and I have faced wave after wave of COVID patients in their 30s, 50s or 80s, many of them extraordinarily ill. Some of these people have died. Its virulence is astonishing, at least among hospitalized patients. Experienced physicians know that this is nothing like the flu.

Dr. Clayton Dalton, Scientific American, June 5, 2020

A colleague shared a BBC article, “Coronavirus: How Scared Should We Be?” This has been in my mind as we plan for reopening. If you have the mindset that every single person you meet may be emitting coronaviruses and every surface you touch is potentially full of coronaviruses, it will be impossible to live a normal life until a vaccine is available. In a UK study that the author Nick Triggle cites, in England, about 1 in 400 people at any one time carry the virus. The chances of having contact with someone is slim. However, schools are a high-dense environment and on our campus for example, there are 500 students and 150 employees. We are planning to break up the school into three isolated areas (Early Childhood / Elementary / Secondary School) which will limit the number of people exposed to each other.

I wonder what the number of people with coronavirus at any one time in Tashkent? According to the statistics from the Ministry of Health and World Health Organization office in Tashkent, there are currently 878 active cases in Uzbekistan. There seems to be a steady number of cases daily, around 50 per day. Most of the cases are in quarantine and few from the general population. However, there is always the question of the accuracy of the data and the number of people tested (approximately 370,000 as reported on Wikipedia).

Wikipedia – accessed June 6, 2020

Triggle refers to the University College London’s tool to calculate your risk of dying of Covid-19. I put in my characteristics, male, age 51-55, no underlying conditions and mitigating my risk through always wearing a mask, mostly keeping physically distant from others, washing my hands often and avoiding crowds. In England there are 1.3 million men like me and about 4,900 of us would be expected to die in normal conditions. Covid-19 pandemic could cause an additional 244 deaths.

For example, an average person aged 40 has around a one-in-1,000 risk of not making it to their next birthday and an almost identical risk of not surviving a coronavirus infection. That means your risk of dying is effectively doubled from what it was if you are infected.And that is the average risk – for most individuals the risk is actually lower than that as most of the risk is held by those who are in poor health in each age group.So coronavirus is, in effect, taking any frailties and amplifying them. It is like packing an extra year’s worth of risk into a short period of time.If your risk of dying was very low in the first place, it still remains very low.As for children, the risk of dying from other things – cancer and accidents are the biggest cause of fatalities – is greater than their chance of dying if they are infected with coronavirus.During the pandemic so far three under 15s have died. That compares to around 50 killed in road accidents every year.”

So basically he is saying one’s chances of dying of Covid-19 are very slim. We live with the risk of death everyday, but it is not in our conscious. The pandemic has brought it to the forefront of many people’s minds and that causes uneasiness. My current thinking is to ease back into my normal life but in a cautious manner, continuing the measures I took during quarantine. We also need to do this as a school, ensuring that no one with symptoms can come onto campus and that we quickly identify and isolate any cases and then contact trace to reduce spread.

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