No new cases of Ebola.  Only 46 people still under watch as a known contact, but they are nearly all out of the incubation period window.  We are a couple weeks from officially over at this point.

On the coronavirus, man, pretty slow week, huh? : )

This will be pretty short (and I mean that this time), because I think it’s obvious to everyone at this point what the stakes are.  Main points from my perspective:

–More testing is coming online each day, but testing capacity is still not nearly enough yet. 

–Diagnostic manufacturers are struggling to keep up with worldwide demand.  Qiagen, which makes a very popular RNA extraction spin column kit, has increased production 70% and still does not have enough to meet demand.  To the point that creative solutions, including temporary licensing of their formulas to others for manufacturing, are being discussed.

–Supply of the necessary testing reagents is sufficiently constrained that some suppliers are being given priorities for shipments based on greatest case numbers and need by CDC and FDA. 

–The next two weeks will be critical for the United States.  At present, confirmed case trends look more like Italy than South Korea.  It is entirely possible, particularly locally, for the healthcare system to be overwhelmed.  As we have discussed, most of the new cases are not serious, but some are.  And each serious case will take up a hospital bed–until none are left.  And difficult decisions get made then.

–All of the cancellations are very reasonable.  Yes, even March Madness.  Control of the velocity of cases is the most critical factor right now.  That takes reasonable precautions, like avoiding big groups, where rapid transmission might occur.  That takes testing to identify cases for treatment and appropriate protective measures.

–I would encourage all of you to take time to read or listen to this:  https://healthblog.uofmhealth.org/wellness-prevention/flattening-curve-for-covid-19-what-does-it-mean-and-how-can-you-help

–The graph is a good illustration of what I mean by control of the velocity of cases.

–Notice something else though.  Something the article does not say.  Lowering the velocity makes the problem manageable.  But, hospital system overwhelmed or not, the disruptions will go on longer than you think.  The supply chain issues will still crop up.  Expect a very unusual year.

–There is a non-zero chance the Four Horsemen of the Apocalypse are riding through the skies as we go to vote in November, given how utterly Biblical (including a locust plague across Asia, no less) 2020 has started.

–I am hopeful I will still get to make the planned trips at the end of the month, but hope is about all I have there.  Realistically, I think odds are more likely than not we will be looking to cancel by the end of next week.  If domestic flights are not clipped by then.  I plan on living as much of the routine as I can, but time to take a few more precautions to avoid getting sick, or more importantly, -spreading- illness in a way that contributes to the velocity of cases.  Flatten the curve.

–As often as I write these, even as it spreads across the globe, coronavirus has still felt somehow distant.  Something afar.  After all, I’m not sick.  Data says it’s not that big a threat–to me.  Or my kids.  I don’t know anyone personally who has popped positive.  Sure, I’ve seen Tom Hanks in movies, but I’ve never met the man.

Then I had the virus in my hands this evening.  We got samples from the Indiana State Department of Health, a mix of known positives and negatives, for a final validation check of our assay.  Our staff is already a little weirded out.  Seems like the entire world is.  So I picked the samples up myself and brought them back to the lab. 

Coronavirus was afar, an intellectual abstraction.  Then I had 5 vials of it in my hand.  The virus is here.  This little living thing, causing so much disruption to the world, trapped inside these little tubes.  A weird day–getting weirder.

–Yes, I washed my hands.

–As for Tom Hanks, at age 63, best available data suggests he has a 99% percent chance of survival.  But my son informed me yesterday that he learned in afterschool care that anyone older than 50 who gets coronavirus dies.  So I can say, with absolute statistical certainty, Tom Hanks’ chance of survival is somewhere between 0-99%.

–That’s about your chances of catching coronavirus this week too.  Ebola–almost 0%.

Love in the Time of Coronavirus:

–Weather was nice this past weekend here.  We took the kids to the park.  Kids these days.  They don’t play tag anymore.  They play “infection.”  The one who is “it” instead “has coronavirus.”  I’m not making that up.  All they were missing was “ring around the rosie”.

–Jazz and Thunder game is cancelled, teams on the floor, about to tip off, when the team doctor runs onto the court to tell the refs that one of the players tested positive for Covid-19.  Watch the report here:  https://twitter.com/QTRResearch/status/1237902521911455745

And lastly, mood check:https://www.youtube.com/watch?v=Z0GFRcFm-aY

Keep calm, and carry on.

<Paladin>