Why we need to keep staying home now

A lot of states recently decided to open up their economies. The federal government has also pivoted to encouraging states to open up their economies, given the truly unprecedented numbers of Americans filing for unemployment and the worse-than-Great-Depression economic numbers that are projected. Many people, who have not had proper haircuts in awhile and long to have fun out with friends, especially now that the weather is nicer, are eagerly taking the advice to come out again.

This is a bad idea. I am, disclaimer, not an epidemiologist or a medical professional or even a real journalist, but I think there are three pretty easy to understand facts that when put together make it easy to understand why we need to continue staying at home to the greatest extent possible. I'm documenting my work with links to the best of my ability, and I welcome anyone to point out why I'm wrong. I wish I were wrong about this, and we could all go outside and live life normally again. But I'm afraid that if we do that, many more people will die, and it will actually prolong the time we need to keep staying away from each other. Here's why:

Fact 1: This virus can kill you

Yes YOU. It is true that it is difficult to pin down exact mortality rates during a pandemic. We know it is more deadly for people the older they are and the worse their underlying health conditions are. But it has killed babies. Multiple babies. It has killed young children. It has killed teenagers. It has cut down athletes in the prime of their lives. It has killed those in middle age. There is no group of people who are 100% guaranteed to live if they get sick. It is, in other words, very much worse than the flu.

Fact 2: This virus spreads very quickly

Some epidemiology speak I remember from the measles outbreaks of recent years: R0, or “R nought,” is basically the number of people that each infected person is likely to infect themselves. So if a virus has an R0 value of less than 1, that means that each infected person on average spreads it to less than one person, meaning the disease is on a path to dying out. If the R0 is around 1, that means each infected person spreads it to about 1 other person, and the disease is on a path to continue existing in a population. If the R0 is greater than 2, then each infected person on average spreads it to 2 or more people, and the number of cases is likely to increase exponentially. According to the above video, best estimates are that covid-19’s R0 is between 2 and 2.5. This makes it more infectious than the flu, though not as infectious as measles, which has an R0 of 12-18 (!!!) among those who have not been inoculated against it. And, unlike both flu and measles, there is no vaccine or cure for Covid-19 (yet), and it's a novel virus, which means no one other than people who have recently had it are likely to have any immunity to it. The bottom line is that an R0 of 2-2.5 means that cases will increase exponentially if nothing is done to mitigate them, which is what you can see from our case studies of cruise ships, prisons, and meat-packing plants, in which almost nothing was done to prevent the spread of the virus.

Fact 3: We don’t know who has the virus and who is immune

Scientists have found that people can be “asymptomatic,” that is, they feel fine and aren’t coughing or feverish or anything, and can still both have covid-19 and spread it to others. This has to do with the “incubation period,” (really, watch that video above) meaning the time between which you become infected and when you start to feel ill, which can be anywhere from 3 to 14 days, though usually about 5-6 days, during which time you can be passing it on to others. 

While there exist tests to tell whether you have the disease or not, we still have not even been able to administer them to all people who are symptomatic, let alone to high-risk people who have no symptoms (i.e. essential workers in hospitals (and senators!), let alone bus drivers, grocery store and nursing home and prison and meat-packing staff), let alone to the general population. While some states have called for an "army of contract tracers" to talk to people who test positive and find out who they've been in contact with so that those people can be told to isolate themselves so as not to spread the disease to others, nothing of the sort exists yet. 

There also is currently an antibody test which can tell if you have had the virus in the past, and are generating antibodies that would fight it off if you come into contact with it again. The problem with these tests is at least twofold: first, we still don’t know their accuracy, and second, there are now different strains of the virus being identified, much like “the flu” is actually many viruses in the same family, which is why you need a new flu shot every year that’s tailored to the strain (or strains) that is medical professionals’ best guess as to which will be circulating that year. It’s still unclear how much protection being immunized against one strain gives you against others.

So, to recap: the virus is deadly for people of all ages. It's very contagious. There is currently no vaccine or cure (don't drink bleach, please). We don’t have good information on who is currently able to spread the virus. We don't know who they've been in contact with. And the virus can be spread by people who have no symptoms.

Put these facts together, and what we should do is clear: STAY AWAY FROM PEOPLE.

The only way to avoid a potentially deadly, definitely highly infectious sickness that could potentially be transmitted to you by anyone you meet is to not come into contact with anyone outside of the people who reside in your home. This is why so many states enforced “stay at home” or “shelter in place” orders that are now expiring in some states and being protested by crowds of gun and sign-toting individuals in others.

Now, some people, like me, have basically unlimited freedom to stay away from other people. Since mid-March, schools have been closed in Illinois, and they will remain closed the rest of the school year; I have still been working from home, interacting with students every day and presenting lessons through Google Classroom. While I’m not a prepper, I did prepare a bit when I heard about how people were brought back into the country from the Diamond Princess in late February, and got a few months of food and paper goods, so I haven’t been inside a grocery store or a restaurant since March 16 (the day after schools were ordered closed). I’ve found that most everything I need can be delivered to me (or picked up with nearly-contactless curbside delivery). Further making me lucky, I live with my wife, who I love and get along with, who is also still getting paid and working from home. We are extremely lucky. People like me should absolutely not interact face-to-face with anyone outside of other people who live with us. Not like people flocking to beaches and parks, not like people throwing huge house parties, and especially not like people storming state capitals with guns that cannot shoot viruses away.

Many people have jobs that require them to continue going out into the world. These people, who were always essential, but are now more essential than ever, should absolutely be provided with as much protection from other people as possible, like masks (N-95s for health care workers), gloves, plexiglass panels and plastic face shields. They should also be tested as much as possible, and DEFINITELY allowed to take sick time (without fear of losing their jobs!!!) at the first sign of feeling ill (by which time, as we’ve established, it’s already too late to avoid having possibly spread the disease to others).

We are currently approaching the worst-case scenario. The economy has gone over a cliff (and cannot be brought back just by opening everything up). Over 1.2 million people in this country alone have been confirmed to have gotten sick, and over 70,000 have died. If stay-at-home orders are lifted, non-essential businesses open back up and people flock to malls and salons and stores and interact with people without covering their faces, it’s not a huge leap of logic to see that many more people will become infected and die. If every infected person infects 2-3 more, then by June 1 we’ll be experiencing something like a 9/11 of deaths every single day according to the Trump administration's own numbers. The biggest fear of everyone in a situation like that would be that our hospitals would run out of healthy workers, beds, and equipment to treat everyone, which would lead to many, many excess deaths as people are unable to get the proper care.

We have a collective responsibility to our health care workers, to our other essential workers, to our immunocompromised individuals, and to everyone who knows and loves someone in those categories (so, pretty much everyone) not to let the worst-case scenario happen. No one enjoys not being able to do things they enjoy doing, like seeing friends and family, eating and drinking at bars and restaurants, travelling, seeing professional sports, getting haircuts, or browsing through stuff at stores, to name just some of the things we’ve collectively lost the ability to do safely. But until the federal government (which has failed at every turn thus far) gets serious about implementing a testing regime, a contract-tracing regime, and possibly a voluntary quarantine in hotels regime, volunteering to stay away from each other is the only way we can safely avoid this disease and reduce its transmission.