Travesty

Years ago I was in Charleston, South Carolina, on business, and one night a colleague and I went to the local baseball park to watch two minor league teams play. After several innings of relatively uneventful play, we got to see something that I had never seen before, and have not seen since. On the third strike the catcher dropped the ball, the batter ran for first, the catcher threw wild, the right fielder had trouble with the ball, the runner rounded first and headed to second, the throw to second was wild, and the runner headed for third. At this point, as I recall, the runner found himself in a rundown situation. The third baseman, however, was impatient and made a wild throw to second, and the runner went home. A batter had just stolen four bases.

My colleague, who was also a friend, and I found this both amusing and unsettling. Certainly we had a story to tell. After a little while we decided to leave; there was no way anything could top what we had just seen, and watching the game continue was actually becoming a bit painful.

I hadn't thought of this evening in years, but watching Messrs. Trump and Pence attempt to deal with the coronavirus brought that balmy evening in Charleston forcefully back to mind.

I'm not going to list all the mistakes I think our leaders have made. Instead, I want to focus on two thoughts that I think are not getting enough attention. Both are based on my impression that this virus is different from anything we have seen before, and my further impression that we really don't have a good understanding yet of how it is different.

First, I think the emphasis on death rates is at this point essentially a distraction. Death total, yes, I think we should be watching those numbers carefully. But a death rate is a fraction: number of deaths over number of infections. And we simply have no idea how many infections there are. Frankly, we don't even seem to be trying very hard to find out.

There are a large number of infected people who have no symptoms. Others have very mild symptoms, and the president seems to think it's just fine for these people to go to work.

I think the various measures taken to contain the virus are good as far as they go, but I also think we need to be clear-eyed about what we can reasonably expect them to do. We can slow the wave, and this is very important. If too many people get sick all at once, the medical system will collapse, and shortly after that, society itself will start to collapse. We know this from the history of epidemics, which is quite grim. I'm not going to go into details here.

But, as things now stand, I don't see how we are going to stop the coronavirus until we have a vaccine. The asymptomatics and the mildly ill will be going about their daily rounds, and they will be continuing to infect others. And some of the newly infected will die.

Make the denominator big enough, and the numerator can look relatively low, even when a great many people are dying.

Second, what happens if some of the asymptomatic carriers continue to harbor the virus in their bodies for long periods of time? There seems to be an assumption that, in all cases, the virus will run its course in a relatively brief period, and the surviving patient will then be disease-free and not contagious.

Many bugs can hide out in the human body for years. This is where shingles comes from. And I've mentioned Typhoid Mary to a number of people. Over the course of her career as a cook she infected at least 122 people, of whom five died. (For a story on Typhoid Mary, click here.)