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Len’s Letter #24 The Lily in the Pond (Thank you to Megan McArcdle of the Washington Post)

This COVID-19 crisis is agonizing.  For now, because of what you don’t see. For now, because you don’t know what your role is and which you are.

You may be a potential victim. You stay home. When you go out, you keep your distance from everyone. You come home you wash your hands. For twenty seconds, singing your favorite 20 second song. You are keeping yourself safe. You are keeping your family safe. They do the same.

Here in New York City, on Sunday, the mayor closed the schools. Not an easy decision. Many kids eat two meals a day at school – reduced price or free. Some families need that to happen. Schools will be open long enough for kids to come and pick up boxed meals. Many kids need supervision. All schools provide a kind of day care. Parents can go to work. As for adolescents. If there is school: Try keeping them home. If there is no school: Try keeping them home. For six or eight weeks. That’s going to be a challenge.

You may be a potential victimizer. You don’t know whether or not you are a victimizer. People have COVID-19 without knowing it. They are asymptomatic. No fever. No shortness of breath. No dry cough. But the disease is there. You can infect your family. Take a walk. You can infect the fruit seller. You can infect the person who picks up the piece of fruit you rejected. You are the danger and you don’t know it.

You may be danger to your family. Try doing something about that. For no apparent good reason, are you going to live in complete isolation? That’s not going to happen.   You live your life in as ordinary way as possible while knowing that you are in danger. You live your life in as ordinary way as possible knowing that you may be dangerous. It could make you crazy. It could make you reject cautionary statements.

When will you know? When you get sick? When you get tested? Testing is the problem. Testing is the crux of the anger against President Trump. As he approached this disease with a combination of ignorance and nonchalance, we were all a little bit more ignorant and nonchalant than we might have been. That was true even those of us who hold him in disdain were . His ignorance and nonchalance led to tests being unavailable. We have fewer than China, fewer than South Korea, fewer than Italy. As we grow out of our nonchalance, so long as there are insufficient tests, we do not grow out of danger.

When will you know? Thank you Megan McArdle. She reminds us of an old riddle:

You have a pond of a certain size, and upon that pond, a single lily pad. This particular species of lily pad reproduces once a day, so that on day two, you have two lily pads. On day three, you have four, and so on.

Now the teaser. “If it takes the lily pads 48 days to cover the pond completely, how long will it take for the pond to be covered halfway?”

The answer is 47 days. Moreover, at day 40, you’ll barely know the lily pads are there.

McArdle explains:

When something dangerous is growing exponentially, everything looks fine until it doesn’t. In the early days of the Wuhan epidemic, when no one was taking precautions, the number of cases appears to have doubled every four to five days….The crisis in northern Italy is what happens when a fast doubling rate meets a “threshold effect,” where the character of an event can massively change once its size hits a certain threshold….

McArdle cited Danielle Macchini, a doctor from Bergamo, northeast of Milan, where my wife and I were tourists a couple of months ago.  He “posted a heart-stopping account to Facebook of what he and his colleagues have endured: the hospital emptying out, the wards eerily silent as they waited for the patients they couldn’t quite believe would come … and then, the “tsunami.”

“One after the other the departments that had been emptied fill up at an impressive pace. … The boards with the names of the patients, of different colors depending on the operating unit, are now all red and instead of surgery you see the diagnosis, which is always the damned same: bilateral interstitial pneumonia.”

It got worse, McArdle wrote:

A British health-care worker shared a message from a doctor in Italy, who alleged that covid-19 patients in their hospital who are over 65, or have complicating conditions, aren’t even being considered for the most intensive forms of supportive treatment.

Will this be our fate? In most of the United States, we are in that quiet time Dr. Macchini described. We proceed with little or no confidence in the federal government. We proceed with less confidence in the President, who wavers between believing a national emergency is sneaking up on him and believing that life can go on in an ordinary way.

We have Adam Silver to thank for alerting all of us.  Adam Silver is the Commissioner of the NBA — the National Basketball Association. After one basketball player was discovered to have COVID-19, he postponed the balance of the professional basketball season. Adam Silver could see what would happen. Other leagues followed. Sports led the country.  Mayors and governors followed, taking the danger seriously. Churches and synagogues followed, replacing services with on-line connections. Community organizations followed.

McArdle writes:

…we can fight it. Despite early exposure, Singapore and Hong Kong have kept their caseloads low, not by completely shutting down large swaths of their economies as China did but through aggressive personal hygiene and “social distancing.” South Korea seems to be getting its initial outbreak under control using similar measures. If we do the same, we can not only keep our hospitals from overloading but also buy researchers time to develop vaccines and therapies. … we are all in this together… It is your responsibility to keep American safe by following CDC guidelines….

Tomorrow is St. Patrick’s Day. Parades are cancelled. Bars and restaurants are open. Are we keeping our distance? Are we taking our responsibility to keep America safe seriously? In my neighborhood, there is a bar with pennants crossing the sidewalk – encouraging people to party on St. Patrick’s Day. (Ten O’Clock last night, the mayor announced bars and restaurants would close.  Beginning on Tuesday morning.  March 17.  St. Patrick’s Day.)

Other holidays follow in April.  Passover. Easter. Ramadan. All holidays that involve gatherings, feasts (You could say fasts and feasts for Passover and Ramadan.). Can we approach these holidays with sufficient social distancing? Much as we might wish for better leadership from the President, Megan McArdle said in the Washington Post: If we do [as Singapore and Hong Kong have done], we can not only keep our hospitals from overloading but also buy researchers time to develop vaccines and therapies. … we are all in this together… It is your responsibility [and mine] to keep America safe by following CDC guidelines.”