Friedrich Engels (1884): The Relative Autonomy of the State: Weekend Reading

Zeynep Tufekci: Preparing for Coronavirus to Strike the U.S. 'The real crisis scenarios we’re likely to encounter require cooperation and, crucially, “flattening the curve” of the crisis exactly so the more vulnerable can fare better, so that our infrastructure will be less stressed at any one time.... The infectiousness of a virus, for example, depends on how much we encounter one another; how well we quarantine individuals who are ill; how often we wash our hands; whether those treating the ill have proper protective equipment; how healthy we are to begin with—and such factors are all under our control. After active measures were implemented, the R0 for the 2003 SARS epidemic, for example, went from around three, meaning each person infected three others, to 0.04. It was our response to SARS in 2003 that made sure the disease died out from earth, with less than a thousand victims globally. Similarly, how many people die of seasonal influenza (or COVID-19) depends on the kind of health care they receive. In China, death rates are much higher in the overwhelmed Hubei province than the rest of the country exactly because of the quality of the care. Hospitals only have so many beds, especially in their intensive care units, and those who have a severe case of COVID-19 often need mechanical ventilation and other intensive care procedures. When they are out of beds, people end up languishing at home and suffering and dying in much larger numbers. All this means that if we can slow the transmission of the disease—flatten its curve—there will be many lives saved even if the same number of people eventually get sick, because everyone won’t show up at the hospital all at once.... This disease is mild to nonexistent in children.... On the other hand, for the elderly or for people who have other diseases or comorbidities, it’s very serious, with death rates reaching up to 15 percent. It’s also a great threat to health workers who handle people with the virus every day, with thousands of cases already. Overall, it appears to have a case fatality rate around 2 percent, which is certainly very serious: seasonal flu, a serious threat in and of itself, has a case fatality rate around 0.1 percent in the United States, so this coronavirus is about 20 times as deadly.... Here’s what all this means in practice: get a flu shot, if you haven’t already, and stock up supplies at home so that you can stay home for two or three weeks, going out as little as possible. The flu shot helps decrease the odds of having to go to the hospital for the flu, or worse yet, get both flu and COVID-19; comorbidities drastically worsen outcomes. Staying home without needing deliveries means that not only are you less likely to get sick, thus freeing up hospitals for more vulnerable populations, it means that you are less likely to infect others.... If you are in a position of authority, that means figuring out how to help people stay at home.... The practical steps facing households are immediate and important; for the sake of everyone else, prepare to stay home for a few weeks. You’ll reduce your own risks, but most importantly, you will reduce the burden on health care and delivery infrastructure and allow frontline workers to reach and help the most vulnerable...

#noted #publichealth #2020-03-07