COVID19 Lockdowns protect Medical Infrastructures

Protecting people is a secondary, *intended* effect

Problems presented by a disease such as COVID19 are not medical in nature. Instead, I posit, they are problems of logistics and physical infrastructure. My rationale for such a claim is perhaps best encapsulated in the fact that COVID19 spreads fast, with a relatively low fatality rate — relative to more deadly diseases like EVD and SARS.

Lockdowns: necessary and lesser of two evils

Yes, people are dying. And people are falling ill, by the millions, in a very short period of time. But what’s hurting people more directly, than the virus itself, are the necessary and draconian lock-downs that have engulfed cities, states and countries all over the world.

These lockdowns are the lesser of two evils — continue with a globally active civilization of people who are very likely to fall ill; or continue with a planet of relatively healthy humans suspended like a bubble of air stuck in frozen ice. Governments, worldwide, picked the later.

Consider what the lockdowns have stopped. The lockdowns have blocked many people from adequately earning a living. The lockdowns have shutdown restaurants and cafes, which is disrupting food-supply chains. Locking down, in many cases, prevents kids from attending school where they are fed as part of school-meal programs (I have seen such programs in both the U.S. and India, and it seems to be a somewhat universal idea). The lockdowns have shutdown medical facilities as well — those that are not actively fighting COVID-19. And given how overworked medical workers already are with the COVID-19 cases, nearly all other health care concerns are getting sidelined, where possible, including cancer treatments and trials. Consider that for a moment. Pause and consider for a moment that COVID-19 lockdowns have punctuated ongoing cancer treatments and trials.

In particular, the fact that an otherwise not-so-deadly a disease is causing this much global havoc, prompts basic questions about our hospitals and medical infrastructure in general.

Why lockdown? Inadequate Medical Infrastructures.

We seem to be forgetting the primary purpose of any COVID19 lockdown — and it is not meant to directly protect people, but rather do so indirectly. The lockdowns are first and foremost designed to give the health care infrastructure — anywhere — some time to bolster themselves. The hope is that such a step would then allow the medical infrastructure to care for people effectively, within their otherwise limited capacities.

Don’t believe me? Think I am wrong? Consider the following chain of news reporting:

1. This is the opening graphic from NYTimes article, “Flatten the Curve”. Notice that on the right margin of the graphic below, it says: “The longer it takes for coronavirus to spread the population, the more time hospitals have to prepare.

Opening graphic from the NYTimes article, “Flatten the Curve

2. This is how Politico.com and the New York Times reported on Gov. Newsom’s order to lockdown California in response to COVID-19:

“The measures are intended both to shield vulnerable residents and to maintain California’s health care systems’ capacity to handle an influx of new patients.

- By JEREMY B. WHITE, 03/19/2020 09:46 PM EDT, Updated 03/19/2020 11:54 PM EDT, Politico

“Officials have described the stay at home orders as an aggressive way to reduce infections and buy time to stock up on medical supplies like ventilators and masks to confront what they expect to be a surge in need for hospital beds.

By Tim Arango and Jill Cowan, March 19, 2020, NYTimes.com

3. Further, as per the New York Times, the following is the first bullet point in the long list of criterion that the Cuomo-led New York state government is looking at, when deciding if/how businesses and services can reopen in New York:

Net hospitalizations for cases of Covid-19, the disease caused by the virus, must either show a continuous 14-day decline or total no more than 15 new hospitalizations a day on average over three days. — By Jesse McKinley, May 4, 2020

Notice that all such public-policy rationale for lockdowns, curve-flattening, and criterion for reopening businesses find their under-pinning in the capacity of the health care infrastructure of a specific location in question. This is not to say that the governments and health care officials do not care about the people — on the contrary, they do so very much. But it is impossible to care for anyone with an overrun health care system. So, we stick with the devil we know.

But the following interpretation of the publicly reported statements above cannot be deemed unfair, even if it comes across as candid, and stark —

Health care infrastructure, the world over, cannot deal with a large-scale, fast evolving epidemic; where, if a sizable percentage of the public were to fall ill and seek medical aid, it will not be able to treat everyone efficiently and effectively.

To be clear, I do not know of any public official to have actually put it like that. That is how I am interpreting the messaging coming out of governments the world over, and real-time news reporting in general.

Some napkin-math: We have about 4 million COVID-19 cases in the world. Out of a planet of 7 billion people, 4 million have been impacted so far — a rate of 0.05%-to-0.06% approx. Now, I get that not all places are impacted equally, and the rate is so low because we are social-distancing so aggressively. But, even when hospitalizing 0.05% of the world’s population, the World is struggling. I expected better.

I do not expect hospitals to maintain a minimum number of beds that correspond to a certain percentage of the net population of the locality that they serve. But I do expect hospitals and governments to plan for, and even engineer emergency makeshift solutions in case such a capacity is desired or becomes necessary.

Interestingly, electoral-districts are typically designed and drawn in democracies while taking the net population of a locality into account. In fact, why do governments not take their country’s health care capacity and general public health with the same seriousness as they do matters such as elections, military spending, literacy rates or GDP and unemployment rates? Questions for another hour.

Crisis of confidence

If health care and medical facilities worldwide had the capacity to treat the ill, at the scale, and for the time, necessary then we would not need to go into such drastic lockdowns. Anyone confined to their homes right now are paying a price, just so that they do not overwhelm the hospitals of their local communities. That is the whole point behind flattening the curve.

If I personally had the confidence that I would get the necessary medical treatment if I were to fall ill, then I would go to work everyday. That is what I and many people in the world do for every other disease that is out there. There is always the risk we will fall ill, but we take that risk, knowing that there is a safety net —perhaps not always adequate, but there is something.

Flu or Common Cold season, I go to work. There is an E.Coli. outbreak in my state or county, I go out to eat … maybe, I do not order the lettuce. I grew up in some of the remotest regions of India, all the while attending school and learning of diseases like diarrhea, tuberculosis, cholera, hepatitis, malaria, and polio that actively threatened our localities — and, I never stopped going to school.

I cannot do those things anymore, because I do not feel confident that a hospital would be able to treat me. So, I stay put.

researcher • software engineer • program analysis . debugging • UCI • blogger • software visualizations • Views are my own. • http://vpalepu.com

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