Our county had its first death from Covid-19 today. The number of active cases has gradually increased as well. Surprisingly, Cornell is not to blame. They’ve only reported 5 new cases in students and staff during the past week. The rest of the county had 30.
This is not just a local problem. Some parts of Upstate NY have even bigger increases. There currently are 226 active cases in Steuben County (2 to the west of here). 870 people are in quarantine (almost 1% of their population). It’s much worse now than in March/April. So far 60 people have died in Steuben, with 15 in the past week. Their population is similar to here.
New York State is actually doing better than most places in the US. Looking ahead, it makes me very concerned.
It’s possible to divide epidemics and pandemics into three levels of severity.
The best option is full containment. It’s what happened with SARS, MERS and Ebola (twice) in this century. There’s a local outbreak, but medical help rushes in to help the infected. Contact tracers find and quarantine everyone exposed to them. There’s public education, to help folks reduce their risk of infection. Eventually the disease stops spreading. Eventually it disappears.
With Covid-19, some countries have reached containment. China is the biggest example, but most of Eastern Asia is fully contained or close. However, until the disease is completely contained in the rest of the world, they all risk new outbreaks.
The next best option is just plain old containment. It still involves contact tracing and quarantines, to reduce the spread. Still public education to help slow things down. But for whatever reason, the growth rate stays about the same. People keep getting sick, but not at crisis levels. That’s where most of Europe is right now. Ditto for much of the US, especially New England. New York was there all summer, but it’s starting to lose it. Europe is starting to lose it too.
The worst option is out of control pandemic. Contact tracing doesn’t work then, because too many people are infected at once. You can’t keep track of everyone, nor quarantine them all. The disease pretty much runs its course exponentially. Eventually there is herd immunity, but it ain’t pretty getting there.
Influenza did that in 1918 to 1920. Plenty of other diseases did that in prior history. This year it happened for a few weeks in one Chinese province, then in Italy, Spain and New York City. Hospitals are overwhelmed. Almost everything becomes unsafe. Things can get very bad, even when a disease isn’t real deadly. It’s worse when every place is in trouble at the same time.
Steuben may be close to the edge now. They have 15 contact tracers, which means each of them is running daily checks on 18 sick people, plus 40 more who were exposed and in isolation. Things were fine there until Sept 23, then it went off a cliff.
Covid-19 has dominated lives for more than seven months. I think all of us are growing very, very fatigued. The problem is that Spring and Summer 2020 were just Covid 1.0. Best guess is that this pandemic will follow the 1918/9 curve. If so, we’re right at the leading edge of the second and bigger wave.
One big thing we have in 2020 that wasn’t common in 1918 is vaccines, plus the science to develop them rapidly. Vaccines are challenging. The immune system in general is not easy to understand. Luckily, Derek Lowe’s latest write-up on vaccine development sums up current progress. He is a writer for Science magazine, and all his posts about Covid-19 are great. UPDATE: the Chairman of Pfizer also just posted info about their vaccine development.
The short answer is that creating a safe & effective vaccine is a slow process. One probably won’t be ready in time to help with that middle bump (if it happens). But it may reduce the 3rd and 4th ones.