Seventy six years ago, in the early hours of an early spring morning, young men from the various allied nations loaded themselves into a series of sequentially numbered metal delivery vessels off the southern coast of England. The ask of them was not complex, but it was difficult.
The potential future of the world depended in no small part in their execution of that ask.
It was simple, but it was not easy. Many knew that they would not even make it to the dry land. But they went.
When asked, they responded.
As a people, no-one in my generation, or those above or below us, has seen a moment quite like that.
Our moment is here.
There is another enemy, but it doesn't wear spit-shined boots. It does not confront us with Panzers or Messerchmitts or Junkers. It is not led by an evil man with bent symbols and a toothbrush moustache.
As of this moment, according to data being tracked here by the Johns Hopkins University, more than three quarters of a million people in the world have contracted the SARS-CoV-2 virus (COVID-19). In the US, we now have 164,000 confirmed cases.
Both numbers are likely an order of magnitude wrong at this point.
We've all seen the images from Italy. Many have seen the devastating numbers in Spain.
Six years ago, during the last viral outbreak (Ebola, at the time), I wrote this about the treats our ancient enemies (viruses and bacteria) present:
There has been a number of movies and books with doomsday stories. In order of decreasing likelihood, the list includes asteroids crashing into the earth. Widespread terrorist attacks, nuclear war. zombie apocalypse. The first is a virtual certainty given sufficient time; the last is, despite an actual epidemiological simulation run at a reputable university in Canada, not ever going to happen outside the imagination of George A. Romero or Rick Grimes. I am not particularly concerned about any of these. But one thing I do actually have on my fear radar is a viral or bacteriological plague.
In short, we are overdue - WAY overdue - for a thinning of the herd, so to speak. The last really great plague was the so-called Spanish Influenza of the early 20th century. What? No. SARS does not count. In 1918, the flu infected nearly a half billion people, killing around 20% of them. 100 million dead is a lot of people just on its face. But considering that the world population then was only about two billion, the Spanish Influenza killed around one out of every 20 people on earth.
- Stay home.
- Wash your hands.
- Avoid unnecessary travel.
SARS-CoV-2 is not likely to be the Spanish flu (and we should be on our hands and knees being thankful for this); but we need to take this seriously.
I repeat - if the epidemiology from 1918 plays out here today, more than one hundred million people around the world are going to die in the next 18 months.
This does not need to be our future.
We are not merely ships tossed on a tumultuous sea of fate and fortune.
Here in California, our governor ordered a state-wide "shelter in place" more than two weeks ago. He made it clear why this was so. And he reminds us, daily, that our future is in our hands.
Like the soldiers who hit the beaches of Normandy in 1944, we have been called. The ask of us, like them, is not complex.
We aren't being asked to load into troop transports pre-dawn. We are not asked to face enemy fire. We are not asked to storm dug-in positions on a beach in a faraway land.
We are asked essentially to do nothing.
And unlike those soldiers, if we follow orders, most of us are going to come out unharmed.
Our moment. Our choice. Our future.
Here is a simple breakdown of the course of disease, from initial infection to resolution.
For most of us, SARS-CoV-2 represents a fairly mild problem. 85 per cent of us fall into the top two cohorts. Most who are infected will have no (30%) or mild to moderate (55%) symptoms.
A small number (10%) will have severe symptoms, and will require hospitalisation.
Fewer still will have critical symptoms.
ALL of those who are infected will have a period where we are contagious. Even those who have no symptoms at all will, for about three weeks, be able to infect other people.
Critically, those in the 5 and 10 per cent cohorts.
And here is the rub. Of those who land in the critical cohort, current data are that fully half will die. In the severe cohort, estimates are that 15% (one in about six) are also going to die.
These two skew heavily into groups who are older (over 60) and/or those who have other underlying conditions. Asthma. Diabetes. Immuno-compromise.
Many people are discovering that they have "underlying conditions" after they are diagnosed with COVID-19.
But you are going to know someone who does.
By these estimates, crudely, if half the critical cohort (5% of the population) and 1/6 of the severe cohort (10%) are at risk of death, that's about four per cent of the population.
SOMEONE you care about is in that group.
Let me put that another way.
Think of twenty people that you know. Your mother. Your uncle. Your sister. Your daughter. A teacher you're fond of from when you were young.
If this model holds true, one of them is not going to be alive in a year if you don't stay home.
Maybe you're young. Maybe you're healthy. Chances are pretty good that you're not going to get terribly sick.
Do you have someone in your life that you want to nominate to be taken away by this? I don't.
The movie does not have to end this way. There is no need to panic; there is absolutely a need to act.
Stay home. Wash your hands. Avoid unnecessary travel.
Our moment. Our choice. Our future.
Please stay home.
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