How Long Must We Keep On Meeting Like This?

Thank you Mr Chair, and all you Raquenteurs, for this opportunity to complete one more speech towards what may be the last CC ever granted!

Fellow Toastmasters, My original title for this speech was We’ve Got To Stop Meeting Like This! But that was intended for a Face-to-Face meeting, and now is out of date, so I’ve changed it to a question instead: How Long Must We Keep On Meeting Like This?

And the answer, I’m afraid, is “maybe longer than we thought”.

But first let’s address whether or not it’s necessary. I’m not suggesting that you think this, but to some people it may seem, from the small amount of illness we see around us, that the amount of social distancing that’s being demanded is excessive. So let me first remind you of some numbers and a picture that may help you convince any sceptics you run into.

According to Robert Fowler, a scientist at the Sunnybrook Research Institute in Toronto, Canada currently has about 150 ICU beds and just 15 ventilators per 100,000 of population. Normally that would be plenty. (At any particular time we may well not know of any of our close friends – or even more distant acquaintances – who are actually in critical care)

But what’s coming is not normal.

Experience around the world so far is that each COVID-19 patient infects between 3 and 4 others over the course of their two week illness (often with the infection occurring before they know they are sick and without direct contact). And indeed, in countries with effective case reporting, it seems that every week or so the number infected doubles. In Canada, its now up to 1500 or one in twenty thousand of us. Which may not sound like much, but with continued normal interactions and weekly doubling, then by next month it would be close to one in a thousand – and if just 15% of those need ventilators we’ll already be approaching full capacity.

This graph from a research group at Imperial College in London shows that the UK is in a similar situation — share screen—

What comes next — switch tab — is the problem

Imagine standing on a beach watching the tide quietly go out while hearing on the radio of an earthquake that has just happened a thousand miles away. It’s not at first obvious that we need to immediately run or climb as far as we can to avoid the impending tidal wave, and our present situation is still a bit like that.

But none of the scenarios in this picture includes the extreme social distancing that is now being asked of us. And fortunately the simulations illustrated in the next picture show that that might work….

— switch tab — ….for a while… — slide right — discuss

So we have accepted the need to shut everything down for a bit in order to prevent a tidal wave of victims from swamping our health care system. But is there any point if the wave is going to catch us anyhow unless we shut down forever?

Well on that last point at least, there may be some good news.

— Change Tab to Hammer&Dance —

The good news is that both numerical modelling and the actual evidence from China seem to indicate that, with a few weeks of strict action, we can bring the infection rate down enough so that on average each victim infects less than one other. If we keep this up for long enough the virus may be caused to die out in our own country but the bad news is that that may take several months rather than just a few weeks and will require us to maintain border vigilance for as long as the disease continues to exist elsewhere — and if we stop too soon the whole process will almost certainly start over again.

But at least it will buy us some time – either to come up with an effective treatment or vaccine or to let the disease more slowly “run its course” enough to leave plenty of immune survivors to act as a barrier. This is called “herd immunity” and trying to reach it quickly was being seriously considered as a policy in the UK and US until quite recently. But that will involve many deaths and if we want to continue to keep the infection rate low enough not to overwhelm the system then it will take a couple of years during which we’ll still need to intermittently apply at least some of the current social distancing. (That’s the “dance” in this picture)

So is there anything else besides this extreme social distancing that we can do to hold back the flood until a medical miracle is found to save us?

Well, perhaps not immediately in our society, but in China and South Korea there may be an approach that could work. It won’t be popular here though because of concerns about privacy, but mandatory testing of everyone with compulsory isolation of cases and quarantine of contacts could perhaps bring this thing to its knees before we all go mad for lack of normal human contact.

In the meantime, I guess we’ll have to settle for virtual hugs!