COVID-19: Beginning of the End.

Just in the span of 2 months, everybody went from, “it’ll pass” to get away from me.

Stores are being overwhelmed by consumers in demand for toilet paper, face masks, hand sanitizers, etc.

But why?

It’s because we don’t know how to react. We’re stuck in this idea of panic buying = more security, but in reality, we don’t know what we’re buying. Countries are in a similar dilemma, they don’t have a great idea about handling outbreaks. Some ordered heavy lockdowns while others dipping feet in the pool of “social distancing”.

COVID-19 infected >300,000 people and >13,000 are dead. It’s important for us to be on top of everything because it’s all about to change.

Let’s get into it.

Here are three themes I’ll identify:

  • What’s happening today?
  • What can we expect & what can we do?
  • What does a good COVID-19 strategy look like?

By the end of this article, this is what you’ll take away:

  • How at this pace, we'll overwhelm healthcare systems around the world, in the end causing them to breakdown.
  • How we’re treating this pandemic as a short term sprint while it’s going to affect us long term.
  • How focusing on creating prevention methods (flattening the curve)will help in the short term sprint, rather than the vaccine process that will take ~1.5 years.
  • How flattening the curve of coronavirus cases, will relieve the healthcare system.
  • The amounts of death in countries if we don’t flatten the curve, in the next 18 months.

#1: What’s happening today?

(From March 8th, 2020 ~ March 20th,2020)

Explosive outbreaks of the virus in countries like the US, Italy, Spain, Germany have taken the world by surprise. The weird thing is, although rich countries have better infrastructure, it seems to be hitting them the hardest. It was clear that developed countries are most affected by the virus. After thinking about how this happened, I boiled it down to two reasons:

  • They haven’t developed the proper systems to tackle something on this magnitude (Bill agrees)
  • Developed countries can better identify the virus through testing

Let’s quickly take a look at what measures these countries are taking.

  • The US and Canada have imposed border restrictions for foreigners
  • The European Union has sealed all its borders to foreigners for 30 days
  • China and other Asian countries are seeing cases being brought in from abroad, and have imposed a 14-day quarantine for those that are coming back from affected countries before they can visit certain places
  • Hong Kong even wants new arrivals to wear an electronic tag, where their movements can be tracked

A decade ago, we were faced with a similar dilemma, where the SARS virus took us by surprise. It was a huge economic hit and the medical response from WHO was delayed, even absent at times. It’s clear that we are going through the same thing with the new coronavirus strain. Here’s some context on the SARS pandemic 👇

SARS Pandemic

Severe Acute Respiratory Syndrome (SARS) is known as the first pandemic of the 21st century. SARS is a type of coronavirus, even though we refer to the new virus as “coronavirus”, coronavirus is used to describe a family of viruses that SARS and COVID-19 belong to. It would act the same as COVID-19, SARS was a virus that would mainly affect the respiratory system, first infecting a human in Guangdong, China (2002).

It quickly spread over multiple continents as it infected over >8,000 people with a 10% mortality rate.

#2: What can we expect & what can we do?

This graph represents the death toll in the US if we were to do nothing. The death toll would be expected to be >10 million, with more than 2.5x increase in the number of infected people.

But there is a huge knowledge gap in how the fatality rates work, does the geographic location affect how severe the virus is?

Let’s first take a look at what fatality rates mean for Covid-19.

Breaking down this graph, the dark blue represents the number of patients that are in the Intensive Care Unit (ICU) while the lighter blue represents the number of patients that are expected to be hospitalized from outbreaks. All of this is in comparison to the capacity of the healthcare system’s ICU beds.

This is a clear example of our unpreparedness.

We can expect numbers to climb up to 3 million people infected with needing mildly severe medical attention and how they don’t have the capacity to handle that.

To be clear, this doesn’t mean everybody in the US that gets infected with the virus is going to go to the ICU, but what it does say is that the virus strain that certain countries are dealing with evolves from different hosts. The strain that infects China may not be as lethal as the one that infects everybody in the US, and this is because the virus evolves to be able to infect more and more people and combat stronger and stronger immune systems.

Visual representation of how many times COVID has mutated in different geographic locations.

All in all, this doesn’t just affect the US, it affects every country and acts as a warning for healthcare systems that can’t currently facilitate the outbreaks in their own country that they need to accelerate preparedness.

But what can we do?

Now you might have heard of this thing called flattening the curve — after all, it’s all anyone can talk about. But what does that actually mean?

What do I mean by flattening the coronavirus curve? The curve is a reference to how many people are being affected by the virus on a daily basis, and flattening would be a reference to how we can implement frameworks and practices to sustainably reduce the number of people being infected.

Flattening the Curve 📉

There are three main things that can help us flatten the curve sustainably:

Change Models

Changing models is all about how we view work or the systems that we put in place for work to get done. Some companies haven’t put in the effort to make systems for situations like these where it would be very beneficial for people to access work from remote environments like home. The more time we invest in changing these types of outdated models, the better we’ll be at sustaining work throughout these types of times.

Industries have no idea what to do. Our models need adaptability if industries can’t change their business models and marketing around rapid advancements in the world, then they're bound to be left behind.

Support Innovation

While similarily, supporting new innovations is also very important, in an age where anybody can learn anything, it’s beneficial to create opportunities for people to able to make an impact on an issue that affects a lot of people. In real life, no one sees coronavirus as an opportunity to beat someone else but as something where they can help impact people and it’s up to us as a community to support people with these mindsets.

Great examples of this here

Increase Transparency

Increasing transparency with companies, governments, and organizations will allow people to get a better sense of what we are dealing with. The more the public knows the more we can accelerate preparedness towards one common goal.

A great addition to this would be, focusing on preventing further spread rather than vaccines. Both, in essence, are solutions that are based on a proactive approach rather than a reactive one, but it’s all about short term and long term. While average vaccines take 1.5 years, instead of focusing on vaccines, a great way of flattening the curve would be looking into how we can prevent spread and infection. This will help relieve the stress on the healthcare system.

But before we move on to what a good strategy looks like when dealing with something like this, why do we have to flatten the curve? Why can’t we just find a vaccine to coronavirus and be done with it all?

How vaccines are created? 👨‍🔬

Of course, that’s the first thing that we would get started working on, that’s also assuming that the virus gives us enough time to develop a vaccine. Creating a vaccine isn’t something that can be created in one day, but takes on average 1.5 years. Let’s take a closer look at the process of creating a vaccine:

  1. Exploratory Stage
  2. Investigational New Drug (IND)
  3. Trials

Researchers start off looking for new drugs that we can use to combat certain viruses, conditions, or diseases and then submit a full report on what they are investigating and why. Where only after careful examination and thorough research, the vaccine moves on to rigorous trials to find any adverse/side effects that cause bad health in a human being.

There are sub-stages of this process that can be sped up, but even then it’s always the trials that are the longest part of the process because we must be careful with what we are experimenting with so that it doesn’t hurt human health. An example of a sub-stage that can be sped up would be the exploratory stage, where we can use new exponential technologies like Artificial Intelligence to find new drugs that we can use to fix problems. While the rest of the process is just administration and validation that can’t be sped up without dangerously cutting corners.

#3: What does a good COVID-19 strategy look like?

If you want to solve anything, your must define what you want.

To progress in how we can find a solution(s) to our current problem, first, we need to define what a good solution would be.

Looking at what Taiwan did, would be a great example of a solution.

Context: Taiwan is 81 miles off mainland China, and was expected to have the second-highest number of cases of COVID-19, with their close proximity and constant flights (ex. 2.71 million visitors from the mainland in 2019). COVID-19 happened just before the lunar new year, where millions of Chinese and Taiwanese were expected to travel.

They’ve been on guard ever since the SARS epidemic in 2003. Once they were informed of the new virus, they quickly mobilized and ideated specific approaches for case identification, containment, and resource allocation to protect public health. In terms of technology, they weren’t hesitant to integrate their health insurance database with their immigration and customs database to provide real-time updates during a clinical visit based on travel history and symptoms to aid identification. People who traveled to high-risk areas were quarantined at home with a government-issued phone that was being tracked to make sure there were no violations, while people that traveled to low-risk areas. While people who didn’t travel to as high-risk areas were given clearance at immigration so they don’t increase traffic.

They proactively searched for citizens with severe respiratory symptoms, that had also tested negative for influenza but had them retested for COVID-19. They had a success rate of 1 out of 113 cases…

“Only 1 out of 113!” wow that’s a really bad rate. Well, pay close attention 👇

If you don’t get it, the reason that the number of confirmed cases goes up is that the number of infected increases exponentially. Here’s a numerical representation:

1 → 3 → 7 → 15 → 31 → 63 → 127 → 255

For reference, the population density in Taiwan is 649 people/ km².

Taiwan's government also provided food, health checks, and encouragement for those under quarantine to address the disease stigma. They were unhesitant to implement a huge list of quick response action items (here are the ones that really stood out to me):

  • Government allocates face masks to retailers and reduces the price to $10 (Jan 17th)
  • The government announced that the spread of fake news for COVID-19 can be fined up to $100,000 (Jan 22th)
  • The government declared that home isolation violators will be fined up to $10,000 USD, while home quarantine regulations will be fined up to $5,000 USD (Feb 12th)
  • If 1+ case in a class (K-9) infected with COVID-19, the class is suspended for 14 days. If 2+ cases in a school, the school is closed for 14 days.

*The whole list of 124 action items that they implemented can be found here

But one of their biggest decisions that started this whole effect, a change in resource allocation.

They actively took a role in setting the price of the masks, while using government funds and military personnel to increase mask production. Their resources included: 44 million surgical masks, 1.9 million N95 masks, and 1100 negative-pressure isolation rooms while also maintaining transparency with the public.

Results: Taiwan managed to regulate its amount of cases down to 30, which is far fewer than the numbers that were expected from the initial model that predicted Taiwan would have the second-highest importation risk. Like with a statistic there may be inaccuracy in terms of true cases in a country, but it’s incredible that Taiwan was able to act swiftly to limit their amount of cases during the lunar new year.

Since we’ve identified what a working solution looks like, this can help us identify what we want in our own countries, now it’s up to you to do something about it. Here are some things you can do: Sign petitions, develop prevention methods, increase awareness in your community (don’t hesitate to reach out to me if you did anything 👋).

On a global stage, we see two types of countries:

(1) Fighting countries

(2) “it’ll pass” countries

We’ve seen this same mentality with other global issues like global warming, education, and poverty. We have this passive mentality when it comes to difficult decisions, the hardest part is starting.

There’s no better time like the present, which is why I ask you to do one thing.

Start.

Announcements!

(1) I’m currently working on a prevention method for COVID-19 from infecting cells in the respiratory system. It involves using ACE2 receptors and Angiotensin Receptor Blockers to block the catalytic site where the virus enters the cell. You can learn more about viruses and COVID-19 here

(2)If this article interests you or you want to keep up with our research for MIT Solve, sign up here.

(3)Don’t hesitate to reach out to my email (valmikrao@gmail.com)!

Just a 16-year-old trying to solve the world’s biggest problems…