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Novel Coronavirus. Microscope virus close up. 3d rendering.

One thing all the Coronavirus experts agree on is the virus will continue to spread for some time. One important question related to this is how contagious is the virus? The key measure is transmissibility, how rapidly the disease spreads. Transmissibility is indicated by its reproductive number, abbreviated as Ro and pronounced R-nought or r-zero. Ro represents the average number of people to which a single infected person transmits the virus. On January 23, the World Health Organization estimated Ro for covid-19 to be between 1.4 and 2.5. Other studies have estimated Ro between 2.4 and 4.0. An outbreak with a Ro less than 1 will gradually disappear. A Ro of 4.0 would produce an extremely bad situation. For comparison, the Ro for the common flu is 1.3 and for SARS it was 2.0.

If we do nothing, then Ro will be high and the number of cases and deaths will be very high. As predicted by some, if we do nothing, the spread could go exponential and lead to millions of cases. If we take aggressive actions, however, the Ro will be lower and the growth rates of the disease will be flattened.

The spread of the disease to date should be a wake up call for every person and organization. Supplies are being hoarded which should already have been on hand. Action plans are rolling out, but they should have been ready from Day 1. The government is prepared for hurricanes but not totally prepared for a pandemic. The good news is the Federal, State, and Local governments are learning a lot from the situation and the emergency plans to reduce bureaucracy should have a very positive impact. Public private partnerships in retail and lab testing are set to solve the critical problem of testing. The wake up call may lead to a silver lining in the coronavirus cloud. Following are some components of the silver lining.

  1. The development time for vaccines must continue to get shorter. The good news on this is they can sequence the genome of the virus in hours. Sequencing the first human genome cost about $1 billion and took 13 years to complete. In the case of the coronavirus, the detection of the virus was confirmed in France on Friday, January 24. Later that day, the Institut Pasteur received samples of three suspected cases they detected with the novel coronavirus and began preparation for the sequencing. The process started on Monday and was completed early Tuesday evening. Remarkable. The next step is the process for creating, testing, and manufacturing a vaccine. The process to get from recipe to tested and available vaccine needs a major upgrade and modernization.
  2. A major information technology (IT) upgrade is needed between state and federal public health organizations. Now that millions of test kits are being distributed, the public will be asking what were the results. As it stands, the answer from the government will have to be, “We don’t know”. This is a problem I wrote about in Health Attitude in 2015. State governments have been reluctant to share data with the Federal government. It is partly cultural and partly because there is no efficient way to do the sharing. The bureaucracy involved is immense. The Feds have spent hundreds of millions on incentives to get states to share their data but it is not happening as it could. The benefits of sharing will be huge. Once millions of consumers, labs, and providers add data to an anonymized national database, a multitude of data will become available for the greater good. Researchers can study the anonymized data and gain insights about the health of the population at a community level, nationally, or globally. This will be extremely helpful for establishing travel bans and imposing quarantines on a more pinpointed basis rather than a cancel everything everywhere approach. Hopefully, better data sharing will be in place before the next pandemic.
  3. A big question which needs an answer is what is the best therapeutic for treating covid-19? Various drugs are being tried. This is new. Historically, if you have a certain disease, you are prescribed a certain drug. For example, if you have breast cancer, then take XYZ drug. Oncologists have learned a combination of drugs may work better than the normally prescribed drug. Either approach in a sense implies one size fits all. In fact, every cancer is different and very personal. This is where AI and machine learning (ML) come in. Globally, more than 350,000 chemical compounds (including mixtures of chemicals) have been registered for production and use. Might one of them work to cure covid-19? I would say it is likely. How do they find the chemicals which can work? ML can be applied to all hundreds of thousands of possible cures based on the genomic sequence of the patient and of the novel coronavirus. You might think of it as a digital clinical trial done in hours, not months. I am confident this type of approach will evolve. 
  4. Like you, I have been receiving emails from a lot of organizations ranging from global travel companies to our local dry cleaner. They are all very similar. One I received caught my eye. They said, “Currently, our entire staff is equipped to work remotely and to support our clients and one another via phone and email. We will send updates to you as appropriate, and information regarding our status and availability will be posted on our website”. This is an organization which was prepared. Many were not. Many companies and schools and conferences are saying they are going remote: e-learning, e-meetings, e-conferences. Saying you are e-whatever doesn’t make it happen. Do all the employees and customers have access to reliable high-speed bandwidth? Probably not. Are they all trained on how the e-engagement works? Probably not. Effective e-whatever takes a lot of planning, testing, and training. The good news is bandwidth is generally much better than it was a decade ago. The wakeup call will result in organizations asking key questions. How well do we function as an e-organization? Before we go back to “normal” do we really need everybody to go back to the way it was? Can we streamline our organization and our services by fine tuning our e-capabilities?
  5. The pandemic is exposing the weaknesses of our paper-based government, including how we vote. Social separation is being urged but to vote, thousands had to stand in line for hours. Those that voted remotely did so by licking an envelope and stamp. Online and mobile voting can work with security, privacy, accuracy, and verifiability if we put our mind to it. Digital discourse can strengthen our democracy. The discourse doesn’t have to be in crowded rooms. Hopefully, the wake up call will get policymakers thinking about the many things we do by touching paper touched by others. Real estate closings, bank loans, paying for things with cash, and the list goes on.

The pandemic has provided a wake up call. If we do nothing, hide like a hermit, and hope it goes away, things will get worse. If we take aggressive actions as described at coronavirus.gov, we can flatten the curves and start thinking about covid-21 and how we can prepare now.