I am a critical care physician and assistant professor of medicine in Canada, and have spent weeks obsessively consuming Covid-19 medical literature. Ultimately, I see only one way to navigate society through this pandemic with neither apocalyptic death rates nor economic devastation. To my surprise, the conclusion I have reached seems very similar to the ‘back to work’ plan the Trump administration floated on Tuesday.
Extreme measures to suppress Covid-19 through enforced social distancing are likely to be successful, and seem to have already succeeded in Wuhan. However, as an Imperial College London paper published last week makes clear, these measures may only work as long as they remain in place (the shaded blue area of the below chart).
Once people begin to travel freely, engage in commerce, and send their children to school again, the epidemic could pick back up right where it left off (the green curve on the chart). Social distancing does not prevent a catastrophe, it merely buys time while we prepare and pray for a game-changer.
Some have suggested that using that delay to increase life support capacity (i.e. sourcing mechanical ventilators) in hospital intensive care units could help. Sadly, preliminary (and limited) data suggests that up to 90 per cent of Covid-19 patients who go on life support will die. So ‘more ventilators’ does not seem like the game-changer we seek. As a life support specialist, myself, I am greatly chagrined to admit this.
Some, such as President Trump, hope that an old malaria drug called chloroquine will have a bigger impact. These hopes are currently based solely on anecdotal reports, and clinical trials of this and other drugs are still ongoing. But it is worth noting that 11 years after the H1N1 influenza pandemic, there are still no