The COVID 19 outbreak. Does it mean MORE backpacking this year?

[Ryan Jordan]

Thanks for the well-wishes.

My mom tested negative for Covid and is at home, isolating with my dad. She had her test results back in 24 hours, they sent the swab to UW for testing, very fast turnaround. Remarkably, she also was able to get a CT scan, which is now being used as sort of a “pre-diagnostic” to admit possible high-risk Covid patients. Her CT was clear, no GGO incidence.

Her hospital is still ahead of the curve, but having made 3 visits to the ER there over the past week between her and my dad’s visits, she said that traffic inside the hospital is increasing significantly and the number of people there for respiratory illness has grown a lot in 7 days – from a couple of cases when she was there the first time to two separate intake centers (one for respiratory cases) and a triage pre-screening room full of sick people a few days ago. This is in South King County, in an area that hasn’t been hit as hard yet – in her region, King County is reporting “only” 50-100 cases per 100k people.

I have friends throughout the King County healthcare system who are saying similar things: hospital traffic, admission, ICU, and intubation have all increased tenfold or more this past week, even though that’s not exactly clear from the stats:

The (“it’s not that big of a deal”) deniers seem to be disconnected from what healthcare personnel on the ground are actually dealing with in real-time. Twitter feeds from healthcare workers in Seattle, Portland, San Francisco, Los Angeles, Salt Lake City, Denver, Detroit, Chicago, New Orleans, Boston, NYC, NJ – try to find some of these and see what they are having to deal with. The rate at which this disease progresses, how dramatically it can infect people without underlying conditions, how ER’s are going from 1-2 probably cases a day to dozens of admissions a day to several intubations a day and what life is like in ER’s and ICU’s right now is something we’ve never seen in our lifetime.

Now, it’s starting to hit home. I know several folks personally who are now sick or tested positive, or have loved ones on the front lines in healthcare who are communicating to us all that “this is like nothing we’ve ever seen”. Damn the math (I know, it’s not my nature) but the reality of the experience in the hospitals looks different. The difference in math and reality is always because of bad or insufficient measurement (test) techniques.

Scientific Method 101.

Go figure.

COVID-19 Update: Sunday, 3/29/20

Closing out the weekend with the latest #Covid_19 crisis update from Dr. Smith: https://t.co/McRhNzMJvf pic.twitter.com/wp93JNAzsp

— Columbia Surgery (@ColumbiaSurgery) March 29, 2020

[HkNewman]

@ Roger Yeah, I meant less patients occupying the present ICU beds (was typing in a car this morning).

 

@ Ryan … that is very good news.

[Jerry Adams]

I knew what you mean HK : )

Great news about your mom Ryan

Yeah, lots of stories now from people in ICUs, it sounds terrible, yet they willingly do it, amazing

That’s why we all have to avoid getting sick, we owe to those people in the ICU

 

[Jerry Adams]

In Wuhan they are now opening malls, but they have to wear masks and do some social distancing.  Vigilant to quickly re-tighten if needed.

That’s what we have to look forward to,  about two months from now based on China

That’s if we can do severe enough measures now so the new cases peaks and then starts dropping

Maybe Washington state is at that point.  https://www.doh.wa.gov/Emergencies/Coronavirus – they just updated their website to show the daily new cases:

[James Marco]

Ha, hey…Edward, you can always narrow any statistical field by adding conditions and conditions and conditions. Conversely, you can expand it greatly by adding more people from lower incidence groups. But, this is simply statistical manipulation. And this is something our glorious American President Trump is doing. “We have a very low mortality rate.” is his statement. Well, he hasn’t waited long enough for a statistically valid sample to be had. He is an idiot.

Acording to the long term statistics from the WHO, even the worst group (>80) shows 14.8% mortality for 80 and over. This is better than 6 in 7 are survivors. Only 1 in 7 are terminal. At 60 – 70, you have a 3.8% fatality rate. At 70 – 80 you have a 8% fatality rate.

This does not discriminate between various so-called “at-risk” conditions, of which there are literally thousands.  Do you have a cold? Which Type? No cold but some chronic condition? Are you under weight? Are you over weight? … and so on. There are just too many to elucidate.

Like any statistical evaluation, it can never apply to an individual case.

COVID19 is NOT a death sentence. In it’s worst form it will kill about 2-3% of our population (mostly elderly,) not the flat 30% of the Black Plague. We have good reason for hope. In the mean time we need to let technology work. It takes time to develop techniques for expanding our knowledge. Less than 1/3 of our population are at risk. And, only about 3% of those are actually likley to die. Does this mean I have to fatalistic about things? No. It is NOT a death sentence.

Yes, I live in NY. Yes, my daughter is an RN in NY. She and I both understand that the risk is minimal, even to her husband who just finished cancer therapy.  Higher risk than normal? You could say that. No higher than Ryan’s parents, really. But I could bet on any one of us being alive at the end of all this and rake in a ton of cash. Ehhh? Good odds! Even 1 in 7 are good odds.

 

[James Marco]

Ryan, I guess we crossed…Glad she is clear for now, just a cold. Stay well!

 

[Roger Caffin]

if we can do severe enough measures now so the new cases peaks and then starts dropping
All the while, dealing with the demands from the rich to restart the economy and the bleating about Constitutional rights for freedom from restrictions.

Hum – I wonder whether the extreme civil rights groups are now being funded by the extreme right, extreme evangelists and extreme Republicans.

Cheers

[jscott]

Ryan: whoo hoo! best of news for sure.

James, there’s a lot more people alive today than during the Black Plague. Potentially–but not certainly–the real numbers are not pretty.

that said, I agree that it’s important to remind everyone that the probable outcome from catching Corona is that you get better at home over a period of time. There’s a lot of justifiable anxiety out there. But the anxiety is about New York being overwhelmed and “the spread”. If you get Corona, there’s every expectation that you’ll come out fine, absent all the conditions that we’re all familiar with. And even then!

I’m not minimizing this. Practice good distancing and it will all be moot. Health care workers and others are daily putting themselves on the line while they await protective equipment. Sounds like King County is working triple time to provide good care.

Stay home!

[Edward John M]

I would like that to be true James but that is not what I am hearing from the doctors in the family in NYC.

[James Marco]

Edward, are you saying that the disease is 100% fatal? If it is that we have nothing to worry about, we’re all dead anyway.

I am simply relaying the numbers from the World Health Organization with some approximate numbers added to illustrate.  Of course, there will be local variation.

It is unfortunate, but we may find that this pandemic will show that close proximity to other people is the single most important factor to it’s rate of propagation. In other diseases it may be sexual activity or air-borne propagation as a couple examples.  Because of the high propagation rates, places where there is a high population density, such as NYC, will show extremely high death rates due to the simple super-volume of cases. This is what Cuomo is talking about though he is simply talking about a “Peak” and assuming everyone can understand simple statistics (not including our federal president.)

While NYC is the first in the USA, it is by no means the only. Again, in analysis, it seems to be population centers that are most prone to transmission of COVID19. Any city with a large number of connected living spaces will have a larger rate of initial infection. Larger distances between people are better at slowing the rate of the spread, indeed making it manageable by our current heath system to treat all cases.   Places like assisted living communities (where daily contact among residents and workers is mandatory and they cannot shelter in place)  can be far worse.

In support of this theory, I offer this: In NYC, for example, it is literally impossible to practice a 6′ social distancing rule. In a normal 8′ building corridor (most are somewhat narrower,)  you have an approximate 6″ between the wall and your shoulder. You have an approximate 12″ between your shoulder and the center of your head. When all is said and done, even in a wide commercial-type corridor you have less distance between two people than 6-10′.  Elevators make social distancing impossible. Stairs make social distancing impossible (grabbing a hand-rail is really poor sterile procedure.) And lots of other examples I can think of…

I am sure you can think of Rural areas on your own…

None of this means a death sentence, though. In every case, there is a possibility that you will survive the disease. A death sentence means you will die with no chance of survival. I will never accept that…ha…not while I live.

[Jerry Adams]

I agree with your calculations James

The worst problem is the hospitals that deal with the 10% of the people with severe symptoms.

The workers are willing to risk their lives and suffer almost unbearable working conditions.  We owe it to them to avoid getting sick and adding to their burden.

If they run out of ventilators the death rate goes up to 5%.  If half the population is infected, that would be about 10 million deaths.  And having that many people dying would make it even worse at hospitals.

[Eugene Hollingsworth]

Seemingly off-topic, but answering the thread title question: more backpacking? Not for me this year. My mid-June trip to Florida just got canceled, so the adjoining backpacking for a couple weeks out East is canceled.

I think it’s for the best. No need to potentially propagate the problem.

[Jerry Adams]

https://www.kgw.com/article/news/health/coronavirus/the-world-is-different-portland-couple-returned-to-new-reality-about-coronavirus-after-24-day-rafting-trip/283-fd7fffe7-8872-4a3b-ae08-41d81e4207d7

A couple just finished a 24 day Colorado River rafting trip

“On February 29, Murphy took one last look at her emails. Oregon had just announced its first suspected case of coronavirus, but it wasn’t confirmed. Health officials encouraged people to wash their hands, but life in Oregon continued as normal.”

When they finished it was like Rip Van Winkle

They’re doctors, one in emergency room

[Roger Caffin]

this pandemic will show that close proximity to other people is the single most important factor to it’s rate of propagation.
Meanwhile, some city planners want to encourage ever-higher housing densities ‘to improve efficiency’.

Cheers

[AK Granola]

I’ve been hoping it would die down quickly, as the previous SARS and MERS viruses did. Both for the sake of our elders especially, and selfishly so I could finish my planned trek this summer. I am hanging onto my Inyo permit, but not buying plane ticket or anything else. As things look now, I will likely spend my outdoor time at home in Alaska, where there are miles of trails and places to go with few people – super easy to distance from others. There are still a lot of places I haven’t gone up here, but they’re expensive to get to. I had hoped to fulfill some bigger goals outside before my arthritis and disintegrating bones prevent me from achieving them. But it is what it is. I’m grateful that even while sheltering in place I can get out into nature any time. I can’t imagine being in one of those big city highrises and truly not be able to go about outside.  A scene like Italy is so removed I can only feel sorry for them. I’ve never experienced anything like that.

I’ve been thinking about all of the vulnerable people I know here, personalizing the epidemic a bit, which is just starting to touch us. Elders in my community who created our trails, our parks, our music and theatre organizations, volunteered for everything, created a local scene that makes it a good place to live. Many of these folks are 70+ or even gone already. Those still here still have much to contribute. I’m unworried about myself and not afraid of getting the virus; my will is written and I’m ready if I have to go (won’t be needing one of the ventilators; that’s against my beliefs). But I am terrified of spreading it and causing suffering. No trip is worth that.

More likely way for me to spread it will be being an unknowing carrier and fulfilling my duties at work, attending receptions and shaking hands. Why oh why must we continue with the hand shaking?! It hurts me awfully with my arthritis, but the older generation in particular seems to love this tradition. I hope the next generation will do away with it. I went to a reception on March 8th, just days before coming down with a bad cough, and shook hands with 50+ people over 65. I was worried for weeks that I might have had it and spread it (tested negative). Little old ladies in particular like to squeeze, and big men of course have much to prove in how they mangle your entire arm. I’d love it if we went with a slight bow and a smile. At least for now there are no receptions but the hand shaking will begin again soon, and I dread it, now for more reasons than just my aching joints.

[Roger Caffin]

@Karen

So be independent and DON’T shake hands. Many people won’t anyhow. Smile and nod your head instead. Or do a namaste.

Cheers

[Jerry Adams]

You can have cities with density and still maintain social distancing when in public during an epidemic.  There are advantages to density.  Resources are more easily allocated.  In a rural environment, if one area has a surge it will overwhelm their one small hospital.

[Roger Caffin]

I suggest that the experience with New York and some rural areas is the opposite.
At city densities you cannot find the space for 2 m distance, and social isolation on the 4th floor is, reportedly, agonising.
At rural densities you have no problems with either.
(We have been doing ‘social isolation’ on our farm for >2 months. Still extremely busy.)

Granted, having 200 people turn up from all over the country to a small country funeral can be a problem. The solution is however obvious. Note that the deceased couldn’t care less.

Cheers

[Jerry Adams]

The first infection in Washington was a nursing home.   One worker?  That spread to a bunch of people in that facility.  Most of the spreading is within one facility.

Or in New York, the lawyer spread it to two neighbors, and from there to all three of their families.  I think that was suburban.  Most of the spreading was within a household.  And to two neighbors.

In New Orleans they think someone in Mardi Gras crowds spread it to many people in a crowd.  Big crowds are definitely a problem but you can have crowds in dense cities or suburban areas.

If you live by yourself in a rural area you’re good, but don’t come out for supplies and get within 6 feet of anyone else.  Or touch anything.

I think you can maintain social distancing in fairly dense cities.

 

[jscott]

Karen, don’t lose hope in your Seki trip just yet! Really, it would be easy to keep distance there, and Seki is hardly a breeding ground of covid. So it all comes down to transportation. It may be that by the time your trip approaches you’ll feel better about flying–it’s a relatively short trip.

As you say, you’re privileged with great open spaces in Alaska. Many people dream of getting to where you are. Maybe a lot of little trips; or something new–kayaking?–or revisiting treasured areas in Alaska will satisfy your soul.

[David Thomas]

I’m glad I’ve already trained the dog to, while on a trail, return to me when anyone / anything is up ahead.  That’ll give us time to step fully off the trail and wave to people as they pass by.   Because I suspect our local trails will be used more frequently than usual due to stir-crazy locals getting out and about.

[W I S N E R !]

California’s Superintendent of Public Instruction just sent a letter to union presidents stating public school will be closed through the remainder of the school year (which is June 12th in my district).  I am expecting (speculation, but some counties throughout the country are already pushing to June) an updated statewide shelter in place order to match this timeline…all of which is pushing into the beginning of the hiking season in the high Sierra.

[Nick Gatel]

I think you’re right Craig. My daughter lives up near Eureka. When they closed the schools, she was told (unofficially) the schools will be closed for the rest of the year.

Given all that is happening, not being able to go camping or backpacking for a season is really just a minor inconvenience — and I had a lot planned for this year.

[W I S N E R !]

“Given all that is happening, not being able to go camping or backpacking for a season is really just a minor inconvenience — and I had a lot planned for this year.”

100%.  At this rate I’ll be ecstatic to have a simple BBQ in my backyard with some family and friends come July.

[HkNewman]

Really depends on the rural area and how close it is to major roads/tourist attractions (ski season ended here).  Some rural areas in the US are already getting hit with virus cases pretty high per capita higher than San Francisco’s. There’s a lot of spacing but many also congregate at the central cafe/bar/town stores.

I’ll probably research whether an area will be “open” and a trip patched together.  Pretty sure their tourist industry wants to start up again.  Of course having a post hike meal at a sit down restaurant is going to be iffy, but with smelly hikers (of all sorts), sweaty bikers, etc.. these places should have had outdoor seating/carry out windows anyways.

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