Partnering with Local Governments to Recruit, Assess and Develop Innovative, Collaborative, Authentic Leaders Everything You Wanted to Know about COVID-19, and Maybe a Few Things you Didn’t…. Safety and Survival in a V.U.U.C.C.A. Environment BILL PETERSON Sr. Vice President, SGR Former Regional DHS/FEMA Director
The Problem We are peering into a void, of the great unknown, and trying to make sense of an array of data that doesn’t fit any morbidity and mortality model, because we have never been here before, and we don’t know how to model for public health conditions that have never existed before, in anyone’s lifetime. And, it's a VUUCCA incident, with widely variable geographic peculiarities.
Safety and Survival in a VUCCA Environment • Volatile • Uncertain • Unprecedented • Complex • Chaotic • Ambiguous
Seasonal Influenza – A Good baseline for Comparison • Seasonal flu sickens 15 million to 60 million Americans each year, • About 200,000 are hospitalized with complications, • On average, 36,000 Americans die each year of seasonal influenza, • In Florida, that’s like losing a little less than the entire population of Clermont every year,
Just how contagious is COVID 19?
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Novel Influenza Viruses of the 20 th and 21 st Centuries Global Impacts of the 20 th and 21 st Century Flu Pandemics • • Virus of avian origin 675,000 deaths in the US • • Began in the US 50 million deaths globally 1918 Spanish Flu • 1/3 of world’s population infected (H1N1) • • Virus of avian origin 116,000 deaths in the US • • Began in Singapore 1.1 million deaths globally 1957 Asian Flu (H2N2) • • Virus of avian origin 100,000 deaths in the US • • Began in the US Estimated 1 million deaths globally 1968 Hong Kong Flu 1968 Hong Kong Flu (H3N2) (H3N2) • • Virus of swine origin 12,000 deaths in the US • Began in Mexico • Estimated 150,000 – 575,000 2009 H1N1 deaths globally Pandemic Step.4 WWW.GOVERNMENTRESOURCE.COM 10
Influenza Viruses Studied as Potential Pandemic Threats Avian Influenza Viruses Being Tracked for Pandemic Potential H5N1 H5N6 H6N1 H7N9 H10N8
Novel Coronaviruses What is a coronavirus? Named after the appearance of a “corona” or crown, when viewed by electron microscopy. SARS coronavirus Image courtesy of New Scientist
Coronaviruses are Common Pathogens in Several Species of Mammals Host Species for Coronavirus • Bats • Camels • Cattle • Cats • Pangolins
7 Known Types of Coronavirus Capable of Causing Human Illness Cause Mild to Moderate Illness Cause Severe Disease in People Similar to the “Common Cold” • 229E – an alphacoronavirus • MERS-CoV – a betacoronavirus that causes Middle Eastern Respiratory • NL63 – an alphacoronavirus Syndrome • OC43 – a betacoronavirus • SARS-CoV-1 – a betacoronavirus that • HKU1 – a betacoronavirus causes Severe Acute Respiratory Syndrome • 2019-nCoV (COVID-19) (SARS-CoV-2) – a betacoronavirus that causes COVID-19 disease
Origin of COVID-19 Coronavirus- ➢ Allegations of origin in Wuhan, China “Live Market.” ➢ Wuhan is also the location for the Wuhan Institute of Virology ➢ Coincidence or Complicity? Who was Patient “0”?
How Does COVID-19 (SARS-CoV-2) Infect People? Human to Human Transmission • Direct contact - assumed • Indirect contact (fomites & physical environment) – unknown but assumed • Droplets (large aerosols from coughing, sneezing, speaking) – assumed, with growing evidence of certainty • Airborne (after water from aerosols evaporates, viruses remain suspended in air) – Highest potential danger (e.g. measles virus) – assumed • Fecal-oral route – (touching people or materials/objects with microscopic particles of infected feces/consuming food or drink contaminated with infected feces) – unknown, but COVID- 19 virus found in patients’ feces and water samples from early December 2019 WWW.GOVERNMENTRESOURCE.COM 16
What Makes the COVID-2019 Coronavirus Outbreak So Different? SGR Phrases: “Corona - anxiety” or Coronaphobia ” 1. Compared to SARS and MERS, this betacoronavirus is spreading more rapidly, and appears more like a novel flu pandemic 2. The power of social media, available to the general population in China and elsewhere, has literally changed the game in terms of information spread (information that is both true and false) – the “ Infodemic ” 3. China and other nations have made rapid decisions to enforce community mitigation techniques (non- pharmaceutical interventions) and are using them to an unprecedented scale – CDC says US states, counties, and cities should also be useing these NPI’s (they have already!) 4. As with SARS and MERS, there are no current pharmaceutical interventions for this coronavirus illness (no vaccine and no proven effective drug treatments)
Major Concerns 1.The Health Care System has no Surge capacity, (J.I.T. Economy) 2.Here in the US, initial testing for the Coronavirus was limited, 3.The people at greatest risk for Coronavirus related mortality are already our most vulnerable age group, (40% Nursing Home fatalities). 4.Hoarding of masks and other protective equipment has stressed the supply chain, putting our health care workers, and others, at risk, 5. Political pressure has made it difficult for Health Officials to tell the truth, 6. Approximately 35% of those who get COVID are asymptomatic, 7. A significant segment of our population thinks this is “Fake News” (Impact of Social Media to spread Conspiracy Theories). WWW.GOVERNMENTRESOURCE.COM 18
Important Reasons for Optimism: 1. We know the disease is mild for most people who do get it, 2. Children seem to be protected from severe Coronavirus disease, 3. There has been, and continues to be, extraordinary global cooperation from doctors, scientists, and health officials, 4. Early on, there was exceptional acceptance of the social distancing concept and practices, 5. Historic progress is being made on the development of a vaccine. WWW.GOVERNMENTRESOURCE.COM 19
Unanswered Questions: As of May 8, 2020 1. How did the new coronavirus get into people? 2. How many people have actually gotten COVID-19? 3. How, exactly, does Covid-19 spread? 4. What makes the coronavirus so good at spreading? 5. How many cases of Covid-19 are in the US, and where are we on the curve? 6. What drives mortality in people infected by the coronavirus? 7. What percent of people infected by the coronavirus die? 8. Why do young people face the least risk of dying? 9. What role do children play in being able to transmit the virus to others? 10.If you recover from the virus, how long will you have immunity? 11.Can you get re-infected? 12.How seasonal is the coronavirus? WWW.GOVERNMENTRESOURCE.COM 20
Unanswered Questions: As of May 8, 2020 13. How long will we be using Social Distancing as a precaution against infection? 14. Are there any safe and effective drugs to treat COVID-19? 15. Will there be a vaccine for the coronavirus, and when? 16. What are the long-term consequences for those who survive COVID-19? 17. Will there be a second wave of the virus? 18. When will it end? And how? 19. Will COVID-19 be with us forever (endemic)? 20. Will our government and society accept additional deaths as an alternative to sustaining the national economy? WWW.GOVERNMENTRESOURCE.COM 21
What’s Necessary for Successful Containment Florida needs to test a larger percentage of the state’s population, ▪ ▪ Isolate those who test positive, ▪ Track down their contacts and ▪ Order those people to quarantine themselves for two weeks. ▪ Massive, ongoing testing to detect where the disease is spreading, ▪ A real-time ability to trace contacts of those infected and isolate them, ▪ A willingness of people to wear masks in crowded public spaces, ▪ Reserves of personal protective equipment (PPE) and other equipment for hospital workers to handle any surge in cases, ▪ And reliable, easily administered blood tests to find out the number of people who have been infected. WWW.GOVERNMENTRESOURCE.COM 22
What’s Necessary for Successful Containment According to a panel of public health experts convened by Harvard University, though, the country needed to be conducting Five (5) Million tests a day by early June for a safe social reopening, and ramping up to 20 million a day by late July. The experts said: ”Doing so, will require personnel and lab capacity for testing and contact tracing that is perhaps an order of magnitude greater than what is currently available.” And they say it will be expensive. WWW.GOVERNMENTRESOURCE.COM 23
The Current Harsh Reality- “We have to all acknowledge that we will have to live with Corona for at least a year and probably two or three years,” said Dr. Ansgar Lohse, a professor at University Medical Center in Hamburg and co-author of a paper that sets out a “flexible, risk-adjusted strategy” for reopening commerce in Germany. WWW.GOVERNMENTRESOURCE.COM 24
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