March 12, 2020
It’s now time.
Napoleon amassed over a half million soldiers on the banks of the Neman river preparing to invaded Russia. Ahead of him was hundreds of tiny villages of profoundly poor, peasants that Napoleon needed to plunder to support his army. But with poverty comes the litany of miseries. The locus that was The Grand Armée was to feast and bath on these miseries: poor food, pestilence and disease. Napoleon failure to comprehend that each village was a pandoras box of infectious diseases was a grand mistake. Each village an island hosting its own brand of insidious diseases and almost immediately, the Grande Armée opened a door of horror – typhus. Once introduced into his army, typhus ate it soldiers from the inside out – literally draining them of fluids. . Typhus had no regard for the strength of the soldier or its rank. By the thousands, his army was gutted.
This was knowable. Armies as have had to deal with disease outbreaks regularly – even typhus. But here Nepoleon’s belief in the superiority of his troops and his failure to isolate his soldiers from each other as well as from the diseased populace he was ransacking, was his ultimate downfall. Over 200,000 never made it to the doors of Moscow and only 10,000 returned to France. And while typhus cannot claim all these victims, may were so weakened they were unable to survive the cold, hunger and other hardships.
Why can we not learn these most basic lessons of history? Isolate diseases from dense populations. Contain local ‘hotspots’. Educate and treat knowing your life actually does depend on it.
We are now seeing that containment is an early response to a disease outbreak. As community spread occurs, mitigation efforts take over and eventually look very much like how we deal with seasonal flu; vaccines, medications, and therapies that are known to work. Both of these strategies are only effective with surveillance level of testing; something we are not yet able to do.
The restrictions on travel that were put in place yesterday will help the public to see the severity of the situation we find ourselves in. It is an admission of the severity of this pandemic.
The effectiveness of this strategy, at this late stage, however, is going to be very limited. For the USA, the party is over. The masque’s are slowly being lifted; and we begin to see how deep our failed response has been.
This travel ban is inverted. The ban really should be ‘No Travel To and From the USA’. With no effective testing, we, the USA, are the ignorant infected. We are the global problem now, as Italy is and as China was. The director of the World Health Organization, in typical subtle manner, called out the USA as such during his ‘Pandemic’ speech. Never was the USA mentioned. Our global leadership, a leadership the world has counted on for decades, has failed.
• We have 50,000,000 Americans over 65 in the USA.
• If the attack rate over 1 year on this population is 10%, that is 5,000,000 sick-elderly we have to add to the healthcare system this year.
• If the fatality of these sick folks is 10%, that is 500,000 deaths added this year.
These numbers are likely pathetically low. In this population, an attack rate of closer to 50% with fatalities closer to 60% … well, you can do the math.
And that’s just the folks over 65.
During the H1N1 crisis, we worked on MOU’s (memorandum of understanding) with local grocery stores and skating rinks not for food and recreation, but for refrigeration.
Every one of our hospitals runs ‘Lean and Mean’. We have some of the lowest reserve capacity of ICU beds in the developed world.
Mortality rates of 0.8% to 3.4% have been offered. In Italy, it is over 8% because the healthcare system is overwhelmed.
SEVERE MEASURES FEEL WEIRD WHEN EVERYTHING LOOKS NORMAL.
I know, I get it.
But the beast is here among us now. The masque is off and we see it is us.
Big Word • Small World 
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