How to talk to your Boomer about Covid-19

I find it offensive that the author assumes that people from older generations are necessarily ignorant or uninformed. The article could have been less patronizing.

How to talk to your millennial about COVID-19:

I know you think this virus only kills people over the age of 60, but that is only true to the extent that we have enough ventilators for everyone.

The early studies have indicated that somewhere between 10-15% of people infected require a period of mechanical ventilation in ICU. Some of those will also require extra-corporeal membrane oxygenation (ECMO). In the early studies from China, patients also received a mixed anti-viral cocktail, even though there is as-yet no evidence that any particular anti-viral is effective.

The 3.5% or so case-fatality rate has been established mostly in circumstances where everyone who needed one could have a ventilator, ECMO, and antivirals.

In Ontario, for example, there are about 5000 ventilators, total. Some are surgical ventilators and some are dedicated ICU ventilators. They are not evenly distributed geographically.

If, for another example, there were 100,000 active cases simultaneously in Ontario, previous reports indicate that we would need up to 15,000 ventilators.

In Italy, all elective surgeries were cancelled so that the surgical ventilators could be used for COVID-19 patients. Anyone who could be moved out of ICU or weaned off a ventilator (not many in this category) was. But this does not mean that every ventilator could be made available for new cases.

If you truly need a ventilator, you will certainly die without it; there is no obvious alternative.

So, if Ontario at some point has 100,000 active COVID-19 cases, then 10,000 people will die. This is a case-fatality rate of 10%, rather than the three-and-a-bit percent that we have been seeing.

If Ontario has 200,000 simultaneous cases, then 25,000 will die. That's 10,000 from the first 100,000 cases and 15,000 from the second 100,000. Because we still have the same number of ventilators.

Reports from the situation in northern Italy suggest that it is not just the over-60 crowd requiring ventilators; it's just that the over-60s aren't surviving their time on mechanical ventilation as well as younger patients.

Also, you should be aware that the mutation rate for SARS-CoV-2 in a single infection chain is about two base pairs per month. Meaning that, in 100,000 cases, we are likely to see about 50,000 point mutations. In 1918, the first wave of novel H1N1 killed people at the extremes of life: the old and the very young. After the virus mutated during the summer of 1919, the virus preferentially killed the young and healthy.

So, millennials, don't be idiots. Practice social isolation. Wash your hands. Don't touch your face. Don't be cavalier about this and incubate the virus. Flatten the curve.

It may be boomer-remover right now, but if you fuck around here you may regret it very deeply and soon.