A Bell-Shaped Curve
By Skip Hellewell
Do you remember the dreaded “pop quiz” from your school days? They often came at mid-semester, when your focus on studies tended to wander, as a check on your diligence. Have you considered the novel coronavirus as a form of pop quiz on the healthfulness of our lifestyle?
Eating a healthy diet and exercising are the first steps to protecting health. We hear this ad nauseam. Chronic disease (heart disease, cancer, lung diseases, diabetes, etc.) accounts for 86% of health care costs per the CDC but to a large degree are preventable with a healthy lifestyle. The risk of ICU admission for COVID-19 is linked to these diseases. Per a recent CDC report, diabetics are about 11% of the population but 32% of COVID-19 deaths, a three-fold higher risk. Lung disease affects 13% but is linked to 21% of deaths. The role of heart disease is less clear; 49% of the population has it to some degree, but it’s identified in just 29% of COVID-19 deaths.
Age is often mentioned as a risk factor but it may be mostly due to higher incidence of diseases such as diabetes, lung diseases, etc. There isn’t clear data, for example, that a healthy 70-year-old is significantly more at risk than the average 40-year-old person. The point is that reserves of health can reduce your risk for COVID-19 morbidity and mortality. Healthfulness is important because we’ll likely be living with the coronavirus for a while. A vaccine is at best 18 months away, and at worst may take decades (after 40 years we’re still working on a vaccine for HIV). It’s a good time to remember William Farr.
William Farr was a London doctor during the cholera and smallpox epidemics of the mid-1800s. He identified population density as a risk factor for disease but also saw that epidemics follow a bell-shaped pattern, rising quickly, leveling off, and they dropping. This is known today as Farr’s Law and we can see this pattern developing with the coronavirus pandemic. The Israeli scientist Isaac Ben-Israel has done a coronavirus study of various countries and reports it following this pattern, rising to a peak around 40 days and then declining. The curious observation is that the pattern holds regardless of the measures taken by countries. Though he supports preventive measures such as sanitizing and social distancing, he questions the benefit of shutting down economies.
Our son Rob, trained as a lawyer but now a partner in a restaurant, reports a two-thirds revenue decline with service reduced to take-out. Through quick action they were able to qualify for interim government funding to retain employees. Times are tough but they’re hanging on in hopes of a recovery. I overheard a conversation between our neighbor and a gardener. He owned his business and in accented English spoke earnestly of the need to get the American people back to work. This is a growing theme. When the first Laguna Beach restaurant reopens, I’m going to invite the Beautiful Wife out to dinner. There’s meaning in that.
Skip fell in love with Laguna on a ‘50s surfing trip. He’s a student of Laguna history and the author of “Loving Laguna: A Local’s Guide to Laguna Beach.” Email: [email protected]