Nisly Paradise

Dear Weavertown Church family (and any others who are interested), I am writing to try to give you an idea of how the COVID-19 Pandemic may impact us at Weavertown. There are three specific things I want you to consider:

1. I think the pandemic will get quite ugly, and last a lot longer than many assume. You should prepare.
2. Please, please take the social distancing concept quite seriously.
3. A follower of Christ’s duty is to lay down his life for his brothers.

Update 3/29/20: some readers have accused me of fear mongering. I apologize for creating that impression. More on that in the final section. Perhaps it would help to share Proverbs 22:3 as somewhat of a theme verse for this post: The prudent sees danger and hides himself, but the simple go on and suffer for it. (ESV).

Pandemic Severity

In the US, the COVID-19 infection and death rate are currently on track with Italy or may exceed it. Following is a several chart to help you visualize this. Also of note is that death rates vary significantly within the US. New York City is rising at about twice the speed of California.

Some hospitals in New York City have already seen deaths of medical staff, presumably due to running out of PPE (personal protective equipment such as masks and gowns). Lack of protection for healthcare workers further increases the possibilities of the pandemic becoming apocalyptic.

Update 3/29/20: here is a short video from a front line ED doctor at the Elmhurst hospital in New York describing increased patient volumes and lack of equipment. I am sharing this to give a taste of the impending medical infrastructure failure that seems likely, all over the US at the same time.

Calculators:

Based on projections from Tomas Pueyo, best case scenario in the US is about 500k deaths (25% of population get infected with death rate of 0.6%), worst case is around 10 million (75% get infected with death rate of 4%). The worst part of this death rate is that many could be preventable if this surge in infections could be spread out enough to give medical resources time to catch up. More on that later.

Penn Medicine has created a calculator called CHIME to project impact on Penn Medicine facilities (which includes LGH). This shows real time data from aggregated Penn Medicine facilities. One of the most interesting details is that the projected peak is not until May 12. Lack of sickness at this point makes it tempting to assume projections are hyperbole, but it’s helpful to realize the infections have only just started. NOW is the lull before the storm.

Please consider reading this article in it’s entirety. It is an excellent summary of different ways the COVID-19 pandemic could play out in the US. All of them are very painful. This is obviously projections and contains some political speak, but I consider this article to be very realistic. It also talks about probable long term implications of such a severe pandemic.

Implications

Based on the probability discussed above, it is likely that at least one person at Weavertown Church will die from COVID-19 in the next 3 months, without family presence (visitors are prohibited at medical facilities). 250 people *0.25 infected * 0.06 = 0.25 persons dying. Or, 250 people * 0.75 infected * 0.04 = 7.5 persons dying. Statistically, most, but not all, will be elderly. There are many 30 year-olds getting severely ill. In this lull, you should put your house in order. Spread some love to your family because tomorrow is not guaranteed!

I also think we are headed into a major worldwide economic depression. At the least, you should consider the possibility that in our area, industries related to tourists, group events, and disposable income will drop off significantly for a 6 months or more (I have no specific data to support this, but it seems only logical to consider). Now is the time to tighten your belts or consider alternate employment or ways to distribute your product, especially if you are in one of these industries. I also think the effects of this pandemic will have significant long-lasting lifestyle changes such as the rise of delivery services, telecommuting, home/hybrid schooling, and tele-medicine, to name a few. I do not think it is realistic to assume that everything will return to “normal” in a few months.

Take Social Distancing Seriously

You may be wondering with Trump if so far the cure is getting worse then the disease. This second article by Tomas Pueyo does an excellent job of explaining how to best prevent mass death while trying to go on with normal life. I would highly encourage you to read it. While you may not agree with shutting down businesses, this will at least give you the math to help you understand why most experts are calling for it.

Here are a few specific reasons why I think social distancing is so important. Symptoms don’t usually appear until 5+ days from exposure, meaning you have lots of time to expose your loved ones before you find out you are contagious. According to South Korean data, those in the 20-50 range were the most prolific infection spreaders. Data from Wuhan showed that many infections were spread from immediate family members. I think it’s easy for those of us in the 20-50 range to feel relatively safe and not seriously consider the very real possibility of serious harm to ourselves or especially our elderly loved ones. Many of my healthcare worker acquaintances are preparing to self-isolate from their family for a couple months to reduce this risk. Also, as you have probably already read, the goal of social distancing is not to prevent everyone from getting COVID-19 (although that would be awesome), but to delay the spread long enough to keep from overwhelming medical resources. Following is a shocking graph on the effectiveness of several different mitigation measures:

One of the most shocking things in this graph is that even with surge capacity of hospitals (e.g. doubling current capacity), the vast majority of patients will not have access to an ICU bed that need one. This is one of the strongest arguments for aggressive suppression strategies (e.g. blue line above). Models like this is why the UK went from considering just letting everyone get infected to one of the more aggressive suppression plans.

Note 3/29/20: some readers have shared with me reports that Ferguson (lead author on the paper which produced the graph above), has rescinded his modeling for projected deaths. Here is a tweet that expressly denies that interpretation, but rather says that the death rate in the UK could be around 20k (instead of 500k) with very aggressive social distancing policies. A bright spot is that he seems to think the surge peak could be in 3 weeks in the UK–this is very welcome news, if true. The main caveat with this is that at any point that social distancing policies are relaxed too far, there could be a recurrence of the surge. He also seems to be rebutting Fauci’s paper that assumes that death rate could be near seasonal influenza if we assume the vast majority of COVID-19 cases are asymptomatic. Clearly, everyone, especially in the US, are severely hampered by the lack of availability of widespread testing. I would expect model numbers to tighten significantly in the US in the next several weeks as the availability of rapid testing becomes wide spread. My hospital reportedly will begin with the 1/2 day turn around test in the next week.

Secondly, please notice the length of this surge in this graph–quarantine and other mitigation efforts will likely be in place for more like three months, not three weeks.

Additionally, there is already evidence that the coronavirus will mutate rapidly, perhaps making this more like the seasonal flu, in that there will be a round of it every year, especially until an effective vaccine or treatment is found. Update 3/28/20: thanks to Joel Iwashige for sharing this article on my facebook post which suggests mutation may not be as rapid as first thought.

I still keep seeing gatherings of our people posted on social media. Although these people are mostly young, it still makes me sad to see this flippant attitude. One bad habit many plain people have is to assume they are the exception to the rule, in this case, both that they will not get critically ill, or that they need to follow the laws. Update 3/29/20: a reader shared with me data that showed that Mennonites in Manitoba had about double the death rate of their neighbors during the Spanish Flu in 1918. Meetings were cited as the expected cause for this worsened rate. Currently, there are at least 7 PA counties under a Stay at Home order (Erie County was added since this screenshot). I would expect that Lancaster County will have the same order soon. You should consider preparing now for a 2 month lockdown. Update 3/27/20 1500: Lancaster County and others now also have a stay at home order.

Here are some ideas for what social distancing means:

• Shop no more than once a week (e.g. for groceries) and/or utilize pickup or delivery services
• Avoid meeting with anyone outside of your immediate family. If you must meet, stay 6 feet apart, try to meet outside, and try not to touch anything.
• Practice good hygiene (wash hands for 20 seconds, try to avoid touching anything in the first place, sanitize high-touch services regularly, cough into your elbow, etc.)
• Assume you are contagious and try to reduce your impact. This is more effective then worrying about catching it from others.
• Do more video chats with grandma–She misses you a lot!
• *This is not an exhaustive list and does not replace instructions from your local authorities.

Jesus Followers Response

A Christ follower will seriously consider that their selfish actions may cause serious harm to their neighbor. Not respecting quarantine or social isolation policy is the main example of this. Ironically, some of the most vocal pro-life/anti-Left people are most vocal against social isolation. I do not believe this attitude shows the mind of Christ.

There will likely be much opportunity to do good for our vulnerable neighbors. This may be the time for Christians to demonstrate to the world the love of Christ.

A Christ follower will show respect to our leaders, including governmental leaders. While I do not consider Governor Wolf a godly man, I believe he is doing his best to follow his responsibility to maintain civil order and mitigate loss of life. I sincerely believe he is awake at night a lot right now, thinking about how many deaths he may cause by not acting sooner/stronger. While we may not agree with these policies, the Christian has an obligation to respect them. Based on this data, I also do not feel at all like the government is trying to ban freedom of religion (in fact, all of Governor Wolf’s directives that I have personally viewed give discretion to religious leaders), nor to impose a global currency/order. Disclaimer: I will freely concede that at this point, my livelihood is not effected by social isolation policies.

One of the fruit of the Spirit is peace. Someone who walks in fellowship with the Spirit will display a peace that comes from knowing that God is in control and that we are his children. Someone who walks in the Spirit will not submit to fear, but will respond with power, love, and self-discipline (2 Timothy 1:7).

We are called to walk in wisdom. As mentioned in my introduction, I consider Proverbs 22:3 the theme verse of this post: The prudent sees danger and hides himself, but the simple go on and suffer for it (ESV). I am asking you to consider what is wise, but not to succumb to fear. Also, Proverbs 6:6, 8 Go to the ant, O sluggard…she prepares her bread in summer and gathers her food in harvest (ESV). At the time of this writing, there was an opportunity for some commerce and still some sense of normalcy that we do not have a guarantee for.

Conclusion and Disclaimer

I was 15 when Y2k went down. Someone gave me a tape set with end of the world predictions which I dutifully listened to and believed every word. Of course nothing happened. Ever since, I have been much more cynical about any kind of doomsday predictions. Virtually all of my medical friends are 100% on the social distancing and it’s going to get ugly bandwagon, so I started there by default. I wonder a lot if by writing this, I am a doomsday crier, and in three months, it will be apparent I was listening to only one side of the argument. Nothing would make me happier than in three months to apologize for crying wolf. However, at this point, the experts I have read, who have real data and know how to crunch it, are projecting it will get ugly as outlined above. I have trouble disagreeing with their conclusions.

I once listened to Ray Dalio, founder of Bridgewater Associates, speak on a interview with Farnham Street blog about how important the idea of meritocracy (something is judged by it’s merit) is to their company. They feel strongly that opposition/disagreement with your idea can make it stronger, not weaker, by pointing out the holes in your theory. If your idea remains intact at the end of a discussion, it is more likely to correspond with reality. I am asking the same of each of you. Please help me understand faulty assumptions I, or authors I’ve quoted, have made. But I ask you to do the same with your assumptions.

Please add your input on this facebook thread.

Thank you for reading and I pray God’s richest blessing on your life.