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For All Health Professionals Now: “Connect the ‘DOTS’, Dump the ‘Hunch’ “

Posted on | March 9, 2020 | No Comments

Mike Magee

There isn’t a health professional (or financial professional for that matter) out there who didn’t shake her head last week when Dr. Trump expressed his “hunch” about Covid-19. Crises and panic breed in an environment of ignorance, loose lips, and misshaped priorities. “Hunches” make all responsible leaders shutter.

Britain’s Adam Kucharski’s new book, “The Rules of Contagion”, recounting the mathematics of 1918 Pandemic, makes clear the critical roles of scholarship and leadership during a health crisis.

Rather than “a hunch”, he explains “DOTS.” As Joe Biden would say, “Here’s the deal.” The critical question we face today, as circuit breakers shut down our markets, and “South by Southwest” (a festival critical to the Austin, Texas livelihoods of thousands since 1987) is cancelled, is: “How worried should we be about infection from Covid-19?”

As Kucharski explains, the answer to that question is packaged in a number – R, for reproductive rate. But to calculate R,  you must know four other numbers signified by the acronym, “DOTS.”

“D” is for “duration”, that is, how long someone is infectious. It appears that with this virus, the answer is one to two weeks.

“O” is for “opportunity”, that is, the number of people an infected person comes in contact with during the period that they are actively infectious. “Social distancing”, self-isolation, eliminating hand shaking are all limits placed on opportunity.

“T” is for “transmission probability”, that is, the chance that the virus will pass from one human to the next during an interaction. For Covid-19, transmission seems most common in close-knit communities, and large gathering situations.

“S” is for “susceptibility”, that is the likelihood that the virus will find a welcoming environment in the contact individual. If and when we develop a vaccine, susceptibility would go way down. So far, children appear least susceptible to this virus. In contrast, the old and frail in some cases appear to have fatality rates in the range of 10%.

“D” x “O” x “T” x “S”  =  “R”

If  we are to bring this pandemic under control, we have to decrease “R” or the reproductive rate to less than one. What the means is that you can’t pass the virus on to more than one person, otherwise the numbers, and population vulnerability continue to explode exponentially.

For all health professionals listening: “No hunches now, just the facts – clear, calm, and consistent!”

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