John,

Covid-19 is hard to think about. It's hard to feel the individual risk when you know many people don't get sick. And it's really hard to act based on exponential growth.

This isn’t an Internet issue per se, but it is a place where urgent collective action is extremely important, so we felt called to act.

It’s personal too. Most of us at Fight for the Future have older parents who are very much at risk of hospitalization or death. So we wanted to send you these two points to help you think about Covid-19 and what to do about it:

1. It’s not obvious that this is true, but you're probably in more danger from Covid-19 than you are from anything else in your daily life.

The best estimate we have says there’s a 0.4% death rate for someone in their 40s. It could be lower, but that’s what it seems to have been in Hubei.¹ As a 40-year-old, I might hear this, or hear that the vast majority of people who die are older than me, and feel safe. The thing is, nothing I ever do in daily life has a 0.4% death rate. Fighting in a war or living in a war zone has a similar death rate. If suddenly normal life becomes 0.4% fatal (or more to someone over 60) and we don’t change our behavior, that’s a big mistake. Changes make total sense.

In the same way, someone younger than me might hear that no one their age has died and feel indestructible. The problem is, even if you don't die, a bad case of Covid-19 is not something you want to go through.² You get sedated and put on a machine that forces your lungs to breathe. In Italy, people as young as 18 required intensive care.³ Even if you are 25 or 40, big steps to protect yourself make sense, and if you are older this is even more true.

2. Exponential growth means that it's completely prudent to cancel or pause every public gathering we can, including school, even if this causes severe strain or inconvenience.

In Italy Covid-19 deaths grew at ~7x per week.⁴ Let's look at what that means in a hypothetical region with 100 free ICU beds with ventilators. (And that’s a lot, by the way.)

Week #1: you have 1 serious case needing an ICU bed and a ventilator. No problem.
Week #2: you have 7 serious cases. No serious problem.
Week #3: you have 49 serious cases. Now you’re at half capacity. Things are starting to get hectic, but life still seems normal. People get the care they need.
Week #4: you have 343 cases. In just 7 days this has become a crisis. People now cannot get the care they need, including for other emergencies like strokes, car accidents, and heart attacks. Doctors now have to choose between caring for a 40 year old mother of two, a healthy 25 year old, and 35-year-old who's pregnant. (This is happening in Italy now.⁵) Your only way to get these people treatment is to move massive numbers of critically ill people to other cities that haven’t been hit yet. This is happening in Italy too, but it’s hard.
Week #5: 2,401 cases for 100 beds. Statistically, your hospitals barely even exist at this point. Moving that many people will be near impossible even if there is room for them elsewhere.

If you want to prevent needless death, the experience in China and now Italy shows you need to take dramatic steps to slow growth *before* the situation looks really bad. That's very hard for policymakers (hence the disasters in China and Italy) so, right now, how this unfolds and how many die depends on you.

What are things you can do to slow the spread of the virus before things get bad?

The obvious meta answer is, advocate for doing what Italy did—but for doing it now, rather than doing it too late.

Italy closed schools and noncritical public places like bars and restaurants, too late.

Can you and the people you love convince your city to do this before it’s too late?

To proceed, instead of a single action or petition, here are some campaigns written by people who seem to know more about this than us. Visit them, make decisions, and, of course, share this email and these campaigns widely. Hustle. When facing exponential growth of death, every day matters.

Read, share & do: https://flattenthecurve.com/
Read, share & do: https://staythefuckhome.com/
Call local school departments and request that they close. (See P.S.)

Stay engaged, this thing matters,

Holmes, Joe, Sarah, Evan, and the Fight for the Future team.

P.S. We’ve heard epidemiological and political arguments against closing schools and, to us as parents and activists, it seems all families—especially the most vulnerable—will be safer from medical and economic hardship if schools are closed. There is still an active debate about this perspective, including within our team, but these are some reasons to consider it: First, kids appear to get infected at the same rate as adults.⁶ Second, any parent has direct personal experience of how many viral infections kids acquire and bring into the household when they first enter school. Finally, many US children live with—or are cared for primarily by—older relatives, who are very much at risk and whose hospitalization or death would be catastrophic for a family.⁷ Right now a family trying to protect an aging caregiver from infection could face legal action for keeping kids home from school—that’s wrong. In many regions, week-long school closures happen every few years due to weather events like snow & ice storms, forest fires, or heat waves—this isn’t unprecedented and parents expect it to a degree. The risk faced by school staff in their 50s and 60s is another important factor. Meanwhile, work to address specific economic hardships can, and must, happen in parallel either way: workers in many industries will have problems making rent and mortgage payments over coming weeks and months, whether or not schools close. Italy has suspended mortgage payment requirements, that’s an example of the level of intervention we’ll likely need given the drop in economic activity; keeping schools open will achieve less and less as many businesses shut down.⁸

Footnotes:

1. medRxIV: https://www.medrxiv.org/content/10.1101/2020.03.04.20031104v1

Providence Journal: https://www.providencejournal.com/news/20200310/first-confirmed-patient-in-ri-talks-about-surviving-coronavirus

2. Republica: https://www.repubblica.it/cronaca/2020/03/10/news/coronavirus_anche_i_giovani_in_terapia_intensiva_niente_psicosi_ma_tutti_restino_a_casa_-250792425/

3. Wikipedia: https://en.wikipedia.org/wiki/Template:2019%E2%80%9320_coronavirus_pandemic_data/Italy_medical_cases

4. The Atlantic: https://www.theatlantic.com/ideas/archive/2020/03/who-gets-hospital-bed/607807/

5. Wired: https://www.wired.com/story/kids-can-get-covid-19-they-just-dont-get-that-sick/

6. Pew Social Trends: https://www.pewsocialtrends.org/2013/09/04/children-living-with-or-being-cared-for-by-a-grandparent/

7. Business Insider: https://www.businessinsider.com/coronavirus-covid-19-italy-mortgage-payments-suspended-during-lockdown-2020-3

Fight for the Future works to protect your rights in the digital age.