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Failing to Plan is Planning to Fail

Dr. Pietro Marghella talked recently to Y’s Men of Westport/Weston about coronaviruses, COVID-19, and preparedness for health related “natural hazards.” 

COVID-19 is this year’s mutation of the coronaviruses that afflict our world from time to time. It is not a pandemic. Yet it has an “infodemic” riding ahead of it on social media, creating viruses that spread fake news faster than more sober sources can get out the real news.

Dr. Marghella said disasters are not predictable surprises. Instead, disasters result from reacting to catastrophic natural hazards without well defined and practiced mitigation plans  — the recent hurricanes in Puerto Rico, the fires in Australia. And, still, potentially COVID-19.

Marghella is a career Naval officer with strong academic credentials and experience in preparedness planning. He assists government agencies in turning existing “knee-jerk reactivity” into a proactive planning process to meet community needs before, during and after a natural hazard occurs.

The name “Coronavirus” comes from its halo-like appearance under a microscope. Viruses live inside cells and cause respiratory infections. They are passed by person to person contact. The weaker a person’s immune system the more likely he is to become infected.

The common cold is a largely benign virus that causes mild respiratory infections. COVID-19 is far stronger, and has been lethal.

COVID-19 originated in the area of Wuhan, China in late December, 2019. The people first infected were working in caves where they came in contact with bat guano, breathed its spores then transmitted the disease to others in a local fish market.

It is not yet a pandemic, a “worldwide spread of a new disease,” largely because 99 percent of the 73,332 cases reported by the World Health Organization as of February 18 are in China. Only 1,873 deaths have been reported globally. Disease lethality, as measured by the Case Fatality Ratio, is a low 2.6 percent.

The government was unprepared and found itself with a disaster on its hands. It has quarantined the Wuhan area to try to contain the disease, and brought much of the country’s economy to a near standstill. It even shut down 70,000 movie screens.

29 cases have been reported in the US — including those quarantined aboard cruise ships — with no deaths as of yet.

Marghella mentioned two prior coronaviruses. SARS (Sudden Acute Respiratory Syndrome) in 2002-03 and MERS (Middle East Respiratory Syndrome) in 2011-12.

SARS had an explosive outbreak but receded quickly. Only 8,098 cases were reported, with 774 deaths and a CFR of 9.6 percent.

MERS saw only 2,298 cases reported, but 774 people died, yielding a more concerning 34 percent CFR. Marghella said experts were asking whether coronaviruses were becoming more lethal.

Viruses are droplets, not airborne particulates. They are spread by person to person contact. We protect ourselves by washing our hands often and by minimizing contact with others. Use a fist bump instead of a hand shake. Use an anti-bacterial sheet to wipe surfaces like your supermarket shopping cart handle.

But it was preparedness that got Marghella going.

He told the group governments and organizations charged with responding to natural hazards must become proactive, create plans, review and update them in real time, train collaboratively to implement them, and be ready at a moment’s notice. Each area of responsibility must know what other groups do.

Medical and public health assets have to be at the core of every preparedness plan.

The flu offers a contrast to the three coronaviruses. We expect the flu every year, we plan for it, we have a protocol to mitigate its impact — we vaccinate against it, and our hospital and public health infrastructure has the capacity to handle the patient load. 

42.9 million people were diagnosed with the flu last year, but its CFR was a mere one tenth of one percent.

He closed with Marghella’s Law: By failing to plan you are planning to fail.

Roy Fuchs