Fixing Tomorrow's Problem, Today

If something happens to people specifically trained for vital infrastructural systems, what happens to the survival chances of everyone else?

There are a number of potentially foreseeable issues in the face of this pandemic; if we use foresight, planning, and logistics, we can resolve most or all of them. These problems include supply chain logistics, food production, electricity, water supply, medical care and facilities for patients, and economic issues.

In the face of the new coronavirus pandemic, also known as COVID-19, or SARS-COV2, a lot is about to change.

How much? Try everything as you know it.

We have no idea just how far and how extensive the changes will be yet. But we have started to glimpse the difficulty which we may be getting into.

Panic Mode

People the world over are shifting into panic mode. Running to the store and purchasing a lot of toilet paper.

Memes abound throughout the internet, wondering why people are buying toilet paper in the face of a respiratory illness, but we don't even have to go there.

A big part of the conversation revolves around resources. What resources do we have, what resources will we need, and how do we allocate them?

Many are proposing to purposefully extend the timeline at which people get sick with the Wuhan coronavirus, assuming most will get sick with it, so that our healthcare resources are not overloaded.

One Thing Is For Sure

Only one thing is truly certain: we have no true idea of what we are dealing with. There is conflicting data coming from many reputable sources. Some say it is most transmissible BEFORE symptoms appear, while others say it is only truly transmissible AFTER symptoms appear.

Assuming The Worst

Let's assume the worst for a little bit. With God's help it won't come to this, not even close to this, but if we wander down this path purposefully for a little while, we may be able to determine some truly valuable next steps.

In a worst case scenario, many, many people get infected with COVID-19 all at the same time. Even if we don't hit the catastrophic numbers quoted by some, we don't need many before it puts a huge burden on a lot of systems that people throughout the United States rely on for their survival.

One of the biggest issues arises in that many of the people who work within these systems are trained and specialized in what they are doing. If something happens to those who are trained – what do the rest of us do?

Please note: this is applicable in every country, but as a citizen of the United States, I will be writing this up from the US perspective.

Healthcare Systems

The healthcare system in the United States is supposed to be very good. First class. But it is built to deal with sickness and disease as we know it, and not necessarily that of pandemic proportions.

There have been numbers floating around the internet, of about 975,000 available hospital beds. In a country of about 350 million people. That is about 1 bed per 350 people.

In even a not-so-bad scenario of 10 million people being infected at once, at an approximate rate of 15-20% of patients needing hospital care, we are looking at 1.5-2 people per hospital bed. That is assuming that every bed is EMPTY!! Which they are not, many of those hospital beds are currently helping people who are suffering from other health issues.

Limited beds. Limited nurses. Limited doctors.

Straining the Healthcare System

One of the big issues we are seeing in Italy, and possibly saw in Wuhan, was a strain on the healthcare system. Too many people needed care too quickly, and there were limits on the people and the places to offer care.

Additionally, there are reports coming out of Washington state that doctors are being quarantined for 14 days after exposure to patients sick with COVID19.

Plan for this Crisis Today

We can make the plan to address this today. There will be many people who are hungry for work and for pay with this global crisis happening. There will be many buildings that can be repurposed.

The basic solution to the healthcare problem is:

• Train in new people to fill the gaps of healthcare
• Convert locations into interim hospitals
• Give greater power to experienced professionals, temporarily

If you have ever read the Bible, when Moses first received the tablets, and was trying to teach the nation the laws, he got quickly overwhelmed with questions. His father in law, Jethro, suggested he delegate. "Leaders over thousands, leaders over hundreds, leaders over tens" is a loose paraphrase.

We can apply that here. If we properly leverage people lower in the educational sphere, to help the people higher, we can make it work and expand the number of available healthcare workers.

Let's start from the top down.

DOCTORS: Doctors and Surgeons cannot be quickly replaced. The training that goes into it is simply too long and too specialized to expect that we can quickly replicate this. BUT!! If we can fast-track medical students to one level higher, we can leverage a lot of the training that has already gone into this. And we can leverage experienced nurses to take some of the burden off the doctors. The media has already popularized the idea that many nurses know a lot of what is going on.

Beef up the ranks of doctors with med-students and highly-experienced nurses.

NURSES: Nurses also have a tremendous amount of specialized training to be able to do what they do. You can't teach someone in a day all of the things that they may need to know to be effective in an ICU, on a hospital floor, et cetera. BUT!! the care that the patients from coronavirus are going to need will likely be similar; lather, rinse, repeat.

There are also many tasks that nurses do currently that someone with less training can do easily. Getting blankets, making sure people are comfortable, these are things that others can step in and take care of.

Help nurses with the burden with CNA's and other temporary designations.

CERTIFIED NURSING ASSISTANTS: We can move the CNA's up in the ranks to help the nurses, and to take the burden off the nurses. With fast, to-the-point training that is focused on only what they need to know for the current pandemic, we can move CNA's and other people into position to help take the burden off the nurses.

Expand the pool of people to help with coronavirus patients with other medical staff.

OTHERS: There are many people throughout the nation with some level of medical training. It may only be as an EMT, or as a Paramedic, or some other certification. However, these people have SOME background knowledge in basic life support, and with a short crash-course, could step in and help take care of the sick if we need them. Imagine a crash course training, to be temporary nurses, TN, or call them something else, temporary nursing assistants, TNA, the name doesn't matter. What does matter is we can leverage expertise.

Gain more healthcare workers from the pool of people already trained to some degree.

How the Healthcare Solution Works

By making designated facilities focused on coronavirus patients only, you can leverage less doctors, less nurses, and a large number of support staff. By making it so the doctors and nurses only have to pay attention to the most severe cases, you can create a system that allows for care of all.

Where To Do It - Or, That's Not a Hospital!

One of our limited resources is hospital beds. In hospitals. So where should we treat these patients? Wuhan tried to erect a hospital quickly, and it ended up collapsing and caused a lot damage. So we need existing structures. Potential structures we can use as interim hospitals include:

• Schools - they aren't being used now anyways, though they may be hard to convert to hospital-like infrastructure.
• Hotels - many rooms, all available through wide hallways, with many hotels having little to no bookings with the crisis at hand.
• Nursing home facilities - this would require moving existing patients and consolidating them in some homes, to leave other homes open for the change into hospitals.

You see where I am going here. We can find structures that are suited to temporarily turn into hospitals, and use them.

If the above steps aren't taken a few days at least before it gets really, really bad, then it may be too late to do so. At the very least a close watch must be kept on what is happening on the ground to make sure that a plan can be put into place quickly if the worst case scenario DOES happen.

Electricity & Water Supply

Another vital piece of infrastructure, to maintain life as we know it, is electricity and water supply. Now, these are not the same, but I am grouping them together because I lack knowledge in these components of infrastructure. I don't know enough about electricity generation, or water supply, how it works, where it happens, who takes care of it, et cetera.

But what I do know is that if there is a massive quarantine effort, or as the media continues to put it, social isolation, and something happens to the electricity generation, OR the water supply, we will have big problems.

In areas up north, where it is cold, there will be issues with it getting too cold. Too much heat, people may start to have heat related issues. People may lose their food due to lack of refrigeration.

Water supply issues can result in additional health issues (think of not being able to flush toilets) as well as dehydration problems and more.

In any case, electricity AND water are going to be important to maintain, to reduce the likelihood of continued mass hysteria.

But how many people are trained to work in these plants? And what happens if something happens to them?

Are there already training programs in place, so if there is no one to train the next set of operators, others can figure it out?

Again, there are going to be millions of people hurting for cash or out of work. Think of the whole gig economy. The regular economy is about to go kaput as many stop working, and even more stop spending. These people will need SOMETHING to do with their time.

We MUST train back up people to be able to maintain the electrical supply and the water supply.

Food Production

Food production is a massive effort happening all over the country. Remember, there are 350 million people here, give or take.

If each person eats only 3 slices of bread a day, and one cup of milk, nothing else, that is 1.05 BILLION slices of bread, and almost 22 million gallons of milk.

Per day.

And that is heavily rationed.

What happens if and when those who are involved in food production take ill?

First one, then more, then it spirals out of control.If no one is handling the food production, there are huge amounts of resources that will go bad and no longer be edible. Think milk production; cheese production. Think yogurt, fruit and vegetable greenhouses, and more.

If we get lax with food production, we start to enter into a potential issue of starvation. Which can be devastating the world over. Starvation can take a higher toll and potentially have a higher death rate than the coronavirus may have. So we MUST put into place plans to take care of this today.

We must be bringing in extra people to these plants, to these production facilities, to make sure that there are enough people on standby that can step in if need be. If the drastic emergency really hits the country like many experts keep predicting, we MUST be ready, or we must be prepared to live (or die) with the consequences.

I would focus on making sure this is handled for essential food plants only. If a place is manufacturing candy, or junk food, I will say straight out: this should not be a governmental or leadership priority. If that plant decides to hire and train backup, no problem. But this should not be something that governments should be concerned with. The new ChooseMyPlate.gov is probably a good starter guideline. Obviously many may have their own opinion of what is vital and what is not. But certain foods, we can all agree on.

Supply Chain Logistics

Just like the food production facilities MUST keep running to make sure that we have enough food to feed out nation – so too the supply chain must keep running, in at least some capacity, or everyone will be in trouble.

We have already seen the effects of this. NO, THE SUPPLY CHAIN IS NOT CURRENTLY IN TROUBLE. What we have seen is the effects of over buying on our normal supply chain.

Our normal supply chain is set up to handle a certain amount of throughput. Let's say (this is an assumption) that it is 2 weeks of goods, for everyone. If people run out and start purchasing 3-4 weeks of goods, that supply chain quickly runs out, long before we get to the point that everyone stocks up.

We have seen this happening the nation over, with toilet paper shortages, pasta shortages, soap and sanitizer shortages, and more. We HAVE the supplies. But the normal supply chain is not set up to handle the multitudes of people running and buying enough of these goods to last 2 or 3 times the normal level of purchasing. And so we run out.

As the supply chain throughput starts to increase, and catch up with the people who have panicked and over-purchased these items, everything will start to go back to normal.

BUT!!

And this is the whole point.

It takes a certain amount of skill and know-how to drive a truck.

What happens if all the truckers get sick at the same time?

We don't necessarily have backup truck drivers waiting in the wings.

The men and women who travel the midnight road, in their huge trucks, bringing tons of goods from state to state – every single person in the country relies on these people. You may not realize it, but you do. These people are the ONLY WAY you are able to drive up to your local grocery store and buy out of season fruit, or baked goods from 1000 miles away.

Now, I am not suggesting we need to keep the supply chain going to move around out of season fruit and baked goods.

But the supply chain MUST keep running to keep certain vital goods stocked.

Food.

Sanitizers / soaps.

Health care equipment.

Toilet paper (I had to say it, didn't I?).

Baby formula.

The list goes on. Yes, perhaps many of the goods available in your local supermarket, Walmart, or Target are not VITAL to survival, but if we are going to be stuck at home, these things just might be VITAL to sanity.

Fortunately, if non-essential items, such as off-season fruit, or baked goods, or TVs, or myriads of other things are not being shipped during this global crisis, then those truckers will be able to repurposed for these items.

But there still MUST be a contingency plan in place, for the off-chance that all truckers are incapacitated at the same time, for the total time the virus may take to run its course - reportedly as long as 3-6 weeks in some of the more serious cases.

Economic Impact

The true economic impact of all of this social isolation and school shutdowns will not fully be known for month, years, perhaps decades. One thing is for sure: what we are doing to combat coronavirus will reverberate for a long time to come, in many unknown ways.

Some of the ways are foreseeable. It is likely there will be more telecommuting when this all blows over. People will know what to do in the event another pandemic strikes, and possibly be willing to do so earlier the next time.

But let's look at some areas of immediate economic impact that we can fight against NOW. Things that millions of people the world over are concerned about.

Jobs

Yes, there are people getting laid off left and right because businesses have to close their doors until further notice. The vast majority of these people are going to be people who are low income workers, and may be living paycheck to paycheck. So when they lose their jobs, it is a huge crisis.

What happens when you take millions upon millions of people, and tell them they can no longer come to work? They can no longer earn the money the need for food, rent, and more?

Nobody knows. Because we have never done this before. But if people are not reassured that the job loss is temporary, that the money will be made up, that we will work through this all TOGETHER, we have no idea what will happen.

The fallout from the lost jobs can be huge. It can also be prevented though. With the right policies. The right policies won't be easy, cheap, or popular. But they will avoid a tremendous amount of calamity.

Some things that might work? Making banks allow people to overdraft, with no fees, and no limits – although that is likely to have further far reaching effects on the economy. An economic stimulus package of money paid directly to every American below a certain income level, or below a certain salary level. As in, don't take that money and give it to the banks, give it to the people who actually need it. These are just a few ideas; I don't claim to have the right idea, I just see the potential problem and that we need a solution to combat it.

Childcare

With schools closed for millions and millions of children, childcare just became a huge national problem. It became a problem for the healthcare workers who need their kids taken care of, it became a problem for the workers in vital jobs, like grocery stores and pharmacies, it became a problem for all those who can't afford to take off.

Andreas Kluth makes a case AGAINST closing all of the schools; with convincing arguments. I am not suggesting that the decision to close schools was wrong. I am only saying that there is no end to this pandemic in sight. It may get worse, and worse, and worse. It may last years. It may continue until next year.

How long do we take children and adults, people who were all acting with purpose, who all knew their place in life, and make them aimless? How long will that last?

Yes, people and companies and school districts are making herculean efforts at devising tele-learning. But a vital part of a child's growth comes from the social aspect of school Learning what to do in different social settings. Learning social norms beyond what is in their own family. If we take these kids out of these settings indefinitely, what are the new problems we are creating? And are we creating these problems for something that is actually a solution?

I digress. The purpose of this is not to point out that kids need to be in school. The purpose of this is to have a PLAN just in case. A plan to implement if the school shutdown continues past that 2-3 week mark. A plan to implement if the viral spread continues.

What happens to the teachers? The kids? Do we leave school closed? Do we get stricter on kids coming to school sick but leave school open? Do we make all teachers over age 49 retire?

There are answers here. I do not profess to know them. I can perhaps offer solutions to the problem, but as of now I can't contemplate just how far reaching the problem will become. And no, I do not think that long term tele-learning for all kids in the country is a solution.

Rent / Mortgage Payments

For all those people with money in the bank, this may not be an issue. This may be an issue for them if the global corona crisis continues more than a few weeks, but for now these people are likely okay.

There are, however, millions of working poor Americans. Millions of people who literally have no idea how they are going to pay their next rent payment, their next mortgage payment.

What will be for these people? Can the banks still foreclose? Can landlords still evict?

And of course, either way, someone loses. Either the landlord or the tenant. But we must think through these issues NOW. Not later. Not as someone is being thrown out of a home they cannot pay for.

This problem is coming. Many people are not working, many people are not getting paid. There will be missed mortgage payments and rent payments throughout the country. And perhaps some will prioritize rent over food – but then we still have the same problem, but with starvation instead of landlords.

Utilities

The same problems that are about to afflict our property rental and mortgage industry are going to affect our utility industry. People who are not working, who are not getting paid, cannot pay basic utilities like water, electricity, gas.

This issue will only compound on itself unless someone recognizes that this is a TOMORROW problem that needs a TODAY solution. It will be a problem VERY soon; it is only by contemplating these things, and acting on them now, that we can head them off and mitigate these problems, and keep them as manageable as possible.

Food

As above, those struggling to pay for rent and utilities, those who were able to meagerly support themselves, are now going to be struggling to put food on the table.

These are the people who may have to go to work, sick or not. If they even still have jobs.

And if they don't have jobs, they will need help. Desperately. To be able to feed themselves, their families, those who depend on them.

Fixing Our Nation's Tomorrow Problems Today

We are all creating these problems, right now. Not purposely. Not maliciously. We all mean well. If epidemiology says the most prudent action right now is social distancing, fine. It seems like we can all deal with that. At least for a while.

But we need to be READY to address all of the problems we are creating with this solution.

No solution will be perfect.

If we say let life go on and let the virus run its course, many experts predict that hospitals will quickly be overrun and we will have a huge health crisis on our hands. Between 6 and 17 people all vying for one hospital bed.

If we say shut down everything, we also have a myriad of problems, as detailed above. Yes, I agree, these do seem to be the lesser of all evils. But we MUST create the solutions to these problems today, to avoid as much of the calamity as possible tomorrow.

Yes, we can point the finger. We can say it was his fault, or it was her fault. We can try to gain political points. But that won't save any of us!!

That won't get us closer to our goal - our goal of saving as many people as possible. Our goal of mitigating the total, world-effect of this virus to the least possible level. Our goal of diminishing this global crisis in exactly the moments we need to be pushing our way to working together.

Working together, not caring whose idea it is, not caring who gets the political points - if we can pull that off, it will both be a miracle, and it will save lives.

Do you care more for your political career, or more for the lives of the humans around you?

If you had to think, that's the wrong answer.

Stay calm. Stay prudent. Above all, stay safe.

-Ari Gunzburg

?March 16, 2020