March 24, 2020
A few clarifying questions.
Ok, Greg, I get it with the Hammer phase. But has the Hammer started yet? What does it look like?
It has started in some places (New York, San Francisco, and Dallas, for instance). So, some places are in it and some aren't. Also, a number of people in places that aren't officially under the Hammer are voluntarily acting like we are under the Hammer by staying at home (Thank you very much!!). The more places in our country that go under the Hammer, the more effective this phase will be because there won't be cross-contamination (and also the sooner we will get out from under the Hammer altogether).
What do you think the Hammer Phase will look like?
I predict the maximum Hammer that our country will tolerate is these "shelter in place" orders that are being issued State and City-wide. As I write this email, Harris County (Houston Tx) just announced theirs. Also, we must realize that every area will have a slightly different curve because this pandemic hit different places at slightly different times.
I imagine Shelter in Place orders will need to be enacted in all populated places. >10k people? >100k? people? I don't know, but the size of the area that will require the hammer will be a smaller number, not a larger one. It will have to do with each region's number of cases and their overall healthcare resources and capabilities. It is significantly more than one-third of our country, which is approximately where we stand today (It seems dangerous to be thinking about lifting the Hammer before it is even down yet). If you forced me to give a guess, my gut says maybe that 80% - 95% of our population will require this Hammer phase?? I really don't know, but I do know that it is a larger percentage. I am not an expert here -- just explaining the concept.
Austin will just be starting the Hammer here tonight btw. Yeah, Austin!
Oh, jeez, so how long again?
Remember in one of my first emails when I mentioned there would be 12 days of exponential growth after a lockdown? The China-style or Italian-style hammer has to be down at least 12 days before we will see if it is working (if it is not working, that means it needs to be stricter). It has to do with the incubation period of the virus (2-14 days). If the incubation period was 2-14 hours, we would see the effect of the lockdown much more quickly.
The 12-days lockdown period came from the data in China, and Italy is following suit. Italy went on lockdown on March 9th. Do you want to guess which day they started to see a downward trend in their daily increase? March 9 + 12 days = March 21...
I hope this is good data and not simply an anomaly from the lack of testing capacity, but either way, we should all be hoping that their trend continues because it gives us at least two hopeful data sets. Basically, we have to get control of the curve, and then we can work to bring it down below the current capacity of our healthcare system. Simply put, it will take a couple of weeks to actually see the outcome of what we have done. This is very, very hard to do, and it will be different for different parts of the country based on their viral burden and their healthcare capacity. The nuances are beyond my expertise, so I'm simply articulating the concept that we will need to be thinking through.
Here's my message -- we seem very hesitant as a society to bring down the hammer fast. We are afraid of the hammer. Don't be afraid of the Hammer. It's a good Hammer. The longer we are afraid of putting it down the longer the Hammer will be around, and the longer it will take for us to get to the Dance. I know we all want to get to the Dance.
Hey, Greg aren't you doing an amazing cool fun webinar today?
In the haste of sending our email last night (which are the efforts of multiple people, by the way, thank you Jeff and Adrienne), I forgot to mention we are doing a fun webinar today that I think you will love. Its quiz time (https://info.kainexus.
I'll let you figure out how many questions there will be ;).
Stay emotionally connected and physically distant,