By Stephen W. Hiemstra
During the spring of 1973 I returned home from college to a new neighborhood in McLean, Virginia where the homes had garages rather than carports. Every day our new neighbors went to and returned from work without leaving their air conditioned houses. An electrical storm the following summer knocked out the power and, with it, the air conditioning. One after the other neighbor came outside to sit on their porch and escape the heat. That was when we finally got to meet them.
Walking in the neighborhood evenings with my wife, Maryam, the past couple weeks, I have seen more kids and adults outside than at any point since my childhood.
Year of the TV Preacher
Over the past two Sundays just about every church that I am associated with (6-8) has started holding services and meditations online. Some have even added midweek online sessions to match Sunday services. TV preacher Joel Olsteen recently reported having broken online attendance records—about five million viewers (link).
Local churches have typically not had a sophisticated online presence and the move online has been challenging. At one church that I know, giving is down about fifty percent in recent weeks.
How are local churches to compete in this new online-only environment?
Two observations come to mind.
First, recognize that local churches are unlikely to compete with Joel Olsteen for media sophistication. Don’t play a game that you are not likely to win.
Second, media sophistication is not what most people want today. People are hurting, lonely, and in need of reassurance—they desperately want to see familiar faces. This is where the local church can shine.
My advice to pastors is to check out what other churches are doing and find a format online that fits your style and audience. Personally, I think that the pastors offering online services from their living room couch with the spouse at their side provide the best fit for the current environment—the visual says from my family to yours. This reassures that pastor and parishioner are in this together.
The daily news is grim. As a former chaplain, my heart goes out to all those patients and hospital staff contending daily with the grim reaper without family support. As field hospitals are built and American companies have diverted their facilities into producing medical supplies, we are writing the book on pandemic response.
Meanwhile, I feel like a contestant in a macabre game show as I spend my days reverse engineering the statistics that Dr. Fauci reports on the daily news. He has earned my respect repeatedly as he focuses on keeping the media and the administration focused on a reasoned response to the crisis. Science has become a contact sport. Perhaps, it always was.
|Corona Virus Cases, Deaths, and Mortality Rates by Region, March 31, 2020
|Australia and New Zealand
|Source: European Centre for Disease Prevention and Control
A key estimate by Dr. Fauci this week was that this pandemic would cost two hundred thousand American lives. Two hundred thousand is two percent of ten million corona virus cases.
Two percent has been the estimated mortality rate for the United States reported since this pandemic began and probably comes from the 1918 experience with the Spanish flu. Today’s rate for the U.S. is 1.9 percent, while the world average is now 4.8 percent (see the table). Italy has a mortality rate today that is 11.4 percent.
Ten million is an estimate of the eventual total case load of corona virus cases for the U.S. Meanwhile, the U.S. population is around three hundred million, suggesting a much larger number of cases.
If I had to guess, Dr. Fauci’s estimate is the result of a government oversight committee negotiation, focused on managing the optics. While this sounds political, managing fear is on every leader’s mind because fear compounds the underlying problem. Whether you consider the mortality rate or the caseload assumed in this calculation, the estimate is the most optimistic figure that could be reported with a straight face.
The two million death figure, which entered the briefing styled as a worst case scenario, arises from considering the population, not caseloads, and reflects a more reasonable set of assumptions. It may still be optimistic. Two percent of three hundred million is about six million, not two and, if the U.S. eventually sees worldwide mortality rates (4.8 percent today), then you have to more than double that figure.
The statistics on mortality depend critically on how one expects this pandemic to end.
Social distancing works to reduce mortality rates by keeping the number of critically ill patients under the carrying capacity of the hospital system, thereby minimizing deaths.
For example, if the Washington metro area has thousand beds with ventilators and support staff, and the caseload remains under a thousand, then deaths are minimized (1.9 percent). As the caseload increases over a thousand, the mortality rate rises (4.8 to 11.4 percent). The mortality rate cannot remain at zero because even well-staffed and supplied hospitals will lose patients with pre-existing conditions.
This pandemic ends when one of two things happens. Either we develop an effective vaccine or so many people get the virus that it can no longer spread (herd immunity). Best estimates that a vaccine is 12-18 months away so the most likely case is that the virus burns itself out like a forest fire that stops spreading because it runs out of forest. This is why Dr. Fauci’s estimate is optimistic—ten million cases is not the forest.
Three caveats are worth mentioning.
First, researchers have been working to develop a therapy involving a direct transfer of antibodies from patients already infected to those in dire straits. This is a novel approach, but it is untested. Other existing therapies are also being tested that relieve the stress that patients experience, improving their chances of survival.
Second, researchers will soon have a quick-turnaround test for corona virus antibodies. While this may not yield a new therapy, it may allow those who have recovered to return safely to work—a critical need in standing up our troubled economy. For many people, getting back to work not only means that they can pay their bills, it improves their access to medical services.
Third, existing conditions kill by offering a one-two punch combined with the corona virus. Continuing to work out and keep a positive attitude improve your chances of survival because a positive attitude strengthens your immune system.
Flu Versus Corona Virus
The story about the flu is helpful in understanding our current dilemma with the corona virus. Influenza is a human pathogen, which implies that the human race has a long history of developing immunity to flu. Johns Hopkins University research recently reported annual deaths ranging from 12,000 to 61,000 deaths in the U.S. per year. These statistics are well-known, which is why I get a flu shot every year.
While the annual death toll from the flu currently seems high relative to this epidemic, the above statistics are annual numbers while the current death toll from corona virus covers only a couple of weeks. Annualizing (take a weekly death figure and multiply by 52) the current number of deaths from corona virus (3,170 today) yields a number from 80-100 thousand, still a low number compared to estimates above that may suggest an alternative way to understand the Fauci estimate.
Keep in mind that annualizing losses is wildly sensitive to your technique for coming up with a weekly rate from a number increasing exponentially over time. Averages (a linear estimator) are not representative of nonlinear processes (like exponentially growing numbers), which to the non-mathematically inclined means that this is a very weak method for forecasting mortality rates.
Corona virus is not a human pathogen, but a virus that has jumped species from bats to pangolins to humans (link). This is why the virus is so lethal and why we do not have a natural immunity. Apparently, the Black Plague was a pathogen with a similar genesis.
When you are in pain or afraid, where do you turn?
When Jesus was facing death in the Garden of Gethsemane, he turned to God instead of his pain and fear.
Then Jesus went with them to a place called Gethsemane, and he said to his disciples, “Sit here, while I go over there and pray.” And taking with him Peter and the two sons of Zebedee, he began to be sorrowful and troubled. Then he said to them, “My soul is very sorrowful, even to death; remain here, and watch with me.” And going a little farther he fell on his face and prayed, saying, “My Father, if it be possible, let this cup pass from me; nevertheless, not as I will, but as you will.” (Matt 26:36-39 ESV)
We face a Gethsemane Moment today worldwide. Where will you turn?
Water Cooler Observations, April 1, 2020
Other ways to engage online: