Surviving COVID-19

Dr. Karim I. Budhwani
Dr. Matthew Might

Today’s guest columnists are Dr. Karim I. Budhwani and Dr. Matthew Might.

Click here to be a guest columnist.

In less than four months, our world has been changed dramatically due to the global COVID-19 pandemic from the spread of a new coronavirus: SARS-CoV-2.

Agencies like the World Health Organization (WHO), the National Institute of Allergy and Infectious Diseases (NIAID), and the Centers for Disease Control (CDC) are leading multi-pronged efforts to combat this pandemic.

These include isolating and studying the virus, developing diagnostics tests and potential treatment strategies, and also monitoring and deflating the speed and spread –flattening the curve – of the disease.

Besides personal preventive measures, such as hand washing, collective measures, such as social distancing, have also been prescribed to aggressively flatten the curve. If you haven’t had a chance to review these, now would be a good time to do so.

While these agencies have done, and continue to do, a remarkable job – including lending a central face and voice – in addressing the pandemic, there are other dimensions to this crisis which must also be addressed urgently with steadying and well-informed leadership.

Our goal in writing this article is to start a dialog around these other dimensions.

Unintended consequences

It would be disingenuous of us to simply omit mentioning missteps along the way.

In the wake of the initial chaos resulting from insufficient information, and even deliberate misinformation, we may have inadvertently accelerated the spread of SARS-CoV-2. For instance, the dissonance caused by labeling this pandemic a political hoax, instead of a clear and present danger, is still reverberating in certain pockets.

On the other end, closing college campuses was a well-intentioned idea with the aim of flattening the curve but ended up creating a slew of unintentional side-effects including the antithesis of social distancing: out-of-state students having to crisscross the country via overcrowded airports. Closing campuses and moving to an online only model has also unleashed the full brunt of socioeconomic disparities on the most marginalized population of students who do not have access to the requisite equipment or bandwidth.

It is vital in the days ahead for local, state, and the federal government to grab this bull by its horns in ensuring that the immediate crisis does not lead to a generational net-negative impact caused by diminished access to education because education is a key driver of socioeconomic advancement.

Atoms, Bits, Dollars, and Sense

And socioeconomic advancement is being blunted at both ends.

A dominant feature of “flatten the curve” is a push for working from home. While this can certainly achieve the goal of reducing the speed and spread of the virus, in the absence of sage leadership, it can trigger opening several Pandora’s boxes downstream.

In today’s economic landscape, we can broadly classify job functions in two categories: those involving physical atoms – such as coffee shops, massage therapists, retail establishments, garbage collection, ride sharing, and so on – and those that involve transmission of bits (for simplicity we will cluster voice and all media in this category) – such as call centers, data processing, social media, and so on.

Working from home is more conducive for the “bits” category of job functions. We see several companies – including universities and schools – making this shift for bits job functions.

However, consider the impact of this on the “atoms” category of job functions and, as a result, on the people performing those functions.

Restaurants are seeing double-digit reduction in business compared to the same time last year. Coffee shops had become de facto icons of “working remotely” but even a behemoth like Starbucks is reeling from the seismic shocks. Retail establishments across the board are closing with layoffs ensuing to the extent that Treasury Secretary sounded the alarm that unemployment rate could reach as high as 20%.

And with unemployment comes the inability for those people to meet rent/mortgage, water, power, and other such obligations. Ironically, a push to work from home could indeed jeopardize the ability for people to have a home.

While at some point, “stay at home” will end and bring these jobs back, significant support is needed in the interim. As we write this, led by Speaker Pelosi, the House, Senate, and President are moving swiftly to propose a first wave of measures in this regard.

Social Distancing without Social Isolation

All this begs the question, are we overreacting or underreacting?

In fighting the pandemic, we believe, this is the optimal locus; neither over nor underreacting. In other words, we want people to be scared but not scared to death. Because going that far would defeat the purpose. In emergency situations, asking people to compromise some quality of life is justified; however, we must strive to keep this to a minimum both in terms of the impact and duration.

Saving lives is paramount but it is also important to ensure that life is worth living. Ramifications of social distancing are far reaching from personal anxiety to stress along the very fabric of society.

Many small businesses and retail establishments have been hit hard, on both ends of the demand curve: with drastic vaporization of demand in some areas (as discussed above), and panic-induced spikes in demand in others. Social media is full of images showing arrays of empty shelves in stores across the country.

The obvious answer to this is to stabilize the supply chains; however, social distancing can make this challenging from manufacturing to distribution. And yet, without a robust supply chain, it will only become more challenging to reduce the speed and spread of the virus.

Even critical care for those affected by the pandemic – and those needing other medical attention – will be impeded or made all but impossible by lack of adequate equipment and supplies and a completely overwhelmed healthcare system.

And that’s not all. Things will most likely get worse before they get better.

How policy makers and leaders at all levels in government, business, and community organizations – and all of us – respond will make an outsized impact on how this pandemic unfolds, and more importantly, on the attenuation of reverberations from its unfolding and from the aftershocks.

Reason for optimism

This may sound daunting – because to a certain extent it is – but there is reason for optimism. Brilliant minds across the globe are working diligently to learn more about the virus and develop effective preventive and treatment strategies.

We are also leveraging advances in technology to develop in silico models to run simulations and analytics to dramatically expedite such discovery. This is already in the works. With continued monitoring and responsible flattening of the curve, we can avoid overwhelming the system and improve overall outcomes for everyone.

We recognize that there is considerable anxiety and a feeling of helplessness in having to face one of the largest threats posed by the tiniest of organisms, but we are confident in the capacity of humanity to wield our powerful twin weapons of knowledge and hope to emerge from this crisis.

Dr. Karim I. Budhwani is CEO of CerFlux, Inc. and Visiting Scientist in the School of Medicine at UAB and in the Department of Physics at Coe College. CerFlux, headquartered in Birmingham, is developing personalized medicine technology to transform cancer treatment here and around the world.

Dr. Matthew Might is Professor and Director of the Hugh Kaul Precision Medicine Institute at UAB

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David Sher is Co-Founder of AmSher Compassionate Collections.  He’s past Chairman of the Birmingham Regional Chamber of Commerce (BBA), Operation New Birmingham (REV Birmingham), and the City Action Partnership (CAP).

Invite David to speak for free to your group about how we can have a more prosperous metro Birmingham. dsher@amsher.com.

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