Wednesday, June 17, 2020

The Expendables


Sylvester Stallone and his band of misfits, all men with honed lethal skills, circulate the globe like a swarm of killer bees, righting wrongs and eliminating the bad guys. They are called the”Expendables” because that’s who they are. Men whose disappearance won’t create any waves anywhere. Who may be missed, but not terribly, considering they had always led a precarious existence.


In any war sacrifices are made. Battles are designed to keep the number of killed and wounded low, but that can’t always happen. When the troops landed on the beaches of Normandy, according to www.historyhit.com, “Using new studies, for the first time we can forensically analyses the chances of survival. As 2,000 paratroopers face 345,000 bullets, across an area of sky covering 9 squares miles, the chances of survival were 1 in 4. But 50% of the men survive.


In todays war against Corona, it seems that it is the “elderly” who are the expendables. Tom Friedman, writing in the New York Times, quoted public health expert Dr. David Katz. “The data are now overwhelming, from here in the U.S. and all around the world, that this infection is a grave threat to the elderly and chronically ill, but generally mild for younger, generally healthy people.” Katz said, “We should guard those most vulnerable until we can sound the all-clear. Only this kind of thoughtful, risk-stratified approach can allow for herd immunity with maximal safety and minimal total harm from infection and the consequences of prolonged lockdown alike.”


Yet, when faced with an economic recession and or depression the pressure is on all countries to ease restrictions and allow the economy to regain its strength. An article by David Horowitz appeared in the Times of Israel today. “Under-50s have little to fear, but even vaccine won’t save millions of elderly.’ He quotes leading epidemiologist Prof. Yehuda Carmeli who says the newest data leaves him more optimistic, but not when it comes to the over-70s; Carmeli predicts some 8,000 Israeli deaths,” caused by the virus over the next few years.


According to Carmeli: “We know now is that in people below the age of 50, the risk of death is two among every 1,000 people diagnosed as having the disease. But what we’ve also learned is that...The real mortality figure for those aged 50 and under (who are exposed to the virus] is two per 10,000-50,000. If we go to the population older than 70, the chance of dying is much higher. It’s eight percent for those over 70 [diagnosed as having the disease]. And 15 percent among those who are over 80. ... that will be about 4,000 or 5,000 Israelis dying in the 70+ age group”


Carmeli, the head of Israel’s National Institute for Antibiotic Resistance and Infection Control also heads the Department of Epidemiology at the Tel Aviv Sourasky Medical Center and is a professor at the Sackler School of Medicine at Tel Aviv University. Carmeli believes, “We are just at the beginning. By the end of this event, we assume that about 80 or more percent of the world population will get infected, unless there is a vaccine.” He adds, “serological tests increasingly shows that the mortality rate for those exposed to the virus is far, far lower than initial data had indicated. The ‘many millions’ he now believes will ultimately die before most of the world’s population becomes immune would have been a far, far higher total otherwise.”


Carmeli says that “the likelihood of someone who’s younger than 50 (dying from the virus) is extremely small. Carmeli holds out little hope for a vaccine that will help the elderly. “...vaccines are usually much less efficacious in the older population and in immunocompromised patients – and those are the people who actually most need the protection.”


Dire predictions. Carmeli says wearing a mask is essential. Wiping off your credit card is silly, “unless someone sneezed on it.” He expects millions to die and the best that can be done is to slow the infection rate so that the health systems are not overrun creating even more deaths because not everyone can be treated, or those with other types of diseases.


So, how does that equate to expendables? Economy versus sacrifice. A recession/depression will, according to experts, kill many more people than the virus, create more social unrest, and violence, domestic and otherwise. If opening the economy is the solution to saving the lives of the masses, and in the event sacrificing the elderly who would be exposed and vulnerable, the decision to open the economy wins. If, as Carmeli believes, the young are more or less safe even if they get the virus, then the soldiers sacrificed on the battlefront with this virus will be the elderly. Actuarial tables, according to pundits, would support this tactic.Who is more likely to contribute to society, a 30-year-old or an 80-year-old? Insurance companies, and judges assessing damages, would go with the 30-year-old.


Wear a mask, keep social distancing, be scrupulous with hygiene, and hope for the best. An Israeli company received FDA approval for an early detection system that can predict a patient’s deterioration once struck with the virus. Netanya based CLEW’s CEO Gal Solomon said his company can estimate when a patient will get critically ill based on AI (artificial intelligence). In Britain, at Oxford University, the discovery was made that a simple steroid used for years can cut mortality in severe cases by up to a third.


While Health Ministry official Prof. Sadetski has said Israel is in a second wave of infections, after 300 cases were discovered in the last 24-hours as apposed to just 20 a day a month ago, Yesh Atid MK Levi said this was fear-mongering. He stressed observing Health Ministry regulations would keep people safe. And anyway, most who would be infected were young and not at terrible risk.


The economy has to open up. Israel Katz, Israel’s new Finance Minister, formally Minister of Transport, wants to restart the trains. TV news is filled with reports of bumper-to-bumper traffic on Israel’s highways caused by the lack of public transport. People are having trouble getting to work. Efficiency is down. Katz also wants to reopen cultural events. Restaurants are already reopened. Gatherings can be held with up to 250 people. Anyone walking around in Tel Aviv would be surprised how few people wear masks. And Tel Aviv has recently seen a spike in infections.


In Israel, as of now, 303 have succumbed to the virus, most elderly. Nearly 20,000 people have been infected, with 27 on ventilators. But these numbers are mild compared to other countries, and even states in the USA like Tennessee that has twice the number of infections and 25 percent more deaths but just a third of Israel’s population. The Israeli government is meeting to decide whether or not to lockdown “hotspots” where the virus seems to have gathered strength. No decision has yet been reached.


Prime Minister Netanyahu’s push to annex the West Bank has met with considerable resistance. It is still unclear if he will carry out his plan to announce annexation on July 1st. Most experts expect he will scale back his ambition. The US has said that Blue and White chief Gantz must agree to any annexation proposal or the US won’t back the plan. Suddenly, Gantz is a key to a major government decision. Analysts across the board warn of the annexation’s ramifications. Jordan, an important strategic ally, has threatened to cut off diplomatic ties, and the Israeli army is preparing for the possibility of a multi-front war.


Both Trump and Netanyahu are in their 70’s and thus in the at risk population the virus threatens.

However, pundits speculate neither of these men would be considered “expendable,” by their base.How those opposed to them would feel is a completely different matter.