Message sent to the MIT Media Lab list on preparing for the nascent pandemic on March 4, 2020

This message is intended to provide a general assessment of the global situation and help organize our collective response.

There is a great deal of information floating around on COVID-19, only some of it accurate. Many people claim that it's just a bad flu and the world is overreacting. Others believe it’s more dangerous than the 1918 influenza pandemic that caused the deaths of 50 million people. The truth is almost certainly somewhere in between.

Before I summarize what is known: this is a societal challenge, and the Lab can help.

This is not a foreign issue. It has nothing to do with race or ethnicity or cultural background.

The virus is in over 76 countries, and is now in the Boston area. Let's not panic. Let’s take action.

Agenda item 1: Discuss how we can help keep our community members safe. Item 2: Identify all relevant Lab projects and find ways to leverage them swiftly to help others. Bring your creativity and a list of ongoing efforts or expertise that you think might be useful.

What we know

• The novel coronavirus SARS-CoV-2, which causes COVID-19 disease, is spreading worldwide

• Everyone appears susceptible: the virus is new to humans, having jumped from an animal

• The typical victim infects 2-2.5 other individuals depending on patterns of contact

• Symptoms include fever (87.9%), dry cough (67.7%), fatigue (38.1%), sputum in the lungs (33.4%), shortness of breath (18.6%), sore throat (13.9%), headache (13.6%), bone pain (14.8%), chills (11.4%), nausea or vomiting (5.0%), nasal congestion (4.8%), diarrhea (3.7%)

• 8 of 10 victims experience mild symptoms; 13.8% moderate to severe; 6% need hospital care

• People without symptoms shed virus and can infect others

• Risk level increases very sharply with age and ill health; children are almost never affected

• ~6.7% of victims ages 15-49 need hospital care, but only 2% of those need an ICU

• Some regions have shown that good hospital care can keep the overall death rate below 2%

• The local mortality rate can rise to 5.8% if the healthcare system is overwhelmed

• Imposing cordons sanitaires and isolation measures can halt transmission for the duration

• A vaccine will not be widely available for 12-18 months; antivirals may arrive earlier

• Those recovered are likely to be resistant for at least a year, but probably not more than 3 years

Therefore, our goal as a society is to keep too many people from getting infected at once. We need to ensure that there will be enough hospital beds for everyone who falls ill if the pandemic continues to spread, which appears likely but not certain. 

That starts here at the Lab.

Community health

We can protect our friends and colleagues by minimizing local transmission. For example:

• Never shake hands! An elbow bump or a polite bow will suffice

• Frequently wash your hands for 20 seconds with soap and water

• Use hand sanitizer often, including to clean your phone

• Clean commonly used objects with wipes and keep doors propped open as much as possible

• Get a flu shot now if you haven't had one, as flu patients often also need hospital beds

• If you feel sick in any way for any reason, stay home!

• If you need healthcare, ask to be tested for infection, and alert MIT Medical if it's positive

To anyone who can’t find hand sanitizer in stores, you can make it yourself:

Hand sanitizer recipe:

• 2/3 cup 99% isopropanol

• 1/3 cup aloe vera gel

• Mix thoroughly and pour into a small bottle to carry

What about cleaning agents?

• Alcohol inactivates >99.9% of coronaviruses in <1 sec

• Bleach is less effective, requiring longer to take effect, but most other disinfectants work well

• Using wipes and cleaners is important, as coronaviruses can linger on surfaces for 2-9 days 

Risk assessment

Statistically, we’re unlikely to have been exposed as yet, but we should take precautions immediately.

There are almost certainly unidentified carriers in the Boston metro area, and the number is likely to grow rapidly, as occurred in Seattle. Keep in mind that the U.S. has not been testing widely, meaning that we should not expect to detect community transmission until there are hospital cases with no obvious source.

If we conservatively assume each victim infects two others 7 days after being infected, and there are 20 carriers in the Boston area this week, then there will be 20,000 newly infected individuals in ten weeks. That assumes transmission does not abate in the interim, which may occur; coronavirus is somewhat seasonal, but much less so than flu. We should hope for the best, but prepare for the worst.

One can hope that local officials will take action before we reach 20,000 active new cases in the area. Those preventive actions will keep us safer, but are also likely to impact our research. We should plan for that.

Preparations

It’s fairly likely that public transit will be closed, and large gatherings discouraged. A (non-peer reviewed) assessment determined that those were probably the most effective of the measures imposed in China.

MIT may advise nonessential personnel to avoid campus this summer, or even sooner. University campuses in China have been closed for some time, with classes conducted remotely. Just in case, it may be prudent to focus on those aspects of your research that require your physical presence, and start thinking about how you could work remotely. Again, hope for the best, but prepare for the worst.

It's possible that schools will close. They are now closed in China, South Korea, Japan, and Italy, but have reopened in Taiwan. Whether Taiwan’s rate of transmission differs may determine whether they are also closed here. Since high schoolers are known to be vulnerable, it’s more likely that high schools will be closed than elementary schools, but we don’t know as yet. This may impact the parents among us. It’s also one of the areas where the Lab’s expertise could make a considerable difference.

Finally, anyone who is infected will need to self-isolate in their home for at least 14 days. Water shouldn’t be a problem, and food deliveries are likely to continue, but it’s not a bad idea to buy a little extra when grocery shopping to prepare, and it's worth ensuring that you have a reasonable supply of any essential medications. As always, hope for the best, but prepare for the worst, at least within reason.

Summary

These events may have a major impact on society and our daily lives. Our actions and especially our research can help mitigate those impacts, if not here then elsewhere in the world. We have an opportunity to make a difference. 

Disclaimer

I am not a medical doctor or epidemiologist, but a generalist whose research overlaps with a number of relevant fields, including pandemic disease. I do not speak for the Lab’s Executive Committee or for MIT leadership. All assessments and opinions are my own or linked from a more knowledgeable source.

Let me know if you have any questions or concerns. 

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Kevin M. Esvelt, Ph.D.

Leader, Sculpting Evolution Group

Assistant Professor, MIT Media Lab

Massachusetts Institute of Technology