by Karl Denninger, Market Ticker:

Facts known:

1. Healthy young children have an effective death rate of zero.

2. Ordinary, healthy adults are at very low risk of having a serious, critical or fatal outcome.  “Serious” is defined as “in hospital required.”  “Critical” is defined as “ICU/Intubated/extraordinary measures.”  Fatal is obvious.

3. Co-morbidities, or serious age (>65) dramatically raises the risk of bad outcomes — by a factor of ten, twenty or even a hundred.

This virus primarily attacks the lungs.  It causes other symptoms but the bad outcomes occur when you are essentially asphyxiated.  Those who have compromised pulmonary capacity (e.g. persons with COPD, diabetes with complications, old people with seriously compromised physical output capacity, asthmatics, etc) are at much higher risk.

While we do not have accurate data, which is likely because our governments don’t want to characterize this, or quite possibly because they haven’t bothered to do the backwork to do so, we can draw some reasonable inferences.

1. This infection causes some damage to the oxygen/CO2 transport mechanism, centered in most cases around the lungs.

2. A healthy person, not an athlete but an ordinary healthy person, can typically sustain a range of 1 MET (sleeping or sitting quietly) to roughly 10 METS.  Each MET is about 3.5 VO2 points, more or less.  Thus, if you know your VO2Max you know, more or less, what your METS capacity is.  (This relationship isn’t exact, but the estimates you can get without a lab test are close enough for this purpose.)

3. Moderate exercise (e.g. walking at ~3 mph) requires somewhere around ~3-4 METS.

4. Vigorous exercise is typically defined as 6 METS or above.

5. Climbing Stairs has been shown to be somewhere between 8 and 9 METs, or materially into the vigorous exercise realm.

6. Many runners, even reasonably-elderly ones (e.g. myself) can radically exceed 6 METS.  In my present (not peak) condition, which is down a couple of VO2 points from typical, I can sustain about 13 METS.  Therefore 6 METS is not really all that impressive at all.

Incidentally, in a few months of effort you can go from a capacity of ~5 METS to quite close to 10.

People do it all the time; it’s called Couch-to-5k and while it takes effort most people can accomplish that in ~3-4 months.  You could start now, but I know damn well if you’re on the couch now you won’t, so I won’t bother trying to urge you to fix that.

Now let’s contemplate what all this means.

First, if you cannot climb stairs without becoming winded you’re in quite a bit of trouble and it doesn’t matter whether that’s due to asthma, COPD or just generally poor physical condition.  Presume that you get hit hard enough that this bug takes 5 METS out of your peak capacity at its worst.  If you can only barely reach 6 you’re at risk of death!  Add some cardiac compromise and the risk goes up quite materially.

I have long harped on the “any size is beautiful” thing, or the “fix it with pills” deal when it comes to diabetes.  That’s flat-out bullcrap and now we’re going to have hundreds of thousands — or even a couple of million people find out why.  None of that virtue-signalling garbage will do a thing for your capacity to move oxygen and CO2 and this virus attacks that ability.  You either have the reserve capacity or you don’t.

Don’t means you’re DEAD.

Further, ICU and similar medical interventions will only change a few of these outcomes.  The reason is somewhat complex, but it hinges on the fact that the body has to fight off the virus before it kills you.  There is only so much medicine can do, irrespective of how invasive, when it comes to oxygen exchange.  You can’t run 100% O2 down someone’s windpipe, forced or otherwise, for more than a few hours; after a day or so that actually causes temporary lung oxygen transport damage, which of course is going to make a situation like this worse.  The maximum concentration that can be tolerated indefinitely is about 50%, which is roughly double that in the atmosphere, and in addition mechanical ventilation is not as efficient as natural to start with.  What this means is that while an ICU can give you some margin back, it’s not much.

A rush on hospitals will likely kill more people by a wide margin than it saves.  The reason is simple — if you don’t have the virus and rush the hospital thinking you do the odds of being exposed approach 100%.  If you’re “at risk” and rush the hospital, and 10% of those “at serious risk” wind up dying, then the hospital has to save one person for every person who rushes the place whether they get in or not.  It’s not at all hard to imagine a situation where this kills ten times as many people as would otherwise expire!

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