It's been interesting over the last few days to watch the reaction to the cancellation of the Ultra Music festival in Miami. The cancellation was due to the coronavirus, and it was big news since it was one of the leading music events to proactively cancel this year's show. With 170,000 attendees last year, it's a pretty major event. The festival was supposed to take place on March 20th through 22nd inclusive, to coincide with Miami Music Week, and was cancelled on March 5th. Actually, I should clarify, the festival was "postponed" for a year, so the same DJ's that were scheduled for this year will play next year, and peoples' tickets for this year will be honoured next year.
Most of the reaction on social media was one of unhappiness from DJ's and from attendees. As a DJ, and someone who enjoys attending music festivals, I understand that.
I also have a fascination with studying infectious diseases. I think that really started around fifteen years ago when I first read a book called
The Great Influenza by John Barry. That book piqued my interest, and although I'm not a medical professional, I started to read more about disease outbreaks. There are dozens of books available about this subject, and I've probably read them all.
First of all, here are a few basic facts that people should be aware of before I continue this post:
1. The virus and the disease that it causes have two different names. Most people refer to this as the "coronavirus" outbreak, but that's not really the most accurate term, since coronaviruses are a group of viruses, and the one we're having a problem with now is a specific type.
2. The current virus is called SARS-CoV-2.
3. The disease that it causes is called COVID-19.
4. The effects of the disease can be fairly similar to influenza. However, COVID-19 is not the same as influenza.
5. Handwashing and social distancing are great precautions to help prevent the spread of COVID-19.
When the cancellation was announced, the main reasons why people were upset included:
- The epidemic had not yet hit Florida. At the time, only one case had been identified anywhere in Florida, and it wasn't in Miami.
- Many people who contract COVID-19 experience the same symptoms as a cold or flu. The mortality rate is low, especially for the demographic of most festival attendees (young adults).
- Influenza already kills tens of thousands of people each year in the US, and festivals aren't cancelled due to influenza.
- People already have travel booked. Those people will still end up going to Miami to party, rather than wasting their flights. The parties will just be more spread out.
- Disneyworld often gets more than 100,000 visitors per DAY to their four theme parks, and they aren't closed.
To be honest, these are all valid arguments! But speaking as someone with a hopefully unbiased look at the situation (since I wasn't going to this year's festival), let me make some suggestions about each of these five arguments, and why I think the festival organizers did the right thing (even if it was the city that forced them to cancel).
1.
"The epidemic had not yet hit Florida." Agreed. At the time of closure, the number of confirmed cases in the US was so low that only about 1 in every four million people were confirmed to have contracted COVID-19. However, I've studied infection rates of various diseases for years (which is irrelevant). More importantly, qualified medical professionals and infectious disease specialists have done the same thing. The potential for explosive spread of COVID-19 is quite high. I think in a few weeks, once we reach the period during which the festival was supposed to take place, there will be hundreds or even thousands of confirmed cases in Florida. At that point, people will look back and admit that the decision to cancel was wise. Already, in the 3 days since the cancellation, Florida is up to 14 cases. Although the infection rate could slow down, this also has the potential to explode. Here's a good website to monitor:
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
Edit, March 21st: The Festival would be taking place right now if it had not been cancelled. And yes, there are over a thousand confirmed cases in Florida. Considering the difficulties in getting people tested, there are probably more than ten thousand actual cases.
2.
"The disease is not much different than a bad cold or flu." Agreed, for some people. However, this isn't entirely correct. Worst-case reports in some regions indicate that as many as 20% of people "require" hospitalization. So there are a lot of salient points arising from that. First, even if that number is highly exaggerated, a large scale infection will completely overwhelm medical facilities in even the most advanced health-care systems. This means that some people in critical condition who really need advanced medical care will die, due to lack of resources. Although data is incomplete, there are indications that the mortality rate of people under the age of 50 is probably quite "low" at only around 1%. However, in a worst-case scenario, 60% of the population could eventually get this. Actuaries would point out that if 60% of 170,000 people come down with COVID-19, and the mortality rate is 1%, that means that about a thousand attendees would die. That's a number that is unlikely, but it's not impossible, and shouldn't be ignored. Although young people in excellent physical condition are at lower risk than the general population, some people in their 20's and 30's are dying.
3.
"Influenza already kills tens of thousands of people each year, and festivals aren't getting cancelled." Agreed. I don't think a lot of people realize the true global impact of influenza, which killed an estimated 34,000 people in the US in 2019 (plus half a million hospitalizations).
4.
"People already have their travel booked, and will still go to Miami to party." I agree. Cancellation will not mean that nobody shows up, and nobody expected that would be the case. However, cancellation of the festival does mean that LESS people will show up. It also means that people will be more spread out, and thus any community transmission will be reduced. It may not be possible to avoid an outbreak, but it's possible to reduce the size of the outbreak, and that will help everyone in the long run.
5.
"Why isn't Disney World closed too, since they get as many attendees?" Rather than using Disney World as a justification for why Ultra should have been allowed to proceed, perhaps Ultra should be used as an example of why Disney World will have to consider closing. It would not surprise me if Disney World was closed by the time Ultra was supposed to take place. And if it's not officially closed, I am pretty confident in saying that if the spread of the infection continues on the trajectory that I expect, Disney World will become a ghost town anyway as people voluntary avoid crowds. Since Ultra was cancelled, SXSW was also cancelled. I'd expect cancellations in the next few months from a number of other festivals, such as Coachella, Electric Daisy, the Governer's Ball, and more, if the outbreak continues on its current trajectory. And what about the Olympics?
Edit, March 10th: Coachella is now affected.
Edit, March 20th: Pretty much everything (except the Olympics) is now closed or cancelled. And the Olympics will probably be cancelled within days. Countries are being locked down, and those that haven't been, should be.
Ultimately, this isn't about a single event. This is about trying to proactively limit the spread of a significant infection, before it gets out of control. It isn't about stopping an infection; it's about trying to slow it down to give the health care sector time to mount a better defense. Will it be possible to have vaccines for SARS-CoV-2 soon? Maybe eventually, say in about 12-16 months time. Massive resources around the world are being thrown at this goal.
In a major epidemic, the first goal is containment. That genie may be out of the bottle soon, as we're starting to see evidence of "community transmission," which means that people are getting it from sources that can't be traced. That's not good.
Ultimately, I think that our best hope is to slow down the epidemic. Eventually, there's a good chance that many of us will get COVID-19. Diseases are a part of our natural lives. If we can slow down the epidemic, our health-care systems are less likely to be overrun, which means that the cases in critical condition are more likely to get the resources that they need to survive.
The United States in particular has what is considered to be a world-class healthcare system, but when you're not a US citizen and you can look at it from the outside (as I can), it's easy to see the flaws. The US is the only major country in the entire world without free and universal health care. In this day and age, that's unbelievable.
I'll leave you with three thoughts:
1. Social distancing has proven to work, repeatedly, in this and previous epidemics for many different diseases. As COVID-19 cases become more prevalent around the world, expect more voluntary and forced social distancing. Governments in various countries will try to implement various degrees of distancing, including various types of travel restrictions, quarantines, and lockdowns. This may seem unlikely, but trust me, you should expect this.
2. The best thing that we can do individually to help minimize the spread of SAR-CoV-2 is to practice basic sanitary measures, including frequent handwashing, and avoiding contact with others if you're starting to get sick.
3. In the US, where there is no free and universal health care, many potential cases are not getting tested for two reasons: ineffective leadership, and because testing isn't free for many people. The number of cases is therefore probably being heavily under-reported. The US currently has the highest fatality rate of all major case clusters (countries with 100+ cases), at almost 5%. But this is most likely due to one of two factors: (1) either under-testing means that there are more cases than anyone knows about and therefore that mortality rate is currently artificially high, so the real rate is lower; or (2) more people are dying in the US than elsewhere because there is no free and universal health care, therefore many victims can't afford proper medical treatment.
Edit, March 10th: The mortality rate in Italy is now higher than the US, at 6%.
