COVID 80/20: A Plan for Easing Out of Quarantine

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If we follow 80/20, most of us can return to (almost) normal. We just need to go out of our way to accommodate those in peril.

1% of people carry 50% of COVID risk. China’s Center for Disease Control issued this age chart:

80% of COVID deaths are people over 60. Half are over 70.

So the #1 COVID 80/20 is age.

The #2 COVID 80/20 is underlying health problems:

The 3rd COVID 80/20 is dense urban areas. Viruses like close neighbors.

Source: Johns Hopkins Interactive Map

If you’re over 60; if you have underlying health problems; if you live in a big city… you’ve got a bullseye on your head. You need to take MAJOR precautions.

On the other hand if you’re healthy and under 50; if you live in a smaller city or town… you’re probably wondering what everybody’s wringing their hands about.

Some folks in rural areas think this is a hoax. It’s not. I live in Cook County Illinois (Chicago). Halfway between O’Hare and Midway airports (international airports are an additional risk). Here, 1 out of 150 people have COVID.

1% of the US population bears 50% of the risk.

So… how do we “let out the clutch,” crawl out of our caves and get back to work?

1) People like myself in dense urban areas must take strong precautions. Social distancing, masks, hand washing. Avoid crowds at all costs.

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2) My friend Elizabeth is in her mid 50s and has immune problems. She has to be stringent about Shelter In Place. So do ALL her family members, including her kids. Even though kids rarely catch the virus.

3) People under 40 in small cities, small towns and rural areas can probably return to normal fairly soon. They just need to be extra considerate of people like Elizabeth.

4) It’s far less costly to deliver food and other services (like unemployment benefits) to Elizabeth than shut down half the economy. People like her need extra support and cooperation. We can all spare the expense.

The tricky part is… it’s not “fair.” (80/20 is by definition unfair.) Which means the fastest path back to normal requires self discipline… and laws by local authorities that discriminate by age, medical conditions, and geography. Such rules will infringe on personal freedoms.

But it also means if 5% of us take extra precautions, 2/3 of this problem gets solved… fast.

This isn’t merely a question of government policy. As businesses open up and people begin to travel, we must all be honest with ourselves about how many COVID 80/20s we fall into.

Over 60 – Immune Issues – Big City. How many COVID 80/20’s apply to you?

I’m low risk health-wise. But I’m in a crowded suburb between two major airports… so while the virus is not likely to take me out, it’s got its eye on Elizabeth.

If you’re healthy and want to get back to business as usual, how do you protect your Elizabeths?

Perry Marshall

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About the Author

Perry Marshall has launched two revolutions in sales and marketing. In Pay-Per-Click advertising, he pioneered best practices and wrote the world's best selling book on Google advertising. And he's driven the 80/20 Principle deeper than any other author, creating a new movement in business.

He is referenced across the Internet and by Harvard Business Review, The New York Times, INC and Forbes Magazine.

20 Comments on “COVID 80/20: A Plan for Easing Out of Quarantine”

  1. Yes, desperately needed now. With the situation that’s emerging in Europe now, we really need a sensible approach that does not create too much collateral damage from government actions while still preventing an overload of the health system.

    A problem with the 80/20 approach is that it does not blend well with contact tracing that’s widely applied now. Because for contact tracing to be feasible the total number of virus carriers (symptomatic and asymptomatic) needs to be kept below some rather low threshold, including in the parts of population with extremely low risk of severe illness or death. Therefore, the contact tracing is accompanied by stricter and stricter semi lockdown measures which create a huge collateral damage in society, health (mental and physical) and the economy.

    But maybe we should stop the contact tracing alltogether: It may be useless anyway because there are so many asymptomatic virus carriers that most of the virus carriers and most of the spread escapes the contact tracing anyway.

  2. Here is the thing Perry, from my layperson’s viewpoint.

    Early detection is a key to saving lives. In the end, we want to save lives. So how does early detection save lives in practice. Well, once detected we can find contacts and early detect them and let them know they need to isolate. Further, for the early detected individual they can take steps to mitigate their chances of pulling through.

    If they isolate, rest, and keep an eye on their oxygen levels there is a better chance that they can avoid compromising their immune system. If second stage covid disease kicks in they will be able to get hospitalisation early if they are aware that their oxygen levels are low. The silent hypoxia is known to cause late admissions with less chance of survival.

    Anti inflammatory non prescription, over the counter precautions, may reduce the onset of an inflamed pair of lungs leading to accute respiratory pneumonia.

    If the above is wrong it seems to me it is not harmful. The immune response is known to deal well with the virus stage, but it seems well ducumented that the cytokine storm that may or may not follow is what leads to potential death.

    Impacting the immune response hinders the control at the initial infection/viral stage and improving the immune response can cause a overheated immune response leading to multiple organ failure and silent hypoxia.

    If we take it that we are going to catch it whatever precautions we take, then we need to prepare not to die when we catch it and to hibernate to reduce the risk of infection if we do. This is not to minimise efforts to prevent infection, but the obvious question to me is: Why are we not cataloguing the best practices from around the world of both infection prevention and disease management from day 1 of diagnosis.

    Take the deathj rate from those infected in Germany and then UK. Vast difference. So what are the Germans doing with their infected ones that the UK is not. 1.3% death rate from covid + patients in Veitnam and 15% in UK, so what are Vietnam doing with their Covid + people to save them? How about asking them. Is that too radical?

    In the UK I can catch it, get a test if I feel like it, go home and just infect my family with no advice on how to manage the infection. CPAP machines were said to be a good way to increase oxygen levels without intubation and I made a rudementary breathing enhancer for less that $30 in my workshop. Possitive airway pressure to deliver breath when needed the most will save lives.

    The above is a laypersons observations and it seems to me that the medical community are wanting to implement a complicated expensive solution when simple steps may work but would expose previous incompetence.

    Just my thoughts

  3. Perry, I think there’s another 80/20 in the situation that we aren’t tracking yet.

    I know you’ve had a team of scientists analyzing the “modular-composition” of the virus.

    Of all the different versions of Covid 19, doesn’t it make sense that most (80%) are in the “mediocre-middle”, and 10% of the strains of the virus are extra-virulent, and 10% of the varieties are extra-weak? Is it possible that in certain places like NYC, the population is being infected with the extra-virulent strains, and in other places the population is being exposed to the “average/ordinary” strain of Covid19?

  4. Perry,

    That was the best explanation for approaching this pandemic. You used facts but not without foregoing the humanity of caring for one another.
    It’s refreshing to see something that’s not either “we all need to stay home” or “we need to open the economy” (with no real regard for what that truly means).

    Thank you Perry for sharing your wisdom!

  5. Don’t forget to mention these interesting “tid bits”. Gov. Cuomo and 4 other states..have had “CoVid Antibody” checks done. Cuomo needs to be congratulated for N.Y. state’s work. First of all, the test was developed by the N.Y. Dept of Health LABS. (You can read all about it on the N.Y. State Health CoVid Website.) Secondly, Cuomo specifically asked for advice on doing “random” testing, and a plan was drawn up to pop up little testing areas at all N.Y. Grocery Stores and Drug Stores. VOLUNTARILY testing only. (No specific selection of people.) As of LAST week, they had 150,000 results showing that 13% of N.Y. State HAD HAD THE VIRUS. Or 2.8 Million people (vast majority, a-symptomatic). The other 3 states (Florida, California, and ???) had similar results. Indicating a 30 to 40 to 1 ratio of “had the virus” vs “tested positive for the active VIRUS. Indicating 30 to 40 Million have had it in the USA.

    Last, the CDC has re-evaluated criteria for linking CoVid to deaths (moving towards CONFIRMED BY TESTING to report “real” deaths. Dropping their original 67K down to 37K (nation wide). When you combine the probably “had” the virus, with the active, use that 37K figure, you keep coming to this conclusion: CoVid = Seasonal Flu.

  6. I think that Sweden pretty much follows this strategy.

    Their case numbers and death rate are about average, compared to other countries (accounted for population size), maybe leaning a bit on the higher side. So, the results are not too bad given that they didn’t do a full lock-down like other countries.

    I think it depends a lot on how self-disciplined and responsible are people in a certain area. People in Sweden seem to be pretty good with this, given the little bit of what I know about Swedish mentality.

    It’s pretty hard to get a clear correlation between measures taken by countries and the results they get. E.g., my country (Austria) is doing exceptionally well. We had a lock-down, but we were always allowed to go outside for a walk. By and large people were compliant but and not all. Some people didn’t respect distancing during walks outside. Sometimes I was passed pretty close where I couldn’t prevent it, e.g. by a cyclist using the pavement. But it still worked. Other countries had a full curfew (like Spain) but it took much longer to get it under control.
    I think it is quite important when the measures started. Every day makes a difference in exponential growth. But this doesn’t explain everything either.

    I guess that there are some influences that are yet to be discovered. It’s not just the measures and the discipline and responsibility of the population. There needs to be something else, possibly multiple things.

  7. We live on a street with at risk neighbors in a similar metro area. A few months before this happened, the Lord told me to start believing that my prayers are powerful. I am more of an undercover prayer warrior but the Lord is happy for my baby steps. LOL

    Here is what we did:

    1. Prayed for Elizabeth and all our neighbors. My husband and I regularly walk our street at night and pray for the Lord to bless and protect each house and its occupants. All on our street have been safe.

    2. Walked by empty stores. We prayed for stores by name, prayed for the owners and the customers who would return to be blessed and protected. We prayed for empty stores that they would be leased and be blessed. Will enter stores that have reopened and celebrate the answer to our prayers. In these stores, I will watch for the Lord to highlight anyone that needs prayer and blessings. Some people I will start a conversation to encourage them.

    3. Tell Elizabeth to look very carefully at the statistics. As we do more tests, we are learning a lot. Millions had the virus but didn’t know they had it. As these millions get factored into the statistics, it is crushing the numbers that die from the virus. Also, the percentage of people who suffer horrible symptoms and death diminishes. Knowing this will help her stress.

    4. Elizabeth might want to check with her doctor about some successful protocols to protect those at risk. Also, inexpensive treatments that are highly successful. Depends on her health issues if these protocols will work for her.

    5. Encourage Elizabeth to find ways to improve her health. Sometimes there are miracles and sometimes little daily consistent healthy things lead to huge positive health changes.

    Five years ago I was probably more at risk than Elizabeth but now my risk factors are very small. Never knew that tiny changes I was making prepared me for such a time as this. Will pray for you and Elizabeth.

    After such a pendulum swing to awful, America and the world will swing to experience incredible blessings. I see the hopeful signs already.

  8. Perry,

    Bravo! These 3 Covid-19 factors are the clearest exposition of Level 0 of 80/20 analysis I’ve seen.

    What we need next is the Level 1 and Level 2 of the Covid-19 fractal. What’s the next 80/20 and the one after that for these 3 factors? I.e. the 64/4 and 51/1?

    As you well know, the insights for what’s needed next to protect Elizabeth are revealed in the deeper level analysis headed towards the bottom of the swamp.

    Remember when I briefly showed you my Sierpinski triangle fractal approach to “Birth, Growth and Death” at the Truth seminar? It’s only as i got to level 2 (the 51/1 level) that i got deep enough to see the connections and the truth began to be revealed to me in my own field.

    There is a real coalescence of ideas and inter-connectedness to deal with as we look at how fragile and unsustainable all our economic and health systems are. It includes all you’ve revealed in Evolution 2.0, Taelb’s ‘Antifragile’, Geoffrey West’s ‘Scale”, everything to do with sustainability, the circular economy and much more.

    Thank you for provoking us to think and to dive into the swamp. The truth is definitely out there.

  9. Awesome! With proper leadership this could happen to a large degree. And personal discipline and modeling of considerate behavior all around, starting from the top. Unfortunately this doesn’t seem to be how things are rolling out. I hope you have or will “inject” this idea into the infectious disease community discussion, perhaps it could bubble up from there.

  10. In theory, it’s about making it as easy as possible for Elizabeth to stay inside and not come into contact with others who might be potential carriers. But she still needs to remain fit and healthy. And that includes being able to see/talk to people.

    So Elizabeth gets to work from home – if she works.

    She shouldn’t have to go out to get food or do her exercise. She should be provided with a guaranteed home delivery from her local supermarket so she doesn’t have to worry about going out to get food. This should be delivered to her front door by a suitably screened/tested/covered person so she just has to move it inside and spray it (in case it was originally packed by someone who might be carrying the infection – but those people should also have adequate covering to do their work without the risk of spreading any infection.

    She should be given guidance on how to spray incoming deliveries to prevent transmission of infection.

    She should be provided with free exercise on a laptop/tablet provided by the Government if she doesn’t already have one – so she doesn’t have to worry about going for a daily walk.

    She should be shown how to use Zoom or other softwares on the laptop/tablet so she can communicate with friends and family. Feelings of isolation are pushing people to go out and meet with others during lockdown.

    She should not have to worry/stress about whether she can afford to pay for the groceries that are being delivered.

    And, of course, Elizabeth has to want to be protected. And be willing to follow the rules that are in place to keep her safe.

    And so do all the people who live in the same house.

    We have friends who have immuno compromised partners. If their kids want to go out, they can’t come back inside. They have to find somewhere else to live for the duration. That can be difficult for all concerned emotionally. Many Elizabeths may be willing to compromise their own health so as not to upset their offspring…

    In practice, there are so many variables… but if it truly is only Elizabeths who are at risk, we should look at a simpler option that doesn’t involve compulsory lockdown for everyone.

  11. Yesterday some shops like IKEA opened here in Germany. It’s as if their life depended on going to IKEA instead of being a risk. Full parking spaces – no social distancing.

    Originally, only shops below 800qm were supposed to open. Because we should take it slow. But no, the larger shops sued the government because that 800qm were unfair. Same with the schools. First only a couple of classes were supposed to come in. Again someone sued the government. Head on desk.

    People don’t think at all. They don’t think about their individual risk.

  12. Good analysis, but my feeling is that it makes a number of assumptions: (1) That the data are accurate, but how accurate is the China data (or even the US data, when the overall mortality has risen beyond what the official COVID19 death rate would?). (2) Is it just about fatalities? There seem to be potentially long-term disabilities among those who recover. How serious are these, how prevalent, and how long-term are these? Currently it seems that we do not know, but we would want to incorporate these as well (3) How good are people at following procedures for their own and others’ safety? Even when given very simple, blanket rules, a large proportion of the population seems to be incapable or unwilling to follow them. Unless each person was able and willing to be ruthlessly accurate in following the set of procedures based on their own 80/20 situation, then the system would be ineffective. So we would also need to know what assumptions would need to be made about lack of rules compliance, and so how much stricter and wider the application of safety procedures would need to be to counteract this.

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