Open letter from Italy to the international scientific community(left.it)
left.it
Open letter from Italy to the international scientific community
https://left.it/2020/03/13/covid_19-open-letter-from-italy-to-the-international-scientific-community/
698 comments
> they don't have training, and the hospital itself has no plans in place
I have a difficult time grasping this part. It’s not like it’s something completely new. We encounter virus infections every year during flu season. The SARS outbreak was 18 years ago and MERS was 8 years ago. Did we not learn anything from it?
Sure, it was not as severe as SARS-CoV-2, but we should know how to handle it. I agree we should take precautions to stop spreading. But from seeing what is going on around here in EU, I am thinking that the panic is over-inflated and is doing more harm than good. Maybe it takes panic and fear to scare the majority of people into taking all precautions to stop the virus from spreading?
I have a difficult time grasping this part. It’s not like it’s something completely new. We encounter virus infections every year during flu season. The SARS outbreak was 18 years ago and MERS was 8 years ago. Did we not learn anything from it?
Sure, it was not as severe as SARS-CoV-2, but we should know how to handle it. I agree we should take precautions to stop spreading. But from seeing what is going on around here in EU, I am thinking that the panic is over-inflated and is doing more harm than good. Maybe it takes panic and fear to scare the majority of people into taking all precautions to stop the virus from spreading?
> The SARS outbreak was 18 years ago and MERS was 8 years ago. Did we not learn anything from it?
> Sure, it was not as severe as SARS-CoV-2, but we should know how to handle it.
The answer appears to be no, we didn't. Remember neither of those really hit here in the US.
CDC SARS FAQ [0]
> How many people contracted SARS in the United States during the 2003 outbreak? How many people died of SARS in the United States?
> In the United States, only eight persons were laboratory-confirmed as SARS cases. There were no SARS-related deaths in the United States. All of the eight persons with laboratory-confirmed SARS had traveled to areas where SARS-CoV transmission was occurring.
CDC MERS FAQ [1]
> Q: Has anyone in the United States gotten infected?
> A: Yes, two patients in the U.S. tested positive for MERS-CoV infection, both in May 2014.
The hospitals (nurses at them) that I've heard from say they don't have the masks on hand and they have received no training for how to deal with something like this on this scale. In fact they are being told things contrary to their training like having them wipe down the disposable shield of a CAPR [2] with bleach to re-use it (they are supposed to be single use).
They have limited (10 in the case of the CAPR shields in one hospital) because it's only required for specific diseases that they see few to no cases of per year. They don't have stockpiles of n95 masks because they could alway just order more if they needed them (same with CAPR). They are having to use the CAPR's temporarily because you need to pass a n95 mask fit test [3] (to insure nothing can get in) but the nurses haven't done that. At one hospital they just so happened (dumb luck) to have someone working that day that knew how to administer it and so they have been rushing to have nurses complete it.
> But from seeing what is going on around here in EU
What do you mean by this?
[0] https://www.cdc.gov/sars/about/faq.html
[1] https://www.cdc.gov/coronavirus/mers/faq.html
[2] http://www.lbs-biotech.com/products/personal-protection/max-...
[3] https://www.osha.gov/video/respiratory_protection/fittesting...
> Sure, it was not as severe as SARS-CoV-2, but we should know how to handle it.
The answer appears to be no, we didn't. Remember neither of those really hit here in the US.
CDC SARS FAQ [0]
> How many people contracted SARS in the United States during the 2003 outbreak? How many people died of SARS in the United States?
> In the United States, only eight persons were laboratory-confirmed as SARS cases. There were no SARS-related deaths in the United States. All of the eight persons with laboratory-confirmed SARS had traveled to areas where SARS-CoV transmission was occurring.
CDC MERS FAQ [1]
> Q: Has anyone in the United States gotten infected?
> A: Yes, two patients in the U.S. tested positive for MERS-CoV infection, both in May 2014.
The hospitals (nurses at them) that I've heard from say they don't have the masks on hand and they have received no training for how to deal with something like this on this scale. In fact they are being told things contrary to their training like having them wipe down the disposable shield of a CAPR [2] with bleach to re-use it (they are supposed to be single use).
They have limited (10 in the case of the CAPR shields in one hospital) because it's only required for specific diseases that they see few to no cases of per year. They don't have stockpiles of n95 masks because they could alway just order more if they needed them (same with CAPR). They are having to use the CAPR's temporarily because you need to pass a n95 mask fit test [3] (to insure nothing can get in) but the nurses haven't done that. At one hospital they just so happened (dumb luck) to have someone working that day that knew how to administer it and so they have been rushing to have nurses complete it.
> But from seeing what is going on around here in EU
What do you mean by this?
[0] https://www.cdc.gov/sars/about/faq.html
[1] https://www.cdc.gov/coronavirus/mers/faq.html
[2] http://www.lbs-biotech.com/products/personal-protection/max-...
[3] https://www.osha.gov/video/respiratory_protection/fittesting...
As an Italian, I raise my eyebrows every time China is mentioned as an example for the successful containment of this virus.
It could do that because it could afford to take the economical hit and because it is an authoritarian state, which means you can get almost everyone to obey, in one way or another. Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
Why on Earth is this a good model?
Undoubtedly for the safety of citizens, but even with all the people shouting about a "fascist revolution" going on with the previous government, it only took three orders to strip everyone of most of their freedoms without anyone batting an eye (especially since no one knows for how long, the April 3rd date is a joke).
Quarantining is probably inevitable (although it won't help the overloaded ICUs until two weeks from now, so more capacity will always be needed), but following rules in place in an outbreak does not mean one should not question their principles.
And this letter should be sent to the media and the government, since both can't even understand an exponential, or basic statistics (even with the so-called "peak" reached, cases will keep on increasing until recoveries are due).
Personally I'd like fast-tracking of anti-SARS-CoV-2 drugs instead (those are the ones which will get out of this mess, quarantining is just flattening the curve, although immensely beneficial), along with setting up place for non-intensive care COVID-19 patients. Every ICU bed freed is a victory.
It could do that because it could afford to take the economical hit and because it is an authoritarian state, which means you can get almost everyone to obey, in one way or another. Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
Why on Earth is this a good model?
Undoubtedly for the safety of citizens, but even with all the people shouting about a "fascist revolution" going on with the previous government, it only took three orders to strip everyone of most of their freedoms without anyone batting an eye (especially since no one knows for how long, the April 3rd date is a joke).
Quarantining is probably inevitable (although it won't help the overloaded ICUs until two weeks from now, so more capacity will always be needed), but following rules in place in an outbreak does not mean one should not question their principles.
And this letter should be sent to the media and the government, since both can't even understand an exponential, or basic statistics (even with the so-called "peak" reached, cases will keep on increasing until recoveries are due).
Personally I'd like fast-tracking of anti-SARS-CoV-2 drugs instead (those are the ones which will get out of this mess, quarantining is just flattening the curve, although immensely beneficial), along with setting up place for non-intensive care COVID-19 patients. Every ICU bed freed is a victory.
> As an Italian, I raise my eyebrows every time China is mentioned as an example for the successful containment of this virus.
China dropped the ball for a full 10 days back when the disease was nicely contained to a small part of Wuhan, and then largely to Wuhan itself and Hubei - they didn't let the population know about the danger, so for quite some time no one was thinking about protecting themselves by wearing masks, social distancing etc. But the trouble is, Italy then made the exact same mistake by being late with containment measures, and now the UK and US are doing the same. So there's nothing to roll one's eyes or raise eyebrows about.
China dropped the ball for a full 10 days back when the disease was nicely contained to a small part of Wuhan, and then largely to Wuhan itself and Hubei - they didn't let the population know about the danger, so for quite some time no one was thinking about protecting themselves by wearing masks, social distancing etc. But the trouble is, Italy then made the exact same mistake by being late with containment measures, and now the UK and US are doing the same. So there's nothing to roll one's eyes or raise eyebrows about.
The full danger was unknown in the initial stages. Provincial officials were downplaying it for various reasons, and until the very end of December it wasn't known to even transmit person-to-person.
Once the threat was clear, the government of China acted much more alacrity and decisiveness than any Western country, which have had months of advance notice.
Once the threat was clear, the government of China acted much more alacrity and decisiveness than any Western country, which have had months of advance notice.
"The very end of December" was 20+ days prior to the Wuhan lockdown, which was was essentially the only instance where China officially acknowledged the disease - before then, the local government was having police caution their doctors and scientists not to talk or "spread untrue rumors" about it. In the meantime, people in Wuhan and elsewhere were just hanging out as usual with no social distancing behaviors whatsoever. Not even wearing protective masks, which is a common habit there unlike the West.
People are very quick to blame Chinese officials, but I think they were correct in avoiding panic before knowing for sure the true dimensions of the problem they had at hand. The government has its credibility at stake: if you start using harsh measures without evidence, you lose credibility for the next time it is really needed.
You have to be kidding.
They were correct in threatening a doctor who reported what he saw (facts) to retract his statements as being _false_?
The local government didn't want to believe in the threat and wanted very much to keep any negative news hushed out of fear of looking bad to the central government.
So there you have it, a country governed by fear where people prefer to hide issues instead of quickly seeking help.
They could have done it through internal channels, without the public knowing but no, they crushed the messengers and tried to hide the facts until it was too late.
The central government admitted it itself: https://news.rthk.hk/rthk/en/component/k2/1506445-20200203.h...
They were correct in threatening a doctor who reported what he saw (facts) to retract his statements as being _false_?
The local government didn't want to believe in the threat and wanted very much to keep any negative news hushed out of fear of looking bad to the central government.
So there you have it, a country governed by fear where people prefer to hide issues instead of quickly seeking help.
They could have done it through internal channels, without the public knowing but no, they crushed the messengers and tried to hide the facts until it was too late.
The central government admitted it itself: https://news.rthk.hk/rthk/en/component/k2/1506445-20200203.h...
> People are very quick to blame Chinese officials, but I think they were correct in avoiding panic
That's for sure but there's a useful middle ground between mindless panic and total complacency, and these Chinese officials were way too far on the complacency side for quite some time.
That's for sure but there's a useful middle ground between mindless panic and total complacency, and these Chinese officials were way too far on the complacency side for quite some time.
spectramax(1)
fma(2)
The local police imprisoned a doctor for speaking out about a fast-growing pneumonia disease. They didn't just ignore it, they actively quashed discussion of it
They did not imprison him.
They did squash discussion of it.
Once the national government found out, they fired the local officials and lauded the doctor as a hero.
They did squash discussion of it.
Once the national government found out, they fired the local officials and lauded the doctor as a hero.
The fact that there wasn't a credible free press to report responsibly on an emerging illness or a free vote to hold officials accountable are not at all unrelated to the authoritarian system that allowed them to build a hospital fast or close a city or whatever they did well on.
I'll admit, though, that I wouldn't trade my right to vote for a cure for the common cold, coronavirus, or anything else.
I'll admit, though, that I wouldn't trade my right to vote for a cure for the common cold, coronavirus, or anything else.
> authoritarian system that allowed them to build a hospital fast or close a city or whatever they did well on.
Look, this is a dangerous meme in more ways than one. Italy and Spain managed to lock down entire cities, and those are countries with a strong tradition of democracy. Emergency powers, martial law etc. are a thing, and there's even quite a bit of precedent for using them to deal w/ disease outbreaks. Even in the US.
Look, this is a dangerous meme in more ways than one. Italy and Spain managed to lock down entire cities, and those are countries with a strong tradition of democracy. Emergency powers, martial law etc. are a thing, and there's even quite a bit of precedent for using them to deal w/ disease outbreaks. Even in the US.
Anglo-American law was strongly influenced by the repeated waves of bubonic plague in England during the middle ages. Though the powers have been rarely used to their full extent, they continue to exist.
well, Spain is still a monarchy (and has been since the caliphate was pushed back), had a Civil war, where fascists won and then ruled for 40 years... Then the king declared that he would like democracy more than autoritarian rule (without him). So much to a strong tradition of democracy...
Spain has a _constitutional monarch_ the same approach as the United Kingdom. This is actually a more stable choice than America's.
In constitutional monarchy the monarch is Head of State, a figurehead role with no real personal power. Because monarchs are born not elected this figurehead has no semblance of democratic legitimacy, it's obvious to everyone that they shouldn't get any power, yet as a symbol they are long-lived and emphasise continuity even as political change happens around them.
Elected Politicians on the other hand actually run the legislature and executive government.
That is, the laws you obey are made by people you elected to make them, but at times of crisis the living symbol of your country isn't some politician roughly half the country doesn't like.
This works so much better than the US system that Americans charged with trying to make new countries or fix broken ones (after "regime change" for example) do not follow the US model for many decades. If you're an optimist, the US model worked once and maybe they got lucky. If you're a pessimist we're just waiting for the cracks to get bad enough that it falls apart.
In constitutional monarchy the monarch is Head of State, a figurehead role with no real personal power. Because monarchs are born not elected this figurehead has no semblance of democratic legitimacy, it's obvious to everyone that they shouldn't get any power, yet as a symbol they are long-lived and emphasise continuity even as political change happens around them.
Elected Politicians on the other hand actually run the legislature and executive government.
That is, the laws you obey are made by people you elected to make them, but at times of crisis the living symbol of your country isn't some politician roughly half the country doesn't like.
This works so much better than the US system that Americans charged with trying to make new countries or fix broken ones (after "regime change" for example) do not follow the US model for many decades. If you're an optimist, the US model worked once and maybe they got lucky. If you're a pessimist we're just waiting for the cracks to get bad enough that it falls apart.
> This is actually a more stable choice than America's.
You can't support that claim. Historically - all of recorded history - there are less than half a dozen examples that can be argued to be comparable to or to have systems that are more stable than the US over two centuries of time.
Go ahead and list all the constitutional + democratic systems that have lasted for more than two centuries. The European region barely had any democracies as recently as WW1. Here is what that looks like:
https://i.imgur.com/fnJNjIn.png
Now go back to 1850 or 1900. How many were there? So where do you plan to get your data from, to support your premise on stability?
There is long-term instability inherent in all functioning monarchy systems: the source of that instability is that people frequently don't like them, which is why nations have spent the last few hundred years gradually abandoning or neutering monarchy systems. Most of what remains is a cultural trinket. It's why the monarchy in the UK is little more than a facade, a figurehead; it has no real governing power or position, it is of relatively little political consequence and probably never will be again. Even including the UK in this, is a questionable data point because of that. What does the Queen do? Answer: not much, she is nothing more than a quaint cultural nod to the past at this point.
In fact the US has the opposite problem. Its system of government tends to produce too much stability and not enough dynamism (which is what the argument for many political parties is arguing in favor of). That stability often means the US moves slower on reforms and its system is highly resistant to change. Those are the trade-offs inherent in having greater stability.
You can't support that claim. Historically - all of recorded history - there are less than half a dozen examples that can be argued to be comparable to or to have systems that are more stable than the US over two centuries of time.
Go ahead and list all the constitutional + democratic systems that have lasted for more than two centuries. The European region barely had any democracies as recently as WW1. Here is what that looks like:
https://i.imgur.com/fnJNjIn.png
Now go back to 1850 or 1900. How many were there? So where do you plan to get your data from, to support your premise on stability?
There is long-term instability inherent in all functioning monarchy systems: the source of that instability is that people frequently don't like them, which is why nations have spent the last few hundred years gradually abandoning or neutering monarchy systems. Most of what remains is a cultural trinket. It's why the monarchy in the UK is little more than a facade, a figurehead; it has no real governing power or position, it is of relatively little political consequence and probably never will be again. Even including the UK in this, is a questionable data point because of that. What does the Queen do? Answer: not much, she is nothing more than a quaint cultural nod to the past at this point.
In fact the US has the opposite problem. Its system of government tends to produce too much stability and not enough dynamism (which is what the argument for many political parties is arguing in favor of). That stability often means the US moves slower on reforms and its system is highly resistant to change. Those are the trade-offs inherent in having greater stability.
So what you've done there is a very common mistake. The US was not the only country built with this approach, it's just the only time it has worked (so far).
Plenty of countries especially in Latin America copied this choice and it didn't work for them. I think the evidence supports the conclusion that's because it's a bad choice.
Plenty of countries especially in Latin America copied this choice and it didn't work for them. I think the evidence supports the conclusion that's because it's a bad choice.
Thry silenced doctors, faked numbers to the medical community and eventually the lockdown was to save the Chinese economy & people not to stop the spread overseas, however, I’m sure the communist party will claim that.
> The full danger was unknown in the initial stages.
The danger was sufficiently known, sufficiently early.
Those sounding the alarm were silenced.
The danger was sufficiently known, sufficiently early.
Those sounding the alarm were silenced.
The containment situation in Wuhan in the early stages cannot be compared to the situation in European countries or the US now, or even the situation in Wuhan now
In the early stages in Wuhan the virus only existed in Wuhan. A severe lockdown that eliminated the virus there would have eliminated it completely. Full stop. It would have been gone forever.
A draconian lockdown right now in e.g. the UK, or even a few weeks ago, might have eliminated the virus in the UK, but then it would just come back in again. We can’t seal the entire country permanently.
Even in Wuhan, they are easing the lockdown so soon the virus will get back into Wuhan again. It’s just a matter of time before they have another outbreak. It’s simply impossible that it won’t happen.
Lockdowns are important tools to slow the spread of the virus, they are a vital part of our response, but they can only slow it down. They cannot stop it or eliminate it. Also lockdowns are most effective the first time you do them, and then they’re the most effective in the first few weeks.
Impose a heavy lockdown too soon, and it’s like using up your most powerful ammunition before the enemy is in effective range of your weapons. Letting the enemy get closer might mean accepting casualties early on, but fewer casualties overall and a better chance of victory. It’s a hard, painful choice to have to take.
In the early stages in Wuhan the virus only existed in Wuhan. A severe lockdown that eliminated the virus there would have eliminated it completely. Full stop. It would have been gone forever.
A draconian lockdown right now in e.g. the UK, or even a few weeks ago, might have eliminated the virus in the UK, but then it would just come back in again. We can’t seal the entire country permanently.
Even in Wuhan, they are easing the lockdown so soon the virus will get back into Wuhan again. It’s just a matter of time before they have another outbreak. It’s simply impossible that it won’t happen.
Lockdowns are important tools to slow the spread of the virus, they are a vital part of our response, but they can only slow it down. They cannot stop it or eliminate it. Also lockdowns are most effective the first time you do them, and then they’re the most effective in the first few weeks.
Impose a heavy lockdown too soon, and it’s like using up your most powerful ammunition before the enemy is in effective range of your weapons. Letting the enemy get closer might mean accepting casualties early on, but fewer casualties overall and a better chance of victory. It’s a hard, painful choice to have to take.
[deleted]
I am not a huge defender of China, but it is disingenuous to claim that not realizing the import of the virus in the first 10 days is anywhere near the magnitude of the Italian government's failure.
The Italian government as the first Western country facing an outbreak was dealing with the prisoner's paradox. If you are the only one instituting strong lockdown measures you are the only one paying the economic price. It was wrong, but it's understandable that the government hoped that the infection could be contained to two clusters. The other European governments and the US on the other hand have absolutely no excuse.
So you're arbitrarily suggesting that being the first western country is special. China's economy was already affected at that point. In our global world, why doesn't that count? By your logic, I could also say the US doesn't do enough for obvious reasons: They're the first western non-European country affected. They don't want to be the only ones (after China and Italy) paying the economic price.
It's special in that the Western world and their economies are much more interconnected and fragile than China or Iran, and South Korea was considered special due to the sect. It's also special in that they didn't have any experience with SARS.
Besides Italy did start to apply lockdown measures to specific towns, and closed schools when they had 20 cases. It was insufficient but at least it was an attempt. The US has had clusters out of control in Washington state for almost as long and the federal agencies were actually trying to silence them. And another in NYC, which is basically the economic powerhouse of the United States.
Besides Italy did start to apply lockdown measures to specific towns, and closed schools when they had 20 cases. It was insufficient but at least it was an attempt. The US has had clusters out of control in Washington state for almost as long and the federal agencies were actually trying to silence them. And another in NYC, which is basically the economic powerhouse of the United States.
> It was insufficient but at least it was an attempt.
And it should've been clear with all the data we had that it would be. Don't get me wrong, I don't think any of the other western countries does it right. Italy got unlucky because it was the first country where shit hit the fan. Might as well have been Germany if they wouldn't have gotten lucky in stopping the spread from their Bavaria case. But I fully stand by my point anyways that no country in the west did a good job, and points like yours are weak excuses at best, since it basically boils down to "well we're delaying taking down our economy a bit and make sure the rest of Europe suffers too, so we're not as ducked in comparison to them." There's certainly some logic to that, but it shows how shallow our advanced civilized world really is.
And it should've been clear with all the data we had that it would be. Don't get me wrong, I don't think any of the other western countries does it right. Italy got unlucky because it was the first country where shit hit the fan. Might as well have been Germany if they wouldn't have gotten lucky in stopping the spread from their Bavaria case. But I fully stand by my point anyways that no country in the west did a good job, and points like yours are weak excuses at best, since it basically boils down to "well we're delaying taking down our economy a bit and make sure the rest of Europe suffers too, so we're not as ducked in comparison to them." There's certainly some logic to that, but it shows how shallow our advanced civilized world really is.
> But I fully stand by my point anyways that no country in the west did a good job
FWIW I totally agree.
> Might as well have been Germany if they wouldn't have gotten lucky in stopping the spread from their Bavaria case.
Yes, that's what Italy was hoping to do. They didn't realize how contagious this thing is.
FWIW I totally agree.
> Might as well have been Germany if they wouldn't have gotten lucky in stopping the spread from their Bavaria case.
Yes, that's what Italy was hoping to do. They didn't realize how contagious this thing is.
[deleted]
It's interesting that the encouragement for self isolation in Washington came from companies like Microsoft about 10 days ago. That raised awareness quite a bit.
> China dropped the ball for a full 10 days back when the disease was nicely contained to a small part of Wuhan...
Uh, China dropped the ball for a full 3 months since the first reports of a novel respiratory disease started back in November. First denying it, then jailing the doctors who tried to raise the alarm. Not to mention not enforcing their own laws regarding food hygiene put in place after SARS which would have prevented the transmission in the first place.
Yeah, they're now showing containment measures that work. But they could have stopped this in its tracks before going global, or prevented it entirely.
Too little, too late.
Uh, China dropped the ball for a full 3 months since the first reports of a novel respiratory disease started back in November. First denying it, then jailing the doctors who tried to raise the alarm. Not to mention not enforcing their own laws regarding food hygiene put in place after SARS which would have prevented the transmission in the first place.
Yeah, they're now showing containment measures that work. But they could have stopped this in its tracks before going global, or prevented it entirely.
Too little, too late.
New viruses come out all the time. This viruses wasn't isolated as different till the end of December.
The Doctor wasn't jailed ...
The virus was spread at the market. It didn't start at the market.
Until we know where it started we don't know if it would have stopped the virus or not.
The Doctor wasn't jailed ...
The virus was spread at the market. It didn't start at the market.
Until we know where it started we don't know if it would have stopped the virus or not.
The doctors were not jailed, because luckily CCP need them to work to fight the virus. Some of them died for it already, mostly due to the hard work, insufficient protection CCP provided to the doctors, and in one case at least, intentionally punish the doc by delay his treatment.
Talking about the origin of this virus, this paper of 2015 is quite interesting: https://www.nature.com/articles/nm.3985 . In this paper, the wuhan P4 institute people basically described how they produced a prototype of the 2019 wuhan virus.
Talking about the origin of this virus, this paper of 2015 is quite interesting: https://www.nature.com/articles/nm.3985 . In this paper, the wuhan P4 institute people basically described how they produced a prototype of the 2019 wuhan virus.
He was brought in to sign a confession/apology on the 3rd before things were out of control.
He is/was also a member of the CCP.
He is/was also a member of the CCP.
"the people who sign this letter are not aware that they're being manipulated by CCP, in the meantime, let me push conspiracy theories".
I said in my comment clearly it is a hypothesis. While it is important and useful to think logically the Euclidean way, it is also important to find clues and make hypothesis, that is how people discover things in the real world.
Without information about how this letter was prepared and signed among these people in detail, my hypothesis stands.
Without information about how this letter was prepared and signed among these people in detail, my hypothesis stands.
> The virus was spread at the market. It didn't start at the market.
The virus came from bats. The "wildlife market" in question sold raw bat meat. How else would it have gotten there?
The virus came from bats. The "wildlife market" in question sold raw bat meat. How else would it have gotten there?
Is this known for a fact? I thought the bat angle was more a most likely scenario but not proven.
No, Chinese markets generally don't sell bat meat or eat bats.
They eat lots of animals but bats are not one of them. (I'm sure there is a village in China where they do eat bats. It is a big country.)
The photos you see online of Chinese people eating bats are Tourist in the Pacific.
They eat lots of animals but bats are not one of them. (I'm sure there is a village in China where they do eat bats. It is a big country.)
The photos you see online of Chinese people eating bats are Tourist in the Pacific.
Correct, Chinese markets generally don't sell such things. I know, I'm Chinese ;)
But this particular part of China does. It's more a subculture derived from one of the minority groups in that province, but it's there.
But this particular part of China does. It's more a subculture derived from one of the minority groups in that province, but it's there.
Never heard about such a thing. Sounds like some sort of conspiracy theory unless you have concrete proof of that.
The original hypothesis was that some other animal sold at the market acted as an intermediate host between bat and human, just like the case in 2003 SARS, but this is also not proven.
The original hypothesis was that some other animal sold at the market acted as an intermediate host between bat and human, just like the case in 2003 SARS, but this is also not proven.
Conspiracy theory has a specific meaning. Their claim might be false but even if this is the case they are not implying the existence of any conspiracy.
Chinese containment measures gave other countries a head start of at least two months. Too bad that no government took the challenge seriously.
None of that is really the point though. The point is that so many other countries are dropping the ball in the same (or worse!) ways than China did after having the luxury of seeing what happened in China.
If you have 3 people and one slips on a patch of ice and falls you could argue they should understand how ice works and should have been more careful, but if you have 2 other people see that person fall and they blithely walk across the ice and also fall, who should you judge more harshly?
For me personally, I'm going with the people who saw the result of the first event and then followed the same path.
If you have 3 people and one slips on a patch of ice and falls you could argue they should understand how ice works and should have been more careful, but if you have 2 other people see that person fall and they blithely walk across the ice and also fall, who should you judge more harshly?
For me personally, I'm going with the people who saw the result of the first event and then followed the same path.
Maybe the best solution would be to get rid of the patch of ice instead of finding someone to blame, while people keep slipping over it.
They traced the virus back to November, but at the time it was not a serious threat. They just didn’t have enough data then.
Let’s put it this way, other countries have had a full 2 months of warning and preparation time and they are also dropping the ball.
Let’s put it this way, other countries have had a full 2 months of warning and preparation time and they are also dropping the ball.
c789a123(3)
> As an Italian, I raise my eyebrows every time China is mentioned as an example for the successful containment of this virus. It could do that because it could afford to take the economical hit and because it is an authoritarian state,
You know what is MUCH more effective than an authoritarian response? An _earlier response_.
An earlier response, even if it weaker, is much more potent than a stronger later response.
The intensity of china's response would not be necessary where the response is faster.
> but following rules in place in an outbreak does not mean one should not question their principles.
The best way to preserve civil rights and not have to bend them to protect against loss of life is to respond as early as you can reasonable justify.
In the US the fact that our principles (and laws!) tie our hands somewhat is all the more reason that it's important that we act aggressively within the space that our society allows.
> Personally I'd like fast-tracking of anti-SARS-CoV-2 drugs instead
Responding earlier keeps people alive longer for those drugs to become available.
You know what is MUCH more effective than an authoritarian response? An _earlier response_.
An earlier response, even if it weaker, is much more potent than a stronger later response.
The intensity of china's response would not be necessary where the response is faster.
> but following rules in place in an outbreak does not mean one should not question their principles.
The best way to preserve civil rights and not have to bend them to protect against loss of life is to respond as early as you can reasonable justify.
In the US the fact that our principles (and laws!) tie our hands somewhat is all the more reason that it's important that we act aggressively within the space that our society allows.
> Personally I'd like fast-tracking of anti-SARS-CoV-2 drugs instead
Responding earlier keeps people alive longer for those drugs to become available.
> You know what is MUCH more effective than an authoritarian response? An _earlier response_.
Absolutely. If this were Kerbal Space Program just about everybody would be able to tell you that the best moment to deflect an orbit is early on when you only need a little push for a giant effect later on. With exponential developments timing is everything.
Absolutely. If this were Kerbal Space Program just about everybody would be able to tell you that the best moment to deflect an orbit is early on when you only need a little push for a giant effect later on. With exponential developments timing is everything.
Agreed. And where is Trump's response? We don't even have enough testing kits. We had 2 months to ramp things up.
Relying solely on the federal government for a response is a single point of failure. Regardless of who is in control of the FDA and CDC, neither agency should have had the ability to block testing. Not having a breakglass feature is downright stupid.
At least he closed the borders. Russia as well. EU can't even do that.
Several EU countries have already closed or will be closing their sovereign borders in the next 24 hours. They can do that. They are doing it.
He did it in an ineffective way. US nationals were returning from the EU without any screening. And it was way too late. All a bunch of xenophobia theater.
Though I agree with your criticism in broad strokes, this is also a numbers game. If it reduced the number of infected people entering then it was useful. It doesn't have to completely eliminate it to be worth doing.
There are legal and logistical challenges in preventing US residents from entering or imposing quarantine.
Would strong or (more importantly) earlier responses have been good? Absolutely! But a weak and late response is much better than an even later response (even if the later response is stronger).
By the numbers we should prefer a non-US-resident ban-- even without screening/quarantine-- on day 20 than a everyone-ban on day 40.
There are legal and logistical challenges in preventing US residents from entering or imposing quarantine.
Would strong or (more importantly) earlier responses have been good? Absolutely! But a weak and late response is much better than an even later response (even if the later response is stronger).
By the numbers we should prefer a non-US-resident ban-- even without screening/quarantine-- on day 20 than a everyone-ban on day 40.
The China travel ban went into effect 6 weeks ago. Italy, South Korea, and Japan followed not too long after.
He was even called a dictator for that.
Correction: South Korea & Japan were "do not travel" not specific travel bans.
He was even called a dictator for that.
Correction: South Korea & Japan were "do not travel" not specific travel bans.
Wait, I hope you are joking because you are spreading misinformation. Japan and Korea were NEVER banned. China was and Italy was just a few days ago.
Japan: level 2 (exercise caution) https://travel.state.gov/content/travel/en/traveladvisories/...
Korea:level 3 (reconsider) https://travel.state.gov/content/travel/en/traveladvisories/...
Japan: level 2 (exercise caution) https://travel.state.gov/content/travel/en/traveladvisories/...
Korea:level 3 (reconsider) https://travel.state.gov/content/travel/en/traveladvisories/...
My mistake. You are correct. They weren't travel bans but "don't go there" recommendations.
Regardless, they're still a response which refutes your original point.
Regardless, they're still a response which refutes your original point.
> could do that because it could afford to take the economical hit and because it is an authoritarian state, which means you can get almost everyone to obey, in one way or another. Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
I don't understand this logic. Because China made a mess at the beginning of the pandemic, so we shouldn't copy the model they employed at later stage that is proven to be working?
Or because China is an authoritarian state, so everything it does is bad and nothing we can learn from them? Well China has been copying and learning from any countries for a while now and that's what makes it stronger by day. Just keep blaming China and do nothing. That will surely make China less powerful and less influential.
You know what's scary? All major democracies failed to manage the pandemic while China becomes the most powerful country after all this.
I don't understand this logic. Because China made a mess at the beginning of the pandemic, so we shouldn't copy the model they employed at later stage that is proven to be working?
Or because China is an authoritarian state, so everything it does is bad and nothing we can learn from them? Well China has been copying and learning from any countries for a while now and that's what makes it stronger by day. Just keep blaming China and do nothing. That will surely make China less powerful and less influential.
You know what's scary? All major democracies failed to manage the pandemic while China becomes the most powerful country after all this.
Nah scratch that. At this point it's hard to tell who are the baddies[1].
1. https://www.bangkokpost.com/world/1879190/us-germany-battle-...
1. https://www.bangkokpost.com/world/1879190/us-germany-battle-...
Drugs are not a solution in the next 2-3 months. There's no way a drug can be tested and ensure safe and scaled up to the tens/hundreds of millions of doses you would need. It's impossible so don't even bother considering it.
Quarantining is the only thing that will help in this situation. There's no other solution we have as a society to slow down the pace of infections. People who normally wouldn't die will die because of the lack of medical care.
The problem we face in the US is lack of testing, which makes it impossible to do anything except a quarantine.
Quarantining is the only thing that will help in this situation. There's no other solution we have as a society to slow down the pace of infections. People who normally wouldn't die will die because of the lack of medical care.
The problem we face in the US is lack of testing, which makes it impossible to do anything except a quarantine.
> Quarantining is the only thing that will help in this situation.
The question is, for how long? Until the infection curve goes down? Until there is not a single infected cases in the whole country?
While you can't know when this will happen (especially the former, most models are inaccurate because too little is still known about this virus), I don't believe it is sustainable to keep an extended lockdown on a whole country (as opposed to "just" Hubei, which however has almost the entire population of Italy) more than a few months.
The question is, for how long? Until the infection curve goes down? Until there is not a single infected cases in the whole country?
While you can't know when this will happen (especially the former, most models are inaccurate because too little is still known about this virus), I don't believe it is sustainable to keep an extended lockdown on a whole country (as opposed to "just" Hubei, which however has almost the entire population of Italy) more than a few months.
The purpose now of social distancing and quarantine is to spread out the infections so that the hospitals are not overrun by everyone being sick at once.
A significant proportion of infected need hospitalization to survive. If we all get sick at once, there simply aren't enough hospital beds to go around, not to mention other supplies. If the hospitals go far beyond capacity, the fatality rate will be _far_ higher than otherwise.
As to how long, I haven't seen good models. In the US we don't have very good data either, because we're testing basically noone.
A significant proportion of infected need hospitalization to survive. If we all get sick at once, there simply aren't enough hospital beds to go around, not to mention other supplies. If the hospitals go far beyond capacity, the fatality rate will be _far_ higher than otherwise.
As to how long, I haven't seen good models. In the US we don't have very good data either, because we're testing basically noone.
The press reports several models which say between next week and the end of April for the so called "peak" (I don't think the press understands what it means, however), but at least to me they're useless because the confidence intervals are not given (I can't expect a newspaper to do so, but providing a source to consult in such cases would be beneficial).
Some of these models are also different in nature, which adds to the uncertainty: some are epidemiological models, some are economical (used to evaluate the impact of the measures on the long term).
Lastly, a lot of qualified people speak and try to give estimates. I'd love if they don't, because currently the best answer is "we do not know yet".
That said, I think that going over two months of lockdown will be probably ruinous for the country as whole.
Some of these models are also different in nature, which adds to the uncertainty: some are epidemiological models, some are economical (used to evaluate the impact of the measures on the long term).
Lastly, a lot of qualified people speak and try to give estimates. I'd love if they don't, because currently the best answer is "we do not know yet".
That said, I think that going over two months of lockdown will be probably ruinous for the country as whole.
The purpose now of social distancing and quarantine is to spread out the infections so that the hospitals are not overrun by everyone being sick at once.
Until we have a vaccine or enough people have been infected to build up natural herd immunity. At least a year is my guess.
I don't know if the country can hold economically and socially being completely locked up for one year. Probably not.
And I'm not sure if people can hold psychologically being locked up for one year.
And I'm not sure if people can hold psychologically being locked up for one year.
Drugs are a solution for mitigation. They already have a preliminary trial result in China that says Chloroquine works. South Korea agrees and I believe is combining it with Zinc. South Korea has the lowest fatality rate of any country.
This has a lot to do with their age distribution. Their fatality rate by age is similar to elsewhere. A large fraction of the infected cult members were young.
Korea also hasn’t had any hospital breakdown related increase in the death rate.
Chloroquine may indeed work, but the Korean stats are misleading if you don’t adjust for ages.
Korea also hasn’t had any hospital breakdown related increase in the death rate.
Chloroquine may indeed work, but the Korean stats are misleading if you don’t adjust for ages.
China’s fatality rate is also way down. Partly of course from less stress on the medical system, but they’ve also just learned a lot about how to treat it, particularly what drugs to use. I believe Chloroquine + Liponavir/Ritanovir + Interferon or Ribavirin is state of the art.
Chloroquine + Liponavir/Ritanovir may cause fatal arrithmias, in the case anyone out there is self medicating. It's one or the other.
Can you cite a source? Current Chinese treatment guidelines allow it.
Also very important to quantify side effect risks, even if it's a rough estimate. For example, if a 70 year old patient has already progressed to dyspena, they might have something like a 20% mortality rate from COVID. Even if there is a side effect profile for the treatment that normally would be considered very dangerous, it may be well worth it to administer it.
We see the same thing with chemotherapy or radiation treatment. The side effects are terrible and fairly often fatal, but they are safer than the disease. This is the situation in which we find ourselves.
Also very important to quantify side effect risks, even if it's a rough estimate. For example, if a 70 year old patient has already progressed to dyspena, they might have something like a 20% mortality rate from COVID. Even if there is a side effect profile for the treatment that normally would be considered very dangerous, it may be well worth it to administer it.
We see the same thing with chemotherapy or radiation treatment. The side effects are terrible and fairly often fatal, but they are safer than the disease. This is the situation in which we find ourselves.
I can't find the original source, but you can easily verify that both drugs increase the QT/QTC and PR interval, which is a high-risk interaction AFAIK (I'm not a doctor). Some doctors recommend doing an EKG before administering Chloroquine.
https://www.sciencedirect.com/science/article/pii/S088394412...
What you're saying is true, but you're assuming that Chloroquine + Kaletra is better than Chloroquine by itself, and we don't have the data for that yet.
Do you have a source for the Chinese recommendations?
https://www.sciencedirect.com/science/article/pii/S088394412...
What you're saying is true, but you're assuming that Chloroquine + Kaletra is better than Chloroquine by itself, and we don't have the data for that yet.
Do you have a source for the Chinese recommendations?
Thanks for the link. Current Chinese treatment guidelines are: https://www.chinalawtranslate.com/en/coronavirus-treatment-p...
They state:
4. Antiviral therapies: Interferon-alpha (adult: 5 million units or equivalent can be added to 2ml sterile injection water and delivered with a nebulizer twice daily), lopinavir/ritonavir (adult: 200mg/50mg/tablet, 2 tablets twice daily; the length of treatment should not exceed 10 days), ribavirin (recommended in combination with interferon or lopinavir/ritonavir, adult: 500mg twice or three times daily via IV, the length of treatment should not exceed 10 days), chloroquine phosphate (adult 18-65 years old weighing more than 50kg: 500mg twice daily for 7 days; bodyweight less than 50kg: 500mg twice daily for day 1 and 2, 500mg once daily for day 3 through 7); umifenovir (adult: 200mg three times daily; the length of treatment should not exceed 10 days).
Pay attention to issues such as adverse drug reactions, contraindications (for example, chloroquine should not be given to patients with heart diseases), and drug interactions. Further evaluate the efficacy of current treatment regimens in clinical applications. Using 3 or more antiviral drugs is not recommended. Corresponding medication should be discontinued should intolerable side effects appear.
They state:
4. Antiviral therapies: Interferon-alpha (adult: 5 million units or equivalent can be added to 2ml sterile injection water and delivered with a nebulizer twice daily), lopinavir/ritonavir (adult: 200mg/50mg/tablet, 2 tablets twice daily; the length of treatment should not exceed 10 days), ribavirin (recommended in combination with interferon or lopinavir/ritonavir, adult: 500mg twice or three times daily via IV, the length of treatment should not exceed 10 days), chloroquine phosphate (adult 18-65 years old weighing more than 50kg: 500mg twice daily for 7 days; bodyweight less than 50kg: 500mg twice daily for day 1 and 2, 500mg once daily for day 3 through 7); umifenovir (adult: 200mg three times daily; the length of treatment should not exceed 10 days).
Pay attention to issues such as adverse drug reactions, contraindications (for example, chloroquine should not be given to patients with heart diseases), and drug interactions. Further evaluate the efficacy of current treatment regimens in clinical applications. Using 3 or more antiviral drugs is not recommended. Corresponding medication should be discontinued should intolerable side effects appear.
Same for many EU guidelines
Source as I posted on other submissions
Chloroquine is mostly admitted as a valid treatment now
https://news.ycombinator.com/item?id=22582374
Source as I posted on other submissions
Chloroquine is mostly admitted as a valid treatment now
https://news.ycombinator.com/item?id=22582374
I thought that remdesivir was the drug showing the most promise? What happened with that one? And my big questions are how soon can they spool up world supplying levels of batches?
It's being tested in a few trials, the earliest one should have data in April, IIRC.
> They already have a preliminary trial result in China that says Chloroquine works
Chloroquine has a long history with many diseases of "sorta, but not really" working when subjected to actual test.
Please don't spread unsubstantiated info.
Chloroquine has a long history with many diseases of "sorta, but not really" working when subjected to actual test.
Please don't spread unsubstantiated info.
This is not unsubstantiated. It is proven in vitro, and this came out the other day: http://news.southcn.com/nfplus/gdjktt/content/2020-03/09/con...
I haven’t found the source paper if there is one yet — I can’t read Chinese except with google translate
I haven’t found the source paper if there is one yet — I can’t read Chinese except with google translate
Drugs shown to be effective in vitro routinely fail to show similar effects in vivo.
Chloroquines have a long history of this in viral studies.
Chloroquines have a long history of this in viral studies.
The point is that according to what the official Chinese medical line is, it works in vivo. This is apparently confirmed by Korean experience. I understand the skepticism, but you go to war with the data you have, and the data we have indicates Chloroquine works.
The “data” is anecdotal, not even close to the standards of an effectiveness trial.
That said, it’s an approved drug, so it will be applied and we’ll see how it goes. But don’t spread rumors about its effectiveness, because the truth is, we don’t know.
That said, it’s an approved drug, so it will be applied and we’ll see how it goes. But don’t spread rumors about its effectiveness, because the truth is, we don’t know.
Bleach or a handgun also work "in vitro".
Relevant XKCD: https://www.xkcd.com/1217/
Chloroquines will be tried since they already pass the "safe" bar.
However, I suspect that if they worked "in vivo", we would have compelling data on that from China already. The fact that we don't have such data suggests that they don't.
We seem to have much better data about the effectiveness of standard anti-virals already.
Relevant XKCD: https://www.xkcd.com/1217/
Chloroquines will be tried since they already pass the "safe" bar.
However, I suspect that if they worked "in vivo", we would have compelling data on that from China already. The fact that we don't have such data suggests that they don't.
We seem to have much better data about the effectiveness of standard anti-virals already.
They can fast track drugs if that drug has been tested for other things. It happens all the time. I mean like all the time doctors do it for other cases, there's not reason it couldn't happen for cov19
There are some existing drugs that help with the treatment but they don't really stop the infection spreading. Chloroquine / hydroxychloroquine are maybe the most useful.
Probably if they handed some out and told people to take a few as soon as they got a cough + some temperature it would help things. (http://news.southcn.com/nfplus/gdjktt/content/2020-03/09/con...)
Probably if they handed some out and told people to take a few as soon as they got a cough + some temperature it would help things. (http://news.southcn.com/nfplus/gdjktt/content/2020-03/09/con...)
> Why on Earth is this a good model?
Pretty much all countries have mechanisms for emergency powers. China being authoritarian has nothing to do with it. I'm not familiar with Italy's constitution or laws, but I assume it has similar provisions?
> Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
Huh? On the one hand you're arguing China was too draconian (and Italy shouldn't copy), then a sentence later you're complaining it wasn't enough and this is all China's fault?
What exactly do you suggest China ought to have done to prevent it from spreading outside of China? I haven't heard any reputable source suggest there was any practical way of containing it perfectly.
Your comment comes across as knee-jerk anti-China rather than anything based in science or public policy.
Pretty much all countries have mechanisms for emergency powers. China being authoritarian has nothing to do with it. I'm not familiar with Italy's constitution or laws, but I assume it has similar provisions?
> Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
Huh? On the one hand you're arguing China was too draconian (and Italy shouldn't copy), then a sentence later you're complaining it wasn't enough and this is all China's fault?
What exactly do you suggest China ought to have done to prevent it from spreading outside of China? I haven't heard any reputable source suggest there was any practical way of containing it perfectly.
Your comment comes across as knee-jerk anti-China rather than anything based in science or public policy.
> I haven't heard any reputable source suggest there was any practical way of containing it perfectly.
Of course there was. If they somehow magically divined the true danger of the virus the day they identified it.
But they didn't, it took time and observation, and they shut down the affected areas as soon as the extent of danger was realized and processed by their bureaucracy. There's plenty of things here that could've been done better, but it's asinine to blame them for the virus taking hold everywhere else. Doubly so given that most of the world had a month+ warning before they registered their first cases.
Of course there was. If they somehow magically divined the true danger of the virus the day they identified it.
But they didn't, it took time and observation, and they shut down the affected areas as soon as the extent of danger was realized and processed by their bureaucracy. There's plenty of things here that could've been done better, but it's asinine to blame them for the virus taking hold everywhere else. Doubly so given that most of the world had a month+ warning before they registered their first cases.
>> processed by their bureaucracy
That is the issue here. They completely ignored it until people were dying in the hallways of hospitals and then implemented a draconian policy.
And now they're locking up anyone who criticizes them. See this article about "Gratitude education", a term that tops Orwell in its dystopian implications:
https://www.theguardian.com/world/2020/mar/09/gratitude-educ...
That is the issue here. They completely ignored it until people were dying in the hallways of hospitals and then implemented a draconian policy.
And now they're locking up anyone who criticizes them. See this article about "Gratitude education", a term that tops Orwell in its dystopian implications:
https://www.theguardian.com/world/2020/mar/09/gratitude-educ...
Where did you read that people were "dying in the hallways of hospitals"?
Italian doctors have been writing about this since ~Tuesday. There's loads of reports and newspaper articles about it. They're in full-on triage mode, and there isn't time or manpower to give people even palliative care.
So, It seems that China did some things very wrong in the beginning, but then took some big actions to turn things around. There was a long form piece in the Wall Street Journal last weekend that looked at the timeline. It seems that in the early phases, authorities didn’t want to have bad news leading up to the end of year / New Years period. There was suppression of information coming out about there being a novel virus — to the extent the doctor had to offer a public apology for ‘spreading rumors’ — dots weren’t connected, etc. The Wuhan banquet wasn’t cancelled, number of cases exploded shortly after.
And, look — I’m sitting here in the US where I’ve been horrified at our own response over the last month. But the question was, could it have been contained? Looking at that timeline, it certainly seems possible that it could have been. Of course, we’ll never know.
https://www.wsj.com/articles/how-it-all-started-chinas-early...
And, look — I’m sitting here in the US where I’ve been horrified at our own response over the last month. But the question was, could it have been contained? Looking at that timeline, it certainly seems possible that it could have been. Of course, we’ll never know.
https://www.wsj.com/articles/how-it-all-started-chinas-early...
> What exactly do you suggest China ought to have done to prevent it from spreading outside of China?
Well, at the very least, take it seriously when there were the first reports of "new viral pneumonia" in Wuhan, instead of locking up or censoring people who reported that.
Yes, this doesn't mean that other countries did not take it as seriously as they should have, and perhaps containment might have failed nevertheless. Still, it was a spectacular failure with long-lasting consequences on every other country in the world.
That, IMO, deserves blame, no matter if other governments are doing the same errors.
Well, at the very least, take it seriously when there were the first reports of "new viral pneumonia" in Wuhan, instead of locking up or censoring people who reported that.
Yes, this doesn't mean that other countries did not take it as seriously as they should have, and perhaps containment might have failed nevertheless. Still, it was a spectacular failure with long-lasting consequences on every other country in the world.
That, IMO, deserves blame, no matter if other governments are doing the same errors.
Not sure why this is greyed out. I might not agree with all of it, but you're not out of line.
Just like China, there was a time when Italy had 1 case, then 2 cases, then 4, etc. Italy was unable to stop the spread before reaching a huge level and spreading to other countries.
Why blame China for "allowing this virus to spread all around the world" when Italy allowed the same?
(Italy even had a warning that it was coming!)
Why blame China for "allowing this virus to spread all around the world" when Italy allowed the same?
(Italy even had a warning that it was coming!)
Doctors and civilians tried to sound the alarm that something was going on, and were silenced until it was too late. To their credit, the CCP fired the Wuhan officials who presumably silenced those people, but it is still their responsibility for fostering a culture where towing the line and hiding problems until they cannot be hidden is acceptable for leadership positions.
There's nothing to credit. Everyone was in on the silencing, the CCP only used those officials as scapegoats. Everyone on all levels of politics was keeping this a secret and hoping it would go away.
You raise a high bar for China but if the virus appeared in many other countries the global outcome would have been much worse.
There are several articles about he CDC being silenced in various ways on early measures because they would hurt the economy.
you're missing that China initially suppressed info abt this virus, which caused it to spread. had they reacted immediately, we might be in a much better situation rn
That's a very important point if we're discussing the upsides and downsides of censorship, or whether China is a bad country and should feel bad about itself.
But if we're looking for an example of how to solve the pandemic, when people point to China as an example, they aren't saying "we should spend a few weeks pretending the virus doesn't exist, threaten doctors who talk about it, order our labs not to study it, and THEN take decisive action". They're saying we should do the stuff that China did, starting from the decisive action part.
But if we're looking for an example of how to solve the pandemic, when people point to China as an example, they aren't saying "we should spend a few weeks pretending the virus doesn't exist, threaten doctors who talk about it, order our labs not to study it, and THEN take decisive action". They're saying we should do the stuff that China did, starting from the decisive action part.
exactly. I don't understand why people are so eager to assign blame when in reality every one would be better of taking the good parts of what China did.
We should assign blame to a drunk driver who hits someone, no matter if he became sober after the accident enough to drive his/her victims to the hospital.
There's certainly lots of blame to assign to China and after all this comes back to a "normal" state again the international community should pressure China into eliminating the things that made all this possible: they should be draconic in not allowing things like the Wuhan wet-market be open ever again, all over China, for ever, they should be forthcoming in allowing international experts come and asses things as soon as a new disease manifests itself, they should allow their local medical experts have the upper hand over local Communist officials, at all times.
There's certainly lots of blame to assign to China and after all this comes back to a "normal" state again the international community should pressure China into eliminating the things that made all this possible: they should be draconic in not allowing things like the Wuhan wet-market be open ever again, all over China, for ever, they should be forthcoming in allowing international experts come and asses things as soon as a new disease manifests itself, they should allow their local medical experts have the upper hand over local Communist officials, at all times.
China was the first to have to handle the issue, so they had the difficult job of figuring out whether this virus was just like the flu (which some people are still claiming even today) or whether it was something to worry about much more than that. Imagine the cost to your credibility if you call it out for a huge danger, and it turns out it is just a new flu variant... The spread to other countries seems to only have started once the Chinese had conclusively shown this virus was very dangerous (and started the lock downs to prevent its spread). Hence, other countries had the benefit of this knowledge which China didn't, yet still failed to act. Some countries like the UK and Sweden even now pretending this is not a big deal and not taking anywhere enough measures to avoid widespread infection rates.
> They’re saying we should do the stuff that China did, starting from the decisive action part
You do realize that some of their “decisive actions” included enforcing quarantine via welded-shut doors, right?[0] I don’t think you’re ready to handle the kind of “decisive action” that China took.
0: https://www.cbc.ca/player/play/1703503427818
You do realize that some of their “decisive actions” included enforcing quarantine via welded-shut doors, right?[0] I don’t think you’re ready to handle the kind of “decisive action” that China took.
0: https://www.cbc.ca/player/play/1703503427818
They only did that to people that refused to self quarantine.
Well, I guess that makes it alright then.
I don’t think you understand the significance of welding the doors shut... it means if they catch you outside you can’t claim you did it on accident. So, wink wink, they’ll cure you of the virus permanently after that.
Again, you’re not ready for Chinese-style “decisive actions.”
I don’t think you understand the significance of welding the doors shut... it means if they catch you outside you can’t claim you did it on accident. So, wink wink, they’ll cure you of the virus permanently after that.
Again, you’re not ready for Chinese-style “decisive actions.”
Don't worry about rights now, if you leave the door open and people walk about they will get even more decisive action from the virus, and gift the virus to others.
With the population it has, China could have been in a much much worse shape today were it not for the quarantine.
With the population it has, China could have been in a much much worse shape today were it not for the quarantine.
Yes, and so could many countries, including Italy. This is the deal we've been had, and need to look to the future.
>you're missing that China initially suppressed info abt this virus
Not only that, refuse to acknowledge, or share any information to international communities. The amount of things they do just to saves faces.
Not only that, refuse to acknowledge, or share any information to international communities. The amount of things they do just to saves faces.
You mean like making the DNA public, posting statistics daily, sending doctors and resources to other countries to help train ...
That kind of not sharing information?
That kind of not sharing information?
Like pretending it was an unknown disease that showed no sign of person-to-person spread when they'd already sequenced its entire RNA and found cases of it spreading within the community. Like having to be pressured into revealing what little details they did. Like, as I recall, only admitting that it was spreading person-to-person when another country spotted this. That kind of not sharing information.
It is a Novela virus. By definition you don't know anything about it until it is proven.
If you don't know the source (which is still unknown) then you cannot verify that it has spread human to human. (They should have assumed that it did)
Researches outside of China said there was no evidence of human to human transmission.
The first 2 weeks of January were handled rather poorly. But lack of information since then isn't really one of them.
What could China have done that would have made you personally happy?
People automatically distrust anything they say. What other information could they have provided?
If you don't know the source (which is still unknown) then you cannot verify that it has spread human to human. (They should have assumed that it did)
Researches outside of China said there was no evidence of human to human transmission.
The first 2 weeks of January were handled rather poorly. But lack of information since then isn't really one of them.
What could China have done that would have made you personally happy?
People automatically distrust anything they say. What other information could they have provided?
When people dislike a certain government or person, they jump to the worst conclusions about them rather quickly. This is extremely dangerous. Imagine a sensitive situation develops where there's weak evidence the victim of your dislike did something that might endanger you or your country... if you immediately jump to conclusions, which you are very likely to do as this thread shows, then the situation would easily develop into a confrontation... this is not hypothetical. With Americans and Chinese (and Russians, Iranians) coming face-to-face in more and more sensitive situations around the world, it's only a matter of time until the mutual distrust will cause one side to pull the trigger under unreasonable circumstances.
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so you mean what happened before JAN/20, now is MAR/14.
You mean like doing all that after they can no longer hide it from any one else and the world needs them before they started doing so.
I blame my own government for this, of course, the same that's getting all the praise and the "calls to responsiblity" from the press.
When we had the first cases its only concern was whether a minority party would leave the coalition or not.
It wasn't fit for the emergency, any emergency. Unfortunately, that's what we will be stuck with until it's over.
When we had the first cases its only concern was whether a minority party would leave the coalition or not.
It wasn't fit for the emergency, any emergency. Unfortunately, that's what we will be stuck with until it's over.
It's a completely different situation. If China contained the disease when they had only 10 cases, there would be no disease anymore. If Italy contained the disease when they had only 10 cases, new cases would arrive, again and again.
>Just like China, there was a time when Italy had 1 case, then 2 cases, then 4, etc.
Just like the spread of fire, the window of opportunity to put it out is right at the beginning.
Yes, Italy could put it out when it first came to Italy but they would have to do it many many more times to successfully contain it. China just had to do it once and they failed.
Just like the spread of fire, the window of opportunity to put it out is right at the beginning.
Yes, Italy could put it out when it first came to Italy but they would have to do it many many more times to successfully contain it. China just had to do it once and they failed.
If it did indeed come from live animals in a wet market, that seems like a potential valid reason for some criticism, although the they did a superb job adapting imho.
The difference is china could have contained it with minimal disruption. The only option italy had was to shut down all borders for the next 6 months.
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teknologist(2)
> Why on Earth is this a good model?
Because it worked. Millions of lives have been saved - 1% of 1.3B is 13M people. That's 1/5 of Italy.
Are there better models? Maybe. But there are also much worse models, as I suspect we might soon find out in the US [1]. Personally I'd much rather take the Chinese model for the next few months than risk me and my family dying or going bankrupt over the next few months.
And, instead of thinking that China could "afford to take the economical hit", consider the economic impact of 13M people suddenly dying. At this point, there's definitely going to be a hit to the economy. It's just going to be either A) from stricter lock downs and government aid, or B) from more people dying due to overrun hospitals. It might not be a wash in terms of the dollar amount, but it's clear which option will save more lives.
[1] Comparing China and US response:
- China has made treatment (not just testing) for coronavirus free for everyone. In the US...better hope you have good insurance.
- Tests performed per million people: China 2,800, US 5
- China is ordering banks to increase loans to SMBs rather than hoarding cash to protect themselves. It has rolled out a bunch of policies to support SMBs and employees. The US...well, not much so far.
Sources: https://www.sciencealert.com/here-s-how-many-coronavirus-tes... https://qz.com/1813181/china-is-taking-pleasure-in-us-mishan... https://www.scmp.com/economy/china-economy/article/3052474/c... https://www.china-briefing.com/news/chinas-latest-regional-m...
Because it worked. Millions of lives have been saved - 1% of 1.3B is 13M people. That's 1/5 of Italy.
Are there better models? Maybe. But there are also much worse models, as I suspect we might soon find out in the US [1]. Personally I'd much rather take the Chinese model for the next few months than risk me and my family dying or going bankrupt over the next few months.
And, instead of thinking that China could "afford to take the economical hit", consider the economic impact of 13M people suddenly dying. At this point, there's definitely going to be a hit to the economy. It's just going to be either A) from stricter lock downs and government aid, or B) from more people dying due to overrun hospitals. It might not be a wash in terms of the dollar amount, but it's clear which option will save more lives.
[1] Comparing China and US response:
- China has made treatment (not just testing) for coronavirus free for everyone. In the US...better hope you have good insurance.
- Tests performed per million people: China 2,800, US 5
- China is ordering banks to increase loans to SMBs rather than hoarding cash to protect themselves. It has rolled out a bunch of policies to support SMBs and employees. The US...well, not much so far.
Sources: https://www.sciencealert.com/here-s-how-many-coronavirus-tes... https://qz.com/1813181/china-is-taking-pleasure-in-us-mishan... https://www.scmp.com/economy/china-economy/article/3052474/c... https://www.china-briefing.com/news/chinas-latest-regional-m...
> Because it worked. Millions of lives have been saved - 1% of 1.3B is 13M people. That's 1/5 of Italy.
This is an inacurrate estimation. I guess your figure of 1% is from South Korea case fatality rate. The confirmed cases represent a biased sample of the population, and the mortality rate could be lower in reality (but not higher).
> consider the economic impact of 13M people suddenly dying.
The mortality is mainly for 70+ years old people, who are already not in the workforce anymore.
Those numbers cannot help us to evaluate or to compare one state's measure versus another state's decision
This is an inacurrate estimation. I guess your figure of 1% is from South Korea case fatality rate. The confirmed cases represent a biased sample of the population, and the mortality rate could be lower in reality (but not higher).
> consider the economic impact of 13M people suddenly dying.
The mortality is mainly for 70+ years old people, who are already not in the workforce anymore.
Those numbers cannot help us to evaluate or to compare one state's measure versus another state's decision
> This is an inacurrate estimation.
Sure, the actual number will likely be different for each country / state / city, but doesn't really matter for the sake of the argument. I was using 1% as a lowball number. Official mortality rate from the WHO is 3-4%; some studies say 2%, Italy is reporting 7%.
And for those 80+, current data suggests a mortality rate of 1/7 - not far off from a round of Russian roulette.
So if you have 4 grandparents who are 80+, there's a ~60% chance at least one will die if the disease spreads through our population in the next few months.
> The mortality is mainly for 70+ years old people, who are already not in the workforce anymore.
Firstly, if hospitals are overrun (which is the way we're headed), people of all ages will die preventable deaths. Hospitals in the US are already postponing elective surgeries.
Secondly, it's simply not true that older people don't contribute to the economy.
The elderly still consume food, housing, health care etc., and a negative demand shock is a recipe for recession. For example, think about what happens to nursing homes or physical therapists if a large percentage of older people die. Or what happens to local housing prices if lots of homes are suddenly put up for sale because elderly owners died en masse.
And many older people continue to work and volunteer (e.g. just look at our president, congressmen, and senators), and that some grandparents help with child care (like in my family right now).
Sources: - https://time.com/5798168/coronavirus-mortality-rate/ - https://www.buzzfeednews.com/article/lamvo/coronavirus-death... - https://nypost.com/2020/03/12/heres-why-the-coronavirus-deat... - https://www.economicshelp.org/macroeconomics/economic-growth...
Sure, the actual number will likely be different for each country / state / city, but doesn't really matter for the sake of the argument. I was using 1% as a lowball number. Official mortality rate from the WHO is 3-4%; some studies say 2%, Italy is reporting 7%.
And for those 80+, current data suggests a mortality rate of 1/7 - not far off from a round of Russian roulette.
So if you have 4 grandparents who are 80+, there's a ~60% chance at least one will die if the disease spreads through our population in the next few months.
> The mortality is mainly for 70+ years old people, who are already not in the workforce anymore.
Firstly, if hospitals are overrun (which is the way we're headed), people of all ages will die preventable deaths. Hospitals in the US are already postponing elective surgeries.
Secondly, it's simply not true that older people don't contribute to the economy.
The elderly still consume food, housing, health care etc., and a negative demand shock is a recipe for recession. For example, think about what happens to nursing homes or physical therapists if a large percentage of older people die. Or what happens to local housing prices if lots of homes are suddenly put up for sale because elderly owners died en masse.
And many older people continue to work and volunteer (e.g. just look at our president, congressmen, and senators), and that some grandparents help with child care (like in my family right now).
Sources: - https://time.com/5798168/coronavirus-mortality-rate/ - https://www.buzzfeednews.com/article/lamvo/coronavirus-death... - https://nypost.com/2020/03/12/heres-why-the-coronavirus-deat... - https://www.economicshelp.org/macroeconomics/economic-growth...
Here's a quote from the first link you have:
"That means the total number of reported cases is very likely an underestimate—and by not counting many mild or asymptomatic cases, we’re likely overestimating the disease’s overall mortality rate."
It is not possible to know the mortality rate with the information we have. Extrapolating that dubious number into a prediction of deaths is not a meaningful exercise.
"That means the total number of reported cases is very likely an underestimate—and by not counting many mild or asymptomatic cases, we’re likely overestimating the disease’s overall mortality rate."
It is not possible to know the mortality rate with the information we have. Extrapolating that dubious number into a prediction of deaths is not a meaningful exercise.
To be fair, they are using 1% which is an underestimate given what we know right now.
In general, with exponential growth the best time to act was yesterday.
In general, with exponential growth the best time to act was yesterday.
The only reliable number are deaths assuming people aren't hiding (or burning) the bodies. The number of tests are reliable among themselves, but we can't necessarily compare specificity and sensitivity of the tests against each other. Maybe those numbers are out there, but i haven't seen them.
The amount of infected is not and will not ever be known and it's a dark time for statistics when many are taking the non-randomly tested and dividing by fatalities and projecting deaths on large populations.
Exponential growth is how successful infections progress. There is nothing new to see here. This sort of aggressive strain was easily foreseeable years ago and we rely on strategic, planned measures to be executed by government.
Random, localized shutdowns only serve to exacerbate the unwarranted panic we are now seeing. The time to think was years in the coming, the actions now display an enormous failure in leadership.
The amount of infected is not and will not ever be known and it's a dark time for statistics when many are taking the non-randomly tested and dividing by fatalities and projecting deaths on large populations.
Exponential growth is how successful infections progress. There is nothing new to see here. This sort of aggressive strain was easily foreseeable years ago and we rely on strategic, planned measures to be executed by government.
Random, localized shutdowns only serve to exacerbate the unwarranted panic we are now seeing. The time to think was years in the coming, the actions now display an enormous failure in leadership.
>>Personally I'd much rather take the Chinese model for the next few months than risk me and my family dying or going bankrupt over the next few months.
Always makes me sad when Americans willing give up essential liberty to purchase perceived safety. Personally I would much rather look the situation rational, may the assessment of risk for myself, then choose on my own what course of action(s) I will take. Not have those actions dictated and imposed on me by an authoritarian government.
I would rather lose my health or my life than to lose my liberty
Always makes me sad when Americans willing give up essential liberty to purchase perceived safety. Personally I would much rather look the situation rational, may the assessment of risk for myself, then choose on my own what course of action(s) I will take. Not have those actions dictated and imposed on me by an authoritarian government.
I would rather lose my health or my life than to lose my liberty
It's not just about your health or your life. This is what R0 means - even if you end up fine after getting the disease, you're going to transmit it to other people who may end up dying because of you.
In other words, it's also your liberty vs other people's lives.
Are you going to be the grandson who kills his grandma? Or the employee who kills the CEO? Or the Trump supporter who ends up helping elect Biden?
In other words, it's also your liberty vs other people's lives.
Are you going to be the grandson who kills his grandma? Or the employee who kills the CEO? Or the Trump supporter who ends up helping elect Biden?
The grandma and the CEO can quarantine themselves at home if they so wish.
Older people cannot just wall themselves off from the rest of society.
What if they live with or are cared for by other family members?
How will they get health care for existing conditions? Hospitals have been shown to be a major vector for transmission [1]. And how do they even get to the hospital if they can't drive?
What about grocery shopping over the next few months? The National Guard is stepping in to help deliver food in New Rochelle now. Can that scale to the entire nation? For how long?
What if they live in a nursing home? Look what happened in the Seattle one [2].
[1] https://jamanetwork.com/journals/jama/fullarticle/2761044
[2] https://www.foxnews.com/health/washington-state-nursing-home...
What if they live with or are cared for by other family members?
How will they get health care for existing conditions? Hospitals have been shown to be a major vector for transmission [1]. And how do they even get to the hospital if they can't drive?
What about grocery shopping over the next few months? The National Guard is stepping in to help deliver food in New Rochelle now. Can that scale to the entire nation? For how long?
What if they live in a nursing home? Look what happened in the Seattle one [2].
[1] https://jamanetwork.com/journals/jama/fullarticle/2761044
[2] https://www.foxnews.com/health/washington-state-nursing-home...
> Hospitals have been shown to be a major vector for transmission
Not sure how this is relevant to my post.
> What if they live in a nursing home in close proximity to other elderly people?
The nursing home could stock up and ban people from coming in or out of it.
Not sure how this is relevant to my post.
> What if they live in a nursing home in close proximity to other elderly people?
The nursing home could stock up and ban people from coming in or out of it.
> Not sure how this is relevant to my post.
Many older people cannot just stop getting medical care, and by doing so will be exposed to COVID-19. Especially because hospitals and clinics are overwhelmed by COVID-19 patients.
> The nursing home could stock up and ban people from coming in or out of it.
And all the nursing home staff will be locked inside and not leave for months? Where do they sleep / shower etc?None of the nursing home staff have families or children to care for?
Many older people cannot just stop getting medical care, and by doing so will be exposed to COVID-19. Especially because hospitals and clinics are overwhelmed by COVID-19 patients.
> The nursing home could stock up and ban people from coming in or out of it.
And all the nursing home staff will be locked inside and not leave for months? Where do they sleep / shower etc?None of the nursing home staff have families or children to care for?
>>Are you going to be the grandson who kills his grandma?
My grandparents are long long dead
>>Or the employee who kills the CEO?
Maybe the CEO should have thought about that and given his employees a work from home, or other policies to allow themselves to self quarantine.
I also find it telling you talk about the employees giving it to the CEO and not the other way around... I am sure there is a Parable in there about unwashed masses
>Or the Trump supporter who ends up helping elect Biden?
Not a Trump supporter, but I do find it amusing you believe only Trump supporters support liberty, and only Biden supporters support authoritarianism
Though I dont think anything will help Biden win, he less electable than Clinton was in 2016
My grandparents are long long dead
>>Or the employee who kills the CEO?
Maybe the CEO should have thought about that and given his employees a work from home, or other policies to allow themselves to self quarantine.
I also find it telling you talk about the employees giving it to the CEO and not the other way around... I am sure there is a Parable in there about unwashed masses
>Or the Trump supporter who ends up helping elect Biden?
Not a Trump supporter, but I do find it amusing you believe only Trump supporters support liberty, and only Biden supporters support authoritarianism
Though I dont think anything will help Biden win, he less electable than Clinton was in 2016
> My grandparents are long long dead
er...what are you trying to say? So other people's grandparents can go f* themselves?
> I do find it amusing you believe only Trump supporters support liberty
Nope, I mentioned Trump supporters because Trump was dragging his feet on cancelling his massive rallies [1]. Thankfully they've been cancelled now.
[1] https://www.vox.com/policy-and-politics/2020/3/11/21174945/b...
er...what are you trying to say? So other people's grandparents can go f* themselves?
> I do find it amusing you believe only Trump supporters support liberty
Nope, I mentioned Trump supporters because Trump was dragging his feet on cancelling his massive rallies [1]. Thankfully they've been cancelled now.
[1] https://www.vox.com/policy-and-politics/2020/3/11/21174945/b...
Far more importantly IMO is the Chinese gov not shutting down live wildlife markets earlier, stopping dangerous non-scientific medicinal use, and enforcing trafficking of known-carriers. Specifically with COVID-19, the trade of Pangolins which are the "most trafficked animal in the world", which largely end up in China and Vietnam often via other SEA countries:
https://www.nature.com/articles/d41586-020-00548-w
https://www.nytimes.com/2020/03/05/opinion/coronavirus-china...
Xi was aggressive shutting stuff down but then went on to praise Chinese medicine (basically Naturopathy) multiple times after the Coronavirus became apparent. Which is where the quack medicine that results in people grinding up Pangolin scales and taking them like medicine, then eating the meat. Not to mention having markets with live wildlife in unsanitary areas in the middle of major urban areas with high density.
I'm surprised the continued spread of woo by Chinese authorities isn't taking more of a beating. Not just doing nothing, but promoting it.
Even the recent wildlife market "ban" has a giant loophole:
> The coronavirus epidemic prompted China to permanently ban trade of wild animals as food, but not for medicinal use.
https://www.nytimes.com/2020/02/27/science/coronavirus-pango...
https://www.nature.com/articles/d41586-020-00548-w
https://www.nytimes.com/2020/03/05/opinion/coronavirus-china...
Xi was aggressive shutting stuff down but then went on to praise Chinese medicine (basically Naturopathy) multiple times after the Coronavirus became apparent. Which is where the quack medicine that results in people grinding up Pangolin scales and taking them like medicine, then eating the meat. Not to mention having markets with live wildlife in unsanitary areas in the middle of major urban areas with high density.
I'm surprised the continued spread of woo by Chinese authorities isn't taking more of a beating. Not just doing nothing, but promoting it.
Even the recent wildlife market "ban" has a giant loophole:
> The coronavirus epidemic prompted China to permanently ban trade of wild animals as food, but not for medicinal use.
https://www.nytimes.com/2020/02/27/science/coronavirus-pango...
China's initial response was terrible. When they realized what they had on hand and how fast it was developing they did what they could to turn it around.
That said, I would take any numbers coming out of China with a very large grain of salt; Italy looks way worse than China going by the numbers but I'd trust the Italian numbers more.
Also: it is much better to go by deaths and critical cases than it is to go by the number of cases themselves. The deaths and the critical cases are a lot harder to hide.
That said, I would take any numbers coming out of China with a very large grain of salt; Italy looks way worse than China going by the numbers but I'd trust the Italian numbers more.
Also: it is much better to go by deaths and critical cases than it is to go by the number of cases themselves. The deaths and the critical cases are a lot harder to hide.
Really.
I mean sure - they dropped the ball on a new virus emerging from a familiar situation and getting blindsided by incompetent and image obsessed party officials who silenced the alarms and it took a while for the highly concentrated power structure of blindly loyal party officials to pivot and move.
However ...
It was not an unknown anymore for Europe There was months of warning time There is no suppression of scientific at scale There was daily warnings from WHO and many countries There was precedent for effective measures from Asia
There is no no no reason this should happen in a western democracy right.
And lets not even look at the US where image obsessed national officials with highly concentrated power and blind loyal party following have been actively downplaying (flu), suppressing the national response and hampering testing and effective containment.
It's like China in reverse - the stupid version playing out right in front of our eyes.
We all here love to repeat the virtues of western democracy over the autocratic China but right now we need to take a really good look at how much the theoretical ideals have been replaced by practices that combine the worst of both systems to absolutely devastating results.
If we don't want a major collapse down the road from all the other wait-and-see known threats, from antibiotic resistance to resource exhaustion to broken pension systems to climate change, we better start thinking about how we get of the 'reality is what we want it to be as long as we vote for people who tell us what we want to hear and cast out people who tell us what we need to act upon' train.
Darwin is about survival of the most adaptable to an ever changing world, not necessarily the strongest and right now China looks a lot more adaptable than we do- so if we like our values and system we better start making sacrifices to the gods of science and reality again.
That however would require us to even admit there is a problem and it's not looking promising
I mean sure - they dropped the ball on a new virus emerging from a familiar situation and getting blindsided by incompetent and image obsessed party officials who silenced the alarms and it took a while for the highly concentrated power structure of blindly loyal party officials to pivot and move.
However ...
It was not an unknown anymore for Europe There was months of warning time There is no suppression of scientific at scale There was daily warnings from WHO and many countries There was precedent for effective measures from Asia
There is no no no reason this should happen in a western democracy right.
And lets not even look at the US where image obsessed national officials with highly concentrated power and blind loyal party following have been actively downplaying (flu), suppressing the national response and hampering testing and effective containment.
It's like China in reverse - the stupid version playing out right in front of our eyes.
We all here love to repeat the virtues of western democracy over the autocratic China but right now we need to take a really good look at how much the theoretical ideals have been replaced by practices that combine the worst of both systems to absolutely devastating results.
If we don't want a major collapse down the road from all the other wait-and-see known threats, from antibiotic resistance to resource exhaustion to broken pension systems to climate change, we better start thinking about how we get of the 'reality is what we want it to be as long as we vote for people who tell us what we want to hear and cast out people who tell us what we need to act upon' train.
Darwin is about survival of the most adaptable to an ever changing world, not necessarily the strongest and right now China looks a lot more adaptable than we do- so if we like our values and system we better start making sacrifices to the gods of science and reality again.
That however would require us to even admit there is a problem and it's not looking promising
> Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
That's not alarming.
What's alarming is that the Chinese regime admitted that the people who they placed in charge of the crisis response have been continuously lying and falsely reporting the real amount of victims and how far the disease has spread. They've done it jus prior of replacing them, but the Chinese regime just replaced them with loyalist party officials, which makes it sound like a desperate attempt to keep falsifying reports.
That's not alarming.
What's alarming is that the Chinese regime admitted that the people who they placed in charge of the crisis response have been continuously lying and falsely reporting the real amount of victims and how far the disease has spread. They've done it jus prior of replacing them, but the Chinese regime just replaced them with loyalist party officials, which makes it sound like a desperate attempt to keep falsifying reports.
"China could afford to take the economical hit"
The faster and better that you deal with it, the smaller the economic hit is going to be. China is going to be the big winner here.
The faster and better that you deal with it, the smaller the economic hit is going to be. China is going to be the big winner here.
This.
The economy is going to be hit either way, it's just a choice between A) a lock down but most people staying alive and healthy or B) lots of people dying or sick and an overrun health care system.
Maybe we don't know which one will have bigger impact on the economy, but we know for sure which one will lead to more human suffering.
The economy is going to be hit either way, it's just a choice between A) a lock down but most people staying alive and healthy or B) lots of people dying or sick and an overrun health care system.
Maybe we don't know which one will have bigger impact on the economy, but we know for sure which one will lead to more human suffering.
Especially because they are in the position to help other countries now, when everybody else have to think only about their own citizens. They sent doctors to Italy with medical equipment (Italy sent some help to China earlier on) so they're going to take some credit for the recovery. Then there will be the real recovery. Western Europe was rebuilt with US money after WW2 and the USA consolidated an hegemony which is still lasting now. I bet that China will be more than willing to help in the next years.
Maybe China will emerge as the winner because they kept the number of victims down, just like the US emerged as the winner of WW2 after its industry was spared destruction by bombing.
Seconded, but the USA also had the will to push their hand. They could have said goodbye and went back to the Americas, instead they did their best to control the world. Of course everybody in that position would have done the same but they had a competitor (the USSR) so it didn't come for free.
Although China has a large internal market, they still rely on exports. If those are curtailed due to slackening demand, quarantine and tariffs, how do they become the "big winner?"
Well, smaller loser than they would have been if they'd allowed the virus to spread unchecked.
I don't see any reason to think that China can better handle the economic hit.
China has more poor people than Italy, it stands to reason they are less well equipped to handle an economic down turn.
China has more poor people than Italy, it stands to reason they are less well equipped to handle an economic down turn.
Maybe not. You want a society to develop herd immunity for a flu-like disease during warmer weather months. Since they failed to contain it, the disease is just going to show up in China again but this time from sick people traveling to China. The worst case scenario is lockdown during warmer months and then having it flare up again in winter months.
That said, we could just apply medical quarantine procedures used for animals to humans. Get a lab test 48 hours prior to international travel and have an additional test performed upon landing at the destination. The first test minimizes the likelihood of someone with viral shedding traveling and the lab test upon landing let’s you get the person and isolate them immediately before they’ve shed virally.
That said, we could just apply medical quarantine procedures used for animals to humans. Get a lab test 48 hours prior to international travel and have an additional test performed upon landing at the destination. The first test minimizes the likelihood of someone with viral shedding traveling and the lab test upon landing let’s you get the person and isolate them immediately before they’ve shed virally.
Even if it's not contained world-wide, there's still the chance that a vaccine can be developed to provide the immunity later.
It could do that because it could afford to take the economical hit and because it is an authoritarian state, which means you can get almost everyone to obey, in one way or another. Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
Can we stop using mode of government as an explanation for success and failure?
Clearly your country have its head screwed on better than mine. Meanwhile, my president is complacency in chief, more worried about the stock market than lives being lost. The local governments know what they're doing moreso than the feds, when it should be the other way around.
South Korea certainly seemed to have its head screwed most on head. They learned from previous lessons and are very successfully in applying them.
Can we stop using mode of government as an explanation for success and failure?
Clearly your country have its head screwed on better than mine. Meanwhile, my president is complacency in chief, more worried about the stock market than lives being lost. The local governments know what they're doing moreso than the feds, when it should be the other way around.
South Korea certainly seemed to have its head screwed most on head. They learned from previous lessons and are very successfully in applying them.
> Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
So did Italy, and they even got a head start in knowledge about the virus of about a month. Yet, the majority of cases here in Germany can be traced back to Italy, and not directly to China.
It's depressing how every country still tries their best to ignore their own failings and defaults to "well China should have stopped it right in the beginning"
I am absolutely sure that things would have been at least as bad if not worse, had this virus originated in Italy. Or Germany, or pretty much anywhere else.
So did Italy, and they even got a head start in knowledge about the virus of about a month. Yet, the majority of cases here in Germany can be traced back to Italy, and not directly to China.
It's depressing how every country still tries their best to ignore their own failings and defaults to "well China should have stopped it right in the beginning"
I am absolutely sure that things would have been at least as bad if not worse, had this virus originated in Italy. Or Germany, or pretty much anywhere else.
Part of the problem here is that people see this as a competition between nations, i.e. arbitrarily defined borders.
China has implemented measures that have objectively worked: that have effectively contained an outbreak of this disease within their nation, despite having had the least knowledge and warning, and within a short amount of time. So, this is a good model to follow, in the absence of any other.
Certain Western governments appear to have decided to stretch the limits of that model to protect their economy in the short-term.
That will potentially result in everyone across the globe suffering further outbreaks.
Your assumption that drugs will save us is not safe. Novel drug development may be quick, or it may take decades.
China has implemented measures that have objectively worked: that have effectively contained an outbreak of this disease within their nation, despite having had the least knowledge and warning, and within a short amount of time. So, this is a good model to follow, in the absence of any other.
Certain Western governments appear to have decided to stretch the limits of that model to protect their economy in the short-term.
That will potentially result in everyone across the globe suffering further outbreaks.
Your assumption that drugs will save us is not safe. Novel drug development may be quick, or it may take decades.
>Why on Earth is this a good model?
While a state like China would be a bad idea, here in America we could perhaps learn the benefits of not heading too far in the opposite direction.
While a state like China would be a bad idea, here in America we could perhaps learn the benefits of not heading too far in the opposite direction.
It is a good model not b/c it's politically correct, nor adopted by an authoritarian state, it's good simply because it worked: brought over 3000 new cases everyday in Wuhan down to single digit in recent days.
Any government or organization is problematic if it puts 'principles' over human lives.
Any government or organization is problematic if it puts 'principles' over human lives.
There are several non-authoritarian states in Asia that have successfully contained the virus by implementing similar strategies as China.
So there is no need to equate the need for an authoritarian government to successfully contain the virus.
So there is no need to equate the need for an authoritarian government to successfully contain the virus.
[deleted]
Maybe they should include this 3Blue1Brown video to explain what 'exponential' means in this context:
https://www.youtube.com/watch?v=Kas0tIxDvrg
https://www.youtube.com/watch?v=Kas0tIxDvrg
What caused this whole mess was the nature, not the Chinese party/people.
In the first few weeks of the virus transmission in China, nobody can anticipate the lethality of the coronavirus. People may think it is just another flu. Who knows? Yes, there were delays in the reporting and yes it could have been handled better. But the following actions of China were swift and determined. The fact is the coronavirus has been contained in China. The cases reported in China are single digit today. Fact shows China's model is effective, no?
You think the governments in EU or US could have done a better job if the coronavirus first appeared there? I'd say no. Why? Because the EU and USA have all the data and information about the coronavirus shared by China for months. You have witnessed all the mess caused by the virus in China for months and so what? Trump was down playing the danger of COVID-19 just a few days ago. The USA cannot even cover a fraction of its citizens for testing the virus.
We know it seemed to be a god sent opportunity to point fingers to the "authoritarian" system of China at this moment. But guess what? The coronavirus does not slow itself down regardless you are a democracy or not. Prove your system/model is better by saving the lives of your own citizens instead of bashing China, will you?
PS. we still don't know from where/what the coronavirus come from. I suggest wait for scientific proof before jumping to the conclusion that it started from China. last time I checked, the Spanish Flu did not originate from Spain.
In the first few weeks of the virus transmission in China, nobody can anticipate the lethality of the coronavirus. People may think it is just another flu. Who knows? Yes, there were delays in the reporting and yes it could have been handled better. But the following actions of China were swift and determined. The fact is the coronavirus has been contained in China. The cases reported in China are single digit today. Fact shows China's model is effective, no?
You think the governments in EU or US could have done a better job if the coronavirus first appeared there? I'd say no. Why? Because the EU and USA have all the data and information about the coronavirus shared by China for months. You have witnessed all the mess caused by the virus in China for months and so what? Trump was down playing the danger of COVID-19 just a few days ago. The USA cannot even cover a fraction of its citizens for testing the virus.
We know it seemed to be a god sent opportunity to point fingers to the "authoritarian" system of China at this moment. But guess what? The coronavirus does not slow itself down regardless you are a democracy or not. Prove your system/model is better by saving the lives of your own citizens instead of bashing China, will you?
PS. we still don't know from where/what the coronavirus come from. I suggest wait for scientific proof before jumping to the conclusion that it started from China. last time I checked, the Spanish Flu did not originate from Spain.
China didn't just drop the ball, they literally went after anyone who tried to tell them there was a ball.
https://www.straitstimes.com/asia/east-asia/wuhan-doctors-sa...
https://www.straitstimes.com/asia/east-asia/wuhan-doctors-sa...
China did handle the situation poorly in the beginning, trying to suppress the numbers maybe. But the thing is, other countries are doing the same mistake, while not being prepared to do what China did next.
Trump said there is nothing to worry about. He even compared the numbers to flu numbers. This is similar to what the CCP did in the beginning.
Wuhan was locked down at 100 new cases a day. This is much faster response than countries who had seen Wuhan and even had better data.
The CCP did screw things up in the beginning, but made up for that by a very effective response. Countries are matching CCP on the initial response, but not ready to match the final response.
Trump said there is nothing to worry about. He even compared the numbers to flu numbers. This is similar to what the CCP did in the beginning.
Wuhan was locked down at 100 new cases a day. This is much faster response than countries who had seen Wuhan and even had better data.
The CCP did screw things up in the beginning, but made up for that by a very effective response. Countries are matching CCP on the initial response, but not ready to match the final response.
You can’t fast track things past what they’ve already been fast tracked. Stop second guessing the experts. What is the use of a hurried vaccine tomorrow if next month it turns out to cause birth defects or global infertility or cancer.
I’m sure there’s still a ton of bureaucracy. We need to go back to first principles and really look at what makes a drug safe and how quickly we can find out.
And also take a look at what safeguards we are willing to cut when every day of delay is thousands of deaths.
And also take a look at what safeguards we are willing to cut when every day of delay is thousands of deaths.
Birth defects and infertility aren’t issues for most of these patients.
You don’t vaccinate patients, you treat them. Everyone else gets the vaccine. These are absolutely concerns for the people that would be vaccinated.
> You can’t fast track things past what they’ve already been fast tracked. Stop second guessing the experts
I'm well aware of how trials work (I happen to work in a scientific institution which does plenty). They may have been fast-tracked elsewhere, but not in my country.
So far there's just compassionate use, which means they're administered only to people who have truly severe sympthoms.
A vaccine can wait, to be honest, it's not as critical as a treatment to lessen the sympthoms. In fact, that's why Gilead is also testing their drug here (not sure when the actual protocols will start, though).
Note that I'm not advocating for "let's scrap all the trials stuff". But trials in phase III have, for obvious reasons, very lengthy time frames. And it's not the first time (I attended a talk a few years ago on the topic) where the system (which works, normally) shows its limits (not only emergencies, but for example orphan drugs).
I'm well aware of how trials work (I happen to work in a scientific institution which does plenty). They may have been fast-tracked elsewhere, but not in my country.
So far there's just compassionate use, which means they're administered only to people who have truly severe sympthoms.
A vaccine can wait, to be honest, it's not as critical as a treatment to lessen the sympthoms. In fact, that's why Gilead is also testing their drug here (not sure when the actual protocols will start, though).
Note that I'm not advocating for "let's scrap all the trials stuff". But trials in phase III have, for obvious reasons, very lengthy time frames. And it's not the first time (I attended a talk a few years ago on the topic) where the system (which works, normally) shows its limits (not only emergencies, but for example orphan drugs).
[deleted]
It is a good model because it works. The end justifies the means. You can't argue with the results.
As a physicist, it still feels odd to me they are talking about statistics with such confidence here.
It seems only SK has earned that right and has tested enough people to get reliable statistics. If you only measure the sick in the hospital...
It seems only SK has earned that right and has tested enough people to get reliable statistics. If you only measure the sick in the hospital...
The pattern is fairly consistent across countries [0]:
[0] https://www.ft.com/__origami/service/image/v2/images/raw/htt...
[0] https://www.ft.com/__origami/service/image/v2/images/raw/htt...
That is the most useful graph on this subject so far. Go look at it now.
Most countries have exactly the same growth trajectory measured from 100 cases. That's solid data about how this behaves.
Singapore and Hong Kong have been able to slow things down by strong measures, but it's still a straight line on a log graph, just with 1/3 of the growth rate. Italy is on the same line, just 8 days ahead of Europe and 13 days ahead of the US.
Only South Korea shows flattening so far.
Singapore and Hong Kong have been able to slow things down by strong measures, but it's still a straight line on a log graph, just with 1/3 of the growth rate. Italy is on the same line, just 8 days ahead of Europe and 13 days ahead of the US.
Only South Korea shows flattening so far.
I still don't get how people - including apparently some governments - don't get or don't believe it. Getting this graph is as simple as 1) taking the daily measurements, and 2) plotting them on log scale (and technically 3) shifting the lines to overlap, but that's just cosmetics). The trajectory of the entire West being the same as Italy's is immediately apparent.
In part, because they think they already understand the situation, and the nature of that understanding precludes taking things like that seriously.
“It’s just the flu”
“It only kills 2% of people”
“The flu, cancer, car accidents, malnutrition, etc have killed far more people”
“People were worried about SARS, Swine Flu, and H1N1, and they turned out to be hardly kill anyone.”
“There number of cases here is small. Why are you panicking over nothing?”
“People need to stop panicking. People are going hysterical. The media is trying to make people panic. Just look at them hoarding toilet paper”.
“People are trying to ruin the economy over nothing”
“The experts — epidemiologists — say there’s nothing to worry about” (I’ve had this said to me and I was given a link to a news article that spun statements from some epidemiologists to make it sound that way. They were saying that they didn’t know how the situation would pan out, and this was presented as if it meant they didn’t think there was any issue).
I imagine that most people aren’t aware of the graphs. I imagine most people would be dismissive of them for reasons like the following:
They simply believe the apparent normalcy in front of them more than some abstract maths. They don’t grasp the notion of exponential growth, so it seems fanciful. They also don’t understand how it’s possible to project into the future like that. Maybe they think it’s just fear-mongering speculation. What concrete evidence do they actually have for the situation in Italy? And why should they believe what’s going on in a different country will apply to their country. Maybe their country has a good health care system, and they assume that Italy doesn't.
“It’s just the flu”
“It only kills 2% of people”
“The flu, cancer, car accidents, malnutrition, etc have killed far more people”
“People were worried about SARS, Swine Flu, and H1N1, and they turned out to be hardly kill anyone.”
“There number of cases here is small. Why are you panicking over nothing?”
“People need to stop panicking. People are going hysterical. The media is trying to make people panic. Just look at them hoarding toilet paper”.
“People are trying to ruin the economy over nothing”
“The experts — epidemiologists — say there’s nothing to worry about” (I’ve had this said to me and I was given a link to a news article that spun statements from some epidemiologists to make it sound that way. They were saying that they didn’t know how the situation would pan out, and this was presented as if it meant they didn’t think there was any issue).
I imagine that most people aren’t aware of the graphs. I imagine most people would be dismissive of them for reasons like the following:
They simply believe the apparent normalcy in front of them more than some abstract maths. They don’t grasp the notion of exponential growth, so it seems fanciful. They also don’t understand how it’s possible to project into the future like that. Maybe they think it’s just fear-mongering speculation. What concrete evidence do they actually have for the situation in Italy? And why should they believe what’s going on in a different country will apply to their country. Maybe their country has a good health care system, and they assume that Italy doesn't.
> I imagine that most people aren’t aware of the graphs.
And even if they are, they aren't aware of log scale.
And even if they are, they aren't aware of log scale.
Definitely. Noticing it's log scale (or anything non-linear) takes a trained eye.
I've worked with, presented, and consumed a lot of scientific data over my career and I still have a tendency to assume plots are linear no matter how many times I tell myself to always check scale first.
I've worked with, presented, and consumed a lot of scientific data over my career and I still have a tendency to assume plots are linear no matter how many times I tell myself to always check scale first.
Any half-decent plot aimed at non-specialists will have "log scale" written in the title or surrounding description. The one linked by 'soVeryTired didn't, which is where FT dropped the ball. But it does not matter here.
The relevant axis on this chart is the time axis, the x axis. The chart is linear in it. You see a bunch of nearly identical trend lines, and you have to just count how many days a given country is behind Italy. It doesn't matter what scale the vertical axis is in.
The relevant axis on this chart is the time axis, the x axis. The chart is linear in it. You see a bunch of nearly identical trend lines, and you have to just count how many days a given country is behind Italy. It doesn't matter what scale the vertical axis is in.
> Any half-decent plot aimed at non-specialists will have "log scale" written in the title or surrounding description
I have to wonder how many non-specialists would even know what “log scale” means.
I have to wonder how many non-specialists would even know what “log scale” means.
I didn't mean a non-specialist as in an average Joe; I meant an above-average Joe with some interest in one or more of: economy, physics, electronics, mathematics, biology. There's loads of such people.
>log scale
There's your answer. To 90% of elected officials, a "log scale" sounds like something a timber company might weigh their product with.
There's your answer. To 90% of elected officials, a "log scale" sounds like something a timber company might weigh their product with.
It's much worse than that. Italy's health system is already collapsing at 20,000 victims. The population of Italy is 60 million. That has to level off at some point due to saturation, but that's at somewhere in the millions or tens of millions.
FWIW, at the moment it's only lombardy's health system which is collapsing, because most of the victims are concentrated there and the growth rate there was _much_ faster because the lock down was only imposed late.
The growth rate is the same in other regions but delayed, and there is some hope that the rest of the country might be able to cope with it better if the lock down measures are effective.
The growth rate is the same in other regions but delayed, and there is some hope that the rest of the country might be able to cope with it better if the lock down measures are effective.
Hopefully. But the health care system in Lombardia has to be the best or at the top of entire the country. Southern Italy will struggle with fewer cases.
Worse still, Italy has one of the better healthcare systems. This doesn't bode well for the rest of Europe.
Well Lombardy does (number 2 in the regions of the EU). I believe that some Italian commentators have said that one of the biggest reasons for the total country lockdown was that the health systems of Southern Italy were much much worse than Lombardy, and would definitely not be able to cope.
Because of normalcy bias: https://en.wikipedia.org/wiki/Normalcy_bias
"Normalcy bias can cause people to drastically underestimate the effects of the disaster. Therefore, people think that they will be safe even though information from the radio, television, or neighbors gives them reasons to believe there is a risk."
People just don't want to believe a disaster is about to happen. They will grasp at straws to explain why everything is going to be fine.
That's usually not a problem because disasters are rare, but it will catch us under-prepped when an actual disaster happens.
"Normalcy bias can cause people to drastically underestimate the effects of the disaster. Therefore, people think that they will be safe even though information from the radio, television, or neighbors gives them reasons to believe there is a risk."
People just don't want to believe a disaster is about to happen. They will grasp at straws to explain why everything is going to be fine.
That's usually not a problem because disasters are rare, but it will catch us under-prepped when an actual disaster happens.
I have one issue with or maybe just question about this graph. Why it starts with 100 detected cases? It seems like arbitrary round number, but it also seems to be the smallest arbitrary-looking number that makes SK overlap other countries. Why is that? Why is the initial slow spread in SK irrelevant? What caused it to be initially slower than in other countries?
It's somewhat arbitrary, but you can't start from "patient zero" because that's not usually known. And the detailed circumstances of the first few patients matter. By 100 or so, the disease is in the population and starts to behave statistically. That's what's called "community spread".
People infected with the coronavirus tend to vary wildly in how many other people they infect from people who stay home with a fever and infect nobody to "super spreaders" who many infect hundreds of others. That means the spread rate when you don't have a statistically significant number of cases is going to be all over the map naturally and not really comparable.
It’s somewhat arbitrary, but also, countries can’t detect the presence of coronavirus when just a single resident has it. 100 is a good starting point for “this country has detected the virus within their borders — what’s going to happen?”
This doesn't really matter, you're just doing that to make it easier to compare. Shifting South Korea so it doesn't overlap the other countries is possible but not terribly useful.
They do seem to be missing Denmark though, which should stick out somewhere top-left of Norway.
They do seem to be missing Denmark though, which should stick out somewhere top-left of Norway.
They do seem to be missing Denmark though, which should stick out somewhere top-left of Norway.
I was just talking, via text, to a friend in Norway. They're going for major restrictions on contact and the people there are not worried enough yet. I sent her that graph.
I was just talking, via text, to a friend in Norway. They're going for major restrictions on contact and the people there are not worried enough yet. I sent her that graph.
Norway is going into full lockdown (stay at home, don't hoard). Borders closing except for export/import from Monday. Hut vacations now getting banned as well.
Which is a good plan and similar to what Denmark is doing, ie. stay at home as much as possible, everyone who can work from home does so, closing the borders for all non-essential traffic, and so on. There is a whole system being set up for compensation to concert venues and other businesses who are severely hit by the lockdown and blanket ban on gatherings of more than 100 people.
Open air walks are ok, as long as you keep a reasonable distance to other people. Only go shopping if it's absolutely necessary.
And yet some people are still going to crowded bars, like nothing's going on. It's amazing how stubborn some people are.
Open air walks are ok, as long as you keep a reasonable distance to other people. Only go shopping if it's absolutely necessary.
And yet some people are still going to crowded bars, like nothing's going on. It's amazing how stubborn some people are.
There's a distribution of who gets it when. The bans will be for those last 20% who just refuse to care about anybody else.
Denmark is now in today's version. https://twitter.com/jburnmurdoch/status/1238913530973339648/...
This could also be a measure of the rate of test kit production by country.
The graph can be reproduced with more recent data here [1]. It is based on WHO data, and lags a bit behind. If you want to see more data and graphs, see [2].
[1] https://ourworldindata.org/grapher/covid-confirmed-cases-sin...
[2] https://ourworldindata.org/coronavirus
[1] https://ourworldindata.org/grapher/covid-confirmed-cases-sin...
[2] https://ourworldindata.org/coronavirus
As a physicist, you are familiar with formulas similar to this:
N_obs = p_detect * 2^( n_days / T_double )
N_obs : The number of observed cases p_detect : The fraction of actual cases that are detected (assumed to be constant) n_days : number of days T_double : The number of days it takes for the number of real cases to double
If you examine the formula, the p_detect constant is almost insignificant. If T_double = 2, a difference in a detection rate of 0.2 and 0.8 is only 4 days for n_days.
As long as T_double is less than several months (and constant), an absolute catastrophy will occur. Within a weeks from now, nearly the entire fraction of the population that is receptive to infection will get infected, and will be sick basically at the same time. With 10-15% of the population requiring intubation, we can end up with a significant part of the population in each country ending up dead.
N_obs = p_detect * 2^( n_days / T_double )
N_obs : The number of observed cases p_detect : The fraction of actual cases that are detected (assumed to be constant) n_days : number of days T_double : The number of days it takes for the number of real cases to double
If you examine the formula, the p_detect constant is almost insignificant. If T_double = 2, a difference in a detection rate of 0.2 and 0.8 is only 4 days for n_days.
As long as T_double is less than several months (and constant), an absolute catastrophy will occur. Within a weeks from now, nearly the entire fraction of the population that is receptive to infection will get infected, and will be sick basically at the same time. With 10-15% of the population requiring intubation, we can end up with a significant part of the population in each country ending up dead.
I believe you're focusing on the days aspect of that equation without considering what a lower T_double/p_detect could mean relative to hospitalizations.
If the real number of cases is doubling significantly faster than those detected -- say due to not testing them because their symptoms are mild enough to be missed entirely or to not seek treatment -- the calculations around things like mortality rate and severity of illness may yet change. As I understand it, scientists have already identified mutations of the virus that may also impact its ability to spread or injure infected hosts. I should note that these changes can swing both good and bad, I'm simply pointing out that there are more variables and that these variables changing may represent something not obvious from the equation.
I'm not an expert; I have fun reading about medical statistics. Most papers I've read take the time to examine these various confounding factors and what unexpected variations in their proposed equations might mean.
If the real number of cases is doubling significantly faster than those detected -- say due to not testing them because their symptoms are mild enough to be missed entirely or to not seek treatment -- the calculations around things like mortality rate and severity of illness may yet change. As I understand it, scientists have already identified mutations of the virus that may also impact its ability to spread or injure infected hosts. I should note that these changes can swing both good and bad, I'm simply pointing out that there are more variables and that these variables changing may represent something not obvious from the equation.
I'm not an expert; I have fun reading about medical statistics. Most papers I've read take the time to examine these various confounding factors and what unexpected variations in their proposed equations might mean.
If the number of real cases double every N days, the number of people needing hospitalization is also likely to double every N days. If not, it probably means that the infection rate spread at different rates in high risk vs low risk part of the population, but unless those populations are strongly segregated from each other, that is unlikely.
This could go in both directions. In both cases, though it would require that the high-risk subpopulation is primarily infected by each other (or staff) instead of being infected from the general population. If high-risk individuals are primarily infected by low-risk individuals, the doubling time for each group should be the same.
Note that such an effect could go in both directions. The high risk subpopulation could get it at a higher rate the rest if we let the infection spread like wildfire in hospitals and elderly housing centers, or it could spread at a lower rate if the risk patients are kept isolated.
This could go in both directions. In both cases, though it would require that the high-risk subpopulation is primarily infected by each other (or staff) instead of being infected from the general population. If high-risk individuals are primarily infected by low-risk individuals, the doubling time for each group should be the same.
Note that such an effect could go in both directions. The high risk subpopulation could get it at a higher rate the rest if we let the infection spread like wildfire in hospitals and elderly housing centers, or it could spread at a lower rate if the risk patients are kept isolated.
The point is that the mortality rate estimates are going to be totally out of whack without accurate measurements. As well as estimates of the currently infected.
This matters a lot. The first number is obviously important. The second matters so Italy can plan for whether things have peaked yet, or how many weeks out until it does.
This matters a lot. The first number is obviously important. The second matters so Italy can plan for whether things have peaked yet, or how many weeks out until it does.
The mortality does matter a lot if we plan to let everyone become exposed. However, if we do that, we must expect 15% of the people that are currently having enough symptoms to be diagnosed in Italy to perish. Even if only 20% of the infected are diagnosed there now, that is up 14 million people in Italy (if everyone gets it), out of which 2-3 million would die.
Or, if applied to the US, 10 million.
Alternatively, we can shut down the virus in the same manners that China, South Korea or Singapore have been doing, and keep it supressed until we develop efficient treatment.
Unfortunately, that means shutting down all affected regions really hard, and maintain a high level of supression for maybe 2 years.
However, if we are going to do so anyway, both the human and economic costs will be lower the earlier we begin.
If we allow exponential growth to continue with a doubling time of only a few days (even if we can move it from 2-3 days to 6 days), the time until this move is forced is very limited.
Or, if applied to the US, 10 million.
Alternatively, we can shut down the virus in the same manners that China, South Korea or Singapore have been doing, and keep it supressed until we develop efficient treatment.
Unfortunately, that means shutting down all affected regions really hard, and maintain a high level of supression for maybe 2 years.
However, if we are going to do so anyway, both the human and economic costs will be lower the earlier we begin.
If we allow exponential growth to continue with a doubling time of only a few days (even if we can move it from 2-3 days to 6 days), the time until this move is forced is very limited.
That assumes you are sampling uniformly, and not in already saturated clusters. The doubling time is also not a known constant, as it depends on actions taken etc, and uncertainty in it will broaden the distribution.
Obviously, all this is basic statistics and should be known to epiodemiologists, who hopefully have some input to policies.
For large N_obs, this will maybe be less important as you're going to find the severe cases anyway, but the uncertainty is significant in the beginning stages, and it is unfortunately these stages where actions will have most impact.
Obviously, all this is basic statistics and should be known to epiodemiologists, who hopefully have some input to policies.
For large N_obs, this will maybe be less important as you're going to find the severe cases anyway, but the uncertainty is significant in the beginning stages, and it is unfortunately these stages where actions will have most impact.
As long as growth remains linear in an exponential plot, you are nowhere near the saturation point. When about half the population is already infected, the number of new cases should grow roughly linearly. In Italy, it seems to still grow exponentially.
Itally has already passed the number of simultanous cases that their healthcare system can handle. I don't believe they really want to find out at what level the saturation point can be found. That could mean hundreds of thousands, potentially millions, dead.
Itally has already passed the number of simultanous cases that their healthcare system can handle. I don't believe they really want to find out at what level the saturation point can be found. That could mean hundreds of thousands, potentially millions, dead.
https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
Start reading at "2. What Will Happen When These Coronavirus Cases Materialize?"
Start reading at "2. What Will Happen When These Coronavirus Cases Materialize?"
Who is this mr Pueyo? And why should we listen to him regarding this subject?
From his Medium profile page it seems he is a 'Storyteller' and 'Viral marketer'. So, someone who knows how to tell a story with confidence even if you know nothing of the subject.
I'm gonna listen to my government regarding this, rather than medium posts by viral marketeers. Thank you.
From his Medium profile page it seems he is a 'Storyteller' and 'Viral marketer'. So, someone who knows how to tell a story with confidence even if you know nothing of the subject.
I'm gonna listen to my government regarding this, rather than medium posts by viral marketeers. Thank you.
Your government is saying the exact. Same. Thing:
https://www.government.nl/latest/news/2020/03/12/new-measure...
https://www.rivm.nl/en/news/current-information-about-novel-...
> 15-03-2020 , 176 new patients, a total of 1135
> 14-03-2020 , 155 new patients, in total 959
> 13-03-2020 , 190 new patients, in total 804
> 12-03-2020 , 111 new patients, in total 614
> 11-03-2020 , 121 new patients, in total 503
> 10-03-2020 , 61 new patients, a total of 382
> 09-03-2020 , 56 new patients, a total of 321
> 08-03-2020 , 77 new patients, a total of 265
> 07-03-2020 , 60 new patients, a total of 188
> 06-03-2020 , 46 new patients, a total of 128
> 05-03-2020 , 44 new patients, a total of 82
> 04-03-2020 , 15 new patients, a total of 38
> 03-03-2020 , 6 new patients, a total of 24
> 02-03-2020 , 11 new patients, a total of 18
> 01-03-2020 , 1 new patient, a total of 7
...
Here's a log-scale graph: https://www.chartgo.com/embed.do?id=7e5c9f30aa
(And just for comparison, not log scale: https://www.chartgo.com/embed.do?id=7e5c9f30aa )
Looks like NL has had steady exponential growth over the past week or even 10 days.
As far as Mr Pueyo, in this context he appears to be an effective science writer, which is what matters. If you want a more succinct source from an academic, there's http://ctbergstrom.com/covid19.html .
https://www.government.nl/latest/news/2020/03/12/new-measure...
https://www.rivm.nl/en/news/current-information-about-novel-...
> 15-03-2020 , 176 new patients, a total of 1135
> 14-03-2020 , 155 new patients, in total 959
> 13-03-2020 , 190 new patients, in total 804
> 12-03-2020 , 111 new patients, in total 614
> 11-03-2020 , 121 new patients, in total 503
> 10-03-2020 , 61 new patients, a total of 382
> 09-03-2020 , 56 new patients, a total of 321
> 08-03-2020 , 77 new patients, a total of 265
> 07-03-2020 , 60 new patients, a total of 188
> 06-03-2020 , 46 new patients, a total of 128
> 05-03-2020 , 44 new patients, a total of 82
> 04-03-2020 , 15 new patients, a total of 38
> 03-03-2020 , 6 new patients, a total of 24
> 02-03-2020 , 11 new patients, a total of 18
> 01-03-2020 , 1 new patient, a total of 7
...
Here's a log-scale graph: https://www.chartgo.com/embed.do?id=7e5c9f30aa
(And just for comparison, not log scale: https://www.chartgo.com/embed.do?id=7e5c9f30aa )
Looks like NL has had steady exponential growth over the past week or even 10 days.
As far as Mr Pueyo, in this context he appears to be an effective science writer, which is what matters. If you want a more succinct source from an academic, there's http://ctbergstrom.com/covid19.html .
Thank you. Recommend everybody to read this.
No one is 'confident' about a lot of things. But everyone who has seen what is happening in Italy is confident that taking a 'wait and see' attitude will cost lives.
i wish more countries did randomized testing over its whole population, or extensive testing, like SK.
Why even test? The decision procedure is the same: treat the ill, lock down everyone else at home, avoiding social contact at the max; enforce social isolation and/or masks in "critical" spaces (power plants, grocery stores, ...). What does a positive or negative test change?
Most complete lockdown would seem to coincide with health care system stress beyond a certain level.
Universal testing and full identification, isolation, and clearance of all patients across multiple checkpoints would result in the fewest number subject to confinement, confined in the least broad of areas for the shortest periods of time.
OTOH if insignificant testing has been achieved, lockdown itself will need to be inversely universal and long-lasting.
There is an exponential component involved, so the effect will be felt sooner than you think.
Theoretically either way, it's possible no one will be able to be unconfined across multiple checkpoints without a real-time valid negative test or credential.
That decision could be the same either way.
But the fewer and less reliable the tests, the fewer the number of citizens that can be expected to be allowed to move about with some freedom.
After pandemic stress exceeds the magnitude where there can be no treatment resources for additional patients anyway, movement will certainly not be relaxed, and those who might have had a chance with earlier & more thorough action & testing will be left to expire undertested in confinement.
Not every scenario is that uplifting.
Due to the excess rate of confinement resulting from inadequate testing, the greater stress on the marginal economic needs of a large contingent of the populace may result in a need for lockdowns to become oppressive enough to theoretically halt the spread of all possible crime in addition to disease.
Depends on how serious it gets, if it's bad enough you could get unrulyness or looting like there is during some disasters regardless.
Universal testing and full identification, isolation, and clearance of all patients across multiple checkpoints would result in the fewest number subject to confinement, confined in the least broad of areas for the shortest periods of time.
OTOH if insignificant testing has been achieved, lockdown itself will need to be inversely universal and long-lasting.
There is an exponential component involved, so the effect will be felt sooner than you think.
Theoretically either way, it's possible no one will be able to be unconfined across multiple checkpoints without a real-time valid negative test or credential.
That decision could be the same either way.
But the fewer and less reliable the tests, the fewer the number of citizens that can be expected to be allowed to move about with some freedom.
After pandemic stress exceeds the magnitude where there can be no treatment resources for additional patients anyway, movement will certainly not be relaxed, and those who might have had a chance with earlier & more thorough action & testing will be left to expire undertested in confinement.
Not every scenario is that uplifting.
Due to the excess rate of confinement resulting from inadequate testing, the greater stress on the marginal economic needs of a large contingent of the populace may result in a need for lockdowns to become oppressive enough to theoretically halt the spread of all possible crime in addition to disease.
Depends on how serious it gets, if it's bad enough you could get unrulyness or looting like there is during some disasters regardless.
How do we know when to initiate or let up on the lockdown if we don’t have any testing?
For the first question, the answer is: ANY country that currently is seeing exponental growth should take action at the same level of severity as China/Korea/Singapora, if not, they will be in the same situation as Italy in 1-3 weeks.
Once the growth is no longer exponential, measures can be rolled back slowly, especially if they have access to enough tests, masks and respirators.
The earlier action is taken, the cheaper it will be to stop this. Every week of delay can increase casualty rates by a factor of 10. A month of delay, can mean the difference between 10000 and 10 million dead.
Also, economic costs, both in direct treatment cost as well as the disruption to the productive side of the economy will rise sharply the longer we wait. (Well, at least if we don't see the death of sick and elderly as an economic benefit.)
Once the growth is no longer exponential, measures can be rolled back slowly, especially if they have access to enough tests, masks and respirators.
The earlier action is taken, the cheaper it will be to stop this. Every week of delay can increase casualty rates by a factor of 10. A month of delay, can mean the difference between 10000 and 10 million dead.
Also, economic costs, both in direct treatment cost as well as the disruption to the productive side of the economy will rise sharply the longer we wait. (Well, at least if we don't see the death of sick and elderly as an economic benefit.)
A decline in cases to treat would be informative, no?
You're assuming that all cases are Coronavirus.
People will continue to get the Flu, Colds, HIV / AIDs even throughout this whole shebang. We need to know COVID19 cases specifically, to know if our lockdown methodology is being effective.
People will continue to get the Flu, Colds, HIV / AIDs even throughout this whole shebang. We need to know COVID19 cases specifically, to know if our lockdown methodology is being effective.
For that you just need to test in hospitals.
USA doesn't have enough tests even for that. I'm proposing we at least test the cases that reach the hospital stage.
[deleted]
Exactly. I don't see how trying to limit testing to people who had contact with known cases or traveled to at risk countries (as practiced in Germany) can be successful.
Are you sure that Germany does not perform extensive testing? I admit that reddit comments should not be used as sources but I would love to know more about German approach to testing.
https://www.reddit.com/r/askscience/comments/fguheu/why_have...
Earl_of_Northesk: The RKI is conducting random sample testing to keep track of Influenza in Germany. These tests now also test on COVID-19. So far, not a single prior undetected case of COVID-19 has shown up in these samples. It is thus highly likely that the extensive early tracking and testing means that Germany has, in comparison to other countries, a very low rate of undetected cases, which would obviously lead to a lower mortality rate. That's what the President of the RKI also said in todays press conference together with Angela Merkel.
Painy_: How big is the RKIs sample size tho?
patientzero_: All cases that had the flu and went to the hospital. So the more severe once. But they also re-ran the tests from the beginning of the year to test for Covid-19. If you can't detect it in there it wasn't in the country most likely
Sounds like a massive amount of testing that no other country can match.
https://www.reddit.com/r/askscience/comments/fguheu/why_have...
Earl_of_Northesk: The RKI is conducting random sample testing to keep track of Influenza in Germany. These tests now also test on COVID-19. So far, not a single prior undetected case of COVID-19 has shown up in these samples. It is thus highly likely that the extensive early tracking and testing means that Germany has, in comparison to other countries, a very low rate of undetected cases, which would obviously lead to a lower mortality rate. That's what the President of the RKI also said in todays press conference together with Angela Merkel.
Painy_: How big is the RKIs sample size tho?
patientzero_: All cases that had the flu and went to the hospital. So the more severe once. But they also re-ran the tests from the beginning of the year to test for Covid-19. If you can't detect it in there it wasn't in the country most likely
Sounds like a massive amount of testing that no other country can match.
For some context, researchers in China went back and reran old flu surveillance samples from Wuhan taken in December and the start of January. According to the WHO joint mission's report, 1 out of the 20 samples from the first week of January and 3 out of the 20 samples from the second week tested positive for Covid-19. China locked down Wuhan on the 23rd. Things were probably already really bad by that point in a way that wasn't reflected in the number of confirmed cases.
No matter good the test coverage in germany is, the growth is still exponential so the currect prevention measures are insufficient.
If the availability of testing kits is low and the ratio of infected to non infected people is extremely low, it makes absolutely no sense to sample randomly from the population.
How many do you need though? If you take 0.1-1% of your testing capacity, those handfuls of samples a day give you some information. Not regional level or very reliable data, but it gives an idea of whether people (as a population) are having it and are having mild symptoms and are not reporting anything, or if it isn't widespread yet and the hospital cases are the only cases.
Aldo if you expect the true positves to be a small percentage (which should still be the case in most countries), false positives will dominate in a ranom sampling. Apparently false positives are high for unsymptomatic cases. Of course if you can estimate the false positive rate well enough, the random sampling might still give useful statistics.
As far as I know lab performed PCR tests are assumed to have 0% false positives and about 29% false negatives.
Antibodies tests have about 10% false-positive rate but to the best of my knowledge countries in Europe widely use PCR tests.
I think most places are switching from testing known contact/at risk countries to testing people in hospital with the symptoms. The first strategy makes sense if you're trying to contain a small number of cases, it doesn't make sense once people are catching it from other people in the area.
Everyone except the UK and the US notably.
If you make a bunch of assumptions about the distribution, you don't need a large sample size to make decent estimations about the population. Of course, the only way that works is with random or stratified random sampling. With reporting bias, I'm not sure any country has enough data to make statistically confident statements with any precision.
Folks with a stronger statistics background are welcome to correct me.
Folks with a stronger statistics background are welcome to correct me.
It's interesting that you lead by saying "as a physicist".
As a physicist I'm used to thinking about orders of magnitude and whether something grows like log(N) or N!. I'm pretty sure all the data points to this being O(a big problem) but I'd leave it to the epidemiologists to say anything with confidence.
As a physicist I'm used to thinking about orders of magnitude and whether something grows like log(N) or N!. I'm pretty sure all the data points to this being O(a big problem) but I'd leave it to the epidemiologists to say anything with confidence.
So, as a physicist, you should know how exponential growth works. Let's say you have a pile of Uranium that's juuuust sub-critical. You would likely to be confident to stand next to it without significant fear.
But if someone throws on just enough additional Uranium for the pile to go supercritical, you would run for your life because none of the following will matter[1] all that much to the final outcome:
1) How much neutron radiation there was to start with.
2) The specific exponential growth coefficient.
3) How much total Uranium there is, as long as it's a nontrivial amount
4) Whether your Geiger counter is off by some constant factor or not.
None of those matter. It's going boom. It might go boom a bit sooner or a bit later, but it is going to go boom. That's just how exponential growth works. There's no maybe. There's no "let us wait and see". There's no "we'll hope for the best". No: It. Will. Go. Boom.
All of the factors that are irrelevant are just shifting a figurative vertical wall on your graph paper a bit to the left, or a bit to the right. It's adding or subtracting "a couple of doubling times". If the doubling time is short, then you're not really achieving anything by fiddling with constant factors.
With the Coronavirus just about every country has a doubling time of 4-5 days.
I live in Australia, where we're about a "month behind" everyone else. So of course, the dumbass government is saying things like "the heat here will slow it down". But it hasn't, our doubling time is 4.75 days at the moment. They're saying that it's "premature to lock down the country". No it isn't, it's already weeks too late and getting literally exponentially worse daily! They're saying that the hospitals are being prepared, but no amount of extra beds or ventilators will help. If they double the number, it just delays the catastrophe by 4.75 days. Not even a whole week! Quadrupling beds and ventilators buys just under 10 days before people are being turned away to go home and die.
So, again. I ask you: If you were the nuclear physicist in charge of a nuclear pile and someone told you it's gone critical and the radiation is rising exponentially, is your first reaction to: just "stand around and wait and see what happens", or to: take drastic action right this second? Do you SCRAM, or do you call the communist party leadership for permission? Are you the hero of the Chernobyl story, or the villain?
[1] Ignoring thermal effects slowing down the reaction. This actually has an analogy with disease spread, where there are fewer susceptible people remaining because everyone is already sick or dead. If we reach this point, we'll be seeing millions infected and hundreds of thousands dead.
But if someone throws on just enough additional Uranium for the pile to go supercritical, you would run for your life because none of the following will matter[1] all that much to the final outcome:
1) How much neutron radiation there was to start with.
2) The specific exponential growth coefficient.
3) How much total Uranium there is, as long as it's a nontrivial amount
4) Whether your Geiger counter is off by some constant factor or not.
None of those matter. It's going boom. It might go boom a bit sooner or a bit later, but it is going to go boom. That's just how exponential growth works. There's no maybe. There's no "let us wait and see". There's no "we'll hope for the best". No: It. Will. Go. Boom.
All of the factors that are irrelevant are just shifting a figurative vertical wall on your graph paper a bit to the left, or a bit to the right. It's adding or subtracting "a couple of doubling times". If the doubling time is short, then you're not really achieving anything by fiddling with constant factors.
With the Coronavirus just about every country has a doubling time of 4-5 days.
I live in Australia, where we're about a "month behind" everyone else. So of course, the dumbass government is saying things like "the heat here will slow it down". But it hasn't, our doubling time is 4.75 days at the moment. They're saying that it's "premature to lock down the country". No it isn't, it's already weeks too late and getting literally exponentially worse daily! They're saying that the hospitals are being prepared, but no amount of extra beds or ventilators will help. If they double the number, it just delays the catastrophe by 4.75 days. Not even a whole week! Quadrupling beds and ventilators buys just under 10 days before people are being turned away to go home and die.
So, again. I ask you: If you were the nuclear physicist in charge of a nuclear pile and someone told you it's gone critical and the radiation is rising exponentially, is your first reaction to: just "stand around and wait and see what happens", or to: take drastic action right this second? Do you SCRAM, or do you call the communist party leadership for permission? Are you the hero of the Chernobyl story, or the villain?
[1] Ignoring thermal effects slowing down the reaction. This actually has an analogy with disease spread, where there are fewer susceptible people remaining because everyone is already sick or dead. If we reach this point, we'll be seeing millions infected and hundreds of thousands dead.
I think this insight is exactly why the UK health experts are not advocating extreme measures yet. They know they will only delay the takeoff and they need to use those measures when it does, not beforehand, and these measures are meant to protect the most at risk from dying from the disease (I think the most contentious thing is how long these measures can work for. The UK experts are of the opinion they have a finite life).
Keep in mind, the UK advisors think the peak is maybe two months away, and that at-risk groups may need to self-isolate for a month either side of that peak. This is a far bigger response than any country has achieved so far (and it's extra difficult because the at-risk groups are probably the most dependent on external aid, as well as already lacking social contact). I don't think they're wrong to think that this will be difficult to achieve, and increasing the difficulty by starting earlier will make things worse.
There is no SCRAM button on this pandemic, not any more at least.
Keep in mind, the UK advisors think the peak is maybe two months away, and that at-risk groups may need to self-isolate for a month either side of that peak. This is a far bigger response than any country has achieved so far (and it's extra difficult because the at-risk groups are probably the most dependent on external aid, as well as already lacking social contact). I don't think they're wrong to think that this will be difficult to achieve, and increasing the difficulty by starting earlier will make things worse.
There is no SCRAM button on this pandemic, not any more at least.
"This is a far bigger response than any country has achieved so far (and it's extra difficult because the at-risk groups are probably the most dependent on external aid, as well as already lacking social contact)"
How have they achieved this? What concrete measures?
How have they achieved this? What concrete measures?
They haven't yet (no-one has). The point is they are recognising that such measures are very hard on people, and so they don't think they can stay in force indefinitely.
Well, if I try hard to imagine how they think, without assuming incompetence, it would be as follows:
Assumption 1: Our country will not be able to take measures that are extreme enough to stop exponential growth. Assumption 2: Once a certain level is reached, we can drastically lower the doubling time so that the number of simultanious cases are kept below what our healthcare system can handle. Assumption 3: If we stay below the level that the healthcare system can handle, mortality rates will be low, maybe lower than 1%. Assumption 4: The total number of individuals that will require hospitalization is low enough that the healthcare system can treat all patients needing treatment in a few months.
If assumptions 2 is not met, the mortality rates of pations that require treatment is likely to be similar to what is seen in Italy, ie roughly 15%.
If assumption 3 is wrong, and the real mortality rate is about 3-5%, having about half the population infected, will still lead to huge numbers of dead, more than the population is likely to accept.
If assumption 4 is wrong. Italy is currently unable to handle 20000 cases. A country like the UK may be able to handle maybe 10000-20000 simultaneusly. If 10% of the population requires hospitalization, and each patient will stay there an average of 1 month, measures will have to be dragged out over several years, anyway.
Assumption 5: This only needs to be done once, meaning there will not be second or third waves or mutaded viruses that will need to spread in a similar fashion in the same time period.
At some point, I think every country will realize that they need to take drastic measures, enough to stop the spread from being exponential. Doing that after detecting 100000 cases is VERY different from doing it after detecting 1000.
The downside, of course, of preventing exponential growth, is that most measures will have to be kept in place until there is a vaccine or other cure, and that could take 2 years.
Assumption 1: Our country will not be able to take measures that are extreme enough to stop exponential growth. Assumption 2: Once a certain level is reached, we can drastically lower the doubling time so that the number of simultanious cases are kept below what our healthcare system can handle. Assumption 3: If we stay below the level that the healthcare system can handle, mortality rates will be low, maybe lower than 1%. Assumption 4: The total number of individuals that will require hospitalization is low enough that the healthcare system can treat all patients needing treatment in a few months.
If assumptions 2 is not met, the mortality rates of pations that require treatment is likely to be similar to what is seen in Italy, ie roughly 15%.
If assumption 3 is wrong, and the real mortality rate is about 3-5%, having about half the population infected, will still lead to huge numbers of dead, more than the population is likely to accept.
If assumption 4 is wrong. Italy is currently unable to handle 20000 cases. A country like the UK may be able to handle maybe 10000-20000 simultaneusly. If 10% of the population requires hospitalization, and each patient will stay there an average of 1 month, measures will have to be dragged out over several years, anyway.
Assumption 5: This only needs to be done once, meaning there will not be second or third waves or mutaded viruses that will need to spread in a similar fashion in the same time period.
At some point, I think every country will realize that they need to take drastic measures, enough to stop the spread from being exponential. Doing that after detecting 100000 cases is VERY different from doing it after detecting 1000.
The downside, of course, of preventing exponential growth, is that most measures will have to be kept in place until there is a vaccine or other cure, and that could take 2 years.
The growth will always be exponential. What you can change is the exponent. I don't think they are crazy for suggesting that extreme measures are unsustainable and their use should be timed correctly. I'm not completely sure they're right, but neither am I sure that extreme measures are right. Keeping a quarantine on a whole country up for 2 years seems unlikely. As I understand it, this plan hasn't just been hastily put together overnight, a team has spent a while researching and modelling outbreaks in preperation for just such a scenario, and as such I am inclined to trust them more than politicians (who are always happy to be seen to be doing something about a problem) and laypeople on the internet.
Growth does NOT have to be exponential (or at least not with any near-constant exponent). Furthermore, if the doubling rate is half a year or more, it really does not matter that much if it exponential, unless the number of already infected is already huge, since a vaccine is likely to come within 2 years.
From my perspective, it appears that politicians do NOT want to take sufficiently drastic measures, as the economic consequences will be huge (let's assume that Spain and Italy will keep or increase the measures they already have for 2 years), and so far, their measures do not seem to be sufficient.
From my perspective, it appears that politicians do NOT want to take sufficiently drastic measures, as the economic consequences will be huge (let's assume that Spain and Italy will keep or increase the measures they already have for 2 years), and so far, their measures do not seem to be sufficient.
Most people will not go to the hospital, they'll stay at home and they wont die unless they dont drink water and eat food with poor nutritional value.
That's why I dont understand the crisis communication on the subject. I understand exponential growth, I dont under and the panic about getting sick with a flu like virus.
If it was something causing skin lesions I'd be in panic mode because the victims would be at a higher risk of co-infectious diseases. This is not that. But hey, fuck my civil liberties some more, for that matter fuck my freedom and that of my countrymen. I dont give a fuck anymore.
That's why I dont understand the crisis communication on the subject. I understand exponential growth, I dont under and the panic about getting sick with a flu like virus.
If it was something causing skin lesions I'd be in panic mode because the victims would be at a higher risk of co-infectious diseases. This is not that. But hey, fuck my civil liberties some more, for that matter fuck my freedom and that of my countrymen. I dont give a fuck anymore.
Most people aren't susceptible to dying from this. They are likely to spread it. Those who are susceptible to dying from this number in the millions. You can worry about your civil liberties and freedom after you worry about infecting someone who might die because you decided that the personal risk to you wasn't worth a few weeks of inconvenience.
I'd rather people die then risk the state grabbing power against the right to organize in groups.
What child of summer you are.
[deleted]
A lot of people have similar statements, but the use of the word "most" in this context just doesn't matter past some cutoff. The flu is very far on the safe side of that cutoff, and the coronavirus is very far on the bad side.
The flu and the common cold virus behave comparably to the current pandemic. The flu in particular kills about 300K per year after infecting about 20% of the global population. That's a mortality rate of 0.02% and a survival rate of 99.98% for the general population, which is not a fun statistic, but nothing to panic about either.
Critically, the hospitalisation rates for the flu are so low that the current infrastructure can handle it. People still die, but only if they couldn't be saved with medical intervention. Much of the time they will receive treatment and live.
Even if you shift the numbers around a lot -- say, 50% infection rate -- the orders of magnitude come out to about the same. Governments can just put out ad campaigns to encourage people to get the flu vaccine to compensate for a particularly bad flu season.
The critical thing with the cold and the flu is that they move well past the initial exponential growth phase into a "logistic curve" long before the hospital systems become overloaded with the sick. That is, each new strain of the flu runs out of victims by hitting the population ceiling of 7.6 billion. Not everyone is vulnerable, and the rest either become immune or protected by herd immunity.
Now compare this to the Coronavirus. It has a mortality rate of about 0.8% of confirmed cases, with medical care. Much more importantly, about 10% of the confirmed cases required intensive care.
Nobody really knows the ratio of confirmed-to-real cases, but I'll be generous and assume that only 20% of all cases get a confirmed diagnosis, with 80% of cases just shrugging it off as a case of the "sniffles". Similarly, I'll assume that the virus will halt at around 20% of the total population.
For Italy, with a population of 60M people, that's 12 million infected, equivalent to 2.4 million confirmed cases, 240K in intensive care, and 19K dead.
But I lied.
I lied when I said "240K in intensive care". There just aren't that many beds, or intubation kits, or CPAP machines, or even oxygen masks. There aren't anywhere near enough doctors, or nurses, or any resource you care to name. I know this to be true because all of these things have run out already.
Long before the exponential curve starts to "slow down" and become logistic, the entire medical infrastructure becomes overwhelmed and the cases that "would survive with intensive care" turn into "deaths".
Worse, this happened at a "confirmed case count" of about 10K. I said 2.4M above!
The conclusion is that the Coronavirus can overwhelm medical systems waaaaaaay before it hits the "knee of the logistic curve", making it a nearly pure exponential curve. Exacerbating this is the incubation time, meaning that any measure taken today will have essentially no effect for at least a week.
Act now and save lives, act tomorrow and see your loved ones die.
This is the difference.
3blue1brown explains it quite well, and I recommend everyone watch his video: https://www.youtube.com/watch?v=Kas0tIxDvrg
The flu and the common cold virus behave comparably to the current pandemic. The flu in particular kills about 300K per year after infecting about 20% of the global population. That's a mortality rate of 0.02% and a survival rate of 99.98% for the general population, which is not a fun statistic, but nothing to panic about either.
Critically, the hospitalisation rates for the flu are so low that the current infrastructure can handle it. People still die, but only if they couldn't be saved with medical intervention. Much of the time they will receive treatment and live.
Even if you shift the numbers around a lot -- say, 50% infection rate -- the orders of magnitude come out to about the same. Governments can just put out ad campaigns to encourage people to get the flu vaccine to compensate for a particularly bad flu season.
The critical thing with the cold and the flu is that they move well past the initial exponential growth phase into a "logistic curve" long before the hospital systems become overloaded with the sick. That is, each new strain of the flu runs out of victims by hitting the population ceiling of 7.6 billion. Not everyone is vulnerable, and the rest either become immune or protected by herd immunity.
Now compare this to the Coronavirus. It has a mortality rate of about 0.8% of confirmed cases, with medical care. Much more importantly, about 10% of the confirmed cases required intensive care.
Nobody really knows the ratio of confirmed-to-real cases, but I'll be generous and assume that only 20% of all cases get a confirmed diagnosis, with 80% of cases just shrugging it off as a case of the "sniffles". Similarly, I'll assume that the virus will halt at around 20% of the total population.
For Italy, with a population of 60M people, that's 12 million infected, equivalent to 2.4 million confirmed cases, 240K in intensive care, and 19K dead.
But I lied.
I lied when I said "240K in intensive care". There just aren't that many beds, or intubation kits, or CPAP machines, or even oxygen masks. There aren't anywhere near enough doctors, or nurses, or any resource you care to name. I know this to be true because all of these things have run out already.
Long before the exponential curve starts to "slow down" and become logistic, the entire medical infrastructure becomes overwhelmed and the cases that "would survive with intensive care" turn into "deaths".
Worse, this happened at a "confirmed case count" of about 10K. I said 2.4M above!
The conclusion is that the Coronavirus can overwhelm medical systems waaaaaaay before it hits the "knee of the logistic curve", making it a nearly pure exponential curve. Exacerbating this is the incubation time, meaning that any measure taken today will have essentially no effect for at least a week.
Act now and save lives, act tomorrow and see your loved ones die.
This is the difference.
3blue1brown explains it quite well, and I recommend everyone watch his video: https://www.youtube.com/watch?v=Kas0tIxDvrg
If they're making this statement based only on the cases they know about, then the argument is even stronger if there are more cases.
There are more cases, they are on average much more mild, the real mortality rate is much lower, it is actually not doubling every two days (it is the tests that are doubling every few days). Lots of possible and very consequential conclusions.
Deaths follow a predictable exponent too.
But with several weeks worth of lag. The number of deaths today should be divided by the number of cases N>10 days ago. The number of cases was much more severely underestimated N days ago than today. The death rate in Italy is basically unknown because the denominator is just noise with a time lag.
As someone who's dealing with analytics data regularely, thank you !
i absolutely don't understand how can someone give any ratio about this disease knowing how only the most severe cases got tested ( except in SK), and that the symptoms are almost undistinguisable from the flu.
i absolutely don't understand how can someone give any ratio about this disease knowing how only the most severe cases got tested ( except in SK), and that the symptoms are almost undistinguisable from the flu.
It simply must be much more dangerous than the flu for the simple reason that comparatively few people have it and it is overwhelming hospitals.
i wonder if it's really true that "few people" have it. We do observe a huge amount of people going to the hospital in italy, but that could very well be because we reached the peak of the epidemie, where almost all of the population have been infected and remain asymptomatic.
in this hypothesis, you implement a lockdown and see number drops over two week but what you're really seing is a population reaching herd immunity.
When we are getting close to the peak of the epidemic, the growth will no longer be exponential, but close to linear. A logistic curve looks exponential for about the first 3rd, close to linear for the second third, and then approaching the asymptote with a negative exponential growth for the last third.
Increasing social distancing will naturally lower the exponential growth rate, but unless the growth becomes linear, there is no reason to believe that herd immunity is anywhere close.
In the asian countries, we more or less know that they have been able to contain the virus, instead of waiting for herd immunity. That meanst that they must have found most of the infected cases (or at least quaranteened them). This gives a good indication of how many deaths are caused by a given number of infected. The numbers are not different enough from Italy to think that more than (at most) a couple of hundred thousand in Italy have reached immunity. If so, it means that we have about 2 more orders of magnitude of growth before herd immunity can be reached. That would be hundreds of thousands of dead, if not millions, just in Italy.
Increasing social distancing will naturally lower the exponential growth rate, but unless the growth becomes linear, there is no reason to believe that herd immunity is anywhere close.
In the asian countries, we more or less know that they have been able to contain the virus, instead of waiting for herd immunity. That meanst that they must have found most of the infected cases (or at least quaranteened them). This gives a good indication of how many deaths are caused by a given number of infected. The numbers are not different enough from Italy to think that more than (at most) a couple of hundred thousand in Italy have reached immunity. If so, it means that we have about 2 more orders of magnitude of growth before herd immunity can be reached. That would be hundreds of thousands of dead, if not millions, just in Italy.
That would be for a homogeneous spread inside a country.
However if the epidemic spreads from region to region, you could reach a local herd immunity in the first regions infected way before seing the country-wide curve becoming linear.
But thanks, trying to find a counter-argument to your post made me realize a single-curve model probably doesn't make a lot of sense to try and understand accurately the spread of an epidemic.
However if the epidemic spreads from region to region, you could reach a local herd immunity in the first regions infected way before seing the country-wide curve becoming linear.
But thanks, trying to find a counter-argument to your post made me realize a single-curve model probably doesn't make a lot of sense to try and understand accurately the spread of an epidemic.
There aren’t large numbers of random people testing positive for it where they’ve done wide spread testing. Korea in particular probably has close to an accurate count, and their mortality rate is still close to 1%
Because differences in testing methodology are a constant factor, which doesn't mean shit to an exponential function.
What do you think of the practice of only testing people who need hospital-level care and people who had contact with confirmed covid-19 patients (and people who traveled to at risk regions)?
I would think that this can only give you the infected from a few clusters and you can be surprised by an unknown cluster of patients suddenly needing intensive care.
Edit: And due to the long incubation period, that cluster can be quite large.
I would think that this can only give you the infected from a few clusters and you can be surprised by an unknown cluster of patients suddenly needing intensive care.
Edit: And due to the long incubation period, that cluster can be quite large.
Testing the entire population is not viable. If you don't have many in-country cases, you can delay the epidemics arrival by controlling just the people that come from elsewhere.
Of course, after the disease starts propagating internally, testing becomes irrelevant, and it's time to reduce its spreading speed.
Of course, after the disease starts propagating internally, testing becomes irrelevant, and it's time to reduce its spreading speed.
I work as Principal ML Engineer, and did a little epidemic modeling in my ML PhD.
I wrote an analysis of how this is going to hit Ireland, including the best calculations I could find on fatality rate:
https://medium.com/@fergal.reid/predicting-the-impact-of-cor...
I think that left unchecked this could kill millions of Americans in a couple of months. I'd love to be wrong.
I wrote an analysis of how this is going to hit Ireland, including the best calculations I could find on fatality rate:
https://medium.com/@fergal.reid/predicting-the-impact-of-cor...
I think that left unchecked this could kill millions of Americans in a couple of months. I'd love to be wrong.
For people who don’t find that clear enough, here’s a bloke comparing the obits in L’Eco Di Bergamo between Feb 9 and Mar 13: https://twitter.com/benphillips76/status/1238854071509016577
February 9 is 1 1/2 pages.
March 13 is 10 full pages.
February 9 is 1 1/2 pages.
March 13 is 10 full pages.
>If that trajectory persists, and we don’t arrest it, in the 2 weeks closest to peak rate, we’ll have seen 75% of our cases emerge.
vs
>in a couple of months.
Why months? If there are 75% of the cases within 2 weeks, won't 75% of the deaths also occur within 2 weeks?
vs
>in a couple of months.
Why months? If there are 75% of the cases within 2 weeks, won't 75% of the deaths also occur within 2 weeks?
It says in the two weeks closest to peak rate. So if the peak is mid-May, those 75% would all fall in May.
I thought that was an excellent analysis. Thank you.
Maybe Italy is a worst case, both because it didn't quarantine early enough, and because greater population inversion.
> It's now a well-established fact that older people and those with underlying health issues are more susceptible to succumbing to Covid-19. With 23 percent Italians aged 65 or above and a median age of 47.3, the Italian population is the oldest in Europe. This is chiefly responsible for the high fatality rate in Italy.[0]
Also these articles.[1,2] And similar to the age effect in China.
0) https://www.ibtimes.sg/fatality-rate-7-16-why-coronavirus-de...
1) https://nypost.com/2020/03/12/heres-why-the-coronavirus-deat...
2) https://www.theguardian.com/world/2020/mar/03/italy-elderly-...
> It's now a well-established fact that older people and those with underlying health issues are more susceptible to succumbing to Covid-19. With 23 percent Italians aged 65 or above and a median age of 47.3, the Italian population is the oldest in Europe. This is chiefly responsible for the high fatality rate in Italy.[0]
Also these articles.[1,2] And similar to the age effect in China.
0) https://www.ibtimes.sg/fatality-rate-7-16-why-coronavirus-de...
1) https://nypost.com/2020/03/12/heres-why-the-coronavirus-deat...
2) https://www.theguardian.com/world/2020/mar/03/italy-elderly-...
Italy isn't the worst case, they're just 2 weeks' ahead of most other countries.
Looking at the latest SitRep from WHO, my home country (Sweden) has small no. infected (775), but grew 25% vs the previous day. If that rate keeps up, number of infected will keep on doubling every 4-5 days and in 14 days' time will be at what Italy is today (17k infected). And then another week later it'll break 100k. Exponential growth is a bastard in that sense.
Looking at the latest SitRep from WHO, my home country (Sweden) has small no. infected (775), but grew 25% vs the previous day. If that rate keeps up, number of infected will keep on doubling every 4-5 days and in 14 days' time will be at what Italy is today (17k infected). And then another week later it'll break 100k. Exponential growth is a bastard in that sense.
In Sweden we've avoided testing people who haven't been in high risk areas, and moved from that to only testing 'risk groups' (elderly and with preexisting conditions), so the numbers shouldn't be seen as reflective of the total number of infected.
Isn't Sweden itself a risk area? Looking at cases per 1M population [1], Sweden is at no 10, and its neighbors Norway and Denmark are at 2 and 6.
How come there are so many cases per capita? All the neighboring regions like Poland, Russia and even the North of Germany, have fewer cases.
[1] https://www.worldometers.info/coronavirus/#countries
How come there are so many cases per capita? All the neighboring regions like Poland, Russia and even the North of Germany, have fewer cases.
[1] https://www.worldometers.info/coronavirus/#countries
Sweden, like the UK and possibly the Netherlands has chosen to let the disease spread among the population to achieve what they call "herd immunity" [1 - Swedish]. There might be some truth to the herd immunity thought, the problem is they don't have any control over the speed at which the infection will spread through society. Eventually everyone who can be infected will get infected no matter what is done so that herd immunity will also occur in a situation where the spread is limited by isolation as is done in most other countries. In other words, herd immunity is a given outcome of all approaches and as such does not need to be stated as a goal. The goal should be to limit the load on the health care system so as to limit the number of people who will die in the wake of reverse triage in an overloaded system.
In short, the stated goal will always be achieved so it is a variable which can be struck from the equation. Having this as a goal is the equivalent of not having any goal at all.
[1] https://www.expressen.se/nyheter/strategin-lat-manga-smittas...
In short, the stated goal will always be achieved so it is a variable which can be struck from the equation. Having this as a goal is the equivalent of not having any goal at all.
[1] https://www.expressen.se/nyheter/strategin-lat-manga-smittas...
Note that it's only the opinion of someone that Sweden is following the "herd immunity" strategy, and it's denied by several officials.
Sweden hasn't closed down schools etc like other countries have done so it's fair to argue that it's being done in practice, but it doesn't seem to be a conscious decision.
Sweden hasn't closed down schools etc like other countries have done so it's fair to argue that it's being done in practice, but it doesn't seem to be a conscious decision.
Statsepidemiolog Anders Tegnell säger att resonemanget om flockimmunitet ”delvis” stämmer, men att det inte är myndighetens strategi. – Vårt huvudsyfte nu är att få smittspridningen att gå så långsamt som möjligt.
...which translates to...
State epidemiologist Anders Tegnell says the reasoning around herd immunity is partly correct but that it is not the organisation's strategy - our main goal now is to get the infection to spread as slow as possible
...but the Swedish government is not actually doing much to limit the spread of the disease other than telling people who show symptoms to stay at home. By now it has mostly been proven that infected people spread the infection for a few days before they show symptoms and the fact that children can be and often seem to be asymptomatic carriers the spread will be rapid and result in a large number of people in need of medical care. The Swedish health care system was already overloaded before the pandemic so it will not be able to handle a large number of patients in need of critical care. The same scenario is now playing out in Italy so this should not come as a surprise.
...which translates to...
State epidemiologist Anders Tegnell says the reasoning around herd immunity is partly correct but that it is not the organisation's strategy - our main goal now is to get the infection to spread as slow as possible
...but the Swedish government is not actually doing much to limit the spread of the disease other than telling people who show symptoms to stay at home. By now it has mostly been proven that infected people spread the infection for a few days before they show symptoms and the fact that children can be and often seem to be asymptomatic carriers the spread will be rapid and result in a large number of people in need of medical care. The Swedish health care system was already overloaded before the pandemic so it will not be able to handle a large number of patients in need of critical care. The same scenario is now playing out in Italy so this should not come as a surprise.
This isn't exactly the stated goal of the UK, so much as something our government has concluded is the inevitable outcome no matter what they do. The goal is the one you suggest - to limit the load on the healthcare system and the number of people who die as a result.
Likely because we travel more and have more tourists in the Nordic.
For Denmark we actually seeded our Corona spread by bringing home hundreds of infected (it turned out) from ski vacation in Italy and Austria (265 from Austria alone) and not putting them in quarantine.
For Denmark we actually seeded our Corona spread by bringing home hundreds of infected (it turned out) from ski vacation in Italy and Austria (265 from Austria alone) and not putting them in quarantine.
I had the same worries for Greece when in just two days recorded cases doubled from 100 to 200, but since the government imposed partial lockdown measures the rate of infections slowed down significantly. My guess is the same will happen everywhere. It's just that it's easier to see the growth slowing when you have an order of magnitude less incidents than Italy. We have to trust the process.
> but since the government imposed partial lockdown measures the rate of infections slowed down significantly.
They shouldn't have; what you're seeing is noise. There's a lag of roughly two weeks between when a person is infected and when they'll get caught by a test, so any benefits of the current lockdown will only be visible close to end of March.
They shouldn't have; what you're seeing is noise. There's a lag of roughly two weeks between when a person is infected and when they'll get caught by a test, so any benefits of the current lockdown will only be visible close to end of March.
> but grew 25% vs the previous day. If that rate keeps up, number of infected will keep on doubling every 4-5 days
1.25^3 ≈ 2 so the doubling period for 25% growth would be closer to 3 days.
1.25^3 ≈ 2 so the doubling period for 25% growth would be closer to 3 days.
Italy may be a worst case, but we haven't seen the worst from it yet.
what's the source for italy being the oldest country? As of 2018 Germany was the oldest in the EU and their crude mortality ratio is among the lowest so far.
https://worldpopulationreview.com/countries/median-age/
https://worldpopulationreview.com/countries/median-age/
That figure may be “% of population >= 85 years old”, where Italy does lead the EU. See p21 in this report [1] from Eurostat for a breakdown by country. About 3.45% of Italy is at least 85, compared to about 2.75 for Germany. That’s about 40% higher.
So Italy is older in the sense of “more people who are very old”. But you are right that the mortality difference so far is not explained entirely by this gap.
It may be informative to watch how this evolves in Greece, and to a greater extent (due to more infection before a lockdown) France and Spain. Those are the next oldest countries in the EU by this measure, and all are well above 3%.
[1] https://ec.europa.eu/eurostat/documents/3217494/10166544/KS-...
So Italy is older in the sense of “more people who are very old”. But you are right that the mortality difference so far is not explained entirely by this gap.
It may be informative to watch how this evolves in Greece, and to a greater extent (due to more infection before a lockdown) France and Spain. Those are the next oldest countries in the EU by this measure, and all are well above 3%.
[1] https://ec.europa.eu/eurostat/documents/3217494/10166544/KS-...
and it doesn't help that italians have a tradition of kissing each other on the cheek, twice, when they meet
On the other hand, Italy has very good food hygiene standards, as anyone who has been told off for touching the fruit and veg in the grocers can tell you. You never have a shop assistant handle money and then touch food, which you see all the time in the UK/US
"Everything we do before a pandemic will seem alarmist. Everything we do after will seem inadequate." - Michael Leavitt, former HHS Secretary under President George W. Bussh
My co-founder and I are really struggling with the decisions ahead of us. We feel we should act quickly, and enforce our team to work from home, but the spread in our city is quite low for now. We also wonder how long this can go on, are we going to be isolated for months?
We are at a critical point where we have just closed our seed round this past week. We have both put so much energy and time into this moment and we were ready to work harder and focus on scaling and growth.
Of course, the more tragic situation around us makes our issues seem small. I think we will likely announce to our team to work from home starting Monday. How surreal.
We are at a critical point where we have just closed our seed round this past week. We have both put so much energy and time into this moment and we were ready to work harder and focus on scaling and growth.
Of course, the more tragic situation around us makes our issues seem small. I think we will likely announce to our team to work from home starting Monday. How surreal.
Here's what Paul Graham wrote on twitter:
> When you're dealing with exponential growth, the time to act is when it feels too early.
https://twitter.com/paulg/status/1237801364023017472
> When you're dealing with exponential growth, the time to act is when it feels too early.
https://twitter.com/paulg/status/1237801364023017472
This is one of those times where it gets bad so quickly by the time you're starting to respond it's too late.
> the spread in our city is quite low for now
If you’re in the United States, where testing has been infuriatingly limited, the fact of the matter is you have no idea what the spread in your community is. The numbers aren’t low because nobody has the virus, they’re low because nobody has been tested. If we did actual testing, they might come in low or they might come in high, who knows. As it stands, nobody has any real idea just how bad the spread is here. Absence of evidence is not evidence of absence.
Given that, the safest course is to assume the spread is high, and act accordingly.
If you’re in the United States, where testing has been infuriatingly limited, the fact of the matter is you have no idea what the spread in your community is. The numbers aren’t low because nobody has the virus, they’re low because nobody has been tested. If we did actual testing, they might come in low or they might come in high, who knows. As it stands, nobody has any real idea just how bad the spread is here. Absence of evidence is not evidence of absence.
Given that, the safest course is to assume the spread is high, and act accordingly.
The state of Ohio has only 26 confirmed cases, but two days ago the Director of the Ohio Department of Health estimated that 1% of the state's population (100k) may be infected due to the high ratio of cases being community-spread [1].
This is the likely reason for such a high number of celebrities in the news testing positive -- it's already everywhere; they are the only ones getting tested.
[1] https://www.wkyc.com/article/news/health/coronavirus/ohio-de...
This is the likely reason for such a high number of celebrities in the news testing positive -- it's already everywhere; they are the only ones getting tested.
[1] https://www.wkyc.com/article/news/health/coronavirus/ohio-de...
Not to downplay things, but celebrities may also be more likely to get it because they travel a lot and are in close contact with a lot of other people who also travel a lot.
That 100k number is for the whole world. It was a poorly worded tweet
She said it out loud. There's nothing confusing or ambiguous about it.
https://www.washingtonexaminer.com/news/top-ohio-health-offi...
Actually we do know one number :the total number of people in ICU is normal for this time of year. There are a handful of confirmed cases (I'm not sure if they are in ICU), but the total number of cases is still low.
It is hindsight, but expontial grow means that despite not testing we didn't have a problem two months ago. Maybe we should have been in lock down a week ago, but anything sooner would be overreacting and not necessary. Most of the US is on lock down now which seems like about the right time to start. No more than a week sooner can be seriously argued.
It is hindsight, but expontial grow means that despite not testing we didn't have a problem two months ago. Maybe we should have been in lock down a week ago, but anything sooner would be overreacting and not necessary. Most of the US is on lock down now which seems like about the right time to start. No more than a week sooner can be seriously argued.
It takes about 7 days after developing symptoms for the hospitalized cases to come in.
Most people who get sick think its a normal cold. They stay at home for a week, and when they can barely breath anymore, they finally enter the emergency room.
Most people who get sick think its a normal cold. They stay at home for a week, and when they can barely breath anymore, they finally enter the emergency room.
Exactly. 2 weeks ago this was a worry but not significant as evidence by current ICU fill rates. Expect Washington, hopefully the rest of the country doesn't follow
Business and money is one thing. Money comes and goes, for the most part. Employees, their health and relationship with your company are a whole different matter.
If you make everyone work from home, you'll end up with a temporary loss in productivity (thus money, which again comes and goes). Even if one of them does get infected anyway, they won't spread it to the rest of the team. The relationship with your employees is preserved because you're not forcing them to take risks.
If you force them to work in the office, it's just a matter of time before all of them get sick. The productivity will drop to zero, yet you'll still have to pay them sick leave and their opinion of your company will be tainted forever because you and your greed are the reason they are now all sick.
Not to mention, this is all assuming your employees are relatively young and have no pre-existing medical conditions that would make the infection life-threatening. Otherwise, we're not just talking about relationships but actual lives being put at risk.
If you make everyone work from home, you'll end up with a temporary loss in productivity (thus money, which again comes and goes). Even if one of them does get infected anyway, they won't spread it to the rest of the team. The relationship with your employees is preserved because you're not forcing them to take risks.
If you force them to work in the office, it's just a matter of time before all of them get sick. The productivity will drop to zero, yet you'll still have to pay them sick leave and their opinion of your company will be tainted forever because you and your greed are the reason they are now all sick.
Not to mention, this is all assuming your employees are relatively young and have no pre-existing medical conditions that would make the infection life-threatening. Otherwise, we're not just talking about relationships but actual lives being put at risk.
WFH. Do it now. Individual actions have outsized impact in the face of exponential growth.
The problem is twice as hard every time the number of cases doubles. If you don't want to work from home for many months, start working from home now.
Working from home isn't as bad as it seems. Modern collaboration tools are great. Our research group and wider laboratory have gotten into the swing of things within a week.
The problem is twice as hard every time the number of cases doubles. If you don't want to work from home for many months, start working from home now.
Working from home isn't as bad as it seems. Modern collaboration tools are great. Our research group and wider laboratory have gotten into the swing of things within a week.
> Individual actions have outsized impact in the face of exponential growth.
Are you sure? I think it's the other way around. Nothing I can do (apart from staying completely indoors, which I can't because I don't have enough supplies (food, etc.) to last for months) can prevent me from being infected (eventually). Luckily I'm in the low-risk group (young); I advised my parents the latter (hopefully they're following my advice).
Are you sure? I think it's the other way around. Nothing I can do (apart from staying completely indoors, which I can't because I don't have enough supplies (food, etc.) to last for months) can prevent me from being infected (eventually). Luckily I'm in the low-risk group (young); I advised my parents the latter (hopefully they're following my advice).
The combined actions of individuals counts. You alone don't mean much (but if you happen to be the one who needs ICU care it matters to you), but when you and a million others avoid going out for anything other than groceries (washing hands well after that trip) there are many less opportunities for this to spread.
Obviously there are a lot of people required to get groceries to you, but if you are not in medicine or groceries stay home. That is a large supply chain but sti tiny and even those people are not going to other functions which reduces risk
Obviously there are a lot of people required to get groceries to you, but if you are not in medicine or groceries stay home. That is a large supply chain but sti tiny and even those people are not going to other functions which reduces risk
[deleted]
If working from home is an option, then you should absolutely make everyone work from home. Not let, make.
The spread may appear low in your city, but how much of that is from lack of testing? If your employees can work from home, it is best for you to implement work from home ASAP.
Businesses in Washington State have shuttered or gone to work from home over the last 3 weeks, had most businesses made this change earlier(eg: at the beginning of those 3 weeks) we would see much less spread and quicker easing of restrictions.
Is Alberta doing widespread Covid-19 testing yet? We had cases of teens with no international travel getting Covid-19 in February according to the Seattle Flu Study, there are likely more cases in Edmonton that exhibit minimal symptoms currently.
Seattle Flu Study: https://www.nytimes.com/2020/03/10/us/coronavirus-testing-de...
Businesses in Washington State have shuttered or gone to work from home over the last 3 weeks, had most businesses made this change earlier(eg: at the beginning of those 3 weeks) we would see much less spread and quicker easing of restrictions.
Is Alberta doing widespread Covid-19 testing yet? We had cases of teens with no international travel getting Covid-19 in February according to the Seattle Flu Study, there are likely more cases in Edmonton that exhibit minimal symptoms currently.
Seattle Flu Study: https://www.nytimes.com/2020/03/10/us/coronavirus-testing-de...
Alberta has been testing at 1800 / million (7100 tests). For context when the US was at our point they were at 5 / million.
I was looking at the numbers for today (because I was curious about the U of A which has gone fully remote for course and exam delivery). There's a model in here https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop... that you can plug numbers into. I would say work from home though, you'll feel absolutely devastated if one of your employees falls ill and you were the cause. Trust them to do their work remotely and they will reward that trust.
Hospital ICU units are not overwhelmed which puts a limit to total infections. (unless this is now less deadly I guess, an unlike win though)
> "Hospital ICU units are not overwhelmed which puts a limit to total infections."
I wouldn't say that; reports coming out of Seattle look pretty grim.
"...Reports from the Seattle area, the epicenter of the U.S. outbreak, indicate that some of the city’s hospitals are nearly overwhelmed. One hospital’s note to staff, shared with New York Times columnist Nicholas Kristof, says the “local COVID-19 trajectory is likely to be similar to that of Northern Italy.” The hospital is down to a four-day supply of gloves..."
https://www.statnews.com/2020/03/14/coronavirus-hospital-wor...
I wouldn't say that; reports coming out of Seattle look pretty grim.
"...Reports from the Seattle area, the epicenter of the U.S. outbreak, indicate that some of the city’s hospitals are nearly overwhelmed. One hospital’s note to staff, shared with New York Times columnist Nicholas Kristof, says the “local COVID-19 trajectory is likely to be similar to that of Northern Italy.” The hospital is down to a four-day supply of gloves..."
https://www.statnews.com/2020/03/14/coronavirus-hospital-wor...
Definitely do it. Way more people are already infected than we know. You can be proactive or reactive, and if you’re reacting it’s already too late.
As a data point: my company liberalized work from home to every employee a week before the first case was detected in our state, under the assumption that it was either already here and just hadn't been discovered in testing yet, or would be very shortly.
When the first case was detected, the office was closed and work from home became mandatory at least through the beginning of April.
When the first case was detected, the office was closed and work from home became mandatory at least through the beginning of April.
Why not work from home? Are your employees not able to get their job done remotely?
The right thing to do from every perspective is close your office. If any of your employees is has a risk factor and dies of covid you will spend the rest of your life wondering if you could have prevented it - trust me I know.
The right thing to do from every perspective is close your office. If any of your employees is has a risk factor and dies of covid you will spend the rest of your life wondering if you could have prevented it - trust me I know.
We went ahead and have all employees working remote for at least the next week and we will be evaluating the situation each week. I struggle with this decision as well feeling like maybe this is an overreaction but the reality is we should be able to function remotely and if doing so can help then we should do it. I’m optimistic our actions will help slow the spread
Here is a great breakdown of the curves and the risks[1]. Scroll to the heading "Risk-based model" or go directly to the spreadsheet[2]. Fill in the numbers for your area.
[1] https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
[2] https://docs.google.com/spreadsheets/u/1/d/17YyCmjb2Z2QwMiRR...
[1] https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
[2] https://docs.google.com/spreadsheets/u/1/d/17YyCmjb2Z2QwMiRR...
Our Singapore office started working from home at beginning of Feb. Everyone in the office here (10 people) have very very young kids, or is pregnant. Don’t want anyone in the team getting sick and making their kids sick. Family is always more important than work. So everyone is working from home till this thing blows over.
In discussing similar issues around this crisis, I noticed that "Things that seem extreme today will, in just a few days, seem obvious, under-done, and late."
Thinking of the cancelation of the NBA season an how Mark Cuban's response was thar it seemed "crazy" and "surreal". Now, it seems obvious and late.
Don't wait - tell everyone now to work from home, prep like mad, and isolate hard.
The damage will be far less than anyone getting it. You'll also get down that critical learning curve far faster.
Congratulations, Good luck, stay well.
Thinking of the cancelation of the NBA season an how Mark Cuban's response was thar it seemed "crazy" and "surreal". Now, it seems obvious and late.
Don't wait - tell everyone now to work from home, prep like mad, and isolate hard.
The damage will be far less than anyone getting it. You'll also get down that critical learning curve far faster.
Congratulations, Good luck, stay well.
Imo (and free advice is best left unheeded): Better that you miss out on this opportunity and get to keep your IP and try again than risk you and your employees contracting a severe respritory illness.
People will understand disruptions due to Covid. It's not business as normal. Google told the entire north american staff to stay home. Be glad that you can still all be relatively productive while remote, and enjoy your runway while you don't have to pay for the lights in your offices.
People will understand disruptions due to Covid. It's not business as normal. Google told the entire north american staff to stay home. Be glad that you can still all be relatively productive while remote, and enjoy your runway while you don't have to pay for the lights in your offices.
Maybe to put a more positive spin on it: the sooner you act the more leeway you have. Better that you realize now that someone has to come in and install a remote power switch on some server. In a week it might be a bit harder to ask someone to shoot over to BestBuy and pick it up. The same goes for your workers: they might appreciate some time to set up their home office.
Exponential growth means employee expectations will go from "completely safe at work" to "don't leave home except for food" pretty fast. You don't want to be that guy who asks employees to violate the (possibly government imposed) lock down to keep the lights on.
Exponential growth means employee expectations will go from "completely safe at work" to "don't leave home except for food" pretty fast. You don't want to be that guy who asks employees to violate the (possibly government imposed) lock down to keep the lights on.
what if you wait and your employees get sick? if you're in tech, just implement a work from home policy right now. don't wait for the gov to do so. it's a matter of time. - a French
I'm in the same position. More than a week ago I wrote an all-hands email to ensure that people realize that if they can work from home they should work from home and that we'd never force them to travel or be in the office if they do not want to and do not feel that it is in their best interest to do so. And of course it goes without saying that any indication of cold or flu like symptoms should cause someone to stay home.
As a co-founder/CEO of any company your first responsibility is for the health of your employees and those that depend on them. If you play games with that then you should not be in a leadership position to begin with.
Here is the full text of our email, feel free to C&P:
As a co-founder/CEO of any company your first responsibility is for the health of your employees and those that depend on them. If you play games with that then you should not be in a leadership position to begin with.
Here is the full text of our email, feel free to C&P:
As you are no doubt aware there is a virus on the loose
and it isn't pretty.
The better ways to acquire it are to spend some time with
a bunch of total strangers in close confinement sharing
each others air. This includes all forms of public
transport.
These are exceptional (hopefully!) circumstances and I want to
make several things perfectly clear:
(1) You do not have to travel if you do not want to,
there is no obligation to participate in any of
the jobs in the next coming weeks/months and
not participating will *never* be held against
you in any form. You may opt to participate
remotely instead of on-site without financial
penalty.
(2) If you do travel, please take all precautions
possible to avoid getting ill, I'd really hate
myself if it turns out that we caused people to
fall ill (or worse) on account of the work we do,
your health comes first, always.
(3) There is a lot of misinformation going around,
some of it - unfortunately - spread by authorities
that really should know better. The current figures
are - to the best of my knowledge - 2-3% mortality
rate and an R0 (the rate at which the disease
spreads) of about 3. This makes this virus between
20 and 90 times more dangerous than the seasonal
flu, which has a .1% mortality rate and an R0 of
about 0.7-1.
(4) If you decide to participate but not in person
then we should enable video conferencing to do some
of the interviews, these should focus on the people
lower in the food chain at the companies we look at.
Please let us know your preference in time, talk to
Marco to ensure he is aware of what will happen so
that we can communicate it to the customers and the
targets alike.
(5) The virus outbreak is still in its early days, the
situation is *extremely* fluid, and you should make
an effort to stay informed and adapt your plans
immediately if you feel the situation warrants it.
Please do communicate any such changes.
Best regards, and please stay safe,
Our employees have always had the choice to work from home. Many just prefer to come to the office, no one has yet opted to work from home full time. The choice we were struggling with (until being shaken up in this thread), was whether to make it mandatory.
[deleted]
Are you kidding?
You should have implemented WoH weeks ago. Thinking whether or not doing it now is a disservice to all humanity and a testament of why we have reached this situation as a society.
You should have implemented WoH weeks ago. Thinking whether or not doing it now is a disservice to all humanity and a testament of why we have reached this situation as a society.
The first case only just made its way to our city a couple of days ago. We have been rather distracted of course by getting signatures and cheques. For context, our schools and daycares are still open, as are city rec centers, gyms, and public transit. Only yesterday did the province recommend no gatherings over 250 people. Perhaps we should have been quicker, but here we are.
Only 150 cases in AU at the time Tom Hanks and Rita Wilson got it. Only a thousand in the US when two NBA players got it. Only 150 in Canada when the Prime Minister's wife got it. Only 150 cases in Brazil when the press secretary got it.
These people certainly have more exposure to other humans than most people do. But not so much that they should be making up whole percentages of the infected population. I believe they are just well connected and wealthy and it's easier for them to get tested.
You can't have confirmed cases without testing. I've come to believe these confirmed case numbers may be having a negative effect on our understanding of the situation.
These people certainly have more exposure to other humans than most people do. But not so much that they should be making up whole percentages of the infected population. I believe they are just well connected and wealthy and it's easier for them to get tested.
You can't have confirmed cases without testing. I've come to believe these confirmed case numbers may be having a negative effect on our understanding of the situation.
There are two sides of that coin.
One side: it's much more widespread than we realize.
Other side: it's much more mild and less fatal than we first thought.
One side: it's much more widespread than we realize.
Other side: it's much more mild and less fatal than we first thought.
A third side is a majority of the infections are still early stage, as was the case in Italy a couple weeks ago.
At the Friday press conference, they said that the LabCorp / LabQuest tests were testing about 2% positive. I don't have much of an insight to this, but isn't that weirdly low if it's truly everywhere? Especially if you factor in the limited testing and that testing will only be given to the more urgent high risk cases. 98% are just something else like the cold or the flu, or a false negative.
You’re assuming all deaths caused by Coronavirus are correctly identified as such. Sadly that’s almost guaranteed to not be the case.
[deleted]
The fatality number is irrelevant. We know it overwhelms health systems, and there's no ICU capacity to handle it.
That's all you need tk knoe.
That's all you need tk knoe.
> The first case only just made its way to our city a couple of days ago.
The first tested case. Given the delay between onset and diagnosis, + amounts of tests being actually done, + the couple days you mention, you may as well have over a thousand infected people in your city now, and you won't know until a) more tests start being made, or b) some of these people will start getting hospitalized in the next couple of days.
The first tested case. Given the delay between onset and diagnosis, + amounts of tests being actually done, + the couple days you mention, you may as well have over a thousand infected people in your city now, and you won't know until a) more tests start being made, or b) some of these people will start getting hospitalized in the next couple of days.
I am just super curious. Do your startup employees need physical infrastructure or deal with super confidential data that require them to be on site?
Do you not trust them the employees to work their part on their own?
Do you not trust them the employees to work their part on their own?
They can work from home. But I'm learning from this thread, that being in a rather northern location where no one in the entire city has started working from home is not the norm. Again, it was only yesterday that the government gave any official guidance on travel or gatherings of people.
For so many reasons, selfish and not, you should target being ‘ahead of the curve’. Your government is not the oracle here. Later, you’ll be happy you acted earlier than others.
Move your employees to WFH now.
Ensure you all have the infrastructure at home to support being as effective as possible.
Move your employees to WFH now.
Ensure you all have the infrastructure at home to support being as effective as possible.
We have let everyone know they must start working from home, and we are purchasing proper audio equipment for our employees. This thread acted as a wake-up call. I fully admit we have had our head down. I have been dismissive in the middle of raising a seed round while running a company of 20 employees, with two very active boys at home. I have had no time to stay up to date on the world, and the general lack of action around me made me feel that it was something we had time to get to later. That is no excuse, only an explanation. I do sincerely hope that nothing negative comes out of our actions.
If your government gave no official guidance at all, then you would do nothing.
If other companies did nothing, then you would do nothing.
Interesting. Entrepreneurs are usually way more forward thinking.
If other companies did nothing, then you would do nothing.
Interesting. Entrepreneurs are usually way more forward thinking.
Perhaps the difference is cultural. In my country we place a lot of confidence in the government and public health care system. We have been tested more in our province of <4 million than the entire US (x2). Additionally, we do not live in constant state of fear, we are comfortable, perhaps to our detriment in this situation, I fully admit.
VectorLock(1)
Here in France even with the Italian experience relayed in the press, i.e doctors having to make many times a day a choices between the ones who will live or die, many people don't take it seriously.
I am shocked but not surprised by the behavior of my fellow citizens. Many people still went out shopping, went to the restaurants, still think it is a simple seasonal flu and do not at all comply with the recommendations of avoiding contacts.
The government decided at last today to close the restaurants and most of the shops except grocery stores and drug stores.
Also I think in France at some point the army will have to be called to help, to let policemen enforce the rules and be used to secure sensitive sites. With the periodic social unrest that France endures since the last major "ethnic" riots of 2005 and the more recent and more social yellow vest protests, I am afraid that in France there will be also a lot of indirect deaths of the sars-cov-2 pandemic.
I am shocked but not surprised by the behavior of my fellow citizens. Many people still went out shopping, went to the restaurants, still think it is a simple seasonal flu and do not at all comply with the recommendations of avoiding contacts.
The government decided at last today to close the restaurants and most of the shops except grocery stores and drug stores.
Also I think in France at some point the army will have to be called to help, to let policemen enforce the rules and be used to secure sensitive sites. With the periodic social unrest that France endures since the last major "ethnic" riots of 2005 and the more recent and more social yellow vest protests, I am afraid that in France there will be also a lot of indirect deaths of the sars-cov-2 pandemic.
> I am shocked but not surprised by the behavior of my fellow citizens. Many people still went out shopping, went to the restaurants, still think it is a simple seasonal flu and do not at all comply with the recommendations of avoiding contacts.
This is what happened in Italy as well. 1. people are recommended to stay the fuck home and reduce physical interactions 2. most people don't care and carry on with their normal life 3. state now needs to enforce harsh rules because people don't seem to understand that it's serious 4. some people still don't care, go to parks, beaches, private parties
This is what happened in Italy as well. 1. people are recommended to stay the fuck home and reduce physical interactions 2. most people don't care and carry on with their normal life 3. state now needs to enforce harsh rules because people don't seem to understand that it's serious 4. some people still don't care, go to parks, beaches, private parties
"Flattening the Curve" is a deadly delusion
https://medium.com/@joschabach/flattening-the-curve-is-a-dea...
"Flatten the curve" scenario requires r0 to between 1.0 and a small number above 1.0, like 1.1. In other words, it's not happening, you either contain the virus or let it explode.
https://medium.com/@joschabach/flattening-the-curve-is-a-dea...
"Flatten the curve" scenario requires r0 to between 1.0 and a small number above 1.0, like 1.1. In other words, it's not happening, you either contain the virus or let it explode.
This argument doesn't negate the fact that a "flatter curve" means fewer people in hospitals (or turned away from hospitals) at a single time. The fact that we probably can't slow the virus enough to prevent overloading hospitals does NOT mean we should just throw up our hands. For instance it would be better for hospitals to be at double capacity than triple capacity.
It's also somewhat troublesome that for the 'flatten the curve' tactic the best case scenario is still infecting everyone...
No it isn't. The hope is that at some point a vaccine or lighter treatment becomes available. If that occurs before the end of the flat curve, that's a major change in outcome.
Most vaccines take 1.5 to 2 years to develop. By then most of the population will have been infected by it and will develop a natural immunity or resistance to it.
How much difference is there between the r0 value of 2 and that of 3? Maybe we can't flatten the curve to fit it under the threshold, but we can probably reduce the area above it?
Trevor Bedford had a tweet that indicated a 25% reduction in social contacts results in a 50% reduction in cases after 1 month:
https://twitter.com/trvrb/status/1237934525281259521
I think it's very likely that Wuhan or Italy style lockdowns will bring r0 under 1, based on the experience in Wuhan and Italy. That means the disease eventually dies out. Because it's endemic elsewhere in the world, it'll eventually be reintroduced and we get multiple waves, until eventually enough people have had it to generate herd immunity. But each wave starts back at the "containment" phase, with contact tracing and individual isolation, so combining lockdown + those measures + travel restrictions could probably buy enough time for a vaccine.
https://twitter.com/trvrb/status/1237934525281259521
I think it's very likely that Wuhan or Italy style lockdowns will bring r0 under 1, based on the experience in Wuhan and Italy. That means the disease eventually dies out. Because it's endemic elsewhere in the world, it'll eventually be reintroduced and we get multiple waves, until eventually enough people have had it to generate herd immunity. But each wave starts back at the "containment" phase, with contact tracing and individual isolation, so combining lockdown + those measures + travel restrictions could probably buy enough time for a vaccine.
- For how long do you have to keep your containment measures up?
- Do you have to introduce new containment measures with every wave of reinfection?
- How many waves / months of total are required to achieve enough herd immunity while keeping the hospitals within capacity?
- Do you have to introduce new containment measures with every wave of reinfection?
- How many waves / months of total are required to achieve enough herd immunity while keeping the hospitals within capacity?
Presumably the answers to these are:
- Until a vaccine is developed.
- Yes
- Until a vaccine is developed.
- Until a vaccine is developed.
- Yes
- Until a vaccine is developed.
Says some guy on medium that's not an epidemiologist. Are you one?
Flattening the curve is the only scenario a lot of countries can realistically do outside of a Wuhan style quarantine.
It's certainly effective propoganda to calm the Populus, from the government to the population and the population to itself. Hopefully leaders are sorting out more drastic measures in the meantime.
My attending went on the news to say that flattening the curve is our best bet at the moment. He's also considered to be one of the top physicians in the region. Y'all can sit here in a bubble, but the medical community has no hallucination that containment should have been done months ago and now it's past that.
It's unlikely that other countries can do what China has done. As an example, China is able to do 200 CT scans a day at each fever station throughout the affected regions. In the US we can maybe do what 10 CT scans a day with a single machine? In China they were able to figure out within a short duration if someone needed to be quarantined. They built hospitals in days. It's not just about locking down. China has people taking temperatures of people entering their apartments or when they show up at work. There are drones patrolling the streets that detect people with a high temperature. I have a hard time seeing us in the US build out what China did in just a few days.
Do CT scans even help?
They're an effective diagnostic, faster than testing for the virus directly. At least they seem to be effective at these fever clinics. NYTimes Daily podcast had a good explanation of how these fever clinics work.
It's like artificially inflated GDP numbers from producing bad steel that nobody will buy. It does something, but in the end it's really nothing, and actually quite wasteful.
The last part urges lockdowns like China and South Korea but my understanding is that South Korea has not been doing lockdowns and instead was able to ramp up testing quickly and isolate infected from others. Is that incorrect?
Yes but Western countries are past the point where that is effective.
https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
> The lengths at which it went to contain the virus are mind-boggling. For example, they had up to 1,800 teams of 5 people each tracking every infected person, everybody they got interacted with, then everybody those people interacted with, and isolating the bunch. That’s how they were able to contain the virus across a billion-people country.
> This is not what Western countries have done. And now it’s too late.
https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
> The lengths at which it went to contain the virus are mind-boggling. For example, they had up to 1,800 teams of 5 people each tracking every infected person, everybody they got interacted with, then everybody those people interacted with, and isolating the bunch. That’s how they were able to contain the virus across a billion-people country.
> This is not what Western countries have done. And now it’s too late.
Yes no lock downs and I believe minimal travel restrictions (only Wuhan, China?). They did extend the school holidays. Even in the center of the outbreak Daegu there was no lockdown in the city.
Other things people probably don't realise about Korea. Self isolating and monitoring for people entering the country. Also they aggressive tracked contact with infected people. Watching supermarket survalence video seeing who they were near and then publishing nationally the time and location of where they had been
plus everyone is wearing a mask
S. Korea has a very aggressive investigation of movements of infected persons. Once a person is found to be infected, they go through CCTV recordings, cellphone location records, etc and warn people who were in the same location at same time.
They also release to the press the location/time infected person was at, such as name of hospital/events. And these are reported to the public.
So S. Korea does not do a carpet bombing type of lock down as China but more of a surgical strike type of lock down. But it is a lock down.
They also release to the press the location/time infected person was at, such as name of hospital/events. And these are reported to the public.
So S. Korea does not do a carpet bombing type of lock down as China but more of a surgical strike type of lock down. But it is a lock down.
> It’s hard for non-specialists to intuitively grasp the way an exponential rate increase can get out of control.
The best way to explain the exponential growth (and shock people) is ask them about https://en.wikipedia.org/wiki/Wheat_and_chessboard_problem
The best way to explain the exponential growth (and shock people) is ask them about https://en.wikipedia.org/wiki/Wheat_and_chessboard_problem
I like the way a teacher explained it in grade school. She said to imagine we had a choice between two deals. One option is that someone would give us $100 each day for a month. The other is to receive 1 cent the first day, 2 cents the second day, 4 cents on the third day, doubling each day until a month has passed.
Of course we all chose $100/day. Then she told us it was too bad we didn't take the other option, because we would have been multi-billionaires.
Of course we all chose $100/day. Then she told us it was too bad we didn't take the other option, because we would have been multi-billionaires.
Keep in mind that your teacher is wrong (or you remember incorrectly). Given that a month has at most 31 days, 0.01 * 2 ^ 30 = 10 737 418.24 (if you sum up all the payments, double that - $20m), so quite far away from "multi-billionaires". The general principle stands though.
Oh right, of course I forgot to divide by 100. I should have also remembered what my other teacher said: always check your units.
instead of pennies, she probably said $1 the first day, $2 the second, ... and then you would still have chosen the $100 a day, and not become billionaires.
Using max possible days in month gives ~21 million
js:
or since the sum is equal to the next sequential (2 to power of n+1) minus 1 cent => 2^31 - 1 = $21,474,836.47
[...Array(31).keys()]
.map(num => Math.pow(2,num))
.reduce((total,num) => total + num)
/ 100
or since the sum is equal to the next sequential (2 to power of n+1) minus 1 cent => 2^31 - 1 = $21,474,836.47
21m. Not billion yet
Or you could present them with the classic cognitive reflection question: A lake has one lily pad. Every day the number of lily pads doubles. After fifty days the lake is completely covered by lily pads. How many days did it take to cover half the lake with lily pads?
That's a big lake to have room for 1125899906842624 lily pads
Fortunately, it will only require space for 1125899906842623 pads.
Nonsense. Nothing in the real world can impede the progress of endlessly extrapolating exponential growth and impressing your friends with Really Big Numbers.
Is there some parable about getting too excited about exponential growth and taking the extrapolation game way too far?
Zeno concluded that all motion was an illusion, so that's taking things pretty far.
Here in the U.S.A. in Indianapolis, my 60 year old dad is out at a club right now dancing with his old people girlfriends. He is a smart dude (on paper - tenured professor of finance), but he doesn't think he has a thing to worry about.
I hope we get a lock down here. Many people are too selfish, arrogant, and stupid to make the right choices even when it is obvious.
I hope we get a lock down here. Many people are too selfish, arrogant, and stupid to make the right choices even when it is obvious.
I would argue that your father's actions are brutally rational: get the virus now, so he still has a shot at a ventilator before the system is swamped. He could be recovered and immune when the rest of you are figthing over the ICU.
Not exactly neighbourly though.
Not exactly neighbourly though.
Just from the start already i dont get a scientific feeling.
"In just 3 weeks from the beginning of the outbreak, the virus has reached more than 10.000 infected people."
Does this mean only tested 10.000 people? Reads a bit odd though too, i assume they were not infected already when the virus reached them?
"From our data, about 10% of patients require ICU (Intensive Care Unit) or sub ICU assistance and about 5% of patients die."
Is this from 10% of the people actually going to the hospital, or 10% of all tested, or 10% of all people that got the virus?
"In just 3 weeks from the beginning of the outbreak, the virus has reached more than 10.000 infected people."
Does this mean only tested 10.000 people? Reads a bit odd though too, i assume they were not infected already when the virus reached them?
"From our data, about 10% of patients require ICU (Intensive Care Unit) or sub ICU assistance and about 5% of patients die."
Is this from 10% of the people actually going to the hospital, or 10% of all tested, or 10% of all people that got the virus?
Who cares. The point is to get people out of their comfortable complacency.
Read this one: "We are now in the tragic situation that the most efficient health system of the richest area of the country (Lombardy) is almost at its full capacity and will soon be difficult to assist more people with Covid-19."
Read this one: "We are now in the tragic situation that the most efficient health system of the richest area of the country (Lombardy) is almost at its full capacity and will soon be difficult to assist more people with Covid-19."
I care. These doom and gloom shrieks and exhortations for President Madagascar to Shut. Down. Everything are distracting from the real work governments have to do to tackle this severe and protracted crisis in a competent manner, i.e. following the advice of real, not collective-letter experts.
The advise from real experts is also to shut everything down.
No. It is to flatten the curve, i.e. to get infected slowly and manageably, in order to minimize peak ICU admissions. This will minimize deaths. If you fuck up initially, like China and Italy, by severely underestimating the problem, you're forced to shut down everything for a bit, but in the end everyone will be doing the same thing - shutting down some things to control the infection, not try in vain to "stop" it.
Best to shut down now and flatten as much as possible, no?
>Does this mean only tested 10000 people?
Italian health services have tested more than 50k people (the number of tests is over 60k but some people got tested more than once). More than 12k were infected. This is likely to be an underestimate, since we know a lot of infections are asymptomatic.
Italian health services have tested more than 50k people (the number of tests is over 60k but some people got tested more than once). More than 12k were infected. This is likely to be an underestimate, since we know a lot of infections are asymptomatic.
> 10% of all people that got the virus?
This one. FTR, there's an additional 5% from this 10%, IIRC, which experiences multi-organ failure and dies within a few days.
This one. FTR, there's an additional 5% from this 10%, IIRC, which experiences multi-organ failure and dies within a few days.
Here in Israel, ministry of health wanted a full lockdown. But business won, so only a partial lockdown is enforced, and they are shutting down only clubs and restaurants. People will still be able to visit parks, roam freely, etc. Today there was an article [1] that some idiot that was in quarantine left it and was arrested on the street. There is no discipline. A hard lockdown is likely the best option everywhere. It works, as evident in countries that have enforced it.
1: https://www.ynet.co.il/articles/0,7340,L-5694758,00.html
1: https://www.ynet.co.il/articles/0,7340,L-5694758,00.html
> Today there was an article [1] that some idiot that was in quarantine left it and was arrested on the street. There is no discipline.
Hopefully he/she was nabbed quickly, without spreading the disease to anyone else. Is Isreal using electronic tagging on those quarantined folks to ensure that they can't just leave their assigned place without anyone knowing about it?
Hopefully he/she was nabbed quickly, without spreading the disease to anyone else. Is Isreal using electronic tagging on those quarantined folks to ensure that they can't just leave their assigned place without anyone knowing about it?
They are starting to talk about it, but there are big privacy concerns of tracking citizens by intelligence agencies. Not sure what the status of this is, but will probably pass parliament because everyone is very scared. They can abolish it later, but we all know they probably won't.
It is unclear of the idiot that evaded quarantine is sick or only precautionary, but that's just the people we have—morons. Very different from Hong Kong and Singapore.
It is unclear of the idiot that evaded quarantine is sick or only precautionary, but that's just the people we have—morons. Very different from Hong Kong and Singapore.
> but there are big privacy concerns of tracking citizens by intelligence agencies.
Huh? An ankle bracelet ("tag") is quite transparent, it's not covert "intelligence". The deal is, you get to wear it for a couple weeks while you recover from your potential illness, and you know you're being monitored so you're not going to just leave your assigned place and hang out anywhere else.
Huh? An ankle bracelet ("tag") is quite transparent, it's not covert "intelligence". The deal is, you get to wear it for a couple weeks while you recover from your potential illness, and you know you're being monitored so you're not going to just leave your assigned place and hang out anywhere else.
What they were speaking about here is using people’s phones.
That lasted for a few days in Italy and then they shut it all down anyway. But more people got infected in the meantime!
Exactly, they should have gone all-in and shut it down.
> Every minute is exceptionally important as it means saving lives. Don’t waste it!
The fact that the US Senate did not speed up the emergency measure by staying is loosing 2 days. At that time the measures are in place the problem is twice as large. In normal times this is just a business day delay but in these times calendar days are the measure and weekends are counted too. We really need to start thinking and acting differently.
The fact that the US Senate did not speed up the emergency measure by staying is loosing 2 days. At that time the measures are in place the problem is twice as large. In normal times this is just a business day delay but in these times calendar days are the measure and weekends are counted too. We really need to start thinking and acting differently.
It's too late for the U.S. There isn't a clear, organized, unified direction of testing and action plan for all humans within its borders. That's the only way to get and organize an effective response.
We're canceling/closing off large groupings of humans and basically hoping/praying? for the best for the next few weeks. It's sad. This type of haphazard response drives conspiracies and confusion that is then opportunistically taken advantage of by all sectors of power.
We're canceling/closing off large groupings of humans and basically hoping/praying? for the best for the next few weeks. It's sad. This type of haphazard response drives conspiracies and confusion that is then opportunistically taken advantage of by all sectors of power.
Lockdown resident: i fear our population will get bored off the lockdown, and/or fearful of shops running out of goods (part caused by sick workers, sick transporters, and people taking a risk and going shopping anyway), and by Wednesday there'll be reports of social unrest.
This will be seen by other countries, who will impose more stringent curfews, and a cycle of restrictions will start. When the forces of law and order get sick, then the real fun will begin.
Of three local food shops to me, one just got closed as a workers spouse has been hospitalised. Tomorrow, do i go get whatever food may be left in the other stores, play hide and seek with the police, then perhaps get sick, or let my family go hungry?
The fact that growth rates seem very similar in all affected countries, baffles me. Surely lifestyles, social structure (number of families/kids etc.), hygiene habits differ slightly and testing rates/effectiveness of the health system varies greatly among them. If these factors aren't important, does social life even matter? The effectiveness of China's lockdown is a good argument for it, but perhaps they were just more effective at identifying and isolating spreaders? My point is that there's a chance that it spreads through the air or in some other way unaffected by curfews etc. (if you leave the windows open...).
Lockdown is not a long term solution though. This virus isn't going to disappear anytime soon. It might be good for countries that are getting out of control, but for places where it isn't a problem yet it just delays when it his.
Places without a problem yet should take reasonable sustainable precautions to flatten the curve instead. (https://www.flattenthecurve.com/)
Places without a problem yet should take reasonable sustainable precautions to flatten the curve instead. (https://www.flattenthecurve.com/)
Lockdown is literally what flattens the curve. The slower the virus spreads, the flatter the curve gets.
The virus still spreads in lockdown, just at a slower pace. We will likely see resurgences when the lockdown(s) are lifted, but the idea is to plan to do that when we can handle it.
The virus still spreads in lockdown, just at a slower pace. We will likely see resurgences when the lockdown(s) are lifted, but the idea is to plan to do that when we can handle it.
We don’t need military patrolling our streets just yet. Not saying it won’t come down to it, but the sentiment in the US is less, uh... flexible, towards being heavily locked down as compared to the aforementioned countries.
Or at least, some people would like to believe that. I suspect an astonishing large number of them will discover differently, should those ideals be put to the test. Just a hunch.
Much of the herd will comply. Many others will make their stand, especially with the current state of sentiment In the right wing population.
There's a large population of Americans that have conservative views, and vigorously fight against perceived encroachment on their liberties. However, these people are not stupid, despite how they're painted in the media.
I suspect if we called up a militia leader from the back woods of Michigan or Kentucky, even they would consent to very temporary quarantines. Even if it meant US army troops patrolling their residential areas.
In fact, I suspect more conservative people would even be more in favor of stricter lockdowns, on average. While progressives are now following the advice of the medical establishment, the initial instinct is to not do things that "sound conservative" like shutting down borders and so on.
(Similarly, while many conservatives would agree with the idea of quarantines, they would remain very cautious of any unnecessary restrictions on their liberties, watchful of the government taking advantage of the situation to pass laws the conservatives oppose. If for example, the military patrols said they wanted to knock on every door and collect all the guns, their support would rapidly reverse itself.)
No offense meant to either side. I don't strongly identify with either of these labels. Just my honest opinion based on my personal observations.
(Also, I'm aware that particular conservatives and particular liberals may have expressed opposite views to those above, but I'm talking about my perception of the group average, not particular high profile examples. Also, particular individuals may take unusual stances due to personal business or financial interests.)
I suspect if we called up a militia leader from the back woods of Michigan or Kentucky, even they would consent to very temporary quarantines. Even if it meant US army troops patrolling their residential areas.
In fact, I suspect more conservative people would even be more in favor of stricter lockdowns, on average. While progressives are now following the advice of the medical establishment, the initial instinct is to not do things that "sound conservative" like shutting down borders and so on.
(Similarly, while many conservatives would agree with the idea of quarantines, they would remain very cautious of any unnecessary restrictions on their liberties, watchful of the government taking advantage of the situation to pass laws the conservatives oppose. If for example, the military patrols said they wanted to knock on every door and collect all the guns, their support would rapidly reverse itself.)
No offense meant to either side. I don't strongly identify with either of these labels. Just my honest opinion based on my personal observations.
(Also, I'm aware that particular conservatives and particular liberals may have expressed opposite views to those above, but I'm talking about my perception of the group average, not particular high profile examples. Also, particular individuals may take unusual stances due to personal business or financial interests.)
After driving around our area today, in the Seattle metro, it seemed like activity (cars in the parking lot, people on the street, etc) was off 25-30% from a usual Saturday with nice weather in March.
I feel like a lockdown / closure order for the Seattle metro counties will be coming within a week or so.
I feel like a lockdown / closure order for the Seattle metro counties will be coming within a week or so.
hoka-one-one(1)
From Italy, don't trust the Italian media, they are the first that are making so much fuss and wrecking chaos, and especially making quite some money because as an industry it was starving for some time.
Statics say clearly what strategy could have been followed to take care of coronavirus without much disruption of the working force. And the people at the government are mostly old farts, which says quite a lot why they panic.
Statics say clearly what strategy could have been followed to take care of coronavirus without much disruption of the working force. And the people at the government are mostly old farts, which says quite a lot why they panic.
The time shifted rates of growth tell a compelling story, along with the fact that 1000 people out of 10000 required hospitalization. That is certainly statistically significant. I am now concerned that my birth country, the UK, has the wrong response. UK hospitals will not be able to handle that much traffic.
I'm not too optimistic. Scnes like this at multiple US airports.
https://twitter.com/JasonWhitely/status/1238986444615618561
I've seen comments here trying to play down the message or discredit the signatories of this letter. Don't.
Please take it seriously. This is not sensationalism.
What the letter means is that if your country is not there yet, you might be DAYS away from widespread panic and total lock down.
I'm writing this from Barcelona, Spain. This last Sunday, 6 days ago, I went on a walk with my girlfriend, had a nice lunch, took beautiful pictures...
The virus was just some nagging news.. A couple of hundred people infected somewhere far away.
6 days later, we're at over 6000 infections, the country is in total lock down.
Same pattern as Italy (even faster), we're just a couple of days away before tens of thousands is reached. This is what exponential growth means.
Please take it seriously. This is not sensationalism.
What the letter means is that if your country is not there yet, you might be DAYS away from widespread panic and total lock down.
I'm writing this from Barcelona, Spain. This last Sunday, 6 days ago, I went on a walk with my girlfriend, had a nice lunch, took beautiful pictures...
The virus was just some nagging news.. A couple of hundred people infected somewhere far away.
6 days later, we're at over 6000 infections, the country is in total lock down.
Same pattern as Italy (even faster), we're just a couple of days away before tens of thousands is reached. This is what exponential growth means.
There is really no excuse for this happening in Europe. There was ample warning and no, not just from China. The math was very clear by early/mid February.
We have to face the truth that the quality of people we vote for government is not where it needs to be and that science has too long been discredited and ignored.
Some of asia learned from SARS but that's it.
Madrid was hosting marches, political rallies and soccer games with 10.000-100.000 people a week ago because people did not want to make the hard choices needed even as Korea was burning and Italy started to.
Excuses that China is authoritarian do not cut it - this was a huge fail of governance and doing what people are elected to do
We have to face the truth that the quality of people we vote for government is not where it needs to be and that science has too long been discredited and ignored.
Some of asia learned from SARS but that's it.
Madrid was hosting marches, political rallies and soccer games with 10.000-100.000 people a week ago because people did not want to make the hard choices needed even as Korea was burning and Italy started to.
Excuses that China is authoritarian do not cut it - this was a huge fail of governance and doing what people are elected to do
Human beings do not intuitively understand exponential growth. It's just too fast for our primitive brains. In some sense, we are standing in the middle of the road, frozen like deer in the headlights.
Science is supposed to mitigate the shortcomings of our natural intuitions and cognitive biases. The problem is that most people are not scientists. When a non-scientist is asked to trust a scientist, he or she is subject to all of the usual suspects: arguments from authority, confirmation bias, Bulverism, appeal to emotion, etc. What this means in practice is that scientists are generally not trusted over the word of one's friends and family.
Science is supposed to mitigate the shortcomings of our natural intuitions and cognitive biases. The problem is that most people are not scientists. When a non-scientist is asked to trust a scientist, he or she is subject to all of the usual suspects: arguments from authority, confirmation bias, Bulverism, appeal to emotion, etc. What this means in practice is that scientists are generally not trusted over the word of one's friends and family.
> Human beings do not intuitively understand exponential growth.
This layman has read that we intuitively think of numbers logarithmically, which makes him wonder if we human beings do, in fact, intuitively understand exponential growth.
https://www.scientificamerican.com/article/a-natural-log/
This layman has read that we intuitively think of numbers logarithmically, which makes him wonder if we human beings do, in fact, intuitively understand exponential growth.
https://www.scientificamerican.com/article/a-natural-log/
...and see it as merely linear. That's the problem.
Exponential growth is like dynamite. It's absurdly fast, compared to anything people see in daily lives.
Exponential growth is like dynamite. It's absurdly fast, compared to anything people see in daily lives.
Population and GDP also grow exponentially, but we’ve been watching those numbers go up for decades. Most things that grow do so exponentially. Growth always comes to an end, but that often happens well before the rate of change becomes “absurdly fast.“
Dropping stuff and falling are good examples. If you're paying attention, anyway. I can still grab stuff that's fallen maybe 10-20 cm, but by 50-100 cm it's moving way too fast.
And that's only quadratic growth, not exponential.
Interesting. I do think that few people understand what a billionaire actually is, i.e. what force you can mobilize if you are one.
Humans don’t understand exponential growth. But they could look at China and Italy and think - those guys are the same as us. We are not special. The same thing that is happening to them is going to happen unless we act now.
The real sad part of all this is that this is simply human nature. And we are next gonna go down the same path with climate change. And then not even lock downs will help.
The real sad part of all this is that this is simply human nature. And we are next gonna go down the same path with climate change. And then not even lock downs will help.
by intuitively I suppose you mean feel it, which I guess is true, but it does not take a genius to actually understand the concept, especially if it is explained as right now you will get this many people per day, in a week you will get this many, in a month this many. That is pretty easy, a politician should be able to follow it.
But as has been pointed out before most people think if you do something big and dramatic to fix an oncoming problem, and it does fix it, lots of people will stupidly assume that you did not need to do the big, dramatic thing because it wasn't really a problem. So any politician who reacted appropriately would run the risk of fixing the problem and losing power in doing so, I would prefer to fix a problem like this even if it meant I would not have the power to fix later problems as my calculation would be if I do not fix this problem now I probably won't have the power to fix later problems anyway.
But as has been pointed out before most people think if you do something big and dramatic to fix an oncoming problem, and it does fix it, lots of people will stupidly assume that you did not need to do the big, dramatic thing because it wasn't really a problem. So any politician who reacted appropriately would run the risk of fixing the problem and losing power in doing so, I would prefer to fix a problem like this even if it meant I would not have the power to fix later problems as my calculation would be if I do not fix this problem now I probably won't have the power to fix later problems anyway.
One way to test this is to ask random people the question:
"The number of lily pads on a pond double every day. If it takes 20 days for the lily pads to completely cover the pond, how long does it take to cover half the pond?"
I think you will be surprised by how many people say "10 days."
"The number of lily pads on a pond double every day. If it takes 20 days for the lily pads to completely cover the pond, how long does it take to cover half the pond?"
I think you will be surprised by how many people say "10 days."
I agreed that people did not understand exponential growth, but I pointed out that "but it does not take a genius to actually understand the concept, especially if it is explained as right now you will get this many people per day, in a week you will get this many, in a month this many."
So if you explain to the politician, once you start getting cases in your country and give them the actual growth rates, and what slowing down the growth rates will mean, with nifty charts and so forth.
Like maybe they should do in the movie Outbreak where they have display of the red spreading across the country on its way to the White House, with a timeline animated below it, then the politician will understand the situation without intuitively understanding exponential growth.
I suppose reasonably competent data visualizers who have ever had to explain complicated things to non-technical people in an important meeting would know how to represent the concept in their particular domain without much problems.
on edit: changed our to your
So if you explain to the politician, once you start getting cases in your country and give them the actual growth rates, and what slowing down the growth rates will mean, with nifty charts and so forth.
Like maybe they should do in the movie Outbreak where they have display of the red spreading across the country on its way to the White House, with a timeline animated below it, then the politician will understand the situation without intuitively understanding exponential growth.
I suppose reasonably competent data visualizers who have ever had to explain complicated things to non-technical people in an important meeting would know how to represent the concept in their particular domain without much problems.
on edit: changed our to your
This is because most people are unable to suppress their reflexive response to being asked what's half of 20, not because people don't understand exponentiation.
My point was not about whether people are incapable of understanding exponentials, it was about whether they understand them intuitively. You used the term “reflexive response” but what we’re both describing is intuitive or automatic thinking.
Why is it relevant that people don’t correctly apply exponential reasoning automatically? Because when people encounter information in everyday life (outside of the specific job they’ve been trained to do) they tend to use intuitive thinking predominantly. This matters a hell of a lot when it comes to making political decisions of a technical nature, such as infectious disease planning and response. Lo and behold, this is the exact problem the Italians are trying to warn everyone about!
Why is it relevant that people don’t correctly apply exponential reasoning automatically? Because when people encounter information in everyday life (outside of the specific job they’ve been trained to do) they tend to use intuitive thinking predominantly. This matters a hell of a lot when it comes to making political decisions of a technical nature, such as infectious disease planning and response. Lo and behold, this is the exact problem the Italians are trying to warn everyone about!
Show someone an animation of the lily pads doubling every day and ask the same question and you’ll realise that they understand exponential growth intuitively, they’re just not good at word problems.
Show someone an animation of the lily pads doubling every day and ask them when the pond is half-covered? You're not even asking them to solve a problem at that point, only to point at the animation when it looks half-covered.
Relating this to the spread of the virus, people aren't carrying around an animation of this in their minds. Perhaps science communicators should do a better job of communication and produce such an animation? But then you're still not getting people to understand the concept. You're telling them "this is what it looks like, sort of, now just trust us." The problem is that people don't trust scientists (and mathematicians) as it is.
Relating this to the spread of the virus, people aren't carrying around an animation of this in their minds. Perhaps science communicators should do a better job of communication and produce such an animation? But then you're still not getting people to understand the concept. You're telling them "this is what it looks like, sort of, now just trust us." The problem is that people don't trust scientists (and mathematicians) as it is.
Yes, the point being that linear halving is much more intuitive for most people than exponential halving. Even when you're told the doubling rate, your brain reaches for the wrong answer every time.
It's so unfortunate that Western society also seems to be losing trust in experts. As the world gets more complicated one would expect that trust in experts would be more important.
Policy makers are often incorrectly or selectively writing experts to push their agenda. Confidence intervals become averages. Multi variate predictions become univariate. 30 year models become absolute truth. No wonder people lose trust.
You don't have to understand exponential growth to look at how seriously other nations have treated the issue. Many large respectable nations have entered some kind of lockdown mode.
And I don't believe you should have to understand exponential growth to listen to clear government messaging about the severity of a problem. This is a failure of messaging by the relevant authorities.
And I don't believe you should have to understand exponential growth to listen to clear government messaging about the severity of a problem. This is a failure of messaging by the relevant authorities.
Allow me to suggest we wait to blame until after things are on the upswing. I completely understand the impulse -- hell, I'm doing it myself -- but for most of the folks reading, the worst of this is ahead. I'm trying to focus on a bit of prep I haven't done, trying to anticipate for different scenarios and being kind to those around me.
And my snarky side says there will be plenty more targets to blame in the coming weeks - think of it as an investment.
And my snarky side says there will be plenty more targets to blame in the coming weeks - think of it as an investment.
This is classic normalcy bias: https://en.wikipedia.org/wiki/Normalcy_bias
People will grasp at any excuse to convince themselves "it'll be fine, it won't happen to me". The fact it started in China made it easy - the Chinese government must be overreacting because it's authoritarian, it's halfway across the world, my government must have gotten this figured out, my health care system must be better than China's, etc etc. And of course the classic "it's just a flu".
It's sad that so many will suffer and die because of this.
People will grasp at any excuse to convince themselves "it'll be fine, it won't happen to me". The fact it started in China made it easy - the Chinese government must be overreacting because it's authoritarian, it's halfway across the world, my government must have gotten this figured out, my health care system must be better than China's, etc etc. And of course the classic "it's just a flu".
It's sad that so many will suffer and die because of this.
No leader wants to take drastic action for their nation when the number of deaths they can point to for justification is smaller than the number of deaths for the seasonal flu. If they save lives and prevent the disease from spreading, it looks like they over-reacted and unnecessarily tanked the economy.
The USA is going to be in terrible shape very soon, just look at this as of tonight: https://twitter.com/davidenrich/status/1239004689338970113
I cannot understand why unnecessary flying was not shut down weeks or months ago.
Go read HN comments from weeks and months ago, and see the posters encouraging prompt measures getting called paranoids. :) Now scale this up to the whole country and account for the fact that HN is probably a little better on average about reasoning about these things.
But now, on HN now we're mostly preaching to the choir...
I've been contacting the officials of my state and surrounding communities since February 28th urging action. If your community isn't taking action you should join in. Even if your politicians don't respond to math, they'll still respond to public outcry.
The best time to respond was a while ago, but today is still vastly better than tomorrow.
But now, on HN now we're mostly preaching to the choir...
I've been contacting the officials of my state and surrounding communities since February 28th urging action. If your community isn't taking action you should join in. Even if your politicians don't respond to math, they'll still respond to public outcry.
The best time to respond was a while ago, but today is still vastly better than tomorrow.
> Go read HN comments from weeks and months ago, and see the posters encouraging prompt measures getting called paranoids.
Exactly. Two weeks ago every coronavirus thread on Hacker News was full of deniers claiming this was no worse than the flu and this was all just media hysteria. Some probably still hold that opinion. I don't think they will be convinced until the hospitals start overflowing.
Exactly. Two weeks ago every coronavirus thread on Hacker News was full of deniers claiming this was no worse than the flu and this was all just media hysteria. Some probably still hold that opinion. I don't think they will be convinced until the hospitals start overflowing.
Elon Musk was one of the deniers. You would think someone who "always starts with physics" would know better.
Wealthy people have a habit of doing this. Being good at something doesn't necessarily make you good at something else, and the hero-worship the wealthy get in the US (not to mention his fan club) can't help but go to one's head.
(Engineers to, too. I try hard to watch it and I still arrogantly show my ignorance sometimes.)
(Engineers to, too. I try hard to watch it and I still arrogantly show my ignorance sometimes.)
He has a responsibility to not feed panic.
Yeah,
When Coronavirus appeared in Wuhan, I tended to the opinion that it would self-limiting in one fashion or another or that is would not be worse than the flu. Only people arguing with me and me investigating the facts changed that. And, yeah, changing your opinion is hard and imagining a force that will upend the world is hard so it's easy to imagine how people stay in their positions.
That said, we have a representative government with the aim of electing people who will think ahead and protect from purely reflex based views. And clearly that control has failed.
When Coronavirus appeared in Wuhan, I tended to the opinion that it would self-limiting in one fashion or another or that is would not be worse than the flu. Only people arguing with me and me investigating the facts changed that. And, yeah, changing your opinion is hard and imagining a force that will upend the world is hard so it's easy to imagine how people stay in their positions.
That said, we have a representative government with the aim of electing people who will think ahead and protect from purely reflex based views. And clearly that control has failed.
As disappointed as I am with much of the response in the US, it could still be a lot worse.
The potential for this kind of pandemic is something that the government was aware of and at least somewhat prepared for. It can be hard to imagine, but if all we had were the concerns of joe-everyman this would have caught us significantly more off-guard than it has.
Where I think we've faltered is in rapidly the hard decisions to trade-off short term economic impact vs long term health and economic impact. But there is still time to do a lot of good, and the level of our response seems to now-- finally-- be increasing exponentially along with the infection.
The potential for this kind of pandemic is something that the government was aware of and at least somewhat prepared for. It can be hard to imagine, but if all we had were the concerns of joe-everyman this would have caught us significantly more off-guard than it has.
Where I think we've faltered is in rapidly the hard decisions to trade-off short term economic impact vs long term health and economic impact. But there is still time to do a lot of good, and the level of our response seems to now-- finally-- be increasing exponentially along with the infection.
Yes, I've had some neighbors ask me why I didn't tell them that we had been preparing for this to potentially happen when we started about 3 weeks. I told them "because you would have thought we were crazy if I told you to do it 3 weeks ago".
And you thought I was crazy when I started 30 years ago.
That apparently makes very little difference. I listened to an interview with a Yale professor who cited stories that showed minimal impact. The supposed reason is that by the time you know a country has an outbreak, it's already to late and people from there will have travelled to your country. What apparently had been shown to be very effective is preemptive school closures. Unfortunately that's a tough call because we can't have a well functioning social system liked other developed countries.
Interview: https://samharris.org/podcasts/190-respond-coronavirus
Interview: https://samharris.org/podcasts/190-respond-coronavirus
I'm in the US, no one cared about this until a few days ago. Now, some stores are getting low on food supplies, and people are posting about it. But, I was at a store today where they were completely stocked, and the only empty shelf was the toilet paper supply! It's insane.
What? I’m in New England tri state and started preparing 28 days ago. https://news.ycombinator.com/item?id=22339369
Parent presumably means no regular people. I had a similar experience: a month ago I suddenly realized we may need to be isolated at home for up to 2 months. I live in a place where that's actually fairly practical. Except our generator was broken. So I left work, drove to town immediately with the idea that I might be able to get the last generator as they sold out given that everyone else surely would be also buying a generator. Then over the next month I watched as Costco stacked a huge pile of generators near the entrance, eventually hand sanitizer sold out, flu medication, Isopropyl alcohol, and finally TP. I think you can still get a generator though.
What city, if I may ask?
That's cause you're smart, and read hN!
I’d argue the smart part :) Well read is a better scarlet letter.
Fairfield county, CT
Surely the hand sanitizer shelf was empty too?
Not empty at all, maybe a shipment came in, though.
Tofu was surprisingly empty here.
I've commented elsewhere on this, but in the Bay Area I saw evidence of people panic buying as far back as March 2nd.
Well, all these people consciously have chosen to fly at the time like this. It was clear that drastic travel disruption is imminent and chance of exposure is high on the plane, and yet they took the risk.
Wow, you're not even considering that each infection in that airport will come back and infect a bunch of people who didn't make the choice to fly?
IE we should not allow people to take risks that are going impact all of society.
The virus has exploded the American myth that we can isolate individual behavior to individual rewards but also this myth means the country is going to seriously suffer.
IE we should not allow people to take risks that are going impact all of society.
The virus has exploded the American myth that we can isolate individual behavior to individual rewards but also this myth means the country is going to seriously suffer.
wow
The science that this was not the flu was clear 6-8 weeks ago. Even if you thought china was under-reporting, it was clear what would happen. Then korea happened.
There was no excuse because there was never a chance for another outcome. The WHO was screaming into the void.
There was no excuse because there was never a chance for another outcome. The WHO was screaming into the void.
That argument might work at a national level. It works less well at a community level, and I think stops working for any community once there is observed community spread there.
After that point it is mathematically clear that you're going to have deaths, and that similarly situated communities who react days later will have a lot more deaths. At that point the political calculus you're arguing for flips the other way around and encourages an over-reaction. ... except innumeracy is so common, we're not seeing too much evidence of that happening.
After that point it is mathematically clear that you're going to have deaths, and that similarly situated communities who react days later will have a lot more deaths. At that point the political calculus you're arguing for flips the other way around and encourages an over-reaction. ... except innumeracy is so common, we're not seeing too much evidence of that happening.
This. No self-preserving politician wold have reacted early to this. And you don't get to that level without being self-preserving.
Clearly self preservation stops at simple math.
We need to confront the fact that democracy in the West by now elects people who sell the most comfortable lies instead of people who help adaptation to reality.
We need to confront the fact that democracy in the West by now elects people who sell the most comfortable lies instead of people who help adaptation to reality.
Political leadership being self serving while convincing people that they are not has been true throughout history, and will continue to do so in the future. There is no way to stop this without modifying human nature itself. I cannot blame the voting populace, yet at the same time, I cannot blame the politicians either. They are part of a larger system of incentives.
Then perhaps we need a better version of democracy. Or a better system of government altogether.
I am hopeful that human civilization and ingenuity can invent or discover that. I am just not confident that it would be anytime soon.
I am hopeful that human civilization and ingenuity can invent or discover that. I am just not confident that it would be anytime soon.
It's not just democracy, it includes all forms of human organization, whether it be democratic or dictatorial. I believe it will only change once we genetically engineer people to be less self serving. Barring that, I don't see how one can solve this problem.
The solution I think would be to somehow get people to lead who have no desire to do so. Politics attracts sociopaths and psychopaths due to the power involved. Competent and compassionate people have no time and patience for the power jockeying while sociopaths live for it. Thus you end up with a government by sociopaths for themselves. But how to make politics unappealing to sociopaths? Beats me.
There are enough honest, intelligent scientifically-minded people who want to be government leaders. They don't get elected. Current political system favors demagogues.
The trouble is that these people need to compete against a subset of people who want power more than anything else.
These honest people decide it's not worth it, and get selected against and never make it to a position where they can affect change.
Alternatively, they do, and the process of getting there makes them less likely to do the things they wanted to do.
Bring back sortition!
Alternatively, they do, and the process of getting there makes them less likely to do the things they wanted to do.
Bring back sortition!
The post-mortem (for want of a better term) on this will be pretty bad for some people in leadership positions. Assuming they survive. Very precious time was squandered with half-assed measures and uninformed decisions.
I don't share your optimism. We already seeing not acting recast as strategy.
At least German politicians had the sense to step aside and hand the mess they made to the scientific experts to clean up.
At least German politicians had the sense to step aside and hand the mess they made to the scientific experts to clean up.
The UK's moronic lack of response?
Have you not been reading the news in the US and Europe the last few years? This is exactly what was to be expected from the current set of government leaders. Respect for expertise and rationality are considered disqualifying qualities in a politician nowadays.
I would think it's the current eco system that makes those who respect for expertise and rationailty happened to have some compettive advantages during the prodedure. They have better odds to be elected over their opponents. There are some observation supporting the hypothesis but too long to discuss here.
>science discredited and ignored
There is a large faction of people in the USA who believe this a politically motivated hoax. This is the world we are living in. How can we vote in competent leaders when a large faction holds such strong influence?
There is a large faction of people in the USA who believe this a politically motivated hoax. This is the world we are living in. How can we vote in competent leaders when a large faction holds such strong influence?
https://www.livescience.com/46123-many-americans-creationist...
This has nothing to do with the politicians.
This has nothing to do with the politicians.
This post is exactly the essence of why I don't like politics.
It's super easy to retrospectively say "they should've done something else". You might think that even you would do the right choice, but you are wrong.
Such decision is hard for any authority. You may vote for any person in the whole world and the result would probably be similar. Lockdown delivered too early could send whole country into chaos.
Also China managed this so well that it actually could work counterproductive for other countries.
What I'm trying to say is: Don't judge others. You have little idea of the situation they are in, and saying retrospectively "you should've known better" is just childish. Just learn from their mistakes.
With your attitude, you can choose any party and will always be unhappy about the choice.
It's super easy to retrospectively say "they should've done something else". You might think that even you would do the right choice, but you are wrong.
Such decision is hard for any authority. You may vote for any person in the whole world and the result would probably be similar. Lockdown delivered too early could send whole country into chaos.
Also China managed this so well that it actually could work counterproductive for other countries.
What I'm trying to say is: Don't judge others. You have little idea of the situation they are in, and saying retrospectively "you should've known better" is just childish. Just learn from their mistakes.
With your attitude, you can choose any party and will always be unhappy about the choice.
Accountability is important.
Also - doing nothing until it is too late - not even educating - is not even a choice. It's not a strategy. Its dereliction of duty.
Also - doing nothing until it is too late - not even educating - is not even a choice. It's not a strategy. Its dereliction of duty.
So if the govt waited until there were 30 million cases in the country in a four month period, that would be irresponsible? If it put 300k people in the hospital, that would be an unthinkable national disaster? What if it killed 20k people in just four months in just one country?
Those are the conservative figures for influenza in the USA since 2019 November.
Where was your outrage last year and the year before. Couldn't we have prevented this influenza tragedy from happening all over again. Is this also dereliction of duty?
Those are the conservative figures for influenza in the USA since 2019 November.
Where was your outrage last year and the year before. Couldn't we have prevented this influenza tragedy from happening all over again. Is this also dereliction of duty?
> Don't judge others.
It is by observing others and judging their decisions and actions that we can learn and avoid other people's mistakes.
Is it not?
It is by observing others and judging their decisions and actions that we can learn and avoid other people's mistakes.
Is it not?
Judgement is pointing fingers.
What you are asking about is just drawing conclusions. I wouldn't mix those up.
What you are asking about is just drawing conclusions. I wouldn't mix those up.
> There is really no excuse for this happening in Europe. There was ample warning and no, not just from China. The math was very clear by early/mid February.
It might be worth revisiting top comments on HN threads relating to Covid19 in the past few weeks. Quite telling how much the 'know-it-all' folks actually know about the real world - makes you even more afraid that these are the same people who run countries and have an outsized influence in the public sphere.
It might be worth revisiting top comments on HN threads relating to Covid19 in the past few weeks. Quite telling how much the 'know-it-all' folks actually know about the real world - makes you even more afraid that these are the same people who run countries and have an outsized influence in the public sphere.
> and that science has too long been discredited and ignored.
There are scandals in the sciences too. Peer review rings, studies that tend toward positive bias due to the pressure to publish, some studies being paid by big companies that favors their vested interests, etc.
There are scandals in the sciences too. Peer review rings, studies that tend toward positive bias due to the pressure to publish, some studies being paid by big companies that favors their vested interests, etc.
Science is a product of human beings and not saints, so of course there are scandals. There always were. What's changed is that now that meme-ing is replacing thought, science is easier to attack, particularly by people with an agenda.
> The math was very clear by early/mid February
The leaders of the country, the people in power, and the populace are not math literate.
The leaders of the country, the people in power, and the populace are not math literate.
The leaders all have math literate advisors. They ignore them for a variety of reasons.
Politicians only listen to experts when it is politically convenient.
I fear that the situation is already at that state in the USA.
There are 1600 confirmed cases but the lack of tests hides how many real infections there are.
There are 1600 confirmed cases but the lack of tests hides how many real infections there are.
Leaving aside the fact that here in the US tests are literally not happening on an epic scale that will be the subject of numerous investigations, hearings (, and prosecutions?) in the years to come. And forget that even if we had legit numbers, those numbers we can see are a tip of the iceberg, representing at most 20% of the actual more-serious cases.
Put that all aside.
Remember-- the numbers we see now are a look at the PAST. The infection incubates silently for a median 5 days. Then symptoms present. Then a week goes by with relatively mild illness. THEN shit gets real. THEN comes the hospital visit, the fight for a test, the time it takes for the test results to come back (if it happens). THEN the number gets added. Then you see it on wikipedia or the news.
These numbers we're seeing today are a time machine view backwards to recognize infections from 14 days ago. So infections spreading TODAY will show up AFTER the current Italy-like situation has already taken hold in the United States.
If it is possible, STAY HOME.
Put that all aside.
Remember-- the numbers we see now are a look at the PAST. The infection incubates silently for a median 5 days. Then symptoms present. Then a week goes by with relatively mild illness. THEN shit gets real. THEN comes the hospital visit, the fight for a test, the time it takes for the test results to come back (if it happens). THEN the number gets added. Then you see it on wikipedia or the news.
These numbers we're seeing today are a time machine view backwards to recognize infections from 14 days ago. So infections spreading TODAY will show up AFTER the current Italy-like situation has already taken hold in the United States.
If it is possible, STAY HOME.
> Don't forget-- the numbers we see now are a look at the PAST. The infection incubates silently for a median 5 days. Then symptoms present. Then a week goes by with relatively mild illness. THEN shit gets real.
And the "shit gets real" part only occurs 20% of the time, give or take - which means the virus might spread quite a bit while showing symptoms no more severe than a common cold. That also introduces some further unpredictable lag between any social distancing behaviors being introduced and their effects on the actual numbers.
And the "shit gets real" part only occurs 20% of the time, give or take - which means the virus might spread quite a bit while showing symptoms no more severe than a common cold. That also introduces some further unpredictable lag between any social distancing behaviors being introduced and their effects on the actual numbers.
Yes, exactly. I said 14 days but again, that's the median. The US is flying blind right now.
We're using a cracked, dirty camera lens to film a small fraction of the tip of a rapidly growing iceberg.... And the photo processing time is two weeks.
We're using a cracked, dirty camera lens to film a small fraction of the tip of a rapidly growing iceberg.... And the photo processing time is two weeks.
It gets hospital-level serious for 20% of cases? I thought the lethality rate wasn’t even that high for the most at-risk demographics (something like 14%).
Yes, hospital-level serious for 20% of cases. 5-10% require ICU care. The ~2% fatality rate is with ICU support and ventilation. When the hospitals get overrun it increases to ~7%, which is what we saw in Wuhan and now Italy. Your chance of dying if you do need hospitalization but don't get it appears to be > 50%.
Death rates by age range also assume ICU care. It's virtually unheard of for healthy middle-aged people if they have access to good medical care, but plenty of 30- and 40-somethings can and have died from it once the hospitals are overrun.
Death rates by age range also assume ICU care. It's virtually unheard of for healthy middle-aged people if they have access to good medical care, but plenty of 30- and 40-somethings can and have died from it once the hospitals are overrun.
It’s far from clear how accurate those numbers for Italy and China are. China essentially gave up on testing the general population in Wuhan and their numbers mostly represent the most serious cases. Italy’s infections seem to be mostly centered around the elderly with 40% of infections in the 70+ age range despite 65+ year olds only representing 21.53% of their population.
https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_I...
https://en.wikipedia.org/wiki/Demographics_of_Italy
https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_I...
https://en.wikipedia.org/wiki/Demographics_of_Italy
The WHO has verified China's numbers.
The WHO has verified China's numbers.
Source?
China plainly lied about the outcomes of the SARS epidemic and reported about half the fatality rate of nearly every other country. Hell, no Chinese person I've talked with recently believes the official numbers.
Source?
China plainly lied about the outcomes of the SARS epidemic and reported about half the fatality rate of nearly every other country. Hell, no Chinese person I've talked with recently believes the official numbers.
The Lancet unverified those numbers quite a while ago https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
I flagged this because it was published in January nearly a month earlier than the WHO's verification.
Essentially this was not in bad faith when it was published but it is now so out of date and misleading and sharing it now is dangerous in that it may cause people to ignore safety advice.
Essentially this was not in bad faith when it was published but it is now so out of date and misleading and sharing it now is dangerous in that it may cause people to ignore safety advice.
It was a nowcast. It's intended to be out of date after a while. And provide an estimation at the time. I don't understand how it is dangerous, could you explain that?... earlier action would have been better.
You are claiming that a study published in January supercedes a study in February.
Given that people are making difficult choices right now that will impact the course of the epidemic we should be very careful sharing outdated information that could lead to people becoming infected.
China's numbers are a minimum. Many people are saying online they are a maximum. I.e. claiming that there are lots of hidden mild infections when there are not.
Given that people are making difficult choices right now that will impact the course of the epidemic we should be very careful sharing outdated information that could lead to people becoming infected.
China's numbers are a minimum. Many people are saying online they are a maximum. I.e. claiming that there are lots of hidden mild infections when there are not.
Sure, but they didn't go back in time to test more people.
Populations of China and Italy are ageing and have a lot of smokers.
> It gets hospital-level serious for 20% of cases? I thought the lethality rate wasn’t even that high for the most at-risk demographics (something like 14%).
Well, substantially all of the cases that end up dying go to the hospital first, and many more besides that and up recovering. It shouldn't be surprising that the hospitalization rate is higher than the fatality rate.
Well, substantially all of the cases that end up dying go to the hospital first, and many more besides that and up recovering. It shouldn't be surprising that the hospitalization rate is higher than the fatality rate.
About 15-20% require hospital care of some kind. Then depending on how prepared/overrun the health care system is, 0.6-5% cases are fatal. These numbers are ballpark and the lack of data makes it hard to know with confidence. The CFR gets more severe with age and comorbidities.
I have been telling a lot of my friends this, but many are scheduled to work on Monday (most in public-interacting roles) and if they don't go to work, they lose their job and can't make rent next month.
This is a real issue, and I have no solutions. The only thing I've been saying to them is that all bars and restaurants will be closed here in 2-3 weeks and that their bosses will understand then. They are understandably worried that in the aftermath of all of this, there will be so many unemployed servers/bartenders/cooks/drivers that it will be difficult or impossible to get their job, or any other job, back, with no way to pay rent in April or perhaps May either.
This is a real issue, and I have no solutions. The only thing I've been saying to them is that all bars and restaurants will be closed here in 2-3 weeks and that their bosses will understand then. They are understandably worried that in the aftermath of all of this, there will be so many unemployed servers/bartenders/cooks/drivers that it will be difficult or impossible to get their job, or any other job, back, with no way to pay rent in April or perhaps May either.
This is not going to be over in April or May, except maybe in the worst case scenario. The point of social distancing etc is flattening the curve and spreading the load on healthcare systems over a longer time.
The only thing that might help there is if warmer weather reduces the spread. But then it could very well come back in the fall.
The only thing that might help there is if warmer weather reduces the spread. But then it could very well come back in the fall.
> If it is possible, STAY HOME.
People need to stay home, period. Unless you work in healthcare, a grocery store, or some essential service, or are going to one of the same, you need to stay home. I know there's lots of reasons people aren't staying home yet, like they don't have paid sick leave, but still, none of this overrides the sheer importance of stopping the pandemic.
So the phrasing should be "Stay home, period." Not "Stay home if possible".
People need to stay home, period. Unless you work in healthcare, a grocery store, or some essential service, or are going to one of the same, you need to stay home. I know there's lots of reasons people aren't staying home yet, like they don't have paid sick leave, but still, none of this overrides the sheer importance of stopping the pandemic.
So the phrasing should be "Stay home, period." Not "Stay home if possible".
I initially had said simply "STAY HOME", but it's just not possible/advised for people in situations such as the ones you mention.
But your point is right. "If possible" means "unless it's absolutely essential for your survival or the survival of others".
But your point is right. "If possible" means "unless it's absolutely essential for your survival or the survival of others".
I wonder if you'd be so absolute if this meant your job ceasing to exist.
Yes, it's a risk vs. benefit calculation where the risk is very very high. And not only risk to yourself but risk to others...
The risks of large portions of the economy shutting down and millions of people losing their jobs is also very significant, particularly in a country where so many live so close to the edge of disaster. It's a difficult balance, but it feels like the economic fallout is sometimes lost on the readers of HN, most of who would quite comfortably live through a period of complete lockdown.
Forget losing jobs - without a lockdown, millions of people will lose their lives. Including many of our loved ones. We already know this from Italy and Wuhan, where entire families have died one by one in their homes. The only way to save some of these lives is to flatten the curve to avoid overrunning hospitals, and reduce deaths before a cure or vaccination is widely available.
People's jobs are going to cease to exist on account of this whether they want it or not. What anyone wants or feels has nothing to do with it. This is what is going to happen, period.
Exactly - I'm tired of hearing people say "oh but the economy". How good do you think millions of dead people are going to be for our economy? Would you rather lose your job or your parents?
I'd rather my job ceased to exist than my parents or grandparents. Because that's the choice we're making now as a society.
Easy to say when you don't seriously have to face your children becoming homeless. While it certainly isn't as dramatic as a pandemic, there are severe human consequences of completely shutting down the economy. I'm sure I don't need to repeat the stats that showcase how close to the edge much of America lives - 40 million Americans don't consistently have access to enough food[1]. 1 in 6 children don't have access to enough food (which has massive effects on development and long-term health). 22 million children rely on school lunches as their primary source of nutrition[2]. Food insecurity is directly correlated with higher rates of diabetes and obesity[3]. Half of America has a negative net worth. Unemployment is correlated with alcohol and drug abuse[4].
Pretending that the only disaster we are facing is medical is blinding yourself to the reality that we are trying to navigate our way between twin catastrophes.
[1] https://www.usnews.com/news/healthiest-communities/articles/...
[2] https://www.nytimes.com/aponline/2020/03/13/us/ap-us-virus-o...
[3] https://www.feedingamerica.org/sites/default/files/2019-04/2...
[4] https://www.theatlantic.com/health/archive/2017/07/how-job-l...
Pretending that the only disaster we are facing is medical is blinding yourself to the reality that we are trying to navigate our way between twin catastrophes.
[1] https://www.usnews.com/news/healthiest-communities/articles/...
[2] https://www.nytimes.com/aponline/2020/03/13/us/ap-us-virus-o...
[3] https://www.feedingamerica.org/sites/default/files/2019-04/2...
[4] https://www.theatlantic.com/health/archive/2017/07/how-job-l...
And there aren't severe human consequences from millions of people dying in the next few months? Easy to say when you don't seriously have to face the possibility of your parents and grandparents dying, I guess. Remember that the mortality rate for people 80+ is 1/7, which isn't far from a game of Russian roulette.
Plus, all the school districts that have shut down so far have continued to offer meals for students AFAIK.
Source: - https://www.buzzfeednews.com/article/lamvo/coronavirus-death... - https://www.santaclarausd.org/site/default.aspx?PageType=3&D... - https://www.sfgate.com/news/article/Bay-Area-school-closures...
Plus, all the school districts that have shut down so far have continued to offer meals for students AFAIK.
Source: - https://www.buzzfeednews.com/article/lamvo/coronavirus-death... - https://www.santaclarausd.org/site/default.aspx?PageType=3&D... - https://www.sfgate.com/news/article/Bay-Area-school-closures...
I actually very much do need to seriously face that possibility. And I still think complete isolation is too extreme.
This is where the government needs to step in and guarantee healthcare, paid sick leave, and improve unemployment. It's already starting to happen. We'd be in much better shape if we were already closer to European countries in this regard, though.
Like China, "the USA" is very large and probably not something that can be treated as an atomic entity. Even much-smaller Italy is probably too large for that. While there may be hot spots that develop in the US, I can tell you from personal experience that there states that have taken strong measures when there are still single-digit numbers of infected in them. The state I'm in is not in a mandatory full lockdown per se, but pretty much every vector the virus has to spread by the dozens/hundreds/thousands at a time has been eliminated; what few are still left are fading fast. I don't know what will happen, but a full on r0-2.3 (or whatever the latest number is) spread isn't going to happen here under these conditions. (I highlight those last three words.)
I live in Dallas and two of my friends who work at hospitals both have multiple corona patients. It's everywhere, the official numbers are lying.
The majority of spread is from small groups/gatherings, not stadiums and such. Restaurants, cafes, offices, homes, et c.
"Small groups and gatherings" have collapsed here, too. Like I said, we're not in total isolation, but most people aren't going out, restaurants are abandoned, etc., and the few foolhardy folks still doing it are fading fast.
The exposure network hasn't been trimmed to zero, but its branching factor has been radically cut down. This is going to have an effect.
The exposure network hasn't been trimmed to zero, but its branching factor has been radically cut down. This is going to have an effect.
'may be hot spots that develop in the US'
You're kidding right? Under what conditions that things are fine are you preposing? If you're not taking this serious, and in the US, you're definitely part of the problem. That attitude, statistics aside, is going to get people killed.
You're kidding right? Under what conditions that things are fine are you preposing? If you're not taking this serious, and in the US, you're definitely part of the problem. That attitude, statistics aside, is going to get people killed.
Settle down and read more carefully.
Among the things you should have derived from reading more carefully is the fact that state I'm living in is taking it quite seriously. Personally, my hatches are battened down and I'm prepared to be isolated for at least a month, maybe two. (Have to admit it's hard to tell how far my supplies will go, I've never actually had to live on them before.)
You're talking to someone who specially prepped for this about seven weeks ago, in addition to the general prep I already had on hand. If you can match that, then maybe consider start lecturing me. I actually got a bit of flak from my wife for the amount of prepping I did, because it was before she'd hardly even heard there was a new virus. Now she's glad I did, because I bought all the things that are missing in the stores around here now long before it was "hoarding".
I'm in the top tier of taking it seriously. At the same time... Don't panic. Don't advise panic. Don't fall into the cognitive trap of modeling this as a zombie apocolypse or some other thing where the virus is intelligently seeking out victims. Isolation measures will slow the virus down. It isn't possible to keep it "out of the US" but it remains possible to keep it out of your county, or your city, or your neighborhood, with sufficient steps. Total doom is not yet inevitable, and even then, how you are impacted remains significantly under your control even if your government is feckless. Or, at least, it was, if you got your prep in before the panic rush... you may be a bit more at the mercies of your government now.
Among the things you should have derived from reading more carefully is the fact that state I'm living in is taking it quite seriously. Personally, my hatches are battened down and I'm prepared to be isolated for at least a month, maybe two. (Have to admit it's hard to tell how far my supplies will go, I've never actually had to live on them before.)
You're talking to someone who specially prepped for this about seven weeks ago, in addition to the general prep I already had on hand. If you can match that, then maybe consider start lecturing me. I actually got a bit of flak from my wife for the amount of prepping I did, because it was before she'd hardly even heard there was a new virus. Now she's glad I did, because I bought all the things that are missing in the stores around here now long before it was "hoarding".
I'm in the top tier of taking it seriously. At the same time... Don't panic. Don't advise panic. Don't fall into the cognitive trap of modeling this as a zombie apocolypse or some other thing where the virus is intelligently seeking out victims. Isolation measures will slow the virus down. It isn't possible to keep it "out of the US" but it remains possible to keep it out of your county, or your city, or your neighborhood, with sufficient steps. Total doom is not yet inevitable, and even then, how you are impacted remains significantly under your control even if your government is feckless. Or, at least, it was, if you got your prep in before the panic rush... you may be a bit more at the mercies of your government now.
> There are 1600 confirmed cases but the lack of tests hides how many real infections there are.
2,695 at the moment, per the NYT tracker
https://www.nytimes.com/interactive/2020/world/coronavirus-m...
2,695 at the moment, per the NYT tracker
https://www.nytimes.com/interactive/2020/world/coronavirus-m...
Last official update from cdc was 1629 [0]. NYT seems to be aggregating data from state reports, and even that is out of date. NYT reports 607 in WA, but the state itself reports 642 [1] (cdc reported 457 in WA on Friday).
[0] https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html
[1] https://www.doh.wa.gov/Emergencies/Coronavirus
[0] https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html
[1] https://www.doh.wa.gov/Emergencies/Coronavirus
2969 right now at https://coronavirus.1point3acres.com/. That site aggregates from news media reports and is the most real-time of the various sites I've seen. Plus it gives county-level breakdowns and links to reports with further details.
This is the interesting case where anecdote really does become data. If there are truly only 1,600 confirmed cases then hearing a few stories from a friend of a friend that they know people are sick should still be very unlikely.
The fact that many people here and around the web are sharing stories of sick friends is are a set of anecdotes that would be nearly impossible if the reported numbers were correct.
I suspect by this coming weekend the US will feel very different. I wouldn't be surprised at all if a major update to official numbers came and completely changed the current state of where things are.
The fact that many people here and around the web are sharing stories of sick friends is are a set of anecdotes that would be nearly impossible if the reported numbers were correct.
I suspect by this coming weekend the US will feel very different. I wouldn't be surprised at all if a major update to official numbers came and completely changed the current state of where things are.
I think some napkin math with the number of celebrities and professional sports players, who presumably have far better access to testing than the US public (which has essentially zero access), would show that we are at least at 150k-200k infections, if not more. At least, immediately before Tom Hanks announced his infection, I saw some napkin math that showed that since no politicians, movie stars, or professional athletes were positive, the rate was less than 1/2000 in the US. Now that we have multiple infections in that group, we are in the > 1/2000 == 150k infection regime.
Does this control for the fact that celebrities and politicians do way more travel and meet way more people?
Nope! Napkin math will treat all cows as spherical. However, if they are traveling and meeting way more people, it's also likely they are spreading it far more in addition to having it at a higher rate than the more socially distant segment of the population. Also, would likely indicate vast amounts of community spread that is going completely undetected.
Canada has a population of 38 million, and only 150 confirmed cases.
But one of those cases is the Prime Minister's wife.
Do we really think there are only 150 cases?
It's obviously way, way, way higher than that.
But one of those cases is the Prime Minister's wife.
Do we really think there are only 150 cases?
It's obviously way, way, way higher than that.
Mme. Grégoire Trudeau seems to have contracted the novel coronavirus in the UK, so your datapoint doesn't really suggest anything about the situation in Canada.
Many people travel between UK and Canada.
>This is the interesting case where anecdote really does become data
I still disagree with this, although I somewhat agree with your sentiment. The anecdotes I have seen range from extremely mild to nightmarish. A large fraction of those made me false, deliberately or by accident. I find the statistics still tell the most concrete story.
I still disagree with this, although I somewhat agree with your sentiment. The anecdotes I have seen range from extremely mild to nightmarish. A large fraction of those made me false, deliberately or by accident. I find the statistics still tell the most concrete story.
There are far more than that today, the number you're quoting is the last cdc report (published mid day Friday). Current number is likely around 3000. NYT last published ~2700 from aggregating state reports, and their per state numbers were a bit lower than every state website I checked.
And this is with extremely limited testing.
And this is with extremely limited testing.
What's being done to fix the lack of tests in the USA?
The CDC is headquartered in Atlanta. Where do the COVID-19 tests from them come from? Where are they manufactured, what ingredients do they require, how much do they cost to make, how long does it take to make them? What's the hold up on getting "unlimited" tests from the CDC? Do the tests even come from the CDC? How many are they producing a day? What are their blockers?
The CDC is headquartered in Atlanta. Where do the COVID-19 tests from them come from? Where are they manufactured, what ingredients do they require, how much do they cost to make, how long does it take to make them? What's the hold up on getting "unlimited" tests from the CDC? Do the tests even come from the CDC? How many are they producing a day? What are their blockers?
There are at least a couple of major upgrades to US testing capacity in progress from Roche[0] and Thermo Fisher[1].
[0] https://www.npr.org/2020/03/13/815522836/u-s-coronavirus-tes...
[1] https://www.statnews.com/2020/03/14/thermo-fisher-to-produce...
[0] https://www.npr.org/2020/03/13/815522836/u-s-coronavirus-tes...
[1] https://www.statnews.com/2020/03/14/thermo-fisher-to-produce...
I'd say we are late and in the 100s of thousands of cases that are untested.
Edit: others seem to feel the same. See epistatis' comment
Edit: others seem to feel the same. See epistatis' comment
>6 days later, we're at over 6000 infections, the country is in total lock down.
Similar anecdote here.
My SO texted me earlier this week saying how she will be taking the train from Madrid to Barcelona to go back to her family. She figured it will be empty on Sunday at 6 am.
I have been following the situation evolve in Italy and told her to get on the train right away and leave immediately before it gets worse.
Luckily, the next day she was on the train. The lockdowns started happening shortly afterwards.
Similar anecdote here.
My SO texted me earlier this week saying how she will be taking the train from Madrid to Barcelona to go back to her family. She figured it will be empty on Sunday at 6 am.
I have been following the situation evolve in Italy and told her to get on the train right away and leave immediately before it gets worse.
Luckily, the next day she was on the train. The lockdowns started happening shortly afterwards.
There's no "luckily". It's the exact behaviour that spread the virus all over Italy.
If you love your family and you have some sense of responsibility your duty is to stay where you are for a while. You can embrace your family in the near future.
If you love your family and you have some sense of responsibility your duty is to stay where you are for a while. You can embrace your family in the near future.
"For a while" is likely until we have a vaccine and produced enough of it to build up herd immunity. That probably takes a year or more.
Is it worse than catching the virus during your trip and bringing it to the family?
No, but for some people it might be worse if you also take into account the probability of catching the virus at this stage. Even in the worst-affected areas at most single-digit percentages of the population have the virus.
And quarantine restricts unexposed confinees to locations having these single-digit percentages which are overwhelmingly higher than the least-affected areas.
It is expected that even with thorough reliable testing and rapid clearance of the non-contagious from confinement, the spread among previously unexposed confinees would be vastly greater than among the unconfined, or further the _isolated clean_.
It is expected that even with thorough reliable testing and rapid clearance of the non-contagious from confinement, the spread among previously unexposed confinees would be vastly greater than among the unconfined, or further the _isolated clean_.
Shame on her
People should stay where they are. Lockdown is not a disaster. People fleeing lockdown are literally the carriers of this disaster.
Stay where you are, wait. Don't travel. Don't fight the locdown. Lockdown is the current, appropriate course of action. A very effective lockdown can eliminate the infection in, well, however long it took to eliminate it in Wuhan.
Fleeing the lockdown now is just going to another area that is going to be on lockdown later on anyway.
People should stay where they are. Lockdown is not a disaster. People fleeing lockdown are literally the carriers of this disaster.
Stay where you are, wait. Don't travel. Don't fight the locdown. Lockdown is the current, appropriate course of action. A very effective lockdown can eliminate the infection in, well, however long it took to eliminate it in Wuhan.
Fleeing the lockdown now is just going to another area that is going to be on lockdown later on anyway.
People should stay where they are. Lockdown is not a disaster. People fleeing lockdown are literally the carriers of this disaster.
There will be test of this thesis in Poland soon. As government closed down universities, some of them told students that they have to vacate their dormitories and go back home (dormitories are usually occupied by students from countryside and smaller cities), and it caused massive migration. It is already confirmed that students in my city were infected for two weeks, but is not known yet how widespread it was. To make situation worse, some dormitories are now being turned into quarantine hotels, so students are told to come back and take their belongings with them (initially they were told they can leave their stuff behind).
There will be test of this thesis in Poland soon. As government closed down universities, some of them told students that they have to vacate their dormitories and go back home (dormitories are usually occupied by students from countryside and smaller cities), and it caused massive migration. It is already confirmed that students in my city were infected for two weeks, but is not known yet how widespread it was. To make situation worse, some dormitories are now being turned into quarantine hotels, so students are told to come back and take their belongings with them (initially they were told they can leave their stuff behind).
Universities in the United States are doing the same thing. Stanford, for instance, is evicting its dorm population.
I didn't see them say anything about "fleeing a lockdown." She was fleeing a potentially life-threatening virus in a scary situation in order to be with her family. That isn't so hard to grok, and obviously she felt she was making the right decision. Shaming someone for looking for security and safety in a scary situation (i.e. for being human) is just absurd.
She was fleeing a potentially life-threatening virus in a scary situation in order to be with her family.
I hate to put this harshly but... She may well be fleeing with a life threatening virus that will kill her family. This has happened already, even documented, in China.
We can't look to our own comfort at this point. All my family visits are postponed and my food is mostly stocked up.
And it's a hard situation where we won't all make the best choices but still want to pressure everyone to make the appropriate choices.
I hate to put this harshly but... She may well be fleeing with a life threatening virus that will kill her family. This has happened already, even documented, in China.
We can't look to our own comfort at this point. All my family visits are postponed and my food is mostly stocked up.
And it's a hard situation where we won't all make the best choices but still want to pressure everyone to make the appropriate choices.
>She was fleeing a potentially life-threatening virus in a scary situation in order to be with her family.
True.
>She may well be fleeing with a life threatening virus that will kill her family.
And true.
True.
>She may well be fleeing with a life threatening virus that will kill her family.
And true.
Shaming somebody for potentially spreading a disease, on the other hand, is precisely the sort of thing that needs to happen in a situation like this. Epidemics don't give a tinker's damn for anyone's feelings.
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We elect governments to protect us from our own fight-or-flight response which is not a good thing in modern society
>Fleeing the lockdown now is just going to another area that is going to be on lockdown later on anyway.
This is readily recognized.
And this can be motivation enough to relocate to a chosen area for upcoming lockdown, while some choice is still possible.
This is readily recognized.
And this can be motivation enough to relocate to a chosen area for upcoming lockdown, while some choice is still possible.
To think that with the modern internet, there should be less incentive to be physically present.
What the letter means is that if your country is not there yet, you might be DAYS away from widespread panic and total lock down.
I gotta say this but I don't think we should put forward the position that total lockdown is an irrational position. Total lockdown seems fully rational, not a product of mere panic at all. Total lockdown worked in Wuhan. Absolute and complete isolation inherently results in exponential decline in the fashion that exposure result in exponential growh. It's a drag but it doesn't seem as much of a drag as millions of dead people.
And that is the bizarre thing I'm saying and hearing in the US - "Uh, just let it infect everyone" - "you know that promises to the largest loss of life on US soil ever" - "well, try to slow it down a bit". Jeesh.
I gotta say this but I don't think we should put forward the position that total lockdown is an irrational position. Total lockdown seems fully rational, not a product of mere panic at all. Total lockdown worked in Wuhan. Absolute and complete isolation inherently results in exponential decline in the fashion that exposure result in exponential growh. It's a drag but it doesn't seem as much of a drag as millions of dead people.
And that is the bizarre thing I'm saying and hearing in the US - "Uh, just let it infect everyone" - "you know that promises to the largest loss of life on US soil ever" - "well, try to slow it down a bit". Jeesh.
I was going to say surely not the largest loss of life but you're right, the high estimate of the Civil War was 1 million, the low estimate of this would be a little over 3 million.
I guess if you put all the Indian wars together it might be more, but that seems cheating.
on edit: saw your other comment, and you're correct, little over 2 million is the low but totally unrealistic estimate.
on edit: saw your other comment, and you're correct, little over 2 million is the low but totally unrealistic estimate.
> "you know that promises to the largest loss of life on US soil ever"
From what I'm aware, if hospitals are able to handle the patients, it shouldn't be up to that level.
And the "slow it down" plan is primarily about not overwhelming hospitals.
From what I'm aware, if hospitals are able to handle the patients, it shouldn't be up to that level.
And the "slow it down" plan is primarily about not overwhelming hospitals.
You understand wrong and these common arguments can be easily seen to have incorrect arithmetic.
There are no countries with mass infections where the fatality rate is plausibly below 1%. Of course, when the health system is overwhelmed, the fatality rate can be 4-5%. But let's just look at a 1% fatality rate to start with.
The US population is 327,000,000. Seventy percent of that is 228,900,000. One percent of that 2,289,000; A little more than two million people if we assume 70% infection and an orderly health care system. But that horrible figure isn't plausible.
Because there's more. Claims you can avoid the overwhelming of the health care system are clearly false. Dividing, assuming, unrealistically that the event could be divided evenly through a year, that means that, that many people dying in a year (365) involves 6271 people dying per day and ten times that many people, ~62,000 people, arriving very sick at hospitals, per day throughout the year. And that is far, far more than could be handled by the US health care system.
Moreover, spreading the deaths evenly is inherently unrealistic, the situation of "flattening the curve" (a good thing in itself), can't stop exponential growth as such. If you decrease the doubling time of a exponential curve, you still have a situation where most of the area, most of the deaths in this case, is in the last double. So the even supposedly flattened curve won't let things go smoothly IF we assume "everyone will get this". And that promises not just 2 million but 10 millions (at the 5% death rate). If assume the US current has 10,000 infections, we approximately 12 "doublings" away from 228,900,000 infections (70% of the population). If we slow the progression to year, half the infection will still happen in the last month, with 10% of those "serious", that 763,000 needing attention per day. We're now talking corpses in the streets levels of horror. And we'd have further deaths from this breakdown situation.
And back to the lockdown scenario. My answer is that Lockdowns are absolutely necessary and thankfully it seems likely in most situations they are coming. The figures above should show that alternative is effectively going to be complete breakdown of the health care system and effectively society.
There are no countries with mass infections where the fatality rate is plausibly below 1%. Of course, when the health system is overwhelmed, the fatality rate can be 4-5%. But let's just look at a 1% fatality rate to start with.
The US population is 327,000,000. Seventy percent of that is 228,900,000. One percent of that 2,289,000; A little more than two million people if we assume 70% infection and an orderly health care system. But that horrible figure isn't plausible.
Because there's more. Claims you can avoid the overwhelming of the health care system are clearly false. Dividing, assuming, unrealistically that the event could be divided evenly through a year, that means that, that many people dying in a year (365) involves 6271 people dying per day and ten times that many people, ~62,000 people, arriving very sick at hospitals, per day throughout the year. And that is far, far more than could be handled by the US health care system.
Moreover, spreading the deaths evenly is inherently unrealistic, the situation of "flattening the curve" (a good thing in itself), can't stop exponential growth as such. If you decrease the doubling time of a exponential curve, you still have a situation where most of the area, most of the deaths in this case, is in the last double. So the even supposedly flattened curve won't let things go smoothly IF we assume "everyone will get this". And that promises not just 2 million but 10 millions (at the 5% death rate). If assume the US current has 10,000 infections, we approximately 12 "doublings" away from 228,900,000 infections (70% of the population). If we slow the progression to year, half the infection will still happen in the last month, with 10% of those "serious", that 763,000 needing attention per day. We're now talking corpses in the streets levels of horror. And we'd have further deaths from this breakdown situation.
And back to the lockdown scenario. My answer is that Lockdowns are absolutely necessary and thankfully it seems likely in most situations they are coming. The figures above should show that alternative is effectively going to be complete breakdown of the health care system and effectively society.
I don't misunderstand, the main difference is that I was going off an expert estimate that had a half percent fatality rate, and might have had a smaller ratio of infected. If you think that fatality rate is wrong, okay, but that's not on me.
> If you decrease the doubling time of a exponential curve, you still have a situation where most of the area, most of the deaths in this case, is in the last double.
The closer you get to affecting the entire population, the less exponential your curve becomes. Especially if you're assuming that a significant chunk of the population doesn't get infected, you have to have a curve that spends a lot of time slowing down. The max infection rate will be a lot lower than an exponential curve that keeps accelerating until it slams into a brick wall and somehow instantly stops.
> If you decrease the doubling time of a exponential curve, you still have a situation where most of the area, most of the deaths in this case, is in the last double.
The closer you get to affecting the entire population, the less exponential your curve becomes. Especially if you're assuming that a significant chunk of the population doesn't get infected, you have to have a curve that spends a lot of time slowing down. The max infection rate will be a lot lower than an exponential curve that keeps accelerating until it slams into a brick wall and somehow instantly stops.
I was going off an expert estimate that had a half percent fatality rate
South Korea has dealt the infection extraordinarily well and they have a %1 fatality rate. But even halving my figures, you get an insane result, an overwhelmed health system and so-forth.
The closer you get to affecting the entire population, the less exponential your curve becomes.
True but that STILL bunches up the deaths a lot, until are at a significant fraction of the population, the growth will exponential (and another point of realism, it's city by city also but health care is also city-by-city). The parabola shaped curves in the "don't flatten the curve" articles are bullshit (but the "don't flatten the curves" actions still should be done. It's just the idea that these will be enough that is untenable).
Edit: And I know well there are experts putting forward these arguments. As far as I tell, this an expression of sleep walking, cognitive dissonance or similar phenomena where people don't notice that their mental tools lead them to untenable approaches since they have relied on these tools for quite a while.
Edit2: I think the standard approach of health departments is "when you go past containment, you go to mitigation" and that's what they have been taught. The thing here is nations quickly discover that the situation cannot be mitigated and they have to go to containment on a region or nation wide basis - the situation in Italy, what the situation is becoming in Spain, what literally the situation should be throughout the entire world.
South Korea has dealt the infection extraordinarily well and they have a %1 fatality rate. But even halving my figures, you get an insane result, an overwhelmed health system and so-forth.
The closer you get to affecting the entire population, the less exponential your curve becomes.
True but that STILL bunches up the deaths a lot, until are at a significant fraction of the population, the growth will exponential (and another point of realism, it's city by city also but health care is also city-by-city). The parabola shaped curves in the "don't flatten the curve" articles are bullshit (but the "don't flatten the curves" actions still should be done. It's just the idea that these will be enough that is untenable).
Edit: And I know well there are experts putting forward these arguments. As far as I tell, this an expression of sleep walking, cognitive dissonance or similar phenomena where people don't notice that their mental tools lead them to untenable approaches since they have relied on these tools for quite a while.
Edit2: I think the standard approach of health departments is "when you go past containment, you go to mitigation" and that's what they have been taught. The thing here is nations quickly discover that the situation cannot be mitigated and they have to go to containment on a region or nation wide basis - the situation in Italy, what the situation is becoming in Spain, what literally the situation should be throughout the entire world.
>>From what I'm aware, if hospitals are able to handle the patients, it shouldn't be up to that level.
With an absolute best case CFR of 0.6%, that's near 2 Million dead. I struggle to think of a larger loss of life on US soil.
Assuming hospitals reach saturation fairly early, yielding a 5% CFR, and we're looking at 16.5 Million dead. That is... a lot. Like we have nothing here to compare that to. To put it into perspective, the US only lost 400 THOUSAND in WWII....
With an absolute best case CFR of 0.6%, that's near 2 Million dead. I struggle to think of a larger loss of life on US soil.
Assuming hospitals reach saturation fairly early, yielding a 5% CFR, and we're looking at 16.5 Million dead. That is... a lot. Like we have nothing here to compare that to. To put it into perspective, the US only lost 400 THOUSAND in WWII....
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I believe you’re correct. The SK approach has been more focused on individual quarantines and aggressive monitoring: https://www.aljazeera.com/news/2020/03/italy-south-korea-dif...
Thank you. Same here in the US. If you are in the US and still shrugging this off, please head all the warnings. The time to act was two weeks ago, and we won't make up that lost opportunity of effort for prevention and precaution.
Can we make sure we’re reading this kind of information when given by people who actually study and work in a relevant field?
Now more than ever we should look at the source of every information.
I know I'm going to get downvoted for saying this, but I think it is important enough.
Now more than ever we should look at the source of every information.
I know I'm going to get downvoted for saying this, but I think it is important enough.
It is fair to observe that the expertise here is math rather than medicine. However, epidemiologists have already made these predictions. Don't see any harm in signalling broader academic support.
Particularly not since none of the signatories could plausibly be accused of exaggerating the danger, in order to extract grant money. As goes the usual cynical claim of innumerate science-deniers.
Particularly not since none of the signatories could plausibly be accused of exaggerating the danger, in order to extract grant money. As goes the usual cynical claim of innumerate science-deniers.
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Despite governments mostly making slow policy decisions, it's amazing how fast news spreads about this. Tons of planes bound for Spain were turned around mid-flight today after a message sent out to air traffic controllers. Absolutely nuts.
https://www.euronews.com/2020/03/14/coronavirus-spain-bound-...
https://www.euronews.com/2020/03/14/coronavirus-spain-bound-...
Thank you for sharing. Your comment has highlighted the importance of making sure my household is prepared
We (Lithuania) are going into more or less total lockdown since coming midnight. With 8 active cases (first confirmed case recovered and was released home). I only wish government would be more aggressive with testing.
Mike Pence is not the right person to manage US response to the virus. We needs someone with different skills. If you live in US, please call your congresspeople and ask them to make a change:
https://www.house.gov/representatives
https://www.senate.gov/senators
https://www.house.gov/representatives
https://www.senate.gov/senators
I was downvoted here recently for sounding the alarm bells on how bad this is going to be and accused of trying to incite panic. Folks, COVID-19 is something that should be taken seriously. President Obama had great advice: "stay calm and listen to the experts". All the experts are saying this is going to be bad and we should be getting ready now for what will happen in the future.
Please also read this, I believe it's the right approach:
https://medium.com/@jb_89278/the-11-day-plan-to-contain-covi...
The guy is tech enterpreneur and VC investor who has been advising our (Czech) PM.
https://medium.com/@jb_89278/the-11-day-plan-to-contain-covi...
The guy is tech enterpreneur and VC investor who has been advising our (Czech) PM.
Maybe we should do a Global 11 Day Quarantine every year. Stop the flu and common colds from spreading too. Time it so it happens before peak flu season.
Or maybe even twice per year, for the northern and southern hemispheres, if they have different flu season schedules. (Edit: Or just do it once per hemisphere, but with restricted travel between hemispheres during the quarantine.)
22 days at home every year... okay, a bit boring, and the economy would take a small hit from that... BUT, there would also be far fewer people taking sick days, and workers would also get more rest and come back more refreshed. It may only be a net loss of a couple days of work, lets say 3 days of work, 1% of Global GDP.
Global GDP grows at about 2-3% per year from what I can see. So a loss of 1% would set us back to the level of late 2019 or New Years' 2020, which was hardly the dark ages.
Not to mention Work From Home policies would adapt so it's likely very little productivity would be lost.
Or maybe even twice per year, for the northern and southern hemispheres, if they have different flu season schedules. (Edit: Or just do it once per hemisphere, but with restricted travel between hemispheres during the quarantine.)
22 days at home every year... okay, a bit boring, and the economy would take a small hit from that... BUT, there would also be far fewer people taking sick days, and workers would also get more rest and come back more refreshed. It may only be a net loss of a couple days of work, lets say 3 days of work, 1% of Global GDP.
Global GDP grows at about 2-3% per year from what I can see. So a loss of 1% would set us back to the level of late 2019 or New Years' 2020, which was hardly the dark ages.
Not to mention Work From Home policies would adapt so it's likely very little productivity would be lost.
It would be impossible to do this in the U.S. I'm not sure he appreciates the size of the U.S., the resistance among many Americans who don't like being told what to do, the denial by Fox et al, the distributed nature of our government and on and on. I can't even imagine it working in my county.
It also doesn't consider that many of the infected are asymptomatic, so they won't be "revealed" within the 11 day period.
Yeah, there would be rioting pretty much immediately if anyone tried that here, and I'm sure the same would happen elsewhere.
I'm personally a fan of controlled, opt-in infections to help speed up research for a vaccine along with moderate quarantine (cancel many public events, encourage self quarantine). It may not be as effective, but it's much less likely to end in riots.
I'm personally a fan of controlled, opt-in infections to help speed up research for a vaccine along with moderate quarantine (cancel many public events, encourage self quarantine). It may not be as effective, but it's much less likely to end in riots.
The alternative may be an explosion of cases and a complete collapse of the health care system. Because there is a good chance that mild social distancing measures are simply not enough.
I've been using https://meet.jit.si/ through OBS with family to share content/games and webcam chat. Works great on mobile with apps, desktop on web.
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It's said Germany does not lock down cities and fatality remains to be extremely low, which gives British, even USA the confidence to practice herd immunity.
I hope in US we will not see this exponential infected scenario, finger crossed.
I hope in US we will not see this exponential infected scenario, finger crossed.
German cities are starting to lock down.
Berlin has canceled any gathering with more than 50 people. If it's less than 50 people, you have to keep a list of everybody who's there for a month. Schools are closed. As are recreational places (cinemas, clubs, museums, gyms, baths). Restaurants have to enforce 1.5 meters separation between patrons.
https://www.berlin.de/rbmskzl/aktuelles/rathaus-aktuell/2020...
It's not quite Italy yet but it's close.
Berlin has canceled any gathering with more than 50 people. If it's less than 50 people, you have to keep a list of everybody who's there for a month. Schools are closed. As are recreational places (cinemas, clubs, museums, gyms, baths). Restaurants have to enforce 1.5 meters separation between patrons.
https://www.berlin.de/rbmskzl/aktuelles/rathaus-aktuell/2020...
It's not quite Italy yet but it's close.
Germany seems to be doing the South Korea solution of very extensive testing and quarantine so that they end up with more confirmed cases that in other places would not even be found. That drives down their mortality rate just because the denominator is bigger. But that just means they're more days behind in the exponential than the confirmed cases number would suggest. It does not mean they have it under control.
Exp is the simplest, and works very well with this virus.
To not get exp you have to basically eradicate it (can be done locally with strict lockdown measures, but one day or another you will have to lift them...)
To not get exp you have to basically eradicate it (can be done locally with strict lockdown measures, but one day or another you will have to lift them...)
Can anyone vouch for the legitimacy of the names on this list? Is this authentic? I've been running my own numbers, and it does not seem far fetched at all. Governments need to be taking this extremely seriously.
For what it means, I know some of the people on that list and I can say that they are real scientists.
My relatives will never open a "left" website. Is there a version of this letter with the graphs on another website?
> From our data, about 10% of patients require ICU (Intensive Care Unit) or sub ICU assistance and about 5% of patients die.
I think that we really need to understand precisely what conclusions these represent when we see statements like this.
Exactly what does "10% of patients" mean? 10% of those who test positive? 10% of those who test positive and also show symptoms?
It seems that a majority of people who contract the virus and test positive (let alone those who are exposed) do not show any symptoms at all.[0]
Of those who do show symptoms, estimates regarding how many any seek out, receive, or require care vary widely, so much so that it's very difficult to draw any conclusions using any dataset that I've seen.
So I ask: When the authors here say "From our data", exactly what dataset are they using and what operations are they performing on this dataset to arrive at this number?
This is crucially important, because if this 10% is actually 10% of those who already seek treatment for respiratory illness, and also subsequently test positive for COVID-19, then the death rate is actually much, much lower than most of the published reports.
It seems to me that we need to know the answer to this before proceeding with any other restrictive public policy solutions.
I'm particularly concerned with the decision to close schools, which in many cases (at least here in the USA) is inevitably going to lead to kids being placed with grandparents for care, which is a terrible outcome if our goal is to reduce exposure to vulnerable populations.
It is OK to question the panic. It is OK to believe, as I do given the available data so far, that the panic is more harmful than the virus itself. I have started a subreddit to gather data and opinions inclined toward using this as an opportunity to appropriately prepare rather than race to drastic solutions likely to hurt vulnerable populations.[1]
0: https://eurosurveillance.org/content/10.2807/1560-7917.ES.20...
1: https://www.reddit.com/r/PrepareInsteadOfPanic/
I think that we really need to understand precisely what conclusions these represent when we see statements like this.
Exactly what does "10% of patients" mean? 10% of those who test positive? 10% of those who test positive and also show symptoms?
It seems that a majority of people who contract the virus and test positive (let alone those who are exposed) do not show any symptoms at all.[0]
Of those who do show symptoms, estimates regarding how many any seek out, receive, or require care vary widely, so much so that it's very difficult to draw any conclusions using any dataset that I've seen.
So I ask: When the authors here say "From our data", exactly what dataset are they using and what operations are they performing on this dataset to arrive at this number?
This is crucially important, because if this 10% is actually 10% of those who already seek treatment for respiratory illness, and also subsequently test positive for COVID-19, then the death rate is actually much, much lower than most of the published reports.
It seems to me that we need to know the answer to this before proceeding with any other restrictive public policy solutions.
I'm particularly concerned with the decision to close schools, which in many cases (at least here in the USA) is inevitably going to lead to kids being placed with grandparents for care, which is a terrible outcome if our goal is to reduce exposure to vulnerable populations.
It is OK to question the panic. It is OK to believe, as I do given the available data so far, that the panic is more harmful than the virus itself. I have started a subreddit to gather data and opinions inclined toward using this as an opportunity to appropriately prepare rather than race to drastic solutions likely to hurt vulnerable populations.[1]
0: https://eurosurveillance.org/content/10.2807/1560-7917.ES.20...
1: https://www.reddit.com/r/PrepareInsteadOfPanic/
One of the most important upvotes of our lives.
Why didn't more people die in China?
Because Wuhan started welding people's doors shut as soon as they passed 400 new known cases in a single day.
That kind of behaviour is not acceptable in the West (nor should it be, anywhere), but we still probably need to be taking this virus a bit more seriously than we are.
That kind of behaviour is not acceptable in the West (nor should it be, anywhere), but we still probably need to be taking this virus a bit more seriously than we are.
I think these claims of "this is not acceptable in the West" are absurd and one of the causes of the current catastrophe.
All you need is to pass a law and enforce it with police and military, it's not hard.
Since there is a good reason for the law, there won't be widespread resistance, and in fact on balance citizen are likely to help enforcement rather than hinder it.
All you need is to pass a law and enforce it with police and military, it's not hard.
Since there is a good reason for the law, there won't be widespread resistance, and in fact on balance citizen are likely to help enforcement rather than hinder it.
This is not "from Italy", it's been organized by a far-left Italian magazine. Yes, they are "from Italy", but the title is disingenuous and misleading.
Note that the page lists "the editors" (of the magazine) as the authors, and the first signature is by the magazine's publisher. The rest appear to be various academic personalities they have reached out to, many of them not from Italy or in Italy.
As for the contents, I don't necessarily disagree with the advice, but this letter is not particularly well written, nor particularly authoritative.
For example, this section:
> The beginning of the outbreak had the exact same number of infections in China, Italy, and other countries. The difference is that China strongly and quickly locked down Wuhan and all of the Hubei region 8 days before Italy [3].
This is an exceedingly poor phrasing, almost seeming to suggest that the outbreak started with a few cases everywhere in the world at the same time. Inadvertently or not, this dovetails with China's PR push trying to claim that the epidemic may not have started there (something that is readily disproven by all epidemiological and genetic evidence).
Even setting aside the potential for confusion, the claim on its face is clearly baseless. Maybe the outbreak started with ten people getting infected in the Wuhan wet market on the same day (if we go by the wet market theory), while in Italy it started with a single infected person entering the country. Or, vice versa, maybe in China it started from a single infected person, and in Italy it was brought in by ten different people carrying it into the country separately. Who's to say?
At any rate, if you look at the source for that claim, you can see that it is shifting the timelines to align at some particular point in the outbreak, and it is comparing the time from that point when China imposed the Wuhan lockdown with the time when Italy imposed the whole-country lockdown.
The source is certainly more interesting, and gives a better picture of the situation than the letter does (although we have seen similar and better analyses in English for a while). However, the "8 days" figure is somewhat arbitrary. For example, Italy imposed a partial lockdown on the areas of the country where individual cases were found days before they shifted to a whole-country lockdown. Maybe that date should have been compared instead?
By the best information currently available, the first case in Italy came from a person who was infected in Germany. According to the letter's claim, the outbreak starts with "the exact same number of infections" (one, presumably), and then grows at the same speed. But then Germany's timeline should be ahead of Italy, yet it's not.
Then there is the elephant in the room, of course. If you cannot rely on China's lockdown to contain the infection, then the rational and prudent thing to do was not to wait for outbreaks in other countries and impose lockdowns there. It was to restrict and heavily control international travel (cancel flights, test all passengers, force visitors to quarantine, etc.). Would that have been accepted by the public? Would that have been accepted by the authors of this letter?
tl;dr: title is grossly misleading, please correct.
Note that the page lists "the editors" (of the magazine) as the authors, and the first signature is by the magazine's publisher. The rest appear to be various academic personalities they have reached out to, many of them not from Italy or in Italy.
As for the contents, I don't necessarily disagree with the advice, but this letter is not particularly well written, nor particularly authoritative.
For example, this section:
> The beginning of the outbreak had the exact same number of infections in China, Italy, and other countries. The difference is that China strongly and quickly locked down Wuhan and all of the Hubei region 8 days before Italy [3].
This is an exceedingly poor phrasing, almost seeming to suggest that the outbreak started with a few cases everywhere in the world at the same time. Inadvertently or not, this dovetails with China's PR push trying to claim that the epidemic may not have started there (something that is readily disproven by all epidemiological and genetic evidence).
Even setting aside the potential for confusion, the claim on its face is clearly baseless. Maybe the outbreak started with ten people getting infected in the Wuhan wet market on the same day (if we go by the wet market theory), while in Italy it started with a single infected person entering the country. Or, vice versa, maybe in China it started from a single infected person, and in Italy it was brought in by ten different people carrying it into the country separately. Who's to say?
At any rate, if you look at the source for that claim, you can see that it is shifting the timelines to align at some particular point in the outbreak, and it is comparing the time from that point when China imposed the Wuhan lockdown with the time when Italy imposed the whole-country lockdown.
The source is certainly more interesting, and gives a better picture of the situation than the letter does (although we have seen similar and better analyses in English for a while). However, the "8 days" figure is somewhat arbitrary. For example, Italy imposed a partial lockdown on the areas of the country where individual cases were found days before they shifted to a whole-country lockdown. Maybe that date should have been compared instead?
By the best information currently available, the first case in Italy came from a person who was infected in Germany. According to the letter's claim, the outbreak starts with "the exact same number of infections" (one, presumably), and then grows at the same speed. But then Germany's timeline should be ahead of Italy, yet it's not.
Then there is the elephant in the room, of course. If you cannot rely on China's lockdown to contain the infection, then the rational and prudent thing to do was not to wait for outbreaks in other countries and impose lockdowns there. It was to restrict and heavily control international travel (cancel flights, test all passengers, force visitors to quarantine, etc.). Would that have been accepted by the public? Would that have been accepted by the authors of this letter?
tl;dr: title is grossly misleading, please correct.
Agreed, though you can find letters from individual Italian medical professionals saying about the same thing. Most authoritative would be a letter from the government of Italy or the equivalent of the AMA.
Also someone from Italy here: never, ever praise China as it is the same authoritarian state that caused all these deaths by silencing the truth when it mattered the most. Had they not violently censored doctors (like their own people or the current holocaust being carried on against Muslims), we would not be suffering through this devastation. This is also absolutely not an open letter "from Italy": it's a message from a minor—poorly written— publication.
x__x(1)
Not sure why this is on the number 1 spot currently.
This is a letter signed by non-experts (albeit sometimes scientists/engineers). To me, it comes off as the climate-change denier letters or 9/11 "truthers" letters.
Please let the experts do their job. Don't spread uninformed opinions backed up by Facebook posts and panicked researchers with expertise "relevant to virus spreading" such as electronics, architecture and art history.
Be safe out there but don't let the fear and resulting panic of this virus be worse than the virus itself.
This is a letter signed by non-experts (albeit sometimes scientists/engineers). To me, it comes off as the climate-change denier letters or 9/11 "truthers" letters.
Please let the experts do their job. Don't spread uninformed opinions backed up by Facebook posts and panicked researchers with expertise "relevant to virus spreading" such as electronics, architecture and art history.
Be safe out there but don't let the fear and resulting panic of this virus be worse than the virus itself.
You don't need expertise beyond elementary school math to understand cases doubling every 2 to 3 days is very, very bad. Look at the charts for any of the countries. They all follow the same pattern.
The US is going to look like France and Italy in a week, 10 days at the most. This is a certainty.
The US is going to look like France and Italy in a week, 10 days at the most. This is a certainty.
> This is a certainty.
Are you an epidemiologist?
Are you an epidemiologist?
I don't need to be. Just look at the graphs across various countries. Then ask yourself, has the US response been better or worse, to date?
jiggawatts(1)
Why do you believe this is misinformation? All it's trying to do is mobilize people who understand what an exponential is to act.
I hope you haven't read the reports from the medical frontline in Lombardie - They are making life or death choices now due to influx of ICU patient without enough equipment and medical staff exhausted and starting to get sick themselves
One frontline story among many here https://twitter.com/jasonvanschoor/status/123714289107769753...
One frontline story among many here https://twitter.com/jasonvanschoor/status/123714289107769753...
Triage, i.e. if you show up and have any condition that reduces your chances of survival you are not treated at all. Palliative care only.
Also the government, despite sounding enlightened and getting most of the praise of the press, is locking everyone up with exceptional measures, but still goes the bureaucratic way to procure respirators (which are essential in the current emergency, and they are needed now, not in the two weeks required for the lockdown to show any effect) and masks (either useless because not certified for medical use, or stuck in a warehouse due to "missing authorizations").
At this point my region (Lombardia) appointed someone with the sole task of getting an emergency hospital up in Milano to house more patients, doing whatever it takes. Hopefully this will help.
At this point my region (Lombardia) appointed someone with the sole task of getting an emergency hospital up in Milano to house more patients, doing whatever it takes. Hopefully this will help.
Nothing in this letter is inaccurate or goes against what the scientific experts have been saying. When you say "experts," you're really talking about the bureaucrats and politicians who get to make these decisions and have been too hesitant to ramp up testing and quarantine measures.
This letter doesn't make any contraversial scientific claims. Please, highlight anything you think is in doubt?
chrisseaton(1)
By "experts" you mean the WHO who delayed declaring it an pandemic for more than a month? I think we're beyond experts already... it's time for leadership, decisive action after experts have failed across the board.
What changed when they declared it a pandemic (i.e. when it meet some necessarily arbitrary bureaucratic definition)? Nothing much. Any government that was holding its breath waiting for this declaration is not listening to its experts anyway.
Stop doing the internet equivalent of running around like a chicken with your head cut off. This is absolutely the Yinge to listen to experts, also known as people who know what they're talking about at a level much deeper than a few weeks' worth of regurgitated Reddit posts.
Stop doing the internet equivalent of running around like a chicken with your head cut off. This is absolutely the Yinge to listen to experts, also known as people who know what they're talking about at a level much deeper than a few weeks' worth of regurgitated Reddit posts.
They declared it a global emergency because it would turn into a pandemic (which has an actual definition and criteria that weren’t met) in January. People ignored them and they were right and were forced to declare it a pandemic a month later.
We are not anywhere near the point where the panic of this virus is worse than the potential outcome of the virus. If anything there is not ENOUGH strong movement being made.
Yes, we need more panic. Maximum panic please! For a disease that has a 0.5% fatality rate, and the medium death age is over the average life expectancy of one's country. And most scientists believe we can't stop it anyway. Yes, let's burn down the modern world and suspend all civil rights for this.
The fatality rate is only as low as 0.5-0.9% in countries that aggressively locked down, quarantined, and built temporary medical facilities in order to flatten the curve so health care facilities could keep up with urgent cases.
In places where no aggressive action is taken, fatality rates are much, much higher (3-5%) — because otherwise treatable cases can not be treated, and the marginally more ill die for lack of treatment.
The difference between 0.9% and 3% of the US population (per Census.gov ~329 million estimate) is 6.9 million people.
https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
In places where no aggressive action is taken, fatality rates are much, much higher (3-5%) — because otherwise treatable cases can not be treated, and the marginally more ill die for lack of treatment.
The difference between 0.9% and 3% of the US population (per Census.gov ~329 million estimate) is 6.9 million people.
https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
Something something 20% hospitalization rate * number of infected people >> healthcare capacity of any country -> a lot more than 0.5% of fatalities, + all the other deaths for all other kinds of medical emergencies, which only happen because doctors have to aggressively triage patients.
Obviously we should try and slow it down. But there's a fine line between slowing it down and overreacting.
Yes we should be so flippant about hundreds of thousands of people dead. How dare you ask me to sacrifice going to a restaurant for that?
nostromo(3)
0.5% is a textbook number, not the sorry-the-hospital-is-full number, which has in some places been closer to 5%.
The “experts” are not doing their jobs! In the US you would have expected the CDC under the President’s leadership to act decisively and promptly. Obviously this did not happen.
The randos are providing much more value than the experts in the US. Other countries like South Korea and Singapore have experts who are doing quite well.
The randos are providing much more value than the experts in the US. Other countries like South Korea and Singapore have experts who are doing quite well.
The CDC can’t dictate state policies. These are executive decisions that the CDC can only strongly advise on.
The CDC effectively dictated who could be tested and what test would be used. But those tests were faulty and now there are supply chain issues with the new tests. That was the point when they gave up and admitted failure. "Mitigation" and "flattening the curve" are admissions of failure. The only hope now is that summer blunts the spread, which is possible but by no means guaranteed.
they did the same thing with slaughterbots when deep learning was making the news.
The left drove us to the same situation here in Spain. I cannot be more concerned with their politics, sadly, we should be prepared to a massive spread.
[deleted]
The handwaving arguments in this letter are not convincing (especially the "You do also understand that, as long as the rate of increase is exponential, no linear solution to contrast it will work (I.e. increasing x times the number of ICU machines, etc.)" nonsense). The stats in this very letter indicate that 10% of patients require ventilators, which cost about $4000. So even if the entire population were sick at the same time, would need population * 0.1 ventilators, at a cost of $400 per resident.
The fact that we haven't spent $400 per resident to stockpile ventilators is a failure of society and a failure of government. The economic damage over these next few weeks will be far, far greater than $400 per resident.
The fact that we haven't spent $400 per resident to stockpile ventilators is a failure of society and a failure of government. The economic damage over these next few weeks will be far, far greater than $400 per resident.
We've stockpiled some number of ventilators in the USA (though still likely insufficient for the task at hand). The bigger issue is the labor needed to staff them, which has very limited scalability.
I wonder how hard it is, and how quickly a moderately intelligent person could be brought up to speed (at least enough to get better outcomes than just leaving the patient to die).
I wonder how hard it is, and how quickly a moderately intelligent person could be brought up to speed (at least enough to get better outcomes than just leaving the patient to die).
If you take every potential apocalyptic scenario and stockpile supplies. It’d add up to much more than 400$/resident.
The real shame is globalization. If manufacturing occurred in Europe. In North America...etc. we’d all just quickly ramp up our respirator production.
Instead the west outsourced this to China
The real shame is globalization. If manufacturing occurred in Europe. In North America...etc. we’d all just quickly ramp up our respirator production.
Instead the west outsourced this to China
This is only the first part of the problem.
The second part is, optimized supply chains that are effectively as empty as possible, all the time.
Here in Canada an 18-day rail blockade by native bands was enough to cause serious concerns in the supply of propane and other fuels in the eastern part of the country.
It's shocking that eastern half of Canada, the majority of its population, faces winters with just 3-weeks supply of fuel. The reason? Nobody wants to carry inventory.
So for many things, we outsource creation, AND we optimize-away buffer stock.
The second part is, optimized supply chains that are effectively as empty as possible, all the time.
Here in Canada an 18-day rail blockade by native bands was enough to cause serious concerns in the supply of propane and other fuels in the eastern part of the country.
It's shocking that eastern half of Canada, the majority of its population, faces winters with just 3-weeks supply of fuel. The reason? Nobody wants to carry inventory.
So for many things, we outsource creation, AND we optimize-away buffer stock.
You may think "it's not here yet". It is.
You may think "the numbers are low". They aren't. We are failing miserably in our testing, our numbers are easily off by a factor of 10 (for infections).
You might not want to be "weird" and not want to practice social distancing. You need to.
You need to act when it feels too early and honestly, in the US, that was a week+ ago so at least act now.
I don't say these things to whip people up in a panic, I say them because we are about to get hit hard here in the US. If you know a nurse maybe send them a text and ask how they feel. I can tell you the nurses I know are freaking out because they know we are not prepared. A have a friend who works at a big hospital. They have 2 cases (at least as of a day ago) and they almost buckled under it. They don't have many masks, they don't have training, and the hospital itself has no plans in place. When asked "How many masks do we have?" the answer (on Thursday of this week) was "I don't know" from the head of infections diseases. Let that sink in. March 12th.
I can understand not knowing the count off the top of your head in November 2019, I can understand it in December 2019, I can still wrap my head around not knowing it in January 2020 but damn it... It's March, you are in a meeting to discuss COVID-19 and you don't know how many masks you have on hand?
The world has been warning us for months now and they had no plans for how to handle visitors. The nurses have not done n95 mask fit tests. They are not getting clear direction on how handle mask reuse. We are not prepared for this. If this hospital (which I would trust for any major procedure) is feeling the strain with 2 patients what happens when there are 4? 8? 16? 32?
[0] https://www.youtube.com/playlist?list=PLRgTUN1zz_oeQpnJxpeaE...