Hey HN, in light of the current situation and the potential ordeal in the coming weeks, may I ask you instead of blaming whoever, let's find some solutions to help people?
As a Chinese, I read first hand materials from Chinese social media and friends on what life is like in a lockdown area. People there depends on deliveries for groceries and medicine, and occasionally restaurants take-outs. All those services, and a bunch of other services for small businesses are possible because of Wechat. Wechat is obviously not a popular option here in N.A. Is there something we can do to help both the people buy whatever they need via delivery and help local businesses?
In Wuhan when the entire family had to be isolated, no one was left to take care of family pets. I heard there's volunteer groups to take them but their capacities were very limited due to the short notice for them to take on such responsibilities. Can we be more prepared and maybe find a technology(-assisted) solution to this before it becomes a huge issue? I feel this will be an issue sooner rather than later because in N.A. it appears the current policy for mild cases is self-isolating, which will very likely infect the entire family.
Also in Wuhan during the lockdown many people felt so lonely, especially the older generation who can't use the internet effectively to stay connected to their families/rest of the world. Can we find ways to help people prepare for it psychologically? A lot of people will break medical suggested self-isolation because of the eagerness to stay connected to certain people/group. Instead of blaming them, can we help them find ways to stay connected yet in isolation?
I'm sure there are more things the mighty HN crowd can do to help others overcome this difficult time. Let's give it a try?
What China did is a complete shutdown and isolation of whole cities, cancellation of public gatherings, prohibition of attendance at school and work, massive mobilization of health and public health personnel as well as military medical units, and rapid construction of entire hospitals.
Wuhan, Iran, Italy have shown us that the health care system simply collapses under the huge number of patients needing hospitalization (20% of infected.) So mobilizing healthcare workers, springing up new "hospitals", and limiting spread with extreme responses is the way to go.
Unfortunately I predict that western governments are going to be less likely to suggest, deploy, and enforce such massive quarantines. Quarantines impede on civil liberties, and people in the West are very protective of freedom and liberties. I think the average American will NOT be okay with his government telling him he is only authorized to exit his house to go shopping once a week...
Singapore offers a compelling counter example entailing enlisting voluntary cooperation, rigorous testing and contact tracing, price controls on masks. I don't think China's fundamentally totalitarian / martial law approach is the place to start. I think Singapore offers a much much better model for dealing with Wuhan Flu.
But Singapore also backs up its "voluntary cooperation" with a big stick that they're not afraid to use: quarantine order violations including giving false/incomplete information for contact tracing can result in $10,000 fines and 6 months in jail for a first offence, plus cancelling work visas/residency permits for non-citizens:
Apparently -- and this is unconfirmed scuttlebutt -- somebody already landed in hot water for neglecting to tell the authorities about their visits to a red light district. (Which, this being Singapore, are both legal and closely regulated.)
That's very different from the martial law that was effectively imposed in China. If you don't follow the law in most countries you will subject to sanctions, it's no different in Singapore. Typhoid Mary was subjected to forcible quarantine in the US https://en.wikipedia.org/wiki/Mary_Mallon
It’s just that the sanction in Singapore are much more harsh than in the West. When I visited I noticed that fines are about 10 times higher than in Canada for the same offense. And there is no caning as well.
that's a fascinating historical case, first time I learned of it. Do we know how exactly Mary spread the disease? Was it unwashed hands or saliva or her breath? How is typhoid transmitted exactly?
She was a cook who did not wash her hands thoroughly after defecating. Salmonella typhi bacteria causes typhoid and is excreted in feces. She transferred it into cold food--e.g. salads, peach ice cream--that she prepared (cooking kills the bacteria). The doctors of the time theorized that the Salmonella typhi had colonized her gallbladder. There were many asymptomatic carriers detected at the time but few if any persisted as cooks or preparing food once they had been warned.
Seems to me like a prison sentence when this blows over is reasonable for somebody violating a quarantine order without a good excuse. It's not outside of the legal traditions of the U.S. to have strong quarantine orders, nor is it particularly authoritarian.
Singapore is a city which acted as soon as the first case popped, with aggressive tracing and testing at entry point. US punctured and smashed that bus.
What about Vietnam? Track records so far says Vietnam did/does a much better job than Singapore in Covid-19 and previous pandemics. Yes Vietnam approach is fundamentally totalitarian (suspected can still deny quarantine, but will be pressured) and the result shows: only about 40 confirmed cases over population of 95 millions so far.
the catch is, if we're really hiding, we must have got thousands of deaths by now. Just see how quickly it spread in Korea, Italy and Iran. Hiding (thus no action can be done) for 1.5 months is a sure way to suicide, given the amount of traffic in/out of Vietnam and the population density.
Or you can see that in the past week alone we got 27 cases, starting from 2 planes. And the number is low because we vigorously chased people down to test them all and quarantine them. Had we let them go loose those 2 cases alone could spread to hundreds.
Vietnam population is around 95 millions, with less confirmed cases than Singapore, despite sharing border with China. Vietnam also acted immediately since first two patients (2 Chinese tourists parent and child), rigorous contact tracing and testing, price control of masks, food and other necessities.
Level of testing / surveillance is not clear.
See https://www.worldometers.info/coronavirus/covid-19-testing/ They have run about 2400 test which is 24 per million in population (on a par with US which is wretched). Italy is 1,000 per million, Hong Kong is 2,000 per million, South Korea is 4,000 per million. Vietnam may be going a good job but they are not testing enough by a factor of 10 to 100 to be sure.
Vietnam is still in containment phase, so tests per million capita is not what I would look at. Rather, about 2400 tests against about 40 confirmed cases is a factor of 60 tests per confirmed cases (this should cover F1, F2). Italy on the other hand is about 60000 tests against 12000 confirmed cases, a factor of only 5. Hong Kong's number is impressive, 120. South Korea's 30.
You make a reasonable argument. In 2003-6 I helped out Viet Cervical cancer project on screening models for Pap smears to detect cervical cancer. Vietnamese incidence was high. Vietnamese public health organization was well organized and effective. Some lessons learned were published in Systems Analysis of Real-World Obstacles to Successful Cervical Cancer Prevention in Developing Countries
I agree and disagree at the same time. Let me tell you why.
Extreme measures without a plan and a data basis will certainly make matters worse. We need a plan, which Western countries have. What is somewhat lacking is the basis to implement it. Aggressive testing of everybody would provide this basis, like South Korea does.
Which increases my critique points of the response to a total of two, a viable social media campaign to inform people and prevent panic reactions, which could totally provided and carried by tech companies. So, Google, Twitter, Facebook, if you are listening do something good with your social power! And the aggressive testing of people, everyone, starting with contact persons, people having traveled to risk areas and ultimately everyone.
Other than that I am quite satisfied, in Europe at least. The US seem to be a different story.
I am not sure there is much time left to be satisfied.
Coming 10-14 days will display how the most of the rest of the Europe will actually handle the critical situation.
Only country that appears to be doing something right is Germany. They should tell others what is their trick to keep most of the people alive. Of course they have highest number of intensive care places in EU https://link.springer.com/article/10.1007/s00134-012-2627-8#... so perhaps just brute force is how they do it but I have heard (but was not able to confirm) that they are also isolating their elderly such that they will just receive food and other goods behind their doors. I do not know how right this is but this would make sense.
As someone who's monitoring the situation over in Germany because I have family there, Germany is definitely not doing "something right". There is a lack of direction in handling the situation, as well as information for the citizens.
People are calling 116117 but getting hang up on, and the weaker central government (due to obvious historical reasons) means that the response differs state to state. Much like in the US.
Communiction and information realls sucks, that's true. Same goes for a coordinated approach between states. Other then that the situation is more or less under control, as far numbers tell us.
Regarding school closings and such things, at last Bavaria is prepared for that (my sons school is over 1,000 students and might be clsed in the next one or two weeks regardless of cases due to that number of people there, but that is just a snapshot, so).
Given the mortality rates by age bracket, this makes a huge amount of sense. Subject to their mental and emotional needs being given every consideration, of course.
Assuming (1) a large amount of the public will eventually be infected, (2) infections are (generally speaking) only fatal in older people... why not best protect the most vulnerable among us?
At this point, nursing homes and assisted living facilities should be staff-only, guaranteed paid sick leave, with teleconferencing equipment set up for families.
Wait until new case rate peaks, then start looking at relaxing the restrictions.
What needs to happen is to reduce the connectedness of the human social graph. The elderly don't need to be totally isolated. They can be seen by family, friends, but we need to limit the number of people that each older person can see, and the number of people that are seen by each younger person. That's what this social distancing is about. The virus travels along nodes where our paths through spacetime intersect or come close, and that is in many cases closely modeled by the human social graph. If you reduce the connectedness of the graph, you reduce the number of potential intersections each carrier has with uninfected people. You do that enough, and you can get the reproduction rate below 1. You do that enough and we can catch up to the infection front and seal it off.
At least, that's the hope as I understand it. That's what I'm trying to help do by staying home and seeing only close friends and only in 1:1 settings.
I'm fifty +- some and became isolated without realising during the years I cared for my mother.
You want to give the old folks, among who I am myself in this respect, something to live for. Attention is the catnip.
Want to kill the olds in droves? Isolate them.
I'm bloody serious about this and believe it's tort that needs a Court hearing for the human sake alone. You don't know anything until you friend all died. Mine did except for who then exited into a new world of economic paranoia and now hides in a regular job after increasingly failing to deal with isolation in the context of a young loving family around him at home at least. I'm so intensely proud of my buddy but he's a truly impractical link back to life for me
From experience, maybe one hour away from the Austrian border, easures are nowhere near what Austria or Denmark are doing. There is a 14 day self-quarantine rule in place for public institutions like schools and so. When you have been to what is determined to be a high risk zone, you have to self quarantine for 14 days, starting with your last day in that zone (happened to us, we have four days left till Sunday). Most big companies I know of have the same rules in place.
Events over 1,000 people are cancelled, how that applies to larger schools is currently being discussed (source: my sons school is over 1,000 students).
Communication is a little bit of an issue so, we found out about the high risk zone declaration by chance, more or less. On the other hand, case numbers are really low, so I think it's kind of trade-of thing. In denmark the increase in cases triggered the response.
In France on the hand, everybody with any symptoms resembling Corona are sent on sick leave for at least a week, over the phone. People not needed in the office work from home.
Perhaps this is simply structural, multiple generations are not living together (less elderly among infected) there is more ICU capability (easier to put people in need under intensive care).
I could not find demographic breakdown of infected in Germany. This could suggest if these assumptions could be true.
> Other than that I am quite satisfied, in Europe at least.
Not in Italy. Our government changed emergency plans at least three times since Sunday and as far as I can tell is not aggressive enough in finding contacts and isolating them. The current trend is just to lock most of the people up and hoping the curve flattens.
Italy seems to me the only western country to have taken decisive action. For once I am actually rather proud of my country. What are the other European countries waiting for?
I'm not proud at all: communication was horrible (what do you think you can accomplish by changing things every few days?), caused panic (it's the fault of those who cause confusion, not of the confused), and it was reluctant in getting a no-red tape team up (even "emergency" supplies of respirators needed to go through the stupid bureaucracy).
There is a lot that could've done better than the current approach.
I think that given the magnitude of the adopted measures it is understandable that they were decided in the course of a few days. Stopping a country of 60 million is no joke. I'm not sure about the panic, but it seems hard to avoid when you tell a whole coutry to not leave their homes. We were also in uncharted territory, in the west: other countries can watch and follow what Italy has done. And yet they seem too slow in taking action. The US hasn't even started testing people.
> I think that given the magnitude of the adopted measures it is understandable that they were decided in the course of a few days
There were a few errors done in my view:
1. First, no preparation at all was done at any level. Other countries are now prepping their ICUs to prepare for the incoming tsunami.
2. Horrible communication and execution. The PM can't be both the head of the government and the one enacting the emergency measures (as in putting them into practice short of giving orders), at least not in bureaucracy-land like my country, and this PM in particular is weak and not particularly capable (and made key communication errors like blaming the hospital where the first case was recorded).
3. Laws given without clarity of "appropriate" or "not appropriate" behavior, which required constant clarification from the government
4. The leak of the "executive order" (inappropriate wording, hard to translate it to the actual Italian way of doing it) draft before it was completed, which caused mass panic and exodus (and instead of blaming the "idiots", people should investigate why that happened).
5. Total lack of clarity of how long the lockdown measures will last (if they don't change yet again).
It's not like changing measures every day will change the curve immediately (first lockdown on Sunday, then another on Monday, then more restrictive measures within a few days).
Lastly, all of this flurry of activity from the PM, aside pressure from other involved parties (like local governments), is, according to rumors, done because the current PM is likely to be asked to step down sooner or later (the country was at a political paralysis before the outbreak, and his handling of the crisis made matters worse).
Followig up contact persons ends to be meaningful once numbers are to high. Fro that point onwards, just closing everybody and everthing down right away is more effective. Following up individuals would have the same result anyway and take much longer.
I think you need to be really careful creating statistics out of thin air, like: "20% of infected people require hospitalization". We don't know how many people in a given region are infected... we only know the positive test cases and all percentages are based upon the positive test cases.
There is evidence that a lot of people contract the virus and have no symptoms or very mild symptoms.
Reported stats out of various countries/egions also do not account for things like the severity of regional air pollution (Wuhan, Tehran, and Milan have BAD air pollution) or the other key statistics, like "do they smoke?" (lot of smokers in China, Italy, and Iran... just saying). Bad air pollution and smoking tears the crap out of the lungs and makes it much easier to contract respiratory infections.
Caution and concern are completely warranted.... significant action needs to be taken to protect all of us, especially our elderly and immune suppressed.
But we need to be careful about pushing information that causes a descent into panic.
Large-scale extreme response measures are a disaster waiting to happen.
1. 38% of nurses have children at school. Shutdown the country and 1/4 of the US healthcare industry will choose their children over work in a blink. We don't want to put any more pressure on the people working in healthcare.
2. 75% of US companies have now a disrupted supply chain. Yes the cons of outsourcing core economic functions like manufacturing drugs, hospital supplies etc... Mass mania followed by ongoing shopping sprees will set in further draining a crippled supply chain.
What we need more of is hygiene education (with strict fines) and detailed data about who, where and how they are affected by the virus. Being politically correct in a time where the world is at the brink of chaos is not going to save anyone. Sometimes hard debates need to be had and tight restrictions enforced. It's sort of like the Trolley problem.
Why do people point to the China response as being a model response, as though that is easily seen. China has had an order of magnitude more deaths and instances than any other country. While you can point to many factors showing why it is disingenuous to look at those raw numbers without context, it seems to me that the burden of proof is on the other side, to show that the China model is actually effective, because naively it looks like it didn't work out too well.
Because China is a good month ahead of the rest of the world, and is much denser populated in the cities (which are also much larger than ours).
The initial cover up didn't help either. Once they instated the lockdown, they could test the backlog of people. That took quitea while. But now the spread has pretty much stopped, while everywhere else on this planet it increases day by day.
After the initial cover-up got public, the West couldn't get enough of reporting about it, and how this is the reason it could spread so fast, how irresponsible it was, and how it's typical for evil China. Now we have that virus here, plus two month of knowledge about it, and we're still mostly being reactive instead of proactive. In China's defense, when they tried to cover it up, much less was known about the disease, like it's asymptomatic spread. Now the cards are on the table and we're being ignorant, as if ignoring a problem makes it go away. But hey, when things are getting really really ugly for us, we can still go back to blaming China for their initial cover-up.
Watch Italy closely the next days, and compare it to China when they were at a similar stage. It will tell you what's to come in your country too. Another thing that's suspicious about Italy is the high CFR of around 6%. It most likely means they're not doing enough testing, only the severe cases, so the rest wanders around the country happily spreading it further.
It's worth noting that South Korea also was able to engage in such mass mobilization. Moreover, if the trends continue for a few weeks, China's not going to have an order of magnitude more death anymore.
Italy's high CFR sounds like a health care that's broken far more than the Chinese health care system, a system which essentially isn't taking any specific extreme measures (which would be building more hospitals, importing more health care workers, etc).
If you don't mind, Where did you find this information? I've been searching for a breakdown of all fatalities so far by age group (raw numbers, not just average percentages) and could not find it.
You may want to reconsider relying on /r/COVID19 as a source of information. There's been a lot of criticism on how they are applying censorship, and no transparency around it.
Because they're still treating them in some regard(before being overwhelmed).
However once things get even more overwhelmed, you have bad cases become critical leading to more fatalities.
The going figure seems to 20% are badly impacted, with 5% of that critical. Some of that 15% will become critical without treatment that might not be available. Thus impacting people <70.
Thus far. Most of the younger critical patients are not out of the woods yet. Also, many of those are left to die without treatment or assessment because there aren't enough ventilators for them.
I'm not sure "advanced" is what's needed for healthcare systems to cope with this. It's relatively low-tech care scaled up quickly. My fear is that the amount of institutional inertia, and where in time the inflection point of overcoming that inertia lies will determine outcomes.
> After the initial cover-up got public, the West couldn't get enough of reporting about it, and how this is the reason it could spread so fast, how irresponsible it was, and how it's typical for evil China. Now we have that virus here, plus two month of knowledge about it, and we're still mostly being reactive instead of proactive. In China's defense, when they tried to cover it up, much less was known about the disease, like it's asymptomatic spread. Now the cards are on the table and we're being ignorant, as if ignoring a problem makes it go away. But hey, when things are getting really really ugly for us, we can still go back to blaming China for their initial cover-up.
I think you're combining two largely-unrelated factors. The news in any country is only going to be interested in the most salacious stories in countries 12 time zones away. This is just how the market operates. A tiny percentage of china dying from a new kind of flu is not as headline-grabbing as people dying due to govt misbehavior.
Meanwhile our govt isn't blind, they have people and plans in place for everything and they think they are ready and in control. Then, it turns out it's a clusterfuck anyway that takes way longer than expected to implement. They need to have dealt with the exact same disaster in recent years to get it right. It's a problem with implementing a large-scale system you can't test until it's needed.
Having plans in place is great, but we're already running out of masks, gloves etc. here in Germany and it's only about to start. We didn't even try to stock up on this, since "lol China flu, won't concern us". Germany actually just intercepted a shipment of gloves from China to Switzerland and kept them. That's how desperate they are over here.
But in fact I doubt there really is a plan in place at all. It seems most countries ignored this, hoping they'll be spared of this, then stumbled along with adhoc measures, and only now slowly start to listen to experts.
Saying there is nothing we could have done better from just looking at what unfolds in China is very questionable.
> The news in any country is only going to be interested in the most salacious stories in countries 12 time zones away. This is just how the market operates.
... for about a month, and still bringing it up to this date.
Compare [1] to [2]. Notice anything? Western, especially US media is becoming more and more of an echo chamber trying to strengthen that simplistic world view that we are the good guys and they are the bad guys. But it's not overly surprising really, considering the financial struggles of traditional media over the last decade. As you said, the focus shifts more and more towards stories and headlines that sell, even for once renowned outlets like the NYTimes.
In the US the most notable problem is the tests. They had this grand plan to gets millions of them produced and be available at every local testing clinic, which ran into one misstep after another.
Do you recall the international coverage of Hurricane Katrina? It was dominated by the stories about rape gangs and anarchy which all ultimately turned out to be false rumors. Media everywhere sucks like that to some degree. As an american, I probably notice the bias towards stories that make the US look bad a lot more than you might.
Though I get what you're saying. US media may be one of the worst in the developed world. I don't even look at it anymore. Lucky I learned about coronavirus from here and adjusted my plans for it. And the NYT in particular seems to be really anti-China since they got blocked in China a long time ago.
Fully agree except that Italy’s CFR is most likely caused by its large proportion of elderly people. Compare to South Korea where the majority of infected are young and thus CFR is sub 1%.
The difference in age demographics isn't nearly enough to account for the differences in outcomes, unless you believe the proportion of people in Italy >70 years old is 5-10x that of South Korea. (Spoiler alert: it's not).
The issue has to do with preparedness and healthcare capacity. South Korea has 3x the number of hospital beds per capita than Italy.
Japan has an even more elderly population than Italy, yet a lower CFR than South Korea. Is Japan testing enough? Are they somehow self-isolating way better than anyone else?
Japan isn't really doing much and many suspect that they are deliberately looking away from the coronavirus outbreak because of the 2020 Olympics later this year. IMO, the gov't willful neglect and concealment is exactly what enabled the coronavirus outbreak in Wuhan, China and I fear this might come back to bite them later.
Well, look at this chart which speaks volume about how successful China is in containing the outbreak, with new cases per day decreasing dramatically since February: https://pbs.twimg.com/media/ESywcEKUwAADhcQ?format=png&name=... And look in particular how cases in other countries are starting to explode since the last week or so.
Or look at cumulative deaths (outside China): https://pbs.twimg.com/media/ESyyxfiUMAEwMVa?format=png&name=... The growth follows a perfect exponential curve, which suggests other countries have so far been completely unable to even bend the epidemic curve a little bit. It is obvious given this data that we will see 10k deaths outside China by March 20. I have a perfect track record at making such predictions in the past: https://twitter.com/search?q=from%3Azorinaq%20%23PredictionW... (short-term predictions are easy to make, long-term not so much)
You also have to take into account that China probably took the right actions, but their big failure was in timing them poorly. If they'd implemented travel restrictions before Chinese New Year, we probably wouldn't be talking about a pandemic right now.
Considering the lack of action, or the very delayed manner in which we, the West, start to put up measures to prevent spread, I very highly doubt so.
Consider the incubation time of 5 days avg, 14 days max during which you're already infectious. Even if China had reacted quickly, not trying to cover it up, we still wouldn't have known about that for a while. Even without the Chinese new year, I'm pretty sure given how dense and large Chinese cities are, this would have spread eventually either way. And I doubt the rest of the world would have reacted any different in that alternate reality than now. We still have travel with China and Italy today. Why would that have been any different had China handled that differently? It would have been slower, but it would have spread to other countries, I have no doubt about that.
> Consider the incubation time of 5 days avg, 14 days max during which you're already infectious."
I have seen several comments like this on this thread suggesting people are contagious during the incubation phase. Do you have a source for this? AFAIK this has not yet been confirmed, other than perhaps a few anecdotal cases.
I'm also just aware of a few anecdotal cases, but I guess this is very hard to scientifically confirm by its nature. There have been several cases in the US where it could not be traced back where they could have been infected (which could or could not be asymptomatic, or just incomplete knowledge of contacts). The first case in Germany was also asymptomatic spread[1]. Even if this just happens in few cases it would still be devastating, especially if it also happens with those that go completely asymptomatic for the entirety of their infection, which is currently said to be about 10 to 20% of all infections.
I check out John Campbell on YouTube every couple days. He has this unique style of presenting current developments and research papers in a no-bs manner and commenting on them, currently urging for more proactive measures mostly.
People need to stop talking about this as a binary yes or no fact. It is almost guaranteed that it is possible to infect someone else while not showing symptoms and this probably has actually happened. The question is how common it is. Most credible sources I've seen seem to say that it is unlikely/uncommon.
It seems likely that if we fully controlled most of the cases that had visible symptoms, the spread would stop, even if we failed to control the cases which did not show symptoms.
The same is true for spread via surfaces: while I'm sure it's possible and happens, it seems like the primary mechanism of infection is breathing infected respiratory droplets from someone else.
Last guidance I saw from the CDC was that people without obvious symptoms were likely to only be contact-infectious, as opposed to airborne-infectious (droplets) once symptomatic.
If true, social distancing, hand hygiene, and not touching ones face would bring asymptomatic transmission down to almost zero.
Hindsight is 20/20. It’s hard to know ahead of time whether you should cancel your nation’s equivalent of Christmas + Thanksgiving because you have preliminary and incomplete information about a disease outbreak somewhere.
Regulation doesn't have to be binary. The point of it isn't to eradicate behavior, just lessen it so the risk can be mitigated and contained. Perhaps I should have said "lessened wildlife trade" to be more specific.
Number of deaths is a lagging indicator while number of PUI (patients under investigation) would be a leading indicator. But since number of deaths is the number that can be easily aggregated let's hope in a few weeks we will find out that the curve has already started to bend.
I mean, don't just look at the absolute numbers, arguable China has 1/5 of the world's population.
I believe the argument to be made here is that most parts in China, excluding Hubei, has a lot less cases than Korea or Italy, when Korea's population is about 3-4% that of China. In most provinces in China there were 0 deaths.
Ideally, European countires like Italty are far further away and should have fewer cases than those regions closer to the epicenter, but reality suggest otherwise.
China seems to have done well to contain the virus in Hubei. The other major cities like Beijing and Shanghai, while affected by the containment measures were relatively lightly affected by the virus itself. If we can manage that I’d call it a success.
Not to mention that China was pretty slow to properly react (nearly 2 months between the start of the outbreak and the start of Wuhan's quarantine, by which point it had already spread to South Korea and Thailand, and likely to Italy), and even outright suppressed the doctors/whistleblowers who originally publicly raised concern about the virus (which the Supreme People's Court even admitted was a bad idea; you know the PRC government done goofed when they're actually willing to admit they made a mistake).
The US should be looking at China as a case study on how not to handle the early stages of a pandemic. Instead it seems like we're making the same mistakes (though thankfully at least some areas are being proactive about e.g. shutting down schools).
The earliest case was found at the start of December but it wasn't correctly identified till the end (they went back and tested existing patients).
It wasn't confirmed as being able to spread person to person until the 17th although there was some evidence that it should have been identified on the 11th. (So a delay of either 5 or 10 days rather than 2 months)
The doctor didn't raise public concern. He told a few friends and told them not to tell people. The official announcement was made the following day.
If you look at the timetable it is significantly better than the SARs response or the N1H1 response so we seem to be learning and making progress which is good.
On 30 December 2019, genetic sequencing report of the pathogen of a patient indicated inaccurately the discovery of Severe acute respiratory syndrome coronavirus (SARS coronavirus) in the test result.[15] After receiving the test result, multiple doctors in Wuhan shared the information via internet, including Dr. Li Wenliang, an ophthalmologist at Wuhan Central Hospital, who posted a warning to alumni from his medical school class via a WeChat online forum that a cluster of seven patients treating within the ophthalmology department had been unsuccessfully treated for symptoms of viral pneumonia and diagnosed with SARS.[20][21][15] Because these patients did not respond to traditional treatments, they were quarantined in an ER department of the Wuhan Central Hospital.[22] In the WeChat forum, Li posted that this cluster of patients appeared to be infected by SARS. Dr. Li posted a snippet of an RNA analysis finding "SARS coronavirus" and extensive bacteria colonies in a patient's airways according to a chat transcript that he and other chat members later shared online. [...] Dr. Li is widely known for the statement he gave before his death exemplifying how the Chinese government botched the containment of the Wuhan coronavirus, stating "There should be more than one voice in a healthy society."[20]
The Chinese National Health Commission announced later that evening that 8 doctors engaging in this WeChat forum had been arrested by Wuhan Police and charged with "llegal acts of fabricating, spreading rumors and disrupting social order."[25]
Wuhan medical authorities forbade doctors from making public announcements and ordered them to report cases internally.[26]
[...]
(31 December)
Qu Shiqian, a vendor at the Huanan Seafood Market, said government officials had disinfected the premises on 31 December 2019 and told stallholders to wear masks. Qu said he had only learnt of the pneumonia outbreak from media reports. "Previously I thought they had flu," he said. "It should be not serious. We are fish traders. How can we get infected?"[29]
"Chinese state television reported that a team of experts from the National Health Commission had arrived in Wuhan on 31 December 2019 to lead the investigation, while the People's Daily said the exact cause remained unclear and it would be premature to speculate."[28][29][38] Chinese state broadcaster CCTV reported that a team of senior health experts had been dispatched to the city of Wuhan and were reported to be "conducting relevant inspection and verification work."[30]
Tao Lina, a public health expert and former official with Shanghai's Centre for disease control and prevention, said, "I think we are [now] quite capable of killing it in the beginning phase, given China's disease control system, emergency handling capacity and clinical medicine support."[29]
[...]
(1 January)
According to the Chinese state-sponsored Xinhua News, the Huanan Seafood Market was closed on 1 January 2020 for "regulation."[22] However, in the Consortium's report of 24 January 2020, it was stated that the Huanan Seafood Market had been closed on 1 January 2020 for "cleaning and disinfection."[36]
[...]
(2 January)
On 2 January, 41 admitted hospital patients in Wuhan, China, were confirmed to have contracted (laboratory-confirmed) the 2019-nCoV (Wuhan coronavirus); 27 (66%) patients had direct exposure to Huanan Seafood Wholesale Market.[8] All 41 patients were subsequently relocated from the hospital they had originally been diagnosed in to the Jinyintan Hospital in Wuhan, China.[8]
[...]
(3 January)
On 3 January 2020, Dr. Li Wenliang, the Wuhan ophthalmologist who had been arrested for spreading false "rumors" on WeChat, was summoned to the Wuhan Public Security Bureau where he was told to sign an official confession and admonition letter promising to cease spreading false "rumors" regarding the coronavirus. In the letter, he was accused of "making false comments" that had "severely disturbed the social order". The letter stated, "We solemnly warn you: If you keep being stubborn, with such impertinence, and continue this illegal activity, you will be brought to justice—is that understood?" Dr. Li signed the confession writing: "Yes, I understand."[21]
[...]
(4 January)
The head of the University of Hong Kong's Centre for Infection, Ho Pak-leung, warned that the city should implement the strictest possible monitoring system for a mystery new viral pneumonia that infected dozens of people on the mainland, as it was highly possible that the illness was spreading from human to human. The microbiologist also warned that there could be a surge in cases during the upcoming Chinese New Year. Ho said he hoped the mainland would release more details as soon as possible about the patients infected with the disease, such as their medical history, to help experts analyse the illness and to allow for more effective preventive measures to be put in place.[43]
[...]
(7 January)
Since the outburst of social media discussion of the mysterious pneumonia outbreak in Wuhan, China, Chinese authorities censored the hashtag #WuhanSARS and were now investigating anyone who was allegedly spreading misleading information about the outbreak on social media.[51]
[...]
(18 January)
On the same day, the Wuhan City government held an annual banquet in the Baibuting community celebrating the Chinese New Year with forty thousand families in attendance despite the officials' knowledge of the spread of the Wuhan coronavirus. They shared meals, plates and ate together.[83] On 21 January 2020 when Wuhan mayor Zhou Xianwang was asked on state television why this banquet was held even after the number of cases had risen to 312 he responded, "The reason why the Baibuting community continued to host the banquet this year was based on the previous judgment that the spread of the epidemic was limited between humans, so there was not enough warning."[26]
[...]
(21 January)
After 300 confirmed diagnoses and 6 deaths, Chinese state media warned lower-level officials not to cover up the spread of a new coronavirus.[40] Officials declared that anyone who concealed new cases would "be nailed on the pillar of shame for eternity", the political body responsible for law and order said. Local Chinese officials initially withheld information about the epidemic from the public. It later vastly under-reported the number of people that had been infected, downplayed the risks and failed to provide timely information that experts say could have saved lives. In its commentary published online on Tuesday January 20, 2020, the Communist Party's Central Political and Legal Commission talked of China having learned a "painful lesson" from the SARS epidemic and called for the public to be kept informed. Deception, it warned, could "turn a controllable natural disaster into a man-made disaster".[40]
[...]
(28 January)
China's Supreme People's Court ruled that whistleblower, Li Wenliang, had not committed the crime of spreading "rumors" when on 30 December 2019 he posted to a WeChat forum for medical school alumni that seven patients under his care appeared to have contracted SARS. In their ruling, the Supreme People's Court stated, "If society had at the time believed those 'rumours', and wore masks, used disinfectant and avoided going to the wildlife market as if there were a SARS outbreak, perhaps it would've meant we could better control the coronavirus today," the court said. "Rumours end when there is openness."[221][222]
----- END WIKIPEDIA QUOTE -----
So:
> The earliest case was found at the start of December but it wasn't correctly identified till the end (they went back and tested existing patients).
By that timeline, it wasn't even correctly identified by the end of December (though the "rumor" Dr. Li et. al. disseminated about it looking like SARS ended up being pretty close).
> It wasn't confirmed as being able to spread person to person until the 17th although there was some evidence that it should have been identified on the 11th. (So a delay of either 5 or 10 days rather than 2 months)
There's evidence that it should've been recognized as at least potentially spreading person to person by the 3rd, at the very latest (given that not all cases were connected to the Huanan Seafood Market).
> The doctor didn't raise public concern. He told a few friends and told them not to tell people.
He told an online forum of his fellow alumni, and he (among others) posted transcripts online, drawing the ire of authorities.
> The official announcement was made the following day.
Yes, after those "rumors" about SARS forced their hand.
> If you look at the timetable it is significantly better than the SARs response or the N1H1 response so we seem to be learning and making progress which is good.
True, and that's commendable, but even China admits it done goofed. It's great that (as far as we can tell) they've course-corrected and are getting a handle on things, but let's not gloss over how their kneejerk tendency toward censorship and their casual "well we don't know for sure if it spreads human to human so let's pretend we're all safe" attitude around the outbreak directly contributed to what's now officially a global pandemic.
The fact that people outside of China don't know what WeChat is make sense. It isn't an "online forum". It is more like a private Whatsapp group. He also told them the wrong information. He shouldn't have been charged but while he used the "internet" it wasn't public. It was passed around and others did post it publically online.
I don't know why Wikipedia is missing a lot of the public information that happened before the 31st. The local government was notified on the 28th. The National government was notified on the 30th. Other hospitals in the region were notified around this time as well.
His "leak" came while a lot of people were being notified about this problem. It "looks" like they would have notified the public and WHO a few days later once they had more information.
We still don't know if the original source is the seafood market. The fact that not all the cases came from there doesn't mean much. The SARS expert (Guan Yi) from Hong Kong said that there was no proof of human to human transmission on the 3rd.
You've counted time before anyone knew it existed in your 2-month delay. The first death was on the 10th. Less than 50 people have the virus. The probably should have done something then or on the 15th (second death).
There was a delay but more like 2 weeks compared to 2 months. If you are saying that they should have done something before they knew it existed then ... what should they have done?
As it is people are constantly bashing them for doing something.
If there are large scale falsified numbers in China, local and national authorities are certainly acting like they believe them. People are out and about; restaurants are opening; going back to work.
I don't get how people can simultaneously think "China instituted unthinkable totalitarian measures to isolate and quarantine people" and "all the numbers out of China are false, it has to be undergoing exponential growth like other countries."
You can choose one or the other, but not both: they're not self-consistent.
They are self-consistent if “unthinkable totalitarian measures” didn’t work, and the Chinese government has switched to a mitigation strategy without informing the populace.
If you think that people being locked up in their apartments for a month would result in the same transmission rates as people going about their lives freely, I don't know what to tell you: apart from all the other fantastic properties people have imagined SARS-CoV-2 to have, it also apparently can magically infect people who don't have contact with it.
Even if testing completely stopped, presumably an over-strained health system would be obvious and almost impossible to hide.
I can see why people are extremely resistant to believing anything the Chinese government says, but there seem to be indicators that don't rely on their statements.
Because I certainly don't know it, and there isn't anybody around here talking about this for some reason (and ok, even if there were, it would be hard to know if they are reliable - and yes, the entire world knows the reason, China prohibited talking about it).
I think I’m retrospect the severity of the lockdown in China will be seen as a mistake. Many of the steps they took were unnecessarily damaging, and realistically It’s only a matter of time before there’s another outbreak over there, in fact it’s probably already happening. There’s just no way to stop this virus, we can only slow it down.
From what I understand, 'slowing it down' is really important, so we can't really tell quite yet how necessary the lockdown in China was. Sure, the virus isn't contained and it will probably return. But how many lives were saved or will be saved because the lockdown 'only' slowed things down?
Not saying I have a strong opinion on this; I really have no clue. But at least from what I understand even just slowdown might be worth quite a high cost.
Yes, that’s all true. It’s just a matter of the scale of the cost and benefits. Welding people into their apartments seems excessive, I have to wonder how many old or sick people died or suffered unnecessarily as a result.
Extreme measures are likely doing more harm than good -- as soon as China loosens them, there will be a flood of cases. You can't eradicate a disease that spreads via the air we breath (and can spread to animals). You can slow it, but much like Influenza you're stuck with it forever now.
With that in mind, the larger impact is going to be the lack of medicine, food, etc. that comes from a large-scale heavy response. We are just at the beginning. Push for social distancing, but over the next two years we're just going to have to learn to deal with this. It'll mutate, we'll find ways to mitigate damage and we'll have a large loss of life.
Push out higher production of medical equipment and push out the best possible safety gear for healthcare workers. On a personal level, try to stay fit, get lots of rest, and try to quickly take care of any other conditions. Stay home if you are sick (to avoid spreading any illness).
That's about the extent we can do.
Closing schools, closing offices, shutting down the economy is going to be far more damaging than this disease will be.
Extreme measures is to slow down the first wave of cases so the number of patients needing medical attention is under the local capacity. Death rate is between 0.6% to 8% depending on how you can treat the patients and that requires that you have enough capacity to handle it. Over time we will have better medicines to reduce the need of ICUs and vaccines and then containment will not be necessary but we will continue to handle it as a seasonal disease.
There are approximately 20 full-service ventilators per 100k population in the united states. Let's say 1% of cases require hospitalization and ventilation. That means we can sustain a sick population of 200 per 100k, or 0.2% at any given time.
You underestimate just how unprepared we are for this situation. It is not possible to "bend the curve" enough to keep everyone safe (infected below 2% of the population). Full stop, that little chart from bendthecurve.com with the nice flat blue curve that goes under "medical system capacity" will not happen. That's fantasy.
By all means we should do everything we can, the more we can slow the disease the fewer people will die, but the happy fantasy scenarios about everybody washes their hands and doesn't go to the sportsball game and we bend the curve enough that our medical system's capacity will be sufficient is just a fantasy.
Further, the lower we reduce the reproduction rate, the longer this crisis will last. This is a crass observation, but if you let it burn through the population it'll be done in a few months. If you really "bend that curve" and substantially decrease reproduction rate, then it'll take correspondingly longer to exhaust its susceptible population. That means sustaining quarantine measures for a longer period of time.
Researchers point to Coronavirus peaking around June or July. That means it will remain a serious problem through at least August or September ("peak" doesn't mean it's done, it just means it's slowing down). Interventions will extend that further. We need to consider the possibility that quarantine will be required for an extended period. How will this work if we need to turn our economy off for 6 months? Nine months? A year?
Grandparent is probably correct that if China loosens its quarantine measures that it's going to bounce back. And in fact that is a problem that everyone has to consider.
I did not said that we are prepared for it. What I was saying that we need extreme measures to slow down the number of cases and not that we will have full success at doing it but we can save a lot of lives and this the only thing that really matters.
There’s never going to be a lockdown in this country. If people need stuff, they’ll go out. It simply won’t work.
I’ve seen the videos coming out of Hubei. If you tried to weld someone’s door shut in the US you stand a good chance of being shot by the resident and both their neighbors. Maybe not in the big cities, but virtually everywhere else.
No. We knew the R0 of this thing in late January, and we knew, at least approximately, the fatality rate and ICU/ventilation requirement rate, in very early February.
Every single "just the flu bro" type has indirectly killed people since that time, including the WHO Chief and US President. These things should not be forgotten, and consequences should be meted out, lest we doom ourselves to repeat the mistakes of complacency in the future.
It would be great if we had some kind of global institution with distributed local branches whose aim was to feed the hungry, tend to the sick, and commune with the destitute.
Taking the same action as China technically is impossible for most countries because of differences on attitude to human rights.
In China, a lot of people can be left at home to die and they cannot do any protest against their government. In the most serious period in Wuhan, citizens were limited to stay home and there were not enough means of transport to do necessary transportation, such as critical patients and food. At the expense of this, another large proportion of people can keep alive.
But in the US, people have weapons and they are very tough. In addition, the information is transparency, so it is impossible to hide such tragedies.
There are structural problems that China needs to address that would help in the future. For example, the lack of indoor heating in southern China exacerbates flus and sicknesses like this because your immunity system is constantly beat down when it is constantly cold everywhere. China is rich enough now that they can afford to heat southern homes, if not for comfort, then for stuff like this (see https://facilityexecutive.com/2020/02/indoor-humidification-...)! And when the quarantine comes, you have to keep warm at home somehow.
Something that we westerners take for granted and why I would guess the virus won’t propagate as quickly. Long term, these kind of things are more important than shiny sky scrapers and HSRs.
I don’t quite get this. Having spent significant time in southern China, while there’s no exceptional water heating that’s (from what I heard and from some brief stays) universal in the north, I can’t think of an urban residence that doesn’t have indoor air conditioning, and rural homes tend to have installed them in the last twenty years, too. It can’t be constantly cold unless people refuse to turn on air conditioning. (I’ve heard that some older college dorms may not have air conditioning, though.)
Meanwhile, I’ve spent significant time in NorCal and NJ residences with extremely crappy heating, too.
What cities in southern China? There is very little indoor heating in Changsha, and I assume nearby Wuhan as well but I’ve never been there. Guangzhou and HK have less indoor heating as well, but they have more mild climates than Changsha so it isn’t much of a problem. Shanghai and Hangzhou do much better with heat, but they are also the richest cities in China.
It stems from a decision Mao made more than 50 years ago. First, people expect the state to be responsible for heating, which is weird to us but follows the soviet model. So the state decided to provide central heating to people in the north but not in the south.
Now you could provide your own heat, but the majority of Chinese live in apartment blocks that are poorly insulated between units. So to heat your home you have to heat all of your neighbors also, which isn’t going to happen. It works fine in northern China because they just pump hit water through the whole building. So people are left with local heating options, eg the kokatsu.
So my wife and her family own a couple of apartments in hunan that we’ve thought about renovating for heat. No one local really knows how to do it because it isn’t done. Coupled with the fact that walls in China are concrete slabs, not wooden posts with room for insulation in the middle, so you have to add something on top of the walls and maybe do heating from the floors. Anyways, it is expensive.
And it’s not just your home, but where you work. The last time I went to the HSR station in my wife’s hometown, the girls selling snacks at the station were really bundled up and if you weren’t wearing gloves your hands with hurt...inside the brand new train station.
Indoor heating is a requirement in much of the states, even in LA (you can skimp on AC, but you can’t rent or sell a unit without heat), and building codes have improved a lot over the years so it’s unlikely you’ll freeze your butt off in something built within the last 30 years.
Okay, I think we differ on the definition of heating here. I consider AC (with heat) a heating solution, and with AC you’re definitely not gonna freeze your butt off. I spent my winters in southern China mostly with a single layer of clothing...
Central heating is lacking in southern China in all but single family homes and high end apartment buildings for sure, but the air conditioner is considered one of the essential household appliances, alongside the refrigerator, television (this one might be on the decline?), etc.
> Now you could provide your own heat, but the majority of Chinese live in apartment blocks that are poorly insulated between units. So to heat your home you have to heat all of your neighbors also, which isn’t going to happen.
Apartments I lived in and visited all have AC (usually more than one unit for moderately sized ones) and I’m pretty sure I never benefited from neighbors’ AC at all, nor did mine benefit them. Insulation may be bad but not that bad. If you were planning in-floor hearting then yeah, you’re probably gonna provide for the household living downstairs too.
> Workplace & HSR station
Ones I’ve been to (Beijing, Shanghai, numerous ones between Shanghai and Nanjing including ones at small towns, etc.) all have indoor AC. Haven’t been to Changsha but kind of hard to imagine it lagging behind too much. Every single office building I’ve been in, too, but I suppose I’ve hardly ever been in a really crappy one.
> Indoor heating is a requirement in much of the states, even in LA (you can skimp on AC, but you can’t rent or sell a unit without heat), and building codes have improved a lot over the years so it’s unlikely you’ll freeze your butt off in something built within the last 30 years.
Not talking about freezing my butt off apparently, just uncomfortably cool to the point of having to wrap myself up even at home. Many houses aren’t built within the last 30 years so there’s that.
AC in American English just means cooling. In China, it usually means an electric air based unit that can cool and heat (central water based indoor heating is done via circulation, I’m not sure if gas heating would be considered AC but I’ve never seen that in China anyways, local coal based heating was also common but the government has cracked down on that).
A concrete slab built without insulation is going to be difficult to insulate after the fact, you just can’t foam it up because there is nowhere for the foam to go. You have to maybe build a false wall and lose some floor space, or use paneling. Anyways, it is complicated.
Zhejiang and jiangsu are China’s richest provinces, and often lack the problems of the rest of south China. Jiangsu is actually north of the Yangtze so they they get heat in the cities anyways, like much poorer Anhui next door. Hunan, Hubei, Jiangxi, and I guess fujian is where the no heat in the south starts to hurt. Guangxi and guangdong also, though winter weather isn’t as bad, but touring Guilin I the winter was also a bit uncomfortable, only the five star hotels provided real heating.
> AC in American English just means cooling. In China, it usually means an electric air based unit that can cool and heat
Yes, I was using the phrase air conditioner (don’t think I’ve seen a unit in China without heat function) for lack of a better one, but the meaning was hopefully clear given the context.
The AC units mostly cost between 1-3k yuan (just looked up the current prices) so they’re affordable to pretty much all (urban) households, even in the poorer regions...
AFAICR commonly seen AC units can usually heat up to something like 25-28 degrees Celsius (except ones that have been sucking up a lot of dust and haven’t got a proper cleaning in a while, in which case they’d be less effective) so they’re okay.
Another thing: Yangtze actually runs through Jiangsu, with the wealth concentrated mostly in the south. I’m not sure where they start to have central heating — the cities bordering Shandong probably do, but Nanjing (sitting on top of Yangtze) and southern cities don’t have it, that I’m sure about.
HN likes to downrank anything regarding the current outbreak. This was posted 53 minutes ago and received around 100 votes in 20 minutes, but was downranked shortly after:
Now this post has inevitably been downranked as well. I'm setting up a HN downranking-watch site right now ;-)
If you know some crowd-funding site where one can donate money to health care workers, please let me know (berthold dot alexander at googlemail dot com)
HN will down rank anything getting a lot of comments, I think votes might be factored in as well. It kills a lot of good topics and often allows astro turfing accounts to kill them.
Every time I make a comment that garners a large number of replies, moderators 'detach' it from the article, which I suppose leaves it in some Netherworld where it can only be accessed from members' profiles. I'm not sure what the point of that is.
No. I'm referring to a moderator making a statement 'this has been detached', not some misunderstanding or confusion I'm having. You can find it on my profile recently.
For the pets there are already various pet care platforms that probably tout themselves as "The Uber/AirBnb for pets!". People can take your pet to their home or visit yours for feeding/walking/yard time.
So if this may be an issue for you it might be good to start looking around to get connections. I assume the issue is that the entire family was moved out of the home? I'd be a little leery of visiting such a home without training if there's a chance the fixtures (doorknobs, fridge handles) can be carrying the virus. In particular if there's any reason to be opening the fridge for pet food because lower temperatures of 4c apparently drastically increase virus survival time to a few weeks, so handling items in the fridge may be a major risk.
Before helping people already in locked regions if you are not I beg you to do whatever you can to talk some sense into your representatives. The level of actions you want from your point of view would probably be seen as "drastic" or "exaggerated". It is not.
> All those services, and a bunch of other services for small businesses are possible because of Wechat.
Ughh, no thanks buddy. I'd rather not have any of this propaganda garbage. WeChat basically contributed to a global pandemic because it's prime instrument of Chinese censorship[1].
If the root cause of the problem is not resolved, even we overcome this virus, then now what? What's next? If the next virus hit us again, would Chinese government still try to cover up the problem and stop people from speaking up? Would WHO stop down playing the problem and advice not taking actions? It's a wake up call, while it's nice to have some heartwarming help from internet, I am more concern about COVID-19 is not the worst case, it's just a test, next thing could be way worse if we only try to look away from the root problem, like all the time we did.
The root cause of this Outbreak in North America is we have a president call it a HOAX, a flu. The incompetency of the government resulted this disaster in here. Even now when we have thousands in isolation. They are still trying to down play it. They have no idea how many people are infected, they have no idea how many possible contact s are out there spreading the virus. No matter how much they blame others, the root cause is right here in North America!
I mean he did say it was not serious that it was just the flu and that it will soon be gone, just disappear. He also said he would have a press conference yesterday to announce major financial moves to help the economy which did not happen. He is also still insisting via his new budget that funding for the cdc be cut by 15%. He also fired the U.S. pandemic response team in 2018 to cut costs.
You are right though, he did not directly call it a hoax.
No he didn't. He characterized the criticism as a hoax. That is an entirely different thing. By perpetuating the lie that he considered the outbreak as a hoax you are adding to the problem. If you disagree, please link to some sort of news account that backs up your statement.
It isn't really hard to understand what he meant either. The President's critics say all sorts of things that aren't true. He is constantly calling them out on it. He has used the term 'hoax' for a long time to refer to the misleading stories his critics tell.
Doesn't mean that there aren't valid criticisms. Just means that much of the back and forth is just hot air. There is no reason to add to the madness though by spreading more misleading information.
It is very clear. He uses it to refer to the unfounded conspiracy theories and accusations directed at him. What is so difficult to understand about that usage?
No, nothing that he says is very clear. The things he labels hoaxes do not correspond to what other people would call a hoax in subtle but significant ways. It doesn't seem that he understands what the word actually means.
Approximately 0% of this discussion should be occurring right now. Presidents should not be throwing around words like this in a middle of a crisis. Period. Recognize this for what it is. This is shit leadership. This is a shit show. I don't give a crap which finely parsed definition to the word "hoax" you give. Don't defend this.
What nonsense. It isn't hard to understand what the President is saying. And the idea that there are particular words that shouldn't be used because we are in a crisis is just weird.
Yes we should strive for clear communication but that doesn't happen by declaring particular words as off limits.
And what exactly am I defending other than accurate reporting?
> It isn't hard to understand what the President is saying.
The most generous interpretation of his words is that he meant it's a political attack from his political opponents.
The fact that his first instinct is his own political fortunes and has to preemptly whine like a baby about it is evidence of shit leadership.
The President and all leadership should be focused on the right response that minimizes loss of life, political fortunes be damned. I mean, seriously. If a sheriff's first instincts in every crisis were his reelection chances, he'd be out on his ass. But sadly, yes, here we are, arguing stupid shit, in the middle of a completely unnecessary distraction because he felt threatened and needed to lash out. So he pitted us against each other at the least opportune time. It is the one of the worst possible things to do in a crisis. Find a way to divide us!
> It isn't hard to understand what the President is saying
The problem is that the public at large will internalise the first interpretation they are presented with, whether this be their own understanding or their favourite news outlet's. Past presidents were smart enough to realise this and therefore appointed professionals (whom they listened to!) to help them craft their messaging to be as precise as possible. Trump, for some reason, has failed to learn this lesson in his first three years on the job. It is because he continues to use inprecise language that his messaging gets corrupted like this.
“Now, the Democrats are politicizing the coronavirus," and, "One of my people came up to me and said, 'Mr. President, they tried to beat you on Russia, Russia, Russia.' That didn't work out too well. They couldn't do it. They tried the impeachment hoax. And this is their new hoax.”
It's hard to parse that, but a reasonable interpretation is to say "this" refers to coronavirus. Notably he didn't say "criticism" at all, and referring to "politicizing" as a hoax doesn't make grammatical or logical sense (which of course doesn't mean it isn't what he meant. He said "the impeachment hoax", and he was impeached so clearly his interpretation of "hoax" is different to the normal interpretation).
Not american here, so didn't read/listen to this, but in all honesty, I would read the last part not as 'calling' the corona virus a hoax, but that democrats were using the corona virus as an attack, as they did with russia or the impeachment (not passing judgement about russia/impeachment, just I would read that as an attack on democrats and not as they calling COVID a hoax)
My initial reading was that he meant the severity of the virus is a hoax (which goes along with his "the flu kills more people" narrative).
Your reading sort of makes sense if "hoax" was a synonym for "attack". It's not, but Trump seems to use it as one, so yes I could see that could be what he meant.
It's interesting, because we end up in situations like this where you can try to read into it what he meant but that really requires guessing!
The Verge has got good, non-political coverage of the issue. Needless to say it isn't clear cut:
Trump surrogates said after the rally that he wasn’t calling coronavirus a hoax. “He was referring to the way he had been treated by the opposite party … in terms of taking every opportunity to bring him down,” said Surgeon General Jerome Adams on SiriusXM’s The Black Eagle with Joe Madison. And you can argue that Trump is limiting his claim to Democrats arguing he’s not prepared for the coronavirus. But the speech simply compares coronavirus to the “impeachment hoax” (which Trump describes as a “perfect conversation” that Democrats twisted into something negative), so it’s also easy to argue that Trump is saying the coronavirus itself is similarly overblown.
It isn't hard to parse at all. He has been using the word "hoax" to refer to false narratives and accusations for months if not years. He is clearly pushing back on the criticisms as being false, as being a "hoax".
There is also the fact that his actions don't make any sense at all if it were true that the President thinks the outbreak is a hoax.
Trumps's actions at the time (28 Feb) were things that indicated exactly that he thought coronavirus wasn't a threat and would go away soon:
Because of all we’ve done, the risk to the American people remains very low.... Hopefully, we’re not going to have to spend so much because we really think we’ve done a great job in keeping it down to a minimum. And again, we’ve had tremendous success — tremendous success — beyond what people would have thought.
and
So we’re at the low level. As they get better, we take them off the list, so that we’re going to be pretty soon at only five people. And we could be at just one or two people over the next short period of time. So we’ve had very good luck.
I really think he is using "hoax" as a synonym for "bad" and is referring to coronavirus, criticisms of his response and the Democrats all at the same time.
I mean we can do 2 things at once. Its like when there is a mass shooting and when someone suggests gun control as a solution the other side yells that people just died and their families are grieving and this is no time to be discussing taking guns away.
I'm failing to see how the "root cause", as you suggested, China, of the problem can somewhat solve the problem. It always us against the virus. Last I recall, they don't take orders from any one. Not even Trump.
Who cares where a virus starts? This is essentially a random event that is going to happen more as human density increases. How we prepare our societies for pandemics (and how we respond to this one) is far more important than allocating blame or litigating damages.
Based on how most nations are responding to the threat of Coronavirus, I think your expectations of China and its leadership are way too high. The Chinese are just people, like the rest of us. Some mistakes were made. But I think there’s a reasonable case to be made that the rest of the world has a lot to thank China for, too.
What's up with these constant purtorting of November as the starting point of the disease? AFAIK. We have no reliable information that this is the case.
Could you give sources to that and some of the other statements in your comment?
I'm saying I'm serious twice in this year already do it had to be the end..
Send everyone over 55 s as my working phone capable of doing Skype or whatever and provide the device a data connection to a Chatroulette app setup and instructions to disable the it and use normally in big big print and grayscale not color screens please color is confusing or color only what you want clicked (NeXT could have been a revolution for just doing that) by us old people anyway...
I don't see any tech solutions mentioned out here. At least i would like to take a shot.
Not relying on government is the way to go.
I think we should build a social network for community welfare which can prepare us for something like this in future. Where people build communities among themselves. Key point being internal resource availability to be exposed to the close knit network and an external pool exposed to an radius. Keeping everything to the close knit shouldn't be encouraged and there should be a proportion. Ideally the network should be split when its crossing a proportion.
How do we keep up with something like covid-19 in future?. I don’t think relying on government is the way to go.
Why not build a social network which helps to build close knit communities and it can have a cascade effect on the whole populace as a side effect("good"). Some of the key points for it to work being:
# Pool resources before hand so that the whole system is not suffocated.
# Internal resources exposed to close knit.
# External resources exposed to a radius.
# Cap on internal vs external resources.
# Split the community into smaller ones when it reaches a proportion.
# Point system to motivate communities.
# Ability to mobilize resource across communities.
This need not be the case with just a pandemic but can help us tide over other eventualities as well.
Here in Austria the government forbade any indoor gatherings of >100 people (outdoor >500), all universities and colleges are closed (except administration and research), including libraries and also museums. All schools and kindergartens will gradually close coming monday. That's more than 1.5m students/pupils against a total population of 8.8m. Nurses and doctors are being honed in from retirement. We completely locked down our borders to Italy. This is all very unprecedented.
Here in Austin, SXSW was cancelled but I've seen numerous "unofficial party" lists of people organizing events.
I understand people want to support the Austin economy since losing SXSW is a big hit, however it was cancelled to limit mass gatherings yet people still want to gather.
People will of course want to gather still... I've always wanted to hit SXSW so I'd be pretty heartbroken, myself.
Even still, my partner and I are keeping an eye open on flights to Europe (we've always wanted to go) and seriously considering taking the risk of buying a flight for in a couple of months time because they are quite literally at half price right now. And I'm not even talking about Italy.
edit: Haha—to clarify, the risk being flight cancellation or border closures not catching or spreading disease.
2nd edit: Wow. I'm drawing a little ire here. I'll reiterate: the risk is in not being able to go because the problem continues. Please take the charitable view (and of my whole comment, not snippets)—not the one that I'm some kind of monster :)
> Even still, my partner and I are keeping an eye open on flights to Europe (we've always wanted to go) and seriously considering taking the risk of buying a flight for in a couple of months time because they are quite literally at half price right now. And I'm not even talking about Italy.
If you do this in the midst of a pandemic, it's an unethical and selfish act.
Please read the entirety of my comment before painting me so negatively...
I'm certain that just purchasing some discounted airline tickets for sometime later in the year will not in itself cause any negative global health effects. The decision to actually travel can be made entirely separately from that gamble.
Yeah, patient zero in Italy was probably just one dude who traveled. You have no effin' clue what consequences of your acts may be. Europe will be still here later.
If we're still in the height of epidemics during your travel, you will be basically locked in someplace and very hard to see anything.
To sum it up, tremendously stupid idea with utterly selfish tones.
After reading your comment including edits it's still not clear when you plan to travel so I understand the negative reactions you're getting.
Buying flight tickets might be cheap right now but the point is if when your trip starts X weeks from now and the situation is still bad and you don't cancel it, then you are indeed selfish and deserving of the negative comments and down votes.
Further, since nobody knows when this will end (it could continue into 2021 for all we know) and you didn't say you'd cancel your plans if it did (instead you expressed concerns you'd lose money if travel was banned), I feel like you're drastically misunderstanding the 2nd order dangers your actions would have and likely deserve the ire and down votes you're getting.
That is the risk I referred to, as I clarified—not being able to take the trip because the situation didn't improve. I've explained this many times over by now.
For the modern SXSW experience, just go to the local supermarket when it's ultra busy and the parking lot is full. Park your car among the rest and just sit in it.
You'd honestly probably have a better time, unless there was something you specifically wanted to see at SXSW. So many people come into town for it that getting anywhere in the city becomes a nightmare.
Taking this thread way off the original topic now, but yeah. Would love to visit for the music scene—SWSX probably would crowd out what I actually want to get out of the place when I think about it longer than 30 seconds.
I used to live in Austin and have experienced SXSW many times. It's still an amazing time and experience. Take all of the comments with a grain of salt (including mine).
Sounds romantic. I wonder how romantic that ancestral village will feel when local health officials have declared a mandatory quarantine and you can’t leave your hotel room.
Thankfully, the tickets are on sale now for dates throughout the year, and the village is so small and old I'd be shocked if anyone really comes or goes from there as it is. :)
Of course. The risk in purchasing tickets for later in the year while they are still cheap is that we may not be able to use them if this situation continues and doesn't improve. I thought that was pretty clear in my original comment.
Either I missed that wording or it wasn't clear to me. I also may be projecting the mentality of other people I've heard planning to get cheaper travel even if it does result in other people getting sick.
I cannot know your intentions, so if they truly are with other people in mind, I apologize.
Do also keep in mind, though, that by purchasing them now you are inevitably biasing yourself towards going.
If my facebook feed is indicative of the general US population, there are still a lot of people who think the media is just trying to scare us. Some of them are your typical nutjobs for Trump, but even my 60-something year old hippie liberal jazz musician friend is on that train. There were women replying to her that the media focuses on Covid-19 because "it's killing old men" who run the world, and the media should instead be focusing on women's issues... I think I'm finally ready to give up facebook after seeing my the thoughts of most of my 'friends'.
If they wanna support the economy just send money to the entities that they can't go to. That restaurant you were going to dine out at, instead you're not microwaving a Lean Cuisine? Send them $10. Otherwise they are doing it for the shills.
You need to approach senior management, and press them on what their plan is.
Why aren't they already transitioning to remote work? Is there a timeline in place? What are their criteria about what would trigger WFH? What about employees with elderly family members at home? Do they have the necessary systems in place to support a fully remote staff?
It's very likely that management has simply avoided thinking about the topic entirely. If the employees press them for a concrete action plan, then that at least prompts them to start engaging in objective analysis.
It's a massive multinational company, so I'm sure they're thinking about it. Technically no barriers to working from home (I do it every Friday), tempted to just start doing it every day, but would rather they made a formal decision on it first.
Yeah “tell, don’t ask” is good advice for both OO design and office communication. If you ask, a manager will always consider whether they will need to ask someone else about it.
You can also take a softer approach and tell the manager your concern and say you would work from home for safety reasons unless they absolutely require you to be there. That way you didn't give an order to your boss and can still go home.
For all their faults my smaller company is very forward thinking on this. They have banned all non-essential visits to sites by clients or contractors, and travel between offices by staff - even within the same metro area. So you can't just pop into the other office on Friday if you feel like it.
You're also asked to work from home for a while if any travelling family member from overseas visits, and if you have no reason to be in the office they won't say no if you just want to work at home and avoid public transport.
Hoping it doesn't cause a big hit to productivity because it's the right thing to do.
I did just that. I couldn't concentrate on work in a big office. I'm canceling meetings (or changing them to video conferences). I think I can get away with it for a week or two. And in two weeks I expect my employer to order home office for everybody anyway.
It makes a tremendous difference, so don't downplay it. Infection due to smear (secondary droplet) is really high IIRC and washing hands is a huge countermeasure.
It's necessary but not sufficient to stop the spread. I'm currently just avoiding bringing the topic up with my sister who traveled from the UK to America last month. She repeatedly brushed off the topic because the UK government kept saying it's essentially the flu. Now she's in America with her 2 year old and I'm betting she'll probably fly back to the UK under these conditions.
It likely will. If all people washed their hands properly and avoid touching their face that would probably slow infection rates down enough. Measures are needed because realistically, no one follows these orders enough.
It has really been a lackadaisical response from the Austrian government - shades of Semmelweis all over again? This is a country that has monuments to Plague victims in its most valued districts ..
Going to be an interesting few weeks as we see how things proceed. To think, somewhere out there, the virus lurks and is headed our way ..
Plague monuments are hardly an Austria specific thing, you can find them almost everywhere in a large part of Europe, including here in Czech Republic:
Austria isn't as badly hit as Italy, despite the short distance to the most affected regions in Italy. They took quite drastic measures early which hopefully slows down the spread. It also helps that much of the traffic from Italy continues on northwards towards Germany and therefore bypasses the main population centers in Austria.
But as in all countries by now, older folks should stay home and self quarantine whenever possible.
Isn't this happening in many places? In Greece, schools are closing for two weeks, all gatherings are prohibited, and celebrations for various holidays have been canceled.
Notably, the Church of Greece has announced that "the virus cannot be spread through Communion" (where everyone drinks wine from the same cup). You can imagine how angry this self-serving move made most people.
> Notably, the Church of Greece has announced that "the virus cannot be spread through Communion" (where everyone drinks wine from the same cup).
Catholics in Greece are overwhelmingly Orthodox. The Orthodox Catholic church distributes holy communion differently, with a spoon (there is a particular term for it, but I don't know it) that doesn't touch the communicant's mouth. So, they're not drinking from a communal cup.
It's entirely possible for the communicant to exhale / cough / sneeze on the spoon. I don't know what the priest would do if this were to happen.
As an aside, it's widespread right now (but maybe not universal) in Catholic dioceses to not even provide the cup to the congregation during Communion (which is perfectly fine according to Catholic theology btw). edit: additionally, I recently heard about a dispensation in at least one diocese for people who are in any of the COVID-19 risk categories that they don't need to receive Communion for now. I don't know whether this also dispenses them from attending Mass on Sundays (which is otherwise an obligation for all Catholics).
Do you mean "Christians"? There are very few Catholics here.
The spoon very much touches the communicant's mouth, and the priest dips it back in the cup afterwards. You're getting spoon-fed wine, essentially, with a whole lot of contact.
> All of the three main branches of Christianity in the East (Eastern Orthodox Church, Oriental Orthodox Church and Church of the East) had always identified themselves as Catholic in accordance with Apostolic traditions and the Nicene Creed. Anglicans, Lutherans, and some Methodists also believe that their churches are "Catholic" in the sense that they too are in continuity with the original universal church founded by the Apostles. However, each church defines the scope of the "Catholic Church" differently. For instance, the Roman Catholic, Eastern Orthodox, Oriental Orthodox churches, and Church of the East, each maintain that their own denomination is identical with the original universal church, from which all other denominations broke away.
The tree of life works better, there were many branches even earlier that died off and the ones that survive did so through evolutionary pressure. The ones that required circumcision for instance weren't great at attracting converts.
Conversely, the Catholics I know prefer (if they have a preference, many don't) the bare term "Catholic" rather than "Catholic Christian". This is likely because I live in the US.
Now that you mention it, I've only heard them called "Catholics" here as well, not "Catholic Christian", so it's "Orthodox" or "Orthodox Christian" and "Catholic", you're right.
I was curious about how you would reliably spoon-feed someone without the spoon touching their mouth, so I looked it up online, and from what I've seen [1] it doesn't look like they avoid touching the mouth.
The Diocese of San Jose gave a dispensation from attending Mass to people in the various risk categories[1]. That means they don't have to attend Mass on Sunday.
> don't need to receive Communion for now
Regardless of the virus you only need to receive Communion once per year, not at every Mass[2].
Same in Poland. Schools, kindergartens, universities all closed starting Monday (Thursday and Friday are "if you must" to give people time to cope), but from what I hear from people, the Church considers itself to be a "hospital for the soul", and "you wouldn't close hospitals during a pandemic". smh.
> "the virus cannot be spread through Communion"
I assume Greece is Catholic, right? Because pope himself told people to take the "spiritual communion" instead of the actual one, and yet the Church in Poland doesn't seem to care.
EDIT: sorry. Somehow I thought Orthodox is mainly in Russia. But my rant against Polish Catholic Church still stands. Pope himself shows people what to do, but in Poland, we're going to do the opposite.
Greeze is probably orthodox not catholic. There is a difference, but I'm not sure what other than they don't report to the Pope, and they do recognize the pope (and vise versa)
There are dogmatic differences such as the Filioque, where one Church says that the Holy Spirit proceeds from the Father only, whereas the other claims that it also proceeds from the son.
It's kind of like the systemd rageforks, only for sillier (unless you're religious, I guess) reasons:
Overreacting? Did you miss the headline of the thread you’re commenting on? This is officially a pandemic. And instead of reading that and thinking “wow, this needs to be addressed with serious action” you instead thought that hundreds of governments across the world are working in tandem to make it easier to raise false flags in the future. Yikes.
Over 49 thousand people die from Pneumonia every year in the United States[1]. Under 5 thousand have died globally from COVID-2019[2]. Does this information change your perspective?
From a Penn State epidemiologist (note that the quote below speaks of the "infection fatality rate", which is different from the "case fatality rate", the difference is explained in the article)[1]:
"Scientists working at the London School of Hygiene and Tropical Medicine, Imperial College London and the Institute for Disease Modeling have used these approaches to estimate the infection fatality rate. Currently, these estimates range from 0.5% to 0.94% indicating that COVID-19 is about 10 to 20 times as deadly as seasonal influenza. Evidence coming in from genomics and large-scale testing of fevers is consistent with these conclusions. The only potentially good news is that the epidemic in Korea may ultimately show a lower CFR than the epidemic in China.
...
"On balance, it is reasonable to guess that COVID-19 will infect as many Americans over the next year as influenza does in a typical winter -- somewhere between 25 million and 115 million. Maybe a bit more if the virus turns out to be more contagious than we thought. Maybe a bit less if we put restrictions in place that minimize our travel and our social and professional contacts.
"The bad news is, of course, that these infection numbers translate to 350,000 to 660,000 people dying in the U.S., with an uncertainty range that goes from 50,000 deaths to 5 million deaths. The good news is that this is not a weather forecast. The size of the epidemic, i.e., the total number of infections, is something we can reduce if we decrease our contact patterns and improve our hygiene. If the total number of infections decreases, the total number of deaths will also decrease."
No, not at all. Because covid is just in the earily stages of spreading. At it's best it will kill far more than 50k this year alone and become endemic so it continues to kill at many on top of flu. At its worst it stands to kill a lot more.
The number of cases in China was been steady for around a week. If we extrapolate from Hubei that should give a decent picture. Around 0.1% of their population were diagnosed with covid and of those diagnosed around 4% died. If we apply the same rates to the United States (328 million * .001 * .04) we get 12,960 deaths. Keep in mind that is somewhat of a worse case scenario. In Henan province the fatality rate is less than half of what it was in Hubei, 1.6%.
It's not a "worse case scenario", it's successful containment through quite strict quarantine measures. Since neither USA nor Italy are taking measures remotely comparable to what Hubei or Henan did when they had a similar amount of spread, we should expect these countries to have a much larger spread than Hubei did, it's really not reasonable to assume that they would be able to limit this to "around 0.1% of their population were diagnosed with covid" - it's plausible that more than half of the population could get it, and leaders of many western countries have acknowledged that.
The population density of Hubei is over 9x that of the United States, the quality of care is better in the United States, and there was basically no action taken for the first 2 months of the outbreak.
"it's plausible that more than half of the population could get it, and leaders of many western countries have acknowledged that."
Will there ever be apologies for spreading mass hysteria?
Will there ever be apologies for downplaying justified warnings and saying "it's just the flu" with dire consequences?
E.g. in a recent turnabout Vice President Mike Pence said today that there has been “irresponsible rhetoric” from people who have downplayed the seriousness of the U.S. coronavirus outbreak.
Let's look at South Korea. The number of daily cases has been declining for a week. There are currently 7,869 cases there. Let's just say that despite the current trend the number of cases manages to increase to 20,000. That would mean around 0.04% of the population of South Korea would be affected. They currently have a death rate of 0.8% but there are still many active cases. Let's say that doubles to 1.6% which would put it in line with regions of China other than Hubei. If we apply that infection rate and mortality rate to the US population (328,000,000 * .0004 * .016) that gives a total number of deaths of 2,099.
The numbers don't need any mitigating factors but those do exist as well. I don't see South Korea doing anything more extreme than what could be done in the US so that doesn't show the US would be worse. The population density of South Korea is 15x that of the US so that would probably mean the infection rate would be lower in the US. The median age is also higher in South Korea and since this disease affects older people more that would also make the outlook for America better.
It's not clear that it's an overreaction; the paradox is, assuming this truly is a pandemic (seems likely), and every nation on earth had taken drastic action early enough, it could have actually been contained; in which case we wouldn't have seen the pandemic manifest, and the public would be left scratching their heads, going "why did we do all that again?", and provoking inquiries into false-flag/etc.
I lean a little tinfoil-hatty; but I get the impression that for all the bullshit self-serving narratives proffered by elites (both economic and political), this is one that they actually seem to believe themselves, privately as well as publicly. If anything, they're more spooked than they're signaling openly.
Playing Devil's advocate, but if the situation does fizzle out in the US due to active measures, people will likely look back and say how it "ended up not being a big deal".
I don’t say that lightly. That was 20 years ago, so maybe you youngsters just read about it in books. But in summary, a bunch of us busted ass to make sure the predictions of ATM and power failures did not come to pass on 1/1/2000. Our reward was, “See? We got all up in arms about nothing.”
Plenty of those same short-sighted dipshits are still alive, and of those now deceased, I’m sure replacements are just reaching voting age.
That’s assuming the U. S. puts forth anything close to the effort of fixing Y2K. Which is not even remotely guaranteed.
I also was around for this but my favourite thing about it wasn't the resignation of "it wasn't a big deal" from the public but the mockery of people at the time talking about 2038 as alarmist nutjobs. It was not going to be a issue in 2038 because we'd all be running 64 bit quantum computers by then.
18 years away now and an absolute ton of affected systems are still out there and mission critical.
These type pf issues, from Corona to 2038 to climate change, always remind me of that Homer Simpson quote.
"Pfft, that's a problem for future Homer. Man I don't envy that guy."
Me, a 13 years old kid who was experimenting with QBASIC in 1999, thought that it was just switching from LEFT$(x, 2) to LEFT$(x, 4) when parsing dates. I still chuckle when I think how massively I had underestimated that problem.
It's a data issue as well as a code issue. Think about what happens if a date of birth with 2 digits is stored in a database or file and read back. You have to change the code and all occurrences of the data, or change the code to detect and repair the data on the fly.
This is also why y2k problems happening on Jan 1st was a bit misleading for many use cases. Things like insurance renewals and investment projections look ahead to future dates and so problems will start showing up earlier and get fixed well before.
In short, it was massively overblown and misunderstood - people expected their own computers to blow up and even made shelters - and some scammers even took advantage of those fears. It made perfect sense for someone who didn't knew what was going on and was fed on doom and destruction to see things continuing without any hitch and wonder what was the fuss all about.
Deus ex machina is unlikely. But we aren't even at the stage of admitting this is going to be anything other than a bad flu season, for sure not like the 1918 flu.
Fauci said today that if we don't get aggressive, the death toll will be many millions.
None of these occurred on anywhere near the current spread or scale. SARS and MERS were almost entirely confined to Asia, Ebola to West Africa, and Zika to South America. The last was most widespread but was still limited to about 10,000 cases outside of South America and Cape Verde. Even then the greatest danger was to the children of pregnant women and, rarely, lasting complications. The number of “deaths from Zika” was <100 in total.
Coronavirus’ combination of “widespread prevalence and awareness” and “killing people” is quite different from previous diseases, I think. It might effect more social change.
There were changes after SARS that led to better containment and reporting measures in China, Hong Kong, Singapore, etc.
Sure, the initial cases were clearly messed up, but it has mostly been contained in Hong Kong and Singapore. And with the way this disease has progressed, I would bet many countries are going to overtake China in case counts.
There have been some quite impressive Covid-19 containment campaigns in the Middle East and Africa thanks to improvements brought on by exactly those outbreaks, so maybe.
I think the scale of global impact is different. I’m now turn into a person who religiously wash my hand, and care about hygiene and stuff much, much more often than before, all thanks to this COVID-19.
Humans don’t seem to be very good about internalizing lessons across more than 2, maybe 3, generations. Especially if there’s any sort of indirect effects or abstract concepts involved.
Besides #2, most of these would disappear after a couple generations. We've obviously forgotten a lot since the Spanish Flu, polio, and other highly infectious diseases.
Most people have little interest in operating their motor vehicles safely, even though doing so would be trivially easy, and not doing so kills a staggering number each year.
There’s some evidence that some of the ‘bad flu’ cases were actually covid-19, present in both the US and Italy as far back as November. Just ask if these bad flu people regained their fitness.
The This Week in Virology podcast was discussing some anecdotal stats from doctors HK who reported lower incidents in many common seasonal disease due to better hygiene. I don't believe they have population wide compulsory quarantine, so it might just be a case of mask usage + hand washing. Would be interesting if on the whole, less people died this year due to elevated vigilance as side affect of corona response.
It's actually not a bad thing that it's between 1% and 3% mortality. Can you imagine if this had been Ebola or MERS? This pandemic will leave us much better prepared for one that could be much much worse.
More dangerous infection often kill their hosts before they can infect many others, so might result in horrendous dead toll locally but might find it hard to spread very far.
My understanding is that it isn't the death rate that makes this different but how long it incubates for, allowing it to spread much further. The death rate could have been much higher and we'd probably still end up with a pandemic.
I actually think its' success is largely due to the low mortality rate.
At the extreme if it killed 100% of the people it infected then everyone would've locked down borders immediately and taken it very seriously.
But instead it's only 10x as deadly as a common virus (the flu) that most people have personally had. Which made people not very wary of it until they saw the exponential spread problem illustrated in Italy. (China also illustrated that but Westerners really only feel something can personally affect them if it happens to other Westerners)
> At the extreme if it killed 100% of the people it infected then everyone would've locked down borders immediately and taken it very seriously.
Depends on how fast it kills too. Something like airborne aids that somehow didn't have respiratory symptoms would be the most terrifying scenario because it would spread world wide before anyone noticed.
One data point might be Toronto. SARS had a pretty large social impact here, and people are far more cautious and measured in the face of COVID-19, but not panicking. Not yet anyway.
But small changes have been impactful—like some businesses immediately getting on wider WFH policies and self-quarantine for returning business travelers as well as general hygiene—people aren't always great at that but it's a conscious act on everyone's part lately. Businesses and buildings even started placing more sanitizer stations, etc.
>Statistical analysis showed significant differences in hematological parameters between vegetarian and nonvegetarian population. People eating vegetarian diet had significantly lower white blood cell count and red blood cell count in both, older (P < 0.01; P < 0.001) and younger (P < 0.01, P < 0.001) populations in comparison with nonvegetarian subjects. Hematological parameters were decreased, but in normal reference range. Reduced white blood cell counts were discovered in individual cell populations. Younger vegetarians had significantly lower count of neutrophils (P < 0.001), monocytes (P < 0.05), and eosinophils (P < 0.01) compared with younger nonvegetarians. In older vegetarians, significantly lower lymphocyte (P < 0.001) and basophile (P < 0.01) counts were found.Immune function analysis displayed significantly lower phagocytosis of monocytes and granulocytes in an older vegetarian population (vs. older nonvegetarians (P < 0.05, P < 0.001). Similar effect of diet was observed as decreased phagocytic activity of granulocytes in younger vegetarians. Regardless of age, respiratory burst of phagocytic cells was also significantly decreased in women vegetarians versus nonvegetarians (P < 0.05, P < 0.001). Older vegetarians revealed significantly suppressed proliferative response of T-lymphocytes to mitogens (P < 0.001).
I suspect that in practice, decreasing the culture of meat consumption would have more of an impact on the emergence of zoonotic diseases than increasing the culture of food safety.
In particular, zoonotic influenza spreads by contact with infected farmed animals, not by insufficient cooking, and E. coli spreads by animal farming contaminating plants that don't normally call for cooking.
Plus, cooking doesn't kill prions, and prions are horrifying.
This is the only actual solution. All of these diseases will continue because of our close proximity to animals, factory farming being the biggest offender.
We also breed super viruses by feeding the vast majority of our produced antibiotics to animals. Yeah, we need to stop eating animals and animal products as quickly as possible. There literally is no other way.
In a few years lab grown meat will be a solution to those who don't want to switch over to a plant-based diet, so there's that.
Exactly which disease outbreak was due to factory farming? SARS, Ebola, and Covid-19 were all caused by wild animals probably hunted/captured by sustenance farmers and kept in a dense, diverse essentially farmers market.
This is all the exact opposite of factory farming and the industrial food supply chain we have in the west.
Swine flu came from domestically raised pigs. Factory farming makes it more likely because the pigs are kept in close, confined quarters, increasing the spread between animals. The virus is passed from the animals to the farm workers.
Not this specific outbreak, but it was from the meat trade (wild caught or farmed). We keep stressed out animals in disgusting conditions in close proximity which is a breeding ground for disease. We then interact with them.
And of course, wild animals (like bats) can transmit diseases to other species (like pigs). Who can then transmit it to all the other pigs around it.
Then we pump them full of medication so they don't get sick, and end up creating antibiotic resistance.
Antibiotics cause super viruses. By killing bacteria? Umm, no.
This virus came from a wildlife market filled with multiple species stacked on top of each other. Let's not act like this is equivalent in danger to chicken/beef production.
Um, yes. If you keep taking the same antibiotics (or feeding them in huge quantities to livestock) then yes, new strains of viruses that are antibiotic resistant will emerge. That's how viruses work and evolve.
Otherwise we'd have discovered a flu vaccine and then no one would have ever gotten the flu again. Yet here we are. The virus evolves and changes over time.
To be fair, his point that it's dangerous stands. They do create super bacteria [1]. Of course, with bacteria, you'll experience it through an unlucky lottery rather than a pandemic.
How's it ignorant? I'd love for you to elaborate on that. Keeping stressed animals in close proximity in filthy conditions and packing them full of antibiotics is not good for anyone (especially the animals). It's a disease breeding ground and all the antibiotics breed antibiotic resistance.
All mosquitoes could be bad. We just need to eradicate the mosquitoes that feed off humans. Last I heard, they don't fill any particular important ecological niche which can't be filled by the other mosquitoes.
Are they the sole food source for some species? Could their niche be filled by something else? As other commenters pointed out, not all species of mosquito are harmful to humans so it could be a more targeted eradication.
Bats don't feed on anopheles mosquitoes. I'm sure some bats feed on some mosquitoes, but do any bats feed exclusively or primarily on mosquitoes that transmit malaria or yellow fever to humans?
Alright Captain Literal, but my point still stands that generally speaking, bats do consume mosquitos, maybe that _not that specific type_ of bat, or _that specific type of mosquito_, but yes, bats consume mosquitos.
Christ talking to people on this site is like talking to the most literal supernerd of all time who just needs to always have a point. It's like reddit 2.0.
Lol. I thought you were being kinda literal too. I obviously didn't mean eradicate all mosquitoes - just the species that hurt humans. So I felt the same way as you. That's kind of funny.
I'm not saying I want this to happen. This would be my parents too, mate. But it's just the morbid reality of the situation. OP was talking about the "bright side", well after the dust settles this is an upside.
And if everyone died all problems would be resolved. You're not wrong (or maybe you are; perhaps those people add more economic value that you give them credit for, even indirectly), but there's difference between pursuing a better world and resolving problems like they're tech support tickets.
It's crass but the implications in demographic shift is interesting to think about. There's massive ramification to society from funding allocations to changes in voting pattern and national identity when the virus disproportionately eliminates an age bracket. And all the 2nd order knock on affects. Demographics is destiny.
man, ethical considerations aside - lets just say i strongly disagree with you in ethical plane too and lets hope you were just controversial in order to explore the issue - you're wrong in pure logical economic sense. You're talking about market losing a million of active consumers in a consumer driven economy - that is recipe for bust, not boom.
I keep reading that because of how insanely transmissible covid is, this doesn't end until enough people have already had it that there just aren't that many people around you to infect anymore. It's been described as "trying to stop the wind". We can maybe slow it down but not stop it, and in the US since our response has been so weak, we especially shouldn't hope to stop it unless we're willing to totally isolate our entire families.
At the same time we're hearing that Italian hospitals are completely overwhelmed to where they are having to "choose who to let die" vs providing acute treatment.
So... (1) is it fair to say that focusing on prevention is pointless and we should just focus on survival which is largely about staying healthy and receiving care and therefore (2) (this is the crazy part) does it actually make sense to get it now before hospitals are overwhelmed and you might be unlucky enough to be sick with something else. Basically choose the most opportune survivable situation to get it versus letting the virus and bad luck pick when you have to fight this battle?
My gut tells me a bunch of people are going to crap all over this question but I'm not coming up with good counter-arguments off the top of my head.
(one other point, I live in SF, a large dense city, and I have two little kids that get everything so I'm maybe more fatalistic about the idea that I and my family will eventually get it either way)
> (2) (this is the crazy part) does it actually make sense to get it now before hospitals are overwhelmed and you might be unlucky enough to be sick with something else. Basically choose the most opportune survivable situation to get it versus letting the virus and bad luck pick when you have to fight this battle?
No.
(1) If you get it, you may spread it, even if you're careful. That chain of spread may lead to additional burdens on the system, or deaths
(2) No matter your age, you may become seriously ill, and may draw resources from the system because of irresponsible behavior
(3) It's highly possible that after some time has passed, the mortality rate will drop significantly because doctors will develop a good protocol. If you get it now, you risk being treated in a system that is still figuring this thing out
(4) If you get it, you will not be available to help anyone else if needed due to the required isolation period
The only ethical thing to do is to try as best you can not to become sick and also to support your community through this difficult time with money or volunteer labor. So, if you are a highly-paid techie who can work from home and limit your interaction with others in the community, do so.
Only number 3 is a potential benefit to the individual. The rest are for the community’s benefit. Remember we are on a site full of people with a rather “every man is an island” attitude...
What you're saying is close to the standard line -- "flatten the curve". By trying to prevent infection, you slow the process down, so that hospitals are not overwhelmed. An overwhelmed medical system means that every aspect is made worse; people are not contained so the spread accelerates, we don't do backtracing with the same effect, medical personnel get infected, people with easily treatable conditions are not treated, etc.
The end state is that almost everyone will be exposed to it, most likely to mutated less deadly variants (because those have higher survivability in viral terms), but if the rate of exposure is slow enough then we can mitigate a disaster.
Looking at Italy as a case study we need to limit the spread of this virus only for the reason of reducing stress on the medical industry at any given single moment while accepting everyone is likely to encounter this thing eventually. Aside from slowing the rate of transmission the guidance, from the medical experts, says to treat this no differently than the flu.
The reality is that this virus will be everywhere because it is at least as transmissible as the flu but with more benign symptoms and a longer incubation period. The incubation period for the flu is generally 5-7 days but the early data from China was suggesting an incubation period of 10-14 days for corvid19. Both of those numbers are variable upon a given snapshot and environmental factors.
On the other hand the earlier people encounter this thing means the earlier a population can build the necessary mass immunity resistance.
This. What is urgently needed is to flatten the curve. Maybe we can't reduce the total number of people who get it, but if we can spread out the infection over a longer time period, we may be able to avoid overwhelming the health care system, to the benefit of all.
That's a good point and highlights a possible misalignment of interests between individuals and the community: me intentionally getting it now, before there are many cases might help me and my family but speeding up spread by doing so might increase the size of the peak for everyone else.
Related question: when I imagine the spread I feel like fast moving spread will burn itself out more quickly and completely. But if it slows down too much, might it become like the flu where if only 1/3 of the people get it in a given year we never hit that critical point where everyone is immune and it peters out within a season, giving it time to mutate and keep reinfecting populations year after year much like the flu does?
> me intentionally getting it now, before there are many cases might help me and my family but speeding up spread by doing so might increase the size of the peak for everyone else.
It's also possible that we'll identify antiviral treatments, etc that will reduce the impact on our health system / death rate (in which case getting it later would be better).
It could take two weeks before you develop severe symptoms sending you to the hospital. After that you may need intensive care for a couple of weeks. How sure are you that your local hospitals won't be overwhelmed in 2-4 weeks?
There are different strains of the virus and it's not clear if getting one of them gives you immunity to other strains.
Yes if you're vulnerable it would be better to get it today than in a month when hospitals are full. However it would be even better not to get it at all or get in 6 months time when doctors know more about how to treat the disease and could have drugs that are known to work.
It sounds like your family is young enough to not really be badly hurt, its more about how many people you'd pass it on to.
> (2) (this is the crazy part) does it actually make sense to get it now before hospitals are overwhelmed and you might be unlucky enough to be sick with something else.
I don't think that's crazy, it would be quite helpful to be able to plan to catch it, and you can quarantine yourself at home so you don't spread it to anyone. The big trick is to be able to avoid spreading it around during the symptomless incubation period. Catching the virus on purpose could help you do that.
> (1) is it fair to say that focusing on prevention is pointless and we should just focus on survival
I don't think so. The point is to lower the exponent. Buying time has a lot of value.
I've read that you need about 40% of the population to be immune to it, for this to die down. Suppose you will inevitably get there no matter what we do (barring a deus ex machina like a vaccine) - you want to do it at a pace that does not overwhelm the health system.
Another thing to consider is, that this is like a friction coefficient. So maybe if people spend 80% less time outside, we can maybe equate that to having 25% of the people already immune or something like that, and then 10-15% actual immunity is enough to make it die down.
So I was on Youtube when WHO was holding the conference giving the promotion and I caught about 10 minutes off it. In there, the spokesperson said exactly concerning 1) that we SHOULD still enact containment measures, and that those containment measures could help nip it in the bud.
No to number one as prevention is very important, as you wont receive care if hospitals are overwhelmed. Also, containing the virus is useless if in the end a vaccine is able to be developed.
Number two makes more sense as not having access to care and equipment later on can be a problem.
I've heard the "you can't escape it" argument too, but I'm not too sure if I believe it. Shouldn't we have to avoid it only until the vaccines are ready?
The only way to ensure escape from a disease is to eradicate or contain it. A vaccine helps tremendously in that regards, but alone doesn't guarantee eradication; as we have flu vaccines since the 1930s, yet the flu still remains amongst us. However, this is arguably just a result of vaccination rates; if more people took the flu seriously and were regularly vaccinated, we may have eradicated the flu by now.
Same for COVID-19. If people don't ever take this seriously enough, then I doubt we'll eradicate it. The virus is on every continent in ~120/195 of the world's countries, all of which happened in a few months, despite travel bans and quarantines setup to initial outbreak areas. To me that sounds like people need to take it more seriously and put more effort into containing this. Otherwise it looks like it'll end up being endemic just like the flu, and we may never eradicate it despite having a vaccine - as what evidence do we have that enough people will vaccinate themselves when we do have a vaccine, if people keep equating it to the flu...
The problem with pandemics is that they tend to grow exponentially. What people often forget about exponential growth is that it's actually very slow around t = 0.
obviously its not going to be exponential forever, no one believes that. The more people get infected, the less people there are to infect. This is obvious. The problem is no one knows where the inflection point is yet, and it depends entirely on how countries react to the illness.
I think t is too far from 0 at this point, at least in the U.S. Our ability to test for SARS-CoV 2 has been completely kneecapped since the beginning, and there still aren't enough tests to screen people for the virus. There are documented cases in my area going back to 3 feb. But those cases were diagnosed outside of the country. As in, they had it while they were here, but they were not diagnosed until they flew back home and visited a doctor.
Anyone following the social media and the news would’ve called the pandemic weeks ago.
I hope this will make people realize that we need to abolish centralized institutions in our highly complex world. They are single points of failure which introduce significant systemic risks.
CDC also dropped the ball on this one. In Washington state local authorities discovered the outbreak only because they defied federal regulators.
We need better organization at the local level, and we need it now.
Why is this evidence that “we need to abolish centralized institutions”? It’s not like every local organization can marshal expertise on every issue. Perhaps the WHO misjudged the coronavirus, but I’m confused about how this is suddenly a referendum on large institutions and the superiority of local ones.
Running the WHO seems hard. Alarm people too often and they will tune you out. Miss an alarm once and they will call you incompetent (“you had one job!”).
There's nothing wrong with having large-scale institutions. The problem is when local organizations can't act without a single centralized institution giving the OK. National health departments listen to the WHO but can take action as needed without WHO signoff; local health departments in the US often literally could not test for the coronavirus, even though they had the tools and the capacity and the desire to make tests, because they didn't have federal approval.
> local health departments in the US often literally could not test for the coronavirus, even though they had the tools and the capacity and the desire to make tests, because they didn't have federal approval
But that’s a judgement against the United States’ federal government, not the WHO. The WHO does not actively constrain governments, they just offer guidance (as far as I know!).
In principle, that's true, and certainly a point in the WHO's favor. In practice, it sounds like a lot of things are happening only conditional on the WHO's statement that it's a pandemic, which if true reflects a lack of local adaptability. I don't think it's the WHO's fault, necessarily, but local authorities need to have the capacity and skills to feel they don't have to rely on the WHO's judgment of such things.
> It’s not like every local organization can marshal expertise on every issue.
In order to be efficient decision makers, local organizations should be concerned with acquiring expertise related to local issues, and then, through cooperation, global expertise becomes an emergent property. It's not like every central institution can marshal expertise on every local issue.
One reason you want to avoid centralization is due to the fact that decision making occurs under imperfect and incomplete knowledge, or bounded-rationality as Herbert Simon called it.
By decentralizing the process of decision making, you mitigate the risks, since you are allowing entities to tackle a problem in parallel, and if one of them turns out to be wrong, the fallout is localized. Whereas in a centralized system, one bad decision can spell trouble for everyone.
> It's not like every central institution can marshal expertise on every local issue.
True, but maybe we disagree on how easy it is for every locality to acquire expertise. Plenty of local governments in the United States are already stretched thin fulfilling the simpler functions of policing, schooling, and basic infrastructure. Adding a staff epidemiologist seems very hard for such places. The same proviso applies to many poorer states and nations. That is why I think it makes most sense to direct effort toward having a competent central authority.
> By decentralizing the process of decision making, you mitigate the risks, since you are allowing entities to tackle a problem in parallel, and if one of them turns out to be wrong, the fallout is localized. Whereas in a centralized system, one bad decision can spell trouble for everyone.
On the flip side, decentralizing makes coordination harder. In coarse terms, there are game-theoretic considerations in an epidemic. For example, if localities are purely self-interested, an unaffected region may attempt to quarantine and keep all of its medical infrastructure ready for itself rather than lend it to nearby affected regions. In such cases a coordinating mechanism can be extremely helpful.
I'm not arguing that one kind of organization is always better or worse. To me it just seems complicated.
> For example, if localities are purely self-interested, an unaffected region may attempt to quarantine and keep all of its medical infrastructure ready for itself rather than lend it to nearby affected regions. In such cases a coordinating mechanism can be extremely helpful.
Reality is already ahead of you. [1] Switzerland is currently having trouble receiving masks and other medical supplies that were commissioned out of state:
Being landlocked, goods bound for Switzerland necessarily have to pass through a different country first, in this case Germany. Germany has a decree by which Corona-related medical supplies must not leave the country - and right now, this even applies to goods destined to Switzerland that are just arriving at a german port.
A fully "decentralised" world full of self-interested microstates would see a lot more of this stuff.
> On the flip side, decentralizing makes coordination harder.
Perhaps technology could help in this regard, at least to some degree. Bitcoin has proven coordination in a low trust environment is possible. Imagine if we could make coordination easier in other industries too.
> I'm not arguing that one kind of organization is always better or worse. To me it just seems complicated.
I agree, it is indeed complicated. But we need to start seriously considering concepts such as scale, systems thinking with its centralization/decentralization paradigms, and incomplete knowledge/risks if we want to design better institutions. Then we can thinker with turning the knobs one way or the other.
The WHO knew (and told people) that this disease had the potential for a pandemic and/or widespread harm a long time ago. Here’s a two-months old article with the title “Narrowing window to contain outbreak, WHO says”: https://www.bbc.com/news/world-asia-51591091
There is a difference between a potential, or even a certain, pandemic and an actual one. You and the WHO knew what it meant when you looked at that egg. But only now has it become an actual chicken.
> Anyone following the social media and the news would’ve called the pandemic weeks ago.
I would not trust the unstoppable gushing torrent of dubious information that is Twitter over whoever may be giving the World Health Organization its information.
That's true. You also need to be sensitive about echo chambers, and that's something humans also routinely fail at. I trust credible experts, not the self-selection of Twitter accounts telling me what I already believe.
Even if you 100% trust everyone you follow, and also believe them to be entirely impartial, the nature of Twitter makes it so easy to spread misinformation (mixed in with real stuff.) Twitter is optimized for viral content, not true content.
If anything, this is evidence that we need to empower centralized institutions. China started late and fucked up early, but they dealt with it (at least for now). And we'd all be in a much different place now if WHO had actual power and could start bossing countries around a month or two ago.
Similar to how the number 1 problem with the UN is that it has absolutely zero power to do anything.
sorry but 3 months ago WHO was complaining that China is taking too strong measures that are hurting the local population and are not proven to work. WHO never recommended shutting down cities or regions, which as we can see is the only thing that works.
WHO fucked up big time IMO. thousands of employees there, most probably appointed politically by country of origin and who have nothing to do with science.
You're not wrong, but to be fair, the CDC has to fight for funding all the time. If Trump gets his way with his budget proposals, it'll only get worse.
>I hope this will make people realize that we need to abolish centralized institutions in our highly complex world.
While I too favor decentralization, what we really need to do is return merit to our institutions. We need a social climate that encourages Pattons and Churchills and the like. Unfortunately to return to such a time of competent leadership (not just in government, but society at large) would require undoing decades of propaganda that convinced some two generations of children that we all have equal ability and any of us can do anything. The dangerous downside of giving everyone a trophy across society is that now people have grown up less able to judge competence and merit in others.
It's funny how in those political discussions, comments often say more about the commenter.
For example, I would argue that the "propaganda" that anybody can do anything isn't that old yet. On the other hand, certain political groups have been sabotaging government leadership for so long - by claiming that government is always incapable - that there's just no good leadership left in many places and it's become a self-fulfilling prophecy.
I'm fairly sure the quality of institutions in this day and age has almost nothing to do with participation trophies/equal ability propaganda, as this kind of thing rapidly gets torn to shreds as soon as one enters the job market.
I suspect it has a great deal to do with decades of people blaming government for their problems and increasingly less faith in government institutions, to the point of some politicians running on the idea that government doesn't work. It strikes me as difficult to get competent people for your organizations when the term "unelected bureaucrats" is used as an epithet, the pay is below equivalent work in the private sector, and the people at the top are selected for idealogical reasons instead of anything related to effectiveness, expertise or capability.
Parents from every school districts in the Bay Area have collected thousands of signatures to close, but the politicians are not doing their job.
I was on call with Santa Clara county hotline and the school district and the standard answer I got was: Oh, the kids are at low risk and the numbers are low so we're not closing yet.
What they don't realize is that the kids can still be carriers and many teachers and parents are in the danger zone (age or underlying conditions)
I listened to Joe Rogan's podcast with Michael Osterholm and he gave an interesting perspective. He said that most nurses who have children will suffer if kids have to be sent home. They most likely don't have people that can help take care of their children while they are supporting the influx of patients. Moreover, many children rely on school provided meals so sending them home will be very tough on the families.
Don't remember where I read, but some district or something has proposed (or implemented) an option where kids are able to get lunch/breakfast and take it with them without needing to attend school.
It does not solve the nurse issue, which perhaps as a community we need to solve. Perhaps limited opening of school monitored by younger healthier teachers/PTA reps.
Only vaguely relevant, but the school district I grew up in had a policy of never closing for weather. The rationale was that if the school were closed and some children showed up anyway (didn't get the message or whatever), they would literally freeze to death. So, no matter how bad things were, there would be someone there to unlock the doors.
Those are actually the least solvable problems. A disproportionate amount of poor people are going to lose their jobs during the next 3-6 months because of a recession. A lot of people especially in the US are going to suffer because of the vast income inequality that has arisen. So there is no good solution, just like quarantine isn't a good solution but at some point we have to do it.
I understand that. In which case at least they should make school optional.
Several Universities are closed, several schools are closed and we need to worry more about the spread because if we don't we'll have the problems you mentioned in addition to a massive spread.
There are a lot of folks on here asserting facts that are not supported by evidence.
The actual facts are this: we don't know what the CFR (case fatality rate) is. CFR is very difficult to accurately calculate, and varies widely with age, location, health conditions and even biological sex (so far, this seems to affect men a bit worse than women). The "2-3%" mortality rate that's being tossed around as fact, is most likely wildly inaccurate.
We don't know what the mutation rate is. Viruses tend to become less lethal over time, because the fatal strains kill the host and don't spread as well, which puts evolutionary pressure on the virus to become milder. Will that happen in this case? We don't know.
We don't know what the appropriate government response is. It's somewhere between welding people into their houses and doing nothing. Which is to say, who knows? Go overboard and everyone criticizes the government for crying wolf and wasting funds. Too little, and everyone criticizes the government for standing by and letting people die. It's a very difficult balance to strike, and I have a lot of sympathy for the folks who are in the position of making these decisions. They'll invariably get some wrong. Hopefully not too many.
IMHO, the best resource to learn about what we do know is the comprehensive Ars Technica article[1], which is frequently updated.
I would like to suggest
a) that folks stop claiming mortality rates in a panicky tone - because we don't know. and
b) that everyone who is reading folks claiming mortality rates and the upcoming apocalypse - reserve judgement until we have more information.
I share an office with a travel agent, and I can tell you a lot of people with "cancel for any reason" travel insurance are getting screwed by force majeure clauses. Unsurprisingly, insurance companies have no interest in paying out policies that threaten the existence of their company.
I think there's going to be so much nuance around this (what does your contract say? when did you sign it? do you have insurers backstopping you? if so, what does their policy say?) that the answer is going to be, "Talk to your lawyer".
Personal opinion, not a lawyer, not your lawyer, is that the further into the global pandemic we were when executing an agreement, the less wiggle room you might have. Again, talk to your lawyer; that's what they get paid for.
It's exactly what force majeure clauses are for. If something gets cancelled or becomes unreasonable because of Covid-19, this gives a reasonable way to exit contracts without penalties, and that is a good thing because given very unusual circumstances, we want people and organizations to be able to adapt instead of being pressured financially to execute things that seemed reasonable last year but are not now.
The first area where I'm seeing widespread uses of force majeure clauses is the cancellation of large events, conferences etc with limited or compensation for the cancellations. And again, while this hurts some people a lot, this is mostly a good thing, because we do want to give the organizers the ability to break their commitments and cancel the conference with much smaller consequences (to them) than an ordinary cancellation would have; we don't want the organizers to be pressured to hold the event at all costs.
For people embedded in companies: make sure your company can work remotely. Buy more VPN licences, update firewalls to handle the traffic, find meeting / conferencing software, whatever else you need to do to keep people working outside of the office.
For really big tech companies (FAANG), improve data analytics for automated reporting of health data to government agencies (CDC, FDA, etc). Google Flu Trends [1] is a great example of this. Basically google combines common symptom queries with geolocation data to track diseases in near-real time across a region. I first read about this in Datacalysm (Christian Rudder) and it's a fascinating thing.
For individuals: maybe make some cool graphs or ways of analyzing the publicly available COVID-19 data? There's a lot of misinformation going around and helping to curb that with real data will help the whole fear thing. For example [2]: people are saying to donate blood to get tested for COVID-19 "for free" but the test itself is a swab, not a blood pull.
Got into it only recently after having known about it for a long time. Just checked the leaderboards and discovered to some amusement that there's crypto based on it: https://curecoin.net
I've been watching COVID-19 very closely since 2019 Dec it, I also witnessed how WHO responses to this Pandemic. If you were me, you will notice that WHO tried very hard to please China, rather than taking people's health into consideration. Many things they did:
- Advice not to ban flight to China after China locked down hubei lockdown (yes, many country trust WHO, like Japan and Korea)
- Met and praised Xi many times, admire how wonderful they did
- Keep down playing how serious the problem can be, and didn't advice any action
Why would the WHO try to please China? It's an international organization. It's not a charity. It doesn't rely on donation. Its membership were to countries, it's operations were maintained based on membership dues. I find it revolting as the OP seems to be insinuating there were financial interest for WHO to please China, which is bizarre and outrageous based on how it's organized.
WHO does rely in large part on donations. See http://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_35-en.pdf page 82. It could certainly be argued that they have an interest in convincing China to boost the voluntary portion of its contribution to match that of some of the other nations on that list.
WHO has "assessed contribution", which is its lifeline upon which it relies. I'm not saying it doesn't accept donation. just that WHO doesn't need donations to survive. It's clearly shown in the pdf which you linked here that China doesn't even make it to the top 10 donor list. Donation from the United States comprised of 76% of WHO total voluntary contribution. Why would WHO risk angering its major donors and pleasing to one specific small donor? Even if finance were taken into consideration, it still doesn't make any sense.
No one really said that. The reasons that international organizations are more trustworthy is that a heck lot more people are watching them and they are mostly composed of delegates from ideally all countries in this world.
Because China threaten them. If they don't bend over backwards for them, China will accuse them of "Sinophobia" and being agents of the CIA all the rest.
See it yourself, not China. They hide data from the world, beat people up on street. How come that now becomes a model for the world? Taiwan is a free country, and yet they did a great job there.
Taiwan has not even been permitted membership to the WHO and is excluded from WHO participation. Maybe it was Taiwan that the WHO was praising when they were talking of China.
People who are so "sinophobic" that they spent their best years in china, learning the language, marrying locals, and creating multiple documentaries about Chinese culture, and only left China because the recent xenophobia of China has become too much for them to continue living there.
I disagree. I haven't lived in China (for more than two months at a time), but traveled there multiple times, which was an eye-opening experience. I've met several foreigners living in China, some of them since before 2010. There is no raise in xenophobia according to those people.
The clickbait that these two Youtubers spread on their channels creates a very, very biased picture of China, and Chinese society (to the negative). Things are blown out of proportion or presented with misleading or no context. Even when they pretend to make a positive video about China, they can't help but add a few dismissive comments here and there.
All of the aforementioned people I know dislike their content, because they feel it misrepresents China as a whole.
I could go on about how and why I think these two guys are toxic, but the gist of it is that I actually used to watch their channel regularly before they became full-time youtubers, which was a turning point. Over the following 6-12 months their content slowly became more clickbaity and generally negative towards China. But I guess once you depend on youtube financially, you simply make videos that get the most clicks. Their comment section slowly turned from "sometimes filled with Chinese trolls and otherwise cool people" to a cesspool of people living in their echo chamber of "murica is awesome, teh commies are evil", and obviously still a lot of Chinese trolls.
Their content doesn't help to get insight into China. It helps you to strengthen the bubble you live in.
I have followed ADVChina for quite some time. The creators provide a unique lens into Chinese culture that is hard to find elsewhere. They are very open about talking about Chinese culture and why it is the way it is. They talk about what they like and don't like about the culture but not in a racist way. The titles of their Youtube videos are click-baity, but the content is informative.
What they say in the channel are all true, they have been traveling in China and living there for long time, they married Chinese wife. If you really look closely, you will notice that they pointed out many problems in China, which I don't think it's Sinophobia. If you point out problems in any country makes you something phobia, then there's no freedom of speech....
Vietnam has done similarly well too. China deserves some blame for not having investigated complaints seriously and allowing it to have spread at least for a month before the alarm bells were rung.
I think most people can agree that no one country has done a stellar job (including the US) to contain and mitigate the virus but given that China was the first to be hit, it gets a larger share of the blame for letting it spread to the rest of the world. If you look at the timeline of the events that transpired in China since December [1], it shows a clear pattern of ignorance and favoring politics over public health. You know things have gone completely wrong when you decide to arrest doctors that have called out the disease. Anybody that says "China has done the best to control this disease" is either a CCP shill or massively uninformed or misled by propaganda. Remember, the only news we get out of China comes from state-sanctioned media.
You've been using HN repeatedly for nationalistic flamewar, which is not a legit use of the site. We've had to ask you more than once to stop doing this since long before Covid-19. Please stop now.
Edit: turns out you've been using HN pretty much exclusively for that. That is a bannable offense as the site guidelines make clear. I'm not going to ban you now, but if you don't stop then we will.
Taiwan have done a stellar job. Pre-prepared, acted quickly (starting on 31st of Dec), and have got the results to show they were doing it right. For more information, see: https://jamanetwork.com/journals/jama/fullarticle/2762689
Edit: This also shows up the lie that China’s suppression of information was the critical factor in delaying everyone’s actions: Taiwan had the information and acted, it is just that other countries chose not to act on the information they had. Li Wenliang (one of the whistleblower doctors) on 30 December he “sent a message to fellow doctors in a chat group warning them to wear protective clothing to avoid infection.
Four days later he was summoned to the Public Security Bureau where he was told to sign a letter.”
Yes, I noticed too that Taiwan did an amazing job at protecting its citizens. It’s even more remarkable because of how close geographically, culturally and economically it is to China.
China has also silenced those who detected it in early stages. China should pay a dear price for doing so as that is the main reason it got out of control. Stay safe folks!
You want visas to go into china and research a pandemic? This is how it is done. Not by throwing people under the bus, but by maintaining a very narrow bandwidth of comment and showing appreciation to the powers that be, for allowing you to enter the country and go about your business. I appreciate Xi Jinping and other chinese official's efforts to contain the disease and assist the WHO on their research mission. That's all I have to say about that.
Yes, I've been saying this from the start as well. Also note that they used China's severely misleading statistics from day 1 with no disclaimer. The WHO is incompetent and/or corrupt.
In what way were China's statistics severely misleading. For a long time, they reported lab-confirmed cases and were upfront that this was limited by the amount of tests they could perform. In addition, they reported how many people were tested and how many tests were still being processed.
Today in the US, the US is reporting only lab-confirmed cases. They are also upfront that this is limited by the amount of tests they can perform. Unlike China, the US is __not__ reporting how many people are tested or how many tests are being processed. They are also not upfront about the fact that testing is severely limited by a very strict policy on who to test.
I'll take China's statistics (which I've not seen to be misleading) over the US's complete censoring of any information about the outbreak, and the CDC preventing people from getting testing.
At this point, all flights from the US should be terminated. Your government is a danger to your own country and to the world.
Random people signing an internet petition is not cause to remove an international health expert. The only legitimate votes could come from doctors or foreign affairs/other experts
Well, NYT also accused him a few years ago of covering up 3 Cholera outbreaks in his home country of Ethiopia.
Given the display across the world right now I don't know if the experts are that much more informed than the collective wisdom of online society at this point, at least for this matter.
The collective wisdom of some online societies is saying that Covid is being played up in a conspiracy to lose Trump an election. We should be skeptical or online wisdom
This is a lot of media. Bizarrely no skepticism, just writing articles matter of factly using dubious (or at the very least opaque/unverifiable) figures from foreign governments.
And a surprising lack of reporting on the dozens of side channel leaks from China - videos of dead bodies, videos from leakers including the young doctor who was admonished and succumbed to the disease...
Yeah a lot of it was rumor and hard to verify but...nothing? You'd almost start to wonder whether our journalists were cooperating with the Chinese government or something in censoring everything. I struggle to come up with a legitimate excuse other than total incompetence. It was all over the internet and a lot of it (first hand accounts from Chinese citizens within China) would have been reasonably easy to verify for a journalist who knew a Chinese speaker.
The name of this virus with respect to the naming convention mentioned above is literally "A/California/7/2009(H1N1)pdm", which you'll note has two specific places in it, one abbreviated and one not.
For the Northern Hemisphere this flu season they recommend strains like A/Brisbane/02/2018(H1N1), A/Kansas/14/2017(H3N2), B/Colorado/06/2017, and B/Phuket/3073/2013.
Those are virus strain identifier names, not disease common names. IN that case the disease is called influenza.
The WHO advice applies to the common usage:
As these best practices only apply to disease names for common usage, they also do not affect the work of existing international authoritative bodies responsible for scientific taxonomy and nomenclature of microorganisms.
Ebola would be one exception, as it is a river. But Spanish flu was not so named (if that's even a formal name) because of anything Spanish in origin; it was named that way because Spain was the only country reporting on it due to suppression of journalists around the world, including in the U.S., due to WWI. People got all their news on the flu from Spain, so it came to be called the Spanish flu.
Totally, and also it is very important. In some Turkish-speaking forums I follow, some people already blame the "Chinese way of living" for such a disaster. This disassociation has been even too late, I'd say.
Covid-19 virus originated in Wuhan "wet market", where freshly-slaughtered wild meat is preferred. It's a perfect setting to facilitate virus movement from animal to animal and from animal to human.
Even if it is so, Chinese way of living is not just that market and people are just being racist. If there is a specific thing wrong with that environment (I'm not the one to tell), it needs to be dealt as a single case, not by talking down the way of living of billions.
Just in one single section of https://en.wikipedia.org/wiki/Norovirus#Classification we find Norwalk virus (its original namesake), Southampton virus, Bristol virus, Lordsdale virus, Toronto virus, Mexico virus, Hawaii virus, Snow Mountain virus, US95/96-US strain, and Farmington Hills virus.
None of these are common-usage disease names, which the WHO advice applies to:
As these best practices only apply to disease names for common usage, they also do not affect the work of existing international authoritative bodies responsible for scientific taxonomy and nomenclature of microorganisms.
The name coronavirus doesn't refer to China at all. And it had to get a better name, because "coronavirus" properly refers to a whole class of viruses than include both the common cold and COVID-19.
WHO is an organization with no real power; it was necessary to kiss China's ass so that they could gain access to the country and get early data on the virus. The alternative was that the rest of the world would have had to rely solely on the manipulated Chinese stats.
Why is gaining access a good idea? If China's being dishonest WHO should just recommend zero travel from/to China and let them stew in it -- they can manipulate their stats internally all they want.
Suppose the WHO did recommend a zero travel ban from/to China, what do you think would happen?
Nothing would have changed. It's still in the hands of the politicians in those countries to enact it. And let's be fair, in each country there's at least one politician in the parliament, congress,... that mocked the current, mild, response to the outbreak. Some said they would, or did in fact, defy quarantine rules to stop spreading the disease.
Countries are also running out of reagents to test for this virus so analysis of the situation is already going to be complex. If China is being dishonest, they'll see it in the data. If country X or Y are dishonest in reporting figures about infection, mortality rates and what not, they will also see it.
To summarize and put it bluntly:
1) I doubt China was the only superpower on the planet that used political force on the WHO to change their messaging.
2) The virus is new and currently raw data in any form is more important than issuing a medical recommendation that will be ignored because of country specific politics.
>I doubt China was the only superpower on the planet that used political force on the WHO to change their messaging
China is the only superpower who prioritizes "saving face" over world health. Nobody else would be stupid enough to falsify health data in the face of a pandemic to make themselves look better.
Otherwise, yeah, you have a point about having data about a new disease. But if we can't trust China to provide accurate data anyway, what did we gain? Arguably, the entire reason we saw such a delayed international response to the outbreak outside of China was their "only 300 infected! whoops it's actually 5k lol" campaign.
> China is the only superpower who prioritizes "saving face" over world health. Nobody else would be stupid enough to falsify health data in the face of a pandemic to make themselves look better.
The US has criminally undertested and is actively hiding information (classifying meetings) by order of the current administration.
Please remember that "China" is not one person, and that the dishonest actions of some in their government should not be used to condemn thousands of innocent others to danger or death.
Instead thousands of innocents not in China have been condemned to danger or death. Last I checked, there are way more people not in China than in China. The classic trolley car problem would have made the call easy: seal off China.
What are HNers doing with elementary age school kids in CA / Bay Area? Seems inevitable that we are heading towards school closures en mass - reasonable to get an early start?
I leave this here for future reference: if we paint a worst case scenario, by the end of summer 2020, we may have 1M+ casualties in Germany alone.
It's hard to assess the global consequences of hundreds of thousands of flats getting vacant (increasing real estate supply in an overvalued market), labor shortages (which is high even today) and economic output reduction and the all the societal costs.
The only positive thing I see is an event, that unites the whole world - you will be able to relate to strangers - and this is actually a very good thing.
A small increase in supply available, even if it's not a large absulute number will probably lead to a proportionally bigger dip in prices as tenants or prospective buyers might have other options, especially in very bubbly markets with high competition (correct me if this line of reasoning is wrong).
What people don't understand is that this can be stoppped so much faster if we just learn from china and do everything we can from the first moment. Gradual escalation of measures is useless.
Quote: "all the insurance companies here, either today, or before today, have agreed to waive all copays on coronavirus testing, and extend coverage for coronavirus treatment in all of their benefit plans"
You should see the list. I've been living in the US for ~21 years now, and at no point I had coverage from a company _not_ on that list. I'm also pretty sure the rest will also get their balls stepped on, this being the election year and all.
Even though I rationally know it’s the right thing to do, I’m terrified about my daughter’s school closing and her and other students severely falling behind academically. I can work from home and watch her, but my spouse and I are not AT ALL equipped to home school her for a lengthy period of time. She is not a good self-learner and already struggles in some areas.
How should we be preparing for that? How are other people doing it who have to keep their children home and away from educational resources and teachers?
Edit: I’m getting mixed reactions to this. I’m not at all saying academics are more important than slowing the spread of the virus. But I see many comments calling for a complete shutdown of schools and very few saying that for many parents this is a legitimate source of hardship and anxiety, even if it’s the right thing to do.
> I’m terrified about my daughter’s school closing and her and other students severely falling behind academically
I wouldn't worry too much. The evidence from prior natural experiments show that unexpected interrupted school years[1] has no persistent effects into adulthood.
I don't mean to be glib, but isn't this a good opportunity for her to learn those skills? I wasn't a good self-learner until I was in AP Bio and the teacher was very incompetent and I had to just face down the book. That groundwork helped me so much as a freshman in college where there were lots of kids who had always had awesome, attentive teachers. Especially if you are there with her!
I love Khan Academy, and the cool thing about youtube is there are so many content creators that there will be someone your daughter thinks has a nice voice or is easy to understand or funny.
YouTube videos are great for some resources, but they aren't a substitute for a competent teacher.
Fun thing to think about: there are videos that measurably improve students' performance on a task, but students rate those videos as "confusing" and "not helpful". The videos that students do like? They have zero effect.
> but isn't this a good opportunity for her to learn those skills?
I think that’s a fair question, and I’d love to be optimistic about her ability to hunker down and build those skills. But, she has some behavioral challenges and just getting her to do homework is a nightly struggle consisting of meltdowns and arguments, so I’m not as hopeful that she’ll be able to do it. She’s a bright kid, but definitely one who -needs- the structure of a classroom to be successful.
We home-schooled from preschool through high-school. Today I am trying to figure out how to help (from the opposite coast) my MIT senior deal with getting kicked out of their dorm in a few days. Home-schooling can work just fine. Chill.
1. Remember that of things that can be measured, the thing most highly correlated with academic success is parental involvement. So no matter how wonky your pedagogy, you will be involved. Hopefully that factoid helps you chill.
2. My first piece of advice to all new home-schooling parents is: Don't try to do everything at once. Get one subject working well, when you have established momentum and routine on that, add another. Cook until done.
3. There are many great online resources now. But I suspect your school is going to be providing curriculum information so you may have a usable starter kit.
4. As to the "self-learner" issues, all that does is help you find your happy place on the home schooling spectrum. At one end you have "school at home" -- trying to replicate the school environment in your dining room. There is also "unschooling" -- completely self-directed learning. This may not work for you. This may be a good chance to help your child develop some self-learning instincts.
(unschooling in my definition is: "You can work on what you want, but you MUST work on something." Which is NOT what I call "raised by wolves" -- a home schooling philosophy that I have seen occasionally, but doesn't often yield a good result.)
I hope my kids school closes, and I'm happy to make a commitment to spending a lot of extra time helping them make up the lost progress.
My plan is to let them enjoy the time off, for the most part, and then spend the next n months on reduced entertainment in favor of extra studying.
Seems a small price to pay given how many lives will be saved by closing schools.
Edit: one concern I heard is that health care workers need schools to take care of their children. Why not start by letting anyone that can take their child home, take their child home. This would reduce the risk for the children that stay in school by a lot, which will help health care workers not get sick.
Because currently I'd risk punishment for taking my child out of school "unexcused". Which seems like some seriously backwards bs.
"falling behind academically" makes sense only if she alone is taking a leave. If whole school is closed then she is keeping with the school. In a 70 year lifetime, taking at worse 3 months of holidays won't affect anyone in life. She'll have a more severe scar if she infects anyone who struggles for life.
With internet and access to online courses find something that helps her self study and improve upon the existing knowledge/skills. Follow the instructions from school.
I'm not a parent, but I had a period of time, about a month, when my Mom had to teach me, because I couldn't attend school. What worked well for us was structuring and scheduling time. What didn't work well was her winging it with the curriculum.
I think if we went through that time again and I was in her shoes, I would take advantage of Khan Academy. Especially for Math, it's incredibly well structured and forces you to convince it that you've truly learned the content with built-in quizzes. It doesn't hold you back if you've got a handle on the lessons and makes sure that if you're having issues that you practice until you've really got it down.
I think the most work for you will be setting her up properly, making sure she's comfortable with the system, and being available if she's got questions that it's not quickly answering.
This is what I'm working on now, I'm trying to set up 'classes' for my second grader with math, reading, writing, typing, and programing. She has music and art at school and I can't really teach that but I may look into a little more. I'm not too worried about her falling behind, but I do want to make sure it's not just idle time, I assume I'll have to do some WFH though I don't really expect to hit full time with it.
This isn't unusual for schools. Last year my kid had so many days off school for bad weather that he had to go an extra week at the end of the year. Maybe your July plans will be messed up because your kid is still in school, but otherwise the school will give your kid enough school.
There is some worry if your kid is hospitalized for a month while the rest of the school goes on (presumably this means containment worked well except for your kid), but even here schools have to deal with kids who are out for months for medical reasons and they provide extra tutoring to catch those kids up. (I'm familiar with this because my cousin missed a month of school his senior year - he still graduated with his class even though he had to go back the next year to finish some classes)
She will probably benefit more from a few weeks of being a child, and being worry-free. School was the most stressful time of my life. Tests and exams always hang over your head. Pop quizzes, mid-terms, finals. There is literally NEVER a peace of mind.
Different people experience differently. Tests were always less stressful for me than non-test days. On a non-test day, there would be a non-zero chance I forgot/didn't know to do homework that was due. But homework was never due when there was a test.
Most school districts may start doing things like video instruction or give parents a curriculum to work on, I'm not worried about that aspect. It may become an entirely remote education for the rest of this school year across the world.
I'm considering taking leave of absence and teaching him the curriculum. The problem is I'm not a good teacher, I know this about myself.
It's impossible to WFH and take care of a child. So your productivity will suffer, hopefully your company understands this, but then again everyone will be in the same boat once the school districts start closing things down.
rather than becoming immobilized, panicked, and/or irrational, fear should be a trigger for a learn-plan-do cycle, which you've apparently started (learning what's possible to do about the situation).
however, it's important not to spread irrational fear, which words like "terrified" tend to do, particularly when overblown. the state of being "terrified" leads to immobilization, panic, and irrationality, so it should literally be avoided like the plague.
on the other hand, being concerned and worried, and acknowledging (unhelpful) anxiety, is reasonable. asking for help and information, like you did, is reasonable. discerning and acknowledging the appropriate level of risk (probably worse than a regular flu but not nearly as bad as the 1918 flu) is reasonable.
with that said, children are constantly learning whether you teach them or not. it's ok if learning is not entirely linear. the world is not linear, and our brains are not either. what's needed will get in there eventually, and we're resilient enough to compensate for nearly any kind of deficiency anyways.
(the same case can be made for overly worrying about "getting into good school districts", something worth considering a little bit, but not a lot, and a commonly-cited driver of localized real estate bubbles)
> however, it's important not to spread irrational fear, which words like "terrified" tend to do, particularly when overblown. the state of being "terrified" leads to immobilization, panic, and irrationality, so it should literally be avoided like the plague.
Very good point. Thank you for calling it out. I am not at all intending to spread irrational fear and realize I should have chosen my word there a bit more carefully. I am definitely anxious about it, but that anxiety is driving a desire to figure out a plan and not causing paralysis on my part, which I agree is what the word "terrified" implies.
This is so culturally unhealthy IMO and it's why America and similar academic oriented countries work work work until they die. It's like 1 year of being off course people act like their lives are going to end.
If she's not in high school I wouldn't worry too much. I essentially missed half of third grade, all of 4th and 5th grade and half of 6th grade, and by 8th-90th grade I was pretty much caught up completely without even a real catch up program. A lot of the stuff your learn at that age simply becomes trivial or at least much much easier just from getting older. In that case, I'd just give her some puzzles to solve or something.
If she is in high school the only answer is probably a bunch of "homework", good books on the subject, and there are also hundreds of video courses online.
It actually might not be the right thing to do for the reason you mentioned but also, for the families that can't work from home, it becomes a huge economic burden to have their kids not in school. It's obviously a necessary step to contain a deadly pandemic but I think, in this particular case, children are actually in the lowest risk pool. Kids seem to survive the virus at near the highest rate but also contract the virus near the lowest rate so closing schools might be an unnecessary burden on working parents with marginal effect on containment.
I don't have kids but there's lots of Khan academy and legit youtube stuff (3blue1brown) that can be used to learn things, even if they don't get credit for the classes.
I don't know how to turn non-self-learners into self-learners though. And admittedly if I was a kid during this, I'd be playing as much video games as possible.
Hopefully most teachers have a clue and will realize this was some pretty serious circumstances and not be as harsh and do more review.
As a parent, if you have the energy & time, a good approach can be to:
* Boast how easy school is these days.
* Wait to get told you're wrong.
* Propose a competition. Your child can pick any subject that neither of you have studied yet, and then have a race over 24 hours, 1 week, etc. to learn the material and do a multi-choice test you both agree on first.
Your child will obviously pick a subject they're good at, and you'll probably loose. But you still made them choose to study really hard.
"Falling behind" what? Even if she and her peers have to repeat a school year because classes don't happen for a long time, which would be quite extreme, what would be the issue with that?
Homeschooling is not rocket science. I've done it for years and I barely know what I'm doing. Just make resources available, sign up for a couple out school classes, and be willing to help them pursue stuff when they're interested in it. You can do it!
I expect your school will have prepared materials for such an eventuality.
Your daughter should be given long youtube playlists of online lessons, homework assignments, scheduled interactive video lessons, etc.
As a parent, all you really need to do is check your daughter is actually doing what the school is providing. The threat of detention doesn't work so well at home when you can just claim the internet broke and that's why you haven't showed up to an online lesson or submitted an assignment...
Honestly this is the last thing I'd be worrying about. A child can skip 6 months to a year of school and have almost no negative effects on their life outcomes. If they get sick and die, or their close family members do, they will definitely have negative effects on their outcomes.
There are tons of resources and communities for homeschooling on the internet. Happy to help point you to stuff if needed, but please prioritise health over potential educational slowdown.
> please prioritise health over potential educational slowdown
My apologies - I didn’t at all mean to make it seem like I was downplaying the public health aspect. I fully understand this is likely what’s necessary and that public health comes first. That being said, it is a source of anxiety for me as someone who values academics because, for me, it was a path to a better life.
Few weeks or even months of lost school - especially at an early age - is something that can be compensated for somewhat easily. Schools are very inefficient at teaching. You'll help her a bit, ensure she does some focused learning, and she'll be fine.
You should not worry since it is a global event and not only your child is affected but everyone is. If it was only one child or insignificant portion of being affected and education of others continued along then your worries would be well founded. As it stands studies will continue as soon as circumstances allow it, maybe your school switches to online learning for some time, or there will be effective drug found that resolves the situation.
No need to apologise at all! You sound like a responsible parent - I commented mostly for other people reading. Your child is gonna do great because they have caring parents.
I would truly love an opportunity to not work for 6 months and have my child not go to school so I could spend that time with them. I'm sure you'll be able to find ways to spend that time enriching their life. Caring is the most important step.
If you had a random six months of your education removed from your memory, how long would it take you to relearn it? If it was prior to high school, would you even bother relearning it?
How important is any particular six months of your education to your ability to do your current job?
Missing 6 months of school isn't ideal, but I think we tend to overestimate the importance of hitting every nail on the head when it comes to education.
Not to mention the fact that if most children in the US miss 6 months of school, they will have that as an excuse when they start sending out resumes in however many years.
> If you had a random six months of your education removed from your memory, how long would it take you to relearn it? If it was prior to high school, would you even bother relearning it?
Due to a mistake in the records, I skipped an entire year of math (pre-algebra, which I was supposed to take in 8th grade). My algebra teacher decided the first month was going to be review, because she didn't expect most of the students to need a refresher after summer break.
Turned out to be the best thing that could have happened to me, at least for that subject - not only did I have no issues catching up, turned out that was close to my natural pace. The topic was no longer boring and became one of my favorites after that.
Everyone's shitting on this dude but I had this exact scenario and I tie a lot of my struggles as a child student to this circumstance.
Miss 6 months of school while changing schools. Come in, I don't understand the math underlying what they're learning. I fall behind because I'm playing catchup while still trying to stay on top of new material. I have no discipline or direction from home so I don't put it any extra time or anything, I just get home and ride my bike around. This makes me hate math in general, and next year I'm still not entirely caught up or even sure of what I learned the previous year, so I'm failing harder. I don't know if there were any extra resources available or not, I was like, 13, but I was also a holy terror so I bet even if the resources existed they wouldn't have been provided to me because my poor performance was chalked up to me being a problem child in general - never mind my stellar performance in literature classes.
And so on. Throughout my entire public school career. By college I "get it" and am trying to catch up but it's already so ingrained in my personality that I'm "not a math person" that I instead pursue a useless humanities degree, then fuck around in Asia for a couple years. Then finally, at 26 years old, I genuinely get my shit together, learn what I missed 13 years prior, find out that I actually am capable of all that, and now I'm an engineer.
So, sure, do what you can to not get your kids killed, obviously, but I don't agree that it's fair to shit on this parent for worrying about what missing 6 months of school might do to their kid. I mean it sounds like they at least know more about discipline and enforcing learning on their kids than my parents did, so maybe the kid will be Just Fine, but homeschooling is no joke either, and the kid might still end up having to play catch up.
Your situation is very different and irrelevant because while you did miss classes your peers didn't and continued along, in a current situation everyone will stop as a group and continue studies as a group, which is very different from your experience.
Why not just re-do the year you half missed instead of trying to play a catch-up game that obviously isn't going to work? Starting to work 1 year later is really not a problem.
In most cases personal problems are the reason why children/young people skip school, not the result – that's why skipping school sounds problematic. But there are cases when it's entirely justified and it's entirely manageable then – surely an epidemic is one such case.
A proper justification, such as a closed school, would explain the delay in the child's education, and likely negate most (all?), negative reactions people might have about the resulting delay.
Citation may be needed in general, but here… that's sounds like a reasonable guess.
My college just basically closed and hour ago saying everything is online now after spring break. Kinda nice for my easy classes. Sucks for my harder ones though.
Read your textbook, do homework exercises, and (above all) feel free to contact your professors and ask them for help. That is what they are paid to do!
Underrated advice. I'd get 10x as much benefit from my undergraduate studies than I did if anyone got it through my head that the academic staff will help you with the stuff that was in the class - and more importantly, they're very happy to tell you everything about their field of research.
I mean I'm a returning student and have always been good with online classes so it's honestly an actual perk for me.
The hardest part is instructors who feel like unlocking everything to let people work at their own pace is somehow egregious...I think it's so stupid that a teacher cant somehow manage grading the same stuff for everybody at the same time but just ignores the other students who are ahead until they get to that point.
The best online teachers I've ever had were the ones that unlocked it all from the start and helped you with the few questions you had along the way.
In the Boston area, Harvard, MIT, Boston University, all five UMASS campuses (including Boston and Lowell), Tufts University, Suffolk University, Emerson College, Northeastern and Olin have all moved to online classes. Plus Amherst College out in western Mass.
That seems like a lot until you realize there's still Boston College, Simmons, Berklee College of Music, Emmanuel, Brandeis, Babson, Bentley, Wellesley, a pharmacology college, two art colleges, and a bunch of community colleges -- and plenty of others I'm forgetting -- I could reach via public transit are still to announce anything, presumably because it's all still being discussed.
For Boston this is really weird and impactful. There is a massive population (somewhere between 350,000 - 400,000 students I think) in the area that is just a transient student population. Though outside of NYC and VERY specific parts of the SFBA, the Boston area is one of the most population dense parts in the US, so there's no more fooling around.
Good luck - I think I would've had a lot of issues had I ever been forced to remote into classes. When I was in college I definitely didn't have the discipline for that.
Cross posting this from the other Pandemic thread since I thought it was interesting:
> d4mi3n
> What happens when the WHO classifies a pandemic? I imagine a number of processes and procedures come into effect--anybody know what they are?
> Hongwei
> My limited understanding understanding is that it automatically releases funding (from the WHO and other bodies) to help with the crisis. It should also trigger some catastrophe and pandemic bond clauses, meaning investors who bought these bonds will lose their money as it now goes towards relief funding.
"The reason the WHO is not declaring the coronavirus a "pandemic" is likely to avoid causing a panic at this point. They will only use the P-word once it is clear to everyone that it is one." https://twitter.com/zorinaq/status/1232094407584710656 I was criticized for being "alarmist." But I was right. It was obvious to those of us who did the research (100+ hours reading peer-reviewed articles) that it was going to turn into a very big deal.
I wonder if the internet "experts" here (and on other forums) who declared two weeks ago that "this is just overblown media hysteria and no more dangerous than the flu" will retract their claims now that the WHO has declared a pandemic? Or will they continue to bury their heads in the sand because denial is easier than acknowledging the seriousness of the situation?
Pointing to the last Sam Harris podcast [1]. He interviewed an infectious disease specialist, who like several other infectious disease specialists I heard before, isn't particularly concerned by this event. It is serious, but not alarming.
I should note that Sam Harris is rather on the worried side of the spectrum (and felt compelled to add a disclaimer at the begining).
Please keep in mind I might be wrong, I just want to understand things outside of the hype.
So I don't buy all the hype, can somebody tell me why i'm wrong? I keep hearing claims from brilliant people that 50-80% of the population could easily be infected.
Exponential growth is obviously the answer, and is occurring because the median person is infecting more than one other person, which right now is coming from people not knowing they have the virus and not worrying about getting the virus. This will change as more people become infected. Assuming even the most BASIC of measures are taken, (people washing their hands, not going to crowded areas often, not travelling etc.) this will probably stop exponential growth.
In China, 5 people have been infected for every 100,000 citizens, and the virus isn't exponentially growing anymore. But fine, maybe they took good measures.
In Italy, it's closer to 20 people per 100,000. Fine, four times as high, but still a TINY portion of the population. If you assume that their graph will ever look anything like China's, there is no way in hell more than 1% of the population will be infected. It probably won't come within two orders of magnitude.
In what god forsaken situation could even 1% of the US get the Coronavirus?
Even without government intervention, as cases increase people will start taking this more seriously and the exponential growth will stop. Even if you don't have symptoms but have the virus, you aren't going to that concert or that vacation because you don't want to catch the virus from someone else. As long as you at most infect 1 other person, the exponential growth stops. This will happen way before 1% of the population is infected.
EDIT: I'm incorrect in the idea that people shouldn't worry about it, you should, but I believe that worrying about it will be enough to stop the exponential growth.
Those examples (China, Italy) have taken drastic measures to keep people from socializing, in order to slow the spread of the disease in order to not overwhelm the health system.
That's the killer - once you reach maximal hospital capacity, people die because of not only the severe virus infections, but because they can't get the required treatment for their other unrelated ailments as well (e.g. a stroke, or a car accident etc...). Italian doctors already have to make really hard decisions with regards to who they will admit into ICU since there are not enough beds for everyone.
So if only 1% of the country gets severe symptoms requiring hospitalization in the US, that's 3 million people needing intensive care unit beds, on top of the normal load.
Measures in Italy and China won't prevent 80% of the country to be infected (mostly, people will not need hospitalization - only a small fraction will), it only tries to reduce the number of people needing intensive care at the same time, in order to not overload the health system and save as many of them as possible (since they can't make enough ICU beds and equipment appear out of thin air)
EDIT: and of course, buy time until a vaccine or other treatment method is available...
It's just harsh restrictive measures are also not free. Sending economy into hard recession, disrupting supply chains etc will cause people to lose jobs, get under poverty line or not get above it etc. I think it would be a good idea to get more research on how to approach it, finding right balance. South Korea seems have curbed exponential spread and without much panic/hard disruption of everyday life, at least according to this video: https://www.youtube.com/watch?v=0ZqgMIrjKOQ
Even if you look at Italy, though, and if you assumed that their numbers were accurate (highly unlikely), 20/100k is only 5-6 doublings away from 1% of the population, or as little as 3-4 weeks if not properly contained.
Hopefully you're correct and it won't grow out of control and infect most of the world, but for now the idea is to keep the burden on the medical systems low to prevent knock-on effects of over-running our caring capacity.
Of course, that is the explanation for the exponential growth in the early stages. US citizens don't care right now. Once the virus grows, people will start being more careful, whether they have symptoms or not, because they don't want to get the virus. This along with some government intervention and businesses closing shop will destroy the exponential growth, as we see with China and will soon see with Italy.
Most countries (and leaders) and not taking this seriously until they are it HARD by it. They should learn from the nations that were first affected and not just minimize it with "They handled it badly, we're gonna be fine".
Norway now ranks near the top (around 4th) among countries in the number of infected people per total population. This happened rather suddenly over the past few days, and I tell you, the government has upgraded its response radically! For example, all events gathering more than 500 people are cancelled, and that limit may well be lowered in the coming days.
Most cases so far have been traced back to people coming back from a vacation trip to Northern Italy and Austria (ski resorts also popular among Italians), but now cases are popping up where health authorities are unable to trace the source of infection, and this, rather than raw numbers, is what has prompted the heightened alert level.
That's a good point, I suppose my argument hinges on the fact we can prevent exponential growth and if that isn't the case because the data is wrong...
I don't know if the most significant pandemic of the last century, that could be slowed if we implement unprecedented draconian measures in time can be over-hyped.
You assume exponential growth will just continue, which I am claiming is false with China as an example. If simple proper measures are taken, (which they will be once more people are infected) like shutting the majority of businesses down, restricted travel, people washing their hands and not going out of their way to concerts and big meetings, you don't have the exponential growth.
I agree, so let's assume the US doesn't intervene at all.
Exponential growth is occurring because the median person is infecting more than one other person, which right now is coming from people not knowing they have the virus and not worrying about getting the virus.
Even without government intervention, as cases increase people will start taking this more seriously and the exponential growth will stop. Even if you don't have symptoms but have the virus, you aren't going to that concert or that vacation because you don't want to catch the virus from someone else.
I think you are underestimating how irrational people are. Only yesterday I was speaking to someone who is hoping to get some discounted flights / hotels for a cheap holiday while this is all going on, as everyone else will be scared to travel...
Hell, I heard someone say that if we stay home and change how we live then the "virus has won.". I don't even know what I'm supposed to say to that.
They aren't scared right now because they are downplaying the idea that they could contract the virus, but once they start seeing more cases of people in their area / other travellers, they will change their mind. Very few people want to roll a dice with 5 / 6 sides giving you Coronavirus, they just aren't seeing the odds yet.
Not sure most would call these measures "simple", but they do indeed seem like something we could do. It wouldn't be hard, though, for some of these simple measures to kill more people than they save, via collateral damage.
Another point to consider is that this virus is apparently "novel", meaning that humans in general have not had time to build up significant immunity. Even if measures are taken, they will likely just push the date of infection for each individual out into the future some--most people will eventually be exposed no matter what.
You're putting words in my mouth, congrats. Every exponential in the "real world" eventually turns into a logistic curve. Can you tell me when the inflection point will occur? No? Okay, good luck to you and your family.
Are you posting in good faith? On the assumption that you are, China locked down at least 760 million people. Italy has locked down 60 million people. The economic consequences are going to be staggering. The virus would be almost impossible to eliminate without a vaccine, so once quarantine measures are lifted it would continue to spread quickly again.
It's pretty obvious if you separated people and kept them in their homes the virus would stop spreading. So what? The world cannot just stop forever. Life will go on, and so will this virus. It is with us now.
Unfortunately this is going to change your life and people you know are going to get very sick and die. Please tell the older people in your life to be very careful and DO NOT downplay the risks to them.
Please don't exaggerate. In another thread here on HN someone from Italy posted exactly what it's like. They go for walks, they go to bars or restaurants and maintain 1 meter distance between people, and if they need to care for a relative or someone else they're permitted to travel to other towns/cities.
Sure, people's lives are a bit different, but say they're on "lockdown" is simply not true.
This is not an exaggeration. Just because people are flouting the lockdown does not mean it isn't serious. This is not "a bit different." The PM just raised the severity of the closures today: https://www.repubblica.it/politica/2020/03/11/news/coronavir...
It seems to me that WHO waited for the stock market to tumble down first, before declaring this pandemic. This way, WHO may avoid getting blamed for the end of the bull market.
Doesn't look like anyone is tracking "pandemics" formally. WHO.int is tracking public health emergencies of international concern, which appear to include epidemics with pandemic potential as well as outbreaks with pandemic potential and extremely egregious likelihood of permanent harm. https://en.wikipedia.org/wiki/Public_Health_Emergency_of_Int...
But from what I could dig up, the last widely accepted pandemic declaration was the H1N1 2009.
The two current pandemics include HIV/AIDS and COVID-19.
There is a list of epidemics, but that list also includes localized or regional matters rather than just global-scale pandemics, and not all of them may amount to PHEICs.
We're that many days behind in raw case numbers. We have a lot more capacity than Italy overall, and our larger hospitals are prepped for mass shootings which means they have procedures in place for a sudden influx of patients who need ventilators.
> What he came up with was that if you have two people who are roughly the same size and tidal volume, you can just double the tidal volume and stick them on Y tubing on one ventilator.
Would this help increase the number of covid-19 patients that could be treated? Or do they not require ventilators? I wonder if the study they mentioned about it was ever completed?
As a US citizen very familiar with the US healthcare system, I'm very glad to be living in Canada during this epidemic where everyone has a Go To The Doctor Free card, literally. At times I am a bit surprised how readily Canadians will go to the doctor because they "woke up with a headache/back is hurting/eyes are red and itchy." Coming from the US it would never occur to me to go to the doctor for such "minor" complaints (to be honest, in the US I didn't go to the doc unless I was worried about immediate mortal peril or had an extremely long-running complaint, it's just too much trouble & they rarely help).
In this scenario, I think it's fantastic that Canadians are so quick to go to the doctor, and that everyone can do it on-demand. It means we're more likely here to catch more cases early & hopefully slow the spread. In the US, who is going to go to the doctor just because they have flu-like symptoms? And pay the 20, 50, 75, ?? dollar copay, wait in the line, then spend hours fighting with insurance later when they refuse to cover it? Yeah right. "May as well stay home," and this is going to cause tons more cases to go undetected & spread.
Canada is not perfectly prepared & is definitely making missteps (parade is still on in Toronto this weekend) but I predict the universal healthcare system will make the impact night & day different from USA.
Honest question - what kind of capacity can possibly be supported during a pandemic when people already go to the doctor for (seemingly) trivial reasons?
I see the benefits here, don't get me wrong, but I can't imagine the waiting rooms when people go to the doctor with actual emergencies.
I'm not sure, but I can say anecdotally that I spend less time waiting for a same-day appointment or drop-in here in Canada than I did in the US when making an appointment in advance with my PCP at my regular doctor's office. So the deterrent effects of private pay & shitty insurance bureaucracy didn't seem to reduce wait times in my area of the USA.
By delaying the "pandemic" designation, the WHO has inadvertently cost more lives. They will strongly need to reevaluate their role and policies going forward, because this was a monumental process and leadership failure.
The messaging from the media (who are laypersons) and the politicians (who are economically motivated laypersons) has been that this is "just the flu". Weak messaging from both the WHO and the CDC has only reinforced this in the public's perception.
The WHO should have taken the decisive move to encourage greater caution by employing the "pandemic" label. That label comes with real power. While there is danger in crying wolf, it was evident months ago from the growth rate of the virus and the lack of quarantine procedures being put in place that this virus would reach the pandemic stage.
If the role of the WHO is to stave off pandemics and not just to monitor them, then elevating the risk profile of the virus should have been a top priority. Since people look to the WHO for guidance, their actions have direct impact to sequestration and bringing the outbreak under control.
Both the WHO and the CDC were too afraid to take early action. Their wait and see approach will ultimately result in more human deaths and suffering.
I was under the impression that the Pandemic label was a response to objective criteria, not subjective decision of leadership.
In particular, one of those factors was sustained duration of the outbreak. My understanding is we finally crossed the time threshold for declaring this a Pandemic.
From the definition: A pandemic is an epidemic of disease that has spread across a large region; for instance multiple continents, or worldwide. We knew and saw that weeks ago.
Declaration of official pandemic means world bank pandemic
relief fund program gets activated as long as many other clauses in different contracts and agreements. There is an influence on WHO and the people behind it didn't want pandemic to be declared too soon. If it was declared 3-4 weeks earlier there could be many lives saved in countries like Iran, what is happening in Africa is not known at all due to no testing but situation is probably bad.
This really highlights the critical design flaw of the World Bank's Pandemic Emergency Financing Facility (funded by the pandemic bonds). By the time the conditions are triggered and funds distributed, it's already way too late into the pandemic. These fund should be made much earlier and more should be diverted into proactive measures to maximise effectiveness.
That's kind of the purpose, if its standards were too low, it would be triggerred too many times that we won't have any of it left to do anything honestly. The World Bank's Program is always suppose to be an emergency backup we hope never to use instead of substitute for a proper government planning in times of pandemic.
Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country [Italy|Iran] in a different WHO region [Europe|Eastern Mediterranean] in addition to Phase 5 that is characterized by human-to-human spread of the virus into at least two countries [China & South Korea] in one WHO region [Western Pacific]. No threshold of cases or deaths triggers the community level definition and is left to discretion of the WHO.
So the WHO has done everything right. It is the hallmark of professionalism to follow rules even under pressure. And the WHo is under a tremendous amount of pressure right now.
As I said there is probably no official WHO definition or criteria due to big economic impact of such declaration and it is decided on a case by case basis.
Yes, it is. Parent never asked for WHO definition in the first place, I wonder if there is any at all, probably a commercial secret. Pandemic in WHO definition is when Director General of WHO declares it a pandemic, probably after confirming with member states who contribute, they were criticized in 2009 for declaring too early too, so criteria might have changed.
This definition has too much room for subjectivity. It needs objective criteria. Or maybe WHO might need to have a numerical metric that says high large the impact of a virus or its associated disease is, just like the earthquake magnitude.
Wow, what is the source of this outrageous claim??
If anything, African states are going to be hit the hardest. South Africa for example, a country I am in, has the world's highest HIV cases. Pneumonia is a death sentence for HIV patients. Also, our infrastructure to manage a spike in infected arriving at state hospitals is abysmal. Right now, we sit with 7 infected (officially) but these are all index based with vectors from recent visits to Italy. If this changes to non-index based vectors, and this disease spreads to the townships, we are done for. If anything, COVID-19 is likely going to hammer Africa the hardest.
By and large improved health care won't affect population resistance all that much, it just improves survival rate. In an earlier time you would have been right, European germs caused more Native American deaths than Europeans themselves when they first colonized, but nowadays with global trade we all end up sharing the same diseases for the most part.
Sedentary lifestyles enabled by modern lifestyles as opposed to a hunter-gatherer lifestyle can contribute to decreased overall health but thats not the issue here since almost nobody is a hunter-gatherer anymore.
When it comes to new viruses, all of us are in the same boat immunity-wise.
First of all "there is still natural selection" in literally all life, so I think you're meaning something else. But to what your point actually is, do you have any source on that?
I know several people that would have not been able to reach adulthood 100 years ago but have now reproduced and have passed on their diseases to their offspring. There is no doubt that natural selection in humans is much weaker now then in the past.
That's not what natural selection means... medical innovations are still natural selection factors. It doesn't stop, we just naturally figure out how to get better at it.
To take you at your intent, all humans will be exposed to this virus with more or less the same chances of suffering. I imagine there may be pockets of resistance within certain gene pools, but it's a crap-shoot who and where.
For H1N1 as far as I remember the pandemic designation happened far earlier and that was a joke of virus compared to covid-19 comparing the mortality rates.
This is exactly right. Disease response can be very paradoxical.
An extreme and early response, can turn a disease into a trivial event. Which raises questions about whether such an aggressive response is necessary.
It can be, in many ways, like using an umbrella in a rainstorm. You get to the destination, and you're totally dry, so what was the point of the umbrella?
With these disease outbreaks, there's no counterfactual we can run to see what would have happened if we didn't respond early.
H1N1 was not successfully contained at all, it infected 15-20% of the world's population and ended up just being a bad flu strain, not a world ending pandemic as only 575k people died (for a mortality rate of around .05%)
>H1N1 was serious and compared to this, well handled.
The current COVID-19 epidemic caused by SARS-CoV-2 is many times more fatal than the 2009 H1N1 epidemic. The current epidemic has similar a fatality rate to the 1918 Spanish Flu.
But this is in the middle of the pandemic and is likely to be revised downward as many cases are undiagnosed.
The 2009 H1N1 outbreak had a inital case fatality ratio of 0.4%, but revised downwards to 0.026% afterwards due to new evidence of more spread than thought -
> COVID-19 currently has a 3.4% case fatality ratio according to the WHO last week -
This number will likely go down to below 1% because:
- S. Korea have implemented large scale tests on asymptomatic cases and their death rate is 0.77%
- the "Princess Diamond" cruise, which can be considered a closed experiment, has had a 1% death rate for people that were not ventilated
- in China if you exclude the Hubei province, the mortality rate is 0.88%
In Italy the mortality rate is 6% but the explanation is quite simple — they stopped testing asymptomatic cases, even people with fever are sent home without a test and instructed to return in case the fever doesn't go away in a few days and they are overwhelmed. At this point they are only admitting people that have trouble breathing.
And northern Italy has really good hospitals, so the only reasonable explanation for the huge disparity is that they have more than 10 times the reported total cases.
In other words, the virus has infected many more people than official numbers.
Remember that those "total cases" are cases that have been discovered via tests, it does not include people that stayed at home and weren't tested, either because the symptoms were too mild or because they were sent home.
“Princess Diamond” deaths are excluding people who died in their home countries that where infected on the cruse ship. They had 6 deaths as of February 28th and then excluded all future deaths and cases “cases found after disembarkation” from the total.
Edit: A Hong Kong national from the ship died on 6 March which is being included as the 7th death. So, this may simply be fragmented rather than explicit exclusions.
I don’t know about the cruse ship, but it seems like it’s double counting a death in Australia on both the cruse ship and an Australian death. I would double check the totals.
I really wish everyone was doing the random-sampling-of-general-population thing. Even if they could only do it on a fairly small scale, I suspect it'd give a much better picture of where we're really at than the "confirmed cases" floor.
In S. Korea the mortality rate is 0.77%. In China outside of the Hubei provence where things have gotten out of control the mortality rate is 0.88%.
People in Italy are only admitted in hospitals if they have difficulty breathing by themselves. People that only have a fever or other mild symptoms are sent home, with no test administered. When the outbreak started they were testing asymptomatic cases, trying to be proactive in identifying infected people, but they stopped doing that once things have gotten out of control. And we will see this pattern repeating.
What's dangerous is spreading nonsense like a 6% death rate, which is factually not true.
South Korea have a lot of early stage cases in those numbers (haven’t died, haven’t recovered), and a very young population on the whole. An undetermined number of those cases will die rather than recover.
Multiple sources have looked for these large majorities of asymptomatic cases and did not find them. There is no evidence other than our collective hunches that these cases exist in significant numbers.
Taking Johns Hopkins numbers (at time of me writing this):
Not sure what the demographics of S. Korea is, whether they have a younger population or not, but it's irrelevant.
At least 80%-85% of all Covid-2019 cases have mild symptoms. We are not talking about completely asymptomatic cases, we are talking about a majority of cases that could pass for a mere cold or flu.
Many of those will not go to a hospital or be tested, especially if the system is overwhelmed.
Italy could easily have more than 10 times the number of reported cases because they stopped testing proactively. Only people with difficulty breathing are now tested and these represent a small minority of cases.
I gave S.Korea as an example because AFAIK they are the only ones doing large scale testing of the population and they aren't China (whom we may or may not trust to be transparent).
The data we have points to a mortality rate that's less than 1%.
When you see a mortally greater than that it is because people aren't tested unless they reach the ICU.
A couple of things I’m not sure are correct there though.
The 80-85% mild cases comes from confirmed cases that we know about. They’re included in the current 6.45% death rate from the JH data.
China may or may not be transparent, but if they have an incentive to hide anything, it would be a higher death rate rather than a lower one.
The data is the data. In any case it’s now global and the 6.45% is actually higher than it was before the virus started growing exponentially outside of China (it was 5.7% from this dataset then).
Those numbers aren't terribly useful since so many cases are mild or even asymptomatic. Most organizations are estimating 2-3% mortality, and are quick to point out that this is probably an overestimation due to the lack of testing in asymptomatic individuals.
Basically we are counting every case severe enough to cause death, but only some of the cases that aren't very severe, and that latter group is already a much bigger piece of the pie even among confirmed cases.
The table in the "comparisons to other pandemics and epidemics" section gives a point estimate for the case fatality rate of 0.03%. If we assume that the final rate for covid-19 is somewhere in the 1-2% range that's what I last heard, that would mean that "10X as fatal" is an understatement - more like 30-70x as fatal.
You've claimed this three times already. Do you have a substantiating link? Furthermore, saying "six point oh one percent" instead of just "approximately six percent" gives a false air of precision that could not possibly hold -- even you admit the estimate is still in flux.
Is there some guarantee that containment measures which are actually too early or too aggressive are "much, much better than the alternative?" It seems to me that such a claim is ignoring that there are actual costs to containment measures instead of actually comparing the costs of containment measures with the costs of delaying them.
H1N1 was declared a pandemic but was not handled at at all and a huge amount of people got it, but luckily it was a joke of virus with 2 orders of magnitude less deaths than covid-19.
Was it? Maybe my perception is skewed from being in one of the earliest countries hit, but my memory of H1N1 is that we pretty much gave up everything but vaccine development once we realized it was uncontainable.
The reason people are trying to downplay H1N1 is because they hate the flu comparison. People understand the risks and accepted deaths, from the flu. That bothers the doom and gloom folks.
I was telling someone the other day that H1N1 is seen as being not that big of a deal, and if another one or two pan out that way, then the next one after that will kill a lot of people because they start thinking that it was a 'cry wolf' sort of situation.
Look at the situation with vaccines. Your grandparents getting vaccines was a no-brainer. They heard stories of people getting polio or the measles and it was serious shit. Three generations later we have conspiracy theories about vaccines, I think because so few iminently deadly diseases have gotten a vaccine lately. We are down to the tricky ones, and cultural memory of the others is starting to crack.
Also, what's hard to remember is that we already had (or were very close) to a vaccine candidate for H1N1 by the time it was declared a pandemic in April 2009. Even before the U.S. declared a national state of emergency, more than 11M+ vaccine doses had been produced for the U.S alone: https://www.cdc.gov/h1n1flu/vaccination/updates/101609.htm
AFAIK, scientists are still trying to develop a covid-19 vaccine candidate. And after they have one, there will be many months before millions of doses can be produced and distributed.
I've heard they were counting off countries with cases. My wife told me the other day that she read that "4 more countries with coronavirus and WHO will call it pandemic".
> Pandemic label was a response to objective criteria
Modeling the causal impact of their criteria in light of data from the COVID-19 pandemic could reveal how different messaging strategies applied at different thresholds impact the spread of the virus.
The leadership could have done this months ago and estimated how proactive versus inactive quarantine efforts would impact morbidity. They have to know their role in persuading the public and government officials.
You don't have to stick to a rigid and inflexible criteria when thousands of human lives are at stake. When you define the criteria, you can also change them.
I don't understand what you think is to be saved by inciting panic. There's plenty of coverage, all this classification does is open up money from the IMF I believe. A Pandemic classification doesn't change most people's behaviors, but it does cause toilet paper/hand sanitizer shortages.
At least in the US, companies and other organizations are hesitant to be the first ones to stick their necks out and cancel events/encourage remote work. Our federal government's incompetent/evasive/opaque response to the crisis has let the burden fall on local governments in the hardest-hit areas.
Labeling this a pandemic would have given cover to organizations that wanted to be more cautious but were afraid of "looking stupid".
Months ago? The first cases were identified in Hubei on 29 December. The first cases of COVID-19 outside of China were identified on January 13 in Thailand and on January 16 in Japan.
They also have to be careful about credibility. It wasn't clear how well the global containment efforts were going to work until very recently. Let's say a week or two ago there's a 33% probability of global pandemic: that means if they call it such then, 2 times out of 3 they're crying wolf and causing people to listen less carefully to the WHO. You already see people claiming all manner of conspiracy theory nonsense and not taking it as seriously as they should; they have to be careful not to amplify that, and balance that against acting too late when it's clear there is a high probability of global community spread.
Other than their censorship in China (they give different advice on their website served to China, even on English-language pages, involving the effectiveness of traditional Chinese medicine against the virus), I think they're doing a mostly okay job so far, from what I can see in the current reporting.
What are you are dismissing as "conspiracy theory nonsense" includes calls to calm from infectious diseases experts and health authorities. When we will look back with hindsight, the conspirary theory nonsense may end up being the unecessary panicking, armchair epidemiologists, "the numbers are worse than we are told", etc.
They were asked about this in their briefing a few days ago and made a multi-point response:
1) There are no objective criteria for calling something a pandemic.
2) They did not feel they knew enough about the propagation pattern to make the subjective call.
3) They were deeply worried that calling it a pandemic would switch government strategies from containment to mitigation, resulting in higher contagion and loss of life.
They especially emphasized the last point. The only question in my mind is whether (1) they decided containment was no longer viable or (2) they decided not calling it pandemic would be seen as unserious, even if containment could still potentially have benefits.
The WHO's entire purpose is to act as health diplomats and coordinators. They have been ringing the alarm bell for weeks now, saying that countries need to take things seriously.
Whether the WHO uses the term "pandemic" is honestly just semantics. You should direct the majority of your criticism at short-sighted governments who have prioritized the economy (or, even worse, markets) over health.
It was incumbent on local authorities to take the WHO's message seriously, especially after their expedition to China released its report.
I think it's easy to criticize their leadership from the outside, but I would assume that they make their decisions with great care, and aren't going to throw around "pandemic" or other words easily. If they do that, people stop listening.
It's akin to people not caring about a major hurricane barreling towards them because they've heard the doomsday scenarios before and nothing has happened.
Declaring pandemic requires data which the WHO simply can't have if its member states do not submit or further, do not test for it. People like to think that international organizations like the UN, WTO, WHO is somewhat superior, or above the states, but they are not.
> By delaying the "pandemic" designation, the WHO has inadvertently cost more lives.
... why?
I mean, it's not like the word of the WHO is a binding thing, where anyone is mandated to take action on any level because of a binary designation in a taxonomy. This whole this is just bureaucratic wheels turning; everyone who needs to take action has all the information they need to do so.
This is just the WHO doing what it does best -- having committees meeting endlessly to decide whether to apply a certain meaningless designation and then announcing the conclusion of that exercise.
Their actual job, of collating and disseminating information and trying to coordinate any large-scale responses, is actually hard, so nobody wants to do it, but having a meeting to decide IS IT A PANDEMIC is an easy bikeshedding meeting that all the MBAs and ex-McKinsey people can attend and offer their stupid opinion on what the definition of a word is.
EDIT: I said "everyone who needs to take action has all the information they need to do so", and that could be interpreted as saying that we know enough to determine what actions to take. But what I mean is that we have enough data to start to make a range of predictions and bound the uncertainty to some degree; having a more precise metric for any aspect of COVID-19 should not affect the response since those metrics are essentially made up and not comparable even on a per-hospital level, much less a per-country level or even a per-test-kit-type level. Uncertainty is part of the game here, and understanding the risk profiles is how people and organizations and governments have to tune their response.
If it is a political and subjective decision as you say, then they have to balance the benefits of the declaration against the risk of the counter-narrative overwhelming it. Too early and even more people would dismiss the problem than are doing so now. And there's no "we said 'pandemic' before, well, it's 'really a pandemic' now" label that can be used.
And leaving aside the immediate difficulties...let's save this kind of retrospective criticism for after, when we're closer to being out of the woods.
If you have prospective criticism -- what should be done now and going forwards -- that would be worthwhile.
But months ago they really couldn’t have known. We still don’t know how many will be infected. All we can do is take precautionary measures. The WHO messaging should have been stronger and earlier, but it isn’t their fault for not labeling a pandemic months ago. Granted, there was enough data and research done to squarely label this as a pandemic, and that’s really where I assign blame on them.
To be fair, China already delcared state of emergency months ago, but for the WHO to declare pandemic and recognize it as a international problem, it has to be that other countries has also done that. WHO cannot predict things, and they can't declare Pandemic when what they have is mere suspicion, it has to be an actual pandemic to declare. I'm pretty sure numerous experts have warned about the pandemic thing.
I'm pretty sure WHO is involved early on along with the Chinese authories when they first spotted it. They are already helping.
WHO is merely declaring matter of fact about the virus's spreading. Which is kind of it's primary function, to declare things and publish reports so the governments can act on them. They can't really do much beyond that.
Wuhan was probably a lot further up the curve of exponential spreading before China took any action than a superficial reading of the stats would suggest. Their reported cases were basically rate-limited by how fast they could test people with the most obvious and serious symptoms at the point they locked down Wuhan. It's not clear exactly how bad it was - I don't think there's much data out there - but there's a couple of alarming numbers quietly tucked away in the WHO joint mission's report. Apparently they went back and tested samples taken from people in Wuhan with influenza-like symptoms at the start of January. 1 out of 20 samples from the first week of January tested positive and 3 out of 20 samples from the second week. That's... not good. (No numbers are given for subsequent weeks.)
There's no particular reason to assume it would take the same path in other countries took some sort of action, even if the actions weren't nearly as forceful as a complete lockdown. Especially since that lockdown was basically a blind and desperate shot in the dark based on incomplete and dubious information.
in Germany in January people talked about:
- well, it's China, you know, they don't have nice hospitals there
- the flu is killing people too and you're not vaccinated!
- our democratic society will be much better at containing that, people are mord open
- the methods in China are soooo stoneage, we are good at contact tracing.
So: no, there was no objective reason to think it would not go global, but it was faaaar away...
As a layperson, I'm not sure I agree with your layperson perception analysis. To me, calling it an epidemic meant that efforts should be focused on containment in order to slow it down or stop its progression. That signaled just how dangerous it was. Calling it a pandemic essentially means that we've given up on that and just like the common flu, most people will catch it. Basically, it's time to just "deal with" it instead of attempting to contain. I'd rather they had kept the epidemic label a bit longer.
I believe it was declared a PHEIC - Public Health Emergency of International Concern - and this should be the signal that governments need to take measures for containment to prevent it from spreading.
I believe the pandemic label is when containment has failed and governments need to go into mitigation mode. Seeing as it had been relatively contained in China, South Korea, Singapore, Hong Kong, Taiwan, etc., it seemed reasonable that taking measures would be sufficient to prevent further escalation.
The WHO defines a pandemic as the worldwide spread of a disease[1]. So the disease only becomes a pandemic after it has spread everywhere; it wouldn't make sense to call a disease a pandemic before it becomes one.
The delayed message of the WHO was really more like a very slow reaction at the cost of potentially millions infected with several thousands dead. By the time it spread to Europe and the US, it was essentially game over.
Perhaps the 'doomsday clock' was right all along but didn't see this one coming.
You must not be watching a lot of TV. I constantly hear and see "experts" and talk show hosts claiming "don't panic, it's just a bad flu", or "nobody speaks about the dead of flu, why do you care now" and some such nonsense. The "wash your hands" meme is also spreading around.
This may be a regional thing. I haven't seen anything like that in Ireland except from true crackpots (the actual insane people seem divided on whether COVID19 is imaginary or a bioweapon). Certainly not on any respectable news source.
To be honest, it is a bad flu, as what we call as flu is also most commonly caused by coronavirus. Though its death rate is 200% worse than a common flu with proper hospitalization.
No; what we call the flu is caused by the influenza virus. What we call the common cold is sometimes caused by a coronavirus (about 25% of cases). And while actual mortality rates are unclear, even the most optimistic figures (South Korea, for instance), are far more than 200% normal seasonal flu rates.
Hygiene is important, of course, but I've seen several people say that if you wash your hands, the likelihood of being infected is zero. That is absolute nonsense, bordering on irresponsible. Coronavirus spreads through air particles. For this virus, washing your hands has no particular benefit.
Every mainstream news outlet in Canada. Followed by National, local polical leaders of all groups. On the advise from health official. Who get directives from the WHO.
Genuine question: What do the alt-right have to gain by dismissing the potency of COVID?
I know the South Korean government took that exact position because of their pro-China stance. They tried really hard to downplay the dangers of the virus simply because of its Wuhan origins. knowing that the Trump administration is on the other side of the fence regarding China, what do they have to gain by dismissing the situation?
They get to excuse their government’s new Katrina. They also tend to be distrustful of science, and of our ability to change anything through centralized action.
Mortality rate for COVID-19 is about 2-3% with medical care, and maybe 10% without. For common flu it's roughly 0.1% depends on when and where of the outbreak.
Most mild cases are reported as they perform temperature check for everyone who enters and exit most if not all enclosures, so unless those people self-quarantined and never go out, they are likely be included in the statistics.
Asymptomatic cases are extremely rare, if they infects multiple others, they will likely be identified through retrospection. Overall, I'd say those cases are unlikely to result in significant difference in the estimate.
Not sure if it makes sense worldwide given that there are a lot of 3rd world countries, but in US the flu has a mortality rate 2 orders of magnitude less than covid-19.
According to the CDC, "between 291,000 and 646,000 people worldwide die from seasonal influenza-related respiratory illnesses each year" [1].
This is likely exacerbated by many countries not having ready access to flu vaccines and/or proper hospitalization for those that need it.
Compare this to America-specific numbers, where 34,000,000 – 49,000,000 Americans catch a flu-related illness each year, yet only 20,000 – 52,000 result in death [2].
I misread parent comment but this was exactly my point. A lot of people die from flu although there is vaccine and mortality rate is at least one magnitude lower than Covid-19 and hospitals are not overwhelmed.
I don't follow. Per the CDC link, seasonal flu hospitalizations result from 1.0% to 1.5% of flu infections. COVID-19 is currently at about 20%. That's a significantly higher hospital load for COVID-18 than for seasonal flu.
There's also the political backlash if the WHO accurately says, "this is a pandemic," early enough to flatten the curve and save lots of lives.
Do you expect politicians to actually think? Especially when they can point at the "fakenews WHO." (I don't know how Trump would actually say it but you get the picture.)
If the WHO declares a pandemic early, they _do_ save lives. But they take the political beating because "nothing happened."
If the WHO declares a pandemic late, they don't save lives. They take a mild wrist slap because "they were late to declare it," which will not be remembered in about a month.
> I don’t know what “media” you’re referring to, put the idea that it’s being dismissed as “just the flu” by anyone except the US government and their alt-right propaganda channels strikes me as blatantly wrong.
Are you sure you've been paying attention longer than a week or two? The virus was being downplayed all of January and February by the media and other people not named Trump as "not a big deal" because "the common flu kills way more people."
America is so polarized politically it depends on which side you're on. If you're a fan of the current administration then they're doing their best and handling things in a realistic pragmatic fashion. If you're not, then the admin is doing everything wrong at every turn. Also, the media is everyone's bogey man because some media sides with the administration and some doesn't.
And, as leader of the Executive Branch of the government, what exactly will he do to change the private media so that it's not serving private interests?
Well, if 30 years of public service Bernie has performed are any indicator, absolutely nothing. Bernie's full of these big, revolutionary, expensive ideas, but he's really accomplished very little in his career. Look at Vermont... second thought, don't look at Vermont (hint: business abandoned the high taxes of Vermont decades ago). Economically, VT is a basket case, do you want Bernie to work his magic on a national level?
It's about what we're saying, it's about sending a message. That we won't be bullied by the corporations and special interest groups, and we'll divert our aid to those who are in need and struggling. There is nothing radical about that.
What country are you in? Both the media and government in my country (US) have been sending the exact opposite message of "just the flu". As with anywhere, there are a few local outlets and politicians trying to downplay it, likely for economic reasons, but I haven't seen it downplayed on the Federal level at all. In fact, there's been an overabundance of information and caution.
The president himself severely downplayed it and gave the opposite advice as his own health officials (including [paraphrasing] "it's just the flu" and "go to work.")
I think the right way to model 45's behavior is an evolutionary feedback loop, where the success condition is pushing the buttons (positive and negative) of the public, for narcissistic attention. He's a paperclip maximizer for outrage and fervor, a Facebook engagement algorithm made flesh.
Because this "skill" has been honed from a lifetime of obsession with media, he's exceptionally good at bypassing anything resembling rational thought, and hitting emotional triggers, resulting in otherwise intelligent people engaging with Frankfurtian Bullshit even when they should know better (opponents and supporters alike).
You are correct. However, the point the previous commenter was making was that it wasn't being downplayed at the federal level.
The president has been visibly out-of-step with the rest of the federal government messaging on this. One voice, no matter the position, doesn't evaporate what the hundreds of others have been saying.
> The president has been visibly out-of-step with the rest of the federal government messaging on this. One voice, no matter the position, doesn't evaporate what the hundreds of others have been saying.
The President has been accusing the "Bureaucrats" of not caring about average Americans, fear-mongering the virus, and claims the Deep State is after him.
The President's followers do NOT believe the government experts. As per the sitting President's plan. The sitting President has cultivated an "Us lay people vs Them bureaucrats" atmosphere.
Case in point: My own Mother believes that the Coronavirus is a Chinese conspiracy to attack the President. And nothing I say could sway her opinion. Unfortunately, the voters of the President support, and believe in him more than even family.
I really don’t understand why the guy can’t keep quiet and let people who obviously know more about the topic do their job. I don’t understand what he is trying to achieve constantly contradicting experts. He should support them.
I really don’t understand why the guy can’t keep quiet and let people who obviously know more about the topic do their job.
What, and let someone else “hog” the attention and the spotlight? I’ve been reading about 45 since the 80s (most of the time, not by choice). “All eyes on me” seems to be far more important to the sitting president than “do the right thing”. I’m not saying “do <what he thinks is> the right thing” isn’t on the list, it’s just way down that list.
I don’t understand how even the people who might agree with you aren’t bored of seeing formulaic offtopic Trump bashing that could be produced by a script polluting every discussion they view on the web.
Assuming you were honestly looking for an explanation: not bored because they don't participate in the same discussions as you might, where the conversations turn to being "formulaic". In my world, and I assume in the world in which the OP lives, it's not immediately obvious why someone would run their mouth about things they know little about when an expert is standing right next to them.
He's a narcissist. This approach gets him far more press (very, very bad press, of course, but he seems broadly okay with that), so it's the obvious route, from that point of view.
”It's not unique to the current administration. Most presidents have done this. ”
I couldn’t imagine any of the presidents of the last decades to stand up and openly contradict his experts on something like this. Maybe behind the scenes but not in the open. He doesn’t seem to understand that he can only lose doing this.
His surgeon general has echoed his sentiment although not so tersely. Yes, they are only two people, but if you can't believe either of these two people, who can you trust, particularly when they are making exclusive claims? Besides, he has made a cult of personality around himself and many people do listen to him.
If you're paying attention you know he's wrong. But there are large swaths of people who when it comes to believing the CDC or the president choose to believe the president. Just this weekend a group of relatives was making fun of the coronavirus as a hoax.
Even scarier, a lot of the people who believe him have been paying close attention the whole time. Trump sounds more like what they expect the truth to sound like than any competent person who is trying to do their job possibly could.
I disagree - the role of president in the USA is quickly marching towards "only voice of the government." This has been clear from many politicians acquiescing to the whims of that One Voice, sometimes to their own detriment, oftentimes to their benefit.
Correct; but the WHO is an international organization, and could easily have made this declaration sooner. The fact that the Trump administration was so clearly downplaying it for PR, only makes it that much more vital for health professionals to read the numbers and set appropriate expectations.
I'm very worried (and in Texas) but when people hear me talk they somehow walk away with "just the flu" anyway. My theory is that people feel cognitive dissonance between the seriousness of the situation and the mild-seeming precautions that are recommended. Cancel nonessential international travel, wash your hands. For most people (talking about the U.S. here) international travel seems extraordinary and optional, if not downright weird, so it's really just wash your hands. It's hard for people to understand that there's a crisis and all they're supposed to do about it is wash their hands, no matter that I say things like "unprecedented mortality and disruption in our lifetime."
Other obstacles to perceiving it as a big deal:
- Not grasping that a fraction of a percent mortality can be a big deal. Numbers under one percent make it sound indistinguishable from flu, even if it's 10x as deadly as flu.
- Having AIDS and Ebola as your mental prototypes for dangerous infectious diseases and feeling relieved when you hear COVID-19 is nothing like either one.
I've heard that from my direct manager. I'm sure that's influenced by who he reports to. He was potentially exposed last week but still comes into the office, and we're discouraged from working from home. We're told to use our "best judgement" but the subtext is pretty clear...
What? The Federal Government has been saying exactly that -- that the flu is far worse, it kills more, and that Covid19 is no big deal. They've said it repeatedly from Day 1 - Up through two days ago when Trump tweeted:
> So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!
Basically the entire GOP leadership structure has decided that people are only worrying as much as they are to damage Trump politically. Essentially the only top level official giving the straight story is Dr. Fauci and he's immediately contradicted by others in the cabinet who seemed to be completely preoccupied with the stock market and the election.
I'm in WA state, where until last week testing wasn't being conducted on anyone that wasn't traveling from a level 3 country or in contact with a known infected person, EVEN IF THE WOULD-BE TESTEE WAS SHOWING SYMPTOMS. We keep talking about the count of infected (and relying on it to decide who to test) but it's unarguably low if we've not been testing, particularly as we apparently have introductions via Europe as well as China, plus community transmission.
Trump just a few days ago said that everyone who wants to be tested can get tested. According to the doctor's offices, that's still false.
Trump himself has a NUMBER of downplaying statements. So many I won't bother to list them. But lots of statements along the lines of "just the flu", among others.
> there's been an overabundance of information and caution
Hard to judge "overabundance" (see other article about how everything with a pandemic is premature until it is too late)
Today's headlines: "The White House has ordered federal health officials to treat top-level coronavirus meetings as classified, an unusual step that has restricted information and hampered the U.S. government’s response to the contagion, according to four Trump administration officials."
Note this prevents any expert who doesn't have clearance from attending.
A few days ago: "US health officials wanted to recommend that elderly Americans avoid flying amid the coronavirus crisis. The White House overruled them"
Are you serious? At the Feb. 26 press conference [0], President Trump literally said: "This is a flu. This is like a flu."
The president tweeted this 2 days ago [1]:
> So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!
This is what the Surgeon General said on Sunday [2]:
> "If we had massive numbers of cases we would be seeing more deaths. And so we actually feel pretty good that some parts of the country have contained it just like when you look at the flu," Adams said on CNN's "State of the Union" Sunday. "When we look at the flu tracker, some parts of the country are having much more severe flu seasons. Some are having very mild flu seasons. The same thing for coronavirus."
Once again HN Civility disease strikes, if you blame anyone specific in politics for anything, expect heavy down voting because somehow that's not "civil", no matter how true it is.
I suppose that depends on your local feeds; if you are in NA you probably have a hard time getting correct information/governance/leadership at this time. (hence your question) It used to be 'good enough' or even 'fine' over there, i.e. with HIV or malaria issues or even H1N1.
But even with the research on pandemic readiness showing that neither capacity nor governance has been up to the task people are still pretending it's just a political choice and the results will be fine. If I remember correctly it as CSIS thing: https://healthsecurity.csis.org/final-report/
80-something percent of the time yes. The remainder is divided between "you need hospital, but will be fine" and "serious intensive care needed".
The trouble is that (1) the people who need hospital to be fine need hospital. They won't be fine if it isn't there, and (2) by being a selfish ass and treating it like just the flu, when it's a disease that grows exponentially in a no-immunity population, people are amplifying the speed and height of the peak, which means not enough hospital places.
If you get a situation where effectively nobody who needs hospital can get it - then those 20-ish percent just drop dead. And then there's your godly death rate.
It's not selfish to treat something like the flu. This means I wash my hands, get vaccinated yearly, and take other common-sense precautions. That's not "being an ass", it's being rational.
And which vaccine were you considering getting for this, precisely?
That's part of the problem; even if it was "just like the flu" (it is not; in particular the percentage of cases requiring advanced medical treatment is much higher, which will lead to a rise in mortality as that treatment is oversubscribed), the flu would be pretty scary if the annual vaccine didn't exist.
Common sense precautions here are much more stringent than the flu. Nobody is immune. There is no vaccination. Herd immunity is nil. And it's very infectious.
This is a new thing and you should treat it as a new thing. There has not in living memory been one this bad, against which we had no defense except to avoid catching it and spreading it.
Except the statistics have been so wildly different across sources it'd be very unwise to follow any of them, and instead check the stories where possible. Only yesterday someone posted the accounts of people in Italy being overwhelmed. Last time I checked, a regular flu doesn't smash through a hospital's capacity so hard they have to ask doctors to change focus.
I think you're referring to a Twitter thread where a doctor relayed descriptions of hospital conditions from another doctor in Lombardy. It was a horrifying story (and scared me, I admit), but I would suggest caution.
Unless there's information that's not making it out of Italy, the death statistics reported today don't seem to align with the picture painted by those tweets.
The thing is, that infrastructure already prepared yearly for the flu. They have capacity designed around it. It is "normal" for thousands to die from the flu yearly, and nobody says anything. (Except that you should obviously be vaccinated.)
There were an estimated 44,000,000 flu cases in the US in 2017-2018. Assuming a worst-case-with-current-data death rate of 3.5%, that's about 1,500,000 deaths. Not millions.
It is remarkable, it's just not civilization destroying. Lots of old and vulnerable people will die. The healthcare system will be taxed for many months to come.
Also the economy will get beaten up, with lots of people finding themselves suddenly in financial distress, and generally almost everyone will have it worse than it would be if the virus never happened.
Something doesn't have to have 25% death rates to be dangerous. Your way of thinking is quite frankly not only flawed but also incredibly harmful to the actual dangers of the coronavirus.
Which is that entire communities can be infected in a very short amount of time, overwhelming local medical infrastructure and resulting in deaths and harm because the doctors simply can't keep up. What was originally something that could be treated then becomes life threatening.
I think it is too early to say much about the mortality rate. 4% is an upper bound, since that is how many lab confirmed cases have resulted in death, but that doesn't account for all of the minor cases where people didn't even know they had it.
4% might be an upper bound under normal situation when there is sufficient availability of intensive care places. When these places become saturated then % of mortality will approach % of people needing intensive care.
Please also note that many people who require intensive care but survive are left with huge chronic damage to their lungs that will affect their quality of life for the rest of their lives.
“Earlier in the epidemic, there was hope that 3.5 percent was grossly overestimated, however as evidence continues to emerge, there is dwindling support for that hope.”
It's collapsing health care systems every where it breaks out. It doesn't take a high hospitalization rate before the CFR jumps way up. Italy's is 4% because they're just letting older people die because they don't have the resources to treat them.
I am an Italian and live in Bergamo, the Italian town that is so far the most affected. The impression that Italy is letting older people die is false, at least at the moment [1]; however, there are people that suggest this might be a guideline to be followed, should the virus continue spreading. I believe that the somewhat higher mortality rate in Italy could partly be due to the fact that our mean age is higher than in other European countries [2].
Name and shame... Also, country please. I don't know if this would also be a thing in Europe or if it's a result of the USA system (for all I know you're from China).
That's outrageous. Every living person deserves full healthcare coverage. Leaving people behind by private insurers is inhumane, and in difficult times like these it's in fact a hazard for the public at large.
That sucks if that's true for your insurance provider. Here in the US it is not always true. For example, Blue Cross Blue Shield in MA are covering expenses for testing and waiving co-payments for medically necessary treatments. https://home.bluecrossma.com/coronavirus
I suspect they have also run numbers and concluded that this is probably within parameters for a normal bad year. We know 80% of those who get it will have mild symptoms, and we also know not everybody will get it (they probably have good numbers). As such the goodwill from accepting a bad year is worth more long term than the savings from not covering it. They may have also factored in future bailouts which they expect to get if things get bad enough.
Insurance companies are all about numbers and are very good at running them. they are not always right, but they are right often enough for their purposes.
That may be the case, but I would guess other insurance companies will buckle under similar pressure. Perhaps I'm being naive, but it seems like the worst kind of PR nightmare to financially cripple a group as big as those who will eventually be infected.
I would imagine it's similar to all insurance: there are events outside the scope of your agreement with the insurance company for coverage.
For example, your home insurance would cover your house burning down but might have a clause along the lines of "if the whole town burns down, we will not cover you."
I'm guessing some health insurance plans have a similar clause of "if there is a WHO declared pandemic, we won't cover you".
The fire example from a real historical event: a German city burned to the ground and put multiple insurance firms out of business. This led to the development of "re-insurance" aka insurance firms that insure other insurance firms.
> For example, your home insurance would cover your house burning down but would have a clause along the lines of "if the whole town burns down, we will not cover you."
This isn't true. Insurance companies can and do regularly cover people in areas where massive destruction occurs within a particular area (e.g. hurricanes). This is why some companies no longer write policies in certain areas: their risk managers usually require them to "spread out risk" and so they write some stuff in some areas and then they may stop and lower rates elsewhere which are deemed "lower risk".
EDITED: Actually, some companies will even cover you in some pretty extreme circumstances, but this is stuff you have to pay for extra and isn't usually included on most policies.
At any rate, what _is_ true is that most insurance companies won't cover you based upon the cause of something: e.g. if your house is burned down due to a riot "civil unrest" or because of something like war, it will not cover you. If your house floods because a pipe bursts, then it is OK. If water comes up from the ground (i.e. a _real_ flood) then it will not cover you because it looks not only at what happened but how it happened.
We are both correct in that they can do all/some/none of the below:
1. Structure their agreements so that some things are covered and others are not e.g. suicide is sometimes NOT covered for life insurance
2. Choose not to cover certain areas e.g. there were insurance firms choosing not to cover Staten Island even pre-Sandy
3. Set their rates at high levels to discourage people e.g. this happened in my old town house where there were too many claims based around water heaters leaking
Funny side story: I remember reading a book about the British Special Forces (S.A.S.) and there was a note that said only Lloyd's of London was willing to insure them due to the high risk of injuries from their line of work.
Funny side story #2:
One of my family members had a friend who was apparently a crazy driver. He drove a delivery truck so a bunch of the driver's friend (including my family member) took out a life insurance policy on him (driver). I didn't even realize you could do this but apparently you can.
In the end, turned out that the driver outlived all of the people who were on the policy!
>One of my family members had a friend who was apparently a crazy driver. He drove a delivery truck so a bunch of the driver's friend (including my family member) took out a life insurance policy on him (driver). I didn't even realize you could do this but apparently you can.
It's generally restricted, since it can incentivize killing them to collect the money. To life-insure anybody you have to convince the insurer that you have an "insurable interest" in their life. That's easy if they're a breadwinner/caretaker in your family, and you could also show it if they were e.g. critical to your business (edit: or had lent them money). I'd be interested to know what the justification was in that case.
Insurers really try to make sure that the payout isn't so high that you want the insured event to happen ("moral hazard").
Hm, I think the "insurable interest" check is more of a standard practice to protect against being exploited by criminals and less of an "oh man, we'd love to do that but for those pesky regulations". Still, if I had to guess, I'd say it's that they don't look too closely if it's a close-enough family member that has a job.
I would assume there are many insurance plans that include force majeure clauses. "Force majeure – or vis major – meaning "superior force", also known as cas fortuit or casus fortuitus "chance occurrence, unavoidable accident", is a common clause in contracts that essentially frees both parties from liability or obligation when an extraordinary event or circumstance beyond the control of the parties, such as a war, strike, riot, crime, or an event described by the legal term act of God, prevents one or both parties from fulfilling their obligations under the contract"
TLDR: If the event affecting you gets big enough/outrageous enough the insurance companies consider it an act of god and you aren't covered.
In English law I think that this kind of clause has to be explicit and something that all parties sign up to - because the principle in English law is that parties can contract freely in any form that suits them. In other systems (and I think in the US - please correct me anyone who knows more!) you don't need an explicit clause to argue force majeure, you just need to get the court to agree that you are in extraordinary times.
I've heard the typical ICU/hospitalization course involves bilateral pneumonia, apparently requiring intubation and ventilation.
It appears to be survivable as long as equipment and personnel are available. And that's the problem: availability.
When health systems are overwhelmed, even people who could survive pneumonia with mechanical ventilation will die - because the equipment supply is exceeded and there are no ventilators left.
So yes, there are treatments for pneumonia, but they are limited in availability.
Quote: "all the insurance companies here, either today, or before today, have agreed to waive all copays on coronavirus testing, and extend coverage for coronavirus treatment in all of their benefit plans"
”Vice President Pence said Tuesday that a group of major health insurance companies”
Assuming that one is insured to begin with, and your insurance company was one of those at the White House, yeah, you could be covered. So “probably still have coverage” is a pretty wishful statement.
Yesterday I had the sudden realization that the US Republican Party is likely to be disproportionately impacted by COVID-19, but also seems to be avoiding taking precautions to prevent the spread.
Mortality and impacts seem to hit people over 50 the hardest, and that is where a majority of the Republican supporters come from.
It would be a curious footnote to have COVID-19 swing an election.
That article is from 2008. A lot has changed since.
The first thing that I would draw your attention to is that social shifts have moved the "silent generation" from being evenly split Democrat/Republican in 2004 to going for Trump by a 13 point margin in 2016. This is the group that will suffer the vast majority of fatalities. See https://www.people-press.org/2016/09/13/2-party-affiliation-... for verification.
Third, the upcoming generations through that 12 years are overwhelmingly Democratic and will have almost no deaths from this disease. Both previous links verify that.
The result is that, a well researched article from a dozen years ago notwithstanding, the impact of COVID-19 are likely to disproportionately hit Republicans over Democrats.
(Not necessarily. The one trend that Republicans can hope for is that diseases spread through urban areas and urban areas are overwhelmingly Democratic. I don't think that this offsets the other phenomena though.)
That's unclear, actually. The biggest single US cluster so far is in a retirement community in suburban Seattle. No one is safe here, novel viruses like this simply transmit too easily.
There's literally a poll elsewhere in this thread showing exactly this kind of effect.
I mean, fine, it's a partisan point. But... I mean, seriously: at what point does it become OK to point out that Fox News and the Republican leadership[1] just plain fucked up the response to COVID-19 really badly? And that they seemingly did so out of a combination of both ignorance and partisan desire to minimize the problem?
Is that not OK? Because it's a real point, and one that needs to be made (and heard by republican voters), even if it's "partisan".
[1] And specifically Fox News and the Republican leaders, and not the "MSM" or Democratic leadership, who were saying opposite things and in hindsight were clearly correct.
My mom drives 90 minutes a day to be with my dad in nursing home rehabilitation, the closest facility. The normal response time for an ambulance is 20 minutes, plus 30-45m to an ER. Their doctors are a similar distance. Note that the ambulance is volunteer, and the average member is 55. They live in NY, in a county with a decent sized city. It’s worse in the real boonies.
I live in a city, a paramedic will be at your door in 7-10m. Hospital 5-10m, etc.
If this gets bad, everyone will be familiar with tragedy. The urban stories will be about neglected patients in overcrowded wards and people who die of untreated strokes, etc. The rural tragedies will be finding grandma, drowned in her own phlegm because sick relatives and travel restrictions isolated her from support.
It's an interesting question. Urban areas, it would seem, are likely to get the spread a lot faster, but they also have way better medical infrastructure. It will spread slower in rural areas, but you have way fewer hospital beds, and less medical infrastructure in general.
The US's rural healthcare is really bad. I was in a very rural part of Ohio recently and was listening to people talk about how they really only have an urgent care facility nearby but the closest hospital is a decent bit away. Even then they talked about how it wasn't a good hospital and recounted horror stories of friends/family and how they always go to a further/different hospital because they don't get good care at the closer one (which again, is not that close).
I live (urban/suburban) in spitting distance of 3-4+ hospitals (I don't even know for sure) with at least 2 of those being ones I would trust my life to in a heartbeat (the others I just don't know enough about). I was really unaware of the disconnect before that trip and it didn't really occur to me that hospital != hospital. So not only do some rural location have limited or no hospitals but they don't trust the ones they do have.
It also doesn't help that Trump is still keeping up his cult rallies and still has one scheduled next week.
The current White House is essentially the worst case scenario in dealing with this outbreak and is going to get people killed. There is still current exponential growth in the USA, and there is near zero testing going on due to incompetence and coverup. Things are going to get much worse.
I didn't downvote, but the politicization is unhelpful. When Trump pondered travel restrictions to/from China a month ago, the media jumped at him for being racist/isolationist. All the "experts" explained us that open borders are necessary to fight an epidemic.
Which legitimate person would ever say open borders help an epidemic? The virus spreading as it is a direct bad side-effect of globalization such as it is.
The main issue right now is the lack of testing and covering up just to try and bump the stock market, and it obviously is having the opposite effect since the problem is just getting worse the longer the problem is ignored.
The WHO's official guidance in late January was that countries should not restrict travel to fight the coronavirus. Travel restrictions "cause more harm than good by hindering info-sharing, medical supply chains and harming economies", they said.
Property values will fall after the next recession. It looks very likely that this set off what will become the next recession. (I mean, a recession is two quarters, so it hasn't happened yet... but it seems really unlikely to me that we won't see a recession, considering.)
The next question is, will they. I know of a town in Indiana where a surprising number of people don't get medical help. Some of it is money, but a big part is cultural. Indianapolis scares them. I dare say, for too many Indianapolis is scarier than COVID-19.
Something like a stroke requires immediate action (say, within 2 hours) to be able to use the best treatments available. Living very far away from a good hospital makes your survival chances quite lower.
For Covid-19, as far as I read, some people have gone to the hospital (already having trouble to breath) and died after a few hours. But those seem extreme cases. Normally you would have a couple days to go to the hospital from the moment you realize something is odd.
Yes, but those bounds are not binary. The faster you arrive, the higher the chance survival (specially for things like strokes, arriving in 30 minutes is way better than in 2 hours).
Then there is the issue of cost for that flight and the poor state of healthcare.
The quality of medical infrastructure is going to play a small role in outcomes when the entire system is overwhelmed many times over in the next month or so.
Everyone will come in contact with the virus. People under 50 years old (as recent reports have stated) have a high chance of survival. The deaths from it will mostly be from those 50 years and old. Voters who are 50 years and older largely vote for the Republican party.
Republicans are older on average, but they also live in less densely-populated places. The most dangerous thing I can think of is commuting on public transportation. That's a feature of cities, predominately Democratic strongholds.
Most republicans were successfully programmed to believe what Trump tells them, which as of today is a mix of underestimation of the risks and then dodging responsibilities.
Yes, she is one of four ministers underneath the health secretary. Care is not in her portfolio luckily (she is responsible for mental health and patient experience).
On the other hand, "Parasite Prevalence Predicts Authoritarianism" [1]. Which wouldn't necessarily swing the election obviously one way or the other (left or right, Democrat or Republican -- although my gut tells me it would swing things to the right to some degree), but could definitely be a confounding factor to the above theory.
That's a bit of a stretch...there are probably dozens of other obvious correlations in places where authoritarianism pops up, because authoritarianism is much more likely to spring up where people are poor and uneducated...
Republicans may be marginally older, but they are also more rural. Presumably cities would be harder hit with a pandemic, but then again city folk might have easier access to care. It's really hard to say.
Beyond direct consequences, it seems reasonable that covid19 would affect the election by tanking the economy and giving Trump nothing to point at as his big accomplishments
Funnily enough, the second in charge of the Spanish far-rightwing party Vox who accused immigrants of bringing diseases like HIV (sic), has just been diagnosed positive after the party gathering on 8th March (intentionally on Women's day). Honestly, everything looks like a fun/scary/dystopic meme these days.
It's right there in their post... older voting population combined with taking fewer precautions against the virus. Both mean it might have a larger affect on the republican block.
Personally I'm not sure if it will outweigh how democrats are more likely to live in denser urban areas where spread is faster.
Parent edited his post without noting the edit. Prior to the edit it did not include any information except that republicans would be more largely effected.
I'm curious how Fox News chose to push for denial rather than, say blaming it on international or ideological opponents.
Perhaps it's just that they can change course without any pushback from their demographic -- they're happy believing that we've always been at war with Eastasia. Still, it must cost them something to be quite so demonstrably wrong on something that's so much in people's faces. (As opposed to, say, climate change, where the effects are much slower and more easily shuffled under "the heat wave and fires are just weather".)
You mean Mexico. He wanted to shut the border with MEXICO, for no apparent practical reason, and refused at first to let Americans off a cruise ship, because he wanted to "keep the numbers low".
I think it's 33% distrust in governmental institutions, especially the liberal elite fake news CDC, 33% the fact that it's mostly hit large cities so far, and 33% the direct actions of the administration and the right wing media machine.
I think the fact that it's an election year, more people are susceptible to thinking the pandemic is overblown and thus a conspiracy to defeat Trump.
That's highly subjective and no doubt any assessment is likely to strongly align with partisanship.
Which is why we need age limits. You can't expect people to objectively evaluate whether those inside or outside their party are still legislating or judging effectively in their 80s. Obviously most Republicans would lean towards arguing that she's senile and most Democrats would lean toward the opposite.
And then I imagine cognitive decline does not affect all faculties equally - so someone may still, say, have no trouble writing essays, but their judgement may be compromised.
How do you know that? I'd be more willing to bet that Americans have been mostly complacent as they haven't dealt with any meaningful threat since 9/11. Most of them don't prepare like they should anyway, even when Obama told them to do so.
If there's any racism going on, it's with the people who fear Asians because they think they're all contaminated with COVID-19.
> They had 3 months to prepare and, still, they believe that to fight the virus is just enough to wash hands and stay a few feet away from their coworkers, just as with a normal seasonal flu. That's ridiculous.
That's what they've been told to do by government officials and journalists.
Interesting point, but the Spanish-American War was only 20 years before that. Attitudes in the US toward Spain were probably much different then than they are now.
It’s a stupid concern. The reason the government is incompetent is that the government is incompetent. That’s not uniquely American, and there’s no evidence that race has played into any of this. We didn’t exactly change our tune when Italy freaked out. Does that mean we’re racist against Italians?
My read from the US is different. I think over the past 20 years Americans have seen coverage of many scary diseases from afar (SARS, west nile, zika, MERS, ebola). None of these had a large impact on American society. So these experiences have led Americans, not wholly unreasonably, to not pay much attention to a new infectious disease in a faraway place.
I doubt it comes down to thinking America is somehow “better”. If anything, people seem more inclined to envy the coordinated responses of Asian countries, especially South Korea.
Sure. When the admins merge dupes, they consider what the best link is and reparent the comments, which has now happened. Now thread had more upvotes and comments.
WHO is a complete joke, from praising China's lack of a response as ground-breaking and refusing to label this thing as a Pandemic until now. Trust in institutions is at an all time low because these institutions perform so poorly that most people dismiss them entirely (even if the advice is sound). I hope the world will learn it's lessons from this outbreak, so at least we can react faster next time.
This should have been done way earlier. WHO's excuse of not declaring it before was that it didn't reach Antarctica yet... which is ridiculous.
Had they raised alarm early on, more countries would have enforced proper procedures (look at South Korea). Instead, the thing spread around and starts impacting economy.
Following organized, rational procedure is exactly what is needed in times of widespread panic. If the WHO based their decisions such as this one on emotions like fear or intuition then they really would be damaging their credibility. Let's be honest, if countries hadn't been enforcing proper procedures to this point, how likely is it that a label by the WHO would make that much of an impact to governments?
Now, inactive governments may be held accountable of not listening to the WHO. Also, calling it a pandemic 2 weeks ago (or more) would have been perfectly rational.
They didn't base their decision on the observed growth curve. Anyone looking at the data could have called this a pandemic the moment it left Asia.
The WHO and CDC botched this. Because of their messaging a lot of people (the majority of people!) didn't take this virus seriously, and that is going to result in real human lives lost.
Holy hell! That site still exists? I remember going on there all the time in the early 2000's cause my parents couldn't afford a newer console and our PS2 basically died.
Who is your goto authority that has supplanted WHO in healthcare matters?
As in, who do people like you, who claim that WHO's maybe flawed handling of this has erased all of the work they've done in the past, consider the best source of truth in these matters?
Credibility is the quality one has when one's statements ought to be believed. OP claims the WHO lacks this quality. OP doesn't illustrate what specific statements the WHO could make that aren't trustworthy; but in the very same comment only quotes a single one from them: the fact that Covid-19 would be a pandemic.
So the only (provided) statement we should disbelieve is that Covid-19 is a pandemic. Which is precisely what OP wanted them to say. Hence the contradiction.
Obviously, this line of reasoning is tenuous, but the initial claim isn't much better, as nothing is said of what it really means for the WHO to have credibility.
I read that comment as an additional armchair semanticist making the strong claim that (exaggeration mine) the WHO should have declared the pandemic before the virus reached their own country.
In preparation of stopping next pandemic, maybe we should have an international agreement like Paris climate change agreement. Like climate change and nuclear weapons this is an existential risk.
Yes, outbreak of zootonic diseases is still possible through widely consumed firm animals (chickens, pigs, or cows). But we can dramatically reduce the risk of next pandemic if we stop eating exotic wild animals like bats, which is not hard to give up. We may have been able to stop outbreak of COVID-19 on the first place if we had learned our lessons from SARS outbreak and stopping eating exotics animals.
EDIT: bat was used as an example. You can replace any exotic animals in place of bats, the point still stands. This video touches on the topic of outbreak of coronavirus: https://www.youtube.com/watch?v=TPpoJGYlW54
Is there any evidence whatsoever that the current coronavirus outbreak was due to eating exotic animals.
Yes, the press has reported that a market in Wuhan sold exotic animals, but it seems this is uncorroborated, and after asking an acquaintance in Wuhan about it, I was told it's fake news, and that said market sells farmed animals as far as she's ever seen.
Animals are absolutely a primary vector for infectious disease. No, there's no definitive evidence as of yet of patient 0, though the cluster of early cases in China had strong connections to the wet market in Wuhan. It's not necessarily the eating of the animals directly, but indirectly – because wild animals are kept stressed, in cages, next to other domesticated animals and people.
Even with conventional animal agriculture, things like bird flu and swine flu are a serious threat.
Well, it's linked to bats (like many such illnesses). One of the biggest exposures to these animals is at such markets, so whether or not this particular outbreak is traced to a particular market is less important than generally lowering exposure.
> Yes, the press has reported that a market in Wuhan sold exotic animals, but it seems this is uncorroborated, and after asking an acquaintance in Wuhan about it, I was told it's fake news, and that said market sells farmed animals as far as she's ever seen.
The Chinese government appears to be trying very hard to not be blamed for it and is spreading fake news of their own, which is what your acquaintance may be telling you.
Although MERS is more deadly than SARS-CoV-2, it looks it's less transmissible between people than SARS-CoV-2. I heard an epidemiologist theorize that it might be because people infected with SARS-CoV-2 shed the virus before they show any signs of COVID.
Maybe that's why MERS never spread widely outside of areas where camels don't exist widely.
I thought that the bat soup origin was debunked. I'd suspect it's pretty rare that you come across a novel virus that's hardy enough to survive cooking at temperature and then the rigors of the human GI tract.
I don't know anything about the likelihood of the bat origin theory, but it wouldn't have to pass through the gut. It could pass from mucous, saliva, or other secretion, or internal fluids/tissues. If it got on a surface at any point during processing, either the people handling the animal or someone else could transfer it to their own noise/eyes/mouth just by accident.
SARS-CoV-2 virus is zoonotic for sure, question is only what kind of animal was immediate host and what was mode of transition. It didn't have to be eating, might as well have been transmission of body fluid like mucus while hunting or cutting meat.
You didn't use it as an example, I was recalling from the initial theories when "coronavirus" was making the news.
It would also be helpful to the discussion if "we" stopped casting broad nets and making sweeping generalizations without specifics and context.
"Eating exotic animals" has no real meaning. Bats may not be exotic in that region. Additionally, you specifically said "eating" and, so, my comment was specifically directed at the consumption of animals. In that case, cattle (not "exotic" in my region) can carry bovine spongiform encephalopathy which _can_ survive ingestion (most likely CNS tissues). So, when dealing with science-y sort of things, making generalizations in order to support an opinion, you're basically opening yourself up to people (like myself) who desire specificity and factual support.
As was mentioned in an erudite child comment, the most likely form of transmission was in the preparation of the foodstuff, so if you believe that more caution should be exercised, then you'd get no complaints from me.
> if we stop eating exotic wild animals like bats, which is not hard to give up
That seems a very first world-centric point of view.
Isn't the eating of such animals partially driven by cultural culinary preferences, and partially driven by the availability of such foods (eg. unable to afford beef or chicken, but can afford the next best thing).
1. It's unlikely that this coronavirus was caused by the consumption of bats. It is more likely that it was transmitted through an intermediate host such as pangolin.
2. A very small minority of people in China consume exotic food not because they are cheap, but because they are more expensive and were considered prestigious.
3. There is now a very strong pushbacks against this culture from both the Chinese government and the vast majority of the Chinese people.
It's also not actually sound to begin with. MERS was transmitted to humans from camels, which are not exotic at all in the middle east. Livestock frequently interacts with wild animals, and this isn't really preventable, especially against bats. Worse yet, livestock is generally kept in large groups in close proximity to each other, and once slaughtered is distributed quickly and widely. While it doesn't get the same media coverage, it is not that uncommon for diseased meat to make it into the food supply. While meat inspection practices go a long way to help, they for obvious reasons have a hard time dealing with new diseases.
> Yes, outbreak of zootonic diseases is still possible through widely consumed firm animals (chickens, pigs, or cows). But we can dramatically reduce the risk of next pandemic if we stop eating exotic wild animals like bats, which is not hard to give up.
Washing your hands is not going to stop every single disease on the earth, but it'll reduce the risk. What exactly is the unsound part here?
The idea that a policy attempting to stop the consumption of wild animals would dramatically reduce the risk of a pandemic isn't sound. Most foodborne zoonotic outbreaks come from livestock, particularly in cases of newly developed farmland encroaching on wild animals, and transmission to livestock does not present a significant barrier for a Novel Coronavirus or other pandemic disease. H5N1 for example spreads to humans predominantly via poultry. The Chinese government also already discourages the consumption of such animals, and it is unlikely that further policy would have much impact, and the political effort could be much better spent elsewhere.
It's not a harmful proposal or anything, I just don't think it would have much impact, and it fixates excessively on the particulars of two specific outbreaks.
Exotic animals are not something poor people eat because they can't afford. It's absolutely the other way around. Exotic meats are mostly consumed by the powerful people as delicacies.
I have no doubt that there are cases of wealthy people consuming exotic meat as a delicacy, but I would bet pound for pound it is largely people in poorer regions without much alternative.
Unfortunately I'm looking for real stats but am having trouble as most of the trade does not keep records, is illegal, etc
How can you even remotely suggest this when the proximity between humans and lifestock animals in horrible conditions is a primary driver of a) transmission of disease, as well as b) increasing resistance to antibiotics due to how much of them we pump into the animals, and then consume ourselves?
It absolutely _is_ about cuisine choices and the sooner we stop eating animals and animal products, the better.
That's impossible to know. We have no idea how many cases there are in the US, because we're not doing a significant amount of testing here, because our government is incompetent and unprepared for this.
True. And we don't care about the number of cases anyway. We care about the growth. Assuming China has been ramping up its testing efforts, that gives us a clear picture of the spread in China. Especially compared to countries with slow-to-start, spotty testing.
It seems to me that the U.S. government would prefer for cases to not be tested. Whatever medical competence there is appears to be sidelined by other interests.
And it should be very obvious from the fact that the rate of positives relative to the number of tests is enormously higher in the US than elsewhere that the number of infected are much higher than believed. Alongside this, cost prevents many from seeking care for things like respiratory illnesses, and in the case of one that actually requires care would probably do so until it is severely progressed.
That's what skeptics in Italy were originally saying. Now people in Lombardy are dying from strokes because hospitals can't admit them because ICU is overrun by Covid-19 patients. Sure, if you break your leg and die from bleeding out because all local hospitals are busy treating bilateral pneumonia patients you technically didn't die from Covid-19, but ....
> Now people in Lombardy are dying from strokes because hospitals can't admit them
Now wait a minute. If you have a source on that, please do provide it. Because I am from Italy and I have never heard of such things. (There were cases of people who died from a stroke and tested positive to COVID-19, but that's all I know)
Thank you, even though I am honestly not sure if I can trust a Twitter thread.
For instance, this article [1] (in Italian) says that "up until now [yesterday], no patient who could have benefited from intensive care has been excluded". BUT it also says Lombardy might be headed that way if the virus keeps spreading at this rate.
Just to be clear, I do not want to downplay what is happening in any way. But I feel it is better if we stick to verifiable info.
This is where I'm currently battling my south-Denver community. They're all up in arms reciting the GP's facts-in-a-vaccuum. They honestly don't give a rip about the extreme pressure it's put on healthcare systems in Italy (let alone Seattle). They're mad at the local government for "bordering on hysteria" because they're following the South Korean model for management.
Once it's fully spread through our community because the've decided they're entitled to be carriers (because, hey, you're more likely to die of the flu), they'll blame that same government for failing to provide the requisite care in the community.
Given what I know about the nature of this disease, and the american response thus far, I don’t think this is true. It is looking very likely that the health system is going to be overloaded in the US. This is what people working in hospitals are telling me and it makes sense to me given the information that’s out there.
According to this dashboard, there are 40k infected outside of China vs 80k inside, and the 40k number is still growing exponentially. It’s just a matter of days until we have more cases outside of China.
This. Last month all of the analysis pointed to the fact that the mortality rate was being severely misrepresented, either through intent or ignorance.
For now. It's still expanding rapidly. A lot of countries, including the US, don't exactly give the impression they've got a good handle on this.
If left to expand, this is going to turn into another unavoidable seasonal flu, except more contagious, more severe, and more deadly. And for now, with no vaccine.
A couple of important reasons to try to slow this thing down are:
* Hospitals don't have the capacity to deal with the number of severe COVID-19 patients they're likely to get. There's a good reason China built a new hospital in a week. Severe cases end up on the ICU, and we could end up with hundreds of thousands severe cases.
* Slowing it down gives scientists more time to find a vaccine.
If you wait for it to get worse than the flu, it will be too late.
Just because something hasn't happened yet does not mean it's completely unpredictable. COVID-19 is coming, and if we don't put significant preventative measures in place, many more people will die from it in 2020 than the yearly flu.
As a Chinese, I read first hand materials from Chinese social media and friends on what life is like in a lockdown area. People there depends on deliveries for groceries and medicine, and occasionally restaurants take-outs. All those services, and a bunch of other services for small businesses are possible because of Wechat. Wechat is obviously not a popular option here in N.A. Is there something we can do to help both the people buy whatever they need via delivery and help local businesses?
In Wuhan when the entire family had to be isolated, no one was left to take care of family pets. I heard there's volunteer groups to take them but their capacities were very limited due to the short notice for them to take on such responsibilities. Can we be more prepared and maybe find a technology(-assisted) solution to this before it becomes a huge issue? I feel this will be an issue sooner rather than later because in N.A. it appears the current policy for mild cases is self-isolating, which will very likely infect the entire family.
Also in Wuhan during the lockdown many people felt so lonely, especially the older generation who can't use the internet effectively to stay connected to their families/rest of the world. Can we find ways to help people prepare for it psychologically? A lot of people will break medical suggested self-isolation because of the eagerness to stay connected to certain people/group. Instead of blaming them, can we help them find ways to stay connected yet in isolation?
I'm sure there are more things the mighty HN crowd can do to help others overcome this difficult time. Let's give it a try?