Regardless of the ability of people to travel to the UK or Canada and get here (which people have done for a long time with other nations we don't take kindly to) it's absolutely going to reduce the number of people who will travel across the pond. Which is the goal, reduce infection rates.
My concern is how economies are going to respond to the US being cut off from Continental ports for a month, which as far as I can tell hasn't happened since U boats were in open waters.
Can anyone comment on supply chains that rely on Europe to source goods? I know medical grade steel comes from over there, but I don't know what else.
Based on the localized infection cases I see across the US and have been watching as well as the characteristics of the virus (life outside host/on surfaces, in air, the degree of asymptomatic transference, etc.), it's well beyond containment IMHO.
Travel isn't going to do too much to reduce infection rates alone. We need significant cultural changes to reduce infection rates, but I don't see that happening for a variety of reasons. This country isn't about proactive action and is all about reactionary action though, so we're just waiting for that reactionary threshold. Some preventative measures have been pushed but they're no where near aggressive enough at this point.
It will be interesting how this is handled in our modern cultural, current political and work culture, etc. I suspect it's going to be fairly nasty but certainly hope not. I've been advising my parents to stock up and minimize any outside interactions for awhile.
All reductions in (non-essential) travel are good in a pandemic. That doesn't mean it's sufficient, but it's something positive.
I think we would all like to see stronger social distancing rules domestically (in the US), but here the US has a problem as it granted the President broad discretionary powers to suspend international travel but not domestic gatherings, which can't be banned via executive order and even if congress were to pass a law banning such gatherings, there would be first amendment implications as well as federalism issues.
It's not easy to pass a law giving the President this type of power and I suspect many in congress already rue passing the laws that gave the president power to suspend international travel. That's one of the prices of living in a federal government with separation of powers and a bill of rights guaranteeing right to assembly rather than in a place like China.
For example, the CDC has issued social distancing guidelines but they are only guidelines not laws: Santa Clara county has said "no thank you we'll follow our own guidelines" instead, when the CDC asked to ban meetings of more than 250 but Santa Clara banned meetings of more than 1000, and just refused to change their target to the CDC recommendation.
So the US simply lacks the tools that would allow the President to go on the air and announce "I'm declaring that the MLB season needs to be delayed and Disneyland must close." He can try to exert pressure, or rather have the CDC exert pressure, but these types of declarations are not going to happen in America.
Banning public gatherings is really something that should be done on the municipal level, maybe the state level. The federal government should not have the power to disrupt every day life from thousands of miles away.
I sympathize with this view, but it does make it harder to respond quickly with nationwide lockdowns, which is the flip side of living in such a connected world.
Long term, I think some mechanism to mandate more social isolation is going to be needed.
For example when travelling from California to Arizona, there is currently no quarantine area or checkpoint, and that's fine if you want free movement, but then it's harder to say that states should run their own pandemic policy as long as there is free movement between states.
And this is a general trade off. More interconnected world => localism is less viable as a means of countering global threats.
Practically, yes, the states these days won't do anything until the federal government tells them to. It'll work out in a nationwide lockdown, but such obedience hurt us in february when the CDC had a monopoly on test kits and nowhere near enough capacity to supply the whole country. We seem to be making all the wrong decisions in this emergency.
Those are valid points. As to the test kits, I keep hearing conflicting info -- e.g. that there was a shortage of ingredients, too much FDA red tape, etc. There will plenty of root cause analysis in the future, but I think we have to reshore critical infrastructure and there is lots of red tape to cut in both CDC and FDA.
The red tape thing is nonsense. What was lacking was/is political will. CDC/FDA/States could increase testing 100-fold overnight if they really wanted to. A decision has been made to proceed differently. Hopefully this decision is reconsidered over the next few days or things are going to get much worse. Currently, as far as I can tell, we are doing about 1000 tests a day nationwide. I can order the necessary reagents and a few water baths and a cheap microtiter plate fluorometer for overnight delivery and do a 1000 of these tests a day by hand.
I have read somewhere that CDC was trying to make a 3-in-1 test kit for SARS, MERS and this new SARS-Cov-2 virus but it was giving bad accuracy and false positives, and now they are making the one for the sars-cov-2 only.
They were making a 3 in 1 kit, but that's because the 1 was an internal control and the other 2 were two different places in the viral genome in case one mutated and became silent.
Any standard first year undergrad level biology book will describe how to run an RT-PCR test (which is what they are doing). None of the reagents and processes are difficult to make or source.
My personal theory is that someone in the executive branch wanted to secure an exclusive contract for a personal friend. Something similar happened in the first few months of the Kuwait oil fires, with certain american fire fighting firms being given exclusive contracts to fight the fires, despite lacking the technology and expertise to extinguish them.
But I'm just a cynical man. It could very well be something else and I'll be very interested to read about this emergency once it's all behind us.
Could be, think of Homeland Security and those new(er) airport scanners. Mike Chertoff, formerly Secretary of Homeland Security, was instrumental in making them happen. He also happened to own a huge stake in the company that made them, since acquired by BAE Systems (who later made him a Chairman).
Even with an exclusive contract, a nation such as the US should be able to quickly ramp production of all the test kits, masks, latex gloves, respirators, oxygen concentrators, antibiotics and other pharmaceuticals that we need.
The who is pretty much everyone in government, egged on by the business community with the tacit approval or at least disinterest of the public. The when is constant over the past half century. The how is outsourcing much of our productive capability around the globe. The why is the race to the bottom for the cheapest production cost.
I don't think so. This is not a case like where we need a bunch of steal but the steel mills are closed so we have to buy the Chinese steel so (as any good business-folks will do) they raise prices 8-fold (see Oakland Bay Bridge Fiasco). The reagents for these tests are all made in america, or would take a few days to ramp up. I once made enough Taq polymerase in 12 hours to supply a lab for 12 years doing 200 PCRs a day. A single person can make gram quantities of the required oligos (enough for 100,000 PCR reactions) in any one of 500 labs in the Bay area alone in 12 hours. RT takes an hour. Amplification takes 4 hours. The readout for a sample can be done 1500 at a time in one second. There are no excuses.
Similarly in Puerto Rico after Hurricane Maria, a politically connected one-man "energy company" called Whitefish, with no experience or skills, emerged out of nowhere and was given the contracts to rebuild the entire Puerto Rican grid.
Months later nothing had happened other than he hired a few people as unskilled as himself who were just dorking around down there, while people died.
So they fired that guy and hired another company called Cobra, with the same terrible terms, and the same ineffective response. Eventually it was found out that Cobra people had paid massive bribes to officials to ensure the deal.
Whitefish was getting stuff done. It was more than one man. It had the needed skill, which was subcontracting. Whitefish got numerous teams operational in Puerto Rico before being yanked off the job by politics.
The whole story of Whitefish being unqualified is just corrupt politics. Subcontracting is a legitimate way to get the work done.
Exactly. And blanket policies are almost always terrible. Local communities have different constraints and different environments. There's no reason to believe that Fargo, North Dakota should have to respond to this in the same way that New York City does.
Singapore and Taiwan are basically cities, very dense. China is a Communist country with all kinds of totalitarian policies. South Korean cases are still climbing at more than 100 a day. You can't tell precisely what the growth curve has been because there's going to be a higher bias when they ramp up testing in many countries.
At any rate, no, a town that has 50 people per square mile should not be forced to respond in the same way as some city with 50,000 people per square mile. In the meantime, the people of Fargo have all the relevant information and their local officials can make calls as needed to suit their demands.
The rule "no gatherings over 250 people" isn't a blanket rule. It will impact cities more than rural places. The flexibility is already built into the schema.
During the Blackhawks game, the announces claim that the official NHL stance is unclear and they will be making an announcement tomorrow. They had 21k in attendance at the game tonight.
>All reductions in (non-essential) travel are good in a pandemic.
All travel is essential to somebody. All restrictions on movement also have a cost, and any analysis that only looks at the benefits of something without looking at the costs cannot hope to be correct.
I'm curious to the downvoters, do you generally believe it's a good idea to make public policy decisions without considering the downsides? It's like people who want to ban encryption because it could marginally increase the number of terrorists caught.
Of course we should consider the downsides when we make public policy decisions. In fact, if we weren't, we wouldn't be making decisions at all but merely reacting.
But we can consider the downsides and decide that we want to restrict travel.
I don't actually need to go visit my rellies. I want to, but I don't have to. On the other hand, if I go on a voluntary trip, I probably have to return home because I can't really afford a hotel indefinitely into the future.
So it's obvious to me that there is some distinction between necessary and nice to have.
I genuinely have been underwhelmed by the reaction to this disease through much of the world. It is necessary in a constitutional democracy to react sometimes to maintain the trust of the voters - or they might say "A democracy is fine when things are going well, but when the chips are down we need a strong leader who can make the decisions we need". Saying "those entertainment business can't open during this outbreak", "keep your tables at least a metre apart" and "don't travel" are reasonable reactions in this circumstance. And we need democratic leaders so that they can know when it's gone on for too long and they have to accept we can't stop it - something a "strong leader" can't tell.
What about to your job, if you don't have a job that you can do remotely? Employers generally don't like paying people who can't make it in to work, and it's hard to pay for food without money.
Aye, just got back from walking there. Pretty essential to doing IT for several hours, though, IMO.
But OPs point stands -- unless you're working from home and never going out to eat / get groceries / not go crazy from cabin fever you have to travel somewhere
I haven't tasted coffee in a decade, and I'm doing just finezzzzzzzz....~
Restricting routine trips to just home-to-work, work-to-home, and large-scale resupply missions is still acceptable at the moment. Make use of your local grocery's picker service with delivery to the parking lot, if you can.
Consider switching your dining-out trips to ordering via phone, fax, or electronic ordering system, and doing drive-through, carry-out, or parking-lot pickup. Pay electronically, in advance, instead of handling cash at the point-of-sale terminal. If you get cabin fever, and need to socialize, do it through screens.
It is essential for Starbucks to serve customers in order for them to stay in business. You don't have to stop going. But you can put in your order via website or app; walk into the retail location only when it's ready; pick it up without speaking to, breathing on, or touching anyone; and then leave immediately. It is possible to minimize the duration and intensity of contact, without eliminating it entirely.
It is better to be in contact with your regular friends, acquaintances, and business associates--that are all the same people every day--than to have a lot of transient contacts with complete strangers. It is slower to traverse a social network one connection at a time than to hit a lot of random, unconnected people all at once with a brodcast.
The hurdle would then be that it’s the feds’ responsibility to prove that this is the smallest infringement that would accomplish the government’s intention.
Strict scrutiny requires not only a compelling state interest but that the restriction be narrowly tailored and the least restrictive means that satisfies the purpose. See: https://en.m.wikipedia.org/wiki/Strict_scrutiny .
> ... the US has a problem as it granted the President broad discretionary powers to suspend international travel but not domestic gatherings, which can't be banned via executive order and even if congress were to pass a law banning such gatherings, there would be first amendment implications as well as federalism issues.
I don't know how strong that actually is. Over the past few years, we've seen some Trump work the courts pretty consistently. Even if his administration is doing something explicitly unconstitutional, running something all the way to the Supreme Court can take 6 to 18 months, during which time the unconstitutional order would stand (if not stayed early on).
OP's point wasn't "this is only going to have very limited effect", to which your reply "better than nothing" would be appropriate.
Their point is that there's absolutely no effect of banning travel between two areas with similar prevalence, based on rather simple logic.
Take two bags with mostly white and a similar number of red balls in them. Then, twenty times, grab one hand from each bag and empty it in the other. What's the expected change in number of red balls?
First infections are not uniformly distributed. Second, by the nature of travel people get into close contact with more and more importantly different people than usual. 200 people sitting in an aircraft for 2 hours is inherently more risky than 200 people sitting in a theater for 2 hours as aircraft mix people from wider geographic areas. So, regardless of infection rates, this is beneficial for both Europe and the US at the same time.
Multiple cities with hundreds of thousands of people in both the US and Europe are infection free right now. Extending that for even a few weeks is very useful.
This is false. Any reduction in travel is going to have a positive effect. The best situation is for people to reduce their exposure to other people and to stay at home. If they do need to be exposed to others, the best is for them to be exposed to the same set of people all the time, and not to different sets of people.
This seems not fully worked out. Assuming total travel is constrained, selectively limiting travel to particular areas concentrates travel in the remaining areas, which increases the average number of contacts between travelers, which violates your “reducing exposure to other people is best” rule of thumb.
By your model, some reductions in travel ought to have a negative effect. Is that a fair corollary?
There’s no such thing as a fixed amount of travel, and constraining it on one way concentrates it in another. That makes no sense. Constraining travel will reduce travel, which will reduce interactions between people, which will reduce the spread of the virus. We know this empirically from previous outbreaks and countermeasures.
The pressure / desire to travel is also dropping sharply, though.
Limiting all Schengen traffic is an extreme example, but it's not obvious that some level of restriction would necessarily produce a significant bottleneck effect (given that citizens are exempt).
Why would you assume total travel is constrained? Restricting travel from Europe to US will just eliminate that portion of travel, not concentrate it in the US.
There is an effect, because traveling itself creates chances for exposure. Anyone traveling on an airplane or train in close quarters, or passing through an airport or transit facility, can pick up or pass on an infection.
By your last analogy, the red balls would have paint rubbed off them in the exchanges.
Yes, but then we should be canceling all flights in the US (we should be). Only canceling flights to Europe is a tiny fraction of what's actually necessary here.
It’s a matter of timing. Europe has higher concentrations of the virus than the US. The chances that a plane from Europe contains an infected individual are getting quite high.
When the concentrations in the US get higher it will start to make sense to constrain travel more over there. Right now the chances a domestic flight contains an infected individual is quite low, but that won’t always be the case.
Bear in mind the virus cannot be stopped, or contained at this point. All we can do is slow it down while also limiting the harm our countermeasures cause.
It’s only a matter of time before it starts over there again, even if through back-propagation from other countries. Everyone’s talking as though China solved the problem. Incredible.
They don't need to solve the problem, just keep the infection rate slow enough to be controlled medically. And then keep everything locked down enough until we can get a vaccine produced. Admittedly, a gargantuan task, and I don't think it's going to happen anywhere else.
They don't need to do that either, they could just let more people die.
That's what you're proposing, if you don't realize it. If you get the growth rate below 1, you can wipe out the disease, instead of merely delaying it.
Apart from the other two replies, the corollary of your point is that travel from a lower incidence area to a higher incidence area actually reduces the risk in the latter.
But this is clearly false because population density is another important factor for contact between people.
It's not just about containment, which signs point to being past us. If we slow the infection and spread it out over time, we do a couple things. Slowing it gives us time to develop tests and treatment and processes and systems to deal with it. Spreading it out over time means that at any given moment fewer people need medical care. Like, if everyone needs care tomorrow, obviously the system can't handle it, but if a few people need it tomorrow, and a few the day after and so on, spreading it out over time, the system can handle a few at a time.
Travel bans alone will not flatten out peak infections that are going to overload our existing healthcare infrastructure that already run at near maximum capacity during regular, non-epidemic periods.
There is a lot more leadership across government (federal, state, local), private industry, and independent individuals could be doing to proactively reduce transference and even stomp out significant portions of infection is followed through. My point is that our cultural trends surrounding all of these (governments, work, personal action) are almost all running counter to what we need to be doing.
We need strong government leadership at all levels pushing support out where possible, be it resources, accurate non-politically influenced/dictated information, etc. Businesses can be more proactively supporting work from home more where feasible, extend sick leave or create sick leave options to reduce pressures to work, provide some security/continued employment for those who need it (especially demographics at high risk). People can avoid attending work when sick, reduce/limit public exposure (be it out shopping, attending an event, etc.), practice frequent hand washing, limit exposing themselves to at risk populations, etc.
Economically it's a disaster (as the markets are also anticipating) but it's going to be one way or another. It seems to me that you're better off to take a well calculated hit that can bounce back to a healthy workforce that doesn't strain existing healthcare infrastructure than trying to pretend nothing is going on, minimal fallout will occur, and play-it-by ear.
Well calculated hit in an economic sense. As a side effect I suppose you could argue that some economic losses can lead to deaths... but that's certainly not the goal.
IMO the only reason we aren't reporting large numbers of new cases is because of the lack of widespread testing currently being done compared to other countries at this moment (other countries are performing magnitudes higher tests a day).
Even if you think you have it, there's still not enough test kits available yet - even if you're swabbed it can be days for a result(Saying this from west michigan).
And because people with mild symptoms aren't likely going to the doctor. They can't afford to take off work and go, and if it's simply mild right now, why risk their livelihood? I kinda hope this whole thing is a wake-up call for why our system is so unsustainable.
People on reddit (take that as you will) have been reporting that even if the symptoms are significant and match the profile, tests aren't being run if no travel has taken place recently. These people get turned away.
COVID-19 doesn't mean there aren't regular flu / colds going around, too.
Long distance travel and exposure to those who have been (e.g. hugging your wife got off a plane from Spain 2 days ago) is still a top predictor for exposure.
> COVID-19 doesn't mean there aren't regular flu / colds going around, too.
Which is exactly why everyone with those symptoms needs to be tested. One of the most important things we need to do right now is detect the people who got the virus through community transmission.
> Long distance travel and exposure to those who have been (e.g. hugging your wife got off a plane from Spain 2 days ago) is still a top predictor for exposure.
I'd say that testing those people should be lower priority, since an assumption they're infected is more likely to be accurate, so they can take preventative measures without needing a test.
> Which is exactly why everyone with those symptoms needs to be tested.
This. I'm in my twenties so it's very possible for me to get COVID and only experience cold like symptoms (or less!). I'm sorry to everyone, but I won't self-quarantine myself for 14 days just because I have a stuffy nose (it's likely a cold right?). I'm fortunate enough to have the ability to take time off/work remote - but what if it's a cold this week and COVID in two weeks? I can't take a month off.
I'm from West Michigan - ATM there's very little testing available, and I'd only be tested if I had recently traveled. But we're past the point where recently traveling is such a big indicator - we're seeing plenty of community transmission for me to believe it's very likely everywhere already, and any lack of cases is because of a lack of testing.
This is a twice-in-a-century event. (Consider AIDS the other pandemic.) Our system should not be built for outlier events. Instead, we should make exceptions for those outlier events. (For example, we could have salary supports for those in quarantine and unable to work remotely equal to their average reported income over the last 12 weeks || a minimum wage and support for landlords or mortgages until the pandemic ends.)
Overpay for an extreme case rather than adapt your system around it.
Now, I have other complaints about our system and how it is unsustainable, but this is a poor argument as to why.
yes, the case count is about to sky rocket because wide spread testing is coming online but hopefully the fatality count doesn't. I think the authorities need to do a better job communicating that a steep rise in cases detected doesn't mean a steep rise in severe or lethal cases.
I think a steep rise in infection counts due to increased testing/detection would be a great thing. More data is always better in these situations and more confirmed infections with confirmed recoveries would probably ease everyone's minds a bit more.
To be clear I'm not saying more infections are a good thing, simply that if there are a lot more cases that already exist, knowing they exist and having more accurate data that shows us COVID19 is less harmful than currently perceived/projected would be good for everyone.
The president didn't say that the virus is a partisan hoax. His actions clearly indicate he doesn't believe it is a hoax.
The president did claim that some criticisms about his handling of the situation were a "new hoax" in the same way he has labeled previous unfounded criticism and accusations as hoaxes.
"His actions clearly indicate he doesn't believe it is a hoax."
Huh?
He called Fox News and said on air ""So if, you know, we have thousands or hundreds of thousands of people [with COVID-19] that get better, just by, you know, sitting around and even going to work, some of them go to work, but they get better,""
His whole schtick until just about a few hours ago was that the risks were all hugely overblown.
I am also curious to know exactly which "previous unfounded criticisms" you are referring to.
I don't know if I'd call that blatantly partisan. Stupid, perhaps, or a hamfisted attempt to prevent panics and economic crashes, but it's not especially political.
Yes. Yes it is. How many times has Trump tweeted about the stock market and how it proves he is a great president? Hundreds. Literally. His NEA chair has explicitly stated "I have long believed that stock markets are the best barometer of the health, wealth and security of a nation. And today's stock market message is an unmistakable vote of confidence for the president." His entire political argument for reelection is premised on his "business acumen." His down playing of coronavirus (to what end? why?) was a blatantly partisan attempt to gamble that this whole thing would blow over rather than risk spooking the markets.
Given the impacts that the stock market crash and his handling of the virus crisis are likely to have on the election, it is definitely a political matter. Realistically any time a president comments on anything it is a political matter.
so? That is not the same thing as saying it is a hoax. Plenty of reasonable criticisms to make but that doesn’t mean the President thinks the virus itself is a hoax. I am arguing for clear communication and facts and people are basically saying screw that let’s just spread rumors because, reasons. How is that helpful?
> Even if you think you have it, there's still not enough test kits available yet
The messaging on this has been pathetic. The other day UW in Seattle announced they had a capacity to test 1,000/day. Not adequate for the nation, but for the PNW, sure.
I'm in Seattle. While there may be official "kits" for this, the protocol can be run in any competent lab set up for this type of assay. DNA primers specific for covid-19 would need to be ordered, but this is routine.
ETA: I'm having trouble locating positive control template sequences.
I am happy for S. Korea running 100,000+ tests, and embarrassed that the US has maybe run 1000s at this point. I also think that the virus is widely dispersed in the US and the best we can hope for is to keep the case load at a level manageable by our health care system. I'm pretty worried about that though.
I'm betting we've been seeded since even before Wuhan's quarantine started. My folks and I all got pretty thoroughly sick during a cruise in early January, and they're becoming increasingly convinced it was COVID (especially since my stepmom tested negative for any sort of flu, and this was well before there were reports of COVID outside of China so of course the doctors wouldn't think to test for it even if they happened to have a test kit); it's increasingly difficult for me to be skeptical of that conclusion.
Thankfully all of us seemed to get over it without much complication, and it doesn't seem like very many of the people we've since interacted with have come down with it. We might very well have just been lucky, though.
It seems very likely that many people (especially in areas with lots of travel to/from China) who had "a bad flu" followed by a chest infection in January or early February actually had COVID.
We are unlikely to ever find out, because we won't have a reason to give everyone antibody tests
Small sample size but: similar experience here (in the middle of the USA). One of my son's friend's mother was even hospitalized for "pneumonia" for a few days. This was the first time I heard of a fairly young fit person having pneumonia due to the flu.
A couple of people I know at work (in Canada) had pneumonia in December (I think). Sometimes pneumonia is pneumonia. I assume even more had it and I just don't know.
Neither of them had traveled anywhere recently.
I dunno, where was your cruise and were there lots of mainland Chinese people on it? Sadly the symptoms for CoVid-19 are pretty common across a variety of diseases, so “flu-like but not flu” doesn’t necessarily point to this. At that time during the outbreak, it seems likely you would have needed to have people from Wuhan on-board.
Los Angeles → Catalina Islands → Ensenada → Los Angeles
> and were there lots of mainland Chinese people on it?
I mean, I didn't exactly go around asking people "are you from China?", but based on the number of people who sounded like they were speaking Mandarin I'd tentatively answer "yes".
> Sadly the symptoms for CoVid-19 are pretty common across a variety of diseases, so “flu-like but not flu” doesn’t necessarily point to this.
Indeed, which is why I'm still at least somewhat skeptical. Still, it's hard to rule it out, especially given the relatively-severe symptoms (not the absolute worst I've felt, but it was pretty bad).
Lots of people live in LA who haven't been to China in decades speak Chinese as a first language. The relevant question is whether there were many people on that cruise directly visiting directly from Wuhan/Hubei. LA-catalina-ensenada-LA? Doubt it. Not exactly the type of cruise someone flies thousands of miles for.
True. Like I said, it ain't like I was going around asking people if they're from Wuhan, lol
That said, you'd be surprised what draws tourists from mainland China; Las Vegas and Reno (for example) both get plenty of Chinese tourists looking specifically to gamble, and I'd imagine the ship's onboard casino to have a similar appeal. Plus, there were plenty of other tourists from long distances, too, both from within the US (East Coast) and from Europe and Australia (from what I gathered from the people whom I did talk to). So evidently there were at least some non-Chinese tourists flying thousands of miles for it; seems reasonable that some mainland Chinese tourists might, too.
That's a really good dataset (with a really clunky visualization, but hey!)
Indeed. There are typically above 3000 deaths/week due to Pneumonia and 200/week due to influenza at this time of year. We had a smallish spike in mid-late January, where for 3 consecutive weeks, deaths were above trend at nearly 4000 & 400 per week.
If you assume a 1% mortality rate for COVID, and you assume all deaths are due to pneumonia, and you assume the entire late-January spike is due to COVID, that could be hiding 300,000-400,000 US cases. (To be clear, those are all questionable assumptions! The mortality rate could easily be either lower or higher, a meaningful fraction of deaths might not show as pneumonia or influenza, and it is normal for there to be a moderate spike above trend at some point in the flu season)
That doesn't mean that there were or weren't a few hundred thousand cases in that time -- it just means that some significant number of cases could easily hide in "routine-looking" spikes in the graph.
This does mean, though, that it is unlikely that everybody who got "the really bad flu" that's been going around this year actually had COVID -- but, especially if you live in a place with lots of people who travel to China regularly (like I do!), it isn't unreasonable to wonder if that "really bad flu followed by a lower-respiratory-tract infection that tested negative for influenza" you got in late January/early February wasn't really COVID.
(Remember, though, that while the rapid influenza test has a pretty low false-positive rate, it's got about a 50% false negative rate -- so testing negative shouldn't lead you to assume it isn't influenza)
If you are in ICU with flu symptoms, they don't just shrug when the rapid influenza test comes back negative. There are reflex tests that can be run to confirm positive or negative.
Critical cases and fatal cases are way more likely to be detected for this reason -- but during the 3 weeks I was talking about, it was believed that there was no COVID in the US, except for folks evacuated from China to quarantine sites.
During that time unexplained pneumonia leading to death -- especially in an older individual -- would likely not have been thought to be COVID, and would just have gone on the books as pneumonia.
14% of cases result in severe pneumonia. R0 is about 4. Average incubation time 6 days. Average time to death/severe illness from onset of symptoms 16 days. If your folks and you got COVID before the Wuhan quarantine you would know someone, likely several people, personally who is/are in the hospital right now with severe respiratory distress.
We're not really hearing any reports of unexplained deaths that might be covid deaths, and the US is advanced enough to not miss deaths like that, so one thing that might put an upper bound on how behind we are. Then again, there's a delay while symptoms progress.
This already happened in Seattle [1]. Undetected COVID deaths are not "unexplained" because they look like flu deaths, so they're simply catalogued as being from the flu.
"In fact, officials would later discover through testing, the virus had already contributed to the deaths of two people, and it would go on to kill 20 more in the Seattle region over the following days."
[1] https://www.nytimes.com/2020/03/10/us/coronavirus-testing-de...
It cannot be contained. That’s what the pandemic declaration means (even though the WHO should have done this weeks ago).
At this point, the only rational thing to do is to try to slow the spread. The good news is that this is a very mild virus, and the vast majority of infected people will have minor symptoms. The fatality rate in Korea is currently 0.6%, and becuase of the comprehensive nature of their testing, this should be considered the upper bound on CFR.
It cannot be contained. That’s what the pandemic declaration means
That's the exact opposite of what the WHO said when they made the pandemic declarations:
"We cannot say this loudly enough, or clearly enough, or often enough: all countries can still change the course of this pandemic," reads a statement from Tedros Adhanom Ghebreyesus, director-general of WHO.[1]
It is not the exact opposite in any way. Your quote does not support your assertion. The truth is that it cannot be contained. It can be slowed down though.
But that's not true. While lethality is estimated at tops 3.6%, the cases requiring hospitalization, including breathing apparatus, etc are quite high, and it WILL overflood the capacity of hospitals in virtually every country that didn't take really really serious precautions, of which there are only a handful.
It will be a big problem both in Europe and in the US, because they are starting to take measures only now.
The vast majority of cases are mild, like a head cold. This is a fact, and has been reported around the world.
You’re arguing about relative hospitalization rates, but that has nothing to do with the discussion here. Mild cases aren’t clogging up ICU wards at all, because they’re quite mild.
I think you mean that this should be considered the goal upper bound on CFR. It's really the lower bound on CFR if you do everything right. If you do everything wrong, like the US is heading towards, you get overloaded health systems, critical shortages, and a 12% CFR or higher.
A 12% CFR is overstating it, but also because we won't be counting the heart attacks that weren't treated, the chemo and radiation therapy that was postponed, and the other health effects.
I think the true measure will be the year over year total mortality.
If we overload our hospitals then CFR will go towards the number of cases that require hospitalization. Which is around 20%. Italy is currently far over hospital capacity and has a CFR today of 8% and rising.
Media and government keep making this claim, yet where are the recovery numbers of people? It drags on for weeks and weeks with no end in sight, correct? And current case fatality rate in Italy is 8%, was 7% this morning, was 6% yesterday - because they do not have hospital resources for the number of serious cases they have.
Serious, critical, and dead outcomes are said to be over 20% of case. This being described as "very low, a very small number" by certain people. That is not a low number at all.
South Korea has been at 0.8% the last two days, and will continue to climb as their open cases resolve one way or another. Plus, didn't they just have a spike in Seoul?
There was a spike in Seoul. Based on their reaction so far, I have a great deal of confidence in their ability to isolate it and react effectively.
Regarding the rise in CFR: it will naturally go up as cases decline, because fatalities stem from a time when the case rate was more rapidly increasing. Korea’s case rate had been declining for several days:
It IS happening in Italy, and it definitely happened in China. The difference is that Japan, South Korea and Singapore have much more powerful nationwide governments. This allowed them to put infection controls in place much earlier than we have in the USA. It remains to be seen where we top out, numbers-wise, vs. hospital capacity.
Here in Washington Governor Inslee declared a State of Emergency, which gives him the power to, among other things, mobilize the National Guard and State militias to establish field hospitals. This is essentially the same reaction China had with regard to building temporary hospitals, but at the state level instead of the federal level. We don't need federal powers, just competent state leadership.
My Bellevue daycare told me today that they probably won’t close unless a worker, kid, or family member gets the virus or...the state shuts them down. Fun times.
I’m ok with their precautions. Not only are they keeping things super clean, but they are giving my kid more hygiene education and training then I could possibly do on my own. For example, washing hands at home is a bit of a struggle because the sink is so high, it is much easier to drill in the habit at daycare, not to mention the peer pressure they apply by making a game out of it for all the kids at once. Child psychology is working for us in this case as long as it remains safe.
The Japanese response has actually been pretty lackluster and haphazard. I'm rather surprised rates there have not been exploding the way they did in Korea, Iran and Italy.
A colleague and myself were pondering this today. He mentioned the 'bow', and general cultural aversion to physical contact. I found that interesting and plausible to consider.
The Japanese response was not so bad when viewed in hindsight.
In comparison, Korea's response was disastrously wrong. Their "Let's test everyone" policy sent lots of people into medical limbo ("We can’t let you go because you're COVID-19 positive ... but meanwhile we have particularly nothing to do for you because you're not that ill") and got their hospitals flooded with mild cases.
Singapore did a top job containing it but it's a small country, one airport..., countries like the US or Italy on the other hand will have a different outcome.
It'd be pretty sweet if it took a pandemic for the government to solidify sick day laws.
Too bad money making is somehow above preventing others getting sick. People wouldnt show up to work if they didn't have to worry about their wages. I'm sorry but 3 sick days is garbage and requiring doctors notes is asine when your healthcare plan is shite. Not to mention wasting a day in a hospital. Companies can afford this stuff. It's not often and it's minimal to say the least. But God forbid a small business can't have someone for 80 hours a week at minimum wage!
I've seen many tech companies in the Boston area announce employees can (or must) work from home, since the governor of Massachusetts declared a state of emergency on Tuesday and encouraged such actions. All governors should do likewise.
Admittedly, the Biogen conference was... a bit of a fuck-up. But yes, all our universities are sending their kids home, white-collar workplaces are moving towards WFH policies, etc. I've been WFH since earlier this week myself, and I went shopping for food and soap with my wife Tuesday night.
I'm seeing more indications of people taking things seriously. The first cases were announced in my state (Michigan) today, and already most universities have cancelled in-person learning, various gatherings are being cancelled, etc. It sounds like my church—on the west side of the state (the two confirmed cases are on the east side)—will be altering plans, perhaps even cancelling services as early as this Sunday. The concept of "social distancing" is rapidly gaining steam.
This depends on how you're defining containment. Grounding aircraft may not decrease the current case count, you're right, but it may help not adding to it, or adding as much, or as fast. Because of this, it may still be worth doing.
The notion that we're going to abandon containment measures in favor of mitigation, which I've seen in many places (not in your comment though of course), is wrong. We're going to be doing both.
As someone posted on FB, the infection rate spikes a lot more with no measures, and flattens with more preventative measures. So while the same number of people may be infected overall, it lessens stress on the healthcare system when it is more spread out.
Which democratic(* - I was going to use Western) nations do though? Seriously the freedom enjoyed by those in these nations and the significant time any global conflict or pandemic have pretty much restricted the ability of leadership in those countries from taking action that would have any true effect short of trying to implement martial law, which in most countries would be met with protests and in some with courts being tied up.
Now I will not attempt to speak for Europe but the US government could certainly push short public advisories and messages to adults and children through broadcast TV and even get the cooperation of streaming services as well. Short thirty to ninety second spots that give helpful non panic information.
The US President is hamstrung by both political disagreement and the law. There were articles he is loathe to declare any national emergency declaration until approached by the governors of many of the states. If he did without states approaching him and asking you can damn well guarantee there were would be Democrats out there claiming he was trying to be a Dictator and comparing him to Putin. The same article concerning the declaration also reveals all the behind the scenes work going on with Congress to get funds in place before any message is put forth so that the government as a whole looks to be cooperating as well as acting appropriately.
The current administration in the US has been more proactive than any previous administration during any previous outbreak, despite the deluge of criticisms that were surprisingly absent during said previous outbreaks. The measures that have been taken thus far are more than aggressive enough, based on the information we currently have. We're just a few steps away from shutting everything down completely, which wouldn't be good for anything at this point. It doesn't get much more proactive than that.
To reiterate what others said, it is long past containment in the United States. In Canada early on the cases were people who came from known hot spots. Now it is almost entirely people coming from the United States, from places with no known cases.
Clearly there are clusters throughout the United States. Unconfirmed, unrecognized clusters. And with the adversity of many to utilizing health care, it seems impossible to deal with now.
It's also worth noting that this flight ban applies only to non-Americans, just as the Wuhan restriction before did. During the prior travel restriction dozens of flights a day were going to and from Wuhan -- they just had Americans on them, who apparently aren't susceptible to the foreign virus. This new restriction is identical, allowing Americans to march the globe with their COVID-19, but at least they kept out the foreigners.
Instead of any actual efforts it is again mere security theater. And again Trump will pat himself on the back for his very-close-to-useless theatrics.
I think elementary/high schools are how this will spread through communities with the most efficiency. Collect a person from each family, mix them together with the poorest respect for hygiene, then send them home, 5 times a week.
Here's the perspective of a San Jose public high school [1] proving that containment isn't a concern:
> Oak Grove High School officials said they were not considering school closures because “children have not been shown to be a high-risk group for serious illness from this virus.” The Centers for Disease Control said last week that limited reports showed child COVID-19 patients in China had generally presented with mild symptoms.
> “As much as possible, children should be allowed to carry on with their education and normal activities,” school officials said.
Related, a family member received a "exposure notice" from her child's school that one of the students tested positive. No closure.
There's no attempt for containment in the US. My hunch is that it's not needed as much as is being suggested by some. I guess we'll see.
> It's also worth noting that this flight ban applies only to non-Americans, just as the Wuhan restriction before did. During the prior travel restriction dozens of flights a day were going to and from Wuhan -- they just had Americans on them, who apparently aren't susceptible to the foreign virus. This new restriction is identical, allowing Americans to march the globe with their COVID-19, but at least they kept out the foreigners.
Well presumably they'll always allow non-Americans to leave. As for americans, they would still have to wade through quarantine or whatever restrictions the other country requires.
For entry into the US, does the govt even has the power to keep americans and permanent residents from entering? Seems like every country will at worst only quarantine its own people.
The US can't restrict its own citizens from returning (although it could certainly impose a quarantine), and I didn't claim or imply that they should.
The point is that the action is farce. Those flights to and from Wuhan were always full of primarily Americans, and continued unabated. Just as Americans can still fly to and from Europe, though obviously carriers are going to drastically cut the flight counts.
Regardless, it is without an ounce of doubt that COVID-19 is spreading, completely uncontrolled, throughout the US. Italy is a week or so ahead of the United States, but sadly the most probable outcome is a catastrophe in the near future.
I agree we are maybe 1.5 weeks behind Italy. Though hopefully it never explodes quite as fast in most of the US due to lower population density and other cultural differences. But as for travel bans, the complaint is that they only slow the spread, in return for economic and other downsides. But I'll take that. The flatter the curve is the better.
> Can anyone comment on supply chains that rely on Europe to source goods? I know medical grade steel comes from over there, but I don't know what else.
I don't see why commercial sea-shipping would be restricted.
Mariners may not be allowed to leave their ship while in port though.
He issued it by now (though the tweet reads as if written by someone else). I think it would've been a disaster banning cargo, with little benefit. Banning people could actually help to slow the spread of the virus. And ironically it could help Europe if they get infections better under control than the US.
> It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.
> In general, because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks at ambient, refrigerated, or frozen temperatures.
The CDC themselves were involved in the study that says you're wrong.
If someone is able to find the source for this info I'd really appreciate it. Just spent like 10 minutes trying to find the paper they're citing but I can't find it and I don't have time to keep looking now. Maybe it isn't published?
I'm just going to quote the CDC again, because public health authorities are really the best sources of information we have and I don't want to participate in the "telephone" effect that paraphrasing begets:
> The virus is thought to spread mainly from person-to-person.
> * Between people who are in close contact with one another (within about 6 feet).
> * Through respiratory droplets produced when an infected person coughs or sneezes.
> These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
As a non-expert on coughing dynamics, it seems incredible that one person can infect 50 others by this mechanism (reported New Rochelle transmission from one patient, confirmed by contact tracing and testing contacts).
At a carnival party in Germany with 350 guests, more than 40 were infected by a single guest. That gives an idea how well it spreads in enclosed spaces. You can assume there was somewhat close contact, but I've been to business meetings with also at least 5-10 people <6ft from me. That's how it can spread through a company within days.
I have not been to carnival parties for 20 odd years, but as I remember them (in NL/border with DE), everyone is drunk, hugging, kissing (often on the mouth with perfect strangers), vomiting, not washing hands after toilet (is there a toilet even??), falling over each other and also having sex. Maybe times have changed, but if it still is remotely like that I can definitely see someone infecting 40+ other people.
I mean, we have city parties here 'for all the family' which result in everyone touching each other (just as friends mostly of course but still touching hands, shoulders, neck, face, back), kissing (mostly on cheeks with strangers, but you mostly 'friendly' kiss everyone meet/talk/dance with and otherwise shake hands or even both) but all the other factors do apply as well; bad/no toilets, no soap/water, everyone drunk so who washes their hands anyway, vomiting and not being so careful with putting your sleeve in front of your face when you sneeze or cough... I only go during the day to such things if I go at all (when most people can still walk up straight) because it is rather disgusting after a while (I am old; I used to like that when I was young), but I can see a few people infecting basically everyone if they are popular/drunk enough.
Thanks, that's interesting and not something I've heard before. I think the CDC etc should make this clear : it isn't "an infected person sneezing near you" but "a volume of air into which someone has sneezed in the past few hours". If people knew this I think they would be more inclined to accept the distancing measures.
So there's a constant conflict between simple and easy to understand but not totally correct info, and scientifically correct but incomprehensible to most info.
Someone sneezing in your face = really bad. Someone sneezing an hour ago vs. touching something they just sneezed on... hard to say which is worse.
I get the statistical mechanics aspect, but surely saying "It can spread through the air in enclosed spaces up to <x> m and for <y> s" is understandable by anyone?
That study isn't saying anything contrary to what the CDC is saying. Or am I the parent that you're agreeing with, and you meant "regardless of whatever the CDC is saying?"
Maybe I misinterpreted what you meant. Your quote from the CDC said that the virus has poor survivability on surfaces, but the study I linked concluded it can survive for 2-3 days.
These are not mutually exclusive statements. It probably can survive for weeks in rare cases, but if it doesn't do that often it doesn't matter.
Any method of transmission that infects fewer than one additional person on average are effectively negligible on the overall exponential curve.
So yes, it is likely possible that symptomatic people can infect others, and it is likely possible that a contaminated doorknob can infect people for a week, but if these things happen rarely enough, it doesn't matter. The virus will die out if other routes of infection (e.g. the more typical person to person transmission) can also be made rare enough.
I see the point you're making from an epidemiological perspective but, because it's so important to people from an individual perspective to avoid contracting the virus, I have to take issue with your claim that it is likely possible to contract the virus from a surface after a period of a week or even weeks. I haven't seen evidence that would substantiate such a claim. According to that preprint linked above, even a period of one week on a steel door handle is more than six half-lives past the "death" of the last detectable viable COVID-19 virus. The science is not all in yet, and it may indeed turn out that COVID-19 is much hardier than we thought, but until then I don't see how you can say that it "probably can" survive for weeks in some cases.
I apologize if this is coming off as pedantic but the damage being done by misinformation and speculation about the coronavirus is significant, and I don't think it's possible to be too zealous about precision here. Trump's claims that fears were overblown and a "hoax" have been amplified into widespread and potentially deadly skepticism that coronavirus is even a danger. People have suggested various quack cures that at best drain the resources of vulnerable people. Even saying something as seemingly-innocuous as "wear a face mask to reduce your risk" ends up having a devastating impact on healthcare providers who really need the masks but can't source them. We should be listening to public health authorities and mainstream health experts, and taking reasonable precautions, but absolutely refraining from speculation that might have unforeseeable consequences.
The relevant part of the CDC quote was "because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks" and the study preprint you linked showed that in the worst case (polypropylene surfaces) no live virus at all was detected after 72 hours while on cardboard it was more like a third of that time (with large error bars).
That might be so, however there are enough names from enough reputable research centers to take it at face value. If we need to wait for printed peer-reviewed journal papers to combat an active pandemic then we might be waiting a while!
China Post has been shipping stuff and spraying it with disinfectant. I don't see why that would be a problem. Also doesn't it take more than 9 days to sail across the atlantic ocean?
Actually, to a large extend it's fuel prices that cause these "low" speeds. Many cargo ships can be a lot faster if they have a reason that's worth the massive increase in fuel usage.
“An analysis of 22 earlier studies of similar coronaviruses, including Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) published online this month in the Journal of Hospital Infection, concluded that human coronaviruses can remain infectious on inanimate surfaces for up to nine days at room temperature.”
It's a half-life thing. The larger your initial sample, the longer the sample can go and still have enough infectious ability left.
Scenario: Infected person sneezes over a large area and deposits over a wide area. Then you come by 6 hours later and touch a deposited surface and then 10 minutes later touch your eyes.
Each transition only picked up a fraction of what was left.
And each time period left only a fraction of what was there.
More important to limit travel, limit direct/close contact and clean commonly used surfaces frequently.
And better to avoid replicating the environmental conditions that created the "up to 9 day" figure: low temperatures and low humidity.
I'm not sure where this level of panic is coming from.
Numbers are about to spike everywhere pretty much no matter what anybody does, because better testing and funding has become available.
Quarantining an entire continent, and even worse than this badly doing it, seems to be an astonishing overreaction. The average age of death for coronavirus victims is 83. The mortality rate seems to be as low as 0.6% in South Korea or as high as 5% in Italy. Italy is especially vulnerable because it has the oldest population in Europe which is one of the factors that is leading to the 5% figure from there.
It is not an End of Days zombie apocalypse.
I recently watched a speech by a US mayor which essentially said that the panic over Corona is going to do much more damage to people than the actual virus and I tend to agree. Simple quarantining measures mixed with best practices for infection control until we have more information about the virus seems perfectly fine. Blowing up the global economy is complete overkill and is a typical move from an administration whose response to topics are either to ignore them or sledgehammer them.
Estimates have said that they expect 20%-60% of people to get it (originally [1] but updated according to [2]. Something like 10-15% of those people require hospitalization [2] and something like 0.5% - 4% of people die [4]. If we use the lower bounds on all those we are talking about 6.5 million Americans hospitalized and 327,000 dead. For the sake of comparison, that is almost half the number of Americans who have ever died of HIV/AIDS [5].
I can't believe the 40-70% number. Looking it up, this underscores just how horribly the internet is set up to have these kinds of conversations. If you backsource it, you discover he said "there's a chance" it will hit 40-70%, and then only if no countermeasures are taken. That's very different than what is represented in the cbs transcript.
I saw another seemingly reputable estimate today - some disease person on Joe Rogan's podcast, who was saying that 96 million people could get it, of which 48 million would need to be hospitalized. This makes no sense unless you are predicting a virus mutation. We're not even close to seeing 50% hospitalization rates.
I can. Look at how seriously China shut down cities etc and it still spreads, though much slower. Do you think western nations will take the level of action China has at all or in anyhting similar to the same time frames?
And to be clear, when I say 'I can' I'm not claiming Im right or predicting anything, I really dont know. But this seems as likely as any other scenario especially when experts are saying levels around this.
I can't pretend to be an expert on this. All I can do is defer to experts, look at the numbers as they currently stand, and do some simplistic math. I also don't have the skills to vet the various experts, but I can tell you I have more faith in the vetting process of places like CBS News, BBC, Harvard, Johns Hopkins, and the German government than I do Joe Rogan.
We don’t know whether you get immunity after recovery because the antibodies can be too weak. There are also already multiple strains and immunity to one strain wouldn’t guarantee immunity to the other strain.
FOR CLARITY - I'm not saying that there isn't a need to take measures to protect people.
However, I do believe that a lot of inaccurate information is being presented. The public attention on this subject is enormous, making it a ripe topic for the media to profit from alarmist headlines.
[0]The source of the 40%-70% figure has since dramatically altered their estimates, and added several qualifiers.
He lowered it from 40-70% to 20-60%, hardly a qualitative change. The fact is that under essentially any epidemiological model, if you have R0 > 1 and no countermeasures, it's going to hit a sizable fraction of the world population, because the exponential growth only gets stopped by running out of victims.
But the point of this thread is discussing why countermeasures are justified. I'm saying that you should expect a disaster if no countermeasures are deployed -- which is exactly what you're saying too.
The subject of this whole discussion is that there's a travel restriction being put in place. This is why I believe promoting numbers that were arrived at prematurely (I would argue unethically, with the intention of being 'first' in the news) and that specifically don't account for countermeasures to be a bad idea.
We should be trying to promote risk assessments that are situationally correct.
Fair enough. I will update my numbers. If you have other sources to show that any of my other numbers are off, I am open to adjusting them. I have a feeling the totals at the end will still be alarming.
I put the sources above. If you read through, you see that not only did the numbers change but also that he specifically made predictions based on a scenario where zero attempts to mitigate infection were taken.
The first time I clicked on that twitter link it only showed two tweets and not that whole thread. The site was probably under unusually high load in the immediate wake of Trump's speech and the NBA news.
After reading the entire thread, he didn't say "zero attempts to mitigate infection". He said "without effective controls". He also said " Increasing evidence that the extremely intense control measures in China have reduced transmission while they are in force. As long as such intense control measures are in place it is possible to imagine keeping the number infected well below 40%. I don't believe most countries (maybe not even China) can keep such controls for months or a year, the minimum time frame for potentially having a vaccine. But even more moderate ones if effective could reduce incidence considerably". Not even Italy has gotten to the extreme measures that China was implementing. Also if you read his more recent tweets you will see that he thinks the European travel ban is futile.
Overall it sounds to me like that 20% number that I have been using since your first post is the updated number based off of our current mitigation strategy. I don't see any indication that he thinks that number is too high given the current path. Once again, I am completely open to learning otherwise if you have something that you can point to that clearly states otherwise.
There's no "they". That's one guy, making a paid appearance to the media.
We don't know enough about the virus to predict almost anything about it and are learning more every day.
I feel like people have already made up their mind about this by reading some extremely poor sources rather than bodies like the WHO so are going to panic no matter what people say.
The best option here would be for me to come back in a month and we'll reexamine the comment. 625,000 is literally insane.
That specific source is not the only one stating those numbers. Here is Angela Merkel saying as many as 70% [1]. Here is another doctor saying 40% [2] (sorry there is an autoplay video on this site).
I tried modeling infection rates, number of infected, and total number recovered and dead. Couple of things stood out.
1. Reducing the transmission rate lowers the total number of people sick at one time. Lowers the ultimate number who contract it. And pushes the peak infection rate out.
2. The above numbers are very sensitive to r0.
3. An exponential when it hits looks like a wall. You end up with a significant percentage of the population sick at once.
Could be my model being shitty but it looks like at high r0 there is a momentum effect which drives the total number infected above what you would expect.
You’re describing a typical SIR model (susceptible infected recovered) which can be solved analytically. You can see the dependence on all those points you mentioned above.
Note this is a “mean-field” model (everyone evenly mixed together) so take it with a grain of salt...
That's what I was trying to do. I thought it would be interesting to build one and play with it. The issue with it being a mean model vs a mixes contact model noted.
Death is not the only thing that coronavirus can do to you.
You can spend weeks or months in therapy before you are recovered, or you can get scarring in your lungs - or worse - that leaves you with a permanent disability. Not to mention damage to other organs.
I think many are discounting, or are unaware of, these other nasty possibilities. We don’t know enough yet of the prevalence of these effects, but we do know they happen.
> You can spend weeks or months in therapy before you are recovered, or you can get scarring in your lungs - or worse - that leaves you with a permanent disability. Not to mention damage to other organs.
Given that we've only been tracking the virus closely for 2 months, and we've only had a decent sample size of patients for only about 1 month, you really can't be making claims like this at this point.
I'm not making these claims. A senior doctor in Western Europe is making these claims[1].
> Fatality is the wrong yardstick. Catching the virus can mess up your life in many, many more ways than just straight-up killing you. "We are all young"—okay. "Even if we get the bug, we will survive"—fantastic. How about needing four months of physical therapy before you even feel human again. Or getting scar tissue in your lungs and having your activity level restricted for the rest of your life.
Because World War 2 killed 3% of the general population.
The coronavirus, in a single country, has killed 5% of infected people and elder people or those with pre-existing conditions are majorly overrepresented in infection rates.
>World War II killed 3% of the human population, and that's where we're headed if we don't stop it.
This isn't just wrong. It's irresponsible for you to be saying these types of absolutely incorrect things.
The chance right now that you will know someone you love being killed by Corona is really realistic.
I'm not sure how you think how critical it is. I personally have never had this issue and do not mind at all to lay still for a whole year to try to reduce the risk of this happening.
> The chance right now that you will know someone you love being killed by Corona is really realistic.
Unless all the people you love are over 80 (in which case the chance of them dying before Corona hit was not much less realistic than it is now) that sentance is just completely false.
It’s not only over 80s. It’s anyone with cardiovascular disease, diabetes, hypertension, morbid obesity, and some others, which collectively describes large swaths of the US population.
Everything from smoking to high blood pressure to diabetes to old age to obsesity is considered a "pre-existing condition."
Yes, killing 5% of infected people is serious, especially when viruses of a similar family regularly infect 20% of the population, and the population has no inborn resistance to this partical virus, and it is, provisionially, more infectious than similar viruses.
Simple models suggest we'll have 500k deaths or so by 2021. Of course, it could be less than that, but it could also be more. It's almost certain we'll end up with some days with a 9/11 worth of deaths; it's just a question of whether that's a few days or for months on end.
No we're not. That's absolutely absurd to claim. It might -- MIGHT -- kill 2-3% of people who are highly susceptible to it, people who are in their 70s+, people with cardiac and respiratory disease. Maybe. We don't even know that will happen, because we can probably save a huge percentage of that population as well.
Additionally, for someone calling others' claims bullshit, your numbers have no correspondence to reality. In Wuhan, the 3% number was for the general population; for the 70+ age range, it was ~20%.
If you don't control a disease, the default assumption is that it infects a substantial fraction of the whole human population.
In almost all examples in human history, whenever a disease stopped, it was either because it burned through most of humanity, or because people decided to make it stop. They don't stop themselves.
> You're pretending we will take no measures to control this at all. That's simply not the case.
the US gov't has spent the last 1.5 months doing nothing to contain this at all. ending flights from europe isn't going to do anything to help if they aren't testing people and preventing spread inside the country
This is false. Studies done in Wuhan show that people with CVD have well over a 10% mortality rate. In addition, COVID-19 has the potential to cause permanent disability if it does not kill you first.
There is a panic.
Doesn't matter if its justified (its not, imho).
But it is real and it has the potential to seriously damage the economy.
A tanked economy will harm far more people than this virus.
If the ban gives sufficient reassurance to the chicken littles to induce them not to sell their stocks and invest in toilet paper, it will be a success.
So when the ICU's are all full, and more people are coming in and a space in the ICU is freed up - who gets the slot? A randomly chosen person? Triage? First come first served? Or someone who can pay extra for VIP access? Because one person will get that space, and the next ten people are going to die in the hallway before the next ICU space opens up.
The reason why it's going to go this way is because we won't have the capacity for everyone who needs critical care. And the reason we won't have the capacity is a) lack of proper investments imagining this scenario, where in Japan and South Korea they have this capacity because they've had this experience and know better; and b) lack of discipline to weld ourselves into our homes or even voluntarily self-quarantine in order to slow things down and effectively give us more critical care capacity.
I spoke to 1/2 dozen people today who are traveling. Three think they have this thing, and have 3 of 3 symptoms. I told them not to travel. They said "Oh well" and are traveling anyway. That's what we're dealing with. A total lack of personal responsibility, upon which both the free market and our democratic government is based - and so far this is about as far as we've come.
The European flights being cancelled, seems sane to me. It's not about 1 or 10 people being sick per plane. It's reasonable to assume after a 6-12 hour flight, that everyone on board is infected if there was even 1 person infected at the start of the flight. I don't know the exact number of incoming European flights per day, I think it's about 80-110K passengers? That's what this stops.
Stopping all domestic travel would be better. Short term pain translates into tens of thousands fewer deaths over the next 3 months. China got a handle on this for now because they welded people in their homes. We aren't doing that which means we haven't slowed it down that much let alone stopped it.
Stopping cargo, if that turns out to be accurate reporting, I think is an overreaction.
Improvement due to the seasons isn't simply due to the physiology of the virus itself. People spend less inside and in confined spaces where its easier to contaminate each other. Additionally, the flu does have significant seasonality, and flu season will be tapering off in the coming weeks and months, meaning more healthcare resources to dedicate to coronavirus infections.
It may, but improvement regarding weather is related to people staying inside and in very close contact with one another when its cold/winter, nothing to do with temperature killing the virus.
And with fewer pre-existing conditions. People that already have the flu or coughs for other reasons are more likely to need treatment. Late spring or summer usually has empty hospitals and fewer people experiencing a cold, helping with the treatment of Covid
The President, for want of a better term is an idiot. When there is plenty of time to act he does nothing, and when the crisis is in full swing he makes symbolic gestures that have but one goal: to increase his chances of re-election. This has absolutely nothing to do with public health.
I couldn't agree more. In the next week, we'll see flights canceled to and from most countries in Europe anyway, so this is a cheap attempt to point the finger at Europe, and away at this administration.
> Can anyone comment on supply chains that rely on Europe to source goods?
You know all of the stuff that's made in China? The machines that make that stuff are made in Europe. Well, not literally the ones that make the stuff in China, but the ones that US companies would buy if they were trying to manufacture more stuff domestically to replace the stuff they can no longer buy from China.
It will get interessting. because of the huge container backlog / production backlog in China Europe is facing a serious container shortage right now. Until this is figured out and solved, supply chain management will be a very interesting job.
But by no means end-of-world serious, all life critical things are still getting through. also money buys a lot, even cargo space on ships and planes.
I think yes, literally, European machinery exported to China.
It's a massive export sector for the EU (€127bn), and a chunk of that is to China, but the easily-available statistics lump machinery and vehicles, so I don't have a source.
China has started making some of their own machinery in the last 30 years. The quality generally isn't going to be as good as machinery coming from a company that's been making the same thing for 300 years, albeit for them using it internally that doesn't matter as much when the person who designed the machine is right there and can trouble shoot it in person.
Trade should not be affected. According to the BBC:
The US president said his travel ban did not include Americans who had undergone appropriate screenings - or "the tremendous amount of trade and cargo".
There are tens of thousands of incubating cases in the United States already. How exactly is a few dozen sick passengers per day going to affect that at all? You'd have to literally be picking up and flying in planes full of active cases to even match what we have here already.
This is insanity. No one with any expertise at all recommended it. No one serious thinks this is a good idea. It's not going to do anything useful at all.
Yep, notice how in the speech how many times he mentioned China and blamed Europe for not closing off to China.
Unfortunately this kind of measure is going to increase the R0 of the virus, because some people will think "oh I see, the virus is over there, and now the president has closed off that vector."
Statistically, it did. The overwhelming (!) majority of COVID-19 cases in the US are domestically transmitted. Who cares where patient zero came from at this point? Banning travel is going to do nothing.
I can't even tell if this is supposed to be about Trump. Also it doesn't matter.
There are thousands of borders and even more politicians on this planet and if you don't think borders are the scapegoat for problems the world over, then you're really thinking very small.
Any restriction in travel will help to slow the spread of the virus. If you look at Europe, a sizeable number of cases outside of Italy are still travel related. Stopping all travel is one of the key measures to keep infections local.
I'm not saying the measure suffices. Obviously domestic travel is also a big issue, as is travel from outside the Schengen area. But being one of the people affected (currently in Schengen), I still believe this is a right step. It might not slow infections down enough but it will certainly prevent many cases. Also, it will remind people how serious the situation is.
There was an AMA on Reddit, yesterday I think, with a guy whose employer is manufacturing the tests. He said one of the challenges was some of the materials had to come from Belgium and it was taking much longer to get the supplies in the needed quantities. I'd assume such materials would be exempt if his statement is correct.
You can't get around it by going through the UK. It applies whether you've been to the countries affected at any point in the last 14 days, even if it's not your immediate origin port.
I would imagine anyone who can answer that question comprehensively is filling their boots on some options dealer page right now, in between sips of champagne.
Uncertainty is the worst for financial markets. And we currently have extreme levels of uncertainty. Economically, it seems likely that we'll see a global recession in the first half of the year. Simply because many companies can't produce as much with travel restrictions in place. If governments step in to help this could recover quite quickly for the second half or latest next year. But no one knows how hard it will hit companies and how quick recovery will be. And until we get first indications, markets will continue to panic.
On the other hand, for long-term investors it doesn't seem like a terrible time to get into the market.
My concern is how economies are going to respond to the US being cut off from Continental ports for a month, which as far as I can tell hasn't happened since U boats were in open waters.
Can anyone comment on supply chains that rely on Europe to source goods? I know medical grade steel comes from over there, but I don't know what else.
Edit: apparently the president misspoke.