I will probably be downvoted for saying this, but...
The seasonal flu alone kills half a million people every year. So any mild disease that is as contagious and barely twice as fatal will kill 1 million. And that's what's going to happen with COVID19. It is far more severe than the flu.
We know COVID19 is as contagious, given how fast it's spreading and how unstoppable it is (R0>2, asymptomatic transmission, airborne). And we now have 4 independent estimates that place the Infection Fatality Ratio at about 0.5% to 1.7% which is between 5x and 17x deadlier than the flu (0.1%): https://twitter.com/zorinaq/status/1230977769795776512
Incidentally, this makes COVID19 comparable to the 1918 Spanish Flu (IFR ~2%) according to experts (see link above). And keep in mind the IFR, unlike the CFR, is the metric that takes into account undetected mild cases. The Case Fatality Ratio is around 9% right now.
So based on this, I predict it will go pandemic and will kill 1 million, and probably a lot more.
COVID19 is the most severe (ie. contagious + fatal) airborne disease since the Spanish Flu.
Fortunately we know a lot more about viruses today than we did in 1918. The virus has already been mapped genetically, and many labs around the world are hard at work on an anti-viral treatment. We shouldn't get complacent of course, but it's likely that this thing can be contained and treated eventually.
I read today about a device[1] from Israel that helps the lungs quickly clear phlegm, thus reducing the coughing behavior that spreads the disease. The Chinese are starting to manufacture and deploy it, so hopefully it will cut back on the spread at least a bit.
In particular, chloroquine has been shown to be helpful in treatment and is readily available in developing countries since it's used as a malaria medicine (and there are replacements available in developed countries).
A vaccine is at least a year or two away from going through all the testing and approval it has to go through before it's ready to be deployed on a mass level... if one that's safe and effective is actually found at all.
It's almost better to get infected now where hospitals are not full (if you're in a developed country and generally a healthy person). Wait out 2 weeks, then you build immunity after. Except when the virus mutates :(
Let’s say 40% of the people in the world get it and a 1% fatality rate:
That 30 million dead, and probably another 300 million hospitalized and maybe 50 million that need icu care.
Should probably go without saying that we don’t have the ICU beds to handle that in the western world, let alone in developing countries.
We also haven’t had anything like the Spanish flu in the US since we’ve had the modern health insurance system. Is blue cross going to have the resources to pay for all those extra hospital visits? What about all the long term side effects from the millions of people that had acute respiratory failure and survived.
edit:
Also something else to consider -- what if this goes epidemic in the US during the elections this year? They'll have to cancel rallies, campaign events, maybe even the party conventions.
Germany has half its 83 million population over 48 years of age. Italy is the 5th oldest country at the median. Covid will hit very hard against older populations.
Building on this, what happens if grocery stores shut down as the Just in Time stocking infrastructure breaks down as truckers / workers stop going to work?
> And keep in mind the IFR, unlike the CFR, is the metric that takes into account undetected mild cases.
Interesting, this is always my argument against these fatality ratio estimates, can you explain how the IFR can take undetected mild cases into account? Does it just assume at random how many of those cases exist?
Most look at infection rates among Wuhan evacuees. Since almost all evacuees were tested, it's a good proxy to estimate the city-wide infection rate. See the 4-5 papers linked in my blog post's last section: https://blog.zorinaq.com/case-fatality-ratio-ncov/#updates--...
> The seasonal flu alone kills half a million people every year. So any mild disease that is as contagious and barely twice as fatal will kill 1 million
That’s assuming no containment effort, like with seasonal flu. Of course, it’s gonna happen if health authorities take the same defeatist attitude as you and do nothing.
>Of course, it’s gonna happen if health authorities take the same defeatist attitude as you and do nothing.
I'm a bit confused. Isn't expecting it to be devastating the very attitude needed for authorities to justify engaging in the containment methods needed to reduce the harm caused?
> Of course, it’s gonna happen if health authorities take the same defeatist attitude as you and do nothing.
how long can they get away with locking people up in their homes? There will be tipping point when those who are supposed to deliver the first-response and do the policing will also become a vector for spreading the disease. Things will escalate quickly no matter if the attitude is "defeatist" or optimistic.
> COVID19 is the most severe (ie. contagious + fatal) airborne disease since the Spanish Flu.
It very clearly is and it's out of the box, they can't stop it now. The US should be shutting down all travel into and out of the country, full quarantine from the rest of the world. We'd have a chance at stopping it from doing to the US what it has done to China, if we acted immediately, before it's across Europe and more of Asia and then imported in stealth mode by travelers from those regions that are unaware they're infected.
Back in reality, the US economy will look like China's frozen economy, within a month or two, unless Covid is stopped soon. More likely, it's going to spread from Italy across Europe, and continue to spread across Asia. From those hyper economic zones, the US will be guaranteed to import it from multiple sources (no single country to shut down travel with).
China went full totalitarian to an extreme, and couldn't stop it. Covid froze the second largest economy and did it in the span of a month. What chance does the rest of the world stand at stopping it? None.
Bill Gates is worried about it spreading across Africa (and said in an interview a few weeks ago, when asked about his plans for the year: "well, I plan to travel a lot less this year" - yeah). He's obviously properly worried. It will kill a large number of people in poorer economic regions that will see their healthcare resources overwhelmed. The US is nowhere near prepared for what's likely about to hit.
> It very clearly is and it's out of the box, they can't stop it now. The US should be shutting down all travel into and out of the country, full quarantine from the rest of the world. We'd have a chance at stopping it from doing to the US what it has done to China, if we acted immediately, before it's across Europe and more of Asia and then imported in stealth mode by travelers from those regions that are unaware they're infected.
If we had a government that wasn't starved, it might also be preparing sufficient resources for if/when the virus does reach epidemic proportions here.
Also, Americans have been trained to avoid the medical system and tough it out for cost-saving reasons, that training is going to be counterproductive here.
It's too late for this approach. The only reason that could explain why the US still does not have many cases is lack of testing and the fact that it goes undetected for a long time.
> Covid froze the second largest economy and did it in the span of a month. What chance does the rest of the world stand at stopping it? None.
This doesn't follow. It doesn't matter how large an economy is affected. The primary factor is contact between infected and healthy people. Areas with less population density might have a good shot at keeping infections down, like a lot of areas in Europe.
> Some 152 cases (and at least three deaths) were confirmed in Italy on Sunday, up from three cases on Thursday. The number of infected people in South Korea jumped to 763 (and six deaths) in just days.
To add an important point: In both countries, they have detected covid-19 only well after it has spread inside the country. E.g. in Italy it started with one severely ill patient who went to the hospital and got tested positive for covid-19. Then they recursively traced people that person has been in contact with and found over a hundred cases. They still haven't found "patient zero" yet, the first person in that chain who entered Italy with the disease. Before, it has been all in the dark. There are likely many such pools of carriers all over the world. This aspect of covid-19 is its real danger: in many cases the disease is asymptomatic so you don't get a test and keep interacting with people normally, but it's still able to infect others.
Right, supposedly Denmark has no cases for example. I find that hard to believe, it seems more likely to me, given the average Danes dislike of going to the Doctor , and the average Doctor response of "you have some sort of virus come back in a couple weeks if it doesn't get better" that it is here, there are probably a few hundred walking around with it, and the first one to go to the hospital just hasn't happened yet.
I think of asymptomatic infectivity as a sitting war between the virus and the host immune system. The virus has taken hold in a region where it a) does not grow at a rate harmful to the host and b) already has access to a spreading mechanism, while the immune system succeeds in keeping the infection away from organs where (either) c) the virus would grow at an unsustainable rate, eventually taking down it's host and/or d) the immune system's counter reaction would be so severe that it would endanger the host. Avoiding c) and d) are in the best interest of both virus and immune system (even though both are obviously not aware of any of that), so both are effectively happy. Sooner or later the immune system will develop a countermeasure nonetheless, but until then the virus will have spread to other hosts generously. Reliably reaching a state like that would be the second best evolutionary outcome of a virus, only topped by permanently resisting the immune system's removal attempts.
A virus doesn’t “want” to kill its host; just use the minimum change to propagate (e.g. induce a cough). In face some symptoms are your own body trying to dislodge it, such as fever, and the cough itself for that matter.
Some viruses of course have gone so far as to become part of our genome. Is that asymptomatic?
As other people said, most viral diseases have a asymptomatic period. What's unique about Coronavirus is that the patient can be infectious during the asymptomatic period. This makes coronavirus so hard to be controlled.
The virus can of course be asymptomatic, in fact it is asymptomatic in anyone when they first contract it. Then it’s up to their immune system to either fight it off or crumble. Whether symptoms show is just a matter of the severeness.
Symptoms like coughing and sneezing that discharge large droplets from the respiratory tract are a lot more effective at spreading the virus onto other hosts, but it appears that this virus is contagious enough that even asymptomatic hosts could spread it.
Being infected just means your cells have been infected and are starting to produce more viruses. That process is heavily dependent on viral load and the host's immune system. You're only symptomatic when your body begins a whole scale fight against the virus, before that, your body is still producing the virus (and you can spread it), but the virus isn't impacting you enough to be symptomatic.
There are several dark pools of concentrated yet totally unexplained and even implausible coronavirus being detected, with no clear discernible path from China. It leads me to wonder if the virus is a lot more long lived on surfaces or maybe in foods or on food packaging that came from China. How else to relatively cut off towns get an infection, but cities are not? Is there something that towns got from China that these cities may not have? Food stuff? agricultural supplies? Produce? … I am open to suggestions.
We have people who have never been and have no contact with anyone who has been to China, been in the vicinity of Chinese (e.g., tourist centers chocked full of Chinese tourists), or are Chinese; developing infections with Coronavirus. I am more than open to other suggestions and theories, but small towns in remote areas of Italy that have very little if any direct contact with the rest of the country, let alone China, especially over winter, seems quite peculiar; unless we simply have not identified (or officials are keeping secret) a far larger outbreak in cities.
And please don't try to tell me that western governments would not keep secrets or be dishonest. We are all adults and smart here, let's act like it.
Our media is referring to "patient zero" in Italy as a 38 years-old man. So either he is known or our media is full of your-know-that. Which would not be surprising.
Edit: a commenter below correctly pointed out that that 38yo man is being referred to as "patient one" not "patient zero". My bad.
That 38 year old man was the one I talked about above, the person who went to the hospital on whom they first found the disease, but not necessarily the person it originated from. Likely they have asked him (as well as anyone else affected) whether he's been outside of the country and he answered no (otherwise they'd say they have found the origin).
I'm not an expert, so I looked up what "Patient Zero" is defined as. Wikipedia [1] defines it as the case that has been detected first, but also says that media has used the term to refer to the source of the disease. So the Italian media's use actually matches the Wikipedia definition, while my use in the post above, as in this CNN post [2] matches the other definition. Sadly the term is a bit vauge.
Things are developing very fast, expect that distortions from the chinese wispers games that is modern media to be worse than ever.
I've seen report that the first case was in contact with a person that had been in China but showed not symptoms and even might have tested negative at some point. If they get re-tested and show positive now, or some of their possessions do, that solves the mystery.
I've been reading la Repubblica a lot today since I live pretty close to where the disease is spreading. They always reiterated that patient 0 who started spreading the virus in Italy is not yet identified. They had a "suspicious" person identified but that person later on was tested negative.
I think they're referring to him as "patient one". Patient zero (i.e. someone who is or was ill and has recently come back from China) hasn't been found yet.
I read a lot about this virus lately, and it looks like the mortality rate depends a lot on the availability of intensive care. If that's the case, slowing down the diffusion of the infection could be really important in keeping down the total number of deaths.
I noticed the same thing. As numbers continue to grow, we run the real risk of even top of the line health care systems being overwhelmed and people passing from lack of access to care. Couple numbers that jump out for me are China with ~3% mortality rate but also rumors of these numbers being vastly unreported.
Iran with a 19% mortality rate (on a small scale)!
Also the mortality rate appears to be 3.2% where for a while it was in the low 2s.
If this grows into a true pandemic, it will to the best of my knowledge be the first stress test of our Just-In-Time style of inventory management at grocery stores.
Iran's mortality rate is almost certainly much lower than 19%, since there's reason to believe the total infection rate is much higher than they're claiming. We wouldn't expect nearly so many travellers from Iran to be infected if coronavirus was as rare there as their figures make it out to be.
Given that it can take N weeks to die, wouldn't it make sense to calculate the mortality rate at a given time t as the number of deaths at time t divided by the number of reported infected people at time t-Nweeks ? (I am using N =3 for my back-of-the-envelope calculations).
In Iran I suspect that either the actual number of cases is much higher than currently reported/known or that the people infected were mostly elderly, or both.
China also reports about 8 recovered for every 1 death, so even if their numbers are accurately reported, there are a lot more who have done neither as of yet, and about 11% of them will die. Which would be a lot more deaths.
Dumb question but what intensive care? Do people need to be on respirators? Need access to drugs only available at ICU? Just curious if any of the things done at an ICU to prevent death really need to be only at the ICU.
The most extreme consequences of infection include acute respiratory distress syndrome (ARDS) and sepsis, which may require ICU-type treatment. See [0] for World Health Organisation guidance on critical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected. The majority of patients don't experience such severe consequences.
Yes, mechanical ventilators and in most cases, supplemental oxygen for roughly 18% of patients.
We can expect CFR in the US to be fairly low (approx 2%) as long as the availability of these resources permits treatment for all who need it. After saturation, however, the CFR will move asymptotically toward approx 15%.
Medical system saturation is believed to be the main reason the CFR in Hubei is much worse than other provinces.
The US has about 62k mechanical ventilators, about half of which are already occupied at any given time, and half of the available ones are purpose-built for infants in NICUs. So let's assume we begin to have a real problem above (62k/4)/0.18 == 86k simultaneous US cases.
I'd assume oxygen supplies should be easy to scale up. No idea about scaling up the manufacture of ventilators, or if the (much more numerous, and cheaper) CPAP machines in the US could be used as stand-ins. Perhaps someone more familiar with these devices can chime in.
I read an article a while back where they said there are a few bands of severity (this was how they treating in China). First level of seriousness was oxygen / respirator. Then for even more serious cases they had to actually oxygenate the blood outside their body. Basically the problem was people can’t breath because of fluid or maybe it’s damage in their lungs so all the treatments of the severe patients were to help that.
As far as I could see in some Twitter videos coming out of China some people need to be on respirators and in a horizontal position. At the limit you can also do that in sports- and concert-halls, which is what the authorities seemed to have done in Wuhan.
if you get the dirty end of the stick and your interaction with the virus is an endangering one you will have problems with your organs due to the virus itself and arising complications
So Italy having an arguably uncontained cluster is probably the most troubling part. The EU has extremely porous borders. The chances of this spreading to the other EU members (and the UK) got a lot higher.
At least in the US you largely have to come in by air. Yes of course there are land borders. Canada is one but fits the same description of most cross-border travel (apart from to the US) is by air. The border with Mexico is... probably more of an issue.
Anyway, the benefit of this is that it gives you a central screening point. Given that carriers can be asymptomatic it's not impossible someone will slip through but it's more difficult for someone to convince themselves they just have a cold and they need to go home, to work or otherwise move across a border and spread the infection.
The Northern hemisphere summer really can't come soon enough.
> The border with Mexico is... probably more of an issue.
AFAIK there are no confirmed cases in Mexico. It wouldn't surprise me if that was because of the inability of the government to detect it.
I live in Mexico and I believe if it gets here it will be unstoppable. The government doesn't have the resources China has to contain and track infected people.
Mexico did well in containing the H1N1 flu in 2009. Granted, COVID19 seems much more infectious, and our current government has repeatedly cut funding to public health, so you're maybe right.
It could be problematic, though, because lots of people travel during the summer. There are probably millions of people queued up to visit Italy, Spain, Britain, etc. The Europeans take long vacations, so populations will be particularly mobile in July and August.
I wonder if the U.S. might be slightly less vulnerable to contagion, since Americans tend to visit beaches, national parks and other less crowded places, whereas in Europe the tourist attractions are in crowded cities.
It's going to be an interesting few months before a vaccine is hopefully found.
> And what should each of us do, beyond staying informed and washing our hands frequently? Keep calm and rational. It might be worth stocking some reserve of critical medications, for example — but not too much, because hoarding could create shortages.
> We, as individuals, can also try to plan for basic contingencies. Companies can cross-train key staff members so that one person’s absence won’t derail the business. Family members and friends should be watchful of one another’s health and welfare, and stand prepared to care for the moderately ill if hospitals become overtaxed.
> “Pandemic” isn’t just a technical public health term. It also is — or should be — a rallying cry.
I would add that it is helpful to have a stock of at least 3 or so weeks of food and supplies so that you can, if needed, quarantine yourself and take care of yourself and your family/relations well. There isn't enough hospital space for everyone and a lot of people with the virus aren't sick enough to take that space from the those that really need it.
> if needed, quarantine yourself and take care of yourself and your family/relations well
How would that work in practice? The last I heard you can catch this virus pretty easily just by having air touch your eye.
A lot of people live in either a city or a suburban area and most apartments and houses aren't air tight. Wouldn't your breath get circulated out of your apartment, mixed in with the outside air and drift over to your neighbor -- or is the virus not that susceptible to spreading?
> A lot of people live in either a city or a suburban area and most apartments and houses aren't air tight. Wouldn't your breath get circulated out of your apartment, mixed in with the outside air and drift over to your neighbor -- or is the virus not that susceptible to spreading?
Not an expert, but if I understand correctly the virus would be unlikely to survive that long outside the body. Even in the cruise ship which was docked in Japan, which would be a bit of a "worst-case" scenario for the transmission you describe, most people didn't get sick.
Coronavirus is possible to transmit via aerosol but not airborne. They differ in the transmission distance, among other things. Virus are infectious only when you receive a certain amount (Viral load). It is possible the virus loaded aerosol drift far away, but the density would become lower the further they drift.
You’re not taking into account panic buying / ordering.
If it gets bad where you are people are just going to order as much as they can and then there won’t be enough - this already happened with masks here in the UK and we only have a few cases. I had to send some to Hong Kong for a family member a few weeks back and paid £20 for packs of 20 for proper n95 respirators. They’re now sold out online and everywhere despite being £15 EACH.
Stock up now while no-one is panicking yet. Don’t waste money buying weird stuff - Just get stuff you’ll use anyway over the next few months.
You're not accounting for the fact that in these types of situations, there is often a run on things like food. You can only get food delivered if the stores still have food.
Why is hacker news censoring covid-19 articles? This article just disappeared from the front page despite having more upvotes than most articles on the first page after being submitted an hour ago. Another covid-19 article over the weekend disappeared from the front page also.
I'm not aware of HN itself actively "censoring" anything, as long as I've been here. If articles are disappearing from the front page, then it's likely due to them being flagged by users.
I'll also note that I use an alternate front-end for HN - hckrnews - which by default sorts by time, so the only way I'm ever aware of this sort of complaint is when someone brings it up in the comments.
As for this topic in particular, there has been a lot of coverage about COVID-19/2019-nCoV recently, but there hasn't been a lot of new information. I suspect people are flagging the topic because they're getting their regular updates on it from other communities and want HN to remain a place where topics that are of particular and specific interest are posted. Once I realized that's how the majority of the community sees it, I stopped thinking of the rise and fall of topics here as being based on whether or not they are "newsworthy" and it started making a lot more sense.
I don't know exactly, but IMHO this weekend it has raised itself up to the point that the tech industry really needs to start paying attention to it on a number of levels. The company I work for has a number of significant international offices, and I think the odds of at least one of them being significantly impacted at some point in the next 2-3 months has to be at least 25%. It isn't just the virus itself, or even necessarily primarily the virus, but also the measures the local government enforces. A lot of us engineers have a relatively easy "work from home" option, but not everyone is a programmer.
You also have localized concerns, like, at what point are all the people ordering from Amazon going to stop because they're afraid of getting the virus shipped to them? What is Amazon doing about their worker's health, especially in light of the rather persistent rumors this can spread while asymptomatic? On the one hand, I see people claiming that the virus can't survive being shipped very well and on the other hand we have Amazon striving to ship faster and faster, to say nothing of the actual delivery person.
Whether we like it or not, this is rapidly becoming "tech industry" news too. Unless we are very lucky, by the end of this week, I suspect that's going to be obvious to everyone.
As I've said a few times about prep, even if you don't get the virus or your area never has to be locked down, you ought to be doing prep work anyhow. If it isn't COVID-19, it'll be a quake, or a really bad normal flu season, or any number of other things. You make society more resilient and better able to deal with "true" emergencies when you've prepped enough to take care of yourself and not drain vital social resources at the worst time. You don't usually get lucky and have this kind of warning about oncoming issues. Prepping for a pandemic isn't identical to all the other things you may actually experience, but there's a lot of overlap.
I feel fairly uncertain as to how seriously I should /personally/ take COVID19 living in a large American city as a healthy young person with no upcoming travel. I see some friends seriously taking precautions (like buying masks) already, which up-to-this-point I've found a little absurd. Could anyone who knows better perhaps enlighten me on how I ought to be reacting to this?
Buy extra food so if you get sick you don't have to go out and infect other people, or if you are in an area with a lot of sick people you don't have to go out to bu food and get infected.
That's a socially-conscious act and I applaud it. But in truth, before this is over every person on earth will have experienced the virus.
The reason to control the spread and delay infection (not avoid it; that's probably impossible) is to allow the health-care infrastructure critical time to manage the flow of sick. If we all got sick at once, there'd be no capacity to treat 99.9% of us. If we spread it out over a year or more, we can treat more people and have a better outcome.
You probably won't die, esp since you're young, but it's certainly possible that you could get caught up in a quarantine. Best to have a good supply of any required drugs, etc.
Readit News
The seasonal flu alone kills half a million people every year. So any mild disease that is as contagious and barely twice as fatal will kill 1 million. And that's what's going to happen with COVID19. It is far more severe than the flu.
We know COVID19 is as contagious, given how fast it's spreading and how unstoppable it is (R0>2, asymptomatic transmission, airborne). And we now have 4 independent estimates that place the Infection Fatality Ratio at about 0.5% to 1.7% which is between 5x and 17x deadlier than the flu (0.1%): https://twitter.com/zorinaq/status/1230977769795776512 Incidentally, this makes COVID19 comparable to the 1918 Spanish Flu (IFR ~2%) according to experts (see link above). And keep in mind the IFR, unlike the CFR, is the metric that takes into account undetected mild cases. The Case Fatality Ratio is around 9% right now.
So based on this, I predict it will go pandemic and will kill 1 million, and probably a lot more.
COVID19 is the most severe (ie. contagious + fatal) airborne disease since the Spanish Flu.
Fortunately we know a lot more about viruses today than we did in 1918. The virus has already been mapped genetically, and many labs around the world are hard at work on an anti-viral treatment. We shouldn't get complacent of course, but it's likely that this thing can be contained and treated eventually.
I read today about a device[1] from Israel that helps the lungs quickly clear phlegm, thus reducing the coughing behavior that spreads the disease. The Chinese are starting to manufacture and deploy it, so hopefully it will cut back on the spread at least a bit.
1. https://www.jpost.com/HEALTH-SCIENCE/New-Israeli-invention-u...
in vitro: https://www.nature.com/articles/s41422-020-0282-0
practice: https://www.jstage.jst.go.jp/article/bst/advpub/0/advpub_202...
e.g. https://www.jpost.com/HEALTH-SCIENCE/New-Israeli-invention-u...
well, for saying that.
That 30 million dead, and probably another 300 million hospitalized and maybe 50 million that need icu care.
Should probably go without saying that we don’t have the ICU beds to handle that in the western world, let alone in developing countries.
We also haven’t had anything like the Spanish flu in the US since we’ve had the modern health insurance system. Is blue cross going to have the resources to pay for all those extra hospital visits? What about all the long term side effects from the millions of people that had acute respiratory failure and survived.
edit:
Also something else to consider -- what if this goes epidemic in the US during the elections this year? They'll have to cancel rallies, campaign events, maybe even the party conventions.
Every cloud has a silver lining :)
>Is blue cross going to have the resources to pay for all those extra hospital visits?
If the government ends up bailing them out this could be a step towards single payer health care in the US.
Median ages:
https://www.cia.gov/library/publications/resources/the-world...
Countries in the West over 40 at the median:
Germany, Italy, Greece, Slovenia, Portugal, Austria, Lithuania, Latvia, Croatia, Spain, Bulgaria, Estonia, Hungary, Serbia, Bosnia, Czech, Finland, Netherlands, Switzerland, Romania, Denmark, Poland, Canada, Slovakia, France, Belgium, Ukraine, Sweden, Belarus, UK, Russia
Germany has half its 83 million population over 48 years of age. Italy is the 5th oldest country at the median. Covid will hit very hard against older populations.
Interesting, this is always my argument against these fatality ratio estimates, can you explain how the IFR can take undetected mild cases into account? Does it just assume at random how many of those cases exist?
That’s assuming no containment effort, like with seasonal flu. Of course, it’s gonna happen if health authorities take the same defeatist attitude as you and do nothing.
I'm a bit confused. Isn't expecting it to be devastating the very attitude needed for authorities to justify engaging in the containment methods needed to reduce the harm caused?
how long can they get away with locking people up in their homes? There will be tipping point when those who are supposed to deliver the first-response and do the policing will also become a vector for spreading the disease. Things will escalate quickly no matter if the attitude is "defeatist" or optimistic.
It very clearly is and it's out of the box, they can't stop it now. The US should be shutting down all travel into and out of the country, full quarantine from the rest of the world. We'd have a chance at stopping it from doing to the US what it has done to China, if we acted immediately, before it's across Europe and more of Asia and then imported in stealth mode by travelers from those regions that are unaware they're infected.
Back in reality, the US economy will look like China's frozen economy, within a month or two, unless Covid is stopped soon. More likely, it's going to spread from Italy across Europe, and continue to spread across Asia. From those hyper economic zones, the US will be guaranteed to import it from multiple sources (no single country to shut down travel with).
China went full totalitarian to an extreme, and couldn't stop it. Covid froze the second largest economy and did it in the span of a month. What chance does the rest of the world stand at stopping it? None.
Bill Gates is worried about it spreading across Africa (and said in an interview a few weeks ago, when asked about his plans for the year: "well, I plan to travel a lot less this year" - yeah). He's obviously properly worried. It will kill a large number of people in poorer economic regions that will see their healthcare resources overwhelmed. The US is nowhere near prepared for what's likely about to hit.
If we had a government that wasn't starved, it might also be preparing sufficient resources for if/when the virus does reach epidemic proportions here.
Also, Americans have been trained to avoid the medical system and tough it out for cost-saving reasons, that training is going to be counterproductive here.
As you said:
> It very clearly is and it's out of the box
This doesn't follow. It doesn't matter how large an economy is affected. The primary factor is contact between infected and healthy people. Areas with less population density might have a good shot at keeping infections down, like a lot of areas in Europe.
To add an important point: In both countries, they have detected covid-19 only well after it has spread inside the country. E.g. in Italy it started with one severely ill patient who went to the hospital and got tested positive for covid-19. Then they recursively traced people that person has been in contact with and found over a hundred cases. They still haven't found "patient zero" yet, the first person in that chain who entered Italy with the disease. Before, it has been all in the dark. There are likely many such pools of carriers all over the world. This aspect of covid-19 is its real danger: in many cases the disease is asymptomatic so you don't get a test and keep interacting with people normally, but it's still able to infect others.
I don't understand how the virus can be asymptomatic? How does it reproduce and what triggers it to become symptomatic?
Some viruses of course have gone so far as to become part of our genome. Is that asymptomatic?
Symptoms like coughing and sneezing that discharge large droplets from the respiratory tract are a lot more effective at spreading the virus onto other hosts, but it appears that this virus is contagious enough that even asymptomatic hosts could spread it.
We have people who have never been and have no contact with anyone who has been to China, been in the vicinity of Chinese (e.g., tourist centers chocked full of Chinese tourists), or are Chinese; developing infections with Coronavirus. I am more than open to other suggestions and theories, but small towns in remote areas of Italy that have very little if any direct contact with the rest of the country, let alone China, especially over winter, seems quite peculiar; unless we simply have not identified (or officials are keeping secret) a far larger outbreak in cities.
And please don't try to tell me that western governments would not keep secrets or be dishonest. We are all adults and smart here, let's act like it.
Edit: a commenter below correctly pointed out that that 38yo man is being referred to as "patient one" not "patient zero". My bad.
I'm not an expert, so I looked up what "Patient Zero" is defined as. Wikipedia [1] defines it as the case that has been detected first, but also says that media has used the term to refer to the source of the disease. So the Italian media's use actually matches the Wikipedia definition, while my use in the post above, as in this CNN post [2] matches the other definition. Sadly the term is a bit vauge.
[1]: https://en.wikipedia.org/wiki/Index_case
[2]: https://edition.cnn.com/2020/02/23/europe/italy-novel-corona...
https://edition.cnn.com/asia/live-news/coronavirus-outbreak-...
I've seen report that the first case was in contact with a person that had been in China but showed not symptoms and even might have tested negative at some point. If they get re-tested and show positive now, or some of their possessions do, that solves the mystery.
Iran with a 19% mortality rate (on a small scale)!
Also the mortality rate appears to be 3.2% where for a while it was in the low 2s.
https://www.worldometers.info/coronavirus/#countries
If this grows into a true pandemic, it will to the best of my knowledge be the first stress test of our Just-In-Time style of inventory management at grocery stores.
[0] https://www.who.int/publications-detail/clinical-management-...
We can expect CFR in the US to be fairly low (approx 2%) as long as the availability of these resources permits treatment for all who need it. After saturation, however, the CFR will move asymptotically toward approx 15%.
Medical system saturation is believed to be the main reason the CFR in Hubei is much worse than other provinces.
The US has about 62k mechanical ventilators, about half of which are already occupied at any given time, and half of the available ones are purpose-built for infants in NICUs. So let's assume we begin to have a real problem above (62k/4)/0.18 == 86k simultaneous US cases.
I'd assume oxygen supplies should be easy to scale up. No idea about scaling up the manufacture of ventilators, or if the (much more numerous, and cheaper) CPAP machines in the US could be used as stand-ins. Perhaps someone more familiar with these devices can chime in.
At least in the US you largely have to come in by air. Yes of course there are land borders. Canada is one but fits the same description of most cross-border travel (apart from to the US) is by air. The border with Mexico is... probably more of an issue.
Anyway, the benefit of this is that it gives you a central screening point. Given that carriers can be asymptomatic it's not impossible someone will slip through but it's more difficult for someone to convince themselves they just have a cold and they need to go home, to work or otherwise move across a border and spread the infection.
The Northern hemisphere summer really can't come soon enough.
AFAIK there are no confirmed cases in Mexico. It wouldn't surprise me if that was because of the inability of the government to detect it.
I live in Mexico and I believe if it gets here it will be unstoppable. The government doesn't have the resources China has to contain and track infected people.
It could be problematic, though, because lots of people travel during the summer. There are probably millions of people queued up to visit Italy, Spain, Britain, etc. The Europeans take long vacations, so populations will be particularly mobile in July and August.
I wonder if the U.S. might be slightly less vulnerable to contagion, since Americans tend to visit beaches, national parks and other less crowded places, whereas in Europe the tourist attractions are in crowded cities.
It's going to be an interesting few months before a vaccine is hopefully found.
https://bnonews.com/index.php/2020/02/the-latest-coronavirus... (most up-to-date counter and news aggregator which includes a source for each reported number)
https://www.reddit.com/r/COVID19/ (strictly moderated, lots of links to scientific reports and papers, no hoaxes and fake news)
https://docs.google.com/spreadsheets/d/1Z7VQ5xlf3BaTx_LBBbls... (spreadsheets with interesting charts)
https://www.who.int/emergencies/diseases/novel-coronavirus-2...
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...
> We, as individuals, can also try to plan for basic contingencies. Companies can cross-train key staff members so that one person’s absence won’t derail the business. Family members and friends should be watchful of one another’s health and welfare, and stand prepared to care for the moderately ill if hospitals become overtaxed.
> “Pandemic” isn’t just a technical public health term. It also is — or should be — a rallying cry.
I would add that it is helpful to have a stock of at least 3 or so weeks of food and supplies so that you can, if needed, quarantine yourself and take care of yourself and your family/relations well. There isn't enough hospital space for everyone and a lot of people with the virus aren't sick enough to take that space from the those that really need it.
How would that work in practice? The last I heard you can catch this virus pretty easily just by having air touch your eye.
A lot of people live in either a city or a suburban area and most apartments and houses aren't air tight. Wouldn't your breath get circulated out of your apartment, mixed in with the outside air and drift over to your neighbor -- or is the virus not that susceptible to spreading?
Not an expert, but if I understand correctly the virus would be unlikely to survive that long outside the body. Even in the cruise ship which was docked in Japan, which would be a bit of a "worst-case" scenario for the transmission you describe, most people didn't get sick.
Stock up now while no-one is panicking yet. Don’t waste money buying weird stuff - Just get stuff you’ll use anyway over the next few months.
I speak from experience preparing for hurricanes. If you wait until the last minute, you're going to be woefully unprepared.
I'll also note that I use an alternate front-end for HN - hckrnews - which by default sorts by time, so the only way I'm ever aware of this sort of complaint is when someone brings it up in the comments.
As for this topic in particular, there has been a lot of coverage about COVID-19/2019-nCoV recently, but there hasn't been a lot of new information. I suspect people are flagging the topic because they're getting their regular updates on it from other communities and want HN to remain a place where topics that are of particular and specific interest are posted. Once I realized that's how the majority of the community sees it, I stopped thinking of the rise and fall of topics here as being based on whether or not they are "newsworthy" and it started making a lot more sense.
You also have localized concerns, like, at what point are all the people ordering from Amazon going to stop because they're afraid of getting the virus shipped to them? What is Amazon doing about their worker's health, especially in light of the rather persistent rumors this can spread while asymptomatic? On the one hand, I see people claiming that the virus can't survive being shipped very well and on the other hand we have Amazon striving to ship faster and faster, to say nothing of the actual delivery person.
Whether we like it or not, this is rapidly becoming "tech industry" news too. Unless we are very lucky, by the end of this week, I suspect that's going to be obvious to everyone.
As I've said a few times about prep, even if you don't get the virus or your area never has to be locked down, you ought to be doing prep work anyhow. If it isn't COVID-19, it'll be a quake, or a really bad normal flu season, or any number of other things. You make society more resilient and better able to deal with "true" emergencies when you've prepped enough to take care of yourself and not drain vital social resources at the worst time. You don't usually get lucky and have this kind of warning about oncoming issues. Prepping for a pandemic isn't identical to all the other things you may actually experience, but there's a lot of overlap.
The reason to control the spread and delay infection (not avoid it; that's probably impossible) is to allow the health-care infrastructure critical time to manage the flow of sick. If we all got sick at once, there'd be no capacity to treat 99.9% of us. If we spread it out over a year or more, we can treat more people and have a better outcome.