Chris Martenson likes to say "If the facts scare you, the problem isn't with the facts". (also check out his COVID-19 updates, I think they are very well done! [0])
You may think "it's not here yet". It is.
You may think "the numbers are low". They aren't. We are failing miserably in our testing, our numbers are easily off by a factor of 10 (for infections).
You might not want to be "weird" and not want to practice social distancing. You need to.
You need to act when it feels too early and honestly, in the US, that was a week+ ago so at least act now.
I don't say these things to whip people up in a panic, I say them because we are about to get hit hard here in the US. If you know a nurse maybe send them a text and ask how they feel. I can tell you the nurses I know are freaking out because they know we are not prepared. A have a friend who works at a big hospital. They have 2 cases (at least as of a day ago) and they almost buckled under it. They don't have many masks, they don't have training, and the hospital itself has no plans in place. When asked "How many masks do we have?" the answer (on Thursday of this week) was "I don't know" from the head of infections diseases. Let that sink in. March 12th.
I can understand not knowing the count off the top of your head in November 2019, I can understand it in December 2019, I can still wrap my head around not knowing it in January 2020 but damn it... It's March, you are in a meeting to discuss COVID-19 and you don't know how many masks you have on hand?
The world has been warning us for months now and they had no plans for how to handle visitors. The nurses have not done n95 mask fit tests. They are not getting clear direction on how handle mask reuse. We are not prepared for this. If this hospital (which I would trust for any major procedure) is feeling the strain with 2 patients what happens when there are 4? 8? 16? 32?
> I don't say these things to whip people up in a panic, I say them because we are about to get hit hard here in the US.
The average person in the US rightly did not have much reason to be concerned a few weeks ago, but that's not the case anymore. It's important to understand that the situation has evolved rapidly for the worse here, and our response ("panic level" if you will) must escalate accordingly.
In particular:
- Each one of us is now at much higher risk of infection, possibly orders of magnitude higher than the official numbers suggest. The bungled testing rollout, the high level of community spread and the number of deaths together suggest the official numbers are grossly under-counting. [1] This is very different from a few weeks ago when the cases where mostly imported or had known transmission routes.
- A few weeks ago, the CDC was still hoping to contain the epidemic by tracing and quarantining cases. But that has changed. Whereas China, Hong Kong, Taiwan etc have succeeded in containing the disease so far, the US has already failed and the CDC now expects it to eventually spread to most of the US population. [2] Its strategy is now to slow it down enough to avoid what's happening in Italy.
- The situation in Italy has shown us the magnitude of human suffering that will result from people "under-panicking" and going about their daily lives at a similar stage of the epidemic. There will be a rapid explosion in cases, leading to a meltdown of the health care system. Many of us will lose our loved ones, and many of us will die unnecessary deaths from hospitals being overrun. Not to mention the impact on the economy, which we can't measure yet in Italy but could well be greater than the cost of locking down early.
So stop thinking "it's fine". It was a few weeks ago. It's not anymore.
100% agree with what you are saying. I really meant more so that I don't want to encourage hoarding or panic buying to the level where other people can't get what they need. You should be worried, you should be preparing in anyway you can (2 weeks+ food, isolate yourself as much as possible, discourage gatherings of any size).
> they don't have training, and the hospital itself has no plans in place
I have a difficult time grasping this part. It’s not like it’s something completely new. We encounter virus infections every year during flu season. The SARS outbreak was 18 years ago and MERS was 8 years ago. Did we not learn anything from it?
Sure, it was not as severe as SARS-CoV-2, but we should know how to handle it. I agree we should take precautions to stop spreading. But from seeing what is going on around here in EU, I am thinking that the panic is over-inflated and is doing more harm than good. Maybe it takes panic and fear to scare the majority of people into taking all precautions to stop the virus from spreading?
> The SARS outbreak was 18 years ago and MERS was 8 years ago. Did we not learn anything from it?
> Sure, it was not as severe as SARS-CoV-2, but we should know how to handle it.
The answer appears to be no, we didn't. Remember neither of those really hit here in the US.
CDC SARS FAQ [0]
> How many people contracted SARS in the United States during the 2003 outbreak? How many people died of SARS in the United States?
> In the United States, only eight persons were laboratory-confirmed as SARS cases. There were no SARS-related deaths in the United States. All of the eight persons with laboratory-confirmed SARS had traveled to areas where SARS-CoV transmission was occurring.
CDC MERS FAQ [1]
> Q: Has anyone in the United States gotten infected?
> A: Yes, two patients in the U.S. tested positive for MERS-CoV infection, both in May 2014.
The hospitals (nurses at them) that I've heard from say they don't have the masks on hand and they have received no training for how to deal with something like this on this scale. In fact they are being told things contrary to their training like having them wipe down the disposable shield of a CAPR [2] with bleach to re-use it (they are supposed to be single use).
They have limited (10 in the case of the CAPR shields in one hospital) because it's only required for specific diseases that they see few to no cases of per year. They don't have stockpiles of n95 masks because they could alway just order more if they needed them (same with CAPR). They are having to use the CAPR's temporarily because you need to pass a n95 mask fit test [3] (to insure nothing can get in) but the nurses haven't done that. At one hospital they just so happened (dumb luck) to have someone working that day that knew how to administer it and so they have been rushing to have nurses complete it.
> But from seeing what is going on around here in EU
As an Italian, I raise my eyebrows every time China is mentioned as an example for the successful containment of this virus.
It could do that because it could afford to take the economical hit and because it is an authoritarian state, which means you can get almost everyone to obey, in one way or another. Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
Why on Earth is this a good model?
Undoubtedly for the safety of citizens, but even with all the people shouting about a "fascist revolution" going on with the previous government, it only took three orders to strip everyone of most of their freedoms without anyone batting an eye (especially since no one knows for how long, the April 3rd date is a joke).
Quarantining is probably inevitable (although it won't help the overloaded ICUs until two weeks from now, so more capacity will always be needed), but following rules in place in an outbreak does not mean one should not question their principles.
And this letter should be sent to the media and the government, since both can't even understand an exponential, or basic statistics (even with the so-called "peak" reached, cases will keep on increasing until recoveries are due).
Personally I'd like fast-tracking of anti-SARS-CoV-2 drugs instead (those are the ones which will get out of this mess, quarantining is just flattening the curve, although immensely beneficial), along with setting up place for non-intensive care COVID-19 patients. Every ICU bed freed is a victory.
> As an Italian, I raise my eyebrows every time China is mentioned as an example for the successful containment of this virus.
China dropped the ball for a full 10 days back when the disease was nicely contained to a small part of Wuhan, and then largely to Wuhan itself and Hubei - they didn't let the population know about the danger, so for quite some time no one was thinking about protecting themselves by wearing masks, social distancing etc. But the trouble is, Italy then made the exact same mistake by being late with containment measures, and now the UK and US are doing the same. So there's nothing to roll one's eyes or raise eyebrows about.
The full danger was unknown in the initial stages. Provincial officials were downplaying it for various reasons, and until the very end of December it wasn't known to even transmit person-to-person.
Once the threat was clear, the government of China acted much more alacrity and decisiveness than any Western country, which have had months of advance notice.
The containment situation in Wuhan in the early stages cannot be compared to the situation in European countries or the US now, or even the situation in Wuhan now
In the early stages in Wuhan the virus only existed in Wuhan. A severe lockdown that eliminated the virus there would have eliminated it completely. Full stop. It would have been gone forever.
A draconian lockdown right now in e.g. the UK, or even a few weeks ago, might have eliminated the virus in the UK, but then it would just come back in again. We can’t seal the entire country permanently.
Even in Wuhan, they are easing the lockdown so soon the virus will get back into Wuhan again. It’s just a matter of time before they have another outbreak. It’s simply impossible that it won’t happen.
Lockdowns are important tools to slow the spread of the virus, they are a vital part of our response, but they can only slow it down. They cannot stop it or eliminate it. Also lockdowns are most effective the first time you do them, and then they’re the most effective in the first few weeks.
Impose a heavy lockdown too soon, and it’s like using up your most powerful ammunition before the enemy is in effective range of your weapons. Letting the enemy get closer might mean accepting casualties early on, but fewer casualties overall and a better chance of victory. It’s a hard, painful choice to have to take.
I am not a huge defender of China, but it is disingenuous to claim that not realizing the import of the virus in the first 10 days is anywhere near the magnitude of the Italian government's failure.
> China dropped the ball for a full 10 days back when the disease was nicely contained to a small part of Wuhan...
Uh, China dropped the ball for a full 3 months since the first reports of a novel respiratory disease started back in November. First denying it, then jailing the doctors who tried to raise the alarm. Not to mention not enforcing their own laws regarding food hygiene put in place after SARS which would have prevented the transmission in the first place.
Yeah, they're now showing containment measures that work. But they could have stopped this in its tracks before going global, or prevented it entirely.
> As an Italian, I raise my eyebrows every time China is mentioned as an example for the successful containment of this virus. It could do that because it could afford to take the economical hit and because it is an authoritarian state,
You know what is MUCH more effective than an authoritarian response? An _earlier response_.
An earlier response, even if it weaker, is much more potent than a stronger later response.
The intensity of china's response would not be necessary where the response is faster.
> but following rules in place in an outbreak does not mean one should not question their principles.
The best way to preserve civil rights and not have to bend them to protect against loss of life is to respond as early as you can reasonable justify.
In the US the fact that our principles (and laws!) tie our hands somewhat is all the more reason that it's important that we act aggressively within the space that our society allows.
> Personally I'd like fast-tracking of anti-SARS-CoV-2 drugs instead
Responding earlier keeps people alive longer for those drugs to become available.
> You know what is MUCH more effective than an authoritarian response? An _earlier response_.
Absolutely. If this were Kerbal Space Program just about everybody would be able to tell you that the best moment to deflect an orbit is early on when you only need a little push for a giant effect later on. With exponential developments timing is everything.
> could do that because it could afford to take the economical hit and because it is an authoritarian state, which means you can get almost everyone to obey, in one way or another. Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
I don't understand this logic. Because China made a mess at the beginning of the pandemic, so we shouldn't copy the model they employed at later stage that is proven to be working?
Or because China is an authoritarian state, so everything it does is bad and nothing we can learn from them? Well China has been copying and learning from any countries for a while now and that's what makes it stronger by day. Just keep blaming China and do nothing. That will surely make China less powerful and less influential.
You know what's scary? All major democracies failed to manage the pandemic while China becomes the most powerful country after all this.
Drugs are not a solution in the next 2-3 months. There's no way a drug can be tested and ensure safe and scaled up to the tens/hundreds of millions of doses you would need. It's impossible so don't even bother considering it.
Quarantining is the only thing that will help in this situation. There's no other solution we have as a society to slow down the pace of infections. People who normally wouldn't die will die because of the lack of medical care.
The problem we face in the US is lack of testing, which makes it impossible to do anything except a quarantine.
> Quarantining is the only thing that will help in this situation.
The question is, for how long? Until the infection curve goes down? Until there is not a single infected cases in the whole country?
While you can't know when this will happen (especially the former, most models are inaccurate because too little is still known about this virus), I don't believe it is sustainable to keep an extended lockdown on a whole country (as opposed to "just" Hubei, which however has almost the entire population of Italy) more than a few months.
Drugs are a solution for mitigation. They already have a preliminary trial result in China that says Chloroquine works. South Korea agrees and I believe is combining it with Zinc. South Korea has the lowest fatality rate of any country.
They can fast track drugs if that drug has been tested for other things. It happens all the time. I mean like all the time doctors do it for other cases, there's not reason it couldn't happen for cov19
There are some existing drugs that help with the treatment but they don't really stop the infection spreading. Chloroquine / hydroxychloroquine are maybe the most useful.
Pretty much all countries have mechanisms for emergency powers. China being authoritarian has nothing to do with it. I'm not familiar with Italy's constitution or laws, but I assume it has similar provisions?
> Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
Huh? On the one hand you're arguing China was too draconian (and Italy shouldn't copy), then a sentence later you're complaining it wasn't enough and this is all China's fault?
What exactly do you suggest China ought to have done to prevent it from spreading outside of China? I haven't heard any reputable source suggest there was any practical way of containing it perfectly.
Your comment comes across as knee-jerk anti-China rather than anything based in science or public policy.
> I haven't heard any reputable source suggest there was any practical way of containing it perfectly.
Of course there was. If they somehow magically divined the true danger of the virus the day they identified it.
But they didn't, it took time and observation, and they shut down the affected areas as soon as the extent of danger was realized and processed by their bureaucracy. There's plenty of things here that could've been done better, but it's asinine to blame them for the virus taking hold everywhere else. Doubly so given that most of the world had a month+ warning before they registered their first cases.
So, It seems that China did some things very wrong in the beginning, but then took some big actions to turn things around. There was a long form piece in the Wall Street Journal last weekend that looked at the timeline. It seems that in the early phases, authorities didn’t want to have bad news leading up to the end of year / New Years period. There was suppression of information coming out about there being a novel virus — to the extent the doctor had to offer a public apology for ‘spreading rumors’ — dots weren’t connected, etc. The Wuhan banquet wasn’t cancelled, number of cases exploded shortly after.
And, look — I’m sitting here in the US where I’ve been horrified at our own response over the last month. But the question was, could it have been contained? Looking at that timeline, it certainly seems possible that it could have been. Of course, we’ll never know.
> What exactly do you suggest China ought to have done to prevent it from spreading outside of China?
Well, at the very least, take it seriously when there were the first reports of "new viral pneumonia" in Wuhan, instead of locking up or censoring people who reported that.
Yes, this doesn't mean that other countries did not take it as seriously as they should have, and perhaps containment might have failed nevertheless. Still, it was a spectacular failure with long-lasting consequences on every other country in the world.
That, IMO, deserves blame, no matter if other governments are doing the same errors.
Just like China, there was a time when Italy had 1 case, then 2 cases, then 4, etc. Italy was unable to stop the spread before reaching a huge level and spreading to other countries.
Why blame China for "allowing this virus to spread all around the world" when Italy allowed the same?
Doctors and civilians tried to sound the alarm that something was going on, and were silenced until it was too late. To their credit, the CCP fired the Wuhan officials who presumably silenced those people, but it is still their responsibility for fostering a culture where towing the line and hiding problems until they cannot be hidden is acceptable for leadership positions.
you're missing that China initially suppressed info abt this virus, which caused it to spread. had they reacted immediately, we might be in a much better situation rn
It's a completely different situation. If China contained the disease when they had only 10 cases, there would be no disease anymore. If Italy contained the disease when they had only 10 cases, new cases would arrive, again and again.
>Just like China, there was a time when Italy had 1 case, then 2 cases, then 4, etc.
Just like the spread of fire, the window of opportunity to put it out is right at the beginning.
Yes, Italy could put it out when it first came to Italy but they would have to do it many many more times to successfully contain it. China just had to do it once and they failed.
If it did indeed come from live animals in a wet market, that seems like a potential valid reason for some criticism, although the they did a superb job adapting imho.
Because it worked. Millions of lives have been saved - 1% of 1.3B is 13M people. That's 1/5 of Italy.
Are there better models? Maybe. But there are also much worse models, as I suspect we might soon find out in the US [1]. Personally I'd much rather take the Chinese model for the next few months than risk me and my family dying or going bankrupt over the next few months.
And, instead of thinking that China could "afford to take the economical hit", consider the economic impact of 13M people suddenly dying. At this point, there's definitely going to be a hit to the economy. It's just going to be either A) from stricter lock downs and government aid, or B) from more people dying due to overrun hospitals. It might not be a wash in terms of the dollar amount, but it's clear which option will save more lives.
[1] Comparing China and US response:
- China has made treatment (not just testing) for coronavirus free for everyone. In the US...better hope you have good insurance.
- Tests performed per million people: China 2,800, US 5
- China is ordering banks to increase loans to SMBs rather than hoarding cash to protect themselves. It has rolled out a bunch of policies to support SMBs and employees. The US...well, not much so far.
> Because it worked. Millions of lives have been saved - 1% of 1.3B is 13M people. That's 1/5 of Italy.
This is an inacurrate estimation. I guess your figure of 1% is from South Korea case fatality rate. The confirmed cases represent a biased sample of the population, and the mortality rate could be lower in reality (but not higher).
> consider the economic impact of 13M people suddenly dying.
The mortality is mainly for 70+ years old people, who are already not in the workforce anymore.
Those numbers cannot help us to evaluate or to compare one state's measure versus another state's decision
>>Personally I'd much rather take the Chinese model for the next few months than risk me and my family dying or going bankrupt over the next few months.
Always makes me sad when Americans willing give up essential liberty to purchase perceived safety. Personally I would much rather look the situation rational, may the assessment of risk for myself, then choose on my own what course of action(s) I will take. Not have those actions dictated and imposed on me by an authoritarian government.
I would rather lose my health or my life than to lose my liberty
Far more importantly IMO is the Chinese gov not shutting down live wildlife markets earlier, stopping dangerous non-scientific medicinal use, and enforcing trafficking of known-carriers. Specifically with COVID-19, the trade of Pangolins which are the "most trafficked animal in the world", which largely end up in China and Vietnam often via other SEA countries:
Xi was aggressive shutting stuff down but then went on to praise Chinese medicine (basically Naturopathy) multiple times after the Coronavirus became apparent. Which is where the quack medicine that results in people grinding up Pangolin scales and taking them like medicine, then eating the meat. Not to mention having markets with live wildlife in unsanitary areas in the middle of major urban areas with high density.
I'm surprised the continued spread of woo by Chinese authorities isn't taking more of a beating. Not just doing nothing, but promoting it.
Even the recent wildlife market "ban" has a giant loophole:
> The coronavirus epidemic prompted China to permanently ban trade of wild animals as food, but not for medicinal use.
China's initial response was terrible. When they realized what they had on hand and how fast it was developing they did what they could to turn it around.
That said, I would take any numbers coming out of China with a very large grain of salt; Italy looks way worse than China going by the numbers but I'd trust the Italian numbers more.
Also: it is much better to go by deaths and critical cases than it is to go by the number of cases themselves. The deaths and the critical cases are a lot harder to hide.
I mean sure - they dropped the ball on a new virus emerging from a familiar situation and getting blindsided by incompetent and image obsessed party officials who silenced the alarms and it took a while for the highly concentrated power structure of blindly loyal party officials to pivot and move.
However ...
It was not an unknown anymore for Europe
There was months of warning time
There is no suppression of scientific at scale
There was daily warnings from WHO and many countries
There was precedent for effective measures from Asia
There is no no no reason this should happen in a western democracy right.
And lets not even look at the US where image obsessed national officials with highly concentrated power and blind loyal party following have been actively downplaying (flu), suppressing the national response and hampering testing and effective containment.
It's like China in reverse - the stupid version playing out right in front of our eyes.
We all here love to repeat the virtues of western democracy over the autocratic China but right now we need to take a really good look at how much the theoretical ideals have been replaced by practices that combine the worst of both systems to absolutely devastating results.
If we don't want a major collapse down the road from all the other wait-and-see known threats, from antibiotic resistance to resource exhaustion to broken pension systems to climate change, we better start thinking about how we get of the 'reality is what we want it to be as long as we vote for people who tell us what we want to hear and cast out people who tell us what we need to act upon' train.
Darwin is about survival of the most adaptable to an ever changing world, not necessarily the strongest and right now China looks a lot more adaptable than we do- so if we like our values and system we better start making sacrifices to the gods of science and reality again.
That however would require us to even admit there is a problem and it's not looking promising
> Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
That's not alarming.
What's alarming is that the Chinese regime admitted that the people who they placed in charge of the crisis response have been continuously lying and falsely reporting the real amount of victims and how far the disease has spread. They've done it jus prior of replacing them, but the Chinese regime just replaced them with loyalist party officials, which makes it sound like a desperate attempt to keep falsifying reports.
It's not but I guess it's the best they have right now.
Taiwan, Hong Kong, Japan and Singapore are still functioning and have "contained" the virus. The number of cases/deaths did not explode despite contracting the virus much earlier.
It's good you put "contained" in quotes. Japan, Singapore, and Hong Kong are all (according to this plot [0]) showing exponential growth in the number of cases. It's a slower exponential than elsewhere, but it's still an exponential.
The economy is going to be hit either way, it's just a choice between A) a lock down but most people staying alive and healthy or B) lots of people dying or sick and an overrun health care system.
Maybe we don't know which one will have bigger impact on the economy, but we know for sure which one will lead to more human suffering.
Especially because they are in the position to help other countries now, when everybody else have to think only about their own citizens. They sent doctors to Italy with medical equipment (Italy sent some help to China earlier on) so they're going to take some credit for the recovery. Then there will be the real recovery. Western Europe was rebuilt with US money after WW2 and the USA consolidated an hegemony which is still lasting now. I bet that China will be more than willing to help in the next years.
Although China has a large internal market, they still rely on exports. If those are curtailed due to slackening demand, quarantine and tariffs, how do they become the "big winner?"
Maybe not. You want a society to develop herd immunity for a flu-like disease during warmer weather months. Since they failed to contain it, the disease is just going to show up in China again but this time from sick people traveling to China. The worst case scenario is lockdown during warmer months and then having it flare up again in winter months.
That said, we could just apply medical quarantine procedures used for animals to humans. Get a lab test 48 hours prior to international travel and have an additional test performed upon landing at the destination. The first test minimizes the likelihood of someone with viral shedding traveling and the lab test upon landing let’s you get the person and isolate them immediately before they’ve shed virally.
It could do that because it could afford to take the economical hit and because it is an authoritarian state, which means you can get almost everyone to obey, in one way or another. Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
Can we stop using mode of government as an explanation for success and failure?
Clearly your country have its head screwed on better than mine. Meanwhile, my president is complacency in chief, more worried about the stock market than lives being lost. The local governments know what they're doing moreso than the feds, when it should be the other way around.
South Korea certainly seemed to have its head screwed most on head. They learned from previous lessons and are very successfully in applying them.
> Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
So did Italy, and they even got a head start in knowledge about the virus of about a month. Yet, the majority of cases here in Germany can be traced back to Italy, and not directly to China.
It's depressing how every country still tries their best to ignore their own failings and defaults to "well China should have stopped it right in the beginning"
I am absolutely sure that things would have been at least as bad if not worse, had this virus originated in Italy. Or Germany, or pretty much anywhere else.
Part of the problem here is that people see this as a competition between nations, i.e. arbitrarily defined borders.
China has implemented measures that have objectively worked: that have effectively contained an outbreak of this disease within their nation, despite having had the least knowledge and warning, and within a short amount of time. So, this is a good model to follow, in the absence of any other.
Certain Western governments appear to have decided to stretch the limits of that model to protect their economy in the short-term.
That will potentially result in everyone across the globe suffering further outbreaks.
Your assumption that drugs will save us is not safe. Novel drug development may be quick, or it may take decades.
It is a good model not b/c it's politically correct, nor adopted by an authoritarian state, it's good simply because it worked: brought over 3000 new cases everyday in Wuhan down to single digit in recent days.
Any government or organization is problematic if it puts 'principles' over human lives.
What caused this whole mess was the nature, not the Chinese party/people.
In the first few weeks of the virus transmission in China, nobody can anticipate the lethality of the coronavirus. People may think it is just another flu. Who knows? Yes, there were delays in the reporting and yes it could have been handled better. But the following actions of China were swift and determined. The fact is the coronavirus has been contained in China. The cases reported in China are single digit today. Fact shows China's model is effective, no?
You think the governments in EU or US could have done a better job if the coronavirus first appeared there? I'd say no. Why? Because the EU and USA have all the data and information about the coronavirus shared by China for months. You have witnessed all the mess caused by the virus in China for months and so what? Trump was down playing the danger of COVID-19 just a few days ago. The USA cannot even cover a fraction of its citizens for testing the virus.
We know it seemed to be a god sent opportunity to point fingers to the "authoritarian" system of China at this moment. But guess what? The coronavirus does not slow itself down regardless you are a democracy or not. Prove your system/model is better by saving the lives of your own citizens instead of bashing China, will you?
PS. we still don't know from where/what the coronavirus come from. I suggest wait for scientific proof before jumping to the conclusion that it started from China. last time I checked, the Spanish Flu did not originate from Spain.
Everyone wants a drug and vaccine, but good science takes time to happen. Make no mistake, no one wants a lock down, but so far, it's the only option in the lack of a functional medical solution. If tons of scientists tell us lock down is the only option for now, we should'd listen rather than discredit them.
Now, if someone really wants to move on to talk about politics. It's about a nation as a whole can do the right thing, not about authoritarian vs. democracy.
A ideal democracy society works because we trust reasonable individuals can collectively make the right decision. In this COVID-19 case, lock the hell down and do the best practice to stop it from spreading. I don't see why a functional democracy nation can't do that. But it has to be a functional one.
Unfortunately, authoritarian was necessary when the general population (including local governments at various level) cannot function as well. China for example, has to reply on THE ONE in the center to make the right call and execute order top down to be functional. At least according to the CCP, the general population cannot be trusted. Thus the authoritarian regime. It's easy to see it's effectiveness when there is the right order in place. But it's also equally easy to neglect the fact that such an order takes really long (from Dec 2019 to end of Jan) to materialize.
IMHO, I think both Italy and China failed here, while we are all ignoring the one did really well, at least so far, Japan. (Or maybe Taiwan and Singapore, but they are small states which is easier to govern).
I wouldn't view it as science vs politics. Science advises, correctly, the politicians. But the ultimate decision stays (for the good, or bad) with politics, because they have to balance things.
As I said elsewhere, a vaccine is likely less "important" in the immediate, especially because it can have far deeper side effects, and no test has been done on humans whatsoever, while most of the drugs are on Phase III (earliest data should arrive in April, at least for the studies I looked up).
Lock downs will help. But they will help in the future. They won't help the overloaded ICUs now, because they're getting now people who had been infected up to 14 days before. In case of no drugs, the alternative is getting makeshift hospitals in place to lessen the burden on the health system, and procure more equipment. However, just as the government was extremely fast in getting people locked in their homes, it was not for these things.
> It's about a nation as a whole can do the right thing, not about authoritarian vs. democracy.
It's hard to tell when the same government gives contradictory or confused statements. Some blamed "the ignorant masses" for the panic fleeing last Sunday, but in my view, people weren't just well equipped to understand (plus the early leak of the document) what was going on. The media also cherry picks the bad apples very well.
China did handle the situation poorly in the beginning, trying to suppress the numbers maybe. But the thing is, other countries are doing the same mistake, while not being prepared to do what China did next.
Trump said there is nothing to worry about. He even compared the numbers to flu numbers. This is similar to what the CCP did in the beginning.
Wuhan was locked down at 100 new cases a day. This is much faster response than countries who had seen Wuhan and even had better data.
The CCP did screw things up in the beginning, but made up for that by a very effective response. Countries are matching CCP on the initial response, but not ready to match the final response.
You can’t fast track things past what they’ve already been fast tracked. Stop second guessing the experts. What is the use of a hurried vaccine tomorrow if next month it turns out to cause birth defects or global infertility or cancer.
I’m sure there’s still a ton of bureaucracy. We need to go back to first principles and really look at what makes a drug safe and how quickly we can find out.
And also take a look at what safeguards we are willing to cut when every day of delay is thousands of deaths.
> You can’t fast track things past what they’ve already been fast tracked. Stop second guessing the experts
I'm well aware of how trials work (I happen to work in a scientific institution which does plenty). They may have been fast-tracked elsewhere, but not in my country.
So far there's just compassionate use, which means they're administered only to people who have truly severe sympthoms.
A vaccine can wait, to be honest, it's not as critical as a treatment to lessen the sympthoms. In fact, that's why Gilead is also testing their drug here (not sure when the actual protocols will start, though).
Note that I'm not advocating for "let's scrap all the trials stuff". But trials in phase III have, for obvious reasons, very lengthy time frames. And it's not the first time (I attended a talk a few years ago on the topic) where the system (which works, normally) shows its limits (not only emergencies, but for example orphan drugs).
That is the most useful graph on this subject so far. Go look at it now.
Most countries have exactly the same growth trajectory measured from 100 cases. That's solid data about how this behaves.
Singapore and Hong Kong have been able to slow things down by strong measures, but it's still a straight line on a log graph, just with 1/3 of the growth rate. Italy is on the same line, just 8 days ahead of Europe and 13 days ahead of the US.
The graph can be reproduced with more recent data here [1]. It is based on WHO data, and lags a bit behind. If you want to see more data and graphs, see [2].
As a physicist, you are familiar with formulas similar to this:
N_obs = p_detect * 2^( n_days / T_double )
N_obs : The number of observed cases
p_detect : The fraction of actual cases that are detected (assumed to be constant)
n_days : number of days
T_double : The number of days it takes for the number of real cases to double
If you examine the formula, the p_detect constant is almost insignificant. If T_double = 2, a difference in a detection rate of 0.2 and 0.8 is only 4 days for n_days.
As long as T_double is less than several months (and constant), an absolute catastrophy will occur. Within a weeks from now, nearly the entire fraction of the population that is receptive to infection will get infected, and will be sick basically at the same time. With 10-15% of the population requiring intubation, we can end up with a significant part of the population in each country ending up dead.
I believe you're focusing on the days aspect of that equation without considering what a lower T_double/p_detect could mean relative to hospitalizations.
If the real number of cases is doubling significantly faster than those detected -- say due to not testing them because their symptoms are mild enough to be missed entirely or to not seek treatment -- the calculations around things like mortality rate and severity of illness may yet change. As I understand it, scientists have already identified mutations of the virus that may also impact its ability to spread or injure infected hosts. I should note that these changes can swing both good and bad, I'm simply pointing out that there are more variables and that these variables changing may represent something not obvious from the equation.
I'm not an expert; I have fun reading about medical statistics. Most papers I've read take the time to examine these various confounding factors and what unexpected variations in their proposed equations might mean.
The point is that the mortality rate estimates are going to be totally out of whack without accurate measurements. As well as estimates of the currently infected.
This matters a lot. The first number is obviously important. The second matters so Italy can plan for whether things have peaked yet, or how many weeks out until it does.
That assumes you are sampling uniformly, and not in already saturated clusters. The doubling time is also not a known constant, as it depends on actions taken etc, and uncertainty in it will broaden the distribution.
Obviously, all this is basic statistics and should be known to epiodemiologists, who hopefully have some input to policies.
For large N_obs, this will maybe be less important as you're going to find the severe cases anyway, but the uncertainty is significant in the beginning stages, and it is unfortunately these stages where actions will have most impact.
Who is this mr Pueyo? And why should we listen to him regarding this subject?
From his Medium profile page it seems he is a 'Storyteller' and 'Viral marketer'. So, someone who knows how to tell a story with confidence even if you know nothing of the subject.
I'm gonna listen to my government regarding this, rather than medium posts by viral marketeers. Thank you.
No one is 'confident' about a lot of things. But everyone who has seen what is happening in Italy is confident that taking a 'wait and see' attitude will cost lives.
If you make a bunch of assumptions about the distribution, you don't need a large sample size to make decent estimations about the population. Of course, the only way that works is with random or stratified random sampling. With reporting bias, I'm not sure any country has enough data to make statistically confident statements with any precision.
Folks with a stronger statistics background are welcome to correct me.
It's interesting that you lead by saying "as a physicist".
As a physicist I'm used to thinking about orders of magnitude and whether something grows like log(N) or N!. I'm pretty sure all the data points to this being O(a big problem) but I'd leave it to the epidemiologists to say anything with confidence.
So, as a physicist, you should know how exponential growth works. Let's say you have a pile of Uranium that's juuuust sub-critical. You would likely to be confident to stand next to it without significant fear.
But if someone throws on just enough additional Uranium for the pile to go supercritical, you would run for your life because none of the following will matter[1] all that much to the final outcome:
1) How much neutron radiation there was to start with.
2) The specific exponential growth coefficient.
3) How much total Uranium there is, as long as it's a nontrivial amount
4) Whether your Geiger counter is off by some constant factor or not.
None of those matter. It's going boom. It might go boom a bit sooner or a bit later, but it is going to go boom. That's just how exponential growth works. There's no maybe. There's no "let us wait and see". There's no "we'll hope for the best". No: It. Will. Go. Boom.
All of the factors that are irrelevant are just shifting a figurative vertical wall on your graph paper a bit to the left, or a bit to the right. It's adding or subtracting "a couple of doubling times". If the doubling time is short, then you're not really achieving anything by fiddling with constant factors.
With the Coronavirus just about every country has a doubling time of 4-5 days.
I live in Australia, where we're about a "month behind" everyone else. So of course, the dumbass government is saying things like "the heat here will slow it down". But it hasn't, our doubling time is 4.75 days at the moment. They're saying that it's "premature to lock down the country". No it isn't, it's already weeks too late and getting literally exponentially worse daily! They're saying that the hospitals are being prepared, but no amount of extra beds or ventilators will help. If they double the number, it just delays the catastrophe by 4.75 days. Not even a whole week! Quadrupling beds and ventilators buys just under 10 days before people are being turned away to go home and die.
So, again. I ask you: If you were the nuclear physicist in charge of a nuclear pile and someone told you it's gone critical and the radiation is rising exponentially, is your first reaction to: just "stand around and wait and see what happens", or to: take drastic action right this second? Do you SCRAM, or do you call the communist party leadership for permission? Are you the hero of the Chernobyl story, or the villain?
[1] Ignoring thermal effects slowing down the reaction. This actually has an analogy with disease spread, where there are fewer susceptible people remaining because everyone is already sick or dead. If we reach this point, we'll be seeing millions infected and hundreds of thousands dead.
I think this insight is exactly why the UK health experts are not advocating extreme measures yet. They know they will only delay the takeoff and they need to use those measures when it does, not beforehand, and these measures are meant to protect the most at risk from dying from the disease (I think the most contentious thing is how long these measures can work for. The UK experts are of the opinion they have a finite life).
Keep in mind, the UK advisors think the peak is maybe two months away, and that at-risk groups may need to self-isolate for a month either side of that peak. This is a far bigger response than any country has achieved so far (and it's extra difficult because the at-risk groups are probably the most dependent on external aid, as well as already lacking social contact). I don't think they're wrong to think that this will be difficult to achieve, and increasing the difficulty by starting earlier will make things worse.
There is no SCRAM button on this pandemic, not any more at least.
Most people will not go to the hospital, they'll stay at home and they wont die unless they dont drink water and eat food with poor nutritional value.
That's why I dont understand the crisis communication on the subject. I understand exponential growth, I dont under and the panic about getting sick with a flu like virus.
If it was something causing skin lesions I'd be in panic mode because the victims would be at a higher risk of co-infectious diseases. This is not that. But hey, fuck my civil liberties some more, for that matter fuck my freedom and that of my countrymen. I dont give a fuck anymore.
There are more cases, they are on average much more mild, the real mortality rate is much lower, it is actually not doubling every two days (it is the tests that are doubling every few days). Lots of possible and very consequential conclusions.
As someone who's dealing with analytics data regularely, thank you !
i absolutely don't understand how can someone give any ratio about this disease knowing how only the most severe cases got tested ( except in SK), and that the symptoms are almost undistinguisable from the flu.
What do you think of the practice of only testing people who need hospital-level care and people who had contact with confirmed covid-19 patients (and people who traveled to at risk regions)?
I would think that this can only give you the infected from a few clusters and you can be surprised by an unknown cluster of patients suddenly needing intensive care.
Edit: And due to the long incubation period, that cluster can be quite large.
Maybe Italy is a worst case, both because it didn't quarantine early enough, and because greater population inversion.
> It's now a well-established fact that older people and those with underlying health issues are more susceptible to succumbing to Covid-19. With 23 percent Italians aged 65 or above and a median age of 47.3, the Italian population is the oldest in Europe. This is chiefly responsible for the high fatality rate in Italy.[0]
Also these articles.[1,2] And similar to the age effect in China.
Italy isn't the worst case, they're just 2 weeks' ahead of most other countries.
Looking at the latest SitRep from WHO, my home country (Sweden) has small no. infected (775), but grew 25% vs the previous day. If that rate keeps up, number of infected will keep on doubling every 4-5 days and in 14 days' time will be at what Italy is today (17k infected). And then another week later it'll break 100k. Exponential growth is a bastard in that sense.
In Sweden we've avoided testing people who haven't been in high risk areas, and moved from that to only testing 'risk groups' (elderly and with preexisting conditions), so the numbers shouldn't be seen as reflective of the total number of infected.
I had the same worries for Greece when in just two days recorded cases doubled from 100 to 200, but since the government imposed partial lockdown measures the rate of infections slowed down significantly. My guess is the same will happen everywhere. It's just that it's easier to see the growth slowing when you have an order of magnitude less incidents than Italy. We have to trust the process.
what's the source for italy being the oldest country? As of 2018 Germany was the oldest in the EU and their crude mortality ratio is among the lowest so far.
That figure may be “% of population >= 85 years old”, where Italy does lead the EU. See p21 in this report [1] from Eurostat for a breakdown by country. About 3.45% of Italy is at least 85, compared to about 2.75 for Germany. That’s about 40% higher.
So Italy is older in the sense of “more people who are very old”. But you are right that the mortality difference so far is not explained entirely by this gap.
It may be informative to watch how this evolves in Greece, and to a greater extent (due to more infection before a lockdown) France and Spain. Those are the next oldest countries in the EU by this measure, and all are well above 3%.
On the other hand, Italy has very good food hygiene standards, as anyone who has been told off for touching the fruit and veg in the grocers can tell you. You never have a shop assistant handle money and then touch food, which you see all the time in the UK/US
"Everything we do before a pandemic will seem alarmist. Everything we do after will seem inadequate." - Michael Leavitt, former HHS Secretary under President George W. Bussh
My co-founder and I are really struggling with the decisions ahead of us. We feel we should act quickly, and enforce our team to work from home, but the spread in our city is quite low for now. We also wonder how long this can go on, are we going to be isolated for months?
We are at a critical point where we have just closed our seed round this past week. We have both put so much energy and time into this moment and we were ready to work harder and focus on scaling and growth.
Of course, the more tragic situation around us makes our issues seem small. I think we will likely announce to our team to work from home starting Monday. How surreal.
If you’re in the United States, where testing has been infuriatingly limited, the fact of the matter is you have no idea what the spread in your community is. The numbers aren’t low because nobody has the virus, they’re low because nobody has been tested. If we did actual testing, they might come in low or they might come in high, who knows. As it stands, nobody has any real idea just how bad the spread is here. Absence of evidence is not evidence of absence.
Given that, the safest course is to assume the spread is high, and act accordingly.
The state of Ohio has only 26 confirmed cases, but two days ago the Director of the Ohio Department of Health estimated that 1% of the state's population (100k) may be infected due to the high ratio of cases being community-spread [1].
This is the likely reason for such a high number of celebrities in the news testing positive -- it's already everywhere; they are the only ones getting tested.
Actually we do know one number :the total number of people in ICU is normal for this time of year. There are a handful of confirmed cases (I'm not sure if they are in ICU), but the total number of cases is still low.
It is hindsight, but expontial grow means that despite not testing we didn't have a problem two months ago. Maybe we should have been in lock down a week ago, but anything sooner would be overreacting and not necessary. Most of the US is on lock down now which seems like about the right time to start. No more than a week sooner can be seriously argued.
Business and money is one thing. Money comes and goes, for the most part. Employees, their health and relationship with your company are a whole different matter.
If you make everyone work from home, you'll end up with a temporary loss in productivity (thus money, which again comes and goes). Even if one of them does get infected anyway, they won't spread it to the rest of the team. The relationship with your employees is preserved because you're not forcing them to take risks.
If you force them to work in the office, it's just a matter of time before all of them get sick. The productivity will drop to zero, yet you'll still have to pay them sick leave and their opinion of your company will be tainted forever because you and your greed are the reason they are now all sick.
Not to mention, this is all assuming your employees are relatively young and have no pre-existing medical conditions that would make the infection life-threatening. Otherwise, we're not just talking about relationships but actual lives being put at risk.
WFH. Do it now. Individual actions have outsized impact in the face of exponential growth.
The problem is twice as hard every time the number of cases doubles. If you don't want to work from home for many months, start working from home now.
Working from home isn't as bad as it seems. Modern collaboration tools are great. Our research group and wider laboratory have gotten into the swing of things within a week.
> Individual actions have outsized impact in the face of exponential growth.
Are you sure? I think it's the other way around. Nothing I can do (apart from staying completely indoors, which I can't because I don't have enough supplies (food, etc.) to last for months) can prevent me from being infected (eventually). Luckily I'm in the low-risk group (young); I advised my parents the latter (hopefully they're following my advice).
The spread may appear low in your city, but how much of that is from lack of testing? If your employees can work from home, it is best for you to implement work from home ASAP.
Businesses in Washington State have shuttered or gone to work from home over the last 3 weeks, had most businesses made this change earlier(eg: at the beginning of those 3 weeks) we would see much less spread and quicker easing of restrictions.
Is Alberta doing widespread Covid-19 testing yet? We had cases of teens with no international travel getting Covid-19 in February according to the Seattle Flu Study, there are likely more cases in Edmonton that exhibit minimal symptoms currently.
As a data point: my company liberalized work from home to every employee a week before the first case was detected in our state, under the assumption that it was either already here and just hadn't been discovered in testing yet, or would be very shortly.
When the first case was detected, the office was closed and work from home became mandatory at least through the beginning of April.
Why not work from home? Are your employees not able to get their job done remotely?
The right thing to do from every perspective is close your office. If any of your employees is has a risk factor and dies of covid you will spend the rest of your life wondering if you could have prevented it - trust me I know.
We went ahead and have all employees working remote for at least the next week and we will be evaluating the situation each week. I struggle with this decision as well feeling like maybe this is an overreaction but the reality is we should be able to function remotely and if doing so can help then we should do it. I’m optimistic our actions will help slow the spread
Here is a great breakdown of the curves and the risks[1]. Scroll to the heading "Risk-based model" or go directly to the spreadsheet[2]. Fill in the numbers for your area.
Our Singapore office started working from home at beginning of Feb. Everyone in the office here (10 people) have very very young kids, or is pregnant. Don’t want anyone in the team getting sick and making their kids sick. Family is always more important than work. So everyone is working from home till this thing blows over.
In discussing similar issues around this crisis, I noticed that "Things that seem extreme today will, in just a few days, seem obvious, under-done, and late."
Thinking of the cancelation of the NBA season an how Mark Cuban's response was thar it seemed "crazy" and "surreal". Now, it seems obvious and late.
Don't wait - tell everyone now to work from home, prep like mad, and isolate hard.
The damage will be far less than anyone getting it. You'll also get down that critical learning curve far faster.
Imo (and free advice is best left unheeded): Better that you miss out on this opportunity and get to keep your IP and try again than risk you and your employees contracting a severe respritory illness.
People will understand disruptions due to Covid. It's not business as normal. Google told the entire north american staff to stay home. Be glad that you can still all be relatively productive while remote, and enjoy your runway while you don't have to pay for the lights in your offices.
Maybe to put a more positive spin on it: the sooner you act the more leeway you have. Better that you realize now that someone has to come in and install a remote power switch on some server. In a week it might be a bit harder to ask someone to shoot over to BestBuy and pick it up. The same goes for your workers: they might appreciate some time to set up their home office.
Exponential growth means employee expectations will go from "completely safe at work" to "don't leave home except for food" pretty fast. You don't want to be that guy who asks employees to violate the (possibly government imposed) lock down to keep the lights on.
what if you wait and your employees get sick? if you're in tech, just implement a work from home policy right now. don't wait for the gov to do so. it's a matter of time. - a French
I'm in the same position. More than a week ago I wrote an all-hands email to ensure that people realize that if they can work from home they should work from home and that we'd never force them to travel or be in the office if they do not want to and do not feel that it is in their best interest to do so. And of course it goes without saying that any indication of cold or flu like symptoms should cause someone to stay home.
As a co-founder/CEO of any company your first responsibility is for the health of your employees and those that depend on them. If you play games with that then you should not be in a leadership position to begin with.
Here is the full text of our email, feel free to C&P:
As you are no doubt aware there is a virus on the loose
and it isn't pretty.
The better ways to acquire it are to spend some time with
a bunch of total strangers in close confinement sharing
each others air. This includes all forms of public
transport.
These are exceptional (hopefully!) circumstances and I want to
make several things perfectly clear:
(1) You do not have to travel if you do not want to,
there is no obligation to participate in any of
the jobs in the next coming weeks/months and
not participating will *never* be held against
you in any form. You may opt to participate
remotely instead of on-site without financial
penalty.
(2) If you do travel, please take all precautions
possible to avoid getting ill, I'd really hate
myself if it turns out that we caused people to
fall ill (or worse) on account of the work we do,
your health comes first, always.
(3) There is a lot of misinformation going around,
some of it - unfortunately - spread by authorities
that really should know better. The current figures
are - to the best of my knowledge - 2-3% mortality
rate and an R0 (the rate at which the disease
spreads) of about 3. This makes this virus between
20 and 90 times more dangerous than the seasonal
flu, which has a .1% mortality rate and an R0 of
about 0.7-1.
(4) If you decide to participate but not in person
then we should enable video conferencing to do some
of the interviews, these should focus on the people
lower in the food chain at the companies we look at.
Please let us know your preference in time, talk to
Marco to ensure he is aware of what will happen so
that we can communicate it to the customers and the
targets alike.
(5) The virus outbreak is still in its early days, the
situation is *extremely* fluid, and you should make
an effort to stay informed and adapt your plans
immediately if you feel the situation warrants it.
Please do communicate any such changes.
Best regards, and please stay safe,
Our employees have always had the choice to work from home. Many just prefer to come to the office, no one has yet opted to work from home full time. The choice we were struggling with (until being shaken up in this thread), was whether to make it mandatory.
You should have implemented WoH weeks ago. Thinking whether or not doing it now is a disservice to all humanity and a testament of why we have reached this situation as a society.
The first case only just made its way to our city a couple of days ago. We have been rather distracted of course by getting signatures and cheques. For context, our schools and daycares are still open, as are city rec centers, gyms, and public transit. Only yesterday did the province recommend no gatherings over 250 people. Perhaps we should have been quicker, but here we are.
Here in France even with the Italian experience relayed in the press, i.e doctors having to make many times a day a choices between the ones who will live or die, many people don't take it seriously.
I am shocked but not surprised by the behavior of my fellow citizens. Many people still went out shopping, went to the restaurants, still think it is a simple seasonal flu and do not at all comply with the recommendations of avoiding contacts.
The government decided at last today to close the restaurants and most of the shops except grocery stores and drug stores.
Also I think in France at some point the army will have to be called to help, to let policemen enforce the rules and be used to secure sensitive sites.
With the periodic social unrest that France endures since the last major "ethnic" riots of 2005 and the more recent and more social yellow vest protests, I am afraid that in France there will be also a lot of indirect deaths of the sars-cov-2 pandemic.
> I am shocked but not surprised by the behavior of my fellow citizens. Many people still went out shopping, went to the restaurants, still think it is a simple seasonal flu and do not at all comply with the recommendations of avoiding contacts.
This is what happened in Italy as well. 1. people are recommended to stay the fuck home and reduce physical interactions 2. most people don't care and carry on with their normal life 3. state now needs to enforce harsh rules because people don't seem to understand that it's serious 4. some people still don't care, go to parks, beaches, private parties
Readit News
You may think "it's not here yet". It is.
You may think "the numbers are low". They aren't. We are failing miserably in our testing, our numbers are easily off by a factor of 10 (for infections).
You might not want to be "weird" and not want to practice social distancing. You need to.
You need to act when it feels too early and honestly, in the US, that was a week+ ago so at least act now.
I don't say these things to whip people up in a panic, I say them because we are about to get hit hard here in the US. If you know a nurse maybe send them a text and ask how they feel. I can tell you the nurses I know are freaking out because they know we are not prepared. A have a friend who works at a big hospital. They have 2 cases (at least as of a day ago) and they almost buckled under it. They don't have many masks, they don't have training, and the hospital itself has no plans in place. When asked "How many masks do we have?" the answer (on Thursday of this week) was "I don't know" from the head of infections diseases. Let that sink in. March 12th.
I can understand not knowing the count off the top of your head in November 2019, I can understand it in December 2019, I can still wrap my head around not knowing it in January 2020 but damn it... It's March, you are in a meeting to discuss COVID-19 and you don't know how many masks you have on hand?
The world has been warning us for months now and they had no plans for how to handle visitors. The nurses have not done n95 mask fit tests. They are not getting clear direction on how handle mask reuse. We are not prepared for this. If this hospital (which I would trust for any major procedure) is feeling the strain with 2 patients what happens when there are 4? 8? 16? 32?
[0] https://www.youtube.com/playlist?list=PLRgTUN1zz_oeQpnJxpeaE...
The average person in the US rightly did not have much reason to be concerned a few weeks ago, but that's not the case anymore. It's important to understand that the situation has evolved rapidly for the worse here, and our response ("panic level" if you will) must escalate accordingly.
In particular:
- Each one of us is now at much higher risk of infection, possibly orders of magnitude higher than the official numbers suggest. The bungled testing rollout, the high level of community spread and the number of deaths together suggest the official numbers are grossly under-counting. [1] This is very different from a few weeks ago when the cases where mostly imported or had known transmission routes.
- A few weeks ago, the CDC was still hoping to contain the epidemic by tracing and quarantining cases. But that has changed. Whereas China, Hong Kong, Taiwan etc have succeeded in containing the disease so far, the US has already failed and the CDC now expects it to eventually spread to most of the US population. [2] Its strategy is now to slow it down enough to avoid what's happening in Italy.
- The situation in Italy has shown us the magnitude of human suffering that will result from people "under-panicking" and going about their daily lives at a similar stage of the epidemic. There will be a rapid explosion in cases, leading to a meltdown of the health care system. Many of us will lose our loved ones, and many of us will die unnecessary deaths from hospitals being overrun. Not to mention the impact on the economy, which we can't measure yet in Italy but could well be greater than the cost of locking down early.
So stop thinking "it's fine". It was a few weeks ago. It's not anymore.
[1] https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
[2] https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/summ... or https://www.youtube.com/watch?v=9cfYC4YLsu4
I have a difficult time grasping this part. It’s not like it’s something completely new. We encounter virus infections every year during flu season. The SARS outbreak was 18 years ago and MERS was 8 years ago. Did we not learn anything from it?
Sure, it was not as severe as SARS-CoV-2, but we should know how to handle it. I agree we should take precautions to stop spreading. But from seeing what is going on around here in EU, I am thinking that the panic is over-inflated and is doing more harm than good. Maybe it takes panic and fear to scare the majority of people into taking all precautions to stop the virus from spreading?
> Sure, it was not as severe as SARS-CoV-2, but we should know how to handle it.
The answer appears to be no, we didn't. Remember neither of those really hit here in the US.
CDC SARS FAQ [0]
> How many people contracted SARS in the United States during the 2003 outbreak? How many people died of SARS in the United States?
> In the United States, only eight persons were laboratory-confirmed as SARS cases. There were no SARS-related deaths in the United States. All of the eight persons with laboratory-confirmed SARS had traveled to areas where SARS-CoV transmission was occurring.
CDC MERS FAQ [1]
> Q: Has anyone in the United States gotten infected?
> A: Yes, two patients in the U.S. tested positive for MERS-CoV infection, both in May 2014.
The hospitals (nurses at them) that I've heard from say they don't have the masks on hand and they have received no training for how to deal with something like this on this scale. In fact they are being told things contrary to their training like having them wipe down the disposable shield of a CAPR [2] with bleach to re-use it (they are supposed to be single use).
They have limited (10 in the case of the CAPR shields in one hospital) because it's only required for specific diseases that they see few to no cases of per year. They don't have stockpiles of n95 masks because they could alway just order more if they needed them (same with CAPR). They are having to use the CAPR's temporarily because you need to pass a n95 mask fit test [3] (to insure nothing can get in) but the nurses haven't done that. At one hospital they just so happened (dumb luck) to have someone working that day that knew how to administer it and so they have been rushing to have nurses complete it.
> But from seeing what is going on around here in EU
What do you mean by this?
[0] https://www.cdc.gov/sars/about/faq.html
[1] https://www.cdc.gov/coronavirus/mers/faq.html
[2] http://www.lbs-biotech.com/products/personal-protection/max-...
[3] https://www.osha.gov/video/respiratory_protection/fittesting...
It could do that because it could afford to take the economical hit and because it is an authoritarian state, which means you can get almost everyone to obey, in one way or another. Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
Why on Earth is this a good model?
Undoubtedly for the safety of citizens, but even with all the people shouting about a "fascist revolution" going on with the previous government, it only took three orders to strip everyone of most of their freedoms without anyone batting an eye (especially since no one knows for how long, the April 3rd date is a joke).
Quarantining is probably inevitable (although it won't help the overloaded ICUs until two weeks from now, so more capacity will always be needed), but following rules in place in an outbreak does not mean one should not question their principles.
And this letter should be sent to the media and the government, since both can't even understand an exponential, or basic statistics (even with the so-called "peak" reached, cases will keep on increasing until recoveries are due).
Personally I'd like fast-tracking of anti-SARS-CoV-2 drugs instead (those are the ones which will get out of this mess, quarantining is just flattening the curve, although immensely beneficial), along with setting up place for non-intensive care COVID-19 patients. Every ICU bed freed is a victory.
China dropped the ball for a full 10 days back when the disease was nicely contained to a small part of Wuhan, and then largely to Wuhan itself and Hubei - they didn't let the population know about the danger, so for quite some time no one was thinking about protecting themselves by wearing masks, social distancing etc. But the trouble is, Italy then made the exact same mistake by being late with containment measures, and now the UK and US are doing the same. So there's nothing to roll one's eyes or raise eyebrows about.
Once the threat was clear, the government of China acted much more alacrity and decisiveness than any Western country, which have had months of advance notice.
In the early stages in Wuhan the virus only existed in Wuhan. A severe lockdown that eliminated the virus there would have eliminated it completely. Full stop. It would have been gone forever.
A draconian lockdown right now in e.g. the UK, or even a few weeks ago, might have eliminated the virus in the UK, but then it would just come back in again. We can’t seal the entire country permanently.
Even in Wuhan, they are easing the lockdown so soon the virus will get back into Wuhan again. It’s just a matter of time before they have another outbreak. It’s simply impossible that it won’t happen.
Lockdowns are important tools to slow the spread of the virus, they are a vital part of our response, but they can only slow it down. They cannot stop it or eliminate it. Also lockdowns are most effective the first time you do them, and then they’re the most effective in the first few weeks.
Impose a heavy lockdown too soon, and it’s like using up your most powerful ammunition before the enemy is in effective range of your weapons. Letting the enemy get closer might mean accepting casualties early on, but fewer casualties overall and a better chance of victory. It’s a hard, painful choice to have to take.
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Uh, China dropped the ball for a full 3 months since the first reports of a novel respiratory disease started back in November. First denying it, then jailing the doctors who tried to raise the alarm. Not to mention not enforcing their own laws regarding food hygiene put in place after SARS which would have prevented the transmission in the first place.
Yeah, they're now showing containment measures that work. But they could have stopped this in its tracks before going global, or prevented it entirely.
Too little, too late.
Dead Comment
You know what is MUCH more effective than an authoritarian response? An _earlier response_.
An earlier response, even if it weaker, is much more potent than a stronger later response.
The intensity of china's response would not be necessary where the response is faster.
> but following rules in place in an outbreak does not mean one should not question their principles.
The best way to preserve civil rights and not have to bend them to protect against loss of life is to respond as early as you can reasonable justify.
In the US the fact that our principles (and laws!) tie our hands somewhat is all the more reason that it's important that we act aggressively within the space that our society allows.
> Personally I'd like fast-tracking of anti-SARS-CoV-2 drugs instead
Responding earlier keeps people alive longer for those drugs to become available.
Absolutely. If this were Kerbal Space Program just about everybody would be able to tell you that the best moment to deflect an orbit is early on when you only need a little push for a giant effect later on. With exponential developments timing is everything.
I don't understand this logic. Because China made a mess at the beginning of the pandemic, so we shouldn't copy the model they employed at later stage that is proven to be working?
Or because China is an authoritarian state, so everything it does is bad and nothing we can learn from them? Well China has been copying and learning from any countries for a while now and that's what makes it stronger by day. Just keep blaming China and do nothing. That will surely make China less powerful and less influential.
You know what's scary? All major democracies failed to manage the pandemic while China becomes the most powerful country after all this.
1. https://www.bangkokpost.com/world/1879190/us-germany-battle-...
Quarantining is the only thing that will help in this situation. There's no other solution we have as a society to slow down the pace of infections. People who normally wouldn't die will die because of the lack of medical care.
The problem we face in the US is lack of testing, which makes it impossible to do anything except a quarantine.
The question is, for how long? Until the infection curve goes down? Until there is not a single infected cases in the whole country?
While you can't know when this will happen (especially the former, most models are inaccurate because too little is still known about this virus), I don't believe it is sustainable to keep an extended lockdown on a whole country (as opposed to "just" Hubei, which however has almost the entire population of Italy) more than a few months.
Dead Comment
Probably if they handed some out and told people to take a few as soon as they got a cough + some temperature it would help things. (http://news.southcn.com/nfplus/gdjktt/content/2020-03/09/con...)
Pretty much all countries have mechanisms for emergency powers. China being authoritarian has nothing to do with it. I'm not familiar with Italy's constitution or laws, but I assume it has similar provisions?
> Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world.
Huh? On the one hand you're arguing China was too draconian (and Italy shouldn't copy), then a sentence later you're complaining it wasn't enough and this is all China's fault?
What exactly do you suggest China ought to have done to prevent it from spreading outside of China? I haven't heard any reputable source suggest there was any practical way of containing it perfectly.
Your comment comes across as knee-jerk anti-China rather than anything based in science or public policy.
Of course there was. If they somehow magically divined the true danger of the virus the day they identified it.
But they didn't, it took time and observation, and they shut down the affected areas as soon as the extent of danger was realized and processed by their bureaucracy. There's plenty of things here that could've been done better, but it's asinine to blame them for the virus taking hold everywhere else. Doubly so given that most of the world had a month+ warning before they registered their first cases.
And, look — I’m sitting here in the US where I’ve been horrified at our own response over the last month. But the question was, could it have been contained? Looking at that timeline, it certainly seems possible that it could have been. Of course, we’ll never know.
https://www.wsj.com/articles/how-it-all-started-chinas-early...
Well, at the very least, take it seriously when there were the first reports of "new viral pneumonia" in Wuhan, instead of locking up or censoring people who reported that.
Yes, this doesn't mean that other countries did not take it as seriously as they should have, and perhaps containment might have failed nevertheless. Still, it was a spectacular failure with long-lasting consequences on every other country in the world.
That, IMO, deserves blame, no matter if other governments are doing the same errors.
Why blame China for "allowing this virus to spread all around the world" when Italy allowed the same?
(Italy even had a warning that it was coming!)
When we had the first cases its only concern was whether a minority party would leave the coalition or not.
It wasn't fit for the emergency, any emergency. Unfortunately, that's what we will be stuck with until it's over.
Just like the spread of fire, the window of opportunity to put it out is right at the beginning.
Yes, Italy could put it out when it first came to Italy but they would have to do it many many more times to successfully contain it. China just had to do it once and they failed.
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Dead Comment
Because it worked. Millions of lives have been saved - 1% of 1.3B is 13M people. That's 1/5 of Italy.
Are there better models? Maybe. But there are also much worse models, as I suspect we might soon find out in the US [1]. Personally I'd much rather take the Chinese model for the next few months than risk me and my family dying or going bankrupt over the next few months.
And, instead of thinking that China could "afford to take the economical hit", consider the economic impact of 13M people suddenly dying. At this point, there's definitely going to be a hit to the economy. It's just going to be either A) from stricter lock downs and government aid, or B) from more people dying due to overrun hospitals. It might not be a wash in terms of the dollar amount, but it's clear which option will save more lives.
[1] Comparing China and US response:
- China has made treatment (not just testing) for coronavirus free for everyone. In the US...better hope you have good insurance.
- Tests performed per million people: China 2,800, US 5
- China is ordering banks to increase loans to SMBs rather than hoarding cash to protect themselves. It has rolled out a bunch of policies to support SMBs and employees. The US...well, not much so far.
Sources: https://www.sciencealert.com/here-s-how-many-coronavirus-tes...https://qz.com/1813181/china-is-taking-pleasure-in-us-mishan...https://www.scmp.com/economy/china-economy/article/3052474/c...https://www.china-briefing.com/news/chinas-latest-regional-m...
This is an inacurrate estimation. I guess your figure of 1% is from South Korea case fatality rate. The confirmed cases represent a biased sample of the population, and the mortality rate could be lower in reality (but not higher).
> consider the economic impact of 13M people suddenly dying.
The mortality is mainly for 70+ years old people, who are already not in the workforce anymore.
Those numbers cannot help us to evaluate or to compare one state's measure versus another state's decision
Always makes me sad when Americans willing give up essential liberty to purchase perceived safety. Personally I would much rather look the situation rational, may the assessment of risk for myself, then choose on my own what course of action(s) I will take. Not have those actions dictated and imposed on me by an authoritarian government.
I would rather lose my health or my life than to lose my liberty
https://www.nature.com/articles/d41586-020-00548-w
https://www.nytimes.com/2020/03/05/opinion/coronavirus-china...
Xi was aggressive shutting stuff down but then went on to praise Chinese medicine (basically Naturopathy) multiple times after the Coronavirus became apparent. Which is where the quack medicine that results in people grinding up Pangolin scales and taking them like medicine, then eating the meat. Not to mention having markets with live wildlife in unsanitary areas in the middle of major urban areas with high density.
I'm surprised the continued spread of woo by Chinese authorities isn't taking more of a beating. Not just doing nothing, but promoting it.
Even the recent wildlife market "ban" has a giant loophole:
> The coronavirus epidemic prompted China to permanently ban trade of wild animals as food, but not for medicinal use.
https://www.nytimes.com/2020/02/27/science/coronavirus-pango...
That said, I would take any numbers coming out of China with a very large grain of salt; Italy looks way worse than China going by the numbers but I'd trust the Italian numbers more.
Also: it is much better to go by deaths and critical cases than it is to go by the number of cases themselves. The deaths and the critical cases are a lot harder to hide.
I mean sure - they dropped the ball on a new virus emerging from a familiar situation and getting blindsided by incompetent and image obsessed party officials who silenced the alarms and it took a while for the highly concentrated power structure of blindly loyal party officials to pivot and move.
However ...
It was not an unknown anymore for Europe There was months of warning time There is no suppression of scientific at scale There was daily warnings from WHO and many countries There was precedent for effective measures from Asia
There is no no no reason this should happen in a western democracy right.
And lets not even look at the US where image obsessed national officials with highly concentrated power and blind loyal party following have been actively downplaying (flu), suppressing the national response and hampering testing and effective containment.
It's like China in reverse - the stupid version playing out right in front of our eyes.
We all here love to repeat the virtues of western democracy over the autocratic China but right now we need to take a really good look at how much the theoretical ideals have been replaced by practices that combine the worst of both systems to absolutely devastating results.
If we don't want a major collapse down the road from all the other wait-and-see known threats, from antibiotic resistance to resource exhaustion to broken pension systems to climate change, we better start thinking about how we get of the 'reality is what we want it to be as long as we vote for people who tell us what we want to hear and cast out people who tell us what we need to act upon' train.
Darwin is about survival of the most adaptable to an ever changing world, not necessarily the strongest and right now China looks a lot more adaptable than we do- so if we like our values and system we better start making sacrifices to the gods of science and reality again.
That however would require us to even admit there is a problem and it's not looking promising
That's not alarming.
What's alarming is that the Chinese regime admitted that the people who they placed in charge of the crisis response have been continuously lying and falsely reporting the real amount of victims and how far the disease has spread. They've done it jus prior of replacing them, but the Chinese regime just replaced them with loyalist party officials, which makes it sound like a desperate attempt to keep falsifying reports.
It's not but I guess it's the best they have right now.
Taiwan, Hong Kong, Japan and Singapore are still functioning and have "contained" the virus. The number of cases/deaths did not explode despite contracting the virus much earlier.
[0] https://www.ft.com/__origami/service/image/v2/images/raw/htt...
The faster and better that you deal with it, the smaller the economic hit is going to be. China is going to be the big winner here.
The economy is going to be hit either way, it's just a choice between A) a lock down but most people staying alive and healthy or B) lots of people dying or sick and an overrun health care system.
Maybe we don't know which one will have bigger impact on the economy, but we know for sure which one will lead to more human suffering.
China has more poor people than Italy, it stands to reason they are less well equipped to handle an economic down turn.
That said, we could just apply medical quarantine procedures used for animals to humans. Get a lab test 48 hours prior to international travel and have an additional test performed upon landing at the destination. The first test minimizes the likelihood of someone with viral shedding traveling and the lab test upon landing let’s you get the person and isolate them immediately before they’ve shed virally.
Can we stop using mode of government as an explanation for success and failure?
Clearly your country have its head screwed on better than mine. Meanwhile, my president is complacency in chief, more worried about the stock market than lives being lost. The local governments know what they're doing moreso than the feds, when it should be the other way around.
South Korea certainly seemed to have its head screwed most on head. They learned from previous lessons and are very successfully in applying them.
Dead Comment
So did Italy, and they even got a head start in knowledge about the virus of about a month. Yet, the majority of cases here in Germany can be traced back to Italy, and not directly to China.
It's depressing how every country still tries their best to ignore their own failings and defaults to "well China should have stopped it right in the beginning"
I am absolutely sure that things would have been at least as bad if not worse, had this virus originated in Italy. Or Germany, or pretty much anywhere else.
China has implemented measures that have objectively worked: that have effectively contained an outbreak of this disease within their nation, despite having had the least knowledge and warning, and within a short amount of time. So, this is a good model to follow, in the absence of any other.
Certain Western governments appear to have decided to stretch the limits of that model to protect their economy in the short-term.
That will potentially result in everyone across the globe suffering further outbreaks.
Your assumption that drugs will save us is not safe. Novel drug development may be quick, or it may take decades.
While a state like China would be a bad idea, here in America we could perhaps learn the benefits of not heading too far in the opposite direction.
Any government or organization is problematic if it puts 'principles' over human lives.
So there is no need to equate the need for an authoritarian government to successfully contain the virus.
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https://www.youtube.com/watch?v=Kas0tIxDvrg
In the first few weeks of the virus transmission in China, nobody can anticipate the lethality of the coronavirus. People may think it is just another flu. Who knows? Yes, there were delays in the reporting and yes it could have been handled better. But the following actions of China were swift and determined. The fact is the coronavirus has been contained in China. The cases reported in China are single digit today. Fact shows China's model is effective, no?
You think the governments in EU or US could have done a better job if the coronavirus first appeared there? I'd say no. Why? Because the EU and USA have all the data and information about the coronavirus shared by China for months. You have witnessed all the mess caused by the virus in China for months and so what? Trump was down playing the danger of COVID-19 just a few days ago. The USA cannot even cover a fraction of its citizens for testing the virus.
We know it seemed to be a god sent opportunity to point fingers to the "authoritarian" system of China at this moment. But guess what? The coronavirus does not slow itself down regardless you are a democracy or not. Prove your system/model is better by saving the lives of your own citizens instead of bashing China, will you?
PS. we still don't know from where/what the coronavirus come from. I suggest wait for scientific proof before jumping to the conclusion that it started from China. last time I checked, the Spanish Flu did not originate from Spain.
https://www.straitstimes.com/asia/east-asia/wuhan-doctors-sa...
Everyone wants a drug and vaccine, but good science takes time to happen. Make no mistake, no one wants a lock down, but so far, it's the only option in the lack of a functional medical solution. If tons of scientists tell us lock down is the only option for now, we should'd listen rather than discredit them.
Now, if someone really wants to move on to talk about politics. It's about a nation as a whole can do the right thing, not about authoritarian vs. democracy.
A ideal democracy society works because we trust reasonable individuals can collectively make the right decision. In this COVID-19 case, lock the hell down and do the best practice to stop it from spreading. I don't see why a functional democracy nation can't do that. But it has to be a functional one.
Unfortunately, authoritarian was necessary when the general population (including local governments at various level) cannot function as well. China for example, has to reply on THE ONE in the center to make the right call and execute order top down to be functional. At least according to the CCP, the general population cannot be trusted. Thus the authoritarian regime. It's easy to see it's effectiveness when there is the right order in place. But it's also equally easy to neglect the fact that such an order takes really long (from Dec 2019 to end of Jan) to materialize.
IMHO, I think both Italy and China failed here, while we are all ignoring the one did really well, at least so far, Japan. (Or maybe Taiwan and Singapore, but they are small states which is easier to govern).
As I said elsewhere, a vaccine is likely less "important" in the immediate, especially because it can have far deeper side effects, and no test has been done on humans whatsoever, while most of the drugs are on Phase III (earliest data should arrive in April, at least for the studies I looked up).
Lock downs will help. But they will help in the future. They won't help the overloaded ICUs now, because they're getting now people who had been infected up to 14 days before. In case of no drugs, the alternative is getting makeshift hospitals in place to lessen the burden on the health system, and procure more equipment. However, just as the government was extremely fast in getting people locked in their homes, it was not for these things.
> It's about a nation as a whole can do the right thing, not about authoritarian vs. democracy.
It's hard to tell when the same government gives contradictory or confused statements. Some blamed "the ignorant masses" for the panic fleeing last Sunday, but in my view, people weren't just well equipped to understand (plus the early leak of the document) what was going on. The media also cherry picks the bad apples very well.
Trump said there is nothing to worry about. He even compared the numbers to flu numbers. This is similar to what the CCP did in the beginning.
Wuhan was locked down at 100 new cases a day. This is much faster response than countries who had seen Wuhan and even had better data.
The CCP did screw things up in the beginning, but made up for that by a very effective response. Countries are matching CCP on the initial response, but not ready to match the final response.
Dead Comment
And also take a look at what safeguards we are willing to cut when every day of delay is thousands of deaths.
I'm well aware of how trials work (I happen to work in a scientific institution which does plenty). They may have been fast-tracked elsewhere, but not in my country.
So far there's just compassionate use, which means they're administered only to people who have truly severe sympthoms.
A vaccine can wait, to be honest, it's not as critical as a treatment to lessen the sympthoms. In fact, that's why Gilead is also testing their drug here (not sure when the actual protocols will start, though).
Note that I'm not advocating for "let's scrap all the trials stuff". But trials in phase III have, for obvious reasons, very lengthy time frames. And it's not the first time (I attended a talk a few years ago on the topic) where the system (which works, normally) shows its limits (not only emergencies, but for example orphan drugs).
Deleted Comment
It seems only SK has earned that right and has tested enough people to get reliable statistics. If you only measure the sick in the hospital...
[0] https://www.ft.com/__origami/service/image/v2/images/raw/htt...
Singapore and Hong Kong have been able to slow things down by strong measures, but it's still a straight line on a log graph, just with 1/3 of the growth rate. Italy is on the same line, just 8 days ahead of Europe and 13 days ahead of the US.
Only South Korea shows flattening so far.
[1] https://ourworldindata.org/grapher/covid-confirmed-cases-sin...
[2] https://ourworldindata.org/coronavirus
N_obs = p_detect * 2^( n_days / T_double )
N_obs : The number of observed cases p_detect : The fraction of actual cases that are detected (assumed to be constant) n_days : number of days T_double : The number of days it takes for the number of real cases to double
If you examine the formula, the p_detect constant is almost insignificant. If T_double = 2, a difference in a detection rate of 0.2 and 0.8 is only 4 days for n_days.
As long as T_double is less than several months (and constant), an absolute catastrophy will occur. Within a weeks from now, nearly the entire fraction of the population that is receptive to infection will get infected, and will be sick basically at the same time. With 10-15% of the population requiring intubation, we can end up with a significant part of the population in each country ending up dead.
If the real number of cases is doubling significantly faster than those detected -- say due to not testing them because their symptoms are mild enough to be missed entirely or to not seek treatment -- the calculations around things like mortality rate and severity of illness may yet change. As I understand it, scientists have already identified mutations of the virus that may also impact its ability to spread or injure infected hosts. I should note that these changes can swing both good and bad, I'm simply pointing out that there are more variables and that these variables changing may represent something not obvious from the equation.
I'm not an expert; I have fun reading about medical statistics. Most papers I've read take the time to examine these various confounding factors and what unexpected variations in their proposed equations might mean.
This matters a lot. The first number is obviously important. The second matters so Italy can plan for whether things have peaked yet, or how many weeks out until it does.
Obviously, all this is basic statistics and should be known to epiodemiologists, who hopefully have some input to policies.
For large N_obs, this will maybe be less important as you're going to find the severe cases anyway, but the uncertainty is significant in the beginning stages, and it is unfortunately these stages where actions will have most impact.
Start reading at "2. What Will Happen When These Coronavirus Cases Materialize?"
From his Medium profile page it seems he is a 'Storyteller' and 'Viral marketer'. So, someone who knows how to tell a story with confidence even if you know nothing of the subject.
I'm gonna listen to my government regarding this, rather than medium posts by viral marketeers. Thank you.
Folks with a stronger statistics background are welcome to correct me.
As a physicist I'm used to thinking about orders of magnitude and whether something grows like log(N) or N!. I'm pretty sure all the data points to this being O(a big problem) but I'd leave it to the epidemiologists to say anything with confidence.
But if someone throws on just enough additional Uranium for the pile to go supercritical, you would run for your life because none of the following will matter[1] all that much to the final outcome:
1) How much neutron radiation there was to start with.
2) The specific exponential growth coefficient.
3) How much total Uranium there is, as long as it's a nontrivial amount
4) Whether your Geiger counter is off by some constant factor or not.
None of those matter. It's going boom. It might go boom a bit sooner or a bit later, but it is going to go boom. That's just how exponential growth works. There's no maybe. There's no "let us wait and see". There's no "we'll hope for the best". No: It. Will. Go. Boom.
All of the factors that are irrelevant are just shifting a figurative vertical wall on your graph paper a bit to the left, or a bit to the right. It's adding or subtracting "a couple of doubling times". If the doubling time is short, then you're not really achieving anything by fiddling with constant factors.
With the Coronavirus just about every country has a doubling time of 4-5 days.
I live in Australia, where we're about a "month behind" everyone else. So of course, the dumbass government is saying things like "the heat here will slow it down". But it hasn't, our doubling time is 4.75 days at the moment. They're saying that it's "premature to lock down the country". No it isn't, it's already weeks too late and getting literally exponentially worse daily! They're saying that the hospitals are being prepared, but no amount of extra beds or ventilators will help. If they double the number, it just delays the catastrophe by 4.75 days. Not even a whole week! Quadrupling beds and ventilators buys just under 10 days before people are being turned away to go home and die.
So, again. I ask you: If you were the nuclear physicist in charge of a nuclear pile and someone told you it's gone critical and the radiation is rising exponentially, is your first reaction to: just "stand around and wait and see what happens", or to: take drastic action right this second? Do you SCRAM, or do you call the communist party leadership for permission? Are you the hero of the Chernobyl story, or the villain?
[1] Ignoring thermal effects slowing down the reaction. This actually has an analogy with disease spread, where there are fewer susceptible people remaining because everyone is already sick or dead. If we reach this point, we'll be seeing millions infected and hundreds of thousands dead.
Keep in mind, the UK advisors think the peak is maybe two months away, and that at-risk groups may need to self-isolate for a month either side of that peak. This is a far bigger response than any country has achieved so far (and it's extra difficult because the at-risk groups are probably the most dependent on external aid, as well as already lacking social contact). I don't think they're wrong to think that this will be difficult to achieve, and increasing the difficulty by starting earlier will make things worse.
There is no SCRAM button on this pandemic, not any more at least.
That's why I dont understand the crisis communication on the subject. I understand exponential growth, I dont under and the panic about getting sick with a flu like virus.
If it was something causing skin lesions I'd be in panic mode because the victims would be at a higher risk of co-infectious diseases. This is not that. But hey, fuck my civil liberties some more, for that matter fuck my freedom and that of my countrymen. I dont give a fuck anymore.
i absolutely don't understand how can someone give any ratio about this disease knowing how only the most severe cases got tested ( except in SK), and that the symptoms are almost undistinguisable from the flu.
I would think that this can only give you the infected from a few clusters and you can be surprised by an unknown cluster of patients suddenly needing intensive care.
Edit: And due to the long incubation period, that cluster can be quite large.
I wrote an analysis of how this is going to hit Ireland, including the best calculations I could find on fatality rate:
https://medium.com/@fergal.reid/predicting-the-impact-of-cor...
I think that left unchecked this could kill millions of Americans in a couple of months. I'd love to be wrong.
February 9 is 1 1/2 pages.
March 13 is 10 full pages.
vs
>in a couple of months.
Why months? If there are 75% of the cases within 2 weeks, won't 75% of the deaths also occur within 2 weeks?
> It's now a well-established fact that older people and those with underlying health issues are more susceptible to succumbing to Covid-19. With 23 percent Italians aged 65 or above and a median age of 47.3, the Italian population is the oldest in Europe. This is chiefly responsible for the high fatality rate in Italy.[0]
Also these articles.[1,2] And similar to the age effect in China.
0) https://www.ibtimes.sg/fatality-rate-7-16-why-coronavirus-de...
1) https://nypost.com/2020/03/12/heres-why-the-coronavirus-deat...
2) https://www.theguardian.com/world/2020/mar/03/italy-elderly-...
Looking at the latest SitRep from WHO, my home country (Sweden) has small no. infected (775), but grew 25% vs the previous day. If that rate keeps up, number of infected will keep on doubling every 4-5 days and in 14 days' time will be at what Italy is today (17k infected). And then another week later it'll break 100k. Exponential growth is a bastard in that sense.
But still, maybe Italy is a worst case.
Trying to be optimistic here, being >70 and all ;)
1.25^3 ≈ 2 so the doubling period for 25% growth would be closer to 3 days.
https://worldpopulationreview.com/countries/median-age/
So Italy is older in the sense of “more people who are very old”. But you are right that the mortality difference so far is not explained entirely by this gap.
It may be informative to watch how this evolves in Greece, and to a greater extent (due to more infection before a lockdown) France and Spain. Those are the next oldest countries in the EU by this measure, and all are well above 3%.
[1] https://ec.europa.eu/eurostat/documents/3217494/10166544/KS-...
We are at a critical point where we have just closed our seed round this past week. We have both put so much energy and time into this moment and we were ready to work harder and focus on scaling and growth.
Of course, the more tragic situation around us makes our issues seem small. I think we will likely announce to our team to work from home starting Monday. How surreal.
> When you're dealing with exponential growth, the time to act is when it feels too early.
https://twitter.com/paulg/status/1237801364023017472
If you’re in the United States, where testing has been infuriatingly limited, the fact of the matter is you have no idea what the spread in your community is. The numbers aren’t low because nobody has the virus, they’re low because nobody has been tested. If we did actual testing, they might come in low or they might come in high, who knows. As it stands, nobody has any real idea just how bad the spread is here. Absence of evidence is not evidence of absence.
Given that, the safest course is to assume the spread is high, and act accordingly.
This is the likely reason for such a high number of celebrities in the news testing positive -- it's already everywhere; they are the only ones getting tested.
[1] https://www.wkyc.com/article/news/health/coronavirus/ohio-de...
It is hindsight, but expontial grow means that despite not testing we didn't have a problem two months ago. Maybe we should have been in lock down a week ago, but anything sooner would be overreacting and not necessary. Most of the US is on lock down now which seems like about the right time to start. No more than a week sooner can be seriously argued.
If you make everyone work from home, you'll end up with a temporary loss in productivity (thus money, which again comes and goes). Even if one of them does get infected anyway, they won't spread it to the rest of the team. The relationship with your employees is preserved because you're not forcing them to take risks.
If you force them to work in the office, it's just a matter of time before all of them get sick. The productivity will drop to zero, yet you'll still have to pay them sick leave and their opinion of your company will be tainted forever because you and your greed are the reason they are now all sick.
Not to mention, this is all assuming your employees are relatively young and have no pre-existing medical conditions that would make the infection life-threatening. Otherwise, we're not just talking about relationships but actual lives being put at risk.
The problem is twice as hard every time the number of cases doubles. If you don't want to work from home for many months, start working from home now.
Working from home isn't as bad as it seems. Modern collaboration tools are great. Our research group and wider laboratory have gotten into the swing of things within a week.
Are you sure? I think it's the other way around. Nothing I can do (apart from staying completely indoors, which I can't because I don't have enough supplies (food, etc.) to last for months) can prevent me from being infected (eventually). Luckily I'm in the low-risk group (young); I advised my parents the latter (hopefully they're following my advice).
Businesses in Washington State have shuttered or gone to work from home over the last 3 weeks, had most businesses made this change earlier(eg: at the beginning of those 3 weeks) we would see much less spread and quicker easing of restrictions.
Is Alberta doing widespread Covid-19 testing yet? We had cases of teens with no international travel getting Covid-19 in February according to the Seattle Flu Study, there are likely more cases in Edmonton that exhibit minimal symptoms currently.
Seattle Flu Study: https://www.nytimes.com/2020/03/10/us/coronavirus-testing-de...
When the first case was detected, the office was closed and work from home became mandatory at least through the beginning of April.
The right thing to do from every perspective is close your office. If any of your employees is has a risk factor and dies of covid you will spend the rest of your life wondering if you could have prevented it - trust me I know.
[1] https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
[2] https://docs.google.com/spreadsheets/u/1/d/17YyCmjb2Z2QwMiRR...
Thinking of the cancelation of the NBA season an how Mark Cuban's response was thar it seemed "crazy" and "surreal". Now, it seems obvious and late.
Don't wait - tell everyone now to work from home, prep like mad, and isolate hard.
The damage will be far less than anyone getting it. You'll also get down that critical learning curve far faster.
Congratulations, Good luck, stay well.
People will understand disruptions due to Covid. It's not business as normal. Google told the entire north american staff to stay home. Be glad that you can still all be relatively productive while remote, and enjoy your runway while you don't have to pay for the lights in your offices.
Exponential growth means employee expectations will go from "completely safe at work" to "don't leave home except for food" pretty fast. You don't want to be that guy who asks employees to violate the (possibly government imposed) lock down to keep the lights on.
As a co-founder/CEO of any company your first responsibility is for the health of your employees and those that depend on them. If you play games with that then you should not be in a leadership position to begin with.
Here is the full text of our email, feel free to C&P:
This was sent on Feb. 28th.Deleted Comment
You should have implemented WoH weeks ago. Thinking whether or not doing it now is a disservice to all humanity and a testament of why we have reached this situation as a society.
I am shocked but not surprised by the behavior of my fellow citizens. Many people still went out shopping, went to the restaurants, still think it is a simple seasonal flu and do not at all comply with the recommendations of avoiding contacts.
The government decided at last today to close the restaurants and most of the shops except grocery stores and drug stores.
Also I think in France at some point the army will have to be called to help, to let policemen enforce the rules and be used to secure sensitive sites. With the periodic social unrest that France endures since the last major "ethnic" riots of 2005 and the more recent and more social yellow vest protests, I am afraid that in France there will be also a lot of indirect deaths of the sars-cov-2 pandemic.
This is what happened in Italy as well. 1. people are recommended to stay the fuck home and reduce physical interactions 2. most people don't care and carry on with their normal life 3. state now needs to enforce harsh rules because people don't seem to understand that it's serious 4. some people still don't care, go to parks, beaches, private parties