Past Time to Tell the Public:It Will Probably Go Pandemic, We Should Prepare Now

Keep in mind, many of these decisions to avoid "pandemic" talk try to take most holistic views in regards to public safety/health. There is a lot of consideration regarding deaths cause by panic actions which are often estimated/modeled as well and if panic related deaths and side effects are higher than a current actual threat, it's often viewed that the best course of action is to suppress panic until warranted.

So lack of pandemic talk doesn't inherently mean there is a legitimate reason not to panic, just that you're being given limited information. At the same time you shouldn't assume experts, the media, etc. are somehow mass conspiring against your health/safety. Assessments are probably reasonable to follow.

The best course of action is to also take a holistic look at situations independent of these groups and make your own rational assessment of risks and impact.

If you don't already have some non-perishable food supplies, you should have completely irrespective of this specific recent viral outbreak--its basic preparedness for emergencies.

Some basic preparedness (I'm not talking bunkers and 2 year food cache craziness) are warranted in general for unpredictable disaster cases so these situations are good reminders for people to check their pantry for food, etc. just in case something awful was to happen, those supplies can help significantly.

The US is barely doing any testing, so if there was community spread of COVID-19 in the US right now, there's a good chance they wouldn't even know about it.

Communities aren't just made of public health organizations and hospitals and emergency workers, they're made of individual citizens and their families and friends. Communities should be made prepared from both the top down, and from the bottom up.

But yes, definitely less edgy and out there.

https://www.politico.com/news/2020/02/20/cdc-coronavirus-116...

For example, if you're a doctor with a case of atypical pneumonia, there's no way to actually test a patient for it unless there's clear China (possibly Hubei!) travel history. And that could take 3-7 days. However, consider the Canadian ER doctor who a few days ago decided to ask for a test for a woman who had traveled back from Iran recently - turned out she had it, and it revealed to us unexpected, but very real vectors of transmission.

These technical issues have to be solved, otherwise there's no way to distinguish this from regular seasonal flu cases and pneumonias, until - like in Wuhan - the atypical cases bubble up. At that point, it's really too late to do much containment.

Recent example: the mom who killed her husband, brother and kids because she and her new lover believe in an "apocalypse" summer 2020.

Fearmongering is the go-to default for absolutely every issue the media covers. Then during an actual literal pandemic they take a short break from every other the-world-is-ending story to give us the "don't fearmonger" lecture.

If you ever find yourself split in doubt between your own sanity and that of the media's, please for the love of God assume they're insane first.

If you think the entire government has your specific best interests at heart, isn't that a sign of schizophrenia? That sounds not much different than people who think that songs on the radio or TV shows were created for them specifically.

> 3. Do you feel like you have special information and insight the rest of us do not?

Most people are following this story very little or not at all, so if you're even remotely paying attention then you have special information and insight that the vast majority of people do not.

> The potential public health threat posed by COVID-19 is high, both globally and to the United States. The fact that this disease has caused illness, including illness resulting in death, and sustained person-to-person spread is concerning. These factors meet two of the criteria of a pandemic. It’s unclear how the situation will unfold, but risk is dependent on exposure. At this time, some people will have an increased risk of infection, for example healthcare workers caring for patients with COVID-19 and other close contacts of persons with COVID-19. For the general American public, who are unlikely to be exposed to this virus, the immediate health risk from COVID-19 is considered low at this time.

From "Coronavirus Disease 2019 (COVID-19) Situation Summary"

> This is an emerging, rapidly evolving situation and CDC will provide updated information as it becomes available, in addition to updated guidance.

> Updated February 22, 2020

https://www.cdc.gov/coronavirus/2019-ncov/summary.html

You could put yourself in the position of someone who grew up poor and disillusioned as part of a visible minority in a US city, or a Hong Kong protestor, or almost any other anti-hedgemony protestor and they'd check the first three boxes. Are they wrong or is the system wrong? Nothing in this list helps determine that.

I hate this advice. It's not "wrong," in the sense that technically it would be a good thing to do, but it's also so wrong that it transcends categories of right and wrong.

Your refill schedule will not allow you to get extra prescription meds early. And if it did, your insurance wouldn't pay for it - which means paying sticker price, which means ... well, depends on the med, right? I used to take an antacid that had a sticker price of about 800/mo.

For almost anyone, "stock up on an extra month of prescription meds" isn't a thing. It's just not a choice. For it to /be/ a thing, someone actually needs to write a law stating something like "once per calendar year, a physician can write an extra parallel prescription for a supply of medications not exceeding three months, and insurers must pay for it," or somesuch.

Until that happens, I don't even know what to /do/ with that kind of "advice."

The risk of panic is that if there ends up no need to panic, then folks won't listen later when there is a need to panic.

I see this all the time with fire alarm tests. No one takes them seriously -- when a real fire comes they will not take the necessary steps to evacuate fast enough.

This is also worth keeping an eye on:

https://www.cdc.gov/coronavirus/2019-ncov/locations-confirme...

What a noob

Seriouslu though, if it strikes it'd be at least for a few months.

Generally, the CDC is quite good at their jobs. If you think they’re shrugging their shoulders right now and being lazy or complacent about something, you’ve probably misunderstood part of the story.

It’s virtually tradition for Internet comment sections to fill with overconfident armchair experts who claim to know better than the professionals as well as the general public in these cases of outbreak. The arguments usually hinge on one or two “gotcha” statistics that they think are evidence of a larger problem. IMO, it’s not helpful. Let’s focus on actionable tips like this article instead of armchair criticisms of professionals based on unsourced information.

Probably unlikely, given the understandable emphasis in the medical community on gold-standard diagnostic methods. But if one of these companies can collaborate with the CDC to get their hands on a large number of patient samples for validation, the FDA for quick approval, and a reliable manufacturing partner for scale-up, the possibility exists.

(Edit: spelling and added required collaborators to the list)

And then there is the risk of having ICU personnel become infected themselves. This is not a trivial challenge.

Just like not everybody dies from many other diseases such as the flu. The difference here is that it also hits hard on otherwise healthy people and that healthcare workers are very much exposed to infection. If that front line does not hold it can get worse rapidly.

Western countries with good medicine and infrastructure in place stand a chance of riding this out with just (possibly substantial) economic impact. Poor countries are in for a rough ride. Check out what is happening in Iran right now (which your linked video conveniently leaves out, possibly because it does not fit their narrative).

Mortality rates around 2-5% for a pandemic are nothing to sneeze at, infection rates in close proximity are very high making it hard to care for those that are showing symptoms and put high density population centers at serious risk.

It's hard to tell what's alarmist with quarantine and shutdown of schools/businessess coming down so hard on the affected areas. People aren't used to that sort of thing.

The right steps are being taken in general. If this does continue to spread, which seems likely, people will need to exercise calm and patience.

Otherwise, I think this assessment is dead on.

Those numbers are dominated by the reports from China. If you look at just the cases outside China, then those are still on an exponential curve with a doubling time of about 6 days.

My plot of the WHO numbers outside China: https://docs.google.com/spreadsheets/d/e/2PACX-1vQTpoR9gmgei...

Source of the numbers: https://www.who.int/emergencies/diseases/novel-coronavirus-2...

This is my thoughts why Covid-19 is much more dangerous than seasonal flu: first it is much more virulent, and hard to detect, many of the infections in Korea were due to one 61 years old woman alone. Secondly the mortality rate is higher too, estimated at 2-3%, with the serious cases at around 10% (please correct me if I am wrong). Those two above combined means if left unchecked, Covid-19 can easily overload our medical system, as what is happening in Wuhan*. So I will most likely won't perish or suffer any long term health problems from Covid-19, but our society as a whole might be devastated if we can't contain it. There is no need to succumb to irrational fear (like what's happening some countries), but we should all be prepared.

Actually I am worried about Iran, the embargo from America means their medical system are lacking all essentials. That's why they have so many deaths, second only yo China.

Infection can be most basically modeled by an ordinary diff eq. And what happens is when everyone knows about it, the infectivity drops off a cliff and the illness reaches a carrying capacity rather quickly and dies out with good sanitation and quarantines. It could be Ebola-deadly and it still dies out because the transmission rate drops to almost 0.

Because of self-preservation and global news, a modern pandemic would only work if it were like Hepatitis C and norovirus: very long incubation period and airborne.

Perhaps I'm misinterpreting your tone, but I'm not so cavalier about performing solo heavy-duty, months-long care of parents & grandparents and the possible loss of company senior execs/mentors and coworkers over 30.

(Not sure there is much we can do in the long run though)

A key point of actions to date has been an attempt to prevent 2019-nCoV from achieving pandemic status, so that it doesn't recur on an annual basis.

If sufficiently widespread, and affecting a quarter to half the globe's population, we're looking at tens of millions of deaths. Contrast 12,000 - 61,000 deaths in the US from influenza (https://www.cdc.gov/flu/about/burden/index.html), and 291,000 - 641,000 worldwide (https://www.beckershospitalreview.com/quality/cdc-global-ann...). That's with effective vaccines and antivirual treatments, neither of which exist presently for 2019-nCoV.

Preventing this coronavirus from becoming "just another flu" would be a Very Good Thing.

Containment can be done early on and if done effectively can get you back into your 'no need to worry' mode. But once containment has failed you are in different territory and will have to play a much more complex game with more substantial impact.

So your present day chances of contracting this in the next 24 hours are looking pretty good but your chances of contracting this in the next couple of months are substantially better than winning the lottery or getting struck by lightning even once. Unless you live the life of a hermit.

A vaccine would be quite handy, but we do not have one - yet , though that race is on - and even if we had it you still need to make it in quantity to be effective. A virus doesn't particularly care about whether you are able to think logically or not. It cares about contact between people and not killing its host too quickly. That way it improves its chances of spreading its genetic code.

If you are only interested in your own well being (which is fairly uncommon, do you not have family or friends?) Then make sure you have stocks of food, water and small bills.

Most of the time there are still ways you can cross, so instead of having known routes where you can test and treat accordingly, you have an unknown number of people crossing the border on unknown points and spreading the virus in unknown regions.

This sucks but if you live in a wealthy country you will likely survive this, it may still impact you economically.

Be careful. Comment sections tend to attract overconfident armchair experts rather than professional advice. This is a forum where technology people congregate, not virologists.

You may get repeated advice about general prepper techniques, but in my experience the mainstream prepper types can be over focused on unlikely doomsday scenarios instead of more realistic extended economy-slowing scenarios.

> What should I personally do to prepare?

I suggest reading the linked article. This is exactly what the article is about.

1. n95 masks, e.g. 50 of them. technically, each mask can only last several hours

2. UVC light for cleaning up used n95 masks so they can last a few days each

3. protective eyeglasses if you need to visit hospital for any reason in the next few months

4. ethanol (not for your masks)

5. medical gloves

https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-t...

> facemaskst “end up creating a false sense of security and most people don’t wear them appropriately,” https://www.marketwatch.com/story/the-cdc-says-americans-don...

Then, if the economy tanked as a result of an epidemic, for 3-5 years, what would you wish you'd bought beforehand?

That's about all you can do.

Remember, if you're homebound, you'll really want to exercise after a few days. Some way of doing that indoors is wonderful.

Keep calm, follow basic hygiene, and be ready to work from home at short notice. Maybe don't travel unless you have to.

This is not the end of the world and the risk is low. Change course only if the risk to you becomes high based on facts.

2019-nCoV is a viral disease spread by droplets and close physical contact, possibly by contaminated fluids, including human waste (sewage). Literature I've seen suggests relatively close prolonged contact is necessary -- hours around an infected individual. There've been some "super spreaders", including apparently a woman within a South Korean church, who've infected numerous other individuals.

There is no vaccine or effective curative treatment. Medical treatment is currently limited to diagnosis, and treating symptoms.

At an epidemiological level, the outbreak will be halted when the level of transmission (R value) of the disease falls below 1: one infected individual on average infects fewer than one other additional persons. The outbreak will continue for some time after this, with occasional new cases, but the total new cases should fall.

Halting transmission means disrupting transmission vectors:

- Less person-to-person contact.

- Less high-risk contact.

- Reduced risk of exposure through contacts.

Keeping yourself and the things you touch clean is the single most effective thing you can do.

Soap and water are a low-tech effective mechanism. Wash your hands. Often.

Alcohol-based hand-sanitizers work.

Antibacterial sterilisers are not effective against 2019-nCoV, though may reduce risks of secondary / opportunistic infections.

Soap, detergent, or bleach sterilisers on high-contact surfaces should be useful. Taps, light switches, door handles, elevator buttons, toilet handles, counters, keyboards, touch devices.

Note that many modern devices disinfect poorly if at all. Many are harmed by water. Consider, e.g., keyboard covers if necessary.

Barrier protections such as gloves, masks, or eye protection may be useful if:

- You cannot avoid touching possibly-contaminated surfaces, e.g., shopping trolleys, on public transit. Discard gloves and masks after the exposure episode, dispose as hazardous waste, and wash hands after removal.

- You are or may be infected yourself, to avoid infecting others.

- You're assiting others who are or may be infected (family, friends, neighbours, etc.).

Masks and gloves should not be worn as a matter of course (e.g., around the home) so long as there's little risk of infection.

Be generally aware that an epidemic may be declared where you are, and what the implications are likely to be.

That includes several weeks of reduced transport, possibly including long-range transport. Schools and businesses may be closed. Medical services may be overextended.

Workplaces should make contingency plans for remote work or possible shutdowns, as well as assess and implement cleaning procedures.

If you have not yet had a flu shot get one now. Not because it will prevent 2019-nCoV infection, but because 1) you don't want to be getting sick with something else in an epidemic and 2) you'll reduce load on medical services and risk of nosocomial infection through healthcare services.

(I've been fighting with close family and friends on this point -- idiotically stubborn individuals are an exceedingly unfortunate and frustrating reality. The elderly, uneducated, and or mentally handicaped (Parkinsons or other conditions) may be especially resistant to sensible preventive actions.)

Consider changes to routines (e.g., work, school, socialising, religious worship, fitness or gym) in the event of a local outbreak. Preparing to minimise transmission risk will be useful. Do so for others in your household as well (partners, children, parents, housemates).

Get in touch with neighbours and have a mutual support plan in effect. Buying supplies for someone who's sick is low-risk, but will make their recovery far easier.

Overall severity for most people is low, deaths outside China have been reassuringly low. The worst places for the outbreak seem to be those with poor public infrastructures, public health, general healthcare, and institutional trust. Unfortunately, the US has been trending in the wrong direction on all these measures, but in large part remains among the more prepared countries. Countries lacking these traits, having poor communications and public health, and cold, dry conditions are most at risk. North Korea has been on my watchlist since early in the outbreak, and the lack of any case reports seems improbably accurate. Iran's outbreak may be concerning.

China's containment efforts seem generally to have been working well, with a few possible exceptions. Prison outbreaks are among the more troubling notes in recent news.

Coronavirus generally thrives in cold and dry conditions, which should become far less prevalent as Northern hemisphere spring and summer arrive. To that extent the epidemic being self-limiting is likely.

Second-order effects, including disinformation and panic, are all but certain to be the most severe disruptions anyone will personally experience. Global economic and supply-chain shocks are possible, though if handled sensible, not a tremendous risk. Money doesn't grow on trees, it's easier to come by than that: central banks can inject it at will.

If you're going to stock up on food, allow me to suggest cans of whole San Marzano tomatoes. San Marzanos (and other close relatives) tend to last really well in a can -- almost as good as fresh!

Keep some extra onions or shallots and a few celery roots in your fridge, and perhaps some Calabrian chili flakes in your pantry, and you can make delicious pasta sauces or soups from them. Also, this works just as well on a random Tuesday night as during a pandemic.

Or just slice the tomatoes and put them on a sandwich. And if there's no real crisis in your area, then you're still in luck, as you've got a good supply of tomatoes for next winter.

Probably you should pick up some beans to go with them too, from a dietary standpoint, but I'm a tomato lover, not a bean lover, so I don't know what the right type is there.

Mmm. Now I'm hungry.

low numbers could just be measuring detection ability instead of actual rates.