Is It a Pandemic Yet?

Fortunately we know a lot more about viruses today than we did in 1918. The virus has already been mapped genetically, and many labs around the world are hard at work on an anti-viral treatment. We shouldn't get complacent of course, but it's likely that this thing can be contained and treated eventually.

I read today about a device[1] from Israel that helps the lungs quickly clear phlegm, thus reducing the coughing behavior that spreads the disease. The Chinese are starting to manufacture and deploy it, so hopefully it will cut back on the spread at least a bit.

1. https://www.jpost.com/HEALTH-SCIENCE/New-Israeli-invention-u...

well, for saying that.

That 30 million dead, and probably another 300 million hospitalized and maybe 50 million that need icu care.

Should probably go without saying that we don’t have the ICU beds to handle that in the western world, let alone in developing countries.

We also haven’t had anything like the Spanish flu in the US since we’ve had the modern health insurance system. Is blue cross going to have the resources to pay for all those extra hospital visits? What about all the long term side effects from the millions of people that had acute respiratory failure and survived.

edit:

Also something else to consider -- what if this goes epidemic in the US during the elections this year? They'll have to cancel rallies, campaign events, maybe even the party conventions.

Interesting, this is always my argument against these fatality ratio estimates, can you explain how the IFR can take undetected mild cases into account? Does it just assume at random how many of those cases exist?

That’s assuming no containment effort, like with seasonal flu. Of course, it’s gonna happen if health authorities take the same defeatist attitude as you and do nothing.

It very clearly is and it's out of the box, they can't stop it now. The US should be shutting down all travel into and out of the country, full quarantine from the rest of the world. We'd have a chance at stopping it from doing to the US what it has done to China, if we acted immediately, before it's across Europe and more of Asia and then imported in stealth mode by travelers from those regions that are unaware they're infected.

Back in reality, the US economy will look like China's frozen economy, within a month or two, unless Covid is stopped soon. More likely, it's going to spread from Italy across Europe, and continue to spread across Asia. From those hyper economic zones, the US will be guaranteed to import it from multiple sources (no single country to shut down travel with).

China went full totalitarian to an extreme, and couldn't stop it. Covid froze the second largest economy and did it in the span of a month. What chance does the rest of the world stand at stopping it? None.

Bill Gates is worried about it spreading across Africa (and said in an interview a few weeks ago, when asked about his plans for the year: "well, I plan to travel a lot less this year" - yeah). He's obviously properly worried. It will kill a large number of people in poorer economic regions that will see their healthcare resources overwhelmed. The US is nowhere near prepared for what's likely about to hit.

I don't understand how the virus can be asymptomatic? How does it reproduce and what triggers it to become symptomatic?

We have people who have never been and have no contact with anyone who has been to China, been in the vicinity of Chinese (e.g., tourist centers chocked full of Chinese tourists), or are Chinese; developing infections with Coronavirus. I am more than open to other suggestions and theories, but small towns in remote areas of Italy that have very little if any direct contact with the rest of the country, let alone China, especially over winter, seems quite peculiar; unless we simply have not identified (or officials are keeping secret) a far larger outbreak in cities.

And please don't try to tell me that western governments would not keep secrets or be dishonest. We are all adults and smart here, let's act like it.

Edit: a commenter below correctly pointed out that that 38yo man is being referred to as "patient one" not "patient zero". My bad.

Iran with a 19% mortality rate (on a small scale)!

Also the mortality rate appears to be 3.2% where for a while it was in the low 2s.

https://www.worldometers.info/coronavirus/#countries

If this grows into a true pandemic, it will to the best of my knowledge be the first stress test of our Just-In-Time style of inventory management at grocery stores.

AFAIK there are no confirmed cases in Mexico. It wouldn't surprise me if that was because of the inability of the government to detect it.

I live in Mexico and I believe if it gets here it will be unstoppable. The government doesn't have the resources China has to contain and track infected people.

It could be problematic, though, because lots of people travel during the summer. There are probably millions of people queued up to visit Italy, Spain, Britain, etc. The Europeans take long vacations, so populations will be particularly mobile in July and August.

I wonder if the U.S. might be slightly less vulnerable to contagion, since Americans tend to visit beaches, national parks and other less crowded places, whereas in Europe the tourist attractions are in crowded cities.

It's going to be an interesting few months before a vaccine is hopefully found.

https://www.who.int/emergencies/diseases/novel-coronavirus-2...

https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...

How would that work in practice? The last I heard you can catch this virus pretty easily just by having air touch your eye.

A lot of people live in either a city or a suburban area and most apartments and houses aren't air tight. Wouldn't your breath get circulated out of your apartment, mixed in with the outside air and drift over to your neighbor -- or is the virus not that susceptible to spreading?

I'll also note that I use an alternate front-end for HN - hckrnews - which by default sorts by time, so the only way I'm ever aware of this sort of complaint is when someone brings it up in the comments.

As for this topic in particular, there has been a lot of coverage about COVID-19/2019-nCoV recently, but there hasn't been a lot of new information. I suspect people are flagging the topic because they're getting their regular updates on it from other communities and want HN to remain a place where topics that are of particular and specific interest are posted. Once I realized that's how the majority of the community sees it, I stopped thinking of the rise and fall of topics here as being based on whether or not they are "newsworthy" and it started making a lot more sense.

You also have localized concerns, like, at what point are all the people ordering from Amazon going to stop because they're afraid of getting the virus shipped to them? What is Amazon doing about their worker's health, especially in light of the rather persistent rumors this can spread while asymptomatic? On the one hand, I see people claiming that the virus can't survive being shipped very well and on the other hand we have Amazon striving to ship faster and faster, to say nothing of the actual delivery person.

Whether we like it or not, this is rapidly becoming "tech industry" news too. Unless we are very lucky, by the end of this week, I suspect that's going to be obvious to everyone.

As I've said a few times about prep, even if you don't get the virus or your area never has to be locked down, you ought to be doing prep work anyhow. If it isn't COVID-19, it'll be a quake, or a really bad normal flu season, or any number of other things. You make society more resilient and better able to deal with "true" emergencies when you've prepped enough to take care of yourself and not drain vital social resources at the worst time. You don't usually get lucky and have this kind of warning about oncoming issues. Prepping for a pandemic isn't identical to all the other things you may actually experience, but there's a lot of overlap.

The fact check seems quite wishy washy https://fullfact.org/health/coronavirus-government-laborator...

and here's the lab leak theorizing for what it's worth https://nypost.com/2020/02/22/dont-buy-chinas-story-the-coro...

Pandemics tend to follow a power-law distribution, like earthquakes, where you have small outbreaks here and there and then one comes along at 100X or 1000X the magnitude of anything ever seen before.

Even people who don't have a statistical understanding of power law vs. normal distribution usually have a good intuition of it, which is why most people worry about terrorism more than one would if they were just looking at just the total number of deaths vs. something car accidents or smoking.

What makes the coronavirus so terrifying is power-law component and the unknown unknowns. We still don't have a good handle on basic things like how exactly how contagious it is, how deadly it is, and how long it will take to run its course. Sure, it could end up being equivalent to a "bad flu", but it could also become a repeat of the 1918 Flu or worse.

It is news that there's a new flu-like virus emerging, spreading, and having a relatively high rate of mortality.

The hype for this is part media sensationalism, part risk of it spreading everywhere.

Also, consider second order effects. What happens to hospitals when you get 20k cases of something in a month, vs 20k over a year.

If I die from smoking, it's probably because I smoked. (Yes, I know that some people can die from second-hand smoke, but it's by far the minority.) And if I die from smoking, it's from smoking for 10 or 50 years, not from one cigarette.

With Covid, though, I can die because someone at my work went the wrong place on vacation. And I can die in days, not in years.

And, Covid today kills fewer than smoking. That may not be true in a year, though. So part of the focus is because the potential is there for it to be an objectively bigger killer than smoking.

Covid-19 appears to be extremely virulent and at least as lethal if not several orders of magnitude more so than influenza.

The immediate reason why is Covid-19 is getting so much attention compared to flu in the news media is that it is new. However, some of the reason why it’s getting so much attention from public health officials is that

1) it’s not well understood yet, and the upper bounds currently on virulence and lethality are very high

2) it appears virulent enough that it could become endemic in humans, meaning that we could be dealing with annual epidemics like the flu.

Once you are past the "new and incredible deadly disease" headlines, the disease is news, because it was previously reported in the newspaper.

Contrast that with a well known disease like the flu, the initial headline is not there because a flu wave is not news, if it is not a once in a decade bad flu season. (And note, once in a decade bad is only known at the tail end of the flu season, not at the start.)

Coronavirus is on the news because we can't control it, we can't see it, it can spread without show of symptoms, it can be deadly... has no vaccine - thus the fear of a pandemic.

It's mostly isolated to 1 province in China. If you extrapolate those deaths world wide, you're talking 10s of millions of people dead if it goes pandemic.

But that wont necessarily the case if there's a corona pandemic.

For perspective, how many country will actually restrict travel or even undergone state wide lock down for an outbreak of regular flu??

E.g.: https://www.reddit.com/r/COVID19/comments/f850n6/a_worst_cas...

The world is going to keep trusting them in the future, and of course we're going to keep thinking for ourselves as well.

They have to consider the reactions of the public and also the potential effects of declaring pandemics too often if it is not necessary.

I don't have many comparison points but a quick Google shows that we are still very far from the 2009 flu pandemic, for example.

Of course that may change...

This one is at the tipping point. The situations in Italy and in Iran are potentially run-away if they can't draw a boundary around all the infections including the original spreader.

The past weeks have been filled with mostly sentiment-heavy reports either downplaying it as just a mere flu, with no masks worn even in places like Tokyo - or on the other end of the spectrum - overblown sensationalist videos of people dropping like flies.

We need more credible and helpful reports not just hearsay.

China's reporting on it absolutely can not be trusted, because:

- their health care system is overwhelmed, so they're not testing everyone who may have been infected (a lot of sick people don't even go to the hospitals because they know they'll get turned away)

- they seem to have run out of testing kits in many places

- their testing may be faulty anyway (which could account for the many reports of people testing positive then negative then positive again)

- their media is tightly controlled so there's no independent verification of what they tell us

- they've changed their reporting criteria multiple times

Outside of China there have been too few cases to know yet either, and the countries where it has spread seem to face some of the same issues as China (such as not testing enough people), so their reporting is likely to be skewed as well.

Btw, influenza is also very lethal to infants. I have those in my family.

Wouldn't that logic only apply to people whose family, friends, and neighbors were only in the 30-something, healthy cohort?

The estimated mortality rates for COV19 is higher than Swine Flu but not quite SARS. So anyone who care about, cares for, or comes into contact with someone who is immunocompromised (including grandparents, etc) would do good to keep an eye on this.