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[edited to change linked article]

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...

That link has a really obnoxious popup banner for a political poll. Can you use one that is just the news, please?

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

Thanks, I've updated my link to the one you supplied. My Brave browser doesn't show the banner.

In particular, chloroquine has been shown to be helpful in treatment and is readily available in developing countries since it's used as a malaria medicine (and there are replacements available in developed countries).

in vitro: https://www.nature.com/articles/s41422-020-0282-0

practice: https://www.jstage.jst.go.jp/article/bst/advpub/0/advpub_202...

Yeah it's one thing that gives some hope. Recently:

>Chloroquine Phosphate, which has been used for more than 70 years, has been tested in 135 cases in Beijing and southern China's Guangdong Province. Among them, 130 patients have light and common symptoms, and five are severe patients.

>None of the patients with light and common symptoms have developed severe symptoms. Four severe patients have been discharged from hospital, and one has seen severe symptoms mitigated to normal, Xu said. http://www.china.org.cn/china/2020-02/22/content_75732846.ht...

Which seems quite promising. Also it could be used prophylactically.

Also a good opportunity to ramp up on gin and tonics.

Is it really the same as the medicine?

Was joke. But yes, tonic water contains quinine, and that medicine is related to the compound used to treat malaria. (I think they're both used, but unclear on the specifics.)

What’s the mechanism of action? This is obviously very different than maleria. Why would it work on both?

There's been some recent discussion that it's actually diarrhea that is causing the spread among 'asymptomatic' carriers.

A vaccine is at least a year or two away from going through all the testing and approval it has to go through before it's ready to be deployed on a mass level... if one that's safe and effective is actually found at all.

It's almost better to get infected now where hospitals are not full (if you're in a developed country and generally a healthy person). Wait out 2 weeks, then you build immunity after. Except when the virus mutates :(

That was the OG notion as regards chickenpox.

It might be possible the second infection will be more severe than the first, see https://en.m.wikipedia.org/wiki/Antibody-dependent_enhanceme...

Considering how many countries are panicking over the virus, and how much research is being shared, we should hopefully see a vaccine soon.

if it's anything like the flu, the virus mutates and even with yearly vaccines 3-5 million people get sick and half a million die

So far no vaccine has ever been developed for a human coronavirus. That includes SARS-COV (2003), MERS and the two common cold coronaviruses. So I wouldn't be counting on a vaccine being developed for SARS-COV-2 any time soon.

> I will probably be downvoted for saying this, but...

well, for saying that.

Let’s say 40% of the people in the world get it and a 1% fatality rate:

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

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

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

edit:

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

Building on this, what happens if grocery stores shut down as the Just in Time stocking infrastructure breaks down as truckers / workers stop going to work?

the army will need to step in to keep peace. you are probably looking at a curfews to prevent looting.

edit: probably also rationing: Canned goods are starting to look a bit bare at our local supermarket in Florence, about 200km from Italy's COVID19 cases. https://twitter.com/JacekWork/status/1231900845802954757

edit-2: Residents in Milan, Italy have raided the grocery stores as panic about COVID19 and city lockdowns sets in. https://twitter.com/RuralCdn/status/1231969752890957824

And the West is very old, I would expect that to offset the highly developed healthcare systems and resources there.

Median ages:

https://www.cia.gov/library/publications/resources/the-world...

Countries in the West over 40 at the median:

Germany, Italy, Greece, Slovenia, Portugal, Austria, Lithuania, Latvia, Croatia, Spain, Bulgaria, Estonia, Hungary, Serbia, Bosnia, Czech, Finland, Netherlands, Switzerland, Romania, Denmark, Poland, Canada, Slovakia, France, Belgium, Ukraine, Sweden, Belarus, UK, Russia

Germany has half its 83 million population over 48 years of age. Italy is the 5th oldest country at the median. Covid will hit very hard against older populations.

there is a graph here. don't know how accurate that is though (sample sizes and the fact that the way it is counted has been revised a couple of times already):

https://www.worldometers.info/coronavirus/coronavirus-age-se...

>They'll have to cancel rallies, campaign events, maybe even the party conventions.

Every cloud has a silver lining :)

>Is blue cross going to have the resources to pay for all those extra hospital visits?

If the government ends up bailing them out this could be a step towards single payer health care in the US.

> And keep in mind the IFR, unlike the CFR, is the metric that takes into account undetected mild cases.

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

Most look at infection rates among Wuhan evacuees. Since almost all evacuees were tested, it's a good proxy to estimate the city-wide infection rate. See the 4-5 papers linked in my blog post's last section: https://blog.zorinaq.com/case-fatality-ratio-ncov/#updates--...

Do you have any proof on the claim of the virus being "airborne"?

what about developing a vaccine?

> The seasonal flu alone kills half a million people every year. So any mild disease that is as contagious and barely twice as fatal will kill 1 million

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

>Of course, it’s gonna happen if health authorities take the same defeatist attitude as you and do nothing.

I'm a bit confused. Isn't expecting it to be devastating the very attitude needed for authorities to justify engaging in the containment methods needed to reduce the harm caused?

I would say if authorities don’t act it could kill a million or more. Which is very different from gp’s argument that it will kill a million or more regardless.

Seasonal flu does have containment efforts - vaccination

Prevention and containment are related but not exactly the same.

> Of course, it’s gonna happen if health authorities take the same defeatist attitude as you and do nothing.

how long can they get away with locking people up in their homes? There will be tipping point when those who are supposed to deliver the first-response and do the policing will also become a vector for spreading the disease. Things will escalate quickly no matter if the attitude is "defeatist" or optimistic.

Long enough for the virus to die out? Let’s just check back in July.

what would change things is a vaccine, guess time alone won't do it.

Air temperature could possibly do it or at least contribute, as was the case with SARS in 2003.

wouldn't that be only a local effect though, e.g. Southern vs Northern Hemispheres?

The Northern Hemisphere account for ~90% of the world's population; the percentage living beyond 23.5°S is very small. It is entirely conceivable that the epidemic is put under control before it gets too cold for those people.

It's 35C in Bangkok, 36C across Malaysia and 32C in Singapore.

How much hotter do you think it would have to get to make that virus die out?

As far as I can tell the virus isn’t spreading like crazy in Bangkok, Malaysia, or Singapore. Singapore had it way worse in 2003, still the SARS virus withered came June.

Most Singapore buildings and its public transport system are fully A/C.

It's similar for Malaysia and Thailand since they're still in the tropics, except those countries are less dense.

There's plenty of AC in the US as well.

> COVID19 is the most severe (ie. contagious + fatal) airborne disease since the Spanish Flu.

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

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

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

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

It's too late for this approach. The only reason that could explain why the US still does not have many cases is lack of testing and the fact that it goes undetected for a long time.

As you said:

> It very clearly is and it's out of the box

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

If we had a government that wasn't starved, it might also be preparing sufficient resources for if/when the virus does reach epidemic proportions here.

Also, Americans have been trained to avoid the medical system and tough it out for cost-saving reasons, that training is going to be counterproductive here.

Starved? $4.1 trillion, and a nearly $1 trillion deficit, is "starved"? What in the world would "overfed" look like?

> Covid froze the second largest economy and did it in the span of a month. What chance does the rest of the world stand at stopping it? None.

This doesn't follow. It doesn't matter how large an economy is affected. The primary factor is contact between infected and healthy people. Areas with less population density might have a good shot at keeping infections down, like a lot of areas in Europe.

> like a lot of areas in Europe.

You misspelled America. Europe has a pretty high population density in comparison.