Seeing the Smoke
putanumonit.com
putanumonit.com
Do these people think coronavirus is going to cause enough unrest to destabilize civic services and affect our municipal water supplies?
Or do these people just parrot this stuff without critical review?
Here's one hypothetical scenario that might be intuitive, not from the article... Say, you live in a dense part of the city, and there's suddenly a lot of confirmed cases around you, so your family decides to stay home for a week, to wait&see how this plays out and what government help arrives. All your city utilities work, but much of the city water utility workers can't afford to live in the city, or otherwise have to stay home, and the remaining workers can't keep up with the ordinary day-to-day level of repairs and maintenance. A pipe fractures, brown water comes out your faucet, and now you have to decide whether to venture out to try to find a store open that has bottled water, and possibly bring the virus back to your family, or stay in and hope water will be fixed and known-safe within 3 days. Ordinary bottle water is $1-$2 a gallon, off-the-shelf from the local store, and some insurance and peace of mind against a very bad and not-too-unlikely situation.
I think we'd do a disservice to people by discouraging them from having a modest backup plan for water during a possible pandemic quarantine. Remember the rough "3" rule: 3 minutes without air, 3 days without water, 3 weeks without food.
A natural disaster or pipe break that forces a water boil alert could happen any time.
Again, I am trying to understand if there is any elevated need to have bottled water at home during pandemic fear vs any other time when run-of-the-mill water boil alerts are issued.
Ultimately, it's your call to make.
Of course, that's the case with seasonal flu as well, which is why it's a good idea to keep water on-hand to start with.
A natural disaster or pipe break that forces a water boil alert could happen any time.
Again, I am trying to understand if there is any elevated need to have bottled water at home during pandemic fear vs any other time when run-of-the-mill water boil alerts are issued.
For the past year or so, my electricity goes out at least half a day every 2-3 weeks. Once, it was out from the moment I woke on a Saturday at 7am until 3-4pm or so. I live in the Mission, San Francisco. Sometimes I get a heads up by text from PG&E a few hours before, sometimes not.
My gut wants to agree with what you wrote, but I feel like re-evaluating my priors is appropriate here.
My sense is a pandemic is not equivalent to a natural disaster. But a lot of the “be prepared” content seems to conflate the two, which I’d argue is not helping matters.
It is recommended everywhere because it is useful, not because people are 'parroting this stuff'. I think any real critical review of the data would conclude with a suggestion that bulk bottled water is a good idea for people to stock up on.
> Do these people think coronavirus is going to cause enough unrest to destabilize civic services and affect our municipal water supplies?
No, I don't think anyone is worried about that. This is the first suggestion of that nature I've seen, I think you are arguing a straw man here. The primary reason for bottled water is to help prevent the spread of germs by reducing shared water sources. A secondary reason would be general risk-reduction: having your own clean safe water is a calming factor and reduces/eliminates at least a few possible contamination sources.
It is a logical move, not some hare-brained silly idea that people are 'parroting'.
On the other hand if you spend money and time gathering in a resource that is easily and continually available then you are not taking the action that really will help you.
Gathering supplies of water is sensible in case of natural disaster and war - for this one, not so much. Spend the money on food and entertainment instead.
a) tap water is going through decontamination procedures
b) there is no evidence that tap water can transmit virus
c) if you don't trust tap water you can boil it easily
d) even in single household people are not really drinking from shared pool of water
It can be argued that it's better to have water and not need it rather not having it in the need, but on the other hand if you're at the point where basic needs like water and electricity are not provided anymore lack of stockpiled water is unlikely your biggest problem.
You can tell because no where in the article does the author advocate the single most powerful thing that you can do to improve you and your families chances of survival in any disaster situation.
Make friends with your neighbors, invite them for a meal, know their first name and get them to know yours. Especially they should know things like "oh, yeah, miss williams is a diabetic"
But on the other hand, while you're stocking up on other stuff, why not include water at the same time? It's always handy to have it for other emergency situations.
It's always like this. People first underreact and want to believe it's nothing, then overreact. For now (2 weeks after the article was written), staying levelheaded amidst the irrational panic is the "rational" thing to do. Exactly the reverse of what's proposed in the article.
https://www.worldometers.info/coronavirus/
Error bars on this would be even better, but note that the growth in cases is still linear, about 3000 new cases per day. It will be interesting to follow how this changes, with more testing in the US for example, but based on this one thing it looks to me like we'll make it to summer without it taking over the world. If you have better data or analysis, I'd like to see it.
[edit]: found the curve that shows new cases outside of China, and it's indeed NOT linear:
https://www.worldometers.info/coronavirus/coronavirus-cases/...
I actually stocked up (we always have lots of bulk dry foods anyways) so I can stay home if needed but there's really no clear picture of what's going on.
If there is widespread transmission coming from asymptomatic people that would mean this is a lot less dangerous than people think, maybe all these people coughing in the office actually have covid19... If there isn't than why worry yet. There is some evidence that suggests this doesn't transmit very well (e.g. many people quarantined through close contact tracing did not catch the virus) yet there is some contradictory evidence (e.g. the cruise ship or larger clusters.). The truth is probably somewhere in the middle.
If you live in an urban area with millions of people what would be a reasonable threshold of cases to isolate yourself completely?
My feel is that it's worthwhile being cautions and also assuming the actual numbers are ahead of the curve we see. As long as the projected numbers are still small relative to the overall population then washing your hands, being careful what you touch (your face and shared surfaces), and reducing unnecessary close contacts with random people are likely good enough safety measures.
As the numbers grow you can consider completely eliminating contact with others though that can be pretty difficult.
it'll either be the most overhyped over preparedness... or the more likely outcome of a lot of death after the hospitals are oversaturated. which is almost guranteed to happen if 70% or our population gets infected.
at least its not "as far" as the climate crisis, so less time you have to listen to deniers.
In which case all hope is probably lost on this hypothetical you.
China has way too many incentives to lie, and has consistently demonstrated that lying is how it operates.
The number of active cases has gone down from 60k at Feb 17 to 40k today.
[0] https://www.worldometers.info/coronavirus/coronavirus-cases/...
I see a low mortality rate for healthy people.
https://www.worldometers.info/coronavirus/coronavirus-age-se...
I see stories about how the virus is circulating because most people have no symptoms, and don't even go to the hospital.
https://www.thelocal.it/20200228/coronavirus-may-have-circul...
The only firsthand account I've read makes it sound like a cold. "If I were at home with similar symptoms, I probably would have gone to work as usual."
https://www.nzherald.co.nz/opinion/news/article.cfm?c_id=466...
Yes, wash your hands. Yes, don't go to work with a cold. Yes, older and sick people may want to self-quarantine. Sure, buy some extra food. No, don't spread panic.
The point estimates for mortality rate, R0 and the like all are subject to interpretation/manipulation. The health agencies have allegedly been subject to regulatory capture both in China and in the USA.
1. The communication of the CDC has changed markedly since the appointment of Pence to the head of the coordinating council. The messaging appears to be more controlled and filtered.
2. The frequent changing of the definition of what a "confirmed case" is in China leads me to completely disregard any published numbers much like other economic metrics published by China.
3. The restrictive testing conditions of the CDC likely has led to multiple cases not yet being discovered in the USA.
As a scientist I'd like to see independently reproduced results across other independent population samples. I think it is healthy to take a more Bayesian approach to these statistics, because you should let your beliefs be updated by additional data and factor in your prior assumptions.
Citing data from a single study from a Chinese health agency just isn't enough for me to change my beliefs completely, my prior knowledge is too strong when combined with everything else circulating in the political/regulatory sphere.
My personal distributions for what the values of mortality and R0 are both still have really fat long tails. But of course that's subject to change.
1-2% case fatality rate combined with the current R0 estimate is not low. If this pandemic goes unmitigated it will kill more people than the spanish flu, given the current trajectory.
I think the GP is saying that mortality is significantly lower than it appears because the asymptomatic carriers aren't counted in that figure.
That's one way these new pathogens can play out but I don't think there's necessary good evidence for this - the 2% figure seems pretty reliable everywhere.
It's worth noting that causes of the Spanish Flu's mortality rates are still being debated:
"Scientists offer several possible explanations for the high mortality rate of the 1918 influenza pandemic. Some analyses have shown the virus to be particularly deadly because it triggers a cytokine storm, which ravages the stronger immune system of young adults.[14] In contrast, a 2007 analysis of medical journals from the period of the pandemic[15][16] found that the viral infection was no more aggressive than previous influenza strains. Instead, malnourishment, overcrowded medical camps and hospitals, and poor hygiene promoted bacterial superinfection. This superinfection killed most of the victims, typically after a somewhat prolonged death bed."
~15% severe cases, ~5% critical. Numbers growing exponentially everywhere.
Long incubation time with little symptoms most of the time making it silent until it's too late.
European governments not even trying to contain it anymore.
Already very loaded health care system are going to be overloaded.
Information heavily controlled to avoid panic.
Seemingly disproportionate Chinese response for something western countries treat as common cold.
The unknown in general :
14% reappearance of disease in recovered cases.
Some cases of sudden death in healthy individuals. (Cytokine storm on reinfection ? )
Probability of mutations becoming higher with increasing number of cases.
The outs :
- Miracle cure : (chloroquine ?, Remdesivir ?, other ?)
- Hot weather (not very optimistic as it seems to spread in hot countries)
- Worldwide quarantines
- Mutation of a less severe variant (virus is from a quite stable family)
- Vaccine in 2 years.
- Everyone gets it, herd immunity builds up, more than 10%-15% percent virus related death among the elderly + unknown complications.
I'm very concerned, taking care of 2 ( > 90 ) relatives.
I stocked a month of food.
Already washing hands and taking precautions.
Would quarantine if I could.
Of course, the virus is spreading and it can explode at random places. That is a risk and WHO rates it as "Very High" currently. However, they also say "If you are not in an area where COVID-19 is spreading,or have not travelled from an area where COVID-19 is spreading,or have not been in contact with an infected patient, your risk of infection is low." [1]
[0] https://experience.arcgis.com/experience/685d0ace521648f8a5b... [1] https://www.who.int/docs/default-source/coronaviruse/situati...
A friend who works in a hospital said that they can only request a test if the patient is bad enough to need intensive care. And even then the request may be denied.
The case count doesn't mean anything anymore. The world's healthcare systems don't have the capacity to track the spread.
I then spent Thursday securing a methodology for water storage just in case. I don’t expect to lose water for a while but earthquake country. It’s a lingering missing hole I’ve felt for a while.
The rest of my prepper is ironically due to burning man. So we are pretty good there.
The window for buying before a panic is closing fast. In terms of face masks it’s already closed. I managed to eek out one more mask this last week by buying a half mask 3m reusable respirator. And P100 organic vapor cartridges. Very over the top for covid-19, but will have dual purpose for paint fumes later. Plus no competition and the prices and delivery were timely.
Soon widespread fear will turn into action and you want to be sitting at home watching YouTube videos.
Of course, that's easy for me to say since I live out in the country, 10 miles from a Walmart :-)
I lived through Hurricane Sandy in NYC. That was something. But I never felt the urge to go preemptively shopping before. Food has always been in abundance and regularly available a few blocks away 24/7. Shoutout to Westside Market in the UWS. Yesterday I became convinced I needed almost a months supply of non-perishables _right now_.
Tonight, there was no other customers shopping with urgency at my local Target as I was buying six spare toothbrushes with two bottles of NyQuil and two cans of saline nasal spray along with all of the food I could fit. All of the aisles were well stocked, mostly. They were less so once I went by. There was one lady with 7 cans of lysol spray, but we just winked at each other and hurried off. I think both of us were trying to not get any more shocked glances from the people just strolling trying decide which flavor of double stuffed Oreo's to buy this Saturday night. Deep down those people know what's going on, but aren't yet ready to take action.
Sure, I'm early and feel guilty because it was so easy to get everything right now. But also feels really good to have it stocked away in my pantry. If I don't use these supplies my local food bank will get everything I don't need.
I'd like to ask of you to consider doing the same! If all of this preparation is unnecessary, there are hungry people that will appreciate it later on. If the possibility to make something good come out of this possibly tragically bad situation motivates you take some time to get ready, I'm pleased.
If the worst that happens is that we don't have to go shopping much for the rest of Lent -- great. I'll be pretty surprised, but i'll be fucking overjoyed, too.
I felt silly. But my justification was that it’s more convenient for me to do my shopping a few weeks ago, than in a month when it’s much more likely we won’t feel as comfortable around large groups of people.
I don't think it's difficult to imagine situations in a lot of places where natural disasters can disable things for several days, maybe a week or two. A couple weeks of food seems like a good thing to have on hand, regardless of place, time or situation.
I just went on Amazon and ordered two blood oxygen saturation meters. One for adults and one for kids. Even if Covid-19 never ends up reaching us, that is a valuable diagnostic tool to have available. Especially for $30 a piece.
I'm tempted (same maker has one for $11) but I don't know how I'd verify the accuracy
1. I checked out all the cheap ones, and Zacurate was the only brand I could find that was under $50 and had actually been properly tested for accuracy.
2. If you buy one from Amazon ("ships from and sold by Amazon.com") or that specific brand from "Beyond Med Shop" (which is owned by Zacurate), you won't get a counterfeit.
1. There is evidence that a still normal, but lower-than-expected SPO2 can be predictive of medical issues - https://journals.lww.com/md-journal/fulltext/2018/06220/can_...
But mainly, 2. If there are overcrowded hospitals, having further insight into the severity of the situation seems useful.
Threat fatigue and lack of experiencing long-tail events can lull people into complacency. I've been in the Loma Prieta, Camp Fire, week-long PSPS, near hurricanes and the Boy Scouts... be reasonably-prepared but don't go crazy buying a BSL-4 universal decontamination shower kit. Panic buying helps no one.
The biggest point is if it accelerates to pandemic is for the elderly, especially men and those with chronic conditions, to be protected from anyone who could possibly have it. For them, the CFR is somewhere 15-35%. For anyone who needs hospitalization, the CFR is about 49%. Occasionally and randomly, healthy people die from it too at very low rates.
It seems this is unique to China as men are much more likely to smoke there.
I truly don't get the assumption "it's worse than they say" when the most likely outcome (putting Hanlons razor into play), is that mortality stats are nearly accurate and caseload is under reported due to lack of testing and self isolation. Death is hard to hide. I believe mortality stats. Any non reported mortality goes to under reported cases, so it evens out.
I know it's optimistic thinking but I am drawn to a belief the effective cumulative death rate in China only drops, as better figures emerge unless unlike all other virus it becomes more lethal not less under mutation.
A different comorbidity outcome eg opportunitistic pneumonia or delayed onset COPD or something, that's different. That would demand a massive change in view. Change in the long-term disease consequence will be interesting and important.
(For instance the effect some disease has on vaccine immunity across the board comes to mind: if this happens, bad news: but, that is in the future)
Well adapted virus mutate not to kill their hosts. Badly adapted virus self limit.
This is not about liking or disliking the Chinese state, I am asking on what grounds people walk to 'under reports of death, over reports of caseload'
No other claim alters mortality into worse places.
Non Chinese deaths predominantly lie in old, lower immunity, comorbidity sick people. And, saying "it's too soon, wait for the wave" is forward facing speculation. Cumulative infection and death rates are inherently backward looking. Explain to me how these a posterior figures get worse not better.
TL;dr it's not smoke, this article is mis applied stupid maths.
Keeping people on a ship (think norovirus and cruises) or having a religious cult uncover huge transmission outcome.. that's not a true reflection of societal risk under self isolation in the home.
I am told the CDC insisted on a home made test. NIH as in "not invented here" and not national institute of health.. bad move guys. Under testing in a US health system with patient cost recovery. That is a recipe for less successful disease control. The US is going to turn out to be under reported. Death rates will probably be right because dying in America is statistically well understood. People won't front for expensive medical test or treatment. High rates of COPD and diabetes and therefore higher risk of death than many other economies. Also large numbers of underinsured older people.
Regarding the fact that the death rate appears to be lower outside of China, that would appear to provide evidence against China mis-reporting their numbers (after all, why would they intentionally report a higher death rate). But the one plausible counter point that I have seen, is that the hospitalization/ICU rate is pretty high, to the point where a wave of COVID-19 infections in a short time-span could overwhelm local capacity causing a large spike in mortality. This is most likely why China was building Hospital facilities in Wuhan and why they imposed such a draconian quarantine. So the numbers outside of China might not really be comparable because the number of cases (so far) have been well below local hospital capacity.
Unfortunately, it looks like we are going to have a third data point soon. Iran has really poor healthcare infrastructure and they are undergoing a wave of infections. If the mortality rate is heavily dependent on ICU treatment, then Iran might be close to the worst case.
The response to any cough or fever should be self isolation. Report by phone. Wait for triage.
The market tanked fast (a sign of efficiency in fact) when it became clear that containment within China had completely failed. Cases were dwindling (https://www.worldometers.info/coronavirus/), due to China's strong protection measures, but all of a sudden there was an upswing due to international spread.
It's interesting to read Ray Dalio's analysis on this whole thing: https://www.linkedin.com/pulse/our-early-thinking-coronaviru...
Finally, note that personal protection is different from stock market protection. It's more likely than not the SP500 will fall another 7% to 2750, but that doesn't mean shorting is a profitable strategy.
[1] Maybe buy protective puts (perhaps volatility was far too low), but that's another story.