How to Work During a Pandemic
techcrunch.com
techcrunch.com
herein lies the problem. everyone knows the virus is costing time and money. but how much do you want to bet that unscrupulous people are going to want to try to keep their employees working in-office or on their retail sites so that their bottom line doesn't get hammered as hard?
without a public health response mandating certain measures -- a response which the US public health bodies have been woefully slow to initiate -- many people will be left at risk.
then there's the other issue: what do we do about people who can't afford to stop working or work remotely? at present, we have no plan. these people are a ticking time bomb because our political apparatus refuses to mobilize in response to this threat.
For really basic goods and services: production and sales of food, fuel, electricity, healthcare, etc., it's easy to imagine the health impact of a prolonged interruption.
But what about less urgent categories, such as building construction, automobile manufacturing, restaurants, and tourism? Is it possible that a prolonged reduction in economic activity from those sectors would have a major impact on public health?
As a back of the envelop calculation from someone who doesn't do epidemiological modeling, the US has ~330M people. The flu itself infects 5-20% of the population from what I read so let's say this virus infects a conservative 3%, we're at 9.9M.
Based on the data I'm seeing, mortality rate is higher than 3% but there's a lot of factors that go into that (so who knows), so were at just shy of 300k deaths. I think those are conservative figures, personally. My guess is the transmission rate and mortality rates are both higher but there are again so many unknowns.
https://hub.jhu.edu/2020/01/23/coronavirus-outbreak-mapping-...
"If borne out by further testing, this could mean that current estimates of a roughly 1% fatality rate are accurate."
If it's 70% of the world gets it approximately 52,710,000 dead
however, I think once we're at 40% of the population having it I would expect things to go worse because that is a lot of people overloading the health system.
People lose their jobs, their homes, and their healthcare.
>In the U.S., especially the nonstop work culture in startups, we tend to think we’re immune to such things and carry on business as usual.
Do we really think we're immune? I mean, there's probably a large set of the population ignorant of how viruses and disease spreads but aside from them, I don't think we believe we're immune. Most people are a little more educated than that.
The vast majority hope they won't be affected because the way our ridiculous business and work culture continues entrenching into our personal lives, in many cases, due to providing financials for necessities. I'm sitting in my office today with a mixed group who frequently travel abroad, especially working with epidemiologists and healthcare, and hoping none of them managed to catch and share it. I would much rather be working remote at home today with a much lower risk of transmission. It's still fairly low but the question is, when it does spread largely across communities (it's pretty certain at this point), will my (and others') office accommodate or be ridiculous about the scenario because their investors concerns and turn around are higher than their concerns of their workforce's health.
And I like to think I work in a fairly progressive environment. Many don't have the option to work remote, I at least do. My SO is a doctor who has to work with others/patients to continue paying our regular bills. Sure, we have a safety net but it'll set us back towards major financial goals (e.g., mortgage/home ownership, etc. -- nothing extravagant).
Many have no safety net and are at the mercy of the humility of their employers. We'll see how this plays out.
The reason it's not been recommended in the US is because it's not really part of our culture, and so we don't have a huge supply of them. Medical workers need them the most. But if we did have enough, yes they're definitely recommended.
I'm also not convinced that a mask stops you from touching your mouth. Some experts are saying that it will actually cause you to touch your face more, and if the mask is not waterproof (are N95 respirators waterproof?) after less than an hour of wear the humidity of your breath will have created a large wet patch directly covering your mouth and nose. Now any time you touch a surface and then readjust your mask, you're planting more bacteria and viruses directly on that wet patch.
Even if the mask isn't perfect in protecting you, it's probably pretty good for protecting others when/if you are sick.
Containing your own viral spread is as important as protecting yourself when you think at the societal level...
Respirator is the correct and less-confusing term for the item you're referring to.
Everyone should probably wear a surgical mask, because it will help contain the virus to those who have it, and help keep it from spreading. That's what masks are designed to do.
Wearing a respirator is overkill for most people, especially for everyday use, and therefore should be avoided because of the supply problems. They also have the usage complexities you mention. The fit tests verify fit, and are used help choose a well-fitting mask. I'm not sure how often the tests force someone to choose a different type.
I'm not convinced respirators are useless for regular people though, if you're a high-risk person in a high-risk area (such as an elderly person visiting an ER), I think their use might be warranted (coupled with more important practices like strict hand hygiene, etc).
Moreover, it's significantly fewer people who are all sick at the same time. This means more available hospital beds. It means more time to develop better treatments. Less pressure on supply chains. Less societal impact from people who can't work.
It's at best marginally effective at reducing a person's probability of catching or spreading a disease. But in the face of potentially exponential growth, reducing that base by a few percentage points is a huge win.
That's why vaccines are incredibly effective despite being only 90% effective. Disease simply doesn't spread when 90% of the population is immune, no matter how virulent the disease is.
(1) the simple paper ones, and
(2) a fancier one with good rubber gaskets for my face, and replaceable filters.
Although the fancier mask (2) is more reliable for intake filtration, I suspect it's less useful for exhaust filtration, e.g. from coughs and sneezes. Because (2) uses a flapper valve to release exhaust, whereas the filtration in (1) is somewhat bidirectional.
There are surgical masks, surgical respirators, and regular respirators.
Surgical masks and surgical respirators meet regulatory requirements about blocking pathogens from the wearer, and I haven't seen any of that type with an exhaust valve.
I'd expect a respirator valve to be at least as effective as that. If you were really worried, you could always wear a surgical mask over your respirator...
It's a part of Japanese culture, and while they may have had a huge supply of them, there are mask shortages now. People there seem more upset about the price gougers than the mask shortage.
Also, US medical facilities and government already don't have a sufficient stockpile, so there will be shortages and they're talking about changing usage practices to conserve the supply. 3M, at least, has said they're going to prioritize medical customers, but they're not going to catch up until April, at least.
https://www.washingtonpost.com/health/shortages-confusion-an...
There's supply and demand, but then there's straight profiteering from a public health crisis.
Of course, there are other ways to achieve this effect: governments could order the mask manufacturers to step up production, or the manufacturers could take a gamble on the future and step up production before seeing an increase in sales (and a bank could finance that if cashflow was an issue). But you know, you wouldn't criticize the mask manufacturers for increasing production and thereby profits, so it's a bit harsh to blame the intermediaries.
No they're not. The profiteers are resellers that bought masks/respirators from the manufacturers at regular price, then sell them with a crazy markup.
I've been watching the prices of these items throughout this whole crisis, and the prices of 3M respirators sold through reputable retailers has not budged. 3M is not increasing them either:
https://news.3m.com/blog/3m-stories/3m-responds-2019-novel-c...:
> 3M has not changed the prices we charge for 3M respirators as a result of the outbreak
Not any more than legitimate customers buying the same masks. They provided no signal that 3M wasn't already receiving loud and clear.
Profiteers don't add anything to the situation except their parasitic markup. They misallocate scarce resources away from where they're needed, and those resources end up wasted either in their personal horde or in the hands of those who have more money than sense.
At first, the prices in the local market here were normal and people were buying hundreds of respirators and masks.
As prices have been driven up (almost exclusively this profiteering and parasitic markup, big retailers have not increased prices), people've been buying closer to what they feel they need rather than trying to stockpile -- when the mask is $2, it's easy to grab 50 or 100. When they're $25 people are only buying 1 or 2.
Gross as it is, this is serving some good -- it's helping to distribute the available inventory over a wider population, instead of concentrating it with the few people that are stockpiling them or exporting them.
One point here, which I think I established previously, is that price movement provided no useful information to the manufactures. The most useful information came directly from institutional medical customers (who were the first to know), not retail profiteers working off of secondary reports in secondary markets.
> As prices have been driven up (almost exclusively this profiteering and parasitic markup, big retailers have not increased prices), people've been buying closer to what they feel they need rather than trying to stockpile -- when the mask is $2, it's easy to grab 50 or 100. When they're $25 people are only buying 1 or 2.
> Gross as it is, this is serving some good -- it's helping to distribute the available inventory over a wider population, instead of concentrating it with the few people that are stockpiling them or exporting them.
However, the profiteers are stockpilers, and they probably stockpile more extremely than even the most aggressive personal-use stockpiler.
For example, looking at it from a pure profiteering standpoint: it's good business if I can buy 1000 masks for $1 each and sell 100 for $20 each during the crisis, I just doubled my money. However, I just wasted 900 masks in the process, from POV of society. Profiteers are panic-driven speculators, and their economic interest is to make wasteful decisions (otherwise they're potentially leaving money on the table). When the crisis is over, they can just unload their (wasted) inventory at the normal price (for instance, by taking advantage of a retailer's return policy).
Also, like TeMPOraL noted, the profiteer's speculative buying could fuel the panic that caused those 100 sales of $20 masks. The signal of empty shelves may be false, or falsely magnified. It's kinda like cornering a market, in that regard.
You also assume people are willing to deal with the profiteers. I don't think that's necessarily the case, especially at a 500-2500% markup. For instance: I'd refuse to buy from a profiteer out of principle, and either live without or use alternatives.
This kind of profiteering is a pretty clear market failure, not an example of the market providing benefit. It's a failure just like government warehouse steering essential supplies away from first responders and the public and towards government elites.
I might have been willing to buy 100 masks for my family at $1/piece (which is roughly for what they sold initially, perhaps even less if I looked harder). But I'm not willing to buy 5 masks at $20 apiece, because there's no point. These masks are disposable, single-use items that cause more risk than they reduce if you wear them for prolonged amount of time (or repeatedly take off and on), so it only makes medical sense to buy them by either by the hundreds, or not at all.
Which means no masks for my family now.
The trouble is that unlike in the perfect world we wish the market worked in, the most deserving are not always the best funded. So it would probably be more ethical for either 3M or the "price gougers" to offer some sort of preferential pricing - although deciding who to offer it to might be tricky.
Perhaps, in an ideal world, the government is competently in charge of any urgent social emergency, and if resources are required the government can pluck them out of any incipient market bubble by gently requiring that the entire stock be sold to them, at a fair market price.
No. Raising prices is the econ 101 solution, but we don't live in an econ 101 world. There are other ways to deal with shortages, and 3M chose one of those other ways:
https://news.3m.com/blog/3m-stories/3m-responds-2019-novel-c...:
> We notified 3M authorized distributors that we are prioritizing orders to help serve our base business – including hospitals – due to high global demand.
Some retailers are also implementing non-price-based solutions to the shortages:
https://www.ajc.com/news/home-depot-limits-coronavirus-mask-...:
> As fears continue rising about the deadly coronavirus outbreak, Atlanta-based The Home Depot is limiting the number of protective respirators to 10 per purchase.
People should start thinking of sanitizing their headphones too.
https://www.cnn.com/2020/03/02/health/surgeon-general-corona...
now, it's way too late. we've had numerous instances of community transmission where we can't track the origin of the infection. we'll need to shutter everything for a longer period if we want to prevent widespread infections.
We have large numbers of essential services (medical, utility, food, etc.) that must keep running. - perhaps you could set up childcare for said workers, but again, you have to be careful here your prevention doesn't cause more harm.
The counterpart to "who's going to work if they have to watch the kids?" is "who's going to work if they're infected because kids braught the virus from school?".
Also, the childcare argument applies to just the first few years of the school - most of school-aged kids are old enough to stay home unsupervised if it's needed, and high school kids can supervise younger siblings.
It's a problem for basically kids ages 0-11 (depending on where your cut-off is); that's strictly the majority of children and hits a huge percentage of the workforce. Again, you very well can end up worse off if you do this (someone needs to work on medical treatments, medical research, etc.)
Of course, that doesn't work for younger kids, but then the main focus should be not on schools closing but on preschools and other daycare options closing.
The actual practical solution would be the old non-nuclear family; i.e. send the kids (and food supplies) to grandparents and have them spend some time in isolation there, while the "middle generation" works.
https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVI/Ch... https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVI/Ch...
It's costly in terms of lost time, but it's much less costly than a full-scale epidemic will be. Will be very interesting to see whether these measures work. My gut feeling says we'll have a full-scale epidemic regardless, but hopefully with a lower peak that the healthcare system will be able to handle.
To start with the latter: this virus cannot be contained anymore, at best it can be slowed down. Which means that sooner or later we all will get it. So the extreme measures to isolate yourself from your environment in hopes of not getting contaminated are a waste of time and resources.
On the other hand, for normal healthy people, who seem to be the group at which this article is targeted, the infection is not much worse than influenza. Many people don't even realize they have it.
"Take the loss" is the only reasonable paragraph in the article.
Not true at all. There is a great benefit to "flattening the curve" to spread out the infections over time, as a high percentage of cases for older individuals will require hospitalization, and there are a limited number of beds available. If reasonable isolation measure are in place, this could happen, as there would be fewer active carriers at any time to transmit the virus to vulnerable populations.
If the GP was referring to messaging that suggests a goal of true containment, then I think you're both right.
Also, delaying infections helps buy time to bring novel treatments to bear on the problem.
Containment is really the only thing at present that is able to slow this thing. Which is the only reason you are seeing the numbers in China starting to drop.
That number is far too high, and likely comes from an under counting of mild cases. Of the 705 infected on the diamond princess only 43 are or have been in critical condition and the people on board skewed much older than the general population. Also only 705/3200 even got infected despite almost everyone likely being exposed.
If everyone takes measures to slow the spread, it will reduce strain on the medical system (because fewer people will be sick at any given time), which will mean the people who do get sick suffer less and are less likely to die.
Even if it's 100% certain that you will be exposed to the virus, that's a long way from saying the best thing you can do is just give up and get it over with.