Italy is extending its coronavirus quarantine measures to the entire country
bbc.com
bbc.com
Read the whole thing, but this passage in particular is just chilling.
"5/ Patients above 65 or younger with comorbidities are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest. Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed."
Similar situations will play out in the US unless strict protocols are enforced now.
That's basically a nice way of saying "We will have to let people die"
If you don't have beds and incubutors, you can't treat people. Then people start dying.
Health service ranking focuses on treatment I suppose. We need a different ranking for epidemic prevention and control.
The stories abound of a hospital visit with a magical bill that appears months later with some unpaid sum that's in the 4 digits. Everyone knows someone who this happened to - I happened to know a couple who received a 5-digit bill for a baby who died many many months later. Now, as a rational person you're not going to go to an ER willy nilly, and sometimes an ER is what you get pointed to by smaller medical centers.
The U.S. medical model doesn't work - for the group. It works - for the individual. I had superb eye surgery recently from a top world center and it was fully paid. But the viruses don't care if one of us can afford care, and the other can't, because the virus views us as a singular organism, and now we're all at risk. Which is exactly how the health system should begin viewing us.
I'm particularly miffed about this because it seems to have spread to our shores and convinced a bunch of people that the reason the UK has lower numbers than Italy is because they're not testing people, to the point they're literally unable to believe that Italy has only tested twice as many patients for the coronavirus as the UK.
I'm by no means an expert, but to me the problem seems to be lack of proactive social distancing; and lack of proactive testing of everyone with symptoms.
Current guidelines seems statistically sound, it's just that we have little mitigation for the few that do slip through.
"The researchers found very high levels of virus emitted from the throat of patients from the earliest point in their illness —when people are generally still going about their daily routines"
https://www.statnews.com/2020/03/09/people-shed-high-levels-...
Any call for drastic measures, even when drastic measures seem like common sense to some people, need to explain why the measures should be implemented and under what circumstances they should be lifted.
> Now long would you maintain that quarantine?
I'd suggest start with 2 weeks, and reassess after 10 days. I note that in TFA Italy's administration extended this (initially) out to the 3rd of April, which seems like a reasonable timeframe.
Incarcerated people rioted ... and a churlish part of my brain suggests that's just to be expected, but each nation state can learn from, and put more effort into educating than, the earlier pioneers.
> Is there some amount of time after which the virus will go away?
We don't really know - but it sounds like a rhetorical question(?).
I know that I'd be happy with a two week lockdown - option to renew - here in AU ... especially if it reduced my chance of dying. The numbers cited in TFA are suggesting a 3% mortality rate now, and massive propagation rates and embarrassingly poor treatment / survival rates even in a first world country early on in the pandemic cycle.
> Any call for drastic measures, even when drastic measures seem like common sense to some people, need to explain why the measures should be implemented and under what circumstances they should be lifted.
I'd invert your usage of the precautionary principle and ask, given what we know so far, why the default response isn't to shut down non-essential travel and public events for a couple of weeks.
I mean, what's your acceptable ratio of dead people : inconvenienced live people?
step 1 should have been to bring military in the streets to enforce the thing, because police is both decimated by the virus and overwhelmed from the new responsibilities and cannot handle what's happening
Where I live I already have to provide my babysitter a signed letter where I certify that she comes to work here. She's from a different township (comune) and the police could fine her if caught without that document.
It's not going to stop 100% of people from moving around, but even it this reduces the spread by a few % it's already a big improvement; even reducing the daily rate from 21% to 20% can have a 20x effect on total cases over a year.
so I guess I was right since the beginning
They're lifted after most of the population has already been infected and the disease has run its course (as in China).
But i askari think it will go exactly like the Spanish flu. We will have a second wave which will also kill the younger.
You can also have non-exponential growth and still have many new cases, if people are getting over their infections faster than they're infecting new people. If a million people were currently infected and every week 500,000 new people were infected but 500,001 of the existing infected people recovered, that means the number of currently infected people declines over time, but you'd still have 500,000 new cases every week and just about everybody might eventually get infected before it dies out, even if it eventually does. (This is similar to what happens with the flu, except that it has exponential growth in winter and then below exponential growth in the other three seasons, so the actually dying out never really comes.)
To really get rid of it you want to have something like 100,000 cases last week and 75,000 cases this week and so on. But even then you might have 25,000 fewer cases this week because 50,000 people recovered but 25,000 new people got infected.
So whether it has exponential growth or not isn't really the issue. It's what the growth rate is. A small exponential growth rate isn't catastrophic -- the number of cases grows but not so fast that everybody is infected by the time they have a vaccine or other more effective countermeasures that get the growth rate back below exponential.
Most importantly, the growth rate isn't immutable. It's affected by things like people washing their hands and having effective testing and quarantines. So will things be fine? They will if people do the right things. Maybe some of them have been and some of them haven't. Maybe they'll get better at it going forward, maybe they won't. As a result there is a significant amount of uncertainty.
But panic is useless. Even if all they can do is reduce the growth rate from 150% to 130%, that still buys more time to respond. Even if everybody ultimately gets it, better that it happen over five years than five months. And if some people are doing it wrong, try to help them do better. Everybody likes to see the bad orange man look stupid on the television, but maybe this is a situation where we come out better off with everybody working together.
So no, panic never helps. Staying calm and level headed does.
But if you want to panic, do it. But do it in private, panic itself is rather contagious as well. Maybe self-quarantine.
At this point, things are so looking so grim that there's no way to tell people not to panic without unacceptable downplaying of the gravity of the situation.
Panic is was caused the toilet paper craze.
This should be taken seriously and people should put effort into prevention, but honestly I would prefer calling upon people's sense of civic duty rather than panic.
If that's the extent of the damage caused by panic, then we are going to be fine.
In at least a few cases though I doubt it was not panic buying.
Here in Denmark, where we're seeing an outbreak take hold, it's the EXACT opposite.
People are going out even though they have been told to self-quarantine, even boarding planes.
A couple refused to cancel a vacation trip even though they had been asked to quarantine because their son has been diagnosed with the virus.
I really think we could use a tiny bit more panic
Another sign that people don't get exponential growth, even if they think they do.
Which is why the growth rate is really what matters. Which isn't immutable. It goes down if people wash their hands. It goes down if sick people stay at home.
This is also why it really matters if the rate is 150% or 130%, even if both are very bad, because the higher rate is very worse. And the rate gets lower if sick people stay home, but it gets higher if idiots panic and start hoarding masks and stealing hand sanitizer which increases the rate of infection when they aren't there for other people to use.
Panic is not just useless, it's actively harmful.
To be fair, that is true of 95% of humanity.
These politicians are representative of their voters, as democracy should be.
Isn't it that they make decisions on behalf of the voters and should take the best professional advice on their behalf?
I don’t have any well-thought-out solutions, but I am tickled by the idea of frequently anarchically randomising the way power gets donated from the people to the government.
The idea is that every citizen would be involved in one, maybe two laws in their entire lifetime, therefore giving them the sense that this is the one time they can contribute to politics in a meaningful way. Also their names are tied to that particular law forever, meaning that fear of social pressure could be more effective than for a politician who votes for 1000s of things in their political career.
So far we have never come up with a working political system that banishes this stuff. It's a game theory problem.
Little trick to know (with some good approximation) the doubling time of some low-percentage growing system: count it linearly up to 10% and then multiply by 7 (which is roughly the doubling time for 10% growth). Example: 2% => 5*7=35 years to double.
If something grows by 2% per day, vs 2.1% per day, after a year the second one is >20x bigger.
>>> 1.02**365
1377.4082919660768
>>> 1.021**365
1969.6808462403098
>>>Apparently I don't understand exponential growth either cause I assumed a 5% difference scales linearly (as in the difference between 20% vs 21% growth rates for a given period should be the same as between 2% and 2.1%).
Silly me.
I would certainly like to see the example of a country able to learn from the mistakes of others.
So yes, just business as usual.
The WHO reports "Globally, about 3.4% of reported COVID-19 cases have died".
If 50% the population gets infected, and if it's not 3.4% but "just" 3% mortality rate, that's already 1 million dead.
And according to some experts, even 70% infection rate is predicted.
Second, this 3.4% percentage of deceased patients, is at the early stages, with fewer patients and preventive measures (so that most patients that needed hospital treatment got it).
A 10% or more of patients of COVID-19 will need hospital treatment and ICU. As the number of patients rise, there wont be as many ICU units (and doctors are getting infected themselves at an alarming rate).
In Italy with ~ 7000 cases, "hospitals are scrambling to increase the number of beds available in intensive care units. Some have closed entire wards to dedicate them to severe coronavirus cases. Others have transformed operating rooms into intensive care units. Doctors are working grueling shifts to cover for colleagues who fall ill".
Let's put it this way, they have 9,172 cases and 463 deaths.
Now imagine with 100,000 or 1,000,000 cases -- still very far from the predicted 70%.
But ok, the source is your own calculations. Thanks for confirming.
That's not how epidemics work when they are contained quickly.
Europe has done a bad job at this.
Epidemics in the past have killed many times as many as the percentages above.
First, using the total population as a basis is just wrong. Some will certainly be immune to a certain degree while others are simply lucky.
Even very aggressive pandemics, hitting totally ill-prepared societies didn't infect every single person. Not even the black death managed to do so. So why do you think COVID-19 would end up doing that?
And using the 3.4% is another issue. Because you have the Wuhan rate, which is much higher than the rate eslewhere. And this thing is a moving target because testing was rather limted earlier. South Korea seems to be the best source to get mortalitiy rates due to their aggressive testing.
south korea is an outlier and most of their cases are not resolved, they may have a lot of false positives
time to act was weeks ago.
Feel happy now about the ad-hominem?
https://www.cnbc.com/2020/03/11/up-to-150-million-americans-...
Countries have to overreact to the circumstances that they are confronted with because in a week the situation will be much worse if they don't. The only options are to overreact when everything seems fine or to overreact when the hospitals are full past capacity.
The choices here are to overreact before the virus gets past the border; overreact when the first cases appear; overreact when the first cluster is identified or overreact when people who can't breath are being turned away from hospitals. We have yet to see what happens past that point because so far everyone has instituted a quarantine then. Germany is at the clusters developing stage.
In line with what you are saying, a problem, is that the proper reaction, if works, looks like an overreaction later. So, politically, there is an incentive to do nothing.
Or if you don't like my turkey reference, let's stay in the realm of technology. Pop quiz: who said "Only the paranoid survive?"
Nobody is suggesting people should quarantine themselves in Berlin, but avoiding crowded spaces, not touching your face and frequently washing your hands doesn't seem at all unreasonable.
EDIT: According to officials, one county in germany is considered high risk (link in German): https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...
Risk matrix example: https://www.researchgate.net/profile/Kevin_Fleming3/publicat...
Assessing risk the way you do has one big issue (it actually has multiple but let's stick with one). When you put Corona in the disastrous category you habe to provide reasons for doing so, otherwise it is just a gut feeling. And by classifying it as disastrous, you run into issues when classifying stuff like Ebola for example. Over-classifying has that effect on measuring systems, that's why you need teams of experts from multiple disciplines to do it properly. And would have to do so at multiple sub levels for each criteria. The whole purpose is to take gut feeling and emotions out of the process. Doing it alone makes the whole exercise pointless.
Now, take that whatever way you want.
Conversely, had they recommended more aggressive contention measures, how many trips would have been avoided? How much slower would the virus come to Europe? If sirens were ringing 4 weeks ago by the WHO "experts", perhaps Italy wouldn't need to be in lockdown now.
> When you put Corona in the disastrous category you habe to provide reasons for doing so, otherwise it is just a gut feeling.
Not really. We put in the disastrous category because we don't have enough information to claim that it is not a mass-extinction event. In the face of a threat of unknown risk and the potential impact is unbounded, we got to treat it as the worst and prepare for the worst, cost-analysis be damned!
But if you prefer to ignore me and refer to experts, please listen to Nassim Taleb, who may know a thing or two about risk analysis: https://www.academia.edu/41743064/Systemic_Risk_of_Pandemic_...
And no, that is exactly not how risk assessment is supposed to work.
It doesn't have to be a literal mass-extinction event for this type of thing to lead to some catastrophic events affecting people you know and care about. If it were to happen (I honestly hope it doesn't) to someone you care about, I am sure that "the experts told me things were fine" will be of little consolation.
How about dropping the sarcasm and word-thinking and start to put some thought into the questions I made regarding the WHO recommendations up until some weeks ago? I bet if you could go back in time to Italy just three weeks ago, you wouldn't be telling people to just "listen to the experts", would you?
Now a slightly longer one. Guidelines on how infection risk can be minimised are very consistent. And they make perfect sense. So yes, that's the advice I give my two kids, my parents (both of which fall into the high risk age groups, luckily they are following that advice already without me), and the advice I follow myself.
WHO recommendations are based on the best available picture to them. I prefer to trust someone changing his opinion when data changes over someone who paints a worst case scenario from day one on.
And yes, if someone from my family ultimately dies, which I really don't hope, having done everything experts told us to do to prevent it would be the only consolation there is. The alternative being fear mongering, panic and paranoia. In which any infections happening toy loved ones (assuming I am the only factor behind there behaviour, which I am thankfully not as my family thinks pretty well for themselves) would be to a certain degree on me.
And the experts have assessed the risk. Hence the advice they give. But you do you, ok? As long as you stop spreading stories about mass extinction and stuff like that.
Also you are being disingenuous. I said
>the risk impact of not quarantining as significant to disastrous and the likelihood as very likely.
which means I would classify it as very significant.
Regardless it doesn't change the risk rating.
I'm close to Hamburg. We've had two or three confirmed cases in the county. Patients are quarantined at home and stable. Schools have been temporarily closed, but reopened now. The administration is taking it very serious and people are stocking up on everything, including cake.
This is in NRW, however, where we have by far the most confirmed cases in Germany. Might be different in other places.
depending on how long friend is employed by this company, the resulting leal case could be rather expensive for the employer. Your friend would still have to look for another job, so...
Actually Covid-19 cleaning solutions would be a temporary business to get into.
EDIT: I realize that this response is easier to do for SAP than for the average company since we are all working in front of computers anyway the entire time, with only 1-2% of tasks tied to physical objects (paper forms, server hardware etc.).
Edited: Just found the article (Malling Skole i Østjylland)
https://www.dr.dk/nyheder/indland/skole-sender-klasse-i-kara...
Quarantines of mass amounts of the population are not going to help, what needs to be done is isolate those most at risk from the general population
Absolute containment is highly unlikely, but delay can help a ton.
All measures we take optimize for that. Vaccination increase the amount of immune people, quarantine pulls the inflection point forward and slows the spreading. Protecting the most at risk population further reduces the risk of spreading. And so on. So yes, the early phases are exponential. But the later phases are not. So modelling this thing exponentially against the max. number people on earth is just wrong.
Italy was slower than that.
[1] https://foreignpolicy.com/2020/03/09/italy-covid19-coronavir...
Italy was slow, and is already a nightmare.
By comparing the number of Corona virus cases and deaths to the annual flu deaths he is implying that the number of deaths from Corona virus in the US is low and the risk is negligible, and while it is currently low this completely misses the point that in other countries it has proven to be extremely contagious and has a much higher mortality rate than flu. In other words, there is a significant risk if adequate steps aren't taken to reduce the risk of transmission. See: Italy, China.
The people that scare the hell out of me are the gaggles of PhDs and other "very smart people" who seem to think that we shouldn't be closing schools and working from home because reasons. Our organization doesn't even have paper towels in the bathrooms (It's bad for the environment!). Actual sanitation is not a priority.
Frankly, nobody knows what to do. Here we are, pondering what to do with the kids.
* The school district is open for business in spite of being the ground zero of USA outbreak. Because no kid has tested positive yet. Meanwhile, the testing scale is tiny [thousands, in a nation of 300M] and the latency is horrendous [5 days]. Most likely the virus is already endemic in the kid population.
* OK, so let's keep the kids at home, as SPS will eventually have to face the obvious and close the schools. For how long? A week? A month? Until summer? Until next year? Send them to school and pray for the best once everybody in the family eventually gets the disease?
Hard to do, when the correct thing for the administration to do is to stand back and hand decision making authority and control of resources to the bureaucracy. As long as the administration keeps interfering in the response, anything about the issue can't avoid being political.
The executive and administrative branches together respond to a crisis like this - for example by coordinating actions, providing more funding for health services or in extremis ordering quarantine in affected areas. None of that has been done. I don't think you can effectively separate the two responses, nor do I think this outbreak is somehow Trump's fault, but he and his administration are responding remarkably badly to it.
Exactly! That is what is meant by not letting polarized politics drive the issue. We shouldn't care what 'side' is doing what, we should be focused on preventing an epidemic. Personally, IDGAF about assigning blame to any side, I'd rather that the petty bickering is dropped and effective measures are taken.
I realize the climate in the US isn't conducive to this, but assigning blame doesn't fix anything. Rather than blaming people, effective steps need to be taken. Focusing on assigning blame just puts the other side on the defensive; which is counterproductive to the kind of cooperation that will be needed to effectively respond to this crisis.
The problem is that this holds true regardless of who you consider to be “the other side.”
Here in Oregon, our governor is politically on the opposite end of the spectrum from the US president. Yet the messaging from both has been nearly identical: everything is fine, carry on, wash your hands.
Making this into a political issue in either case just creates conflict, and causes the target to dig in their heels. It does very little towards a more effective response.
Disclaimer: I've spent quite a lot of holidays in the south, since both my parents grew up there.
I can't believe I'm saying this as a libertarian but you have to put some faith into the government's action here. The public in a panic already took away all the masks healthcare providers needed to safely attend patients, diminishing the capacity to serve.
I think I have 5 tweets in the last 10 years.
see infosec twit, fintwit (financial advisor twit)
https://www.ecodibergamo.it/stories/bergamo-citta/con-le-nos...
this is an online profile for the doctor:
https://www.dottori.it/daniele-macchini-516895
The post was originally shared on Facebook.
It could absolutely be true -- but there are definitely interests out there who may wish to spread panic.
I could just as easily create a similar low-volume Twitter account with the opposite portrayal -- doesn't mean people should believe me.
https://www.cbc.ca/radio/asithappens/as-it-happens-monday-ed...
He's behaving entirely consistently with how he always has: deny everything, project perfection.
There's no signal here of a secret weapon, it's a complete shit show.
> There's no signal here of a secret weapon, it's a complete shit show.
Can't really disagree, but I feel like I'm taking crazy pills with the way people in the US are talking about the response now. Was the US MSM not spending all of January and February telling us "calm down, you know the common flu kills WAY more people than this thing and we don't freak out about it!" and complaining how Trump's proposed Chinese traveler ban was both a) racist and b) would have little to no effect?
People not trained well in math and science don't even have/know the tools to help them understand it analytically.
We need (much) better math education for people studying all majors.
I wish I was making this up.
The whole song is disturbingly accurate/prophetic.
https://www.azlyrics.com/lyrics/nofx/idiotsaretakingover.htm...
I'm completely unsurprised by what you're describing. I observed similarly disturbing behavior waiting in line @ Home Depot the other day. A customer was excited to find they had hand sanitizer in stock, and another customer told him there's a whole aisle full of the stuff and that all the covid stuff is fake news which devolved into nonsensical madness between yokels I had to just walk away from. Of course our Home Depot had some in stock, we're in rural bumblefuck middle of nowhere. Our stores only run out of things when the employees forget to do their jobs.
Oh well, I tried.
- Some old irresponsibly stupid males are still sexually active. Darwin would stop them reproducing.
- The old irresponsibly stupid neighbour is still a magnet for younger, sexually reproductive irresponsibly stupid people, probably more so than for others.
Ignorance is not transmitted genetically.
I wish I was making this up.
Edit: Source added.
https://twitter.com/jasonvanschoor/status/123714289107769753...
Perhaps you've been drinking too much of their coolaid.
"Mainstream media" was a term long before people on the right started complaining about it.
That doesn't mean Trump is doing a good job.
I don't actually know why the ruling class in the US is taking this so easy. There's some kind of brain disorder they have that is located between American exceptionalism, raw stupidity, and a complete disregard for the welfare of the people. I hope they all shake hands with a COVID patient like they did at CPAC.
People know full well that Fox is part of the MSM, but regardless of which way you lean, there's no question that the deck is stacked against conservative viewpoints.
Conan O'Brien has some great segments on this: https://www.youtube.com/watch?v=TM8L7bdwVaA
They also do this for serious political stuff, repeating the same phrases over and over again, but posting those video compilations would just invite downvotes.
> The Trump administration’s quarantine and travel ban in response to the Wuhan coronavirus could undercut international efforts to fight the outbreak by antagonizing Chinese leaders, as well as stigmatizing people of Asian descent, according to a growing chorus of public health experts and lawmakers.[0]
> The Trump administration’s decision to severely restrict travel from China to the US and to implement a mass quarantine, the first in the US in more than 50 years, could be an overreaction that causes unnecessary fear and weakens the global response[1]
I can provide more if you’re not convinced that, just like every single other thing Trump does, right or wrong, he was attacked for actions related to the Coronavirus earlier this year...
0: https://www.politico.com/news/2020/02/04/coronavirus-quarati...
1: https://www.theguardian.com/us-news/2020/feb/04/coronavirus-...
A flight ban simply makes traceability harder, as people reroute through multiple hops. Victimizing Chinese communities is bad and will only make things worse (as people start hiding from authorities). And in the end, the virus was in Germany already in January, according to the tracing, so focusing on China would have helped little.
BUT
they could have mandated self-isolation for two weeks for all flight passengers disembarking, regardless of provenience. You get a tourism hit but slow down infection rates substantially.
They could have ensured better procedure for care in death. Those elderly people dying in high number right now, have probably infected hundreds of others already; they should have been tested weeks ago, and handled as infection carriers.
They could have prepared temporary field hospitals to spike capacity like the Chinese were forced to do. Chances are they will need them anyway, might as well do it advance than later under pressure.
They could have started shutting down large gatherings and prepare for curfew measures.
They’ve done none of that - and I say “they” as in US administration, UK administration, Australia (where they’ll even host a F1 GP with crowds this weekend!), France etc... They all hoped it would go away “on its own” like SARS did. Sadly, SARS was a lucky strike, this is the real deal.
I am not sure what he is doing is even remotely serving himself that well either. Addressing the Coronavirus upfront is the only way to cheer up the market right now. Did he really think he can just fight this virus with speech or tweets?
This is bothering me no end, and severely impact my confidence in US itself overall. Damn it, this is a full on crisis, the shit is about to hit the fan so hard.
This is true until last Thursday, but now the government had acknowledged at least 19 confirmed cases. Still super late though.
As some point one might consider if governments see COVID-19 as an opportunity to "cull the herd". Japan and Italy have the two largest aging populations of any countries. The US has a large number of citizens with COVID-19 comorbidities.
I'm not sure if the long term savings on entitlements and health care costs would outweigh the short term economic damage, though.
China got COVID-19 first. And got over it first. US and Europe are going to be devastated by it. I'm guessing Russia will fare no better. In the aftermath, who's going to be on top on the global scene?
China didn't get over COVID-19. They're still seeing double-digit deaths daily and new infections. They're going to see recurring new networks and pockets appear repeatedly. Endlessly if the virus has endured in other countries. They aren't coming out on top of this, especially given the absolutely enormous GDP damage they've already endured.
A chilling, and somewhat likely simulation.
The possible death of nn millions of people is way worse than a global lockdown for a couple of weeks/months.
If they go away, we might lose on the knowledge or their investments might stop working and the new youth might not manage it any better. So a total loss of society.
Massive knowledge -- retired and not using it
Making money for the healthcare system -- fundamental life science advances could be lost or slowed down, but most healthcare spending is pure consumption, the labor could be better deployed to something more productive
Just saying the situation is handled badly is easy. Just like being a better football coach after a big game. There is a german saying that everytime the national soccer team looses Germany has 81 million national soccer trainers. Providing better solutions is the hrd part, almost as hard a judging why exactly current solutions are not sufficiet.
Drive-through testing where everybody with any symptoms can get themselves tested.
A good public education campaign with calm TV documentaries that show the facts of what was going on in Wuhan and is now going on in Italy, and explains why these actions need to be taken.
Report by an italien doctor from Bergamo: https://www.ecodibergamo.it/stories/bergamo-citta/con-le-nos...
Translated to english: https://threadreaderapp.com/thread/1236933818654896129.html
The only next step is large scale lock downs.
Why should we wait 20 days for things to get terrible before going to quarantines and lock down? Surely China and Italy have shown us our future.
I partly think the problem is political. If you quarantine and the virus is controlled, then it looks like you panicked over nothing, because you took this huge reaction and nothing much happened. However, if you wait till it's sufficiently bad and then you quarantine everyone will understand what you did, and later, you may get praised for your decisive leadership in a time of struggle.
What I mostly wish is that citizens could throw some sort of flag now to say "This crisis is being poorly handled. If this goes badly, let's have a review, figure out why, and correct the problem once this is settled."
Nails it. You could be so good at your job that people think your job isn’t even necessary; or you could be putting out fires caused by your incompetence all day every day and people think you’re a hero.
His base is, however, going to be disproportionately impacted by this virus.
I think this is exactly what's happening. It's an extension of the way individuals feel -- no one wants to be seen preparing too early, because people might think they're silly.
This need not be this case. Any authorities who take action to shut down social contact now, before they turn into Italy, will be praised several months hence for being forward thinking because it will be clear what happened in every jurisdiction where they didn't shut down social contact, i.e. absolute catastrophe.
The election season is in full swing and you should have the opportunity to vote on how well you think the crisis has been handled by November.
Example: Why didn't we start testing with 100x or 1000x the number of tests? Maybe the reason is regulation on independent labs doing their own tests. Maybe there wasn't enough money banked up at the CDC such that, when a pandemic it's recognized, we can't immediately start mass producing tests.
The point is, I want it documented and explained what the failures were so that future people handling future disease outbreaks will perform better or at least not make the same mistakes. Further, a practice of exploring major mistakes would help motivate government bureaucrats to avoid making them. There should be a potential political cost to be dramatically wrong in vital scenarios.
https://www.businessinsider.com/coronavirus-testing-covid-19...
While I don't agree with the US's lackluster response, bear in mind there's other repercussions besides "just political". The quarantines and shutdowns will almost certainly destroy a lot of people's livelihoods. From people that aren't getting paid so can't pay their bills, to small business owners that will lose their businesses because they can't pay their bills. The effects of even a 1 week shut down can expect to be massive, and impact exactly the people who are already most struggling financially.
Yep. People do this with Y2K, for example. "Nothing happened, what an overreaction!"
Nothing happened because an enormous amount of work was done in advance, but people don't see that side of it as it's reasonably hidden.
Though to be fair, most of the media predicted bad outcomes were completely unrealistic and wouldn't have happened even if no effort was put into mitigation.
https://twitter.com/realDonaldTrump/status/12370273563148697...
https://twitter.com/realDonaldTrump/status/12370245512943820...
I'm amazed not only at these affirmations, but at the likes they get. Incredible.
And people distrust anything coming out of China's government so they simultaneously think China covered up a lot and there were way more dead, and they exaggerated how bad the virus is...
“You know what solves it? When the economy crashes, when the country goes to total hell and everything is a disaster, then you’ll have a, you know, you’ll have riots to go back to where we used to be when we were great,”
https://www.rawstory.com/2019/01/country-goes-hell-2014-vide...
I don't want to go into longer detail as it will be subjective and seem political, but I'm expecting things to Get Weird.
Nobody knows the long term development of this virus. You could lock up everything, the economy collapses and it would hurt people even more than the virus might have. It is a gamble at this point.
Political games come into play if people demand answers that nobody can give. If some presume to be able to do that, they are lying to your face.
If this is over in June and 100,000 people died, what would we call this? It would just be another disease probably.
For people who lost loved ones it was a catastrophe, for other part of the normal life risk. Any publicly uttered judgement has to keep that in mind, so it will always be relative. Some are more forthcoming, but probably not public officials.
Of course the virus is not under control, how could it be? I would prefer measures to reduce its spread, but that is basically intuition and listening to some doctors with the knowledge that it just buys time.
Anyone using this crisis for political points doesn't really win any cookies with me personally, on the contrary.
The incentive to cover something up is just a reflex to save face. I don't like covering something up. There is a risk of disproportionate overreaction, but I think a bad information policy reinforces this. If they covered something up, it must be really bad, right?
More like few millions in US alone, based on what happened in Italy which is more representative than China. Italy has >4% mortality rate last time I checked. And we talk about very well equipped and highly rated healthcare. I can't imagine this not having brutal effects on global economy.
Another point - unless we have proper fully working cure / vaccine, this ain't going anywhere. June ain't some magical time when virus decides to roll back because enough is enough. Southern hemisphere will keep the virus going on through our summer, so it will come back in autumn.
An additional point - this might be early to judge but it seems immunity is not gained after recovery, so re-infection is probable.
There are more points, like its high infection rate etc.
> so re-infection is probable.
I have the info the virus is not inclined to mutate. But it is just too early to tell.
We also talk about a country in which 20%+ of the population is over 65 years old [0], compare that to China (11%) [1]
[0] https://www.indexmundi.com/italy/demographics_profile.html
[1] https://www.indexmundi.com/china/demographics_profile.html
Sad but people are their own now. Hopeless.
What does arrest mean? Is that cardiac arrest? Is that how people are dying? If they’re dying and people aren’t attending, should they even be there at all?
Most fatalities are from pneumonia. Lots of details are available all over. You may want to read up.
As well there’s a technical skill component that takes a while to master due to variations in person-to-person anatomy. Took me about 8-10 real live intubations in life or death emergency situations (not training where I had all the time in the world) to feel comfortable enough to be unsupervised.
https://m.yna.co.kr/view/AKR20200307046000017?fbclid=IwAR0tl...
Someone is exaggerating, or something is fundamentally inadequate about the Italian response.
0.7% have died, and even that's gone up in the last few days as more cases progress. I don't know the specific stats of how many were severe/critical but it's probably much higher than the mortality rate. If you take a look at the age breakdown of the infected it seems they've been good about keeping it away from the elderly, <2000 out of 7000+ cases have been 60+ years old: https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_S...
The error bars on that estimate certainly encompass 1-2%, but they don’t span to 20%. Either Korea is doing something fundamentally different, or the 20% number is wrong.
I strongly suspect that OP simply took the “80% of cases are minor” stat, subtracted from 100%, and concluded that 20% are therefore hospitalized. This method is wrong.
> "23 people in severe stage and 36 people in serious stage".
Which is a current snapshot, not a total of the cases that have been severe/serious. It seems like they've done pretty well at keeping it away from the elderely where the fatality rate increases dramatically: https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_S...
There is plenty of evidence that many cases are asymptomatic or mild which means the true infection numbers for most countries are likely understated. So the true number of infected individuals in Italy is likely much higher than the reported number of cases.
The other thing to consider, is that with more comprehensive testing, quarantines become more targeted and effective. So South Korea might be having better success in keeping the virus away from at risk populations.
Also, the last time I checked, something like 75% of patients were part of the Shinjonji "religion" whose members skew very young demographically.
Note also that S Korea has 3x the beds of the US, and covid-19 requires very high hospitalization rates and oxygen for weeks.
Tldr: don't expect US or Europe final stats to look anything like S Korea"s current stats.
Lots more detail, and responses to common misunderstandings, here: https://www.fast.ai/2020/03/09/coronavirus/
Here's a brief analysis of the current numbers from SK: https://twitter.com/jeremyphoward/status/1237324005108924417
The death rate is lower in China than Italy, but the death rate is lower within each age group in Italy vs China. Most people are too innumerate to understand this statement.
As an aside, I REALLY hate how this guy on twitter says “it could be 5.0%, look at this spreadsheet that assumes 5.0%!” Then refers to a paper as a good analysis which claims 1.6% and a set of facts which differ greatly from all of his assumptions.
From a well respected friend and intensivist/A&E consultant who is currently in northern Italy:
I feel the pressure to give you a quick personal update about what is happening in Italy, and also give some quick direct advice about what you should do.
First, Lumbardy is the most developed region in Italy and it has a extraordinary good healthcare, I have worked in Italy, UK and Australia and don't make the mistake to think that what is happening here is happening in a 3rd world country. The current situation is difficult to imagine, and numbers do not explain things at all. Our hospitals are overwhelmed by COVID-19, they are running 200% capacity.
We've stopped all routine, all Operating Rooms have been converted to Intensive Care Rooms and they are now diverting or not treating all other emergencies like trauma or stroke. There are hundreds of patients with severe respiratory failure and many of them do not have access to anything above an oyxgen mask.
Patients above 65, or younger patients with comorbidities, are not even assessed by Intensive Care. I am not saying not tubed, I'm saying not assessed and no staff attends to them when they arrest. Staff are working as much as they can, but they are starting to get sick themselves and are emotionally overwhelmed.
My friends call me in tears, because they see people dying in front of them and they can only offer some oxygen. Ortho and pathologists are being given a leaflet and sent to see patients on ventillation. PLEASE STOP, READ THIS AGAIN AND THINK.
We have seen the same pattern in different areas a week apart, and there is no reason that in a few weeks it won't be the same everywhere, this is the pattern:
1) A few positive cases, first mild measures, people are told to avoid the Emergency Department. People still hang out in groups, everyone says not to panic.
2) Some moderate respiratory failures and a few severe ones that need intubation, but regular access to Emergency Departments is significantly reduced so everything looks great.
3) Tons of patients with moderate respiratory failure, that over time deteriorate to saturate intensive care first, then intubation equipment, then CPAP hoods, then even O2 masks.
4) Staff gets sick, so it gets difficult to cover for shifts, mortality spikes from all the other causes that can't be treated properly.
Everything about how to treat them is online but the only things that will make a difference are: do not be afraid of massively strict measures to keep people safe. If the governments won't do this at least keep your family safe: your loved ones with a history of cancer or diabetes or any transplant will not be tubed if they need it even if they are young. By safe I mean YOU do not attend them and YOU decide who does and YOU teach them how to. Another typical attitude is read and listen to people saying things like this and think "that's bad dude" and then go out for dinner because you think you'll be safe.
We have seen it, you won't be safe if you don't take it seriously. I really hope it won't be as bad as here but prepare.
That's why call out every twitter thread like that when I come accross them. In this case it was a guy you referenced a friend of his. So uncorborated. Bad reporting, plain and simple.
If people refuse to take it seriously, no amount of reporting will change these individuals behaviour. What it does so, is causing overreaction of others which can have kind of side effects. Ranging from funny to plain dangerous.
I'm not sure if you can overreact to that, to be honest.
But people in countries that aren't at that stage yet think it won't be so bad there. Because it's all fake and second-hand information, not well sourced, and therefore probably not true and so we shouldn't overreact. Wrong! You should take precautions now, while you still can.
Because what is described in the thread fits completely with an exponentially growing disease that everyone seemingly gets at once and thus completely overwhelms the hospitals. You shouldn't try to shush people who point that out.
This will get much worse, but it's still worth maintaining some perspective.
Even if you yourself aren't vulnerable, you're potentially screwing up people's lives. Not just vulnerable elders, but also doctors who, for better or worse, are unconsciously taken advantage of by requesting them to overwork themselves in poor conditions. The alternatives to not having them overwork are coordinated efforts (which increases contamination, and requires serious coordination that hasn't been shown in Italy yet if the stories are to be believed) or simply leaving people to die. How many people do you think truly understand the consequence of their actions and would willingly continue to do so with full knowledge?
And for what? Some abstract concept called "economy" that 90%* likely won't feel a thing of? Isn't it at least a little ironic that we aren't allowed to panic about corona, but are allowed to panic about anything potentially affecting the economy 'negatively', which just as many people don't know anything about, including tons of self-proclaimed experts?
* Disclaimer: This statistic is indeed picked randomly.
I feel like a wingnut even writing that. My opinion would change except lots of health experts and all the smartest people I've talked to on this seem to agree.
What does tubed mean here?
"From a well respected friend and intensivist/A&E consultant who is currently in northern Italy:"
Basically, that make this twitter thread uncorborated news unless someone reached out to the Italian doctor referenced in it.
Personally I know a girl whose soon-to-be husband from zero symptoms went to being intubated in 3 days. Luckily for him there were still machines available and he's relatively young and in good shape so they have allocated it to him.
One can surely ignore these reports as they are not provided first hand by doctors. In that case it is sufficient to wait. Soon this situation will be a reality in many more regions/countries so it will be easy to experience this first hand.
Also, pretty much in line emergency handling. There is a reason why national emergencies are getting declared. It is the sesantional, alarmist way this stuff is reported that is driving me mad. We should all stay calm and follow guidelines. Instead people buy toilet paper (still just finny) and masks (where gets less funny pretty fast). This kind of reporting, amplified by social media, is a huge part of the problem.
We also have quite some stock of necessities at home, but that isn't any different from, say, last November or any other random months before the virus outbreak. Is it serious? Sure it is. Are we at Black Death levels? NO, and nobody says we ever will be there. I am also rather happy with the general way authorities are handling the situation. Sure, it could be improved here and there, especially at the messaging and side and by aligning policies.
Two things to note so: - When you are not old without any preconditions, your personal risk of complications is rather low. And no, I don't care about one guy being interviewed by whom ever. - Even during the Black Death panic didn't help
However official statements widely reported in the media are essentally saying similar things:
Antonio Pesenti, head of the Lombardy regional crisis response unit, told the Corriere della Sera newspaper the health system in Lombardy was “a step away from collapse” as intensive care facilities came under growing strain from the new cases.
“We’re now being forced to set up intensive care treatment in corridors, in operating theaters, in recovery rooms. We’ve emptied entire hospital sections to make space for seriously sick people,” he said.
https://www.reuters.com/article/us-health-coronavirus-italy/...
https://translate.google.com/translate?sl=it&tl=en&u=https%3...
It is possible than one hospital may be overwhelmed, but surely it cannot be representative of hospitals across Italy or even a region.
[1] for french speakers: https://www.youtube.com/watch?v=pb8Q1yr2cjo
Sadly, it is representative of hospitals across all northern Italy: https://www.ilpost.it/2020/03/08/pesenti-emergenza-ospedali-... https://www.ilpost.it/2020/03/09/coronavirus-terapia-intensi... ("Affollamento e scelte difficili")
I remember my nurse friends freaking out in 2017 because they were having trouble dealing with the extra flu cases.
If we had the hospital capacity to deal with it, it wouldn't be so bad. But the suffering (and mortality rate) spikes pretty significantly when you run out.
If we were halfway rational we'd be rapidly scaling up medical capacity now and practicing strong social distancing now... but people are too worried it would unduly wreck the economy.
We are, as much of the world, importers from China, but many enterprises here are also, somewhat, strong exporters to China (I can see it from my dayjob as industrial automation SI), and if you factor in the small average size of Italian companies requiring many individual contacts (contrast with Germany where companies on average are bigger), you can imagine that there is a strong flow of people to and fro. Maybe the small size of companies requiring more people to establish commercial links + population being more uniformly settled across the country (no huge wildland or sparsely inhabited area left in Po Valley, except maybe some parts of Piedmont?) + a certain cultural inclination for useless quarreling hindering political action + inefficiencies in the administration + an unsolved conflict of power between central gov't and periphery possibly causing some waste of time in other quarreling + having to keep the vast group of small business owners somewhat quiet has resulted in a vast spreading of the virus.
The interesting thing is that, if you replace China with Germany in the paragraph above (wrt. the possible German origin of the outbreak in Italy), the consideration about business links would still apply.
Another interesting thing I have just noticed is that some journalists are now openly praising the Chinese handling of the crisis. Maybe this may sound strange to an American :D but there has been for some time a growing cross-partisan movement calling for stronger links to China. In fact this movement is somewhat present in European business community, so it is not so special to Italy, but nonetheless it is interesting to see these comments of open praise.
(the original links in Italian are at the bottom of the post if you prefer that)
"Sorry, but to me, as a doctor, it's not reassuring that the most serious are mainly elderly people with other pathologies."
This could not be less helpful or more harmful. There is no useful information (that i got to, couldnt get all the way through). This is not an letter to the who or CDC trying to affect policy. This is a goddamn reddit post to scare people, vaguely, with the feelings of hospital staff. Im glad this doctor cares about comorbid patients, but this emotional non-rational prose is what drives mass hysteria and panics. We need data and recommendations.
Seemed quite helpful to me. Much more so than the pure speculation I'm hearing from other sources.
I got the impression the poster wanted to get their truth out, not fear monger.
But outside of Wuhan, there is likely a number of infected persons in the population still transmitting it and waiting to resurface into more serious cases after people get back to work.
There are even multiple foreigners in China who can confirm the situation. Checkout the Youtube videos by Daniel Dumbrill in February.
Might there still be hidden carriers in the population? Absolutely. China must remain vigilant. This stuff is hard.
My wife is considering flying back to China if things get worse here in the Netherlands. I agree with her: I also think that by now China is probably safer than anywhere else in the world. Multiple provinces have downgraded their emergency level, some are even virus free. Within Wuhan, multiple temporary hospitals have closed because they are no longer needed. People are slowly getting back to work. Containment efforts are shifting from ‘preventing the virus from getting out’ to ‘prevent it from getting in from foreign countries’.
As such, we'll know when life resumes and people go back to work en masse.
In my opinion, the distrust in WHO just reflects poorly on the people who are distrustful. They are so hell-bent on confirming their world view that China must be the bad guy, that they would rather believe that the WHO is corrupted than accepting the facts.
I think this is a very interesting effect. China has a fantastic ability to mobilize as one when needed. The vast majority of the time, the insane amount of control this requires, is something we're simply not comfortable with giving to governments. But sometimes, just sometimes, the results are worth it.
The closest equivalence I could think of that'd be familiar to American ears, would be the WW2 war effort. It's not how most of us would want a country run day-to-day, but the ability to do so when needed is incredibly powerful.
Pumping a hospital out in a week or a battleship out in a month aren't dissimilar in national focus. And they're both achievements. What makes China feel alien to us is that this is their default stance.
(And that said, there's plenty to be critical of in the earlier days of China's response. But in the interest of sharing data and research, we're catching more flies with honey.)
Isn't having a massive military Americas default stance as well?
The US was sometimes able to mobilize quickly in response to extraordinary circumstances (WWII production being an example), but that isn't really our default state, and requires consensus-building rather than orders from on high. But sadly our ability to do so even in extraordinary circumstances has atrophied.
But as a European, the US's military footing doesn't feel alien to us at all. They're essentially the modernization of the British Empire, in that their single greatest "weapon" is force projection, rather than the million-man-armies of the East. We don't necessarily identify with it anymore, but it still feels more familiar than alien.
After this pandemic has died down, we should compare and contrast different countries' responses and try to appraise objectively just how much of a difference they made. China is trying really hard to make the case that their authoritarian approach is a model for the world, and it's too easy to be persuaded by that rhetoric when everyone is afraid and panicking. Meanwhile, some countries are trying just as hard to persuade their citizens that everything is okay when in fact it isn't. When all is said and done, we'll see how well that works, too.
Depending on how things go, I think South Korea could become either a model for the free world or a lesson in the shortfalls of democracy. They were doing pretty well until mid-February without imposing any travel bans or other measures that might be considered authoritarian, but then the number of cases exploded and everyone had to scramble. Instead of strong central control, most things were delegated to local governments. Different cities and provinces took different initiatives, quickly learning from each other when one of them came up with a new idea such as drive-thru testing. The shortage of hospital beds was met by large companies (hello, Samsung) and megachurches donating their own resorts and conference facilities for use as quarantine centers. Hundreds of doctors rushed to Daegu to help with the medical crisis there, and faced very little bureaucratic red tape in doing so.
The decentralized approach has its own inefficiencies, of course, especially in places with incompetent leaders or when dealing with a cult that refuses to cooperate. But when South Korea says that there were only 35 new cases last night, compared to hundreds a week ago, you can actually trust that it's a good-faith report because it's been cross-checked by so many independent players. The central government misreported the case count for my city a couple of times lately, and the city immediately issued corrections.
The way the Chinese bureaucracy works is that lower-level local government officials have less experience than higher-level officials. They get promotions based on results. Xi Jinping himself was, during the SARS period, the head of a province, and did very well within containing SARS within that province. It doesn’t surprise me if local Wuhan officials simply weren’t as competent in matters of disease containment than the central government.
The Chinese government is not a monolith. Comparing to 1984-style authoritarianism wouldn’t be entirely accurate either. I think it is best compared to a large corporation.
You seem to be afraid of China exporting its model. Chinese diplomats have repeatedly said that they are not interested in doing that. They say: the Chinese way of international relations is one of mutual respect: we will not impose our system on you and you will not impose your system on us. But if you voluntarily want to learn from us then you are welcome.
I'm not judging, just want to bring some balance to this "truth" you speak of...
You can disagree with their claims. But that is not the same as arguing that any form of self promotion is bad.
Of course, China is far from perfect. Bad things do happen, I am not denying that. If we are speaking about balance, then I think that in western discourse the balance has tipped too much towards the ‘china is always bad in every aspect’ side, totally ignoring or actively denying the good sides, and ignoring equally bad things that happen in their own places.
Will China meddle when their interests are threatened? Of course, and so will any other country in the world.
If China’s interests conflict with yours, then it is fine to point that out. It is not fine to paint them as the bad guys just because they have conflicting interests. And even then, such issues can be resolved peacefully: China has shown that it is interested in negotiation and being reasonable. You wouldn’t believe how much land China has given up since the 40s as part of negotiation deals with other countries. It is time to stop this cold war mentality where it is us vs the evil commies who are out to conquer the world.
I relate to this a lot based on my visit there. Things seem very unified. Hell, even dozens of old people get together every night and dance on the street. When have you ever seen communities like that in the US? We're too busy being self absorbed. We have no shared mission.
Italy also has a surprisingly large number of Chinese migrant workers, mainly in the fashion and leather goods sector. Skilled Chinese workers in Milan and Prato provide the kudos of the "Made in Italy" label at considerably lower cost.
https://www.economist.com/special-report/2018/05/17/long-ter...
As for praising the Chinese response - I think the reasons will be very clear soon to most people - without a very decisive and heavy handed response the health care systems in most developed countries will face very severe consequences or collapse.
We are at the denial stage still with people finding excuses why Italy is different, etc, etc
The US is 8 days behind Italy is 8 days behind Korea.
Italy has 3.18 beds per 1,000 people. The United States has 2.77 beds per 1,000 people.
https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hosp...
I'm in the US, but if you think that makes me think the US is prepared, you have it backwards. I'd guess that if we're not in worse shape than Italy in two weeks, we'll be very lucky.
For the country as a whole, I have it at 20 days until we run out of beds. Like Italy, seems reasonable to expect some areas will hit it sooner.
Here's my growth equation:
BedsNeeded = CurrentCases * DailyGrowthRate ^ DaysOfGrowth * SevereAndCriticalRate
708 = CurrentCases, the number of COVID-19 cases in the US as of March 9, 2020. [1]
1.6 = DailyGrowthRate, Number of today's cases / Number of yesterday's cases. [2]
20 = DaysOfGrowth, how many days to run the simulation.
0.1 = SevereAndCriticalRate, the percentage of cases requiring a hospital bed. [3]
855,919 = BedsNeeded
This is based on the above-quoted 2.77 beds per 1000 people, and a US population of 327.2M people, for 906,344 beds available.
[1] https://www.worldometers.info/coronavirus/country/us/ [2] Ibid, rough average of last week's growth rate [3] Rough guess from above comments and other reading.
Working sheet:
https://docs.google.com/spreadsheets/d/15CRanm0MHyappT_3J1qc...
People here are trying to find any reason that they can point to about other countries to indicate that the drastic measures that they've taken aren't necessary here.
That the hospitals being pushed to the breaking point won't happen here.
I wasn't sure if that's what cjbprime was going for (and it wasn't!), but I thought I'd respond to that sentiment just in case. I think it's important that more people here (specifically in the United States) consider the possibility that we'll be in a similar situation as Italy in a few weeks.
Hell, my folks think we all might've gotten in way back in early January on a family cruise we took; a bunch of us came down with what we all thought was a particularly nasty flu, but without any nausea (just headaches, muscle aches, fatigue, and coughing) midway through. My stepmom ended up going to the hospital when she didn't get over it after a week (but it was still well before anyone thought SARS-CoV-2 had spread beyond China, so nobody tested for it, despite testing for the more typical flus and not finding anything; they ended up treating her as if it was a flu anyway). The rest of us toughed it out and eventually got over it, me figuring "alright I guess the normal seasonal flu is just extra bad this year; next year I'm totally gonna remember to get that flu shot, promise".
The thought was in the back of my mind for awhile that "maybe we did get Coronavirus somehow" (e.g. from other tourists on the boat), especially when the reports of cruise ship quarantines hit the news. In hindsight, I probably should've acted on it and gotten checked out, or otherwise at least said something. If only foresight was 20/20, too. I still don't think it really was SARS-CoV-2 (if it was, I'd expect coworkers and friends and non-cruise-attending family to have gotten it, too, but that didn't seem to be the case; then again, maybe they did get sick and made the same assumption of "nah, this is just the usual winter flu or cold"), but still.
Not sure where I was going with that, but yeah. I think the denialism's just because of previous epidemics in recent memory getting widespread news coverage (swine flu, bird flu, West Nile, etc.) only to end up being minor compared to, say, Spanish flu or polio or measles or other "realer" pandemics from "back in the olden days" (or even current ones like HIV/AIDS, which we all were fine with ignoring 'cause "we're good Christians boys and girls and not them there homosexuals or adulterers").
And then we see the same pattern unfolding here and expect it to blow over again. For all we know we've all been getting infected but we laugh it off as "oh yeah, sure, I totally have the beer virus, guess I get to call in sick, hahaha" and work through it, hoping that there's no truth to that particular joke.
As an example: The Netherlands, where I live, has had a significant rise and our measures are.. self-isolate on showing symptoms, wash hands more often and don't shake hands. The former completely misses the problems with spreading during the incubation period (and worse, there are cases where you may leave, despite not being tested negative yet, solely on the basis of not showing symptoms. This totally misses the fact one can still be a carrier for at least a few days: antibodies don't work outside your body, last time I checked biology). The middle one is self-explanatory, but may also hurt your microbiome and can cause resistant bacteria when done too aggressively. The third measure.. completely misses the scope of the problem. You can still touch objects others have touched on the regular, still opening up a potentially worse way for the virus to carry over. Not to mention the primarily presented alternative is to.. touch elbows? Which looks like a poor joke and still results in touch.
What are some alternatives that would have more effect? Work from home unless coming to the office is absolutely necessary, don't go to social places (especially not large city centers like Amsterdam, Utrecht, etc.), avoid social contact with strangers or outgoing people. All measures that could be implemented fairly easily and have minimal impact on the economy given the alternatives: can't shop physically? Shop online. Can't have social contact online? Play an online game, chat through VoIP. Not working at the office? Surely you can be at least 80-90% as efficient as at the workplace with some etiquette, have some discipline. And don't get me started on people who get the flu, infect others and completely ignore that other illnesses may mask the virus.
Maybe survival of the fittest just needed to weed out stupidity. But hey, that's all just my opinion / hypothesis.
Are you thinking of Singapore?
If you can afford to wait, I'd ride it out a bit longer.
But expect that this disease expands to almost everywhere so what's going to be the status of your country by then, regardless where you are from? I'm not expecting to be able to travel much this summer, not because I'm from Italy but because every country is going to have its own share of problems.
https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_I...
https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_t...
I have an interest in this (I booked a business trip to Italy end of May / beginning of June), but my gut feeling is that the country will not stand for two months of complete lockdown. Two weeks, sure; a month, probably; two months is a very long time to keep so many things on hold. Italy is not China.
I expect some measures will stay in place (particularly about large gatherings), but not all.
Given the nature of this outbreak the real issue is not 'when' it is gonna happen anywhere else, but 'when'.
Italy has been hit first and I must say the reaction of the regions has been uneven, but in the future if the virus doesn't stop with the warmer weather, maybe your country is gonna keep people from flying abroad, so I think it's very difficult to make proper plans right now and, as far as tourism is concerned, 2020 is gone.
Otherwise, EU's future is jeopardy.
People of your ideological ilk see this as some sort of negative but it's absolutely vital. You may think of banks as evil and having a lot of money, but that money is not theirs but "the people's."
But so far, debt markets are still open and there's no reason to panic. Therefore governments focus on more pressing problems for now.
After the human factor, the virus will hit the economy hard. It's probably only a matter of time till it triggers a serious recession. I'd really like to be wrong here.
Although they tried to blame this on Coronavirus that's a small part of it most likely. They nearly folded a few months ago and the government promised them massive tax subsidies which it appears they never followed through on. Regardless my point is that Flybe collapsing his little to nothing to do with Coronavirus. It just accelerated things ever so slightly.
There's nothing simple about any ECB decision on monetary policy, and the composition of the EU when combined with the nature of the Euro is such that pain almost by definition can't be evenly distributed.
The ECB's balance sheets are bad enough as it is, and one country's "cost sharing" is another country's forced-austerity to bail out another country's bad loans.
The Eurosystem has serious issues that are about to get even worse. The ECB is practically insolvent by their own standards, and would be technically insolvent by American standards.
If this virus does indeed require such intense hospital resources (as in Wuhan and now Northern Italy) letting it spike is just madness. Must put into place heavy restrictions now.
We don't need travel lockdowns, but public events, movie theatres, etc should be closed, and businesses should be highly urged to allow workers to WFH if nec and/or try furloughs with public money (ha! good luck...)
In any case, just waiting until we see a spike in cases and then trying to get behind it seems like so much madness.
Large sports events? Museums? sigh
The only thing that be called reasonable statistic is the number of deaths and that hasn't spiked - I hate to say - yet. It's possible hospitals are even missing those, it's a big country. And it's a dispersed country so things might not spread as quickly.
But other, what you say. Stopping large public events and doing mass testing seems crucial. South Korea seems to have gotten a handle on their infection process at the moment things are out-of-hand in Italy. South Korea has done mass testing for a while.
1) the CDC told all the other labs to stand down and wait for the CDC test kit
2) the CDC refused permission to test except under very narrow conditions
3) the CDC test kit was defective due to being over engineered, and delayed availability during a very critical period
Now that we're behind the exponential growth curve, any measures that politicians can take are going to be much less effective.
https://www.nbcnews.com/health/health-news/after-missteps-cd...
Why did CDC depart from this and make a 3 part test (1 part of which had nothing to do with this virus) when there was already tests available they could just copy?
During an emergency, you don't screw around and try to come up with the perfect test. You don't exercise turf rights over other concerns.
https://www.corriere.it/video-articoli/2020/03/09/dopo-cina-...
Genuinely looking to learn.
0: https://www.nationalgeographic.com/science/2020/02/here-is-w... 1: https://en.wikipedia.org/wiki/Cytokine_release_syndrome 2: https://en.wikipedia.org/wiki/Tocilizumab
Rheumatoid arthritis is an autoimmune disease and not a "oh I'm old and I've worn down all of my cartilage" disease.
Chloroquine remains quite promising for the early stages http://news.southcn.com/nfplus/gdjktt/content/2020-03/09/con...
https://observablehq.com/@jashkenas/italy-coronavirus-daily-...
I reply with my humble contribution, based mainly on John Hopkins' data. I tried to understand if the effect of restrictions is already visible (I hope it will... since I live in Milan), thus I fitted an exponential on the data from the week before March 1 (when the initial mild restrictions started) and compared with the actual growth.
https://www.kaggle.com/mattiamonga/covid19
The model is quite simplistic, but the decrease seems real. Let's hope a bigger one will happen in the next days.
Expect other Western European Countries to follow this pattern as the number of cases increase [1]. I would specifically be looking at France, Spain and Germany as potential next candidates.
If people here haven't already, I would recommend not leaving your shopping to the last minute and to stock up on a few extra supplies to help not exhaust the local food-chain when people do start panic buying.
Without that irresponsible leak, and the irresponsible reaction of people trying to "escape", this total lockdown would probably not be necessary.
People sometimes are right shits.
> reaction of people trying to "escape", this total lockdown
> would probably not be necessary.
The leak was far from ideal, but I still think Italy would be in the same situation. I suspect there were already an un-contained spread in the South before the lockdown in the North.
> People sometimes are right shits.
This is still true, but I am not so sure they can be completely blamed. When people are scared they act irrationally and this should be incorporated into any plan.
Sensible choice all things considered. I think instant noodles are also a pretty good bet, I personally make a noodle soup with vegetables to bring up the nutrition a bit. I would also add frozen vegetables to the list as it keeps for ages and balances out most meals, whilst still being quite good for you.
I like pasta too, but don't eat as much as I used to. Rice is so versatile!
I like rice, but am concerned by the number of people who don't wash it (arsenic) [1]. Then you have the issue of reheating/leaving to cool [2].
With the amount of idiocy going around it seems like a massive risk. Pasta is very difficult to mess up, worst case you're just going to get some crunchy or over-boiled pasta.
[1] https://www.recapo.com/the-doctors/the-doctors-diet/the-doct...
[2] https://www.nhs.uk/common-health-questions/food-and-diet/can...
It's the kind of article/site like one you'd see taking a graph of the effects 2011 Japanese quake on currents across the world, and claiming it to be a graph of how radiation has reached California...
> Now, some ways of cooking rice reduce arsenic levels more than others. We carried out some tests with Prof Meharg and found the best technique is to soak the rice overnight before cooking it in a 5:1 water-to-rice ratio.
> That cuts arsenic levels by 80%, compared to the common approach of using two parts water to one part rice and letting all the water soak in. Using lots of water - the 5:1 ratio - without pre-soaking also reduced arsenic levels, but not by as much as the pre-soaking levels.
[1] https://www.bbc.com/news/health-38910848 [2] https://www.bbc.co.uk/programmes/articles/2F1MDzyW55pg97Tdpp...
Even if you don't use it now because food supply chains don't end up majorly affected, this kind of stuff is handy to have around in case of an a more immediate emergency.
I believe that the world is mocking a phantom.
That said, toilet paper in general has been driven by media hype 100%. I think I remember some early stories where idiots purchased tonnes of it and emptied the shelves. I think the reason for toilet paper being purchased so much is because of it being randomly reported on in the beginning and that it's so cheap. A person on a modest income could easily purchase an entire shelf of toilet roll, whereas you're unlikely to see such things with higher cost items that have to be consumed within a certain time.
https://math.mit.edu/projects/traffic
It’s basically a normal occurrence in dense traffic.
I think you're right for the most part, but in Australia there have been videos/pictures of people overloading shopping carts with enough toilet paper to last a family for years. These people are out there but it's hard to tell if they're in significant numbers or just a few idiots. I think we needed a little bit of panic a lot sooner to smooth over these bumps, but most people did not heed the advanced warning that China gave us.
Where as with other things, you could grab a months supply of cans and pasta and there will still be so much left, as well as the fact that not everyone is grabbing the same kinds of foods so the hit is spread over pasta, rice, flour and a huge range of canned food.
I just hope that other government in Europe will take it seriously, because it seems spreading fast over France, Germany, Spain and Netherlands.
I don't know how the count is made, but since the pressure will affect the care for the other patients as well, it makes sense to at least take them in consideration in the stats.
Data provided by the government’s Centre for Health Protection show the incidence of infection with influenza had fallen to less than 1 per cent by the end of February, marking an end to the winter flu season, which normally extends to the end of March or into April.
...
Ho Pak-leung, a leading microbiologist at the University of Hong Kong, said data showed the flu season had shortened from an average of 98.7 days to 34 days this year.
https://www.ft.com/content/ad7ae6b4-5eab-11ea-b0ab-339c2307b...
* Twitter link to above to possibly bypass paywall: https://twitter.com/Birdyword/status/1236491746541895685?s=2...
It's going to be interesting how society changes as a result of this, for those of us who live through it.
It's going to be a clusterfuck.
I won't go so far as to say that the position of the president is a figurehead, but it's been more than a little advisory for several generations.
I watch a lot of BBC, NHK, and DW, and see it all the time. I don't blame the foreign journalists. If you're an overseas news organization working in America, of course the president is going to be fully staffed. But few orgs go much beyond that. Because of this, the European view of how America works is very simplified.
I believe you are seriously underestimating the effect of chaff being thrown into the air over this issue on a number of fronts. It makes it much, much harder to have people follow public health advice or put pressure on lawmakers to pass the necessary appropriations that will be required to address the situation.
Except when a major global catastrophe hits, like a pandemic, the response requires massive coordination across local, state, and federal levels. What he says now may not be so relevant but the president's lack of appoints to key executive branch positions within the CDC and the rest of the healthcare apparatus (including eliminating health related positions from the National Security Council, one of the most important multi-agency coordination bodies) has drastically hampered the COVID-19 response effort.
People from other countries more often tend to underestimate the sheer scale and complexity created by a local-state-federal separation of powers weighed down by over two hundred years of judicial baggage and thousands of miles of geography. In a crisis like this, even figuring out who has legal jurisdiction and authority is complicated. Doing it without an effective executive body, whose job is to navigate and command that mess, is far more difficult.
That's not even true of just stable democracies, much less every country. In fact, the differences in practice have been satisfied quite a bit.
Yes, but more semipresidențial systems.
That's cute, but in the real world the US Presidency has gotten much stronger over time, not become “more than a little advisory”.
It should be almost irrelevant to the discussion, but by now he has enough appointees in various departments for the problem to grow roots.
You end up with supporters of the President even denying coronavirus exists or a conspiracy of the left. Truly frightening.
https://www.politicususa.com/2020/03/07/trump-supporters-are...
In Michigan, they just launched michigan.gov/coronavirus last week, and have commercials on the radio to inform citizens.
Source: https://www.theguardian.com/world/2009/dec/16/dr-beetroot-di...
There is also a psychological factor to count in of course...
Social and ALL other media have been flooded with the virus 24/7 since the first confirmed case.
It generates good views, everyone wants a piece of that, and now we have this nation-wide phicosys
[1] https://www.worldometers.info/coronavirus/country/italy/
7M people catching it next month, vs 7M people catching it over the span of a year, are two very different 7M's. The rate is far more problematic than the actual number.
And yeah Wuhan says they've got it under control. We'll see.
It is a guarantee, and it has been since 1 month ago. Italy was first because someone has to be first.
People, even informed audiences like HN's, are just fooling themselves and thinking wishfully.
I've found countries (Slovakia springs to mind) that would say "a quarter of 8" for 7:15 (think "7 hours and a quarter of the eighth hour") and "half 8" for 7:30. Time can translate in rather interesting ways.
It is not about those dams politician that only care about reelection numbers, it also about keeping the wheel of society turning.
To say nothing of how much total hysteria that would cause.
What has changed is that almost everything is being delivered from online store or purchased from supermarket or pharmacy during restricted hours. Anybody who worked a pink collar job before has no job now. Anybody who owned a brick and mortar business before is hoping that the government grants will cover the rent and allow it to reopen if/when things finally go back to normal.
Lockdown like this is no doubt devastating to the economy. I don't think we've seen the worst of it yet. But so far it hasn't affected supply of food, clothing, shelter.
Probably means people and businesses in places like China will be mostly 'fine' and people in the US are going to get savaged.
I agree that we have not fully realised the effect of the lockdown yet, but from what I have gathered things are not very promising. It's unlikely that people will ever go without food or shelter, however the economic progress they worked hard to achieve in the past decade could very easily be undone.
"According to the official Weibo news of the "News 1 + 1" column of CCTV, on March 6, Bai Yansong talked with Wu Hao, the head of the community prevention and control expert group of the central steering group.
"Wu Hao said: Patients discharged from Wuhan must have 14 days of centralized isolation observation and 14 days of home medical isolation observation, and they must go through a total of 28 days of isolation observation period. The first 14 days are the observations of centralized medical isolation points, which are usually requisitioned and modified medical isolation points such as hotels or training schools for observation. In principle, each isolation point is matched by a doctor and a nurse for every 50 people, and there are other life support personnel. At the same time, there is a division-level leader cadre at the isolation point."[1][2]
Also, when it comes to trying to squash the epidemic nation-wide, even 28 days might not be enough, as you have to reset the clock with every new infection.
Let me give an example. Let's say everyone in Italy isolates themselves (with their families or whoever they're living with) for 14 days. At day 13, someone of them that's infected could infect someone else they're living with, and if they then go out in to society on day 14 they can start the epidemic all over again.
Of course, if this was perfect isolation, with every single individual keeping completely away from every other individual, then 14 days (or 28 days) might be enough (assuming no atypical cases that take longer to resolve). But that's not going to happen in the real world.
People will need to have some contact for getting food from each other, for example, and for keeping essential utilities like water and electricity running, for keeping hospitals open, etc. That's not to mention group living facilities like nursing homes and prisons. There are just not enough individual living accommodations to make perfect isolation possible.
Worse, even if there was perfect isolation in Italy, when the isolation period ends the epidemic could still start all over again when one single sick person from another country enters.
In order to be really effective, such isolation measures would have to be both perfect and simultaneously held all over the world, or else once a country is clear of the disease it would have to somehow prevent sick people from other countries from entering, which isn't going to happen either.
[1] - http://www.bjnews.com.cn/news/2020/03/06/700265.html
[2] - https://old.reddit.com/r/Coronavirus/comments/feql65/wuhan_i...
No dinners at restaurants. Probably no take aways after 6 pm. Dinner is usually at 8 or 9 pm here.
It's difficult to practice sports, except running or whatever you can do at home.
Everything else is normal. I already worked from home, self employed.
Folks, get mentally ready to know someone that will die because of this. Luckily, almost everyone in this thread will be alive, but those that have diabetes, cancer, coronary artery disease, and the elderly are the ones who will have poor outcomes because of it.
>http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9... >https://pubmed.ncbi.nlm.nih.gov/32031570-clinical-characteri... >https://pubmed.ncbi.nlm.nih.gov/31986264-clinical-features-o... >https://pubmed.ncbi.nlm.nih.gov/32007143-epidemiological-and...
That tells me that case count will grow at a rate of test rate * 10% for days to come even if the actual spread has peaked.
IMO, and I’m not sure why more people aren’t saying this, the hospitalization rate in the general population under typical exposure rates is probably closer to 1% than it is 10%, and so just multiply the severe or critical cases by 100x to see the general population infection rate.
And if severe case count is not growing, than neither was the infection rate ~7 days ago.
And has one of the lowest fertility rates [1] in not just the EU, but in the World. Odd considering how just a generation ago having a large catholic, and poor, family was one of the most prominent qualities of Italian life.
They keep trying to monetarily incentivize increasing birth-rates, much like Japan, but its not working. I often wondered what implications all of these austerity measures and under-employment in regards to population growth would look like in the West, and it seems to be following the Japanese model quite well.
With that said, this is incredibly terrifying; the implications are looking dire.
1: https://www.thelocal.it/20160517/why-italys-facing-a-birth-r...
I would not say so, no. That's speculation, this has not been true even for the south for a long time now. The only large, poor families you see are from immigrants nowadays.
But, and this was just my personal experience since I was in the EU during the financial crisis; Italy, much like Spain and the other so called PIIGS, is a country plagued with underemployment and little to no social mobility for those under the age of mid 30s for the most part.
And while I cannot attest to the number of their siblings or their religious beliefs, to say Italy itself is not is rather difficult to believe given my first hand experiences.
I remember walking down the piazzas during the day to set up shop in the central parts of town, and the amount of large groups of 20 year olds (I was in my 20s back then too) were there day and night drinking in public was astonishing.
I'm from Poland, where the fertility rate is also very low, but parents in their 20s are still not that uncommon in this country.
Emilia Romagna hasn't been communist since at least 2 decades.
Emilia Romagna is largely an industrial compound with better average welfare state than the rest of Italy.
At best I would say Italian-socialist with some communist folklore
> the amount of large groups of 20 year olds (I was in my 20s back then too) were there day and night drinking in public was astonishing.
1) All the cities in Italy have large student populations because of well-respected universities. Bologna has one of the oldest universities in Europe, which is now massive. Chances are 95% of the kids you saw were students.
2) People in Italy like to hang out. Even if you have a job, anytime after 6pm is fair game for an aperitivo and whatever comes next, particularly when you are 20. Also, in smaller cities and towns, shops close at lunchtime and people go out to eat together, coming back around 2 or 3pm.
Edit: guess not, suppose I should spell it out: "Gypsy" is widely viewed as a slur, and thus is not appropriate as a cutesy spelling of a group of countries.
Its literately the first line in the link:
>> It’s been almost two years since Prime Minister Matteo Renzi introduced an €80-a-month ‘baby bonus' for low-and-medium income families.
>>> But now Health Minister Beatrice Lorenzin wants to double that amount in a bid to stave off what she describes as a “catastrophic” decline in the country’s birth rate, as well as introduce higher payments for second and subsequent children.
The sad truth is that Italy is hard for young people with the wrong degree (or without a degree). Postponing children is often a necessity, if you don't want to depend on your parents (who often own an house and have a nice pension). And so many skilled people just leave.
That's pretty much the millennial plight, and I agree; the sum is absurd when put in proper context, but that is what the Italian Government deems 'necessary' to pay just to keep the native population (targeted low income and likely low educated) churning out more numbers. Apparently the secretary general wanted to double that, and 2-3x it for subsequent children.
The US probably subsidizes it even more with all the tax credits for having children, too.
I'm not saying this to be supportive of the process, just restating my observations. Also, Italy has the easiest immigration laws of all of the EU to help boost its population numbers.
Speaking of depending on their parents, I met a girl in Croatia visiting her Italian BF (she was from Washington) as she was thinking about staying long-term and living 'la dolce vita' a bit longer at her to be in-laws place when she realized all she had to do was marry her BF and would be granted complete citizenship.
They thought about taking a year to just travel if they did it, I wonder if she went along with it?
The restrictive measures themselves are hardly enforceable, with some very important exceptions, e.g. schools. Hopefully, they would induce some change in habits.
I am from Milano, and my daily life has certainly been affected. I left the city two weeks ago. It was easy for me, though, as I can distance teach and I have a place in the mountains.
Frankly, I expected that these measures will be extended to the entire country not later than by the end of the week. We're still in the exponential growth phase.
I am not sure you are right in assuming the leakage was unintended, though. If they wanted people to run, the effective way was to force a choice under the imminent and vague threat of being trapped in the ‘red zone’.
In a major west coast city and trying to think through when to leave. Too early better than too late but I don’t have a cabin in the mountains so it will be a significant cost to hide out for a month.
Two examples:
"Nothing to worry about, it is just a little more than a regular flu" (Attilio Fontana, Governor of Lombardia)
"#milanononsiferma" (Giuseppe Sala, Major of Milano)
But, don't lockdown also create massive barriers of people, including of those who need access to life essential products/services?
Most of us are working from home, but I won’t call it a “lock down”
One area that does seem to be lacking is gyms, beauty salons, barber shops etc. But really those things are luxuries - people are able to go on without it.
Lockdown really sucks but it doesn't suck because of a lack of goods. It sucks because a massive number of people in pink collar/service roles are unable to work. It sucks because the government, and other fearful people, have essentially decided that face-to-face social interaction is not a prerequisite for a functioning society. That might sound fine to someone who is introverted and a homebody anyways, but when interactions have been forced onto the internet or behind masks and checkpoints for months, I dunno... For me it's really trying. I don't so much miss the products of life before coronavirus as I miss the society we had.
https://files.catbox.moe/3ns6c1.mp4
This file is several weeks old by now, a search on the 'net finds a number of pages where the link is mentioned (including one from the 21st of januari 2020 - according to Google that is - hoax alert? if so a prescient hoax in that they knew it would start in the north of Italy).
This being the internet it it hard to ascertain the veracity of the thing. If it is for real it sounds way worse than e.g. the situation on the cruise ship 'Diamond Princess' which saw 700+ infections but only a few deaths as far as I know, nor does it tally with the situation in Korea. In the (supposed) transcription they talk about a larger number of cases in younger people without existing medical conditions, again something which goes counter the current narrative. One of the possible explanations given for the higher mortality in Italy (~4%) compared to Korea (~0.7%) is that Italy has a generally older population (the oldest in Europe) but that does not explain the mentioned incidence of cases among younger people. Of course the way countries count 'cases' can also differ so there is another possible explanation but this still does not explain those cases among younger people.
Are you really still claiming this is not real?
Here the cases country by country: https://www.worldometers.info/coronavirus/
It's interesting to see that the growth is almost everywhere the same. In some countries it just started earlier.
It took just 1 week (or 5 days min) to have cases from less than 100 to roughly 1000. Same in Italy, same in S. Korea, same in Germany, etc.
Some countries are following the chinese example of "authoritarian democracy", particularly European countries with big commercial ties to China.
Then you have the reverse side of things: USA, where not even tests are being done in obviously suspect cases. But people can still go to work, buy things, live their life.
There's pros and cons to both approaches, but compared to how H1N1 was handled I definitely see a turn to authoritarianism, at least in Italy.
Here is KCDC's English daily reports about COVID-19. https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=00...
For instance, closing universities could result many years later in ill-trained doctors and then bad diagnostics.
The economic downfalls could result in an increase of poverty and homelessness-related deaths and suicides.
Estimate the economic loss and you have a back of a napkin death toll.
But no, people don't seem to be talking about it.
https://www.statista.com/statistics/569187/average-age-of-th...
Only 17% of the Chinese`population is over 60.
We should expect to see a devastating impact on Italy with a much higher CFR.
Because I have no real explanation how a few hundred people on ventilators are supposed to bring the healthcare system down.
https://www.cbc.ca/radio/asithappens/as-it-happens-monday-ed...
Granted, she was not the only one publishing them on Twitter, but she was the one I was following the most. Also to add, news organisations like the FT or the BBC were only publishing news that could be taken for a political spin, like in the case of Li Wenliang, they were not publishing news about people committing suicide on their home as not to infect their loved ones or desperate phone calls made by people who were trying to get their loved ones into an hospital (which were already full by that point).
Also, many of the hospital scenes I was seeing on Twitter on her account are similar to what now surfaces from hospitals located in Northern Italy.
The question is to which one we are closer? That's what I think no one knows. Like how reddit says "2 million will die in the US" and some people say "it's just a flu" the truth maybe between the two half way there or so
https://www.thedailybeast.com/six-inmates-dead-scores-escape...
Quite funny, but the stats don't lie[0]. The number of new cases in Italy has grown at an exponential rate. This is a developed economy. Similar rates are being seen in France, the UK and Switzerland. The same will happen in the US. We're all going to get this, and most of us will be fine, but if you take the midpoint of experts' forecast of 40-80% of people being infected and multiply that for a conservative 1% death rate (the WHO has mentioned 3.4% and 2% is also often thrown around), that yields
7.8 billion * 0.6 * 0.01 = 46.8 million dead
At an 80% infection rate and an 3.4% mortality rate (worst case scenario), you get 212.2 million dead.
That's a once-in-a-century, catastrophic black swan event.
[0] https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_I... – see the chart below the table for the unbelievable exponential rate
[1] https://twitter.com/EricTopol/status/1236321986122375168
[2] https://twitter.com/NBCNews/status/1235956761015783427
Not a doctor, but I suspect 3.4% is the upper end of the case fatality ratio (i.e. death among people tested positive) as opposed to the infection fatility ratio (i.e. death among estimate of people infected).
Problem is, given the current numbers, the projected total number of people who will require hospitalization, and of those that will require ICU, significantly exceed availability. So if it spreads too fast, and all these people get sick at the same time, we won't have enough beds to go around - and that will cause the mortality rate to spike again.
One of the issues working against this scenario is the fact that the worst-affected regions are also the ones with the best health services. The other regions might struggle to respond as efficiently as the "pioneers", although they will benefit from the accumulated experience.
The whole point of locking down Wuhan/Hubei and then northern Italy and now the whole country and other places and cancelling large public gatherings and events is that local, regional, and national authorities start seeing the numbers soaring and initiate extreme mitigation strategies.
We don't know how successful these strategies will be individually/collectively in the long run but if China is anything to go by it can severely retard the spread of the virus.
To show I'm not spouting out of my derriere compare the logarithmic infection and death rates of China[1] and Italy[2]
So you have to modify your formula: `7.8 billion * 0.6 * 0.03 * mitigation_factor = ?` We just don't know what the mitigation_factor is yet and because the spread is exponential any dent in the rate of spread brings the fatality number tumbling down[3].
I happen to believe this virus is a very serious global threat and I assure you that I am not one given to alarmism. But I also have never seen governments respond to the onset of an epidemic like this before and I'm nearly fifty and my mother says she can't remember anything like this in her lifetime. So yes, tens of millions absolutely could die but I'm willing to bet that between lock-downs and modern medicine tens of millions won't and I pray to, you know, $deity I am not wrong.
[1] https://www.worldometers.info/coronavirus/country/china/
[2] https://www.worldometers.info/coronavirus/country/italy/
[3] https://www.youtube.com/watch?v=Kas0tIxDvrg [Exponential growth and epidemics]
Here are my calculations based on current data[1]:
Country tot. deaths pop. (1m) tot. deaths/1m pop.
Italy 463 62 7.46
Iran 237 83 2.85
China 3120 1384 2.25
South Korea 53 51 1.03
Spain 30 49 0.61
France 30 67 0.44
USA 26 329 0.08
With any luck we'll have a vaccine in 18 to 24 months. The flu season is halted by warmer weather. We can change our behaviour for a few years until we get it under control.
China has 1.4 billion people, and they've had ~3,000 deaths (let's assume it's several times higher in reality). But we'll see tens of millions dead globally? No we will not. If you killed every person that has been infected in China, and extrapolated that event globally, we would not see tens of millions dead. So that premise is absurd, to an extreme.
I consider this to be a very serious situation, however, it's not very serious as a great mass mortality threat (unless it mutates and becomes far more deadly and we prove unable to slow it down or vaccinate against it). It's a serious threat for massive disruption to our daily lives, including severely harming the global economy. It's a serious threat to swamping our healthcare systems due to ICU demands and diverting our resources to managing the ongoing crisis (instead of routine, normal productive work).
Assuming this isn't going to burn out come Spring & Summer, the next step is to rush to vaccine, at any cost. That will end this thing globally. Maybe we'll need to vaccinate against it annually, maybe it won't come back after this year, who knows of course.
Tens of millions will not die. Tens of thousands might die in the plausible worst case scenario, before we get a vaccine ready. We can rush to vaccine at greater patient risk and financial cost, as necessary.
We might ballpark the number of global deaths – in the optimistic case† at between 20,000 and 30,000 souls. Not a global tragedy, on a scale of the recent Ebola outbreak, but warranting much more drastic action.
There's a huge sense of urgency. We could have a vaccine before the next flu season in the northern hemisphere.
† assuming not every country acts quickly when the time comes nor acts as effectively as China
That's quite unlikely. We're looking at 12-18 months if everything goes perfectly according to plan and we get it right on the first try.
> nor acts as effectively as China
Only if you take China's numbers at face value, which nobody really seems keen on doing.
1. We don't know the actual reality of what's happening on the ground in China. Hubei and Italy have approximately the same population, yet Italy is suffering more proportionally. I think the obvious explanation is drastic underreporting of cases and fatalities in China. When all is said and done I think China probably has underreported by at least a magnitude if not double that.
2. Most Western countries won't impose the type of strategies that China undertook; they simply can't. When things get too bad to impose draconian quarantines, it'll be too late. Even Italy's efforts in quarantining the nation are not enough.
3. Most of the world doesn't have good healthcare. I'm talking about Africa, Southwest Asia, South America. There simply aren't enough ICU beds and ventilators to go around. Even in the US, I've read reports of only 100K ventilators nationwide. If the pandemic keeps growing exponentially with a doubling period of 4 days, the US alone will have 1M cases by mid-April.
4. Simple math. World population outside of China is 6.5B. If 10% are infected (very conservative imho) we're looking at 650M cases world wide. If the CFR drops to 1%, then we're in the neighborhood of 6.5m fatalities. And the survivors? Roughly 81% of those infected survive with no serious side effects. The remainder have serious health issues even after the disease runs its course. That's 117M casualties. This is world altering.
To address (1.) You and others are going to have to provide sources for why you think that China "probably has under-reported by at least a magnitude if not double that". I've seen the ill feeling and distrust towards China increase on HN and elsewhere in the last 5 years and this fits the bill.
You can explain the differences between Hubei and Italy by the differences in responses. As has been pointed out, China built two make-shift hospitals in ~ 10 days and quarantined 100s of millions in cities. Have you not seen the pictures coming out of China. Now that Italy is taking drastic steps we'll see the outcome in a few weeks and it will tell us if it is an effective strategy. If any of the reported numbers is suspect it is the total number of cases that the USA is reporting: https://www.worldometers.info/coronavirus/ It's completely out of whack with every other country. This implies the US has been under-testing, something which we have lots of evidence for. On the other hand we have no evidence China is under-reporting.
To address (2.) "Most Western countries won't impose the type of strategies that China undertook; they simply can't." Why not? Why can't they?
To address (3.) "Most of the world doesn't have good healthcare." But most of the world has soap, most of the world understands what it means to self-isolate, most of the world can implement quarantining. "If the pandemic keeps growing exponentially with a doubling period of 4 days," Looks like mitigation strategies slow the doubling period to three weeks, why pick the worst case scenario?
To address (4.) "Simple math." Yes! Times an unknown mitigation factor of ? This outbreak is scary because it's exponential (highly lethal and highly infectious), but the total fatalities is also highly susceptible to interventions exactly for the same reason.
I have no ill feeling towards China other than the fact that they have a repressive, authoritarian government. Those types of government necessarily try to control and spin the news to maintain their authority. If a country is willing to censor Winnie the Pooh to make their leader feel better, than they'll naturally minimize the effect of SARS-Cov2.
I also agree that the US is underreporting due to inadequate testing. Estimates in the US should be closer to 9-10K. I think that we'll see a large spike in cases as soon as testing approaches levels in other countries.
My inclination regarding quarantine controls in Western countries stems from the willingness of these societies to restrict freedoms. Italy's quarantine is very basic, a 1 on a 1-10 level. Compared to what China implemented, it's not even close.
Soap isn't the ability to treat cases; it's a way of trying to mitigate the spread.
- The US plays along. We are likely a hotspot now, whether we go the “undertest and live in ignorance” route, or not.
- We have an effective plan for rebooting out of the lockdown. Which, until we have an effective treatment or vaccine, to me means temperature scanning in most public places imaginable, continued vigilance around disinfecting, continued limits on public gatherings, and more.
(The # of deaths for Germany is suspiciously low, as is the # of deaths for S. Korea.) I actually think the Chinese data is fairly accurate. the Iranian data, well, who knows. I'd like to think the European data is reliable, but again, who knows.
If the USA becomes a hot-spot then other countries will undoubtedly institute a travel ban to/from there like is happening with parts of China, S. Korea, Italy, Iran, and so on.
(chance of contracting virus) * (chance of contracting disease from virus) * (chance of fatality from disease).
The first is dependent on containment efforts. The second is not 100%. The third is also partly dependent on containment efforts, as fatality goes up if hospitals get overwhelmed.
I don't see how you get "we're all going to get this" when China and South Korea are already reporting decreases in daily cases.
It's a catastrphic event but I don't see any reason it won't happen again in the coming years / decades. The virus itself could even have worse characteristics in terms of transmissibility and mortality. Our transportation network is so great and modern society so dependent on it there is no hope stopping these outbreaks going global, only slowing them down.
In fact it should probably be fairly easy for a malicious actor to engineer a worse virus. Longer incubation period, truly airborne, super lethal. Whatever the final death toll is, I don't think it'll be the last or the worst of the 21st century.
In that case (https://news.ycombinator.com/item?id=22274728) also, the article wasn't in English, which makes it off topic here (we deeply respect other languages, but HN is an English-language site).
[1] https://twitter.com/nytimes/status/1236484352965521408
[2] https://twitter.com/nytimes/status/1236479276586807296
I mean the events happened are similar, but the point of reporting is totally different.
While an authoritarian government may be better suited to positively addressing some very specific problems (such as a pandemic), I do not personally consider the benefits to be worth the costs of infringing on everyone's freedoms. A government built around liberty and individual rights simply cannot enforce a sufficiently useful quarantine here to contain something approximately as infectious as the flu.
Even China, which has severely curbed the spread of the coronavirus at tremendous expense, is still dealing with an exponential decay of new cases, at best. At the current rate (and assuming no incoming infections from abroad), it could take China a full year to go 14 days with no new cases. And if they let up restrictions sooner than that, perhaps they will lose ground to the virus once more. It does not seem sustainable.
Also note that most cases are not being tested and reported. Anecdotally, I have second degree connections who are mildly infected and being responsible (although still probably exposing some people who live near them), but see no point of getting tested because they don't need the hospital and it's just an extra trip out in public. Other seemingly sick people are out and about in the city in which I live, coughing without covering their mouths in busy areas, etc. Perhaps I am just noticing it more, but I suspect the official case numbers are still off by a factor of 10 or more, so considering roughly a million people are likely infected throughout the world, containment is a fantasy at this point.
Still, I wonder what the math looks like. It has indeed been shown that flu outbreaks in ideal conditions are more intense, but conversely, the flu seasons are shorter [0]. If medical attention makes a significant difference in patient outcome, then the longer virus season is presumably preferable. However, the significance of medical attention needs to somehow be weighed against the total number of people who end up being infected and the costs of shutting down pieces of the global economy for longer periods of time (not to mention limiting individual rights.)
Consider that less vulnerable people may be more likely to become infected in their daily lives since they are more active and likely come into contact with more people. In this case, a faster outbreak with many mild cases may actually result in faster herd immunity, and therefore fewer total infections in vulnerable populations. Perhaps a partial quarantine of at-risk populations is the best solution.
[0] https://www.citylab.com/environment/2018/10/big-cities-have-...
Why do you say this is futile? Quarantines work. They're just very expensive.
[0] https://en.wikipedia.org/wiki/Eradication_of_infectious_dise...
You quarantine to halt the rate of infection and give your health care facilities time to care for the seriously infected. And that saves lives. A lot. It can save a lot of lives.
This is a poor time for armchair analysis when we're looking at worst case scenarios involving millions of deaths.
I've never heard of an entire country being shut down because of the flu.
My wife is an administrator at a Nursing facility that is much larger, and this many people DYING so quickly is terrifying.
[0] - https://www.kiro7.com/news/local/coronavirus-number-confirme...
Without widespread testing, we are going to have no idea how bad this is and how seriously fast we need to lock down facilities, particularly nursing homes, and this particular nursing home has shown that in a lot of places, the disease is going to strike and kill FAST.
Which indicates one really big issue. People are, for a large degree, scared by numbers now. Not because the nmbers look black death level bad, but rather because there are no numbers on stuf like, say, the flu or some other disease out there to compare them against. Not blaming people for it, that's just how numbers work, not just for diseases.
bad thing is, nobody is addressing this, or anything else related to testing, numbers and so on, in the public. Which includes TV, internet, papers... Instead we have fake news spreading. This fake news is then erroding trust in official information. And as a reult you have to sides, one that believes the virus is at most a flu and the other one believing it will at least be the spanish flu if not the black death. Both are wrong, but the true facts are not getting through. Also the official information is badly presented.
26 people have died in a matter of weeks at that nursing home from Coronavirus.
If this thing gets into these other facilities, it's going to wipe them out.
The number is much higher than that, as there are an additional 12 deaths that haven't been tested for coronavirus yet. 26 have died in the last three weeks as compared to 7 in a typical month.
Another 26 are in the hospital, with the rest being quarantined at the home. Over 1/3rd of the staff there is showing symptoms ~70/180 people.
https://www.bellevuereporter.com/news/life-care-center-of-ki...
Out of curiosity, I tried to find examples where many people died of a flu outbreak in nursing homes. Here are some articles I found:
This article describes a nursing home in Sheffield where 9 of 60 residents died from the flu during the 1997--1998 season: https://pdfs.semanticscholar.org/e54b/27d527dd0612d0899f22ea...
This article describes a nursing home in Honolulu where 6 of 37 residents died from the flu during the 1989--1990 season: https://www.ncbi.nlm.nih.gov/pubmed/7657975
This article describes a nursing home in Los Angeles where 8 of 101 residents died from RSV in 1979: https://www.ncbi.nlm.nih.gov/pubmed/6527041
This article describes a nursing home in Devon where 4 of 50 residents died from RSV within one week: https://www.ncbi.nlm.nih.gov/pubmed/6736667
I am mostly following the french news on this and the doctors interviewed (some of whom seem to have impecable credentials) are calling this an irrational panic. It is a serious disease, one of many viruses around, not a particular dangerous one either. But mostly not something that calls for these drastic measures.
I predict that:
1. France will have an exponential explosion of cases.
2. France, after dragging its heels, will eventually undertake similar quarantine measures.
3. Whatever economic damage that early mitigation would have caused will be inflicted multi-fold, as the country reacts too late.
4. Those same doctors will be shrugging their shoulders, and crying: "How could anyone have foreseen this?"
5. People in the next country over will be busy arguing that the virus is causing irrational panic, and that all these measures are an overreaction.
2. Possibly, I don't think Macron is immune to over-reaction
3. The economic damage is the damage caused by the reaction, not by the virus itself
4. I am not talking about some rural generalist. These are infectious diseases specialists, who from what I can tell publish in the likes of the New England, I give them more credit on that topic than the average TV anchor or newspaper editor
Exactly. I wonder what would have happened if this entire virus was treated similarly to the seasonal flu.
We will see how this entire issue will be treated in a year. I presume that even if it still prevalent, it will normalize in the eyes of the public and everyone will move on with their lives. And that point we will also have corrected and more accurate numbers and statistics, just like with every other outbreak.
That's only because we're considering one branch in the multiverse though, right? If we get in our time machine and imagine that we didn't have the "mass-panic", then presumably the impact of the virus would therefore be much worse.
>Why is the effect so big compared to other pandemics?
Compared to the 1918 flu you mean? I guess I'm not sure what other pandemic we have had recently to compare with.
"From a well respected friend and intensivist/A&E consultant who is currently in northern Italy:"
"Patients above 65 or younger with comorbidities are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest. Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed."
https://twitter.com/jasonvanschoor/status/123714408985596313...
https://www.sciencedirect.com/science/article/pii/S120197121...
H1N1 in Mexico [1], I was a Biology major during this time at a University in San Diego less than an hour away from the border. I recall this vividly and it still stands out in my mind just how corrupt Big Pharma is [2] and what control it wields, but Corona seems to be having a more political and economic destablizing effect than H1N! did, then again H1N1 was happening in the aftermath of the 2008 financial crisis. Still, given the wide-spread nature of this I can't help but draw parallels.
1: https://www.npr.org/templates/story/story.php?storyId=103502...
2: https://web.archive.org/web/20150710024016/https://www.marke...
It's very much not just a flu though, that much is pretty clear at this point.
And now, let the donwvotes come. I am pretty done with this site anyway. BTW, why doesn't HN allow me to delete my account? This seems worse then FaceBook. Even Twitter lets you delete your account and your posts. I smell bigotry, and that is why I want to run away.
However the left wing (and the current ruling coalition) has some serious responsibilities here, and I hope they are held accountable once this mess is over. A few weeks ago we were told that 'the only virus there is, is racism', implying that people worried about the virus spreading were doing so because of an anti-Chinese sentiment. The other popular talking point was that there are more flu deaths every year, so one shouldn't worry.
I see a link between this attitude and the current disaster.
The situation is bad, though. I was particularly shocked by an ICU medic from Lombardia declaring that in his hospital they cannot treat all the patients, and that they have to select those that appear to have the highest survival chances, something you do in times of war.
(throwaway since my coworkers know my username here, and they wouldn't like my political opinions, I hope this is allowed, otherwise please remove.)
I am not sure how you can say the government's response is worse than other countries, where other governments are doing absolutely nothing even after they reached a thousand cases.
(BTW the right spelling of your otherwise beautiful nick should be furioterzapi).
In my opinion there was no actual racism, just common sense measures. That work against any strain.
> I am not sure how you can say the government's response is worse than other countries
I am thinking of our prime minister, for instance. Two weeks ago he was on TV 16 times in a single day, to denounce the emergency. Then we went into the 'business as usual' phase, and the situation slipped out of hand. Today he was quoting Churchill, and I had the impression that it was more to inflate his ego, rather than to do something useful for the country.
All in all I see a very amateurish management of the crisis.
> furioterzapi
That's a debated point, on live versions of the song you can clearly hear "Fulvio". On the booklet they write "Furio".
* The two worst-hit regions (Lombardia and Veneto) are ruled by right-wing coalitions
* Not even the administrations of those regions, who should be politically on the same page, can agree on what to do / what should have been done
* Prato in Toscana, the "unofficial Chinese capital of Italy", has seen no cases whatsoever.
But sure, let's use a worldwide pandemic to throw around some casual racism - like the rest of Europe is doing against "dirty Italians" right now.
But the rest of the information you provided is very interesting! That the "Chinese capital" of Italy has no cases is very interesting, in particular.
The political situation in Italy has been an absolute powder-keg of not-even-casual racism for years now, not unlike some areas of the UK. The "political boss" of those two regional administrations I mentioned, Matteo Salvini of Lega Nord, tried to scapegoat Asian communities pretty brutally at the onset of the epidemic, with the usual result (Asian-looking people being shouted at in the streets etc).
We now know that the European "patient 0" was likely from Germany, so these right-wingers were left with egg on their faces and are now running around like headless chickens - just yesterday Lombardia asked for more rigorous lockdown measures, whereas Veneto was asking for the opposite. So I get pretty pissed off at the strenuous attempts to go back to the original talking points about discrimination of entire ethnic groups, particularly when Italians abroad (a category that includes me) have to suffer the same idiotic attitudes at the moment.
You could say the same of the left-wing, that promoted for weeks a reckless attitude, pushing the message that we just needed to do business as usual, and to "overcome the fear".
The secretary of the most prominent left-wing party, Zingaretti is now infected. About two weeks ago was posting picture of him drinking at a bar with other people. On top of the picture he wrote: "Our slogan is: normality. [...] Our economy is stronger than fear: let's go out and drink an aperitif, a coffee or have a pizza".
While I wish him a speedy recovery, it's undeniable the left wing downplayed the risks.