Covid-19 update and guidance to limit spread
flattenthecurve.com
flattenthecurve.com
Edit: Sorry, I didn't include the original source. I had taken a screenshot and couldn't find the original article. But the original data is from Mark J Handley [2] who is (non-medical) Professor of Networked Systems and part-time Roboticist at UCL. And the article I took the picture from is at [3] (I don't normally read the Daily Mail, I promise).
[2] https://twitter.com/MarkJHandley/status/1237119688578138112
[3] https://www.dailymail.co.uk/health/article-8095299/Man-under...
New Cases: [1]
March 6 - 640
March 7 - 1145
March 8 - 2314
March 9 - 1797
March 10 - 977
March 6 - 640
March 7 - 1145
March 8 - 1326
March 9 - 1598
March 10 - 529
[1] - Direct from daily government reports - e.g. http://www.salute.gov.it/portale/news/p3_2_1_1_1.jsp?lingua=...
[2] - http://opendatadpc.maps.arcgis.com/apps/opsdashboard/index.h...
Source: https://old.reddit.com/r/Coronavirus/comments/fgh9v4/italy_r... and https://old.reddit.com/r/Coronavirus/comments/fgh9v4/italy_r....
http://www.salute.gov.it/imgs/C_17_pagineAree_5351_4_file.pd...
vs. yesterday
http://www.salute.gov.it/imgs/C_17_pagineAree_5351_2_file.pd...
And the day before...
http://www.salute.gov.it/imgs/C_17_pagineAree_5351_0_file.pd...
The drop in new Lombardy cases is precipitous, I agree, we'll know for sure in a couple days.
I.e. the first PDF you link doesn't have complete numbers per official government admission.
A few countries look like they have reached an inflection point (see number of daily new cases going back for example) but that could be a problem of testing (or lack thereof).
Also note RE today's Italy stats - they're only partial, Lombardy (i.e. the region with most cases) isn't counted in yet.
The pressure on the healthcare system from the virus seems to be simply massive and the system cannot keep up nor maintain a level of care for everyone who enters the system.
[1] https://twitter.com/jasonvanschoor/status/123714289107769753...
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.
6/ My friends call me in tears because they see people dying in front of them and they con only offer some oxygen. Ortho and pathologists are being given a leaflet and sent to see patients on NIV. PLEASE STOP, READ THIS AGAIN AND THINK.
Here's my question: If we had real-time dashboards and 24/7 news coverage of every flu case, hospitalization, and flu death... would it look much different? I think it would actually look much worse.
Reported case mortality of H1N1 during the pandemic was similarly upwards of ~5% in some countries, [2] although later retrospective studies found that H1N1 was actually less lethal than a typical flu season (0.01-0.08%). [3]
ICU utilization was very significant in some countries, e.g. 30 people per million admitted to the ICU [4]. (Italy is currently at 14 per million.)
Hospitals definitely had to adopt "surge management" although in 2009 it often had as much to due with managing fear and panic as it did with getting people access to ventilators. [5]
[1] - https://en.wikipedia.org/wiki/2009_flu_pandemic
[2] - https://en.wikipedia.org/wiki/2009_flu_pandemic_in_India
[3] - https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemi...
[4] - https://www.nejm.org/doi/full/10.1056/NEJMoa0908481
[5] -https://www.reliasmedia.com/articles/136827-the-next-pandemi...
There's plenty of evidence that this is much worse than the flu. R0 is >2, compared to 1.3. Mortality rate seems to be at least 5x higher. And those are low bounds. And this is all adding to the regular load on hospitals. It has observably overloaded hospital capacity in China and Italy.
[1]: https://www.chron.com/news/education/article/Washington-viru...
Also, I'd love to see it broken down by city. I figure my city is at least a week ahead of Seattle.
https://www.businessinsider.com/coronavirus-testing-covid-19...
Scroll down to the table showing testing rates per million.
Guangdong China: 2820
South Korea: 3692
Italy: 826
US: 5I used logarithmic scale and normalized per million people, so despite the ugliness the exponential growth is quite clear, even in countries with relatively few cases.
https://github.com/CSSEGISandData/COVID-19
I've been plotting this data myself for a few countries in EU over the past days, and the trend is plainly visible.
Steps to reproduce the effect:
1) Load https://github.com/CSSEGISandData/COVID-19/blob/master/csse_... into your favourite data processing package (mine is Excel, here's the PowerQuery for data mangling I did, valid up to yesterday's cases: https://gist.github.com/TeMPOraL/2a26d3a1da551fb818efce87493...),
2) Select Italy and other countries of interest, and plot on a log scale.
If anyone has any ideas about how to communicate about this with them, I am all ears.
30 min/weekday a science journalist talks to Christian Drosten, a world-renowned expert on Coronaviruses, who explains things in a very concise manner. Yesterdays episode was „We have to protect the elderly“, where Drosten talked about the high risk for the sick and elderly and trying to fully get this point across to his own father over the weekend. He also mentioned that we should work on hopefully achieving a broader societal awareness of this over the next week or two.
I talked to my mother and father a bit first, sent my mother a link to this episode and told her to put me on speakerphone. We then listened to it together and discussed it a bit afterwards. I found this to be really helpful.
My mother was in denial until 2 weeks ago, when she went a bit hysterical for a day and has been concerned (but okay) since. My father was mostly in denial until today. He also bailed out soon after the podcast ended, because it was a bit much for him. But overall he took it quite well and is taking it more seriously now.
Overall I am very happy with the way this went. Sorry, this isn‘t very helpful if you don‘t speak German. But maybe you are able to find a similar thing in your native language.
It sounds like you need to convince her of two things: (1) she is vulnerable; and (2) she must change.
How about focusing on #2?
Instead of asking her to change for herself, perhaps suggest this could protect friends and others around her who may be more vulnerable. An appropriate analogy may be secondhand smoke. Maybe her lungs are resilient enough to withstand the toxic effects of smoking, but what about the lungs of all her loved ones?
Hopefully others can chime in with better ideas. I hope you and your family, and we all, can remain safe and healthy during this crisis.
First of all, respect them. Even if they might be wrong, they are adults, who have the right, to make their own decisions. You can stress the point, how worried you are and provide them with a good article etc., that in this case some caution is advised, but try not to push them.
Also, eventually everybody has to die. When you are 70+ it can happen any moment. I can understand to not want my last years to live in fear of every disease there is. And there are plenty of them, which are especially dangerous for old people, because .. they are older and weaker.
Your parents are on death's doorstep as is everyone in their later years. It may be more meaningful to figure out what experiences you'd like to share with them in the limited time you have left instead of trying to prolong their existence at the cost of straining the relationship.
In other words don't put off whatever you might potentially regret not having done if they were to pass away suddenly - with each passing day, the inevitable conclusion every human being shares only draws closer.
"Please take this seriously" is not a request. It's barely even english. It also contains an out of context judgement which you should also try to avoid. Use objective observations instead. So rather than saying "I think you're irresponsible", tell them the actual concrete things they said or did, that led you to that assessment. Something like "I notice you rode the bus during peak hours five times last week." is an example of an objective observation, devoid of judgement or criticism.
The overriding public health concern is slowing the spread as much as possible. Even if in the asymptote the same number of people are infected, spreading that burden out over a protracted time period minimizes overloading on the healthcare system.
If even a small percent of the population became "bug-chasers", it would supercharge the rate of transmission. Especially because the incubation period is so long. The same unhygienic behavior of trying to acquire the disease, would very likely also spread the disease by the asymptomatic.
If you put any ethical weight on the consideration of other human beings, then the very minor plausible individuals benefits are more than outweighed by the massive social harm.
Now there are a lot more people in those time slots all competing for the same doctors and hospital beds, etc.
Congratulations, you made the curve a little less flat :(
Odds are decent an even more effective treatment will be found in the coming months, and if you can stave off your infection date till then you'll be better off (which of course presumes that you will get the virus at all, which is far from a given).
[1] https://www.businessinsider.com/wuhan-coronavirus-risk-of-re...
If the reality is that only a small fraction of people would think like that, the we don't need to worry about that line of reasoning.
But I agree with your point that it's moot due to the potential for reinfection.
Over the long haul, reinfection is quite possible, since immunity wears off with time. It is not considered unlikely that this disease will be with us forever. In that case, vaccination will perhaps be our best tool to manage it.
The more practical problem is that the growth is exponential, so the window between "no one has it, it's safe to get it now" and "everyone has it, mass quarantine" is just a few weeks. Add to that that the virus has a 5-6 day incubation period and it basically doesn't work. Statistically, by the time you know someone sick from whom you can infect yourself, the number of people with still-incubating cases (who are AHEAD of you in the "queue"!) is probably enough to overwhelm health care facilities anyway.
Don't do this.
Even with that there seem bureaucratic type delays till it gets used. I just took some as a prophylactic which is totally unproven but as a clinical treatment it seems to work well in trials.
> Don’t be that person. It might not be about you but it is everyone’s problem. Don’t be careless in the hopes you get sick when you can “avoid the rush.” There is zero benefit to individuals or the population to getting sick early in the pandemic. You would be putting the lives of others at risk. It is not just that people are dying, but how they are dying. To say nothing of the physical trauma, emotionally speaking this is the opposite of a “good death”. People are dying alone, quarantined from those they love.
> Early reports are that people who recover develop antibodies that provide immunity if they are infected with the same strain again. However, this is great news for vaccine development, so flatten the curve and wait it out.
> This can get very serious; one person described the pain as feeling like her lungs were being put through a pasta maker. 10% of cases require ICU care and mechanical ventilation. Even if autopsy reports from China have been misrepresented or overstated, there is a possibility of long term or permanent lung damage if you do get sick and recover. There are lot of gaps in the information about lung damage, mostly because everyone qualified to let the public know exactly what is going on is already very busy saving lives and putting their own at risk.
If you're under 60 or so, it's quite likely you won't need any medical attention at all after contraction.
This is why it's spreading -- most middle-aged and younger people feel like they have the common cold.
Is that actually the case? Don't the details look like a low grade flu? It's not sore throat or sniffles, it's still a cough and a fever.
Untreated, it's basically like playing Russian Roulette. 5 out of 6 times, nothing bad happens. 1 out of 6, you die. The disparity in outcomes is probably what makes this so insidious: a lot of folks look at the numeric outcomes for healthy people in the presence of ventilators and ICUs and reasonably think "Oh, I have a 1 in 500 chance of dying, it's no big deal". Medical professionals look at the exponential infection curve, the capacity to overwhelm health care systems, and the number of patients requiring hospitalization and think "this is the scariest disease I've ever seen".
South Korea is a better dataset because they have tested so many people.
Basically, I saw that this domain was available and saw the increasing talk of “flattening the curve” on Twitter. I grabbed it and wanted to do something helpful, like post just the pic of the tall and flat graph that was making the rounds, because I loved how simple the visual was, and how powerful the point it made. I thought at least people could share the concept easily.
But then someone shared Julie’s post, which was living on a gdoc at the time, and even that was struggling with the amount of readers... and was very much not an easily shareable link.
So I reached out and asked if she’d like to have it live at flattenthecurve.com, and promised to give her a login to update and add more info etc.
She said yes and I got the site live in half a day mostly spent reformatting the gdoc into WP.
I’m thrilled that the domain is really living up to its best use!
I hope you have something like cloudflare behind it -- or at least static HTML. That sucker is "going viral", no pun intended.
> Zero universal guaranteed paid sick leave [1]
The United States of America in the same list as India, North Korea, South Korea, Somalia, Angola, Liberia, and Guinea-Bissau. Some of these countries are poor or low income. The USA isn't one of them though. I'd be ashamed of my country.
In The Netherlands, an entire [large] province (North Brabant) has been ordered to stay home if they have anything resembling illness. People are asked to work from home. Children can't go to school. Still, working from home is better than nothing.
Also, some people are in quarantine. The people who have COVID-19 but otherwise don't have it severe can stay home, in quarantine, instead of in the hospital.
One thing I wish I knew way earlier is that COVID-19 victims rarely suffer from a runny nose. I recently got it from Our World In Data [2], it was linked here on HN. I did not read about this in our local media, sadly.
[1] https://www.worldpolicycenter.org/policies/for-how-long-are-...
[2] https://ourworldindata.org/uploads/2020/03/Coronavirus-Sympt...
This is a false statement. There are 12 states which require paid sick leave, amounting to 30% of the population [1]. Federal employees are guaranteed paid sick leave days [2]. According to the Bureau of Labor Statistics, 61% of workers have paid sick leave, 78% have paid vacations, (80%/90% in large employers with 500 or more workers) [3].
That whole section is just political garbage. There's plenty of reasons to believe that businesses will take precautions themselves to limit the spread of the virus internally, which includes offering paid sick leave to encourage people to be extra careful.
[1] https://www.ncsl.org/research/labor-and-employment/paid-sick... [2] https://www.opm.gov/policy-data-oversight/pay-leave/leave-ad... [3] https://www.bls.gov/ncs/ebs/benefits/2009/ownership/private/...
Wouldn't this mean it is an impossible goal since unemployed people don't have it. This might sound a bit snarky, but I am being serious because unemployed does account for people who are working under the radar, often through illegal means. An illegal sex worker, panhandler, or someone doing odd jobs and taking straight cash payments are likely not covered even in places that would be said to have universal paid sick leave.
This is the problem with reducing it to a fully binary clarification where everything but fully true is false. 99.999% is so much easier to hit than 100%.
Are you trying to make an actual point about real-world responses to pandemics? Or is this just some sort of language-is-imperfect cul-de-sac you're in? If the latter, please leave me out of it.
> Or is this just some sort of language-is-imperfect cul-de-sac you're in?
Come now, have you forgotten when you said the following?
>It is a literally true statement. Universal means covering everybody. That some slices of the population have it in no way contradicts that.
Please do not suggest me being in some language-is-imperfect cul-de-sac when you were the one driving.
I realize that this sounds like a really stupid comment to make.
It seems a variant of reductio ad absurdum but I'm not fully certain it qualifies.
This seems a bit difficult to define to begin with (look at the cases with countries deciding differently for gig workers at places like Uber), and it doesn't seem to have been a qualified exception to the universal that the original comment called out.
It also achieves much the same effect as the very original article in that it allows a sort of propaganda by being able to say no countries in Europe have universal sick leave. And being able to technically make such statements, be their reasoning extremely tedious or not, is the topic at hand.
BUT, the data is highly skewed if you look at income. [also 1] The worst paid workers also have much less paid sick leave. Only 45% of the lowest 25% income group do. According to the BLS there were 130 million workers in 2019, thus leaving roughly 15 million people (130 x 0.25 x 0.45) without paid sick leave and likely without the financial means to go on unpaid sick leave or get medical help (like testing).
Also, the average paid sick leave varies between 6-10 (working) days. Suggested quarantine is 14 days. [2] Only 3% of workers have sick days "as needed". [3] This supports the argument that these circumstances make matters worse. I tend to agree to the general argument.
[1] https://www.bls.gov/opub/ted/2018/higher-wage-workers-more-l...
[2] https://www.bls.gov/opub/ted/2019/private-industry-workers-w...
[3] https://www.bls.gov/ncs/ebs/benefits/2019/ownership/civilian...
A person who doesn't have any paid sick leave nor PTO they can use it place of it has to take a sick day doesn't get paid for that day. One way of thinking about it is that they do get paid, but then have to give up pay equal to what they get (and all this is calculated before tax purposes). A person who has to use a PTO day that isn't only for sick leave is giving up something with a near value equal to a day of pay. In most cases, any benefits or the like are not cut for either person, meaning they still receive some level of pay when you look at the averaged out of those benefit values over the day.
This may feel like a needless distinction, but I think it matters because when a person without paid sick leave or PTO is sick they have to weigh staying home against not making money, while a person who doesn't have paid sick leave but is allowed to use PTO has to weigh staying home against losing a day of PTO that they can't use for vacation. A person with true sick leave has no such calculation, sick leave they can only use when they are sick means they aren't giving up anything. Well, there is an argument to be made for the day's worth of experience and other such matters are still loss, which for some positions can be enough to choose to work even when there is paid sick leave.
Paid sick leave except for the people who, y'know, prepare food, handle groceries at checkout, and move packages around warehouses.
Better than nothing... but is it though? Like really?
All the more reason to treat coronavirus as an exception that needs to be considered, as-needed, business by business. Or state-by-state, or county-by-county. Just because something like coronavirus happens every so often doesn't mean we need a 1-size fits all policy for every year and occasion.
I think businesses should be encouraged to play a role in helping limit the spread of the virus, but if everyone just decides they need to take 2 weeks off because of the cold, that's going to cause some economic troubles. Maybe something like that is needed this year, but for every year, that would be excessive and not help.
It's not even on their radar. Not too long ago, a major university hospital in the Southern US held a town hall on the coming plague. It was an embarrassment. Several times, members of the audience asked about sick leave, in case they are under quarantine or have to care for dependents. Crickets from the leadership.
What is going to happen is that hourly support staff will drag themselves to work sick - that actually happened at an Atlanta school, a substitute teacher collapsed at work with Coronavirus and had to be taken away in an ambulance - and will spread disease to those lucky enough to enjoy better benefits.
Where is political discussion about this threat to public health?
If the sick leave is limited, it isn't worth much.
38% without any sick leave is already pretty bad. How many of the rest can take 14-21 days of payed sick leave?
Obviously to some extent this is just pedantry, but at times like this it's really important that we get these things right consistently. If all you have is a sore throat you are very unlikely to have COVID-19 given what we know right now.
[1] Here's the Mayo clinic's: https://www.mayoclinic.org/diseases-conditions/coronavirus/s...
As of 20 February 2020 and based on 55924 laboratory confirmed cases, typical signs and symptoms include:fever (87.9%), dry cough (67.7%), fatigue (38.1%), sputum production (33.4%), shortness of breath (18.6%), sore throat (13.9%), headache (13.6%), myalgiaor arthralgia (14.8%), chills(11.4%), nausea or vomiting (5.0%), nasal congestion (4.8%), diarrhea (3.7%), and hemoptysis (0.9%), and conjunctival congestion (0.8%)
Page 12
https://www.who.int/docs/default-source/coronaviruse/who-chi...
Several states are proposing bills to protect people who are in hourly or contract roles where if they do self-quarantine, their jobs are covered and they will still be paid.
I feel like companies and the states are able to do more for their people than the government can. I've never been a huge fan of UHG, but they're putting their money where their mouth is this time and protecting their employees and working to contain the spread of the virus within the company.
Today I read in the news that 4% of all employees of hospitals in North Brabant, The Netherlands have COVID-19.
[1] This has its pros and cons but that is beyond the scope of the point.
What I meant with "beyond the scope of the point" is that the discussion of the pros and cons of such system (of casual workers / interim) i a tangent I'm not going on about.
In this context it'd be proper to include an amount/percentage of people who have such a job versus those who have a normal job (with permanent contract). I'm also interested in differentiation between different states, but then again there might also be differences in say Germany's provinces.
On another note, the USA is not unique among developed economies in this context; South Korea is also a developed economy.
Definitely worth knowing, especially with hay fever season just about to kick off.
A day late and a dollar short, breaking news in the last half-hour or so suggests a one-mile containment zone is being setup in New York (New Rochelle), National Guard troops have been sent.
What proportion in countries with guaranteed sick leave is pressured into coming to work anyway by social stigma?
Not everything needs to be legislated. Especially not at a federal level.
This is the environment that rabidly pro-business regulation and the erosion of worker protections has created; assertions that the hideously benighted situation of low-paid workers in the USA will magically "self-resolve" without strong legislation go against the entire history of the labor rights movement and basic common sense.
I don't doubt that - but I'm asking for numbers because I also know that some proportion of supervisors even in shitty jobs are understanding enough to offer sick days. And just as in this current system some people are understanding enough to give people time off, under legislation there will also be some proportion of people who ostensibly are doing nothing illegal but indirectly pressure employees not to take time off - the same way people often accumulate vacation time from the same pressures!
That's why I'm legitimately asking for numbers. Because neither case is going to be black or white. Laws are hard do undo and frequently have unintended consequences. Some things are better solved through social reform, if they are necessary at all.
It's like the oft quoted idea that millions of Americans are struggling working multiple jobs to make ends meet and this requires some form of price floor - but if you look at official BLS reports, less than a couple percent (can't remember exactly) are actually in this state. For decisions which affect millions of people, numbers are everything.
I agree that neither case may be black or white; however, one is dark, dark gray and the other is eggshell.
Here in IL and IA we've been "right to work" for a good while. Most purposefully misleading euphemism ever.
I'd vote for anyone who had a reasonable shot at forcing those laws to be rescinded and basic worker termination protection restored.
Wisconsinite here: We really love to screw ourselves over. It's our state pastime. Scott Walker went to blue collar neighborhoods and said "I'm going to take away your right to organized negotiation!" and we said "Yes, I LOVE that!" We put his signs in our yards. Then as a joke we voted to remove, and then changed our minds.
When our some of our legislatures refused to go to work because some silly people stood outside the capital with signs, we decided to unelect the ones that stayed in the capital throughout the protests, and reward the ones that left the state entirely. We just love it :)
The immediate problem needs the best fix possible and I do have to say the response from the federal government so far has been underwhelming at best.
Where is that? And why? A five year old would realize that sick people hurt productivity by infecting others?
How about when you have a big project coming up for a client and your team is depending on your contributions?
I'm not advocating for this sort of pressure, but I'm saying that even a law requiring paid sick leave is not going to guarantee that people go home when they're sick. Even in low paying jobs, managers still have to cover shifts. There's always pressure to work. Laws aren't magic.
It’s the second that is counterproductive.
If it’s the deadline day and you can afford three people to be off next week so long as the one sick person comes in this week, then it’s a conscious tradeoff at least. But in general it’s short sighted and counterproductive, not to mention rude to coworkers.
From afar, the biggest problem looks like the CDCs iron clad grip on test kit certification slowing the response by a month. This compounds a general view of mine that the American healthcare system is crippled by existing regulation that links insurance to employment. Linking emergency response funding to employment is another terrible idea that will hardly assist the situation.
What everyone needed was a disaster preparedness plan. Forcing companies to pay money that they are probably not going to have in a pandemic is a great way to obscure from people how much planning they need to do. Companies don't have magically deep pockets.
This isn't true though. We're simply behind them on the infection timeline, thanks solely to geographical proximity and luck. We're several weeks behind Italy, Korea, Japan, and Iran in terms of how long the virus has been spreading here, and months behind China. You can't compare us now to them now.
Take a look at the cases/country chart on [4] and sort by cases/population. The US is many orders of magnitude better than European countries. It's absolutely worth comparing for specifically the reasons mentioning in OP's post, that being ahead of this makes all the difference in the world.
[1] https://www.nytimes.com/2020/01/31/business/china-travel-cor... [2] https://www.statista.com/chart/20629/ability-to-respond-to-a... [3] https://www.reuters.com/article/us-china-health-italy/third-... [4] https://www.worldometers.info/coronavirus/
Meanwhile, we're gonna be at 1,000 confirmed cases in the US in another day or so and the exponential increase is continuing. We're not doing better than European countries by any stretch; what's happening there is going to be happening here in a month's time.
And being "best prepared for an epidemic" may have been true back in 2016, but it's certainly not true under Trump. He fired the highly successful crack epidemiologist team that was initially assembled to fight ebola, and the administration's response to the crisis so far has been largely incoherent, focusing more on the stock market than actually preventing the spread of the disease, and with officials continually contradicting each other and downplaying the serious of the pandemic. Pence, the man in charge of the response, is notable for having presided over an HIV epidemic in his home state. We simply don't have the right people at all in charge to manage this, and that matters greatly. And we still have way too many people not making a livable wage, who aren't guaranteed paid sick days and can't afford to not work.
What we need are hospital beds and ventilators. Are we doing ANYTHING to prepare those? Anything at all? Or will we wake up when people are literally dying in the streets, like as is certainly happening in other places in the world?
But the major point here I am happy to concede; it is far to early to start comparing how the US is doing with how everyone else is doing.
I hate to sound so bleak, but I believe it is mostly accurate.
A few tips on things that can be stocked (or should be checked) for general disaster preparedness:
0. bottles of clean water. Old milk jugs of tap h20 will do. 1. dry goods like beans and rice which are compatible with boil-water advisories. peanut butter is also good.
2. a fever reducer of some sort. even a few Acetaminophen or aspirin.
3. Cheap bar soap. dollar store or discount brand. The article is correct in that every emergency needs good hygiene. bar soap can be split up among family members.
if you're handy with technology, you should consider an amateur radio license. http://www.arrl.org/ amateur operators are absolutely appreciated by military and red cross workers as the fastest way to get in touch with affected communities.
This only works if there enough chlorine in your tap water. In my country, the tap water starts to taste foul after a few days left in a clean bottle.
You can add a few drops of unscented bleach, and the water should be good for months or years:
Rice is relatively quick and easy to boil and cook. However dried beans can take a lot of boiling and soaking to become edible.
I'm not trying to say don't store dried beans, but just be aware of their cooking requirements.
[1] https://www.seriouseats.com/2014/09/soaking-black-beans-faq....
[0] https://www.fda.gov/downloads/Food/FoodborneIllnessContamina...
My experience with most beans-qua-beans is that a pre-soak or pressure is needed or they'll still be somewhat chalky even after 90+ minutes at a boil. Lentils and peas don't have this limitation.
Given our propensity towards liquid versions (at least in my circles and from what I can see culturally) I wonder if solid soap will be easier to acquire over liquid soap and hand sanitizer...
If you want to maximize credibility, remove the line about supporting artists, and anything that can be perceived as political like the line about healthcare.
Artists are a small percentage of people impacted, restaurant workers, nail salons, retail, hotels, airline employees, contractors, massage professionals etc. The list is almost limitless. If you are in another group, you are going to read that line, and think, what about me?
Healthcare is a politically charged issue, right or wrong, listing that here discredits the message for half the readers.
The overall message is important, and I encourage the author to make a few tweaks to get it in front of more people and save lives.
If one party is against them, should experts (in this case economic) not weigh in?
Muddying that message with political and partisan discussion is not helpful. Your comments are not constructive to this discussion and the messaging around healthcare and artists is not constructive to the messaging in the document.
The fact that you cannot see that only highlights my point.
But this idea of yours that by disagreeing with you, it means you're right, is absurd. If we agreed, would that mean you were wrong?
US Coronavirus team referenced this (very short, very clear) paper with short, concrete guides for school, work and home. It's completely apolitical.
and regardless of what one thinks about the issue, there is no way the US is passing sweeping legislation overhauling the whole system, and getting it implemented, in time to do any good at all in the current situation.
Congress saying they are going to pass a bill to pay for testing and then doing it would not be difficult, and it would reduce qualms about getting tests.
There will have to be a bailout, and the aftermath should mean nationalization. Public health has been neglected for far too long.
The people that have the money to do so.
Which is kind of amazing in itself given it's a basic human right in so many countries and taken for granted.
"Live performers are going to be hard hit economically. Consider supporting their work on Patreon, directly via PayPal, or attend only the smaller shows. Promote them on social media. Buy their work directly."
I do not really agree with removing this line, as it is good advice. I wouldn't be against expanding the content to include other professions, although the single-payer advocacy kind of does that for some of them.
In addition, artist are indeed a small fraction of the population, but this offending sentence is also a very small fraction of the writeup..
Unless you have real property, reserves or a salary to ride, the only option is to try and adapt.
Apart from this in the age of streaming the only spurce of income for eg bands are live gigs, so the advice is good, and not just now; do support your favourite bands, painters, musicians, etc., and do it directly. If the gig is out, buy merch.
The idea that we should ignore the state of our healthcare system because we find politics icky is counter-productive to building an effective system for dealing with public health systems. We can't avoid facts because they're uncomfortable and the public needs to be engaged with political leadership for problems to be solved. That's politics.
You don't "save lives" by saying discussion of the healthcare system is off-limits. The two things are quite related to one another!
Sure, you can argue that single-payer healthcare would have been good to solve this crisis and others would certainly argue that it would make things worse, but the debate is totally fruitless because implementing such a system will take years--well after coronavirus is either endemic or wiped out. Thus, even bringing it up makes me question whether you, as an expert, are capable of divorcing your personal bias from your scientific objectivity. I immediately think, "is this person speaking from their objective expertise, or do they look for the data that satisfies their political arguments, and ignoring the rest?"
Scientists should tell people the facts as objectively as possible because that is the purpose of the field and discipline. Leave activism to others, who will use the facts to come to whatever conclusions they can.
There's a separate point you make about what things can and cannot be done in this moment. But that's not the original point made. Most of the "politics" recommendations could in fact be done during this time. Some are even being discussed, short-term.
> by introducing a highly charged political wedge issue that offers no solutions to the problem at hand
which seems to be their core issue.
Some proposed solutions may become political as you describe, but that doesn't change their utility as proposed solutions to the problem. Whereas it seems like the entire section "Relative to Other Countries, US Labor and Healthcare Policies are a Perfect Storm for Pandemics" could have been omitted entirely without losing any value related to slowing the spread of COVID-19.
How about experts talk about what's in their experience and then it's the job of open-minded citizens to evaluate it, hopefully with good political leadership from elected officials? Now, it's fair to weigh different public health experts advice, and it's fair to also weigh what experts on economics have to say, so that we can evaluate pros and cons.
But this idea that experts shouldn't talk about healthcare systems that need to be changed in order to better meet the moment because talking about it is "politics"... Sorry, but I don't think it makes sense. You don't solve problems by running away from them. Experts can do more than say that we should wash our hands. In fact, we need them to!
There's legislation being discussed as we speak that may deal with many of these things, even if only on a temporary basis. It's simply false that the only things we can do, we must do as individuals and cannot do through government and with political leadership.
If you're making a narrower point about Medicare for All, I'd put that in a different category than most of these political recommendations simply because it would take years to implement. But that's different from arguing that we should ignore the merits of sound public health recommendations on the basis that some people have an ideological aversion to hearing it.
> There's legislation being discussed as we speak that may deal with many of these things, even if only on a temporary basis. It's simply false that the only things we can do, we must do as individuals and cannot do through government and with political leadership.
I'm arguing that any such attempt is doomed to failure if it so much as even stirs the beast of partisanship because of how far gone our civic discourse is. I believe most or all of the things you listed can be done quickly by the executive branches of local, state, and federal governments within the bounds of existing legislation. At this point, anything but the most bipartisan bills are impossible to do on a short time frame. The place to be is lobbying governors, political appointees that lead state and federal agencies, and civil servants on the ground. They have unilateral power to actually do something about the situation because emergency powers are very broad (Lincoln used his to suspend habeas corpus!) and justices will be even more hesitant to reign in executive power during a pandemic than whatever immigration state of emergency enabled the travel bans. That way, even judicial branch challenges will slow down partisan interference instead of obstructing the intended goal.
I hope I'm wrong and our legislature does pull it together under threat of an emergency. After all, if JFK getting shut down was enough to end the government shutdown, maybe a pandemic cratering the global economy is more than enough to bring us together, at least for a little bit. However if the goal is to get something done instead of arguing over what to do, I'd look to the executive branch, not legislative. The former is meant to do, the latter is meant to argue.
Edit: I wasn't trying to make a point with medicare for all, just trying to pick out some examples from different sides of the isle (single payer on the left, free market reforms on the right). I'll admit I don't know enough about either group of ideologies to predict which relevant bills would be bipartisan enough to pass quickly but based on how antagonistic partisans have become, I don't think it'd be much since we don't have much time for the normal pork barreling process to work.
So really, here's the comparison: 647,000 Americans die from heart disease each year. Do I think doctors should be afraid to talk about obesity because it might turn people off listening to their other recommendations?
No, listen to experts.
I am not even from US, we have universal healthcare, but it is even more broken than yours.
Which is outrageous. The manner in which basic societal discussion get short-circuited into being partisan is grotesque.
Though recall that Donald J. Trump promised universal healthcare (several times). Seems like it isn't partisan at all.
Regardless of your political point of view, when you see political statements like this, it should raise serious doubts about the veracity of everything else in the article, regardless of how factual it may be. Even if every fact in it is true, the clearly political motives of the author indicate that they likely cherry picked facts to support their viewpoint. One only need tune into CNN or Fox News to see how political propaganda masquerading as “news” is toxic for society and how “facts” can be warped to support any point of view.
Take a look at https://news.ycombinator.com/item?id=22527396 for a fuller explanation, and if there's still something I haven't answered, let me know.
Editing in response to the comments below ...
This submission is of a different resource. This resource goes into more detail about lots of things. However, the "Flatten the Curve" idea had already been submitted in the referenced submission above. It was less complete, but had already sparked a large discussion.
So should the resulting discussion be started all over again here on this, more complete submission? Or should the discussion remain in one primary location to avoid repetition and to gather the insights, thoughts, rebuttals etc in one place?
Who knows ... I provided the cross-reference to allow the decision to be made. This submission has now hit the top spot on the front page and is spawning a conversation. So the decision is made, and the cross-reference has been rendered moot.
Further edit ...
I think it unreasonable that the people who responded to me should be downvoted, and I've upvoted them in an attempt to balance that. I think the comments are fair and reasonable, and belong in the discussion.
It's the same data, it's the same idea, it's the same argument, but from a different source.
It's also all now all over the place ... I could find 8 or 10 different sites to submit, all with the same message. Is it useful then to have 8 or 10 discussion on HN all hacking over the same ground, all making the same points, all having the same "insights" and disagreements?
I think not, and that's why I linked this submission to the existing discussion.
Because the American government does not have the state capacity to carry out necessary measures and the American population doesn't have the discipline to listen.
Same is probably true for a bunch of other countries and failed states, I don't even want to know how many people in iran are actually infected at this point.
Maybe then, people will stop going out.
https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_S...
The US should immediately adopt measures used in South Korea.
no, you don't. killing it completely would (hand-waving) require taking R0 < 1, and holding it there indefinitely.
any reduction in R0 at all will flatten the curve, at least a bit. and small changes in the rate of growth can have a huge impact when you're dealing with (even temporarily) exponential growth. https://www.youtube.com/watch?v=Kas0tIxDvrg
The only option is to delay the spread and inject people with a deactivated carona vaccine as soon as possible, which should stop half the population from getting it, and reduced lethality for those who do get it.
Any proof for that, I guess based on China?
Even worse, imagine all the thing we have to do to get back to our baseline economy. A civil war would be very quick
I'm not saying this is good, I'm saying if you don't like a huge state intervention, don't pat yourself on the back saying it would go miserably enough to make the government change its mind.
If shit gets bad, the courts will rubber stamp literally anything done in the name of national security. I fully expect constitutional rights to be thrown out the window temporarily.
https://en.wikipedia.org/wiki/The_Constitution_is_not_a_suic...
At best, even if they're telling the truth about numbers, the moment that they stop lying about economic activity and actually bring workers back to work, than their case numbers will go back up again.
https://www.nytimes.com/2020/03/04/health/coronavirus-china-...
(can use reader mode to bypass paywall)
The less likely scenario in my mind 2. is that the claims of the WHO being compromised by China are true. This article doesn't do much for me to dispel those concerns given that it's a prominent WHO doctor who penned your linked article.
Maybe I'm totally wrong and China is telling the truth, but that sort of intuition when applied to basically any other part of economic activity with the Chinese is just blatantly wrong (just ask people who work with Chinese suppliers about how crappy their "save face" system is re: trying to get a straight answer about any problems)
What they're failing to consider is that Wuhan, Italy, New York, Seattle, and San Jose are not anomalies. If your community has no reported infections, it's rapidly becoming the anomaly.
Consider those places you keep hearing about as a glimpse into the future - your future. Then take steps to do what you can as an individual to prevent that from happening.
Would like to see how fast the recent numbers are growing.
Despite the differences in start times, the similarities in the curves are remarkable - although so are the deviations. I've basically been watching the US follow the same path as a few European countries, just on a lag of a few days.
[1] https://github.com/CSSEGISandData/COVID-19
[2] https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594...
The odd image of folks wearing masks saying masks don't help is not lost on most americans.
Here's a different doctors advice on masks:
The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth. Use disposable surgical masks and use them to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you - it is lung-specific. The mask is just to prevent hand to mouth contact, it will not avoid the sneeze part of things.
Masks are a low cost, non-hospital, low side effect, low economic impact intervention. Even if only minimally effective there are very few downsides to mask usage for an individual.
I've come to think that the re-assurance that this virus is "fully contained" - see Kudlow, that masks don't help (see this and others) will come back as some pretty bad advice later on. We'll see I guess.
I do that, on the theory that it will trap much of the contaminated droplets leaving my body, preventing the from reaching the air and surfaces nearby.
My concern here is that a lot of it is going to get through the shirt and onto your hand, after which you'll touch surfaces.
The elbow sneeze is probably the better choice tbh.
I don't know where the don't wear masks they aren't helpful push came from. I think perhaps a misguided attempt to deal with a resource constraint (ie, lie to them about mask benefit so they won't wear them and worry others and won't use them?)
It's totally unique to the US however. Asia is going the other way.
The closest thing the article says is that you should not hoard masks, that their usefulness is against airborne particles is limited to 30 min and that masks can make some people touch their face more.
Where is the evidence?
"Experience in these settings indicates that respirators can function within their design specifications for 8 hours of continuous or intermittent use. Some research studies (14, 15) have recruited healthcare workers as test subjects and many of those subjects have successfully worn an N95 respirator at work for several hours before they needed to remove them. Thus, the maximum length of continuous use in non-dusty healthcare workplaces is typically dictated by hygienic concerns (e.g., the respirator was discarded because it became contaminated) or practical considerations (e.g., need to use the restroom, meal breaks, etc.), rather than a pre-determined number of hours." https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguid...
Remind people not to touch their face. Put a surgical mask to reinforce that over nose and mouth. Other benefits if they happen to be sick themselves. etc.
There was even thought of encouraging mask use to handle seasonal flu - they are very effective, normal issue is low adherence (people don't like wearing them).
In this situation adherence might improve.
What studies? Doctors wear masks to catch droplets from their own mouth and nose. Masks aren't designed to stop viruses, which can enter from the side. They may help if someone sneezes directly in front of you, but that's about it.
Masks are an absolutely basic viral control measure.
Seriously, a virus is on a surface, you touch a surface, then you touch your mouth. You're done. A mask reduces this risk.
"In an adjusted analysis of compliant subjects, masks as a group had protective efficacy in excess of 80% against clinical influenza-like illness." - https://www.ijidonline.com/article/S1201-9712(08)01008-4/ful...
If you are going to pump out lies please do it when folks are not facing something like covid. Seriously, wearing a mask has almost no downside if you are in a high risk area / are older, and some proven upsides.
Reality - masks are a valid, additional step. And given all the other crazy, high cost, high impact steps being taken to "flatten the curve" a low cost low impact step like mask wearing should be on the recommendations list.
Even kids (ultra low risk) in shanghai are wearing masks in the playgrounds. And here we have older adults squeezed onto mass transit and are telling them all the reasons why masks may not help.
To flatten the curve all low cost low impact steps should be taken.
Single-digit percentages of Asians are wearing masks under normal circumstances, some for pollution and mostly because it's expected if you have a respiratory infection.
Masks are now required in public in substantial parts of China. You can be arrested if you leave the house without one.
Can the author of the website or someone else please provide a hyperlink to the original source of that graphic, so its authenticity can be validated.
Consider a hypothetical scenario: authorities encourage young and healthy people to go out and about their daily lives and get sick, and they institute a voluntary quarantine for people who would be considered highly at risk. Would more or fewer "at-risk" people become infected?
These are some other factors to consider:
- Could a short term quarantine for at-risk groups (shorter because the faster general infection rate would result in faster herd immunity) be more effective? Do quarantines and social distancing measures suffer from "quarantine fatigue"?
- What are the comparative mortality rates between people with medical care and those without it? (i.e. those in an overwhelmed system due to the fast spreading scenario)
- Does recovering from the illness result in strong immunity?
- What are the comparative costs of quarantines to society and economy at large?
- At what point is a vaccine or treatment likely to be widely available (if it is soon, then the slower spread is obviously crucial).
I suspect the answer is very nuanced. If I get some time, I will put together a simulation and try my hand at the math, but I am curious if anyone has already considered and compared these factors quantitatively.
I long for the day that concern trolling and virtue signalling are not included in otherwise helpful resources like this one.
Especially if you read the two sentences that the author writes under that section. It's pretty damn tame. (and that's why I'm pretty sure you didn't based on your response)
When people are fearful, their higher executive functions become impaired, and it is exactly these executive functions that are needed to weigh the facts and to avoid impulse blaming, which in this context manifests in xenophobic behaviors.
All of us need occasional reminders to help us realize that we can rise above our baser survival instincts. We all impulse-blame -- that's just human nature, I do it too. But we can do better than that.
I've heard this fact before and immediately discarded it as most likely based only on anecdotal evidence.
I'd need to see unbiased data proving it as true. Specifically that Asian-American businesses are suffering more than other, similar businesses in the same geographic locations.
Immediately? Without even thinking it through or investigating it? As a Chicagoan, I can cite this [1]. And I have seen it for myself since I live close to the area. Traffic has been back up, but nowhere close to what it was.
[1] https://chicago.eater.com/2020/2/19/21142285/chinatown-resta...
We are already seeing that people assess the severity of COVID-19's spread through a partisan lens. I don't want this. I want the best possible response no matter what, because I am not willing to martyr my aging parents to make a political point.
"Do not be careless" and "do not binge the news" are equally useless pieces of advice.
Racism/xenophobia is an undesired 2nd-order effect. When people are in survival mode they only care about 1st-order effects, and every man/woman for him/herself.
It's understandable, yet this also causes damage to society in ways that cannot be foreseen. It entrenches selfishness and normalizes lack of empathy for others. When things return to normalcy, there will be a cost.
Unless you're taking a stand strictly against 24 hours cable news, you still need to be informed, and that'll involve viewing some form of news.