What we can learn from the 1918 flu pandemic
wsj.com
wsj.com
He said the covid-19 would eventually slow once enough people get it then we’ll have sufficient immunity that it won’t spread.
Of course, he also said a lot of people are going to get it and we’re at the very beginning of a multi-year problem.
But with each outbreak more people will acquire immunity, and eventually the peaks will be lower than capacity.
But it's going to be a rough road to get there, and we'll all suffer on some level. This isn't going to be "over" for quite some time.
If you’re under 30 without any other health issues, you should be fine? Might not realize you have it?
I wonder if it would be easier to create a low dosage vaccine for younger people, thus creating a bit of a firewall so it doesn’t spread as rapidly.
I know nothing about medicine so this may be silly.
https://www.nytimes.com/2020/03/08/health/fauci-coronavirus....
We have a ways to go before a vaccine is available.
iirc he reiterated this to congress this morning before hearings were terminated to allow Trump to hold a press conference. Witnesses were told to stop their testimony and leave immediately.
> “This morning we were informed that President Trump and Vice President Pence have called our witnesses to an emergency meeting at the White House,” Maloney said. “We don't know the details, just that it is extremely urgent.”
> At about 11:30 a.m., she ended questioning from lawmakers, saying she received notice from the White House that the witnesses needed to leave “now.”
https://thehill.com/homenews/house/487014-trump-officials-cu...
If you have that, you give it to everybody you can.
I guess deciding what safe enough is can be a problem (for many people the bar will be "getting the vaccine has better odds for a good outcome than getting the infection", but that is sort of a minimum).
I think people are underestimating what an over-capacity, health care system looks like and the increase in risk of other infections can have.
Also patient 1 in Italy was a healthy marathon runner who at least ended up in intensive care, not sure if dead yet or not.
You basically get in real trouble if you need a respirator - they're pretty much out of those and they have to assess your chance of survival to decide if they can tube you.
Interestingly ERs are seeing much less load because people have stopped going there for stupid reasons, because they are afraid of catching COVID-19. All medical stuff is still busting their ass if course, a lot of them have been lended to ICUs, rooms have been repurposed, etc.
This is not to say that the situation isn't bad. It's really bad. And if you think that your country has such a good health care system that it will hold better, you should know that Lombardy hospitals are top notch.
Whatever your age, stop traveling. If there's been a single case in your region, stop risky behaviors now: don't go shopping, have it delivered. Work from home. Don't use public transit. Teach your parents how to shop online and force them to stay home. Don't shake hands and wash them often.
As someone living in Milano, I'm afraid that if the panic in the government (as opposed to the population) keeps on going on, this won't be possible when they shut down almost everything (given that the rules change every 24h and no one knows how to properly follow them, let alone evaluate the effect of them).
I hope so, but
- it will kill some number of younger people, even healthy ones.
- it’s also worth considering that we don’t (AFAIK) have a clear picture about potential long-term complications (eg lung damage). We should not simply assume there won’t be these.
I’m saying this to emphasize the seriousness of the situation.
I'm sorry, but that's a stupid assumption to make.
I'm "only" 29 and last year I managed to catch a parvovirus B19 from someone - it's a virus that's relatively common in children, but has very mild symptoms - it's almost unheard of in adults, mostly because you either already have immunity, or there are no symptoms/the symptoms are no worse than a mild cold/flu. Well, except that in about 10% of adults it causes severe response with a high fever that last weeks, with arthretic swelling of joints - and in 10% of those the joint issues don't go away for years. Well, it's been nearly a year now and my knees and other joints are still fucked from the virus, I'm constantly on steroids just to control the inflammation.
So no, this has changed my "I'm young so I'll be fine" outlook on this - the chances are not always in your favour.
I hope you get better soon.
Note that assumes that such containment measures would have been enacted many more times over the last decade, incurring inconveniences [which you can model as "life energy and time lost", even if few lives are lost from them] if the containment criteria were tight enough to stop the initial outbreak of a virus that has relatively high transmissibility, many infected who feel relatively mild symptoms, those symptoms mimic other common diseases, and a week or more incubation period before serious symptoms show up.
It would have been sensible to close our borders and halt international travel 8-12 weeks ago, and begin widespread screening of suspect individuals. But at the time everyone said that was nuts, you want to tank our economy over some virus that's barely even outside Wuhan!?
Right now we could still contain it with radical isolation measures like Italy is doing. Nobody leaves their house without a good reason, everything comes to a halt, we perform mass testing on everybody and if you're infected you get an even stronger quarantine. But you want to shut down our economy over just a few hundred "isolated cases"!?
By the time people are dying en masse and hospitals are overwhelmed, it's too late. There's nothing you can really do at that point.
The basic problem is that people don't understand quadratic or exponential curves. If you have a pond that starts with one lily pad and they double in number each day, and it takes one month to fill the pond completely, then when is the pond 50% full? The answer is the day before. And the lesson is - exponential growth requires extrapolating from "who cares, it's just a few cases" to what could happen if it's allowed to grow unchecked. Which humans are incredibly bad at doing.
http://jonathanbecher.com/2016/01/31/lily-pads-and-exponenti...
Types easy; is hard.
11 weeks ago was Christmas. How many Americans were overseas on holidays for Christmas? How many Americans with Chinese relatives were in China? How many Chinese students of American universities were home on break? Is flying Boston to Seattle meaningfully different than flying Boston to Toronto? If you halt international travel and close the borders, where do the stranded travelers now live? For how long? Who pays for it? Do they lose their jobs/have to quit college? On average, nearly half of international travelers are on their way home, not out. These are real people.
> But at the time everyone said that was nuts, you want to tank our economy over some virus that's barely even outside Wuhan!?
If you set the system parameters tightly enough to prevent the virus from leaving Wuhan, I think you're basically closing travel all the time. How many people get sick and die of random, novel things? How many of those have the theoretical potential to be silently but exponentially transmissible? How can you set a system tight enough to prevent all of them while having travel and commerce?
It seems quite possible that such a tight system would be a cure that's worse than the disease. I'm not suggesting that we're doing all that we can or that we shouldn't have taken some of today's steps last week, but I am saying that I think it's completely unrealistic to think we could prevent this entirely in any sane way.
We had 6 weeks to prepare for this, and we did nothing, and we're still not doing nearly enough.
That was a month ago. Managed to get done most of the preparations designed for a quarantine of about a month length as predicated by Chinese data. And a few extras. Not exactly hoarding food levels.
What I didn't consider was how strict and well executed were the containment measures applied by China. Without these, we'll probably get much longer, three month run. The measures I've taken definitely will help but potentially are not enough.
But for the last month I knew it was coming. Everyone who was paying attention knew this was coming. This crisis has been happening in slow motion.
We're still not doing enough now, and we know it's coming and Italy has shown us exactly how bad it going to be.
https://www.fox9.com/news/minnesota-confirms-3rd-coronavirus...
> the risk of death among young adults would be smaller than that of older adults, e.g., at most 0.1%–0.2%. Whether to perceive this estimate as severe or moderate is a matter for discussion, but we consider 0.1%–0.2% among young adults to be unusually high.
> https://www.mdpi.com/2077-0383/9/2/580
So although it is not as deadly as SARS (which had 20% fatality rate), you definitely don't want to catch it.
To put that into perspective that’s the mortality rate of measles [1] and our grandparents were still going to measls parties.
Our grandparents went to measles parties because they knew that they'd eventually be exposed and wanted to do it under controlled conditions where they knew treatment was available and had a plan for early detection of symptoms.
The situation with COVID-19 is that people who get sick are going to do so in an environment where they and their government are surprised as "how fast it grew" and where all the hospital beds (and oxygen masks, and ventilators, and intubation kits, and doctors, and nurses, and...) are going to be filled by other sick people.
And a lot of them are going to die, who didn't need to if we had just taken this seriously and not told people "it's just like measles".
To that teambayleaf pointed out that it comes at high individual risk.
But in the past this was done for measles at similar risk.
China sending equipment to Italy now is a good sign.
Last time I checked there are at least 3 or 4 different strains circulating now. That's why some folks who got cured got it again. So don't have such naive hopes that all will be rosy on its own soon.
If the story will be similar to flu, we're pretty much fucked - every year the strain is so different that prior vaccinations/immunity doesn't work on them. I certainly hope that's not the case, too early to tell.
Plus thinking that when we have few (even if 2) variants of the virus within first 3 months there won't be any more mutations is a bit naive IMHO.
But strains don't correlate perfectly to immune respnse, so the upthread point about reinfection risk remains speculation. We just don't know yet. But all endemic viruses eventually reach equilibrium with the population immune response (and vaccination regime), even if it requires regular updates a-la the yearly change in flu shots.
I've seen a surprising amount of panic and unfounded assumptions towards the worst from many commentators here on HN and though it's perhaps to be expected from a crowd with a notable number of visible hypochondriacs, it's disappointing to see too. This isn't to say that concerns about the virus should be neglected or that people shouldn't take practical precautionary measures seriously but someone leaping to cataclysmic conclusions based on early figures is no more substantive than another person dismissing the whole thing as nothing major. Both are based on notions without backing and impossible foreknowledge.
Is/was there a whole lot of evidence of this? Was it a local problem in some parts of China? Or was it unfounded? It seems to me there's been just as much of this going on in the west + we're doing a much worse job of handling the epidemic than China has done. I don't have any personal opinion on China generally but the amount of China bashing + hypocrisy in the last few weeks has been astonishing. Supposedly they are even at the point where they are shipping supplies they no longer need to Italy (masks + other equipment) and considering sending people to help too.
There's almost zero chance you see peak virus before end of March in the US. From what I hear, most people are predicting peaks in Europe in late April / early May and peaks in the US a week or two after.
I'm not sure how much faster you think we'll see peak than that.
Maybe you mean the tail will be shorter? Most people I see are predicting Coronavirus will impact consumer behavior until end of year. I don't have the first clue how likely that is.
After draconian measures. Unless there are huge lockdowns, that same point won't be reached so soon elsewhere.
The potential downsides for "dismissing the whole thing as nothing major" are a lot higher than "leaping to cataclysmic conclusions". Better safe than sorry. Better to be prepared than unprepared.
And at a similar death toll, and with the epidemic continuing to flatten towards an asymptote if they were lifted today?
The US is not prepared for those methods. Not culturally or legally. For better or for worse, it's the sort of thing that can only happen in an authoritarian dictatorship.
I fully expect the US to inflect much, much later than China did.
The best is to not get the infection.
I'm not sure you can learn the same lessons.
I don't shop in the same stores as any of my friends for instance. I only occasionally see acquaintances at the shops.
H1N1 case study in Texas is interesting.
Italian Grandparents Step in as Schools Close Amid COVID https://time.com/5797637/italian-grandparents-coronavirus-ba...
[1] The Great Influenza: The Story of the Deadliest Pandemic in History https://www.amazon.com/dp/0143036491.
Flatten the curve. Reduce the rate of spread. Buy time to keep the strain on the health care industry as low as possible. Increase the probability that vaccinations can be produced in time to assist. And stop spreading this ridiculous idea.
> In the face of highly variable responses from public officials, the media served as an essential ally of the public health community in fighting the pandemic.
However, the difference between private media outlets, such as WSJ, and the public health administration is that the latter is being paid for by taxes. Your taxes.
The only "free" media are public media such as public broadcasters. Even so, those aren't "free" as in "free beer", they are part of a fiscal budget and the only reason why you can consume them with little restrictions is because that's foundational to public policy.
It's perfectly acceptable for private ventures, such as WSJ, NYT or WaPo, to put their articles behind a paywall. Put differently, even during the 1918 pandemic, you would still pay the paperboy on the corner of the street a few nickles to get a copy of the daily.
If you think that the WSJ or NYT are mere outlets for public health administration, you're very much mistaken. The "independence" of the Press serves one goal in particular: to critically assert public governance. That independence is a constitutional right, but it's not a guarantee nor an entitlement.
Good journalism needs to be paid for. The digital age didn't suddenly deprecate the expense associated with doing research and writing a good piece.
So, the statement needs to be amended:
> the media served as an essential ally of the public health community in fighting the pandemic, but it can only do so if the audience is willing to pay for the efforts.
Yes, I understand that in modern economics, particular outlets are part of larger corporations. A newspaper can be a losing proposition if the costs can be covered through other income channels.
The downside of that is the reduction of quality as media channels devolve in sheer revenue machines (ads, subscriptions,...) or heavily biased outlets. Hence why I feel that supporting journalist organisations, who aren't "brands" bought by larger corporations, is where audiences can really make a difference if we hope to let a true "free and independent" press survive.
TL;DR: The "free" in "free press" doesn't mean free lunch.
When I stated "private", I implicitly referred to for-profit and non-profit organizations a-like.
I could go on a tangent about the merits and differences between public and private legal entities, non-profit and profit based organizations. I could even dive into the rabbit hole of private organizations who receive grants from public endowments and such.
It's an interesting discussion. But that would be splitting hairs.
It should be clear that organizing any media outlet implies incurring costs and expenses, regardless. Those need to be covered somehow. And the strategic choices made in picking sources of revenue are going to affect independence in subtle and less subtle ways regardless.
> and you don't need a paywall to get paid - see Guardian
I didn't say news outlets "need" a paywall. I said that there is no such thing as a free lunch and someone always pays for putting the news out.
The last paragraph in that op-ed explicitly states how necessary it is to pay for content:
> In the last three years, more than one million people around the world have chosen to support The Guardian financially. Thank you to all of you who have supported us and we hope more of you will consider joining us on this mission — you can do this through voluntary contributions, subscriptions to the Guardian, the Observer and Guardian Weekly, or as part of our patrons programme. As we approach the Guardian’s 200th anniversary in 2021, your support will help ensure we can keep holding the powerful to account, with purpose, for many generations to come.
I was also well aware of the choice made by the Guardian. I omitted the example because their choice entails taking a calculated but huge risk: politely asking their audience to pay for free content could have gone horribly wrong. The audience of the Guardian was willing to follow suit, but another audience might simply indulge in freeloading without limits.
This is where context matters and Marshall McLuhan's "The medium is the message" starts to make sense.
> He said that a medium affects the society in which it plays a role not only by the content delivered over the medium, but also by the characteristics of the medium itself.
https://en.wikipedia.org/wiki/The_medium_is_the_message
> Perhaps the biggest question is whether it's ok to profit from the pandemia?
I think it's hard question to answer because you're implicitly asking "can we find a universal standard that provides a consistent answer in different contexts?" and the answer is "no" because ethical and moral standards are always based on a collective consensus emerging from the interplay between many individual, contradicting beliefs. This is why moral standards can also shift and change over time.
It's worth observing that there will always be unscrupulous outlets ready to profit from a good crisis ("don't let a good crisis go to waste!").
This is where it's up to society to define their own moral standards and give individuals the leverage through education to critically assert the value of the news. Is this item truly informative or is it clear fearmongering and not worth the paper it was printed on? And how much do we value voicing our own dissent or disagreement with what was printed?
But there is a silver lining here. This is probably the first time in history that a disease will have this much attention from so many researchers. There's a good chance someone will find a cure or prophylactic relatively soon, even if a vaccine is unlikely.
Also any potential drug will be put on rush evaluation so things should move quickly - there's Hope yet.
Pretty sure public response so far, at least stateside.
1720 is not as clearcut but you could cherry-pick some candidates. Likewise 1620
https://en.wikipedia.org/wiki/List_of_epidemics
So, have we a 100-year event ??
It's just to wash it for copyright.
It's actually a good business case for GANs (In the underground)