California governor issues statewide 'stay at home' order
reuters.com
reuters.com
Judging by how long the shelter in place has lasted and affected curves in Asia, we should be prepared for ~2 months as a baseline. From what we're hearing from friends, life is starting to return to normalcy in Hong Kong, with no new domestic cases reported (though now they're contending with new imported cases from overseas travelers returning home). They have a really effective screening/tracking quarantine system in place where they'll give you a location tracking wristband for remote monitoring.
Our family has been affected by this since late January, and there's a big mental challenge aspect to this. Being able to walk outside (unlike in Wuhan) is really big.
It's truly unfortunate that the the country's health services bungled their initial testing and screening ramp up.
The best data we have at this point is from China. They have 81,000 confirmed cases to date, most of them happened over an 8 week period. Obviously not all cases of the virus were confirmed but people were hospitalized and tested aggressively.
Even if only 10% of the cases in China were confirmed (and 10% is a low guess at the percentage that might need to go to the hospital with serious symptoms, and thus be confirmed), that means under a million cases in a population of 1.4 billion.
California's population is 35x smaller than China's but Newsom is predicting California will have over 25x more cases.
Sure you can argue that China is lying about their cases (WHO disagrees). Or that they are authoritarian superhumans with a superior response. Or whatever. But this discrepancy is just too big to make sense. I don't think CA will have 25 million cases in 8 weeks.
I think he is trying to scare people into staying home. Staying home is still a good idea, because the health care system will collapse at a lot fewer than 25M cases in 8 weeks. But I think it's fearmongering.
Take deaths, multiply by 400 and that's how many cases you have. This comes from the assumption of 1% mortality and 3 weeks to die.
So CA has ~8000. A doubling time is ~5 days. 8 weeks ~= 11 doublings. So 8000 * 2048 = 16M. Not too far off for a ballpark. Obviously, the exponential starts to breakdown somewhere... but where?
I don't think it's fear mongering. It's getting the public to understand the back of the envelope worst case... which is really bad. People NEED to panic... to get them to hunker down and take this seriously. The sooner than happens, the sooner we get it under control.
I had to yell at my inlaws to stop taking the train to work and going to the gym. They are 70 and have pre-existing conditions. This action will force them to take it seriously.
I don't see where 400 comes from.
If we assume that people who died today now are 1% of those who got it 20 days ago, then that is a factor of 100. Project that forward through 4 doublings for the fact that we have about 20 days of doubling every 5 days and we get to a factor of 1600. You can complicate the toy model in a number of ways, but I can't get it as low as 400.
Anyways it is worth pointing out that the curve of reported cases will continue rising for a couple of weeks as people both get symptoms then get sick enough to come to the attention of hospitals. And if the measures work, it won't be obvious from death rates for about 4 weeks. And at that point the critical question is whether we managed to slow the rise, or create an exponential decline.
My bet is that we are only going to get a slow in the rise. Hopefully enough for us to get ahead of the need for emergency treatments.
Look at the curves for every where else on the planet, the US will be the same, take it seriously
But even our dutch government is claiming it's 4 days standing in front of a chart where it's obviously 2 days.
After you reach the limit it's hard to count because people stop going to the hospital that can't take them in anyway. At that point you should just consider any increase in deaths compared to the normal the result of Corona. Wether it's a cancer treatment that got postponed because of Corona or Corona itself.
So that 400 multiplier gives the number of cases as of 3 weeks prior to the death count used in the calculation?
By Jan 25th, China declared a Level 1 Health Emergency in 30 out of 31 provinces, and began locking down other provinces.
On Jan 26th, China cancelled all inter-province bus service.
On Jan 30th, China closed the highways between provinces.
Also, all of this nicely coincided with the lunar new year holiday, when the vast majority of the country is already on holiday for 2 weeks, and not going to work, or school.
It's not really comparable.
People were literally dragged away by police/medical personnel in door to door temperature testing. Like physically picked up kicking and screaming and bundled into waiting vans. And at the time hospitals were so overloaded sick people were sat in corridors with the dead on the floor beside them covered by sheets. I think most people are pretty oblivious to what draconian means. I know I was!
The documentary was Danish and called De advarede om corona-krisen - og forsvandt for those interested.
The other thing to note is that a bunch of the people that recorded the footage are now missing which is terrifying in itself.
The UK and South Korea reported their first cases on the first day; SK has slowed new cases to a trickle and the UK is facing mass infection.
"It stopped in China, so we don't need to do anything."
It stopped in China precisely because they did something. Diseases don't magically stop themselves. This is on the level of thinking your dirty dishes wash themselves, because your roommate grudgingly does them.
No, but they usually stop, when the immune system is done fighting them, either successfully or not. And pandemies usually stop, when enough people build up immunity, or failed doing so. Or when the disease is so deadly it kills quicker than it can spread. Which is here not at all the case.
So even if nobody would be doing anything, this disease would eventually go away.
It is "only" a question of how many casualties it will take. And we are discussing the cost/benefit of the measures to society as a whole. Shutting everything down has real costs, too.
2. This white paper may explain Newsom’s numbers.
https://www.imperial.ac.uk/media/imperial-college/medicine/s...
The growth is exponential and not linear which throws off most people. Surprisingly, even though the paper’s R0 is on the conservative side (2.2-2.4) and so is their case fatality rate. However, their simulations still predict 2.2 million deaths in the US if there’s no gov intervention for social distancing
Sadly https://www.theguardian.com/world/2020/mar/18/top-uk-covid-1... says that the lead author of the study has COVID and likely was infectious while he attended a press conference on COVID.
No.
Our response in the west is just terrible because of all the political nonsense, the fact that scientists don't influence our countries, and most people are just too stupid or too spoiled to listen. Look at our countries, have you seen the kids partying in Miami? The people still protesting in France? How about everyone still going out for dinner?
Don't go blaming other countries' good performance for our crappy one.
Edit: on that note, other countries have been testing people on entry for months on entry. Russia has been testing people on entry. The Philippines tests everyone on the public transportation.
The lockdown is every word that true to its literal meaning during that period of time. People are not allowed to leave their own apartment. It is more like national level home arrest than volunteered quarantine.
All policies are enforced through each individual district, roughly equals to each apartment complex, that entering or leaving the complex requires its own passes. Let alone make a mask a requirement for everyone, without which you would put arrested in public.
I don't think any other countries can implement such a strict lockdown really. In California's case, I think the spread will no doubt slow down, but it is not going to be enough to burn out the virus. In the meantime, we need an effective treatment to be deploy to really battle this.
Can't believe this timeline is getting so intense this quickly in 2020, this is history making by everyday...
> People are not allowed to leave their own apartment
that's literally what's happening right now in Italy (and I think other European countries). It is not voluntary quarantine; although the level of enforcement is not at the level of China, you can get arrested if you are found outside without a good reason.
I believe he was making a point over what would happen without any mitigation. China put in place very aggressive mitigation efforts to keep its numbers from exploding out of control.
There's also a lot of monitoring and risk mitigation in place, so they should be able to catch inevitable slipups (eg medical staff treating remaining patients) pretty early.
81k is what China got after instituting lockdown as soon as they saw 400 new cases in one day.
The US flu death in 2018-2019 is estimated to be 34k. [1] China's flu death in the same year is 144. [2]
China's population is 4x to that of US. While the numbers cannot be compared directly, the difference in magnitude says at least something about its counting methodology, if not straight out lying
If I am to extrapolate, the corona virus death in china is at least two magnitude under reported
Have you considered that those countries just simply have had a better response to mobilize than the western countries?
They literally welded doors shut on apartment buildings. They are not superhuman. They just have a different take when it comes to individual rights.
There is no reason to assume the growth rate will taper off in country x like it did in China if country x does not take similar, or equivalent measures.
Yet next door mostly democratic Taiwan started acting on 31st December, and no one’s talking about them because they have prepared well and avoided an outbreak. Most other countries haven’t done so well...
Everything I have read states they closed off certain doors to ensure that you couldn't get in / out of the building without getting a health screen.
They built 2000 isolation hospital bed capacity in something like 6 days.
The estimate Newsom presented is credible.
The bigger difference is that California’s cases were more broadly diffused across the population than China’s at the same numbers (in part because it didn't originate from a single point in CA but had multiple points of introduction, and in part probably because of differences in lifestyle and social interaction patterns.)
I think that you discount this option too quickly. Have you been to China before?
There are urrently around 675 cases in California according to the CDPH (https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization...). So this trend would lead to 6 million cases in 8 weeks. The governor probably assumes there are 4 times more cases than detected. So 6M × 4 = 24 million.
But those that get sick get very very sick. And this will put much pressure on health care.
The fear is real. Take a look at the footage of Chinese hospitals and doctors.
Without lockdown the numbers will go up in 8 weeks.
Unless the numbers are crap, then it makes total sense.
But the WHO disagrees, ah well, then I guess we should stop using our thinking machines.
It really didn't "grow unchecked for months".
>using our thinking machines.
OK. You first, then.
Just stay inside, shut up, and be glad we aren’t being overrun by witches like back in Salem. Those were terrible days.. witches everywhere! Thankfully, Quick thinking politicians got rid of them.
There will need to be back-and-forth quarantines, or targeted quarantines, or some other creative method of allowing people to live roughly normal lives after a few weeks.
Think about it this way. The Ro spread factor is somewhere between 2.2 and 3.0 by most reports. People are contagious for 7 to 14 days before they know it. Therefore every infected person spreads a new case only once every 2 to 5 days on average. The problem isn't that the virus is explosively contagious per-interaction (measles is higher), it's that the incubation period is so long across so many interactions.
Cut that recognition time from that 7-14 days to 2, cut off those interactions, and that's how you get Ro below 1 to stop it. That's what South Korea did, by way of both rapid testing and contact tracing to test them too. Reports are that their rapid test gives false positives of up to 10%, but that's okay, a false positive is much less consequential than a false negative.
What jurisdictions in the Western world have the means and will to implement that remains to be seen.
Why? In a total lockdown situation, the positive cases might infect their close people the live with, but not really anyone else. And in a half lockdown, with still going out/shopping ... the infection rate is much slowed, if a high enough percentage of the infected isolate enough. That is all that we want, I thought.
That works if there is a relatively low number of cases, or you have enough testing capability to carpet bomb everyone with tests.
Once the number of cases gets too high, contact tracing has lost, because you have too many unknown cases in the community.
If you can’t test a large percentage of your population, you can’t detect pre-symptomatic or asymptomatic people that are spreading the virus.
There are still millions of people going about their day here in LA and nobody will stop them.
Many people (medical people) have experienced SARS in 2003 and they stay on alert this time. Except there are still enough people (especially the government personnel) not learning from / haven't experienced SARS.
If the current measure can eliminate the spread, I will feel lucky. But if the virus keeps spreading, I won't be surprised.
Keeping in mind that most young people who get the virus will survive, this is a massive generational sacrifice by the same people who left college around the time of the 2008 crash to protect older people. Anyone who thinks this is only going to last 3 weeks is just not being realistic.
Of course nobody wants to callously stand by while older Americans die of the virus. My own parents are at risk. I myself have asthma and I don't really know what my chances would be. However, the worst-case scenario in 20 years is that the older people we saved by sheltering in place will be gone, but the consequences of shutting down the economy will still haunt everyone living.
There are long-term trade-offs to consider here, particularly ruining the lives of the young in order to save the old, and I don't think they are being considered properly.
In an ideal world we would not need to make choices like this, but the choice is real and we can't fumble it.
I feel like a bit of a dick for posting this, but after reflection I do think it's a valid point and we cannot escape the trade-offs I described.
Neither of these is a final or accurate number: many of the current cases will progress to death, and many who have been (or are) infected have not been tested (e.g. because they were asymptomatic or had only minor symptoms).
Here’s a more careful attempt to determine the numbers for Wuhan (published today) which results in numbers substantially lower (though still scary) than those suggested by the WHO previously https://www.nature.com/articles/s41591-020-0822-7
Source: https://www.wsj.com/articles/italys-virus-death-toll-on-the-...
# Italian deaths / Italian cases = percentage dead [1]
2_978 / 35_713 = 0.0833870019
# USA population * percentage dead = USA death scenario [2]
329_414_824 * 0.0833870019 = 27_468_914
It's prob not gonna get that bad, but Italy didn't see a scenario where people would die at a rate over 8%. So there's a scenario. Don't panic, but also don't dismiss scenarios you'd rather not believe. Americans who get laid off lose access to cheap healthcare, and many as already don't have it. Lack of healthcare doesn't sound like a great a situation.
[1] Source: Coronavirus disease (COVID-2019) situation reports # 59 for March 19
Wealthy people have power.
It takes time to accrue wealth, most wealthy people are old.
Coronavirus kills 10% of 80+, and 5% of all 65+.
Old people vote.
If the hospital systems are overwhelmed because we don't flatten the curve, those percentages likely double or triple.
Look at how much we've learned about treating this virus in the 3-ish months we've been paying it the attention it deserves. If we slow it for another month, maybe these percentages could be cut in half.
You should find the actuarial tables and life expectancies for an 80 year old. It ain’t sunshine and rainbows.
Every year nearly 3 million people die in the US already.
https://www.cdc.gov/nchs/fastats/deaths.htm
Are you saying we experience the worst catastrophe year in and year out?
The hyperbole and exaggerated fearmongering over coronavirus is something to keep an eye out for. Also, if everyone gets infected, it likely means that the virus is far less deadly than you assume and the death rate is far lower than 1%. Think about it rather than cherrypicking data to push an agenda.
People who are elderly or have health conditions that put them at high risk could isolate themselves for the next several months while the virus makes its way through the population. When enough people get it, herd immunity will develop and then those people will be protected. High risk individuals have a personal responsibility to isolate and protect themselves.
I don't know if this is just my community, but I went to the store (out of necessity) twice during the past week or so... and both times it was filled with elderly individuals. It very much made me feel like we were all sacrificing so that the elderly didn't have to.
It seems like their current plan is to do what everyone else is doing, after wasting a lot of time.
What people don't seem to get is that this was best-practice even before COVID-19. Influenza also disproportionately affects people with high-risk health profiles and there are millions of cases in the US every year, already, with thousands to tens of thousands of deaths.
For teachers in OECD countries I found this chart: https://4cdn.hu/kraken/image/upload/s--n8f4dn-h--/c_limit,w_...
For GPs in Hungary I found this: https://4cdn.hu/kraken/image/upload/s--HqWJo4dH--/7Qfxe7y7fM...
In the UK and Colombia (and maybe elsewhere) there are mandatory quarantines only for the elderly. I can see this being tried in other Western nations if blanket quarantines go on too long.
What if we all shelter in place but hospitals end up overwhelmed anyway? That seems like a real possibility and it kind of makes the argument irrelevant.
If we didn’t “flatten the curve” enough to get the imaginary hump below the imaginary dotted line, then the benefits of “shelter in place” are going to end up being a lot less valuable.
There aren't just two modes: Hospitals OK and Hospitals Overwhelmed. The idea behind flattening the curve is to reduce the burden on the hospitals to whatever degree is possible. How is it "irrelevant" if a hospital is 200% over capacity versus 500% over capacity? The people who would die in the worst-case scenario but not in the "flattened" scenario would probably think it is extremely relevant.
Otherwise, what on earth is the strategy? Flatten the curve only to have an explosion later?
I had no idea they had audited the age of the bankers who caused that mess. Only one I'm aware of was https://en.wikipedia.org/wiki/Nick_Leeson who brought down an entire bank at the age of 25.
As for your darwinistic-eugenics as an old person, sure I'm happy with that, but the question is - would you be happy with that when your older and somebody else's kids suggests the same thing. Not that easy to answer.
But whatever age people are, the penchant to begrudge the age groups above them to varying degrees and reasons tends to be strong, at least until they reach their 40's. At least that is what I have observed from many years of experience of many age ranges.
> In an ideal world we would not need to make choices like this, but the choice is real and we can't fumble it.
I suspect the film Logan's Run would be worth a watch if you have not seen it. https://www.imdb.com/title/tt0074812/
Oh I'd also add, we have not seen results of sterility post infection - that data might change your perspective if we end up finding out that the chances of becoming sterile due to infection of this are high. Which is still an unknown and not to be ruled out.
Still, once you put a price upon a life, you find yourself more open to other equations in which you have that variable and then you start reducing the value of that variable. It's a slippery slope.
The decisions we make now will affect everyone, not just those who die.
My point is that we can't avoid the trade-offs. We cannot pretend that saving the lives of sick people does not affect other lives.
Our society is not having that discussion, but is focused on saving as many lives as possible. Not enough attention is being paid to the other side of that trade-off.
Economic downturns lead to deaths of despair - long-term unemployment causes spikes in suicides, drug overdoses, even domestic terrorism brought on by a potent mixture of sheer nihilism and depression. Just because it's more difficult to count those future lives (more likely to be young) against a current model - who are you to discount them?
Parents? Grandparents? Who needs them! They’re just a strain on the economy.
/s
Edit: I should add that ramping up testing may take longer than that. I'm not an expert; just going by what I've read. Even so though, we should definitely aim to scale up testing as much as possible; the better our testing, the less restrictive and long-lasting isolation measures will need to be.
Two months of this is going to be the beginning of the next depression.
If we don’t, what happens to the rather large percentage of young people who require hospitalization? It’s no stretch to assume that many would die. Let alone the fact that mortality for young people is already many times higher than the flu. Break the healthcare system and that goes up dramatically.
On top of that, break the healthcare system and what happens to all the normal, baseline, hospitalization needs? They’re not going to suddenly disappear. Survivable medical events become fatal.
How do you recover as a society from that, without an economic depression like none we’ve seen in our lifetime?
We desperately want to prevent an economic depression, and for good reason! But the chessboard is what it is. We don’t have a whole lot of moves.
That “flatten the curve” graph people are sharing is just a visual aid. It’s not based on real data. How could it be? Hospital capacity varies by region but everyone in the country is passing around the same graph.
It’s nice to flatten the curve, but if the flattened curve isn’t low enough then we will overload our health care system anyway, and we will add an economic shutdown on top of that.
We are lucky this is not a super deadly virus, because I don’t think we would have handled it any better.
Based on last week’s numbers, unemployment claims are up almost 10x compared to the normal level. That is one indicator of the damage to the economy.
We need to consider that the human suffering caused by the economic shutdown will outweigh the human suffering caused by deaths, and it will last longer too.
Only when everyone panics and people fight over live saving toilet paper, instead of keeping the power running, then the economy will shut down for good.
So I am not really scared of the virus, but rather panicked mobs.
Nonetheless I also think that they do factor this in. If your health system breaks down around the world it might become very catastrophic.
And in Italy there have been enough not only old people dying.
At $10M/life, 1M deaths in the US is a $10 trillion cost. That's 50% of GDP - I fail to see how it can't be cheaper to "shut down the economy" (a term I find quite hyperbolic anyway) for a month.
It's possible that a massive global economic slowdown could help solve the collective action problems there a bit, right? Maybe the spirit of cooperation necessary to achieve "war time" resistance to the pandemic can seamlessly transition into building a new economy that's more sustainable?
And when we get kicked into the man made depression two weeks from now, anyone that doesn’t already have savings and wealths, their lives are ruined.
And that’s gonna be much more than 1 or even 5 percent of the population
However, if hospitals are completely overrun with uncontrolled spread, along with virus related deaths (1% to whatever), normal hospital cases of heart attacks, strokes, cancer, accidents etc will result in straight death too. Health services were already struggling to cope with those cases alone before the virus hit. Total death toll would be an almost guaranteed disaster. Any economic downturn of lockdown will seem a barely perceptible blip atop that body count. Lockdown naysayers need to get a grip on reality.
I'm here stressing about finding toilet paper. I'd hate to be worried about affording toilet paper.
Once testing becomes widespread enough that it's feasible to test a lot more people it's quite plausible to relax the restrictions. One big problem before the recent "shelter in place" state is that community transmission by asymptomatic people was/is out of control.
If only strongly symptomatic people are "allowed" to be tested and health care professions aren't tested, it's basically impossible to restrict spread of something as infectious as covid-19. And once people with a lot of contacts have it, and stay in contact, further spread will obviously accelerate.
If you look at the buildup of test capacity in the US (far far to late obviously), it's improving at a decent rate (from a totally embarrassing starting point):
https://covidtracking.com/us-daily/
(there's a lot of differening sources, several lagging, but the trend is similar afaictl)
So there finally does appear to be some serious and successful effort in building up test capacity. Testing everyone in the US seems far off still though.
Given the rates of hospitalization and available beds / respirators, it'd however be insane to rely on testing at this point. Spread would be far too fast, and there's obviously not enough testing.
But if infections slow down due to the isolation, and testing ramps up at the same time...
Anyone who has had the disease and recovered can afterward go about their life again, as they cannot (for at least a few months, if not longer) be reinfected or spread the disease.
I read it more as a "Shut it all down please, then let's figure out which parts we can start to re-open in 4-6 weeks" order.
It's the equivalent of firebreaks in forest fires. We know it's there, let's prevent it from spreading where/when we can.
the embarrassing point is that in the US, isolation is the only effective tool at this point. it's embarrassing because ramping up testing was what South Korea did, and they started much sooner, and that's why they are over the hump now. the US simply doesn't have the testing scaled up.
https://www.reuters.com/article/us-health-coronavirus-testin...
They traced the chains of the infections and quarantined everyone until they were tested clean. They found new chains through sick people who were tested.
Without investigation and tracing the chain of infections, you can't contain it through testing alone.
And the fact that were was an undetected outbreak in the west coast of the United States for several weeks probably made containment impossible, even using the South Korean model.
Korea and other nations in the area took it seriously due to their proximity to China and previous recent experience with infectious disease: HK experienced SARS, Korea experienced MERS.
These discussions are so far divorced from the reality of the interventions available to policymakers.
Also need to give our healthcare workers time to mobilize all their emergency measures to handle surge capacity. I'd imagine the Bay Area is about 2-3 weeks away from its peak number of cases given the quarantine just started last weekend.
[0] https://twitter.com/jasonfried/status/1240818423795515393
Frankly, I expect in 3 weeks people won't need the order because it will be like Italy and people will be terrified to go outside. But at that point, you STILL have 3-4 weeks before things turn around.
Also consider the asymmetric knowledge here. The people in power surely know things they aren't telling you. Destroying the economy is not in their best interest. How bad must it have to be for them to be willing to destroy the global economy and potentially their own fortunes and power structures?
People treat this like a binary choice between “save the economy” and “save the elderly”, but if you’ve been following this at all it’s clear that there’s no simple answer in either direction.
We didn't shut down. We stopped doing what's unnecessary.
There's a big difference, and now that reality has made us "wake up" we should probably reevaluate how we structure our economy and society.
It's also hard to imagine that couples who live apart are actually going to stay away from each other until the vaccine.
China is down to zero cases. South America except for the two black sheep (Mexico and Brazil) is shutting down (Peru had curfew-in-place since the weekend; anyone even driving their car outside is arrested). Europe is also going there, plus Israel, several Arab countries, etc.
Only big black sheeps right now are the US, parts of Europe, India, and Africa (which is only now getting their first wave).
The US doesn't have even close to the necessary number of testing kits or infrastructure to test 300 million people. They're working on ramping up production and availability of tests.
There's already a plan in place, and most people don't know it but there's already a timeline. At this point testing people is useless: hospitals already provide numbers to the government.
I don’t think it would get quite that far, though, because once people start literally dying in the streets, people will be afraid and massively self-quarantine. So... maybe four million dead and the economy completely shuts down anyway.
Really, the quicker and more aggressively we jump on this, the less the damage, both in terms of human life and economic impact.
We’re too late to have a small impact. We’ll feel this for years. Let’s at least try to make something we’ll forget in a generation. Let’s especially make sure we don’t have something they’ll be talking about hundreds of years from now.
It is much, much more comforting to have a plan than just hunkering down and waiting your turn to find out if you will live or die.
https://www.imperial.ac.uk/media/imperial-college/medicine/s...
They seem to have picked the green line and not the orange line. Hopefully they’re planning for intermittent social distancing, or have some other medium term plan.
I read that the paper cited does not include the effects of isolating cases and contact tracing to suppress new infections.
Added: Waiting period will result in asymptomatic people showing symptoms and they can then be tested and isolated. That is why the stay-at-home practice is useful during the incubation period. If the actual number of cases in CA is not too large and within family infections can be controlled, then part of everyday life can resume in about 1 month.
Actually, I'm sure it is not.
Why do people think that waiting 2 weeks or 2 months will solve it? Only way that works is if enough people have it and now have immunity, which helps prevent spread when quarantine is over.
We are going to have a worse economic impact from mass quarantine than the 200 thousand people (mostly over 60) that would have died.
Essentially: either this disease overwhelms us, in which case most people you know will have had it and multiple people you know will have died, or (statistically) no one you know will have gotten sick and the whole thing will look like a nothingburger.
But it wasn't. It was a disease that would have killed tens of millions if unchecked, we just got it under control. At least, that's what we hope.
IMO, this thing is a trap for politicians. A true lose lose for them.
[0] less so for some.
Besides, it's better to contain it 'too much' because then you can loosen restrictions a bit and still have managable number of cases, than not contain it enough and have run away process you won't be able contain even with most severe measures you are able to enforce.
https://www.nbcnews.com/news/us-news/ny-gov-cuomo-says-no-ne...
Look at the graph.[1] Those are actuals, not predictions. This gets 10x bigger each week. The US is 12 days behind Italy. US at 10,000 now. 100,000 next week. 1 million in two weeks. The lockdown may slow that down. Probably not enough.
[1] https://www.ft.com/content/a26fbf7e-48f8-11ea-aeb3-955839e06...
https://joindiaspora.com/posts/73d4e930421d0138028e002590d8e...
Exponential growth boggles the mind.
Script source: https://pastebin.com/raw/j89ZUdVq
The 25M number doesn't seem realistic because every country that has had a COVID-19 outbreak has freaked out trying to control it, and either succeeded via very expensive means or (in most cases) hasn't had the outbreak grow far enough to know whether or not they've failed.
My interpretation is overreaction should be what's done to mitigate the pandemic for the foreseeable future. Right now, almost every country is playing catch-up.
Would the US democracy survive it? I don't think so.
Second order effects would be huge though and you'd still take all sorts of economic and social hits.
I don't see why democracy would die. Spanish flu was far worse.
"Perhaps our most significant conclusion is that mitigation is unlikely to be feasible without emergency surge capacity limits of the UK and US healthcare systems being exceeded many times over. In the most effective mitigation strategy examined, which leads to a single, relatively short epidemic (case isolation, household quarantine and social distancing of the elderly), the surge limits for both general ward and ICU beds would be exceeded by at least 8-fold under the more optimistic scenario for critical care requirements that we examined.In addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US.
... We therefore conclude that epidemic suppression is the only viable strategy at the current time.
"
ONE MILLION DEAD AMERICANS.
You shit your pants after 3000 died at 9/11.
"Fortunately it appears the parameters used in that model were too negative. The experience in China is the most critical data we have. They did their “shut down” and were able to reduce the number of cases. They are testing widely so they see rebounds immediately and so far there have not been a lot. They avoided widespread infection. The Imperial model does not match this experience. Models are only as good as the assumptions put into them. People are working on models that match what we are seeing more closely and they will become a key tool. A group called Institute for Disease Modeling that I fund is one of the groups working with others on this."
The numbers that matter are local numbers surrounding you. No leader will tell you that cause they want obedience.
the short term plan alone will flatten the curve too much, if successful, and we simply dont have confirmations about whether we build immunity or the virus dies out, so without those features the short term plan being the long term plan or a recurring plan (even if we build immunity but we flattened too much, then clusters reemerge). But in conjunction with the medium term plan and most people not being reinfected its the best solution
long term plan either way is a vaccine, effective treatment
edit: can you engineers please tell me and the world what some of you disagree with about this information? this isn't the place to write a dissertation on every edge case necessary to explain whats going on, and the lack of that dissertation doesn't undermine the point or utility of what is written
What is up with this obsession with testing? We need to lower R0 and scale up medical infrastructure. Elimination at this point is a fantasy.
To be clear, testing is important. But to suggest that it should be the priority over isolation and distancing seems misguided.
The executive order at https://covid19.ca.gov/img/N-33-20.pdf cites Government Law 8665 to enforce itself, which reads:
CA Govt Code § 8665 (2017)
Any person who violates any of the provisions of this chapter or who refuses or willfully neglects to obey any lawful order or regulation promulgated or issued as provided in this chapter, shall be guilty of a misdemeanor and, upon conviction thereof, shall be punishable by a fine of not to exceed one thousand dollars ($1,000) or by imprisonment for not to exceed six months or by both such fine and imprisonment.
> This Order shall be enforceable pursuant to California law, including, but not limited to, Government Code section 8665.
https://www.sfgate.com/bayarea/article/Coronavirus-Atria-Bur...
> The order is completely identical to the one in the Bay Area, meaning individuals can also leave their houses to take a walk or go for a jog so long as they are practicing the requisite precautions when coming into contact with another individual.
I read what I thought was the most official version of the California order [1], and it's frustratingly short. After reading it, I can't tell whether I can go for a bike ride. Even the fact that I can go to a grocery store isn't stated explicitly. Is there a clearer, more detailed version?
By comparison, the SF order [2] impressed me by how clear it is. For instance, it clearly allows recreation with sensible caveats.
UPDATE: The video announcement [3] implies that the intent of the CA order is, indeed, to allow all the things the SF order allows. Not sure whether that has legal force, but good enough for me.
[1]: https://covid19.ca.gov/img/N-33-20.pdf
[2]: https://www.sfdph.org/dph/alerts/files/HealthOrderC19-07-%20...
https://www.cisa.gov/critical-infrastructure-sectors
>The Commercial Facilities Sector consists of eight subsectors:
Entertainment and Media (e.g., motion picture studios, broadcast media). Gaming (e.g., casinos). Lodging (e.g., hotels, motels, conference centers). Outdoor Events (e.g., theme and amusement parks, fairs, campgrounds, parades). Public Assembly (e.g., arenas, stadiums, aquariums, zoos, museums, convention centers). Real Estate (e.g., office and apartment buildings, condominiums, mixed use facilities, self-storage). Retail (e.g., retail centers and districts, shopping malls). Sports Leagues (e.g., professional sports leagues and federations).
I do also agree that the video you reference implies that the CA-wide order allows the same sorts of things (Newsom references "walking your dog") but hopefully there is more explicit guidance.
I've been walking and hiking every day since reading that. Some funny stuff...
- I always wear a floppy sun hat. Been there, had the dermatologist appointment. I can tell people think I'm a weird prepper. But I'm just going hiking, and need good sun coverage...
- Sitting on a bench in the city park, holding a tiny shortwave radio, with antenna clipped on... I've been doing this for years now, but these days people slow down their cars and stare...
- Having some family fun with our GMRS license, as we do about 1-2x weekly, anyway my son had a walkie talkie in his hand when we visited a nearby store and the cashier said we gave him a "zombie apocalypse vibe" (then handed me a card and asked me to email him about getting a license)
- Walking near seniors and the elderly...SO sad. They look terrified and take ~20 foot detours. (Not terrified at me, just in general...I hope)
- Seeing groups, like families talking in the street... They're out just enjoying a bit of sun, laughing, but then they completely disperse or go inside when someone walks down the street toward them.
- People seem to be putting on a weird act if they see that you are looking at them, like, "see, this is how I get out of my car during a pandemic." lol.
- If you go around a corner and run into somebody... Even if no physical contact... Awkward. Lmao
- So quiet. It's like most of our city already died off. But there's only one case reported in our county, far to the south
It's weird. When I take a ham radio out hiking, I take one with a blue case, so people don't get the wrong idea...
What they don't realize is that those figures are the result of tough lockdowns, without which, the death toll would've been easier an order of magnitude greater.
California has shown true leadership in this crisis. I hope New York and Washington will soon follow.
Some statistics on lower wage workers
* 152 Million people worked in US in Feb 2020
* 16 Million of those in retail (A huge majority of them would be unemployed ~50%)
* 17 Million people worked in Leisure and Hospitality (If bars/restaurants/movie theaters/theme parks/casinos stay closed around 80% of them are unemployed
* 3 Million people work in educational services . With schools and colleges closing a majority of them are unemployed.
Source of data https://www.bls.gov/news.release/empsit.t17.htm
* You can only keep things shutdown until people are either begging on the streets or rioting
The Bay area one allows people to get out and walk for exercise. This does not.
The article doesn't bother linking to the actual order. https://covid19.ca.gov/img/N-33-20.pdf has the text of the order. It just said the critical infrastructure sections. The (non-linked) URL for which is https://www.cisa.gov/critical-infrastructure-sectors. Which is extremely vague.
For example should my local Best Buy remain open because it is part of the Information Technology sector? Or is providing people with headphone adaptors for work at home not critical infrastructure? I have no clue! I hope that they do.
OC is letting factories stay open with conditions and LA is saying the port stays open as well as the trains, airports (especially KSBD which is Amazon's home base). What a mess.
The statewide order is similar. Strongly recommended that people stay indoors, but outdoor activities are still allowed.
In both cases, the orders do not include any potential punishments (to individuals) for violating the order. (There are punishments outlined for businesses.)
I think this one is up to the state governors who typically do have the power to do this through state health laws -- as has now happened in CA and undoubtably will happen in many more states over the next 48 hours.
Further, we are supposed to avoid groups of more than ten people.
Is that not the case on the coasts?
To be honest, a few times I've heard of something happening that is proactive, and in a biased way assumed that "Well it must be a Democratic governor". Mike DeWine kind of made me realize I shouldn't do that.
Judge not by labels, but by actions.
Based on the linked definition, every worker fits into one of the critical business types.
They are being asked to continue a commute into Los Angeles, continue a job that doesn't allow for social distancing, and isn't being provided with any protection items, whatsoever.
They are told that they are essential, and that they cannot have time off. Let me make this clear : They are a civilian, entirely.
I SURE hope that those who do indeed get sick from the poor decisions of their employers will have some path available to them legally to make the irresponsibility righted in some way.
https://www.mercurynews.com/2020/03/19/coronavirus-read-the-...
Given that at least one employee of a grocery store has tested positive in CA, it seems that grocery stores, where large numbers of people congregate and touch surfaces, could be a loophole to be addressed... somehow.
Yeah, let's all stay at Home. But let's also not get punished for it.
We here in Sydney are (as usual) sleep walking into a big mess.
The order says only those part of CISA define critical infrastructure should show up to work, which doesn't seem to include pizza delivery or short order cooks.
Tons of governors are issuing meaningless statements like these. Ping me when someone actually imposes martial law.
It's not martial law to the letter, but it's damned close.
You need to check your privilege. Working from home isn’t realistic for most people. For many, the decision is squarely between a paycheck and staying home. You’re pretty out of touch if you would call someone narcissistic or psychopathic for struggling with that.
US has awful social support and this will hit the working population really hard.
The best case I see is we can ramp up testing kits and masks to 100s of millions. Test everyone repeatedly. Track and quarantine rigorously. At the same time give monthly stipends to everyone while “sit in a hole or die” order is going on.
Make sure banks don’t foreclose, people still have insurance and jobs (too late for some parts like hotels and restaurants).
I can see why people are panicking and buying guns in poor neighborhoods. We’re putting people on survival mode.
We first downplayed this for a long time when we had a 2 month head start (Thanks Trump and team) and still feel unprepared for the worst.
I think the LA times article is better: https://www.latimes.com/california/story/2020-03-19/gavin-ne...
> The state projects that 25.5 million people in California will be infected with the coronavirus over an eight-week period, Newsom said in a letter sent to President Trump on Wednesday requesting the deployment of the U.S. Navy’s Mercy hospital ship to the Port of Los Angeles through Sept. 1.