Seoul's full cafes, Apple store lines show mass testing success
bloomberg.com
bloomberg.com
To repeat: don't take this as a sign that Korea believes it has successfully managed the outbreak.
Certainly, a lot of it has to with migrant workers and their living situations, but it also underscores how even when you have things under control, the virus can spread rapidly when your guard is down.
A lot of people were perplexed by Japan's lack of testing. Seems like Japan's strategy (whatever it was) didn't work out in the end.
[1] https://en.wikipedia.org/w/index.php?title=Template:COVID-19...
South Korea is still testing aggressively. Recently they even started re-testing recovered patients. Those who tested positive had their contacts traced and tested too. As long as they remain vigilant, they will not see another big explosion. They seem to have the right attitude.
I’m waiting to see if there will be a little outbreak as a result of the elections they held recently.
It is closer to 20% A lot of articles stating more are mis-interpreting those numbers from prospective studies. It is possible that the authors of such studies would downplay false positives as well.
So at the moment no-one really knows for certain.
Most of them will eventually begin showing symptoms
Almost everyone shut down travel from China (particularly Wuhan) but no one shut down travel from Europe during March. Biggest mistake ever. I don't know enough if it was tourists or whether it was returning Singaporeans but they should have instructed them to remain where they were for the sake of the country.
The USA did shut their border to a lot of Europe in early March. But at the time the WHO opposed border closure.
Over 10 million a year from Germany, Italy, Spain, France, and UK alone. Just tourist visas.
https://en.wikipedia.org/wiki/Tourism_in_the_United_States#V...
My point was that tourism to the US is probably not uniform throughout the year, and March is likely on the lower end of tourism. Hence the ratio of traffic being Americans returning home is higher.
The mistake was not letting them it, but to let them self-quarantine at home. This led to them infecting other family members who then spread it further.
This has changed now as anyone entering Singapore has to be quarantined in a separate facility.
As I mentioned in the previous post, they now quarantine them in dedicated facilities for 2 weeks.
Numbers outside these locations are going down because of the recent "circuit breaker" they introduced a few weeks ago.
You can get the immunity only two ways 1) enough people have been gone trough the disease or 2) vaccination.
South Korea must use mitigation/supression until they have enough people vaccinated or it flares up again. Complete eradication without immunity is not feasible unless you isolate whole country from the rest of the world permanently.
Just something like 1 infected entering per day or week means that you must keep up suppressing and tracing.
However, the latest cluster in Heilongjiang involved an asymptomatic student returned from USA, completed 14 day quarantine, tested negative before and after, but still went on to infect her family and neighbors who infected more at the hospital. Total confirmed cases in this cluster is ~50 right now.
Most of the spread in this case happened because of negligence in the hospital thinking coronavirus is eradicated there so they didn’t take precautions. Coastal cities like Shanghai are taking good measures so there hasn’t been a problem despite it being where most international flights land and basically 100% back to work for over a month now. The biggest danger is people becoming tired of wearing masks and avoiding gatherings over time.
Meanwhile, the on the street observations in the article are: masks, masks, masks. Masks are cheap and easy. So let's start with masks, masks, masks first while we figure out and ramp up testing and contact tracing.
the first Apple store to reopen outside China had lines snaking out the door as many South Koreans -- almost all wearing masks
At Han River park in Seoul’s Banpo district, families -- also in masks -- were having picnics
including requiring voters to wear masks and disposable plastic gloves while casting their ballots
People are still wearing masks and mind talking face-to-face with strangers
A Chinese study found that the virus was probably being moved around by people's shoes https://wwwnc.cdc.gov/eid/article/26/7/20-0885_article
There are not any reported cases of the virus infecting anyone by shoe though.
Of course, I'm only suggesting that the idea of shoes as vectors might be something.
Exactly. I wonder how many lives could have been saved if we (western/European countries) didn’t have such an aversion to wearing face masks, even in a time of pandemic?
The reason government and medical signaling on the subject has been so mixed is that it isn’t apparent they are very effective, especially the jury rigged cloth masks that people are using.
https://www.preprints.org/manuscript/202004.0203/v1
The reason government and medical signaling on the subject has been so mixed is that it isn’t apparent they are very effective
The reason signaling has been mixed is because they were trying to preserve supply for medical professionals. The reason that medical professionals need them is because they work.
I have yet to see a single western leader to recommend those masks for all the interactions (indoor at least). Case point - yesterday I went shopping in fairly large supermarket in Switzerland, and there were maybe 5 other customers (out of at least 100 in the store during that time, probably close to 200 plus all the staff) wearing masks, or gloves. People at least often kept their distance (not always possible in aisles), but that's about it. In a country which has one of most per-capita infections globally.
Why? They rely heavily on politicians doing right stuff. Mostly it works, but in these times politicians prefer keeping economy running (they delayed strong measures when things were getting worse than bad in Italy few kms from their border due to fear of financial impacts... well now they are worse but delayed by few days).
Can't remember seeing any controlled studies on the efficacy of social distancing either.
Many of the healthcare professionals in the countries that dealt with SARS are calling for universal mask wearing. I'd much rather trust their intuition and judgement than governments and media outlets passing the buck to the WHO.
No, but we have mountains of evidence from respiratory diseases throughout history, including the common cold and seasonal flu, that distancing lowers transmission.
It's why people are encouraged to stay home from work when they are sick, and why in normal situations, people in lines of work where they cannot afford to stay home from work get sick more often.
Social distancing is one of the oldest public health protocols we have for disease transmission control.
Sure, many old practices for disease prevention amount to nothing but old wives tales, but social distancing likely isn't one of them.
Healthcare workers wear masks. I'm pretty sure they have a pretty good idea whether masks work.
All we need to do is bring the reproductive number below 1, not necessarily all the way to 0.
Didn't even have to go out and buy more materials.
My wife and I were one of the few people wearing masks at the start of the pandemic, before the closing and work from home orders came. We were harassed by random people shouting at us.
Also, I don't really get the societal penalty for disaster preparation. It's completely illogical. Just a few weeks before the news was really onboard with the pandemic, a woman at my apartment was looking at how many amazon boxes I had on my hand cart. I told her, "In times like this, it pays to be prepared." She looked at me like I was scum. My understanding is that some news outlets were actually denigrating disaster preparation at that point.
It makes a lot of sense: if you're preparing for a disaster, you won't go down with everyone else when disaster strikes. This creates some feeling of resentment which caused people to lash out at you.
A well known psychologist was castigated a few years back for his likening people to lobsters. Yet here we have a perfect example of people acting like the proverbial lobsters who drag the escaping lobster back into the pot.
Jump to mid-March, when the pandemic was obvious to anyone with the least amount of curiosity, and the same group was saying "It's just a flu." The only thing that was socially acceptable to discuss was how many guns you might need in an apocalypse.
Denial is a powerful opiate.
Technically, not an influenza virus. However, from what we know of virus diseases that cross species, it's not the 1st time a virus with this severe capability to spread rapidly has crossed over into humans. It's also not going to be the last.
The aspect of that statement that's true, which is worse than a lie, is that, "It's just a flu," puts people in mind of a disease that's a normalized part of everyday life. It's often the case, that when a virus crosses over to our species, the situation is far more dire than normal.
IIRC, when syphilis crossed over into humans, it would flat-out kill people in 2 weeks.
But banning the sale of masks isn't the most stupid idea we had in France, I'd say it was forbidding jogging from 10h to 19h in Paris was the worst, with all the joggers clustering from 8h to 10h and 19h to 20h
The US has a huge advantage in its low population density and spread out population. That slows down the spread of disease. Not to mention the advantage of a car centric society. In the US you can travel from A to B without exposing yourself to other people. Americans also mostly live in separate houses further reducing the risk of the spread of disease.
All through human history population density has been a major contributor to pandemics. One can see e.g. how New York is much harder hit than LA. LA is low density housing and almost no public transport.
Europe and Asia in contrast is almost all more like New York. IMHO that makes the success in South Korea more impressive not LESS.
We see the same in Europe. The densely populated countries tend to be harder hit. E.g. Denmark has enacted equally strict measures as Norway sooner yet has twice the number of deaths. Norway has an advantage in being more like the US, having a relatively spread out population.
I don't think the decentralization is the main problem at the moment. Germany is also decentralized. It is a federal republic like the US. However unlike the US, Germany has a cooperation oriented leadership where the central government listens to the leaders of the states and coordinate with them.
In the US it seems to be all postering and blame game. It is very hard to evaluate the US results without taking into account its current disastrous leadership. The US is lead by a reality star. Germany is led by a former scientific researcher with a PhD in quantum chemistry. Should we be surprised why Germany is having the best results in the West, while the US is rapidly approaching the worst results?
What saves the US is that there are numerous governors who are good leaders and to some degree counterweight the absurdity of the federal government.
But seriously in what country does the President encourage riot in provinces of their own country? Looking from abroad the US is looking increasingly like a Banana republic. I how things work out fine for everybody. But I am worried.
"People are reacting like this is the Ebola virus. This is not the Ebola virus. This hysteria that you see, this fear that you see, the panic that you see is unwarranted. We have dealt with worse viruses. This spreads like the flu, but most people will have it and they get on with their lives."
> Not to make this too political but can't the same logic be applied to the POTUS too? Changed tone and done a decent job using the fed muscle to beef up on ventilators and testing. What am I missing when I hear contradicting analysis around politicians, presumably based on which "side" one is on. We should be consistent in acknowledging that no one (at least in the US) got the severity of this correct.
The same logic does apply to President Trump. But he has not changed his tune. He's done some of the right things under pressure, but then goes and says that he wants to re-open the country by Easter, etc. I don't follow what he says closely (after all, I don't live in the US), but the picture I've gotten about him is that he's inconsistent and not really trustworthy.
From what I noticed (it's been a while) the reporting on that was a bit weird. The statement was more like "I hope it'll be fine by Easter". That's still a weird thing to say, but less strange than what was reported.
The way statements were made to the public seems to be different per country. E.g. in NL the prime minister said something like "we need to take this very seriously and it will take a long time". They showed a similar presentation from France, were the statement included stuff about "fighting a war". So despite needing to say similar things, the messaging can differ quite a bit per country. In US the statements seem quite strange; dismissing the importance as authority figure seems dangerous and irresponsible.
We should not be panicking. We should be mitigating the disease based on the evidence at hand.
If I were to make an informed estimate based on the limited testing data we have, I would say that covid-19 will result in fewer than 40,000 deaths this season in the USA,
Ioannides in his mid-March article was predicting "10,000" deaths in total in the US, without measures...
From his article [1]:
> If we assume that case fatality rate among individuals infected by SARS-CoV-2 is 0.3% in the general population — a mid-range guess from my Diamond Princess analysis — and that 1% of the U.S. population gets infected (about 3.3 million people), this would translate to about 10,000 deaths.
[1]: https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-a...
He ventured a prediction of the CFR. And then just calculates the amount of deaths from a pretty arbitrary infected percentage of the population (there's no mention of the time scale either). Never does he predict that 1% will be infected. He's arbitrarily picking a number to illustrate the amount of deaths we'd see, but that all depends on how the disease spreads. Oddly enough his serology study ends up being somewhat close - instead of 1%, they saw 1.80-3.17% (in Santa Clara).
But he uses exactly this in his argument, in the same paragraph: "If we had not known about a new virus out there, and had not checked individuals with PCR tests, the number of total deaths due to “influenza-like illness” would not seem unusual this year. At most, we might have casually noted that flu this season seems to be a bit worse than average."
Then later: "Some worry that the 68 deaths from Covid-19 in the U.S. as of March 16 will increase exponentially to 680, 6,800, 68,000, 680,000 … along with similar catastrophic patterns around the globe. Is that a realistic scenario, or bad science fiction?"
Then he claims that "The most valuable piece of information for answering those questions would be to know the current prevalence of the infection in a random sample of a population"
But I claim he already had, at the moment he wrote that article, much better data than that already available: specifically, that all the statistics everybody could find even in the Wikipedia already gave much more information that he claimed has to be obtained by "a random sample of a population."
One can evaluate "how random" all already known cases, at the time he wrote the article, were. But also one can evaluate, if these known cases, even if they weren't random, were actually saying more, not less, by the nature the numbers were obtained.
And that was exactly the case: time and again, in country after country, the statistics included much more people than the small randomness based study would include, and it gave reasonable estimates about both the speed of the spread and percentage of the people affected.
His argument was not based on analyzing already available data, but on "not knowing" by *refusing to even look at the already available data.
Which is fraudulent, ignorant or both. But there were some big names doing exactly the same, exactly at the time he published that article. So his article was just political, not scientific at all.
your comparison of the 2 mil which was the worst case scenario months ago, and now irrelevant, with 40k which was his prediction from 10 days ago is wrong.
At this point he should stop predicting...
Ioannidis' already 4x surpassed prediction was 10K deaths without measures.
Given that we have 4x WITH measures, this means we would be many times more wrong if we followed his advice and didn't take any...
Err, it spreads much better, several times more than the flu.
>and Dr. Ioaniddis recently published a serological study showing it seems to have a mortality rate similar to the flu
Dr. Ioaniddis study was cherry-picked and bogus, much like the studies he was famous for criticizing...
"I think the authors of the above-linked paper owe us all an apology. We wasted time and effort discussing this paper whose main selling point was some numbers that were essentially the product of a statistical error."
https://statmodeling.stat.columbia.edu/2020/04/19/fatal-flaw...
Test kit availability adds another layer. At some point New York had 200 confirmed cases, and two weeks later 400 deaths, yet CFR is unlikely to be as high as 200%.
So yes, all statistics should be taken with a grain of salt, but magnitude and direction of that grain may be different.
A town in Italy, Castiglione d'Adda, had 1.4% of its population die in March. Normally 0.1% dies in a month. That town did a serological survey of blood donors, and 70% came up positive. That exact number won't apply everywhere because there are different age distributions, different comorbibitities, different genes, etc., but that is the ballpark we're looking at.
0.15% of New York City has already died. That should tell you how reliable Ioaniddis' numbers are.
It's infinitely cheaper than shutting down the economy and the massive ensuing bailouts.
"on the street observations in the article are: masks, masks, masks. "
There is no evidence that masks are a solution.
Just the opposite: contact tracing is definitely a primary driver of success.
We should have enacted aggressive contact tracing and widespread testing a long time ago, and recommended 'surgical/cloth' masks for public but strongly discouraged N95's as there are limited quantities and those need to go to the front lines.
Masks are not meant to solve/prevent Corona. It's meant to slow down the spread of the virus. It needs to be used in combination with other measures such as social distancing.
Unfortunately the Dutch government keeps saying that masks do not help, sometimes they suggest that a mask can make things worse. The reason behind this seems to be to prevent people from stealing masks from hospitals, something that seemed to have happened in every country.
That said, please check the effectiveness of masks. It doesn't need to be perfect, just slow down the spread.
If they did materially help, governments everywhere would support them.
The fact 'they use them in Asia' is not evidence.
South Korea has had fewer deaths than other nations, South Korea has a semi-open economy now. What better model for managing the outbreak is there? (The condition of Europe and the US look very dismal) It's kind of strange seeing this claim with no substantiation beside "repeat" apparently staying on the top of HN for a while.
South Korea hasn't entirely averted the danger and is clearly still keeping it in mind. The virus is going to be around for a while and normalizing life is needed and it seems South Korea has to the testing and contact tracing infrastructure needed for this. What is the counter-argument?
Uh really?
South Korea suppressed an epidemic and strengthened the tools they had for suppressing epidemics, maintaining economic strength and social cohesion.
How are they not best position in the stage of managing the epidemic (the appropriate term used by the ggp).
Oh, I know one really bad answer people are ready with - they didn't let the virus burn through their population to acquire herd immunity. The degree to which any other approach is going to leave a society ready to deal with new waves of this seems really, really low. Certainly, current US events aren't preparing for any future crisis.
For example: behavioural scientists tell us that people will only stand one major lockdown; using that lockdown early to keep deaths to a minimum initially may not be the best strategy. So thinking about the long-term is essential.
Not saying you're wrong that South Korea has a good track record to this point. I am saying you're wrong to extrapolate that out to the likely arrival of a vaccine programme in 2021.
Should we trust those numbers? I'm going to say no.
Social distancing, wearing masks, staying home when sick, cleaning all fomites frequently are things the Japanese were doing before this pandemic culturally, I imagine those actions are in over drive now.
I'm reminded of when the subway tunnels in Japan flooded and the water was so clear you'd have thought it was a swimming pool. Even Chinese netziens commented on how absurdly clean Japan is when the pictures emerged.
Also note Japan has a large elderly population, or about 32+K, who die unnoticed in solitude every year.
Testing isn't even useful at this point, we should operate under the assumption everyone has or will have it, and just treat those who are having complications. You don't need to get tested to know you have a cold, just deal with it.
In the US it wasn't just a matter of getting tests made, but getting all the various states and private testing centers connected so the federal government could aggregate the data. Smaller countries or those with socialized/public healthcare had an easier time at this because their systems were already unified. Tiny countries like South Korea trying to talk down the US for not getting tests out as fast is them is humorous. California alone has greater landmass and 80% of SK's population.
Besides that, Japan is still doing very well despite their population density meeting/exceeding many major hotspots. And the US is likely out of the woods, we should definitely be back to normal next month.
Japan = Olympics; willful neglect, deception
Or is that just that the family clusters are good news copy (ugh) and over-represented?
but they have successfully managed it. it's just that they're still managing it and are not done.
For people who are interested in current Korea's situation:
There were 18 new cases two days ago, and 8 new cases yesterday. The number of new cases have been consistently falling since April 14th. 'Intense social distancing' was stopped yesterday (April 19th), and the Korean government is planning to drop the 'social distancing' policy on May 5th.
Schools are planned to open on May 6th, and the ban of churches, bars, etc. are expected to be dropped in the following days (probably tomorrow).
The KCDC is saying that to drop the 'social distancing', there should consistently have less than 30 cases (which is true for a week) and cases which infection routes are unknown should be less than 5% of all new cases. (It was about 5%~10% when it was announced, and AFAIK it's now true.)
There's still some anxiety because people started to become dull to the social distancing movement - so people are worrying that new cases might increase.
Otherwise, won't there be a new wave of infections when they let 'outsiders' back in from places where the virus is still running rampant?
Airports in South Korea has never been closed - South Korea has never banned anyone coming & going outside. A quarantine of two weeks became mandatory since April 1th, but South Korea has never closed Airports or has done a lockdown.
> Otherwise, won't there be a new wave of infections when they let 'outsiders' back in from places where the virus is still running rampant?
Definitely that's a concern, 5 out of 8 new cases yesterday were people that were infected from foreign countries. However since South Korea has never closed it's airports, people generally think it's controllable(like it always was).
> Korean government is planning to drop the 'social distancing' policy on May 5th.
Are the people divided about whether it was a good idea to wait until new cases got this low before making decisions about moving forward? Or is there very broad support for the kind of discipline it takes to wait until May 5 despite the cases being so low already?
Have people's opinions about the appropriate level of response become politicized? Have the facts and statistics and science of it all become politicized?
People are generally agreeing that it's a good idea to wait b.c. they also think that there's still the possibility that a new wave of outbreak can happen.
> Or is there very broad support for the kind of discipline it takes to wait until May 5 despite the cases being so low already?
The policy of dropping the 'social distancing' was decided by the KCDC (consistently have less than 30 cases / cases which infection routes are unknown should be less than 5% of all new cases) on April 12th when the count has dropped less than 30 for the first time.
The government is still saying that if a new outbreak happens within the next two weeks, the day might be pushed back. It's still very elastic.
> Have people's opinions about the appropriate level of response become politicized? Have the facts and statistics and science of it all become politicized?
It's only targeting the people of Seoul, but 97% of all people agreed that the 'social distancing' policy should be dropped sometime soon, but 64% also agreed that April 19th was too fast - hence the May 5th decision.
Even for the opponents, it seems the majority criticism was that the government didn't do enough - somehow they're very angry about not blocking visitors from China. (Many conservatives have a strong pro-America, anti-China sentiment, and frequently accuse the president of being the opposite.)
I consider myself a newbie and neutral on SK politics and had dismissed all the criticism of Moon being a commie and all before, but I'm starting to see through the garbage now.
We may argue which side was right in retrospect, but it's not like Moon ignored the expert consensus.
Besides, Korean Medical Association is not exactly a neutral expert organization. The current head of KMA is this guy here [1], with pickets reading "Impeachment is void! Stop framing innocent President Park! Let's rescue innocent President Park with people's power and restore her honor!" blah blah, referring to Park Geun-Hye, kicked out in 2017 after corruption scandal.
[1] https://namu.wiki/w/%ED%8C%8C%EC%9D%BC:%EC%8B%9C%EC%9C%84%ED...
But its completely wrong to think they passed it. They also have massive impediments at the moment. Back to normal? Far from it.
from http://91-divoc.com/pages/covid-visualization/ if anyone wants to compare other stats.
The problem is contact tracing only works when the number of new infections is manageable, though. That's why it's so critical to react early and aggressively. Once it becomes unmanageable, the only solution is mass quarantines until the numbers are manageable again.
The best analogy is a fire. If it's just embers, one person can stomp it out. If you wait for it to become a forest fire, then it requires drastic measures.
But once the "fire" has burned far enough, we will testing and contact tracing. And so we need to be getting these up and running NOW so they will be ready when the "fire" has subsided sufficiently (and hey, we are failing on this too).
But I don't see much evidence we are really trying to do that.
I also wonder if its possible to test and trace if its every minor city in the country in low numbers. We will have a million patient zeros.
https://unherd.com/thepost/coming-up-epidemiologist-prof-joh...
The problem with the approach is that it assumes several things that, shall we say, there is not yet evidence for.
1. The disease is relatively mild, certainly less than an order of magnitude more fatal than influenza.
2. It is possible to protect older people and other vulnerable populations while the disease spreads through most of the rest of society.
3. After people recover from the infection, there is lasting immunity.
If these three things are true (and some other things that I'm not going to argue with, including that it will take a long time to get a vaccine), then herd immunity is a reasonable strategy. But let's look at each in turn.
1. The death rate in New York City is already 0.1% of the entire population. Even under very strict assumptions, that we're exactly at the peak of a totally symmetrical curve, and that herd immunity results in 50% of the population being infected, that results in a lower bound of the IFR at 0.4%. Lombardy gives similar results (0.12% of the population directly attributed to Covid-19)
2. Prof. Giesecke admitted that they failed to do so in Sweden. It is not clear how this could be done, as elderly people do not live in a bubble, but rather have lots of workers coming in and out of the facility to help take care of them.
3. SARS-CoV-2 is a new virus, and we just don't have the data yet. You can extrapolate from existing coronaviruses, which suggest that immunity will last at least a year for most people, but there are worrying signs (low antibody production, reports of reinfection that might or might not be testing artifacts). We just don't know.
To me, it was a gamble, and we'll know before long whether it pays off. There were some things that bothered me about Prof. Giesecke, such as his dismissal of the experience of China ("it's a different world"), and other things that made a lot of sense. People who want to believe will be citing this video as authoritative support for their beliefs. If these assumptions turn out not to be consistent with evidence, then people will be citing this video as a case study in how smart people can get stuff horribly wrong.
This should not be called “reinfection” (even though there are a bunch of sloppy media headlines calling it that) but rather “poor test sensitivity during the last stages of the infection”.
Covid-19 is a “mild disease” and similar to the flu, and it was the novelty of the disease that scared people.
It's a fair bit nastier, certainly in some cases, or the hospitals wouldn't be full.
The actual fatality rate of Covid-19 is the region of 0.1%
How can we be sure until we have widespread testing?
At least 50% of the population of both the UK and Sweden will be shown to have already had the disease when mass antibody testing becomes available
Again how can we be sure of this? It all seems very speculative.
> How can we be sure until we have widespread testing?
I think we can be sure that this is an incorrect number, with the data we have right now. At least 8448 people have died of COVID-19 in New York City, and if only 0.1% of the infected die, then we have 8,448,000 infected New Yorkers. This is the entire population of the city (including those who fled to other states) and would mean that we've reached herd immunity and can stop worrying about it now.
shows a significant drop in caseload. There might be herd immunity effect if you assume a death rate of ~0.2%.
Just to add: be very careful to compare deaths across countries. Every country seems to count deaths differently. Some only count it if you didn't have any other condition. E.g. you had something with your lungs? That death might not be reported.
In Netherlands they compared the amount of people dying per week. There was a sudden huge increase of deaths. It seemed to indicate the number of deaths for Netherlands was 2x as high as they were reporting. Though they did report the deaths with a very clear remark that the numbers were highly likely to be too low. Unfortunately such remarks were often ignored by the public, leading to eventual distrust of any figure. Interestingly, the press at various times did make it clear that the figure could be unreliable. Seems people often just read a headline :-p
PS: My point is that the 8448 might be greatly higher. Depends on how the 8448 was collected/reported.
While I agree that it probably is indeed nastier than your average flu, it actually wouldn't have to be much nastier to achieve health system saturation in places where it hits groups that are particularly vulnerable (the elderly mainly). Almost all healthcare systems operate on fairly thin margins of tolerance for overload, and a virus of even mild percentages for hospital-worthy or lethal cases could easily, temporarily overload clinical infrastructure if it comes out of the blue and is moving through a population that was entirely virgin to it before the infection in question arrived. This lack of immunity among all parts of society means massive numerical surges in cases very quickly and consequently, major numerical surges in that small fraction of cases that end up being bad enough to warrant hospitalization.
The same number of deaths will occur are likely to occur in the long term unless Sweden's ICU beds get full.
If anyone has an alternative interpretation I am open to hearing it.
https://sjtrem.biomedcentral.com/track/pdf/10.1186/s13049-02...
In Germany you are only tested under some conditions. I know many people that had quite a few symptoms and have not been tested even though they wanted to get a test. Only the ones that got severe problems or had relatives with a positive test. The conclusion is that we only know the death count quite well, the rest is mostly guess work.
From what I see, people are generally behaving responsibility regards social distancing and, I assume, this is just a gamble our Govt took?
Without making sweeping generalisations also, it isn't so common for young adults to spend much time with parents/grandparents/older relatives. So, I reckon, that's one big risk factor that is less of an issue here?
https://www.gov.uk/government/publications/full-guidance-on-...
"one form of exercise a day"
While this disease is pretty contagious, you are pretty unlikely to get it walking around outside or going for a run. Especially if everyone is wearing a mask.
It's possible you could catch it by running through a cloud of an infected persons breath, but the risk is low enough that we shouldn't ban outside activities.
The vast, vast majority of infections occur from sustained contact (>15min) within a few feet of someone.
https://mobile.twitter.com/zeynep/status/1251556084424347649
https://www.who.int/news-room/commentaries/detail/modes-of-t...
Spain has such a hard lockdown and yet even after 5 weeks there are still thousands of cases every day. How are so many new people getting infected? The same has been true in Italy.
“South Korea's foreign minister, Kang Kyung-wha, speaking to the BBC last week, said the key lessons from her country are that it developed testing for the virus even before it had a significant number of cases. "In mid-January, our health authorities quickly conferred with the research institutions here [to develop a test]," Kang said. "And then they shared that result with the pharmaceutical companies, who then produced the reagent [chemical] and the equipment needed for the testing."
Comparing absolutes is not very useful so I thought I'd double check this. The difference is obviously less when normalized but the US is still an order of magnitude worse than SK:
USA:
700e3 / 328.2e6 * 100 = 0.213%
SK:
10e3 / 51.64e6 * 100 = 0.019%https://www.worldometers.info/coronavirus/country/south-kore...
This reduces the rate of spread by catching community transmission before the end of its cycle. And it's worked with other outbreaks in the past. But it depends on having a very large available pool of rapid testing, so you can't do it when you have thousands of cases per day. But a few dozen... probably. It definitely seems to be working in Korea.
But again, it only works once the outbreak is well contained. Stay home.
Not necessarily. You can just aggressively quarantine - basically the strategy in China.
> so you can't do it when you have thousands of cases per day
At what scale? Iceland was able to do it with ~200 new cases per day per million. The majority of US states haven't had spikes this high - nowhere in CA has even come close to that.
For some reason, we've only recently started building up the volunteer armies needed to do this (https://www.sfgate.com/bayarea/article/San-Francisco-coronav...) - this should have been done on day 1.
Iceland's per capita new infection rate peaked higher than basically any nation in the world, and while it's dropping comparatively rapidly it hasn't reached a stable baseline yet. I don't think this is a good example at all.
While it's clear their lockdown "worked" (in the sense of recovering them from a disastrous peak), I think it's still very much an open question as to whether their testing capacity will sustain this success.
To that point, their death rate is lower than the Bay Area.
To a second point, Iceland is under a very weak lockdown, if you can even call it that. Their elementary schools remain open.
Actually worse than China by that metric, though given credibility issues of Chinese data, let's just say about the same.
Countries with large outbreaks are only testing people with severe symptoms. Korea is testing anyone who comes near someone with the virus. So are catching close to everyone who has it.
SK and China went for full containment: every single positive case is hospitalized and close contacts are quarantined in hotels so few cases are missed.
While in New York, hospitals are focused on saving critical patients. If you test positive but have mild symptoms, you are usually let home anyway so it doesn't really make sense to test most people who would be taken very seriously in Asia.
There are zero deaths and zero cases in Turkmenistan, must have gotten their treatment protocols tight.
It's mind boggling anyone has to ask now this has been going on so long but here goes.
1) They had an approach plan beforehand because they had observed the previous SARS epidemic and took the danger seriously.
2) They had "quarantine hotels" freely available for those who were positive to prevent them from infecting others. (Seattle has a few of these, I've heard but they aren't widespread in the US. The idea of housing people freely is anethema to the US.)
3) They did testing early and often.
4) Their doctors and nurses worked with full PPEs, full anti-contamination suits, so they didn't themselves massively spread the illness.
5) They reserved hospitals specifically for the epidemic and had protocols for sending people to these hotel.
6) They had drive through testing and other testing easily and freely available (the US plan of profiting from testing is just so "I can't even").
7) They did systematic contact tracing with an app for people to discover where infectious people had been.
8) They did social distancing with mask from the start.
-- The US had literally done NONE of this. What the US has done is last-ditch efforts by states after the ostensibly responsible parties (the CDC etc) failed massively. And the Federal government is now literally sabotaging the states.
- With exponential growth, most cases will new and so not become potentially lethal. This can lower the observed fatality rate (I think this explained Germany's original "great" rate which doesn't look at great any more).
- With cases rising quickly, most countries don't have infrastructure or the time to increase testing (US testing is failing on multiple levels but even France, Spain and Italy are just overwhelmed with the sick and testing is less important).
- With cases rising quickly, the fatality rate increases as hospitals are no longer able to provide adequate care.
- Different countries have different age-profiles and the disease hits the elderly harder (but once hospitals break down, the odds for the young decrease).
South Korea's fatality rate is similar to the ostensible fatality rate of Turkey and Luxembourg but likely for different rate. We probably won't have a complete idea what's happened until these events are done.
If you are effective at preventing the spread, then you can get lucky in terms of protecting the more vulnerable. I'd love to see some demographic breakdowns of deaths/infections in SK to see if they mirror the general population, or skew a different direction.
One problem with the death of journalism is that no one is even reporting on this.
I'm especially looking for reporting on why it's so slow, what the bottlenecks are, and who's responsible.
Even if there is some good reporting out there, I think this should me one of the main news items in a healthy society.
I have seen reporting on the bungling of the initial testing rollout, like this one: https://www.washingtonpost.com/investigations/contamination-...
https://www.cnn.com/2020/04/19/health/us-coronavirus-sunday/...
That is better than I've seen.
I'm still missing anything beyond summarizing what officials have said.
The Ohio Governor blaming FDA regulations is the closest to an analysis in there.
I am hoping for the best for the US, but I am quite offended by how the US is scrambling to undo its own mistakes by steamrolling everybody else.
The US dropped many balls and started late with ramping testing in particular, but now the ramping is happening and just takes time. There was also no way the US could test enough people using the original set of tests that simply took too long. New technology had to be developed.
A large country has a lot of people to test, but also a lot of people to manufacture and perform the tests. So that argument doesn't work for me. Especially when we're talking about the richest country in the world.
Now, if the test making and executing is done by a single centralized organization, it does make some sense. Which is why that way of doing things is an anti-pattern.
Shows the following stats:
Country--------Date-----Tests-------Positive----%-------Tests/mil ppl----Positive/mil ppl
-----------------------------------------------------------------------------------------
United States--18 Apr---3,700,388---720,747-----19.5----11,273-----------2,196
Russia---------19 Apr---1,949,813---42,853------2.2-----13,287-----------292
Germany--------15 Apr---1,728,357---132,766-----7.7-----20,786-----------1,597
Italy----------19 Apr---1,356,541---178,972-----13.2----22,474-----------2,965
Spain----------13 Apr---930,230-----169,496-----18.2----19,905-----------3,627This is unequivocally not why some states are preparing to relax the so-called "safer at home" orders. Waiting until "it's all over" was not the goal of safer-at-home. Flattening the curve in order to prevent an immediately overwhelmed healthcare system was the goal. In multiple US states, the curve is acceptably flattened (or is expected to be in the next few weeks), and hospitals have plenty of available capacity. Those states are going to continue encouraging physical distancing, good hygiene, etc. while allowing closed non-essential businesses to resume limited operations.
Someone should tell that to the Italian authorities. At least until recently, some public statements seemed to inch in that direction ("zero new infections"), although more recently they realized that this is hardly possible at this point (especially if the estimates of the actual vs effective cases are true - talking about at least one order of magnitude).
I guess we'll have to see what happens. Personally, although I'm very aware of the risks and will prepare accordingly, I'll be glad if I can finally get out of this isolation.
IMO loosening restrictions without really aggressive testing and case tracing is going to undo lots of good work by other states by allowing the virus to spread, but time will tell.
For all of MSNBC's faults, their anchors have been repeating testing like a broken record. They even mention how much they sound like a broken record but that testing is simply the most important thing in reopening, and that the US is doing very little of it.
1 person has died this year from coronavirus in Seoul
Looks to be near the end of the outbreak for Korea
Ideally we want to save lives but there will be a line drawn somewhere where we must open up businesses again.
There will be second-order effects that people aren't considering. In Seattle, for example, all of the builders I know are saying multi-family residential construction projects have become indefinitely non-viable due to the systemic collapse of the business ecosystem they rely on. Even if things opened up tomorrow, most of their projects will stay dead for the foreseeable future. This will have a large impact for housing costs, construction worker employment, etc many years beyond the term of the lockdown.
I think many people are oblivious to the long-term second-order damage that is being inflicted in some industries that cannot be fixed on any kind of timeframe that matters to ordinary people.
Unfortunately, in the US, the federal government has presented the false choice of safety vs economy. Yes there are trade-offs in tactics, but it's not one or the other. Stop playing politics, unify messaging, and increase spending money on both. I'm helping organize projectdomino.org as part of staving off the currently-likely upcoming shitstorm of reopening without public health funding, coordination, infrastructure, and compliance. I encourage aiding local causes and telling your local Republican leaders that you're tired of their shit that has now stepped up to pathogens literally attacking us at home.
> “With the global recession gathering pace, there could be hundreds of thousands of additional child deaths in 2020”, the Secretary-General warned.
> This scenario would effectively reverse progress made in reducing infant mortality over the past two to three years.
Sibling comment to your original comment seems to suggest US wasn't able to 'similarly quickly' due to lack of onsite manufacturing.
Even the article suggests this,
> The country was testing people for the virus at the fastest pace in the world
Seegene, a company that makes Covid-19 testing equipment is in Korea. They just needed approval and to ramp up manufacturing. For most countries, like the US, we don't have the manufacturing ability anymore, so we have to go beg and buy tests while we figure how to make again. Seegene alone has been responsible for 80% of the tests in Korea.
The population is also better prepared for this situation. They still remember it and know they have to follow all the advice coming from government and health experts.
Even before the spread of Covid-19 outside China, all East Asians started to use face masks. I'm not saying mask helped them, I mean that just shows how their society still remembers the last time that they were hit by a virus.
They where probably better prepared as well. Preparedness varies a lot. In the Nordic region where I am from the Finns have done better than the rest of us because they are a prepper nation. They constantly prepare for the worst.
Finland has enormous bunkers under their cities that can hold the whole population with air filters, water, food stock piles etc. Finland has massive stock piles of medical equipment, even stockpiles of raw materials for making ammunition medication etc.
In many ways I think it has paid for them to not be NATO members. They know they are alone and have to take care of themselves just like in the winter war against the Soviet Union.
In Norway I think we place too much faith in NATO. If it was up to me I would get the hell out and focus on self reliance instead.
Interesting that three of the best prepared countries have valid real world concerns about their adjacent neighbors.
While some nations surrounded by oceans and/or friendly countries are taking a beating.
I am sure the Finns have done a fine job, but I don't think one can say that "the Finns have done better than the rest of us because they are a prepper nation" without studying this in detail. Being prepared is important, but just one part of the equation.
Travelling is also another important part (I am sure there are many others as well). Looking at passenger statistics, the Finnish population seems to be traveling less by air than most Nordic countries as well. I have not extracted domestic flights and if flights are done by the citizens of the country where the airports are located, so these numbers are ballpark figures, but I guess they can give some insight (although domestic flights might cause more rapid spread of virus as well).
Numbers from: https://en.wikipedia.org/wiki/List_of_the_busiest_airports_i...
Looking at the five biggest Airports in each country in: Finland, Sweden, Denmark, Norway and Iceland, I get the following passenger numbers for each country per year:
Iceland: 21,7 flights per person, per year.
Norway: 8,5 flights per person, per year.
Denmark: 6,2 flights per person, per year.
Finland: 4,4 flights per person, per year.
Sweden: 4,4 flights per person, per year.
The passenger numbers correlates relatively well with detected cases when the pandemi hit the Nordic Countries (chose March 4th, arbitrarily); Sweden and Denmark changes place:
====
Iceland – March 4, 1]: Coronavirus cases detected: 26 cases
Population-size adjusted, up to the size of Sweden (biggest country): 730 cases
====
Norway – March 4, 2]: Coronavirus cases detected: 59 cases
Population-size adjusted: 109
====
Sweden – March 4, 3]: Coronavirus cases detected: 52 cases
(Not Population-size adjusted)
====
Denmark – March 4, 4]: Coronavirus cases detected: 14 cases
Population-size adjusted: 25
====
Finland – March 4, 5]: Coronavirus cases detected: 7 cases
Population-size adjusted: 13
====
So when this awful pandemi is over, I think it is important to study all aspects of what happened in each country before one draws firm conclusions. And LEARN from the good stuff, and do more of that! :-)
Sources:
1] https://www.worldometers.info/coronavirus/country/iceland/
2] https://www.worldometers.info/coronavirus/country/norway/
3] https://www.worldometers.info/coronavirus/country/sweden/
4] https://www.worldometers.info/coronavirus/country/denmark/
5] https://www.worldometers.info/coronavirus/country/finland/
So they have the know how, and it's just a matter of effort and time to execute.
https://www.propublica.org/article/how-south-korea-scaled-co...
Also, Taiwan has done an excellent job, and they didn't need to perform nearly as many tests. AFAIK there hasn't been a single additional confirmed case in Taiwan for the last three days.
In my city, people are still arguing whether or not people in the mass transit system should be wearing masks.
Also, over what timeline are we talking? South Korea has fewer deaths now, will that be the case in two years time?
I've seen a lot of articles lately drawing conclusions from the state of the world as it exists now. But this is a highly dynamic situation. Today's assumptions are next month's fallacies. We need more humility.
Edit I don't see why the downvotes. It is easily fact-checkable. Those 65 persons were hospitalized for their symptoms, considered treated and released and about 2 weeks later showed symptoms again.
A theory is that these asymptomatic cases simply had latent virus in their nasal passages (thus testing positive), and not actually be building any antibodies from an infection.
And public masks, good contact tracking, and they say gloves but hand PPE, like alcohol, also I assume a good isolation system that doesn't scare people but seen no reports on this.
Investing on making testing to be cheap and quick has however been something people missed, compared to pie in the sky things like vaccines.
Also compared to masks which are obvious but have been religiously attacked in the West.