COVID COVID-19 Coronavirus Containment Efforts

[kadiot]

It’s so bad in N Italy. overwhelmed ICUs, shortage of beds, staff, ventilators pushing the death toll higher... patients are being treated in operating rooms, hospital corridors, or recovery rooms. This is what to come elsewhere

https://www.vice.com/en_us/article/...jPpwX5eaNoQHj2APv88B3pZjeOI5HJNfF4sIW9PcHnQoQ

 

[DennisN]

Just now I read that we have the first confirmed death in Sweden due to the coronavirus. It was an elderly man with underlying health problems, and he was treated at intensive care at a hospital in the capital Stockholm. This news is so recent that it is not yet reflected in the international statistics.

Edit: I've now found a news agency source¹ for this info (only in Swedish, sorry):
http://www.dn.se/sthlm/en-person-i-stockholm-dod-i-nya-coronaviruset/

¹And thereby I also in a small way promote the importance of mentioning sources , and checking sources, which I think is particularly important in a time like this. We are dealing with a brand new virus, and regardless of this we also live in a time when the spread of disinformation, intentional or unintentional, is sadly not uncommon.

 

[kyphysics]

Pro-Tip 1: Costo has LOTS of rubbing alcohol.

NONE at: Walmart, grocery stores, and Target. . .

Pro-Tip 2: Dollar Tree has hand sanitizers

None at: ...

 

[bhobba]

Maybe Germany just has more accurate statistics due to widespread testing? If it is true, it might suggest the mortality rate is nearer to that of the flu.

.
That's my understanding. What I have been reading (eg in South Korea it has a death rate of about 0.5%) when more testing is done (eg in Aus we are setting up drive though testing stations, fever clinics etc like a number of other countries) you get more accurate results. The flu is 0.1% but we have the vaccine and while worse for older people the flu seems to have a lower death rate in that age group, again possibly due to the vaccine. It's hard to tell, but the feeling I get is its about the same as the flu if we didn't have a vaccine for those under 60. It's more deadly over 60, but, as mentioned before, that may also be because we do not have the vaccine.

On a positive note I just looked at the website of the local medical clinic I go to, and they look like they are doing the right thing:
https://www.redlandsclinic.com.au/

I didn't expect anything else from them really - the senior doctor there is very good. The previous senior doctor was one of the most famous in Australia - he had a column in the Australian Medical Associations Journal advising on the more difficult cases and educating on often difficult to recognize diseases like Polymyalgia Rheumatica.

Thanks
Bill

 

[chemisttree]

Pro-Tip 1: Costo has LOTS of rubbing alcohol.

NONE at: Walmart, grocery stores, and Target. . .

Pro-Tip 2: Dollar Tree has hand sanitizers

None at: ...

Where are you? In San Antonio sanitizer and wipes are in short supply but IPA alcohol is still available at Wal Mart. I imagine on the west coast and New York the situation is different.

 

[kadiot]

W.H.O. Declares Pandemic as Number of Infected Countries Grows.

https://www.nytimes.com/2020/03/11/...fmKUPkaH7Gr5nDMjAZkvSJHEF4hmfVa0ameiwwyR8hVrU

 

[chemisttree]

A CDC Norovirus report from 6 years ago notes the following.

“However, 1 in 5 food service workers have reported working at least once in the previous year while sick with vomiting or diarrhea. Fear of job loss and not wanting to leave coworkers short-staffed were cited as significant factors in their decision.”

My advice: learn to cook and stay home!

 

[chemisttree]

W.H.O. Declares Pandemic as Number of Infected Countries Grows.

https://www.nytimes.com/2020/03/11/...fmKUPkaH7Gr5nDMjAZkvSJHEF4hmfVa0ameiwwyR8hVrU

Oh YES! That will change things! You’ll see!

 

[atyy]

One thing that is interesting is the disparity between mortality rates in different countries. In Germany, with 1,565 cases, the mortality (based on deaths/total cases) is only about 0.13%, and critical cases (based on critical case/active cases) 0.58%. In Italy, mortality is 6.2% (48X higher) and critical cases 10.3% (17.7X higher).

Maybe Germany just has more accurate statistics due to widespread testing? If it is true, it might suggest the mortality rate is nearer to that of the flu. But I am wondering how those rates are calculated for the flu since most people don't get tested for the flu. It could also be that Germany's COVID-19 testing is outpacing normal flu testing. Is it possible that the mortality rate of the flu is exaggerated as well?

Even if the true rate is 0.13% or lower, Italy is still struggling pretty hard to handle the additional strain on the hospitals.

That's my understanding. What I have been reading (eg in South Korea it has a death rate of about 0.5%) when more testing is done (eg in Aus we are setting up drive though testing stations, fever clinics etc like a number of other countries) you get more accurate results.

The death rate could also depend on the quality of care available. If the health system is overwhelmed, and there is a shortage of equipment such as mechanical ventilators, then the death rate could go up. If the death rate is not a fixed number (ie. there is no "true" death rate that is invariant across situations), but depends on what we do, then it is very important to slow the spread of the virus, to make sure that health systems have enough staff, space and equipment to treat patients.

 

[Rive]

One thing that is interesting is the disparity between mortality rates in different countries. In Germany, with 1,565 cases, the mortality (based on deaths/total cases) is only about 0.13%, and critical cases (based on critical case/active cases) 0.58%. In Italy, mortality is 6.2% (48X higher) and critical cases 10.3% (17.7X higher).

As it seems right now in Italy (or at least in the most affected area) anybody with respiratory illness is asked to stay at home. Only the severe cases are transferred to hospital (and being tested): already with pneumonia or short breath/low oxygen.

So, if I take it right that specific '80 percent' of the ill is just not visible now, there.

 

[kolleamm]

I keep hearing in videos that the Corona virus may be 10 to 15 times worse than the flu. What does this actually mean? Does it mean that the symptoms the virus produces are stronger or that it's more contagious?

 

[Ygggdrasil]

The death rate could also depend on the quality of care available. If the health system is overwhelmed, and there is a shortage of equipment such as mechanical ventilators, then the death rate could go up. If the death rate is not a fixed number (ie. there is no "true" death rate that is invariant across situations), but depends on what we do, then it is very important to slow the spread of the virus, to make sure that health systems have enough staff, space and equipment to treat patients.

Agreed. Here's one graph which might explain why countries like South Korea and Germany have lower death rates than countries like Italy and China:

https://data.oecd.org/healtheqt/hospital-beds.htm

Note the position of the Unites States in the graph.

 

[DennisN]

I keep hearing in videos that the Corona virus may be 10 to 15 times worse than the flu. What does this actually mean? Does it mean that the symptoms the virus produces are stronger or that it's more contagious?

It's a bit difficult to actually say, since you did not provide any source. From what I understand from the experts I've seen interviews with¹, is that the mortality rate of the virus seems to be many times higher than the flu. The attack rate also seems to be higher than the flu.
(Someone please correct me if I am wrong here )

¹One interview is this one.

 

[kolleamm]

It's a bit difficult to actually say, since you did not provide any source. From what I understand from the experts I've seen interviews with¹, is that the mortality rate of the virus seems to be many times higher than the flu. The attack rate also seems to be higher than the flu.
(Someone please correct me if I am wrong here )

¹One interview is this one.

I believe I heard it on this Joe Rogan interview

 

[DennisN]

I believe I heard it on this Joe Rogan interview

I'm two minutes into the interview and they mentioned 10 to 15 times higher "fatalities", which is a bit unclear to me. But I interpret "fatality" here as mortality rate, i.e. death rate.

 

[kolleamm]

I'm two minutes into the interview and they mentioned 10 to 15 times higher "fatalities", which is a bit unclear to me. But I interpret "fatality" here as mortality rate, i.e. death rate.

Even so I'm still confused, is the higher death rate from the virus spreading more easily or because it produces harsher symptoms?

 

[DennisN]

Even so I'm still confused, is the higher death rate from the virus spreading more easily or because it produces harsher symptoms?

Hi again @kolleamm, I am really hesitant to reply in detail, as (1) biology nor epidemiology is definitely not my strong side and (2) this is a brand new virus.
That being said, I think the higher death rate mainly depends on the symptoms, where the worst symptoms of severely ill cases are, if I understand correctly, (1) severe respiratory problems and (2) organ failures.

I hope a more knowledgeable PF member corrects me if I am wrong.
Edit: Like e.g. @Ygggdrasil, @atyy or @BillTre who if I remember correctly each know much about biology. And "much" means much more than me.

 

[chirhone]

There is no need for police to guard those blocks. Almost everyone is aware the situation. There are only several volunteers guarding at gates. In Wuhan, people are not allowed to go out. Instead, volunteers deliver food and daily supplies to every family. People just have to submit their needs on mobilephones.

Days ago you mentioned there was no need for police to guard those blocks and volunteers deliver food and daily supplies to every family. I felt better. Then i saw at tv today.

The police are more fearsome than the virus.

I have a cousin who has a friend who has been in jail for over 7 years already. During a checkpoint, the police inserted heroin/drugs into his car, and then arrest him for possession of illegal drugs. The police asked him to give them $50,000. The victim has no money, so got jailed.

If you park your car in hotels through valet. The police contacts would insert heroin in the car in the parking. Then the police would wait for the car outside then arrest him and ask for money.

This is the normal in my country. Once I went out at 3am at night. Then saw police car. And ran. The police chased me through the city blocks. Then try to book me for "resisting arrests". Fortunately. I was with my auntie and elderly so the police let us go in the middle of it.

Bottomline is. We fear the police more than the virus here.

How many police are involved in your country's lockdown? What is their role?

It seems there is evidence that the virus is brought to the market from other places. The origin may not be trackable. However, the market, with high population density, bad ventilation and high moisture, did provide a perfect environment for the virus to spread.
I am not sure what you are referring here. If you mean that the virus may be designed by someone, it would seems impossible. I remember there are some paper saying the virus are naturally produced.

 

[kyphysics]

https://www.cnbc.com/2020/03/11/up-...he-coronavirus-congressional-doctor-says.html

Dr. Brian Monahan, the attending physician of Congress and the U.S. Supreme Court, said he expects 70 million to 150 million people in the United States will become infected with COVID-19, NBC News reported Wednesday, citing two sources.

Monahan made the comments to Senate staff during a closed-door meeting Tuesday afternoon, according to NBC News. The meeting did not include senators and was for administrative office staff and personnel from both parties, NBC News reported.

any thoughts on this? Is that number probable (not just plausible)?

 

[kyphysics]

also, not sure if it's been discussed, but how many people carry the virus and have NO negative symptoms/side effects ever?

 

[Ygggdrasil]

https://www.cnbc.com/2020/03/11/up-...he-coronavirus-congressional-doctor-says.html
any thoughts on this? Is that number probable (not just plausible)?

The numbers seem in line with estimates from other experts. For example, a Professor at the University of Nebraska Medical center provided these estimates to the American Hospital Association:

https://www.independent.co.uk/news/...-warning-us-hospitals-infection-a9385031.html

See also https://www.washingtonpost.com/heal...c5d088-5c9d-11ea-9055-5fa12981bbbf_story.html for more discussion

Here's another estimate from another group:

Another forecast, developed by former CDC director Tom Frieden at the nonprofit organization Resolve to Save Lives, found that deaths in the United States could range widely, depending on what percentage of the population becomes infected and how lethal the disease proves to be. Frieden, who oversaw the U.S. response to the 2009 H1N1 influenza pandemic, the 2014 Ebola epidemic and the 2016 Zika epidemic, says that in a worst-case scenario, but one that is not implausible, half the U.S. population would become infected and more than 1 million people would die.

His team put together a simple table that looks at various scenarios using case fatality ratios ranging from .1, similar to seasonal flu, to .5, a moderately severe pandemic, and 1.0, a severe one. The infection rate ranged from 0.1 percent of the population to 50 percent. That put the range of deaths at 327 (best case) to 1,635,000 (worst case). The deaths would not necessarily happen over a month or a year, but could occur over two or three years, he said.

https://www.washingtonpost.com/heal...177e0a-63b4-11ea-acca-80c22bbee96f_story.html

Again, the 1.6 million death figure is a worst case scenario, so lower numbers (like the 0.5 million death estimate above) are more probable.

 

[Haorong Wu]

Days ago you mentioned there was no need for police to guard those blocks and volunteers deliver food and daily supplies to every family. I felt better. Then i saw at tv today.

The police are more fearsome than the virus.

I have a cousin who has a friend who has been in jail for over 7 years already. During a checkpoint, the police inserted heroin/drugs into his car, and then arrest him for possession of illegal drugs. The police asked him to give them $50,000. The victim has no money, so got jailed.

If you park your car in hotels through valet. The police contacts would insert heroin in the car in the parking. Then the police would wait for the car outside then arrest him and ask for money.

This is the normal in my country. Once I went out at 3am at night. Then saw police car. And ran. The police chased me through the city blocks. Then try to book me for "resisting arrests". Fortunately. I was with my auntie and elderly so the police let us go in the middle of it.

Bottomline is. We fear the police more than the virus here.

How many police are involved in your country's lockdown? What is their role?

I am sorry that the police may not play a good role in your country. As I said, most of police in Wuhan act as drivers, nurses, repairers, etc. Police can be drivers to drive people to hospitals since they cannot go out by themselves, or be nurses to help those who are tripped or have trouble to get home.

I guess my only advice is that please stay at home as long as possible to avoid contact with those bad cops, and store enough food and supplies in case of a sudden lockdown.

Good luck.

 

[mfb]

4.8 million admissions
1.9 million ICU

Compare this to ~1 million hospital beds in the US - and most of them are filled already. `<=100,000 ICU beds.
Even if the wave needs 4 times as long as people need hospitalization (so every bed is used for 4 patients over time) this scenario will be a problem.

 

[Greg Bernhardt]

US suspends travel to Europe and NBA season is suspended! Tom Hanks has the virus. Wild day!

 

[atyy]

https://www.cnbc.com/2020/03/11/up-...he-coronavirus-congressional-doctor-says.html

any thoughts on this? Is that number probable (not just plausible)?

Perhaps we are still at the stage where actions can be taken so that the number although plausible, need not be highly probable. If the spread cannot be contained, the number is plausible because (very) roughly 50% of the population must have gotten the disease and developed immunity against it for the spread to stop. However, that is assuming that the spread cannot be stopped. The experience of China suggests that much worse scenarios can be reversed, so there is still hope for containment. Even if containment fails and we instead hope for mitigation, which is to slow the spread as much as possible so that health systems are not overwhelmed, we should note that strategies for containment also apply to mitigation, so containment and mitigation should not be seen as distinct strategies, but rather on a continuum.

https://www.nytimes.com/2020/03/11/health/coronavirus-pandemic-who.html
The W.H.O. is emphatically not suggesting that the world should give up on containment, Dr. Tedros said.
"We are suggesting a blended strategy,” he said, referring to a blend of containment and mitigation. “We should double down. We should be more aggressive."
...
The fact that 90 percent of the world’s cases are in four countries — China, Italy, Iran and South Korea — indicates that the pandemic can still be contained if countries act fast, Dr. Tedros said
...
At a hearing before the House Oversight Committee on Wednesday morning, Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, told members of Congress that “if we are complacent and don’t do really aggressive containment and mitigation,” the number of COVID-19 cases “could go way up and be involved in many, many millions.” But he also insisted that this was not an assured outcome. The epidemic “is going to get worse,” he said, but how much worse will depend on “our ability to do two things: to contain the influx of people who are infected coming from the outside, and the ability to contain and mitigate within our own country.”

 

[kyphysics]

US suspends travel to Europe and NBA season is suspended! Tom Hanks has the virus. Wild day!

Bout time we had travel suspension!

Good on teh NBA too...looking out for health over profits!

 

[kyphysics]

Stores were selling out of essentials near me, but still not at "panic" levels. I feeel like many people still have complacency over this. IT's like they don't care (just my impression).

 

[russ_watters]

US suspends travel to Europe and NBA season is suspended! Tom Hanks has the virus. Wild day!

It seems like we turned a corner over the weekend and it's really snowballing this week. Going to be a surreal couple of months.

 

[chemisttree]

It seems like we turned a corner over the weekend and it's really snowballing this week. Going to be a surreal couple of months.

First two weeks on May are when the full force of it will hit us. Reading the triage going on in Italy right now in Lombardy is heartbreaking! Cases with any comorbidity are simply given O₂ when available! Regardless of age. Recovered cancer patients are red-shirted (Star Trek reference alert) regardless of age! That's my daughter they’re talking about, who just turned 18 last weekend. We are maybe 10 days behind where Italy is today. My son’s spring break has been extended until March 23 when all classes will resume online!

Very scary times. Is it time for lockdown?

 

[Ygggdrasil]

Compare this to ~1 million hospital beds in the US - and most of them are filled already. `<=100,000 ICU beds.
Even if the wave needs 4 times as long as people need hospitalization (so every bed is used for 4 patients over time) this scenario will be a problem.

Yes, these figures emphasize the importance of flattening the epidemic curve—taking measures like social distancing and other steps to slow the rate of spread of the disease. The more we can slow the spread of the disease, the better the chances we have of not overwhelming out healthcare system:

Death rates in countries that have enough capacity to treat patients can be as low as ~0.5% in South Korea. However, in areas where the health systems are overwhelmed, fatality rates in the 3-5% have been observed (source). Speaking as an American citizen, what we do now to slow the spread of the disease while the number of cases is still fairly low will have a profound impact on the death rates from the disease.

 

[DennisN]

However, in areas where the health systems are overwhelmed, fatality rates in the 3-5% have been observed (source).

I read the entire article, a very interesting, and sobering read. And thank you very much for your informative posts, @Ygggdrasil !

And I wasn't aware that we had so few hospital beds in Sweden until you posted that graph. I guess it's a consequence of the "lean and mean" policies in our healthcare system, which I was somewhat aware of, due to various domestic news and also personal experience (which is anecdotal, of course):

A couple of years ago I was hospitalized for a couple of days due to hyponatremia (I felt awful), and during my brief visit I was moved between parts of the hospital three times, and when my sodium levels had stabilized I was sent home rather quick, since they said they had few hospital beds.

Hmm, reading the data and projections I am getting a bit concerned about what the situation in Sweden will be. We have historically been pretty proud of our healthcare, but I now think there is clearly a potential that this virus outbreak could become a very harsh stress test on our system. I hope our government does the right thing and locks down in time if needed.

 

[robphy]

Here's a variation of the graph posted by @Ygggdrasil
https://upload.wikimedia.org/wikipedia/commons/c/c5/Covid-19-curves-graphic-social-v3.gif
It's an animated gif.

See below for more details...
https://twitter.com/search?q=#FlattenTheCurve&src=typed_query

 

[chirhone]

I am sorry that the police may not play a good role in your country. As I said, most of police in Wuhan act as drivers, nurses, repairers, etc. Police can be drivers to drive people to hospitals since they cannot go out by themselves, or be nurses to help those who are tripped or have trouble to get home.

I guess my only advice is that please stay at home as long as possible to avoid contact with those bad cops, and store enough food and supplies in case of a sudden lockdown.

Good luck.

In your country. Is the military also involved? In China, Italy, South Korean, etc.?

In the Philippines. The military is already mobilizing awaiting orders for lockdown.

Prior to this year. When and what country has encountered such lockdown?

 

[atyy]

In your country. Is the military also involved? In China, Italy, South Korean, etc.?

South Korea seems not to have a lockdown, but I think they have a very good chance of bringing the situation under control using other measures.
https://asiatimes.com/2020/03/why-are-koreas-covid-19-death-rates-so-low/

 

[DennisN]

Since there now may be more and new people reading this thread than before, I'd like to repeat the link to the WHO (World Health Organization) advice page:

Coronavirus disease (COVID-19) advice for the public:
http://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

The three main symptoms to look out for according to WHO are:

• Fever
• Coughing
• Difficulty breathing

If you have fever, cough and difficulty breathing, seek medical care early
Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance. Follow the directions of your local health authority.

------------------------------------------------------------------------------------------------------------------------

Sidenote:

I was in contact with Swedish healthcare today, because I currently have a cold with fever and I asked about if taking a flu shot would be advisable. The nurse said the flu season here is over, and they had no flu shots, so she said no. I also asked about the Coronavirus situation in the region in Sweden I live in, Scania, and she said the only known cases were people who had been traveling from other countries, or those who had been in direct contact with such people. And she said there was no indication at the moment of community spread in Scania, and this made me feel calmer. And she repeated the WHO advice: if I would feel fever, cough and difficulty breathing then I should call the healthcare again.

I hope for the best here in Sweden, and everywhere else in the world.

 

[Jarvis323]

Since there now may be more and new people reading this thread than before, I'd like to repeat the link to the WHO (World Health Organization) advice page:

Coronavirus disease (COVID-19) advice for the public:
http://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

The three main symptoms to look out for according to WHO are:

• Fever
• Coughing
• Difficulty breathing

------------------------------------------------------------------------------------------------------------------------

Sidenote:

I was in contact with Swedish healthcare today, because I currently have a cold with fever and I asked about if taking a flu shot would be advisable. The nurse said the flu season here is over, and they had no flu shots, so she said no. I also asked about the Coronavirus situation in the region in Sweden I live in, Scania, and she said the only known cases were people who had been traveling from other countries, or those who had been in direct contact with such people. And she said there was no indication at the moment of community spread in Scania, and this made me feel calmer. And she repeated the WHO advice: if I would feel fever, cough and difficulty breathing then I should call the healthcare again.

I hope for the best here in Sweden, and everywhere else in the world.

I'm basically in the same situation. I had a fever last week, but no breathing problems or much of a cough. They don't test, so I just assume the worst and isolate for a month I guess.

 

[DennisN]

isolate for a month I guess

And that's what I've planned too. We're in this together.

 

[russ_watters]

It seems like we turned a corner over the weekend and it's really snowballing this week. Going to be a surreal couple of months.

I guess I have not been taking this outbreak as seriously as I thought I have. It is a lot easier to process something dispassionately when it isn't happening to you. I'm pretty logical and not prone to overreaction, but can also under-react:

A week ago I bought a bunch of stock after that first bad week for the market. That new position is down now, and the market seems like it is still absorbing the impacts (as I am). A global economic recession seems likely. It may be a short recession, but nevertheless it was a poorly timed purchase. And not just for the purchase itself -- I'm suddenly thinking I may want to have some ready-cash available, as this is likely to affect my work.

On Sunday, I bought Flyers hockey tickets for a game in 3 weeks. Not only did I overpay for what should have been a good game, it's now very unlikely to be held. The NBA postponed the rest of its season last night and I would expect the NHL to follow suit today or soon.

Another note on that last one: on Tuesday the city of Philadelphia "recommended" that people "not attend" gatherings of more than 5,000 people. "Recommended". "Not attend". Tuesday's Flyers game was packed (20,000 people for a rivalry game) and last night's 76ers (basketball) game in the same arena had maybe 17,000 (not a good match-up). I'm not sure if the city has the power to shut down these events, but even if it doesn't, it should act like it does if it wants to be serious about this. Shutting down the games takes the choice away from fans and also likely enables them to get their money back. Similarly, the biggest disease petri-dishes of all, are still incubating: schools. A school with 1,000 disgusting kids is certainly as bad as a hockey game with 20,000 adults.

We have only a handful of confirmed cases in southeastern Pennsyvania, but it has been instructive to note the impact. Last weekd a doctor at a Children's Hospital of Philadelphia branch in the suburbs (10 miles from me) tested positive, which triggered quarantines and tracing of contact. A nurse working with him later also tested positive, and several school districts associated with her kids and others potentially exposed have been shut down. I think it is only a matter of a couple of days or at most a couple of weeks before they all get shut down. Easter is April 12 and most have spring break around that time. If they get that far, that could be the time they tell their kids not to come back, like many colleges have done, with their spring breaks happening now.

Many businesses in my area came out of the weekend and immediately implemented work-from-home policies, some as aggressive as requiring it for non-essential workers ("Anyone who can work from home MUST work from home."). Road traffic has dropped in my area, but not by a huge amount. The immediate impact for my business (A&E/construction for pharma) has been more people in the office, as people who would otherwise be visiting clients are now here. But I would think that either by policy or individual choice there will be significant working from home starting soon (school closures will trigger the need if nothing else). A large pharma manufacturing conference I was supposed to attend in NYC in April has been postponed to the summer. I've been on a monthly travel rotation to California (got back last Friday) and a colleague is scheduled to fly out on Sunday. He's still planning to go but will re-evaluate as it gets closer.

 

[StatGuy2000]

I guess I have not been taking this outbreak as seriously as I thought I have. It is a lot easier to process something dispassionately when it isn't happening to you. I'm pretty logical and not prone to overreaction, but can also under-react:

A week ago I bought a bunch of stock after that first bad week for the market. That new position is down now, and the market seems like it is still absorbing the impacts (as I am). A global economic recession seems likely. It may be a short recession, but nevertheless it was a poorly timed purchase. And not just for the purchase itself -- I'm suddenly thinking I may want to have some ready-cash available, as this is likely to affect my work.

On Sunday, I bought Flyers hockey tickets for a game in 3 weeks. Not only did I overpay for what should have been a good game, it's now very unlikely to be held. The NBA postponed the rest of its season last night and I would expect the NHL to follow suit today or soon.

Another note on that last one: on Tuesday the city of Philadelphia "recommended" that people "not attend" gatherings of more than 5,000 people. "Recommended". "Not attend". Tuesday's Flyers game was packed (20,000 people for a rivalry game) and last night's 76ers (basketball) game in the same arena had maybe 17,000 (not a good match-up). I'm not sure if the city has the power to shut down these events, but even if it doesn't, it should act like it does if it wants to be serious about this. Shutting down the games takes the choice away from fans and also likely enables them to get their money back. Similarly, the biggest disease petri-dishes of all, are still incubating: schools. A school with 1,000 disgusting kids is certainly as bad as a hockey game with 20,000 adults.

We have only a handful of confirmed cases in southeastern Pennsyvania, but it has been instructive to note the impact. Last weekd a doctor at a Children's Hospital of Philadelphia branch in the suburbs (10 miles from me) tested positive, which triggered quarantines and tracing of contact. A nurse working with him later also tested positive, and several school districts associated with her kids and others potentially exposed have been shut down. I think it is only a matter of a couple of days or at most a couple of weeks before they all get shut down. Easter is April 12 and most have spring break around that time. If they get that far, that could be the time they tell their kids not to come back, like many colleges have done, with their spring breaks happening now.

Many businesses in my area came out of the weekend and immediately implemented work-from-home policies, some as aggressive as requiring it for non-essential workers ("Anyone who can work from home MUST work from home."). Road traffic has dropped in my area, but not by a huge amount. The immediate impact for my business (A&E/construction for pharma) has been more people in the office, as people who would otherwise be visiting clients are now here. But I would think that either by policy or individual choice there will be significant working from home starting soon (school closures will trigger the need if nothing else). A large pharma manufacturing conference I was supposed to attend in NYC in April has been postponed to the summer. I've been on a monthly travel rotation to California (got back last Friday) and a colleague is scheduled to fly out on Sunday. He's still planning to go but will re-evaluate as it gets closer.

Interesting to hear about your experiences in terms of work impact -- thanks for sharing. I try to avoid overreaction to various scenarios myself.

Here in Canada we've seen a gradual increase of cases, but no large-scale community transmission (yet). I believe as of this moment we have 117 confirmed cases nationwide (with 42 being in my home province of Ontario).

The Chief Medical Officer of Canada has announced a pandemic response plan in place which at least in my opinion is calm and measured, and continuing to focus on containment (including contact tracing, emphasis on self-monitoring of those who have traveled internationally, self-isolation for those who have flu-like symptoms), and social distancing where possible, so cancelling large conferences, etc. But no shutdowns of public transit, no closures of universities (with one exception, Laurentian University). We've already faced elementary and secondary school closures in Ontario due to a teacher's union strike, but as far as I know, no school closures elsewhere in Canada.

In my personal case, not much has changed, as I already work from home full time. But both the main client I work for and my parent company have instituted various travel and work-from-home policies in response to COVID-19. And I don't foresee myself really changing my personal routines, as I already wash my hands frequently and have always avoided sick people and hospitals.

[Update: The Ontario provincial government has just announced that all publicly funded schools be remained closed from March 14 through to April 5.]

 

[kith]

This study has interesting data about the development in China from December to February. It estimates the number of true cases for each day from patients being asked when they first showed symptoms. If this is a good estimate, really big effects have shown up immediately after the lockdown of Wuhan and other cities. Here's the graph:

 

[russ_watters]

Here in Canada we've seen a gradual increase of cases, but no large-scale community transmission (yet). I believe as of this moment we have 117 confirmed cases nationwide (with 42 being in my home province of Ontario).

We only have 21 confirmed in pennsylvania, but 13 are in my county, and with a shortage of test kits the actual number is surely much higher.

...and actually I double checked the news and that infected doctor who is the source of many of the cases was just identified on Monday, having worked since March 1 after returning from an overseas vacation.

 

[Evo]

Many businesses in my area came out of the weekend and immediately implemented work-from-home policies, some as aggressive as requiring it for non-essential workers ("Anyone who can work from home MUST work from home."). Road traffic has dropped in my area, but not by a huge amount. The immediate impact for my business (A&E/construction for pharma) has been more people in the office, as people who would otherwise be visiting clients are now here. But I would think that either by policy or individual choice there will be significant working from home starting soon (school closures will trigger the need if nothing else). A large pharma manufacturing conference I was supposed to attend in NYC in April has been postponed to the summer. I've been on a monthly travel rotation to California (got back last Friday) and a colleague is scheduled to fly out on Sunday. He's still planning to go but will re-evaluate as it gets closer.

My youngest daughter's company has ordered everyone to work at home starting Monday, indefinitely. It's a software company and she's a project manager, so it makes sense, they do a lot of video conferences already.

On the crazy side, Walmart was completely sold out of toilet paper, paper towels, cleansing wipes, all shelves empty, you can't order anything online either, not at regular prices. Some scammer had a pack listed for $300, they should have a "report fraud" button. Small companies can sell through Walmart online and set their own price, similar to Amazon.

Right now I'm eyeing the leaves that blew over into my lawn from next door...

 

[bhobba]

Even so I'm still confused, is the higher death rate from the virus spreading more easily or because it produces harsher symptoms?

The death rate varies from country to country depending on the number tested and how good the health system is. I will take Singapore with a rate of about .5 and the flu .1. Naively that would be 5 times. But other factors come into it - most notably we have a vaccine for the flu - the WSJ quoted Neil Fishman, who is chief medical officer at the Hospital of the University of Pennsylvania and an infectious-disease specialist: “I think what we’re seeing with Covid-19 is what influenza would look like without a vaccine,” So I do not think its 5 times worse than the flu except for older people where its worse than the flu - maybe over 5 times worse. There are a couple of other differences:

1. It's inverted who it affects. In the flu it affects badly the young and the old - for the Coronovirus the old are mostly affected and have a higher death rate. In the middle - say between 20 and 50 it seems about the same.

2. The number of people an infected person passes on the disease onto, called r0, is about 1.7 for the flu and 2 for the Coronovirus. This means it spreads faster - making measures to slow that down such as constant hand-washing and social distancing more important. It is also important when we get a vaccine - you need an r0 less the 1 to get what's called heard immunity ie it basically dies out. For the flu a little math shows if everyone gets vaccinated it only needs to be 40-50% effective for that to happen - but they rarely get the flu viruses going around exactly right, and not enough people get vaccinated. With the Coronovirus you will need a vaccine to be 50-60% effective and nearly everyone gets vaccinated. Also note how fast it spreads does not affect the death rate - just how fast they get it and hence, in the same time period, how many die.

We are learning more all the time. But my guess from what I have read is if you are under 50 its not much worse than if you were not vaccinated for the flu - over 50 - especially over 60 - that's when you have to worry - it looks likely for that age group its worse than the flu and the group that really has to watch it.

Tom Hanks is about 64 and in that age group, plus has diabetes as well - it will be interesting to see, with modern treatment here in Australia, exactly how he goes - almost certainly he will be fine - but of course we will need to wait and see. The hospital he is in (University Gold Coast Hospital) has said rather 'immodestly' if you get Coronovirus its the hospital you want to be treated at.

Thanks
Bill

 

[Mary Conrads Sanburn]

U.S Food & Drug Administration

For Immediate Release:

March 09, 2020

FDA NEWS RELEASE

Coronavirus Update: FDA and FTC Warn Seven Companies Selling Fraudulent Products that Claim to Treat or Prevent COVID-19

The U.S. Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) issued warning letters to seven companies for selling fraudulent COVID-19 products. These products are unapproved drugs that pose significant risks to patient health and violate federal law. The FDA and FTC are taking this action as part of their response in protecting Americans during the global COVID-19 outbreak. The warning letters are the first to be issued by the FDA for unapproved products intended to prevent or treat “Novel Coronavirus Disease 2019” (COVID-19).

“The FDA considers the sale and promotion of fraudulent COVID-19 products to be a threat to the public health. We have an aggressive surveillance program that routinely monitors online sources for health fraud products, especially during a significant public health issue such as this one,” said FDA Commissioner Stephen M. Hahn, M.D. “We understand consumers are concerned about the spread of COVID-19 and urge them to talk to their health care providers, as well as follow advice from other federal agencies about how to prevent the spread of this illness. We will continue to aggressively pursue those that place the public health at risk and hold bad actors accountable.”

“There already is a high level of anxiety over the potential spread of coronavirus,” said FTC Chairman Joe Simons. “What we don’t need in this situation are companies preying on consumers by promoting products with fraudulent prevention and treatment claims. These warning letters are just the first step. We’re prepared to take enforcement actions against companies that continue to market this type of scam.”

The FDA is particularly concerned that products that claim to cure, treat or prevent serious diseases like COVID-19 may cause consumers to delay or stop appropriate medical treatment, leading to serious and life-threatening harm.

[. . .]

###

https://www.fda.gov/news-events/pre...es-selling-fraudulent-products-claim-treat-or

 

[DennisN]

The U.S. Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) issued warning letters to seven companies for selling fraudulent COVID-19 products. These products are unapproved drugs that pose significant risks to patient health and violate federal law.
[...]
The FDA is particularly concerned that products that claim to cure, treat or prevent serious diseases like COVID-19 may cause consumers to delay or stop appropriate medical treatment, leading to serious and life-threatening harm.

Yet another example of the actual and serious health risks that can be associated with pseudoscientific (alternative) medicine in general. The list is long.

EDIT:

It has been previously mentioned a few times in this thread that it is believed the corona virus may have its origin in bats and spread to humans via pangolins. Since I am generally a curious person I yesterday read on the pangolin wiki page:

Pangolins are in high demand for Chinese traditional medicine in southern China and Vietnam because their scales are believed to have medicinal properties. Their meat is also considered a delicacy.

and

Nucleic acid sequences of viruses taken from pangolins have been found to be a 99% match to those of the virus which causes COVID-19, SARS Coronavirus 2 (SARS-CoV-2) and is responsible for the 2019–20 Coronavirus pandemic.

I am not suggesting alternative medicine is to blame¹ for the virus outbreak, but I find the coincidence to be very ironic.

¹ I have not read anything about this, and have very little knowledge about the actual source of the outbreak.

 

[WWGD]

Where are you? In San Antonio sanitizer and wipes are in short supply but IPA alcohol is still available at Wal Mart. I imagine on the west coast and New York the situation is different.

Isn't standard soap : for hand-washing and showering enough to create sanitary conditions?

 

[bhobba]

Isn't standard soap : for hand-washing and showering enough to create sanitary conditions?

It's actually a bit better because it removes skin oils the virus could otherwise stick to. But alcohol based products are still fine,

Thanks
Bill

 

[nsaspook]

I still need to build things using parts shipped directly from China. A little PPE can't hurt.
https://forum.allaboutcircuits.com/threads/ppe-for-pcbs-directly-from-china.167875/post-1486334

 

[bhobba]

It seems like we turned a corner over the weekend and it's really snowballing this week. Going to be a surreal couple of months.

Yes.

Thanks
Bill

 

[Evo]

It's actually a bit better because it removes skin oils the virus could otherwise stick to. But alcohol based products are still fine,

Thanks
Bill

Twenty seconds of hand washing is a very good recommendation, but 60% ethanol will supposedly kill the virus. If you are out and regular hand washing is not an option, this is where the ethanol hand sanitizer would come into play. You shouldn't need hand sanitizer if you are at home and not living with someone with the virus.