COVID COVID-19 Coronavirus Containment Efforts

[anorlunda]

By what mechanism could this virus stop spreading and die out? A reduction in new cases each day means that the curve was flattened. Fewer new cases per day, does not necessarily mean fewer cases in the indefinite future.

 

[nsaspook]

As expected, there is pushback from the young.
https://www.wsj.com/articles/a-generational-war-is-brewing-over-coronavirus-11584437401

On a recent night in the semiautonomous city, Peel Street, a thoroughfare lined with bars and popular with expats, thronged with hundreds of maskless drinkers. A band played in the lower half of the street, where people stood shoulder to shoulder.

“I stayed at home for two months. I’m not staying any more,” said Ryan, 26, who was walking with his friends down the main strip of nearby Lan Kwai Fong, a series of streets filled with bars and clubs. “Life goes on.”

“We worry,” said Nicole, 25. “But either you worry yourself to death or you drink yourself to death.”

 

[bhobba]

By what mechanism could this virus stop spreading and die out? A reduction in new cases each day means that the curve was flattened. Fewer new cases per day, does not necessarily mean fewer cases in the indefinite future.

The better the lockdown the fewer the cases. What will stop it eventually is the vaccine when it is available which is why its being fast-tracked.

Thanks
Bil

 

[wukunlin]

Please scrutinize if the following procedure is correct. In our complete lockdown we have this guideline:

https://www.gmanetwork.com/news/new...enhanced-community-quarantine-in-luzon/story/

"
7. Only 1 (one) person per household is allowed to go outside their homes to buy basic necessities. Use of private vehicles for this purpose shall be allowed; "

What happens is that people drive to friends house or go elsewhere besides buying basic necessities (hence there are still many cars in the street). In Wuhan. You can still drive around the city allegedly to buy food? Or are even private cars prohibited? Then how do you buy basic necessities? You walk in streets?

For Wuhan, there are a lot of check points limiting where people can or cannot drive to. There are also shuttles arranged for people who wants to buy food

 

[chirhone]

For Wuhan, there are a lot of check points limiting where people can or cannot drive to. There are also shuttles arranged for people who wants to buy food

So this kind of lineups also occurred in Wuhan? Next week I'll be one of the people who will line up (what if the person behind me with virus sneeze?)

 

[wukunlin]

So this kind of lineups also occurred in Wuhan? Next week I'll be one of the people who will line up (what if the person behind me with virus sneeze?)

View attachment 258846

I think only 1 person per household is allowed to go out shopping every 2 days. If the density of supermarkets are anything like Shenzhen, there shouldn't be a line anywhere that long for any particular supermarket. Face masks well help if someone sneezes. Stay at least 1m away from anyone, especially when you are in a line. Most important, wash your hands thoroughly when you get home.

 

[sqljunkey]

I don't see how this is a deadly disease. Has the deathrate in wuhan increased disproportionately? Wuhan has a pop of 11 million people and so far only ppl who died who had the virus were old ppl.

For a serious deadly virus it seems to have a low deathrate compared to the average daily global deathrate.

 

[mfb]

by the way it is covering 150 countries ?

Depends on what exactly you consider a country. This map recognizes 155 "countries/regions", not all of them are independent countries.

IIRC, in Wuhan (also a big, modern metro), pretty much EVERYONE was locked in, except for government workers and essential workers (hospitals, obviously). They delivered food and essentials to people.

Could that work for NYC? Could everyone be forced to stay in - enforced by police. And, then, you have a group of volunteers and government workers deliver things to people (non-essential workers) for a month or two?

It'd be miserable, but a way to prevent a health system overcrowding disaster if COVID19 ramped up. High crime neighborhoods would also need extra policing. This sort of idle time, lockdown, and lack of money from commission of crime could cause criminals to "act up."

China could pool resources from all over the country in Hubei because it was a single large outbreak. If the US tries the same approach it might work well in New York, but what happens in the other states in that time?

Agreed. Right now it does not seem we are weighing the risks, but only thinking "stop Coronavirus at all costs". The costs should be considered.

Various US agencies put the cost of a human life at several millions.
Without a slowdown in the spread and overwhelmed hospitals the US will probably look at millions of deaths, or tens of trillions of USD by that metric. Scale by a factor 20 for global numbers. That's not including the economic damage and other induced deaths (from insufficient healthcare for other patients, a potential lack of access to food, transportation or whatever) such a dramatic disruption of life everywhere will cause, even though the time might be shorter. You can now argue that most deaths will be older people and that we ... yeah, go ahead and find a politician who will do that.
Doing nothing is so cost-prohibitive that all the approaches to fight it are cheap in comparison.

Italy is under comlete lockdown but it records 350+ deaths in single day. How is virus transmitted during complete lockdown? Our groceries and essentials remain open (all else are close) and there are long lineups with customers close to one another. Is this the mode of transmission in Italy?

It takes a while from infection to death. ~5 days of incubation period, and maybe 1-2 weeks from first symptoms to death, in some cases even longer. Italy's nationwide lockdown is just a week old. The lockdown in Lodi started 3.5 weeks ago, we might see results there but it just affected 50,000 people. Lombardy, the region that has half the cases of all Italy, might have stabilized its daily new cases (1500, 1400, 1100, 1900, 1600, 1400 in the last days). Could also come from a lack of available tests, of course.

By what mechanism could this virus stop spreading and die out? A reduction in new cases each day means that the curve was flattened. Fewer new cases per day, does not necessarily mean fewer cases in the indefinite future.

China-style measures seem to work if they are kept up long enough, but the world won't apply these everywhere. The approaches of South Korea, Singapore and Taiwan work, but it's too late for them in many countries. Wait until a significant fraction of the population got it will work, but will come with a high cost. A vaccine should work but won't be available until later.

 

[chirhone]

I think only 1 person per household is allowed to go out shopping every 2 days. If the density of supermarkets are anything like Shenzhen, there shouldn't be a line anywhere that long for any particular supermarket. Face masks well help if someone sneezes. Stay at least 1m away from anyone, especially when you are in a line. Most important, wash your hands thoroughly when you get home.

And if we have to follow complete lockdown like in Wuhan. We still have to contend with 80,000 infections and 3000 deaths?

 

[PeroK]

By what mechanism could this virus stop spreading and die out? A reduction in new cases each day means that the curve was flattened. Fewer new cases per day, does not necessarily mean fewer cases in the indefinite future.

As I understand the Chinese position it is that once a region is cleared there are literally no active cases of the virus remaining. And, this could be achieved globally. The virus could be completely eliminated.

However, the news reports in the UK suggest that there is no way out of a national lockdown. As soon as we come out again, the virus may flare up again.

Also, it seems, the longer a national shutdown lasts, the harder it would be to sustain the emergency health measures. Sooner or later vital supplies and government money must run out - if people generally are not at work.

If it takes 18 months, say, to find a vaccine, I find it hard to believe that western society could survive that long in lockdown. It's a difficult question whether that represents something worse than a national pandemic.

 

[wukunlin]

And if we have to follow complete lockdown like in Wuhan. We still have to contend with 80,000 infections and 3000 deaths?

That will depend on how many people are already infected and running around before the lockdown happened. Unfortunately . Wuhan was such a mess because the lock down was a bit late, and it was new Chinese New Years where people are seeing each other and there are lots of travellers through Wuhan.

 

[vxiaoyu18]

Please scrutinize if the following procedure is correct. In our complete lockdown we have this guideline:

My English is not good, is to use the translation software to chat with us. Each country has the basic conditions of each country. Wuhan in our country is a relatively large city in China, where there are many community service centers or community property management offices, which serve their respective communities. So after the outbreak, they worked with the government and the police to serve the community, and in some places they collected the demand from the instant messaging software, and then they purchased it and distributed it to the families. Also some places is every two days can come out a purchase, come out must wear good mask to measure the temperature, some places come back when the spray disinfection can go into the community. Your country's situation is different, what measures to adopt to block the virus, to follow the advice of your country's medical experts. Do not gather activities, go out wearing masks, frequent hand washing is the most basic method in all countries.Droplets are the most contagious, and masks are worn for mutual safety.

 

[PeroK]

And if we have to follow complete lockdown like in Wuhan. We still have to contend with 80,000 infections and 3000 deaths?

That's only sounds bad if you ignore the normal death rate for a large country. It's about 1400 people per day in the UK. Half a million people die every year in the UK. It must be much the same in Italy.

If the UK or Italy could get out of this with only 3000 (additional) deaths, that would be like a miracle now.

The risks are hundreds of thousands (or even millions) of additional deaths per country and/or complete economic meltdown - which may take large parts of the health service with it.

 

[chirhone]

My English is not good, is to use the translation software to chat with us. Each country has the basic conditions of each country. Wuhan in our country is a relatively large city in China, where there are many community service centers or community property management offices, which serve their respective communities. So after the outbreak, they worked with the government and the police to serve the community, and in some places they collected the demand from the instant messaging software, and then they purchased it and distributed it to the families. Also some places is every two days can come out a purchase, come out must wear good mask to measure the temperature, some places come back when the spray disinfection can go into the community. Your country's situation is different, what measures to adopt to block the virus, to follow the advice of your country's medical experts. Do not gather activities, go out wearing masks, frequent hand washing is the most basic method in all countries.Droplets are the most contagious, and masks are worn for mutual safety.

In the initial days of lockdown in Wuhan. It's also like this (where crowds converge at checkpoints)?

https://newsinfo.inquirer.net/1243304/checkpoints-lead-to-crowds-chaos

 

[russ_watters]

As I understand the Chinese position it is that once a region is cleared there are literally no active cases of the virus remaining. And, this could be achieved globally. The virus could be completely eliminated.

However, the news reports in the UK suggest that there is no way out of a national lockdown. As soon as we come out again, the virus may flare up again.

Also, it seems, the longer a national shutdown lasts, the harder it would be to sustain the emergency health measures. Sooner or later vital supplies and government money must run out - if people generally are not at work.

If it takes 18 months, say, to find a vaccine, I find it hard to believe that western society could survive that long in lockdown. It's a difficult question whether that represents something worse than a national pandemic.

Yes, these are the sorts of questions I think need to be answered. In my area, most shutdowns have been announced to have 2-weeks duration. That's just not realistic. Two months? We're probably still ok. But 18 monts? Yes, that's civilization-collapse level of disruption.

 

[vxiaoyu18]

Luckily, our government closed the city before the Spring Festival, otherwise the Spring Festival is the peak of Chinese passenger flow, it will be out of control. We still don't have enough care and care for the new virus. Human beings want to live in peace with nature, and there is still a lot to learn.

 

[vxiaoyu18]

If everyone cooperate with the government and epidemic prevention departments, do not use so long, the virus infection cycle is generally within 24 days, as long as we stay together for 3-4 weeks, can isolate the infected people received hospital treatment, the hospital outside the people are much safer, can gradually resume work. So, this needs everybody's joint effort very much. I also spent a month in isolation at home and have been back at work for over a month now. Wuhan area is also gradually lifting the blockade. If the infection in your country is not serious, it is feasible to isolate for 2 weeks. In our country, people who come out from the key epidemic areas are also arranged to be quarantined for 2 weeks, and then they can move freely. Don't be afraid of this virus, just try to do a good quarantine.

 

[russ_watters]

Various US agencies put the cost of a human life at several millions.
Without a slowdown in the spread and overwhelmed hospitals the US will probably look at millions of deaths, or tens of trillions of USD by that metric.

Ok, well at least that's some numbers; ~$5-$10M. We'll use the top one.

For additional reference; the flu kills around 35,000 people in the US every year (highly variable). Can we say that flu prevention measures save an additional 100% or another 35,000? At $10B direct and $87B indirect costs, that's $285,000/$2.4M per death or life saved. We're erring on the side of life there (cost savings is less than the value placed).

The Great Recession stimulus package was $830B and the recession itself had a lifetime cost of $24 trillion ($70,000 ave per American, 350M Americans).
https://www.washingtonpost.com/busi...4b76ba-af10-11e8-a20b-5f4f84429666_story.html

In other words, according to the $10M value, it would be worth avoiding another Great Recession to let 2.4 million Americans die. But by comparison to the flu prevention benefit, it would be worth allowing 10 million deaths.

I'm not saying we should, I'm just saying it should be talked about. And part of the difficulty in that discussion is that the costs and lives are mostly separate groups of people.

 

[wukunlin]

China is going to start Human trials of vaccines.

https://www.physiciansweekly.com/china-gives-go-ahead-for/

 

[mfb]

In other words, according to the $10M value, it would be worth avoiding another Great Recession to let 2.4 million Americans die.

I'm quite sure we'll get a worldwide recession no matter what. It's not like a large share of the population being sick at the same time would come without any impact. The question is how strong it will be. Do you have estimates for different scenarios?

But 18 monts? Yes, that's civilization-collapse level of disruption.

Europe survived 6 years of world war. And yes, "your workplace was hit by a bomb last month, your neighbor's house was hit last week, your house might be hit any day as well" is more disruptive than "you need to keep some distance to others in public". My grandparents lived through this.

Here is an up to 2.2 million death estimate if the US does nothing serious.

 

[kyphysics]

By what mechanism could this virus stop spreading and die out? A reduction in new cases each day means that the curve was flattened. Fewer new cases per day, does not necessarily mean fewer cases in the indefinite future.

Maybe not die out, but lockdowns/social distancing/self-isolation hope to buy time for:

a.) a vaccine
b.) having more hospital beds and respirators capable of dealing with a potential giant fallout
c.) having less people get infected all at once

Even if the SAME # get infected over time, there's a difference between it happening all in 2 months vs. over the course of 12 months (spread out evenly).

We cannot handle the # of people needing hospital beds and critical care if too many get infected and need hospitalization at all once. That's why we need to flatten the curve. If there are 100 hospital beds and 150 COVID19 patients needing them + gunshot victims + burn victims + workplace injury people, etc. that could jeopardize human life at a significant scale.

If we buy time, we can have it ideally so that people who need hospital services don't all go in at once and overwhelm the institutions.

 

[kadiot]

Oh no!

https://www.wsj.com/articles/singap...oronavirus-cases-11584445836?mod=hp_lead_pos3

 

[chemisttree]

The checkpoint could use big sack to cover each person and insert the thermometer in the anus. But the problem is, the vagina is very near the anus. Some as short as 1 inch. If there is wrong insertion, it could cause Urinary Track Infection.

Hence it is decided to initiate Wuhan style Total Lockdown.

Your logic is inescapable.

 

[anorlunda]

I understand flattening the curve. I'm trying to judge the claim that 40-70% of all people will be infected eventually, with corresponding deaths. I'm also trying to judge the news that the UK says that the crisis and the lockdown will last for a year; whereas people here keep saying 2 weeks.

A vaccine 12-18 months into the future would cut it short, but that's a long way away.

Dr. Anthony Fauci said on TV that he hoped to both flatten the curve and shorten the duration. That's the opposite of flattening the curve which prolongs the duration. I'm trying to judge the credibility of that claim. What possible actions both flatten and shorten?

 

[russ_watters]

I'm quite sure we'll get a worldwide recession no matter what. It's not like a large share of the population being sick at the same time would come without any impact. The question is how strong it will be. Do you have estimates for different scenarios?

Well, the actions taken so far may cause the recession (and there's a huge difference between "a recession" and "The Great Recession"), but I don't think it is self-evident that the "do nothing" case would have. The flu costs about $100B a year, mostly over 1 quarter, and doesn't cause a recession every year. Annual GDP is about $19.4 T and growth has been 2%, so spread over 2 quarters, it would have to cost at least twice what the flu costs in lost productivity and direct spending. Maybe it would have,

Europe survived 6 years of world war. And yes, "your workplace was hit by a bomb last month, your neighbor's house was hit last week, your house might be hit any day as well" is more disruptive than "you need to keep some distance to others in public". My grandparents lived through this.

Wars are local and severe impact, so it is hard to judge them in such qualitative terms -- but I don't agree that "Europe survived".

In terms of global deaths statistics impact, the Spanish Flu was much, much worse; something like an order of magnitude worse. In terms of economic impact, I'm not sure. I haven't looked at the cost of WWII or Spanish Flu.

 

[chemisttree]

I'm in guangzhou, China. On the second day after academician li lanjuan proposed to the state on January 22 that "wuhan must be closed down", China resolutely took measures to close down the city, which prevented the outbreak of the epidemic in the first place. Thanks to the right decision, the outbreak in our country is now pretty clear and almost under control. So the best way to deal with this outbreak is for everyone to stay at home and be quarantined and work together to stop the source of infection and get this virus over with. Our country and people are very friendly and will try our best to help people around the world fight the virus during this time of crisis. Good luck to all of you.

Are y’all still locked down?

 

[anorlunda]

if the US does nothing serious.

What are Sweden and Switzerland doing that's more serious than the US? I just checked svd.se and saw nothing serious on the front page.

 

[kadiot]

There's been so much flip-flopping about airborne vs droplet infection.

Let's just assume that it's airborne so that we don't miss out on any safety precaution.

https://www.cnbc.com/2020/03/16/who...udy-shows-coronavirus-can-survive-in-air.html

 

[atyy]

I understand flattening the curve. I'm trying to judge the claim that 40-70% of all people will be infected eventually, with corresponding deaths. I'm also trying to judge the news that the UK says that the crisis and the lockdown will last for a year; whereas people here keep saying 2 weeks.

A vaccine 12-18 months into the future would cut it short, but that's a long way away.

Dr. Anthony Fauci said on TV that he hoped to both flatten the curve and shorten the duration. That's the opposite of flattening the curve which prolongs the duration. I'm trying to judge the credibility of that claim. What possible actions both flatten and shorten?

I think we'll have to see what happens when China starts relaxing its measures. Will things bounce back worse than before, or will relaxing some measures with strengthened contact tracing and quarantines of close contacts be able to keep things under control. If it is the latter, then in a sense the curve would have been flattened and the duration shortened. For example, could they switch to something more like the South Korean strategy?

 

[chemisttree]

Europe survived 6 years of world war. And yes, "your workplace was hit by a bomb last month, your neighbor's house was hit last week, your house might be hit any day as well" is more disruptive than "you need to keep some distance to others in public". My grandparents lived through this.

I don’t think so. Russ was referring to an 18 month lockdown. Lockdown means nobody working. Nobody making anything.

Farming? Forget it.
Mining? Forget it.
Transportation? Forget it.
Electrical generation? Forget it.

No, your grandparents didn’t live through an 18-month total lockdown like this.

 

[chemisttree]

Simulations for the spread of a coronavirus.

https://www.washingtonpost.com/graphics/2020/world/corona-simulator/

 

[DennisN]

What are Sweden and Switzerland doing that's more serious than the US? I just checked svd.se and saw nothing serious on the front page.

I can't speak about Switzerland, but here in Sweden we haven't gone into a major lockdown yet. But it has now been recommended that high schools, colleges and universities should be temporarily closed and students should study at home via the computer. I don't rule out that we could come to a point where a complete lockdown would be needed, but our government estimates that we are not at that point yet.

Even if people reading this may be aware of it, I'd like to say that comparing Sweden or Switzerland to the entire US may not be entirely useful. The US is much, much bigger and has got a much larger population. I think it is better to compare Sweden to a US state. But I don't know which one. Our population is about 10 million.

 

[chemisttree]

Even though you probably are aware of it, comparing Sweden or Switzerland to the entire US may not be entirely useful. The US is much, much bigger and has got a much larger population. I think it is better to compare Sweden to a US state. But I don't know which one. Our population is about 10 million.

That would be Georgia or North Carolina. Wow! I must be infected and it’s affecting my brain. Now I’m comparing Georgia and North Carolina to Sweden.

 

[gmax137]

I think it is better to compare Sweden to a US state. But I don't know which one.

Now I’m comparing Georgia and North Carolina to Sweden.

yeah, I'd go with Minne-soota

 

[Ygggdrasil]

But that doesn't change the fact that -as far as I can tell - weighing the economic cost hasn't been part of the conversation at all.

People are still talking about the lifetime of economic damage done to millennials by the great recession. I haven't heard anyone say the same for the next generation.

If one truly believes this disease would kill tens of millions of people, then it is probably worth "containment at all costs", but only probably, and it should be said: "sorry guys, we know we are likely dooming you to a lifetime of economic underachievement/hardship, but we believe it is worth it."

One could argue that until maybe a week ago, decision makers had been weighing too heavily on the side of avoiding economic costs (I'm speaking mostly from the perspective of decisions made in the US), and that has contributed to the point we are at now. Major sports leagues were going against recommendations to hold games without fans right up until the point that a player in one of the leagues was diagnosed with the virus, which forced the NBA to shut down, and other leagues followed. Similarly, the Presidential administration had seemed to focus mostly on downplaying the risks of the Coronavirus to avoid panicking the markets versus warning the nation of the potential for severe disruption.

However, while there has been a lot of news coverage over the potential health consequences of the coronavirus, I agree that I have not seen too much coverage forecasting the potential economic consequences, so I do agree that there should be more discussion of the costs/benefits.

I'm quite sure we'll get a worldwide recession no matter what. It's not like a large share of the population being sick at the same time would come without any impact. The question is how strong it will be. Do you have estimates for different scenarios?

I agree here. The economy is global and interconnected. The Coronavirus has already done huge amounts of damage to the Chinese economy, and the effects of the virus and lockdowns in Europe are likely damage the global economy further, so this would have to also be considered in judging the effects of policy and its effects on the economy.

Edit: for those skeptical of the current response to the coronavirus, here's a good read: https://www.statnews.com/2020/03/17...e-are-making-decisions-without-reliable-data/

 

[Ygggdrasil]

There's been so much flip-flopping about airborne vs droplet infection.

Let's just assume that it's airborne so that we don't miss out on any safety precaution.

https://www.cnbc.com/2020/03/16/who...udy-shows-coronavirus-can-survive-in-air.html

STAT News had a useful piece on the issue:

Now there are conflicting reports on whether the new Coronavirus can. The studies suggesting that it can be aerosolized are only preliminary, and other research contradicts it, finding no aerosolized Coronavirus particles in the hospital rooms of Covid-19 patients.

The weight of the evidence suggests that the new Coronavirus can exist as an aerosol — a physics term meaning a liquid or solid (the virus) suspended in a gas (like air) — only under very limited conditions, and that this transmission route is not driving the pandemic. But “limited” conditions does not mean “no” conditions, underlining the need for health care workers to have high levels of personal protection, especially when doing procedures such as intubation that have the greatest chance of creating Coronavirus aerosols. “I think the answer will be, aerosolization occurs rarely but not never,” said microbiologist and physician Stanley Perlman of the University of Iowa. “You have to distinguish between what’s possible and what’s actually happening.”

https://www.statnews.com/2020/03/16/coronavirus-can-become-aerosol-doesnt-mean-doomed/

In other words, the precaution largely applies to health care workers as certain medical procedures performed on people in respiratory distress can create aerosolized virus. In most everyday situations, however, the virus is unlikely to spread through aerosols. Indeed, contact tracing of known infected individuals provides very little evidence of significant amounts of spread of the virus through aerosols. Again, from the STAT news piece:

“If it could easily exist as an aerosol, we would be seeing much greater levels of transmission,” said epidemiologist Michael LeVasseur of Drexel University. “And we would be seeing a different pattern in who’s getting infected. With droplet spread, it’s mostly to close contacts. But if a virus easily exists as an aerosol, you could get it from people you share an elevator with.”

According to the Centers for Disease Control and Prevention, that is not happening. Earlier this month, CDC scientists reported that the rate of symptomatic infection among a patient’s household members was 10.5%. The rate among other close contacts was 0.45%. In the case of one particular patient, none of his five household members, although continuously exposed to the patient during the time he was isolated at home, tested positive for the virus.

Even if the virus infects only a small fraction of those who come into contact with it, the extremely low rate among close contacts and the absence of infections in some household members of patients suggests that it rarely exists as an aerosol in most real-world situations.

 

[Ygggdrasil]

Italy is under comlete lockdown but it records 350+ deaths in single day. How is virus transmitted during complete lockdown? Our groceries and essentials remain open (all else are close) and there are long lineups with customers close to one another. Is this the mode of transmission in Italy?

The virus has a quite long incubation period, so even after a complete lockdown, those infected before the lockdown will begin to show symptons during the lockdown. More people getting sick during the lockdown does not mean that the lockdown has failed; it just reflects the incubation preiod of the virus.

Here's a paper that studies the incubation period of the virus:

There were 181 confirmed cases with identifiable exposure and symptom onset windows to estimate the incubation period of COVID-19. The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days), and 97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection. These estimates imply that, under conservative assumptions, 101 out of every 10 000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine.

https://annals.org/aim/fullarticle/2762808/incubation-period-coronavirus-disease-2019-covid-19-from-publicly-reported

This means that people who were infected before the lockdown began would begin showing symptoms up to about two weeks after the beginning of a lockdown.

This also means that if you start showing symptoms of the disease, it's not due to anything you did yesterday, but what you were doing ~5 days ago.

 

[BillTre]

1.) Contagion (virus movie)

I highly recommend this movie for non-scientists. It parallels the corona virus situation pretty well (different symptoms, but similar problems with spreading, lack of supplies and hospital space).
I watched it with my wife (not a scientist) and afterward she said that it helped a lot for her in making sense of the current situation.
Probably helped that I was watching it with her and could answer questions.

The movie is on HBO now which makes it easy to watch if you get HBO.

 

[DennisN]

That would be Georgia or North Carolina.

Interesting!
And regarding land area, I just checked and saw that Sweden is about the same size as California.
But Sweden has much worse weather and it's way much colder here!

 

[Rive]

Oh no!

Well, not exactly unexpected.

We do know that a lockdown is effective and can squash an outbreak. So the task is, to maintain some kind of partial lockdown with acceptable economic consequences what can keep the number of cases within the manageable level - till some vaccine becomes available.

 

[russ_watters]

One could argue that until maybe a week ago, decision makers had been weighing too heavily on the side of avoiding economic costs (I'm speaking mostly from the perspective of decisions made in the US), and that has contributed to the point we are at now.
[snip]
However, while there has been a lot of news coverage over the potential health consequences of the coronavirus, I agree that I have not seen too much coverage forecasting the potential economic consequences, so I do agree that there should be more discussion of the costs/benefits.

Yes, I don't want to speculate much on individual motivations, but suffice to say economic and just general societal disruption issues likely weighed heavily. But only vaguely and qualitatively.

Major sports leagues were going against recommendations to hold games without fans right up until the point that a player in one of the leagues was diagnosed with the virus, which forced the NBA to shut down, and other leagues followed. Similarly, the Presidential administration had seemed to focus mostly on downplaying the risks of the Coronavirus to avoid panicking the markets versus warning the nation of the potential for severe disruption.

That is an issue of both law and business. Businesses - including sports leagues - essentially have no choice but to remain open until ordered to close. To do otherwise is financial suicide. So "recommendations" from government in that regard are totally pointless.

I'm not clear on what the powers of government are in this regard (the law side), but obviously governments can easily close government functions (such as schools). Ordering businesses to close is harder, but I'm sure there is a mechanism (or several), I just don't know what they are. The city of San Francisco is attempting it, though.

To that end; on Saturday the Mayor of Philadelphia suggested everyone should go out to eat at restaurants (and be sure to tip your wait staff!) and on Monday, the governor of Pennsylvania ordered all of them to close their dining rooms.

I agree here. The economy is global and interconnected. The Coronavirus has already done huge amounts of damage to the Chinese economy, and the effects of the virus and lockdowns in Europe are likely damage the global economy further, so this would have to also be considered in judging the effects of policy and its effects on the economy.

Just to be clear: I also believe we are already in a recession. My question was whether the recession would still have happened without those government interventions.

 

[Ygggdrasil]

We do know that a lockdown is effective and can squash an outbreak. So the task is, to maintain some kind of partial lockdown with acceptable economic consequences what can keep the number of cases within the manageable level - till some vaccine becomes available.

A vaccine is not going to be widely available for another 1.5 years, and locking down the world for 1.5 years is not a viable strategy.

Rather, here's the rational for a 2-4 week lockdown as I understand it. We know that the virus has a long incubation time and the long inucbation time, combined with the ability of people with no or mild symptoms to spread the disease, contributed to its contagiousness (mathematical modeling studies estimate that 80% of new infections come from people who are undiagnosed).

By implementing a lockdown and social distancing for 2-4 weeks, we are able to halt the transmission of the disease and give carriers of the virus the chance to begin showing symptoms (the median incubation period for the virus is ~5 days, and https://annals.org/aim/fullarticle/2762808/incubation-period-coronavirus-disease-2019-covid-19-from-publicly-reported). Meanwhile, people appear to no longer be infectious ~ 10 days after they begin showing symptoms (though this study is still preliminary and has not undergone peer review). Therefore, a 2-4 weeks of lockdown and/or social distancing should enable us to identify infected individuals for testing and isolation (2 weeks) or eliminate most contagious individuals (4 weeks). These measures could decrease the number of infected greatly, enabling better tracking and quarantine of new infections (assuming widespread testing is available).

Furthermore, we are currently in the middle of a bad flu season, which is taking up a lot of hospitals' capacity to deal with respiratory infections. The nearer we get to summer and the farther away from flu season, the more capacity our healthcare system has to deal with COVID-19 cases.

Will this strategy work? It seems like it would require a global effort as eliminating the virus from one country would not be much help if it persists in other countries. However, there seems to be good evidence that social distancing measures can stop the spread of the pandemic diseases (e.g. from studies of measures taken during the 1918 flu pandemic)

Would the potential lives saved from the intervention be worth the economic costs? I'm not an economist, so I can't make that judgement. However, here's a case from a statistician that maybe we don't have sufficient data to make that call yet.

 

[Klystron]

@Ygggdrasil Thanks for posting this STAT article from post #1,285.

As I understand the premise, the author, an information scientist in my career field, essentially claims Insufficient Data. That if this virus had not been identified and heavily publicized, life would continue as usual for the unaffected.

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.

Information science requires strong skepticism but even as a senior citizen I question whether a virus that does not adversely affect young people should be considered an existential threat to our species.

The vast majority of this hecatomb would be people with limited life expectancies. That’s in contrast to 1918, when many young people died.

The deaths and consequences of the 1918 influenza epidemic remain shrouded in the data from World War I (1914 - 1918) where mobilizations and dislocations also led to increased exposure and transmission. Despite our improved diagnosis and data gathering abilities over 100 years later, the author appears pessimistic that actual infection data will be clearer.

 

[russ_watters]

Edit: for those skeptical of the current response to the coronavirus, here's a good read: https://www.statnews.com/2020/03/17...e-are-making-decisions-without-reliable-data/

Thanks for that, it is aligned with a point I made a few weeks ago:

Reported case fatality rates, like the official 3.4% rate from the World Health Organization, cause horror — and are meaningless...

Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125%. But since this estimate is based on extremely thin data — there were just seven deaths among the 700 infected passengers and crew — the real death rate could stretch from five times lower (0.025%) to five times higher (0.625%). It is also possible that some of the passengers who were infected might die later, and that tourists may have different frequencies of chronic diseases — a risk factor for worse outcomes with SARS-CoV-2 infection — than the general population. Adding these extra sources of uncertainty, reasonable estimates for the case fatality ratio in the general U.S. population vary from 0.05% to 1%.

The Diamond Princess also had a total of 3700 passengers and crew, or a 19% infection rate in a setting that was as close to perfect for disease transmission as can be imagined.

And on my recent point about economics:

A population-wide case fatality rate of 0.05% is lower than seasonal influenza. If that is the true rate, locking down the world with potentially tremendous social and financial consequences may be totally irrational. It’s like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies...

 

[Rive]

Will this strategy work? It seems like it would require a global effort as eliminating the virus from one country would not be much help if it persists in other countries. However, there seems to be good evidence that social distancing measures can stop the spread of the pandemic diseases...

I'm not a big believer of this strategy. Wuhan after the lockdown lifted might still prove otherwise, but I think this thing will just stay with us. Just as the descendants/relatives of the 1918 flu still lingers around.

A vaccine is not going to be widely available for another 1.5 years, and locking down the world for 1.5 years is not a viable strategy.

The key there is the 'partial'. If the goal is not to immediately squash a free-spreading pandemic but to keep one at bay then there is some room to maneuver and adapt.

 

[vela]

Information science requires strong skepticism but even as a senior citizen I question whether a virus that does not adversely affect young people should be considered an existential threat to our species.

I don't think the concern is that the virus is going to wipe out our species. It's that if it's allowed to go unchecked, the severe cases may overwhelm the health care system, like what happened in Italy.

 

[OmCheeto]

I don't see how this is a deadly disease. Has the deathrate in wuhan increased disproportionately? Wuhan has a pop of 11 million people and so far only ppl who died who had the virus were old ppl.

For a serious deadly virus it seems to have a low deathrate compared to the average daily global deathrate.

Perhaps this will answer your question.
This is an extrapolation of the growth of deaths each day, plotted alongside the number of normal number of deaths each day.

The COVID19 plot:

1. assumes everyone on the planet will be infected​

2. assumes the "case fatality rate" turns out to be 1%​

3. excludes data from China​

I think the graph is open to interpretation.
One thing is a fact: 60 million people were going to die this year, mostly from old age, regardless.

--------
reference material
curve fit for COVID19 death rate is derived from 2/21/2018 thru 3/15/2018 data

 

[BillTre]

It's that if it's allowed to go unchecked, the severe cases may overwhelm the health care system, like what happened in Italy.

If it were to overwhelm the health care system, then the death rate would go up for the strongly affected people, increasing the overall death rate and the overall numbers of deaths.

It would likely also lead to increased infections of the health care personnel due to their working under more difficult conditions, which in turn would further stress the health care system and further exacerbate problems for the sick.

Classic vicious cycle and something that should be avoided if possible!
That is why the flatten the curve strategy has received so much attention.

 

[sqljunkey]

OmCheeto I don't understand your plot very well. You said one fact is true and that is that 60 million people are going to die this year for certain, mainly of old age. So I divide 60 million by 365 days and I get an average of 164,383 of mostly old people dying on average daily. If I multiply that by 60 days for the two months we had this year, jan and feb, I get 9,863,013 people who died mostly of old age on average.

Has this number drastically changed from last year, during the same months? By at least a million, I know the aging population is growing globally, and perhaps that may affect these numbers.

So far we know that less than 10,000 people who had the corona virus who were also in their twilight years have passed away during these two months. If I divide that by the 10 million people who already died, who were mostly old, I get 0.001%.

I did this in another post already, but I will do it here also for reference, Wuhan has a population of 11 million and statistics show that 7 out of 1000 people die a year in china, mostly of old age. If I extrapolate that to Wuhan, in a rather crude way I get that 77,000 people die on a yearly basis in Wuhan mostly of old age. Dividing that by twelve and multiplying the answer by 2 months gets me 12,833 people who probably died of old age in Wuhan this or last year during the first two months on average.

Dividing that with the current GLOBAL, not local to Wuhan, but GLOBAL corona death reported numbers gives me, 10,000 / 12,833 = 0.78 or 78%. So if we were to use this number even, which is probably a ridiculous number, I find that it is less than the 100% total of people who probably died in Wuhan these past months of old age. Even here I see that, the total corona deaths have been less than expected in Wuhan alone.

But I don't know the numbers of total death in Wuhan for these two months, I don't know who keeps track of them. Maybe the doctors are and are not showing it. Maybe you have it OmCheeto, and if we get it we can see better whether this virus has indeed claimed more lives than the usual expected death rate in the aging population.

 

[OmCheeto]

OmCheeto I don't understand your plot very well.
...

sqljunkey I don't understand the "..." portion of your post.

hmmm...