Covid-19

[Hashi Lebwohl]

Hashi, again, if you were in a position of authority and could make the call, what actions would you take (if any)?

Have those who are in high-risk groups self-quarantine or engage in "social distancing"--the elderly, those with chronic conditions, those with compromised immune systems, etc. Everyone else--wash your damn hands, sneeze or cough into some disposable napkin or paper towel, be mindful of your symptoms, and limit your contact with groups of people.

I would not go around forcing "non-essential" businesses to close at 8pm (or close altogether), closing schools--seriously, many of them aren't even trying to hold virtual classes, forbidding groups larger than 50--now 10--or suggesting that we need to nationalize medical equipment suppliers. Those are overreactions which make this seem worse than it really is. edit/add: I see now that the White House is suggesting not gathering in groups of more than 10. Most family get-togethers have more people than that--too damned bad, Aunt Edna, you can't come this time. Also, Ohio is ordering places like gyms to close. Are they going to close laundromats, too? I guess the poor people aren't going to be going anywhere, anyway, so they won't need to wash clothes for a while.

We don't need to retaliate against China. Businesses will start doing that as they realize that they don't want manufacuring located there, even if the cost of business is low, because the risk for another rebound outbreak is too high. In recent years, the majority of widespread outbreaks of diseases have originated in China...which is also where the Spanish Flu in 1917-1918 got started.

Now....what happens if a group of 75 people gather together, quietly and peacefully, outside a State Legislature building? Are they going to be dispersed by force?

Incidentally, Mexico is thinking of putting up some sort of physical barrier to prevent people with corona from entering from the United States. Okay, that one isn't true, but it hilarious. I do suspect illegal immigration is down, though.

[Gaius Octavius]

They should move the Chinese manufacturing to Mexico. Mexico is our neighbor and it creates jobs for them while still giving us cheap labor.

[Lazy Luke]

We don't need to retaliate against China. Businesses will start doing that as they realize that they don't want manufacuring located there, even if the cost of business is low

Here in England I work at Amazon, and 80% of the goods we process are from China. I know this because the boxes have Hanzi Chinese writing on them. Who else can build cell phones and computers to meet today's demand?

[SoulBiter]

It will be interesting in a morbid way to see what happens when the "Spring Breakers" return home after having been all together in one large party. In a few weeks we might think we have this under control only to see a new wave of cases as they potentially infect people when they get home.

Take a look at the Spanish flu and what happened to Philly when they refused to cancel a parade to promote war bonds and to implement social distancing. They were skeptical that it would do anything but hurt their local economy. So they refused to do much of anything to limit person to person contact. It was a catastrophic set of decisions and 12K died in six weeks. People died without ever seeing a doctor or a nurse because not enough were available.

St Louis on the other hand cancelled all events and went to draconian segregation. City officials ordered all schools, theaters and churches closed indefinitely. And then the bars, pool rooms and dance halls.. In the end St Louis had 700 deaths.

[Ur Dead]

Virus followers can use the John Hopins site

https://www.arcgis.com/apps/opsdashboar ... 7b48e9ecf6

[TheFallen]

For all that I've up till now criticised the UK government for not taking clear and decisive action quickly enough in the face of the COVID pandemic, today things changed. And the strategy now in place - albeit a week or two late in my view - steers a measured course between authoritarianism and libertarianism.

Today the UK populace was told that it should self-quarantine for 7 days if it has any flu-like symptoms (or 14 days if we're talking about a household of more than one). We were also told that we should avoid bars, theatres, restaurants, cinemas, gyms and their like until further notice - so basically any place of social gathering.

Also people have been urged to work from home wherever possible and also not to travel even locally unless strictly necessary.

Moreover, those over the age of 70, plus those in perceived high risk categories have been told to self-isolate for a period of 12 weeks as of now, to minimise their risks of becoming infected. That's actually a hell of an ask and will require the assistance of family and friends or neighbours, but still...

However - and here's the key point - none of the above is any more than advisory. Extremely strongly advisory - but advisory nonetheless. There's no legislation due to be put in place (at least yet) to compel anyone to follow the UK government's recommendations. It depends upon there being a voluntary buy-in from the UK's citizenry.

And you know what? I reckon that the vast majority of UK residents will go along with these highly important containment steps without the need for any legal coercion. The British government has decided to treat the people as if they are rational and responsible - and I think that will prove to be an effective approach.

Edit/Add...in direct and specific support of SB's Philadelphia vs St Louis Spanish Flu exemplar, I've just read about the most recent piece of modelling based on the latest available data by the much-respected Imperial College London. It strongly suggested that, if the UK government had not today issued its advice (and of course if such advice is not followed by the vast majority of people), the UK could then expect in excess of 250,000 COVID-19 caused deaths in fairly short order, with the majority of these being also as a result of our health services being overwhelmed by the expected very sharp exponential rise in cases.

With the UK government's advice now in place (and of course, presuming it is followed), the same modelling now predicts total UK COVID-19 deaths in the 5 or even possibly 4 figure ranges. Which is of course exactly why the UK government issued the advice it did today.

I wouldn't necessarily get too hung up on points of conceptual principle here, my US libertarian friends...

[peter]

Collateral damage. The Law of Unintended Consequences. Mission creep. Butterfly effect. The question is what kind of normality are we going to return to after the dust settles. 9/11 changed our world immeasurably - opened up the possibility for all sorts of things to be justified that previously were unthinkable. The point above about no good crisis being allowed to go to waste is a serious one. People have died for the freedoms we now enjoy - we might now be required to be prepared to do the same, albeit in a different way.

Recommend, advise, inform - this is the job of Government in a situation like this. That and to ensure that our health services quickly and robustly prepare themselves for what the science tells them is coming. From our point, our job is to listen and follow the advice given to the best of our ability. But life has to be allowed to proceed. The moment that the thing moves into bannings and restrictions and soldiers on the streets, the red lights should start flashing. We're not there yet - but I see slightly disturbing little signs that the temptation to move from the advising to the enforcing modus operandi might be too great to resist, especially if the public mood (notorious for it's hyperbolic response.....witness the panic buying epidemic) seems to be in favour of such.

On a local level, I'll take a moment to describe what is happening where I live and work. The village pub and social club have decided to shut; this has killed our trade in the shop in the evening as passing trade from patrons of the same was a significant part of the footfall. Hours in the shop are thus to be cut and opening times restricted. Jobs in all three establishments will be lost, not to return in the near future, disease outbreak or not. The local economic fallout from this is incalculable; businesses will go under, people will loose their livelihoods and many will find themselves unable to meet the payments on their homes, their cars, their services. The knock on effect ripples outward from every closed front door in the land no amount of forecasting can predict where that ends.

But in the silver lining vein of thinking, at least one positive thing has emerged. ISIS have issued their own travel advice to their adherents in respect of Covid-19 ....... terrorists should avoid Europe for the foreseeable future!

Good wishes to all of you.

[aTOMiC]

China now reporting less than 9k active cases, again, if it can be believed. Definitely trending downward at a steady pace. Fyi.

[TheFallen]

Well...

I see you've bought into the hype.

This is simply not anything to be extra worried about.

It's not going to kill millions. Ebola didn't. H1N1 didn't. SARS didn't.

and

IT. IS. NOT. THAT. FUCKING. BAD.

In 6 months, when this is all over, I hope people look back and are ashamed at how they overreacted.

Sorry, but you two are underplaying this. To a massive degree. I understand why - and I get the real concern about erosion of rights (the "mission creep" that Peter refers to in his post above) - but you're simply not dealing with the reality of things.

Yes, there's been large-scale and in some cases utterly irrational overreaction (whether gargling with cow piss or supplies hoarding as two examples). And yes, certain factions are utterly cynically looking to weaponise the COVID outbreak to score political points. And the latter is beyond shameful.

But put all that to one side and look at the damn impartial, objective and agenda-free science here for a minute - in as much as we've got some upon which to base our best guess modelling.

Here is your link to the report I referred to from Imperial College London, authored in full collaboration with the WHO Collaborating Centre for Infectious Disease Modelling, the MRC Centre for Global Infectious Disease Analysis and the Abdul Latif Jameel Institute for Disease and Emergency Analytics.

20 page modelling report on COVID-19 issued yesterday

This is the report that's defining UK government strategy re the COVID pandemic. It models outcomes in both the UK and the US. I'd strongly urge the pair of you (and others) to give that a read-through and then decide if your comments as quoted above are still entirely on point. Because they're just not. And why would anyone ignore the damn science???

If pretty rigorous action is not taken (whether voluntarily or via legal compulsion), that report states that over 500,000 UK deaths and over 2.2 million US deaths would occur over the next four months, courtesy of a combination of COVID-19 and an overwhelming of healthcare resources by a factor of 30 when it comes to ICU beds/ventilators, meaning many of those cases could not be saved. Figure 1 on page 7 of that report applies - and the same data modelling can be applied to any first world democracy with the same percentile results.

Against any measure, sorry guys. That is Quite. Fucking. Bad. That is definitively not "hype". This is a seriously unusual event, the likes of which this planet has not seen in just over 100 years.

I am NOT scaremongering here - I'm falling back on the dispassionate science, because what better basis is there on which to form an opinion?

So, the best modelling in place to date strongly suggests that a laissez faire/do nothing approach results in about 2 and three quarter million COVID related deaths between the US and the UK alone over the next 16 to 20 weeks. Sure, the highest proportion of those will occur among the elderly and the already infirm - but that's still a seriously noteworthy number of extra deaths. And sure the numbers wouldn't quite reach those elevated levels, because people are in general smart enough to take appropriate safeguarding action on their own initiative... but not so much if they're being wrongly assured that this is a minor flu-like hiccup.

The report then goes on to model the likely effect of MITIGATION strategies (combining home isolation of suspect cases, home quarantine of those living in the same household as suspect cases, and social distancing of the elderly and others at most risk of severe disease). The strong suggestion is that just doing the above would halve the number of eventual COVID-related deaths - primarily by reducing the short-term loading on healthcare services... but that healthcare services would still be overloaded, just by a factor of 8, rather than 30.

The report then goes further and models the likely effect of additional SUPPRESSION strategies (primarily social distancing of the entire population as much as is feasible, with the potential additional closure of universities and schools). If this is realistically achievable - and it may need to be intermittently done over a period of more than a year, being triggered by new case thresholds being reached at any time - then overall COVID-19 deaths are estimated to be manageable down by 80%.

But if and only if such suppression measures are also taken.

Gents, that's what the current best guess science is telling us. Surely that's what we should be basing opinion and strategy on?

Regardless, this is not a small deal.

I'm entirely leaving aside whether mitigation and suppression measures should be voluntary/advisory (as they are in the UK currently) or legally enforced (as they are in much of mainland Europe currently). Obviously the former would be preferable, if a population can be relied upon generally to act in its own best interests.

I'm also entirely leaving aside the simply massive economic impacts that COVID-19 is going to have one way or the other. Governments are going to need to have radical shifts in entire fiscal policies to stop their economies going into meltdown - whether that involves huge levels of emergency funding for businesses, suspension of taxes, payment holidays on mortgages and utility bills etc etc is for far wiser macroeconomic heads than mine - where's Brinn when you need him? Anyways, dramatic measures will be needed - synchronised and omnilateral quantitative easing, maybe?

I'll even listen to (but not agree with) an extreme purely Libertarian view that may say "Screw it. Carry on as we are. Our rights are utterly inviolable and sacrosanct and if that means that a few hundred thousand Brits or a million or so Yanks have to snuff it, so be it - that's life. Shit happens - it's a price worth paying".

I could pay more - but extremely reluctant - attention to a quite brutally pragmatic argument that says "Sorry - the bald truth is that economically as a culture and society, the West simply can't afford the ramifications of the measures necessary to maximise lives saved. We are going to have to let people die."

However, what is neither useful nor appropriate is to downplay the severity and impact of COVID-19. I'm not suggesting any form of panic, just that people rely on the science to get a better grip on the actual realities of things and the likely outcomes.

Read, digest and understand that report - knowledge is power. Then decide on your positions.

[wayfriend]

As coronavirus suspends life in America, Fox changes its tone

Last Monday, Tucker Carlson delivered a warning on his Fox News show. He said the coronavirus posed a great threat. He said it was much more severe than the flu. And he said that people have "spent weeks minimizing what is clearly a very serious problem." While he delivered that monologue, his colleague Trish Regan was on Fox Business dismissing coronavirus as nothing more than an attempt to impeach Trump.

"Since then, just 168 hours have passed, not even enough time to watch every episode of 'The Simpsons' and in that time, everything has changed," Carlson said Monday. Indeed, everything has changed, including Fox News' overall coverage of the lethal virus.

Regan is no longer on the air. And Fox's biggest stars are no longer denying the crisis. "With Trump's declaration on Friday that the virus constitutes a national emergency, the tone on Fox News has quickly shifted," wrote WaPo's Paul Farhi and Sarah Ellison in a Monday story. [...]

Why Fox's coverage is so important

Given that Republicans largely turn to Fox for their news, it's likely the network's previous dismissive coverage has affected how Republicans view the crisis. A Gallup poll published Monday found that "political party identification reflects the starkest differences in levels of worry about coronavirus exposure."

According to the poll, "Democrats (73%) are the most worried of any group, and their level of worry has increased the most out of any group. Meanwhile, less than half of Republicans (42%) report having this level of concern -- the lowest of any group Gallup measured." Hopefully things will change with the network's shift in tone... [link]

Posting this to support TheFallen's comments.

[Hashi Lebwohl]

China has 81,058 cases and 3,111 deaths. Current population esimate for China (well, the 2018 estimate): 1,427,647,786. Infection rate for China: 0.0056777%, or 1 person out of 17,612. Death rate: 0.0002179% or 1 person in 458,903.

Rate of death for people who caught the virus: 3111/(81058+3111) = 0.03696 or just about 4%. That bottom number is 81058+3111 because the deaths are not currently active cases.

Current population of the United States (2019 estimate): 328,239,523.

If the same rates apply here like they did in China, then we should see 18,637 cases and 715 deaths. Unless, of course, you think China is cleaner and has better health care than the United States. Alternatively, maybe somehow this particular virus became more lethal once it left China--those are the only two ways which the amount of deaths here meet the projections even the scientists predict.

By page 7 of that report you linked, TF, I lost count of the number of times they used the word "assume". That is far too many assumptions to be solid science. That spooky number they mention--510,000 deaths in the UK and 2.2 million in the U. S.--is the end result of the scenario where no one did anything at all--no closing businesses, no social distancing, etc. It is the worst possible scenario and thus not an accurate number.

No one has ever suggested "doing nothing" in response the virus. Even I said to sequester people in high-risk groups, keep yourself washed, be mindful of symptoms, and limit exposure to other people. What is happening, though, is that the cure is worse than the disease--what good will it do you to survive COVID-19 only to find that the government is rationing your food to you and there are permanent restrictions on when you can go out, where you can go out, and how long you can go out?

Scare enough of the people sufficiently and they will gladly submit and put the yoke around their neck.

[Gaius Octavius]

Starting to get sick. Here's hoping I'm catching the bug. ~

[TheFallen]

Hashi, with respect, you're being disingenuous here.

First off, ANY future modelling is going to be based upon best guess assumptions arising from the available hard data. That's what modelling is, FFS.

The report I cited specifically stated that its "do nothing" predictions were absolute worst case - so those 2.2 million US deaths and 500k UK deaths were massively unlikely to be reached - if only because people would on the basis of sheer personal common sense take their own actions to mitigate risk and thus lessen that number.

That number was an absolute extreme backstop - and clearly stated as such. It's based on an 80% global infection assumption and an R factor (reproduction - the number of additional infections one active COVID case on average produces) at the upper end of the currently predicted 2.0 to 2.6 range.

Now, leaving aside that quite clearly stated extreme endpoint assumption, more cogent are the "do something, but don't push for social distancing for all) figures - which suggest against all current known data that the above-quoted extreme death rate would be halved. Down to a million Yanks and 250k Brits. And yes that's another assumption, but best guess from experts in the field, given currently available data. As I stated in my previous post, still 80% of these predicted reduced deaths would arise from the overwhelming of health services, with them not being able to provide the necessary care, due to a shortage of beds, equipment or both.

What you as a mathematician surely must realise is that you can't make a naive and simplistic extrapolation from the number infected in China, the number dead in China and the overall Chinese population. That's false accounting in the extreme.

China's done superbly well in limiting new cases - and thus deaths - because of its extremely stringent (and of course entirely liberty-infringing from a Western point of view) imposed lockdowns - the data clearly shows that. Unfortunately, because there is currently no vaccine and as yet entirely insufficient so-called herd immunity, if/when China becomes more lenient with its current restrictions, COVID-19 is simply bound to break out again - just like an unextinguished bushfire. (See quote below).

I do take the point - and indeed stated that I did - that in a strategy of seeking the highest survival rates, the "cure" may in fact be worse than the disease. I say this from a purely economic point of view, not one based on political or ethical considerations or philosophy.

Anyhow, the following article from the BBC website sums things up more succinctly as to the strategic COVID management choices presented, with a direct view to the stated assumptions within yesterday's ICL report.

https://www.bbc.co.uk/news/health-51915302

And specifically on China, that link contains the following quote, which highlights the ongoing and unresolved issue for the Chinese government now - and all other governments soon:-

However, the suppression approach comes with major problems.

It effectively requires shutting down parts of society and there is no exit strategy.

As fewer people would be infected there would be little immunity in the population and cases would soar soon after measures were lifted again.

This is the conundrum China now faces. Research suggests 95% of people in Wuhan were still susceptible to the virus at the end of January.

Precisely. That's why one recommendation is the "switch on/switch off" of social distancing to keep COVID cases in line with healthcare resources - but that's a hell of a long-term strategy that'd take months and months to play out. It may well be economically unsustainable.

[Zarathustra]

Hashi, are you taking into account that China achieved those numbers after imposing the most draconian lockdown measures on the planet?

I am not particularly worried about this virus for myself, I don't expect to die from it. But even those who recover from it have impaired lung function. That's not good. I liked to jog and bike, I need my lungs at full capacity. But what is even more troubling is overloading the healthcare system. If all of our intensive care beds are full, which could easily happen in the next few months if we do nothing, then you better not get in a car wreck and need one of those beds. This virus could be a death sentence for anyone, even the young and healthy, when we take out of the equation a healthcare system we are counting on for emergencies for other injuries and illness. Healthcare is a finite resource. This could easily overwhelmed it. That is not hype.

And for the record, Tucker Carlson has been warning that this is a serious problem for weeks now.

[Hashi Lebwohl]

We don't even know if the Chinese numbers are accurate at all, given the CPC's propensity to lie. They were keeping a lid on the story until they couldn't contain it any more. One of the early doctors who reported on the story subsequently contracted cornoavirus and died, which is both tragic and ironic but definitely not suspicious in the least.

If strict lockdowns are required to slow the spread, then why hasn't our government implemented full martial law and set up checkpoints where we must give a valid reason why are out of our house? If more authoritarian measures result in fewer cases or fewer deaths, then the most authoritarian measure should result in even fewer deaths. What are they waiting for, bodies in the streets?

None of you can go be in gatherings of more than 10 people but Congress can still be in session. I guess the rules don't apply to them and most people are happy with that.

By the way, note that there are no end dates on the measures/orders about closing public venues, events, and setting limitations on small businesses like diners, bars, or gyms. Those things are simply going to remain closed until the government decides when--or even if--they may reopen.

edit/add; CNN is reporting that a guy who actually caught corona discharged himself from the hospital and went home; sheriff's deputies are parked outside his house to make sure he doesn't go around spreading it.

Now...you might think that I would support this guy, but you would be wrong. This guy should not have been able to discharge himself--the guard should have been posted at the end of the hall near the elevator (or ward, depending on the layout) and he should have been sent back to his room at that time--his right to wander around is superceded by other people's rights not to be exposed to this illness.

[Wosbald]

+JMJ+


Chris Lu @ChrisLu44 | Twitter

[Hashi Lebwohl]

That is part of the reason we are having a panicked overreaction now.

[TheFallen]

Wosbald, with absolutely no respect at all...

What the living fuck is the point of posting that third party rant from some ex-Obama admin apparatchik? What possible even minuscule value does it add to addressing the current situation? Even if what he states is 120% true?

Abso fucking lutely none. It's pure futile blamestormng - and pure political agenda. Truly fucking pathetic - do you seriously believe there's any point in facile political points scoring right now?

Hashi, yes, the most draconian (and thus liberty-infringing) measures will result in the fewest deaths - if that's on balance the most desired goal.

Back to the brutally pragmatic here. Those most draconian measures would need to be in place for 12 to 18 months - maybe on an "off and on" basis, dependant on healthcare resource capacity at any one time - in order to achieve minimum deaths from COVID.

Forget the individual rights conversation. I'm not sure that the crippling economic fall-out of such tactics can be afforded by the West over such an prolonged period of time.

It may therefore be more brutally pragmatic and realistic not to push for maximising COVID survival rates and instead going for a sub-optimal (but less economically damaging) approach.

[Zarathustra]

We don't even know if the Chinese numbers are accurate at all, given the CPC's propensity to lie.

You were the one using China's numbers:

China has 81,058 cases and 3,111 deaths. Current population esimate for China (well, the 2018 estimate): 1,427,647,786. Infection rate for China: 0.0056777%, or 1 person out of 17,612. Death rate: 0.0002179% or 1 person in 458,903.

Rate of death for people who caught the virus: 3111/(81058+3111) = 0.03696 or just about 4%. That bottom number is 81058+3111 because the deaths are not currently active cases.

Current population of the United States (2019 estimate): 328,239,523.

If the same rates apply here like they did in China,

If we can't trust China's numbers (reasonable, I'd say), then your argument above is useless.

Either way, it's true that China had to impose draconian lockdown measures to achieve even the level of success that they are advertising. The numbers might be much higher, but that would argue for even *more* lockdown measures here, not fewer.

I don't like the government telling me what to do. But this is a case of national security. This is one of those things that the government is supposed to do. If the risky behavior of our neighbors puts the entire healthcare system at risk, then the government has to step in and save us from ourselves. If people will voluntarily quarantine or isolate, then this won't be necessary. But drastic action must be taken, either by us or the government. For us to be telling each other it's no big deal only makes it more likely that people won't act on their own, and will need the less pleasant method of government intervention. So maybe you are hastening the very thing you dread.

[TheFallen]

I'm glad that at least some here have a demonstrably appropriate and realistic take on the actual situation (as best as it can be predicted from current hard data).