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I have a lot of very smart, research-inclined friends and it's been interesting to watch their reactions as this potential pandemic develops. About half are taking it extremely seriously (prepping and encouraging others to do the same) and have been since China declared a quarantine of Hubei. The other half are completely brushing it off with statements like "the flu kills [x] people every year anyway". It's one extreme or the other; almost nobody I talk with, who is following the storyline, has a moderate perspective.
COVID-19 makes ~20% seriously ill and 10% dead. Influenza kills about, what, 2 out of every 100,000? Don't get me wrong, the flu killed my aunt in her early 50s, but COVID-19 is much worse.

Beyond the immediate medical consequences, there is also the societal reaction and potential overreaction. The world economy has been poised for a pullback and this just might trigger the next global recession(my money is on that happening, even if we find a vaccine next week).

Like always, it's a good idea to have a disaster plan in place. Make sure you have a few weeks of critical medications and food on hand. Help those around you put the current events into perspective, help them stay calm, and help them prepare.

my understanding is 2% dead (think that number is being borne out in both italy and s korea), which is still much more lethal than the flu
Your probably both right 10% if you get put in a big room on a bed with just basic med care and 2% with the best hospital care we are currently able to provide (antiviral pumped oxygen ect).
It is 2% dead if you assume that all today infected will recover in the end. It is much more pessimistic when you do not have such assumption but project current dead to number of infected about 2-3 weeks ago.
I think it would help people understand this is is worse than the flu if we start calling it sars 2.0. Because that’s what it is, sars. https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndr...
People had the same dismissive attitude towards SARS which turned out to be much less deadly than the seasonal flu. I am a betting man and say that this year Coronavirus won't become as big as the flu this year.
SARS had a mortality rate of 10 %. The flu is 0.1 %
Yes, though factor in how many get it.

In this case say 100 people got SAR - 10 people die Now Flu - 1000 people get that and - same net result.

Lets face it, how many got SARS in total - less than 10k How many people catch the flu each year? - millions litterly millions.

But as with most of these - it is overall health and underlying preexisting conditions that can and do skew statistics and not all countries log things to the same standard.

You are forgetting that highly aggressive measures are put in place to fight SARS.

If you did what China is doing now to deal with flu, you'd drastically cut transmission rates.

We got lucky last time. Does it seem logical to you that China would put half the country, 750 million people, on lockdown and crash the economy if it was just some flu equivalent? China’s actions speak for itself.
How many people you know ever got Sars? Now how many people you know ever got the flu? That is literally the major difference betweena killer that makes headlines and a silent killer that no one notices.
You need to factor in the fear-factor and as fear spreads much more effectively than any virus known to man, then the net effect I'd bet will be bigger.

Remember - there are still people who believe the earth is flat - when you're up against that basic ilk of intellect, the World becomes a strange place very easily when you push a few variables.

Even sadder is, most people will think of this CV as the flu of the year and with that, many statistics will become entwined.

If it doesn't become as big as the flu, it's because people are more afraid of it and some governments are taking steps to control it.

If HIV had the same response as this year's coronavirus is getting, it would've been stopped dead in its tracks. Meanwhile people around the world would say governments overstepped their bounds, fear ran rampant, and it really wasn't that dangerous--the common cold kills more in absolute numbers.

We really don't know much about the disease yet. SARS had a huge fatality rate, but it was well contained. If it weren't and absolutely nobody panicked or worried, it would've decimated some urban centers. Sometimes it's fine to be extra careful in the beginning and easing up only after you're certain that it's not that bad, and unknown diseases are one of those times. Taking a more carefree approach doesn't look so good if deaths start tallying up.

>COVID-19 makes ~20% seriously ill and 10% dead

COVID-19 death rates in China are about 2-3% and significantly lower outside of China. (less than one percent). Probably due to the healthcare systems in the Hubei region being pushed to its limits.

Bad flu seasons in the US generally have a fatality rate of about 0.2% and infect about 30 million people annually, killing about 60000.

So even if COVID-19 cannot be contained and will linger around it will likely not be as deadly as influenza.

10% is dead / recovered. Don’t look at dead / infected, that’s skewed by an exponential infection rate.
Dead/recovered is also skewed because if someone is going to die, they will die before the illness has "run its course," whereas someone who is going to recover will have it for longer before they count for their statistic. As a result it is also skewed by the exponential growth, albeit in the opposite direction. I really feel like none of the statistics I am seeing are satisfying...
That's not clear. Many people are getting antivirals and clearing the disease in a few days.
Presumably there are also people who die abnormally early. Unfortunately I have not seen what we really need to see: a breakdown of dead/recovered by day since infection. Without it there is no way to accurately assess the deathrate in an environment where new people are quickly falling ill.
There is no evidence to date that anti-retrovirals are successful at treating this infection.
It assumes we know the amount of infected people.
We have very accurate numbers for surprisingly large group due to the cruse ship. As of 20 February 634 infected including 328 asymptomatic cases. https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_c...

Adjusting for the delay between infection and first symptoms a relatively small percentage of people avoided symptoms.

That's a sample population biased toward the elderly, though.
80% were age 60 or over. Normal is 11%.
People stuck on the same ship 24/7 is not very representative of actual daily life.
>Probably due to the healthcare systems in the Hubei region being pushed to its limits.

What happens when the Italian healthcare system gets pushed to its limits? With a conservative estimate of 15% hospitalization (which I can't vouch for, but offer for the sake of discussion), there may be no medical system in the world which is prepared for this.

I notice a lot of downvoting without responses here. It smacks of denial and motivated reasoning. Usually on HN, when you get down-voted, you get a counter-argument. I think it speaks volumes when there's none.
If the original commenter here is suggesting that 15% of Italy's population will be hospitalized...that is its own counter-argument. That's pretty clearly not going to happen.
> That's pretty clearly not going to happen.

Sure, if you mean that the capacity isn't there.

And sure, if you mean it won't be 15% of the total, but rather 15% of the 70% of the population who catch it, then ok.

If you mean that that level of care isn't required for the 15% of severe cases which was seen in the studies, then you'll have to refute the studies of people who know more about this than you, with some better arguments than that.

http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9...

>of the 70% of the population who catch it,

Sorry, but where in gods name is this number coming from? There are currently a few hundred cases documented in Italy,rate of new coronavirus cases worldwide has slowed down to about 500-1000 per day.

For reference, the US has about 1 million hospital visits for pneumonia every year. I couldn't find numbers for Italy but I assume it's in the ballpark of 200k relatively speaking. So a few hundred extra cases or even a few thousand aren't going to push the system anywhere.

> Usually on HN, when you get down-voted, you get a counter-argument.

Not really.

When you say "15% hospitalization" are you suggesting that 15% of the population will be hospitalized?
There are some estimates that 15% of conavirus cases end up needing to go to the hospital. So, 15% of however many Italians catch it might end up needing medical services, plus the standard baseline that already need it. That's going to be pretty tough for the system to handle.
Doesn't that depend entirely on how many Italians end up catching it?
It does, but in an average flu season, how many escape unscathed? Now factor in that the transmission rates may be significantly higher for this virus (R0 below 2 versus anywhere from 1.4-6.6).
What you're missing is the multiplier. It seems to be substantially more contagious.

edit: To put a finer point on it, the estimates of the R nought range from the same as the Spanish Flu, to double the Spanish Flu.

I’ve seen C19 rates of 20% seriously ill (hospitalization) and 5% critical care (ICU). Almost no country has the capability for this, even in large cities.

There are vaccines for flu; none for C19 for 18 months at the earliest. Also, C19 is contagious when victims are asymptomatic. It aerosolizes so it can spread across rooms and potentially through ventilation systems.

Many C19 healthcare workers are becoming infected, some dying. This is unheard of with the flu.

And C19 is uncontained, unlike SARS. It meets the definition of pandemic now (2+ continents and community spread). The WHO will finally recognize this any day now.

To equate C19 with the flu is inaccurate and dangerous.

Watch this video from CNBC last Friday.[1] It’s excellent, and features experts who do not mince words.

[1] https://youtu.be/8A9BT3lAGHU

Curious why you say 18 months at the earliest for a vaccine. Is this a standard vaccine timeline? Are we guaranteed to be able to make a vaccine for this virus? I am not at all educated on how vaccines are developed.
I'm not understanding your conclusion at all. In an environment not taking precautions above normal flu season, the r0 for covid-19 is significantly higher than flu (2.6 vs 1.6) - in part because we have partially working flu vaccines. If it can't be contained, it'll be far worse.

Now I suppose measures China style will drop its transmission rate below flu, but at the minimum that's a heavy economic cost to be concerned with.

Actually what the data says is the older you get the more deadly it is and below certain ages it's less than 2.

There are actually 5 episodes on "this week in virology". These people are virology professors in the US.

This episode an interesting look at the percentages.

http://www.microbe.tv/twiv/twiv-588/

EDIT: two other interesting aspects, over 80% of the cases were mild and over 50% of chinese males smoke.

The latter extreme ("Flu / falling off ladders is worse!") is a dangerously misguided line of thinking. Inconvenience is always better than dead, and lest anyone think "dead" is an abstract/unlikely outcome, collapse of supply chains (medical or otherwise), overloaded health systems, lack of hospital/ICU beds, etc can all contribute to death-rates-in-a-pandemic, even if those folks never got infected in the first place.

So the smart money is to be cautiously prepared -- have 1-2 weeks of "stay-at-home" supplies, that is food, water, and self-medicating items. You do not want to dependent on being out and about if this gets worse. Best case, you can have a canned food party once this clears.

1-2 weeks? That seems dangerously optimistic to me.
Yes. But more than that and you run into space issues. FWIW, Mormons are experts at having enough for a full year for a family that might be 12 members, but they have special things they get like gallon sized cans of unground wheatberries, for making flour by grinding it.

US Government is currently recommending citizens have enough food and water for 2 weeks for every member: https://www.ready.gov/pandemic

This isn't a new page it's their advice for being prepared in general for a pandemic.

Here's a similar page put together by the CDC: https://cchealth.org/pandemic-flu/pdf/individuals_and_famili...

> FWIW, Mormons are experts at having enough for a full year for a family that might be 12 members, but they have special things they get like gallon sized cans of unground wheatberries, for making flour by grinding it.

Latter-day Saint here. This indeed was a teaching of the Church for quite some time, not so much anymore as it has shifted to general emergency preparedness [1][2][3][etc]. Some indeed still keep decent food stores though, we can order cases of #10 cans for varying things from the Church online [4] (the general public can too).

Some people keep a lot of freeze dried stuff, some can their excess that they grow, others just keep a lot of staples on hand that they rotate through. Personally I can feed myself for a few months on freeze dried stuff and 10-30 year canned staples then another 1-2 months on stuff I rotate through and eat daily (beans, oats).

[1] - https://www.churchofjesuschrist.org/study/manual/gospel-topi...

[2] - https://newsroom.churchofjesuschrist.org/article/preparednes...

[3] - https://www.churchofjesuschrist.org/church/news/church-annou...

[4] - https://store.churchofjesuschrist.org/ click all categories, food storage (direct linking to the page will often generate errors)

Neat resources, thanks for sharing.
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The average American adult has a good 40+ days with of food stored in body fat.

Americans are well prepared... Even if they haven't tried to be.

Exactly. You can be prepared and be wrong every time and be okay. You can ignore preparations just once and that's the end of you and your family.

I am not sure why people are so reluctant to see the risk asymmetry in this.

Canned food lasts forever too. Just get a huge supply and slowly eat/replace it for some meals.
Having a cabinet of canned food is good policy even without a potential pandemic to worry about.
Yes, you should be prepared for things like pandemics, because it is not that difficult to have a small amount of preparation. But if you are not in China, you have no reason to prepare for coronavirus specifically. Saying things like "the flu is more dangerous" seems like a perfectly reasonable line of thinking - if you are in North America you should not be preparing for coronavirus any more than you already do for things like the flu. If you do not feel prepared for a coronavirus outbreak, it just means your preparation for the far more serious existing threats was lacking.
> But if you are not in China, you have no reason to prepare for coronavirus specifically.

Tell that to people in Italy or South Korea.

I think you are underestimating how quickly things can change. At this time, I really believe the best time to prepare for the Coronavirus is now while other people aren't paying that much attention.

It will become more difficult to stock up if it becomes apparent to the masses that they need to prepare.

> Best case, you can have a canned food party once this clears

Also frozen food. Even in worst case scenarios it's hard to see the grid going down for long periods, assuming raw coal/gas can keep arriving or your country has a lot of renewable energy.

What's the maximum time the grid can go down until the frozen food is unthawed/inedible? 1 Day or less probably?
4 days after a tornado, the food in our chest freezer was still half frozen. We cooked up a good fraction of it and tossed the rest. But only because refreezing it would have caused freezer burn. In an emergency, freezer burnt food is better than no food.

The key was that we never opened the freezer while power was out. Regularly opening an unplugged freezer would have melted things a lot faster. Chest freezers also do much better than fridge freezers.

Thank you very much, was really not sure how long a frozen but unplugged freezer would last.
The bigger the freezer, and the more full of frozen stuff, the longer it will last. Bigger freezer because the volume to surface area ratio is larger, and more full because there's just more thermal mass at a low temperature to buffer any heat leaking in.
Let's say 12 hours? I've had it last longer than that but in the scenario I'm thinking about there would be rolling blackouts on the order of hours, not days.
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What are they doing for prepping?
Well, for me - having an nice supply of lucozade and other foods that can consume whilst having bad flu based upon experience of a few bad flu's in my life (50 yrs+).

So basic foods - soups (non dairy based ones btw as always find anything diary for me turns instantly into mucus and soon builds up on my lungs). Biscuits and other dry foods that palatable. Kinda things you stock for a just in case period anyhow.

Oh and tissues and toilet rolls, never want to be short of those.

In general, common sense and what works for you when you're ill.

> Oh and tissues and toilet rolls, never want to be short of those.

Better yet, buy and install a cheap bidet.

> Better yet, buy and install a cheap bidet.

I rent and live in a flat, and I've also tried a bidet before. I would say that I've more success with the three shells.

Agreed, I'm more of the "you are fined 1 credit for a violation of the verbal morality statute" kinda guy when it comes to the toilet. The way you get stuff clean is by scrubbing, not squiring it with water and calling it a day and I'm sure as heck not squirting my under carriage and then using my fingers to scrub it outside of a shower.
You spray then use a piece of toilet paper to finish the business. Probably the same way you’d clean anything.
I might be the middle you are referring to. I see it as a potential issue that may or may not become a larger issue.

I am buying extra case of water, ramen during weekly grocery runs. But I did not go into full prep mode.

I initially completely dismissed it as media induced panic though.

Second group of friends needs to take a class in network theory.
Every country needs to take a hard look at the supply chain of critical goods such as medical supplies or chemicals and figure out how to reshore these factories. Even if the Chinese migrant workers comes back to the factory (estimated only around 20-30% did), most of the small businesses might be gone by then.

https://asia.nikkei.com/Business/Industry-in-focus/Virus-hit... 35% of 1,506 Chinese SMEs surveyed in early February expect to run out of cash within 1 month, 85% within 3 months. Chinese small business which account for 99.8% of registered companies in China and employ 79.4% of workers, according to the latest official statistics. They contribute more than 60% of gross domestic product and, for the government, more than 50% of tax revenue.

https://www.zerohedge.com/economics/chinese-workers-refuse-g... Chinese workers refuse to go back to work

https://www.zerohedge.com/economics/jpmorgan-now-expects-chi... JPMorgan Now Expects China Q1 GDP To Drop To 1%, Crash To -4% If Coronavirus Is Not Contained

And imagine what would happen if an incident like this hits TSMC, the world definitely needs some reconsideration on where we manufacture things.
America's response has been somewhat alarming. In 2018, the Trump admin cut funding to a lot of health programs to deal with pandemic responses at the CDC, HHS, etc: https://foreignpolicy.com/2020/01/31/coronavirus-china-trump...

Recent proposals are asking for more cuts: https://foreignpolicy.com/2020/02/10/trump-world-health-orga...

Recently, the CDC has botched test kit rollouts, preventing widespread testing: https://www.politico.com/news/2020/02/20/cdc-coronavirus-116...

Without getting too political, I don't have any confidence that America's response will get it done.

Yeah the messed up testing is very concerning. The US has done 500 or so tests in total. SK is ramping to 10,000 per day. I don’t think it’s clear when the US would be in a position to mount a similar response if needed.
It might trigger the bigger move to automation and robotization of the scale manufacturing and services. On the other hand, more people will be left without the job.
It's hard to tell the scale of it, especially as an outsider but I've read a couple of articles like this one: https://www.techinasia.com/chinas-ecommerce-robots-delivery . Once the dust has settled many might not have jobs to go back to and in turn this probably makes it harder to quarantine people, would you take a "holiday" if there was a good chance you'd be replaced by a robot before you returned?
more unemployment definitely... whatever..
This is the exact equivalent of distributed service going down or suffering latency issues and affecting critical downstream services. There are supply chains set up but no real thoughts or solutions when catastrophic problems occur, like if China suffers a pandemic crisis for example.

I wonder if those things will be in consideration going forward or if we will keep making the same mistakes over and over again.

I mean, it's literally a coordination problem. Redundancy and resiliency rarely decrease costs in normal operation. If you're operating in a vertical, and all your competitors are operating diverse/redundant supply lines, you are at a tremendous advantage to defect and slim down. It's only when disruptions become frequent enough to model in a straight forward way (and also frequent enough to loom in people's memories) that we can expect a pure market solution.

The same way tech companies rarely actually go for multi-cloud setups.

Our primary system of incentives are not setup to consistently deliver black swan redundancy.

We shouldn't forget that the novelty of this disease, and the unknowns surrounding it, are causing the (probably necessary) extreme reactions like those we're seeing now.

In the longer run, after the patterns are better understood and treatment protocols are in place, we will probably normalize to whatever the non-zero steady state infection and fatality rates that results, much as we do with diseases like influenza, malaria, etc.

As that happens, the reactionary controls that are in place today will gradually lessen and we'll be back to a business as usual.

Of course, the short term shock of this might send a fragile world economy off the rails, but pretty much any globally correlated emergency incident would have done that.

I understand that the impact of COVID-19 plays an important role. Shouldn't we be pointing out on other systemic issues that impact the global economic system? Is it as robust as it could get?