As someone living in Hong Kong, it kind of blows my mind how little attention Americans have given this situation. All but a few Americans have their head in the sand on this, and the markets have not at all priced in the all but certain long term impact of this.
I've personally broken my long-time rule of no trading public markets and opened a Robinhood account to hedge against this. So far this week I'm up 5x on those hedges. Markets are starting to realize, but I don't think we're even close to having fully priced in the impact of this.
Everybody remembers the 2008 recession. A subset of people during that recession made a killing. The Big Short was a great book (and movie) about this. This is probably the first new opportunity to be a "big shorter."
Good time to load up on gold and us dollars. I think coronavirus will be the catalyst to end the business cycle and blow the top off some of the major fiscal problems that have popped up.
I'd love to agree with you, but I keep being reminded that 'the market can remain irrational longer than you can remain solvent.'
Sure, I'm nearly certain this is going to give us 2-4 quarters of negative growth, worldwide, but I don't know when the market is actually going to price that in.
Generally each bank has many fund managers and analysts that do a lot of public speaking about their bets, thoughts, and speculations. You'll see them on public news stations as guest commentators
Given what they say has an effect on how others trade, do you think that they may not be completely forthright unless it was in the best interest of their bet?
Either we know different Americans, or have different expectations of what their response is likely to be. I have heard from several friends and from family about their acquisition of significant quantities of non-perishable food, boxes of face masks, and ammo. Definitely don't have their heads in the sand.
I'm somewhat closer to "head in the sand" myself. I am watching the news closely, but don't feel anything I can do in my immediate daily life is consequential to the situation.
Well, a lot of the folks I know who stockpile ammo are cops or veterans (or both) and as such would very much not be looking forward to any collapse, since they've very likely experienced a taste of what that would actually be like.
I just bought 5k of 9mm... virus unrelated. Season is coming up and I’m out of practice. After these, I’ll have fresh brass and reload. Last year I ran about 15k, this year I bet 8k tops. Just too busy.
Well, none of them are the weirdo doomsday prepper types who (as you say) seem to almost look forward to societal collapse in a creepy, power-fantasy way. For these friends and family, it is just a commonly-assumed, shared ethos. They do the same every time a hurricane draws near their part of the gulf coast, and are the first to try and help neighbors, friends or even strangers who need it if those folks are in need.
Stocking up in advance of $WIDELY_REPORTED_THREAT is not something you really question, because it is what you, and everyone you know, has always done for as long as you can remember. Sometimes it has even come in handy and helped people.
I admit I “panic bought” some ammo. It’s for a practical reason, though - my preferred manufacturer for .300 AAC is Australian, and I figure there is at least a chance that the economic disruptions will impact its availability. If so, I picked up as much as I’d normally expect to shoot in the next six months.
Is owning guns and ammo "for shooting" a hobby throughout the country or just in the more rural areas? I'm wondering what facilities are there for something like that in urban environments.
Indoor range exist, but they're often expensive and poorly ventilated. People certainly use them, and some indoor ranges even host USPSA or IDPA matches. You'll want access to an outside range for most forms of recreational rifle shooting.
There absolutely are. I've only ever lived in Urban and Suburban environments in the US for the last 10 years, and the furthest I've ever been from a gun range is probably 15 minutes.
Ranges are far easier to find in urban areas. I live in a town of about 10k, and there is only one pistol range nearby. It opened last year. Before that, you had to either have land or have access to land to shoot.
Hearing gunfire isn’t at all uncommon here. I live right on the edge of city limits, and I doubt a day goes by without being able to hear someone shoot if I’m sitting on my back porch. I totally get that it’s a cultural difference, but it’s very common throughout the US. The only exceptions are very dense urban areas, really.
I’ve heard it said that there are two kinds of places in the US, and they’re categorized by what sound makes you worry. In some places, if you hear an emergency vehicle’s siren you ignore it, but get concerned if you hear gunfire. In others, you ignore the sound of gunfire but get concerned if you hear an emergency vehicle. I definitely live in the latter kind of place.
Ammunition is a durable good as long as it’s kept dry and stays for years. In situations you can bargain with it, use it, and in a best case scenario nothing happens and you simply go shoot it for fun. In a worst case scenario... well it’s pretty self explanatory at that point.
I don't find worst case there to be self explanatory. People put general "self explanatory" in there, cause they dont want to say what they intend to do with those guns.
I don't recall armed individuals with whatever they stocked for themselves to make difference when real issues happen.
What made difference were organized trained ideological groups with those arms. So, in that case, I am really interested to know which ideological group are those people stocking for - and against who they intend to use those guns.
That is why it dont make sense to stock some ammo in abstract and why the expression is slimmy.
In most countries you definitely can own a gun as long as you have some suitable grounds for that, likely hobby in hunting or range shooting (maybe requiring a club membership). Those just aren't super common hobbies.
Owning a gun just for self-defence isn't generally allowed or needed, and would of course be counterproductive anyway as using lethal force would likely land you in much deeper trouble than the looter would face. I'd end with "rightfully so" but I do realize there are deep cultural differences regarding this point.
> Owning a gun just for self-defence isn't generally allowed or needed, and would of course be counterproductive anyway as using lethal force would likely land you in much deeper trouble than the looter would face. I'd end with "rightfully so" but I do realize there are deep cultural differences regarding this point.
Not in certain US states (look up "stand-your-ground" laws).
I agree with you, but that's exactly what I was talking about. In a place where majority of the people cannot just go and buy a firearm without getting a bunch of special permits and club memberships (with gun ownership being pretty rare to begin with), it would definitely seem weird to stockpile ammo.
What's your plan if something does happen, be it this virus, a war or other?
Sit back and wait for the state to save you? I'm not American myself but the lack of self-reliance exhibited by non-Americans, particularly Europeans, is sometimes bewildering.
Those who have lived through a failed state know that no amount of personal fire-power will protect you from a ruling-party politician with the local constabulary in his pocket.
A more generous interpretation of comment you're replying to: It's not that guns and ammo are useful for resisting your local government. They're saying that in the event of catastrophe, it's not a smart bet to rely on local government for protection from human chaos (like looters after your food).
I didn't think my comment was ungenerous - apologies.
What I mean is that evidence shows that when a society collapses, the corrupt and evil will explicitly use the state's monopoly on violence to take what you are trying to defend.
Typically they juice this by exploiting local grievances to de-ligitimise your claim to your property and co-opt the local law enforcement with promises of future gains.
Then they will appear at your homestead WITH the local enforcement - who will do nothing when the mob takes yours assets.
At one level this is to discourage you and increase your sense of isolation - to get you to just abandon your assets and leave. At which point they move onto the next property/resource owner.
However, at another level they WANT to to fight back - with firearms preferably. Not only will this still be deemed illegal (under laws passed by the old functioning society) but hopefully (from their perspective) you injure or kill one of the riled-up mob - further de-legitimising you.
At this point, the co-opted law enforcement will step in, arrest you, etc.
Zimbabwe, the Balkans, and Indonesia are text-book examples.
When society fails violently, there really is no hope.
I like to think that police and military personnel have family and friends they care about too, and aren't soulless robots ready to gun down their fellow men and women who they took vows to serve when they joined the force at the command of a suit in Washington. Think, if you were them, what kind of world would you like you, your family, and friends to live in? I find that enough of them would make the right decision that if the PEOPLE fought back, they would have a winning chance. Think about the rest of the world too. Is Russia going to sit back and do nothing, when they could be funding/supporting those rebels against the U.S. government instead? AND they can do it from the moral high ground too, since they're helping the oppressed rebels against a totalitarian government. Extra power.
The U.S. was founded on rebellion. And I believe enough Americans would readily backstab an illegitimate U.S. government (one that has stopped serving its people and instead serves itself) in pursuit of good.
If the army come after you no amount of arms will save you because they have more and they’re better trained. But if you have a defensible position, enough food and ammunition a small armed group can absolutely hold off another small armed group or a much larger worse armed one. Most of these people are no doubt basically LARPing in their heads. See the Koreans during the LA riots. Even against the state a small group can hold out for a relatively long time. See Waco. It took tanks to breach their defenses.
Few are buying guns and ammo to protect themselves from the government. They are buying them to protect themselves from other citizens should riots break out and rule of law break down, even momentarily. In the last 30 years there have been riots in the US after the announcement of the results of criminal trials in which millions of dollars in damages and people attacking each other. People assault each other every year during Black Friday sales. It's not all that absurd of a notion that it might be good to be able to protect oneself in the event of a truly destructive pandemic.
What's your plan if something does happen, be it this virus, a war or other?
This varies very much on the "something". In the case of a virus like this I have plans to do what seems sensible - keep washing my hands, isolate myself as much as possible.
In the case of a war I'll hope my side wins and keep my head down if it doesn't. Not sure stockpiled ammo is going to be the critical factor there!
Regarding war before the 20th century, Total war[1] was an exception. The plan for European civilians since antiquity was basically life as usual, war was a matter of political power and resources, farms weren't burned and population killed since they were the goal of the war in the first place.
Everyone here is raised learning the history of USA, overthrowing a tyrannical empire and creating our own democracy. We're taught that the Constitution was designed with inherant distrust and selfishness of politicians in mind. Many of us in non-urban areas grew up in areas with police response times greater than 20 minutes. All this and more combines into a self-reliant culture somewhat distrustful of the government that makes us ready to protect ourselves and our families. When considering this culture and context, guns and ammo during times of stress makes more sense.
The plan for European civilians since antiquity was basically life as usual, war was a matter of political power and resources, farms weren't burned and population killed since they were the goal of the war in the first place.
Total war may have been the exception, but farms and cities both suffered enormously during pre-20th century European warfare. Indeed the page you linked gave a bunch of examples of total destruction prior to the 20th century.
Outside those examples, most warfare then relied on looting farms for supplies (including seed crops)[1]. Indeed there was a whole technique of warfare called Chevauchée which relied on this before the 14th century:
A chevauchée [..] was a raiding method of medieval warfare for weakening the enemy, primarily by burning and pillaging enemy territory in order to reduce the productivity of a region, as opposed to siege warfare or wars of conquest... The chevauchée has gained recognition for its use during the Hundred Years' War between the Kingdom of England and the Kingdom of France. It was not a new tactic and had been used many times before; for example, William the Conqueror had used the tactic before the Battle of Hastings to encourage Harold to engage in a battle.[2]
Social distancing, avoiding crowds and certain events, washing hands routinely and before meals, wearing masks when ill would help reduce the spread speed a lot.
Wearing masks also helps set a new social norm. It is now common in Taiwan subways and trains--basically everyone wears a mask.
I have lived in Asia, so I am familiar with the model. Currently I am in a medium-sized city that isn't a major transit hub. I would take my own personal medical precautions, to be sure, if anyone within 2-3 counties away were a suspected case. That is the reason for my keeping an eye on the news. I don't have money to stockpile, much less concern myself with market-related shenanigans.
> It is now common in Taiwan subways and trains--basically everyone wears a mask.
Not clear if it's useful to wear a mask if not displaying any symptoms. I didn't see any official recommendations for doing so. I've been traveling quite a bit in Asia these last few weeks, and I'd say 80% in planes wear masks. However, most of them don't use them properly. They take them on and off, reuse them, adjust them, touch their faces. Sometimes they don't even wear masks, but piece of clothes.
Switzerland has fairly strict gun possession laws, people have a military issue rifle at home, but do not possess ammunition. They also aren't allowed to carry/transport it except very specific situations (eg going from/to shooting range for training).
The argument is essentially that if there comes a time of great shortage, whatever you've stashed for your own survival can be taken from you on a whim if you haven't the resources to defend that stash from those who would seek to take it from you for themselves.
During Hurricane Sandy in the New York area, I was flooded in Jersey City and there was no power — there were roving gangs stealing throughout the neighborhoods. The police response was impossible. So yes, in the event of a serious catastrophe, you aren’t going to be able to depend on police to protect you.
During Katrina, there was widespread looting but also violent gang rapes and other assaults. People, especially in inner cities, are easily victims of violence and theft.
Ammo is in case of violent civil unrest. As a European here is the complete list of European countries that did not have a civil war and were not invaded in Europe 1900-2000. Sweden, Switzerland, Lichtenstein.
Sample size of one, but, everyone at the office today was talking about this, my parents and my wife's parents both called to ask what we thought about it... seems like it's very top of mind for most people I know.
I think it's because the death rate is hard to track and while "high" does not seem nearly as bad as the spanish flu. In part, the damage appears to be China's methods of trying to contain the virus that are making it worse...
For instance, the death rates appear to have a distribution mostly impacting the elderly (incidentally those who are also most likely to have a weaker immune system, but also believe in less conventional medicine:
Not saying this isn't bad, the current stats are showing something around a 0.7% mortality rate[2][3]. The real scare here, is like the spanish flu, there's a chance it can evolve into a more deadly strain (such as SARS) the more people who contract it. If that's the case, we could be seeing 10% fatality rates across the board.
In any case, general point, people American's aren't super worried about it because we have a great healthcare system, and it's spread is limited thus far. I do think a panic will set in as every major city likely now has infected individuals. So it's a good time to pull out of the market.
The reason that the Spanish Flu evolved into a more deadly strain was because WWI was going on. The mild cases stayed at the front lines while the severe ones went home and spread the severe strain around.
This won't happen here because the severe strain will die out. Viruses generally become less lethal as they spread.
> This won't happen here because the severe strain will die out.
Can you please elaborate why this is the case? What if mild cases stay home while patients with severe cases go out looking for medical care, spreading it around? I know nothing about epidemiology, virology, etc. so I would appreciate a little hand-holding.
Viruses undergo natural selection too. A virus that's less lethal has the host as a virus factory for longer. A virus with less overt symptoms is more readily spread to new hosts.
That's the history of syphilis if i understand correctly. It started out as a serious plague that covered its host in oozing sores and killed them in a couple months, now its symptoms are much less severe and it kills in a matter of decades.
Viruses are trying to replicate, not necessarily kill the host. Hence selection pressures will skew it towards “Antibody resistant, lower fatality”.
The common-cold is the most successfully virus for a reason. It’s constantly being spread...which is all the virus ultimately “cares” about. (I know viruses / dna don’t have desires, I’m just using shorthand to discuss the selection pressures).
Viruses that kill their host ultimately are losing a means of transmission.
> Hence selection pressures will skew it towards “Antibody resistant, lower fatality”
But that's my question: Will it in this case? If those with severe symptoms are more likely to go out and spread the disease, wouldn't the more severe version be positively selected?
> Hence selection pressures will skew it towards “Antibody resistant, lower fatality”
That is pressure on the humans. All the humans that will die easily will die and all the survivors will be the more resistant ones.
The virus itself does not behave strategically. Species, other than humans, have no particular ability to plan how they evolve. The only pressures on the virus itself are for longer incubation times, faster ability to spread and the ability to reinfect people. Even if it could strategise there is no particular pressure on the virus whether it kills its host or not as long as it gets passed on to a few people in excess of the original host.
Not really true. The selective advantage is to viruses which can spread to more new hosts. The longer you keep the host arrive, the more new hosts are colonised. If it kills without spreading it’s not going to survive.
> Hence selection pressures will skew it towards “Antibody resistant, lower fatality”
Those selection pressures don't appear until the exponential growth slows down. From the virus perspective right now and in the near term it's super successful, so there's no need to adapt.
The problem here isn't with the mortality per se, it's with the strain on healthcare resources. We just don't have the capacity to deal with an influx of cases requiring hospitalization. Currently about 10%+ of COVID-19 require that. We don't have the beds, the oxygen support, the ventilators, and generally the ability to keep these people from infecting others. That leads to scenes like in Wuhan where people get turned away from hospitals, where they end up dying at home, where bodies require mass cremation, etc. This could happen anywhere. The US healthcare system is not prepared for this. (I don't believe for a second in the assertion that it's the best in the world. Perhaps quality of care is good, but the system that pays for it is a joke. But it's also hugely variable, with some great hospitals attached to university research centers, and a ton of terrible underfunded ones.)
There was article yesterday that one of cruise passenger coming back to USA felt weak and had fewer, but Miami Hospital told him it will cost $3,700 to test his blood. He went home without testing and 3 days later came back with positive result for cornv-19. so much for “best healthcare” if you can’t afford it.
Wuhan later realized the problem that you cannot build ICU rooms as fast. But what is actually need is isolation. They turned stadiums into huge hospitals for those mid-age non-urgent positives. At least they are not spreading viruses to family members. So far it worked pretty well and I just don't see a better way.
This is a war. Been in US for several years, I would say US medical system is not designed for scalability and I have huge doubt if it would work.
Considering the vast majority of Americans do not have jobs that provide good insurance nor have thousands of dollars in savings, I would say you are agreeing that no, the vast majority does not have "great healthcare".
The situation is not good but not quite as dire as you claim. Roughly half of Americans get healthcare from their employer. And while “good insurance” is subjective, it looks like 75% of those people have deductibles under $2000. So not great, but not quite as horrible as “vast majority” imo.
Not sure how you came up with 2/3rds. A significant portion of the half of Americans who don’t get healthcare from their employer get it from Medicare, Medicaid, or other government programs.
Not as bad as the Spanish flu isn't really assuring:
> The global death toll was inconceivable: according to the most recent estimates, between 50 million and 100 million people worldwide perished in the three pandemic waves between the spring of 1918 and the winter of 1919. Adjusting for population growth, that is equivalent to between 200 million and 425 million today.
About the US healthcare system, I was reading this article about a guy who had to pay to be tested. I don't know if this is representative, but it seems quite worrying.
> A subset of people during that recession made a killing.
And a lot of people lost a lot of money trying to time that. It wasn't if, but when. People were talking about the mortgage driven bubble for years by the time 2008 rolled around.
Your timing was good since you bought when the market may have been mispricing volatility. Assuming these are puts, a lot if your gain is from the volatility shoot up.
At this point, the market has corrected volatility pricing dramatically (vix is doubled). Odds are over 50% we'll see sp500 drop below 2900 in next month (Black Scholes). But that doesn't mean a short is profitable - I recall 2008 but also the false recession of late 2018 - few people could have accurately predicted both results.
If you come out on top with your hedging, will you donate the profits to relief / training / prevention / education causes? Otherwise, you're literally profiting from the misfortune of others.
"If things are mispriced, the trade is going to happen. There is absolutely no way it could not."
That's fatalistic. The only way the trade happens is if someone places the trade. If you see the trade as immoral, don't place the trade. If someone else profits from it, so be it, but at least you didn't. Please extrapolate the consequences of your trades. If it feels even slightly dodgy, it probably is, and no matter how you justify it, it was a bad thing to do.
As far as that goes, I don't see trades as immoral, as long as traders are following our laws and the rules of the market. I'd go so far as to say it's virtuous. Trades communicate price information, and that's good for everyone.
If you're concerned about the immorality of economic choices, then you should consider the idea that you yourself are already acting in grossly immoral ways with your money. Read this to see why: https://www.nytimes.com/1999/09/05/magazine/the-singer-solut...
Efficient markets are good for society, they give us accurate prices for things, and inform us of the impact of events. They're not perfect, but they're better than everything else.
Sometimes they are wrong, the price is wrong. If my intuition is correct, my trades help push the price towards the correct direction and make the markets more efficient. If I'm wrong, I lose money.
Hopefully I will profit from spotting an inefficiency in the market that many other did not.
Not everything must be altruistic. The misfortune (some inevitable, some preventable due to bad leadership) will happen anyways. I don't see anything wrong with profiting off of it.
"Efficient markets are good for society, they give us accurate prices for things, and inform us of the impact of events."
Efficient evolution is also good for society. This doesn't mean that we actively kill off the branches of humanity that seem less than ideal.
Every trade you make has effects in the lives of actual people. Don't look at "markets" as the flow of currency. They are often the livelihood of actual people, and when you start hedging on literal life and death, you don't have much wiggle-room to moralize.
"Not everything must be altruistic". No, but if it can be, it should be.
"The misfortune (some inevitable, some preventable due to bad leadership) will happen anyways". Yes, this is why I asked if the profits would go to alleviating this in future incidents. You can't stop the current misfortune, but you may be able to stop the future misfortune.
Here are estimates from MRC Centre for Global Infectious Disease Analysis at Imperial College:
=> Estimated fatality ratio for infections 1% (including those who with mild cases and don't go to see doctors)
=> Estimated Case Fatality Rate (CFR) for travellers outside mainland China (mix severe & milder cases) 1%-5%
=> Estimated CFR for detected cases in Hubei (severe cases) 18%
The last line (18%) applies when the outbreak becomes prevalent in an area and overwhelm hospital capacity.
No country has sufficient ventilators, ECMO machines, and medical staff if infections become widespread since about 20% of infections requires hospitalization. People who need medical care from other causes would suffer from resource shortages as well. If not contained, dozens of cities around the world may become Hubei!
Marc Lipsitch, Professor of Epidemiology at Harvard, believes that it might infect 40-70% of population (excl. kids) without effective control measures.
His articles here: https://twitter.com/mlipsitch/status/1232504457377861632
From Report 6: "we estimated that about two thirds of COVID-19 cases exported from mainland China have remained undetected worldwide, potentially resulting in multiple chains of as yet undetected human-to-human transmission outside mainland China."
Report 4 was published on Feb 10 (the report itself doesn't include any date info, which IMO is a huge mistake, but you bet the data is even older -- the last death recorded in the attached CSV file was from Jan 23), with a couple of stats derived from only two deaths. I would take this report with a bowl of salt, or even mark it as obsolete.
I have followed the news closely, the CFR might decrease a bit in Hubei because China has reinforced it with 20,000 medical staff and hospitals. They also have found some better treatments (not a cure, to be clear).
The approx. 20% hospitalization figure is the elephant in the room. Even if reduced to 10% or 5%, it would still overwhelm medical resources of any country.
The point is if a country gets complacent, it could be too late to contain it without drastic measures and mass sufferings.
> The approx. 20% hospitalization figure is the elephant in the room, even if reduced to 10% or 5%, would still overwhelm medical resources of any country though.
That's for sure. Hopefully fewer people will be touting the "it's just a slightly worse flu" or "common flu kills more" nonsense by now.
This is my big concern too. The bills are going to be massive, people are going to avoid the doctor because they don't have the financial means to pay. Everyone will be at increased risk because we've failed to have the decency to put together even basic universal health care in this country.
That's exactly why people will ignore the symptoms till they fall dead. This virus will be an interesting lesson for both China and America: China will learn the cost of being too authoritarian, since people there are afraid to seek help, and America will learn the cost of greed, since people here are afraid to well.. seek help, but for financial reasons.
This is 100% true, not sure why you're being downvoted. I imagine this will be the leading cause for the spread in the US. We like to on the image that we're first world, but that's only in regards to our professions and their education and training. Once you get into the details of the rest of the system we are anything but that. The healthcare system is merely another profit generating tool in this capitalism-above-all nation.
And would you rather be in a Chinese hospital or an American one? And, before you answer, you might want to have visited a regular Chinese hospital first. In China, you would be safer far away from a hospital.
None of that is commonly required either. For the large majority of cases you stay home and wait until you're better. The primary danger here isn't that it's more severe than the flu, it's that it's more infectious to other people.
Contrary to popular rhetoric, only a small percentage of people in the US don't have health insurance. If so many people get infected that the intersection of people with such severe cases that they need ECMO and people without health insurance is any significant number of people, they're not going to have enough hospital rooms and equipment anyway. Which is hopefully not going to happen regardless.
Everything is thousands of dollars in a hospital emergency room. They charge hundreds of dollars for a band aid. It's not the place to go for a routine diagnostic test if you care at all about the price.
The test that cost thousands of dollars in your article was the routine diagnostic test for the flu. It didn't cost thousands of dollars because it was for the coronavirus, it cost thousands of dollars because it was done in an emergency room.
There will be exactly zero medical bankruptcies because of this.
If you are poor you get free healthcare, or at least subsidized. If you have more money you buy insurance, or your employer offers it.
At most you'll have to pay a several thousand dollar deductible, which isn't going to bankrupt anyone (remember that poor people get the free version).
> It took four days for the patient to be tested for the coronavirus by the CDC, according to the letter, because the patient didn’t fit the initial criteria of a likely patient. The CDC confirmed the diagnosis on Wednesday, according to the report.
This is what’s scary to me as that means the patient probably wasn’t isolated with daily healthcare.
Does this mean everyone who came in contact with them during that time is self monitoring for symptoms for some large number of days?
They isolated some patient care personnel as a precaution. However since they suspected the patient had covid19 they took strong protective measures already.
Prior to Sunday they only used droplet precautions when interacting with the patient. After Sunday they switched to airborne precautions. Anybody that interacted with the patient prior to Sunday should absolutely be quarantined.
I'm doing my best to _try_ to understand why the CDC is operating as it has been, and why the test count is so low to date.
The CDC issued test kits this far have been faulty, and a charitable interpretation of their slow response time is that the CDC would prefer people are treated as unknowns rather than false negatives (infected thinking they're clean because they tested negative).
As an Australian, and trying to be non-partisan, it seems that there were a large number of funding cuts to the CDC, especially in the areas that are responsible for pandemic control.
I hope that this isn't the reason, but it may be worth looking into.
My guess is that the world didn't really understand what and why China did take such draconian measures (Shutting down whole cities, locking people in their homes, stopping transportation, building hospitals in record time, etc...). From the graph it looks like China successfully contained the disease. China has around 78,500 cases; around 65,000 of those are in Hubei which has 50 million people.
If we were to extrapolate these numbers to the rest of the world (ex. China), that would be around 8.19 million cases and around 350k deaths. But this assumes that the cities of the rest of the world could implement the strict curfews that China implemented.
It's also important to remember that Hubei had a big support network of neighboring cities which could provide resources. Countries where all cities will break out at the same time will have a hard time copping.
And people will continue to go to work with C-19 unless they are physically stopped by authorities because that's what our culture teaches. Frankly, I can't blame them given the shitty economic conditions here, but it'll be horrific for any kind of containment efforts.
> And people will continue to go to work with C-19 unless they are physically stopped by authorities because that's what our culture teaches. Frankly, I can't blame them given the shitty economic conditions here, but it'll be horrific for any kind of containment efforts.
I think the bigger take-away here is that Insurance providers, especially the lower tier ones, will fight you tooth and nail to provide the medical coverage and incur all the costs associated with that (billing personnel, lawyers etc...) instead of just paying for the costs as agreed upon.
This is very distressing, and I was looking at my medical bills from last year, the blood work done cost nearly $800, and I opted for a cortisone level exam that was $280, of which I only paid $15. But it took a ton of legwork, calling for procedure numbers, speaking to clueless CSR outside the US. The costs for basic procedures are just outlandish, so both the hospital as well as the Insurance play this war of attrition where the only real loser is the patient caught in between, often while ill and with no other recourse.
This poor guy got screwed and even with medical insurance they wanted HIM to do the legwork to prove he shouldn't pay when his exams were complete.
I'm kind of on-board for a Megacorp like Walmart to enter this space at this point, if only to see what other alternatives they could come with.
Their vision stuff wasn't bad at all, I had a hard time getting an appointment with a local provider with my medical insurance due to time/schedule constraints, so I went to a Walmart, got an exam during lunch (covered by insurance), gave them my frames and 1.5 week later I had them in my hand with new lenses for $155 with 2 year warranty waiting for me in the evening (7pm?).
I think my Insurance savings would have been like $40 had I gone into a network optometrist so it was hardly a deal breaker as my time was a bigger concern.
Although many might want to blame private companies in some political agenda, there are reports that it isn't the private sector that is inhibiting testing, it's govt and govt regulations.
Oh, absolutely. I can't even get a straight answer out of my insurance as to when the deductible period starts. Or how many visits to a certain specialist I'm allowed. That is the most basic of information. If you call 3 different times with a simple question, you get 3 different answers, all contradictory.
This has to stop and the only way it'll stop is with proper government regulations that are enforced. The patient should never see a bill for anything other then a set monthly premium (which ideally should come out of taxes, but it doesn't have to completely). Anything else, at this point, is fucking barbaric, primitive, and shameful. To be the richest country in the world and have the worst healthcare system in the developed world is disgusting.
When it costs $3270 to take a COVID-19 test [1], and if I’m young, and poor, and broke, then well, F that. I’m going to just take my chances and risk it. And try to not cough on some rich guy, because well, he has insurance that’ll probably pay for it.
And then our President tells us that not everyone can get a vaccine, just because it’s too expensive [2], and they can’t afford to pay for it. Tough luck. Meanwhile, he gives another tax cut to his rich billionaire buddies.
remember what the USSR did with chernobyl? They constantly downplayed the numbers to save face. I suspect that's what they're doing here. No 100% guarantee but considering the CCP's record of doing everything they can to maintain their pride and not showing weakness this would make sense.
The 1918 flu killed ~0.01% of Philadelphia in one winter.
The Liberty Loan Parade on September 28th was a major event in the pandemic. Health officials knew that the flu was in Philadelphia and had warned City Officials about it in very clear terms. The parade continued on and 3 days later, people started showing up to hospitals, just as predicted. The morgue was rated for 36 bodies. Hundreds came in every day that winter. They had priests operating backhoes to bury the dead, as the workers were too sick to do so. The entire city was quarantined.
Still, newspapers published day after day that everything was fine, despite the obituaries becoming an ever thickening section. People knew and it wasn't hard to guess.
The Soviets did it with Chernobyl, the Chinese are doing it right now, and the US did it nearly 100 years ago.
These are human things, not specific to any country.
It seems that it’ll be safer to be in China, in 2 months, because they were actually serious about this, and forced all the quarantines and draconian measures.
Meanwhile the rest of the world is going to get ravaged.
I think Europe is going to explode in cases by next week.
Then the Middle East in 2 weeks.
Then South America in 3 weeks.
I think it’s already silently spreading in America. Maybe it’ll explode in 2 weeks.
Edit: I'm not sure why I'm being downvoted. I think this is worth sharing and discussing.
I've been watching this a bit too closely and am probably becoming an alarmist, but I find the smartphone video footage of this outbreak both fascinating and worrying.
I've compiled a list of unverified videos from Reddit, TikTok, and Twitter. They're not journalistic, so take things with a grain of salt, but at the same time I think it's worth synthesizing into your understanding of this virus.
WARNING: these can be graphic or disturbing.
Nurse in Iran reports eight deaths. Deaths of a twenty year old with no prior health issues and two thirty year olds. Deaths are sudden and unexpected:
Reports of elderly infected in Wuhan being stuffed into body bags for cremation while still alive. Please be aware that this is from NTD, a news organization that is the mouthpiece of the Falun Gong, a religious group persecuted by China, which is an absolutely biased source:
Another NTD report that claims China's death toll is being grossly under reported. An investigator supposedly calls a funeral home employee and enquiries about their daily volume. The employee finally relents (15m20s mark) and reports that their funeral home processed 127 in a single day. There are over 10 such funeral homes in Wuhan running 24/7.
I'm personally a little worried as I'm not sure why these measures would be taken over flu or a disease that only impacts the elderly (as macabre as that sounds).
I've seen other videos I can't find the links to right now:
- Chinese police patrolling the street with rifles that look like they're "hunting" for anyone not obeying the quarantine.
- Prisoners(?) tied into a lengthy chain gang and being escorted by masked guards.
- Lots of videos of people suddenly falling over dead in public. Chinese videos mostly, but also videos from Iran.
- Dead bodies lining the streets covered in sheets as the videographer drives by. This one was possibly debunked as homeless people asleep.
- Death rattle videos. These are tragic and horrifying.
Some of them could be from just about anywhere, anytime. In an age of HD video being the norm for even consumers, grainy footage that then ALSO doesn't have a source or date and is posted by anonymous people on social media? Just no.
This post is not informative or helpful at all, you’re just fearmongering by posting a bunch of disturbing videos with scary summary text. It’s obvious your motivation is to simply stoke fears - whether that’s for financial gain or to demonize Chinese/Asian people is hard to tell
Oh, fuck off. It's obvious from your username that you're simply into watching people drown alive as their lungs fill with liquid, and furthermore a simple character count + tea leaf analysis shows you pooped on a pigeon yesteday at 4 pm, while praying to Satan for SARS2 to wipe humanity away. Any attempt to deny it would just prove it further, if further proof were even possible at this point of 100% proof.
> whether that’s for financial gain or to demonize Chinese/Asian people is hard to tell
I love how you add this as if to offset you just making an authoritative claim about the inner motivations of a person you haven't spoken a word with in your life. How very fucking scientific.
I have nothing to gain from this. I'm not selling anything, unless you consider the concept that the virus is "more dangerous than they lead you to believe" a meme that is seeking to replicate in the Dawkins sense.
I love the Chinese people and culture. I studied the language in college. I have moral disagreements with the CCP, but I'm not trying to attack or disparage it here.
To refer back to the videos, in the case where there has been a claim that critically sick people are being sent off to the crematoriums while still alive, I doubt that there is a high ranking official making that decision. It's probably fear, volume of cases, and utter exhaustion of some limited individuals in the health care system. If the story is even true.
I admit that many of these videos are dubious (especially the Falun Gong ones), but taken together there is some underlying theme here. Whatever that is, I think it's prudent to be cautious. We haven't seen an event like this in our lifetimes, so it's easy to forget how drastic and extensive they can be.
As an aside, I took two semesters of immunology in undergrad, a special topics virology course, and a bunch of biochem. I only have an undergraduate understanding, and a foggy one at that. Zoonotic diseases often have trouble when they jump the species barrier: they're too lethal, have a low transmission, etc. This one seems to have won the genetic lottery.
Many of these claims are from low-quality sources. For the specific point about funerals, you cite a single number in a single funeral home on a single day and try to extrapolate from that.
China banned funerals and mandated cremations, and my guess is that they did so for the purpose of masking the death toll. We would be foolish to trust China's words rather than its actions, and its actions indicate that the death toll was sufficient to justify a substantial shutdown of an entire industrial region of the country.
"The order also prohibits funeral ceremonies for those who have died from the virus, potentially cutting off the grieving process and any religious ceremony for families and entire communities who are mourning the loss of their loved ones, and there is little sign such an arrangement is even necessary."
> you cite a single number in a single funeral home on a single day and try to extrapolate from that.
I did. Thank you for calling me out on that.
I still find it interesting that the funeral home employees were (allegedly--again, this is Falun Gong) instructed not to talk to anyone about cremation volume and that the numbers provided were an order of magnitude lower than what this individual cited.
> China banned funerals and mandated cremations, and my guess is that they did so for the purpose of masking the death toll.
I was thinking it could be more innocuous: preventing bodies with high viral titers that are shedding from being hugged by uninfected loved ones. But you could also be right.
"There are indications that other hospitals could be involved in the case. Kris Concepcion, fire chief and acting public information officer in Vacaville, Calif., said county officials had issued a directive not to transport any new patients to two local hospitals — NorthBay VacaValley Hospital in Vacaville and NorthBay Medical Center in nearby Fairfield. Concepcion declined to say why those orders had been given."
Having this patient at my place of work does not worry me at all. Not one bit.
Time to use some of my vacation days.
Note: I'm not a medical practitioner, I am a research scientist and can do my work remotely. I admire and applaud the doctors and nurse who are there, and UC Davis has some of the best.
I'm confused about the Coronavirus mortality figures. The published numbers appear to be computed as deaths/cases. But cases is growing exponentially and deaths take time.
If you use deaths/(deaths+recoveries) you get a much higher figure, but presumably recoveries take longer than deaths.
This absolutely isn't accurate. The website promoting this garbage is dangerous. Nobody knows the total infected, nor the real fatality rate. But pay attention to how many on the cruise liners have died. 14% is a joke. My completely off the cuff, uneducated guess would be closer to 3%.
I would expect a dismissal of a website as inaccurate garbage to be supported by a better counter-argument than a "completely off the cuff, uneducated guess."
> If you use deaths/(deaths+recoveries) you get a much higher figure
You also have to take into account that mild cases are probably never detected and counted. So you are calculating the fraction of deaths among severe cases, not among all cases.
People have tried proper mathematical modelling but the data is fuzzy and it depends on how good the treatment is. Estimates seem to be about 2% of those getting it will die. I'm cautiously optimistic that chloroquine may drop the fatalities a fair bit. (http://www.china.org.cn/china/2020-02/22/content_75732846.ht...)
2-3% is the number you get from taking deaths divided by cases. This appears to be an obvious erroneous estimation technique.
The a parallel response links an article pointing to a paper evaluating this very question for the SARS outbreak. The paper shows that-- as I suggested-- dividing death by cases gives an extremely biased (low) estimate until the rate of new infections drops off. For SARS, deaths/(deaths+recoveries) was an accurate estimation.
I kinda foresee this spreading in US the worst, people who work in low paid jobs like McDonalds (which requires lots of people contact) rarely take sick days there as far as i remember.
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[ 3.5 ms ] story [ 228 ms ] threadI've personally broken my long-time rule of no trading public markets and opened a Robinhood account to hedge against this. So far this week I'm up 5x on those hedges. Markets are starting to realize, but I don't think we're even close to having fully priced in the impact of this.
Everybody remembers the 2008 recession. A subset of people during that recession made a killing. The Big Short was a great book (and movie) about this. This is probably the first new opportunity to be a "big shorter."
Sure, I'm nearly certain this is going to give us 2-4 quarters of negative growth, worldwide, but I don't know when the market is actually going to price that in.
I'm somewhat closer to "head in the sand" myself. I am watching the news closely, but don't feel anything I can do in my immediate daily life is consequential to the situation.
Yeah those type of people always think civilisation is about to collapse. And lots of them are looking forward to it.
Stocking up in advance of $WIDELY_REPORTED_THREAT is not something you really question, because it is what you, and everyone you know, has always done for as long as you can remember. Sometimes it has even come in handy and helped people.
Hearing gunfire isn’t at all uncommon here. I live right on the edge of city limits, and I doubt a day goes by without being able to hear someone shoot if I’m sitting on my back porch. I totally get that it’s a cultural difference, but it’s very common throughout the US. The only exceptions are very dense urban areas, really.
I’ve heard it said that there are two kinds of places in the US, and they’re categorized by what sound makes you worry. In some places, if you hear an emergency vehicle’s siren you ignore it, but get concerned if you hear gunfire. In others, you ignore the sound of gunfire but get concerned if you hear an emergency vehicle. I definitely live in the latter kind of place.
I don't recall armed individuals with whatever they stocked for themselves to make difference when real issues happen.
What made difference were organized trained ideological groups with those arms. So, in that case, I am really interested to know which ideological group are those people stocking for - and against who they intend to use those guns.
That is why it dont make sense to stock some ammo in abstract and why the expression is slimmy.
Owning a gun just for self-defence isn't generally allowed or needed, and would of course be counterproductive anyway as using lethal force would likely land you in much deeper trouble than the looter would face. I'd end with "rightfully so" but I do realize there are deep cultural differences regarding this point.
Not in certain US states (look up "stand-your-ground" laws).
Sit back and wait for the state to save you? I'm not American myself but the lack of self-reliance exhibited by non-Americans, particularly Europeans, is sometimes bewildering.
But if it makes you feel better…
I don't have an answer for this, but it's something worth keeping in the back of your mind when discussing theoretical catastrophes.
What I mean is that evidence shows that when a society collapses, the corrupt and evil will explicitly use the state's monopoly on violence to take what you are trying to defend.
Typically they juice this by exploiting local grievances to de-ligitimise your claim to your property and co-opt the local law enforcement with promises of future gains.
Then they will appear at your homestead WITH the local enforcement - who will do nothing when the mob takes yours assets.
At one level this is to discourage you and increase your sense of isolation - to get you to just abandon your assets and leave. At which point they move onto the next property/resource owner.
However, at another level they WANT to to fight back - with firearms preferably. Not only will this still be deemed illegal (under laws passed by the old functioning society) but hopefully (from their perspective) you injure or kill one of the riled-up mob - further de-legitimising you.
At this point, the co-opted law enforcement will step in, arrest you, etc.
Zimbabwe, the Balkans, and Indonesia are text-book examples.
When society fails violently, there really is no hope.
I wish it wasn't thus, but is is and will be.
The U.S. was founded on rebellion. And I believe enough Americans would readily backstab an illegitimate U.S. government (one that has stopped serving its people and instead serves itself) in pursuit of good.
FTFY
2.The U.S. was founded on rebellion.
So was Somalia. Its not a sufficient reason to protect you from the failure mode I explained above.
This varies very much on the "something". In the case of a virus like this I have plans to do what seems sensible - keep washing my hands, isolate myself as much as possible.
In the case of a war I'll hope my side wins and keep my head down if it doesn't. Not sure stockpiled ammo is going to be the critical factor there!
https://en.m.wikipedia.org/wiki/Total_war
Total war may have been the exception, but farms and cities both suffered enormously during pre-20th century European warfare. Indeed the page you linked gave a bunch of examples of total destruction prior to the 20th century.
Outside those examples, most warfare then relied on looting farms for supplies (including seed crops)[1]. Indeed there was a whole technique of warfare called Chevauchée which relied on this before the 14th century:
A chevauchée [..] was a raiding method of medieval warfare for weakening the enemy, primarily by burning and pillaging enemy territory in order to reduce the productivity of a region, as opposed to siege warfare or wars of conquest... The chevauchée has gained recognition for its use during the Hundred Years' War between the Kingdom of England and the Kingdom of France. It was not a new tactic and had been used many times before; for example, William the Conqueror had used the tactic before the Battle of Hastings to encourage Harold to engage in a battle.[2]
[1] https://en.wikipedia.org/wiki/Medieval_warfare#Supplies_and_...
[2] https://en.wikipedia.org/wiki/Chevauchée
Wearing masks also helps set a new social norm. It is now common in Taiwan subways and trains--basically everyone wears a mask.
Not clear if it's useful to wear a mask if not displaying any symptoms. I didn't see any official recommendations for doing so. I've been traveling quite a bit in Asia these last few weeks, and I'd say 80% in planes wear masks. However, most of them don't use them properly. They take them on and off, reuse them, adjust them, touch their faces. Sometimes they don't even wear masks, but piece of clothes.
But for what on earth do they need to stock up on ammo?
For an European that's beyond strange
So yes not comparable.
Ammunition is relatively cheap and extremely high value if it's needed, and more likely to be needed in an emergency.
During Katrina, there was widespread looting but also violent gang rapes and other assaults. People, especially in inner cities, are easily victims of violence and theft.
A good look into what this looks like would be the Algiers Point shooting in the Hurricane Katrina aftermath.
Russia, Germany, Finland, Ireland, Austria, Portugal, Yugoslavia three times, Spain, Poland, Greece, Romania, Cyprus, Georgia, Albania
For instance, the death rates appear to have a distribution mostly impacting the elderly (incidentally those who are also most likely to have a weaker immune system, but also believe in less conventional medicine:
80+ years old 14.8%
70-79 years old 8.0%
60-69 years old 3.6%
50-59 years old 1.3%
40-49 years old 0.4%
30-39 years old 0.2%
20-29 years old 0.2%
10-19 years old 0.2%
0-9 years old no fatalities
https://www.worldometers.info/coronavirus/coronavirus-age-se...
Not saying this isn't bad, the current stats are showing something around a 0.7% mortality rate[2][3]. The real scare here, is like the spanish flu, there's a chance it can evolve into a more deadly strain (such as SARS) the more people who contract it. If that's the case, we could be seeing 10% fatality rates across the board.
If you're interested in the history of the spanish flu, there's a great series here: https://www.youtube.com/watch?v=XQ9WX4qVxEo&list=PLhyKYa0YJ_...
In any case, general point, people American's aren't super worried about it because we have a great healthcare system, and it's spread is limited thus far. I do think a panic will set in as every major city likely now has infected individuals. So it's a good time to pull out of the market.
[2] https://www.statnews.com/2020/02/25/new-data-from-china-butt...
[3] https://www.marketwatch.com/story/coronavirus-update-79339-c...
This won't happen here because the severe strain will die out. Viruses generally become less lethal as they spread.
Can you please elaborate why this is the case? What if mild cases stay home while patients with severe cases go out looking for medical care, spreading it around? I know nothing about epidemiology, virology, etc. so I would appreciate a little hand-holding.
> Hence selection pressures will skew it towards “Antibody resistant, lower fatality”
But that's my question: Will it in this case? If those with severe symptoms are more likely to go out and spread the disease, wouldn't the more severe version be positively selected?
That is pressure on the humans. All the humans that will die easily will die and all the survivors will be the more resistant ones.
The virus itself does not behave strategically. Species, other than humans, have no particular ability to plan how they evolve. The only pressures on the virus itself are for longer incubation times, faster ability to spread and the ability to reinfect people. Even if it could strategise there is no particular pressure on the virus whether it kills its host or not as long as it gets passed on to a few people in excess of the original host.
Those selection pressures don't appear until the exponential growth slows down. From the virus perspective right now and in the near term it's super successful, so there's no need to adapt.
The problem here isn't with the mortality per se, it's with the strain on healthcare resources. We just don't have the capacity to deal with an influx of cases requiring hospitalization. Currently about 10%+ of COVID-19 require that. We don't have the beds, the oxygen support, the ventilators, and generally the ability to keep these people from infecting others. That leads to scenes like in Wuhan where people get turned away from hospitals, where they end up dying at home, where bodies require mass cremation, etc. This could happen anywhere. The US healthcare system is not prepared for this. (I don't believe for a second in the assertion that it's the best in the world. Perhaps quality of care is good, but the system that pays for it is a joke. But it's also hugely variable, with some great hospitals attached to university research centers, and a ton of terrible underfunded ones.)
This is a war. Been in US for several years, I would say US medical system is not designed for scalability and I have huge doubt if it would work.
So far this proved to be working.
Good joke. You may have great healthcare if you are very rich. Otherwise...
If you are poor you get free healthcare, if you have a bit more money you get great healthcare by buying insurance, usually your employer offers it.
The worst you can say is that most people have a several thousand dollar deductible, which isn't great, but it's also not bank breaking.
Which is precisely what was claimed.
https://www.nytimes.com/2019/09/25/health/employer-health-in...
Alright, it is not a vast majority numerically. It is still a catastrophe waiting to happen in comparison with other countries.
40% of Americans couldn’t come up with $400 for an unexpected expense.[0]
[0] https://www.cnbc.com/2019/07/20/heres-why-so-many-americans-...
> The global death toll was inconceivable: according to the most recent estimates, between 50 million and 100 million people worldwide perished in the three pandemic waves between the spring of 1918 and the winter of 1919. Adjusting for population growth, that is equivalent to between 200 million and 425 million today.
https://www.independent.co.uk/news/world/americas/coronaviru...
I am sorry, have you ever been to a hospital? I cannot read that with a straight face at all.
In our culture, providers are more interested with how they get paid than providing care.
People tend to avoid care completely just to avoid the hassle.
And a lot of people lost a lot of money trying to time that. It wasn't if, but when. People were talking about the mortgage driven bubble for years by the time 2008 rolled around.
At this point, the market has corrected volatility pricing dramatically (vix is doubled). Odds are over 50% we'll see sp500 drop below 2900 in next month (Black Scholes). But that doesn't mean a short is profitable - I recall 2008 but also the false recession of late 2018 - few people could have accurately predicted both results.
I dollar cost average, but I plan to pick up extra stock in corona bear market if I can scratch any extra cash together.
If it makes you feel better, many of the wealthiest traders do in fact donate a lot of money to such causes.
That's fatalistic. The only way the trade happens is if someone places the trade. If you see the trade as immoral, don't place the trade. If someone else profits from it, so be it, but at least you didn't. Please extrapolate the consequences of your trades. If it feels even slightly dodgy, it probably is, and no matter how you justify it, it was a bad thing to do.
If you're concerned about the immorality of economic choices, then you should consider the idea that you yourself are already acting in grossly immoral ways with your money. Read this to see why: https://www.nytimes.com/1999/09/05/magazine/the-singer-solut...
Sometimes they are wrong, the price is wrong. If my intuition is correct, my trades help push the price towards the correct direction and make the markets more efficient. If I'm wrong, I lose money.
Hopefully I will profit from spotting an inefficiency in the market that many other did not.
Not everything must be altruistic. The misfortune (some inevitable, some preventable due to bad leadership) will happen anyways. I don't see anything wrong with profiting off of it.
Efficient evolution is also good for society. This doesn't mean that we actively kill off the branches of humanity that seem less than ideal.
Every trade you make has effects in the lives of actual people. Don't look at "markets" as the flow of currency. They are often the livelihood of actual people, and when you start hedging on literal life and death, you don't have much wiggle-room to moralize.
"Not everything must be altruistic". No, but if it can be, it should be.
"The misfortune (some inevitable, some preventable due to bad leadership) will happen anyways". Yes, this is why I asked if the profits would go to alleviating this in future incidents. You can't stop the current misfortune, but you may be able to stop the future misfortune.
Anyway, good health to you and yours.
=> Estimated fatality ratio for infections 1% (including those who with mild cases and don't go to see doctors)
=> Estimated Case Fatality Rate (CFR) for travellers outside mainland China (mix severe & milder cases) 1%-5%
=> Estimated CFR for detected cases in Hubei (severe cases) 18%
The last line (18%) applies when the outbreak becomes prevalent in an area and overwhelm hospital capacity.
No country has sufficient ventilators, ECMO machines, and medical staff if infections become widespread since about 20% of infections requires hospitalization. People who need medical care from other causes would suffer from resource shortages as well. If not contained, dozens of cities around the world may become Hubei!
Marc Lipsitch, Professor of Epidemiology at Harvard, believes that it might infect 40-70% of population (excl. kids) without effective control measures. His articles here: https://twitter.com/mlipsitch/status/1232504457377861632
--
Reference: Report 4 here: https://www.imperial.ac.uk/mrc-global-infectious-disease-ana...
From Report 6: "we estimated that about two thirds of COVID-19 cases exported from mainland China have remained undetected worldwide, potentially resulting in multiple chains of as yet undetected human-to-human transmission outside mainland China."
For concise interviews with experts and other info: Follow their Twitter at @MRC_Outbreak https://twitter.com/MRC_Outbreak
The approx. 20% hospitalization figure is the elephant in the room. Even if reduced to 10% or 5%, it would still overwhelm medical resources of any country.
The point is if a country gets complacent, it could be too late to contain it without drastic measures and mass sufferings.
That's for sure. Hopefully fewer people will be touting the "it's just a slightly worse flu" or "common flu kills more" nonsense by now.
Edit: Downvotes? Really?
It will be the number of medical bankruptcies.
Also it'll be interesting to see how much more contagious it will be in a country where people avoid hospitals because of the cost.
There is little to none surge capacity at US hospitals.
Anyone who has experienced both can speak to the disparity.
The bigger problem is people who keep going to work when they're sick instead of staying home.
Contrary to popular rhetoric, only a small percentage of people in the US don't have health insurance. If so many people get infected that the intersection of people with such severe cases that they need ECMO and people without health insurance is any significant number of people, they're not going to have enough hospital rooms and equipment anyway. Which is hopefully not going to happen regardless.
https://www.google.com/amp/s/amp.miamiherald.com/news/health...
And treatment for at least some cases involves hospital stays similar to pneumonia.
As of February 23, 11 travelers were referred to a hospital and tested for infection; one tested positive and was isolated and managed medically.
https://www.cdc.gov/mmwr/volumes/69/wr/mm6908e1.htm
I daresay the quality may not be the same. Really the US govt should do free testing.
There will be exactly zero medical bankruptcies because of this.
If you are poor you get free healthcare, or at least subsidized. If you have more money you buy insurance, or your employer offers it.
At most you'll have to pay a several thousand dollar deductible, which isn't going to bankrupt anyone (remember that poor people get the free version).
40% of Americans would have difficulty paying an unexpected 400$ expense: https://www.federalreserve.gov/publications/2019-economic-we...
Tens of millions more are under-insured.
40% of Americans can't afford $400 for an emergency expense: https://www.federalreserve.gov/publications/files/2017-repor...
You have no idea what you're talking about.
This is what’s scary to me as that means the patient probably wasn’t isolated with daily healthcare.
Does this mean everyone who came in contact with them during that time is self monitoring for symptoms for some large number of days?
They isolated some patient care personnel as a precaution. However since they suspected the patient had covid19 they took strong protective measures already.
CDC needlessly put medical personnel in harms way by setting extremely stringent testing criteria.
The CDC issued test kits this far have been faulty, and a charitable interpretation of their slow response time is that the CDC would prefer people are treated as unknowns rather than false negatives (infected thinking they're clean because they tested negative).
I hope that this isn't the reason, but it may be worth looking into.
This means several people in contact with the unconfirmed infected case may not yet self-isolate and can spread it around during the wait time.
If we were to extrapolate these numbers to the rest of the world (ex. China), that would be around 8.19 million cases and around 350k deaths. But this assumes that the cities of the rest of the world could implement the strict curfews that China implemented.
It's also important to remember that Hubei had a big support network of neighboring cities which could provide resources. Countries where all cities will break out at the same time will have a hard time copping.
But in the US some guy owes thousands for getting a test that turned out to be negative.
https://www.miamiherald.com/news/health-care/article24047680...
I think the bigger take-away here is that Insurance providers, especially the lower tier ones, will fight you tooth and nail to provide the medical coverage and incur all the costs associated with that (billing personnel, lawyers etc...) instead of just paying for the costs as agreed upon.
This is very distressing, and I was looking at my medical bills from last year, the blood work done cost nearly $800, and I opted for a cortisone level exam that was $280, of which I only paid $15. But it took a ton of legwork, calling for procedure numbers, speaking to clueless CSR outside the US. The costs for basic procedures are just outlandish, so both the hospital as well as the Insurance play this war of attrition where the only real loser is the patient caught in between, often while ill and with no other recourse.
This poor guy got screwed and even with medical insurance they wanted HIM to do the legwork to prove he shouldn't pay when his exams were complete.
I'm kind of on-board for a Megacorp like Walmart to enter this space at this point, if only to see what other alternatives they could come with.
Their vision stuff wasn't bad at all, I had a hard time getting an appointment with a local provider with my medical insurance due to time/schedule constraints, so I went to a Walmart, got an exam during lunch (covered by insurance), gave them my frames and 1.5 week later I had them in my hand with new lenses for $155 with 2 year warranty waiting for me in the evening (7pm?).
I think my Insurance savings would have been like $40 had I gone into a network optometrist so it was hardly a deal breaker as my time was a bigger concern.
https://marginalrevolution.com/marginalrevolution/2020/02/wh...
And there are demands now for increasing general surveillance to provide for better CDC responses. It's just disgusting.
This has to stop and the only way it'll stop is with proper government regulations that are enforced. The patient should never see a bill for anything other then a set monthly premium (which ideally should come out of taxes, but it doesn't have to completely). Anything else, at this point, is fucking barbaric, primitive, and shameful. To be the richest country in the world and have the worst healthcare system in the developed world is disgusting.
When it costs $3270 to take a COVID-19 test [1], and if I’m young, and poor, and broke, then well, F that. I’m going to just take my chances and risk it. And try to not cough on some rich guy, because well, he has insurance that’ll probably pay for it.
And then our President tells us that not everyone can get a vaccine, just because it’s too expensive [2], and they can’t afford to pay for it. Tough luck. Meanwhile, he gives another tax cut to his rich billionaire buddies.
[1] https://www.miamiherald.com/news/health-care/article24047680...
[2] https://www.businessinsider.com/trump-administration-says-co...
The Liberty Loan Parade on September 28th was a major event in the pandemic. Health officials knew that the flu was in Philadelphia and had warned City Officials about it in very clear terms. The parade continued on and 3 days later, people started showing up to hospitals, just as predicted. The morgue was rated for 36 bodies. Hundreds came in every day that winter. They had priests operating backhoes to bury the dead, as the workers were too sick to do so. The entire city was quarantined.
Still, newspapers published day after day that everything was fine, despite the obituaries becoming an ever thickening section. People knew and it wasn't hard to guess.
The Soviets did it with Chernobyl, the Chinese are doing it right now, and the US did it nearly 100 years ago.
These are human things, not specific to any country.
Meanwhile the rest of the world is going to get ravaged.
I think Europe is going to explode in cases by next week.
Then the Middle East in 2 weeks.
Then South America in 3 weeks.
I think it’s already silently spreading in America. Maybe it’ll explode in 2 weeks.
I don't think so.
I've been watching this a bit too closely and am probably becoming an alarmist, but I find the smartphone video footage of this outbreak both fascinating and worrying.
I've compiled a list of unverified videos from Reddit, TikTok, and Twitter. They're not journalistic, so take things with a grain of salt, but at the same time I think it's worth synthesizing into your understanding of this virus.
WARNING: these can be graphic or disturbing.
Nurse in Iran reports eight deaths. Deaths of a twenty year old with no prior health issues and two thirty year olds. Deaths are sudden and unexpected:
https://twitter.com/AlinejadMasih/status/1232779487647031302...
Multiple children (around age 8) being wrapped into the same body bag by doctors wearing masks.
https://youtu.be/sImeSvSS_60
Mobile crematoriums:
https://twitter.com/JoeB14ck/status/1230040837255380993
Reports of elderly infected in Wuhan being stuffed into body bags for cremation while still alive. Please be aware that this is from NTD, a news organization that is the mouthpiece of the Falun Gong, a religious group persecuted by China, which is an absolutely biased source:
https://youtu.be/YpeNO8PSuyY?t=5m39s (at 5:39)
Another NTD report that claims China's death toll is being grossly under reported. An investigator supposedly calls a funeral home employee and enquiries about their daily volume. The employee finally relents (15m20s mark) and reports that their funeral home processed 127 in a single day. There are over 10 such funeral homes in Wuhan running 24/7.
https://youtu.be/-KFxCqV1fPQ?t=15m20s
Forced quarantines:
https://youtu.be/nNeTWX7WgwA
https://youtu.be/CDePjw3w0xg
Welding families inside their homes regardless of the fire risk:
https://twitter.com/Terrence_STR/status/1226535217055313921
Those locked in Wuhan screaming at night. (Media says these are "chants of solidarity".)
https://youtu.be/opFCAWZHpzg
I'm personally a little worried as I'm not sure why these measures would be taken over flu or a disease that only impacts the elderly (as macabre as that sounds).
I've seen other videos I can't find the links to right now:
- Chinese police patrolling the street with rifles that look like they're "hunting" for anyone not obeying the quarantine.
- Prisoners(?) tied into a lengthy chain gang and being escorted by masked guards.
- Lots of videos of people suddenly falling over dead in public. Chinese videos mostly, but also videos from Iran.
- Dead bodies lining the streets covered in sheets as the videographer drives by. This one was possibly debunked as homeless people asleep.
- Death rattle videos. These are tragic and horrifying.
Oh, fuck off. It's obvious from your username that you're simply into watching people drown alive as their lungs fill with liquid, and furthermore a simple character count + tea leaf analysis shows you pooped on a pigeon yesteday at 4 pm, while praying to Satan for SARS2 to wipe humanity away. Any attempt to deny it would just prove it further, if further proof were even possible at this point of 100% proof.
> whether that’s for financial gain or to demonize Chinese/Asian people is hard to tell
I love how you add this as if to offset you just making an authoritative claim about the inner motivations of a person you haven't spoken a word with in your life. How very fucking scientific.
I love the Chinese people and culture. I studied the language in college. I have moral disagreements with the CCP, but I'm not trying to attack or disparage it here.
To refer back to the videos, in the case where there has been a claim that critically sick people are being sent off to the crematoriums while still alive, I doubt that there is a high ranking official making that decision. It's probably fear, volume of cases, and utter exhaustion of some limited individuals in the health care system. If the story is even true.
I admit that many of these videos are dubious (especially the Falun Gong ones), but taken together there is some underlying theme here. Whatever that is, I think it's prudent to be cautious. We haven't seen an event like this in our lifetimes, so it's easy to forget how drastic and extensive they can be.
As an aside, I took two semesters of immunology in undergrad, a special topics virology course, and a bunch of biochem. I only have an undergraduate understanding, and a foggy one at that. Zoonotic diseases often have trouble when they jump the species barrier: they're too lethal, have a low transmission, etc. This one seems to have won the genetic lottery.
China banned funerals and mandated cremations, and my guess is that they did so for the purpose of masking the death toll. We would be foolish to trust China's words rather than its actions, and its actions indicate that the death toll was sufficient to justify a substantial shutdown of an entire industrial region of the country.
https://www.aljazeera.com/news/2020/02/china-virus-funeral-o...
"The order also prohibits funeral ceremonies for those who have died from the virus, potentially cutting off the grieving process and any religious ceremony for families and entire communities who are mourning the loss of their loved ones, and there is little sign such an arrangement is even necessary."
I did. Thank you for calling me out on that.
I still find it interesting that the funeral home employees were (allegedly--again, this is Falun Gong) instructed not to talk to anyone about cremation volume and that the numbers provided were an order of magnitude lower than what this individual cited.
> China banned funerals and mandated cremations, and my guess is that they did so for the purpose of masking the death toll.
I was thinking it could be more innocuous: preventing bodies with high viral titers that are shedding from being hugged by uninfected loved ones. But you could also be right.
https://www.washingtonpost.com/health/northern-californian-t...
"There are indications that other hospitals could be involved in the case. Kris Concepcion, fire chief and acting public information officer in Vacaville, Calif., said county officials had issued a directive not to transport any new patients to two local hospitals — NorthBay VacaValley Hospital in Vacaville and NorthBay Medical Center in nearby Fairfield. Concepcion declined to say why those orders had been given."
Are these hospitals open now?
Time to use some of my vacation days.
Note: I'm not a medical practitioner, I am a research scientist and can do my work remotely. I admire and applaud the doctors and nurse who are there, and UC Davis has some of the best.
I imagine it’s the same for copyrighted material?
If you use deaths/(deaths+recoveries) you get a much higher figure, but presumably recoveries take longer than deaths.
My comment was driven by my own experience with process estimation, though other commenters have pointed out that it's also supported by research on SARS: https://academic.oup.com/aje/article/162/5/479/82647
You also have to take into account that mild cases are probably never detected and counted. So you are calculating the fraction of deaths among severe cases, not among all cases.
The a parallel response links an article pointing to a paper evaluating this very question for the SARS outbreak. The paper shows that-- as I suggested-- dividing death by cases gives an extremely biased (low) estimate until the rate of new infections drops off. For SARS, deaths/(deaths+recoveries) was an accurate estimation.
:-/