Oysters were poverty food right up to Dicken's day. Times change!
If I was a lobster (they can live over 50 years, so its not impossible given I'm old now) I'd be delighted if people stopped pulling me out of the sea for no cents.
> Dirt-cheap because they were so copious, lobsters were routinely fed to prisoners, apprentices, slaves and children during the colonial era and beyond. In Massachusetts, some servants allegedly sought to avoid lobster-heavy diets by including stipulations in their contracts that they would only be served the shellfish twice a week.
I think its really interesting how most people imagine expensive things taste better just because they are expensive, specifically lobster, caviar. They exist in scarcity right now and thats the only distinction as there are longer periods of time where they weren't "delicacies" but still tasty parts of a meal.
Sorry, but I love caviar. In fact any sort if fish roe is good. It does not have to be expensive. In Russia they eat fish roe/caviar on buttered bread for breakfast. It's really good.
I think you, and others, misread what I wrote. I said they were always deemed tasty, but people covet them as even more tasty luxuries because they are expensive. As opposed to the capabilities that a chef's rare experiments can achieve in a similar price range.
The story I’d heard is that lobster became a delicacy when it was shipped to the US interior, where butter was relatively cheap and plentiful. Seems kind of implausible—wouldn’t it be easier to ship the butter to the coast?—but it’s a story.
There's also the aspect that, as the price goes up, the more it'll be cooked by more expensive/better chefs -- which presumably produce better food, or at least, better looking food (and if you believe in eating with your eyes, translates to better food)
In which case, it does actually taste better as a group. It probably finds better recipes as more experienced cooks take a stab at it (whereas before, it was so low-class few would likely even consider doing anything with it beyond the simplest/cheapest combinations).
These kinds of things are usually compounding, or even feedback loops; it's rarely useful to only look at a single step of impact. Though I wouldn't doubt cost isn't a part of the explanation (and ofc it goes the other way too -- good things made cheap, cheapen the perceived value. Perhaps they were also good when it was cheap... But cost was so low you wouldn't accept it as good-eatings)
This is so true. Lobster is not particularly flavorful on its own. People typically drown it in butter, salt, and maybe some Old Bay seasoning here in the US. It has always been pretty obvious to me that folks are enjoying the salt and the butter probably more than the lobster!
Honestly, I like lobster but the thought of having to eat it twice a week (reg the comment above) makes me nauseous. Some things are much better in moderation.
Is it that hard to imaging people just like something that you don’t? Especially in food, where different people demonstrably have different neurological responses to he chemicals that touch their tongues.
I for one loved lobster long before I had any concept of the meaning of money.
Were you guys eating plain lobster, or enjoying it with lots of butter, salt, seasoning, etc?
It's not just perception. Lobster is not very flavorful on its own. I don't mean, "this flavor is an acquired taste" - I mean there really is not much flavor there.
It's both exactly like eating bugs and nothing like eating bugs.
It's exactly like eating bugs in that crustaceans are actually related to bugs, but nothing like eating bugs in the sense that the "grossest part" of eating bugs is that the whole thing is consumed; eyeballs, organs, brains, poop, shell, etc.
The sellers sold a commodity in the world’s strongest currency to a single country that is loathed by their government and the source of multiple previous epidemics.
Here’s a tip: diversify your sales. Even if (horror) you have to lower your price or accept another currency.
Really curious to see data on the California commercial lobster fishery, 98% of which goes abroad to Japan and China. They run $35-40/lb over the last year or two, so I imagine they have much further to fall, which is great for the recreational divers in the area.
Edit: wow, falling to $25 already, I saw this same site for $42/lb last year.
California's lobsters had the finest flavour, are more dangerously deceiving to naive fishermen (crushing's fingers creature), and much more challenging to catch and put in a table. They have a bad habit of losing legs at the slightest opportunity (and nobody wants to buy a three legged lobster).
They just taste sweeter. Plus a 1 pound California lobster has more edible meat than a 1 pound Maine lobster, despite the huge claws of the Maine lobster. It's all tail meat. Plus the "face meat" (meat underneath the giant spiny antennas) is an amazing and distinct flavor.
It's a smaller fishery too, they aren't that common north of Point Conception.
Hopefully the collapse in lobster sales is just an isolated example in a relatively small sector of the economy, and not a portend of things to come.
If more companies are forced to shut down or cut/postpone spending in response to sharp drops in revenues, their suppliers and employees will react by cutting or postponing their own spending, leading yet others to do the same, in the worst case fueling a sudden and self-reinforcing feedback loop of global contraction in economic activity.
It's possible that stock markets worldwide are now pricing such a scenario. Let's hope it doesn't get that bad.
But hope is not a plan. Please make sure you're well positioned to survive a sharp economic downturn, just in case!
The US Fed's actions recently (emergency meeting, 50 bps rate cut [1], futures markets anticipating a 89% chance of a 75 bps cut in March and a 59% chance of a cut to 0% in April [2]) seem to indicate that these events are "canaries in the coal mine"; policymakers and central banks are already seeing current and forward looking data ahead of what is publicly available indicating an economic contraction is in progress. I know the Fed has access to electronic payment data (credit card transactions) in the US through an agreement with those networks, and uses that info for decisioning (among other data sources not publicly available).
Also, 10 year treasuries are at a record low today below 0.7% [3]. This is unheard of, and an indicator that capital markets are seeing an unprecedented flight to safety [4].
Not intended to be alarmist, these are simply observations (although I heard someone say very recently, "the bond market is basically signaling that all hell is going to break loose."). It appears macro econ policy folks are trying to engineer a soft economic landing, but monetary policy only goes so far. Be prepared, make good personal finance choices in the near term.
Thank you. Whats your opinion re personal prepardness in terms of your financials? Leave cash in bank? Withdraw some? Withdraw plenty? Keep it in USD or convert to something like Euro. Or buy large quantities of bullion? If so - “less better” like palladium bars or “more better” like silver coins at low value per coin.
Don't lose your job. Strengthen your professional network, ensure you can land somewhere else rapidly if your role evaporates. Keep at least 6 months expenses in an FDIC insured savings account (although if you haven't done this already, it's too late to liquidate investments to have those cash reserves on hand without locking in losses assuming you've been invested during recent high volatility). Keep cashflow positive as much as possible, don't incur debt needlessly. Converting to other currencies is going to incur a currency risk that is unlikely worth hedging at such a small scale.
I wouldn't go so far as to keeping cash on hand beyond what you'd normally have; if things get that bad, cash will be your least concern. ATM card access is sufficient.
Disclaimer: I am not your certified financial planner/manager, but I do manage the finances and assets of others gratis. This advice is the same advice I practice myself.
It's not that common shocks to an economy to have a permanent effect. Businesses and investors understand that the event will be temporary, some businesses may shut down during the event but once the event ends, the pent-up demand it generates and allow spending on recovery, tends to more than compensate.
That said, the economy was an extremely fragile condition before all this began so this might be an exception.
For many of the things affected by the coronavirus (events, going to restaurants, going on holiday etc), you basically don't aggregate any pent-up demand. People won't take twice as much holidays next year. It's tricky to argue for the recovery on that.
A great portion of people have very little self control when it comes to spending and will spend the money that would have been on a vacation on something else (weekend travel, a new phone, extra eating out, etc) so the money does indeed usually flow back.
Well, from the perspective of the overall economy over a longer period of time, maybe. But for individual companies, it's a small comfort that their missed income will eventually get spent somewhere else. If companies go out of business now, there is no quick fix to just bring them back later, so the impact to the economy is long lasting in this sense.
Almost all airlines are operating on the line. I think we will see many more go out of business. Budget airlines because no vacations and scheduled airlines because no business travel. Only the larger ones would survive based on bank relationships.
To be fair, Flybe was on borrowed time. It feels like Coronavirus was a fig leaf for poor management and the owners wanting the UK government to give a loan rather than them investing in their own business.
That’s not to say this virus isn’t affecting the economy but the government’s decision not to offer a loan is what pushed Flybe over.
On the island where live, the local fishermen had a below normal haul and the co-op was not paying well per pound, so 2019 was already a bad year. I also understand that many of the fishermen have extended themselves for larger boats and more traps. With the decreased demand, these things will add up to lost boats/homes/livelihoods. Without a doubt, this will have an impact beyond the immediate fishing industry.
Or the panic could be a great boost to the ocean ecosystems. Just like WWII was because fishing boats were afraid to leave ports lest they get caught in cross fire.
Probably meant cross-fire in the colloquial sense more than the literal one. The ocean is indeed pretty big and it would be hard to get accidentally caught in crossfire.
We in Spain would gladly buy all your surpluss lobsters at reduced price, but there is a small problem with a certain US ban to our spanish olive oil also, because some issue about airplane companies figthing, so...
All is like orange agent poured over the economy wherever you look.
I am extremely worried about the global economy. The air travel and cruise industries are getting hit really bad. WP had an article today that for travel industry it is becoming the worst crisis since 2001, when the towers went down. There is a talk of tax breaks, and other nations have already enacted tax relief.
The prices of air travel in the US are laughable at the moment. I can fly roundtrip from Chicago to LA for $140.
I wonder if we'll see actual price reductions on the consumer end. Somehow I don't see franchises like Red Lobster bothering to pass their savings on to the customer.
For restaurants that sell the lobster at "market price", you might see it change by a dollar or two. But in general, note that the price of a meal is driven much more by demand than by the cost of ingredients, which are only about a third of the actual price of a meal.
Most stores near me sell chicken lobsters (1-2lbs). Most recent years, the lobster catches have been really good, and prices are generally 4.99$-5.99$/lb. Getting them steamed adds very little to the prices.
Those same chicken lobsters will cost you 20+ at a restaurant, and would be 15-20 for a lobster roll. Restaurant prices haven't moved (up or down) in more than decade.
Restaurants routinely run specials and sales when commodity prices fall. Red Lobster competes with a bunch of other chains, why wouldn't they advertise "2 for 1 lobster!" to drag people away from Carraba's or TGI Friday's?
My chef son-in-law, who's worked at some great restaurants in the Pittsburgh area, says that they almost never pass on cheaper ingredient costs to the consumer.
“Great restaurants” with chefs presumably have a less price-sensitive clientele than fast casual chains, who have a less price-sensitive clientele than fast food.
In 2019 the lobster fishermen in my area of Canada sold lobsters to buyers for about $6 each. That was for "markets" the size that are sold to restaurants.
The lobster fisher has boat payments, fuel ($1,000 to fill the tank per trip), wages for helpers, insurance, zone license. Now more rules to prevent right whales from getting caught in ropes. Which means new rope or new ways of handling the traps and equipment. And there is a quota so you can only catch so many.
Meanwhile that $6 lobster goes for maybe $50 or $100 in a restaurant in a large city.
I'm seeing it where I am at least. It used to 10-12 dollars per lb now it's down to 6 dollars a lb. A month ago I got some at 8 dollars a lb and I already thought it was a steal.
This sounds like the story leading up to a very smart marketer who comes in with a creative solution to solve the problem. Comparable to the northern european guy who convinced all of Japan that eating raw salmon was safe.
I assume the lobstermen are hoping that this is what their government will pay them to do (i.e. subsidies). I would rather hope that we leave the poor sea bugs alone.
Lobstermen use so much herring to bait lobster traps it dramatically boosts the population. All the females and juveniles are thrown back, so to a lobster a fisherman's pot(trap) is an easy meal. Even the market size males will frequently go in a pot to eat and then escape before they can be caught.
Lobsters are a species that actually benefits from fishing. Herring on the other hand...
I'm honestly more worried about the economic toll than I am the health impacts.
So many people are going to lose their jobs, their homes, and their healthcare, if everyone continues to cancel all travel and entertainment. These economic events have real impacts on families for a generation. And service workers will be the hardest hit.
The median age of fatal infections is 75. And yet we have healthy 25 year olds holed up in their apartments, hitting local economies hard. It's nonsensical. Most people should be behaving normally with some added protections (like washing their hands), and those who are at high-risk should be protected.
This is a conversation between two respected journalists, from NBC and the New York Times, quoting Twitter as fact, and failing the most basic of simple math questions.
Most people should be behaving normally with some added protections (like washing their hands), and those who are at high-risk should be protected.
You would think, but you would be wrong.
Here is the fundamental math. There is a number called https://en.wikipedia.org/wiki/Basic_reproduction_number which is how many people the average infected person infects in turn. If that figure is above 1, the epidemic spreads and some nontrivial fraction of the total population will get sick. The exact number who catch it is impossible to calculate since the relationship between the basic reproduction number and how many people eventually get the disease is chaotic.
But if that figure can be reduced below 1, the disease dies out on its own. It took draconian measures, but this is already happening in China.
Public health officials have a variety of strategies available depending on the situation. But the choices from most desirable to least is as follows.
1. If possible, get the basic reproduction number below 1.
2. If not possible, encourage at risk groups to get extra protection so that as the disease sweeps through, as many as possible don't get it.
3. Be overwhelmed.
The current strategy is focused on the first option. As noted, the basic reproduction rate is already below 1 in China and the disease is dying out there. If it escapes, the second option will be tried. But an epidemic that hospitalizes 20% of victims and kills 3% will, if we accept #2, leave us quickly at #3.
And as much as a temporary slowdown of the economy loses us all, figuring out how to some up with a reasonable substitute for hospitalizing 20% of the country when we don't have medical staff (knowing that a failure to figure it out will result in much higher casualty rates) will have much greater economic impacts.
It turns out that we can quantify it. Based on https://www.theglobalist.com/the-cost-of-a-human-life-statis... it is reasonable to say that we value a human life at about $8 million. If half of 327 million Americans get sick and (as current rates have it, 3.7% of them die, the economic impact is about $48.4 trillion. That is about the same as the US economy for 2 years. If losing 1/4 of our economy for 6 months, and then suffer similar economic damage on the path to recovery, gives us even odds of preventing this, we absolutely should panic.
And, as China demonstrates, it IS still possible to prevent this outcome. It will take heroics. But it is possible.
> it is reasonable to say that we value a human life at about $8 million
We're talking about the very elderly dying a bit earlier than they would have otherwise. Before you accuse me of being heartless, I agree that that is indeed sad and worth mourning. But, no, it is not the same economically as a working-age person or younger dying in large quantities.
And keep in mind it's March, and flu season will naturally be on the decline this month.
3.7% is the measured rate in China. Which has the best available data set. Which is why I used it.
The CDC has consistently concluded that the real rate will be somewhere in the 2-4% range.
There are admittedly researchers who think that cases are severely underreported. However data from other countries has been in line with the Chinese experience. If dramatically more get it, those dramatically more seem to also be less infectious.
Given this, it is better to act on the higher end of evidence based estimates and to have possibly overestimated than it is to believe on the low end and find that a higher figure was appropriate.
But even if you disagree with that reasoning, dropping all of my figures by a factor of 4 still comes up with figures that justify truly shocking disruptions to our lives. And the basic facts about epidemiology that I gave are still worth understanding.
On the Princess Cruise everyone received top notch care. What if there were no available hospital beds and respirators?
What would be the death rate when the medical system is so overwhelmed none of the acute cases can receive any medical care? That's the number that should influence how far we go in trying to control transmission.
In Israel the single serious case is 38 years old. He is on a respirator. No some 80+. IIRC from the Washington cases there were some in their 20s who are hospitalized. Israel is less likely to have random unknown cases given their stringent border control, quarantines and testing.
There are multiple conflicting reports of the death rate. However, if hospitals are overwhelmed by the serious cares, which I've seen estimated at 15-20% then the death rate, whatever it is, will surely rise as serious cases go unattended.
No they don't. They have large biases from the fact that mild and asymptomatic cases are underrepresented. To avoid that you want to look at data sets where they tested 100% of people whether they had symptoms or not.
As far as I know that is the cruise ship and the South Korean church. And they show a lower death rate.
Now Diamond Princess let's us estimate Serious / Total, and say Italy let's us estimate Death / Serious (they probably catch all serious cases, and have less variance since they have larger numbers). So it may be possible to combine to get a good estimate of Death / Total.
This study estimated the case fatality rate (CFR, deaths among those presenting symptoms) and infection fatality rate (IFR, deaths among all who tested positive) of infected passengers on the Diamond Princess: https://cmmid.github.io/topics/covid19/severity/diamond_crui...
CFR was estimated at 2.3% and IFR at 1.2%, reflecting that roughly half of infections were asymptomatic. The downside is that the median age of passengers was 58, so it's not truly representative of CFR for all ages. (That's why people are still using data from China; the cruise ship isn't demographically representative.)
You also need to consider that 15% of cases are serious, and may require mechanical ventilation. If medical systems are overwhelmed, it will go up. We saw that in Wuhan.
The age of the South Korean church members was largely in 20s and 30s. The cruise ship crew was a large portion of total affected and few were over 65 where the big risk kicks in, and on top of that immune compromised people don’t go on cruises.
Saying it's sad and worth mourning doesn't mean you're not still heartless. People aren't numbers, and turning them into numbers is what makes you heartless for making an argument like this. This is a prime example of a "shit hackernews says" post.
They’re responding to a comment that’s explicitly making an economic argument based on the numbers. I think it’s reasonable to respond to that on its own terms.
While it is tempting to say that "people aren't numbers", a refusal to quantify human impacts just results in poor decision making.
Because we still do make decisions. We still do allocate resources to our own pleasure that could have gone to saving someone else's life. We pass regulations limiting how much people can be exposed to chemicals that impact health. And trade off the convenience of being able to travel in cars for how many of us will die from doing so.
We still make those decisions. The only question is whether we think clearly while making them, or whether we shy away from the ideas that could let us think clearly.
> This is a prime example of a "shit hackernews says" post.
I'd say that applies to your post more than OP. Was that really necessary?
In my family there are four grandparents in their 70's with various health problems, and my two young children. All four grandparents have commented that they're relieved that this virus appears to target old people more than children, and we'd all consider it to be at least less bad news if the numbers confirm that. My father in law, who is a doctor, remarked that he's less concerned about losing his own life because he's "already lived 90% of it".
I'd never want to have to decide whether my parents or children get to live, but if I did, I'd choose my children in an instant.
These are our opinions -- no more or less valid than your own. Do you suppose we, or anyone else for that matter, cares whether someone like yourself thinks we're "heartless"?
I honestly believe that the Corona virus is more of an illness of mass psychological fear than it is a Virus. I'm not saying the virus isn't real, or that those who suffer from it aren't real.
I'm simply saying that, at least for the US according to the CDC, 260 people have become ill and 14 people dead... which is nothing compared to 300,000,000 entering a state of unreasonable fear.
I know people who don't get a yearly flu shot (50,000 dead/year), don't wash their hands before eating (most viral and bacterial infections aren't airborne), smoke (400,000 dead/year), drink (80,000 dead/year) and regularly drive late at night when tired (35,000 dead/year)... yet they are taking every possible precaution against corona virus, because they don't want to be the 15th death. It's so weird.
Again, not saying it isn't an issue or doesn't exist or can't become a bigger issue. Just that the fear is so disproportional to the threat, it's mind blowing for me. It feels like some mass psychotic event. I'm just disconnected enough from most people's reality that I can't seem to share in it, so I stand a contrarian outsider like I've always been, scratching my head.
Sadly, this is true for so much of American culture re: our current politics and social fears. We live in a culture that explicitly governs on and trafficks in fear. I don’t think we ever got out of fear mode after 9/11, but reasonable people can disagree here.
Also, people aren’t just thinking about themselves, they’re taking into account the risk of transmission to a loved one who’s in a higher-risk age group. I’d hate to contract coronavirus and pass it on to my parents who’re in their 60’s.
It's odd, the safer our societies become, the more fearful people get. I used to live in a 2nd world country and it seems people were less fearful there, even if they had more to fear. It's like we collectively somehow miss having real things to worry about.
I guess the biggest issues in first world countries (heart disease, cancer, suicide, car accidents), are mostly things that boil down to individual internal battles related to our daily choices. And improving those is a humbling, long and not particularly glamorous process. It's grappling with the millions of shortcomings we all know we have and we all know how to fix.
It's odd, the safer our societies become, the more fearful people get.
My theory is the law of diminishing returns. We’ve made incredible progress in identifying and minimizing risks of disease and accident. Once we deal with those, we go down the list to the next one.
At this point, we’re working on things that are relatively minor risks, but still treat them as if they were high risks.
> It's odd, the safer our societies become, the more fearful people get. I used to live in a 2nd world country and it seems people were less fearful there, even if they had more to fear. It's like we collectively somehow miss having real things to worry about.
maybe it’s akin to allergic reactions... where certain people who grow up unaccustomed to certain allergens end up with their immune system overreacting... maybe in our society, in everyday life we aren’t accustomed to certain stimuli and even relatively (to other countries) small shocks can lead to overreaction... just an idea...
If we fail to take dramatic measures, the projected number of deaths in the USA is similar to the Holocaust.
If we take dramatic measures we have a good chance of heading off that outcome. This is worthwhile even though it will hopefully look like a crazy overreaction to the actual fatalities.
I agree that most of the people who are reacting are way overreacting to the actual facts and risks. But I strongly preferring them erring in the direction that they err than having them dismiss the risk based on few current fatalities as you are doing.
Only numbers that meet your world view count? Got it.
If you use the smaller number of ISS confirmed cases in Italy the numbers look much worse. Meanwhile Spain and Hong Kong are showing CFRs around 2%, France around 1.3%. The United States? About 5.4% so far. As for me, I'd trust the Italian numbers far more than anything coming out of China, especially after their reporting on the SARS-1 outbreak.
Thing is, the lower later rates are for people who received proper care, even in the most serious cases - because China rapidly ramped up hospital bed availability, and other countries haven't yet had enough cases to overwhelm their hospitals. One of the reasons why Wuhan had such a high rate is because theirs got overwhelmed very early.
But the numbers indicate that there's an order of magnitude difference between the number of available beds, and the number that will actually need them, in most developed countries. For those who will get inadequate treatment because of that, the fatality rates will be higher.
No, you're misunderstanding that number. That's the crude case mortality rate, of deaths per confirmed cases. They say the infection mortality rate, which is deaths per infection, will be lower.
Meanwhile, our hospitals in Seattle are already filling up, and they're diverting people to further hospitals; as this is a virus with an extremely high hospitalization rate. We all need to do what we can to keep those hospitalizations low, so our medical system doesn't collapse and turn people away who need ventilation. That means doing your part to not be a vector of infection.
I would love it if you're all correct on this. The problem I face is that I do notice other countries who are a week or two ahead of us really struggling, and taking increasingly drastic measures to try and maintain control. I guess I just don't really understand the argument people are making who are saying we are overreacting.
Are you saying we should do nothing, and just accept some tens of thousands of deaths and overburdened hospitals across all major cities? Or that this isn't really a big deal or contagious, and we should just ignore it?
It seems to me that the prudent and responsible thing is for us all to do our best to lower the secondary infection rate, in order to guard against these outcomes.
Not at all... follow best practices... wash your hands (before and after restroom use, before and after food prep or touching money), stay home if you're sick and for employers emphasize this and work as well as possible around the issue. Don't panic.
In the end, it will spread, it will kill, and the only thing panic does is make things worse. If people washed their hands more and stayed home when sick instead of working through it, that's the most you probably should do.
I disagree. Containment still seems to be the correct course of action, which requires drastic up-front measures to prevent millions of cases simultaneously. You might disagree with that strategy, in which case that's fine, I think you're wrong. But you're mischaracterizing that strategy as panic.
It's not sufficiently containment, due to the high incubation time, there is transmission amongst many who do not think they are sick. That's a property of this virus that makes it different.
>I do notice other countries who are a week or two ahead of us
It is being reported that South Korea is testing 10k per day. The USA is still having an issue in even delivering test kits where required. That's months ahead, not weeks.
In one place I know of with a significant number of confirmed cases, I'm told by someone working on the problem that hospital visits are actually declining as sick people are too afraid to go to the hospital to get tested, for fear of being infected by COVID-19 if they don't yet, in fact, have the virus. And that is directly hindering efforts to diagnose, treat, quarantine and control the spread of the virus.
Overreaction can take many forms, depending on what people think is in their individual interest (even if it's at the expense of the collective interest).
> That means doing your part to not be a vector of infection.
I believe I do my part for this and every flu season which literally kills 50,000 Americans each year. The extra dozen deaths from this new virus really don't change my existing habits: I wash my hands frequently, thoroughly wash fruits and veggies, I stay home if I'm sick, and I get my flu shot each year. I also get regular check ups.
I also try to eat a rich, varied diet, get good sleep, do some exercise, don't smoke and avoid over drinkings or overindulging in sweets/fats/salts.
I also, and this is real important for me at least, try to avoid getting stressed over things I have no control over. Again, this is just me.
Without containment, COVID-19 will directly kill at least 10x more people in the US this year. Worse, it will overwhelm hospitals and suffocate medical supply chains, resulting in more indirect deaths as well. You're comparing the deaths of multiple already pandemic flus to a single disease which has not yet spread throughout the United States.
> kill at least 10x more people in the US this year
Since the Corona virus has a 3% mortality rate, your estimate of 'at least 10x' would mean 500,000 american dead by the end of year, which would require 150,000,000 to be infected this year, or basically, 48%~ of the population getting infected this year.
I'm not saying your wrong, but can you provide a link to a reputable site such as CDC/WHO that supports your claim?
Unlike the flu, nobody has prior immunity to the disease, so everyone is susceptible to getting the disease. Without containment, nearly everyone will get the disease. You have also undercounted the US population by 10%.
You are absolutely right to ask if I'm not following. Sometimes I fail to follow. In terms of Pure logic, I'd love to learn about that one day.
Anyway, deducting a conclusion from reality can be possible, though I'm not sure I agree trivial. I will say I think using statistical past experiences to model future outcomes without understanding underlying mechanisms of action would normally be consider inductive reasoning, not deductive.
But even if you arrived at your conclusion using deductive reasoning you could still create a logically valid statement that is unsound. Which is why I ask, what were the original observations that allowed you to deduct that the infection rate will be near 100%.
I didn't capitalize pure logic. You did. Don't put words in my mouth. Clearly, I am using pure to mean "only" or "100%."
We can deduce that the infection rate will be nearly 100% because there is no significant subpopulation that is isolated from the rest of the population. Without isolation, the infection spreads. See also: rhinovirus-based colds, which have infected 100% of the US population despite different people having prior immunity to different strains, slowing its spread.
Thanks for your reference. I looked up Rhinovirus. According to wikipedia, it seems that:
> 99 serotypes of human rhinoviruses affecting humans have been sequenced.
Of which, one seems to be the most contagious:
> The human Rhinovirus Strain 1A (which was at the time held responsible for at least 30 percent of the common cold infections)
Since the 'cold' is something that about 10% of the population get, and since one strain of Rhinovirus once managed to account for 30% of common cold infections, it would stand to reason that the most infectious Rhinovirus managed to infect 3% of the population in a year.
Please help me understand how that allows you to 'deduct' that COVID-19 will have a near 100% infection rate?
How did you manage to ignore the entire part of my post about what slows the rate of Rhinovirus infections and why that doesn't apply to SARS-CoV-2? It is half of the entire sentence that talks about Rhinovirus.
Oh I read your sentence. I didn't ignore it. I just don't see how one thing 'logically' follows another, let alone allows for a 'deduction'. I mean, I can see your sentence is a point that could be supportive of your argument. But to connect them like your doing, implying proof, is to make many assumptions which I don't see as necessarily true. For me you are not fulfilling the burden of proof that your assertion requires. Saying this will have a near 100% infection rate is an extraordinary claim, since I've not known of any single deadly virus that has achieve that.
I won't continue since more fundamentally, I think you and I have a very, very different definition for what 'logic' and 'deduction' mean. To me these words, like the word ironic, have a very narrow definition that many people don't seem to conform to. I guess we'll have to agree to disagree. I do wish you the best and think we can all agree that we hope the new virus has the smallest possible toll on humanity. :)
> since I've not known of any single deadly virus that has achieve that
The flu.
I didn't say SARS-CoV-2 will achieve nearly 100% infection rate in a year, but over the lifetime of most young people today, certainly. In the next year, it will have infected enough people to dwarf the flu over that year, however much we hope against it.
Specifically, what assumptions am I making that are erroneous?
Half the population becoming infected this year is not that unlikely if no preventive measures are taken. The CDC and WHO stopped being reputable sites about a month ago.
The current rate of estimated infection doubling from genomic analysis is 7 days, absent containment measures and other interventions. Assume there are 1000 cases today and do the math. You get there pretty quick:
Assuming a mortality rate of 1%, only 55 million people, or about 1/6 of the US population will need to be infected to reach 550k deaths directly from COVID-19. The 1/6 and 1% numbers are both conservative. Hence, at least 10x the flu.
The indirect deaths will be larger still because 10x more will be hospitalized, which the medical infrastructure is not prepared to handle.
My point was people's reaction is probably the main issue. And I tried to illustrate how illogical it is based on the risks people take when it comes to things that are currently proven to be deadly, not maybe deadly. The other day someone complained to me about the dangers of Corona Virus WHILE smoking a cigarette! (blew my mind, though I didn't say anything)
The overreaction is perfectly illustrated by Marc Lipsitch who estimated 70% of the world population will have Corona Virus before the years end. At 7 billion, and with 3% death rate, it would mean 147,000,000 million dead by the year's end. I think we can agree that this is a VERY extraordinary assertion. I seem to also remember him making similar claims about SARS and MERS in years past.
But going back to his extraordinary claims, even if this virus was 10x as deadly as ALL the flu strains put together we'd still be talking about 3 to 6 million dead world wide (high no doubt, but still less than tobacco deaths which stand at 7 million/year) By calculating 10x all flus we are actually calculating 30-100x worse than any single virus strain we know, since the 'flu' is an umbrella for many different viral strains. So basically, IF this virus was 100x worse than any previous virus, we'd see Lipsitch is exaggerating by a factor of 50x. And if this new virus is 'only' as bad as regular 'colds', he'd be exaggerating by 5,000x.
There seems to be a feedback loop: the more people get scared, the more the media sells fear. The more the media sells fear, the more scared they become.
Again, I can't stress this enough, Corona Virus is real, it needs to be addressed, our leaders need to make it a priority. People will die and we should avoid it. But also true is people need to stop fretting over things they can't control and the media needs to stop whipping them into a frenzy with fear mongering tactics. They should be using this to remind people that they should ALWAYS, every year, get their flu shot. That they should ALWAYS wash their hands, not just when they fear Corona Virus. Overreactions can be just as bad as under reactions and humans have a long history of mass hysteria that only make things worse.
Well then, anecdotes aside, your point is just patently incorrect. Per the leaked slide in the Business Insider article, experts are privately warning hospitals of a disease surge that will almost certainly overwhelm them, with at least 500,000 deaths in the US. That’s not a crisis manufactured by the media nor an overreaction by the public. It’s the reality of what’s being prepared for.
Also, the other article you posted from bedford.io seems to confirm this won't be a big deal. But even if it is, what do you suggest I do about it to improve the situation? I mean that question seriously.
Further more, I'm not saying that one slide doesn't exist. But maybe it isn't the end all, be all of authority? Maybe the other link you yourself posted also has some validity?
I think we need to do what Bedford himself said is necessary and lobby for it in our circles, even if authorities themselves refuse to act:
> The author of the analysis, a computational biologist named Trevor Bedford, said there are likely already at least 500 to 600 cases of Covid-19 in the greater Seattle area. He urged health authorities and the public to immediately begin adopting non-pharmaceutical interventions — imposing “social distancing” measures, telling the sick to isolate themselves, and limiting attendance at large gatherings.
So, practice social distancing as much as possible and encourage your friends and family to do the same (especially if you know them to be in one of the high risk groups or frequently). Similarly, advise against mass gatherings. There was just a 100,000+ person comic convention that planned to just barrel through in Seattle, but was forced to cancel because artists and attendees pushed back against it.
But I’ll add that there’s mostly also agreement from the two sources. Per the above article:
> Bedford said Seattle faces a stark choice — take aggressive actions to slow down the spread of the new coronavirus now or face the type of outbreak that engulfed Wuhan’s health facilities and led to a lockdown of the city that remains in place six weeks later.
IF the WHO estimated 80% infection rates I would be very concerned and would not have written any of this. Please, if you have a WHO link that predicts what you mention, please share it with me.
> The extra dozen deaths from this new virus really don't change my existing habits
This is either deliberately misleading, or you are not properly able to reason about and understand exponential growth. No one cares about 12 deaths. It's the exponential growth in something that has the potential to be the flu, but roughly 10x worse.
Oh I know what exponential growth is, it is a basic mathematical concept and I'm quite good at math. The thing is, extrapolating the growth rate of new phenomena is not logical. If this isn't intuitive, think of it this way: I have $1 today. I earn $100 and by tomorrow I have $101. I sell my car and the day after tomorrow I have $10,101. Would it make sense to continue projecting my increased asset accumulation at the rate of 10,000% daily for the next 10 years? Of course not, it would mean I would have more assets than exist in the world. Growth rates are higher when numbers are lower and lower when numbers are higher. It's the nature of change in any finite data set.
> roughly 10x worse
According to the WHO Corona virus has a 3% mortality rate, your estimate of 'at least 10x' would mean 500,000 american dead by the end of year, which would require 150,000,000 to be infected this year, or basically, 48%~ of the population getting infected this year.
I'm not saying your wrong, but can you provide a link to a reputable site such as CDC/WHO that supports your claim?
The CDC/WHO are still trying to push for containment, so I'm unaware of any concrete predictions they are taking with regards to the final infection rate.
More generally, the more I've been binge studying epidemiology (not claiming to be an authority), the more I'm learning that, as a field, it has difficulty with long-run predictions. That's not super surprising, I work in the statsy/ML forecasting world, and these types of unstable, unknown processes are very hard to forecast accurately.
What we do know though is that there is good reason to believe it's parameters governing infection (e.g. secondary infection distribution) are more infectious that diseases such as H1N1, which went on to infect ~20% of the world. We do know that the mortality is 1-3%, depending on ICU saturation. There are reasonable base rate scenarios to view this as a likely outcome.
We need to do our best to contain this and keep it as a slow burn, or we will be dealing with hundreds of thousands of Americans dead, and millions hospitalized.
To be a little more specific, the deaths given a functioning health system are less concerning to me. It's the fact that this has a very high hospitalization rate of 5-20%. That's why we need to keep spread slow, so the hospitals can manage.
Isn't Marc Lipsitch the same guy who had dire predictions for SARS and MERS? While the Atlantic is a good publication, I'd rather take my medical advice from the CDC and WHO, who have not published such dire predictions.
BTW, I completely agree that Corona Virus is an issue that needs to be addressed. I'm simply saying the reaction is out of proportion to the reality of the threat.
Is he? It sounds like you might know more about him than I do. Having said that, I do worry sometimes that people who make dire predictions about unconstrained infection, which then don't materialize because people take it seriously, get an unfair track record.
Otherwise I think you're insisting on an unreasonable burden of evidence, in that unless the CDC or WHO specifically make a prediction, then its not justified. The best known parameters on secondary infection distributions are strongly suggestive that this spreads more readily than the flu, and the flu infects ~20% of the population a year. Those are good priors to start with, given that we don't have enough realized empirical evidence to know the truth.
It basically says and I quote:
"The most effective preventive measures in the community include:
performing hand hygiene frequently with an
alcohol-based hand rub if your hands are not visibly
dirty or with soap and water if hands are dirty;
avoiding touching your eyes, nose and mouth;
practicing respiratory hygiene by coughing or
sneezing into a bent elbow or tissue and then
immediately disposing of the tissue;
wearing a medical mask if you have respiratory
symptoms and performing hand hygiene after
disposing of the mask;
maintaining social distance (a minimum of 1 m)
from individuals with respiratory symptoms. "
Notice how these are basically the same precautions people should keep always, regardless of Corona Virus being there. That's why I said, what I do now is exactly what I'd do last year to avoid dying from a virus. Nothing has changed for me.
Also notice how the list of precautions doesn't include: 'horde face masks when not sick, stay indoors and cancel all travel plans'. Those actions actually hurt.
Read my original post. It never said Corona virus isn't an issue. My point was people's reaction is probably the main issue. And I tried to illustrate how illogical it is based on the risks people take when it comes to things that are currently proven to be deadly, not maybe deadly. The other day someone complained to me about the dangers of Corona Virus WHILE smoking a cigarette! (blew my mind, though I didn't say anything)
The overreaction is perfectly illustrated in the Atlantic article where they estimate 70% of the world population will have Corona Virus before the years end. At 7 billion, and with 3% death rate, it would mean 147,000,000 million dead by the year's end.
Given that you mentioned modeling on other diseases, you should be able to recognize this as wildly exaggerated fear mongering. Even if it was 10x as deadly as the flu we'd still be talking about 3 to 6 million dead world wide (high no doubt, but still less than tobacco deaths which stand at 7 million/year) And that's a pretty grim outcome since it would be 10x worse than any virus we know. This basic back of the envelop math makes me think the figure of 147,000,000 dead (the logical implication to the Atlantic's estimates) is pure quackery. There seems to be a feedback loop: the more people get scared, the more the media sells fear. The more the media sells fear, the more scared they become.
Again, I can't stress this enough, Corona Virus is real, it needs to be addressed, our leaders need to make it a priority. But also true is people need to stop fretting over things they can't control and the media needs to stop whipping them into a frenzy with fear mongering tactics. Overreactions can be just as bad as under reactions and humans have a long history of mass hysteria that only make things worse.
> And that's a pretty grim outcome since it would be 10x worse than any virus we know. This basic back of the envelop math makes me think the figure of 147,000,000 dead (the logical implication to the Atlantic's estimates) is pure quackery.
You seem to be unfamiliar with the Spanish Flu, which killed almost 200k Americans in October 1918 alone, and travel has gotten much easier since then. SARS was contained, and COVID-19 looks like it won't be, so it is grossly misleading to pretend the total deaths will be in the same ballpark.
Yes, the 500k number is what will happen if we don’t enact emergency measures to slow down the spread of the disease. That you have not seen numbers approaching that is only because countries like China and South Korea and Italy have already done so.
> I sell my car and the day after tomorrow I have $10,101.
That doesn't change your net worth, so it's a nonsensical example.
> I'm not saying your wrong, but can you provide a link to a reputable site such as CDC/WHO that supports your claim?
How does that need much of a "reputable site"?! It's an infectious disease with long incubation, infectiousness for a bit while not having symptoms, no vaccine and no cure ... what do you think would happen if we didn't do anything to prevent spreading?
Current R0 estimates seem to be around 3, so you would need 66% immunity to drop that below 1, currently the only likely way to get immunity is through infection and survival, so that's 200 million americans infected before infected cases shrink naturally.
I understand why you might feel that way. I used to feel the same. But I think at this point if you're not panicking, you might not have fully absorbed the literature.
From my point of view here in Seattle, we're already seeing some minor effects: No one can find any toilet paper. Sounds minor, right? But it won't feel so minor when it's food rather than TP.
The virus isn't the issue. The issue is people. Everyone wants to maximize their chance of being completely unaffected by this disease. When everybody does that simultaneously, we're in trouble.
Suppose a million cases do happen. Who will care for them? Do we even have a million hospital beds? We just surpassed 100k cases today.
I recommend watching https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h... over the next week or so. It's quite astonishing to see the numbers climb. I remember when South Korea hit 100 cases. That was about two weeks ago. Now they're at 6.5k.
>in Seattle, we're already seeing some minor effects: No one can find any toilet paper.
The only report on this I could find was one costco. And the costco's around seattle are already basically mad chaos even during normal times. Every safeway, qfc, target, bartells, etc I've been to this week is well stocked on toilet paper. No hand sanitizer, but plenty of TP.
And if you are that desperate, Amazon Prime Now has plenty of toilet paper ready for 1-hour delivery right this second. At least in my zip code.
I'm right there with you. This is serious enough that production and supply chains may be disrupted. So far, it is proactive people preparing to stay home. What about the other 90% of the population that is reactive? Will there be enough food on shelves to supply people when schools close and community quarantines start?
I am down the supply chain from Seattle. I fully expect to see empty shelves in our grocery in a month.
This is the normal human cycle. We did the same for things as big as terrorism and as small as every tiny thing that teenagers have ever done, broadcast via the local news.
People freak out at things that are different; not normal. It absolutely is irrational. The fact that smoking marketing smoking is still legal is all the proof you need that numbers and death rates are meaningless.
Influenza has a CFR of 0.1%, COVID has CFR of 2-3% (20-30x higher). Officially the CFR for COVID is ~3.3% but it is thought that is too high because there is thought to be many people who have it who are asymptomatic or have a mild reaction. It is estimated that 40-70% of adults will contract it in the US this year. That is 83 million people in the US alone. 10-15% of COVID patients have Acute Respiratory Distress. 10% * 40% * 209M adults => 8.3 million people that would need to be hospitalized. What is the CFR when hospitals can't cope with a fraction of that? If the CFR is 2% and 40% get it, that is 2.1 million dead people this year alone, in the US, alone.
As paulg tweeted the other day (I'll update his number)... There are 20.5k cases outside of China. That number doubles every 3 days. That means there will be 2.6 million cases in 3 weeks.
We have to do everything we can to slow it down, buy us time to try antivirals, buy us time to get to summer where heat, humidity and mass doses of Vitamin D can help keep numbers down.
The pg response is particularly interesting because he's spent a good chunk of his life thinking about the startling implications of trends on exponential curves. (With particular reference to helping startups get on and maintain exponential curves, and making a lot of money as a result.)
Has pg spent a good chunk of his life studying viruses and infection rates? No. If he had, he'd note that exponential curves don't fit the real world... if it did why is China only at 80K after almost 2 months?
pg should have taken the time to study some biology and he would have seen that virtually all exponential looking functions in complex ecosystems are s-curves, or else we would have likely been wiped off the planet by now.
PG and people in tech seem to be afflicted by what could be called "singularity brain disease", which routinely mistakes everything that goes up to the right on a graph too quickly for an exponential function. See also the club of rome paranoia about human overpopulation, the mentioned robot apocalypse, or whatever else is the fad of the year.
What turns exponential functions into s-curves is a feedback loop. In the case of epidemics in the wild, the feedback loop is that people who have already had the disease tend not to get it again. Which means that, without external effort, a disease remains exponential until it has burned through a significant fraction of victims where it has already been.
A disease that has affected thousands in regions with hundreds of millions should not yet be slowed by that kind of consideration.
there are other exogenous factors like changes in temperature diminishing the spread of respiratory diseases over the summer, and avoidance of sick individuals happens quite naturally without having to stir up panic about exponential graphs on twitter.
According to the WHO this virus, unlike influenza, does not seem to spread rapidly among asymptomatic people so the net effects of causing drama on twitter are probably going to create unnecessary anxiety in the population that will lead to mask hoarding or other unecessary behaviour.
China was on an exponential curve until they took public health measures at which they went on a different curve.
And this is familiar territory. pg is very aware that "your current exponential curve is adjustable". So any country whose curve goes the wrong way needs to adjust their actions, and the sooner the better. But once behavior is adjusted, that projection stops being accurate.
So his comment is that, based on current infection curves, the level of effort outside of China is way too little for the threat. Turning that around, if dramatic effort causes the disease to have a halving time of 3 weeks, then every day we wait to implement those changes is a week longer that we will have to live under a dramatic regime to limit total casualties.
I wish I could vote you up more than once... I've been saying to people, pragmatically have a couple weeks of food and water, just to get past any logistical issues likely to come up... you don't need to panic, don't need to buy into the fear and for the most part things will be fine.
But if I get the virus, sure I'll probably be ok. Others that I pass it to might not.
I'll need to self isolate, which means I'll need to stay away from my children and parents for two weeks? four weeks? That's going to be very hard to do. Maybe I could stay at home with my children and they will be fine, but then they will need to be kept isolated. How long will the stigma and fear around them last, six months? How long till the rest of my family are comfortable letting my kids see their grandparents again. If I get the virus, it will be very difficult to do all the things I'll need to do as a responsible adult.
It would be magnificent if we all treated this like a natural disaster and for the next two months, not in a state of panic in which we're all gunning to be the last player standing, but from an intention of mutual aid - do what we can to make it very difficult for viruses to transmit - wash our hands, wear masks and disposable gloves out in public, clean surfaces with disinfectant wipes. In two months this might be gone.
It's a small, thin hope, but what if we can use this current enigmatic and existential crisis, to practise co-operating to handle the much bigger crises that loom further ahead in the century?
> It would be magnificent if we all treated this like a natural disaster
We already have massive issues that are an enigmatic and existential crisis in the US: 647,457 deaths/year from heart disease. 599,108 deaths/year from cancer. 169,936 deaths/year from accidents. 160,201 deaths/year from respiratory illnesses. 50,00 deaths/year from influenza and another 48,000 deaths/year from suicide. 14 deaths total for Corona Virus.
If literally half the American population was infected by the Corona Virus (which is way, way, way higher than any health official estimate puts it), we would have less deaths than we do from heart disease alone.
I believe this: our real existential crisis require complex solutions that will take way more than two months. They generally involve making better personal choices: avoiding sugar and fatty/salty foods, not smoking, driving less, getting some exercise, being less stressed, being kinder to each other.
But the thing is, when we know the issue and the solution, then we are the problem and it involves looking inward and having a humbling, horrible, daily struggle with the shortcomings we all have. We have to make millions of choices and we will fail making the correct ones most of the time. That's a pretty grim reality. It's quite grating to be constantly recognizing our shortcomings in an effort to self improve.
Like the procrastinator who cleans his desk because he doesn't want to sit down and do the hard work, I feel the Corona Virus is a real issue, but at the same time a distraction. Sure, we need to clean our desk, and pay attention to the Corona Virus. But if there's a big problem which is hard to solve and involves looking in, most people will focus on the small problem and look out. A lack of perspective can make a person easily enter into a state of frenzy and uncontrolled fear, especially when others around them are entering it.
> 647,457 deaths/year from heart disease. 599,108 deaths/year from cancer.
I think I heard the last time "old age" was listed as cause of death was in the 1980s. There will always be a reason that people die, and we don't live forever. You can't say that if we cured "heart disease", that half a million people wouldn't die. Your comparison of causes of death to the virus is not logical.
The vast majority of those who died from Corona Virus were old. So would you say those also died from old age?
I personally wouldn't make that argument, but I'm asking since it would seem to be a necessary conclusion if we follow your path of reasoning. I think a cohesive argument has to be something that can be applied both ways (in favor and against the desired conclusion)
You're asking us to be better people, which is a good thing to ask, it should be the goal of our civilisation to be even better people that those who got us here and to leave behind better people that we were.
our failure to be
>> kinder to each other
is part individual selfishness, and partly that we're not brave enough to trust each other,
because we know that we do too little collectively to protect each other against the fraction of people who would exploit our kindness.
So we're buying toilet paper, getting ready to hunker down and hide.
We could fix this virus in two months with discipline and cooperation,
and make a start on your list too.
The fear of this virus, in relation to the threat is way off the plot compared to our our response to those other dangers. But I am frightened by it and other people seem to be too. I have a whole bunch of incomplete thoughts about maybe i / we can can use that fear constructively, and treat the next two months as a short course on how to recognise when I am acting in a way that is following patterns and norms, when there are other better choices
I love what you wrote. Everything except the using fear part.
I also love the honesty of using the word 'frightened by it'. That's what people are feeling and it's absolutely real. I can feel it in people when they talk about it. Being frightened is no joke, nor would I make fun of the feeling. My whole point was to highlight it being irrational. I don't share it. And I don't share it not because I'm special, but because I'm disconnected. When people are happy in a group and the feeling is contagiously moving through a room, I have a hard time getting 'in with it'. So I'm not taking credit for being disconnected, nor am I bragging about it, just explaining that I am, and therefore less likely to become infected with the feelings that seem to virally move through communities who are well connected.
But I do think we've accepted fear when we shouldn't. I love the stoics, who seem to think we need to accept fate more than our society seems to view it. In terms of using fear, let me quote one of histories greats, who said it better than I could ever say it:
https://youtu.be/nHFTtz3uucY?t=25
I don't read anything mocking or hostile in your tone.
You're calling attention to an obvious contradiction in our emotional response to different kinds of risk.
The using the fear part wasn't well articulated, I had a small person climbing on me, i may not be able to articulate it better now either:
emotions seem to be most productive when we allow them to call attention to something, and perhaps to direct our action in a fast moving situation, but not in a slow moving circumstance like this where we have time to respond rationally. The terrible thing is how often we fail to make that transition from emotion to rational action, instead we stifle the emotion until it cannot be stifled, at which point we let emotion run us.
I see people must be frightened - otherwise why are they buying out the masks and toilet paper?
That hording is happening in private - without an FDR to give us the social license to take more rational action we are doing nothing in public. The only public action people seem to be taking is to withdraw.
Hong Kong, where people are wearing masks and maintaining good hygiene is at only had 108 cases.
Meanwhile on Friday I had colleagues sick at their desks with flu like symptoms, some fresh back from overseas travel, and no-one saying a damn thing to them about it.
If we all wore gloves and masks starting tomorrow, we could put in a booking tomorrow with a struggling bar or restaurant for a corona's over party in two months time.
But that's not going to happen.
So I am frightened that like the person who doesn't stop smoking, drinking, and eating shitty processed bacon-yums, I'm worried we are going to sleepwalk into the horrible moment when we are overwhelmed and driven by fear, and that is a path to an avoidable pandemic.
So that's what I mean by using the fear, recognising it and transitioning to rational action to address the fear.
You've also questioned whether the risk of this virus - even in the worst case - is significant enough to stimulate this level of fear:
I live in an unusual small town on the coast. This is where most of the medical staff from the major hospital in the city 30 minutes away live. Family and friends work in the local emergency ward. This town skews older than most, if feels like half the town are retirees - we have five podiatry clinics. Also on the other side of the wetlands is one of the labs where people are working on the virus.
So this town is more exposed and vulnerable, and may be harder hit that most if there is significant transfer in the community.
However this town is also wealthy, well educated, has serious medical expertise and strong community organisations.
So the people around me should be in a good position to respond collectively - I don't know how those potentials resolve.
I've had dengue fever, had guns pointed and shot at me (missed), fallen off a cliff (improbably caught a tiny ledge as I slid down the ocean cliff) and been quite emotionally unmoved by my own mortality, not through the meditations of marcus aurelius, there wasn't any struggle there to overcome. So I can understand what you mean about 'not bragging' from this context
But not being here to raise my children frightens me. I don't believe stoicism or buddhism offers a convincing way to accept the loss of children, or pain to your children.
I think instead you have to come to terms the vulnerability to your own integrity that your children represent.
While I was unexpectedly comfortable with not existing, the horror of what my getting sick could mean for them is enough to derange me.
So today I'm having a happy day with the kids, we've played legos, and are hanging out in the sun.
I think a lot of people at the moment have a small part of their mind ticking over, looking forward a couple of months, not knowing whether this will pass lightly for them, or whether this is something that will push them to derangement - the fear of fear itself - and we look around for lea...
But I am frightened by it and other people seem to be too.
I wrote a long rambling comment in reply to this earlier and then deleted it. I'm looking for "beta readers" for a website to try to share useful information about germ control.
I have a lot of personal baggage from being mistreated by a lot of people on the internet. I'm not confident there's any point whatsoever in trying to put out useful info. The world likes to come up with ridiculous justifications for claiming I know zip, nada, zilch and I'm a loon and, also, I'm overly sensitive for not liking the ugly personal attacks.
So I actually think this is probably a completely pointless exercise that will go nowhere, which is why I deleted the comment, but one person enthusiastically emailed me already, so I guess I didn't redact my request for beta readers quickly enough. Thus I'm basically reposting it, though there is zero hope of faithfully recreating the original rambling post, so you are getting a completely original, slightly less rambling version.
Seven weeks ago there were ~100 cases in Wuhan, now there's 60k. What's to stop that from happening in Seattle, or the Bay, or anywhere else in the developed world that isn't taking the precautions China did?
Absolutely nothing. It is likely that Seattle is already out of control. But, we won't know how bad its going to be for a week or two. King County buying a motel to house sick people is rather telling. Its an action that suggest they know it is going to be bad but don't want to say so and freak people out.
I think it is going to be worse in the US than China. We have an individualist culture that routinely goes to work sick.
This is going to be the real issue, in my opinion. People will go to work sick because they have no other choice. And it'll spread. And, who knows, we might even have some crazy-ass cult here that purposefully goes in sick and tries to spread it (I read an article that Korea had a cult like that).
It's frustrating. We have no office hours and staff can work anywhere with internet - and anytime so long as they get work done. They are salaried no incentive to show up at offie whatsoever. We've sent emails, reminded at in person meetings. Yet they still show up coughing. One employee like every minute a dry cough.. We talked to them in person, sent them home. And then they show up two days later same cough if not worse! The excuse: i had an in person meeting!!!
drives me insane. I can only do so much and really feels like the only thing I can control is my exposure but I don't want to over react and become a hermit
if we cant get our salaried staff who can already work from anywhere to stay home I feel scared that there's no way in hell hourly service workers would do it.
There are at least 6 people on my team who come into work when they are sick. All of us can work from home, have excellent medical insurance, and are on salary. I asked in a staff meeting and was told that telling or suggesting people go home violates their right to privacy.
Your argument against caution would have worked just as "well" in China after the first 14 cases, but if you had made that argument then, think how stupid it would sound now with what has already happened in Wuhan.
None of the annual death counts you cite are exponential processes (with unknown growth rates) at the beginning of the growth curve. So either you don't understand exponential growth or you are being intellectually dishonest in acting as if these numbers are in any way comparable.
In the face of a pandemic that may kill an unknown percentage of the population the precautionary principle absolutely applies, and even if the total cases in the US never goes over 1000, the measures now being taken will have been the right choice because the risk of uncontrolled spread is unacceptable.
I'm baffled that you found a way to read my comment and think it's 'against caution'. Could you please tell me where I said that I'm 'against caution' or in any way implied it. I'm really interested.
I'm not sure what you consider "hysteria", since you haven't said, but in case you forgot, the comment you replied to was about people staying home and canceling travel plans, and the economic impact of this, not about hoarding PPE.
Staying home and canceling travel plans is the caution your comment seems to argue against. I responded to your comment in this context, and to your non sequitur "number 15" argument.
I generally use words based on their dictionary definitions as colloquial terms (which is generally implied since I've not identified as an expert). So in this case, I say hysteria as in the definition: "ungovernable emotional excess".
So basically doing things that aren't reasonable as indicated by health experts. This means for everyone:
For people who smoke, cancelling travel seems silly no matter where they go; they are already exposing themselves to a 33% mortality rate for something they choose to do. The worst place in the world for this virus still has a less than 0.005% probably of death (less than 0.1% of the population in Wuhan have the illness and less than 5% of those that do die). Surely we can agree that someone who smokes and fears the virus is having 'emotional excess' when it comes to risk assessment.
Now, how is mentioning the total number of US deaths from the virus as reported by the CDC a 'non sequitur' in relationship to fearing death from the virus in the US? It seems to me to actually follow quite reasonably.
Also, if your accusation that I'm 'against caution' is to be cohesive and reasonable, it would seem to necessitate me asking people not to engage in precautionary activities that are recommended, so I'd like to know which they are. Surely we can agree that IF I did what you accused me, it would be very irresponsible. And I don't want to be irresponsible.
I explained why your number 14 was not comparable with the other numbers in my first comment. If you claim not to understand it, unless you are innumerate, I struggle to see how you are arguing in good faith.
I answered your question in detail and with references, I think that is a pretty obvious attempt of good faith. You literally accused me of doing something horrific (telling people to not have caution against a deadly disease is a horrible thing in my book) and then refused to substantiate your accusation, but I'm the one arguing in bad faith? OK.
but we have to slow it down so we can spread out the demands on hospitals over a longer period of time. Drastic measures are working in china. I wish there was another way. Maybe you say it isn't worth it. Maybe you don't have any elderly relatives. The Case Fatality Rate for 60-69 year olds is 3.6%. For 70-79 is is 8%. For 80+ it is an astounding 14.8%.
What are the average mortality rates for those age groups from before this latest virus? What's the absolute increase in risk over the course of a year? I'd be surprised if it wasn't close to those numbers anyway.
It spikes to about a 5x yearly mortality multiplier for those between 50-60, diminishing a bit as you near 80+ (since their natural mortality rate was already high - about 12%(?)).
20-30 year olds have about a 2x multiplier. You're twice as likely to die this year if you get coronavirus.
Think it comes out to like - 80+ people are 25-30% likely to die that year total.
This seems more of a policy issue than an economic issue. In Europe you'll have healthcare and you will keep getting paid when you're in isolation. Kenia or Peru mit lack the budget to do that for their population, the U.S. does not have that problem.
It's a choice to value the economic value a person brings over their life, heath and wellbeing and I find it really odd to read a comment such as yours.
This doesn't need to hit families and definitely not for generations. It's your national choice, by how you vote and what policies you do and do not accept, that a few weeks out of work means you lose the job, your livelihood and at the top of absurdity also your healthcare. Somehow you've come to consider that as normal but in a country that finds trillions each year to buy overpriced fighter jets or similar things, making the choice to NOT let families go into intergenerational poverty due to a health emergency should really not be that difficult.
While I do largely agree.. in the U.S. the politics are bundled in ways that are largely unable to be agreed upon. The influence of large industries also cannot be underestimated. That also doesn't even consider the issue of the number of politically motivated people working in media that want an economic crisis to unseat Trump.
The advent of woke tribalism has been more damaging to both freedom, democracy, sane policy negotiation etc. Stone-walling is now the norm. It's really hard to say how any of this will shake out in the end.
If people stay calm, keep about 2 weeks of food/water as a normal point (don't stockpile for months), you can easily overcome any logistical issues. Panic only exacerbates the problems. In the end, some will suffer, but it's like we're overestimating the impact.
Worst case, this will probably be similar to the 1932 flu... I don't think it will get even that bad in practice (which was pretty bad). Within a year or 3, it should be fully recovered, unless too many people, do too many stupid things and panic too much, making wierd economic shifts.
Bill Maher for one, but have seen similar sentiments from other media celebrities. First link below. There's video out there, I've seen similar suggestions about half a dozen times in the past year or so.
While that might help individuals, it doesn't help the travel industry. Yes, employees in Europe will generally not lose healthcare, but what about the businesses they'd like to return to? Such as hotels, tour guides, restaurants, etc.
1. Young people interact with older people and those with pre existing conditions, and can pass on the disease.
2. More importantly, an unique characteristic of this disease is that although mortality rates for the young are low, hospitalization rates appear to be high, which poses a severe threat of overwhelming hospital systems. The disaster in Wuhan was at least in part due to that and unless precautions are taken, Seattle could be heading that way soon.
> The disaster in Wuhan was at least in part due to that and unless precautions are taken, Seattle could be heading that way soon.
This is almost happening right now in the Northern Italian region of Lombardy, hence today's mentions by some of the authorities of instituting a red-zone for the region itself (or parts of if, nothing is certain for now). [1] (in Italian)
15% of all confirmed cases in China were serious at some stage and require some kind of oxygen assistance. This is the one number we need to focus our minds on. Death rate is entirely dependent on the availability of resources. If we don't slow down the spread we will face disastrous consequences.
There are thousands in Wuhan who have been on life support for weeks if not months. Even if they do survive they will face diminished lives and this is with China sending all available resources (doctors, nurses, ventilators) of the nation there. Death rate itself is worthless to argue over unless one names the context: sporadic outbreaks here and there or tidal waves?
>15% of all confirmed cases in China were serious at some stage and require some kind of oxygen assistance.
the death rate in the hubei region itself is also several times higher than in most western countries so it's fair to assume that the rate of undetected cases in China is simply very large.
What we know from well controlled cases like the cruiseship with 600 infected people appears to suggest that about 20% of people develop more serious conditions like pneumonia and a fraction of those require intensive care.
You use the word "pneumonia" to describe seriousness, but this IS a viral pneumonia. The virus infects the lung first. Detection is through the sputum coughed up from the lung. If you test positive you basically have pneumonia. China's definition of a serious case is blood oxygenation less than 93% without assistance.
the virus does not cause pneumonia in the majority of cases. A pneumonia is an infection of the lower respiratory tract (which is a quite serious condition leading to significant symptoms).
In the majority of patients this virus causes an infection of the upper respiratory tract, which causes symptoms comparable to a common cold.
The virus infects the cells through ACE2 receptors, which are highly expressed in some lung cells but not the upper respiratory tract. High fever and dry cough are the most common symptoms while runny nose is rare. So no the symptoms are not comparable to a common cold.
To be precise, the COVID-19 virus is not “viral pneumonia”. Viral pneumonia is a symptom (pneumonia caused by a virus) which results from COVID-19 in the minority of cases.
Studies of the number of known cases which resulted in viral pneumonia find, for example;
“A total of 81% of cases in the JAMA study were classified as mild, meaning they did not result in pneumonia or resulted in only mild pneumonia.”
That is not to say that 20% of all cases are severe, but 20% of the cases in that study were.
What were mild, severe and critical? We think of “mild” as like a minor cold.
No. “Mild” was a positive test, fever, cough — maybe even pneumonia, but not needing oxygen. “Severe” was breathing rate up and oxygen saturation down, so needing oxygen or a ventilator. “Critical” was respiratory failure or multi-organ failure.
So saying 80 percent of all cases are mild doesn’t mean what we thought.
I’m Canadian. This is the Wayne Gretzky of viruses — people didn’t think it was big enough or fast enough to have the impact it does.
And many of those cases are new. How many of them have recovered, and how many are still battling it out?
CFR can change tomorrow for a given population. Another reason it’s such an elusive number.
When the infection spread is increasing, more new cases are coming in today than yesterday, and so the CFR contains a good portion of people who are still early in the illness lifecycle. Just because some haven’t died yet doesn’t mean they won’t. Meanwhile, as the spread continues, the healthcare infrastructure may reach a tipping point where it can’t treat people as effectively.
This! Think of the people you can spread it to unknowingly. This is why I am a young person holed up in their apartment, and starting to work from home until this thing tapers off.
As of today in King County, people are already being directed to ICUs in other counties south of it [1]. It does not help that the first major outbreak is in a long-term care facility filled with elderly and vulnerable people.
Which is why it boggles my mind that so many people live in a society that encourages no savings social net, no healthcare if you don't go to work, houses that are over 100% mortgaged, car loans, phone loans, furniture loans etc. etc.
This wouldn't be an issue if society just encouraged people to save 10 or 20 grand to have a "just in case" fund to last a few months, and if people got healthcare even when they didn't go to work.
With a strong social safety net it isn’t as necessary, which was his point. Is that US number using median values? That’s what will matter for more people.
In a first world country like the US most people can save if they want to. It is not the 1%, more like the 80%.
Think about it this way. Imagine your household income is $50k, the median. But for one year, you decide to live like you are at $30k, barely above poverty. It may be a difficult year but there is no reason you can't manage, 1 in 5 people live their entire life with that. At the end of the year, you are left with $20k. You can now start living your life like anyone with a median income will. Because of that 1 frugal year, you are left with a average balance of $20k for your entire life. No more living paycheck to paycheck. And even better, when you die, your children will inherit these $20k so they won't need that year of poverty to keep their balance positive. So these $20k will actually last forever.
Of course, it is a simplification, but the idea is that keeping savings is just a matter of living with the paycheck of a few months ago instead of the last one.
Now what are the benefits of having an average of $20k that you won't touch.
First, it is insurance. Insurance costs you money in the long run, that's how insurance companies pay their employees. That sum is your own insurance for small things, like phones.
Second is that you can take advantage of opportunities, like volume discounts. Money will make you save money.
For those who are above the poverty line, the reason they can't save is lack of discipline. Not "the 1%". But to be fair, society in North America doesn't really help, with ads everywhere and credit everything.
Mike Bloomberg spent 500 million dollars on advertisements for a failed presidential bid. With this money, he could've given every American a million dollars, still have 173 million left over, and have made no discernible impact on his net worth.
It's absolutely an issue of the 1% versus everyone else, and especially given these people's opposition to providing basic social safety nets to all people.
No, what I am saying is that by making your life "more miserable" for a short time, you can make the rest of your entire life better.
It is called delayed gratification and it is linked to success in general. That is just an instance of it.
And sure, I can save my whole life and make less than some people can make in an hour. Ok, good for them. But now what can we do? Take their money? It is not going to happen, so I think it is smarter to do with what we have instead of dreaming about a better world that will solve all our problems.
And even if we manage to take all the money from "the 1%" and redistribute it to everyone else, it will be around $20k/year more per household. It is a lot, but not that much. Let's take our $50k/year median household, it is now $70k. In theory that means $20k/year of savings. But when you consider that many $70k/year households are living paycheck to paycheck (but with a nicer car and a slightly bigger house), it probably wont change the saving ability of the average American.
Another way to show that the 1% has nothing to do with savings is to look at other countries. Even when adjusted to purchasing power and inequality, US households has less savings and more income than most western Europe countries.
You end up with some of the following barriers to saving:
1. Cost of housing.
We mostly don't have affordable housing. This is a serious burden for many Americans. It's not legal to live in a hut without electricity or the like, even if you wanted to.
2. Our public transportation and walkability sucks.
Most Americans need a car. This is a huge financial and logistical burden for many people.
3. Healthcare
The US spends insane amounts on healthcare and people who are poor let problems linger because they aren't sure if it's worth getting seen and having the bill for it.
I've escaped that pattern. It was really challenging to escape it and I've been dirt poor a long time, in part because not having a car is a logistical barrier to earned income and even if isn't, it's a social signal that "I'm an incompetent loser" which helps suppress my income.
I'm gradually making progress on all of it, but it is tough to swim against the tide and our current tide is highly problematic and burdensome for most people in the US. So it's a damned if you, damned if you don't situation.
I can see people at one point being burdened by some of the scenarios you mention but do they happen every year or every other year to everyone without 20k in the bank?
Yes, cars being the biggest problem. If you're broke and you buy a new car, you end up with a lease or something with a big down payment; the other option is you have a huge finance issue, where you won't finish paying off your car for 7 years after it has 100k+ miles, and now you still owe 5k on a car that's breaking down, with monthly payments of $500/month+.
During this time, your rent has likely been raised each of these years.
Also during this time, you started making 50k, and are probably still making 50k.
The United States is in a very vicious cycle, mostly based around living, working, and commuting.
You need a car to get a job. You need a job to afford a car.
It's a systemic problem in the US where employers don't really want to hire you if you have no car because our public transit sucks, so they assume you can't get to work without a car.
And cars tend to be the second biggest household expense, after rent.
My brother has been in the automotive industry most of his life. Thanks to how computerized cars are, you can't really service your own vehicle anymore, even if you are a talented mechanic.
And cars just don't last like they used to. If it isn't new, you are probably paying so much more on maintenance that it isn't really saving you money compared to getting a new car.
Americans are prisoners of the need to own a car. It's a huge financial burden and my life works as well as it does because I escaped that trap more than a decade ago. It's part of why I can survive at all while supporting three people on well under $20k annually.
But most Americans can't imagine escaping it. I get a lot of deer in the headlights looks and have largely stopped talking about the fact that it's possible to make other choices because it's just so unimaginable for many Americans and they just act like I'm a loon and out of my mind completely.
You don't need a new car though. I've managed to hold down a job for years driving used cars.
> employers don't really want to hire you if you have no car because our public transit sucks, so they assume you can't get to work without a car
Other than delivery jobs, I didn't think employers even asked "do you have a car?" in job interviews. It seems like such a weird thing to ask in a country where, as you say, pretty much everyone has a car.
> And cars just don't last like they used to.
This is straight-up BS. Cars last longer than ever these days. [1] Buy Honda or Toyota and it will likely last over 200k miles.
> If it isn't new, you are probably paying so much more on maintenance that it isn't really saving you money compared to getting a new car.
New cars cost a lot more in insurance and interest than used cars. That's extra money you will definitely spend if you buy a new car - versus money you might spend if your used car turns out to be a lemon requiring a ton of repairs.
New cars also depreciate faster. The minute you drive a new car off the lot, it's worth 20% less than you paid for it. That's literally money out of your pocket, but no one seems to count it when saying "used cars cost more in maintenance."
Why would you buy a new car? Buy a $2000 used 15 year old Honda Civic. You need to be able to go from point A to point B, perhaps a working A/C and heat in the car.
This is the thing, middle class people have been spoiled to spend $$$ in entertainment, useless gadgets and 65" TVs where they could just entertain themselves with frugal means - there are many! Go hike. Play chess and board games.
Stop buying sugary drinks at Starbucks for $5 every day. Everytime I think about middle class folks living paycheck to paycheck - I have no sympathy.
If you don't have disability, and have good physical and mental health, and are earning a middle class wage - you can become wealthy by saving and investing wisely.
What level of wealth are you talking about? Cancelling your Starbucks habit will save you 1-3k a year. What are you investing in to turn savings like this into real wealth?
If you saved 150 dollars a month for 50 years and got 2% interest on your savings, at the end you'd have an extra 150k or so. That's nice, but not really wealthy. Especially because we're not taking into account fifty years of inflation.
If you want to be wealthy you need to figure out ways to earn gigantic amounts of money, not save small amounts by cutting out the pleasant parts of life. Wealthy people tend to either inherit or produce their wealth, not save it by a lifetime of penny pinching.
Yeah, save that money and may be invest in education or learning a new skill? Living paycheck to paycheck is a problem of lifestyle and not the problem of affordability.
I bought a new car when I got a corporate job. The first 90 days were training. Missing any of the training -- even just being late -- could get you booted.
I had been a homemaker for about two decades. I was like 41 years old and it was my first full-time job. I have a bunch of college, but had job hunted a long time before finally getting a job offer. My POS older car was not reliable and was potentially going to cost me the job.
This was kind of "my big break" and I was sharing a single room with my teenager sons while living at a relative's house and going through a divorce.
People often spend money trying to make sure they can adequately qualify for a good job and it may not pan out. This is also essentially the TLDR behind a lot of crushing student debt in the US.
I will note: I'm pretty tired of the "poor people just need to stop drinking Starbucks coffee" trope, and have spoken about that previously:
> "It's generally disingenuous to act like if poor people just give up a few small luxuries, they, too, can invest their way to being millionaires. This is generally not true."
I read some of your arguments but I am not convinced, at all. You can't just say "This is generally not true" without substantiating your argument. Its a bold claim to say "Keep enjoying your $120/month coffee" when your condition is dire and you're trying to lift yourself from poverty.
> My POS older car was not reliable and was potentially going to cost me the job.
That's twisting the argument at hand. I didn't say buy a $2000 honda civic that's gonna leave you astray for your job interview.
I've lived and pulled myself out of poverty - just FYI.
People make decisions in the context of their actual lives. People trapped in poverty usually need something more than "one cool investing tip" or so-called self discipline.
The problem is that encouraging savings of that magnitude all at once will grind our economy to a halt, potentially resulting in the loss of their income source as the economy severely contracts.
Nonsensical until someone aged 25 gives nCov to their grandparent aged 75, and that person dies. Suddenly, your work just doesn't seem so important.
(don't have to wait for a vaccine, we can return to life when there's a reasonable therapy which should be 2-4 months... unless all 50+ late-stage drug trials all fail...)
The silver lining here is that this dramatic drop in production and travel is exactly what the environment needed. We're finally giving working from home a serious go. Holidaying within our borders.
I'm sure it'll all look pretty silly in 24 months time, when this recedes into a background seasonal and we finally finish our personal stockpiles of toilet paper, but we might learn important lessons too.
The silver lining here is that this dramatic drop in production and travel is exactly what the environment needed.
Yeah, everyone will be so happy the environment is cleaner. They won’t care that they are laid off, lose their house and the economy spirals in a recession.
It's nonsensical to you because you're not looking at it from their perspective. The healthy 25 year olds that are holed up in their apartments value playing it safe with their health more than they value helping businesses that they don't own.
I don't know any healthy people literally holed up in their apartments. But most people I know have kids. We still take our kids to school. We still go to the grocery store. We still take them to soccer practice. Even the most paranoid person I know is not holed up in their apartment.
What I'm not doing is flying my kids, with my 74 year old mother, so we can go to Disneyworld in Florida. I'm not taking my young children to Disneyland, which is local, because it's an international destination and if we run across a bug they will catch it because young children have no ability to not constantly stick their fingers in their mouth.
We could just say "we aren't going to see grandma anymore" but my sister in law also just had a baby. Should I tell my wife she can't see her newborn nephew because we could transmit it to the grandparents through visits? Or maybe we can just not go to Disneyland for a little bit? I understand that the odds of this chain of events playing out is low. But I would feel really, really stupid if it happened to.
I also talked my mom out of going to Vegas. Why? Because the US has tested damn near no people. If we had been testing aggressively like South Korea I could justify saying "there's been no found cases in Vegas, you should probably be good". Instead I have to say "No found cases in Vegas, no fucking clue what that means".
FWIW, most parents I talk to think this is a big nothing. One is keeping their trip to Italy this month. Another is immune compromised and as of yesterday, still flying into Seattle for some reason. I think it's a poor choice.
my issue is how to reconcile the way different countries have handled it. i don't think this is a nothing burger, but i'm also wary of the "overreaction" by the media and then you add signaling and political issues and it becomes a mess.
- america and some european countries. we haven't tested anybody in the US and are basically treating it like it's nothing, but it's clear that this thing has been spreading already. still yet to be seen how it plays out in terms of overwhelming the system.
- contrast this to a place like korea which is aggressively testing 10k people per day, finding a low mortality rate, but still trying to balance hospital resources.
- compare that to italy and iran, where they are struggling w/ resources and people seem to be dying at an alarming rate (imagine if like 3 politicians just dropped dead from this thing).
- now compare that to china, where they literally quarantined tens of millions (and still are), had to build extra hospitals in a matter of days, and are still implementing draconian measures to manage it. they basically had to shut down their production briefly. and even then the actual numbers might not be clear.
if someone could help enlighten me with an explanation that would fit all these cases that would be much appreciated. right now it's too black and white, that this is some world ender or "just the flu, bro".
What confuses me is how China had Chernobyl-style liquidators spraying down the insides of malls and outdoor public areas, supposedly with bleach. Contrast that with America's relatively tame "don't touch your face, do wash your hands for 20 seconds" advice.
This article helped me answer those questions. This will probably become another cold/flu in addition to the current cold/flu seasons-as a better possible outcome:
This is a very serious disease for many of the infected when left untreated: it causes pneumonia (inflammation of the lungs/airways) which makes people’s respiratory system less effective, leading their blood oxygen levels to drop and potentially leading to death, especially in the elderly and people with pre-existing conditions like cardiovascular problems, obesity, diabetes, compromised immune systems, asthma, other chronic respiratory issues, ....
A significant proportion of people over 60, a non-negligible proportion of people ages 40–60, and still some proportion of people aged 20–40 need to be hospitalized and put on supplemental oxygen. In severe cases people need support from a mechanical respirator. In the WHO report from China 20% of positive cases needed hospitalization. This might be a substantial overestimate if there are many mild cases not caught by tests, but even if that estimate is off by a factor of 5 or 10, if there are many cases this can overwhelm hospital capacity.
When treated aggressively by a capable healthcare system (caught early before severe symptoms start, treated with antiviral meds, patients put on supplemental oxygen as soon as blood oxygen starts to dip, hospitals have enough respirators for severely affected patients) so that people don’t die while waiting for their immune systems to fight the virus off, many fatalities can be avoided, as is happening in Singapore or some wealthier provinces in China. But this depends on social distancing in the community, widespread testing, aggressive isolation and contact tracing of infected people, and efficient triage of cases.
If cases are not caught early and treated aggressively or if medical systems get overwhelmed, it is bad news. If this virus is not checked and spreads throughout the world quickly, the death toll could be in the millions.
Beyond being very dangerous to a substantial proportion of infected people, it is also extremely contagious, and has been spreading very rapidly. It is contagious even among pre-symptomatic or asymptomatic people. Perhaps most dangerously, its early symptoms are close enough to ordinary cold/flu symptoms (and some of the infected seem to not advance to the more serious stage) that people who are shedding the virus continue to go about their everyday lives without realizing they are infected with novel coronavirus instead of a typical cold or flu.
To be clear, at this time we only the “CFR” - known case fatality rate. Likewise, we only know the known case hospitalization rate.
What we do not know, and can only estimate, is the “IFR” or the overall infection fatality rate, and the overall infection hospitalization rate.
Imagine the flu was a brand new virus which we didn’t have any test for. In 3 months we would see 100,000 hospitalizations and 10,000 deaths from this new virus.
Only after testing became inexpensive and widespread would we come to realize that actually 32 million people were infected with this virus, but only 200,000 per year went to the hospital, about 20,000 of which end up dying.
My point is, we do not know the infection hospitalization rate, nor the infection fatality rate of COVID-19, but its upper bound is the CFR and it’s reasonable to suspect the actual value is at least an order of magnitude lower than the current CFR data might indicate.
It’s not reasonable to state anything definitively about the overall hospitalization rate of COVID at this time without the qualifier that it’s based on only known cases and therefore overstated by some unknown amount.
You may find this letter (written March 4th) from doctors specializing in Emergency Medicine more compelling than my own summary:
Edit: I was basing my comment on a 2018 newspaper story, but thanks for tracking down a peer-reviewed model estimate. I deleted my comment as it didn’t make a grounded comparison.
We can only wait and see how many people die from ncov-19 in Italy or anywhere else.
> “We estimated excess deaths of 7,027, 20,259, 15,801 and 24,981 attributable to influenza epidemics in the 2013/14, 2014/15, 2015/16 and 2016/17, respectively, using the Goldstein index. The average annual mortality excess rate per 100,000 ranged from 11.6 to 41.2 with most of the influenza-associated deaths per year registered among the elderly.”
> “In the winter seasons from 2013/14 to 2016/17, an estimated average of 5,290,000 ILI cases occurred in Italy, corresponding to an incidence of 9%. More than 68,000 deaths attributable to flu epidemics were estimated in the study period.”
(Edited) The wording here is confusing. It’s an average of 5.2 million cases per year for 4 years resulting in a total of 68,000 deaths over 4 years. Meaning an average of 0.325% IFR due to Flu (ILI - “influenza-like illness” in Italy.
That’s a high confidence IFR based on a well established surveillance network and widespread testing. Meaning it is likely not being overstated. Versus COVID’s know case fatality rate, which is an upper bound on the IFR and known to be missing a significant number of mild cases in the general population from the denominator.
I agree that it remains to be seen how bad this will be in Italy and elsewhere, but putting it in perspective to the flu (which we do not generally “fear”) is useful.
If any of this were true, China would already be totally overrun. Instead they are reported fewer than 150 new cases per day and closing their temporary hospitals.
My prediction is that we will see the same thing happening in Italy and South Korea in two/three weeks time.
My hyperbole: It’s known that preexisting conditions contribute to deaths: if we presumptuously view atmosphere in a Chinese city as a condition, then the Wuhan death toll makes some sense.
Also for “just the flu”: it’s a coronavirus. A cousin of common cold. So it gets you like common cold, you usually don’t know when or where or how you got it. Most effective prevention, not vaccination, not facemasks or spacesuits, but washing hands often, facing away from people when sneezing, eating more vegetables, getting good nights’ sleep, those mom of 5-year-old kid items. There are not many effective meds save for NyQuils and lab experiment Ebola shots. I think “just the common cold” is a technically accurate description regardless of whether it’s world ending or not.
320 comments
[ 4.3 ms ] story [ 275 ms ] threadIf I was a lobster (they can live over 50 years, so its not impossible given I'm old now) I'd be delighted if people stopped pulling me out of the sea for no cents.
> Dirt-cheap because they were so copious, lobsters were routinely fed to prisoners, apprentices, slaves and children during the colonial era and beyond. In Massachusetts, some servants allegedly sought to avoid lobster-heavy diets by including stipulations in their contracts that they would only be served the shellfish twice a week.
https://www.history.com/news/a-taste-of-lobster-history
Yeah that agrees with what I wrote. Why are you apologizing for thinking you are disagreeing
Nothing like a fresh lobster roll on the Eastern seaboard!
In which case, it does actually taste better as a group. It probably finds better recipes as more experienced cooks take a stab at it (whereas before, it was so low-class few would likely even consider doing anything with it beyond the simplest/cheapest combinations).
These kinds of things are usually compounding, or even feedback loops; it's rarely useful to only look at a single step of impact. Though I wouldn't doubt cost isn't a part of the explanation (and ofc it goes the other way too -- good things made cheap, cheapen the perceived value. Perhaps they were also good when it was cheap... But cost was so low you wouldn't accept it as good-eatings)
And crustations generally are a very satisfying meat to bite into
http://www.binions.com/dining/binions_steakhouse.php
I for one loved lobster long before I had any concept of the meaning of money.
It's not just perception. Lobster is not very flavorful on its own. I don't mean, "this flavor is an acquired taste" - I mean there really is not much flavor there.
Do you also find it a little too crunchy?
Maybe it’s time to stop eating the shell.
It's exactly like eating bugs in that crustaceans are actually related to bugs, but nothing like eating bugs in the sense that the "grossest part" of eating bugs is that the whole thing is consumed; eyeballs, organs, brains, poop, shell, etc.
[Crawdads](https://en.wikipedia.org/wiki/Crayfish), lobsters, crabs, and shrimp are all arthropods.
The sellers sold a commodity in the world’s strongest currency to a single country that is loathed by their government and the source of multiple previous epidemics.
Here’s a tip: diversify your sales. Even if (horror) you have to lower your price or accept another currency.
Edit: wow, falling to $25 already, I saw this same site for $42/lb last year.
https://store.catalinaop.com/products/live-whole-california-...
California's lobsters had the finest flavour, are more dangerously deceiving to naive fishermen (crushing's fingers creature), and much more challenging to catch and put in a table. They have a bad habit of losing legs at the slightest opportunity (and nobody wants to buy a three legged lobster).
It's a smaller fishery too, they aren't that common north of Point Conception.
If more companies are forced to shut down or cut/postpone spending in response to sharp drops in revenues, their suppliers and employees will react by cutting or postponing their own spending, leading yet others to do the same, in the worst case fueling a sudden and self-reinforcing feedback loop of global contraction in economic activity.
It's possible that stock markets worldwide are now pricing such a scenario. Let's hope it doesn't get that bad.
But hope is not a plan. Please make sure you're well positioned to survive a sharp economic downturn, just in case!
See also: https://medium.com/sequoia-capital/coronavirus-the-black-swa...
Also, 10 year treasuries are at a record low today below 0.7% [3]. This is unheard of, and an indicator that capital markets are seeing an unprecedented flight to safety [4].
Not intended to be alarmist, these are simply observations (although I heard someone say very recently, "the bond market is basically signaling that all hell is going to break loose."). It appears macro econ policy folks are trying to engineer a soft economic landing, but monetary policy only goes so far. Be prepared, make good personal finance choices in the near term.
[1] https://www.reuters.com/article/us-usa-fed/in-an-emergency-m...
[2] https://www.cmegroup.com/trading/interest-rates/countdown-to...
[3] https://www.marketwatch.com/investing/bond/tmubmusd10y?count...
[4] https://en.wikipedia.org/wiki/Flight-to-quality
I wouldn't go so far as to keeping cash on hand beyond what you'd normally have; if things get that bad, cash will be your least concern. ATM card access is sufficient.
Disclaimer: I am not your certified financial planner/manager, but I do manage the finances and assets of others gratis. This advice is the same advice I practice myself.
That said, the economy was an extremely fragile condition before all this began so this might be an exception.
I've heard variants of this from so many people at this point that I'm convinced the default human behavior is to consume - not to preserve or save.
It was? This bear case hasn’t had much data supporting it. Can you elaborate what made it “extremely fragile”?
That’s not to say this virus isn’t affecting the economy but the government’s decision not to offer a loan is what pushed Flybe over.
Just the cross-fire? Weren't they also being directly targeted themselves?
https://www.cnbc.com/2020/03/06/10-year-treasury-yield-falls...
All is like orange agent poured over the economy wherever you look.
The prices of air travel in the US are laughable at the moment. I can fly roundtrip from Chicago to LA for $140.
Places that aren't going to soak you will put a price and that price won't be insane. Like places in Maine that say
"Surf and Turf - $19"
"Add a lobster - $9"
"Twins - $14"
Those same chicken lobsters will cost you 20+ at a restaurant, and would be 15-20 for a lobster roll. Restaurant prices haven't moved (up or down) in more than decade.
The lobster fisher has boat payments, fuel ($1,000 to fill the tank per trip), wages for helpers, insurance, zone license. Now more rules to prevent right whales from getting caught in ropes. Which means new rope or new ways of handling the traps and equipment. And there is a quota so you can only catch so many.
Meanwhile that $6 lobster goes for maybe $50 or $100 in a restaurant in a large city.
And here's a little bit more detail on it: https://www.norwayexports.no/norways-introduction-of-salmon-...
I hope that not. Would be a disaster
Pay me, then put the lobster back so I can catch it again!
I assume the lobstermen are hoping that this is what their government will pay them to do (i.e. subsidies). I would rather hope that we leave the poor sea bugs alone.
Lobsters are a species that actually benefits from fishing. Herring on the other hand...
So many people are going to lose their jobs, their homes, and their healthcare, if everyone continues to cancel all travel and entertainment. These economic events have real impacts on families for a generation. And service workers will be the hardest hit.
The median age of fatal infections is 75. And yet we have healthy 25 year olds holed up in their apartments, hitting local economies hard. It's nonsensical. Most people should be behaving normally with some added protections (like washing their hands), and those who are at high-risk should be protected.
"There's another infected person in [YOUR_COUNTRY] - 10 ways COVID-19 can kill you! You won't BELIEVE number 3!"
This is a conversation between two respected journalists, from NBC and the New York Times, quoting Twitter as fact, and failing the most basic of simple math questions.
Your logic has the same faults as "I don't need the flu vaccine, I'm not at risk because I'm healthy/young."
You would think, but you would be wrong.
Here is the fundamental math. There is a number called https://en.wikipedia.org/wiki/Basic_reproduction_number which is how many people the average infected person infects in turn. If that figure is above 1, the epidemic spreads and some nontrivial fraction of the total population will get sick. The exact number who catch it is impossible to calculate since the relationship between the basic reproduction number and how many people eventually get the disease is chaotic.
But if that figure can be reduced below 1, the disease dies out on its own. It took draconian measures, but this is already happening in China.
Public health officials have a variety of strategies available depending on the situation. But the choices from most desirable to least is as follows.
1. If possible, get the basic reproduction number below 1.
2. If not possible, encourage at risk groups to get extra protection so that as the disease sweeps through, as many as possible don't get it.
3. Be overwhelmed.
The current strategy is focused on the first option. As noted, the basic reproduction rate is already below 1 in China and the disease is dying out there. If it escapes, the second option will be tried. But an epidemic that hospitalizes 20% of victims and kills 3% will, if we accept #2, leave us quickly at #3.
And as much as a temporary slowdown of the economy loses us all, figuring out how to some up with a reasonable substitute for hospitalizing 20% of the country when we don't have medical staff (knowing that a failure to figure it out will result in much higher casualty rates) will have much greater economic impacts.
It turns out that we can quantify it. Based on https://www.theglobalist.com/the-cost-of-a-human-life-statis... it is reasonable to say that we value a human life at about $8 million. If half of 327 million Americans get sick and (as current rates have it, 3.7% of them die, the economic impact is about $48.4 trillion. That is about the same as the US economy for 2 years. If losing 1/4 of our economy for 6 months, and then suffer similar economic damage on the path to recovery, gives us even odds of preventing this, we absolutely should panic.
And, as China demonstrates, it IS still possible to prevent this outcome. It will take heroics. But it is possible.
https://www.nejm.org/doi/full/10.1056/NEJMe2002387
> it is reasonable to say that we value a human life at about $8 million
We're talking about the very elderly dying a bit earlier than they would have otherwise. Before you accuse me of being heartless, I agree that that is indeed sad and worth mourning. But, no, it is not the same economically as a working-age person or younger dying in large quantities.
And keep in mind it's March, and flu season will naturally be on the decline this month.
The CDC has consistently concluded that the real rate will be somewhere in the 2-4% range.
There are admittedly researchers who think that cases are severely underreported. However data from other countries has been in line with the Chinese experience. If dramatically more get it, those dramatically more seem to also be less infectious.
Given this, it is better to act on the higher end of evidence based estimates and to have possibly overestimated than it is to believe on the low end and find that a higher figure was appropriate.
But even if you disagree with that reasoning, dropping all of my figures by a factor of 4 still comes up with figures that justify truly shocking disruptions to our lives. And the basic facts about epidemiology that I gave are still worth understanding.
Again, see the NEJM:
https://www.nejm.org/doi/full/10.1056/NEJMe2002387
Or any of the better data sets:
On the Princess Cruise, a naturally controlled study, the death rate was less than 1%, with a cruise full of old people.
Non-Wuhan death rate in China, where more mild cases were identified, ended up being 0.7%.
https://www.livescience.com/is-coronavirus-deadly.html
Goodness, there are so many chicken littles on HN nowadays.
What would be the death rate when the medical system is so overwhelmed none of the acute cases can receive any medical care? That's the number that should influence how far we go in trying to control transmission.
In Israel the single serious case is 38 years old. He is on a respirator. No some 80+. IIRC from the Washington cases there were some in their 20s who are hospitalized. Israel is less likely to have random unknown cases given their stringent border control, quarantines and testing.
No they don't. They have large biases from the fact that mild and asymptomatic cases are underrepresented. To avoid that you want to look at data sets where they tested 100% of people whether they had symptoms or not.
As far as I know that is the cruise ship and the South Korean church. And they show a lower death rate.
Now Diamond Princess let's us estimate Serious / Total, and say Italy let's us estimate Death / Serious (they probably catch all serious cases, and have less variance since they have larger numbers). So it may be possible to combine to get a good estimate of Death / Total.
Possibly significant source of error is age skew.
CFR was estimated at 2.3% and IFR at 1.2%, reflecting that roughly half of infections were asymptomatic. The downside is that the median age of passengers was 58, so it's not truly representative of CFR for all ages. (That's why people are still using data from China; the cruise ship isn't demographically representative.)
You also need to consider that 15% of cases are serious, and may require mechanical ventilation. If medical systems are overwhelmed, it will go up. We saw that in Wuhan.
The 62 year old still in the workforce, living with managed diabetes.
The 55 year old with asthma.
The active and healthy 72 year old who just retired.
The 32 year old with an autoimmune disorder.
The 43 year old healthcare worker with repeated exposure to the pathogen.
...
Because we still do make decisions. We still do allocate resources to our own pleasure that could have gone to saving someone else's life. We pass regulations limiting how much people can be exposed to chemicals that impact health. And trade off the convenience of being able to travel in cars for how many of us will die from doing so.
We still make those decisions. The only question is whether we think clearly while making them, or whether we shy away from the ideas that could let us think clearly.
I'd say that applies to your post more than OP. Was that really necessary?
In my family there are four grandparents in their 70's with various health problems, and my two young children. All four grandparents have commented that they're relieved that this virus appears to target old people more than children, and we'd all consider it to be at least less bad news if the numbers confirm that. My father in law, who is a doctor, remarked that he's less concerned about losing his own life because he's "already lived 90% of it".
I'd never want to have to decide whether my parents or children get to live, but if I did, I'd choose my children in an instant.
These are our opinions -- no more or less valid than your own. Do you suppose we, or anyone else for that matter, cares whether someone like yourself thinks we're "heartless"?
I'm simply saying that, at least for the US according to the CDC, 260 people have become ill and 14 people dead... which is nothing compared to 300,000,000 entering a state of unreasonable fear.
I know people who don't get a yearly flu shot (50,000 dead/year), don't wash their hands before eating (most viral and bacterial infections aren't airborne), smoke (400,000 dead/year), drink (80,000 dead/year) and regularly drive late at night when tired (35,000 dead/year)... yet they are taking every possible precaution against corona virus, because they don't want to be the 15th death. It's so weird.
Again, not saying it isn't an issue or doesn't exist or can't become a bigger issue. Just that the fear is so disproportional to the threat, it's mind blowing for me. It feels like some mass psychotic event. I'm just disconnected enough from most people's reality that I can't seem to share in it, so I stand a contrarian outsider like I've always been, scratching my head.
Sadly, this is true for so much of American culture re: our current politics and social fears. We live in a culture that explicitly governs on and trafficks in fear. I don’t think we ever got out of fear mode after 9/11, but reasonable people can disagree here.
Also, people aren’t just thinking about themselves, they’re taking into account the risk of transmission to a loved one who’s in a higher-risk age group. I’d hate to contract coronavirus and pass it on to my parents who’re in their 60’s.
I guess the biggest issues in first world countries (heart disease, cancer, suicide, car accidents), are mostly things that boil down to individual internal battles related to our daily choices. And improving those is a humbling, long and not particularly glamorous process. It's grappling with the millions of shortcomings we all know we have and we all know how to fix.
My theory is the law of diminishing returns. We’ve made incredible progress in identifying and minimizing risks of disease and accident. Once we deal with those, we go down the list to the next one.
At this point, we’re working on things that are relatively minor risks, but still treat them as if they were high risks.
maybe it’s akin to allergic reactions... where certain people who grow up unaccustomed to certain allergens end up with their immune system overreacting... maybe in our society, in everyday life we aren’t accustomed to certain stimuli and even relatively (to other countries) small shocks can lead to overreaction... just an idea...
If we take dramatic measures we have a good chance of heading off that outcome. This is worthwhile even though it will hopefully look like a crazy overreaction to the actual fatalities.
I agree that most of the people who are reacting are way overreacting to the actual facts and risks. But I strongly preferring them erring in the direction that they err than having them dismiss the risk based on few current fatalities as you are doing.
Fatality rates in places other than Wuhan (which had many undiagnosed cases due to limited resources in the outbreak) have all been less than 1%.
At the low end (deaths / total cases) Italy is seeing a 4.25% CFR.
If you use the smaller number of ISS confirmed cases in Italy the numbers look much worse. Meanwhile Spain and Hong Kong are showing CFRs around 2%, France around 1.3%. The United States? About 5.4% so far. As for me, I'd trust the Italian numbers far more than anything coming out of China, especially after their reporting on the SARS-1 outbreak.
It's not a minor, nothing-to-see here event.
But the numbers indicate that there's an order of magnitude difference between the number of available beds, and the number that will actually need them, in most developed countries. For those who will get inadequate treatment because of that, the fatality rates will be higher.
They may indeed be using bad data. However I trust their analysis of the data over a random internet commentator like you.
I encourage anyone reading this conversation to do their own research and note the uncertainties before forming their own opinions.
edit: see, e.g. here https://www.who.int/docs/default-source/coronaviruse/situati...
The point you responded to, of not overreacting, is indeed correct.
Are you saying we should do nothing, and just accept some tens of thousands of deaths and overburdened hospitals across all major cities? Or that this isn't really a big deal or contagious, and we should just ignore it?
It seems to me that the prudent and responsible thing is for us all to do our best to lower the secondary infection rate, in order to guard against these outcomes.
In the end, it will spread, it will kill, and the only thing panic does is make things worse. If people washed their hands more and stayed home when sick instead of working through it, that's the most you probably should do.
e.g. https://marginalrevolution.com/marginalrevolution/2020/03/fr...
It is being reported that South Korea is testing 10k per day. The USA is still having an issue in even delivering test kits where required. That's months ahead, not weeks.
Overreaction can take many forms, depending on what people think is in their individual interest (even if it's at the expense of the collective interest).
I believe I do my part for this and every flu season which literally kills 50,000 Americans each year. The extra dozen deaths from this new virus really don't change my existing habits: I wash my hands frequently, thoroughly wash fruits and veggies, I stay home if I'm sick, and I get my flu shot each year. I also get regular check ups.
I also try to eat a rich, varied diet, get good sleep, do some exercise, don't smoke and avoid over drinkings or overindulging in sweets/fats/salts.
I also, and this is real important for me at least, try to avoid getting stressed over things I have no control over. Again, this is just me.
Since the Corona virus has a 3% mortality rate, your estimate of 'at least 10x' would mean 500,000 american dead by the end of year, which would require 150,000,000 to be infected this year, or basically, 48%~ of the population getting infected this year.
I'm not saying your wrong, but can you provide a link to a reputable site such as CDC/WHO that supports your claim?
You might be right in your claims. But can you provide me with any reputable sources to verify your claim?
Anyway, deducting a conclusion from reality can be possible, though I'm not sure I agree trivial. I will say I think using statistical past experiences to model future outcomes without understanding underlying mechanisms of action would normally be consider inductive reasoning, not deductive.
But even if you arrived at your conclusion using deductive reasoning you could still create a logically valid statement that is unsound. Which is why I ask, what were the original observations that allowed you to deduct that the infection rate will be near 100%.
We can deduce that the infection rate will be nearly 100% because there is no significant subpopulation that is isolated from the rest of the population. Without isolation, the infection spreads. See also: rhinovirus-based colds, which have infected 100% of the US population despite different people having prior immunity to different strains, slowing its spread.
> 99 serotypes of human rhinoviruses affecting humans have been sequenced.
Of which, one seems to be the most contagious:
> The human Rhinovirus Strain 1A (which was at the time held responsible for at least 30 percent of the common cold infections)
Since the 'cold' is something that about 10% of the population get, and since one strain of Rhinovirus once managed to account for 30% of common cold infections, it would stand to reason that the most infectious Rhinovirus managed to infect 3% of the population in a year.
Please help me understand how that allows you to 'deduct' that COVID-19 will have a near 100% infection rate?
I won't continue since more fundamentally, I think you and I have a very, very different definition for what 'logic' and 'deduction' mean. To me these words, like the word ironic, have a very narrow definition that many people don't seem to conform to. I guess we'll have to agree to disagree. I do wish you the best and think we can all agree that we hope the new virus has the smallest possible toll on humanity. :)
The flu.
I didn't say SARS-CoV-2 will achieve nearly 100% infection rate in a year, but over the lifetime of most young people today, certainly. In the next year, it will have infected enough people to dwarf the flu over that year, however much we hope against it.
Specifically, what assumptions am I making that are erroneous?
I'm open to learning, maybe you can teach me.
https://bedford.io/blog/ncov-cryptic-transmission/
Maybe I misread it, but your article does not corroborate the 50% infection of the US population.
The indirect deaths will be larger still because 10x more will be hospitalized, which the medical infrastructure is not prepared to handle.
https://www.businessinsider.com/presentation-us-hospitals-pr...
As the article also references, Marc Lipsitch at Harvard projects the same.
The overreaction is perfectly illustrated by Marc Lipsitch who estimated 70% of the world population will have Corona Virus before the years end. At 7 billion, and with 3% death rate, it would mean 147,000,000 million dead by the year's end. I think we can agree that this is a VERY extraordinary assertion. I seem to also remember him making similar claims about SARS and MERS in years past.
But going back to his extraordinary claims, even if this virus was 10x as deadly as ALL the flu strains put together we'd still be talking about 3 to 6 million dead world wide (high no doubt, but still less than tobacco deaths which stand at 7 million/year) By calculating 10x all flus we are actually calculating 30-100x worse than any single virus strain we know, since the 'flu' is an umbrella for many different viral strains. So basically, IF this virus was 100x worse than any previous virus, we'd see Lipsitch is exaggerating by a factor of 50x. And if this new virus is 'only' as bad as regular 'colds', he'd be exaggerating by 5,000x.
There seems to be a feedback loop: the more people get scared, the more the media sells fear. The more the media sells fear, the more scared they become.
Again, I can't stress this enough, Corona Virus is real, it needs to be addressed, our leaders need to make it a priority. People will die and we should avoid it. But also true is people need to stop fretting over things they can't control and the media needs to stop whipping them into a frenzy with fear mongering tactics. They should be using this to remind people that they should ALWAYS, every year, get their flu shot. That they should ALWAYS wash their hands, not just when they fear Corona Virus. Overreactions can be just as bad as under reactions and humans have a long history of mass hysteria that only make things worse.
I'll use the advice by the WHO which literally says not to panic since it hurts their response efforts: https://www.who.int/news-room/detail/03-03-2020-shortage-of-...
Instead of panicking, I'll do what they recommend, which is what I do anyway since it works against all viruses and is really quite reasonable: https://apps.who.int/iris/bitstream/handle/10665/331215/WHO-...
Also, the other article you posted from bedford.io seems to confirm this won't be a big deal. But even if it is, what do you suggest I do about it to improve the situation? I mean that question seriously.
Further more, I'm not saying that one slide doesn't exist. But maybe it isn't the end all, be all of authority? Maybe the other link you yourself posted also has some validity?
> The author of the analysis, a computational biologist named Trevor Bedford, said there are likely already at least 500 to 600 cases of Covid-19 in the greater Seattle area. He urged health authorities and the public to immediately begin adopting non-pharmaceutical interventions — imposing “social distancing” measures, telling the sick to isolate themselves, and limiting attendance at large gatherings.
https://www.statnews.com/2020/03/03/washington-state-risks-s...
So, practice social distancing as much as possible and encourage your friends and family to do the same (especially if you know them to be in one of the high risk groups or frequently). Similarly, advise against mass gatherings. There was just a 100,000+ person comic convention that planned to just barrel through in Seattle, but was forced to cancel because artists and attendees pushed back against it.
But I’ll add that there’s mostly also agreement from the two sources. Per the above article:
> Bedford said Seattle faces a stark choice — take aggressive actions to slow down the spread of the new coronavirus now or face the type of outbreak that engulfed Wuhan’s health facilities and led to a lockdown of the city that remains in place six weeks later.
Google translate should give you the jist.
This is either deliberately misleading, or you are not properly able to reason about and understand exponential growth. No one cares about 12 deaths. It's the exponential growth in something that has the potential to be the flu, but roughly 10x worse.
Oh I know what exponential growth is, it is a basic mathematical concept and I'm quite good at math. The thing is, extrapolating the growth rate of new phenomena is not logical. If this isn't intuitive, think of it this way: I have $1 today. I earn $100 and by tomorrow I have $101. I sell my car and the day after tomorrow I have $10,101. Would it make sense to continue projecting my increased asset accumulation at the rate of 10,000% daily for the next 10 years? Of course not, it would mean I would have more assets than exist in the world. Growth rates are higher when numbers are lower and lower when numbers are higher. It's the nature of change in any finite data set.
> roughly 10x worse
According to the WHO Corona virus has a 3% mortality rate, your estimate of 'at least 10x' would mean 500,000 american dead by the end of year, which would require 150,000,000 to be infected this year, or basically, 48%~ of the population getting infected this year.
I'm not saying your wrong, but can you provide a link to a reputable site such as CDC/WHO that supports your claim?
There are smart epidemiologists who project those claims >https://www.theatlantic.com/health/archive/2020/02/covid-vac...
The CDC/WHO are still trying to push for containment, so I'm unaware of any concrete predictions they are taking with regards to the final infection rate.
More generally, the more I've been binge studying epidemiology (not claiming to be an authority), the more I'm learning that, as a field, it has difficulty with long-run predictions. That's not super surprising, I work in the statsy/ML forecasting world, and these types of unstable, unknown processes are very hard to forecast accurately.
What we do know though is that there is good reason to believe it's parameters governing infection (e.g. secondary infection distribution) are more infectious that diseases such as H1N1, which went on to infect ~20% of the world. We do know that the mortality is 1-3%, depending on ICU saturation. There are reasonable base rate scenarios to view this as a likely outcome.
We need to do our best to contain this and keep it as a slow burn, or we will be dealing with hundreds of thousands of Americans dead, and millions hospitalized.
To be a little more specific, the deaths given a functioning health system are less concerning to me. It's the fact that this has a very high hospitalization rate of 5-20%. That's why we need to keep spread slow, so the hospitals can manage.
BTW, I completely agree that Corona Virus is an issue that needs to be addressed. I'm simply saying the reaction is out of proportion to the reality of the threat.
The WHO is seemingly asking for dramatic action, although you can judge that for yourself: https://news.un.org/en/story/2020/03/1058461
https://www.cdc.gov/coronavirus/2019-ncov/php/preparing-comm...
Otherwise I think you're insisting on an unreasonable burden of evidence, in that unless the CDC or WHO specifically make a prediction, then its not justified. The best known parameters on secondary infection distributions are strongly suggestive that this spreads more readily than the flu, and the flu infects ~20% of the population a year. Those are good priors to start with, given that we don't have enough realized empirical evidence to know the truth.
> Containing the COVID-19 coronavirus epidemic should still be everyone’s “top priority”
I agree. But the WHO also has an issue with people's insane reaction which are hurting the response, not helping: https://www.who.int/news-room/detail/03-03-2020-shortage-of-...
In fact, they published a guide on what to do: https://apps.who.int/iris/bitstream/handle/10665/331215/WHO-...
It basically says and I quote: "The most effective preventive measures in the community include: performing hand hygiene frequently with an alcohol-based hand rub if your hands are not visibly dirty or with soap and water if hands are dirty; avoiding touching your eyes, nose and mouth; practicing respiratory hygiene by coughing or sneezing into a bent elbow or tissue and then immediately disposing of the tissue; wearing a medical mask if you have respiratory symptoms and performing hand hygiene after disposing of the mask; maintaining social distance (a minimum of 1 m) from individuals with respiratory symptoms. "
Notice how these are basically the same precautions people should keep always, regardless of Corona Virus being there. That's why I said, what I do now is exactly what I'd do last year to avoid dying from a virus. Nothing has changed for me.
Also notice how the list of precautions doesn't include: 'horde face masks when not sick, stay indoors and cancel all travel plans'. Those actions actually hurt.
Read my original post. It never said Corona virus isn't an issue. My point was people's reaction is probably the main issue. And I tried to illustrate how illogical it is based on the risks people take when it comes to things that are currently proven to be deadly, not maybe deadly. The other day someone complained to me about the dangers of Corona Virus WHILE smoking a cigarette! (blew my mind, though I didn't say anything)
The overreaction is perfectly illustrated in the Atlantic article where they estimate 70% of the world population will have Corona Virus before the years end. At 7 billion, and with 3% death rate, it would mean 147,000,000 million dead by the year's end.
Given that you mentioned modeling on other diseases, you should be able to recognize this as wildly exaggerated fear mongering. Even if it was 10x as deadly as the flu we'd still be talking about 3 to 6 million dead world wide (high no doubt, but still less than tobacco deaths which stand at 7 million/year) And that's a pretty grim outcome since it would be 10x worse than any virus we know. This basic back of the envelop math makes me think the figure of 147,000,000 dead (the logical implication to the Atlantic's estimates) is pure quackery. There seems to be a feedback loop: the more people get scared, the more the media sells fear. The more the media sells fear, the more scared they become.
Again, I can't stress this enough, Corona Virus is real, it needs to be addressed, our leaders need to make it a priority. But also true is people need to stop fretting over things they can't control and the media needs to stop whipping them into a frenzy with fear mongering tactics. Overreactions can be just as bad as under reactions and humans have a long history of mass hysteria that only make things worse.
You seem to be unfamiliar with the Spanish Flu, which killed almost 200k Americans in October 1918 alone, and travel has gotten much easier since then. SARS was contained, and COVID-19 looks like it won't be, so it is grossly misleading to pretend the total deaths will be in the same ballpark.
That doesn't change your net worth, so it's a nonsensical example.
> I'm not saying your wrong, but can you provide a link to a reputable site such as CDC/WHO that supports your claim?
How does that need much of a "reputable site"?! It's an infectious disease with long incubation, infectiousness for a bit while not having symptoms, no vaccine and no cure ... what do you think would happen if we didn't do anything to prevent spreading?
Current R0 estimates seem to be around 3, so you would need 66% immunity to drop that below 1, currently the only likely way to get immunity is through infection and survival, so that's 200 million americans infected before infected cases shrink naturally.
I understand why you might feel that way. I used to feel the same. But I think at this point if you're not panicking, you might not have fully absorbed the literature.
From my point of view here in Seattle, we're already seeing some minor effects: No one can find any toilet paper. Sounds minor, right? But it won't feel so minor when it's food rather than TP.
The virus isn't the issue. The issue is people. Everyone wants to maximize their chance of being completely unaffected by this disease. When everybody does that simultaneously, we're in trouble.
Suppose a million cases do happen. Who will care for them? Do we even have a million hospital beds? We just surpassed 100k cases today.
I recommend watching https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h... over the next week or so. It's quite astonishing to see the numbers climb. I remember when South Korea hit 100 cases. That was about two weeks ago. Now they're at 6.5k.
The only report on this I could find was one costco. And the costco's around seattle are already basically mad chaos even during normal times. Every safeway, qfc, target, bartells, etc I've been to this week is well stocked on toilet paper. No hand sanitizer, but plenty of TP.
And if you are that desperate, Amazon Prime Now has plenty of toilet paper ready for 1-hour delivery right this second. At least in my zip code.
I am down the supply chain from Seattle. I fully expect to see empty shelves in our grocery in a month.
People freak out at things that are different; not normal. It absolutely is irrational. The fact that smoking marketing smoking is still legal is all the proof you need that numbers and death rates are meaningless.
As paulg tweeted the other day (I'll update his number)... There are 20.5k cases outside of China. That number doubles every 3 days. That means there will be 2.6 million cases in 3 weeks.
We have to do everything we can to slow it down, buy us time to try antivirals, buy us time to get to summer where heat, humidity and mass doses of Vitamin D can help keep numbers down.
PG and people in tech seem to be afflicted by what could be called "singularity brain disease", which routinely mistakes everything that goes up to the right on a graph too quickly for an exponential function. See also the club of rome paranoia about human overpopulation, the mentioned robot apocalypse, or whatever else is the fad of the year.
What turns exponential functions into s-curves is a feedback loop. In the case of epidemics in the wild, the feedback loop is that people who have already had the disease tend not to get it again. Which means that, without external effort, a disease remains exponential until it has burned through a significant fraction of victims where it has already been.
A disease that has affected thousands in regions with hundreds of millions should not yet be slowed by that kind of consideration.
According to the WHO this virus, unlike influenza, does not seem to spread rapidly among asymptomatic people so the net effects of causing drama on twitter are probably going to create unnecessary anxiety in the population that will lead to mask hoarding or other unecessary behaviour.
And this is familiar territory. pg is very aware that "your current exponential curve is adjustable". So any country whose curve goes the wrong way needs to adjust their actions, and the sooner the better. But once behavior is adjusted, that projection stops being accurate.
So his comment is that, based on current infection curves, the level of effort outside of China is way too little for the threat. Turning that around, if dramatic effort causes the disease to have a halving time of 3 weeks, then every day we wait to implement those changes is a week longer that we will have to live under a dramatic regime to limit total casualties.
People are going crazy on this one.
But if I get the virus, sure I'll probably be ok. Others that I pass it to might not.
I'll need to self isolate, which means I'll need to stay away from my children and parents for two weeks? four weeks? That's going to be very hard to do. Maybe I could stay at home with my children and they will be fine, but then they will need to be kept isolated. How long will the stigma and fear around them last, six months? How long till the rest of my family are comfortable letting my kids see their grandparents again. If I get the virus, it will be very difficult to do all the things I'll need to do as a responsible adult.
It would be magnificent if we all treated this like a natural disaster and for the next two months, not in a state of panic in which we're all gunning to be the last player standing, but from an intention of mutual aid - do what we can to make it very difficult for viruses to transmit - wash our hands, wear masks and disposable gloves out in public, clean surfaces with disinfectant wipes. In two months this might be gone.
It's a small, thin hope, but what if we can use this current enigmatic and existential crisis, to practise co-operating to handle the much bigger crises that loom further ahead in the century?
We already have massive issues that are an enigmatic and existential crisis in the US: 647,457 deaths/year from heart disease. 599,108 deaths/year from cancer. 169,936 deaths/year from accidents. 160,201 deaths/year from respiratory illnesses. 50,00 deaths/year from influenza and another 48,000 deaths/year from suicide. 14 deaths total for Corona Virus.
If literally half the American population was infected by the Corona Virus (which is way, way, way higher than any health official estimate puts it), we would have less deaths than we do from heart disease alone.
I believe this: our real existential crisis require complex solutions that will take way more than two months. They generally involve making better personal choices: avoiding sugar and fatty/salty foods, not smoking, driving less, getting some exercise, being less stressed, being kinder to each other.
But the thing is, when we know the issue and the solution, then we are the problem and it involves looking inward and having a humbling, horrible, daily struggle with the shortcomings we all have. We have to make millions of choices and we will fail making the correct ones most of the time. That's a pretty grim reality. It's quite grating to be constantly recognizing our shortcomings in an effort to self improve.
Like the procrastinator who cleans his desk because he doesn't want to sit down and do the hard work, I feel the Corona Virus is a real issue, but at the same time a distraction. Sure, we need to clean our desk, and pay attention to the Corona Virus. But if there's a big problem which is hard to solve and involves looking in, most people will focus on the small problem and look out. A lack of perspective can make a person easily enter into a state of frenzy and uncontrolled fear, especially when others around them are entering it.
I think I heard the last time "old age" was listed as cause of death was in the 1980s. There will always be a reason that people die, and we don't live forever. You can't say that if we cured "heart disease", that half a million people wouldn't die. Your comparison of causes of death to the virus is not logical.
I personally wouldn't make that argument, but I'm asking since it would seem to be a necessary conclusion if we follow your path of reasoning. I think a cohesive argument has to be something that can be applied both ways (in favor and against the desired conclusion)
You're asking us to be better people, which is a good thing to ask, it should be the goal of our civilisation to be even better people that those who got us here and to leave behind better people that we were.
our failure to be >> kinder to each other
is part individual selfishness, and partly that we're not brave enough to trust each other, because we know that we do too little collectively to protect each other against the fraction of people who would exploit our kindness.
So we're buying toilet paper, getting ready to hunker down and hide.
We could fix this virus in two months with discipline and cooperation, and make a start on your list too.
The fear of this virus, in relation to the threat is way off the plot compared to our our response to those other dangers. But I am frightened by it and other people seem to be too. I have a whole bunch of incomplete thoughts about maybe i / we can can use that fear constructively, and treat the next two months as a short course on how to recognise when I am acting in a way that is following patterns and norms, when there are other better choices
I also love the honesty of using the word 'frightened by it'. That's what people are feeling and it's absolutely real. I can feel it in people when they talk about it. Being frightened is no joke, nor would I make fun of the feeling. My whole point was to highlight it being irrational. I don't share it. And I don't share it not because I'm special, but because I'm disconnected. When people are happy in a group and the feeling is contagiously moving through a room, I have a hard time getting 'in with it'. So I'm not taking credit for being disconnected, nor am I bragging about it, just explaining that I am, and therefore less likely to become infected with the feelings that seem to virally move through communities who are well connected.
But I do think we've accepted fear when we shouldn't. I love the stoics, who seem to think we need to accept fate more than our society seems to view it. In terms of using fear, let me quote one of histories greats, who said it better than I could ever say it: https://youtu.be/nHFTtz3uucY?t=25
The using the fear part wasn't well articulated, I had a small person climbing on me, i may not be able to articulate it better now either:
emotions seem to be most productive when we allow them to call attention to something, and perhaps to direct our action in a fast moving situation, but not in a slow moving circumstance like this where we have time to respond rationally. The terrible thing is how often we fail to make that transition from emotion to rational action, instead we stifle the emotion until it cannot be stifled, at which point we let emotion run us.
I see people must be frightened - otherwise why are they buying out the masks and toilet paper?
That hording is happening in private - without an FDR to give us the social license to take more rational action we are doing nothing in public. The only public action people seem to be taking is to withdraw.
Hong Kong, where people are wearing masks and maintaining good hygiene is at only had 108 cases.
Meanwhile on Friday I had colleagues sick at their desks with flu like symptoms, some fresh back from overseas travel, and no-one saying a damn thing to them about it.
If we all wore gloves and masks starting tomorrow, we could put in a booking tomorrow with a struggling bar or restaurant for a corona's over party in two months time.
But that's not going to happen. So I am frightened that like the person who doesn't stop smoking, drinking, and eating shitty processed bacon-yums, I'm worried we are going to sleepwalk into the horrible moment when we are overwhelmed and driven by fear, and that is a path to an avoidable pandemic.
So that's what I mean by using the fear, recognising it and transitioning to rational action to address the fear.
You've also questioned whether the risk of this virus - even in the worst case - is significant enough to stimulate this level of fear:
I live in an unusual small town on the coast. This is where most of the medical staff from the major hospital in the city 30 minutes away live. Family and friends work in the local emergency ward. This town skews older than most, if feels like half the town are retirees - we have five podiatry clinics. Also on the other side of the wetlands is one of the labs where people are working on the virus.
So this town is more exposed and vulnerable, and may be harder hit that most if there is significant transfer in the community.
However this town is also wealthy, well educated, has serious medical expertise and strong community organisations.
So the people around me should be in a good position to respond collectively - I don't know how those potentials resolve.
I've had dengue fever, had guns pointed and shot at me (missed), fallen off a cliff (improbably caught a tiny ledge as I slid down the ocean cliff) and been quite emotionally unmoved by my own mortality, not through the meditations of marcus aurelius, there wasn't any struggle there to overcome. So I can understand what you mean about 'not bragging' from this context
But not being here to raise my children frightens me. I don't believe stoicism or buddhism offers a convincing way to accept the loss of children, or pain to your children.
I think instead you have to come to terms the vulnerability to your own integrity that your children represent. While I was unexpectedly comfortable with not existing, the horror of what my getting sick could mean for them is enough to derange me.
So today I'm having a happy day with the kids, we've played legos, and are hanging out in the sun.
I think a lot of people at the moment have a small part of their mind ticking over, looking forward a couple of months, not knowing whether this will pass lightly for them, or whether this is something that will push them to derangement - the fear of fear itself - and we look around for lea...
I wrote a long rambling comment in reply to this earlier and then deleted it. I'm looking for "beta readers" for a website to try to share useful information about germ control.
I have a lot of personal baggage from being mistreated by a lot of people on the internet. I'm not confident there's any point whatsoever in trying to put out useful info. The world likes to come up with ridiculous justifications for claiming I know zip, nada, zilch and I'm a loon and, also, I'm overly sensitive for not liking the ugly personal attacks.
So I actually think this is probably a completely pointless exercise that will go nowhere, which is why I deleted the comment, but one person enthusiastically emailed me already, so I guess I didn't redact my request for beta readers quickly enough. Thus I'm basically reposting it, though there is zero hope of faithfully recreating the original rambling post, so you are getting a completely original, slightly less rambling version.
I think it is going to be worse in the US than China. We have an individualist culture that routinely goes to work sick.
And a lack of a social safety net to help people avoid going to work sick.
drives me insane. I can only do so much and really feels like the only thing I can control is my exposure but I don't want to over react and become a hermit
if we cant get our salaried staff who can already work from anywhere to stay home I feel scared that there's no way in hell hourly service workers would do it.
None of the annual death counts you cite are exponential processes (with unknown growth rates) at the beginning of the growth curve. So either you don't understand exponential growth or you are being intellectually dishonest in acting as if these numbers are in any way comparable.
In the face of a pandemic that may kill an unknown percentage of the population the precautionary principle absolutely applies, and even if the total cases in the US never goes over 1000, the measures now being taken will have been the right choice because the risk of uncontrolled spread is unacceptable.
I 100% support the recommendations of the CDC and WHO, who literally advise against the hysteria since it is hurting their response: https://www.who.int/news-room/detail/03-03-2020-shortage-of-...
They also provide a list of suggestions which I think is what people should focus on, and then continue living as normal: https://apps.who.int/iris/bitstream/handle/10665/331215/WHO-...
Since I literally already do all the things they suggest, and I think most reasonable people do, then I'm not sure what else we should do?
Staying home and canceling travel plans is the caution your comment seems to argue against. I responded to your comment in this context, and to your non sequitur "number 15" argument.
So basically doing things that aren't reasonable as indicated by health experts. This means for everyone:
- Staying home in areas with no contagion
- Cancelling travel to place where there isn't a particularly high risk of contagion as defined by the CDC (basically, everything in grey here: https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.ht...)
- Hording PPE
For people who smoke, cancelling travel seems silly no matter where they go; they are already exposing themselves to a 33% mortality rate for something they choose to do. The worst place in the world for this virus still has a less than 0.005% probably of death (less than 0.1% of the population in Wuhan have the illness and less than 5% of those that do die). Surely we can agree that someone who smokes and fears the virus is having 'emotional excess' when it comes to risk assessment.
Now, how is mentioning the total number of US deaths from the virus as reported by the CDC a 'non sequitur' in relationship to fearing death from the virus in the US? It seems to me to actually follow quite reasonably.
Also, if your accusation that I'm 'against caution' is to be cohesive and reasonable, it would seem to necessitate me asking people not to engage in precautionary activities that are recommended, so I'd like to know which they are. Surely we can agree that IF I did what you accused me, it would be very irresponsible. And I don't want to be irresponsible.
At some point they'll need groceries or some other form of care - and cannot maintain sufficient isolation for what you're describing.
It spikes to about a 5x yearly mortality multiplier for those between 50-60, diminishing a bit as you near 80+ (since their natural mortality rate was already high - about 12%(?)).
20-30 year olds have about a 2x multiplier. You're twice as likely to die this year if you get coronavirus.
Think it comes out to like - 80+ people are 25-30% likely to die that year total.
It's a choice to value the economic value a person brings over their life, heath and wellbeing and I find it really odd to read a comment such as yours.
This doesn't need to hit families and definitely not for generations. It's your national choice, by how you vote and what policies you do and do not accept, that a few weeks out of work means you lose the job, your livelihood and at the top of absurdity also your healthcare. Somehow you've come to consider that as normal but in a country that finds trillions each year to buy overpriced fighter jets or similar things, making the choice to NOT let families go into intergenerational poverty due to a health emergency should really not be that difficult.
The advent of woke tribalism has been more damaging to both freedom, democracy, sane policy negotiation etc. Stone-walling is now the norm. It's really hard to say how any of this will shake out in the end.
If people stay calm, keep about 2 weeks of food/water as a normal point (don't stockpile for months), you can easily overcome any logistical issues. Panic only exacerbates the problems. In the end, some will suffer, but it's like we're overestimating the impact.
Worst case, this will probably be similar to the 1932 flu... I don't think it will get even that bad in practice (which was pretty bad). Within a year or 3, it should be fully recovered, unless too many people, do too many stupid things and panic too much, making wierd economic shifts.
Citations?
https://www.google.com/amp/s/www.washingtonexaminer.com/wash...
2. More importantly, an unique characteristic of this disease is that although mortality rates for the young are low, hospitalization rates appear to be high, which poses a severe threat of overwhelming hospital systems. The disaster in Wuhan was at least in part due to that and unless precautions are taken, Seattle could be heading that way soon.
This is almost happening right now in the Northern Italian region of Lombardy, hence today's mentions by some of the authorities of instituting a red-zone for the region itself (or parts of if, nothing is certain for now). [1] (in Italian)
[1] https://milano.repubblica.it/cronaca/2020/03/06/news/coronav...
There are thousands in Wuhan who have been on life support for weeks if not months. Even if they do survive they will face diminished lives and this is with China sending all available resources (doctors, nurses, ventilators) of the nation there. Death rate itself is worthless to argue over unless one names the context: sporadic outbreaks here and there or tidal waves?
the death rate in the hubei region itself is also several times higher than in most western countries so it's fair to assume that the rate of undetected cases in China is simply very large.
What we know from well controlled cases like the cruiseship with 600 infected people appears to suggest that about 20% of people develop more serious conditions like pneumonia and a fraction of those require intensive care.
In the majority of patients this virus causes an infection of the upper respiratory tract, which causes symptoms comparable to a common cold.
The part about the upper respiratory tract is wrong though, cold-like symptoms are not a normal feature of COVID-19.
Studies of the number of known cases which resulted in viral pneumonia find, for example;
“A total of 81% of cases in the JAMA study were classified as mild, meaning they did not result in pneumonia or resulted in only mild pneumonia.”
That is not to say that 20% of all cases are severe, but 20% of the cases in that study were.
People are confused about what "mild" means:
https://www.nytimes.com/2020/03/04/health/coronavirus-china-...
What were mild, severe and critical? We think of “mild” as like a minor cold.
No. “Mild” was a positive test, fever, cough — maybe even pneumonia, but not needing oxygen. “Severe” was breathing rate up and oxygen saturation down, so needing oxygen or a ventilator. “Critical” was respiratory failure or multi-organ failure.
So saying 80 percent of all cases are mild doesn’t mean what we thought.
I’m Canadian. This is the Wayne Gretzky of viruses — people didn’t think it was big enough or fast enough to have the impact it does.
Italy now has a higher case fatality than Hubei, and getting close to Wuhan.
CFR can change tomorrow for a given population. Another reason it’s such an elusive number.
When the infection spread is increasing, more new cases are coming in today than yesterday, and so the CFR contains a good portion of people who are still early in the illness lifecycle. Just because some haven’t died yet doesn’t mean they won’t. Meanwhile, as the spread continues, the healthcare infrastructure may reach a tipping point where it can’t treat people as effectively.
Also, is it not possible to provide this oxygen assistance/therapy at home without hospital intervention?
[1] https://www.thenewstribune.com/news/local/article240963446.h...
This wouldn't be an issue if society just encouraged people to save 10 or 20 grand to have a "just in case" fund to last a few months, and if people got healthcare even when they didn't go to work.
https://www.theglobeandmail.com/business/economy/economic-in...
And no, Canadians don’t save as much because of the safety net, it’s because there is a massive housing bubble there encouraging it.
Think about it this way. Imagine your household income is $50k, the median. But for one year, you decide to live like you are at $30k, barely above poverty. It may be a difficult year but there is no reason you can't manage, 1 in 5 people live their entire life with that. At the end of the year, you are left with $20k. You can now start living your life like anyone with a median income will. Because of that 1 frugal year, you are left with a average balance of $20k for your entire life. No more living paycheck to paycheck. And even better, when you die, your children will inherit these $20k so they won't need that year of poverty to keep their balance positive. So these $20k will actually last forever.
Of course, it is a simplification, but the idea is that keeping savings is just a matter of living with the paycheck of a few months ago instead of the last one.
Now what are the benefits of having an average of $20k that you won't touch.
First, it is insurance. Insurance costs you money in the long run, that's how insurance companies pay their employees. That sum is your own insurance for small things, like phones.
Second is that you can take advantage of opportunities, like volume discounts. Money will make you save money.
For those who are above the poverty line, the reason they can't save is lack of discipline. Not "the 1%". But to be fair, society in North America doesn't really help, with ads everywhere and credit everything.
It's absolutely an issue of the 1% versus everyone else, and especially given these people's opposition to providing basic social safety nets to all people.
EDIT:
I'm an idiot and didn't think through the math.
https://twitter.com/KFILE/status/1235808311834021888
It is called delayed gratification and it is linked to success in general. That is just an instance of it.
And sure, I can save my whole life and make less than some people can make in an hour. Ok, good for them. But now what can we do? Take their money? It is not going to happen, so I think it is smarter to do with what we have instead of dreaming about a better world that will solve all our problems.
And even if we manage to take all the money from "the 1%" and redistribute it to everyone else, it will be around $20k/year more per household. It is a lot, but not that much. Let's take our $50k/year median household, it is now $70k. In theory that means $20k/year of savings. But when you consider that many $70k/year households are living paycheck to paycheck (but with a nicer car and a slightly bigger house), it probably wont change the saving ability of the average American.
Another way to show that the 1% has nothing to do with savings is to look at other countries. Even when adjusted to purchasing power and inequality, US households has less savings and more income than most western Europe countries.
1. Cost of housing.
We mostly don't have affordable housing. This is a serious burden for many Americans. It's not legal to live in a hut without electricity or the like, even if you wanted to.
2. Our public transportation and walkability sucks.
Most Americans need a car. This is a huge financial and logistical burden for many people.
3. Healthcare
The US spends insane amounts on healthcare and people who are poor let problems linger because they aren't sure if it's worth getting seen and having the bill for it.
I've escaped that pattern. It was really challenging to escape it and I've been dirt poor a long time, in part because not having a car is a logistical barrier to earned income and even if isn't, it's a social signal that "I'm an incompetent loser" which helps suppress my income.
I'm gradually making progress on all of it, but it is tough to swim against the tide and our current tide is highly problematic and burdensome for most people in the US. So it's a damned if you, damned if you don't situation.
During this time, your rent has likely been raised each of these years.
Also during this time, you started making 50k, and are probably still making 50k.
The United States is in a very vicious cycle, mostly based around living, working, and commuting.
That right there sounds like a self-created problem.
It's a systemic problem in the US where employers don't really want to hire you if you have no car because our public transit sucks, so they assume you can't get to work without a car.
And cars tend to be the second biggest household expense, after rent.
My brother has been in the automotive industry most of his life. Thanks to how computerized cars are, you can't really service your own vehicle anymore, even if you are a talented mechanic.
And cars just don't last like they used to. If it isn't new, you are probably paying so much more on maintenance that it isn't really saving you money compared to getting a new car.
Americans are prisoners of the need to own a car. It's a huge financial burden and my life works as well as it does because I escaped that trap more than a decade ago. It's part of why I can survive at all while supporting three people on well under $20k annually.
But most Americans can't imagine escaping it. I get a lot of deer in the headlights looks and have largely stopped talking about the fact that it's possible to make other choices because it's just so unimaginable for many Americans and they just act like I'm a loon and out of my mind completely.
You don't need a new car though. I've managed to hold down a job for years driving used cars.
> employers don't really want to hire you if you have no car because our public transit sucks, so they assume you can't get to work without a car
Other than delivery jobs, I didn't think employers even asked "do you have a car?" in job interviews. It seems like such a weird thing to ask in a country where, as you say, pretty much everyone has a car.
> And cars just don't last like they used to.
This is straight-up BS. Cars last longer than ever these days. [1] Buy Honda or Toyota and it will likely last over 200k miles.
> If it isn't new, you are probably paying so much more on maintenance that it isn't really saving you money compared to getting a new car.
New cars cost a lot more in insurance and interest than used cars. That's extra money you will definitely spend if you buy a new car - versus money you might spend if your used car turns out to be a lemon requiring a ton of repairs.
New cars also depreciate faster. The minute you drive a new car off the lot, it's worth 20% less than you paid for it. That's literally money out of your pocket, but no one seems to count it when saying "used cars cost more in maintenance."
1. https://www.consumerreports.org/car-reliability-owner-satisf...
This is the thing, middle class people have been spoiled to spend $$$ in entertainment, useless gadgets and 65" TVs where they could just entertain themselves with frugal means - there are many! Go hike. Play chess and board games.
Stop buying sugary drinks at Starbucks for $5 every day. Everytime I think about middle class folks living paycheck to paycheck - I have no sympathy.
If you don't have disability, and have good physical and mental health, and are earning a middle class wage - you can become wealthy by saving and investing wisely.
[1] https://www.schwab.com/public/schwab/investing/accounts_prod...
If you want to be wealthy you need to figure out ways to earn gigantic amounts of money, not save small amounts by cutting out the pleasant parts of life. Wealthy people tend to either inherit or produce their wealth, not save it by a lifetime of penny pinching.
I bought a new car when I got a corporate job. The first 90 days were training. Missing any of the training -- even just being late -- could get you booted.
I had been a homemaker for about two decades. I was like 41 years old and it was my first full-time job. I have a bunch of college, but had job hunted a long time before finally getting a job offer. My POS older car was not reliable and was potentially going to cost me the job.
This was kind of "my big break" and I was sharing a single room with my teenager sons while living at a relative's house and going through a divorce.
People often spend money trying to make sure they can adequately qualify for a good job and it may not pan out. This is also essentially the TLDR behind a lot of crushing student debt in the US.
I will note: I'm pretty tired of the "poor people just need to stop drinking Starbucks coffee" trope, and have spoken about that previously:
https://news.ycombinator.com/item?id=19585270
https://news.ycombinator.com/item?id=19585789
I read some of your arguments but I am not convinced, at all. You can't just say "This is generally not true" without substantiating your argument. Its a bold claim to say "Keep enjoying your $120/month coffee" when your condition is dire and you're trying to lift yourself from poverty.
> My POS older car was not reliable and was potentially going to cost me the job.
That's twisting the argument at hand. I didn't say buy a $2000 honda civic that's gonna leave you astray for your job interview.
I've lived and pulled myself out of poverty - just FYI.
People make decisions in the context of their actual lives. People trapped in poverty usually need something more than "one cool investing tip" or so-called self discipline.
(don't have to wait for a vaccine, we can return to life when there's a reasonable therapy which should be 2-4 months... unless all 50+ late-stage drug trials all fail...)
I'm sure it'll all look pretty silly in 24 months time, when this recedes into a background seasonal and we finally finish our personal stockpiles of toilet paper, but we might learn important lessons too.
Yeah, everyone will be so happy the environment is cleaner. They won’t care that they are laid off, lose their house and the economy spirals in a recession.
Silver linings!!
Any economic slow down can still be unfortunate. And not taking any precautions could kill the economy too, perhaps even more quickly.
We need to find a new model of existence.
What I'm not doing is flying my kids, with my 74 year old mother, so we can go to Disneyworld in Florida. I'm not taking my young children to Disneyland, which is local, because it's an international destination and if we run across a bug they will catch it because young children have no ability to not constantly stick their fingers in their mouth.
We could just say "we aren't going to see grandma anymore" but my sister in law also just had a baby. Should I tell my wife she can't see her newborn nephew because we could transmit it to the grandparents through visits? Or maybe we can just not go to Disneyland for a little bit? I understand that the odds of this chain of events playing out is low. But I would feel really, really stupid if it happened to.
I also talked my mom out of going to Vegas. Why? Because the US has tested damn near no people. If we had been testing aggressively like South Korea I could justify saying "there's been no found cases in Vegas, you should probably be good". Instead I have to say "No found cases in Vegas, no fucking clue what that means".
FWIW, most parents I talk to think this is a big nothing. One is keeping their trip to Italy this month. Another is immune compromised and as of yesterday, still flying into Seattle for some reason. I think it's a poor choice.
The alternative idea, is that you should just tell people to wear gloves.
This will prevent them from touching their eyes, nose, and mouth. Because ideally, they won’t touch their mouth if they are wearing an outdoor glove.
- america and some european countries. we haven't tested anybody in the US and are basically treating it like it's nothing, but it's clear that this thing has been spreading already. still yet to be seen how it plays out in terms of overwhelming the system.
- contrast this to a place like korea which is aggressively testing 10k people per day, finding a low mortality rate, but still trying to balance hospital resources.
- compare that to italy and iran, where they are struggling w/ resources and people seem to be dying at an alarming rate (imagine if like 3 politicians just dropped dead from this thing).
- now compare that to china, where they literally quarantined tens of millions (and still are), had to build extra hospitals in a matter of days, and are still implementing draconian measures to manage it. they basically had to shut down their production briefly. and even then the actual numbers might not be clear.
if someone could help enlighten me with an explanation that would fit all these cases that would be much appreciated. right now it's too black and white, that this is some world ender or "just the flu, bro".
https://slate.com/technology/2020/03/coronavirus-covid19-pan...
A significant proportion of people over 60, a non-negligible proportion of people ages 40–60, and still some proportion of people aged 20–40 need to be hospitalized and put on supplemental oxygen. In severe cases people need support from a mechanical respirator. In the WHO report from China 20% of positive cases needed hospitalization. This might be a substantial overestimate if there are many mild cases not caught by tests, but even if that estimate is off by a factor of 5 or 10, if there are many cases this can overwhelm hospital capacity.
When treated aggressively by a capable healthcare system (caught early before severe symptoms start, treated with antiviral meds, patients put on supplemental oxygen as soon as blood oxygen starts to dip, hospitals have enough respirators for severely affected patients) so that people don’t die while waiting for their immune systems to fight the virus off, many fatalities can be avoided, as is happening in Singapore or some wealthier provinces in China. But this depends on social distancing in the community, widespread testing, aggressive isolation and contact tracing of infected people, and efficient triage of cases.
If cases are not caught early and treated aggressively or if medical systems get overwhelmed, it is bad news. If this virus is not checked and spreads throughout the world quickly, the death toll could be in the millions.
Beyond being very dangerous to a substantial proportion of infected people, it is also extremely contagious, and has been spreading very rapidly. It is contagious even among pre-symptomatic or asymptomatic people. Perhaps most dangerously, its early symptoms are close enough to ordinary cold/flu symptoms (and some of the infected seem to not advance to the more serious stage) that people who are shedding the virus continue to go about their everyday lives without realizing they are infected with novel coronavirus instead of a typical cold or flu.
What we do not know, and can only estimate, is the “IFR” or the overall infection fatality rate, and the overall infection hospitalization rate.
Imagine the flu was a brand new virus which we didn’t have any test for. In 3 months we would see 100,000 hospitalizations and 10,000 deaths from this new virus.
Only after testing became inexpensive and widespread would we come to realize that actually 32 million people were infected with this virus, but only 200,000 per year went to the hospital, about 20,000 of which end up dying.
My point is, we do not know the infection hospitalization rate, nor the infection fatality rate of COVID-19, but its upper bound is the CFR and it’s reasonable to suspect the actual value is at least an order of magnitude lower than the current CFR data might indicate.
It’s not reasonable to state anything definitively about the overall hospitalization rate of COVID at this time without the qualifier that it’s based on only known cases and therefore overstated by some unknown amount.
You may find this letter (written March 4th) from doctors specializing in Emergency Medicine more compelling than my own summary:
https://www.bmj.com/content/368/bmj.m606/rr-5
We can only wait and see how many people die from ncov-19 in Italy or anywhere else.
> “In the winter seasons from 2013/14 to 2016/17, an estimated average of 5,290,000 ILI cases occurred in Italy, corresponding to an incidence of 9%. More than 68,000 deaths attributable to flu epidemics were estimated in the study period.”
(Edited) The wording here is confusing. It’s an average of 5.2 million cases per year for 4 years resulting in a total of 68,000 deaths over 4 years. Meaning an average of 0.325% IFR due to Flu (ILI - “influenza-like illness” in Italy.
That’s a high confidence IFR based on a well established surveillance network and widespread testing. Meaning it is likely not being overstated. Versus COVID’s know case fatality rate, which is an upper bound on the IFR and known to be missing a significant number of mild cases in the general population from the denominator.
I agree that it remains to be seen how bad this will be in Italy and elsewhere, but putting it in perspective to the flu (which we do not generally “fear”) is useful.
[1] - https://www.sciencedirect.com/science/article/pii/S120197121...
If any of this were true, China would already be totally overrun. Instead they are reported fewer than 150 new cases per day and closing their temporary hospitals.
My prediction is that we will see the same thing happening in Italy and South Korea in two/three weeks time.
I sincerely hope you are right though.
Also for “just the flu”: it’s a coronavirus. A cousin of common cold. So it gets you like common cold, you usually don’t know when or where or how you got it. Most effective prevention, not vaccination, not facemasks or spacesuits, but washing hands often, facing away from people when sneezing, eating more vegetables, getting good nights’ sleep, those mom of 5-year-old kid items. There are not many effective meds save for NyQuils and lab experiment Ebola shots. I think “just the common cold” is a technically accurate description regardless of whether it’s world ending or not.
Korea is next door to China, so it's alerted early on.
Tiny countries like Singapore cannot survive a quarantine. So containment is not an option, they have to work out an effective mitigation plan.
Different countries also have different demographics, population density, and confidence about their healthcare system.