Including cargo doesn't make much sense to me. Did they include a justification for this?
In contrast, the CDC's take is that "in general, because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from products or packaging that are shipped over a period of days or weeks at ambient temperatures." -- https://www.cdc.gov/coronavirus/2019-ncov/faq.html
What cargo it does and doesn't cover isn't really clear from the announcement. What Trump says often doesn't completely match what the policy turns out to be. When agencies release the actual rules we will know more. I wouldn't be surprised if cargo only meant air cargo.
Honestly given how long a cargo ship takes from the EU to the USA and given that the crew of ships has basically no contact with the cargo crates this makes no sense at all...
The only think I can come up with is that this will allow Trump to show how bad it is that the USA is so much international dependent for certain goods and use that then to push through regulations to enforce more local production. But if it's really that it's quite crazy.
A normal travel ban on the other side will slow/reduce/eliminate cross infection between the EU and the USA which can be helpful to slow the spread. But then from all what I can tell it might be at a point where the slowing of the spread caused by EU/USA cross infection doesn't matter due to many more local sources of infection... Well we will see. At least during the ban he can't really put the blame of any increase onto the EU anymore as travel was cut.
I suspect that Monday will shortly be the second largest drop in absolute terms after tomorrow. We might even see tomorrow crack the top 10 in percentage terms.
Yes, it's strange that a lot of articles don't seem to be mentioning that. Here's the relevant section of the address: https://youtu.be/pdO2HEtv92c?t=105
> And these prohibitions will not only apply to the tremendous amount of trade and cargo, but various other things as we get approval. Anything coming from Europe to the United States is what we are discussing.
It's all about flattening the curve at this point.
You can do your best to identify those infected and have them self-quarantine, but if the gates are open and infected people are streaming into your country, you're not going to get far.
Ugh, USA is at the moment likely on level with Europe.
The idea that this will prevent "infected people streaming into USA" is uninformed.
This step limits transfer both ways, between two regions that both have similar level of infection spread.
It may help both sides contain the virus, but it won't limit the amount of infected people in the USA on its own.
Please, be careful about the language you use, the way you wrote the sentence promotes FUD.
You're also eliminating one potential source of infected people leaving the country before symptoms show. Assuming prevalence is equal in the US and Europe, you gain exactly nothing.
(Op already said as much. Your answer reminds me of my Grandmother: "I know God doesn't exist, but it can't hurt to go to church.")
> Assuming prevalence is equal in the US and Europe, you gain exactly nothing.
That assumption is wrong, the prevalence will not be equal. One will be better off, one will be worse off. There is no scenario where the prevalence is going to be identical across such massive populations with such dramatically different cultures, population densities and healthcare systems. The US and various European nations will not act the same, they will not quarantine the same, death rates will vary, and so on. In fact, it'll vary considerably just within Europe, as we're already seeing.
It's better to separate accordingly, for both sides.
It’s more precise to say you don’t know whether you have 1000 deaths yet, as you are not testing even dead people at the same rate as elsewhere. Washington state got “lucky” by having a pretty obvious cluster that could not be brushed under the carpet, but there are likely hundreds of other pneumonia-related deaths going on right now who might well be undiagnosed covid19.
The estimate of how many deaths might be undiagnosed might be speculation, but it has already happened in Seattle that COVID deaths were misattributed to seasonal flu. In both cases, the death and symptoms will look identical the difference being in the underlying virus causing the issues.
"In fact, officials would later discover through testing, the virus had already contributed to the deaths of two people, and it would go on to kill 20 more in the Seattle region over the following days."
The US has failed to do any significant level of testing given its population, so it's understandable why many people are not confident in the official figures, especially when it becomes apparent infections have been running unchecked for weeks before testing started.
>In both cases, the death and symptoms will look identical the difference being in the underlying virus causing the issues.
As stated before that is absolutely false which is why those cases were caught. Will data be imperfect, yes, but that doesn't mean we should start throwing around Chinese propaganda.
But doesn't that require the notion that infection rates are higher in the excluded place? Given the US's incredible failure to test widely, I am not seeing why flights from Sweden or Ireland are any more dangerous than flights from Seattle at this point.
Flights seem like fertile grounds for spread of the virus, so that may be reasonable. Obviously disruptive, but keeping people out of airports and planes should help flatten the curve to some extent
> I am not seeing why flights from Sweden or Ireland are any more dangerous than flights from Seattle at this point.
I'd favor grounding most flights at this point. However, the reason to restrict people from eg Sweden or Ireland or anywhere, is because those people in Seattle are our people (legally, citizenship-wise), which are the ones we should be concerning ourselves with and attempting to control/restrict/observe/test/treat. The US is about to enter mass quarantine, as numerous other countries are. It's better if people from other countries stay outside of the US / stay in their own countries.
And further, it's dramatically better to only have to deal with our own people as a vector, not foreign persons. It's obvious that the fewer people that are infected within the US, the better.
You seem to be imagining some sort of net inward migration, but I don't see any evidence for that. I do agree that general travel restrictions make sense, but I again don't see why Europe in specific matters here.
You’re describing the opposite of flattening the curve. Closing the gates now does nothing.
I do not mean to be patronizing, but this is literally life or death and the math is very simple.
Today there are k infected people. Tomorrow there will be kn people.
If n is unsustainable, any positive value for k is equivalent. Arbitrarily large changes to k today make an arbitrarily small contribution to the final doubling.
“Infected people streaming in” means k becomes k+c. How much does reducing c flatten the curve? How much does it increase the time span of the critical last few doublings?
It doesn’t. That’s only dependent on n.
Ok, we can’t “flatten” the curve, but we can move the peak, right? How much does reducing c move the peak?
Well, every day we prevent k additional people from entering buys us one day. Remember, tomorrow that’s kn. Act fast.
If we could, this week alone, prevent a quantity of infected Europeans equal to the infected population already within the US from entering, that buys us one single doubling period before the collapse of healthcare. Maybe a week if we got lucky.
I will guesstimate that that is not a realistic target in fact. The actual benefit scales proportionally.
And next week it’s the same work for half the benefit.
I agree on all points, but are restrictions on internal travel much different from restrictions on external travel? Seems to depend on the definition of the boundaries, and I think it’s hard to quantify the relative costs of external/internal travel restrictions. So I’m not sure what we lose by also restricting “external” travel other than another level of inconvenience.
For a country the size of the US? Yes, there is a MASSIVE difference between the two. The volume of movement by air between California and, say, Colorado is massively larger than that between California and China, and one of those places currently has a COVID-19 outbreak and one does not.
The distinction between the two for the sake of definitions is also very clear - whether the restrictions apply to travel that does not cross the borders of the United States. The currently-announced restrictions do not.
The question isn't of restricting external traffic in addition to internal traffic; we're only limiting external traffic. We probably need to be doing a bit of both, though with less draconian limitations on internal traffic to accommodate economic realities.
You're all over this thread with the same point: what makes you think that not letting new cases in (in this case, travel from hotspots) is somehow not improving the situation?
>the math is very simple
Yes it is. There are infected people in Europe. Stopping travel from Europe = less infected people in the US. Yes, there are already infected people in the US, but a travel ban will neither increase or reduce that number; it's irrelevant.
Even if it is closed people can still cross easily from the southern border, there is no way to hermetically closing everything, you can only slow things down a bit and control the pace. Turns out that controlling the borders is not such an insane and "racist" idea, but that's also a bit too late.
As others have commented the goal at this point is curve flattening.
What is "flattening" in this case? it's attempting to limit the peak concurrent cases. There will likely not be a hugely significant reduction in total cases, but that isn't the goal.
The reason this is important is because no matter where you are, healthcare systems have a finite limit to the number of people they can treat at once, and if you exceed that you'll get a massive increase in mortality - both due to "survivable". cases not being treated, as well as unrelated medical events that don't get treated because there isn't capacity, e.g. you have a stroke, but there's no ED or ICU beds available.
Not that this ban makes a lot of sense, but not including the UK makes even less sense, considering they've already reported 400 cases (compared to the ~1,200 in the U.S.)
edit: to be fair, maybe the administration would've preferred to just ban travel from Italy. But I'm guessing it's not possible to restrict travel from just one member of the EU.
UK is already a hotspot. 100 confirmed cases in London (as of 11 Mar) means we should expect 10x that in practice. They just started later than some other countries.
Haven't seen any official details yet so just speculating at this point, but the China travel ban applies to "any foreign national who was in China during the last 14 days" (except green card holders/diplomats). It'll likely be a similar definition with the EU.
Without far more serious containment measures within the United States, this is a meaningless move. A dribble of people coming in from the EU when it's already in dozens of US states isn't going to meaningfully change the numbers.
Analogies can also be used to dehumanize victims. It's pretty unproductive to refer to people as vermin, coyotes, animals, etc. Unless you're trying to "highlight common characteristics."
A knife can be used to murder but if you point that out to the chef discussing technique in the kitchen, then you are not adding useful information to the conversation.
Which would be relevant in a discussion about technique.
Murder and knife crime discussions would not be.
A knife can be used for those things, but when discussing knives in cooking it makes no sense to talk about those topics.
Likewise in a discussion wherein the example of the farmer trying to protect the herd from a predator by closing the fence after the predator is already inside the farm - it is not the selection of predator animal used in the example which is the topic at hand. The example is used to illustrate the futility of the act. It does not mean that the government is a farmer. It does not mean the people are farm animals. Farm animals do not elect their farmers. Farmers do not have 3 branches and an independent judiciary or a legislature. Getting into these aspects of the comparison make no sense whatsoever. Likewise getting into the specifics of the coyote - patient zero comparison also serves no purpose. Coyotes have 4 legs and a snout. Humans don't have snouts, we have noses. Discussing all of this is not productive at all.
Also what xenophobic thing have I discussed? I am pointing out the fact that the comment you were replying to used an analogy - which is a linguistic device intended to draw a comparison. There are many phrases and figures of speech like "fox in the hen house" and "bull in a China shop" or "frog in the well". These phrases are never intended to compare the person to an actual fox or bull or frog.
I get that they excluded the UK for diplomatic reasons, but it's literally only a few days behind the rest of Europe in terms of infection count, which means this will have almost no effect.
I actually think banning travel from China months ago was a good call, but by analogous reasoning, the right time to ban travel from Europe (including the UK) was last week.
The reason the UK is behind continental Europe is the lack of testing. Their numbers are no worse than continental Europe (excluding Italy, of course). The US, on the other hand, are lightyears behind Europe on testing, the real number of infections is closer to 5000 than to 1250, again bringing it in line with the rest of Europe.
> the right time to ban travel from Europe (including the UK) was last week.
The US had active uncontained clusters, and was known to have them, two weeks ago. Once that's true, there's no way that mere travel numbers are going to move that needles significantly.
Again: we banned travel from China and it was too late already. This does not work. And I'm horrified at the number of people on this site that don't see that.
Banning travel isn't a magic cure-all that guarantees zero cases, it just lowers the initial caseload. That's extremely important because exponential growth is extremely slow in the beginning -- it takes as long to go from 1 to 100 as 100 to 10,000. If banning travel reduces 100 starter cases to 1, you double the time you have.
Problem being, best information is there is no solid numbers on initial case load in the US, for structural reasons. So while your argument may be correct, it may be too late for this to make a difference (perhaps with equal likelihood, but we don't know.)
Yeah, I'd agree with that. At this point it would help a tiny bit, but only because it slightly decreases links between people, like a social distancing measure does.
Every little bit also has a cost, and it's possible for the cost to outweight the benefits, especially when a decision is made without even considering the cost.
True and fair point with which I agree. I don't know all the considerations that went into this decision but I lean towards supporting such plans that limit unnecessary chances for exposure
I was thinking more for data gathering purposes and so on before the healthcare system collapses under the weight of exponential growth. But I take your point.
I beg to differ. US was the first major country to ban travel from China. Other countries only followed suit after. South Korea, Japan, France, Germany and Italy never did, and see where they are now.
Please do not spread disinformation: Italy banned direct flights from China pretty quickly too.
It did not matter, because patient-0 in Europe was a German. It’s now accepted that the virus arrived by crossing the Alps in some sort of Euro-business trip, not directly from China.
So banning international travel could have at least stopped it from reaching Germany. I think you are making his point while arguing on a technicality. I see no conceivable way that the economic loss of tourism or "business trips" is worse than what is about to go down in Europe.
The infection in Germany happened mid-January, when the Chinese had not even fully admitted to the problem. Chances are it had already reached all continents by the time any travel ban was even considered.
Unless you can read minds, these things happen very quickly now that the world is a global village.
> is worse than what is about to go down in Europe.
It's going down in the US too! We're merely a few days behind. If we had no cases, or a few contained clusters, then this would be an arguably useful policy. We have multiple uncontained outbreaks already, and have yet to enact meaningful policies to contain them.
It's too late. All this ban does is try to shift blame.
It's rational. UK epidemic is not yet out of control. If you look at the region breakdown in UK the cases are very well geographically distributed, the highest concentration as of yesterday is Hertfordshire with only 13 cases, or London with 100 cases if you consider that one administrative unit. Some epidemics in Schengen are highly focused on specific areas which means the growth rate can be expected to be higher. It makes sense to consider Schengen as one unit as it has open borders. It would make little sense to ban travel from individual countries in Schengen.
> it's literally only a few days behind the rest of Europe in terms of infection count
And it's ahead of some Schengen countries.
Besides that, it is the 'per capita' part that matters and there are great differences between the various countries as to how many tests have been administered, leading to severe discrepancies in the relative pictures between countries.
At least they are consistent. Following at a far enough distance gives you 20/20 hindsight for those you follow, but only if you can internalize the lesson fast enough. Otherwise you just slo-mo replicate their same mistakes.
Do you really think some moron bumbled his way into the most powerful office in the world? Have you stopped to think about how unlikely something like that is?
You may not agree with his style (I don't) or his personality (hate it) but the guy has to be minimally intelligent to make it as far as he has. At the very least he knows how to work a crowd and spot opportunity.
I think you're confusing different kinds of intelligence.
Just to lower the temperature, I'll use a non-political example. My grandfather, long since departed, was a master salesman. He sold all sorts of stuff door to door, including the highly dubious Kirby vacuum cleaners, before ending up in real estate. He was an incredibly good manipulator of people, but he was a very bad planner. He once famously sold the same piece of property to two different people, just for the thrill of the sale. (My grandmother had to sort it all out after.)
Being good at manipulation and bad at planning were deeply related in him and some other scoundrels I've met. Why? Because if you don't care at all about facts or repercussions, you can devote 100% of your attention to telling other people what they want to hear, what they'll believe. And it works the other way, too. If you're very good at talking your way out of problems, you never need to learn things like being disciplined or facing facts.
So yes, it is perfectly possible that some goof bumbled his way into the most powerful office in the world. My grandfather, thank goodness, was never very ambitious, so he had a pretty small blast radius. I shudder to think what harm he could have done if he had actually applied himself.
Well, that seems a little strong. The measure used in the US is one that I don't think is used in any other democracy. Every non-American I've talked with about this believes that national popular vote is definitely the number that matters.
Short term pain may lead to long term political gains. This all plays into the narrative, the story that certain political fractions push.
It’s not like it will change too much anyway(EU and USA will be like Italy in few weeks, they already have the infection spreading). Besides, it was “just a flu” few days ago according to him.
The restrictions are simultaneously overly broad and yet narrowly tailored. I can't find any sensible justification for it.
If you're trying to draw a cordon sanitaire, then why leave out the busiest hub in the region? I don't see any indication that there's any intention to prevent people from the Europe getting to the US via indirect means (which includes Canada, Iceland, and it seems even the Azores).
And if you're not trying to draw a cordon sanitaire, why go to such an extreme measure? Banning entry of people who have visited afflicted regions in the recent past (as was done for China) is possible, so why not do that instead? Why ban cargo in addition, given that the coronavirus is thought to be unable to survive the week-long voyage without live hosts?
Furthermore, why include Ireland (an island nation so far relatively unaffected by coronavirus) in the ban, but not the UK (an island nation with greater connections to continental Europe, including a connecting tunnel, that is more heavily affected)?
Regardless of the ability of people to travel to the UK or Canada and get here (which people have done for a long time with other nations we don't take kindly to) it's absolutely going to reduce the number of people who will travel across the pond. Which is the goal, reduce infection rates.
My concern is how economies are going to respond to the US being cut off from Continental ports for a month, which as far as I can tell hasn't happened since U boats were in open waters.
Can anyone comment on supply chains that rely on Europe to source goods? I know medical grade steel comes from over there, but I don't know what else.
I'm not sure where this level of panic is coming from.
Numbers are about to spike everywhere pretty much no matter what anybody does, because better testing and funding has become available.
Quarantining an entire continent, and even worse than this badly doing it, seems to be an astonishing overreaction. The average age of death for coronavirus victims is 83. The mortality rate seems to be as low as 0.6% in South Korea or as high as 5% in Italy. Italy is especially vulnerable because it has the oldest population in Europe which is one of the factors that is leading to the 5% figure from there.
It is not an End of Days zombie apocalypse.
I recently watched a speech by a US mayor which essentially said that the panic over Corona is going to do much more damage to people than the actual virus and I tend to agree. Simple quarantining measures mixed with best practices for infection control until we have more information about the virus seems perfectly fine. Blowing up the global economy is complete overkill and is a typical move from an administration whose response to topics are either to ignore them or sledgehammer them.
I tried modeling infection rates, number of infected, and total number recovered and dead. Couple of things stood out.
1. Reducing the transmission rate lowers the total number of people sick at one time. Lowers the ultimate number who contract it. And pushes the peak infection rate out.
2. The above numbers are very sensitive to r0.
3. An exponential when it hits looks like a wall. You end up with a significant percentage of the population sick at once.
Could be my model being shitty but it looks like at high r0 there is a momentum effect which drives the total number infected above what you would expect.
You’re describing a typical SIR model (susceptible infected recovered) which can be solved analytically. You can see the dependence on all those points you mentioned above.
Note this is a “mean-field” model (everyone evenly mixed together) so take it with a grain of salt...
That's what I was trying to do. I thought it would be interesting to build one and play with it. The issue with it being a mean model vs a mixes contact model noted.
Because World War 2 killed 3% of the general population.
The coronavirus, in a single country, has killed 5% of infected people and elder people or those with pre-existing conditions are majorly overrepresented in infection rates.
>World War II killed 3% of the human population, and that's where we're headed if we don't stop it.
This isn't just wrong. It's irresponsible for you to be saying these types of absolutely incorrect things.
The chance right now that you will know someone you love being killed by Corona is really realistic.
I'm not sure how you think how critical it is. I personally have never had this issue and do not mind at all to lay still for a whole year to try to reduce the risk of this happening.
> The chance right now that you will know someone you love being killed by Corona is really realistic.
Unless all the people you love are over 80 (in which case the chance of them dying before Corona hit was not much less realistic than it is now) that sentance is just completely false.
It’s not only over 80s. It’s anyone with cardiovascular disease, diabetes, hypertension, morbid obesity, and some others, which collectively describes large swaths of the US population.
Everything from smoking to high blood pressure to diabetes to old age to obsesity is considered a "pre-existing condition."
Yes, killing 5% of infected people is serious, especially when viruses of a similar family regularly infect 20% of the population, and the population has no inborn resistance to this partical virus, and it is, provisionially, more infectious than similar viruses.
Simple models suggest we'll have 500k deaths or so by 2021. Of course, it could be less than that, but it could also be more. It's almost certain we'll end up with some days with a 9/11 worth of deaths; it's just a question of whether that's a few days or for months on end.
No we're not. That's absolutely absurd to claim. It might -- MIGHT -- kill 2-3% of people who are highly susceptible to it, people who are in their 70s+, people with cardiac and respiratory disease. Maybe. We don't even know that will happen, because we can probably save a huge percentage of that population as well.
Additionally, for someone calling others' claims bullshit, your numbers have no correspondence to reality. In Wuhan, the 3% number was for the general population; for the 70+ age range, it was ~20%.
If you don't control a disease, the default assumption is that it infects a substantial fraction of the whole human population.
In almost all examples in human history, whenever a disease stopped, it was either because it burned through most of humanity, or because people decided to make it stop. They don't stop themselves.
> You're pretending we will take no measures to control this at all. That's simply not the case.
the US gov't has spent the last 1.5 months doing nothing to contain this at all. ending flights from europe isn't going to do anything to help if they aren't testing people and preventing spread inside the country
This is false. Studies done in Wuhan show that people with CVD have well over a 10% mortality rate. In addition, COVID-19 has the potential to cause permanent disability if it does not kill you first.
Again, you're assuming a 100% infection rate, which is an absolutely absurd assumption. Also, you are basing your mortality rate on a subsample of the population, not the whole population.
There is a panic.
Doesn't matter if its justified (its not, imho).
But it is real and it has the potential to seriously damage the economy.
A tanked economy will harm far more people than this virus.
If the ban gives sufficient reassurance to the chicken littles to induce them not to sell their stocks and invest in toilet paper, it will be a success.
So when the ICU's are all full, and more people are coming in and a space in the ICU is freed up - who gets the slot? A randomly chosen person? Triage? First come first served? Or someone who can pay extra for VIP access? Because one person will get that space, and the next ten people are going to die in the hallway before the next ICU space opens up.
The reason why it's going to go this way is because we won't have the capacity for everyone who needs critical care. And the reason we won't have the capacity is a) lack of proper investments imagining this scenario, where in Japan and South Korea they have this capacity because they've had this experience and know better; and b) lack of discipline to weld ourselves into our homes or even voluntarily self-quarantine in order to slow things down and effectively give us more critical care capacity.
I spoke to 1/2 dozen people today who are traveling. Three think they have this thing, and have 3 of 3 symptoms. I told them not to travel. They said "Oh well" and are traveling anyway. That's what we're dealing with. A total lack of personal responsibility, upon which both the free market and our democratic government is based - and so far this is about as far as we've come.
The European flights being cancelled, seems sane to me. It's not about 1 or 10 people being sick per plane. It's reasonable to assume after a 6-12 hour flight, that everyone on board is infected if there was even 1 person infected at the start of the flight. I don't know the exact number of incoming European flights per day, I think it's about 80-110K passengers? That's what this stops.
Stopping all domestic travel would be better. Short term pain translates into tens of thousands fewer deaths over the next 3 months. China got a handle on this for now because they welded people in their homes. We aren't doing that which means we haven't slowed it down that much let alone stopped it.
Stopping cargo, if that turns out to be accurate reporting, I think is an overreaction.
Estimates have said that they expect 20%-60% of people to get it (originally [1] but updated according to [2]. Something like 10-15% of those people require hospitalization [2] and something like 0.5% - 4% of people die [4]. If we use the lower bounds on all those we are talking about 6.5 million Americans hospitalized and 327,000 dead. For the sake of comparison, that is almost half the number of Americans who have ever died of HIV/AIDS [5].
FOR CLARITY - I'm not saying that there isn't a need to take measures to protect people.
However, I do believe that a lot of inaccurate information is being presented. The public attention on this subject is enormous, making it a ripe topic for the media to profit from alarmist headlines.
[0]The source of the 40%-70% figure has since dramatically altered their estimates, and added several qualifiers.
He lowered it from 40-70% to 20-60%, hardly a qualitative change. The fact is that under essentially any epidemiological model, if you have R0 > 1 and no countermeasures, it's going to hit a sizable fraction of the world population, because the exponential growth only gets stopped by running out of victims.
But the point of this thread is discussing why countermeasures are justified. I'm saying that you should expect a disaster if no countermeasures are deployed -- which is exactly what you're saying too.
The subject of this whole discussion is that there's a travel restriction being put in place. This is why I believe promoting numbers that were arrived at prematurely (I would argue unethically, with the intention of being 'first' in the news) and that specifically don't account for countermeasures to be a bad idea.
We should be trying to promote risk assessments that are situationally correct.
Fair enough. I will update my numbers. If you have other sources to show that any of my other numbers are off, I am open to adjusting them. I have a feeling the totals at the end will still be alarming.
I put the sources above. If you read through, you see that not only did the numbers change but also that he specifically made predictions based on a scenario where zero attempts to mitigate infection were taken.
The first time I clicked on that twitter link it only showed two tweets and not that whole thread. The site was probably under unusually high load in the immediate wake of Trump's speech and the NBA news.
After reading the entire thread, he didn't say "zero attempts to mitigate infection". He said "without effective controls". He also said " Increasing evidence that the extremely intense control measures in China have reduced transmission while they are in force. As long as such intense control measures are in place it is possible to imagine keeping the number infected well below 40%. I don't believe most countries (maybe not even China) can keep such controls for months or a year, the minimum time frame for potentially having a vaccine. But even more moderate ones if effective could reduce incidence considerably". Not even Italy has gotten to the extreme measures that China was implementing. Also if you read his more recent tweets you will see that he thinks the European travel ban is futile.
Overall it sounds to me like that 20% number that I have been using since your first post is the updated number based off of our current mitigation strategy. I don't see any indication that he thinks that number is too high given the current path. Once again, I am completely open to learning otherwise if you have something that you can point to that clearly states otherwise.
There's no "they". That's one guy, making a paid appearance to the media.
We don't know enough about the virus to predict almost anything about it and are learning more every day.
I feel like people have already made up their mind about this by reading some extremely poor sources rather than bodies like the WHO so are going to panic no matter what people say.
The best option here would be for me to come back in a month and we'll reexamine the comment. 625,000 is literally insane.
That specific source is not the only one stating those numbers. Here is Angela Merkel saying as many as 70% [1]. Here is another doctor saying 40% [2] (sorry there is an autoplay video on this site).
I can't believe the 40-70% number. Looking it up, this underscores just how horribly the internet is set up to have these kinds of conversations. If you backsource it, you discover he said "there's a chance" it will hit 40-70%, and then only if no countermeasures are taken. That's very different than what is represented in the cbs transcript.
I saw another seemingly reputable estimate today - some disease person on Joe Rogan's podcast, who was saying that 96 million people could get it, of which 48 million would need to be hospitalized. This makes no sense unless you are predicting a virus mutation. We're not even close to seeing 50% hospitalization rates.
I can. Look at how seriously China shut down cities etc and it still spreads, though much slower. Do you think western nations will take the level of action China has at all or in anyhting similar to the same time frames?
And to be clear, when I say 'I can' I'm not claiming Im right or predicting anything, I really dont know. But this seems as likely as any other scenario especially when experts are saying levels around this.
I can't pretend to be an expert on this. All I can do is defer to experts, look at the numbers as they currently stand, and do some simplistic math. I also don't have the skills to vet the various experts, but I can tell you I have more faith in the vetting process of places like CBS News, BBC, Harvard, Johns Hopkins, and the German government than I do Joe Rogan.
We don’t know whether you get immunity after recovery because the antibodies can be too weak. There are also already multiple strains and immunity to one strain wouldn’t guarantee immunity to the other strain.
Death is not the only thing that coronavirus can do to you.
You can spend weeks or months in therapy before you are recovered, or you can get scarring in your lungs - or worse - that leaves you with a permanent disability. Not to mention damage to other organs.
I think many are discounting, or are unaware of, these other nasty possibilities. We don’t know enough yet of the prevalence of these effects, but we do know they happen.
> You can spend weeks or months in therapy before you are recovered, or you can get scarring in your lungs - or worse - that leaves you with a permanent disability. Not to mention damage to other organs.
Given that we've only been tracking the virus closely for 2 months, and we've only had a decent sample size of patients for only about 1 month, you really can't be making claims like this at this point.
I'm not making these claims. A senior doctor in Western Europe is making these claims[1].
> Fatality is the wrong yardstick. Catching the virus can mess up your life in many, many more ways than just straight-up killing you. "We are all young"—okay. "Even if we get the bug, we will survive"—fantastic. How about needing four months of physical therapy before you even feel human again. Or getting scar tissue in your lungs and having your activity level restricted for the rest of your life.
Improvement due to the seasons isn't simply due to the physiology of the virus itself. People spend less inside and in confined spaces where its easier to contaminate each other. Additionally, the flu does have significant seasonality, and flu season will be tapering off in the coming weeks and months, meaning more healthcare resources to dedicate to coronavirus infections.
It may, but improvement regarding weather is related to people staying inside and in very close contact with one another when its cold/winter, nothing to do with temperature killing the virus.
And with fewer pre-existing conditions. People that already have the flu or coughs for other reasons are more likely to need treatment. Late spring or summer usually has empty hospitals and fewer people experiencing a cold, helping with the treatment of Covid
It isn't just the travel ban that spooks markets. It's the feeling that there are no functioning adults in charge of the response for something that requires real leadership.
Each and every time Trump has spoken to this, as he attempts a mulligan for his last catastrophic bungling of it [1], his raw and profound unsuitability is laid bare (it is incredible that this point is even remotely contentious, as some people clutch onto denial with such vigor. For someone to still be a believer in Trump requires some serious mental gymnastics and/or impairment).
[1] - It was a hoax. The flu. An overreaction. 15 patients soon would be 0. A vaccine in a month. Contained.
His sole desperate need was to try to buoy the market -- it is literally the single and only thing he has going for him -- but unfortunately reality is ready to make its presence known the next day, not concerned with his chronic lying and bluster. Having an egocentric narcissist liar/grifter as POTUS turns out to not be a great thing. But I hear that Jared Kushner is putting together a response so everything should be great. He has the qualification of being married to Trump's daughter.
Uncertainty is the worst for financial markets. And we currently have extreme levels of uncertainty. Economically, it seems likely that we'll see a global recession in the first half of the year. Simply because many companies can't produce as much with travel restrictions in place. If governments step in to help this could recover quite quickly for the second half or latest next year. But no one knows how hard it will hit companies and how quick recovery will be. And until we get first indications, markets will continue to panic.
On the other hand, for long-term investors it doesn't seem like a terrible time to get into the market.
> Can anyone comment on supply chains that rely on Europe to source goods? I know medical grade steel comes from over there, but I don't know what else.
I don't see why commercial sea-shipping would be restricted.
Mariners may not be allowed to leave their ship while in port though.
China Post has been shipping stuff and spraying it with disinfectant. I don't see why that would be a problem. Also doesn't it take more than 9 days to sail across the atlantic ocean?
Actually, to a large extend it's fuel prices that cause these "low" speeds. Many cargo ships can be a lot faster if they have a reason that's worth the massive increase in fuel usage.
> It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.
> In general, because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks at ambient, refrigerated, or frozen temperatures.
That might be so, however there are enough names from enough reputable research centers to take it at face value. If we need to wait for printed peer-reviewed journal papers to combat an active pandemic then we might be waiting a while!
That study isn't saying anything contrary to what the CDC is saying. Or am I the parent that you're agreeing with, and you meant "regardless of whatever the CDC is saying?"
Maybe I misinterpreted what you meant. Your quote from the CDC said that the virus has poor survivability on surfaces, but the study I linked concluded it can survive for 2-3 days.
The relevant part of the CDC quote was "because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks" and the study preprint you linked showed that in the worst case (polypropylene surfaces) no live virus at all was detected after 72 hours while on cardboard it was more like a third of that time (with large error bars).
These are not mutually exclusive statements. It probably can survive for weeks in rare cases, but if it doesn't do that often it doesn't matter.
Any method of transmission that infects fewer than one additional person on average are effectively negligible on the overall exponential curve.
So yes, it is likely possible that symptomatic people can infect others, and it is likely possible that a contaminated doorknob can infect people for a week, but if these things happen rarely enough, it doesn't matter. The virus will die out if other routes of infection (e.g. the more typical person to person transmission) can also be made rare enough.
I see the point you're making from an epidemiological perspective but, because it's so important to people from an individual perspective to avoid contracting the virus, I have to take issue with your claim that it is likely possible to contract the virus from a surface after a period of a week or even weeks. I haven't seen evidence that would substantiate such a claim. According to that preprint linked above, even a period of one week on a steel door handle is more than six half-lives past the "death" of the last detectable viable COVID-19 virus. The science is not all in yet, and it may indeed turn out that COVID-19 is much hardier than we thought, but until then I don't see how you can say that it "probably can" survive for weeks in some cases.
I apologize if this is coming off as pedantic but the damage being done by misinformation and speculation about the coronavirus is significant, and I don't think it's possible to be too zealous about precision here. Trump's claims that fears were overblown and a "hoax" have been amplified into widespread and potentially deadly skepticism that coronavirus is even a danger. People have suggested various quack cures that at best drain the resources of vulnerable people. Even saying something as seemingly-innocuous as "wear a face mask to reduce your risk" ends up having a devastating impact on healthcare providers who really need the masks but can't source them. We should be listening to public health authorities and mainstream health experts, and taking reasonable precautions, but absolutely refraining from speculation that might have unforeseeable consequences.
I'm just going to quote the CDC again, because public health authorities are really the best sources of information we have and I don't want to participate in the "telephone" effect that paraphrasing begets:
> The virus is thought to spread mainly from person-to-person.
> * Between people who are in close contact with one another (within about 6 feet).
> * Through respiratory droplets produced when an infected person coughs or sneezes.
> These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
As a non-expert on coughing dynamics, it seems incredible that one person can infect 50 others by this mechanism (reported New Rochelle transmission from one patient, confirmed by contact tracing and testing contacts).
At a carnival party in Germany with 350 guests, more than 40 were infected by a single guest. That gives an idea how well it spreads in enclosed spaces. You can assume there was somewhat close contact, but I've been to business meetings with also at least 5-10 people <6ft from me. That's how it can spread through a company within days.
I have not been to carnival parties for 20 odd years, but as I remember them (in NL/border with DE), everyone is drunk, hugging, kissing (often on the mouth with perfect strangers), vomiting, not washing hands after toilet (is there a toilet even??), falling over each other and also having sex. Maybe times have changed, but if it still is remotely like that I can definitely see someone infecting 40+ other people.
I mean, we have city parties here 'for all the family' which result in everyone touching each other (just as friends mostly of course but still touching hands, shoulders, neck, face, back), kissing (mostly on cheeks with strangers, but you mostly 'friendly' kiss everyone meet/talk/dance with and otherwise shake hands or even both) but all the other factors do apply as well; bad/no toilets, no soap/water, everyone drunk so who washes their hands anyway, vomiting and not being so careful with putting your sleeve in front of your face when you sneeze or cough... I only go during the day to such things if I go at all (when most people can still walk up straight) because it is rather disgusting after a while (I am old; I used to like that when I was young), but I can see a few people infecting basically everyone if they are popular/drunk enough.
Thanks, that's interesting and not something I've heard before. I think the CDC etc should make this clear : it isn't "an infected person sneezing near you" but "a volume of air into which someone has sneezed in the past few hours". If people knew this I think they would be more inclined to accept the distancing measures.
So there's a constant conflict between simple and easy to understand but not totally correct info, and scientifically correct but incomprehensible to most info.
Someone sneezing in your face = really bad. Someone sneezing an hour ago vs. touching something they just sneezed on... hard to say which is worse.
I get the statistical mechanics aspect, but surely saying "It can spread through the air in enclosed spaces up to <x> m and for <y> s" is understandable by anyone?
The CDC themselves were involved in the study that says you're wrong.
If someone is able to find the source for this info I'd really appreciate it. Just spent like 10 minutes trying to find the paper they're citing but I can't find it and I don't have time to keep looking now. Maybe it isn't published?
“An analysis of 22 earlier studies of similar coronaviruses, including Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) published online this month in the Journal of Hospital Infection, concluded that human coronaviruses can remain infectious on inanimate surfaces for up to nine days at room temperature.”
It's a half-life thing. The larger your initial sample, the longer the sample can go and still have enough infectious ability left.
Scenario: Infected person sneezes over a large area and deposits over a wide area. Then you come by 6 hours later and touch a deposited surface and then 10 minutes later touch your eyes.
Each transition only picked up a fraction of what was left.
And each time period left only a fraction of what was there.
More important to limit travel, limit direct/close contact and clean commonly used surfaces frequently.
And better to avoid replicating the environmental conditions that created the "up to 9 day" figure: low temperatures and low humidity.
He issued it by now (though the tweet reads as if written by someone else). I think it would've been a disaster banning cargo, with little benefit. Banning people could actually help to slow the spread of the virus. And ironically it could help Europe if they get infections better under control than the US.
Based on the localized infection cases I see across the US and have been watching as well as the characteristics of the virus (life outside host/on surfaces, in air, the degree of asymptomatic transference, etc.), it's well beyond containment IMHO.
Travel isn't going to do too much to reduce infection rates alone. We need significant cultural changes to reduce infection rates, but I don't see that happening for a variety of reasons. This country isn't about proactive action and is all about reactionary action though, so we're just waiting for that reactionary threshold. Some preventative measures have been pushed but they're no where near aggressive enough at this point.
It will be interesting how this is handled in our modern cultural, current political and work culture, etc. I suspect it's going to be fairly nasty but certainly hope not. I've been advising my parents to stock up and minimize any outside interactions for awhile.
IMO the only reason we aren't reporting large numbers of new cases is because of the lack of widespread testing currently being done compared to other countries at this moment (other countries are performing magnitudes higher tests a day).
Even if you think you have it, there's still not enough test kits available yet - even if you're swabbed it can be days for a result(Saying this from west michigan).
yes, the case count is about to sky rocket because wide spread testing is coming online but hopefully the fatality count doesn't. I think the authorities need to do a better job communicating that a steep rise in cases detected doesn't mean a steep rise in severe or lethal cases.
I think a steep rise in infection counts due to increased testing/detection would be a great thing. More data is always better in these situations and more confirmed infections with confirmed recoveries would probably ease everyone's minds a bit more.
To be clear I'm not saying more infections are a good thing, simply that if there are a lot more cases that already exist, knowing they exist and having more accurate data that shows us COVID19 is less harmful than currently perceived/projected would be good for everyone.
The president didn't say that the virus is a partisan hoax. His actions clearly indicate he doesn't believe it is a hoax.
The president did claim that some criticisms about his handling of the situation were a "new hoax" in the same way he has labeled previous unfounded criticism and accusations as hoaxes.
so? That is not the same thing as saying it is a hoax. Plenty of reasonable criticisms to make but that doesn’t mean the President thinks the virus itself is a hoax. I am arguing for clear communication and facts and people are basically saying screw that let’s just spread rumors because, reasons. How is that helpful?
"His actions clearly indicate he doesn't believe it is a hoax."
Huh?
He called Fox News and said on air ""So if, you know, we have thousands or hundreds of thousands of people [with COVID-19] that get better, just by, you know, sitting around and even going to work, some of them go to work, but they get better,""
His whole schtick until just about a few hours ago was that the risks were all hugely overblown.
I am also curious to know exactly which "previous unfounded criticisms" you are referring to.
I don't know if I'd call that blatantly partisan. Stupid, perhaps, or a hamfisted attempt to prevent panics and economic crashes, but it's not especially political.
Yes. Yes it is. How many times has Trump tweeted about the stock market and how it proves he is a great president? Hundreds. Literally. His NEA chair has explicitly stated "I have long believed that stock markets are the best barometer of the health, wealth and security of a nation. And today's stock market message is an unmistakable vote of confidence for the president." His entire political argument for reelection is premised on his "business acumen." His down playing of coronavirus (to what end? why?) was a blatantly partisan attempt to gamble that this whole thing would blow over rather than risk spooking the markets.
Given the impacts that the stock market crash and his handling of the virus crisis are likely to have on the election, it is definitely a political matter. Realistically any time a president comments on anything it is a political matter.
And because people with mild symptoms aren't likely going to the doctor. They can't afford to take off work and go, and if it's simply mild right now, why risk their livelihood? I kinda hope this whole thing is a wake-up call for why our system is so unsustainable.
People on reddit (take that as you will) have been reporting that even if the symptoms are significant and match the profile, tests aren't being run if no travel has taken place recently. These people get turned away.
COVID-19 doesn't mean there aren't regular flu / colds going around, too.
Long distance travel and exposure to those who have been (e.g. hugging your wife got off a plane from Spain 2 days ago) is still a top predictor for exposure.
> COVID-19 doesn't mean there aren't regular flu / colds going around, too.
Which is exactly why everyone with those symptoms needs to be tested. One of the most important things we need to do right now is detect the people who got the virus through community transmission.
> Long distance travel and exposure to those who have been (e.g. hugging your wife got off a plane from Spain 2 days ago) is still a top predictor for exposure.
I'd say that testing those people should be lower priority, since an assumption they're infected is more likely to be accurate, so they can take preventative measures without needing a test.
> Which is exactly why everyone with those symptoms needs to be tested.
This. I'm in my twenties so it's very possible for me to get COVID and only experience cold like symptoms (or less!). I'm sorry to everyone, but I won't self-quarantine myself for 14 days just because I have a stuffy nose (it's likely a cold right?). I'm fortunate enough to have the ability to take time off/work remote - but what if it's a cold this week and COVID in two weeks? I can't take a month off.
I'm from West Michigan - ATM there's very little testing available, and I'd only be tested if I had recently traveled. But we're past the point where recently traveling is such a big indicator - we're seeing plenty of community transmission for me to believe it's very likely everywhere already, and any lack of cases is because of a lack of testing.
This is a twice-in-a-century event. (Consider AIDS the other pandemic.) Our system should not be built for outlier events. Instead, we should make exceptions for those outlier events. (For example, we could have salary supports for those in quarantine and unable to work remotely equal to their average reported income over the last 12 weeks || a minimum wage and support for landlords or mortgages until the pandemic ends.)
Overpay for an extreme case rather than adapt your system around it.
Now, I have other complaints about our system and how it is unsustainable, but this is a poor argument as to why.
> Even if you think you have it, there's still not enough test kits available yet
The messaging on this has been pathetic. The other day UW in Seattle announced they had a capacity to test 1,000/day. Not adequate for the nation, but for the PNW, sure.
I'm in Seattle. While there may be official "kits" for this, the protocol can be run in any competent lab set up for this type of assay. DNA primers specific for covid-19 would need to be ordered, but this is routine.
ETA: I'm having trouble locating positive control template sequences.
I am happy for S. Korea running 100,000+ tests, and embarrassed that the US has maybe run 1000s at this point. I also think that the virus is widely dispersed in the US and the best we can hope for is to keep the case load at a level manageable by our health care system. I'm pretty worried about that though.
It cannot be contained. That’s what the pandemic declaration means (even though the WHO should have done this weeks ago).
At this point, the only rational thing to do is to try to slow the spread. The good news is that this is a very mild virus, and the vast majority of infected people will have minor symptoms. The fatality rate in Korea is currently 0.6%, and becuase of the comprehensive nature of their testing, this should be considered the upper bound on CFR.
South Korea has been at 0.8% the last two days, and will continue to climb as their open cases resolve one way or another. Plus, didn't they just have a spike in Seoul?
There was a spike in Seoul. Based on their reaction so far, I have a great deal of confidence in their ability to isolate it and react effectively.
Regarding the rise in CFR: it will naturally go up as cases decline, because fatalities stem from a time when the case rate was more rapidly increasing. Korea’s case rate had been declining for several days:
It IS happening in Italy, and it definitely happened in China. The difference is that Japan, South Korea and Singapore have much more powerful nationwide governments. This allowed them to put infection controls in place much earlier than we have in the USA. It remains to be seen where we top out, numbers-wise, vs. hospital capacity.
Here in Washington Governor Inslee declared a State of Emergency, which gives him the power to, among other things, mobilize the National Guard and State militias to establish field hospitals. This is essentially the same reaction China had with regard to building temporary hospitals, but at the state level instead of the federal level. We don't need federal powers, just competent state leadership.
My Bellevue daycare told me today that they probably won’t close unless a worker, kid, or family member gets the virus or...the state shuts them down. Fun times.
I’m ok with their precautions. Not only are they keeping things super clean, but they are giving my kid more hygiene education and training then I could possibly do on my own. For example, washing hands at home is a bit of a struggle because the sink is so high, it is much easier to drill in the habit at daycare, not to mention the peer pressure they apply by making a game out of it for all the kids at once. Child psychology is working for us in this case as long as it remains safe.
The Japanese response has actually been pretty lackluster and haphazard. I'm rather surprised rates there have not been exploding the way they did in Korea, Iran and Italy.
A colleague and myself were pondering this today. He mentioned the 'bow', and general cultural aversion to physical contact. I found that interesting and plausible to consider.
The Japanese response was not so bad when viewed in hindsight.
In comparison, Korea's response was disastrously wrong. Their "Let's test everyone" policy sent lots of people into medical limbo ("We can’t let you go because you're COVID-19 positive ... but meanwhile we have particularly nothing to do for you because you're not that ill") and got their hospitals flooded with mild cases.
Singapore did a top job containing it but it's a small country, one airport..., countries like the US or Italy on the other hand will have a different outcome.
But that's not true. While lethality is estimated at tops 3.6%, the cases requiring hospitalization, including breathing apparatus, etc are quite high, and it WILL overflood the capacity of hospitals in virtually every country that didn't take really really serious precautions, of which there are only a handful.
It will be a big problem both in Europe and in the US, because they are starting to take measures only now.
The vast majority of cases are mild, like a head cold. This is a fact, and has been reported around the world.
You’re arguing about relative hospitalization rates, but that has nothing to do with the discussion here. Mild cases aren’t clogging up ICU wards at all, because they’re quite mild.
It cannot be contained. That’s what the pandemic declaration means
That's the exact opposite of what the WHO said when they made the pandemic declarations:
"We cannot say this loudly enough, or clearly enough, or often enough: all countries can still change the course of this pandemic," reads a statement from Tedros Adhanom Ghebreyesus, director-general of WHO.[1]
It is not the exact opposite in any way. Your quote does not support your assertion. The truth is that it cannot be contained. It can be slowed down though.
I think you mean that this should be considered the goal upper bound on CFR. It's really the lower bound on CFR if you do everything right. If you do everything wrong, like the US is heading towards, you get overloaded health systems, critical shortages, and a 12% CFR or higher.
A 12% CFR is overstating it, but also because we won't be counting the heart attacks that weren't treated, the chemo and radiation therapy that was postponed, and the other health effects.
I think the true measure will be the year over year total mortality.
If we overload our hospitals then CFR will go towards the number of cases that require hospitalization. Which is around 20%. Italy is currently far over hospital capacity and has a CFR today of 8% and rising.
Media and government keep making this claim, yet where are the recovery numbers of people? It drags on for weeks and weeks with no end in sight, correct? And current case fatality rate in Italy is 8%, was 7% this morning, was 6% yesterday - because they do not have hospital resources for the number of serious cases they have.
Serious, critical, and dead outcomes are said to be over 20% of case. This being described as "very low, a very small number" by certain people. That is not a low number at all.
We're not really hearing any reports of unexplained deaths that might be covid deaths, and the US is advanced enough to not miss deaths like that, so one thing that might put an upper bound on how behind we are. Then again, there's a delay while symptoms progress.
This already happened in Seattle [1]. Undetected COVID deaths are not "unexplained" because they look like flu deaths, so they're simply catalogued as being from the flu.
"In fact, officials would later discover through testing, the virus had already contributed to the deaths of two people, and it would go on to kill 20 more in the Seattle region over the following days."
[1] https://www.nytimes.com/2020/03/10/us/coronavirus-testing-de...
I'm betting we've been seeded since even before Wuhan's quarantine started. My folks and I all got pretty thoroughly sick during a cruise in early January, and they're becoming increasingly convinced it was COVID (especially since my stepmom tested negative for any sort of flu, and this was well before there were reports of COVID outside of China so of course the doctors wouldn't think to test for it even if they happened to have a test kit); it's increasingly difficult for me to be skeptical of that conclusion.
Thankfully all of us seemed to get over it without much complication, and it doesn't seem like very many of the people we've since interacted with have come down with it. We might very well have just been lucky, though.
I dunno, where was your cruise and were there lots of mainland Chinese people on it? Sadly the symptoms for CoVid-19 are pretty common across a variety of diseases, so “flu-like but not flu” doesn’t necessarily point to this. At that time during the outbreak, it seems likely you would have needed to have people from Wuhan on-board.
Los Angeles → Catalina Islands → Ensenada → Los Angeles
> and were there lots of mainland Chinese people on it?
I mean, I didn't exactly go around asking people "are you from China?", but based on the number of people who sounded like they were speaking Mandarin I'd tentatively answer "yes".
> Sadly the symptoms for CoVid-19 are pretty common across a variety of diseases, so “flu-like but not flu” doesn’t necessarily point to this.
Indeed, which is why I'm still at least somewhat skeptical. Still, it's hard to rule it out, especially given the relatively-severe symptoms (not the absolute worst I've felt, but it was pretty bad).
Lots of people live in LA who haven't been to China in decades speak Chinese as a first language. The relevant question is whether there were many people on that cruise directly visiting directly from Wuhan/Hubei. LA-catalina-ensenada-LA? Doubt it. Not exactly the type of cruise someone flies thousands of miles for.
True. Like I said, it ain't like I was going around asking people if they're from Wuhan, lol
That said, you'd be surprised what draws tourists from mainland China; Las Vegas and Reno (for example) both get plenty of Chinese tourists looking specifically to gamble, and I'd imagine the ship's onboard casino to have a similar appeal. Plus, there were plenty of other tourists from long distances, too, both from within the US (East Coast) and from Europe and Australia (from what I gathered from the people whom I did talk to). So evidently there were at least some non-Chinese tourists flying thousands of miles for it; seems reasonable that some mainland Chinese tourists might, too.
Small sample size but: similar experience here (in the middle of the USA). One of my son's friend's mother was even hospitalized for "pneumonia" for a few days. This was the first time I heard of a fairly young fit person having pneumonia due to the flu.
A couple of people I know at work (in Canada) had pneumonia in December (I think). Sometimes pneumonia is pneumonia. I assume even more had it and I just don't know.
Neither of them had traveled anywhere recently.
It seems very likely that many people (especially in areas with lots of travel to/from China) who had "a bad flu" followed by a chest infection in January or early February actually had COVID.
We are unlikely to ever find out, because we won't have a reason to give everyone antibody tests
That's a really good dataset (with a really clunky visualization, but hey!)
Indeed. There are typically above 3000 deaths/week due to Pneumonia and 200/week due to influenza at this time of year. We had a smallish spike in mid-late January, where for 3 consecutive weeks, deaths were above trend at nearly 4000 & 400 per week.
If you assume a 1% mortality rate for COVID, and you assume all deaths are due to pneumonia, and you assume the entire late-January spike is due to COVID, that could be hiding 300,000-400,000 US cases. (To be clear, those are all questionable assumptions! The mortality rate could easily be either lower or higher, a meaningful fraction of deaths might not show as pneumonia or influenza, and it is normal for there to be a moderate spike above trend at some point in the flu season)
That doesn't mean that there were or weren't a few hundred thousand cases in that time -- it just means that some significant number of cases could easily hide in "routine-looking" spikes in the graph.
This does mean, though, that it is unlikely that everybody who got "the really bad flu" that's been going around this year actually had COVID -- but, especially if you live in a place with lots of people who travel to China regularly (like I do!), it isn't unreasonable to wonder if that "really bad flu followed by a lower-respiratory-tract infection that tested negative for influenza" you got in late January/early February wasn't really COVID.
(Remember, though, that while the rapid influenza test has a pretty low false-positive rate, it's got about a 50% false negative rate -- so testing negative shouldn't lead you to assume it isn't influenza)
If you are in ICU with flu symptoms, they don't just shrug when the rapid influenza test comes back negative. There are reflex tests that can be run to confirm positive or negative.
Critical cases and fatal cases are way more likely to be detected for this reason -- but during the 3 weeks I was talking about, it was believed that there was no COVID in the US, except for folks evacuated from China to quarantine sites.
During that time unexplained pneumonia leading to death -- especially in an older individual -- would likely not have been thought to be COVID, and would just have gone on the books as pneumonia.
14% of cases result in severe pneumonia. R0 is about 4. Average incubation time 6 days. Average time to death/severe illness from onset of symptoms 16 days. If your folks and you got COVID before the Wuhan quarantine you would know someone, likely several people, personally who is/are in the hospital right now with severe respiratory distress.
I'm seeing more indications of people taking things seriously. The first cases were announced in my state (Michigan) today, and already most universities have cancelled in-person learning, various gatherings are being cancelled, etc. It sounds like my church—on the west side of the state (the two confirmed cases are on the east side)—will be altering plans, perhaps even cancelling services as early as this Sunday. The concept of "social distancing" is rapidly gaining steam.
This depends on how you're defining containment. Grounding aircraft may not decrease the current case count, you're right, but it may help not adding to it, or adding as much, or as fast. Because of this, it may still be worth doing.
The notion that we're going to abandon containment measures in favor of mitigation, which I've seen in many places (not in your comment though of course), is wrong. We're going to be doing both.
All reductions in (non-essential) travel are good in a pandemic. That doesn't mean it's sufficient, but it's something positive.
I think we would all like to see stronger social distancing rules domestically (in the US), but here the US has a problem as it granted the President broad discretionary powers to suspend international travel but not domestic gatherings, which can't be banned via executive order and even if congress were to pass a law banning such gatherings, there would be first amendment implications as well as federalism issues.
It's not easy to pass a law giving the President this type of power and I suspect many in congress already rue passing the laws that gave the president power to suspend international travel. That's one of the prices of living in a federal government with separation of powers and a bill of rights guaranteeing right to assembly rather than in a place like China.
For example, the CDC has issued social distancing guidelines but they are only guidelines not laws: Santa Clara county has said "no thank you we'll follow our own guidelines" instead, when the CDC asked to ban meetings of more than 250 but Santa Clara banned meetings of more than 1000, and just refused to change their target to the CDC recommendation.
So the US simply lacks the tools that would allow the President to go on the air and announce "I'm declaring that the MLB season needs to be delayed and Disneyland must close." He can try to exert pressure, or rather have the CDC exert pressure, but these types of declarations are not going to happen in America.
OP's point wasn't "this is only going to have very limited effect", to which your reply "better than nothing" would be appropriate.
Their point is that there's absolutely no effect of banning travel between two areas with similar prevalence, based on rather simple logic.
Take two bags with mostly white and a similar number of red balls in them. Then, twenty times, grab one hand from each bag and empty it in the other. What's the expected change in number of red balls?
There is an effect, because traveling itself creates chances for exposure. Anyone traveling on an airplane or train in close quarters, or passing through an airport or transit facility, can pick up or pass on an infection.
By your last analogy, the red balls would have paint rubbed off them in the exchanges.
Yes, but then we should be canceling all flights in the US (we should be). Only canceling flights to Europe is a tiny fraction of what's actually necessary here.
It’s a matter of timing. Europe has higher concentrations of the virus than the US. The chances that a plane from Europe contains an infected individual are getting quite high.
When the concentrations in the US get higher it will start to make sense to constrain travel more over there. Right now the chances a domestic flight contains an infected individual is quite low, but that won’t always be the case.
Bear in mind the virus cannot be stopped, or contained at this point. All we can do is slow it down while also limiting the harm our countermeasures cause.
It’s only a matter of time before it starts over there again, even if through back-propagation from other countries. Everyone’s talking as though China solved the problem. Incredible.
They don't need to solve the problem, just keep the infection rate slow enough to be controlled medically. And then keep everything locked down enough until we can get a vaccine produced. Admittedly, a gargantuan task, and I don't think it's going to happen anywhere else.
They don't need to do that either, they could just let more people die.
That's what you're proposing, if you don't realize it. If you get the growth rate below 1, you can wipe out the disease, instead of merely delaying it.
This is false. Any reduction in travel is going to have a positive effect. The best situation is for people to reduce their exposure to other people and to stay at home. If they do need to be exposed to others, the best is for them to be exposed to the same set of people all the time, and not to different sets of people.
This seems not fully worked out. Assuming total travel is constrained, selectively limiting travel to particular areas concentrates travel in the remaining areas, which increases the average number of contacts between travelers, which violates your “reducing exposure to other people is best” rule of thumb.
By your model, some reductions in travel ought to have a negative effect. Is that a fair corollary?
The pressure / desire to travel is also dropping sharply, though.
Limiting all Schengen traffic is an extreme example, but it's not obvious that some level of restriction would necessarily produce a significant bottleneck effect (given that citizens are exempt).
Why would you assume total travel is constrained? Restricting travel from Europe to US will just eliminate that portion of travel, not concentrate it in the US.
There’s no such thing as a fixed amount of travel, and constraining it on one way concentrates it in another. That makes no sense. Constraining travel will reduce travel, which will reduce interactions between people, which will reduce the spread of the virus. We know this empirically from previous outbreaks and countermeasures.
First infections are not uniformly distributed. Second, by the nature of travel people get into close contact with more and more importantly different people than usual. 200 people sitting in an aircraft for 2 hours is inherently more risky than 200 people sitting in a theater for 2 hours as aircraft mix people from wider geographic areas. So, regardless of infection rates, this is beneficial for both Europe and the US at the same time.
Multiple cities with hundreds of thousands of people in both the US and Europe are infection free right now. Extending that for even a few weeks is very useful.
Apart from the other two replies, the corollary of your point is that travel from a lower incidence area to a higher incidence area actually reduces the risk in the latter.
But this is clearly false because population density is another important factor for contact between people.
> ... the US has a problem as it granted the President broad discretionary powers to suspend international travel but not domestic gatherings, which can't be banned via executive order and even if congress were to pass a law banning such gatherings, there would be first amendment implications as well as federalism issues.
I don't know how strong that actually is. Over the past few years, we've seen some Trump work the courts pretty consistently. Even if his administration is doing something explicitly unconstitutional, running something all the way to the Supreme Court can take 6 to 18 months, during which time the unconstitutional order would stand (if not stayed early on).
Banning public gatherings is really something that should be done on the municipal level, maybe the state level. The federal government should not have the power to disrupt every day life from thousands of miles away.
Exactly. And blanket policies are almost always terrible. Local communities have different constraints and different environments. There's no reason to believe that Fargo, North Dakota should have to respond to this in the same way that New York City does.
Singapore and Taiwan are basically cities, very dense. China is a Communist country with all kinds of totalitarian policies. South Korean cases are still climbing at more than 100 a day. You can't tell precisely what the growth curve has been because there's going to be a higher bias when they ramp up testing in many countries.
At any rate, no, a town that has 50 people per square mile should not be forced to respond in the same way as some city with 50,000 people per square mile. In the meantime, the people of Fargo have all the relevant information and their local officials can make calls as needed to suit their demands.
The rule "no gatherings over 250 people" isn't a blanket rule. It will impact cities more than rural places. The flexibility is already built into the schema.
I sympathize with this view, but it does make it harder to respond quickly with nationwide lockdowns, which is the flip side of living in such a connected world.
Long term, I think some mechanism to mandate more social isolation is going to be needed.
For example when travelling from California to Arizona, there is currently no quarantine area or checkpoint, and that's fine if you want free movement, but then it's harder to say that states should run their own pandemic policy as long as there is free movement between states.
And this is a general trade off. More interconnected world => localism is less viable as a means of countering global threats.
Practically, yes, the states these days won't do anything until the federal government tells them to. It'll work out in a nationwide lockdown, but such obedience hurt us in february when the CDC had a monopoly on test kits and nowhere near enough capacity to supply the whole country. We seem to be making all the wrong decisions in this emergency.
Those are valid points. As to the test kits, I keep hearing conflicting info -- e.g. that there was a shortage of ingredients, too much FDA red tape, etc. There will plenty of root cause analysis in the future, but I think we have to reshore critical infrastructure and there is lots of red tape to cut in both CDC and FDA.
My personal theory is that someone in the executive branch wanted to secure an exclusive contract for a personal friend. Something similar happened in the first few months of the Kuwait oil fires, with certain american fire fighting firms being given exclusive contracts to fight the fires, despite lacking the technology and expertise to extinguish them.
But I'm just a cynical man. It could very well be something else and I'll be very interested to read about this emergency once it's all behind us.
Even with an exclusive contract, a nation such as the US should be able to quickly ramp production of all the test kits, masks, latex gloves, respirators, oxygen concentrators, antibiotics and other pharmaceuticals that we need.
The who is pretty much everyone in government, egged on by the business community with the tacit approval or at least disinterest of the public. The when is constant over the past half century. The how is outsourcing much of our productive capability around the globe. The why is the race to the bottom for the cheapest production cost.
I don't think so. This is not a case like where we need a bunch of steal but the steel mills are closed so we have to buy the Chinese steel so (as any good business-folks will do) they raise prices 8-fold (see Oakland Bay Bridge Fiasco). The reagents for these tests are all made in america, or would take a few days to ramp up. I once made enough Taq polymerase in 12 hours to supply a lab for 12 years doing 200 PCRs a day. A single person can make gram quantities of the required oligos (enough for 100,000 PCR reactions) in any one of 500 labs in the Bay area alone in 12 hours. RT takes an hour. Amplification takes 4 hours. The readout for a sample can be done 1500 at a time in one second. There are no excuses.
Could be, think of Homeland Security and those new(er) airport scanners. Mike Chertoff, formerly Secretary of Homeland Security, was instrumental in making them happen. He also happened to own a huge stake in the company that made them, since acquired by BAE Systems (who later made him a Chairman).
Similarly in Puerto Rico after Hurricane Maria, a politically connected one-man "energy company" called Whitefish, with no experience or skills, emerged out of nowhere and was given the contracts to rebuild the entire Puerto Rican grid.
Months later nothing had happened other than he hired a few people as unskilled as himself who were just dorking around down there, while people died.
So they fired that guy and hired another company called Cobra, with the same terrible terms, and the same ineffective response. Eventually it was found out that Cobra people had paid massive bribes to officials to ensure the deal.
Whitefish was getting stuff done. It was more than one man. It had the needed skill, which was subcontracting. Whitefish got numerous teams operational in Puerto Rico before being yanked off the job by politics.
The whole story of Whitefish being unqualified is just corrupt politics. Subcontracting is a legitimate way to get the work done.
The red tape thing is nonsense. What was lacking was/is political will. CDC/FDA/States could increase testing 100-fold overnight if they really wanted to. A decision has been made to proceed differently. Hopefully this decision is reconsidered over the next few days or things are going to get much worse. Currently, as far as I can tell, we are doing about 1000 tests a day nationwide. I can order the necessary reagents and a few water baths and a cheap microtiter plate fluorometer for overnight delivery and do a 1000 of these tests a day by hand.
I have read somewhere that CDC was trying to make a 3-in-1 test kit for SARS, MERS and this new SARS-Cov-2 virus but it was giving bad accuracy and false positives, and now they are making the one for the sars-cov-2 only.
They were making a 3 in 1 kit, but that's because the 1 was an internal control and the other 2 were two different places in the viral genome in case one mutated and became silent.
Any standard first year undergrad level biology book will describe how to run an RT-PCR test (which is what they are doing). None of the reagents and processes are difficult to make or source.
During the Blackhawks game, the announces claim that the official NHL stance is unclear and they will be making an announcement tomorrow. They had 21k in attendance at the game tonight.
The hurdle would then be that it’s the feds’ responsibility to prove that this is the smallest infringement that would accomplish the government’s intention.
Strict scrutiny requires not only a compelling state interest but that the restriction be narrowly tailored and the least restrictive means that satisfies the purpose. See: https://en.m.wikipedia.org/wiki/Strict_scrutiny .
>All reductions in (non-essential) travel are good in a pandemic.
All travel is essential to somebody. All restrictions on movement also have a cost, and any analysis that only looks at the benefits of something without looking at the costs cannot hope to be correct.
I'm curious to the downvoters, do you generally believe it's a good idea to make public policy decisions without considering the downsides? It's like people who want to ban encryption because it could marginally increase the number of terrorists caught.
Of course we should consider the downsides when we make public policy decisions. In fact, if we weren't, we wouldn't be making decisions at all but merely reacting.
But we can consider the downsides and decide that we want to restrict travel.
I don't actually need to go visit my rellies. I want to, but I don't have to. On the other hand, if I go on a voluntary trip, I probably have to return home because I can't really afford a hotel indefinitely into the future.
So it's obvious to me that there is some distinction between necessary and nice to have.
I genuinely have been underwhelmed by the reaction to this disease through much of the world. It is necessary in a constitutional democracy to react sometimes to maintain the trust of the voters - or they might say "A democracy is fine when things are going well, but when the chips are down we need a strong leader who can make the decisions we need". Saying "those entertainment business can't open during this outbreak", "keep your tables at least a metre apart" and "don't travel" are reasonable reactions in this circumstance. And we need democratic leaders so that they can know when it's gone on for too long and they have to accept we can't stop it - something a "strong leader" can't tell.
Aye, just got back from walking there. Pretty essential to doing IT for several hours, though, IMO.
But OPs point stands -- unless you're working from home and never going out to eat / get groceries / not go crazy from cabin fever you have to travel somewhere
I haven't tasted coffee in a decade, and I'm doing just finezzzzzzzz....~
Restricting routine trips to just home-to-work, work-to-home, and large-scale resupply missions is still acceptable at the moment. Make use of your local grocery's picker service with delivery to the parking lot, if you can.
Consider switching your dining-out trips to ordering via phone, fax, or electronic ordering system, and doing drive-through, carry-out, or parking-lot pickup. Pay electronically, in advance, instead of handling cash at the point-of-sale terminal. If you get cabin fever, and need to socialize, do it through screens.
It is essential for Starbucks to serve customers in order for them to stay in business. You don't have to stop going. But you can put in your order via website or app; walk into the retail location only when it's ready; pick it up without speaking to, breathing on, or touching anyone; and then leave immediately. It is possible to minimize the duration and intensity of contact, without eliminating it entirely.
It is better to be in contact with your regular friends, acquaintances, and business associates--that are all the same people every day--than to have a lot of transient contacts with complete strangers. It is slower to traverse a social network one connection at a time than to hit a lot of random, unconnected people all at once with a brodcast.
What about to your job, if you don't have a job that you can do remotely? Employers generally don't like paying people who can't make it in to work, and it's hard to pay for food without money.
executive orders are SUPPOSED to only be directives to the Executive Branch on how to conduct operations. Unfortunately this power has been abused by past Presidents. Executive Orders have no force of law.
It's not just about containment, which signs point to being past us. If we slow the infection and spread it out over time, we do a couple things. Slowing it gives us time to develop tests and treatment and processes and systems to deal with it. Spreading it out over time means that at any given moment fewer people need medical care. Like, if everyone needs care tomorrow, obviously the system can't handle it, but if a few people need it tomorrow, and a few the day after and so on, spreading it out over time, the system can handle a few at a time.
Travel bans alone will not flatten out peak infections that are going to overload our existing healthcare infrastructure that already run at near maximum capacity during regular, non-epidemic periods.
There is a lot more leadership across government (federal, state, local), private industry, and independent individuals could be doing to proactively reduce transference and even stomp out significant portions of infection is followed through. My point is that our cultural trends surrounding all of these (governments, work, personal action) are almost all running counter to what we need to be doing.
We need strong government leadership at all levels pushing support out where possible, be it resources, accurate non-politically influenced/dictated information, etc. Businesses can be more proactively supporting work from home more where feasible, extend sick leave or create sick leave options to reduce pressures to work, provide some security/continued employment for those who need it (especially demographics at high risk). People can avoid attending work when sick, reduce/limit public exposure (be it out shopping, attending an event, etc.), practice frequent hand washing, limit exposing themselves to at risk populations, etc.
Economically it's a disaster (as the markets are also anticipating) but it's going to be one way or another. It seems to me that you're better off to take a well calculated hit that can bounce back to a healthy workforce that doesn't strain existing healthcare infrastructure than trying to pretend nothing is going on, minimal fallout will occur, and play-it-by ear.
Well calculated hit in an economic sense. As a side effect I suppose you could argue that some economic losses can lead to deaths... but that's certainly not the goal.
I've seen many tech companies in the Boston area announce employees can (or must) work from home, since the governor of Massachusetts declared a state of emergency on Tuesday and encouraged such actions. All governors should do likewise.
Admittedly, the Biogen conference was... a bit of a fuck-up. But yes, all our universities are sending their kids home, white-collar workplaces are moving towards WFH policies, etc. I've been WFH since earlier this week myself, and I went shopping for food and soap with my wife Tuesday night.
It'd be pretty sweet if it took a pandemic for the government to solidify sick day laws.
Too bad money making is somehow above preventing others getting sick. People wouldnt show up to work if they didn't have to worry about their wages. I'm sorry but 3 sick days is garbage and requiring doctors notes is asine when your healthcare plan is shite. Not to mention wasting a day in a hospital. Companies can afford this stuff. It's not often and it's minimal to say the least. But God forbid a small business can't have someone for 80 hours a week at minimum wage!
Which democratic(* - I was going to use Western) nations do though? Seriously the freedom enjoyed by those in these nations and the significant time any global conflict or pandemic have pretty much restricted the ability of leadership in those countries from taking action that would have any true effect short of trying to implement martial law, which in most countries would be met with protests and in some with courts being tied up.
Now I will not attempt to speak for Europe but the US government could certainly push short public advisories and messages to adults and children through broadcast TV and even get the cooperation of streaming services as well. Short thirty to ninety second spots that give helpful non panic information.
The US President is hamstrung by both political disagreement and the law. There were articles he is loathe to declare any national emergency declaration until approached by the governors of many of the states. If he did without states approaching him and asking you can damn well guarantee there were would be Democrats out there claiming he was trying to be a Dictator and comparing him to Putin. The same article concerning the declaration also reveals all the behind the scenes work going on with Congress to get funds in place before any message is put forth so that the government as a whole looks to be cooperating as well as acting appropriately.
As someone posted on FB, the infection rate spikes a lot more with no measures, and flattens with more preventative measures. So while the same number of people may be infected overall, it lessens stress on the healthcare system when it is more spread out.
The current administration in the US has been more proactive than any previous administration during any previous outbreak, despite the deluge of criticisms that were surprisingly absent during said previous outbreaks. The measures that have been taken thus far are more than aggressive enough, based on the information we currently have. We're just a few steps away from shutting everything down completely, which wouldn't be good for anything at this point. It doesn't get much more proactive than that.
There are tens of thousands of incubating cases in the United States already. How exactly is a few dozen sick passengers per day going to affect that at all? You'd have to literally be picking up and flying in planes full of active cases to even match what we have here already.
This is insanity. No one with any expertise at all recommended it. No one serious thinks this is a good idea. It's not going to do anything useful at all.
I can't even tell if this is supposed to be about Trump. Also it doesn't matter.
There are thousands of borders and even more politicians on this planet and if you don't think borders are the scapegoat for problems the world over, then you're really thinking very small.
Yep, notice how in the speech how many times he mentioned China and blamed Europe for not closing off to China.
Unfortunately this kind of measure is going to increase the R0 of the virus, because some people will think "oh I see, the virus is over there, and now the president has closed off that vector."
Statistically, it did. The overwhelming (!) majority of COVID-19 cases in the US are domestically transmitted. Who cares where patient zero came from at this point? Banning travel is going to do nothing.
Any restriction in travel will help to slow the spread of the virus. If you look at Europe, a sizeable number of cases outside of Italy are still travel related. Stopping all travel is one of the key measures to keep infections local.
I'm not saying the measure suffices. Obviously domestic travel is also a big issue, as is travel from outside the Schengen area. But being one of the people affected (currently in Schengen), I still believe this is a right step. It might not slow infections down enough but it will certainly prevent many cases. Also, it will remind people how serious the situation is.
I would imagine anyone who can answer that question comprehensively is filling their boots on some options dealer page right now, in between sips of champagne.
Trade should not be affected. According to the BBC:
The US president said his travel ban did not include Americans who had undergone appropriate screenings - or "the tremendous amount of trade and cargo".
To reiterate what others said, it is long past containment in the United States. In Canada early on the cases were people who came from known hot spots. Now it is almost entirely people coming from the United States, from places with no known cases.
Clearly there are clusters throughout the United States. Unconfirmed, unrecognized clusters. And with the adversity of many to utilizing health care, it seems impossible to deal with now.
It's also worth noting that this flight ban applies only to non-Americans, just as the Wuhan restriction before did. During the prior travel restriction dozens of flights a day were going to and from Wuhan -- they just had Americans on them, who apparently aren't susceptible to the foreign virus. This new restriction is identical, allowing Americans to march the globe with their COVID-19, but at least they kept out the foreigners.
Instead of any actual efforts it is again mere security theater. And again Trump will pat himself on the back for his very-close-to-useless theatrics.
I think elementary/high schools are how this will spread through communities with the most efficiency. Collect a person from each family, mix them together with the poorest respect for hygiene, then send them home, 5 times a week.
Here's the perspective of a San Jose public high school [1] proving that containment isn't a concern:
> Oak Grove High School officials said they were not considering school closures because “children have not been shown to be a high-risk group for serious illness from this virus.” The Centers for Disease Control said last week that limited reports showed child COVID-19 patients in China had generally presented with mild symptoms.
> “As much as possible, children should be allowed to carry on with their education and normal activities,” school officials said.
Related, a family member received a "exposure notice" from her child's school that one of the students tested positive. No closure.
There's no attempt for containment in the US. My hunch is that it's not needed as much as is being suggested by some. I guess we'll see.
> It's also worth noting that this flight ban applies only to non-Americans, just as the Wuhan restriction before did. During the prior travel restriction dozens of flights a day were going to and from Wuhan -- they just had Americans on them, who apparently aren't susceptible to the foreign virus. This new restriction is identical, allowing Americans to march the globe with their COVID-19, but at least they kept out the foreigners.
Well presumably they'll always allow non-Americans to leave. As for americans, they would still have to wade through quarantine or whatever restrictions the other country requires.
For entry into the US, does the govt even has the power to keep americans and permanent residents from entering? Seems like every country will at worst only quarantine its own people.
The US can't restrict its own citizens from returning (although it could certainly impose a quarantine), and I didn't claim or imply that they should.
The point is that the action is farce. Those flights to and from Wuhan were always full of primarily Americans, and continued unabated. Just as Americans can still fly to and from Europe, though obviously carriers are going to drastically cut the flight counts.
Regardless, it is without an ounce of doubt that COVID-19 is spreading, completely uncontrolled, throughout the US. Italy is a week or so ahead of the United States, but sadly the most probable outcome is a catastrophe in the near future.
I agree we are maybe 1.5 weeks behind Italy. Though hopefully it never explodes quite as fast in most of the US due to lower population density and other cultural differences. But as for travel bans, the complaint is that they only slow the spread, in return for economic and other downsides. But I'll take that. The flatter the curve is the better.
> Can anyone comment on supply chains that rely on Europe to source goods?
You know all of the stuff that's made in China? The machines that make that stuff are made in Europe. Well, not literally the ones that make the stuff in China, but the ones that US companies would buy if they were trying to manufacture more stuff domestically to replace the stuff they can no longer buy from China.
I think yes, literally, European machinery exported to China.
It's a massive export sector for the EU (€127bn), and a chunk of that is to China, but the easily-available statistics lump machinery and vehicles, so I don't have a source.
China has started making some of their own machinery in the last 30 years. The quality generally isn't going to be as good as machinery coming from a company that's been making the same thing for 300 years, albeit for them using it internally that doesn't matter as much when the person who designed the machine is right there and can trouble shoot it in person.
It will get interessting. because of the huge container backlog / production backlog in China Europe is facing a serious container shortage right now. Until this is figured out and solved, supply chain management will be a very interesting job.
But by no means end-of-world serious, all life critical things are still getting through. also money buys a lot, even cargo space on ships and planes.
There was an AMA on Reddit, yesterday I think, with a guy whose employer is manufacturing the tests. He said one of the challenges was some of the materials had to come from Belgium and it was taking much longer to get the supplies in the needed quantities. I'd assume such materials would be exempt if his statement is correct.
You can't get around it by going through the UK. It applies whether you've been to the countries affected at any point in the last 14 days, even if it's not your immediate origin port.
The President, for want of a better term is an idiot. When there is plenty of time to act he does nothing, and when the crisis is in full swing he makes symbolic gestures that have but one goal: to increase his chances of re-election. This has absolutely nothing to do with public health.
I couldn't agree more. In the next week, we'll see flights canceled to and from most countries in Europe anyway, so this is a cheap attempt to point the finger at Europe, and away at this administration.
I know people will try to come up with all sorts of edge cases to figure out how to get from Europe to the US, but the fact is if you lie about where you’ve been you will likely end up in federal prison. Don’t try it, wait 30 days.
Excluding China (which they wisely banned early) and South Korea (one city daegu is the center and majority of infection) there is only japan with 639 cases. Europe has close to 20,000 cases.
But if an Asian country’s cases quickly spikes, pretty sure Asia will be shut down in travel to US
They had no screening for incoming travelers at airports just a couple of days ago - no health questions or temperature checks, nothing. And now a 30 day ban? This won't solve the problem, but it will vastly exacerbate the economic disruption.
I feel like there are some particular cultural attributes in the United States that make this useless at this point.
The United States has a very individualistic attitude. Sure, we can pause travel from Europe, but the current administration is very anti-europe. Can we pause travel in the US? I strongly doubt that we can effectively given the strong anti-expertise attitudes as well.
My guess is that the United States will become a more major hot spot for the virus than other locales. It will spread rapidly and the supply hoarding and sad state of our medical system will mean that in a few months, other nations will be rejecting flights from the US.
It's a prediction, a guess, but there are aspects of our culture that just makes it seem very likely. I'm not going to make any more predictions than the idea that we'll have more cases per capita than any other developed nation.
It's be interesting when I'm proven incorrect over time.
More or less doesn't matter. It's a classic case of "one person can ruin it for everyone", which is why in many countries there is strict enforcement rather than just recommendations.
It isn't a classic case of one person can ruin it for everyone. When I choose not to go to the bar, the guy at the bar that ignored the advice about not going out in public still doesn't infect me.
So less dramatically: individuals can (and will!) reduce their exposure to infected people that make poor choices.
Of course the more people that do the right thing the better, but it isn't a situation where the outcome is controlled just by the worst actors.
Unless you hermetically seal yourself from the outside world, you are still at risk. Yes that risk can be reduced, but as more and more people are affected, your own chances go up exponentially, no matter what measures you take.
On the other hand, Americans have much larger and more comfortable homes than Europeans. Americans have big garages to stockpile supplies, which means less trips to the store. Very few people use public transportation regularly. Most people have private back yards. Many more meals are take-out or drive-thru. More Americans use e-commerce for shopping than Europeans.
In Europe by contrast, much more of life revolves around public spaces, like the park, cafes, the city square, and public transport. Americans tend to spend little time in restaurants, whereas Europeans relax and enjoy the meal, thus increasing their exposure time.
Think of the areas in the US that seen the worst outbreaks. Seattle, the Bay Area, New York, Boston. These are the metros, where the average resident is least likely to live a typical middle-American lifestyle. San Francisco in many ways is closer to Copenhagen than it is to Jacksonville.
Overall, social distancing is probably easier for Americans because our way of life already involves a good deal of social distance to begin with.
I mean there was literally a guy on the post from yesterday talking about how we're all paranoid and he's going to enjoy "exploring Boston and eating out while the lines are short".
Yeah some people are going to take advantage of cheap flights and small crowds. The thinner crowds is the point though. it still achieves the objective of lowering the R value.
I bought an annual unlimited longhaul flight pass on AirAsia for ~$150 USD, still have to pay taxes and airport charges. One return flight home and it pays for itself. Will see how that turns out, but is very much bargain hunting time for the brave.
Also traffic is great now. One good thing to come out of this is that governments might see the huge infrastructure benefits from just a small increase in remote workers.
> Americans have big garages to stockpile supplies
No they don't. No one in NYC, Boston, San Francisco, Seattle, ... have big garages to stockpile supplies and most of the US lives in those big cities with apartments without garages.
In the suburbs they do but that's a minority of the population.
How does a garage help? Many people living in urban areas in Europe have a basement. And even those who don't shouldn't have issues storing 2 weeks worth of food in their houses or apartments. Fridge space is probably the only restriction for that.
Majority of US population lives in the suburbs. Roughly 30% live in urban areas and many of them would have garages or basements. For example, my town is considered urban and all the houses have garages.
> About 46 million Americans live in the nation’s rural counties, 175 million in its suburbs and small metros and about 98 million in its urban core counties.
> As a group, the population in rural counties grew 3% since 2000, less than their 8% growth in the 1990s. Urban county population rose 13% since 2000 and the population in suburban and small metro counties went up 16%, growth rates somewhat higher than in the 1990s.
It's hidden in plain sight: you mention "Boston, San Fransisco, and Seattle" in the same breath as NYC, but numbers-wise those are all pretty small and you're leaving out not only their suburbs but also the LA, Chicago, DFW and Houston areas which all have considerable amounts of suburbs and single family living, and hold almost 40M people alone...
And hell, a decent portion of SF at least land-wise is covered in single-family homes and duplexes, many (most?) of which are decently spacious and have garages. Even in cities, Americans tend to have more space than equivalently-situated Europeans.
Common most of the houses in outer richmond, sunset, ingleside, ... have multiple in-law units and converted garages. The cost of living is too expensive in those cities.
> No one in NYC, Boston, San Francisco, Seattle, ... have big garages to stockpile supplies
I think most of San Francisco by area is zoned "RH-" (Residential Housing), and most of that RH- area is RH-1 or RH-1D (single family). Most of the homes in those regions have lots of space.
We're not just talking about Zuck's mansion either, plenty of homes in the Sunset or other West SF areas that have that kind of room.
Friend of mine went on a walkabout. Camping in his van and decided to live off just what was in his food bin. Basically a short half full rubber maid container. Lasted him three weeks.
It sounds like you've never been outside of a city in Europe and never been to a city in the US? Urban population in the EU in 2018 is 76% while 82% for the same year in the US according to The World Bank.
Lived in Sweden for the last 15 years. Yeah, people out of cities have big back yards (people in cities have none), most workers eat out every day for lunch, shopping online (except for food) is pretty much the default. Denmark's pretty much the same.
I've lived in both, and you're missing how large the difference is. Not to mention you seem to be missing the point.
What the OP was saying is that americans don't eat out that much, is a very heavily home-oriented society - thats why the OP mentioned take out and delivery - not going out for lunch.
And yes people out of cities in nearly all countries have big backyards, but you are missing the people have big back yards in the US EVEN inside city limits. There are ofcourse the couple exceptions like NYC etc. but mostly even big cities have the weird suburban style houses even in the most expensive areas!
Guys, you are missing the point - these stereotypes, however true they might have been (or not), are over currently for Europe. Restaurants are empty or closed, people limit their social interaction and overall exposure to minimum. It doesn't matter much if we speak about Sweden or Italy or anything in between.
What will happen or won't in US or Europe is not anymore dependent on these behaviors.
Not sure how the backyard argument is relevant anyway. It's not like that makes not spreading the disease that much easier. Public transport is certainly a risk. But I'm not even sure if e-commerce helps. Going to Walmart at 1am and using self checkout is probably much safer than receiving your delivery from someone who might be infected and visits several hundred homes a day.
Got a citation for those numbers? Another poster claims that the US suburb population alone is 175M, and that's roughly half the country right there. Add in the rural population (46M), and 82% urban seems not even remotely correct.
Urban population in Europe also includes suburbs. Yes, there's less sprawl but enough people in Europe living in urban settings have backyards and reasonably large houses.
> Overall, social distancing is probably easier for Americans because our way of life already involves a good deal of social distance to begin with.
While that's true, behavior trumps lifestyle I think. I had a dentist appointment scheduled for this morning in San Francisco. I called my dentist office and explained that my wife has some mild-flu symptoms and asked if we should reschedule. They said that's since I don't have symptoms myself it's not necessary to postpone the appointment. That may happen in Jacksonville too.
omg yes! The dentist's going to stick their face right in his! after having stuck their face right into a bunch of other patients! and then they'll stick their face into a few more patients! It sounds like the perfect breeding ground. Even if I wasn't sick, I'd want to cancel for that alone!
Yeah but they use protections like masks, gloves. I think it's reasonable to assume that a dentist's office likely know better than you about how to minimize the risk. They have motivation in not ruining their business by being a source of local outbreak.
Americans all gather together in the same room 5 days a week to work. They also have less protections for paid sick days so you will have min wage mcdonalds workers coming in sick and coughing on your burgers.
>Americans have big garages to stockpile supplies, which means less trips to the store
This is FUD. That isn't where you risk getting sick. The countries with the most effective response to COVIR-19 doesn't even try to stop everyday shopping or movement in cars at all.
>In Europe by contrast, much more of life revolves around public spaces, like the park, cafes, the city square, and public transport.
You don't get sick by being in a park or city square with someone else. More FUD. Please do some reading on the appropriate measures and what actually constitutes a risk of infection.
From what I've read, China tries to get people to go grocery shopping only once per week. They are the only ones who appear to manage to get the infection rate from 1.3x down to 0.3x in the past days.
- we have a better healthcare system than is US (better as in public and for everyone)
- we own the most cars per capita in the west and are second in the world, public transport wasn't a big factor in this pandemia here
- food is much more controlled and we have a tradition of home made, home grown food, that doesn't require to go to the supermarket
- things are closer so trips are shorter and you can shop at many non packed smaller shops
- we react better to panic and are not armed
- infection has spread in small cities in the country where houses are larger, they have more storage, don't use public transport and social distancing in theory was easier
Wait until all the coronavirus infected hourly workers, who can't get treated because of a lack of healthcare and who have to continue going to work so they can pay rent, infect everyone through the take-out food :)
Only time will tell, but fairly aggressive measures are already being taken in California and Washington where the cases are only in the hundreds, and many other states are following close behind when they have few to no cases. One thing even many Americans don’t properly appreciate is the degree to which most things are actually run at the state and local level. So far the federal dysfunction has not stopped the states and cities from moving. If that stays the case, the US may be okay.
One other factor in the US favor, it’s extremely low population density compared to the rest of the world. The US, Canada, Australia, and New Zealand are all similarly low density and in this specific case likely to benefit from that.
Washington has just, for example, banned all events with over 250 people in them for the three most affected counties.
Cities and counties in CA had been doing the same with different thresholds. Which meant an NBA game was going to be played without fans (since then, the NBA season has been suspended, which is a pretty significant measure in and of itself).
Many schools have been closing in the Seattle area, and just today the Seattle school district, and many outlying school districts closed for at least two weeks. That's a lot of school closures.
Many companies are having employees work from home wherever possible. The amount of traffic in Seattle during rush-hour is an astronomical change. There's very light traffic during rush hour in places that used to be wall-to-wall vehicles.
As someone living in the Seattle area, it feels like life has substantially changed.
School districts are closing down, for one. For example, my hometown's school district (Elk Grove Unified School District) shut down all campuses this week (but are apparently allowing athletic and academic team activities - i.e. sports - tomorrow): http://www.egusd.net/covid-19/
I have a few friends that teach at K-12 schools in California and they've all been told to figure out what platform they want to use to do teach remotely. Our local school district sent out an email to parents outlining an online teaching plan.
I don't know if they're all just being exceptionally prepared or if there's plans for a more widespread school shutdown here.
Bay Area, I'm wfh, my wife is wfh, all our family and friends that work for major tech companies are wfh, 85-N had no traffic at 9:30 AM this morning, we pulled our kid out of gymnastics class 2 weeks ago, we haven't been going to museums (one of which is closed, because of coronavirus), and his day care (which nominally has 12 students) was down to 7 last Friday and now 3 of those are out because of hand-foot-mouth disease. Berkeley, Stanford, and Santa Clara University have all gone remote-only and sent the students home. Stores are completely out of rice, beans, toilet paper, hand sanitizer, etc, and a bunch of people are wearing masks. I figure it's just a matter of time before we're on complete lock-down.
Allow me to rephrase then: while the overall population density of the US is low, we have some pretty large dense areas, including Southern California and the northeast megalopolis
Compared to similar areas elsewhere in the world, especially Asia, these areas are not dense at all. Wuhan, which you surely hadn't heard of before this crisis, is ~denser than~ nearly as dense as New York City, for example.
I'm not sure the average population density across the entire country is that relevant - it doesn't tell you anything about the distribution of population.
The US is actually rather an urban country - 82% live in urban areas which is more than Italy (75%):
This is actually due to the inclusion of suburbs and exurbs in the “urban” category for US, Canada & Australia.
Half of the US population lives in the suburbs (see above posters). What we would recognize as a real urban environment only accounts for less than a third of the US population (98M people).
Maybe its my UK bias - the distinction between urban and suburban doesn't seem to feature a lot in statistics here - things are often just usually "urban" (including suburbs) or "rural".
I did see a figure of about 55% of everyone in England and Wales living in suburbs - but I suspect our suburbs look pretty dense to someone from Houston or indeed Achiltibuie!
You pretty much can't compare the definition of "city" or "urban area" in different countries, so that tells you nothing.
I mean, Berlin has 3.7 million people in a city of 890 sq km. Melbourne has about 5 million people in a city of almost 10,000 km. They're incomparable, and so the urban population of Australia and Germany are incomparable. (You can play with the definitions as much as you like but you'll never be able to compare arbitrary Australian and German cities.)
Europe is a huge place and it's hard to pin it down to a single culture. The collectivism is mainly seen in northern Europe and Scandinavian countries. If you've ever been to Napoli or Sicily you wouldn't feel the same way. Feels more like Morocco sometimes.
Many parts are really not as collectivist as people seem to think. Not as collectivist as Asia at least, not even close. Individualistic tendencies are strong over there, although not as strong as in the US.
I would've thought that the closer personal contact in Southern Europe (hugging/kissing for greetings) would spread it faster. But if you look at infection rates, most more Northern countries now look pretty similar to how it spread in Italy 1-2 weeks ago. So not sure if culture actually plays a role.
I guess it's all down to the economy, business travel spread it a lot. that's why areas with strong economies seem to be affected more than others (at least in Spain, Italy and Germany). Banning travel could work quite effectively for that.
I said the strong parts of each country were most affected. Not saying economically strong countries more than weaker countries but stronger regions more than weaker regions.
For Italy it's the North, for Germany South & West, for Spain the regions around Barcelona & Madrid. In each case, they were hit hardest. I don't believe that this is coincidence. There are other factors, like wealth leading to more travel and general, as well as population density. But interconnection by economic activity looks to me like a major factor.
Just yesterday I listened to an interview with a medical expert, and the host asked him if he should cancel his domestic holiday plans. The host assured him that was premature.
And yet here we are the next day. The situation is evolving rapidly.
>The host assured him that was premature. And yet here we are the next day. The situation is evolving rapidly.
Meh.
Your personal risk to become infected via $generic_domestic_holidays is pretty low, but the risk to increase the overall threat-vector by allowing open flights from domestic zones is very high.
The personal assessment just differs from the supervising political assessment, while the observed/assessed situation is exactly the same. Also: be careful with "experts", whenever that label is used, you should be very wary. A "medical expert" doesn't inherently know anything about politics at scale, he just (simplification alert) knows which medication to apply when which symptoms arise.
Agreed, it’s amazing the range of guests Joe Rogan has on his show. Admittedly some are more witch doctors than actual doctors but his recent conversation with Michael Osterholm was the real deal.
Even India is pausing all travel from Europe for next one month. It's not about US/India, Europe got lot of exposed cases and currently it's the best way to prevent further spreading.
"He [Trump] said he would instruct the Treasury Department to “defer tax payments without interest or penalties for certain individuals and businesses negatively impacted.”
Why deferments for businesses? Don't they only pay tax on profits?
Probably is targeted more at small businesses who might have trouble getting all of their bookkeeping and records in order in time to file in a few weeks. If this somehow benefits large corporations, they will no doubt take full advantage of the situation.
Depends on how imaginative/paranoid you are. It sure seems odd that this week has included an oil price war between Saudi Arabia and Russia, a pandemic declaration, and now the biggest disruption of international travel/commerce since WW2. https://twitter.com/RusEmbUSA/status/1237048071223160833
We also found out this week that a man that is showing signs of dementia is all but certain to win the democratic primary and face Trump for the presidency. Weird times.
(In the USA) Is this going to accomplish anything?
The virus is already here and has been spreading out-of-control for quite a while now. The only reason the numbers are still so low here is the incredibly low number of tests being done.
Only vs. China, Iran and Italy. We're within a factor of two (that is, about 5-6 days) of everyone else. A 5-6 day head start is not enough window to save ourselves with a travel ban.
And just like Italy went from "contained" to a country-wide lockdown in the space of a week, so will we at this point. Those tens of thousands of cases are incubating right now and will emerge in the coming days.
But it's also not the case when looking only at absolute numbers either. I would also argue that per capita is implied because it's the only way you can really make that comparison.
I’m not sure this is true, as the deaths from coronavirus are distinguishable based on their clinical features, as I understand it (e.g., the chest X-ray of a COVID-19 patient is readily identifiable)
In order to not significantly undercount the number of coronavirus deaths attributed to other causes in the US, there would need to be wide-spread testing here... which there isn't.
Imaging (by the way, you're referencing tests on live patients not dead ones) could be used as another kind of coronavirus test, though an extremely inefficient one, so probably is essentially un-used. Anyway, for pneumonia I believe we're talking about x-rays which is poor at distinguishing coronavirus (see link). Not to mention all of this is brand new. So approximately zero Radiologists are trained and using radiology in a clinical setting to diagnose coronavirus in people who have apparently died of pneumonia.
It certainly helps, it’s easier to control, and has a smaller impact on most people’s lives so more easily accepted. It’s not the most effective but other factors have to be considered, including social unrest. It seems a sensible decision IMO
That doesn't answer the "significant" part, I think. It's an easy decision for the reasons you mention, but that doesn't mean it has a significant impact.
Depending on how spread goes, it would be easier to ban internal travel after banning international travel than going 0 to 100% ban in one swoop. Don’t underestimate that the damage of social unrest can easily surpass the potential damage of the virus. Remember public policies deal with people with emotions, not robots.
This would make more sense if the travel ban was bidirectional. But as you said, a lot depends on how things are progressing, which we don't actually know in the US due to poor monitoring. Which is why I said it's not clear if this is a step that will make any significant impact, although to your point it might work as theater either way.
>it certainly helps, it’s easier to control, and has a smaller impact on most people’s lives
it has quite a lot of significant costs, in particular on the airline industry and business travel which is smaller in number but pretty important. And given that community spread is going to be a far bigger issue this ban is nonsensical.
A little, not a lot. On the very pessimistic side, it will at least convince all the casual travelers who go "ooo look at the cheap airfare! I'm sure I'll be fine" from booking/traveling. Overall this will have a very chilling effect on travel, even to non-targeted regions.
However, we do already have the virus in the USA. So it's not suddenly going to go away because of this proclamation.
it will at least convince all the casual travelers who go "ooo look at the cheap airfare! I'm sure I'll be fine" from booking/traveling
I don't think it'll have such an effect on Americans since they are exempt from the ban. But now they're guaranteed to have more room to stretch out on the plane.
But you know what would have such an effect? If the government just came out and said "We strongly recommend that you cease all non-essential overseas air travel, including vacations"
No! This will do nothing. How are people on HN asking this? You all know math, right?!
The healthcare system is at risk of being overwhelmed by an exponential function. That means, to a first approximation, nothing matters except the last doubling.
Discussion questions: How does this policy, implemented now, affect the time span of the last doubling of COVID cases in the US? Does it do fuck all? Why, or why not?
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[ 2.9 ms ] story [ 376 ms ] threadI personally feel this policy will get altered as the markets tank further.
In contrast, the CDC's take is that "in general, because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from products or packaging that are shipped over a period of days or weeks at ambient temperatures." -- https://www.cdc.gov/coronavirus/2019-ncov/faq.html
The only think I can come up with is that this will allow Trump to show how bad it is that the USA is so much international dependent for certain goods and use that then to push through regulations to enforce more local production. But if it's really that it's quite crazy.
A normal travel ban on the other side will slow/reduce/eliminate cross infection between the EU and the USA which can be helpful to slow the spread. But then from all what I can tell it might be at a point where the slowing of the spread caused by EU/USA cross infection doesn't matter due to many more local sources of infection... Well we will see. At least during the ban he can't really put the blame of any increase onto the EU anymore as travel was cut.
I suspect that Monday will shortly be the second largest drop in absolute terms after tomorrow. We might even see tomorrow crack the top 10 in percentage terms.
> And these prohibitions will not only apply to the tremendous amount of trade and cargo, but various other things as we get approval. Anything coming from Europe to the United States is what we are discussing.
but DHS is now clarifying that it doesn't apply to cargo, and the order itself doesn't mention cargo[1].
So who knows?
[1] https://www.whitehouse.gov/presidential-actions/proclamation...
You can do your best to identify those infected and have them self-quarantine, but if the gates are open and infected people are streaming into your country, you're not going to get far.
The idea that this will prevent "infected people streaming into USA" is uninformed. This step limits transfer both ways, between two regions that both have similar level of infection spread.
It may help both sides contain the virus, but it won't limit the amount of infected people in the USA on its own.
Please, be careful about the language you use, the way you wrote the sentence promotes FUD.
I never said it would. By stopping flights, you're removing one potential source of new infections.
(Op already said as much. Your answer reminds me of my Grandmother: "I know God doesn't exist, but it can't hurt to go to church.")
That assumption is wrong, the prevalence will not be equal. One will be better off, one will be worse off. There is no scenario where the prevalence is going to be identical across such massive populations with such dramatically different cultures, population densities and healthcare systems. The US and various European nations will not act the same, they will not quarantine the same, death rates will vary, and so on. In fact, it'll vary considerably just within Europe, as we're already seeing.
It's better to separate accordingly, for both sides.
Probably not true, as we don't have 1000 deaths yet. Though, give it two weeks, and we'll easily have caught up (to where Europe is today).
Let's just throw around blatant speculation, that will help.
Speculation aside that is extremely unlikely to be the case for a variety of clinical reasons
https://news.ycombinator.com/item?id=22553193
"In fact, officials would later discover through testing, the virus had already contributed to the deaths of two people, and it would go on to kill 20 more in the Seattle region over the following days."
The US has failed to do any significant level of testing given its population, so it's understandable why many people are not confident in the official figures, especially when it becomes apparent infections have been running unchecked for weeks before testing started.
https://www.nytimes.com/2020/03/10/us/coronavirus-testing-de...
As stated before that is absolutely false which is why those cases were caught. Will data be imperfect, yes, but that doesn't mean we should start throwing around Chinese propaganda.
https://www.washingtonpost.com/world/asia_pacific/conspiracy...
I'd favor grounding most flights at this point. However, the reason to restrict people from eg Sweden or Ireland or anywhere, is because those people in Seattle are our people (legally, citizenship-wise), which are the ones we should be concerning ourselves with and attempting to control/restrict/observe/test/treat. The US is about to enter mass quarantine, as numerous other countries are. It's better if people from other countries stay outside of the US / stay in their own countries.
And further, it's dramatically better to only have to deal with our own people as a vector, not foreign persons. It's obvious that the fewer people that are infected within the US, the better.
I do not mean to be patronizing, but this is literally life or death and the math is very simple.
Today there are k infected people. Tomorrow there will be kn people.
If n is unsustainable, any positive value for k is equivalent. Arbitrarily large changes to k today make an arbitrarily small contribution to the final doubling.
“Infected people streaming in” means k becomes k+c. How much does reducing c flatten the curve? How much does it increase the time span of the critical last few doublings?
It doesn’t. That’s only dependent on n.
Ok, we can’t “flatten” the curve, but we can move the peak, right? How much does reducing c move the peak?
Well, every day we prevent k additional people from entering buys us one day. Remember, tomorrow that’s kn. Act fast.
If we could, this week alone, prevent a quantity of infected Europeans equal to the infected population already within the US from entering, that buys us one single doubling period before the collapse of healthcare. Maybe a week if we got lucky.
I will guesstimate that that is not a realistic target in fact. The actual benefit scales proportionally.
And next week it’s the same work for half the benefit.
What are you talking about.
No, shutting down the travel from a country with an outbreak that is not contained is not a bad idea.
Stop politicizing this matter and either trust your government or go to your bunker.
Everyone the past week has been plain fearmongering and it's disgusting.
2. Isolation for those exposed or showing symptoms
3. Paid time off work for people who can't do their jobs in isolation, to make sure people report exposure and symptoms
4. Suspension of public gatherings
Some of these are being done voluntarily and/or by local governments, but that's very patchy.
The distinction between the two for the sake of definitions is also very clear - whether the restrictions apply to travel that does not cross the borders of the United States. The currently-announced restrictions do not.
The question isn't of restricting external traffic in addition to internal traffic; we're only limiting external traffic. We probably need to be doing a bit of both, though with less draconian limitations on internal traffic to accommodate economic realities.
>the math is very simple
Yes it is. There are infected people in Europe. Stopping travel from Europe = less infected people in the US. Yes, there are already infected people in the US, but a travel ban will neither increase or reduce that number; it's irrelevant.
What is "flattening" in this case? it's attempting to limit the peak concurrent cases. There will likely not be a hugely significant reduction in total cases, but that isn't the goal.
The reason this is important is because no matter where you are, healthcare systems have a finite limit to the number of people they can treat at once, and if you exceed that you'll get a massive increase in mortality - both due to "survivable". cases not being treated, as well as unrelated medical events that don't get treated because there isn't capacity, e.g. you have a stroke, but there's no ED or ICU beds available.
edit: to be fair, maybe the administration would've preferred to just ban travel from Italy. But I'm guessing it's not possible to restrict travel from just one member of the EU.
I've no idea why other than language.
https://www.statista.com/chart/18742/most-popular-destinatio...
Only reasoning I can see is political - UK did Brexit. For limiting the spreading this seems like a weird exception.
https://www.theguardian.com/uk-news/2016/jun/22/sudanese-ref...
Edit: https://www.dhs.gov/news/2020/03/11/homeland-security-acting... confirmed this (countries in Schengen area)
The point of travel restrictions is not to be 100% effective, but instead to reduce the number that travel.
They can be purposely interpreted on the basis of their obvious uncommon characteristics but that is very unproductive
You're not an expert and you're spouting xenophobic bullshit. Take the L.
Murder and knife crime discussions would not be.
A knife can be used for those things, but when discussing knives in cooking it makes no sense to talk about those topics.
Likewise in a discussion wherein the example of the farmer trying to protect the herd from a predator by closing the fence after the predator is already inside the farm - it is not the selection of predator animal used in the example which is the topic at hand. The example is used to illustrate the futility of the act. It does not mean that the government is a farmer. It does not mean the people are farm animals. Farm animals do not elect their farmers. Farmers do not have 3 branches and an independent judiciary or a legislature. Getting into these aspects of the comparison make no sense whatsoever. Likewise getting into the specifics of the coyote - patient zero comparison also serves no purpose. Coyotes have 4 legs and a snout. Humans don't have snouts, we have noses. Discussing all of this is not productive at all.
Also what xenophobic thing have I discussed? I am pointing out the fact that the comment you were replying to used an analogy - which is a linguistic device intended to draw a comparison. There are many phrases and figures of speech like "fox in the hen house" and "bull in a China shop" or "frog in the well". These phrases are never intended to compare the person to an actual fox or bull or frog.
See what dehumanizing analogies results in? Congratulations.
I actually think banning travel from China months ago was a good call, but by analogous reasoning, the right time to ban travel from Europe (including the UK) was last week.
https://www.worldometers.info/coronavirus/covid-19-testing/
I don't know where you get that info from but it is severely outdated or just outright wrong.
Number of tests: 3395 Source: https://www.ontario.ca/page/2019-novel-coronavirus Population: 14,659,616 (estimated for 2019-Q4 found on Wikipedia)
The source for each of the figures is in the last column of the table.
Did you just want to post Ontario's numbers (Canada was not in the table at all) or are you questioning the accuracy of the worldometers page?
Can you elaborate on this with some sources?
Like extraditing Julian Assange while the world is looking elsewhere.
The US had active uncontained clusters, and was known to have them, two weeks ago. Once that's true, there's no way that mere travel numbers are going to move that needles significantly.
Again: we banned travel from China and it was too late already. This does not work. And I'm horrified at the number of people on this site that don't see that.
If it's done in time to prevent the bulk of that initial caseload, which is almost certainly not the case here.
It did not matter, because patient-0 in Europe was a German. It’s now accepted that the virus arrived by crossing the Alps in some sort of Euro-business trip, not directly from China.
Unless you can read minds, these things happen very quickly now that the world is a global village.
It's going down in the US too! We're merely a few days behind. If we had no cases, or a few contained clusters, then this would be an arguably useful policy. We have multiple uncontained outbreaks already, and have yet to enact meaningful policies to contain them.
It's too late. All this ban does is try to shift blame.
No, Ireland is also exempt. In other words, the US is banning travel from the Schengen Zone.
And it's ahead of some Schengen countries.
Besides that, it is the 'per capita' part that matters and there are great differences between the various countries as to how many tests have been administered, leading to severe discrepancies in the relative pictures between countries.
France is the 2nd most impacted country in Europe, and the DoS' last update was 11 months ago where their primary concern was terrorism.
https://travel.state.gov/content/travel/en/traveladvisories/...
Only Italy is currently at "Reconsider Travel" or "Do Not Travel" for the Northern regions.
Edit: apparently not, looks like it just applies to foreign nationals https://www.dhs.gov/news/2020/03/11/homeland-security-acting...
That experience doesn't include American airports though, so YMMV.
Edit: Apparently it’s limited to Schengen Zone: https://www.dhs.gov/news/2020/03/11/homeland-security-acting...
You may not agree with his style (I don't) or his personality (hate it) but the guy has to be minimally intelligent to make it as far as he has. At the very least he knows how to work a crowd and spot opportunity.
Yes, and in light of anecdotes of how decisions are made in the current administration: double yes
Just to lower the temperature, I'll use a non-political example. My grandfather, long since departed, was a master salesman. He sold all sorts of stuff door to door, including the highly dubious Kirby vacuum cleaners, before ending up in real estate. He was an incredibly good manipulator of people, but he was a very bad planner. He once famously sold the same piece of property to two different people, just for the thrill of the sale. (My grandmother had to sort it all out after.)
Being good at manipulation and bad at planning were deeply related in him and some other scoundrels I've met. Why? Because if you don't care at all about facts or repercussions, you can devote 100% of your attention to telling other people what they want to hear, what they'll believe. And it works the other way, too. If you're very good at talking your way out of problems, you never need to learn things like being disciplined or facing facts.
So yes, it is perfectly possible that some goof bumbled his way into the most powerful office in the world. My grandfather, thank goodness, was never very ambitious, so he had a pretty small blast radius. I shudder to think what harm he could have done if he had actually applied himself.
He did win. The only way to say he lost is by focusing on a measure that everyone agrees isn't the one that matters.
It’s not like it will change too much anyway(EU and USA will be like Italy in few weeks, they already have the infection spreading). Besides, it was “just a flu” few days ago according to him.
If you're trying to draw a cordon sanitaire, then why leave out the busiest hub in the region? I don't see any indication that there's any intention to prevent people from the Europe getting to the US via indirect means (which includes Canada, Iceland, and it seems even the Azores).
And if you're not trying to draw a cordon sanitaire, why go to such an extreme measure? Banning entry of people who have visited afflicted regions in the recent past (as was done for China) is possible, so why not do that instead? Why ban cargo in addition, given that the coronavirus is thought to be unable to survive the week-long voyage without live hosts?
Furthermore, why include Ireland (an island nation so far relatively unaffected by coronavirus) in the ban, but not the UK (an island nation with greater connections to continental Europe, including a connecting tunnel, that is more heavily affected)?
My concern is how economies are going to respond to the US being cut off from Continental ports for a month, which as far as I can tell hasn't happened since U boats were in open waters.
Can anyone comment on supply chains that rely on Europe to source goods? I know medical grade steel comes from over there, but I don't know what else.
Edit: apparently the president misspoke.
Numbers are about to spike everywhere pretty much no matter what anybody does, because better testing and funding has become available.
Quarantining an entire continent, and even worse than this badly doing it, seems to be an astonishing overreaction. The average age of death for coronavirus victims is 83. The mortality rate seems to be as low as 0.6% in South Korea or as high as 5% in Italy. Italy is especially vulnerable because it has the oldest population in Europe which is one of the factors that is leading to the 5% figure from there. It is not an End of Days zombie apocalypse.
I recently watched a speech by a US mayor which essentially said that the panic over Corona is going to do much more damage to people than the actual virus and I tend to agree. Simple quarantining measures mixed with best practices for infection control until we have more information about the virus seems perfectly fine. Blowing up the global economy is complete overkill and is a typical move from an administration whose response to topics are either to ignore them or sledgehammer them.
https://www.flattenthecurve.com/
1. Reducing the transmission rate lowers the total number of people sick at one time. Lowers the ultimate number who contract it. And pushes the peak infection rate out.
2. The above numbers are very sensitive to r0.
3. An exponential when it hits looks like a wall. You end up with a significant percentage of the population sick at once.
Could be my model being shitty but it looks like at high r0 there is a momentum effect which drives the total number infected above what you would expect.
Note this is a “mean-field” model (everyone evenly mixed together) so take it with a grain of salt...
A few percent is a lot. World War II killed 3% of the human population, and that's where we're headed if we don't stop it.
The coronavirus, in a single country, has killed 5% of infected people and elder people or those with pre-existing conditions are majorly overrepresented in infection rates.
>World War II killed 3% of the human population, and that's where we're headed if we don't stop it.
This isn't just wrong. It's irresponsible for you to be saying these types of absolutely incorrect things.
I'm not sure how you think how critical it is. I personally have never had this issue and do not mind at all to lay still for a whole year to try to reduce the risk of this happening.
Unless all the people you love are over 80 (in which case the chance of them dying before Corona hit was not much less realistic than it is now) that sentance is just completely false.
Why spread such fear and misinformation?
Unless none of the people you love are over 70, that sentence is completely true.
Yes, killing 5% of infected people is serious, especially when viruses of a similar family regularly infect 20% of the population, and the population has no inborn resistance to this partical virus, and it is, provisionially, more infectious than similar viruses.
Simple models suggest we'll have 500k deaths or so by 2021. Of course, it could be less than that, but it could also be more. It's almost certain we'll end up with some days with a 9/11 worth of deaths; it's just a question of whether that's a few days or for months on end.
You're fearmongering, and it's bullshit.
Additionally, for someone calling others' claims bullshit, your numbers have no correspondence to reality. In Wuhan, the 3% number was for the general population; for the 70+ age range, it was ~20%.
In almost all examples in human history, whenever a disease stopped, it was either because it burned through most of humanity, or because people decided to make it stop. They don't stop themselves.
You're pretending we live in the 1400s. We don't.
You're pretending we will take no measures to control this at all. That's simply not the case.
the US gov't has spent the last 1.5 months doing nothing to contain this at all. ending flights from europe isn't going to do anything to help if they aren't testing people and preventing spread inside the country
We are testing people, and we are doing quite a bit to prevent spread inside of the country and out.
[1]https://www.worldometers.info/coronavirus/usa-coronavirus/
In short, you're lying with statistics.
But it is real and it has the potential to seriously damage the economy.
A tanked economy will harm far more people than this virus.
If the ban gives sufficient reassurance to the chicken littles to induce them not to sell their stocks and invest in toilet paper, it will be a success.
The reason why it's going to go this way is because we won't have the capacity for everyone who needs critical care. And the reason we won't have the capacity is a) lack of proper investments imagining this scenario, where in Japan and South Korea they have this capacity because they've had this experience and know better; and b) lack of discipline to weld ourselves into our homes or even voluntarily self-quarantine in order to slow things down and effectively give us more critical care capacity.
I spoke to 1/2 dozen people today who are traveling. Three think they have this thing, and have 3 of 3 symptoms. I told them not to travel. They said "Oh well" and are traveling anyway. That's what we're dealing with. A total lack of personal responsibility, upon which both the free market and our democratic government is based - and so far this is about as far as we've come.
The European flights being cancelled, seems sane to me. It's not about 1 or 10 people being sick per plane. It's reasonable to assume after a 6-12 hour flight, that everyone on board is infected if there was even 1 person infected at the start of the flight. I don't know the exact number of incoming European flights per day, I think it's about 80-110K passengers? That's what this stops.
Stopping all domestic travel would be better. Short term pain translates into tens of thousands fewer deaths over the next 3 months. China got a handle on this for now because they welded people in their homes. We aren't doing that which means we haven't slowed it down that much let alone stopped it.
Stopping cargo, if that turns out to be accurate reporting, I think is an overreaction.
[1] - https://www.cbsnews.com/news/coronavirus-infection-outbreak-...
[2] - https://twitter.com/mlipsitch/status/1234879949946814464?s=2...
[3] - https://www.statnews.com/2020/03/10/simple-math-alarming-ans...
[4] - https://www.worldometers.info/coronavirus/coronavirus-death-...
[5] - https://www.kff.org/hivaids/fact-sheet/the-hivaids-epidemic-...
EDIT: I originally didn't post sources, so I backfilled those in and slightly tweaked the numbers to match.
EDIT 2: I adjusted the numbers again because as a reply points out one of my sources updated their estimates.
However, I do believe that a lot of inaccurate information is being presented. The public attention on this subject is enormous, making it a ripe topic for the media to profit from alarmist headlines.
[0]The source of the 40%-70% figure has since dramatically altered their estimates, and added several qualifiers.
[0]https://twitter.com/mlipsitch/status/1234879949946814464?s=2...
> Summary: Should have said 40-70% of adults in a situation without effective controls.
There's an enormous difference between 40-70% of everyone and 20-60% of adults - specifically if no countermeasures are deployed.
We should be trying to promote risk assessments that are situationally correct.
I mentioned that here - https://news.ycombinator.com/item?id=22552973
> [0]The source of the 40%-70% figure has since dramatically altered their estimates, and added several qualifiers.
> [0]https://twitter.com/mlipsitch/status/1234879949946814464?s=2....
After reading the entire thread, he didn't say "zero attempts to mitigate infection". He said "without effective controls". He also said " Increasing evidence that the extremely intense control measures in China have reduced transmission while they are in force. As long as such intense control measures are in place it is possible to imagine keeping the number infected well below 40%. I don't believe most countries (maybe not even China) can keep such controls for months or a year, the minimum time frame for potentially having a vaccine. But even more moderate ones if effective could reduce incidence considerably". Not even Italy has gotten to the extreme measures that China was implementing. Also if you read his more recent tweets you will see that he thinks the European travel ban is futile.
Overall it sounds to me like that 20% number that I have been using since your first post is the updated number based off of our current mitigation strategy. I don't see any indication that he thinks that number is too high given the current path. Once again, I am completely open to learning otherwise if you have something that you can point to that clearly states otherwise.
We don't know enough about the virus to predict almost anything about it and are learning more every day.
I feel like people have already made up their mind about this by reading some extremely poor sources rather than bodies like the WHO so are going to panic no matter what people say.
The best option here would be for me to come back in a month and we'll reexamine the comment. 625,000 is literally insane.
[1] - https://www.bbc.com/news/world-us-canada-51835856
[2] - https://www.wbaltv.com/article/what-percent-of-people-in-the...
I saw another seemingly reputable estimate today - some disease person on Joe Rogan's podcast, who was saying that 96 million people could get it, of which 48 million would need to be hospitalized. This makes no sense unless you are predicting a virus mutation. We're not even close to seeing 50% hospitalization rates.
I can. Look at how seriously China shut down cities etc and it still spreads, though much slower. Do you think western nations will take the level of action China has at all or in anyhting similar to the same time frames?
And to be clear, when I say 'I can' I'm not claiming Im right or predicting anything, I really dont know. But this seems as likely as any other scenario especially when experts are saying levels around this.
Source: https://futurism.com/neoscope/scientists-warn-coronavirus-mo...
You can spend weeks or months in therapy before you are recovered, or you can get scarring in your lungs - or worse - that leaves you with a permanent disability. Not to mention damage to other organs.
I think many are discounting, or are unaware of, these other nasty possibilities. We don’t know enough yet of the prevalence of these effects, but we do know they happen.
Given that we've only been tracking the virus closely for 2 months, and we've only had a decent sample size of patients for only about 1 month, you really can't be making claims like this at this point.
> Fatality is the wrong yardstick. Catching the virus can mess up your life in many, many more ways than just straight-up killing you. "We are all young"—okay. "Even if we get the bug, we will survive"—fantastic. How about needing four months of physical therapy before you even feel human again. Or getting scar tissue in your lungs and having your activity level restricted for the rest of your life.
[1]: https://www.newsweek.com/young-unafraid-coronavirus-pandemic...
Oil and other commodities also took a dump.
https://m.investing.com/indices/indices-futures
https://m.investing.com/commodities/
The last couple of weeks have been very profitable for "finance".
Each and every time Trump has spoken to this, as he attempts a mulligan for his last catastrophic bungling of it [1], his raw and profound unsuitability is laid bare (it is incredible that this point is even remotely contentious, as some people clutch onto denial with such vigor. For someone to still be a believer in Trump requires some serious mental gymnastics and/or impairment).
[1] - It was a hoax. The flu. An overreaction. 15 patients soon would be 0. A vaccine in a month. Contained.
His sole desperate need was to try to buoy the market -- it is literally the single and only thing he has going for him -- but unfortunately reality is ready to make its presence known the next day, not concerned with his chronic lying and bluster. Having an egocentric narcissist liar/grifter as POTUS turns out to not be a great thing. But I hear that Jared Kushner is putting together a response so everything should be great. He has the qualification of being married to Trump's daughter.
On the other hand, for long-term investors it doesn't seem like a terrible time to get into the market.
I don't see why commercial sea-shipping would be restricted.
Mariners may not be allowed to leave their ship while in port though.
Ocean liners that carry passengers take 4-5
> It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.
> In general, because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks at ambient, refrigerated, or frozen temperatures.
Which would you say is the most credible source then?
https://www.medrxiv.org/content/10.1101/2020.03.09.20033217v...
Any method of transmission that infects fewer than one additional person on average are effectively negligible on the overall exponential curve.
So yes, it is likely possible that symptomatic people can infect others, and it is likely possible that a contaminated doorknob can infect people for a week, but if these things happen rarely enough, it doesn't matter. The virus will die out if other routes of infection (e.g. the more typical person to person transmission) can also be made rare enough.
I apologize if this is coming off as pedantic but the damage being done by misinformation and speculation about the coronavirus is significant, and I don't think it's possible to be too zealous about precision here. Trump's claims that fears were overblown and a "hoax" have been amplified into widespread and potentially deadly skepticism that coronavirus is even a danger. People have suggested various quack cures that at best drain the resources of vulnerable people. Even saying something as seemingly-innocuous as "wear a face mask to reduce your risk" ends up having a devastating impact on healthcare providers who really need the masks but can't source them. We should be listening to public health authorities and mainstream health experts, and taking reasonable precautions, but absolutely refraining from speculation that might have unforeseeable consequences.
very low risk != no risk.
How does it spread then? Seems hard to believe all these people are being infected through hand shakes or being coughed on.
> The virus is thought to spread mainly from person-to-person.
> * Between people who are in close contact with one another (within about 6 feet).
> * Through respiratory droplets produced when an infected person coughs or sneezes.
> These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
https://www.cdc.gov/coronavirus/2019-ncov/about/transmission...
I mean, we have city parties here 'for all the family' which result in everyone touching each other (just as friends mostly of course but still touching hands, shoulders, neck, face, back), kissing (mostly on cheeks with strangers, but you mostly 'friendly' kiss everyone meet/talk/dance with and otherwise shake hands or even both) but all the other factors do apply as well; bad/no toilets, no soap/water, everyone drunk so who washes their hands anyway, vomiting and not being so careful with putting your sleeve in front of your face when you sneeze or cough... I only go during the day to such things if I go at all (when most people can still walk up straight) because it is rather disgusting after a while (I am old; I used to like that when I was young), but I can see a few people infecting basically everyone if they are popular/drunk enough.
How do we explain spreading from asymptomatic people? They're not sneezing.
And it’s the small droplets that float around the longest. These penetrate deep into your lungs and get stuck there.
So there's a constant conflict between simple and easy to understand but not totally correct info, and scientifically correct but incomprehensible to most info.
Someone sneezing in your face = really bad. Someone sneezing an hour ago vs. touching something they just sneezed on... hard to say which is worse.
The CDC themselves were involved in the study that says you're wrong.
If someone is able to find the source for this info I'd really appreciate it. Just spent like 10 minutes trying to find the paper they're citing but I can't find it and I don't have time to keep looking now. Maybe it isn't published?
It might be this one, actually. This one suggests it can live up to 72 hours on certain surfaces. https://www.medrxiv.org/content/10.1101/2020.03.09.20033217v...
I'd love to have some more data on this if anyone can provide.
Even a day is a long period of time in optimal conditions, and not many situations are close to optimal.
https://news.trust.org/item/20200228215640-n07fz
It's a half-life thing. The larger your initial sample, the longer the sample can go and still have enough infectious ability left.
Scenario: Infected person sneezes over a large area and deposits over a wide area. Then you come by 6 hours later and touch a deposited surface and then 10 minutes later touch your eyes.
Each transition only picked up a fraction of what was left.
And each time period left only a fraction of what was there.
More important to limit travel, limit direct/close contact and clean commonly used surfaces frequently.
And better to avoid replicating the environmental conditions that created the "up to 9 day" figure: low temperatures and low humidity.
Me either, but Trump did seem to say that. Vaguely. Stand by for "clarification".
Based on the localized infection cases I see across the US and have been watching as well as the characteristics of the virus (life outside host/on surfaces, in air, the degree of asymptomatic transference, etc.), it's well beyond containment IMHO.
Travel isn't going to do too much to reduce infection rates alone. We need significant cultural changes to reduce infection rates, but I don't see that happening for a variety of reasons. This country isn't about proactive action and is all about reactionary action though, so we're just waiting for that reactionary threshold. Some preventative measures have been pushed but they're no where near aggressive enough at this point.
It will be interesting how this is handled in our modern cultural, current political and work culture, etc. I suspect it's going to be fairly nasty but certainly hope not. I've been advising my parents to stock up and minimize any outside interactions for awhile.
I'm considering the USA fully seeded at this point.
Even if you think you have it, there's still not enough test kits available yet - even if you're swabbed it can be days for a result(Saying this from west michigan).
To be clear I'm not saying more infections are a good thing, simply that if there are a lot more cases that already exist, knowing they exist and having more accurate data that shows us COVID19 is less harmful than currently perceived/projected would be good for everyone.
The president did claim that some criticisms about his handling of the situation were a "new hoax" in the same way he has labeled previous unfounded criticism and accusations as hoaxes.
Huh?
He called Fox News and said on air ""So if, you know, we have thousands or hundreds of thousands of people [with COVID-19] that get better, just by, you know, sitting around and even going to work, some of them go to work, but they get better,""
His whole schtick until just about a few hours ago was that the risks were all hugely overblown.
I am also curious to know exactly which "previous unfounded criticisms" you are referring to.
Yes. Yes it is. How many times has Trump tweeted about the stock market and how it proves he is a great president? Hundreds. Literally. His NEA chair has explicitly stated "I have long believed that stock markets are the best barometer of the health, wealth and security of a nation. And today's stock market message is an unmistakable vote of confidence for the president." His entire political argument for reelection is premised on his "business acumen." His down playing of coronavirus (to what end? why?) was a blatantly partisan attempt to gamble that this whole thing would blow over rather than risk spooking the markets.
It matches this article on restrictive testing.
https://www.theatlantic.com/health/archive/2020/03/coronavir...
Long distance travel and exposure to those who have been (e.g. hugging your wife got off a plane from Spain 2 days ago) is still a top predictor for exposure.
Which is exactly why everyone with those symptoms needs to be tested. One of the most important things we need to do right now is detect the people who got the virus through community transmission.
> Long distance travel and exposure to those who have been (e.g. hugging your wife got off a plane from Spain 2 days ago) is still a top predictor for exposure.
I'd say that testing those people should be lower priority, since an assumption they're infected is more likely to be accurate, so they can take preventative measures without needing a test.
This. I'm in my twenties so it's very possible for me to get COVID and only experience cold like symptoms (or less!). I'm sorry to everyone, but I won't self-quarantine myself for 14 days just because I have a stuffy nose (it's likely a cold right?). I'm fortunate enough to have the ability to take time off/work remote - but what if it's a cold this week and COVID in two weeks? I can't take a month off.
I'm from West Michigan - ATM there's very little testing available, and I'd only be tested if I had recently traveled. But we're past the point where recently traveling is such a big indicator - we're seeing plenty of community transmission for me to believe it's very likely everywhere already, and any lack of cases is because of a lack of testing.
Overpay for an extreme case rather than adapt your system around it.
Now, I have other complaints about our system and how it is unsustainable, but this is a poor argument as to why.
The messaging on this has been pathetic. The other day UW in Seattle announced they had a capacity to test 1,000/day. Not adequate for the nation, but for the PNW, sure.
https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-pcr-detecti...
https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-pcr-panel-p...
ETA: I'm having trouble locating positive control template sequences.
I am happy for S. Korea running 100,000+ tests, and embarrassed that the US has maybe run 1000s at this point. I also think that the virus is widely dispersed in the US and the best we can hope for is to keep the case load at a level manageable by our health care system. I'm pretty worried about that though.
Akin to how securing a network is more than setting up a firewall at the perimeter.
At this point, the only rational thing to do is to try to slow the spread. The good news is that this is a very mild virus, and the vast majority of infected people will have minor symptoms. The fatality rate in Korea is currently 0.6%, and becuase of the comprehensive nature of their testing, this should be considered the upper bound on CFR.
Regarding the rise in CFR: it will naturally go up as cases decline, because fatalities stem from a time when the case rate was more rapidly increasing. Korea’s case rate had been declining for several days:
https://mobile.twitter.com/AdamJKucharski/status/12297080012...
https://www.google.com/amp/s/www.nytimes.com/2020/03/05/heal...
At some point, this scary story is going to have to be adjusted to reflect reality.
Buy a stool for crying out loud, they're like $10
In comparison, Korea's response was disastrously wrong. Their "Let's test everyone" policy sent lots of people into medical limbo ("We can’t let you go because you're COVID-19 positive ... but meanwhile we have particularly nothing to do for you because you're not that ill") and got their hospitals flooded with mild cases.
But more importantly, you’re not dying and not clogging up a hospital. That’s what’s relevant to this discussion.
It will be a big problem both in Europe and in the US, because they are starting to take measures only now.
The vast majority of cases are mild, like a head cold. This is a fact, and has been reported around the world.
You’re arguing about relative hospitalization rates, but that has nothing to do with the discussion here. Mild cases aren’t clogging up ICU wards at all, because they’re quite mild.
That's the exact opposite of what the WHO said when they made the pandemic declarations:
"We cannot say this loudly enough, or clearly enough, or often enough: all countries can still change the course of this pandemic," reads a statement from Tedros Adhanom Ghebreyesus, director-general of WHO.[1]
South Korea has shown this to be correct.
[1] https://www.usatoday.com/story/news/nation/2020/03/11/corona...
I think you mean that this should be considered the goal upper bound on CFR. It's really the lower bound on CFR if you do everything right. If you do everything wrong, like the US is heading towards, you get overloaded health systems, critical shortages, and a 12% CFR or higher.
I think the true measure will be the year over year total mortality.
If we overload our hospitals then CFR will go towards the number of cases that require hospitalization. Which is around 20%. Italy is currently far over hospital capacity and has a CFR today of 8% and rising.
Media and government keep making this claim, yet where are the recovery numbers of people? It drags on for weeks and weeks with no end in sight, correct? And current case fatality rate in Italy is 8%, was 7% this morning, was 6% yesterday - because they do not have hospital resources for the number of serious cases they have.
Serious, critical, and dead outcomes are said to be over 20% of case. This being described as "very low, a very small number" by certain people. That is not a low number at all.
YES! Restricting US<=>EU travel is just about the least useful thing we need to be doing right now.
"In fact, officials would later discover through testing, the virus had already contributed to the deaths of two people, and it would go on to kill 20 more in the Seattle region over the following days." [1] https://www.nytimes.com/2020/03/10/us/coronavirus-testing-de...
Thankfully all of us seemed to get over it without much complication, and it doesn't seem like very many of the people we've since interacted with have come down with it. We might very well have just been lucky, though.
Los Angeles → Catalina Islands → Ensenada → Los Angeles
> and were there lots of mainland Chinese people on it?
I mean, I didn't exactly go around asking people "are you from China?", but based on the number of people who sounded like they were speaking Mandarin I'd tentatively answer "yes".
> Sadly the symptoms for CoVid-19 are pretty common across a variety of diseases, so “flu-like but not flu” doesn’t necessarily point to this.
Indeed, which is why I'm still at least somewhat skeptical. Still, it's hard to rule it out, especially given the relatively-severe symptoms (not the absolute worst I've felt, but it was pretty bad).
That said, you'd be surprised what draws tourists from mainland China; Las Vegas and Reno (for example) both get plenty of Chinese tourists looking specifically to gamble, and I'd imagine the ship's onboard casino to have a similar appeal. Plus, there were plenty of other tourists from long distances, too, both from within the US (East Coast) and from Europe and Australia (from what I gathered from the people whom I did talk to). So evidently there were at least some non-Chinese tourists flying thousands of miles for it; seems reasonable that some mainland Chinese tourists might, too.
We are unlikely to ever find out, because we won't have a reason to give everyone antibody tests
No "massive uptick" yet, but there are quite a few every week, so it could be that it's still blending in with non-COVID pneumonia cases.
Indeed. There are typically above 3000 deaths/week due to Pneumonia and 200/week due to influenza at this time of year. We had a smallish spike in mid-late January, where for 3 consecutive weeks, deaths were above trend at nearly 4000 & 400 per week.
If you assume a 1% mortality rate for COVID, and you assume all deaths are due to pneumonia, and you assume the entire late-January spike is due to COVID, that could be hiding 300,000-400,000 US cases. (To be clear, those are all questionable assumptions! The mortality rate could easily be either lower or higher, a meaningful fraction of deaths might not show as pneumonia or influenza, and it is normal for there to be a moderate spike above trend at some point in the flu season)
That doesn't mean that there were or weren't a few hundred thousand cases in that time -- it just means that some significant number of cases could easily hide in "routine-looking" spikes in the graph.
This does mean, though, that it is unlikely that everybody who got "the really bad flu" that's been going around this year actually had COVID -- but, especially if you live in a place with lots of people who travel to China regularly (like I do!), it isn't unreasonable to wonder if that "really bad flu followed by a lower-respiratory-tract infection that tested negative for influenza" you got in late January/early February wasn't really COVID.
(Remember, though, that while the rapid influenza test has a pretty low false-positive rate, it's got about a 50% false negative rate -- so testing negative shouldn't lead you to assume it isn't influenza)
Critical cases and fatal cases are way more likely to be detected for this reason -- but during the 3 weeks I was talking about, it was believed that there was no COVID in the US, except for folks evacuated from China to quarantine sites.
During that time unexplained pneumonia leading to death -- especially in an older individual -- would likely not have been thought to be COVID, and would just have gone on the books as pneumonia.
This depends on how you're defining containment. Grounding aircraft may not decrease the current case count, you're right, but it may help not adding to it, or adding as much, or as fast. Because of this, it may still be worth doing.
The notion that we're going to abandon containment measures in favor of mitigation, which I've seen in many places (not in your comment though of course), is wrong. We're going to be doing both.
All reductions in (non-essential) travel are good in a pandemic. That doesn't mean it's sufficient, but it's something positive.
I think we would all like to see stronger social distancing rules domestically (in the US), but here the US has a problem as it granted the President broad discretionary powers to suspend international travel but not domestic gatherings, which can't be banned via executive order and even if congress were to pass a law banning such gatherings, there would be first amendment implications as well as federalism issues.
It's not easy to pass a law giving the President this type of power and I suspect many in congress already rue passing the laws that gave the president power to suspend international travel. That's one of the prices of living in a federal government with separation of powers and a bill of rights guaranteeing right to assembly rather than in a place like China.
For example, the CDC has issued social distancing guidelines but they are only guidelines not laws: Santa Clara county has said "no thank you we'll follow our own guidelines" instead, when the CDC asked to ban meetings of more than 250 but Santa Clara banned meetings of more than 1000, and just refused to change their target to the CDC recommendation.
So the US simply lacks the tools that would allow the President to go on the air and announce "I'm declaring that the MLB season needs to be delayed and Disneyland must close." He can try to exert pressure, or rather have the CDC exert pressure, but these types of declarations are not going to happen in America.
Their point is that there's absolutely no effect of banning travel between two areas with similar prevalence, based on rather simple logic.
Take two bags with mostly white and a similar number of red balls in them. Then, twenty times, grab one hand from each bag and empty it in the other. What's the expected change in number of red balls?
By your last analogy, the red balls would have paint rubbed off them in the exchanges.
When the concentrations in the US get higher it will start to make sense to constrain travel more over there. Right now the chances a domestic flight contains an infected individual is quite low, but that won’t always be the case.
Bear in mind the virus cannot be stopped, or contained at this point. All we can do is slow it down while also limiting the harm our countermeasures cause.
Saying the virus cannot be stopped seems defeatist. China seems to have managed it locally, albeit with some very aggressive measures.
That's what you're proposing, if you don't realize it. If you get the growth rate below 1, you can wipe out the disease, instead of merely delaying it.
By your model, some reductions in travel ought to have a negative effect. Is that a fair corollary?
Limiting all Schengen traffic is an extreme example, but it's not obvious that some level of restriction would necessarily produce a significant bottleneck effect (given that citizens are exempt).
Multiple cities with hundreds of thousands of people in both the US and Europe are infection free right now. Extending that for even a few weeks is very useful.
But this is clearly false because population density is another important factor for contact between people.
I don't know how strong that actually is. Over the past few years, we've seen some Trump work the courts pretty consistently. Even if his administration is doing something explicitly unconstitutional, running something all the way to the Supreme Court can take 6 to 18 months, during which time the unconstitutional order would stand (if not stayed early on).
China, South Korea, Taiwan, Singapore and Hong King all slowed the curve, and have rules governing their whole country.
At any rate, no, a town that has 50 people per square mile should not be forced to respond in the same way as some city with 50,000 people per square mile. In the meantime, the people of Fargo have all the relevant information and their local officials can make calls as needed to suit their demands.
Long term, I think some mechanism to mandate more social isolation is going to be needed.
For example when travelling from California to Arizona, there is currently no quarantine area or checkpoint, and that's fine if you want free movement, but then it's harder to say that states should run their own pandemic policy as long as there is free movement between states.
And this is a general trade off. More interconnected world => localism is less viable as a means of countering global threats.
But I'm just a cynical man. It could very well be something else and I'll be very interested to read about this emergency once it's all behind us.
Yet we can't.
That's crazy and it has to change.
https://en.wikipedia.org/wiki/Michael_Chertoff
Similarly in Puerto Rico after Hurricane Maria, a politically connected one-man "energy company" called Whitefish, with no experience or skills, emerged out of nowhere and was given the contracts to rebuild the entire Puerto Rican grid.
Months later nothing had happened other than he hired a few people as unskilled as himself who were just dorking around down there, while people died.
So they fired that guy and hired another company called Cobra, with the same terrible terms, and the same ineffective response. Eventually it was found out that Cobra people had paid massive bribes to officials to ensure the deal.
https://www.nytimes.com/2019/09/10/us/puerto-rico-fema-arres...
The whole story of Whitefish being unqualified is just corrupt politics. Subcontracting is a legitimate way to get the work done.
The NBA just suspended their season "until further notice".
Isn't there an obvious compelling state interest?
All travel is essential to somebody. All restrictions on movement also have a cost, and any analysis that only looks at the benefits of something without looking at the costs cannot hope to be correct.
But we can consider the downsides and decide that we want to restrict travel.
I don't actually need to go visit my rellies. I want to, but I don't have to. On the other hand, if I go on a voluntary trip, I probably have to return home because I can't really afford a hotel indefinitely into the future.
So it's obvious to me that there is some distinction between necessary and nice to have.
I genuinely have been underwhelmed by the reaction to this disease through much of the world. It is necessary in a constitutional democracy to react sometimes to maintain the trust of the voters - or they might say "A democracy is fine when things are going well, but when the chips are down we need a strong leader who can make the decisions we need". Saying "those entertainment business can't open during this outbreak", "keep your tables at least a metre apart" and "don't travel" are reasonable reactions in this circumstance. And we need democratic leaders so that they can know when it's gone on for too long and they have to accept we can't stop it - something a "strong leader" can't tell.
I travelled to starbucks today. I’d hardly consider that essential.
But OPs point stands -- unless you're working from home and never going out to eat / get groceries / not go crazy from cabin fever you have to travel somewhere
Restricting routine trips to just home-to-work, work-to-home, and large-scale resupply missions is still acceptable at the moment. Make use of your local grocery's picker service with delivery to the parking lot, if you can.
Consider switching your dining-out trips to ordering via phone, fax, or electronic ordering system, and doing drive-through, carry-out, or parking-lot pickup. Pay electronically, in advance, instead of handling cash at the point-of-sale terminal. If you get cabin fever, and need to socialize, do it through screens.
It is essential for Starbucks to serve customers in order for them to stay in business. You don't have to stop going. But you can put in your order via website or app; walk into the retail location only when it's ready; pick it up without speaking to, breathing on, or touching anyone; and then leave immediately. It is possible to minimize the duration and intensity of contact, without eliminating it entirely.
It is better to be in contact with your regular friends, acquaintances, and business associates--that are all the same people every day--than to have a lot of transient contacts with complete strangers. It is slower to traverse a social network one connection at a time than to hit a lot of random, unconnected people all at once with a brodcast.
I assume the U.S. government will be pumping money directly into the hands of small businesses and employees.
Not at all.
https://www.flattenthecurve.com/
There is a lot more leadership across government (federal, state, local), private industry, and independent individuals could be doing to proactively reduce transference and even stomp out significant portions of infection is followed through. My point is that our cultural trends surrounding all of these (governments, work, personal action) are almost all running counter to what we need to be doing.
We need strong government leadership at all levels pushing support out where possible, be it resources, accurate non-politically influenced/dictated information, etc. Businesses can be more proactively supporting work from home more where feasible, extend sick leave or create sick leave options to reduce pressures to work, provide some security/continued employment for those who need it (especially demographics at high risk). People can avoid attending work when sick, reduce/limit public exposure (be it out shopping, attending an event, etc.), practice frequent hand washing, limit exposing themselves to at risk populations, etc.
Economically it's a disaster (as the markets are also anticipating) but it's going to be one way or another. It seems to me that you're better off to take a well calculated hit that can bounce back to a healthy workforce that doesn't strain existing healthcare infrastructure than trying to pretend nothing is going on, minimal fallout will occur, and play-it-by ear.
Too bad money making is somehow above preventing others getting sick. People wouldnt show up to work if they didn't have to worry about their wages. I'm sorry but 3 sick days is garbage and requiring doctors notes is asine when your healthcare plan is shite. Not to mention wasting a day in a hospital. Companies can afford this stuff. It's not often and it's minimal to say the least. But God forbid a small business can't have someone for 80 hours a week at minimum wage!
Now I will not attempt to speak for Europe but the US government could certainly push short public advisories and messages to adults and children through broadcast TV and even get the cooperation of streaming services as well. Short thirty to ninety second spots that give helpful non panic information.
The US President is hamstrung by both political disagreement and the law. There were articles he is loathe to declare any national emergency declaration until approached by the governors of many of the states. If he did without states approaching him and asking you can damn well guarantee there were would be Democrats out there claiming he was trying to be a Dictator and comparing him to Putin. The same article concerning the declaration also reveals all the behind the scenes work going on with Congress to get funds in place before any message is put forth so that the government as a whole looks to be cooperating as well as acting appropriately.
edit: air cargo flights between US and Europe also suspended
There are tens of thousands of incubating cases in the United States already. How exactly is a few dozen sick passengers per day going to affect that at all? You'd have to literally be picking up and flying in planes full of active cases to even match what we have here already.
This is insanity. No one with any expertise at all recommended it. No one serious thinks this is a good idea. It's not going to do anything useful at all.
I can't even tell if this is supposed to be about Trump. Also it doesn't matter.
There are thousands of borders and even more politicians on this planet and if you don't think borders are the scapegoat for problems the world over, then you're really thinking very small.
Don't look into yourself and see what can be fixed, always blame the other.
Unfortunately this kind of measure is going to increase the R0 of the virus, because some people will think "oh I see, the virus is over there, and now the president has closed off that vector."
I'm not saying the measure suffices. Obviously domestic travel is also a big issue, as is travel from outside the Schengen area. But being one of the people affected (currently in Schengen), I still believe this is a right step. It might not slow infections down enough but it will certainly prevent many cases. Also, it will remind people how serious the situation is.
>You'd have to literally be picking up and flying in planes full of active cases to even match what we have here already
Even one person with corona can do a lot of damage.
For example, a singular person boarded Diamond Princess. The ship had 696 confirmed positive cases and 7 deaths from 1 person who had the virus.
Clearly there are clusters throughout the United States. Unconfirmed, unrecognized clusters. And with the adversity of many to utilizing health care, it seems impossible to deal with now.
It's also worth noting that this flight ban applies only to non-Americans, just as the Wuhan restriction before did. During the prior travel restriction dozens of flights a day were going to and from Wuhan -- they just had Americans on them, who apparently aren't susceptible to the foreign virus. This new restriction is identical, allowing Americans to march the globe with their COVID-19, but at least they kept out the foreigners.
Instead of any actual efforts it is again mere security theater. And again Trump will pat himself on the back for his very-close-to-useless theatrics.
Here's the perspective of a San Jose public high school [1] proving that containment isn't a concern:
> Oak Grove High School officials said they were not considering school closures because “children have not been shown to be a high-risk group for serious illness from this virus.” The Centers for Disease Control said last week that limited reports showed child COVID-19 patients in China had generally presented with mild symptoms.
> “As much as possible, children should be allowed to carry on with their education and normal activities,” school officials said.
Related, a family member received a "exposure notice" from her child's school that one of the students tested positive. No closure.
There's no attempt for containment in the US. My hunch is that it's not needed as much as is being suggested by some. I guess we'll see.
[1] https://www.mercurynews.com/2020/03/08/oak-grove-high-school...
Well presumably they'll always allow non-Americans to leave. As for americans, they would still have to wade through quarantine or whatever restrictions the other country requires.
For entry into the US, does the govt even has the power to keep americans and permanent residents from entering? Seems like every country will at worst only quarantine its own people.
The point is that the action is farce. Those flights to and from Wuhan were always full of primarily Americans, and continued unabated. Just as Americans can still fly to and from Europe, though obviously carriers are going to drastically cut the flight counts.
Regardless, it is without an ounce of doubt that COVID-19 is spreading, completely uncontrolled, throughout the US. Italy is a week or so ahead of the United States, but sadly the most probable outcome is a catastrophe in the near future.
You know all of the stuff that's made in China? The machines that make that stuff are made in Europe. Well, not literally the ones that make the stuff in China, but the ones that US companies would buy if they were trying to manufacture more stuff domestically to replace the stuff they can no longer buy from China.
It's a massive export sector for the EU (€127bn), and a chunk of that is to China, but the easily-available statistics lump machinery and vehicles, so I don't have a source.
But by no means end-of-world serious, all life critical things are still getting through. also money buys a lot, even cargo space on ships and planes.
I don't see them restricting the rest of asia specifically unless they close it ALL down.
But if an Asian country’s cases quickly spikes, pretty sure Asia will be shut down in travel to US
The United States has a very individualistic attitude. Sure, we can pause travel from Europe, but the current administration is very anti-europe. Can we pause travel in the US? I strongly doubt that we can effectively given the strong anti-expertise attitudes as well.
My guess is that the United States will become a more major hot spot for the virus than other locales. It will spread rapidly and the supply hoarding and sad state of our medical system will mean that in a few months, other nations will be rejecting flights from the US.
It's a prediction, a guess, but there are aspects of our culture that just makes it seem very likely. I'm not going to make any more predictions than the idea that we'll have more cases per capita than any other developed nation.
It's be interesting when I'm proven incorrect over time.
I think there's more of the latter.
So less dramatically: individuals can (and will!) reduce their exposure to infected people that make poor choices.
Of course the more people that do the right thing the better, but it isn't a situation where the outcome is controlled just by the worst actors.
(I'm being sarcastic, but changing the exponent is (literally) what all the public health messaging about flattening the curve is about)
Community mitigation changes the rate.
https://www.khanacademy.org/economics-finance-domain/core-fi...
By that logic, unless you hermetically seal yourself from the outside world, you are still putting everyone else at risk.
And in either case, by that same logic, isolation apparently doesn't matter, so might as well still go to the bar.
In Europe by contrast, much more of life revolves around public spaces, like the park, cafes, the city square, and public transport. Americans tend to spend little time in restaurants, whereas Europeans relax and enjoy the meal, thus increasing their exposure time.
Think of the areas in the US that seen the worst outbreaks. Seattle, the Bay Area, New York, Boston. These are the metros, where the average resident is least likely to live a typical middle-American lifestyle. San Francisco in many ways is closer to Copenhagen than it is to Jacksonville.
Overall, social distancing is probably easier for Americans because our way of life already involves a good deal of social distance to begin with.
Also traffic is great now. One good thing to come out of this is that governments might see the huge infrastructure benefits from just a small increase in remote workers.
https://newsroom.airasia.com/news/2020/2/29/eng-aaunlimitedp...
No they don't. No one in NYC, Boston, San Francisco, Seattle, ... have big garages to stockpile supplies and most of the US lives in those big cities with apartments without garages.
In the suburbs they do but that's a minority of the population.
https://en.wikipedia.org/wiki/List_of_most_populous_cities_i...
People in the suburbs do have big garages (think long island vs manhattan)
https://www.citylab.com/life/2018/11/data-most-american-neig...
https://www.pewsocialtrends.org/2018/05/22/demographic-and-e...
> About 46 million Americans live in the nation’s rural counties, 175 million in its suburbs and small metros and about 98 million in its urban core counties.
> As a group, the population in rural counties grew 3% since 2000, less than their 8% growth in the 1990s. Urban county population rose 13% since 2000 and the population in suburban and small metro counties went up 16%, growth rates somewhat higher than in the 1990s.
It's hidden in plain sight: you mention "Boston, San Fransisco, and Seattle" in the same breath as NYC, but numbers-wise those are all pretty small and you're leaving out not only their suburbs but also the LA, Chicago, DFW and Houston areas which all have considerable amounts of suburbs and single family living, and hold almost 40M people alone...
I think most of San Francisco by area is zoned "RH-" (Residential Housing), and most of that RH- area is RH-1 or RH-1D (single family). Most of the homes in those regions have lots of space.
We're not just talking about Zuck's mansion either, plenty of homes in the Sunset or other West SF areas that have that kind of room.
Have you? Most of the US urban population in the US fits the points of the OP:
- Very few people use public transportation regularly (they use cars, in the cities, yes)
- Most people have private back yards (the infamous "American suburbs", where 50% of Americans live, count towards the urban population you mention)
- Many more meals are take-out or drive-thru
- More Americans use e-commerce for shopping than Europeans
Poke around https://www.hemnet.se/topplistor
What the OP was saying is that americans don't eat out that much, is a very heavily home-oriented society - thats why the OP mentioned take out and delivery - not going out for lunch.
And yes people out of cities in nearly all countries have big backyards, but you are missing the people have big back yards in the US EVEN inside city limits. There are ofcourse the couple exceptions like NYC etc. but mostly even big cities have the weird suburban style houses even in the most expensive areas!
> you are missing the people have big back yards in the US EVEN inside city
hardly.
What will happen or won't in US or Europe is not anymore dependent on these behaviors.
I don’t think I know anyone who haven’t ended up in a house eventually tbh.
> The World Bank.
Here's some direct links though:
- https://data.worldbank.org/indicator/SP.URB.TOTL.IN.ZS?locat... - https://data.worldbank.org/indicator/SP.URB.TOTL.IN.ZS?locat...
While that's true, behavior trumps lifestyle I think. I had a dentist appointment scheduled for this morning in San Francisco. I called my dentist office and explained that my wife has some mild-flu symptoms and asked if we should reschedule. They said that's since I don't have symptoms myself it's not necessary to postpone the appointment. That may happen in Jacksonville too.
Do you have a source for that? I couldn't find a great single source but this says 9% of retail sales were ecommerce in Europe in 2018:
https://ecommercenews.eu/ecommerce-in-europe/
and this says 8% in the US in 2018:
https://www.invespcro.com/blog/global-online-retail-spending...
If you treat North and South Europe separately, it looks like Northern Europe has most ecommerce, then the US, then Southern Europe.
Stopping the CTA would virtually shut down Chicago.
This is FUD. That isn't where you risk getting sick. The countries with the most effective response to COVIR-19 doesn't even try to stop everyday shopping or movement in cars at all.
>In Europe by contrast, much more of life revolves around public spaces, like the park, cafes, the city square, and public transport.
You don't get sick by being in a park or city square with someone else. More FUD. Please do some reading on the appropriate measures and what actually constitutes a risk of infection.
- we have a better healthcare system than is US (better as in public and for everyone)
- we own the most cars per capita in the west and are second in the world, public transport wasn't a big factor in this pandemia here
- food is much more controlled and we have a tradition of home made, home grown food, that doesn't require to go to the supermarket
- things are closer so trips are shorter and you can shop at many non packed smaller shops
- we react better to panic and are not armed
- infection has spread in small cities in the country where houses are larger, they have more storage, don't use public transport and social distancing in theory was easier
All in all, there are many ways to look at this
Wait until all the coronavirus infected hourly workers, who can't get treated because of a lack of healthcare and who have to continue going to work so they can pay rent, infect everyone through the take-out food :)
One other factor in the US favor, it’s extremely low population density compared to the rest of the world. The US, Canada, Australia, and New Zealand are all similarly low density and in this specific case likely to benefit from that.
Such as??
I'm living California, outside a major city. I don't see anything.
Cities and counties in CA had been doing the same with different thresholds. Which meant an NBA game was going to be played without fans (since then, the NBA season has been suspended, which is a pretty significant measure in and of itself).
Many schools have been closing in the Seattle area, and just today the Seattle school district, and many outlying school districts closed for at least two weeks. That's a lot of school closures.
Many companies are having employees work from home wherever possible. The amount of traffic in Seattle during rush-hour is an astronomical change. There's very light traffic during rush hour in places that used to be wall-to-wall vehicles.
As someone living in the Seattle area, it feels like life has substantially changed.
https://www.usnews.com/news/education-news/articles/2020-03-...
Washington Gov. Jay Inslee said he’s banning gatherings of more than 250 people in several counties.
https://www.cnbc.com/2020/03/11/washington-state-bans-large-...
Many local businesses have soft-closed their offices at behest of city including Amazon and Microsoft.
Gatherings are also being shut down. Public meetings are shutting down.
What else would you have them do?
I don't know if they're all just being exceptionally prepared or if there's plans for a more widespread school shutdown here.
This now includes Bellevue School District (Bellevue WA).
King (Ground Zero, US), Pierce and Snohomish Counties all have a ban on any event with 250 or more people (this was declared by WA State's governor)
City council meetings are being conducted remotely.
University of Washington has moved all their classes online for the remainder of the semester.
laughs in jersey
----------------------------
Wuhan Central Districts
population: 6,434,373
density: 7,242/km2
----------------------------
New York
population: 8,398,748
density: 10,715/km2
I'm not sure the average population density across the entire country is that relevant - it doesn't tell you anything about the distribution of population.
The US is actually rather an urban country - 82% live in urban areas which is more than Italy (75%):
https://en.wikipedia.org/wiki/Urbanization_by_country
Edit: Also noticed that Australia is 86% and Canada 81%!
Half of the US population lives in the suburbs (see above posters). What we would recognize as a real urban environment only accounts for less than a third of the US population (98M people).
I did see a figure of about 55% of everyone in England and Wales living in suburbs - but I suspect our suburbs look pretty dense to someone from Houston or indeed Achiltibuie!
I mean, Berlin has 3.7 million people in a city of 890 sq km. Melbourne has about 5 million people in a city of almost 10,000 km. They're incomparable, and so the urban population of Australia and Germany are incomparable. (You can play with the definitions as much as you like but you'll never be able to compare arbitrary Australian and German cities.)
Many parts are really not as collectivist as people seem to think. Not as collectivist as Asia at least, not even close. Individualistic tendencies are strong over there, although not as strong as in the US.
I guess it's all down to the economy, business travel spread it a lot. that's why areas with strong economies seem to be affected more than others (at least in Spain, Italy and Germany). Banning travel could work quite effectively for that.
Are you saying Spain and Italy has strong economies?
For Italy it's the North, for Germany South & West, for Spain the regions around Barcelona & Madrid. In each case, they were hit hardest. I don't believe that this is coincidence. There are other factors, like wealth leading to more travel and general, as well as population density. But interconnection by economic activity looks to me like a major factor.
And yet here we are the next day. The situation is evolving rapidly.
Meh.
Your personal risk to become infected via $generic_domestic_holidays is pretty low, but the risk to increase the overall threat-vector by allowing open flights from domestic zones is very high.
The personal assessment just differs from the supervising political assessment, while the observed/assessed situation is exactly the same. Also: be careful with "experts", whenever that label is used, you should be very wary. A "medical expert" doesn't inherently know anything about politics at scale, he just (simplification alert) knows which medication to apply when which symptoms arise.
"He [Trump] said he would instruct the Treasury Department to “defer tax payments without interest or penalties for certain individuals and businesses negatively impacted.”
Why deferments for businesses? Don't they only pay tax on profits?
Or just travel originating from Europe and going inbound to USA?
Travel to and from doesn't lower the number of infections in the US, assuming prevalence is about equal on the two continents.
The virus is already here and has been spreading out-of-control for quite a while now. The only reason the numbers are still so low here is the incredibly low number of tests being done.
And just like Italy went from "contained" to a country-wide lockdown in the space of a week, so will we at this point. Those tens of thousands of cases are incubating right now and will emerge in the coming days.
This travel ban does nothing.
What are you on about? We have fewer deaths than far more countries than that (France and Spain for instance) and per capita we are doing even better.
The US has fewer deaths than the following countries per capita:
Italy, Iran, China, S. Korea, Spain, France, Switzerland, Hong Kong, Albania, Lebanon, Netherlands, Belgium, Panama, Ireland, Iraq, Bulgaria, Japan, Australia, UK
Country Population and coronavirus numbers can be pulled here:
https://www.worldometers.info/coronavirus/
> What are you on about? We have fewer deaths than far more countries than that
You edited out the second sentence. The full quote is:
Only vs. China, Iran and Italy. We're within a factor of two (that is, about 5-6 days) of everyone else.
which is accurate.
The statement is inaccurate any way you slice it. Why use incomplete information when more is available?
The statement was accurate. It may not be a useful metric, but it was an accurate one.
But it's also not the case when looking only at absolute numbers either. I would also argue that per capita is implied because it's the only way you can really make that comparison.
https://www.aafp.org/afp/2011/0601/p1299.html
In order to not significantly undercount the number of coronavirus deaths attributed to other causes in the US, there would need to be wide-spread testing here... which there isn't.
Imaging (by the way, you're referencing tests on live patients not dead ones) could be used as another kind of coronavirus test, though an extremely inefficient one, so probably is essentially un-used. Anyway, for pneumonia I believe we're talking about x-rays which is poor at distinguishing coronavirus (see link). Not to mention all of this is brand new. So approximately zero Radiologists are trained and using radiology in a clinical setting to diagnose coronavirus in people who have apparently died of pneumonia.
it has quite a lot of significant costs, in particular on the airline industry and business travel which is smaller in number but pretty important. And given that community spread is going to be a far bigger issue this ban is nonsensical.
However, we do already have the virus in the USA. So it's not suddenly going to go away because of this proclamation.
I don't think it'll have such an effect on Americans since they are exempt from the ban. But now they're guaranteed to have more room to stretch out on the plane.
But you know what would have such an effect? If the government just came out and said "We strongly recommend that you cease all non-essential overseas air travel, including vacations"
The healthcare system is at risk of being overwhelmed by an exponential function. That means, to a first approximation, nothing matters except the last doubling.
Discussion questions: How does this policy, implemented now, affect the time span of the last doubling of COVID cases in the US? Does it do fuck all? Why, or why not?
However, the US is not necessarily obliged to allow any particular vessel into the country.