COVID19 Factors We Should Consider/Current Events

[lazygun37]

The latest from the scientists who actually try to model this. All the usual caveats apply obviously, but I think this is the best we / governments have to help us make decisions / policy. There aren’t any good options, but “getting it over with” seems particularly bad.

“We find that that optimal mitigation policies (combining home isolation of suspect cases, home quarantine of those living in the same household as suspect cases, and social distancing of the elderly and others at most risk of severe disease) might reduce peak healthcare demand by 2/3 and deaths by half. However, the resulting mitigated epidemic would still likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over. For countries able to achieve it, this leaves suppression as the preferred policy option.“
...
”The major challenge of suppression is that this type of intensive intervention package – or something equivalently effective at reducing transmission – will need to be maintained until a vaccine becomes available (potentially 18 months or more) – given that we predict that transmission will quickly rebound if interventions are relaxed.“
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“Last, while experience in China and now South Korea show that suppression is possible in the short term, it remains to be seen whether it is possible long-term, and whether the social and economic costs of the interventions adopted thus far can be reduced.”

https://www.imperial.ac.uk/media/imp...16-03-2020.pdf

[Rob Waskis]

A brilliant case of epidemic management? I am amazed. Stupefied. Doesn't happen often.

You don't think that's how this will be spun? If it blows up, it's because we didn't act soon enough. If it doesn't, there will be much back slapping and congratulations thanks to the implementation of almost-martial-law "flattening the curve".

NJ just shut down gyms, restaurants, movie theaters, etc. PA shut down liquor stores. Now NJ is pushing for a curfew, because I guess the virus is more transmissible when the sun goes down.

NJ has had two (2) corona virus deaths.

[Kitsuma]

This will be viewed as one of the most embarrassing events in the history of the world.

And again, if this thing was a Chinese bioweapons test (as some have suggested), we just failed it.

We failed when we learned nothing from Lyme disease (another man-made bug).

Maybe this research is a bad idea? Who funded this laboratory's research? Who owns patents to these superbugs? Why is this allowed and even applauded?

The failure happened long ago.

[Gerald Boggs]

I doubt it. It will either be a disease that simply couldn't be stopped or a brilliant case of epidemic management. At least for most people.

You mean like the flu season that happens every year. Before the Chinese Virus showed up and caught the media's eye: "So far, 16,000 people have died and 280,000 people have been hospitalized during the 2019-2020 flu season, according to preliminary estimates from the CDC". Add to that, at least 9.7 million in the US had the flu. This happens every year, so what's different, other then the attention the media is giving it.

Yes, the old in Italy are dropping like flies, but apparently, Italy has long had a higher then everyone else death rate from the flu.

[bracemaker]

I'm continually impressed by how so many folks, even those with moderately high intelligence, continue to act incredibly stupid and irrational in this day and age. I suppose it's always been this way, much like everything else in our society. We just notice it all now because we're "connected" for better or worse.

I Live in a small town, more than a hundred miles from a confirmed case, yet a majority of people screaming to stay at home, don't go out, we need to close all our businesses for a month, etc. The virus is apparently lurking around the corner, it's going to fly through the air on a cloud of dumbassery.

[Mark Rippetoe]

PA shut down liquor stores.

Can someone please explain the reasoning here?

We failed when we learned nothing from Lyme disease (another man-made bug).

My point was not that the Wuhan COVID19 is a bioweapon. My point is that our response to it makes it an excellent bioweapon.

[Kitsuma]

My point was not that the Wuhan COVID19 is a bioweapon. My point is that our response to it makes it an excellent bioweapon.

Agreed, we know nothing. We have been told it is man-made.

My point is apply the power of government at the origin of the problem rather than during the repeated cleanups (like now).
Forbid the creation of virus' like this, and don't do business with countries that we suspect are ignoring this rule.

Latest government cleanup action: Trump / Mnuchin plan to send checks to Americans within 2 weeks during this crisis.

[mpalios]

You are quite correct that the cat is likely already out of the bag and widespread infection of the populace is now likely. From a policy standpoint we have shifted from an infection containment strategy to one of mitigation of the effects of the pandemic. However, we desperately need to avoid “getting this over ASAP” as the spike in demand for healthcare services in that setting will far outstrip our ability to provide care, not just for those with COVID but for anyone else who has the misfortune of suffering a major medical event during the pandemic. If all of of our icu beds are full of patients on ventilators from COVID and you have a a stroke or heart attack, what will happen? This is exactly the scenario playing out in Italy now, where impossible triage decisions are being made and is quite likely to happen here if we don’t move aggressively to flatten the curve of infection. You’re right: The numbers of dead from the collateral damage from COVID may well outstrip those from the disease itself, even before you take the economic ramifications into account.

Thank you for posting this....it answered and confirmed a few things I had spinning in my mind.

[lazygun37]

NJ just shut down gyms, restaurants, movie theaters, etc. PA shut down liquor stores. Now NJ is pushing for a curfew, because I guess the virus is more transmissible when the sun goes down.

NJ has had two (2) corona virus deaths.

Can someone please explain the reasoning here?

I really wish that everybody who thinks this is all one big over-reaction would carefully read the modelling paper I linked to above. Have any of you? It's this analysis, I believe, that has led both UK and US governments to adjust course in the last couple of days.

For anybody who really tries to digest what is being said there, it is brutal reading.

I also wish people would stop citing small current numbers as if they were evidence for this whole thing being overblown. It is in the nature of exponential growth that we find it hard to wrap our heads around it. In the exponential growth phase, the number of people infected by this virus doubles every ~5 days. Take the current number of cases and work out on a piece of paper how many you'll have in 1 month, 2 months or 3 months. And remember that nobody has any true immunity against this yet. Even if you optimistically assume that some significant fraction of the population never become symptomatic, the numbers are likely to be overwhelming. And asymptomatic people may still be carriers.

The detailed modelling is particularly scary in what it suggests about the only options we currently have on the table:

(a) MITIGATION, i.e. strategies designed not to reduce the total number of infections, but just to spread them out to manageable levels ("flattening the curve"): these strategies are vastly better than doing nothing, but even the most optimistic scenario ends up with 8x more critical care patients than there are beds/equipment, at peak. Think about what that means. Seven out of 8 patients who need to be on a ventilator in the ICU would simply not get that care at the peak of the outbreak.

(b) SUPPRESSION, i.e. strategies designed to actually kill off the outbreak, by reducing the average number of people infected by each carrier to < 1: these can work, at least in the short term (see e.g. China). However, they require *drastic* social interventions. And what's worse is that suppression means the number of people who will become infected (and then immune) will be too small to provide herd immunity. This, in turn, means that as soon as the intervention is relaxed, you can expect the next massive outbreak. And *that* means that to make suppression work properly you'll need to keep these Draconian interventions going for most of the interval until there is a vaccine. Which people expect will be 12-18 months.

So, no, I personally don't think the things local, state and federal governments are doing represent an over-reaction. Panic is obviously counter-productive, and also irrational. It is absolutely worth remembering that even though many or most of us will probably get this, the vast majority of us will recover. But that doesn't mean everything will be just fine.

Finally, I think people are fundamentally misunderstanding the main point of limiting social interactions. It's not primarily about stopping *you* from getting infected. It's about (a) stopping all of us from infecting vulnerable populations we come into contact with, and (b) preventing the health care system from being brought to its knees. It's obviously tempting to say "but I'm sure that I personally am not a carrier". But that's non-sense from a public health perspective: some small fraction of the people who say this -- and this includes you and me -- are going to be wrong. And that's enough to make (a) and (b) not work. And in this day and age, nobody can be 100% certain they're not a carrier (unless you literally haven't had contact with anybody for the last few months).

So, in my view, limiting social interactions is clearly the ethical thing to do. This is true even if you personally feel sure you aren't infected at the moment. And it's true even -- perhaps especially -- if you personally do not belong to a vulnerable population.

[dalan]

Big pharma and the pending vaccine must play a role in here somewhere. They must love the mass craziness about now.