
Seeing the Smoke - ctoth
https://putanumonit.com/2020/02/27/seeing-the-smoke/
======
double0jimb0
Will someone please explain why stocking up on water is consistently being
advised?

Do these people think coronavirus is going to cause enough unrest to
destabilize civic services and affect our municipal water supplies?

Or do these people just parrot this stuff without critical review?

~~~
cryptoz
Having bottled water on hand seems like a super useful thing right now, to me
anyway. It makes it easier for families to not share water sources, reduce the
spread of disease at offices if you bring a bottle vs using a communal tap,
and a thousand other things in that vein.

It is recommended everywhere because it is useful, not because people are
'parroting this stuff'. I think any real critical review of the data would
conclude with a suggestion that bulk bottled water is a good idea for people
to stock up on.

> Do these people think coronavirus is going to cause enough unrest to
> destabilize civic services and affect our municipal water supplies?

No, I don't think anyone is worried about that. This is the first suggestion
of that nature I've seen, I think you are arguing a straw man here. The
primary reason for bottled water is to help prevent the spread of germs by
reducing shared water sources. A secondary reason would be general risk-
reduction: having your own clean safe water is a calming factor and
reduces/eliminates at least a few possible contamination sources.

It is a logical move, not some hare-brained silly idea that people are
'parroting'.

~~~
sgt101
I see and hear of no cases of Corvid spread via water supply.

On the other hand if you spend money and time gathering in a resource that is
easily and continually available then you are not taking the action that
really will help you.

Gathering supplies of water is sensible in case of natural disaster and war -
for this one, not so much. Spend the money on food and entertainment instead.

------
SZJX
I can't really take this piece seriously when it's claimed that the fatality
rate is "20 times" that of seasonal flu... If the author claims to be
"rational", surely he understands how many cases are not being detected and
how the numbers from South Korea and Diamond Princess approach the real
fatality rate much more.

It's always like this. People first underreact and want to believe it's
nothing, then overreact. For now (2 weeks after the article was written),
staying levelheaded amidst the irrational panic is the "rational" thing to do.
Exactly the reverse of what's proposed in the article.

------
b_emery
Definitely prepare, I mean there is not really a down side to it, but my
instinct is to cut through the hype and look at the data. The site this
article links to is good:

[https://www.worldometers.info/coronavirus/](https://www.worldometers.info/coronavirus/)

Error bars on this would be even better, but note that the growth in cases is
still linear, about 3000 new cases per day. It will be interesting to follow
how this changes, with more testing in the US for example, but based on this
one thing it looks to me like we'll make it to summer without it taking over
the world. If you have better data or analysis, I'd like to see it.

[edit]: found the curve that shows new cases outside of China, and it's indeed
NOT linear:

[https://www.worldometers.info/coronavirus/coronavirus-
cases/...](https://www.worldometers.info/coronavirus/coronavirus-cases/#case-
tot-outchina)

~~~
YZF
But China shows us you can't just extrapolate the exponential curve. As cases
grow there will be a response and China shows us (if you trust the numbers)
the response makes a big difference. There may be a short term exponential
growth but with contact tracing and various quarantine measures that curve may
decay (e.g. many of the contacts may catch the virus, their families might,
but the following transmission could be reduced).

I actually stocked up (we always have lots of bulk dry foods anyways) so I can
stay home if needed but there's really no clear picture of what's going on.

If there is widespread transmission coming from asymptomatic people that would
mean this is a lot less dangerous than people think, maybe all these people
coughing in the office actually have covid19... If there isn't than why worry
yet. There is some evidence that suggests this doesn't transmit very well
(e.g. many people quarantined through close contact tracing did not catch the
virus) yet there is some contradictory evidence (e.g. the cruise ship or
larger clusters.). The truth is probably somewhere in the middle.

If you live in an urban area with millions of people what would be a
reasonable threshold of cases to isolate yourself completely?

My feel is that it's worthwhile being cautions and also assuming the actual
numbers are ahead of the curve we see. As long as the projected numbers are
still small relative to the overall population then washing your hands, being
careful what you touch (your face and shared surfaces), and reducing
unnecessary close contacts with random people are likely good enough safety
measures.

As the numbers grow you can consider completely eliminating contact with
others though that can be pretty difficult.

~~~
trevyn
> _if you trust the numbers_

In which case all hope is probably lost on this hypothetical you.

China has way too many incentives to lie, and has consistently demonstrated
that lying is how it operates.

~~~
YZF
I'm not sure what their motivation to lie is here. Also there is the
observable number of exported cases from China which seems to have fallen in
correlation with their reported successes.

------
nostromo
I'm not seeing smoke.

I see a low mortality rate for healthy people.

[https://www.worldometers.info/coronavirus/coronavirus-age-
se...](https://www.worldometers.info/coronavirus/coronavirus-age-sex-
demographics/)

I see stories about how the virus is circulating because most people have no
symptoms, and don't even go to the hospital.

[https://www.thelocal.it/20200228/coronavirus-may-have-
circul...](https://www.thelocal.it/20200228/coronavirus-may-have-circulated-
unnoticed-for-weeks-in-italy-say-researchers)

The only firsthand account I've read makes it sound like a cold. "If I were at
home with similar symptoms, I probably would have gone to work as usual."

[https://www.nzherald.co.nz/opinion/news/article.cfm?c_id=466...](https://www.nzherald.co.nz/opinion/news/article.cfm?c_id=466&objectid=12312836)

Yes, wash your hands. Yes, don't go to work with a cold. Yes, older and sick
people may want to self-quarantine. Sure, buy some extra food. No, don't
spread panic.

~~~
missosoup
> I see a low mortality rate

1-2% case fatality rate combined with the current R0 estimate is not low. If
this pandemic goes unmitigated it will kill more people than the spanish flu,
given the current trajectory.

~~~
joe_the_user
A 1-2% mortality rate is indeed a huge rate promising massive death.
Essentially 20-40 times higher than the conventional flu.

I think the GP is saying that mortality is significantly lower than it appears
because the asymptomatic carriers aren't counted in that figure.

That's one way these new pathogens can play out but I don't think there's
necessary good evidence for this - the 2% figure seems pretty reliable
everywhere.

It's worth noting that causes of the Spanish Flu's mortality rates are still
being debated:

"Scientists offer several possible explanations for the high mortality rate of
the 1918 influenza pandemic. Some analyses have shown the virus to be
particularly deadly because it triggers a cytokine storm, which ravages the
stronger immune system of young adults.[14] In contrast, a 2007 analysis of
medical journals from the period of the pandemic[15][16] found that the viral
infection was no more aggressive than previous influenza strains. Instead,
malnourishment, overcrowded medical camps and hospitals, and poor hygiene
promoted bacterial superinfection. This superinfection killed most of the
victims, typically after a somewhat prolonged death bed."

[https://en.wikipedia.org/wiki/Spanish_flu](https://en.wikipedia.org/wiki/Spanish_flu)

~~~
michaelt
First time I've heard a large portion of asymptomatic carriers cited as a
_good_ thing.

------
ryanobjc
I had my urgent prepper moment last Monday. I realized that the chances of
doing stock up prior to panic and price and crowded places was shrinking and I
didn’t know how fast. I got spooked when a target seemed to be out of a lot of
things. Turned out to be luck.

I then spent Thursday securing a methodology for water storage just in case. I
don’t expect to lose water for a while but earthquake country. It’s a
lingering missing hole I’ve felt for a while.

The rest of my prepper is ironically due to burning man. So we are pretty good
there.

The window for buying before a panic is closing fast. In terms of face masks
it’s already closed. I managed to eek out one more mask this last week by
buying a half mask 3m reusable respirator. And P100 organic vapor cartridges.
Very over the top for covid-19, but will have dual purpose for paint fumes
later. Plus no competition and the prices and delivery were timely.

Soon widespread fear will turn into action and you want to be sitting at home
watching YouTube videos.

~~~
HeyLaughingBoy
If you're having trouble finding stuff my recommendation is to head to a
Walmart in a rural area. Walmart has amazing logistics and handles emergencies
well: they are rarely out of anything for more than a day or two. Rural areas
are pretty low-density and would have a much lower disease propagation rate.

Of course, that's easy for me to say since I live out in the country, 10 miles
from a Walmart :-)

------
rustyconover
Tonight after purchasing more groceries than I've bought in the last decade,
I'm reflecting on how strange it felt. I've never filled a shopping cart. A
grocery basket, sure, but an entire cart with the bottom shelf filled with
bottled water, never.

I lived through Hurricane Sandy in NYC. That was something. But I never felt
the urge to go preemptively shopping before. Food has always been in abundance
and regularly available a few blocks away 24/7\. Shoutout to Westside Market
in the UWS. Yesterday I became convinced I needed almost a months supply of
non-perishables _right now_.

Tonight, there was no other customers shopping with urgency at my local Target
as I was buying six spare toothbrushes with two bottles of NyQuil and two cans
of saline nasal spray along with all of the food I could fit. All of the
aisles were well stocked, mostly. They were less so once I went by. There was
one lady with 7 cans of lysol spray, but we just winked at each other and
hurried off. I think both of us were trying to not get any more shocked
glances from the people just strolling trying decide which flavor of double
stuffed Oreo's to buy this Saturday night. Deep down those people know what's
going on, but aren't yet ready to take action.

Sure, I'm early and feel guilty because it was so easy to get everything right
now. But also feels really good to have it stocked away in my pantry. If I
don't use these supplies my local food bank will get everything I don't need.

I'd like to ask of you to consider doing the same! If all of this preparation
is unnecessary, there are hungry people that will appreciate it later on. If
the possibility to make something good come out of this possibly tragically
bad situation motivates you take some time to get ready, I'm pleased.

~~~
aorth
Why the NyQuil?

~~~
gremlinsinc
It's a cold virus derivative right? ... gotta treat the sniffles...if it hits.

------
hprotagonist
I have laid in about a 3-week supply of nonperishable goods and basic home
supplies, and I don't feel bad about this _at all_.

If the worst that happens is that we don't have to go shopping much for the
rest of Lent -- great. I'll be pretty surprised, but i'll be fucking
overjoyed, too.

------
newshorts
I’m not seeing smoke either, but I still went out and bought my family a two
weeks supply of food.

I felt silly. But my justification was that it’s more convenient for me to do
my shopping a few weeks ago, than in a month when it’s much more likely we
won’t feel as comfortable around large groups of people.

~~~
rndmize
I don't think there's any reason to feel silly. I grew up with parents that
would take reasonable preparations for a variety of possible disasters -
earthquakes and fires being the two of note for California. Cans of fish and
fruit will last decades and can be cycled out over time, dried pasta will last
years. Jars of sauce or preserves have similar lifespans, crackers can last
months, dry grains as well.

I don't think it's difficult to imagine situations in a lot of places where
natural disasters can disable things for several days, maybe a week or two. A
couple weeks of food seems like a good thing to have on hand, regardless of
place, time or situation.

~~~
xyzzyz
Indeed. Just buy stuff that you'll go through anyway, but more of it. Instead
of buying 2 pounds of rice, buy 25. You can store it pretty much indefinitely
(white rice at least), and so even if you don't normally eat lots of rice,
you'll eat it eventually and won't see it spoil. Same with oil, pasta, flour,
nuts etc.

------
war1025
Something I had been thinking about, which the article mentioned and pushed me
over the edge into doing:

I just went on Amazon and ordered two blood oxygen saturation meters. One for
adults and one for kids. Even if Covid-19 never ends up reaching us, that is a
valuable diagnostic tool to have available. Especially for $30 a piece.

~~~
sosilkj
can anyone recommend an alternative to amazon for such a device? i don't want
to take the chance of buying one that's a fake...

~~~
timcederman
Two bits of advice:

1\. I checked out all the cheap ones, and Zacurate was the only brand I could
find that was under $50 and had actually been properly tested for accuracy.

2\. If you buy one from Amazon ("ships from and sold by Amazon.com") or that
specific brand from "Beyond Med Shop" (which is owned by Zacurate), you won't
get a counterfeit.

~~~
masonic
"ships from and sold by Amazon.com" is _no_ guarantee of authenticity.

------
anonsivalley652
This pathogen has a long incubation period and it takes time for small numbers
of people to become spreaders, so there will be a time lag between recognition
and acceleration.

Threat fatigue and lack of experiencing long-tail events can lull people into
complacency. I've been in the Loma Prieta, Camp Fire, week-long PSPS, near
hurricanes and the Boy Scouts... be reasonably-prepared but don't go crazy
buying a BSL-4 universal decontamination shower kit. Panic buying helps no
one.

The biggest point is _if_ it accelerates to pandemic is for the elderly,
especially men and those with chronic conditions, to be protected from anyone
who could possibly have it. For them, the CFR is somewhere 15-35%. For anyone
who needs hospitalization, the CFR is about 49%. Occasionally and randomly,
healthy people die from it too at very low rates.

~~~
nostromo
> especially men

It seems this is unique to China as men are much more likely to smoke there.

------
ctoth
I really hope this gets traction this time. A very worthwhile article for the
people here.

~~~
pbourke
Yeah I agree. It seems like many people have picked up on it. Much different
than even a week ago.

------
ggm
Can anyone explain to me a rational upside for the Chinese state to over-
report detected cases and under-report mortality? Bear in mind, the impact on
the domestic economy of failing to reign in an epidemic is as real as the
upside of claiming it's fixed to settle export income. Basically it's not in
any states interest, one party or otherwise. China's domestic economy depends
on people getting better.

I truly don't get the assumption "it's worse than they say" when the most
likely outcome (putting Hanlons razor into play), is that mortality stats are
nearly accurate and caseload is under reported due to lack of testing and self
isolation. Death is hard to hide. I believe mortality stats. Any non reported
mortality goes to under reported cases, so it evens out.

I know it's optimistic thinking but I am drawn to a belief the effective
cumulative death rate in China only drops, as better figures emerge unless
unlike all other virus it becomes more lethal not less under mutation.

A different comorbidity outcome eg opportunitistic pneumonia or delayed onset
COPD or something, that's different. That would demand a massive change in
view. Change in the long-term disease consequence will be interesting and
important.

(For instance the effect some disease has on vaccine immunity across the board
comes to mind: if this happens, bad news: but, that is in the future)

Well adapted virus mutate not to kill their hosts. Badly adapted virus self
limit.

This is not about liking or disliking the Chinese state, I am asking on what
grounds people walk to 'under reports of death, over reports of caseload'

No other claim alters mortality into worse places.

Non Chinese deaths predominantly lie in old, lower immunity, comorbidity sick
people. And, saying "it's too soon, wait for the wave" is forward facing
speculation. Cumulative infection and death rates are inherently backward
looking. Explain to me how these a posterior figures get worse not better.

TL;dr it's not smoke, this article is mis applied stupid maths.

Keeping people on a ship (think norovirus and cruises) or having a religious
cult uncover huge transmission outcome.. that's not a true reflection of
societal risk under self isolation in the home.

I am told the CDC insisted on a home made test. NIH as in "not invented here"
and not national institute of health.. bad move guys. Under testing in a US
health system with patient cost recovery. That is a recipe for less successful
disease control. The US is going to turn out to be under reported. Death rates
will probably be right because dying in America is statistically well
understood. People won't front for expensive medical test or treatment. High
rates of COPD and diabetes and therefore higher risk of death than many other
economies. Also large numbers of underinsured older people.

~~~
qqqwerty
I think your logic is sound, but I assume the folks who claim 'you can't trust
the numbers coming our of China' are probably assuming that the numbers are
being intentionally underreported for political reasons. I have no idea how
those numbers are generated, but I suppose it is at least in the realm of
possibility that they could be deliberately reporting lower numbers, and it is
not like anyone can really check the math with out doing some extensive
verification.

Regarding the fact that the death rate appears to be lower outside of China,
that would appear to provide evidence against China mis-reporting their
numbers (after all, why would they intentionally report a higher death rate).
But the one plausible counter point that I have seen, is that the
hospitalization/ICU rate is pretty high, to the point where a wave of COVID-19
infections in a short time-span could overwhelm local capacity causing a large
spike in mortality. This is most likely why China was building Hospital
facilities in Wuhan and why they imposed such a draconian quarantine. So the
numbers outside of China might not really be comparable because the number of
cases (so far) have been well below local hospital capacity.

Unfortunately, it looks like we are going to have a third data point soon.
Iran has really poor healthcare infrastructure and they are undergoing a wave
of infections. If the mortality rate is heavily dependent on ICU treatment,
then Iran might be close to the worst case.

~~~
ggm
I have read that even when widespread infection is inevitable, simply by
changing the slope of the curve it reduces impact, spreading disease control
for a broadly similar overall infection rate in time has benefits.

The response to any cough or fever should be self isolation. Report by phone.
Wait for triage.

------
usaar333
Great overall summary of what happened though somewhat misses what hit the
market ultimately hard- and doesn't necessarily prove that if you were
rational about the risks, you should have sold short [1].

The market tanked fast (a sign of efficiency in fact) when it became clear
that containment within China had completely failed. Cases were dwindling
([https://www.worldometers.info/coronavirus/](https://www.worldometers.info/coronavirus/)),
due to China's strong protection measures, but all of a sudden there was an
upswing due to international spread.

It's interesting to read Ray Dalio's analysis on this whole thing:
[https://www.linkedin.com/pulse/our-early-thinking-
coronaviru...](https://www.linkedin.com/pulse/our-early-thinking-coronavirus-
pandemics-ray-dalio/)

Finally, note that personal protection is different from stock market
protection. It's more likely than not the SP500 will fall another 7% to 2750,
but that doesn't mean shorting is a profitable strategy.

[1] Maybe buy protective puts (perhaps volatility was far too low), but that's
another story.

