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Is It a Pandemic Yet? (nytimes.com)
174 points by kgwgk 34 days ago | hide | past | web | favorite | 281 comments



I will probably be downvoted for saying this, but...

The seasonal flu alone kills half a million people every year. So any mild disease that is as contagious and barely twice as fatal will kill 1 million. And that's what's going to happen with COVID19. It is far more severe than the flu.

We know COVID19 is as contagious, given how fast it's spreading and how unstoppable it is (R0>2, asymptomatic transmission, airborne). And we now have 4 independent estimates that place the Infection Fatality Ratio at about 0.5% to 1.7% which is between 5x and 17x deadlier than the flu (0.1%): https://twitter.com/zorinaq/status/1230977769795776512 Incidentally, this makes COVID19 comparable to the 1918 Spanish Flu (IFR ~2%) according to experts (see link above). And keep in mind the IFR, unlike the CFR, is the metric that takes into account undetected mild cases. The Case Fatality Ratio is around 9% right now.

So based on this, I predict it will go pandemic and will kill 1 million, and probably a lot more.

COVID19 is the most severe (ie. contagious + fatal) airborne disease since the Spanish Flu.


[edited to change linked article]

Fortunately we know a lot more about viruses today than we did in 1918. The virus has already been mapped genetically, and many labs around the world are hard at work on an anti-viral treatment. We shouldn't get complacent of course, but it's likely that this thing can be contained and treated eventually.

I read today about a device[1] from Israel that helps the lungs quickly clear phlegm, thus reducing the coughing behavior that spreads the disease. The Chinese are starting to manufacture and deploy it, so hopefully it will cut back on the spread at least a bit.

1. https://www.jpost.com/HEALTH-SCIENCE/New-Israeli-invention-u...


In particular, chloroquine has been shown to be helpful in treatment and is readily available in developing countries since it's used as a malaria medicine (and there are replacements available in developed countries).

in vitro: https://www.nature.com/articles/s41422-020-0282-0

practice: https://www.jstage.jst.go.jp/article/bst/advpub/0/advpub_202...


Yeah it's one thing that gives some hope. Recently:

>Chloroquine Phosphate, which has been used for more than 70 years, has been tested in 135 cases in Beijing and southern China's Guangdong Province. Among them, 130 patients have light and common symptoms, and five are severe patients.

>None of the patients with light and common symptoms have developed severe symptoms. Four severe patients have been discharged from hospital, and one has seen severe symptoms mitigated to normal, Xu said. http://www.china.org.cn/china/2020-02/22/content_75732846.ht...

Which seems quite promising. Also it could be used prophylactically.


Also a good opportunity to ramp up on gin and tonics.


Is it really the same as the medicine?


Was joke. But yes, tonic water contains quinine, and that medicine is related to the compound used to treat malaria. (I think they're both used, but unclear on the specifics.)


What’s the mechanism of action? This is obviously very different than maleria. Why would it work on both?


That link has a really obnoxious popup banner for a political poll. Can you use one that is just the news, please?

e.g. https://www.jpost.com/HEALTH-SCIENCE/New-Israeli-invention-u...


Thanks, I've updated my link to the one you supplied. My Brave browser doesn't show the banner.


There's been some recent discussion that it's actually diarrhea that is causing the spread among 'asymptomatic' carriers.


A vaccine is at least a year or two away from going through all the testing and approval it has to go through before it's ready to be deployed on a mass level... if one that's safe and effective is actually found at all.


It's almost better to get infected now where hospitals are not full (if you're in a developed country and generally a healthy person). Wait out 2 weeks, then you build immunity after. Except when the virus mutates :(


It might be possible the second infection will be more severe than the first, see https://en.m.wikipedia.org/wiki/Antibody-dependent_enhanceme...


That was the OG notion as regards chickenpox.


Considering how many countries are panicking over the virus, and how much research is being shared, we should hopefully see a vaccine soon.


So far no vaccine has ever been developed for a human coronavirus. That includes SARS-COV (2003), MERS and the two common cold coronaviruses. So I wouldn't be counting on a vaccine being developed for SARS-COV-2 any time soon.


if it's anything like the flu, the virus mutates and even with yearly vaccines 3-5 million people get sick and half a million die


> I will probably be downvoted for saying this, but...

well, for saying that.


Let’s say 40% of the people in the world get it and a 1% fatality rate:

That 30 million dead, and probably another 300 million hospitalized and maybe 50 million that need icu care.

Should probably go without saying that we don’t have the ICU beds to handle that in the western world, let alone in developing countries.

We also haven’t had anything like the Spanish flu in the US since we’ve had the modern health insurance system. Is blue cross going to have the resources to pay for all those extra hospital visits? What about all the long term side effects from the millions of people that had acute respiratory failure and survived.

edit:

Also something else to consider -- what if this goes epidemic in the US during the elections this year? They'll have to cancel rallies, campaign events, maybe even the party conventions.


>They'll have to cancel rallies, campaign events, maybe even the party conventions.

Every cloud has a silver lining :)

>Is blue cross going to have the resources to pay for all those extra hospital visits?

If the government ends up bailing them out this could be a step towards single payer health care in the US.


And the West is very old, I would expect that to offset the highly developed healthcare systems and resources there.

Median ages:

https://www.cia.gov/library/publications/resources/the-world...

Countries in the West over 40 at the median:

Germany, Italy, Greece, Slovenia, Portugal, Austria, Lithuania, Latvia, Croatia, Spain, Bulgaria, Estonia, Hungary, Serbia, Bosnia, Czech, Finland, Netherlands, Switzerland, Romania, Denmark, Poland, Canada, Slovakia, France, Belgium, Ukraine, Sweden, Belarus, UK, Russia

Germany has half its 83 million population over 48 years of age. Italy is the 5th oldest country at the median. Covid will hit very hard against older populations.


there is a graph here. don't know how accurate that is though (sample sizes and the fact that the way it is counted has been revised a couple of times already):

https://www.worldometers.info/coronavirus/coronavirus-age-se...


Building on this, what happens if grocery stores shut down as the Just in Time stocking infrastructure breaks down as truckers / workers stop going to work?


the army will need to step in to keep peace. you are probably looking at a curfews to prevent looting.

edit: probably also rationing: Canned goods are starting to look a bit bare at our local supermarket in Florence, about 200km from Italy's COVID19 cases. https://twitter.com/JacekWork/status/1231900845802954757

edit-2: Residents in Milan, Italy have raided the grocery stores as panic about COVID19 and city lockdowns sets in. https://twitter.com/RuralCdn/status/1231969752890957824


> And keep in mind the IFR, unlike the CFR, is the metric that takes into account undetected mild cases.

Interesting, this is always my argument against these fatality ratio estimates, can you explain how the IFR can take undetected mild cases into account? Does it just assume at random how many of those cases exist?


Most look at infection rates among Wuhan evacuees. Since almost all evacuees were tested, it's a good proxy to estimate the city-wide infection rate. See the 4-5 papers linked in my blog post's last section: https://blog.zorinaq.com/case-fatality-ratio-ncov/#updates--...


Do you have any proof on the claim of the virus being "airborne"?


what about developing a vaccine?


> The seasonal flu alone kills half a million people every year. So any mild disease that is as contagious and barely twice as fatal will kill 1 million

That’s assuming no containment effort, like with seasonal flu. Of course, it’s gonna happen if health authorities take the same defeatist attitude as you and do nothing.


>Of course, it’s gonna happen if health authorities take the same defeatist attitude as you and do nothing.

I'm a bit confused. Isn't expecting it to be devastating the very attitude needed for authorities to justify engaging in the containment methods needed to reduce the harm caused?


I would say if authorities don’t act it could kill a million or more. Which is very different from gp’s argument that it will kill a million or more regardless.


> Of course, it’s gonna happen if health authorities take the same defeatist attitude as you and do nothing.

how long can they get away with locking people up in their homes? There will be tipping point when those who are supposed to deliver the first-response and do the policing will also become a vector for spreading the disease. Things will escalate quickly no matter if the attitude is "defeatist" or optimistic.


Long enough for the virus to die out? Let’s just check back in July.


what would change things is a vaccine, guess time alone won't do it.


Air temperature could possibly do it or at least contribute, as was the case with SARS in 2003.


It's 35C in Bangkok, 36C across Malaysia and 32C in Singapore.

How much hotter do you think it would have to get to make that virus die out?


Most Singapore buildings and its public transport system are fully A/C.

It's similar for Malaysia and Thailand since they're still in the tropics, except those countries are less dense.


There's plenty of AC in the US as well.


As far as I can tell the virus isn’t spreading like crazy in Bangkok, Malaysia, or Singapore. Singapore had it way worse in 2003, still the SARS virus withered came June.


wouldn't that be only a local effect though, e.g. Southern vs Northern Hemispheres?


The Northern Hemisphere account for ~90% of the world's population; the percentage living beyond 23.5°S is very small. It is entirely conceivable that the epidemic is put under control before it gets too cold for those people.


Seasonal flu does have containment efforts - vaccination


Prevention and containment are related but not exactly the same.


> COVID19 is the most severe (ie. contagious + fatal) airborne disease since the Spanish Flu.

It very clearly is and it's out of the box, they can't stop it now. The US should be shutting down all travel into and out of the country, full quarantine from the rest of the world. We'd have a chance at stopping it from doing to the US what it has done to China, if we acted immediately, before it's across Europe and more of Asia and then imported in stealth mode by travelers from those regions that are unaware they're infected.

Back in reality, the US economy will look like China's frozen economy, within a month or two, unless Covid is stopped soon. More likely, it's going to spread from Italy across Europe, and continue to spread across Asia. From those hyper economic zones, the US will be guaranteed to import it from multiple sources (no single country to shut down travel with).

China went full totalitarian to an extreme, and couldn't stop it. Covid froze the second largest economy and did it in the span of a month. What chance does the rest of the world stand at stopping it? None.

Bill Gates is worried about it spreading across Africa (and said in an interview a few weeks ago, when asked about his plans for the year: "well, I plan to travel a lot less this year" - yeah). He's obviously properly worried. It will kill a large number of people in poorer economic regions that will see their healthcare resources overwhelmed. The US is nowhere near prepared for what's likely about to hit.


> It very clearly is and it's out of the box, they can't stop it now. The US should be shutting down all travel into and out of the country, full quarantine from the rest of the world. We'd have a chance at stopping it from doing to the US what it has done to China, if we acted immediately, before it's across Europe and more of Asia and then imported in stealth mode by travelers from those regions that are unaware they're infected.

If we had a government that wasn't starved, it might also be preparing sufficient resources for if/when the virus does reach epidemic proportions here.

Also, Americans have been trained to avoid the medical system and tough it out for cost-saving reasons, that training is going to be counterproductive here.


Starved? $4.1 trillion, and a nearly $1 trillion deficit, is "starved"? What in the world would "overfed" look like?


It's too late for this approach. The only reason that could explain why the US still does not have many cases is lack of testing and the fact that it goes undetected for a long time.

As you said:

> It very clearly is and it's out of the box


> Covid froze the second largest economy and did it in the span of a month. What chance does the rest of the world stand at stopping it? None.

This doesn't follow. It doesn't matter how large an economy is affected. The primary factor is contact between infected and healthy people. Areas with less population density might have a good shot at keeping infections down, like a lot of areas in Europe.


> like a lot of areas in Europe.

You misspelled America. Europe has a pretty high population density in comparison.


> Some 152 cases (and at least three deaths) were confirmed in Italy on Sunday, up from three cases on Thursday. The number of infected people in South Korea jumped to 763 (and six deaths) in just days.

To add an important point: In both countries, they have detected covid-19 only well after it has spread inside the country. E.g. in Italy it started with one severely ill patient who went to the hospital and got tested positive for covid-19. Then they recursively traced people that person has been in contact with and found over a hundred cases. They still haven't found "patient zero" yet, the first person in that chain who entered Italy with the disease. Before, it has been all in the dark. There are likely many such pools of carriers all over the world. This aspect of covid-19 is its real danger: in many cases the disease is asymptomatic so you don't get a test and keep interacting with people normally, but it's still able to infect others.


Right, supposedly Denmark has no cases for example. I find that hard to believe, it seems more likely to me, given the average Danes dislike of going to the Doctor , and the average Doctor response of "you have some sort of virus come back in a couple weeks if it doesn't get better" that it is here, there are probably a few hundred walking around with it, and the first one to go to the hospital just hasn't happened yet.


If this is asymptomatic do they eventually get sick or do they just harbor the virus?

I don't understand how the virus can be asymptomatic? How does it reproduce and what triggers it to become symptomatic?


I think of asymptomatic infectivity as a sitting war between the virus and the host immune system. The virus has taken hold in a region where it a) does not grow at a rate harmful to the host and b) already has access to a spreading mechanism, while the immune system succeeds in keeping the infection away from organs where (either) c) the virus would grow at an unsustainable rate, eventually taking down it's host and/or d) the immune system's counter reaction would be so severe that it would endanger the host. Avoiding c) and d) are in the best interest of both virus and immune system (even though both are obviously not aware of any of that), so both are effectively happy. Sooner or later the immune system will develop a countermeasure nonetheless, but until then the virus will have spread to other hosts generously. Reliably reaching a state like that would be the second best evolutionary outcome of a virus, only topped by permanently resisting the immune system's removal attempts.


A virus doesn’t “want” to kill its host; just use the minimum change to propagate (e.g. induce a cough). In face some symptoms are your own body trying to dislodge it, such as fever, and the cough itself for that matter.

Some viruses of course have gone so far as to become part of our genome. Is that asymptomatic?


As other people said, most viral diseases have a asymptomatic period. What's unique about Coronavirus is that the patient can be infectious during the asymptomatic period. This makes coronavirus so hard to be controlled.


My understanding is that most viruses have some short period of infectiousness before symptoms develop, like the flu https://www.cdc.gov/flu/about/disease/spread.htm https://www.nhs.uk/common-health-questions/infections/how-lo...

Coronavirus however has a really long infectious period before symptoms can appear. Which I guess is to its evolutionary advantage and thus unlikely to disappear (just guessing on this part)


The virus can of course be asymptomatic, in fact it is asymptomatic in anyone when they first contract it. Then it’s up to their immune system to either fight it off or crumble. Whether symptoms show is just a matter of the severeness.

Symptoms like coughing and sneezing that discharge large droplets from the respiratory tract are a lot more effective at spreading the virus onto other hosts, but it appears that this virus is contagious enough that even asymptomatic hosts could spread it.


Being infected just means your cells have been infected and are starting to produce more viruses. That process is heavily dependent on viral load and the host's immune system. You're only symptomatic when your body begins a whole scale fight against the virus, before that, your body is still producing the virus (and you can spread it), but the virus isn't impacting you enough to be symptomatic.


There are several dark pools of concentrated yet totally unexplained and even implausible coronavirus being detected, with no clear discernible path from China. It leads me to wonder if the virus is a lot more long lived on surfaces or maybe in foods or on food packaging that came from China. How else to relatively cut off towns get an infection, but cities are not? Is there something that towns got from China that these cities may not have? Food stuff? agricultural supplies? Produce? … I am open to suggestions.

We have people who have never been and have no contact with anyone who has been to China, been in the vicinity of Chinese (e.g., tourist centers chocked full of Chinese tourists), or are Chinese; developing infections with Coronavirus. I am more than open to other suggestions and theories, but small towns in remote areas of Italy that have very little if any direct contact with the rest of the country, let alone China, especially over winter, seems quite peculiar; unless we simply have not identified (or officials are keeping secret) a far larger outbreak in cities.

And please don't try to tell me that western governments would not keep secrets or be dishonest. We are all adults and smart here, let's act like it.


Our media is referring to "patient zero" in Italy as a 38 years-old man. So either he is known or our media is full of your-know-that. Which would not be surprising.

Edit: a commenter below correctly pointed out that that 38yo man is being referred to as "patient one" not "patient zero". My bad.


That 38 year old man was the one I talked about above, the person who went to the hospital on whom they first found the disease, but not necessarily the person it originated from. Likely they have asked him (as well as anyone else affected) whether he's been outside of the country and he answered no (otherwise they'd say they have found the origin).

I'm not an expert, so I looked up what "Patient Zero" is defined as. Wikipedia [1] defines it as the case that has been detected first, but also says that media has used the term to refer to the source of the disease. So the Italian media's use actually matches the Wikipedia definition, while my use in the post above, as in this CNN post [2] matches the other definition. Sadly the term is a bit vauge.

[1]: https://en.wikipedia.org/wiki/Index_case

[2]: https://edition.cnn.com/2020/02/23/europe/italy-novel-corona...


Well, then our media is wrong.


I just read a CNN article entitled “Italy has yet to identify the source of its outbreak”, apparently from 8 minutes ago, citing a regional official.

https://edition.cnn.com/asia/live-news/coronavirus-outbreak-...


Things are developing very fast, expect that distortions from the chinese wispers games that is modern media to be worse than ever.

I've seen report that the first case was in contact with a person that had been in China but showed not symptoms and even might have tested negative at some point. If they get re-tested and show positive now, or some of their possessions do, that solves the mystery.


Dutch media reported yesterday that this person (who had been in China and had dinner with the 38 year old "patient 1") still tested negative on a second test, so the search for the real patient zero continued.


Didn't China changed how they were confirming cases to an MRI scan as people were still testing negative on tests 2-5 before testing positive.


Yes, but the problem with using that in this context is that an MRI scan can't fully distinguish COVID from other severe respiratory infections. It definitely won't work on someone who's asymptomatic.


I've been reading la Repubblica a lot today since I live pretty close to where the disease is spreading. They always reiterated that patient 0 who started spreading the virus in Italy is not yet identified. They had a "suspicious" person identified but that person later on was tested negative.


I think they're referring to him as "patient one". Patient zero (i.e. someone who is or was ill and has recently come back from China) hasn't been found yet.


Why does it have to be China? Couldn't it be Thailand/Singapore/S.Korea/Japan/Israel/Iran etc?


True, that would have been more correct. However, keep in mind that these people who are found ill now in Italy probably have contracted the virus weeks ago, before it started spreading substantially to other countries. Or before we knew it was already spreading anyway.


I'm strongly skeptical. Current research suggest mean incubation time is 5 days and stddev is 2 days. That means most cases will be asymptomatic within a week. Clearly, there were cases in the countries I listed above ~10 days ago, except Israel and maybe Iran was still in its infancy. The >20 days incubation time we see in news seems sensational and there is no research to back it up, except one non-peer-review paper published a few weeks ago.


Udik should have used e.g. rather than i.e.


You are correct. And to clarify further: I was talking about Lithuanian media, not the Italian one.


I read a lot about this virus lately, and it looks like the mortality rate depends a lot on the availability of intensive care. If that's the case, slowing down the diffusion of the infection could be really important in keeping down the total number of deaths.


I noticed the same thing. As numbers continue to grow, we run the real risk of even top of the line health care systems being overwhelmed and people passing from lack of access to care. Couple numbers that jump out for me are China with ~3% mortality rate but also rumors of these numbers being vastly unreported.

Iran with a 19% mortality rate (on a small scale)!

Also the mortality rate appears to be 3.2% where for a while it was in the low 2s.

https://www.worldometers.info/coronavirus/#countries

If this grows into a true pandemic, it will to the best of my knowledge be the first stress test of our Just-In-Time style of inventory management at grocery stores.


Iran's mortality rate is almost certainly much lower than 19%, since there's reason to believe the total infection rate is much higher than they're claiming. We wouldn't expect nearly so many travellers from Iran to be infected if coronavirus was as rare there as their figures make it out to be.


Given that it can take N weeks to die, wouldn't it make sense to calculate the mortality rate at a given time t as the number of deaths at time t divided by the number of reported infected people at time t-Nweeks ? (I am using N =3 for my back-of-the-envelope calculations).


No, since not everyone who dies will have had a confirmed case 3 weeks back - both because the actual time the disease takes is (almost surely) variable and because detection isn't perfect. The mortality rate in Iran is infinity by that metric, for example.


In Iran I suspect that either the actual number of cases is much higher than currently reported/known or that the people infected were mostly elderly, or both.


China also reports about 8 recovered for every 1 death, so even if their numbers are accurately reported, there are a lot more who have done neither as of yet, and about 11% of them will die. Which would be a lot more deaths.


China also has a relatively old population, due to their one child policy. And age is a risk factor for covid-19. Italy on the other hand... Oh, nevermind.


Dumb question but what intensive care? Do people need to be on respirators? Need access to drugs only available at ICU? Just curious if any of the things done at an ICU to prevent death really need to be only at the ICU.


The most extreme consequences of infection include acute respiratory distress syndrome (ARDS) and sepsis, which may require ICU-type treatment. See [0] for World Health Organisation guidance on critical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected. The majority of patients don't experience such severe consequences.

[0] https://www.who.int/publications-detail/clinical-management-...


You mean specifically SARS, which is a syndrome not a name of the virus. The really really agent is immune pneumonitis, or cytokine storm related sepsis.


IANAD, but I'm pretty much exactly quoting the linked WHO material (dated 28 January 2020) relating to 2019-nCOV, which describes acute respiratory distress syndrome (ARDS) as something that might need to be managed in an ICU, as per the original question.


Yes, mechanical ventilators and in most cases, supplemental oxygen for roughly 18% of patients.

We can expect CFR in the US to be fairly low (approx 2%) as long as the availability of these resources permits treatment for all who need it. After saturation, however, the CFR will move asymptotically toward approx 15%.

Medical system saturation is believed to be the main reason the CFR in Hubei is much worse than other provinces.

The US has about 62k mechanical ventilators, about half of which are already occupied at any given time, and half of the available ones are purpose-built for infants in NICUs. So let's assume we begin to have a real problem above (62k/4)/0.18 == 86k simultaneous US cases.

I'd assume oxygen supplies should be easy to scale up. No idea about scaling up the manufacture of ventilators, or if the (much more numerous, and cheaper) CPAP machines in the US could be used as stand-ins. Perhaps someone more familiar with these devices can chime in.


> After saturation, however, the CFR will move asymptotically toward approx 15%.

> Medical system saturation is believed to be the main reason the CFR in Hubei is much worse than other provinces.

This would practically be a Denial of Service Attack on any health system, no matter the country in which that health system is based in. Which is why it is so important to try to contain the virus spread before we get to the "move asymptotically toward approx 15%" phase.


CPAP is definitely a viable intervention for ARDS. Some percentage of patients will still end up needing intubation/ventilation, but CPAP is a good way to prevent that in some percentage of cases (esp if used pretty "aggressively" to support the patient while they're still able to breathe on their own, if they get to the point where they can't breathe for themselves effectively enough, then CPAP isn't going to do anything for them)


I read an article a while back where they said there are a few bands of severity (this was how they treating in China). First level of seriousness was oxygen / respirator. Then for even more serious cases they had to actually oxygenate the blood outside their body. Basically the problem was people can’t breath because of fluid or maybe it’s damage in their lungs so all the treatments of the severe patients were to help that.


As far as I could see in some Twitter videos coming out of China some people need to be on respirators and in a horizontal position. At the limit you can also do that in sports- and concert-halls, which is what the authorities seemed to have done in Wuhan.


From what I understand, there just aren't that many artificial respirators/ventilators.

Worse, a lot of medical equipment (though not sure about artificial respirators/ventilator) is made in China, whose manufacturing capacity has been drastically affected by this epidemic.


A doctor on youtube went over 3 cases and how they were handled, 2 older people and a younger one. https://www.youtube.com/watch?v=Q0A0LyMru3I


if you get the dirty end of the stick and your interaction with the virus is an endangering one you will have problems with your organs due to the virus itself and arising complications


So Italy having an arguably uncontained cluster is probably the most troubling part. The EU has extremely porous borders. The chances of this spreading to the other EU members (and the UK) got a lot higher.

At least in the US you largely have to come in by air. Yes of course there are land borders. Canada is one but fits the same description of most cross-border travel (apart from to the US) is by air. The border with Mexico is... probably more of an issue.

Anyway, the benefit of this is that it gives you a central screening point. Given that carriers can be asymptomatic it's not impossible someone will slip through but it's more difficult for someone to convince themselves they just have a cold and they need to go home, to work or otherwise move across a border and spread the infection.

The Northern hemisphere summer really can't come soon enough.


> The border with Mexico is... probably more of an issue.

AFAIK there are no confirmed cases in Mexico. It wouldn't surprise me if that was because of the inability of the government to detect it.

I live in Mexico and I believe if it gets here it will be unstoppable. The government doesn't have the resources China has to contain and track infected people.


Mexico did well in containing the H1N1 flu in 2009. Granted, COVID19 seems much more infectious, and our current government has repeatedly cut funding to public health, so you're maybe right.


Hopefully I'm wrong, but COVID2019 is a much different beast than H1N1. Time will tell.


Summer = fewer colds?

It could be problematic, though, because lots of people travel during the summer. There are probably millions of people queued up to visit Italy, Spain, Britain, etc. The Europeans take long vacations, so populations will be particularly mobile in July and August.

I wonder if the U.S. might be slightly less vulnerable to contagion, since Americans tend to visit beaches, national parks and other less crowded places, whereas in Europe the tourist attractions are in crowded cities.

It's going to be an interesting few months before a vaccine is hopefully found.


Summer = better air flow, both inside and because people spend more time outside.


Not an expert, but it's been stated by experts that coronoviruses, in general, spread slower during summer. This has not been proven for COVID-19, but presumably there will be some nontrivial affect on this virus as well.


This is likely due to hotter temperatures having an effect on humidity.

Very cold and very hot temperatures would reduce range of droplet transmission and viability of fomites. (contamination)


Should I take risk of downvotes and explain it?


C’mon man just explain it, damn internet votes.


Vector Koltsevo 16.09.2019


A couple of excellent sources for COVID19:

https://bnonews.com/index.php/2020/02/the-latest-coronavirus... (most up-to-date counter and news aggregator which includes a source for each reported number)

https://www.reddit.com/r/COVID19/ (strictly moderated, lots of links to scientific reports and papers, no hoaxes and fake news)

https://docs.google.com/spreadsheets/d/1Z7VQ5xlf3BaTx_LBBbls... (spreadsheets with interesting charts)


I’ll through out the daily who situation reports:

https://www.who.int/emergencies/diseases/novel-coronavirus-2...



> And what should each of us do, beyond staying informed and washing our hands frequently? Keep calm and rational. It might be worth stocking some reserve of critical medications, for example — but not too much, because hoarding could create shortages.

> We, as individuals, can also try to plan for basic contingencies. Companies can cross-train key staff members so that one person’s absence won’t derail the business. Family members and friends should be watchful of one another’s health and welfare, and stand prepared to care for the moderately ill if hospitals become overtaxed.

> “Pandemic” isn’t just a technical public health term. It also is — or should be — a rallying cry.

I would add that it is helpful to have a stock of at least 3 or so weeks of food and supplies so that you can, if needed, quarantine yourself and take care of yourself and your family/relations well. There isn't enough hospital space for everyone and a lot of people with the virus aren't sick enough to take that space from the those that really need it.


> if needed, quarantine yourself and take care of yourself and your family/relations well

How would that work in practice? The last I heard you can catch this virus pretty easily just by having air touch your eye.

A lot of people live in either a city or a suburban area and most apartments and houses aren't air tight. Wouldn't your breath get circulated out of your apartment, mixed in with the outside air and drift over to your neighbor -- or is the virus not that susceptible to spreading?


The virus is not airborne, it propagates via aerosol so it is very short lived "in the air" and over surfaces.


[flagged]


A claim like this needs a source


I think OP might be confusing "airborne" with "aerosolized" because the latter is transmitted through the air, just over very short distances. Although, in the case of aerosolized fecal transmission due to buildings with decrepit/faulty plumbing, the distances can be fairly large. And it does appear Covid-19 can be spread that way:

https://www.newsweek.com/coronavirus-may-spreading-so-fast-b...

https://www.tandfonline.com/doi/full/10.1080/22221751.2020.1...

https://www.vox.com/2020/2/20/21143785/coronavirus-covid-19-...

https://www.bloomberg.com/news/articles/2020-02-20/fecal-tra...


This is not correct.


> A lot of people live in either a city or a suburban area and most apartments and houses aren't air tight. Wouldn't your breath get circulated out of your apartment, mixed in with the outside air and drift over to your neighbor -- or is the virus not that susceptible to spreading?

Not an expert, but if I understand correctly the virus would be unlikely to survive that long outside the body. Even in the cruise ship which was docked in Japan, which would be a bit of a "worst-case" scenario for the transmission you describe, most people didn't get sick.


Coronavirus is possible to transmit via aerosol but not airborne. They differ in the transmission distance, among other things. Virus are infectious only when you receive a certain amount (Viral load). It is possible the virus loaded aerosol drift far away, but the density would become lower the further they drift.


What's your prepper food of choice?


You don't need to stock up if you can get food delivered. They can leave the delivery on the doorstep.


That might be what the other 1.5 million people in my city are counting on. Which means, I’m not going to count on that.


If your city's supermarkets can feed people with in-person shopping, they can feed people with deliveries as easily, it's the same number of people buying food.


That's assuming that every supermarket has enough delivery staff. That's not a valid assumption in many places.


With an extra layer of logistics that will have failed because the delivery drivers or pickers are sick.


You’re not taking into account panic buying / ordering. If it gets bad where you are people are just going to order as much as they can and then there won’t be enough - this already happened with masks here in the UK and we only have a few cases. I had to send some to Hong Kong for a family member a few weeks back and paid £20 for packs of 20 for proper n95 respirators. They’re now sold out online and everywhere despite being £15 EACH.

Stock up now while no-one is panicking yet. Don’t waste money buying weird stuff - Just get stuff you’ll use anyway over the next few months.


> Stock up now while no-one is panicking yet

That's what triggers panic buying... It's a snowball effect.


Call it tragedy of the commons, call it whatever you like; your not buying stuff now isn't going to prevent a run later.

Socially, you're probably still better off buying sooner rather than later, because that means the system has more time to restock and ship things around for people later. If you're part of the end pile up, you're another stresser at the worst time.

As evidence of this... the ideal time to stock up with emergency supplies was months or even a couple of years ago, when it would bother nobody. I've buffed up some supplies a bit, but I wasn't starting from scratch because I've been keeping stuff on hand for a while now. Giving the system months or years of headstart is better than weeks, but weeks or even a single week is better than nothing.


Thanks for this comeback - exactly. Ordering a few extra tins of beans and spaghetti is hardly going to create a snowball effect if you do it now. Food isn’t in short supply in general, it just may become in relatively short supply in the shops near you. They’ll reorder more by tomorrow with no issues. It’s just about having it in your house VS in a storage centre some place.

Masks is slightly different I will agree. They are genuinely in short supply and medical workers need them more.


Do not count on this. Buy food stuffs that are non-perishable, which you can eat anyway if it turns out to not be needed.

I speak from experience preparing for hurricanes. If you wait until the last minute, you're going to be woefully unprepared.


You're not accounting for the fact that in these types of situations, there is often a run on things like food. You can only get food delivered if the stores still have food.


What about the people that made the food you got delivered.


They won't once the quarantine is in effect


A quarantine that tries to prevent people getting food is a quick way to get riots. No government would be stupid like that.


If it gets bad enough, it's quite likely that there'll be martial law, and possibly food rationing enforced.


Indeed. If a whole city is under quarantine then the supply of food has to be managed by the authorities.


Show me a person who values their minimum wage so much that they will risk making pizza deliveries (or even bake the pizza) in a quarantined city, please. Typically, the government does it in these cases, and often it's not enough or not what you need or prefer, so it's advisable to prepare.


Why is hacker news censoring covid-19 articles? This article just disappeared from the front page despite having more upvotes than most articles on the first page after being submitted an hour ago. Another covid-19 article over the weekend disappeared from the front page also.


I'm not aware of HN itself actively "censoring" anything, as long as I've been here. If articles are disappearing from the front page, then it's likely due to them being flagged by users.

I'll also note that I use an alternate front-end for HN - hckrnews - which by default sorts by time, so the only way I'm ever aware of this sort of complaint is when someone brings it up in the comments.

As for this topic in particular, there has been a lot of coverage about COVID-19/2019-nCoV recently, but there hasn't been a lot of new information. I suspect people are flagging the topic because they're getting their regular updates on it from other communities and want HN to remain a place where topics that are of particular and specific interest are posted. Once I realized that's how the majority of the community sees it, I stopped thinking of the rise and fall of topics here as being based on whether or not they are "newsworthy" and it started making a lot more sense.


At 141 points and 215 comments, it might have triggered the flamewar detector.


I don't know exactly, but IMHO this weekend it has raised itself up to the point that the tech industry really needs to start paying attention to it on a number of levels. The company I work for has a number of significant international offices, and I think the odds of at least one of them being significantly impacted at some point in the next 2-3 months has to be at least 25%. It isn't just the virus itself, or even necessarily primarily the virus, but also the measures the local government enforces. A lot of us engineers have a relatively easy "work from home" option, but not everyone is a programmer.

You also have localized concerns, like, at what point are all the people ordering from Amazon going to stop because they're afraid of getting the virus shipped to them? What is Amazon doing about their worker's health, especially in light of the rather persistent rumors this can spread while asymptomatic? On the one hand, I see people claiming that the virus can't survive being shipped very well and on the other hand we have Amazon striving to ship faster and faster, to say nothing of the actual delivery person.

Whether we like it or not, this is rapidly becoming "tech industry" news too. Unless we are very lucky, by the end of this week, I suspect that's going to be obvious to everyone.

As I've said a few times about prep, even if you don't get the virus or your area never has to be locked down, you ought to be doing prep work anyhow. If it isn't COVID-19, it'll be a quake, or a really bad normal flu season, or any number of other things. You make society more resilient and better able to deal with "true" emergencies when you've prepped enough to take care of yourself and not drain vital social resources at the worst time. You don't usually get lucky and have this kind of warning about oncoming issues. Prepping for a pandemic isn't identical to all the other things you may actually experience, but there's a lot of overlap.


I feel fairly uncertain as to how seriously I should /personally/ take COVID19 living in a large American city as a healthy young person with no upcoming travel. I see some friends seriously taking precautions (like buying masks) already, which up-to-this-point I've found a little absurd. Could anyone who knows better perhaps enlighten me on how I ought to be reacting to this?


Buy extra food so if you get sick you don't have to go out and infect other people, or if you are in an area with a lot of sick people you don't have to go out to bu food and get infected.


That's a socially-conscious act and I applaud it. But in truth, before this is over every person on earth will have experienced the virus.

The reason to control the spread and delay infection (not avoid it; that's probably impossible) is to allow the health-care infrastructure critical time to manage the flow of sick. If we all got sick at once, there'd be no capacity to treat 99.9% of us. If we spread it out over a year or more, we can treat more people and have a better outcome.


That's not typically how it works. Historical pandemics have only infected about 30% of the population.


This one is air-borne with many days of no initial symptoms. That's the whole deal right there, why this is especially problematic.


This is not correct. The virus is not airborne.


Carried in a sneeze or cough? What do we call it then?


Aerosolized. The difference is important because the aerosolized virus only survives in the bodily fluids expelled by the sneeze/cough, which gives it a much, much shorter range than if it was actually airborne, which would imply that the virus could survive long enough to spread without the need for a bodily fluid to host it.


You probably won't die, esp since you're young, but it's certainly possible that you could get caught up in a quarantine. Best to have a good supply of any required drugs, etc.


What are those required drugs?


I think people generally mean drugs that are required for you. E.g. if you have some medication you need to take regularly, make sure you have a large enough supply to be able to last a few weeks without access to renewing your supply.


A study from Germany said that by day 10, all patients had produced antibodies against coronavirus. The key to treatment is to make sure that the patients don’t have severe symptoms before then and then the body will naturally fight it off. If the body gets overwhelmed before day 10 then it becomes more severe and possibly fatal.


can you link me to the source?


Last week google had a promoted 'fact check' snippet for searches about covid-19 being released from a lab. Predictably, it was an article debunking the story as a crack-pot conspiracy theory. Today stories about covid-19 being released from a lab are front page at news.google.com.


Those new articles have basically the same exact conspiracy theory reasoning behind them as the ZeroHedge and friends ones from last week, so this isn't as much of a slam dunk as you make it sound like.


Not sure why you need to characterize it as a slam dunk. That wasn't my intention. It is simply an observation of a contradiction.

If we're capable of consuming news from a variety of sources, digesting them and coming to our own conclusions, that should be enough. If not, hand holding isn't going to help.


There are two versions. It being genetically engineered is highly unlikely. However it being studied in the Wuhan lab and getting out through a screw up is possible. Not that it makes a huge difference at the end of the day.

The fact check seems quite wishy washy https://fullfact.org/health/coronavirus-government-laborator...

and here's the lab leak theorizing for what it's worth https://nypost.com/2020/02/22/dont-buy-chinas-story-the-coro...


The hit rate on conspiracy theories is getting to be better than the official narrative these days.


Can someone explain to me why coronavirus is getting so much coverage? According to Wikipedia, Coronavirus has killed about 2000 people. Each year smoking kills 480,000 people in the US. In two days smoking will have killed more people in the US than coronavirus has worldwide.

Shouldn't we have headlines about this every day? Or any of the other far more deadly things (traffic accidents, heart disease, suicide, etc.)?

(I'm not trolling, I honestly don't understand why this is different.)


It has to do with catastrophic risk and the fact that pandemics follow a power law distribution instead of a normal one. The deaths from things like smoking or auto accidents are normally distributed with very very small deviations around a known mean. Smoking may kill 480,000 Americans per year, but there's never a year where it will kill 10X 100X or 1000X that number.

Pandemics tend to follow a power-law distribution, like earthquakes, where you have small outbreaks here and there and then one comes along at 100X or 1000X the magnitude of anything ever seen before.

Even people who don't have a statistical understanding of power law vs. normal distribution usually have a good intuition of it, which is why most people worry about terrorism more than one would if they were just looking at just the total number of deaths vs. something car accidents or smoking.

What makes the coronavirus so terrifying is power-law component and the unknown unknowns. We still don't have a good handle on basic things like how exactly how contagious it is, how deadly it is, and how long it will take to run its course. Sure, it could end up being equivalent to a "bad flu", but it could also become a repeat of the 1918 Flu or worse.


> Even people who don't have a statistical understanding of power law vs. normal distribution usually have a good intuition of it, which is why most people worry about terrorism more than one would if they were just looking at just the total number of deaths vs. something car accidents or smoking.

I think this is a poor example, by any measure terrorism is an irrational concern for Americans, it's nothing like a pandemic that could actually affect the whole country.


Not irrational, since, like pandemics, terrorism involves a lot of "unknown unknowns". You're thinking past terrorism attacks == future terrorism attacks, which is the wrong way to look at it. It's not a linear concept like auto accidents. Deaths from terrorism can jump around wildly from year to year. You can have zero deaths from terrorism one year and one million the next. That's how certain phenomena work. Others are linear and it's important not to confuse the two.


Indeed, while I haven't seen anyone even theorize that COVID-19 is a terrorist attack in the darkest rumors I've seen, it's the sort of thing you need to worry about if you let a terrorist organization ever got far enough to produce one of these things, which is a completely realistic concern.

To my eyes, COVID-19 looks like a single source that is spreading like wildfire, but, imagine this was a deliberate attack. Things spread fast enough on their own; consider how fast this would be spread if there was an organization doing it on purpose. What if this basically appeared in every major US city simultaneously?


It has the ability to affect the global economy in ways that the others dont. If people don't want to go to work due to an increased risk of mortality, business will shut down. If everyone is forced to go to work and they all get sick and are unable to work for several weeks, business shuts down. Finally if everyone gets sick and 3% of your workforce then dies, that again causes massive economic disruption. This is also occurring on a time scale far shorter that people getting sick from smoking or heart disease.


But couldn't the same thing apply to traffic deaths? In 2018, in the US, over 36,000 people died in car accidents. That's higher than coronavirus deaths, so logically shouldn't we all stay off the roads and quit going to work? Wouldn't that have the same impact?

Source: https://www.reuters.com/article/us-usa-autos-traffic-deaths-...


Sure, and I think it is a good comparison in that the numbers are large and it is unexpected. The difference is that we as a society have come to regard them as an acceptable risk. In addition, they are isolated, so while they are common, the odds of 10 people you know dying in a car crash are very low. With a virus, an entire office could get sick or even worse an entire school. For me this is my primary fear. My kids entire school gets infected and kids start dying or being hospitalized in large numbers.

This also adds to the economic impact. Its the clustering aspect of this that drives fear and uncertainty.


It is disingenuous to compare last years total traffic deaths to total coronavirus BEFORE coronavirus has spread. The coronavirus deaths haven't happened yet.

If I told you due to a newly discovered automotive manufacturing defect, 2% of cars would explode and kill the occupants, and 20% of drivers would be hospitalized in serious condition, that wouldn't be worthy of being on the front page of every newspaper?


Something like traffic deaths - which occur fairly routinely and regularly - are probably already factored in by large companies (i.e. companies expect N people to leave every year, of which M might be unexpected deaths).

The new coronavirus hasn't been accounted for yet by our society, and probably can't be accounted for given that we don't know how far it will spread and how many will die.


Too bad life is all about work and world economy... I guess we'll have to wait a bit for the PS5 and the next iphone, how sad.


? Its hard to live without shelter,food and water. All cost money, which in turn is a product of the economy and work. It you are saying that everyone should be guaranteed all 3 regardless of work that is another conversation, but not really the reality of today.


If I had to guess it's uncertainty. If coronavirus infects half the world by the time it's run its course that would be 77 million people dead, on top of however many normally die in that time frame. I have no idea how likely a 50% infection rate is but it's a lot more likely than an equivalent 11x jump in the rate of deaths from smoking over the same time span.


Because smoking has been in the headlines, but it's not news anymore that it's killing so many. The editor of that newspaper would get fired for making that a headline everyday.

It is news that there's a new flu-like virus emerging, spreading, and having a relatively high rate of mortality.


People also discount things that will probably kill them decades from now in a horrible way if they don't change their behavior instead of things that will maybe kill them weeks from now in a horrible way if they're unlucky.


If you touch a smoker, you don’t get lung cancer and risk death.

The hype for this is part media sensationalism, part risk of it spreading everywhere.


Because the number of death from smoking or traffic accidents doesn't grow exponentially, as they're not caused by an infectious disease. You don't go from 100 lung cancer cases to 80,000 within a matter of weeks.

Also, consider second order effects. What happens to hospitals when you get 20k cases of something in a month, vs 20k over a year.


Part of it may be volition, and part may be time, and part of it may be the unknown.

If I die from smoking, it's probably because I smoked. (Yes, I know that some people can die from second-hand smoke, but it's by far the minority.) And if I die from smoking, it's from smoking for 10 or 50 years, not from one cigarette.

With Covid, though, I can die because someone at my work went the wrong place on vacation. And I can die in days, not in years.

And, Covid today kills fewer than smoking. That may not be true in a year, though. So part of the focus is because the potential is there for it to be an objectively bigger killer than smoking.


Not smoking might be a solution to one of those problems but not coronavirusing isn't for the other.


Exponential Growth


It's the same with terrorism - when random attacks seemed to be growing in frequency but were still not super common, it was the same question. They might not grow exponentially, but they appeared to be growing in some manner.

My answer now is the same as then: fear is about the future!


For why we are collectively concerned about a good comparison is influenza (flu), which kills millions worldwide each year and has a case fatality rate of around 0.1%. I believe flu is the single deadliest pathogen worldwide currently.

Covid-19 appears to be extremely virulent and at least as lethal if not several orders of magnitude more so than influenza.

The immediate reason why is Covid-19 is getting so much attention compared to flu in the news media is that it is new. However, some of the reason why it’s getting so much attention from public health officials is that

1) it’s not well understood yet, and the upper bounds currently on virulence and lethality are very high

2) it appears virulent enough that it could become endemic in humans, meaning that we could be dealing with annual epidemics like the flu.


> a good comparison is influenza (flu), which kills millions worldwide each year

That's a slight exaggeration. The number is in the hundreds of thousands, not millions.


You are right, except on exceptional bad years. Apologize, had the higher number in my head.


I guess because somewhat bad diseases make good news. When you discover a new disease, then the mortality will be quite high, because you only see the cases so bad that people went to specialized hospitals, while you don't know anything about all the people with light cases, they just take a day off from work and never bother a doctor.

Once you are past the "new and incredible deadly disease" headlines, the disease is news, because it was previously reported in the newspaper.

Contrast that with a well known disease like the flu, the initial headline is not there because a flu wave is not news, if it is not a once in a decade bad flu season. (And note, once in a decade bad is only known at the tail end of the flu season, not at the start.)


It kills 2-3% of the people it infects (within days, not years) and it's very contagious. If it spreads throughout the US, that's 6-9 million deaths in the US alone.


I would be ok, if you had compared coronavirus with the flu we have learned to live with, which kills way more people each year... but smoking? is smoking transmitted over the air? If someone smokes next to you, then you will also start smoking? Do you die from smoking in a few days?

Coronavirus is on the news because we can't control it, we can't see it, it can spread without show of symptoms, it can be deadly... has no vaccine - thus the fear of a pandemic.


smoking is not contagious, a smoker can't infect or kill you directly with cigarettes


Except that according to the CDC, second hand smoke causes 41,000 deaths per year in the US: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/heal...


> Except that according to the CDC, second hand smoke causes 41,000 deaths per year in the US: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/heal....

The thing with second hand smoke is your senses can warn you of this danger before it's a threat.

You can often see someone smoking before you can smell the smoke. You can also smell the smoke if you happen to not see them and then choose to react to the situation. You can either continue inhaling that smoke or walk about 30 feet in any direction away from the source to put yourself out of danger.

But with this virus, you don't have such luxuries. It's invisible, tasteless, odorless and can kill you after being exposed to it once. That's pretty much as scary as it gets.


you need to be exposed to second hand smoke for long periods of time before it can kill you, the covid-19 exposure take considerably less time in comparison, then again are they really comparable at this point?


well because people are used to those figures and it won't grab people's eyeball anymore. While coronavirus can potentially kill a lot more people if it becomes a global break out.


So it's what I'm thinking, it's the news hyping it up to get clicks, ad impressions, etc? Seems kind of irresponsible to get the public into a frenzy just to make money.


> it's the news hyping it up to get clicks, ad impressions, etc?

No. You've already had several good answers on the difference between multiplicative & systemic risk vs additive risk. That's the reason that people are taking this outbreak seriously and why it is getting significant media coverage.


> According to Wikipedia, Coronavirus has killed about 2000 people.

It's mostly isolated to 1 province in China. If you extrapolate those deaths world wide, you're talking 10s of millions of people dead if it goes pandemic.


You can't really extrapolate things like that though. Try extrapolating west virginia diabetes related death to the world and we'd be fucked too.


I don't know that this needs to be said, but -- diabetes isn't contagious.


West virginia diabetes is not rapidly spreading around the globe just now.


As someone flying through Europe for the past three days and the next six, I'm just pushing that out of my mind while I flinch every time someone around me coughs...


[flagged]


As a European, I agree.


For those who are worrying, don't bother with medical masks.

A decent DIY rebreather for spray painting, sanding or house clearance should work.

I have stockpiled gloves and goggles along with a rebreather FFP3 level.

Total cost along with sanitization wipes and alcohol gel - £49

Piece of mind - priceless!


NY Times would do well to let people read at least this article for free.

It potentially concerns the health of every person on the planet, so sticking it behind a paywall/accountwall seems like particularly...poor taste?


What is the worst case? 15% of the worlds population dies ?


Nearer 2%.


2% is the number of death when you have Intensive Care Unit beds to provide oxygen, fluids, anti viral drugs to serious case.

15% is the number of serious cases on average.

So once you have filled all your ICU, you cannot take any serious case anymore, so I would say the most apocalyptic case is that all hospitals are overwhelmed, and you cannot address any serious case, so 15% is still possible in the most horrific case. (But not the more likely if you quarantine everyone)

However in poor countries without any healthcare infrastructure we could have quite a number of serious case dying.


So we can stop this right now if everyone goes home and stays there


Non-paywalled link?



Blocked at my school :/ you can use Firefox's (probably Chrome's as well) reader mode to bypass the paywall though.


If you are using Brave or Firefox, you can just use "reader mode" to bypass the paywall.


How do you enable reader mode in Brave?


For Brave 1.5.5 you toggle: Settings -> Accessibility -> Simplified view.

After making this change, the option to switch views will appear at the bottom of the screen, but only if Brave detects/decides that the page is suitable for this view.

Edit: Since Brave is built on chromium, other versions of Brave have a similar feature via chrome://flags/#enable-reader-mode


It seems that a number of publications have lowered there paywalled for coronavirus articles. As an important public service article, it seems like a crappy thing for the NYT to keep it up.


I suspect because its an opinion piece, not actual news.


That's a funny business model for a news site.

Paywall everything except really important critical news which isn't an opinion piece and end up in a situation where 99% of your site is paywalled. So basically almost everything written isn't important enough to consider reading.


Can someone ELI5?

Why is it so hard to produce a vaccination for this virus? We have vaccinations targeting viruses all the time, isn’t it?


Vaccines are being worked on as we speak but the testing and approval process takes a long time.


IMO, if testing shows a good effectiveness, approval will be fast-pathed.


The fast path for vaccine approval is 2+ years.


It looks like it was fast tracked quite a bit faster than 2 years during the H1N1 pandemic.

I don't have a better resource right now than Wikipedia, but I guess we could follow the links for more. https://en.wikipedia.org/wiki/2009_flu_pandemic#Vaccines

But according to this page by 19 November 2009 the vaccine was distributed to 16 countries. I think it was first really noticed in April 2009.

Not making any claims about what to expect for COVID-19, just that they have fast tracked vaccines faster than 2 years in the recent past.


Yes. Definition of "pandemic": https://en.wikipedia.org/wiki/Pandemic

Even though the fatality rate in developed economies seems relatively low (on the order of 1%, perhaps lower), significant economic and logistical disruption appears inevitable in the short run, judging by the reaction of financial markets.

Please don't overreact -- there's no need to blow things out of proportion -- but don't be stupid and dismiss this as unnecessary fear-mongering either. It's best to be prepared, just in case.

For more details, see:

* https://news.ycombinator.com/item?id=22403200

* https://apnews.com/32540d09ec101aac057660ef1b0aa970

* https://www.wsj.com/articles/what-we-know-about-the-wuhan-vi...

* https://www.washingtonpost.com/world/asia_pacific/coronaviru...

* https://www.nytimes.com/2020/02/24/business/stock-market-cor...

By the way, the OP's headline appears to be an exception to Betteridge's Law of Headlines: https://en.wikipedia.org/wiki/Betteridge%27s_law_of_headline...


For perspective, numbers from the regular flu this winter: "At least 14,000 people have died and 250,000 have already been hospitalized during the 2019-2020 flu season, ..."


Yes, and we can expect 10X to 20X that number at risk when this virus spreads.


Why stop at 10x or 20x? Why not 1,000x? What's the science behind that?


0.5% mortality vs 2-3.5% mortality, look the number of recovered cases is still small, so we can't actually count the in progress numbers just yet


Death rate of .1% for the flu and 1% for Corona.


2.5-3.5%? In China anyway.


For further perspective, Coronavirus' death rate is 10 to 40 times that of the regular flu. Of course, this number is an early estimate, but there is no doubt that this virus is much more dangerous than the flu.


The difference is we know what the flu can do and how bad it usually gets. And it's less lethal -- it's just more cases that's why there are lots more deaths with flu.

But that wont necessarily the case if there's a corona pandemic.


We don’t though. It varies wildly.

2018-2019 flu season saw 50 million infected and 80,000 deaths in the United States.


Are you comparing covid-19 cases against the sum of ALL cases of *regular flu(H_N_ influenza( A B C D) virus)?

For perspective, how many country will actually restrict travel or even undergone state wide lock down for an outbreak of regular flu??


Some worst possible case models predict 15 million people dying from this in the US; making it 1000x worse than flu in the worst case.

E.g.: https://www.reddit.com/r/COVID19/comments/f850n6/a_worst_cas...


Of course it is. The officials at WHO failed us because they are more worried about the politics than the truth. This type of behavior will make us not trust them in the future.


I think that a misunderstanding of the official definitions that the WHO uses is maybe what has "failed us". The WHO has been pretty alarmist and helpful in getting people to prepare. They also were instrumental in getting China to start reporting clinical diagnoses as well.

The world is going to keep trusting them in the future, and of course we're going to keep thinking for ourselves as well.


It may not seem like it, but when you say things like, "The officials at WHO failed us because they are more worried about the politics than the truth" you are peddling conspiracy theories.


It's still actually quite limited according to official data.

They have to consider the reactions of the public and also the potential effects of declaring pandemics too often if it is not necessary.

I don't have many comparison points but a quick Google shows that we are still very far from the 2009 flu pandemic, for example.

Of course that may change...


The problem there's very little testing being done for this novel pathogen.

New tests can't just be created by hospitals and labs out of thin air, and they can't be used without undergoing a lengthy bureaucratic approval process.

For a novel pathogen like this the tests are still in the early phases of being manufactured and approved, so most people who go in with symptoms just aren't going to be tested.

There's also a manpower issue that has to be taken in to account: if everyone with flu-like symptoms came in to get tested the hospitals and labs would be overwhelmed even if they had enough tests available and those tests were already approved. Many labs and hospitals are already close to being overwhelmed from seasonal flu.

So I really wouldn't consider official data to be very reliable at this point. We really need to wait and see.

Meanwhile, though, it would be prudent to err on the side of caution.


Pandemic has a definition, and a disease that seems to be being detected and contained doesn't meet it.

This one is at the tipping point. The situations in Italy and in Iran are potentially run-away if they can't draw a boundary around all the infections including the original spreader.


There is no definition of a Pandemic. Even the WHO states they don't have it. I quote the article:

The World Health Organization no longer uses the classification pandemic, but the COVID-19 coronavirus outbreak remains an international emergency that is likely to spread further, a spokesman said on Monday.

https://www.reuters.com/article/us-china-health-who/who-says...


Please cite defensible sources.

The past weeks have been filled with mostly sentiment-heavy reports either downplaying it as just a mere flu, with no masks worn even in places like Tokyo - or on the other end of the spectrum - overblown sensationalist videos of people dropping like flies.

We need more credible and helpful reports not just hearsay.


Thankfully, this is a relatively mild virus. Part of what makes it hard to detect is that most cases (>80%) are mild, and many are actually asymptomatic:

https://www.google.com/amp/s/www.bbc.com/news/amp/world-asia...

The vast majority of people who have died have been elderly and/or infirm. The death rate under 60 is well under 1%. If you’re young and healthy, this is a chest cold.

The biggest thing the media needs to do is to walk back as much of the panic and overreaction that has been circulating as possible.

(edit: thanks to HN’s overbearing moderation system, I am unable to respond to replies. The censor-downvoting of factual information is apparently not a problem for HN mods, however.)

JoeAltmaier, to respond to your comment, unless you know hundreds of elderly people, about the same number of people you know will die as in the average flu season. Do you find yourself regularly worried about the flu? Perspective is important.


We actually don't know how bad this disease is.

China's reporting on it absolutely can not be trusted, because:

- their health care system is overwhelmed, so they're not testing everyone who may have been infected (a lot of sick people don't even go to the hospitals because they know they'll get turned away)

- they seem to have run out of testing kits in many places

- their testing may be faulty anyway (which could account for the many reports of people testing positive then negative then positive again)

- their media is tightly controlled so there's no independent verification of what they tell us

- they've changed their reporting criteria multiple times

Outside of China there have been too few cases to know yet either, and the countries where it has spread seem to face some of the same issues as China (such as not testing enough people), so their reporting is likely to be skewed as well.


So basically, you’re choosing to ignore everything we actually know, and replace it with your theories and FUD.

For the record? China is definitely, absolutely, positively under-reporting the infection rate. They have admitted it. They know that there are many mild cases that are not being counted.

Among other things, this means that the commonly cited fatality rates are a gross overestimate, and would be much lower if we could count all of the mild and asymptomatic cases.


"China is definitely, absolutely, positively under-reporting the infection rate."

They also seem to be underreporting the fatalities, by (for example) counting them as not caused by COVID-19 when they may well be.

Because both infection rates and fatalities are likely being underreported, and because we don't know by how much they are being underreported, it's premature to draw conclusions as to the severity of this disease.


No, this isn’t likely at all. The reason they are undercounting cases is because the cases not being counted are mild. If some of those mild cases go on to die, it’s pretty unlikely that it’s due to misdiagnosed severe atypical pneumonia.

Absolutely no reputable sources have advanced this theory, just people who are scaring each other on HN and reddit.

To summarize: undercounting mild cases is definitely happening. Undercounting of covid deaths is extremely unlikely to be happening. Therefore, we know that the current death rates are overestimates of the real values.

These are facts.


You are stating your own probability estimates. Those aren't facts except to the extent that it may be a fact that you do believe them.

Otherwise probability estimates and guesses about what China is or isn't doing and why aren't facts... they're just that: guesses.

Thanks for sharing them, though. It's always nice to hear the reasons for another person's opinion.


Influenza is the single most deadly pathogens currently circulating and we could end up with an entirely separate pathogen circulating annually with similar or worse fatality statistics? Yes that is terrifying, even if I personally have a low likelihood of dying.

Btw, influenza is also very lethal to infants. I have those in my family.


Disagree. The more people are conditioned to be vigilant the safer people will be. You don’t think you have any skin in the game, but I bet you wouldn’t be saying that if you were in Northern Italy right now.


Vigilant about what? There is no action you should be taking besides maybe storing some water and food.


So only 1 or two people I know will die of it? How is that 'mild' exactly? Relative to what? The plague?


0.8% of the people you know die every year anyway. If all of the people you know get infected it might bump it to 3%. Not that radical in my opinion.


That 0.8% includes 'old age'. In fact, its mostly old age.

The corona virus increases the death rate from influenza 10,000X. By communicable disease, 100X?


>mostly old age

Same as corona, no?

Edit: I'm not arguing it's less deadly than something else but in perspective I think 'mild' is an accurate description.


No, for most it takes a lifetime to accrue heart disease and cancer problems. It takes a moment to be infected with this virus, and will probably infect everyone ultimately(a year or two?)


What about non young or healthy people you might interact with when you’re asymptomatic?


Age in low 60’s is not really “elderly”...


The distribution is strongly biased toward the elderly no matter how you cut the data; above 60, most of the deaths are in the oldest cohort.


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