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Ask HN: How are you preparing for COVID-19 disruptions?
297 points by Spellman 31 days ago | hide | past | web | favorite | 539 comments
See title



My father had the misfortune of being a civilian in Kuwait during the first gulf war. What I learned from his stories is that the line between normalcy and utter chaos is thinner than one would think.

The war itself from the perspective of someone not actively participating is mostly boring (his words) - you can't really go outside, cable is down(no internet back then), not much is happening.

But the brief transition period between peace and war is the worst. People desperately trying to stock up in the last minutes, quickly realizing that it's pointless to stand in line and pay when there are so many more of them than the supermarket's staff.

I, for one, "prepared" by weighing 10kg more than a few years ago. I have body fat to spare. My only worry is a good source of water-soluble vitamins.


Fat is actually one of the last things the body burns during starvation. Your muscles usually go first.


Not true.

https://en.wikipedia.org/wiki/Starvation_response

> the body burns fat after first exhausting the contents of the digestive tract along with glycogen reserves stored in liver cells and after significant protein loss.[2] After prolonged periods of starvation, the body uses the proteins within muscle tissue as a fuel source.


I'm pretty sure Fat goes first. You mostly loose fat when fasting. It's not till much much later that you loose muscle (BMI has to reach a really low level for that to happen)


Talk to any bodybuilder and they'll tell you that for every 4kg of fat you lose you'll also drop 1kg of muscle.

So yes it is mainly fat but some muscles will be lost at the same time, especially if you have a high muscle mass.


As a Marine who has gone through many, many building and leaning cycles, I call BS on this. When you drop that fat, you aren't actually losing muscular tissue (at least not much). I've gotten down to Olympian levels of body fat, 9-10%, and what you are losing besides the fat is water weight. Your muscles shrink because they hold in less blood; your body regulates this to keep blood pressure normalized with all the decrease in fatty tissues. At less that 8% (on average, for men at least), most bodies will start to break down and metabolize muscle tissues (started happening to me around 9%, and was NOT a fun experience).


Yeah, came here to say this (was in the Army). My experience is the same. When it started to happen you could actually smell it (smells like ammonia ... like cat urine, almost).



Took me weeks to figure out what the heck that smell was; mostly assumed we'd gotten a bad batch of MRE's


I've always been a fat-ass (somewhere from 15-25% BF) so I've also never experienced considerable loss of muscle tissue (at least as far as the scales tell me) - however the body-builder club are at 6% body fat when cut and at what, 12-15% when bulking? They are absolutely going to metabolize muscle tissue when cutting.


Did you continue to work out while cutting? Because that reduces the muscle lost. If you're an average joe and you're starving yourself, your muscle will reduce comparably to fat.


As long as I'm able to lift weights I lift weights. I've never cut significantly though, I'm happy with 15% body fat as a lower bounds - I look good, feel good and am strong at that weight.

Maybe I'll try to drop to 12% to see if I can do it sometime, but I'm a long way from that right now (our third kid is 5 months old so I'm back to being a fat-ass).


I continued to do physical activity. I think your muscles will "shrivel" if you don't use them; they won't be engorged with blood on a regular basis, thus will lose plasticity at a cellular level. Then when you do use them, they'll fill with less blood, and look smaller. It takes a lot to actually lose muscular tissue. Mostly people just lose muscular plasticity, and they appear smaller.


are we all bodybuilders here? I don’t think you can compare.


This makes no sense. Why would the body prefer to break down a functional store of energy when has access to a non-functional one?


Pretty sure that’s exactly the purpose (evolutionarily speaking) of fat. It’s an intermittent store of energy to fill in the gaps between the sporadic meals we evolved eating.

It just makes so much sense that when food is plentiful (peak season) you want to be able to pack on the fat in order to get you through the cold season when food is scarce.


It also makes sense that we eat more heavy, carb-wise, in the winter and lighter foods in the summer, with spring and autumn being the transitional periods. Its to sustain our body fat, or move it into the direction of the next season. A lot of body in the summer makes it hotter (undesired; already hot), not much body fat in the winter makes it colder (undesired; already cold).

And it isn't only that. Squirrels even harvest so they got food in winter. We've also learned to maintain foods, such as sushi with rice, or with salt or acid so it wouldn't go rancid. Plus, like I said, there's "winter vegetables" which are high on carbs, low on water.


Because the functional store requires energy to maintain? Getting rid of it reduces the daily caloric need.

Pure speculation


It depends on which variant of PPARG you have.


You do have a source? I d heard the opposite.


i've read that your earlobes are the first to go


Yep, and the process is hard on the kidneys.


Which one, muscle or fat burning?


Breakdown of muscle tissue releases proteins that are damaging to the kidneys. It's called rhabdomyolysis. Excessive exertion, infections and starvation can cause it.


Rhabdo is no joke people. Drink your water, pace yourself when working out, an don't let any heavy objects fall on you.


I'm not.

There's no meaningful preparations for avoiding what is essentially a really dangerous variant of the common cold at an individual level.

Now governments and the medical field should be preparing for it. But most of that is logistical problems (e.g. number of hospital beds, preparing quarantine plans, test kits, etc).

You can order a bunch of masks if it makes you feel better, but countries with common mask usage are still seeing a large scale spread so YMMV.


Do not overstock on masks or other supplies. Masks especially should be available to the sick. It's ironic that (I'm sure) someone out there will stock up on 10,000 masks and it will cause them to be in even greater danger because the sick people around them will have fewer masks.

The CDC recommends that sick people wear masks to keep droplets in, and that people who directly interact with sick people wear masks while interacting with the sick person (to stop projectile droplets I presume). The CDC does not recommend masks be worn generally.

Masks help remind you not to touch your face, but you can just put tape on your fingers or something for the same effect (this is just my personal idea).

(This is more of a PSA than a direct reply to your comment.)


Sorry, but the tape on your fingers is a bad idea. The adhesive from tape attracts germs, and far more than just having bare skin.

Wear gloves instead, to avoid touching your face.


It was just an idea. You're right that it may have adverse effects.

Yet I wonder: Viruses live longer on a "clean-looking" doorknob than they do in a towel, for example. This was very counter-intuitive to me. So when it comes to a virus, would they live longer on skin or on a bandage or piece of tape?


Thank you for acknowledging this. I really appreciate it.

The issue is that the adhesive from tape is a form of glue. It attracts and keeps hold of germs. Plus, it is extremely hard to get fully off in terms of disinfection purposes.

I had a central line (dialysis catheter) in my chest for 4 months for a procedure called plasma exchange. You cannot take a shower with an exposed central line. A single drop of water on your line, or even the moisture/condensation from the shower can literally cause sepsis, as water has a lot of bacteria in it. This happens no matter how well the line is cleaned.

Anyways, I tried taking a shower by covering the line with a Ziploc bag and putting tape around it. I also cut the fingers off of gloves and /sealed the fingers of the glove onto the line with tape/. I literally put glue on the central line, which runs straight to my heart.

I never ended up with sepsis, due to the line only being in me shortly (4 months), but I did get chewed out by the sterility nurse.

Trust me, it is not a good idea.


You got very lucky. Lottery level winning lucky.


Basic lottery is 1 in 14 million winning. I guess "citation needed", having that exact winner on hn is pretty low probability. This is an irrational comment in an irrational subthread. I'm not sure adhesive tape doesn't have high germs density but i'm pretty sure there is little correlation between your finger sticking to a material and a germ sticking to that same material. This message has no positive outcome besides making feel good while i press "reply", it's not intended for you to read it, it's intended for me to re-read it while thinking of this moment.


It does attract bacteria plus other pathogens, plus makes them hard to remove.

For example, in the 90s, roll tape (versus now: single use sterile IV tape) was sometimes used to secure IV lines. Here is a study on IV lines (not central lines):

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1496597/

I was phenomenally stupid and also phenomenally lucky not to go in to sepsis for this move.

I do know. Even though I am currently in pharmaceutical remission, I have cheated death a few times as an adult, and I am more aware of medical risks. You would be surprised to know that I am doing well and prospering, especially if you knew my health situation.


> You would be surprised to know that I am doing well and prospering, especially if you knew my health situation

As someone who is in the midst of a difficult medical situation right now (and who cheated death myself 2 years ago during the episode that sent me to ICU and gifted me with yet another chronic condition), I'm very happy for you and hope I can join you in your wellness in the coming months.

Some 15 years ago, I almost fully recovered from a serious medical condition that left me partially paralyzed, in severe pain, and out of work for many months. This time around it's a lot harder, and is taking years instead of months.

Aging sucks.


This complete internet stranger just wants to say he's happy to hear you're doing well and prospering, and wishes you the best in the circumstances you're in!


Thank you for understanding this.


2-3 weeks ago people on here were advocating stocking up on masks and selling at a high profit.


In Italy it's illegal, you cannot hoard or speculate on basic necessities (as the masks are being considered during the epidemic).

https://www.repubblica.it/economia/2020/02/26/news/coronavir...


Perfect way to guarantee shortages. Let the price float and there is an incentive for businesses to figure out how to increase the supply quickly, thus causing the price to drop.

The economic theory on this is rock-solid and yet it seems impossible to educate the general public or government officials regarding the consequences of price controls.


It's not as clear cut as you say.

For example, the large increase in price creates perverse incentives to reduce the available supply and make it available at a higher price (eg. buying all the masks at $n and reselling them at a price greater than n).

A higher price also encourages counterfeiting; making fake masks that sell for $1 isn't that profitable, but if they sell for $50, there's definitely more of an incentive to do so.


The problem of low-quality or defective merchandise exists at any price point. Adding price controls doesn't prevent that problem and in fact would encourage black markets where defective merchandise is less likely to be detected by consumers or regulators.


You suppose that you only have one "hoarder" (or speculator) in the market.

Once you have many, and if they don't talk together (which would be forbidden), masks would sell lower than what you think


In cases of extremely skewed demand/supply the price never actually goes down, and all the buyers get hosed. See: concert tickets.


Not the situation we are talking about but even in that situation a government control on the price of the concert tickets could easily create a shortage. An entertainer would just choose to have concerts in a different jurisdiction that didn't limit the prices leading to 0 seats in the location with price controls.


The entertainer makes zero money on the added price of tickets from trading dynamics we are talking about, it’s all middlemen.


Doesn't change the analysis re: supply and demand. Just changes to a discussion of the middlemen as a supplier.


It invalidates what you mentioned re. the entertainer avoiding a certain location due to price control. And btw, price control in this case means “no resale above ticket price” or something similar, not the government controlling the pricing itself. The supply is fixed so there can’t be a shortage (except when it’s caused by price gouging performed by middlemen).


You could also try directly killing people for money if that's your thing.


what is profitable for the individual may not be profitable for the group.


I agree strongly that we shouldn't overstock on masks.

That said, I'd urge everyone to get a few P95 [1] masks for themselves and their family members, in the event that you have to accompany them to a hospital, or even to wear in public if you live in an urban environment.

1. P95 have same filtering capacity as N95, but last for much longer.


Considering the fact that even alcohol-based hand-sanitizer is already sold out at 8 confirmed cases over here, masks seem extremely difficult to get a hold of...


Home Depot has been out of masks and respirators here for weeks now.


And what use is of mask with a valve for a sick person? They are already sick and valve will let contaminated air straight out? Can healthy people at least buy these?

I think that not recommending masks for everyone is very myopic considering that the virus tends to spread asymptotically.


Even if asymptomatic people transmit the virus "asymptomatic transmission likely plays a minor role in the epidemic overall, WHO says. People who cough or sneeze are more likely to spread the virus, the agency wrote"[1]

[1] - https://www.sciencemag.org/news/2020/02/paper-non-symptomati...


WHO can say what they want but considering how the virus popped up in Italy tells a different story. Something has been overlooked.


I agree. It's probably aliens. Or reptilians.


Naturally argumentum ad hominem is always the best strategy.


I think that's a fallacy fallacy right there, but I also think fallacies can be fun responses to stupidity. Fallacy is a strange word. Fallacy.


There is at least one preparation that you can take: Make sure you have enough (non quickly perishable) food and essentials such as tooth paste and toilet paper at home so you don't have to go out shopping if you are at home sick for a week.


It's not just if you get sick yourself. If your company closes down its offices and you have to stay at home you may want to minimize your shopping during that time as well.


There's no meaningful preparations for avoiding what is essentially a really dangerous variant of the common cold at an individual level.

Right, but you can prepare for potential societal disruption(s) caused by the disease. Even if you don't get sick yourself, you could be impacted.


Masks don't help because of low quality and people lack proper training... you shouldn't touch the mask, you shouldn't reuse it, you should properly dispose it, etc.

A saner advice is to wash your hands frequently and to avoid touching your face when in public. Because you can get this virus by touching infected surfaces and then touching your face. It doesn't seem to be an airborn virus, but it does survive on surfaces.

I cary a hand sanitizer for those moments in public when I feel the need to scratch my face :-)


> It doesn't seem to be an airborn virus, but it does survive on surfaces.

I just read this last night, and from this I had the impression that it is an airborne virus, and that surface spreading is not the main vector:

https://www.cdc.gov/coronavirus/2019-ncov/about/transmission...


The "airborne" transmission in that link is what I believe is called "aerosol transmission", not airborne. Because it relies on liquid droplets in the air, and not actually able to transmit on something like dist in the air.


Thank you for correcting that. Big difference between the two and people will happily play 'Chinese whispers' with these bits of information leading to a totally different overall picture.

Airborne transmission doesn't require any other medium than the air itself, even dust is optional.


There is also transmission (actually the first one mentioned) "Between people who are in close contact with one another (within about 6 feet)"--this does not mention liquid droplets at all, which is why I figured it to be airborne.


That's because many people are disgusting and don't give a fuck about proper hygiene. Just among my acquaintances I need both hands an a foot to count the number that don't even vaguely cover their mouth / nose -- let alone _properly_ cover -- while coughing or sneezing.

No amount of gentle reminder -> passive aggressive suggestion -> explicit suggestion had lasting effects on their behavior. All I could do is be vigilant and recluse myself from their company whenever one's clearly showing symptoms.


The number of people I've seen 'properly' covering their mouth when they sneezed, with their hand instead of, say, elbow sleeve, and then touching all the things, is worrying.


Wearing simple masks and glasses (!!!) would then protect against this vector.


Is any virus truly airborne?


Measles is indicated as airborn transmission on the R0 wiki[1]. It is pretty crazy with an R0 of 12-18.

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


> A saner advice is to wash your hands frequently and to avoid touching your face when in public

I wouldn't use a urinal either (I never do anyway, as a former licensed plumber, thosef'n things are NASTY imo). I also flush twice with my back turned before using a public toilet.. not ideal but better than not I think.

I work in hospital


> I also flush twice with my back turned before using a public toilet.. not ideal but better than not I think.

Flushing toilets leads to aerosolized water droplets from the toilet spreading around the room and contaminating nearby surfaces[1].

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


I know, but so does peeing into it. At least when you flush it's re-diluted.


Masks do help and you explained why. Its harder to touch your face, nose, lips when wearing a mask. So it does help fight the spread and getting yourself sick easier.


is it possible to reuse a mask if you put the mask through an autoclave?


You might be able to use UV-C light sterilization. Strangely, these types of lights are all suddenly sold out on amazon, wonder why... https://www.amazon.com/gp/product/B07W1PHS9P/ref=ppx_yo_dt_b...


Remember that light can only sterilize the surfaces it contacts. It can not sterilize beneath the surface.

So if droplets containing viruses penetrate beneath the surface of the mask, sterilization with light will not be able to reach them.


Obviously something like this would only make sense under extreme circumstances, when you have to leave the house, but can't use a fresh mask every time, because of shortages.


An N95 isn't going to survive an autoclave...


I think my P100 filters might survive an autoclave. They are the pink disc kind from 3M. Pressure cooking only goes up to 121C @ 15psi, so it isn't as hot as it may seem.


It's not just the pressure and the temperature, it's also the steam. Autoclaves are are pretty nasty environments, and I wouldn't trust a filter that had gone through one. It's very likely the filter medium would have been degraded.


I assumed the reason not to re-use them is that the paper mask structurally wears out and no longer creates the proper seal on your face.


what about the P100 filter cartridges used on half/full face respirators? Those have a plastic skeleton with a rubber gasket.


They last indefintely, i.e. change the filter when it becomes clogged, which will be approximately never if you're not actually using it in a dusty environment. But check the manufacturer's instructions.


What if you microwaved it? To be clear, I don't have any idea if this works or not, I'm just asking. And of course it couldn't have any metal parts.


That works for sponges but it breaks the material down pretty fast. You could possibly use ozone to sterilize the masks if you sealed a container and let it sit at a proper concentration for the correct time period.


I heard a report that soaking them in salt water and allowing it to completely dry can destroy viruses as the salt crystals from. YMMV. Web search for more information.


Question is about disruptions caused by people's reaction to the outbreak, not the virus itself.

Stuff like this: https://www.ibtimes.sg/wuhan-virus-italy-supermarkets-are-ru...

The freaking panic is already starting in my country too. People buying up food in 10x the quantities than the usual shopping visit, etc..

I've gone shopping yesterday, when the virus was found in the country next to mine, to buy enough food for a week, just to avoid the inevitable initial panic that's starting today, when the first case appeared in my country.


It's not panic. It's reality. Many of us did the same. I went with 2 weeks worth of food, water and toiletries and we already have the usual stock which including refrigirated stuff should be enough for full month if needed. When you see small towns put into quarantine in Europe allowing people in and out only with 'written permission' you know you should prepare family and yourself asap. Get food, water, medicine and everything that might make life easier for you and your family during weeks of quarantine.


Well, I saw a lady who bought out a full cart of flour packages yesterday. There was last 1kg package of salt, and around 6 packages of flour left on the shelf. (normally there's ~200) Yes, it's not a generalized panic, but individual people like that can really screw up the shopping experience for others.

Is it panicking? Dunno, maybe she's just setting up a flour shop, or has 50 hungry necks to feed. But it was certainly unusual.


We regularly buy 10kg of flour because we have a bread maker. The last time I bought bread (not counting when on holiday) is 3.5 years ago. 10kg is enough for over a week.

Full cart is a bit much though if it's like 50kg+


My wife was in a pretty typical Walgreens today and noted that there was a sign in front saying that they didn't have any masks left and that they didn't know when they were going to get more. Inside, there were a number of sections besides masks that were completely empty.

This Walgreens is in Mountain View, a few miles from the main Google campus in California.


>The freaking panic is already starting in my country too. People buying up food in 10x the quantities than the usual shopping visit, etc..

>I've gone shopping yesterday, when the virus was found in the country next to mine

What's the old saying? "You're not sitting in traffic, you are the traffic." :)


All animals panic even in minor danger.


What country are you in, if you don’t mind me asking?


CZ


You can maximize immune system functioning by making sure you get proper nutrition and plenty of sleep.


I know this sounds trivial, but there's data that suggests common immune-systems boosters such as zinc and vitamin C do help with covid-19.

https://journals.plos.org/plospathogens/article?id=10.1371/j...


Just get some green lentils from the bulk section. Lentils are high in zinc and It's always better to get your nutrition from actual food, rather than supplements which are unregulated and contain god knows what (not to mention it's not how your body normaly absorbs nutrients).


As far as I know, zinc pyrithione isn't available in any consumer product, because it is pretty toxic in moderate levels. Without it (from the article) "the concentration of free Zn2+ is maintained at a relatively low level by metallothioneins".

Zinc supplementation may of course help if you are deficient, but the study can't really tell if 'healthy' Zn2+ concentrations contribute anything to the inhibition of viral replication.


There's not really such a thing as 'boosting' your immune system - it's either working properly, or it's not. A 'boosted' / over-active immune system results in auto-immune diseases like Crohn's (which is what I have). Funnily enough I'm being treated with Stelara which actually suppresses my immune system - so it's no 'live' vaccines for me and other vaccines might not work effectively or at all, and I need to be extra careful to avoid getting ill. Working 100% remote is something I am appreciating more and more currently.


> it's either working properly, or it's not

It can be normal, over-active, under-active, and likely both. "working or not" is too simplistic for this discussion.

> A 'boosted' / over-active immune system results in auto-immune diseases like Crohn's (which is what I have).

Yes, but that doesn't mean that a temporary boost couldn't potentially help in certain situations.

Along those lines, I bet if you really needed a specific live vaccine your doctor would have you suspend that drug for a little bit.


I'm taking modest levels of Ascorbic Acid, Vitamin D, Quinine Hydrochloride, Zinc, and standardized Forsythia Extract.


Don't forget exercise.


Do you suppose gyms are a bad place to go during an outbreak? So far I haven't stopped going, but seems like it could be an especially nasty hotbed of airborne and surface-based viruses.


You don't have to go to the gym to exercise. Plenty of bodyweight exercise (like push-ups, L-sits, planks, burpees, etc) can be done at home without any equipment.

Investing in a little bit of equipment, like barbells or maybe a pull-up bar, can let you do even more exercise at home.


While I could Google this, I often prefer asking people I 'know' even as tangentially as via HN comments: any suggestions for resources about this? I'd like to exercise more, and I have an entire room available, but I'm not sure where to start. I have the one-handed weight thingies, for one, but a pull-up bar is not an option. I heard one of those ball thingies with a handle is useful?


https://darebee.com is another good site. They have lots of videos explaining various exercises. Just make sure you start with the entry-level exercises to slowly build up your strength.

I'd even recommend to not worry so much about timing your workouts as this causes too much stress, just focus on the exercises themselves in the beginning to make sure you do them properly.


This app may be useful to you. I've used it for about 6 months and have been pretty happy with it. You can customize what equipment you have available so that it builds you a workout based on that. On the other side, you can look at what equipment it lists and determine what you want to buy.

https://www.fitbod.me


Awesome, thanks for the link!


if you're excercising for health, you don't need a gym. Just go for a vigorous walk, do some gardening, maybe a run, or vacuum the house. All of those count as excellent ways to get exercise.


I have no idea why you're being downvoted. Have people forgotten how to exercise without gyms?


I'm not sure I'd personally suggest that hoovering the house is an "excellent" form of exercise, but at least they didn't blindly assume the person was going to the gym purely because they were not aware how to exercise outside of it. Perhaps the community aspect of their gym is what attracts them. None of the replies actualy answer the original question of are gyms are a particularly bad place to go. I would suggest they absolutely are a bad idea as they involve a lot of air conditioning and a lot of shared surfaces. And also a lot of coughing even at the best of the times.


There is a nice book by a convict who used his time in jail to exercise using whatever available, a very inspiring read. The title is Convict Conditioning.


You can limit your exposure.

Lots of people only wash their hands when they use the bathroom, if even that. They touch their faces and mouths a lot more often than they think. If they can learn to change their habits, wash their hands regularly if they go in public, and work from home more often if allowed by their employer, I'd say those are meaningful preparations.


Is there a procedure for when your face itches? Use your arm? Part of a shirt?


It's hard not to down vote this.

It's wrong, but the question was about what people are doing and thinking.

I think it's important to see what people think and people shouldn't be down voted for being honest.

But I have to be OT and say "a really dangerous variant of the common cold" - It's killing 14% of people over 80 who get it at last estimates. And permanently hurting a lot of people over 80 as well.

And we don't really do flu season as well as we could, as a society we need to step up a bit in general. We could all prepare for even the flu season more than we do. Common cold, perhaps meh.


You should be. My business operation supply chains are disrupted. Without certain goods, I can't work.

I am not without, but my suppliers have rationed some things I buy.


How bad are they disrupted? Any idea when they’ll be back up? If you have backup suppliers, are they down too?


I don't think OP is asking about preparing for or avoiding actually getting the disease. OP is asking about preparing for potential shortages of goods if quarantines are ultimately deployed in the US (which is what's already happening globally).


Me neither, I trust my government will if its required. Could burn some 10 kg and still be OK on weight. More concerned about rest of family.


[flagged]


This is so infuriatingly false. The mortality rate for the flu this season has been ~0.1%.

The coronavirus is over 10x deadlier than the usual flu according to early estimates.

https://www.cnbc.com/2020/02/03/the-flu-has-already-killed-1...


10x deadlier for 50+ yr olds for younger folks is probably 5-7x lower


“… and nobody in my Bay area startup is over 50, because we hire for culture fit.”


Lower overall, but I believe it isn't lower than the flu for any age range, except maybe 0-10 or 0-20. I'll try and find the relevant study link.


I disagree with your sentiment about preppier mentality strongly. For me, it’s not about prepping to survive like THIS is a world-ending event, it’s about not getting caught in a rush to get supplies or stampedes when people panic. Tbh, that’s more of a concern than the disease.

That said, the serious complication rate is higher than the flu.

The r0 is much higher than the flu.

The disease is spread asymptomatically.

Nobody is ready if the disease does take hold and spreads widely.

Markets are/will continue to take a massive shit.


Either A. the r0 is much higher due to asymptomatic spreading OR B. the serious complication rate is higher. It’s likely not both. If A. is true, the serious complication rate is likely overstated because there are lots of asymptomatic people who are getting counted.


The serious complication rate is ~20% or so of confirmed cases, that's pretty high.


But how do we know it is 20%? If R0 is higher than we think due to asymptomatic spreading, then we likely aren’t counting all the asymptomatic cases. If we did, it would result in a lower serious complication rate. That’s why I said it can’t be both.


You are just among the first to panic.


> There is only a ~2% mortality rate from COVID-19

Correct.

> less than the usual flu

I'm pretty sure that's wrong. From a quick Google the best I could find was an Atlantic article saying the rate is typically around 0.1%. https://www.theatlantic.com/health/archive/2020/02/covid-vac...


I was wrong about the season flu being less deadly. However if we look past lay press like CNBC or The Atlantic because this is cutting edge/developing research, and into the academic press, we see that the mortality rate is significantly lower than other outbreaks like SARS & MERS (9%,35%) https://academic.oup.com/view-large/figure/199362642/dyaa033... https://doi.org/10.1093/ije/dyaa033

So it seems prudent to reiterate that the only causes for social disruption & need to prep would be to have unjustified panic and run at stores like the behavior seen in Italy.


significantly less deadly than sars but also significantly more contagious. sars was only contagious once you showed symptoms, which does not appear to be the case here. for covid, los alamos suggests a pre-intervention r0 of 4-6: https://www.medrxiv.org/content/10.1101/2020.02.07.20021154v...

the fatality rate increases with age, up to ~15% for >80. i don't know about you but i have older people in my family that i'm very concerned about.


Yes I agree with you, I am concerned with the elderly & infants. As these are the demographics which usually have higher fatal outcome both in diseases, and even adverse effects from drugs/surgery.


Young children are surprisingly resilient against Coronavirus infections, their mortality is so low that it hardly figures in the stats (on an individual level it is still just as much a tragedy).


As the father of a newborn, grateful to hear this. Do you have a source?


I have kids too and wondered about this. Chinese CDC epidemiology study indicates that kids seemed to be spared from Covid-19 (See table 1) http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9...

Age is very significant for mortality rate: 0-9: 0%, ..., 60-69: 3.6%, 70-79: 8.0%, 80+: 14.8%. Also the regional breakdown is apparently a useful approximation of what happens when the healthcare system is overwhelmed (Hubei 2.9%) vs not (other Chinese provinces 0.4%). Also 81% patients reported mild symptoms.


Even 'healthy' age people can get hit hard. One of the first people in Italy to be diagnosed with it is just now coming out of intensive care.

If those beds start to fill up... people that might otherwise be helped through the worst might be in trouble.

https://www.lastampa.it/cronaca/2020/02/27/news/coronavirus-...


The spread seems to be plateu as well. Total numbers will probably be less than 100,000.


It plateaued in China following an incredibly massive quarantine effort. The infection is hitting countries with not nearly the social control measures that China has.


You might be surprised. There are some old laws and powers that are going to be dusted off, and in some other cases it may be the case that governments just claim powers on an emergency basis and essentially nobody other than the absolute political fringes of society is going to complain.


Much of the world isn't actually under control of a government. Here in the developed world, we've basically bought into the nation-state system, with a strong central government controlling a defined territory with border checkpoints. But many parts of central Asia, the Middle East, Africa, and rural areas in other continents aren't like this. The dominant social organization is by tribe, clan, cartel, gang, or warlord; borders are porous or nonexistent; and the government has no authority, not even a monopoly on physical force.

The virus doesn't care whether you believe in governments, and it's just now hitting these regions - Pakistan, Africa, North Korea, etc.


"essentially nobody other than the absolute political fringes of society is going to complain"

I very much dont think that is the way this plays out in the western world.

In China, they welded the doors shut on entire residential buildings leaving the people in there to either die or survive on their own. They bagged and gagged people with elevated temperature and force quarantined them. They had crematoriums working over time.

China has complete military control of their population, this is going to go very differently in the West.

China's process was very effective and probably greatly reduced the rate of infection but there is no way people in other countries are just going to sit silently while the same actions are carried out.


Source for these claims?


China's numbers are absolutely not reliable, because:

- they've changed their reporting standards multiple times

- they don't seem to be testing enough people because of test kit shortages, because many people seem to have given up going to hospitals when they're sick because they know they won't get in or because they're barricaded in to their homes or forbidden from leaving

- their media censorship makes it difficult to independently verify the numbers they are reporting


It also plateaued in China IF you happen to believe the numbers they are reporting are genuine, which I would wager they are not.


This is complete wishful thinking. It is nowhere near contained


I'm really surprised there's 300 comments (with lots of panic) and nobody mentioned the official WHO guidelines https://www.who.int/emergencies/diseases/novel-coronavirus-2... especially the part about "How to cope with stress during 2019-nCoV outbreak"


Thank you for linking this.

I commented below about doing what I am doing to not worry about it. Naturally it and was immediately dismissed by a panic induced response.

FUD is extremely powerful people.

If you want to stock up on some extra water and food - cool beans. But stay conscious of your own fears and manage your stress levels. Do what you can to stay calm about things and handle your emotions wisely.


I'm wondering how realistic a water or power shutoff is, those seem like much bigger concerns for a hurricane or earthquake. For covid-19 it seems like the municipal authorities will be able to keep at least the handful of people working that are required to keep the grids up (even if just about everyone gets infected, it sounds like ~80% of cases only have minor symptoms).

Restaurants shutting down and grocery stores running low on food seems like a more likely scenario.

Regardless, I've now stocked up on 2 weeks of water and about the same of food. Which is a good idea anyway for earthquake preparedness, but something I'd never gotten around to actually doing. So I'm feeling a good balance of prepared but not too stressed about it.


> 2 weeks of water and about the same of food

Everyone keeps saying that, but what does it mean? What food did you buy, and how much water? I can't get a handle on how much that is. I'm not panicing, at all, I just want to have enough when everyone ELSE panics.

I also hate the thought of boredom, so I'm trying every canned fish I can to see what I like, so I at least have some variety and flavour for those two weeks.


> Everyone keeps saying that, but what does it mean?

It's not rocket science. Take what you eat in a day and multiply it by 14. Go for non perishable things of course (pasta, rice, lentils, canned fruits etc.)

I mean, realistically speaking you could probably go two weeks with <1k cal a day without much trouble.


Water - 1.5 litres for each day.

Food - 2000 calories per day for every male, 1500 for every female.

And buy a water filter and gas burner/camping stove.


> If you want to stock up on some extra water and food - cool beans

Honestly, more people should be doing this anyway. If you live in an earthquake zone and don't have an emergency preparedness kit, you're in trouble if significant infrastructure damage happens in an earthquake. Likewise for snowstorms, floods, power outages, etc.

It's probably not going to happen, and it's probably not a big deal, but if there is an emergency at some point I don't want to have to tell my neighbours they're on their own for a week because we (minimally) prepared and they didn't.


I personally can’t really imagine the water or utility systems going offline. Is there a realistic risk or recent precedent of that? Eg, I never heard of that happening in China for example and I think we have better infrastructure here


While I recognize there might be a good number of people who experience FUD, I imagine there's another segment of people who couldn't be bothered. Procuring extra water and food for something that has a low likelihood of occurring (food and water insecurity stemming from COVID-19) sounds onerous.


It's more an isolation strategy than an actual shortage. If there is news of an outbreak in my immediate area, there will be a run on the grocery store, and they will sell out of items immediately in stock. I'd rather not stand in line, in close contact with strangers in my community, at that moment.


Over the last few weeks, we have acquired enough food/supplies to stay isolated at our house for about 2 months (a combination of bulk rice/beans/grains, and pre-purchasing anything we use regularly which has a long expiration date). We also have medicines/toiletries/etc to last that long.

Maybe 10-12 years ago I read the book 'The Great Influenza'[1], and there are enough similarities between that outbreak and this one that we are taking it fairly seriously.

Although that book isn't perfect, it has a lot of detailed and fascinating explanation on (a) the development of scientific medicine in Europe and then the US (b) the way flu works, is transmitted, etc (c) the way that specific pandemic played out.

[1] https://www.amazon.com/Great-Influenza-Deadliest-Pandemic-Hi...


I was under the impression that the Spanish flu was very different from the regular flu and COVID-19, because it was the young/old people that survived it and the healthy 20-50 year old that died the most. Most people died of the Spanish Flu because of their immune response. It looks like COVID-19 is really mild* for lots of people in that age group.

Am I missing something? Did the Spanish flu start like COVID-19 and evolved later?


The flu regularly migrates between pigs, chickens and humans. Whenever it does, the poorly adapted flu is unusually lethal.

The misnamed Spanish flu seems to have killed by triggering a strong immune response. That response is called a cytokine storm. Which means that the stronger your immune system, the more likely you were to be hit hard. It therefore killed the reverse of the groups that normally get killed by diseases.

There is also some evidence that people who experienced the "Russian flu" of 1889-1890 had some level of protection from the Spanish flu.


Primarily death was due to bacterial pneumonia, the cytokine storm likely accelerating the deterioration of the lungs. That particularly viral strain may have been more dangerous, but overall the current pandemic is comparable in death rates.

It would seem during the Spanish flu your best chance of survival was being in a location where strict quarantine and travel restrictions were imposed so the health system was able to cope with those who did contract the virus.

The places with the highest fatality rates were those with poor or non-existent health services or where people didn't seek medical assistance.

The mortality rate in the US was around 0.5%, <1% in East Asia, but 5% in India and as high as 20% in some Pacific nations. Iran's current Covid-19 mortality rate is quite comparable to the Spanish Flu around 14%.


I.e 5x deadlier than the seasonal flu TODAY with an approx 0.1% mortality rate in the US, which has been decreasing steadily, so perhaps only 2-3x deadlier than the normal seasonal flu today on average.

"In 1918, doctors lacked intensive care units, respirators, antiviral agents, and antibiotics, an important fact in light of historical evidence of interactions between influenza and secondary bacterial respiratory pathogens (e.g., Haemophilus influenzae) as a significant cause of death during the pandemic." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2374803/


Yes, the book says the 1918 flu hit healthy robust people the hardest. There are many other differences. For example, that flu had a super short incubation time, so it swept through communities in 7 weeks, and military bases in 4-5. On many bases thousands could become ill in a single day. It's spread was much more rapid.

But there are lots of other similarities as well: Hospitals were rapidly overwhelmed. With both flu and coronavirus, it is the pneumonia that is dangerous (also, apparently true of measles). Some people died very quickly of their own immune response and massive lung damage (SARDs, severe acute respiratory distress) while others succumbed later to secondary bacterial pneumonia. Health authorities were reluctant to acknowledge the problem for fear of creating panic. Many people and communities attempted to self-isolate, with very limited success.

There are some possible similarities that have not yet played out - notably multiple waves of infection with different mortalities and characteristics.

Overall, the book has a lot of detailed scientific explanations that I enjoyed. One of my favorite parts was a detailed explanation of the significance of "H" and "N" in flu names (e.g. H1N1), and why flu mutates so rapidly, and is so likely to cross over in certain animals. Overall, I recommend it if you like detailed but comprehensible scientific explanations.


I wish people stop calling that Spanish Flu where it's totally unrelated to Spain...


Yeah! Coronavirus doesn't even have anything to do with the beer!


Since you made me wonder:

> corona: "crown" (from latin corōna, meaning "crown")

> virus: "poisonous secretion" (from latin vīrus, meaning "venom" or "poisonous secretion")

> Coronavirus, the virus responsible for 30% of common colds, as well as SARS, has the appearance of a crown (corona) under electron microscopy, due to the spike proteins that coat the viral surface. Viruses, being so small, might have been thought of before they were discovered, to be poisonous secretions (virus) of unknown origin, hence their name.

https://medicaletymology.fandom.com/wiki/Coronavirus


Apparently, corona beer sales are way down due to this unfortunate coincidence


It is unrelated but the mechanism by which the association came about is funny: it was first widely (read: honestly) reported by Spain, therefore everyone associated it with Spain, even thought first cases, including initial deaths, were in other countries which suppressed the news.


That ship has sailed for just about a century.


With a 2% mortality rate, if there is a breakout then there will be few people who don’t lose somebody they know. I’m worried about my parents. If I stock up on food etc, it will be to enable them stay indoors


Here is another one, Spillover, by David Quammen. Apologies for the ugly link.

https://www.amazon.com/Spillover-Animal-Infections-Human-Pan...


This is very likely to overwhelm not just medical infrastructure, but shut down supply chains for basic necessities for months. If the pandemic hits, most businesses will shutter, just like in China. It is prudent to stock up now for 1-2 months of cheap, non- perishable foods like rice and beans (complete protein together) at a minimum. There's just no excuse not to now if you make a tech salary - a couple hundred dollars and you have an emergency stash which is good for years.

This isn't just about personal protection - the whole community and nation can expect better outcomes of we stagger preparations, lessening the chance and impact of everyone running to the store at the same time. There is no question now that this is an unprecedented event, now is the time to prepare to mitigate risk.


I find this to be pretty alarmist.

"If the pandemic hits" ... the virus has already hit.

The WHO itself has backed off the Pandemic classification [1].

The virus has an overall 98% survival rate, and most diagnosed cases in the US, are not actually showing any symptoms (which itself is a cause for concern re: spread).

The annual Flu, MERS and SARS were far far worse. The flu kills between 26,000 and 52,000 annually in the US [2], and as much as I love prepping, this just does not fit the bill for the amount of FUD it has generated.

edit: comments are making me re-think my position. COVID is far worse mortality rate wise in 65+ patients vs flu.

1 - https://arstechnica.com/science/2020/02/who-tries-to-calm-ta...

2 - https://www.cdc.gov/flu/about/burden/index.html


>The annual Flu, MERS and SARS were far far worse

This is NOT TRUE. I urge you to stop relying on the news and look at the literature that is being published in real time. I don't have time for a full response but 15% of cases require ICU care to survive. There are less than 100k ICU beds in the U.S. and the virus spreads 2-5x (R0 estimates from 3 up to 8 depending on source) more readily than SARS or MERS or the 1918 Spanish flu.

Now is the time to be alarmed. The media is behind, for understandable reasons, do not rely on them when in 2020 you have access to the same sources they do. The literature being publishes is almost universally grave. At this point anyone minimizing ncov by comparing it to regular flu is being irresponsible.


What led you to believe I cited the news? I cite the WHO and CDC where I could. If I am interpreting that information incorrectly based on my previous experience in epidemiology, please educate me.

- SARS case fatality rate = 15% (WHO - 1)

- MERS case fatality rate = 34.4% (WHO - 2)

- COVID19 case fatality rate = 2.3% (WHO - 3^)

1- https://www.who.int/csr/sars/en/WHOconsensus.pdf

2-https://www.who.int/emergencies/mers-cov/en/ MERS case fatality rate =

3 - https://www.who.int/docs/default-source/coronaviruse/situati...

^ estimation efforts are ongoing and may change.


You are citing case fatality rate for MERS and SARS, but not the flu (which is typically 0.1%), and yet in any given year the flu has killed many more people than MERS or SARS. Why? Because millions get the flu whereas MERS and SARS were contained.

Now consider that COVID-19 is much more contagious than the flu and it has a significantly higher case fatality rate than the flu.

Furthermore, people can and do protect themselves against the flu with a vaccine. There is no vaccine for COVID-19. And still further, no one is immune because the disease is new to humans.

So yes, while covid-19 has a 98% survival rate, a widespread outbreak could kill hundreds of thousands of people.


This was enlightening and has let me revise my original position. Thanks


The numbers from China are totally innaccurate and underestimating the infection rate by at least an order of magnitude for a multitude of reasons. The WHO has been irresponsibly mirroring the Chinese numbers from the start and frankly cannot be trusted - the director of the WHO was accused by the NYT years ago of covering up 3 cholera outbreaks in his home country of Ethiopia.

China has been overwhelmed. They ran out of testing kits weeks ago. They have been turning people away from hospitals for months. Major infection areas have been under lockdown, where people are not allowed to leave their homes or drive, even for emergency trips to the hospital. Their official reported diagnosed cases are nowhere the true numbers. They've also punished doctors for reporting new cases. It's all a giant sham.

This pandemic is revealing just how incompetent global organizations and news media are.

Edit: I just read that the WHO also has some incentive to downplay the virus - $425 million in catastrophe bonds were issued that may default if the virus is officially labeled a pandemic...can't seem to find the actual default conditions but there's a clear conflict of interest here. https://markets.businessinsider.com/news/stocks/pandemic-bon...


Regarding the bonds, that doesn’t seem true. The conditions for payout are:

“ On the face of it, the class B bond should have incurred losses during the 2018 ebola crisis in the Democratic Republic of Congo and the recent coronavirus from Wuhan, China, as both have resulted in deaths north of 250 people, the primary condition for a payout.”

“ But an important secondary condition states that there must be at least 20 deaths in a second country for the bond to release any funds, a requirement that has not been met by the coronavirus or the ebola outbreak.”

https://www.marketwatch.com/story/the-world-bank-has-an-insu...


Iran is at 19, South Korea and Italy 13 and 12.


As of this hour, Iran's now at 26 deaths.


Curiously Iran's smoking rate is low - 1/3 of America's. I had thought that lung-compromised smokers were responsible for high mortality in some countries. Hm.


That could still be true. I imagine there are a huge number of variables that influence mortality rates, to the point where finding correlations is difficult.

If I understand correctly, even the effect of weather/heat on various strains of viruses is extremely difficult to predict because of how many other factors play a role (air-conditioning, for example).


Where can I find "the literature that is being published in real time"?


Nature and pubmed for starters. Search 2019 ncov. Most of the papers were originally being collected and circulated on 4chan - honestly, as vile as a place as it is, the threads have been 1-2 months ahead of media. More recently reddit.com/r/coronavirus has popped up which is sharing papers and there's a more official subreddit who's name escapes me.

This is an event which illuminates the folly of relying excessively on media and government. I think it's easy to forget that these organizations are managed and staffed by people just like you and me - worse in many cases, as the average person is not exactly sharing research papers with their grandma, so to speak.

Here's one of the conservative estimates for R0 straight out of China. There's another which estimates 6-8 but I'll leave that to you to look for.

https://www.sciencedirect.com/science/article/pii/S120197122...


”Now is the time to be alarmed.”

And this accomplishes what, exactly? Shortages of gloves and canned goods?

Being “alarmed” is not a positive choice, even if your worst-case projections of the future turn out to be true.


Oh hey guys, Comical Ali is back[1]!

In all seriousness, I'm truly baffled what motivates you to stand out so strongly in your anti-hysteria hysteria. I mean, I'm the anxious type who just like to prepare for stuff just in case, especially if the cost is low, but you appear to go actively out of your way to spend energy on countering any degree of concern, and it's frustratingly difficult to understand the underlying motivation.

[1]: https://en.wikipedia.org/wiki/Muhammad_Saeed_al-Sahhaf


If people start trickling into stores to stock up now, as the Canadian government is urging it's citizens, there will be less of a rush later. Perhaps we can avoid the chaos of empty store shelves.


Your wording seems a bit off mark. The Minister of Health is recommending everyone to always have an emergency reserve in case of any unforseen event, from illness to power blackout.


I'd say the vast majority of people that I know don't have such a reserve, and are seriously considering it now.

If they all go and stock up, what with the JIT-style of many supermarkets, I wouldn't be surprised to encounter shortages.

Even just to avoid the inconvenience of that, stocking up now, while the majority of the population is not too concerned, seems prudent and even beneficial to everyone else


The annual flu was worse in terms of numbers, but this illness is still early and was showing a much higher mortality rate, in proportional terms.

Of course, from what I can tell, growth in mortality has been shrinking in percentage terms. [1]

But if judging based on the early stats, it was literally hundreds of times more deadly than a common flu. Approximately to 4% of people in their 60s who contracted it died. And 15% of those in their 80s who contracted it were killed. The annual flu is not nearly that bad.

[1] https://www.worldometers.info/coronavirus/coronavirus-death-...


I think the Flu mortality rate is 0.1% and Coronavirus is 2%?

That seems pretty dramatic, the earlier article about the disease in China stated that some percentage of people that get infected require ICU attention to oxygenate their blood or they die (and it doesn't seem like it's limited only to old or at risk people).

That seems a lot worse than the seasonal flu?

With SARS and MERS we got lucky because they didn't end up spreading that widely even though the mortality rate was higher. I'm not convinced that's evidence that this won't be a problem.


The higher mortality rate of SARS and MERS - counterintuitively - helped to contain it, as well as the fact that it was only spread by people showing symptoms.


Not implying anything: But this tracks with my understanding of how USSR and USA wanted to select bacterial/virologic bioweapons [1]:

An agent that killed very quickly e.g. Ebola is actually not a very good bioweapon. You want something with a long incubation period that is infectious before people are symptomatic.

Things that incubate in short order + kill hosts quickly "burn the epidemic out" before it can spread.

Ideally it also can survive outside of a host for some period of time as well.

1 - Demon in the Freezer by Richard Preston


That is naive. Yes the virus has hit some places and we know a little about it, but pandemic means something different. Look what is happening in China, this can happen in any open borders country. Cases keep growing in Europe. If the virus hits more strongly in some country due to higher vulnerability of the population, or if it mutates into something nastier, we can have big disruption of daily life for millions of people, supply chains may get broken, empty shelves, curfew, etc.

WHO tainted its image by being too slow/cautious to react.

The ilness may have great survival rate, but nobody knows what percentage of survivors will have nasty long-term health condition. The virus can smoke your heart, or other organs. It is new, Chinese are falling like flies, that's why alarm is in place.


>The virus has an overall 98% survival rate

You say this as if 2% of people dying is somehow nothing. Think about everybody in your life that you care deeply about. Relatives, friends, mentors, etc. If this goes pandemic, at least one person in that category will likely die.


People should not just focus on the mortality rate of the virus itself, as people can also die:

- if the health care system is overwhelmed and they can't get treatment for other life-threatening illnesses

- if there are medicine shortages (because a lot of medicines are made in China, and it has shut down a lot of its manufacturing)

- if people lack necessities like food as panic sets in people start hoarding

- if people start refusing to help each other out of fear they'll get infected

In addition, something like 20% of the people who do survive can suffer lung damage that can seriously impact their life.

This is not something to be complacent about. Prepare and take care.


Indeed. If you have 20 to 30 people that you love or care about a 2% mortality rate means that there is about a 50% chance at least one of them will die.


How is a virus, more contagious and more lethal than flu/MERS/SARS, a smaller problem?


> more lethal than flu/MERS/SARS

WHO reports a 34% fatality rate for MERS, while at present it is around 2.4% for COVID-19 [2]. So it would be helpful if you provide sources when throwing down comments like this. I'll admit it's more contagious, as they state below, but again, most US cases are asymptomatic.

1 - https://www.who.int/emergencies/mers-cov/en/

2 - http://www.cidrap.umn.edu/news-perspective/2020/02/study-720...


The mortality rate is likely to increase of health services get overwhelmed.

This happened in China, hopefully current measures can prevent breakout infections.

I worry what will happen if the outbreak reaches densely populated areas in India.


Speaking of overwhelmed health systems, here's a comment from Dr. Bruce Aylward (renowned expert who led the team of experts on the ground in China)[1][2]:

"The bottom line is this virus kills people... it kills our elderly and vulnerable... but this is not always the case - young people do die of this disease even in industrialized countries.

People are looking at this saying that but in China they don't have this, they don't have that, etc. If I had COVID-19, I'd want to be treated in China.

We'd go into these hospitals, how many ventilators do you have? 50-60. A scale we aren't used to seeing. How many ECMO systems do you have? 5. We don't have that in Europe.

When we look at how dangerous this disease is, we have to be careful looking at the China data. China know how to keep people alive from COVID - they are super committed to it and they are making a massive investment in it. That is not going to be the case everywhere in the world....

It is a serious disease and I worry that people are going to look at the China numbers and get a false sense of security."

[1] - https://old.reddit.com/r/Coronavirus/comments/f9mxwn/for_tho...

[2] - https://youtu.be/-o0q1XMRKYM?t=3058


This is spot on. As long as ICU capacity is not overwhelmed this can be dealt with.


The 2003 SARS outbreak resulted in under 8500 confirmed cases and the 2012 MERS outbreak in around 2500. Confirmed COVID-19 cases are currently over 80000. Only considering fatality rate paints a flawed picture.


> it would be helpful if you provide sources

Actually, to be honest, it would be helpful if everyone refrained from cherry picking information to support their current emotional state.

Please, please, please, let's rely on experts who specialize infectious diseases to do the communicating and go back to our code.


>>> Please, please, please, let's rely on experts who specialize infectious diseases to do the communicating and go back to our code.

Thank you.


From the CDC

> However, it is important to note that current global circumstances suggest it is likely that this virus will cause a pandemic.

https://www.cdc.gov/coronavirus/2019-ncov/summary.html#risk-...


>most diagnosed cases in the US, are not actually showing any symptoms

Where did you hear this? Why would these people even be tested, much less diagnosed, if they are not showing symptoms?


See 1.

It's Because they were evacuated e.g. from Cruise ships with other symptomatic patients, and were quarantined + tested, it's a CDC standard protocol [2]. They even put one of them down the street from me as we speak [3]

1 - https://www.beckershospitalreview.com/quality/15th-us-corona...

2 - https://wwwnc.cdc.gov/travel/yellowbook/2020/posttravel-eval...

3 - https://www.pressdemocrat.com/news/10751105-181/sonoma-count...


There have been reported problems with the CDC tests.


Those problems would cause false negatives, not false positives.


But that story (1) says they had sore throats. They do not consider a sore throat a symptom? So this is the new CDC? Ignorance is strength? War is peace?


> the virus has already hit.

It's now an epidemic, not at pandemic level.


Not true. In the colloquial sense, and actually every sense of the word, this is a pandemic. At the point it became undeniably a pandemic per the WHO definition, the WHO announced they were "no longer going to use the category pandemic." The coronavirus is on every continent but one now.


the virus itself is not the biggest threat. It's the sideeffects of everyone's fear. Once fear starts to take hold, anything can happen.

Also, the steps that authorities might take in response to that fear...


Thanks for editing your post, but given the nature of the subject matter, I would urge you to just take it down. It contains misinformation which can be dangerous.

This is serious. You don't have to panic, but this is serious.


Nah I think it generated some good discussion, if nothing else. If you are coming to HN for emergency preparedness and health advice, I’d say you are screwed already. This site is for entertainment and discourse right? Relax.

And If the WHO and the CDC are “misinformation”- so be it.


Not too worried, but that's what I'm doing just in case supplies chains break down. Mostly beans, dried fruit, chicken stock. You might want to get a few things to boost your immune system, and to compensate for less then ideal nutrition. Vitamin C, D, B12 are the most important ones. Thyme is supposedly very good. Tea, green & rosehip. Red wine, chocolate.

Don't bother with masks or anything, you probably won't be able to avoid infection anyway. Also I'm already convinced the panic & paranoia will cause way more disruption then the virus itself.


Zinc.

Evidence shows that if taken before exposure it reduces the risk of catching the cold, and if taken during the first 24 hours of symptoms it reduces the length and severity of the cold.

Some evidence suggests it works for the SARS Coronaviruses too (i.e. not just Rhinoviruses)

https://www.researchgate.net/publication/47794995_Zn_Inhibit...

Beware. Taking Zinc regularly, especially in the high doses necessary for the cold/flu resistance effect, is NOT a good idea. It leads copper deficiency and anemia.


as far as vitamins go, the most important ones are vitamin C and B because they are water soluable, so your body doesn't store those. The fat soluable ones can be stored in your body for a very long time (A,D,E,K), so you don't need to worry about those as much in times of fasting.


> It is prudent to stock up now for 1-2 months of cheap, non- perishable foods like rice and beans (complete protein together) at a minimum.

Despite the rest of your post being overly alarmist this is a good recommendation. You should have extra staple food at all times. The cost is minimal, you can keep extra of foods you'd eat anyway, and the benefit in an unlikely supply chain disruption could be significant.


FYI: You can get get a 50 lbs bag of pinto beans at Sams for $33 and a 50 lbs bag of rice for $17. They will keep as is at least a year and provide, respectively, 76,000 calories and 82,400 calories. Maybe 80 days worth of food for a single individual.

It would be a pretty monotonous diet but better than the alternative.


Drinking water is frequently the bottleneck, as stable food stores are cheap and straightforward.


If you have drinkable tap water you should be ok.


In this instance, a pandemic. There are many other scenarios where even if you have drinkable tap water under normal circumstances, disaster might render that useless.

I drink bottled/filtered only due to negative side effects (for me personally, most don’t have any) of drinking chlorinated water, so simply increasing my input buffer is really straightforward.


You could also donate these types of items after a vaccine is developed.


Refill your medication(s), that's the biggest one. India produces a lot of drugs and if they get infected, we will see shortage. China also produces a lot of the base chemicals used in medication, so this is worry some. If you have chronic conditions, you really don't want to be without.

Soap and sanitizer. Mostly soap. Soap is equally effective as sanitizer in washing hands, etc. Soap is also much cheaper and more available. If the local region goes into lock down, you're not going out much so soap will work well.

Get one to two weeks of food and supplies in case. There isn't going to be a global shortage, but we may see short term runs on supplies. Include stuff like tooth brush, mouth wash, and etc. For my wife I also stocked up on a larger supplies of feminine hygiene products.

Masks. I got 20 per family member in our local area. For when you need to go out and restock food. Also learn how to properly use the mask.


>Refill your medication(s), that's the biggest one.

I take a prescription medication that is a controlled substance. I feel like a criminal each time I fill it. I'm only given exactly the amount I need for the next 30 days and it routinely causes problems when I need to travel out of state around the time of my next refill.

I really wish there was some way of saying "I've been taking this stuff for years, I've clearly never abused it, please give me some buffer for emergencies."


If I were in your shoes I would go to the black market and would secretly maintain a 90-180 day supply buffer, pandemic or no.

This is clearly a case of a law that may have been well-intentioned majorly infringing upon your rights.


The problem with this is that it will cause a practical relief effect that will create a small but consistent reordering latency. "You don't seem too $symptomatic today, how did you handle the past N days?"

This could be easily discerned through individual scrutiny or large-scale automated analysis.


My girlfriend takes medications that are critical to her and there are a few effective things she done that are legal.

Ups the dosage to twice as much and breaks the meds in half. Usually the price is still the same but now there’s twice as much.

Stops taking the meds on some weekends to create a buffer.

Asks a doctor to try another similar medications and express fear about going off the current med incase the new one doesn’t work. Unintended side effect is that you now have twice as much for that month.

Gradually reduce medication dosage and occasionally stop taking it. If you can live without it you’ll be more independent.


Friend of mine was working for FEMA after Hurricane Katrina. He said he went to lots of houses where they had an elderly family remember with cancer who had run out of their pain meds. And no way to get more.


Wow, that is terrible.


If you're a raging alcoholic, don't forget that. Sudden withdrawal can kill you.


Trust me, no alcoholic is going to forget to stock up on booze.



Actually last year a few pharmacies in France told us they were short of some pills. Then we learned that only a few brands were manufacturing them .. so almost a single point of failure.


Globalization as made this less likely but most countries will now allow emergency imports if the situation gets critical.


Globalization makes this more likely. Before globalization there were manufacturers distributed all over serving different markets. Now there are global monopolies on production (for particular drugs), which makes production very vulnerable to supply chain disruption.


AFAIK that's what the pharmacist hinted at, there are brands, but the manufacturing plants are shared.


A lot of us take controlled medications :/..which are also usually needed more than the easier to get ones that you can stock up on.


Some things to consider (we're doing most of these):

1. Find out what is going on, the Interwebs are your friends. The press and politicians aren't much use. The bureaucracy (China, Japan, Iran for example) are not much use and may make things worse.

2. Carry around some sanitising, no water, hand cleaner.

3. Get a few decent masks and read up how long to use them.

4. Find out what Fomites are and think about what that means.

5. Read up on hand cleaning. What you do now, CDC style, WHO style, operating theatre style and decide what to do. Start now.

6. Practice coughing and sneezing in a safe way, even if you're not naturally doing that now.

7. Study up on the Bayesian priors of the different ways the disease may hit you, 80% pretty mild. Check incubation times, up to 24 days, so who knows why they're still using 14. Asymptomatic people can spread for all, or most, of those incubation days. Get your mind into thinking about those and all the mechanics. If you're really determined solve some of the ODE's, for SIR, SEIR etc. program that and run your own epidemic progression models.

8. Prepare for a siege if it comes to that. Maybe write out operating procedures and lay in some supplies. For example if people have to deliver food etc. and leave it on the doorstep or whatever, work out the details.

9. Go visit people you care about who are frail or have compromised immune systems BEFORE anything breaks.

10. With Epidemics the populace is generally slow to realise it has started and also slow to realise it has finished. Think about that, prepare yourself. Don't be one of the fools.

11. If you don't already work from home, or have an understanding about that, get it fixed right away.

12. All the above also for your nearest and dearest too.

ENUF.


Working from home doesn't account for having kids who are going to school. That is a larger vector than most workplaces.


We ran a drill a couple of weeks back where everybody worked from home to ensure that if we have to close our office we are able to continue working (assuming we're not ill, of course). This was really just to shake out any issues.

Fortunately, since most of us already work remotely for at least some of the time we didn't have any significant issues.

Beyond that, nothing really.


Wow, that's refreshingly forward thinking! I wish my company took remote work seriously.


Yeah there is nothing special about the internet in the office!


We can watch people and make sure they work - Management

And what happens when the Management goes on Vacation during the holiday break? - Me

* Stunned Management


We are in a similar situation. 99% of the time everyone is working remote so we don't even really think about this stuff anymore. Our company has been operating like this for nearly a decade. There is a core group that works at a physical office, but they also have the ability to work remote for an indefinite period of time if the need arises.

Distributed/remote companies are amazing for handling disaster scenarios like this. Hurricanes, floods, pandemics, zombies, you name it. We usually just work right through it.


That's proactive thinking, good job. We're looking at the maximum user limits of our hardware and licenses and expect to buy some more licenses for the VPN appliance.


If we are constrained to work remotely, the network may experience issues too.

The 4G and internet also need actual interventions. If we must work remotely, internet companies may also have to.


Having one or just a handful guys work on-site shouldn't be a problem.


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