Read the whole thing, but this passage in particular is just chilling.
"5/ Patients above 65 or younger with comorbidities are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest. Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed."
Please note that Lombardy has a very very good health service. The OECD put a score on this [1]: 9.9/10. This is in the top 5% across all regions.
Other european regions seem to have lower average scores and their governments are not taking serious actions. [2]
How the US is reacting from my perspective (italian confined near Rome) seems borderline madness.
Something about this situation confuses me a lot.
Politicians have no understanding of exponential growth. They look at low numbers and think "we have a lot of time" then are surprised later when they in fact don't.
They don’t need an understanding of exponential growth, they only need to look at examples: China, extreme measures and barely contained it; Italy delayed measures, turning fast into a disaster. How many examples do we need?
In Germany a friend of mine refused to go to a meeting at a client's office where someone tested positive and HR threatened him because he was violating his employment contract.
Counter-datapoint: My employer (SAP) has had one case of COVID-19 among their German workforce. The entire office building has been closed down for disinfection and the employees there are asked to work from home for the quarantine period. All other employees (worldwide afaik) can work from home without informing their manager beforehand (as is the usual policy). All non-essential business travel is prohibited, with exceptions requiring high-tier management approval. Only two examples for exceptions were given: travelling to a data center to access physical hardware, and travelling to a customer site to access intranet services.
EDIT: I realize that this response is easier to do for SAP than for the average company since we are all working in front of computers anyway the entire time, with only 1-2% of tasks tied to physical objects (paper forms, server hardware etc.).
The German ratio of infections to deaths is very low compared to other countries. It may be too early to judge, but given how it's unfolding, this speaks positively about how Germany is responding to the epidemic.
It’s a point of discussion in Europe. They might be skewing the data because they are willfully not testing dead patients with comorbidities. e.g. a late stage cancer patient dies with a respiratory syndrome? Italy tests the body and that person counts against the total coronavirus death toll if the result is positive. Germany doesn’t make the test.
Well, in Bavaria at least, people are forced to self-quarantine for two weeks if they had contact to people from o where in high risk areas. Same goes for children in schools and kindergardens. Some schools are closed already. Corporate travel came more or less to a halt and soccer games are most likely taking place without spectators.
That's Berlin for you though. I think you need to have a much higher threshold for disgust and fear to consider living there.
I'm close to Hamburg. We've had two or three confirmed cases in the county. Patients are quarantined at home and stable. Schools have been temporarily closed, but reopened now. The administration is taking it very serious and people are stocking up on everything, including cake.
That is an incredibly short sighted view. We need to be proactive not reactive. This virus is here and it's here in a big way. Positive cases are not the full picture. Median incubation period is 5 days. Italy is a warning and we're not taking it. We should all be in quarantine now so this doesn't get out of hand rather than wait for it to become uncontrollable and then trying to de-escalate it.
We have months of data now. If the virus gets out of control; countries find that out because the hospital system gets overwhelmed and they have to bring in a hard quarantine.
Countries have to overreact to the circumstances that they are confronted with because in a week the situation will be much worse if they don't. The only options are to overreact when everything seems fine or to overreact when the hospitals are full past capacity.
The choices here are to overreact before the virus gets past the border; overreact when the first cases appear; overreact when the first cluster is identified or overreact when people who can't breath are being turned away from hospitals. We have yet to see what happens past that point because so far everyone has instituted a quarantine then. Germany is at the clusters developing stage.
I don't think you are using "overreact" properly. If it's the appropriate response, then, by definition, is not overreacting.
In line with what you are saying, a problem, is that the proper reaction, if works, looks like an overreaction later. So, politically, there is an incentive to do nothing.
It does sound extremely over the top indeed, but it might be the only way to prevent the spreading. It appears that by the time you find the first case, you are too late as the virus has been spreading all over the place. Maybe quarantining everybody, even from area with zero cases, is too much... but at least people should make a strong effort to reduce social activities for a few months.
Andrea Ricciardi, Professor of Hygiene and adviser to the Ministry of Health: "The most frightening point is the pitted figures on how much the virus can spread. the curves of the graphs elaborated by the epidemiologists and not only in Italy: according to the models, it could strike until 60% of the population, which means that according to the mortality rates there could be a million deaths only in Italy."
This is coming from 3.4% mortality rate from reported cases, but how many are not reported? How many people just suffer a mild cold, or are completely asymptomatic and never get reported? As an overall mortality rate, it is almost certainly too high.
The WHO reports "Globally, about 3.4% of reported COVID-19 cases have died".
If 50% the population gets infected, and if it's not 3.4% but "just" 3% mortality rate, that's already 1 million dead.
And according to some experts, even 70% infection rate is predicted.
Second, this 3.4% percentage of deceased patients, is at the early stages, with fewer patients and preventive measures (so that most patients that needed hospital treatment got it).
A 10% or more of patients of COVID-19 will need hospital treatment and ICU. As the number of patients rise, there wont be as many ICU units (and doctors are getting infected themselves at an alarming rate).
In Italy with ~ 7000 cases, "hospitals are scrambling to increase the number of beds available in intensive care units. Some have closed entire wards to dedicate them to severe coronavirus cases. Others have transformed operating rooms into intensive care units. Doctors are working grueling shifts to cover for colleagues who fall ill".
Let's put it this way, they have 9,172 cases and 463 deaths.
Now imagine with 100,000 or 1,000,000 cases -- still very far from the predicted 70%.
First, using the total population as a basis is just wrong. Some will certainly be immune to a certain degree while others are simply lucky.
Even very aggressive pandemics, hitting totally ill-prepared societies didn't infect every single person. Not even the black death managed to do so. So why do you think COVID-19 would end up doing that?
And using the 3.4% is another issue. Because you have the Wuhan rate, which is much higher than the rate eslewhere. And this thing is a moving target because testing was rather limted earlier. South Korea seems to be the best source to get mortalitiy rates due to their aggressive testing.
Andrea Ricciardi, Professor of Hygiene and adviser to the Ministry of Health: "The most frightening point is the pitted figures on how much the virus can spread. the curves of the graphs elaborated by the epidemiologists and not only in Italy: according to the models, it could strike until 60% of the population, which means that according to the mortality rates there could be a million deaths only in Italy."
Because turkeys are always fat. Happy and healthy is a diiferent story. And they get slaughtered, becasue that is the reason the are at the farm in the first place. Using that analogy for a disease is jst plain wrong.
Because it's only a matter of time before the virus will be in Berlin (if it's not already).
Nobody is suggesting people should quarantine themselves in Berlin, but avoiding crowded spaces, not touching your face and frequently washing your hands doesn't seem at all unreasonable.
It's futile arguing that the risk is low because the officials classified it as such when I stated that I disagree with their risk assessment and management strategy. If I look at a risk matrix I would classify the risk impact of not quarantining as significant to disastrous and the likelihood as very likely. That puts the current situation in all of the world at the highest risk.
One last comment because you clearly seem to prefer to live in your own world.
Assessing risk the way you do has one big issue (it actually has multiple but let's stick with one). When you put Corona in the disastrous category you habe to provide reasons for doing so, otherwise it is just a gut feeling. And by classifying it as disastrous, you run into issues when classifying stuff like Ebola for example. Over-classifying has that effect on measuring systems, that's why you need teams of experts from multiple disciplines to do it properly. And would have to do so at multiple sub levels for each criteria. The whole purpose is to take gut feeling and emotions out of the process. Doing it alone makes the whole exercise pointless.
This over-reliance on "experts" is what got things to this state in the first place. Not that long ago, WHO was adamant in saying that flying to China was still okay and that "there was no reason to take extreme measures". How many lives were lost because of that?
Conversely, had they recommended more aggressive contention measures, how many trips would have been avoided? How much slower would the virus come to Europe? If sirens were ringing 4 weeks ago by the WHO "experts", perhaps Italy wouldn't need to be in lockdown now.
> When you put Corona in the disastrous category you habe to provide reasons for doing so, otherwise it is just a gut feeling.
Not really. We put in the disastrous category because we don't have enough information to claim that it is not a mass-extinction event. In the face of a threat of unknown risk and the potential impact is unbounded, we got to treat it as the worst and prepare for the worst, cost-analysis be damned!
Your comments are breaking the site guidelines by being snarky and posting in the flamewar style. Please don't do that. It's not what this site is for, and it evokes worse from others.
Do you have kids? Older parents? Would you tell them that is totally fine to keep doing what they are doing just because the experts haven't assessed the risk yet?
It doesn't have to be a literal mass-extinction event for this type of thing to lead to some catastrophic events affecting people you know and care about. If it were to happen (I honestly hope it doesn't) to someone you care about, I am sure that "the experts told me things were fine" will be of little consolation.
How about dropping the sarcasm and word-thinking and start to put some thought into the questions I made regarding the WHO recommendations up until some weeks ago? I bet if you could go back in time to Italy just three weeks ago, you wouldn't be telling people to just "listen to the experts", would you?
You might think this is strange, but the short answer is yes.
Now a slightly longer one. Guidelines on how infection risk can be minimised are very consistent. And they make perfect sense. So yes, that's the advice I give my two kids, my parents (both of which fall into the high risk age groups, luckily they are following that advice already without me), and the advice I follow myself.
WHO recommendations are based on the best available picture to them. I prefer to trust someone changing his opinion when data changes over someone who paints a worst case scenario from day one on.
And yes, if someone from my family ultimately dies, which I really don't hope, having done everything experts told us to do to prevent it would be the only consolation there is. The alternative being fear mongering, panic and paranoia. In which any infections happening toy loved ones (assuming I am the only factor behind there behaviour, which I am thankfully not as my family thinks pretty well for themselves) would be to a certain degree on me.
And the experts have assessed the risk. Hence the advice they give. But you do you, ok? As long as you stop spreading stories about mass extinction and stuff like that.
The entire world seems to be acting like that, it's not unique to Germany. Nobody pays attention because the numbers are low, and it's not worth stopping human activities. Then you wake up one day with thousands of cases.
I have a very different experience. I see lots of hand sanitizer everywhere, people are washing their hands constantly, my employer has relaxed rules for working from home (i.e. do it as much as you feel is feasible and reasonable), some schools are closed, people generally avoid crowded trains and buses.
This is in NRW, however, where we have by far the most confirmed cases in Germany. Might be different in other places.
If they closed the office, cleaned it, and tested everyone else, it would be reasonable. But I guess they didn't do this. Which really our society is not set up for.
Actually Covid-19 cleaning solutions would be a temporary business to get into.
i think the focus should be on keeping immune systems up. having supplies of water and vitamin c available. stress-reduction is good for the immune system too. i think it's time to assume we're all going to get it and how best to ride through it.
Well, if they did that is more or less ground for legal action. Managers have something "Fürsorgepflicht", meaning htey have to take care employees are safe. Usually things go the other way round, your employer would not allow you to travel.
depending on how long friend is employed by this company, the resulting leal case could be rather expensive for the employer. Your friend would still have to look for another job, so...
Quarantine isnt just about preventing the illness in the most vulnerable, it's about keeping the explosion if cases at a level that doesn't swamp the healthcare system.
Absolute containment is highly unlikely, but delay can help a ton.
This is exactly the kind of measures that should be taken in the beginning. Italy is far past that: With 9000 confirmed cases they would need to isolate hundreds of thousands of people. For comparison: Italy's entire prison population is 60,000 people. At that point it's just logistically easier to suspend public life over the entire country for a few weeks.
But if you don’t understand exponential growth and you look at China’s example you might think (mistakenly): “they had this illness and over reacted. Look how much it hurt their economy, and it wasn’t even anything big as it turns out!” This is obviously wrong, but you can’t recognise the precipice they pulled themselves back from without understanding exponential growth itself.
I haven't heard any expert (doctor, epidemiologist, virologist,...) making the claim that epidemics can be extrapolated until the number of infected people equals the total number of people. Pandemics burn out eventually by their own way before that.
Which they do by themselves. Not everyone who is infected dies, survivors develop a certain level of immunity (generally speaking), cured people don't infect other people. Some people are "immune" right from the start. So epidemics slow down, the part of a given population not getting it or infecting others increases with time. Which automatically slows down the spreading of the disease.
All measures we take optimize for that. Vaccination increase the amount of immune people, quarantine pulls the inflection point forward and slows the spreading. Protecting the most at risk population further reduces the risk of spreading. And so on. So yes, the early phases are exponential. But the later phases are not. So modelling this thing exponentially against the max. number people on earth is just wrong.
All correct, but a highly contagious virus might still infect 20-70% of the entire population. Not 100% of the population, but the difference does not matter.
A couple of weeks ago it was "China was slow and it turned into a disaster". Now China was fast and Italy is turining into a disaster. Someties it seems that people want to be that a disaster, so they push that narrative. Same thing happens with the deniers, so.
Or you know, both narratives are right. China was slower than it should, it turned into a disaster, but they did a 360o and bounced back with strict measures quite fast.
I don't think we're actually slow. Yes, the risk was clear from the beginning, but the government had to take care of the economic situation too, which was (and is) rapidly collapsing. Some choices are maybe arguable, but when compared to other EU countries Italians were quite fast to converge to some decisions.
Professional advice is not necessarily the best political advise, unfortunately. It's a giant PR/social-media game and they have to play it otherwise the other side will get the upper hand. It's very unfortunate that we've turned "democracy" into such a game instead of a mechanism for societal-level decision making.
The same is true in all political systems. A king must constantly play a social media game too or their rivals may gain the upper hand. A modern despot must constantly ensure that they never show weakness for the same reasons. There are always rivals and there is always a game.
So far we have never come up with a working political system that banishes this stuff. It's a game theory problem.
Democracy is just as vulnerable to Goodhart's law as everything else.
I don’t have any well-thought-out solutions, but I am tickled by the idea of frequently anarchically randomising the way power gets donated from the people to the government.
I somewhat like the idea of having a democracy without parliament or elections. Instead, whenever a law needs to be made (either because the administration identifies the need or because something akin to a ballot initiative gets enough signatures) 100 people are drawn from the population at random and tasked with writing that law. They are allowed to summon/subpoena as many experts as they like to help them with drafting the law.
The idea is that every citizen would be involved in one, maybe two laws in their entire lifetime, therefore giving them the sense that this is the one time they can contribute to politics in a meaningful way. Also their names are tied to that particular law forever, meaning that fear of social pressure could be more effective than for a politician who votes for 1000s of things in their political career.
In my opinion, this is really the main reason why this virus is spreading globally. In fact, the average incubation period seems to be 5 days, which is already a lot.
But apparently, some subjects had an incubation period up to 24 days, if correct, this is huge and the main reason why it suddenly raised in Italy.
Imagine only one relatively social person in Italy, in 24 days he/she can probably meet at least 50 person directly and much much more if he/she goes to some public activities. Like SARS, it just need a few super-spreaders who aren't even aware of being sick, to start an epidemic.
Risk of infecting others when you're without symptoms is supposedly small..
I'm by no means an expert, but to me the problem seems to be lack of proactive social distancing; and lack of proactive testing of everyone with symptoms.
Current guidelines seems statistically sound, it's just that we have little mitigation for the few that do slip through.
"People who contract the novel coronavirus emit high amounts of virus very early on in their infection, according to a new study from Germany that helps to explain the rapid and efficient way in which the virus has spread around the world."
"The researchers found very high levels of virus emitted from the throat of patients from the earliest point in their illness —when people are generally still going about their daily routines"
The US is probably a much larger vector than we realize. The testing rate is the lowest in the world and Americans travel like mad. Who knows how many undiagnosed Americans have been globe trotting over the last couple weeks?
And also unpredictable and variable (and delayed) medical bills for those who don't have great employer-provided healthcare (and even sometimes when they do).
The stories abound of a hospital visit with a magical bill that appears months later with some unpaid sum that's in the 4 digits. Everyone knows someone who this happened to - I happened to know a couple who received a 5-digit bill for a baby who died many many months later. Now, as a rational person you're not going to go to an ER willy nilly, and sometimes an ER is what you get pointed to by smaller medical centers.
The U.S. medical model doesn't work - for the group. It works - for the individual. I had superb eye surgery recently from a top world center and it was fully paid. But the viruses don't care if one of us can afford care, and the other can't, because the virus views us as a singular organism, and now we're all at risk. Which is exactly how the health system should begin viewing us.
Not really. Even though the US media has focused on the raw number of tests carried out for domestic political reasons and left a lot of people with the belief that the number of confirmed cases is basically just a function of the number of tests, Italy has been visibly struggling to test people. If you look at the percentage of tests that came out positive rather than the absolute numbers, it's obvious that Italy was only testing people who were very likely to have the disease, especially during and after the big spike in cases that got everyone's attention. It was in the very high single digits for quite a while, compared to the 3% that the CDC's old, very restrictive policy of only testing a handful of people very likely to have it There's other evidence that Italy's numbers were off too.
I'm particularly miffed about this because it seems to have spread to our shores and convinced a bunch of people that the reason the UK has lower numbers than Italy is because they're not testing people, to the point they're literally unable to believe that Italy has only tested twice as many patients for the coronavirus as the UK.
You sound correct about the hypocracy but as far as I can find out the normal tests are reported about 40-70% accurate (reports vary but my understanding is more near 40 than 70) in non-symptomatic people and around here they are thus only used and done twice if one has symptoms as even then they are not fool-proof. The test is thus pretty useless to perform on everybody as it gives too many false positives and too many false negatives to be useful to people with no symptoms. It would be a lot better though if they explained that. People here (Netherlands) are also complaining about not being tested before having symptoms or even after being admitted, as they assume the test will give them a yes/no answer which it won't.
This is incorrect. The sequence test has low false positive rate and higher false negative rate. The positive results alone are significant and informative from a policy perspective. Combined with other measurements like CT, the accuracy can be high.
CT for a virus? You can only see that something is inflamed. I mean you can guess the diagnosis, but that doesn't really increases my confidence in testing. If inflammation can be detected, you probably also have symptoms already. That aside, you should limit CTs if possible. And you won't be able to do mass scans anyway. So it is just for specific cases. MRTs could also help and are not as invasive, but maybe they don't show enough.
This Chinese paper compares the sensitivity of diagnosis with chest CT vs RT-PCR:
"In a series of 51 patients with chest CT and RT-PCR assay performed within 3 days, the sensitivity of CT for COVID-19 infection was 98% compared to RT-PCR sensitivity of 71% (p<.001)."
Good to know about the positive rate. The media has not been very forthcoming with actual data an usually only quotes wide numbers. What I meant is that is test alone will not do the job perfectly and that is what people expect. Higher false negative rates is what bothers me as people generally think "oh I'm safe now" when that might not be the case. Considering they wait here with testing to after symptoms it would likely make the tests way more useful then to test everyone. It requires labs and those might also be stressed to a point of breaking if you start testing everyone (if that is even possible) for instance.
To be fair they'd be incentiviced not to... assuming they understand the exponential nature of the money, which I guess they don't. But as soon as they do learn they won't want to explain.
Also, growth narrative is always about adding/subtracting percent points - which makes most people think this is a linear phenomenon, because they don't make the connection that the quantity discussed is a multiplier, and charts they see are on log scale.
As long as you stay with low percentages, the linear approximation works pretty well: two times 1% lead to a 2.01% increase. But it starts breaking down as soon as you reach 10%.
Little trick to know (with some good approximation) the doubling time of some low-percentage growing system: count it linearly up to 10% and then multiply by 7 (which is roughly the doubling time for 10% growth). Example: 2% => 5*7=35 years to double.
This is identical to the Rule of 72, https://en.m.wikipedia.org/wiki/Rule_of_72. Except that you are using 70. The amazing thing about the rule of 72 is that it works pretty well even for rates greater than 10%.
Thanks for the correction, I didn't actually do the math for that, just remembered something I've read a while back, but the numbers where different 20% vs 21%.
Apparently I don't understand exponential growth either cause I assumed a 5% difference scales linearly (as in the difference between 20% vs 21% growth rates for a given period should be the same as between 2% and 2.1%).
But a good exmple showing why numbers are so important. A 50% difference is an order of magnitude away from a factor 20. Thing is, once out there the wrong factor 20 is impossible to correct.
Now long would you maintain that quarantine? Is there some amount of time after which the virus will go away?
Any call for drastic measures, even when drastic measures seem like common sense to some people, need to explain why the measures should be implemented and under what circumstances they should be lifted.
They are undertaken so that the health service is not overwhelmed with cases. When that happens (as in Italy), you need to triage infected and let some number of people die, who otherwise would not have died. So it is best avoided.
They're lifted after most of the population has already been infected and the disease has run its course (as in China).
Presumably as soon as the number of patients requiring ICU goes above the number of available ICU beds then those kind of measures must be taken - even though its clearly a pretty terrible choice for someone to have to make.
I concur with GP - but here in Australia we're run by fantasists, so it's not going to happen here either.
> Now long would you maintain that quarantine?
I'd suggest start with 2 weeks, and reassess after 10 days. I note that in TFA Italy's administration extended this (initially) out to the 3rd of April, which seems like a reasonable timeframe.
Incarcerated people rioted ... and a churlish part of my brain suggests that's just to be expected, but each nation state can learn from, and put more effort into educating than, the earlier pioneers.
> Is there some amount of time after which the virus will go away?
We don't really know - but it sounds like a rhetorical question(?).
I know that I'd be happy with a two week lockdown - option to renew - here in AU ... especially if it reduced my chance of dying. The numbers cited in TFA are suggesting a 3% mortality rate now, and massive propagation rates and embarrassingly poor treatment / survival rates even in a first world country early on in the pandemic cycle.
> Any call for drastic measures, even when drastic measures seem like common sense to some people, need to explain why the measures should be implemented and under what circumstances they should be lifted.
I'd invert your usage of the precautionary principle and ask, given what we know so far, why the default response isn't to shut down non-essential travel and public events for a couple of weeks.
I mean, what's your acceptable ratio of dead people : inconvenienced live people?
most people outside of the previous red zone is uncaring about the new emergency restrictions
step 1 should have been to bring military in the streets to enforce the thing, because police is both decimated by the virus and overwhelmed from the new responsibilities and cannot handle what's happening
Where I live I already have to provide my babysitter a signed letter where I certify that she comes to work here. She's from a different township (comune) and the police could fine her if caught without that document.
It's not going to stop 100% of people from moving around, but even it this reduces the spread by a few % it's already a big improvement; even reducing the daily rate from 21% to 20% can have a 20x effect on total cases over a year.
In the past 5 days, some organizations who can afford it have shut down offices and are providing just that. I'm not at liberty to expose info on who, because I'm not sure it's been made public or not.
Nope, the first wave of the flu only killed older people and people with a low immune system. Just like the corona virus. The Spanish flu hit in three waves. The first like this one. The second wave hit the younger. The third wave hit the rest.
I don't get the criticism for Trump. He's just basically saying "don't panic" in his own way. That also seems to be consensus among the experts and on HN, judging by yesterday's "don't hoard" threads... (I disagree, but it seems I'm the minority.)
I find it weirdly reassuring--he's not an expert and isn't even trying to look like one.
The people that scare the hell out of me are the gaggles of PhDs and other "very smart people" who seem to think that we shouldn't be closing schools and working from home because reasons. Our organization doesn't even have paper towels in the bathrooms (It's bad for the environment!). Actual sanitation is not a priority.
He's said he's smart and understands this because his grandfather went to MIT; said grandfather who died of the Spanish Flu. There's irony in almost everything he tweets or utters...
Sure, but what higher standard is that? The standard of "don't panic", currently followed by WHO and pretty much all heads of state (with possible exceptions being Putin and possibly Italy & Austria), or the standard of "panic", universally shunned by experts and wanna-be experts alike?
You can say "don't panic" without misleading people by using numbers completely out of context.
By comparing the number of Corona virus cases and deaths to the annual flu deaths he is implying that the number of deaths from Corona virus in the US is low and the risk is negligible, and while it is currently low this completely misses the point that in other countries it has proven to be extremely contagious and has a much higher mortality rate than flu. In other words, there is a significant risk if adequate steps aren't taken to reduce the risk of transmission. See: Italy, China.
Its misuse of the term "don't panic". "Don't panic" should mean "remain calm yet vigilant", not "stop being a crybaby and follow everyday life like a good sheep". Panicking doesn't make sense unless you wish to activate people who wouldn't otherwise, and neither does misleading people with poor, incomplete or flat-out wrong statistics. Pretty sure that's why the term "don't panic" gets a bad rep: one party means to be serious but calm, the other party uses it as means to ridicule those who err on the side of caution.
"Exponential growth" in itself isn't really the issue. If every week you have 10,000% as many cases as last week, you're screwed. If every week you have 105% as many cases as last week (i.e. 5% more), that's exponential, but after a year there would be less than a 13X increase, by which point there could be a vaccine or other measures that cause the weekly number to go from 105% to 95%.
You can also have non-exponential growth and still have many new cases, if people are getting over their infections faster than they're infecting new people. If a million people were currently infected and every week 500,000 new people were infected but 500,001 of the existing infected people recovered, that means the number of currently infected people declines over time, but you'd still have 500,000 new cases every week and just about everybody might eventually get infected before it dies out, even if it eventually does. (This is similar to what happens with the flu, except that it has exponential growth in winter and then below exponential growth in the other three seasons, so the actually dying out never really comes.)
To really get rid of it you want to have something like 100,000 cases last week and 75,000 cases this week and so on. But even then you might have 25,000 fewer cases this week because 50,000 people recovered but 25,000 new people got infected.
So whether it has exponential growth or not isn't really the issue. It's what the growth rate is. A small exponential growth rate isn't catastrophic -- the number of cases grows but not so fast that everybody is infected by the time they have a vaccine or other more effective countermeasures that get the growth rate back below exponential.
Most importantly, the growth rate isn't immutable. It's affected by things like people washing their hands and having effective testing and quarantines. So will things be fine? They will if people do the right things. Maybe some of them have been and some of them haven't. Maybe they'll get better at it going forward, maybe they won't. As a result there is a significant amount of uncertainty.
But panic is useless. Even if all they can do is reduce the growth rate from 150% to 130%, that still buys more time to respond. Even if everybody ultimately gets it, better that it happen over five years than five months. And if some people are doing it wrong, try to help them do better. Everybody likes to see the bad orange man look stupid on the television, but maybe this is a situation where we come out better off with everybody working together.
Problem with exponential growth is that you can be a little off in the exponent and be totally off in the result. Such is the fragility of any assumption about exponents being "small".
> Problem with exponential growth is that you can be a little off in the exponent and be totally off in the result.
Which is why the growth rate is really what matters. Which isn't immutable. It goes down if people wash their hands. It goes down if sick people stay at home.
This is also why it really matters if the rate is 150% or 130%, even if both are very bad, because the higher rate is very worse. And the rate gets lower if sick people stay home, but it gets higher if idiots panic and start hoarding masks and stealing hand sanitizer which increases the rate of infection when they aren't there for other people to use.
Not really, only if you don't recalibrate every so often... but this can happen in any kind of growth. Even linear growth with unequal coefficients diverges after some amount of time, exponential growth just gets there faster.
This is so wrong. The ratio between exp(x+ϵ) and exp(x) for even ϵ arbitrarily close to zero is infinity in the limit of large x. There is nothing like it with any polynomial growth for any exponent. The ratio between (x+ϵ)^p and x^p for arbitrarily large p is 1 in the limit of large x, for any ϵ.
Another sign that people don't get exponential growth, even if they think they do.
No, panic is making it much more difficult to implement counter measures. It also takes away crucial man power from fighting the disease to fighting the panic. And finally, panic makes it harder for health care professionals to actually care for patients.
So no, panic never helps. Staying calm and level headed does.
But if you want to panic, do it. But do it in private, panic itself is rather contagious as well. Maybe self-quarantine.
The point I was raising was that calls to not panic suppress non-panic activities. They are sending the message that there's nothing much to worry about. This is extraordinarily dangerous. If necessary precautions will also cause some to panic, so be it.
At this point, things are so looking so grim that there's no way to tell people not to panic without unacceptable downplaying of the gravity of the situation.
But then the counterpoint is that once panic steps in it becomes hard to manage. People should be called to take this seriously and to proper civic duties.
That is actually entirely possible, I imagine supermarkets try to minimize storage as much as anyone else so shortages might just mean that people are just synchronously doing normal shopping.
In at least a few cases though I doubt it was not panic buying.
In Germany (and probably other places too), people are stealing masks and desinfectant from hospitals - places where this is really needed. I think this is a big issue and it needs to be addressed.
This, not this toilett pper issue, is why panic is bad. Toilett paper hording just is a great early sign from from the more serious stuff happening as well.
I would say that the biggest threat is a dichotomy fallacy. Just because an extreme is wrong it does not mean that the other is right.
This should be taken seriously and people should put effort into prevention, but honestly I would prefer calling upon people's sense of civic duty rather than panic.
At this point, if we're not seeing at least some panic we're doing it wrong. The level of warning has to be such that the most skittish elements of society are freaked out, otherwise the average person will not be taking it seriously enough.
Because at the beginning, a logistic curve is often confused with exponential growth. There are very few truly exponential processes in the nature. All things come to an end. Epidemics, population growth, economic growth... no such thing as exponential growth with limited resources.
the logistic curve is what happens to the initial exponential grow when there's no more way to grow, because there is no more population to infect or when severe social exclusion is set, but the initial grow is still exponential.
I spent a few months in the region with a sick toddler and can attest to the speed, quality and friendliness of the public health system there.
That the virus is spreading so quickly, and that the health system is getting overwhelmed is cause for real concern. If northern Italy can't handle the outbreak, I'm not sure anywhere will do much better.
There is an answer, and it is political (thank you for allowing me the indulgence to bring this room-elephant up). There is a slow burn civil war between mission-focused bureaucrats and administration loyalists. Consider: https://twitter.com/Imm_Judges_NAIJ/status/12371515163955363...
I'm not even sure who are the "mission-focused bureaucrats" and who are the "administration loyalists" in that thread. But for the love of God, can we please stop politicizing this issue? Can we please have a moratorium on blaming the other side for whatever measures should / should not be taken?
Frankly, nobody knows what to do. Here we are, pondering what to do with the kids.
* The school district is open for business in spite of being the ground zero of USA outbreak. Because no kid has tested positive yet. Meanwhile, the testing scale is tiny [thousands, in a nation of 300M] and the latency is horrendous [5 days]. Most likely the virus is already endemic in the kid population.
* OK, so let's keep the kids at home, as SPS will eventually have to face the obvious and close the schools. For how long? A week? A month? Until summer? Until next year? Send them to school and pray for the best once everybody in the family eventually gets the disease?
> But for the love of God, can we please stop politicizing this issue? Can we please have a moratorium on blaming the other side for whatever measures should / should not be taken?
Hard to do, when the correct thing for the administration to do is to stand back and hand decision making authority and control of resources to the bureaucracy. As long as the administration keeps interfering in the response, anything about the issue can't avoid being political.
There's actually a really good test of your claim: the botched CDC rollout of testing kits. The CDC went about developing and producing the kits just like they would for any other disease under any other administration, free from meddling and micro-management, and they botched the rollout. The issue was immediately politicized. Mainstream publications made it a point of saying that it was the "Trump administration" that butched the rollout, blamed the lack of micro-management, and there's an endless wave of conspiracy theories everywhere about this being a deliberate cover-up by Trump.
The "U.S. pandemic response team" that article is talking about were White House staff, part of the Trump administration rather than the non-partisan bureaucracy. The actual, on-the-ground organisations and bureaucracy involved in pandemic response - the stuff most people would probably think of as the pandemic response team and that the comment I'm replying to seems to suggest should be in charge - is still there. The staff it's talking about were also all part of the national security side of the administration rather than the health side, and of course it's the health side which is in charge of the CDC and the FDA.
So you're saying that the administration which refuses to admit Coronavirus is a problem, which a year ago let go its entire pandemic coordination staff, which has proposed a 16% cut to CDC funding, and which today ordered immigration judges to remove CDC posters aimed at slowing the outbreak has nothing to do with the terrible response, and it should all instead be blamed on the officials at the CDC?
The executive and administrative branches together respond to a crisis like this - for example by coordinating actions, providing more funding for health services or in extremis ordering quarantine in affected areas. None of that has been done. I don't think you can effectively separate the two responses, nor do I think this outbreak is somehow Trump's fault, but he and his administration are responding remarkably badly to it.
The administration has put the vice president in charge. What is said publicly does not match actions - as is typical for this administration (or any other administration though this is more blatant about it)
Are you saying we should stop blaming the other side because you think the other side isn’t to blame? What if there’s reasonable ways to explain how the other side is to blame? Or are you making an epistemological claim that the other side is never to blame? Or are you claiming that, even if the other side is to blame, we shouldn’t focus on that until we solve the problem?
>>even if the other side is to blame, we shouldn’t focus on that until we solve the problem?
Exactly! That is what is meant by not letting polarized politics drive the issue. We shouldn't care what 'side' is doing what, we should be focused on preventing an epidemic. Personally, IDGAF about assigning blame to any side, I'd rather that the petty bickering is dropped and effective measures are taken.
I realize the climate in the US isn't conducive to this, but assigning blame doesn't fix anything. Rather than blaming people, effective steps need to be taken. Focusing on assigning blame just puts the other side on the defensive; which is counterproductive to the kind of cooperation that will be needed to effectively respond to this crisis.
The problem is that this holds true regardless of who you consider to be “the other side.”
Here in Oregon, our governor is politically on the opposite end of the spectrum from the US president. Yet the messaging from both has been nearly identical: everything is fine, carry on, wash your hands.
Making this into a political issue in either case just creates conflict, and causes the target to dig in their heels. It does very little towards a more effective response.
This outbreak may put an end to this "post-truth world" nonsense. There is no such thing and never will be, or at least not for long. Eventually Darwin puts his foot down. Recognize reality or it recognizes you.
The CDC is updating their recommendations for healthcare providers several times a day. There's plenty of epidemiologists working on this topic in the us: shutting down airports and roads also kill people and it has varying effects depending on the point of the epidemic you are in.
I can't believe I'm saying this as a libertarian but you have to put some faith into the government's action here. The public in a panic already took away all the masks healthcare providers needed to safely attend patients, diminishing the capacity to serve.
Note that OECD's 9.9/10 is based on mortality rate and life expectancy, and therefore not a direct indicator of health service quality. Maybe the air in Italy is just very clean and the food healthy.
Air quality is the lowest in all Italy in Lombardy, as it is a plain with the most industries of the countries, so if anything there would be an anticorrelation because of that.
Actually this event may also become a test of the validity of those measures / indicators. One may argue those measures / indicators are not setup for this purpose.
I am struggling to reconcile this story with the numbers of deaths so far vs the number of deaths in any given year. A french infectious disease specialist mentioned that 2017 had been a bad year for infectious respiratory diseases in France, with over 60,000 additional deaths in winter, to the point that it affected life expectancy tables [1]. I don’t remember any mention of hospitals being overwhelmed and doing war-time triage then.
It is possible than one hospital may be overwhelmed, but surely it cannot be representative of hospitals across Italy or even a region.
Which shows how damn important context is. Without 100% testing (which I don't think to be necessary) for COVID-19 and comaprative baselines case numbers aren't tellig us anything. Without the proper domain expertise to actually interpret the numbers that is. So whithout that particular domain expertise, epidemilogy and virology, I don't interpret the numbers or build models, rather I believe the experts to make sense out of them.
Remember with Flu, the doctors and nurses can't get it, and can't spread it. The danger with this is that all the doctors get sick/quarantined and then no-one gets treated.
By making that point though, you deliberately making an argument to support the 'it's just like flu' theory of not worrying. Which is a flawed viewpoint.
I am from Italy and every single friend of mine working in healthcare as a doctor has confirmed me that the situation is like the one described here. A friend of mine who is an orthopedist outside lomdardia has also confirmed that they have already asked him to work extra hours and they are already at full capacity, so he's preparing to assist covid patients.
Personally I know a girl whose soon-to-be husband from zero symptoms went to being intubated in 3 days. Luckily for him there were still machines available and he's relatively young and in good shape so they have allocated it to him.
One can surely ignore these reports as they are not provided first hand by doctors. In that case it is sufficient to wait. Soon this situation will be a reality in many more regions/countries so it will be easy to experience this first hand.
So doctors work overtime during situations like this. Surprise. My problem with these reports is that they have a tendency to spread fear, especially the way the are presented. They also undermine trust in public information which only makes it harder to implement measures, in turn making it harder to contain the virus.
But orthopedists can support hospitals elsewhere, freeing up proper resources for for stuff like pneumonia. It is not that because of corona nothing else happens at hospitals.
Also, pretty much in line emergency handling. There is a reason why national emergencies are getting declared. It is the sesantional, alarmist way this stuff is reported that is driving me mad. We should all stay calm and follow guidelines. Instead people buy toilet paper (still just finny) and masks (where gets less funny pretty fast). This kind of reporting, amplified by social media, is a huge part of the problem.
Stop projecting, ok? We are following the guidelines. No unnecessary travel, frequent hand washing, keep physical contact like hand shaking down.
We also have quite some stock of necessities at home, but that isn't any different from, say, last November or any other random months before the virus outbreak. Is it serious? Sure it is. Are we at Black Death levels? NO, and nobody says we ever will be there. I am also rather happy with the general way authorities are handling the situation. Sure, it could be improved here and there, especially at the messaging and side and by aligning policies.
Two things to note so:
- When you are not old without any preconditions, your personal risk of complications is rather low. And no, I don't care about one guy being interviewed by whom ever.
- Even during the Black Death panic didn't help
Not necessarily. Excess panic can easily create more destruction than the disease ever would have. Look at the hospital that was burned down in Iran because of misinformation about the coronavirus.
Fair point. But you do need a bit of fear. What we have at the moment is complete denial and it's dangerous. Although that does seem to be changing in the last few days.
I know what you mean, that phrase 'from a friend' rings a few alarm bells.
However official statements widely reported in the media are essentally saying similar things:
Antonio Pesenti, head of the Lombardy regional crisis response unit, told the Corriere della Sera newspaper the health system in Lombardy was “a step away from collapse” as intensive care facilities came under growing strain from the new cases.
“We’re now being forced to set up intensive care treatment in corridors, in operating theaters, in recovery rooms. We’ve emptied entire hospital sections to make space for seriously sick people,” he said.
Which is a message much better way to communicate these things. Because now the official statement ment confirms Twitter. The other way round, when Twitter and social media is wrong, people don't believe official statements. Strange enough the wave around cases where officials confirmed social media to prove social media is right and thus officials, in the case they don't want to be true, wrong. Which is very, very dangerous.
I think in this case these comments are really important to show people what is really happening, or you prefer full negationism like most countries are doing?
The rate of death counts confirms it. Im in south korea most of the death is because theres no available hospital bed and they have to stay home and call the ambulance when symptoms get really bad and they die on the way to the hospital.
That's the problem with coronavirus that everyone's missing.
If we had the hospital capacity to deal with it, it wouldn't be so bad. But the suffering (and mortality rate) spikes pretty significantly when you run out.
If we were halfway rational we'd be rapidly scaling up medical capacity now and practicing strong social distancing now... but people are too worried it would unduly wreck the economy.
I am a Chinese living in Bay Area. What's described by the Italian doctor was exactly like the situation in Wuhan right after the lockdown for the first 2-3 weeks. Unfortunately, I think it will hit Italy harder this time, China locked down Wuhan but every other provinces send in supplies and doctors to help, just building new hospitals is not enough, and I don't see France/Germany doing the same to Italy. The US response so far feels very much like what I saw early Jan in China, the government kept assuring the public everything is in control and risk is very low. One could argue it's either cover up or they simply didn't know, I think it's a combination of both. But I really cannot understand why US is handling it this way after seeing what happened in Wuhan and now Italy, it almost feels like Trump has some secret weapons ready to save the day. You would think that, since most of the leaders are in a high risk demographic and spend large chunk of their time shaking hands with strangers, they would be more vigilant
I am extremely disappointed in the American government on this. We have had a significant warning and we've seen the virus in multiple countries and the response has been so lackluster.
Why should we wait 20 days for things to get terrible before going to quarantines and lock down? Surely China and Italy have shown us our future.
I partly think the problem is political. If you quarantine and the virus is controlled, then it looks like you panicked over nothing, because you took this huge reaction and nothing much happened. However, if you wait till it's sufficiently bad and then you quarantine everyone will understand what you did, and later, you may get praised for your decisive leadership in a time of struggle.
What I mostly wish is that citizens could throw some sort of flag now to say "This crisis is being poorly handled. If this goes badly, let's have a review, figure out why, and correct the problem once this is settled."
> If you quarantine and the virus is controlled, then it looks like you panicked over nothing, because you took this huge reaction and nothing much happened.
Nails it. You could be so good at your job that people think your job isn’t even necessary; or you could be putting out fires caused by your incompetence all day every day and people think you’re a hero.
> I partly think the problem is political. If you quarantine and the virus is controlled, then it looks like you panicked over nothing, because you took this huge reaction and nothing much happened.
While I don't agree with the US's lackluster response, bear in mind there's other repercussions besides "just political". The quarantines and shutdowns will almost certainly destroy a lot of people's livelihoods. From people that aren't getting paid so can't pay their bills, to small business owners that will lose their businesses because they can't pay their bills. The effects of even a 1 week shut down can expect to be massive, and impact exactly the people who are already most struggling financially.
> If you quarantine and the virus is controlled, then it looks like you panicked over nothing, because you took this huge reaction and nothing much happened. However, if you wait till it's sufficiently bad and then you quarantine everyone will understand what you did, and later, you may get praised for your decisive leadership in a time of struggle.
This need not be this case. Any authorities who take action to shut down social contact now, before they turn into Italy, will be praised several months hence for being forward thinking because it will be clear what happened in every jurisdiction where they didn't shut down social contact, i.e. absolute catastrophe.
> What I mostly wish is that citizens could throw some sort of flag now to say "This crisis is being poorly handled. If this goes badly, let's have a review, figure out why, and correct the problem once this is settled."
The election season is in full swing and you should have the opportunity to vote on how well you think the crisis has been handled by November.
What I want though is a report that explains what incorrect actions the government took and the proximate and ultimate causes for those reactions. I want the causes addressed so we'll do better in the future.
Example: Why didn't we start testing with 100x or 1000x the number of tests? Maybe the reason is regulation on independent labs doing their own tests. Maybe there wasn't enough money banked up at the CDC such that, when a pandemic it's recognized, we can't immediately start mass producing tests.
The point is, I want it documented and explained what the failures were so that future people handling future disease outbreaks will perform better or at least not make the same mistakes. Further, a practice of exploring major mistakes would help motivate government bureaucrats to avoid making them. There should be a potential political cost to be dramatically wrong in vital scenarios.
How do you start testing with 100x the number of tests? You have to figure out how to make a test this takes time in itself. The disease is only a few months old so it isn't like there was time to prepare. This is a very hard supply management problem. Don't forget to account for tests that fail quality control, something that happens but can't be predicted.
South Korea has done almost 4k tests per million people. Guangdong in China has done 3k per million. The US has done 5 tests per million. That's three orders of magnitude worse than China or South Korea. Explanations like "This is a hard problem" or "There wasn't enough time" are simply unacceptable given that other countries are doing dramatically better.
If you're disappointed in the American government on this, you haven't been paying attention for the past two years. They are handling this crisis exactly as they showed us they would.
I'm feeling the same. I just started becoming concerned on Friday, and trying to keep up on accurate news. Do you, or anyone else in the US know how to help raise public awareness for prevention, preparedness for the worse, or lessening the impact on healthcare systems and communities? I feel like this needs its own thread, or platform for collaboration. I'm worried that without wider availability of testing, we're already fucked and that quarantine = police state.
good luck with that. you think it would be possible for people to look at china and italy and realize the same thing is now happening here in the US. but large percentage populace has already been fed multiple contradictory narratives and have convinced themselves it's "just the flu" as it's the most convenient reality. your "science" is fairly useless in combatting ignorance, arrogance and selfishness. but regardless i hope you do try.
Combatting selfischness is absolutely necessary. Unfortunately, news outlets are to bussy spreading panic to adress the actual risks of hording stuff fromm food over medical PTE to toilett paper.
> I partly think the problem is political. If you quarantine and the virus is controlled, then it looks like you panicked over nothing, because you took this huge reaction and nothing much happened.
Yep. People do this with Y2K, for example. "Nothing happened, what an overreaction!"
Nothing happened because an enormous amount of work was done in advance, but people don't see that side of it as it's reasonably hidden.
Don't think we know why "nothing happened". I think the remediation was generally worth doing, but that's just a guess. There is no final reveal that tells you whether or not it was. We'll never really know.
There were a lot of small scale reveals. I worked in a lab in 1997 that turned the clock on some machines forward and watched what happened. We then told all customers this machine hasn't been made since 1975: it breaks and we won't update it - they responding by setting the clock back. We spent a lot more time testing (and fixing) the then current replacements.
Though to be fair, most of the media predicted bad outcomes were completely unrealistic and wouldn't have happened even if no effort was put into mitigation.
> I partly think the problem is political. If you quarantine and the virus is controlled, then it looks like you panicked over nothing, because you took this huge reaction and nothing much happened.
I think this is exactly what's happening. It's an extension of the way individuals feel -- no one wants to be seen preparing too early, because people might think they're silly.
It's not just the US though, you have other countries in Europe handling this abysmally like The Netherlands. Indonesia is still in the "pray to make it go away" stage despite multiple cases in Singapore being traced back to Indonesian travel (including one rich Indonesian who couldn't find anyone to treat them in Indonesia so deliberately flew to Singapore on a private plane to get healthcare).
To be clear, I don't believe the following (Hanlon's razor, etc), but it would make a good dystopian/thriller:
As some point one might consider if governments see COVID-19 as an opportunity to "cull the herd". Japan and Italy have the two largest aging populations of any countries. The US has a large number of citizens with COVID-19 comorbidities.
I'm not sure if the long term savings on entitlements and health care costs would outweigh the short term economic damage, though.
Pretty much by definition in countries with large populations of old people, the current governments largely rely on the vote of those old people to stay in power. This makes the cull-the-herd theory rather unlikely in my opinion. I think simple incompetence is a sufficient explanation.
What makes you assume that the economic output of these old people, on total, is negative? They might be holding/running investments, collected massive knowledge along their careers or have enough savings and are making money for the private healthcare system.
If they go away, we might lose on the knowledge or their investments might stop working and the new youth might not manage it any better. So a total loss of society.
Holding/running investments -- investments would be passed to beneficiaries, who should have longer time horizons
Massive knowledge -- retired and not using it
Making money for the healthcare system -- fundamental life science advances could be lost or slowed down, but most healthcare spending is pure consumption, the labor could be better deployed to something more productive
I'll give you a different basis for a conspiracy theory:
China got COVID-19 first. And got over it first. US and Europe are going to be devastated by it. I'm guessing Russia will fare no better. In the aftermath, who's going to be on top on the global scene?
In the tabletop exercise performed at Johns Hopkins just a few months ago, the world didn't fare so well. Even though some countries initially control it, it continues to spread and be reintroduced, ultimately leading to 65 million deaths worldwide: http://www.centerforhealthsecurity.org/event201/scenario.htm...
China didn't get over COVID-19. They're still seeing double-digit deaths daily and new infections. They're going to see recurring new networks and pockets appear repeatedly. Endlessly if the virus has endured in other countries. They aren't coming out on top of this, especially given the absolutely enormous GDP damage they've already endured.
It’s extremely far-fetched, but I think the implication is either China engineered the virus or at least allowed it to spread, either because they already have a vaccine/treatment, or at least know they can control spread among their population better than other superpowers. Not to mention the power they wield by being the world’s supply chain.
Going with the abysmal handing theory. What concrete steps should, in your regard, be taken to contain the virus from spreading? How would these steps contribute to contain the virus and how would the be implemented without causing disproportional damage elsewhere?
Just saying the situation is handled badly is easy. Just like being a better football coach after a big game. There is a german saying that everytime the national soccer team looses Germany has 81 million national soccer trainers. Providing better solutions is the hrd part, almost as hard a judging why exactly current solutions are not sufficiet.
Quarantine a whole neighbourhood when a case is found, keep it locked down until everyone has tested negative for two weeks.
Drive-through testing where everybody with any symptoms can get themselves tested.
A good public education campaign with calm TV documentaries that show the facts of what was going on in Wuhan and is now going on in Italy, and explains why these actions need to be taken.
I'm hoping TV crews get into Lombardy hospitals and show the West what is happening there, it might get people to take this seriously. But then someone needs to also give them clear instructions or it will just be panic.
That brings me back to my core question. What are people not taking serious about it? I get it that some people a scred and feel better when other share tht feeling, and they get external confirmation from th outside. But does this actually do any good? I don't think so.
Just letting you know that the measured, fact based response has been abandonned in some european countries as it simply does not scale/is not feasible after widespread community spreading is happening.
Yeah, but if multiple Singaporeans who are spending just a few days in Indonesia are coming back with COVID, it's obviously not 19 cases. Indonesia is where Iran was just a few weeks ago.
The USA is a disaster waiting to happen. I've lived through a disease outbreak that required lockdown/curfews in another country and I don't think the US is logistically or culturally prepared.
I don't want to go into longer detail as it will be subjective and seem political, but I'm expecting things to Get Weird.
No clue. Given the way it seems to be more deadly for older people or those with comorbidities African countries may not have as big a % of the population at risk, plus it might not travel as fast there as there is less commercial and discretionary travel. But it's easy to think of other factors which would make it far worse.
That's a good point, I can't say anything about Africa right now. It seems the virus hasn't affected the continent too much for now, it's difficult to say why, maybe bad conditions for the virus, luck or just a lack of testing (that's what I fear).
Doesn't Africa at least have the benefit of being a warmer continent, with the current claims of the virus preferring milder, wet climates? Or has that last statement been debunked yet?
They didn't believe what happened in Wuhan would happen to them, mostly because of racist superiority I think. Surely our hospitals must be better than China's, we are healthier, et cetera.
And people distrust anything coming out of China's government so they simultaneously think China covered up a lot and there were way more dead, and they exaggerated how bad the virus is...
> it almost feels like Trump has some secret weapons ready to save the day. You would think that, since most of the leaders are in a high risk demographic and spend large chunk of their time shaking hands with strangers, they would be more vigilant
He's behaving entirely consistently with how he always has: deny everything, project perfection.
There's no signal here of a secret weapon, it's a complete shit show.
> He's behaving entirely consistently with how he always has: deny everything, project perfection.
> There's no signal here of a secret weapon, it's a complete shit show.
Can't really disagree, but I feel like I'm taking crazy pills with the way people in the US are talking about the response now. Was the US MSM not spending all of January and February telling us "calm down, you know the common flu kills WAY more people than this thing and we don't freak out about it!" and complaining how Trump's proposed Chinese traveler ban was both a) racist and b) would have little to no effect?
One of our older neighbors are inviting everyone on the nextdoor app to go to their house for movie night to prove that this is just a flu. The entire thread is people making fun of covid19 and how they are angry their retirement accounts are getting hit.
I'm completely unsurprised by what you're describing. I observed similarly disturbing behavior waiting in line @ Home Depot the other day. A customer was excited to find they had hand sanitizer in stock, and another customer told him there's a whole aisle full of the stuff and that all the covid stuff is fake news which devolved into nonsensical madness between yokels I had to just walk away from. Of course our Home Depot had some in stock, we're in rural bumblefuck middle of nowhere. Our stores only run out of things when the employees forget to do their jobs.
Yeah it's crazy. I suggested in the thread that they should take this a little more seriously and was immediately attacked for being a doom mongering idiot.
The last sentence applies to all stores, so. Unless people freak out and stock up for the apocalypse, in which case resupply might take a couple of days.
Geez, what part of the country if you don't mind me asking? Arrogance, ignorance, and disinformation is literally going to kill us. Thanks for sharing that.
It might help telling him that in some regions of northern Italy, patients over 65 with arrests are not assessed any longer and are not treated in an ICU, they are left to die.
I have to concede you're partly right. Darwin will solve more than you think though:
- Some old irresponsibly stupid males are still sexually active. Darwin would stop them reproducing.
- The old irresponsibly stupid neighbour is still a magnet for younger, sexually reproductive irresponsibly stupid people, probably more so than for others.
The whole “people don’t understand exponential growth” thing isn’t a very good explanation, considering that it applies to any contagious disease for which every person tends to infect some constant number of other people.
Which there are few in circulation, thanks to vaccines among other reasons (which lower effective transmission rate), so most people haven't really experienced it working. Somebody mentioned noroviruses the other day as probably the closest relevant thing people may have experienced - let someone with one loose on a cruise ship, and shit literally hits the fan very fast.
They also do this for serious political stuff, repeating the same phrases over and over again, but posting those video compilations would just invite downvotes.
Mainstream media has a blinkered center-right bias that on CNN and MSNBC rewards the center-right democratic party and punches left. They don't care about the well being of the population, only about selling ads and preventing reform. On Fox, it's borderline fascist, actually fascist if you think about immigration and the concentration camps.
I don't actually know why the ruling class in the US is taking this so easy. There's some kind of brain disorder they have that is located between American exceptionalism, raw stupidity, and a complete disregard for the welfare of the people. I hope they all shake hands with a COVID patient like they did at CPAC.
Yeah, the only major conservative cable outlet. Against CNN, NBC, ABC, MSNBC, CBS, NPR...Not to mention almost every major web source.
People know full well that Fox is part of the MSM, but regardless of which way you lean, there's no question that the deck is stacked against conservative viewpoints.
No, I think that some news outlets do have that and some do not. Do you think that every modern news outlet has a consistent, left-leaning, anti-Trump agenda?
Mainstream media tends to target their audience. Their audience is Americans who by popular vote are left of the government on average, and a higher percentage of them that live in cities, which adds to the left bias yet again. So no big surprise that most of the big MSM outlets appear left-leaning if you personally are right of center at all.
You must not have been paying much attention then.
> The Trump administration’s quarantine and travel ban in response to the Wuhan coronavirus could undercut international efforts to fight the outbreak by antagonizing Chinese leaders, as well as stigmatizing people of Asian descent, according to a growing chorus of public health experts and lawmakers.[0]
> The Trump administration’s decision to severely restrict travel from China to the US and to implement a mass quarantine, the first in the US in more than 50 years, could be an overreaction that causes unnecessary fear and weakens the global response[1]
I can provide more if you’re not convinced that, just like every single other thing Trump does, right or wrong, he was attacked for actions related to the Coronavirus earlier this year...
Yes, and this is a huge problem. Countries like Singapore which have managed to control the coronavirus have done so using travel restrictions much stricter than the US ones. The Washington Post found a solution to this though. They ran an op-ed "Coronavirus testing might have stopped it early. Now it's too late." pointing to Singapore's success as proof the coronavirus could've been contained, but completely omitting any mention of its use of border controls and pinning it entirely on aggressive testing. This went viral on social media, turning Singapore's success into a confirmation of people's existing belief seeded by the media that Trump's obsession with travel restrictions had screwed up the US coronavirus response.
The two statements don’t need be false or contradict the fact that it was mishandled.
A flight ban simply makes traceability harder, as people reroute through multiple hops. Victimizing Chinese communities is bad and will only make things worse (as people start hiding from authorities). And in the end, the virus was in Germany already in January, according to the tracing, so focusing on China would have helped little.
BUT
they could have mandated self-isolation for two weeks for all flight passengers disembarking, regardless of provenience. You get a tourism hit but slow down infection rates substantially.
They could have ensured better procedure for care in death. Those elderly people dying in high number right now, have probably infected hundreds of others already; they should have been tested weeks ago, and handled as infection carriers.
They could have prepared temporary field hospitals to spike capacity like the Chinese were forced to do. Chances are they will need them anyway, might as well do it advance than later under pressure.
They could have started shutting down large gatherings and prepare for curfew measures.
They’ve done none of that - and I say “they” as in US administration, UK administration, Australia (where they’ll even host a F1 GP with crowds this weekend!), France etc... They all hoped it would go away “on its own” like SARS did. Sadly, SARS was a lucky strike, this is the real deal.
It just turned out that being wrong was a political universal... when you have two parties that are completely set on disagreeing on a matter of fact, then it's guaranteed that at least one will have it wrong, at any given time. This doesn't change the fact that Trump is currently being more wrong.
Italy is following China's lead. It has been harder to change social behavior here. But it will change due to the severity of the situation. The lag in response will definitely make things more severe. But the climate may help, assuming warmer temperatures reduce transmission.
Trump's performance so far is a massive disappointment to say the least, and more of a parody even by Trump's standard.
I am not sure what he is doing is even remotely serving himself that well either. Addressing the Coronavirus upfront is the only way to cheer up the market right now. Did he really think he can just fight this virus with speech or tweets?
This is bothering me no end, and severely impact my confidence in US itself overall. Damn it, this is a full on crisis, the shit is about to hit the fan so hard.
His anti-intellectualism, anti-science history of saying catastrophically stupid things earned him that response. Just to be clear, this is an anti-vax president who continues to state just completely wrong things, and you're complaining about the poor guy being mistreated? The fact that this isn't much bigger news, the guy ousted by his own party, indicts the entire US political system.
And to be clear, a pretty heady amount of the criticism of Trump is coming from "The right". Sam Harris, George Conway, David Frum -- these are not "the left". They also think Trump is an imbecile at the worst possible moment.
I don't have this impression. Many nations are trying to find a cure or a vaccine.
Nobody knows the long term development of this virus. You could lock up everything, the economy collapses and it would hurt people even more than the virus might have. It is a gamble at this point.
Political games come into play if people demand answers that nobody can give. If some presume to be able to do that, they are lying to your face.
If this is over in June and 100,000 people died, what would we call this? It would just be another disease probably.
For people who lost loved ones it was a catastrophe, for other part of the normal life risk. Any publicly uttered judgement has to keep that in mind, so it will always be relative. Some are more forthcoming, but probably not public officials.
Of course the virus is not under control, how could it be? I would prefer measures to reduce its spread, but that is basically intuition and listening to some doctors with the knowledge that it just buys time.
Anyone using this crisis for political points doesn't really win any cookies with me personally, on the contrary.
The incentive to cover something up is just a reflex to save face. I don't like covering something up. There is a risk of disproportionate overreaction, but I think a bad information policy reinforces this. If they covered something up, it must be really bad, right?
> If this is over in June and 100,000 people died, what would we call this? It would just be another disease probably.
More like few millions in US alone, based on what happened in Italy which is more representative than China. Italy has >4% mortality rate last time I checked. And we talk about very well equipped and highly rated healthcare. I can't imagine this not having brutal effects on global economy.
Another point - unless we have proper fully working cure / vaccine, this ain't going anywhere. June ain't some magical time when virus decides to roll back because enough is enough. Southern hemisphere will keep the virus going on through our summer, so it will come back in autumn.
An additional point - this might be early to judge but it seems immunity is not gained after recovery, so re-infection is probable.
There are more points, like its high infection rate etc.
This is completely debased. You don't have reliable info on recoveries, infections or death rate. Currently around <3000 people died in China to my info and yes, that number will increase unfortunately. While I think you should take it seriously, it is another thing to predict millions of dead people. It is a respiratory disease and yes, those can kill you.
> so re-infection is probable.
I have the info the virus is not inclined to mutate. But it is just too early to tell.
The lack of mutation is both good and bad. It means the virus is less likely to get worse, but also means the virus is less likely to mutate to a less lethal form that would likely still provide some immunity to the more lethal one. On the brightest side, it may mean that we're not going to see waves of new infection each year like we do from influenza.
Trump is indifferent to the suffering to come, and doesn’t feel it will touch him. He welcomes chaos, because it provides opportunity for personal enrichment.
“You know what solves it? When the economy crashes, when the country goes to total hell and everything is a disaster, then you’ll have a, you know, you’ll have riots to go back to where we used to be when we were great,”
I fixed the formatting, typos, and expanded the jargon:
From a well respected friend and intensivist/A&E consultant who is currently in northern Italy:
I feel the pressure to give you a quick personal update about what is happening in Italy, and also give some quick direct advice about what you should do.
First, Lumbardy is the most developed region in Italy and it has a extraordinary good healthcare, I have worked in Italy, UK and Australia and don't make the mistake to think that what is happening here is happening in a 3rd world country.
The current situation is difficult to imagine, and numbers do not explain things at all. Our hospitals are overwhelmed by COVID-19, they are running 200% capacity.
We've stopped all routine, all Operating Rooms have been converted to Intensive Care Rooms and they are now diverting or not treating all other emergencies like trauma or stroke. There are hundreds of patients with severe respiratory failure and many of them do not have access to anything above an oyxgen mask.
Patients above 65, or younger patients with comorbidities, are not even assessed by Intensive Care. I am not saying not tubed, I'm saying not assessed and no staff attends to them when they arrest. Staff are working as much as they can, but they are starting to get sick themselves and are emotionally overwhelmed.
My friends call me in tears, because they see people dying in front of them and they can only offer some oxygen. Ortho and pathologists are being given a leaflet and sent to see patients on ventillation. PLEASE STOP, READ THIS AGAIN AND THINK.
We have seen the same pattern in different areas a week apart, and there is no reason that in a few weeks it won't be the same everywhere, this is the pattern:
1) A few positive cases, first mild measures, people are told to avoid the Emergency Department. People still hang out in groups, everyone says not to panic.
2) Some moderate respiratory failures and a few severe ones that need intubation, but regular access to Emergency Departments is significantly reduced so everything looks great.
3) Tons of patients with moderate respiratory failure, that over time deteriorate to saturate intensive care first, then intubation equipment, then CPAP hoods, then even O2 masks.
4) Staff gets sick, so it gets difficult to cover for shifts, mortality spikes from all the other causes that can't be treated properly.
Everything about how to treat them is online but the only things that will make a difference are: do not be afraid of massively strict measures to keep people safe. If the governments won't do this at least keep your family safe: your loved ones with a history of cancer or diabetes or any transplant will not be tubed if they need it even if they are young. By safe I mean YOU do not attend them and YOU decide who does and YOU teach them how to. Another typical attitude is read and listen to people saying things like this and think "that's bad dude" and then go out for dinner because you think you'll be safe.
We have seen it, you won't be safe if you don't take it seriously. I really hope it won't be as bad as here but prepare.
Did you also fix the uncoroborated nature of the news? You know, the "well respected friend" part of it by reaching out to said person? If not, this whole thing just shows again how dangerous Twitter can be in that regard.
I am not denying that. I am simply worried when I see alarmist posts, uncorborated, that have the tendency to spread panic.
That's why call out every twitter thread like that when I come accross them. In this case it was a guy you referenced a friend of his. So uncorborated. Bad reporting, plain and simple.
What you are doing is very dangerous. People need to be aware of what is about to hit them so that they can prepare. Calling into question second-hand reports as "unreliable", even though this particular twitter thread is completely unremarkable and in line with many other reports, makes people wonder if this whole Corona thing is nothing more than hot air. It's just super irresponsible to give people that impression.
News is basically just about Coronavirus by now, whether it is print, online, TV, radio... People are aware, unless you are living in a bunker since last smmer, in which case you would be safe anyway.
If people refuse to take it seriously, no amount of reporting will change these individuals behaviour. What it does so, is causing overreaction of others which can have kind of side effects. Ranging from funny to plain dangerous.
Did you read what was in the original Twitter thread? Hospitals at 200%, people who need intensive care that aren't even looked at, staff who get sick and are otherwise completely overworked...
I'm not sure if you can overreact to that, to be honest.
But people in countries that aren't at that stage yet think it won't be so bad there. Because it's all fake and second-hand information, not well sourced, and therefore probably not true and so we shouldn't overreact. Wrong! You should take precautions now, while you still can.
Because what is described in the thread fits completely with an exponentially growing disease that everyone seemingly gets at once and thus completely overwhelms the hospitals. You shouldn't try to shush people who point that out.
You can absolutely overreact to that. People will get sick and die, yes, but it's also not worth sitting down make parts of the economy and falling into panic.
This will get much worse, but it's still worth maintaining some perspective.
If what the accounts say so far is true, most people aren't ready to accept what maintaining some perspective means or lack some serious virtue.
Even if you yourself aren't vulnerable, you're potentially screwing up people's lives. Not just vulnerable elders, but also doctors who, for better or worse, are unconsciously taken advantage of by requesting them to overwork themselves in poor conditions. The alternatives to not having them overwork are coordinated efforts (which increases contamination, and requires serious coordination that hasn't been shown in Italy yet if the stories are to be believed) or simply leaving people to die. How many people do you think truly understand the consequence of their actions and would willingly continue to do so with full knowledge?
And for what? Some abstract concept called "economy" that 90%* likely won't feel a thing of? Isn't it at least a little ironic that we aren't allowed to panic about corona, but are allowed to panic about anything potentially affecting the economy 'negatively', which just as many people don't know anything about, including tons of self-proclaimed experts?
* Disclaimer: This statistic is indeed picked randomly.
What's dangerous is our government is severely downplaying it and undertesting to make the numbers look good, and we have to rely on social media to find the truth.
I feel like a wingnut even writing that. My opinion would change except lots of health experts and all the smartest people I've talked to on this seem to agree.
There was a video taken of one of the hospitals in Wuhan around that time, with what looked like at least 1000 people lined up and corpses in the hallways. Put two and two together.
What do the healthcare workers actually do while caring for these people? Is this something that actually requires significant medical knowledge?
What does arrest mean? Is that cardiac arrest? Is that how people are dying? If they’re dying and people aren’t attending, should they even be there at all?
Most severe cases require trained medical staff. Since ~20% of infections requires hospitalization, no healthcare system is prepared for an exponential rise in SARS-CoV-2 infections.
Most fatalities are from pneumonia. Lots of details are available all over. You may want to read up.
There is plenty of evidence that many cases are asymptomatic or mild which means the true infection numbers for most countries are likely understated. So the true number of infected individuals in Italy is likely much higher than the reported number of cases.
The other thing to consider, is that with more comprehensive testing, quarantines become more targeted and effective. So South Korea might be having better success in keeping the virus away from at risk populations.
The SK death rate of 0.7% assumes that all 98% of the cases with outcome currently classified as "unknown" will recover. That isn't rational! You need to do proper survival analysis to account for the growth in cases.
I think the real takeaway is from all this is that death rate is a pointless metric. It is highly dependent on the local demographics, it requires precise information which is rarely available, it is biased by the level of care available, it has numerous ways to estimate it all of which are hard to explain and not actual estimates but upper or lower bounds, it tends to naturally decrease over time, etc.
The death rate is lower in China than Italy, but the death rate is lower within each age group in Italy vs China. Most people are too innumerate to understand this statement.
As an aside, I REALLY hate how this guy on twitter says “it could be 5.0%, look at this spreadsheet that assumes 5.0%!” Then refers to a paper as a good analysis which claims 1.6% and a set of facts which differ greatly from all of his assumptions.
SK have tested 5 times more people than anywhere else so are picking up more mild cases that other countries are not detecting. So I'm hoping the SK numbers are closer to 'real'
> The numbers out of Korea are nowhere near 20%. About 0.8% of cases are considered severe.
0.7% have died, and even that's gone up in the last few days as more cases progress. I don't know the specific stats of how many were severe/critical but it's probably much higher than the mortality rate. If you take a look at the age breakdown of the infected it seems they've been good about keeping it away from the elderly, <2000 out of 7000+ cases have been 60+ years old: https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_S...
There’s a link, right there in my post, with more recent and relevant data than you’re citing, and it is directly from the Korean health services: 59 / 6767 confirmed cases were severe or critical in Korea at the time of the report. That’s a rate of 0.89%
The error bars on that estimate certainly encompass 1-2%, but they don’t span to 20%. Either Korea is doing something fundamentally different, or the 20% number is wrong.
I strongly suspect that OP simply took the “80% of cases are minor” stat, subtracted from 100%, and concluded that 20% are therefore hospitalized. This method is wrong.
The numbers part is where people are confused. Becase the baseline is scetchy, depends on testing (so you risk measruing your tsting at least as much as the spreading itself) and moving. Add to that a methodology that requires a lot of domain knowledge to properly understand these numbers, and this reaction is kind of expected. Which is basically the only point I have to call the WHO, CDC and other, similar bodies out on. Explain what you are doing, why and how these things work! Especially the numbers part, I have the impression most of the panic comes from not understanding the nmbers and less the disease itself. Then people toy around with incomplete sets of these figures, usually out of date as well, and come up with stuff like 20%.
> "23 people in severe stage and 36 people in serious stage".
Which is a current snapshot, not a total of the cases that have been severe/serious. It seems like they've done pretty well at keeping it away from the elderely where the fatality rate increases dramatically: https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_S...
98% of cases in S Korea are classified as "no outcome" at this stage - that is, it's too early to make a call. It takes 11 days on average for the disease to get really severe, so we won't see the deaths for a while. With exponential growth the pct will consistently under report the severity.
Note also that S Korea has 3x the beds of the US, and covid-19 requires very high hospitalization rates and oxygen for weeks.
Tldr: don't expect US or Europe final stats to look anything like S Korea"s current stats.
My point is that medical staff are trained to respond to many things. Training newbies to respond to one thing would probably be easy and fast. Especially if most people just need fluids, oxygen, and aspirin. Burning out doctors to maximize survival rates up front is... bad
It isn’t that easy to train someone to handle medical emergencies. They don’t typically fall into the same “path”.
As well there’s a technical skill component that takes a while to master due to variations in person-to-person anatomy. Took me about 8-10 real live intubations in life or death emergency situations (not training where I had all the time in the world) to feel comfortable enough to be unsupervised.
I was not very surprised that Italy turned out to be the (first?) major hit in Europe. Considering the strong business connections, it had to be either us or Germany.
We are, as much of the world, importers from China, but many enterprises here are also, somewhat, strong exporters to China (I can see it from my dayjob as industrial automation SI), and if you factor in the small average size of Italian companies requiring many individual contacts (contrast with Germany where companies on average are bigger), you can imagine that there is a strong flow of people to and fro. Maybe the small size of companies requiring more people to establish commercial links + population being more uniformly settled across the country (no huge wildland or sparsely inhabited area left in Po Valley, except maybe some parts of Piedmont?) + a certain cultural inclination for useless quarreling hindering political action + inefficiencies in the administration + an unsolved conflict of power between central gov't and periphery possibly causing some waste of time in other quarreling + having to keep the vast group of small business owners somewhat quiet has resulted in a vast spreading of the virus.
The interesting thing is that, if you replace China with Germany in the paragraph above (wrt. the possible German origin of the outbreak in Italy), the consideration about business links would still apply.
Another interesting thing I have just noticed is that some journalists are now openly praising the Chinese handling of the crisis. Maybe this may sound strange to an American :D but there has been for some time a growing cross-partisan movement calling for stronger links to China. In fact this movement is somewhat present in European business community, so it is not so special to Italy, but nonetheless it is interesting to see these comments of open praise.
> Another interesting thing I have just noticed is that some journalists are now openly praising the Chinese handling of the crisis.
I think this is a very interesting effect. China has a fantastic ability to mobilize as one when needed. The vast majority of the time, the insane amount of control this requires, is something we're simply not comfortable with giving to governments. But sometimes, just sometimes, the results are worth it.
The closest equivalence I could think of that'd be familiar to American ears, would be the WW2 war effort. It's not how most of us would want a country run day-to-day, but the ability to do so when needed is incredibly powerful.
Pumping a hospital out in a week or a battleship out in a month aren't dissimilar in national focus. And they're both achievements. What makes China feel alien to us is that this is their default stance.
(And that said, there's plenty to be critical of in the earlier days of China's response. But in the interest of sharing data and research, we're catching more flies with honey.)
China's ability to mobilize as one as quickly as it did is no doubt a consequence of strong central control. The same centralization, though, is also to blame for its inadequate early response. Officials in Wuhan didn't have the authority to act on their own without Beijing's permission.
After this pandemic has died down, we should compare and contrast different countries' responses and try to appraise objectively just how much of a difference they made. China is trying really hard to make the case that their authoritarian approach is a model for the world, and it's too easy to be persuaded by that rhetoric when everyone is afraid and panicking. Meanwhile, some countries are trying just as hard to persuade their citizens that everything is okay when in fact it isn't. When all is said and done, we'll see how well that works, too.
Depending on how things go, I think South Korea could become either a model for the free world or a lesson in the shortfalls of democracy. They were doing pretty well until mid-February without imposing any travel bans or other measures that might be considered authoritarian, but then the number of cases exploded and everyone had to scramble. Instead of strong central control, most things were delegated to local governments. Different cities and provinces took different initiatives, quickly learning from each other when one of them came up with a new idea such as drive-thru testing. The shortage of hospital beds was met by large companies (hello, Samsung) and megachurches donating their own resorts and conference facilities for use as quarantine centers. Hundreds of doctors rushed to Daegu to help with the medical crisis there, and faced very little bureaucratic red tape in doing so.
The decentralized approach has its own inefficiencies, of course, especially in places with incompetent leaders or when dealing with a cult that refuses to cooperate. But when South Korea says that there were only 35 new cases last night, compared to hundreds a week ago, you can actually trust that it's a good-faith report because it's been cross-checked by so many independent players. The central government misreported the case count for my city a couple of times lately, and the city immediately issued corrections.
China’s system is, in fact, pretty decentralized. Local authorities have a lot of autonomy. Many people doing business in China for the first time thought they needed to talk to the central government to get things done. The central government nodded and said ‘that’s a good idea’, but then nothing happened. The businessmen are then surprised to find out that they need to talk to local authorities to actually get things done and that the central government is usually not very involved in the process. The same applies the other way around: the central government is surprised that foreigners don’t know this.
The way the Chinese bureaucracy works is that lower-level local government officials have less experience than higher-level officials. They get promotions based on results. Xi Jinping himself was, during the SARS period, the head of a province, and did very well within containing SARS within that province. It doesn’t surprise me if local Wuhan officials simply weren’t as competent in matters of disease containment than the central government.
The Chinese government is not a monolith. Comparing to 1984-style authoritarianism wouldn’t be entirely accurate either. I think it is best compared to a large corporation.
You seem to be afraid of China exporting its model. Chinese diplomats have repeatedly said that they are not interested in doing that. They say: the Chinese way of international relations is one of mutual respect: we will not impose our system on you and you will not impose your system on us. But if you voluntarily want to learn from us then you are welcome.
Not exporting? They might say that, but in reality they are actively promoting themselves. They also kidnap other countries citizens in third party countries and lock them up without proper trials. See their treatment of Gui Minhao (sry if spelling is off). When things collide (and they will), China will not only care about their own issues with their own people on their own turf, but actively meddle.
I'm not judging, just want to bring some balance to this "truth" you speak of...
Promoting themselves, sure. But that is not the same as exporting (imposing their system on others, claiming that others are evil for not following their way). Wanting to have a good image is not the same as exporting. All countries talk about themselves in a positive manner In order to uphold their image. Why shouldn’t China do the same? Nobody else is going to do it for them.
You can disagree with their claims. But that is not the same as arguing that any form of self promotion is bad.
Of course, China is far from perfect. Bad things do happen, I am not denying that. If we are speaking about balance, then I think that in western discourse the balance has tipped too much towards the ‘china is always bad in every aspect’ side, totally ignoring or actively denying the good sides, and ignoring equally bad things that happen in their own places.
Will China meddle when their interests are threatened? Of course, and so will any other country in the world.
If China’s interests conflict with yours, then it is fine to point that out. It is not fine to paint them as the bad guys just because they have conflicting interests. And even then, such issues can be resolved peacefully: China has shown that it is interested in negotiation and being reasonable. You wouldn’t believe how much land China has given up since the 40s as part of negotiation deals with other countries. It is time to stop this cold war mentality where it is us vs the evil commies who are out to conquer the world.
"What makes China feel alien to us is that this is their default stance" - Very well said!
I relate to this a lot based on my visit there. Things seem very unified. Hell, even dozens of old people get together every night and dance on the street. When have you ever seen communities like that in the US? We're too busy being self absorbed. We have no shared mission.
Parent's comment had nothing to do with military, but with an authoritarian executive's power to unilaterally get things done quickly, if they so desire.
The US was sometimes able to mobilize quickly in response to extraordinary circumstances (WWII production being an example), but that isn't really our default state, and requires consensus-building rather than orders from on high. But sadly our ability to do so even in extraordinary circumstances has atrophied.
It's perhaps worth noting that even in the U.S., these wartime mobilizations have often been carried out by comparatively authoritarian governments (especially in comparison to peacetime U.S. government), e.g. the suspension of habeas corpus and mass arrests during the U.S. Civil War, German internment and the Espionage and Sedition Acts of World War 1, and mass Japanese internment camps and the Office of Censorship during World War 2.
An entirely accidental comparison - I recently finished a series of novels set in the US's pacific fleet during ww2, so that was simply the example at the forefront of my mind.
But as a European, the US's military footing doesn't feel alien to us at all. They're essentially the modernization of the British Empire, in that their single greatest "weapon" is force projection, rather than the million-man-armies of the East. We don't necessarily identify with it anymore, but it still feels more familiar than alien.
As a percentage of GDP, the American military isn’t massive. It’s smaller than China’s. It’s smaller than India’s and only slightly bigger than little North Korea.
Live in n. italy.
Went shopping today to large supermarket. On way, few people in cars, many people out walking though, especially with kids. Supermarket nose-wipe section hit fairly hard, but that was it. Stockers were tending to other areas (either no nose wipes left, or not bothered?). Nobody was panicking buying. There was a pa with 'keep a meter away from everybody' announce, which made my kid laugh as we'd been watching you tube video on how far a sneeze can travel. Italians are touchy-feely poeople and this scare might make them take things a bit more seriously healthwise. Friday, i have a hospital appointment for a recent leg injury - will let you know :-) as three weeks ago i was in hospital for 6 days and i got the impression they were 'preparing' for a big outbreak - very few actual doctors around, nurses stepping up, orderlies assisting nurses with basics.
No, not worried. To me it's 50/50 (im about 1.5hr drive from bergamo)chance that can be tilted in my favor by cleanliness, but more luck… but airborne is airbone. I was out again today - people are a bit 'aware'… but i went to 2 different stores - both fine, asked the cashiers how they are... they're fine. I got the impression shoppers are buying what they need. A middle-aged lady coughed without covering her mouth, that was annoying. Today looks like all kids are 100% at home, not even being out with their friends - that might last two days max, but it's no worse than having measles.
I am sorry about hijacking this, but I don't know what's happening in Bergamo. Particularly hard flare of the virus, or something else? Tried searching for news, didn't get far.
And long comments full of vivid imagery lile this are EXACTLY why people are dissuaded from making social media posts, exemplified by the poster:
"Sorry, but to me, as a doctor, it's not reassuring that the most serious are mainly elderly people with other pathologies."
This could not be less helpful or more harmful. There is no useful information (that i got to, couldnt get all the way through). This is not an letter to the who or CDC trying to affect policy. This is a goddamn reddit post to scare people, vaguely, with the feelings of hospital staff. Im glad this doctor cares about comorbid patients, but this emotional non-rational prose is what drives mass hysteria and panics. We need data and recommendations.
Did you read his post? He has recommendations: social distancing, especially for older people. Don't get into crowds. And really: stop complaining that you can't do this or that fun thing, this shit is getting real, and it's coming to a town near you. That last message is really important when lots of people don't seem to take this seriously.
This doctor is simply trying to warn people of what is to come. Anecdotal evidence is never ideal, but in some situations it’s the best we can have. I don’t see any motive for this doctor to create undue panic or hysteria.
>We are, as much of the world, importers from China, but many enterprises here are also, somewhat, strong exporters to China
Italy also has a surprisingly large number of Chinese migrant workers, mainly in the fashion and leather goods sector. Skilled Chinese workers in Milan and Prato provide the kudos of the "Made in Italy" label at considerably lower cost.
You hit the nail on the head. In addition to the fashion industry, Italy is a favourite destination for Chinese tourists for sightseeing as well as buying luxury and said fashion goods.
There is good evidence the initial cases in Italy were tourism related.
As for praising the Chinese response - I think the reasons will be very clear soon to most people - without a very decisive and heavy handed response the health care systems in most developed countries will face very severe consequences or collapse.
We are at the denial stage still with people finding excuses why Italy is different, etc, etc
The US is 8 days behind Italy is 8 days behind Korea.
Yes. Both Italy and the US are below average. South Korea and Japan, currently taking extremely drastic measures like mass-closing schools, have around 5x as many beds as either.
I'm in the US, but if you think that makes me think the US is prepared, you have it backwards. I'd guess that if we're not in worse shape than Italy in two weeks, we'll be very lucky.
Also keep in mind that we need ICU beds (ventilators) in particular for this, and that they have some base rate of utilization unrelated to COVID-19 that isn't easily moved.
I'm not sure what the GP's comment has to do with one's nationality. Both are facts, regardless of whether or not the United States is worse on one of those metrics.
In the United States there's a lot of denialism right now.
People here are trying to find any reason that they can point to about other countries to indicate that the drastic measures that they've taken aren't necessary here.
That the hospitals being pushed to the breaking point won't happen here.
I wasn't sure if that's what cjbprime was going for (and it wasn't!), but I thought I'd respond to that sentiment just in case. I think it's important that more people here (specifically in the United States) consider the possibility that we'll be in a similar situation as Italy in a few weeks.
Fair, though I don't think the US is especially unique in that regard; plenty of other countries seem to be denying the issue until it's too late. Even China waited until right before the start of the Chinese New Year (by which point a bunch of people were already out and about traveling) to impose its quarantine on Wuhan; by that point, South Korea already had confirmed cases, and the virus was likely already in Italy (the first two cases were confirmed just a couple days later).
Hell, my folks think we all might've gotten in way back in early January on a family cruise we took; a bunch of us came down with what we all thought was a particularly nasty flu, but without any nausea (just headaches, muscle aches, fatigue, and coughing) midway through. My stepmom ended up going to the hospital when she didn't get over it after a week (but it was still well before anyone thought SARS-CoV-2 had spread beyond China, so nobody tested for it, despite testing for the more typical flus and not finding anything; they ended up treating her as if it was a flu anyway). The rest of us toughed it out and eventually got over it, me figuring "alright I guess the normal seasonal flu is just extra bad this year; next year I'm totally gonna remember to get that flu shot, promise".
The thought was in the back of my mind for awhile that "maybe we did get Coronavirus somehow" (e.g. from other tourists on the boat), especially when the reports of cruise ship quarantines hit the news. In hindsight, I probably should've acted on it and gotten checked out, or otherwise at least said something. If only foresight was 20/20, too. I still don't think it really was SARS-CoV-2 (if it was, I'd expect coworkers and friends and non-cruise-attending family to have gotten it, too, but that didn't seem to be the case; then again, maybe they did get sick and made the same assumption of "nah, this is just the usual winter flu or cold"), but still.
Not sure where I was going with that, but yeah. I think the denialism's just because of previous epidemics in recent memory getting widespread news coverage (swine flu, bird flu, West Nile, etc.) only to end up being minor compared to, say, Spanish flu or polio or measles or other "realer" pandemics from "back in the olden days" (or even current ones like HIV/AIDS, which we all were fine with ignoring 'cause "we're good Christians boys and girls and not them there homosexuals or adulterers").
And then we see the same pattern unfolding here and expect it to blow over again. For all we know we've all been getting infected but we laugh it off as "oh yeah, sure, I totally have the beer virus, guess I get to call in sick, hahaha" and work through it, hoping that there's no truth to that particular joke.
What interests me in the cases is specifically, Western or Western-style countries seem to be rising up far quicker than others. The more withheld a country is and/or the more draconian their measures, the less cases they have. Finland stood out as an interesting case so far where the number hasn't risen terribly. There was an Asian island (not Japan or Indonesia, don't remember) that was also doing incredibly well and specifically had lots of draconian measures. So the countries that end up getting lots of cases are at least somewhat outgoing in nature (accepting or taking part in a lot of tourism, lots of social activities in open communities instead of closed communities leading to lots of varied social contact) and unwilling to change this.
As an example: The Netherlands, where I live, has had a significant rise and our measures are.. self-isolate on showing symptoms, wash hands more often and don't shake hands. The former completely misses the problems with spreading during the incubation period (and worse, there are cases where you may leave, despite not being tested negative yet, solely on the basis of not showing symptoms. This totally misses the fact one can still be a carrier for at least a few days: antibodies don't work outside your body, last time I checked biology). The middle one is self-explanatory, but may also hurt your microbiome and can cause resistant bacteria when done too aggressively. The third measure.. completely misses the scope of the problem. You can still touch objects others have touched on the regular, still opening up a potentially worse way for the virus to carry over. Not to mention the primarily presented alternative is to.. touch elbows? Which looks like a poor joke and still results in touch.
What are some alternatives that would have more effect? Work from home unless coming to the office is absolutely necessary, don't go to social places (especially not large city centers like Amsterdam, Utrecht, etc.), avoid social contact with strangers or outgoing people. All measures that could be implemented fairly easily and have minimal impact on the economy given the alternatives: can't shop physically? Shop online. Can't have social contact online? Play an online game, chat through VoIP. Not working at the office? Surely you can be at least 80-90% as efficient as at the workplace with some etiquette, have some discipline. And don't get me started on people who get the flu, infect others and completely ignore that other illnesses may mask the virus.
Maybe survival of the fittest just needed to weed out stupidity. But hey, that's all just my opinion / hypothesis.
> There was an Asian island (not Japan or Indonesia, don't remember) that was also doing incredibly well and specifically had lots of draconian measures
Maybe not in the fine details but in the broad outlines yes. With a doubling time in cases of four or five days without containment measures it would be obvious to me here in Shanghai that people were getting sick and hospitals were overloaded with new cases.
WHO's legitimacy is declining after their approach on china and the general covid19 situation. people seem to think the WHO tried to downplay the severity
I see nothing in WHO’s actions that suggest they are downplaying things. If anything, WHO has repeatedly issues warnings for western countries to do more.
In my opinion, the distrust in WHO just reflects poorly on the people who are distrustful. They are so hell-bent on confirming their world view that China must be the bad guy, that they would rather believe that the WHO is corrupted than accepting the facts.
The CCP claims new cases are almost eliminated outside of Wuhan city limits; that'd be a hard thing to fake if it were really churning along at peak strength.
This is actually the hardest to believe. The virus has run it course in Wuhan and it is likely dieing down as a significant number of people having developed immunity to it.
But outside of Wuhan, there is likely a number of infected persons in the population still transmitting it and waiting to resurface into more serious cases after people get back to work.
I have family in China outside Hubei province. If COVID-19 really did spread widely to the rest of China then I would have known it, and hospitals would have absolutely been overwhelmed.
There are even multiple foreigners in China who can confirm the situation. Checkout the Youtube videos by Daniel Dumbrill in February.
Might there still be hidden carriers in the population? Absolutely. China must remain vigilant. This stuff is hard.
My wife is considering flying back to China if things get worse here in the Netherlands. I agree with her: I also think that by now China is probably safer than anywhere else in the world. Multiple provinces have downgraded their emergency level, some are even virus free. Within Wuhan, multiple temporary hospitals have closed because they are no longer needed. People are slowly getting back to work. Containment efforts are shifting from ‘preventing the virus from getting out’ to ‘prevent it from getting in from foreign countries’.
That's expected based on data from South Korea - the hospitalisation rate is lower than in China with more widespread testing. The virus is both more transmissible and less virulent than the Chinese data suggests. The outcome is the same - hospital bed and ICUs swamped.
As such, we'll know when life resumes and people go back to work en masse.
Yes, I think the CCP could only stretch the truth by about one order of magnitude without the lie being obvious. Has China reported accurately every prison outbreak? Probably not. Is COVID-19 spreading widely in China now? No.
Yikes, please stop this now. You've been breaking the site guidelines left and right in this thread and others (https://news.ycombinator.com/item?id=22531394). We ban people for that kind of thing, but when it looks like someone going on tilt (it happens), it's usually better to ask them to step away for a while and let the problem correct itself.
Italy is a country of 60M+ people and the 8th largest economy in the world, with a very high national debt and that significantly relies on tourism for its economy. Above and beyond the Coronavirus, this can terribly affect the long-term solvency of the country.
As the EU is mostly only its parts and everyone now in alert, I highly doubt it. Everyone is keeping their medical items to themselves now, because there is not even sufficient for their own country. EU will mostly be talk.
They are mostly talk because the EU has little actual power. Giving debt relief to Italy has to be decided by head of states. I'm pretty certain that there's a lot of public support across the EU to help Italy if they need to. If Italy cannot refinance, issuing debt backed by several countries would be an easy option. You wouldn't even need support by all EU countries, Germany, Netherlands, Belgium and France backing it would be more than enough. And those would certainly be sympathetic to do that, a collapsing Euro would hit all of those states harder.
But so far, debt markets are still open and there's no reason to panic. Therefore governments focus on more pressing problems for now.
Good question, I'm thinking that the EU (because at that point this will have become a political issue) will have to put all its geo-political weight to good use and force a debt moratorium, I don't think that just plain old QE (or whatever else they'll decide to call it) will work anymore. That could at least relieve some pressure off Italy, which has one of the highest debts to service from the OECD group.
The ECB, of course. It can create an unlimited money and use it to support the stability of banks that are the largest holders of sovereign debt. It's done this before and it will do it again.
A full-scale failiure of the Italian economy and/or failing of any major Italian bank is "game over" for the Euro. The Greece bailout already had the Eurozone down on its knees, but this is a different dimension.
Yes, the ECB is there to support and regulate the banks, that is its job. There is a very good reason for this: if you don't have stable and healthy banks you don't have a functioning economy.
People of your ideological ilk see this as some sort of negative but it's absolutely vital. You may think of banks as evil and having a lot of money, but that money is not theirs but "the people's."
National debt is merely a number's game. ECB can simply eat it. They are suffering from deflation after all and they could use some inflationary move. Debt accounting for the national governments is there to enforce financial discipline in normal times. Right now it is much more akin to war time. Evenly distributing the pain through bond and currency holders will be seen as just compared to the lives that can be saved through decisive actions.
National debt may be a numbers game, but it's not merely that.
There's nothing simple about any ECB decision on monetary policy, and the composition of the EU when combined with the nature of the Euro is such that pain almost by definition can't be evenly distributed.
ECB already implicitly backs every country's bonds. They just need to stick to their stance. After the crisis is over there will be time to work out the cost sharing among European countries.
The ECB's balance sheets are bad enough as it is, and one country's "cost sharing" is another country's forced-austerity to bail out another country's bad loans.
The Eurosystem has serious issues that are about to get even worse. The ECB is practically insolvent by their own standards, and would be technically insolvent by American standards.
Fully agreed, this is a big concern of mine as well. We've got a 2 week trip planned to Italy in May, but that is likely to get cancelled this week based on the growing concerns throughout the country. I am fully expecting to reschedule our same trip later in the year, but until the virus starts to slow down significantly, I'm not comfortable rebooking.
Had one end of March. Booked well before COVID-19 was a thing, paid for before it was in Europe. Already cancelled, now we're fighting with the travel agency to waive the cancellation fee.
My gut feeling from Italy: May, difficult. June, maybe.
But expect that this disease expands to almost everywhere so what's going to be the status of your country by then, regardless where you are from? I'm not expecting to be able to travel much this summer, not because I'm from Italy but because every country is going to have its own share of problems.
I have an interest in this (I booked a business trip to Italy end of May / beginning of June), but my gut feeling is that the country will not stand for two months of complete lockdown. Two weeks, sure; a month, probably; two months is a very long time to keep so many things on hold. Italy is not China.
I expect some measures will stay in place (particularly about large gatherings), but not all.
I have been thinking about this for a week while monitoring travel alerts. I have two business trips scheduled—-one in May and the other in June. My employer just canceled my May trip today and I feel that the same is going to happen for June. While I can always reschedule, I fear that my colleagues and friends in Italy, whose families depend on visitors during the months of May and June, will not recover from this.
Even if the flight isn't canceled, that's going to be a pretty unpleasant vacation. Make contingency plans and expect that there will be a change fee waiver for you to rebook your trip to later.
I'm supposed to start a short contract there end of March, and I'm considering cancelling. UK seems to be <del>4-6 weeks</del>(EDIT: 2-3 weeks) behind Italy now, and I don't want to get stuck in a different country than the rest of my family, without even an insurance number (apparently, it takes more than a month to acquire one; end of April, I'm betting the country will be in total lockdown).
Given the nature of this outbreak the real issue is not 'when' it is gonna happen anywhere else, but 'when'.
Italy has been hit first and I must say the reaction of the regions has been uneven, but in the future if the virus doesn't stop with the warmer weather, maybe your country is gonna keep people from flying abroad, so I think it's very difficult to make proper plans right now and, as far as tourism is concerned, 2020 is gone.
It seems a little silly to talk about how some particular instance of desperate measures will effect some particular polity, without considering the context of that these measures and the devastation that's tied to them will be present absolutely everywhere within 1-2 months.
The ripple effect is already in place. Flybe airline just defaulted, I've read a post on Linkedin that a small catering firm is suffering in Hungary due to cancelled events and other companies in the food chain will probably suffer a lot more especially if they operate with a razor thin margin.
After the human factor, the virus will hit the economy hard. It's probably only a matter of time till it triggers a serious recession. I'd really like to be wrong here.
Although they tried to blame this on Coronavirus that's a small part of it most likely. They nearly folded a few months ago and the government promised them massive tax subsidies which it appears they never followed through on. Regardless my point is that Flybe collapsing his little to nothing to do with Coronavirus. It just accelerated things ever so slightly.
I agree - Flybe is the British Alitalia, they would have cracked at the first crisis anyway. Still, I'm happy to bet that, by June, they will not be the only airline to have folded.
If the ECB forbears they can in turn forbear with their own customers. That is the only sane thing to do. This is not the banks' doing and they don't need to be disciplined at this particular moment.
You would be right; Italy's private savings are in the ballpark of $10T+, which means a "patrimoniale" (tax on wealth) would be the last resort to avoid bankrupcy.
The US really really /really/ needs to get out in front of this. We have the lowest per-capita testing rate in the world, there are likely already significant outbreaks in Seattle, Santa Clara co, NYC, and DC. Probably elsewhere. We are literally like 12 days behind and can see into our future.
If this virus does indeed require such intense hospital resources (as in Wuhan and now Northern Italy) letting it spike is just madness. Must put into place heavy restrictions now.
We don't need travel lockdowns, but public events, movie theatres, etc should be closed, and businesses should be highly urged to allow workers to WFH if nec and/or try furloughs with public money (ha! good luck...)
In any case, just waiting until we see a spike in cases and then trying to get behind it seems like so much madness.
Why did CDC depart from this and make a 3 part test (1 part of which had nothing to do with this virus) when there was already tests available they could just copy?
During an emergency, you don't screw around and try to come up with the perfect test. You don't exercise turf rights over other concerns.
The only thing that be called reasonable statistic is the number of deaths and that hasn't spiked - I hate to say - yet. It's possible hospitals are even missing those, it's a big country. And it's a dispersed country so things might not spread as quickly.
But other, what you say. Stopping large public events and doing mass testing seems crucial. South Korea seems to have gotten a handle on their infection process at the moment things are out-of-hand in Italy. South Korea has done mass testing for a while.
Yeah but deaths are still the most unambiguous, the thing that inadequate testing and controls are least likely to hide. A lot of hidden infection would appear at least some death - several days I pointed to mortality rates as the biggest marker for areas where infection would spike. I am not happy to be right about this since this awful however you cut it but there you are.
Tocilizumab drug in Naples hospital seems promising: «The health of the patient suffering from covid 19, who arrived in critical condition, intubated and treated with the new drug therapy is recovering. Maybe we extubate him because his conditions have improved a lot ». They also say they got confirmation from Chinese colleagues who tested that earlier on 21 cases. The drug is now undergoing trial at Roche.
I'm incredibly ignorant, can someone explain why a drug used to treat arthritis might work against a Coronavirus? I just don't understand the connection/interaction, or why this was even tried originally?
Rheumatoid arthritis is an autoimmune disorder. The severe cases who contracted the Coronavirus seem to experience an autoimmune reaction towards otherwise healthy lung tissue.
The two doctors in the video say that it interferes with a similar auto-immune reaction that happens at pulmonary level because of the Coronavirus, so that it works.
The Italian Department of Civil Protection is now publishing detailed confirmed case statistics on GitHub. I just finished throwing together a little animated map of of how it's been spreading across provinces:
I reply with my humble contribution, based mainly on John Hopkins' data. I tried to understand if the effect of restrictions is already visible (I hope it will... since I live in Milan), thus I fitted an exponential on the data from the week before March 1 (when the initial mild restrictions started) and compared with the actual growth.
Just spoken to an Italian friend, apparently they got a few hours notice before this was enforced (much more kept under-wraps than the previous quarantine of Northern Italy).
Expect other Western European Countries to follow this pattern as the number of cases increase [1]. I would specifically be looking at France, Spain and Germany as potential next candidates.
If people here haven't already, I would recommend not leaving your shopping to the last minute and to stock up on a few extra supplies to help not exhaust the local food-chain when people do start panic buying.
> Without that irresponsible leak, and the irresponsible
> reaction of people trying to "escape", this total lockdown
> would probably not be necessary.
The leak was far from ideal, but I still think Italy would be in the same situation. I suspect there were already an un-contained spread in the South before the lockdown in the North.
> People sometimes are right shits.
This is still true, but I am not so sure they can be completely blamed. When people are scared they act irrationally and this should be incorporated into any plan.
The toilet roll thing seems to be everywhere (Germany is full of "why toilet paper!" outrage as well), but do people really panic buy so much? Toilet paper is an item you buy once every few weeks or months, depending on household size, it's very high volume per unit of money so shops stock just enough to satisfy an even random distribution of individual buying times. Now if all of a sudden, triggered by news, a considerable number of the people who would otherwise be in the market for a fresh pack sometime in the next few weeks decide to stock up a bit earlier there will inevitably be a brief but highly visible local shortage everywhere. Stocking up a bit earlier is far from panic buying, but due to the low price per volume of this specific product the result (empty shelves) will easily give that impression. This might admittedly trigger some second order panic buying effects, but that's not the effect of a coming virus, is the effect of people setting empty shelves.
This reminds me of the phenomenon where a slowdown in traffic on a road causes all of the cars to bunch up. And then after the blockage is gone, the bunch up continues to cause more cars to bunch up and the slowdown exists long after the issue is gone. It seems like the fact that toilet paper is gone causes people to buy it whenever its available which causes it to be gone.
I see this on I88 outside of Chicago all the goddamn time. Takes a little bit of aggressive driving to get past it, but eventuallually you'll find a point where there is a mile gap in the left lane, becausr people dont accelerate after a slowdown. Its fruatrating and caises me easily 10 minutes per day. I'm fine if you want to drive below the speed limit, but move put of the way (I'm talking people driving 45 in a 60 zone, when prevailing traffic wants to run 85).
Holding up traffic is technically illegal, even if you're exceeding the speed limit, but in practice, its seldom enforced.
Its not entirely peoples fault. There is a delay between when you see space ahead of you and when your car accelerates. You also have to wait for the car in front to move far enough away for you to have a safety gap. To avoid this issue, everyone has to accelerate at the same time, but since you can't know if/when/how fast the person in front will accelerate, you can't possibly plan this without putting yourself at a huge risk of crashing in to the back of them. There are plenty of traffic simulations that show this same effect happening even with simulated, non distracted, rule following drivers.
A reason to buy a little extra would be simply to avoid going into populated areas (i.e. shopping). I think shopping is a very likely place to contract a virus given the number of times people handle the same items without washing them (think trollies, baskets, food on shelves, checkout machines, etc).
That said, toilet paper in general has been driven by media hype 100%. I think I remember some early stories where idiots purchased tonnes of it and emptied the shelves. I think the reason for toilet paper being purchased so much is because of it being randomly reported on in the beginning and that it's so cheap. A person on a modest income could easily purchase an entire shelf of toilet roll, whereas you're unlikely to see such things with higher cost items that have to be consumed within a certain time.
I think you're right for the most part, but in Australia there have been videos/pictures of people overloading shopping carts with enough toilet paper to last a family for years. These people are out there but it's hard to tell if they're in significant numbers or just a few idiots. I think we needed a little bit of panic a lot sooner to smooth over these bumps, but most people did not heed the advanced warning that China gave us.
Seeing the same thing happen across different cultures over very different kinds of crises I came to the conclusion that this has to be a Freudian slip of the fact that people subconsciously care more about being able to keep their rear end tidy than eating.
It has been explained a few times that its more related to the fact that stores stock only just enough toilet paper to keep up with demand which is usually almost perfectly regular. Even if everyone just grabs one more bag than they normally do, its enough to totally wipe out the stores.
Where as with other things, you could grab a months supply of cans and pasta and there will still be so much left, as well as the fact that not everyone is grabbing the same kinds of foods so the hit is spread over pasta, rice, flour and a huge range of canned food.
The box milk you buy in Europe can keep about a year when unopened. That stems from a combination of aseptic packaging and UHT pasteurization. I just peeked at a few containers in my house and they have expiration dates around early July.
It’s probably a good thing honestly. Better that people panic buy now, when the disease is still rare, than later when it isn’t. There’s only so many toilet rolls that a person needs.
Yes, surely it’s better to have a slow rise in demand for food while supply chains are still intact, rather than having a sudden panic when it gets worse.
Sensible choice all things considered. I think instant noodles are also a pretty good bet, I personally make a noodle soup with vegetables to bring up the nutrition a bit. I would also add frozen vegetables to the list as it keeps for ages and balances out most meals, whilst still being quite good for you.
I like rice, but am concerned by the number of people who don't wash it (arsenic) [1]. Then you have the issue of reheating/leaving to cool [2].
With the amount of idiocy going around it seems like a massive risk. Pasta is very difficult to mess up, worst case you're just going to get some crunchy or over-boiled pasta.
I eat a lot of rice and am now worried, but man, [1] is just a random blog that looks like it's a fake news website. The author blurb just says she married the love of her life in 2012. Uh, how is that relevant?
It's the kind of article/site like one you'd see taking a graph of the effects 2011 Japanese quake on currents across the world, and claiming it to be a graph of how radiation has reached California...
After researching it, the arsenic isn't "fake news", and I would trust the BBC to actually have asked real experts [1], [2], and their recommendation is:
> Now, some ways of cooking rice reduce arsenic levels more than others. We carried out some tests with Prof Meharg and found the best technique is to soak the rice overnight before cooking it in a 5:1 water-to-rice ratio.
> That cuts arsenic levels by 80%, compared to the common approach of using two parts water to one part rice and letting all the water soak in. Using lots of water - the 5:1 ratio - without pre-soaking also reduced arsenic levels, but not by as much as the pre-soaking levels.
While you're prepping, lentils, dal (dried split peas), and dried beans, are all very shelf stable proteins. Pair with hard skin squash and pumpkins, which also keep for a while, and of course rice. Powdered butter is a shelf stable fat, also nuts though they're more expensive.
Even if you don't use it now because food supply chains don't end up majorly affected, this kind of stuff is handy to have around in case of an a more immediate emergency.
Australia has had every supermarket totally cleared of toilet paper for 2 weeks now. Long life foods have had unstable availability as well. At least everyone will be stocked up while the supply chain is still fine and before any real issue comes up.
I am living in Italy (not in the zones where the virus starts spreading) and I want to say that our healthcare system is still working even if it's struggling.
The big problem is that the number of places for critical care is going to saturate; they are starting moving sick persons from Lombardia to other regions in order to reduce pressure on the critical care hospitals departments.
The number of death is so high because they count person who had other illness (cancer, heart disease, etc) and because we have lot of elder persons (the probability of dying is higher for over 75).
I just hope that other government in Europe will take it seriously, because it seems spreading fast over France, Germany, Spain and Netherlands.
> The number of death is so high because they count person who had other illness (cancer, heart disease, etc) and because we have lot of elder persons (the probability of dying is higher for over 75).
I don't know how the count is made, but since the pressure will affect the care for the other patients as well, it makes sense to at least take them in consideration in the stats.
Yes, it make sense.
The strange value is the one from Germany with more than 1000 cases and only 2 died. I suspect that the criteria for counting the death is not the same across different EU countries.
I'm curious, do we have good data on typical influenza infection rates per month, and if so, are we seeing a sooner than expected drop in influenza transmissions? I figure it would be a good gauge of how well people are adopting safer hygiene protocols.
This has been seen in Hong Kong already. It's been noted that residents there were very receptive to social distancing measures due to their experience with SARS in 2003.
Data provided by the government’s Centre for Health Protection show the incidence of infection with influenza had fallen to less than 1 per cent by the end of February, marking an end to the winter flu season, which normally extends to the end of March or into April.
...
Ho Pak-leung, a leading microbiologist at the University of Hong Kong, said data showed the flu season had shortened from an average of 98.7 days to 34 days this year.
The united states is going to fare a lot worse. Their president is actively contradicting his own experts and essentially encouraging people to go on spreading the disease.
He seems to just treat everything as an us-vs-them argument. I get the impression he's facing an issue where there is no "them" and trying to figure out how to win this argument.
It should be almost irrelevant to the discussion, but by now he has enough appointees in various departments for the problem to grow roots.
Not only is it the President, but also the media like Fox News. They're downplaying the severity and pushing a narrative that the left is stoking fears of coronavirus and secretly hoping for a stock market crash to win the elections.
You end up with supporters of the President even denying coronavirus exists or a conspiracy of the left. Truly frightening.
This is pretty much how Australia is run right now. Although when there is no "Them" to blame the government makes up total nonsense and if that gets called out they say "This is has always been a problem and nothing could be done about it. 'they' would have handled it even worse than we did"
We use to have that mentality in South Africa a few years ago where our medical minister "Doctor Beetroot" told patients HIV is not that bad and they should just shower and eat garlic and beetroot !
I've only started seeing good measures being taken in the last 5 to 7 days as the confirmed cases are rising, but only at the state government level. Currently, I'm sure I can't just show up at the hospital and say I want tested.
In Michigan, they just launched michigan.gov/coronavirus last week, and have commercials on the radio to inform citizens.
People in other countries put too much weight in what the president says, Trump or otherwise, because they don't fully understand that there is an entire system of government that can fully function with or without the president.
I won't go so far as to say that the position of the president is a figurehead, but it's been more than a little advisory for several generations.
I watch a lot of BBC, NHK, and DW, and see it all the time. I don't blame the foreign journalists. If you're an overseas news organization working in America, of course the president is going to be fully staffed. But few orgs go much beyond that. Because of this, the European view of how America works is very simplified.
> there is an entire system of government that can fully function with or without the president.
Except when a major global catastrophe hits, like a pandemic, the response requires massive coordination across local, state, and federal levels. What he says now may not be so relevant but the president's lack of appoints to key executive branch positions within the CDC and the rest of the healthcare apparatus (including eliminating health related positions from the National Security Council, one of the most important multi-agency coordination bodies) has drastically hampered the COVID-19 response effort.
People from other countries more often tend to underestimate the sheer scale and complexity created by a local-state-federal separation of powers weighed down by over two hundred years of judicial baggage and thousands of miles of geography. In a crisis like this, even figuring out who has legal jurisdiction and authority is complicated. Doing it without an effective executive body, whose job is to navigate and command that mess, is far more difficult.
Just look at the testing for an example. There's absolutely no reason we couldn't be doing 10 times as many tests as we are; there's just nobody sitting at the top insisting that test capacity must be available and demanding that everyone do what they can to make it happen.
In this case the President has weaponized the virus as a political issue. A sizeable number of people in the country don't believe that it's a serious issue and won't until their local hospitals are literally overrun. Maybe even not then.
I believe you are seriously underestimating the effect of chaff being thrown into the air over this issue on a number of fronts. It makes it much, much harder to have people follow public health advice or put pressure on lawmakers to pass the necessary appropriations that will be required to address the situation.
That's not the point. Every modern country ends up working the same in practice, whatever the bureaucracy is and whatever the president/prime minister/king/queen legally wields more or less power.
I'm not sure how much that counts since my understanding is that the president's decrees are essentially laws, and when the judicial branch said that was unconstitutional the president just ignored them. Not exactly a lot of checks and balances.
That absolutely is a (strong) Presidential Republic, a term which does not depend on checks and balances (though some Presidential Republics feature that trait.)
Well, depends on the number of cases and the effected area.
If Milan is affected in Italy, you are guaranteed the virus will spread anywhere, it's a key place after all.
There is also a psychological factor to count in of course...
Social and ALL other media have been flooded with the virus 24/7 since the first confirmed case.
It generates good views, everyone wants a piece of that, and now we have this nation-wide phicosys
I wouldn't call it a psychosis, because in this case people are right. If you look at the numbers [1] it went 10x in 10 days in Italy. Despite the counter measures. Now it's only 7.3k if the efficiency of the counter measures don't increase, it will be 73k in 10 days, 730k in 20 and probably 7M in a month. With 20% requiring hospitalization. Which simply cannot be managed at this scale. (Probably not even at the 730k mark.)
The hospitalisation part really is key here. At this point stopping it really isn't on the cards. We need to slow it enough that hospitals can keep up.
7M people catching it next month, vs 7M people catching it over the span of a year, are two very different 7M's. The rate is far more problematic than the actual number.
There aren't many countries with the capabilities of China in that regard. Though ones that get out front much earlier (SKorea, Japan mostly so far, Vietnam) seem to be doing alright
Honestly I think stopping this thing is a huge challenge. But I think it is a challenge most countries are up to, once they care about it enough. But it seems like no one is very good at responding to this virus before it becomes a crisis.
Honestly we are more careful with cattle and pets, than with people. It's going to be hard to change the entitled attitudes. Nobody can stop me from visiting anywhere I want!
Why do we keep circling back to this? It is/was a catastrophe in Wuhan, and the cat is reluctantly being forced back into the bag. By existence, it is not too late. See my earlier comment in this thread: https://news.ycombinator.com/item?id=22532892
yes, but it seems like that strict of measures are necessary to bring it rapidly to heel. Different countries can go different ways (japan and skorea doing nicely just keeping the curve nice and flat so far) but US has no socialized anything, poor federal govt response so far, inability of people to take time off work etc...not saying it's impossible, I'm just saying that if we're gonna have a nice little quantitative lesson in a year of which societies responded well and which ones didn't, I'm kinda pissed to be in the "don't be them" experimental group
I don't feel it was transmitted 10x in ten days. Those people were already infected. Otherwise, you'd have to wait a couple weeks for them to become symptomatic to know to test them. (Unless they are testing everybody, and the 10x included people that weren't symptomatic).
You are right, they were infected a few days before (I think 6.6 on average). But still, the growth was 10x in ten days as you can see on the graphs. It's just that the measurements are always a few days behind the real numbers. In other words, there is a delay in the system, but it does not change the shape of the graph, it simply shifts it right (towards the future) on the time axis.
Lockdown in Italy is a concept that is difficult to enforce. And it's probably very different to what it means in China or even just South Korea or any other more organised and centrally governed country in Europe like France.
But in essence:
Schools are closed until next month.
People can still move around freely for work reasons, and in general people still work in offices.
Bars and restaurants close after 18pm.
Shops are closed only on weekends.
People over 65 have free deliveries from most supermarkets, but very few use them.
Big groups of people are not allowed outside public places.
The social structure in Italy is still very much based on families, so people will remain with their close relatives and go out for a walk around home.
Completely random and off-topic. I'm in the US and used to 12-hour time. I personally prefer 24-hour time, and am comfortable with 18:00 or similar for a time indicator. I don't know that I've ever seen a 24-hour time with am/pm attached to it. Is this common?
To feed off your random comment, I live in the US as well but switched all of my clocks (that I was able to) over to 24-hour time a few years ago. It just makes more sense to me. But everybody around me thinks I'm some sort of weirdo for it.
I've got a handful of software (Skype, my ereader) that don't have 24h time options. Super annoying, especially for software where all they'd have to do is use the OS time convention.
I've found that a lot of software that moved to Electron or similar solutions has trouble adhering to OS settings. Heck, even Chrome ignores my date format in the history tag. That's what you get with a technology that's not really supposed to interact with the user's OS settings much.
I say 6pm but write 18:00. I imagine things like that can very easily lead to awkward translations.
I've found countries (Slovakia springs to mind) that would say "a quarter of 8" for 7:15 (think "7 hours and a quarter of the eighth hour") and "half 8" for 7:30. Time can translate in rather interesting ways.
I have been reviewing the situation with a colleague of mine, and we have now realized that the new measures are not enough. It makes no sense to allow burger king or any bar to stay open util 6 p.m. And it makes no sense to allow to go to work for any undeferrable (or also deferrable) reason. The only effective measure seems logically to be quarantine, and for me and my family (2+2), from tomorrow afternoon quarantine will be. The government will finally arrive to the same conclusion, but a later stage. At the moment they seem to be still trying to balance the counteracting of the epidemic and the economic damage, but to us that's not the correct thing to do.
The problem with this is that a 14 day total economic halt will be devastating. Even assuming all office workers work remote basic social structure will be endangered. The hospitals need to stay open, people need to keep operating water and electricity utilities, food distribution needs to continue as many do not have 14 days of stock at home.
It is not about those dams politician that only care about reelection numbers, it also about keeping the wheel of society turning.
To say nothing of how much total hysteria that would cause.
In China we have been on economic halt since late January. The hospitals stay open, utilities are running, food deliveries, all of that is still working. There is no shortage of food or other daily products.
What has changed is that almost everything is being delivered from online store or purchased from supermarket or pharmacy during restricted hours. Anybody who worked a pink collar job before has no job now. Anybody who owned a brick and mortar business before is hoping that the government grants will cover the rent and allow it to reopen if/when things finally go back to normal.
Lockdown like this is no doubt devastating to the economy. I don't think we've seen the worst of it yet. But so far it hasn't affected supply of food, clothing, shelter.
Hospitals in China have been cancelling all elective surgeries and sending the majority of their in-patient home. This was done partly due to the fears of the virus but also because a large part of irregular staff (nurse assistants contractors, medical students and registrars) were away and unable to work. Bear in mind the outbreak happened in late winter when most hospitals would run at near capacity anyway and there is no way to avoid the loss of life.
I agree that we have not fully realised the effect of the lockdown yet, but from what I have gathered things are not very promising. It's unlikely that people will ever go without food or shelter, however the economic progress they worked hard to achieve in the past decade could very easily be undone.
I think how devastating it is depends on whether the government will just step in to make things whole or not. Seriously the government could just tell payroll companies to cut checks as normal and put it on the treasuries dime. They could just declare debt holidays.
Probably means people and businesses in places like China will be mostly 'fine' and people in the US are going to get savaged.
Quarantine for everything but the very bare minimum services (the ones you mention but the food which can be distributed home to home) seems the only logical path to the resolution of the matter.
The spread of the virus caused by a relaxed quarantine (as the one enforced now, based on people good will) will certainly cause the collapse of the system you are describing due to the saturation of the hospitals.
During tonight's news, journalist Mentana showed graphs describing a significant decrease in contagion in the Lodi and Codogno areas, i.e. in those areas where the most drastic measures have been taken.
In order to have a functioning economy, I believe it is necessary to have a population and not just what remains of it.
To my understanding now there is little hope to "stop" the virus in geographical terms; to avoid collapse it would be enough for it to spread slow enough.
The recommended isolation period might not be a mere 14 days for much longer.
"According to the official Weibo news of the "News 1 + 1" column of CCTV, on March 6, Bai Yansong talked with Wu Hao, the head of the community prevention and control expert group of the central steering group.
"Wu Hao said: Patients discharged from Wuhan must have 14 days of centralized isolation observation and 14 days of home medical isolation observation, and they must go through a total of 28 days of isolation observation period. The first 14 days are the observations of centralized medical isolation points, which are usually requisitioned and modified medical isolation points such as hotels or training schools for observation. In principle, each isolation point is matched by a doctor and a nurse for every 50 people, and there are other life support personnel. At the same time, there is a division-level leader cadre at the isolation point."[1][2]
Also, when it comes to trying to squash the epidemic nation-wide, even 28 days might not be enough, as you have to reset the clock with every new infection.
Let me give an example. Let's say everyone in Italy isolates themselves (with their families or whoever they're living with) for 14 days. At day 13, someone of them that's infected could infect someone else they're living with, and if they then go out in to society on day 14 they can start the epidemic all over again.
Of course, if this was perfect isolation, with every single individual keeping completely away from every other individual, then 14 days (or 28 days) might be enough (assuming no atypical cases that take longer to resolve). But that's not going to happen in the real world.
People will need to have some contact for getting food from each other, for example, and for keeping essential utilities like water and electricity running, for keeping hospitals open, etc. That's not to mention group living facilities like nursing homes and prisons. There are just not enough individual living accommodations to make perfect isolation possible.
Worse, even if there was perfect isolation in Italy, when the isolation period ends the epidemic could still start all over again when one single sick person from another country enters.
In order to be really effective, such isolation measures would have to be both perfect and simultaneously held all over the world, or else once a country is clear of the disease it would have to somehow prevent sick people from other countries from entering, which isn't going to happen either.
Yes, and small and medium companies have expenses, yes? And a plurality of those expenses go to billion dollar, multinational companies, yes? If you quarantine an area, people stop purchasing oil, yes?
It's being modelled and shaping policies. It makes no sense to try to stop it, cease all activity. That's too late, difficult and costly. But it makes sense to delay and spread it over time. So measures need to be, imperfect.
writing from Pavia(Lombardia), 15 min of drive from the city where the first cases have developed.
There is less people on the street but still too many people conducting normal life, taking public transport or having drinks etc in crowded places.
These new measures are meant to force to change lifestyle and be more conscious of the risks.
Daily life has changed in that you stay at home, work at home,think twice every time you need to go to the store: do I really need it? It's a possible vehicle of contagion, do I really need to get out?
Being stuck at home is not easy but neighter as easy nor as terrible as some would think: it simply has to be done.
Italian here: not really a lockdown, we can go to work and the country discovered remote working. Supermarkets are open, pharmacies too. No shortage of goods except surgical masks
N.italy, all ok. Less people around, shops ok: i withdraw cash every day, rather than waiting for the gov to do it for me. Which they will, then they'll find a away [o line their pockets with it. Nb never voted, never will, but italians are already being political about this. Seen a few comments here, too.
The real impact will be when the rest of eu gets hit. At least day2day italians know you can't blame any single person/ location as you don't know how you'll get infected.
Developer here, we now work in separate rooms in the office.
Gotta work remotely if someone gets infected I guess.
My train to work is 10% the usual people.
Social life is voip only now. Groceries are still easy to get, even If there's 3x the people at the queues.
People with children have to work from home if they can, schools are closed
All my medical colleagues kept saying this was bad. In the first cohorts of patients, 10-20% needed ICU level care. I have privy to the latest peer reviewed guidelines for medicine and had a double take when I read the initial complications: 19.6% Acute Respiratory Distress Syndrome (ARDS). ARDS has a supportive type of treatment, which means that we give you all the basics for life and hope that you pull through. It's the last resort of care. It's only ~150 people, that statistics might be off. Then the cohort study came out that was looking at 44k patients. It lined up with the first cohort so close you could consider it a rounding error.
Folks, get mentally ready to know someone that will die because of this. Luckily, almost everyone in this thread will be alive, but those that have diabetes, cancer, coronary artery disease, and the elderly are the ones who will have poor outcomes because of it.
Yes, it's Simpson's paradox. Fatality rate is lower in Italy than in China for all individual age ranges, but the overall rate is higher in Italy because of the older population.
> The fatality rate of Italy is scary high. I read the reason is that they have such a high percentage of elderly.
And has one of the lowest fertility rates [1] in not just the EU, but in the World. Odd considering how just a generation ago having a large catholic, and poor, family was one of the most prominent qualities of Italian life.
They keep trying to monetarily incentivize increasing birth-rates, much like Japan, but its not working. I often wondered what implications all of these austerity measures and under-employment in regards to population growth would look like in the West, and it seems to be following the Japanese model quite well.
With that said, this is incredibly terrifying; the implications are looking dire.
>just a generation ago having a large catholic, and poor, family was one of the most prominent qualities of Italian life.
I would not say so, no. That's speculation, this has not been true even for the south for a long time now. The only large, poor families you see are from immigrants nowadays.
What is a long time? I lived and worked in the Central part in Emilia Romanga, an affluent albeit largely communist part of Italy, and I saw it amongst farming families, although most had since abandoned Catholicism. Many of the older children had left for Germany, Switzerland, Austria or Holland for work to send money back home.
But, and this was just my personal experience since I was in the EU during the financial crisis; Italy, much like Spain and the other so called PIIGS, is a country plagued with underemployment and little to no social mobility for those under the age of mid 30s for the most part.
And while I cannot attest to the number of their siblings or their religious beliefs, to say Italy itself is not is rather difficult to believe given my first hand experiences.
I remember walking down the piazzas during the day to set up shop in the central parts of town, and the amount of large groups of 20 year olds (I was in my 20s back then too) were there day and night drinking in public was astonishing.
Demographic trends in Italy bottomed out the year I was born (1979), and were then absolutely stuck until 2001, with no growth whatsoever. Without migration, the population would have long shrunk pretty dramatically. So your image of "large italian families" has not been mainstream for at least 40/50 years - two generations, like many (most?) other European countries.
> the amount of large groups of 20 year olds (I was in my 20s back then too) were there day and night drinking in public was astonishing.
1) All the cities in Italy have large student populations because of well-respected universities. Bologna has one of the oldest universities in Europe, which is now massive. Chances are 95% of the kids you saw were students.
2) People in Italy like to hang out. Even if you have a job, anytime after 6pm is fair game for an aperitivo and whatever comes next, particularly when you are 20. Also, in smaller cities and towns, shops close at lunchtime and people go out to eat together, coming back around 2 or 3pm.
Edit: guess not, suppose I should spell it out: "Gypsy" is widely viewed as a slur, and thus is not appropriate as a cutesy spelling of a group of countries.
> In which way would be Italy incentivizing births?
Its literately the first line in the link:
>> It’s been almost two years since Prime Minister Matteo Renzi introduced an €80-a-month ‘baby bonus' for low-and-medium income families.
>>> But now Health Minister Beatrice Lorenzin wants to double that amount in a bid to stave off what she describes as a “catastrophic” decline in the country’s birth rate, as well as introduce higher payments for second and subsequent children.
Eur 80 / month is terribly low. I can pay a single day of babysitting with that money. But I don't receive it, it's for lower income families only.
The sad truth is that Italy is hard for young people with the wrong degree (or without a degree). Postponing children is often a necessity, if you don't want to depend on your parents (who often own an house and have a nice pension). And so many skilled people just leave.
> The sad truth is that Italy is hard for young people with the wrong degree (or without a degree). Postponing children is often a necessity, if you don't want to depend on your parents (who often own an house and have a nice pension). And so many skilled people just leave.
That's pretty much the millennial plight, and I agree; the sum is absurd when put in proper context, but that is what the Italian Government deems 'necessary' to pay just to keep the native population (targeted low income and likely low educated) churning out more numbers. Apparently the secretary general wanted to double that, and 2-3x it for subsequent children.
The US probably subsidizes it even more with all the tax credits for having children, too.
I'm not saying this to be supportive of the process, just restating my observations. Also, Italy has the easiest immigration laws of all of the EU to help boost its population numbers.
Speaking of depending on their parents, I met a girl in Croatia visiting her Italian BF (she was from Washington) as she was thinking about staying long-term and living 'la dolce vita' a bit longer at her to be in-laws place when she realized all she had to do was marry her BF and would be granted complete citizenship.
They thought about taking a year to just travel if they did it, I wonder if she went along with it?
Somewhat ironically, this virus might be great news for the overall demographics: couples are now stuck at home with nothing to do, NYC-blackout-style; I fully expect an increase in births (and divorces) in the next 12 months.
10% is extremely high. Yeah, that shows that they are severely test restricted and the actual infection rate is significantly higher.
That tells me that case count will grow at a rate of test rate * 10% for days to come even if the actual spread has peaked.
IMO, and I’m not sure why more people aren’t saying this, the hospitalization rate in the general population under typical exposure rates is probably closer to 1% than it is 10%, and so just multiply the severe or critical cases by 100x to see the general population infection rate.
And if severe case count is not growing, than neither was the infection rate ~7 days ago.
I think the sequence of choices is what matters most. First they ‘quarantined’ Lombardia and some surrounding provinces. This looked nonsensical, or worse, as the contagion spread was nationwide already. Not two full days after, they are extending the restrictive measures to the whole of Italy. The net result is to have scared back home a lot of people working or studying in Lombardia, thereby easing the potential burden on the collapsing regional health system.
The restrictive measures themselves are hardly enforceable, with some very important exceptions, e.g. schools. Hopefully, they would induce some change in habits.
I am from Milano, and my daily life has certainly been affected. I left the city two weeks ago. It was easy for me, though, as I can distance teach and I have a place in the mountains.
The new decree is probably a response to many potentially contagious people fleeing to the south. As I see it, if the draft version of the previous decree were not leaked, the final version would not cause so many people to run away.
Frankly, I expected that these measures will be extended to the entire country not later than by the end of the week. We're still in the exponential growth phase.
You are right about the leakage. The final decree places no restrictions on traveling back to residence, and even admits self-certification of other reasons for traveling.
I am not sure you are right in assuming the leakage was unintended, though. If they wanted people to run, the effective way was to force a choice under the imminent and vague threat of being trapped in the ‘red zone’.
You left really early. What indicators were you looking at to make the call? Is it just you?
In a major west coast city and trying to think through when to leave. Too early better than too late but I don’t have a cabin in the mountains so it will be a significant cost to hide out for a month.
The US case growth and death growth curves are same as Italy ten days ago (Feb 28 & 29 respectively for March 9). I wonder if the US will take as drastic actions, or perhaps individual US states.
I'm curious to how does these measures affect individuals ability to get help and solve their problems they may have given the nation wide shutdown. I understand that WHO questioning of China's decision to lockdown of many of it's regions is now seen as helpful in buying the world time to deal with covid19 spread (at the cost of individual freedom and access to help in those lockdown regions).
But, don't lockdown also create massive barriers of people, including of those who need access to life essential products/services?
There has been no product shortages in China except for facemasks. Since the first days of the lockdown till today, e-commerce is still working, deliveries are still being made. Supermarkets and pharmacies are still open. There are reduced hours and the vast majority of brick and mortar shops are closed, but no one is struggling to find daily necessities.
One area that does seem to be lacking is gyms, beauty salons, barber shops etc. But really those things are luxuries - people are able to go on without it.
Lockdown really sucks but it doesn't suck because of a lack of goods. It sucks because a massive number of people in pink collar/service roles are unable to work. It sucks because the government, and other fearful people, have
essentially decided that face-to-face social interaction is not a prerequisite for a functioning society. That might sound fine to someone who is introverted and a homebody anyways, but when interactions have been forced onto the internet or behind masks and checkpoints for months, I dunno... For me it's really trying. I don't so much miss the products of life before coronavirus as I miss the society we had.
This is supposed to be a trasnscription of some Whatsapp calls between medical personnel in the north and south of Italy where the northerners try to update the southerners on the situation
This file is several weeks old by now, a search on the 'net finds a number of pages where the link is mentioned (including one from the 21st of januari 2020 - according to Google that is - hoax alert? if so a prescient hoax in that they knew it would start in the north of Italy).
This being the internet it it hard to ascertain the veracity of the thing. If it is for real it sounds way worse than e.g. the situation on the cruise ship 'Diamond Princess' which saw 700+ infections but only a few deaths as far as I know, nor does it tally with the situation in Korea. In the (supposed) transcription they talk about a larger number of cases in younger people without existing medical conditions, again something which goes counter the current narrative. One of the possible explanations given for the higher mortality in Italy (~4%) compared to Korea (~0.7%) is that Italy has a generally older population (the oldest in Europe) but that does not explain the mentioned incidence of cases among younger people. Of course the way countries count 'cases' can also differ so there is another possible explanation but this still does not explain those cases among younger people.
No, I am claiming that this specific sound file might not be real given that there are references to it from the 21st of january (i.e. way before it hit Italy) and given the stated incidence of cases in younger people while the narrative is that the disease is mostly mild in those under 50. There is no doubt that there is a pandemic going on, I can see it happen around me here in Sweden.
If anyone wants to help out they might like to consider joining this volunteer effort. There are people working on data analysis and visualisation, communications and messaging, and other efforts.
I hope other countries follow the same example. China gave a great demonstration that it's unfortunately the only way to stop such a thing from spreading. People just don't give a f*.
This sounds authoritarian as fuck, you have to sign a document to say why you're outside.
Some countries are following the chinese example of "authoritarian democracy", particularly European countries with big commercial ties to China.
Then you have the reverse side of things: USA, where not even tests are being done in obviously suspect cases. But people can still go to work, buy things, live their life.
There's pros and cons to both approaches, but compared to how H1N1 was handled I definitely see a turn to authoritarianism, at least in Italy.
Since the mortality for younger people seems to be quite low I wonder, given the serious circumstances, whether it would be useful to give some (maybe volunteers?) medical staff in endangered regions "controlled" exposures to corona-virus so that the hospitals don't have a staffing problem due to sick doctors/nurses if a serious outbreak happens.
What? I do think that doctors in training will be able to go back to school in a few months. Have you missed the part about hospitals being on the edge of being overwhelmed already?
What surprises me is the number of deaths in relation to the number of infections. Even higher than Iran where I would expect less effective patient management than in northern Italy. What is your opinion on this?
And yet Germany (median age 48, nearly the oldest in the world, slightly older than Italy and similar to Japan) has seen only two deaths so far out of ~1,100 cases. I've yet to see a definitive explanation for the extreme difference between what we're seeing in Italy vs South Korea vs Germany when it comes to mortality rates. Italy has a developed-world, universal healthcare system. Perhaps the cases in Germany are not far enough in yet to produce a higher rate of death (seems unlikely, in many cases elsewhere older patients are dying rapidly). The only explanation that seems plausible that I've seen, is that their healthcare system (locally) was quickly overwhelmed and they're leaving the worst cases to die, unable to tend to them.
another fairly obvious explanation would also be that the Italy's numbers are underreported and there's significantly more sick people, which would also explain the healthcare breakdown.
Because I have no real explanation how a few hundred people on ventilators are supposed to bring the healthcare system down.
Three people travelled from Venice, Italy to Kerala on Feb 29th and skipped the tests at the airport. Today Kerala has confirmed 12 cases of COVID-19 and around 3000 people are under observation.
Would make more sense for the elderly and vulnerable, and those that work/live in close proximity with those to be self-quarantined. Makes little sense to apply those measures to the young and healthy, for whom the effects (both symptoms and mortality rate) are similar to contracting flu without vaccine.
Unreal, a month ago (February 7th) I was posting this news story [1] related to the city of Shenzen which was about to be put into some form of lockdown, it only received one upvote. A month from that event and we have an entire European country (a G7 member to add) under lockdown. I guess the normalcy bias [2] was too strong for too many people until reality hit us hard in the face.
I had a trip booked to Italy starting on March 20 so have been following the news very closely since at least mid February... I Ask HN'd how people were tracking the virus, and the answers I got were "I'm not tracking it in any way, shape or form and I hope it reciprocates the courtesy."
Quite funny, but the stats don't lie[0]. The number of new cases in Italy has grown at an exponential rate. This is a developed economy. Similar rates are being seen in France, the UK and Switzerland. The same will happen in the US. We're all going to get this, and most of us will be fine, but if you take the midpoint of experts' forecast of 40-80% of people being infected and multiply that for a conservative 1% death rate (the WHO has mentioned 3.4% and 2% is also often thrown around), that yields
7.8 billion * 0.6 * 0.01 = 46.8 million dead
At an 80% infection rate and an 3.4% mortality rate (worst case scenario), you get 212.2 million dead.
That's a once-in-a-century, catastrophic black swan event.
Not a doctor, but I suspect 3.4% is the upper end of the case fatality ratio (i.e. death among people tested positive) as opposed to the infection fatility ratio (i.e. death among estimate of people infected).
Mortality rates are low because hospitals are working. Intensive care beds in Italy are projected to be full in less than 10 days. You’ll see the rate grow by then.
Areas that were locked down exactly 15 days ago, now seem to have seen a significant decrease in infection rates in the last few days. So there is hope that the system will fire on all cylinders and hold the line just long enough to weather the storm. Also, Southern Italy is significantly drier and warmer than Northern Italy, which might (might) help.
One of the issues working against this scenario is the fact that the worst-affected regions are also the ones with the best health services. The other regions might struggle to respond as efficiently as the "pioneers", although they will benefit from the accumulated experience.
The range varies a lot depending on the quality of the treatment. The early initial estimates were based on data from Wuhan, where hospitals were overwhelmed early. The later, lower numbers were from areas where all new cases had hospital beds and ICUs available if they needed them.
Problem is, given the current numbers, the projected total number of people who will require hospitalization, and of those that will require ICU, significantly exceed availability. So if it spreads too fast, and all these people get sick at the same time, we won't have enough beds to go around - and that will cause the mortality rate to spike again.
(chance of contracting virus) * (chance of contracting disease from virus) * (chance of fatality from disease).
The first is dependent on containment efforts. The second is not 100%. The third is also partly dependent on containment efforts, as fatality goes up if hospitals get overwhelmed.
I don't see how you get "we're all going to get this" when China and South Korea are already reporting decreases in daily cases.
> That's a once-in-a-century, catastrophic black swan event.
It's a catastrphic event but I don't see any reason it won't happen again in the coming years / decades. The virus itself could even have worse characteristics in terms of transmissibility and mortality. Our transportation network is so great and modern society so dependent on it there is no hope stopping these outbreaks going global, only slowing them down.
In fact it should probably be fairly easy for a malicious actor to engineer a worse virus. Longer incubation period, truly airborne, super lethal. Whatever the final death toll is, I don't think it'll be the last or the worst of the 21st century.
People keep extrapolating that tens of millions will die, and I don't doubt that tens of millions surely would _if_ there were no lock-downs! (The subject of this article!)
The whole point of locking down Wuhan/Hubei and then northern Italy and now the whole country and other places and cancelling large public gatherings and events is that local, regional, and national authorities start seeing the numbers soaring and initiate extreme mitigation strategies.
We don't know how successful these strategies will be individually/collectively in the long run but if China is anything to go by it can severely retard the spread of the virus.
To show I'm not spouting out of my derriere compare the logarithmic infection and death rates of China[1] and Italy[2]
So you have to modify your formula: `7.8 billion * 0.6 * 0.03 * mitigation_factor = ?` We just don't know what the mitigation_factor is yet and because the spread is exponential any dent in the rate of spread brings the fatality number tumbling down[3].
I happen to believe this virus is a very serious global threat and I assure you that I am not one given to alarmism. But I also have never seen governments respond to the onset of an epidemic like this before and I'm nearly fifty and my mother says she can't remember anything like this in her lifetime. So yes, tens of millions absolutely could die but I'm willing to bet that between lock-downs and modern medicine tens of millions won't and I pray to, you know, $deity I am not wrong.
There is cause for optimism in the numbers out of South Korea and China. Even assuming China has lied about their numbers (population ratios with Italy and South Korea vs China make that plainly clear, they lied to a large degree on the numbers), if China has managed to bring it under control through their extreme quarantine measures, then we can prevent it from killing tens of millions. South Korea seems to have considerably slowed it there. Japan has done a good job of limiting its spread.
China has 1.4 billion people, and they've had ~3,000 deaths (let's assume it's several times higher in reality). But we'll see tens of millions dead globally? No we will not. If you killed every person that has been infected in China, and extrapolated that event globally, we would not see tens of millions dead. So that premise is absurd, to an extreme.
I consider this to be a very serious situation, however, it's not very serious as a great mass mortality threat (unless it mutates and becomes far more deadly and we prove unable to slow it down or vaccinate against it). It's a serious threat for massive disruption to our daily lives, including severely harming the global economy. It's a serious threat to swamping our healthcare systems due to ICU demands and diverting our resources to managing the ongoing crisis (instead of routine, normal productive work).
Assuming this isn't going to burn out come Spring & Summer, the next step is to rush to vaccine, at any cost. That will end this thing globally. Maybe we'll need to vaccinate against it annually, maybe it won't come back after this year, who knows of course.
Tens of millions will not die. Tens of thousands might die in the plausible worst case scenario, before we get a vaccine ready. We can rush to vaccine at greater patient risk and financial cost, as necessary.
1. We don't know the actual reality of what's happening on the ground in China. Hubei and Italy have approximately the same population, yet Italy is suffering more proportionally. I think the obvious explanation is drastic underreporting of cases and fatalities in China. When all is said and done I think China probably has underreported by at least a magnitude if not double that.
2. Most Western countries won't impose the type of strategies that China undertook; they simply can't. When things get too bad to impose draconian quarantines, it'll be too late. Even Italy's efforts in quarantining the nation are not enough.
3. Most of the world doesn't have good healthcare. I'm talking about Africa, Southwest Asia, South America. There simply aren't enough ICU beds and ventilators to go around. Even in the US, I've read reports of only 100K ventilators nationwide. If the pandemic keeps growing exponentially with a doubling period of 4 days, the US alone will have 1M cases by mid-April.
4. Simple math. World population outside of China is 6.5B. If 10% are infected (very conservative imho) we're looking at 650M cases world wide. If the CFR drops to 1%, then we're in the neighborhood of 6.5m fatalities. And the survivors? Roughly 81% of those infected survive with no serious side effects. The remainder have serious health issues even after the disease runs its course. That's 117M casualties. This is world altering.
To address (1.) You and others are going to have to provide sources for why you think that China "probably has under-reported by at least a magnitude if not double that". I've seen the ill feeling and distrust towards China increase on HN and elsewhere in the last 5 years and this fits the bill.
You can explain the differences between Hubei and Italy by the differences in responses. As has been pointed out, China built two make-shift hospitals in ~ 10 days and quarantined 100s of millions in cities. Have you not seen the pictures coming out of China. Now that Italy is taking drastic steps we'll see the outcome in a few weeks and it will tell us if it is an effective strategy. If any of the reported numbers is suspect it is the total number of cases that the USA is reporting: https://www.worldometers.info/coronavirus/ It's completely out of whack with every other country. This implies the US has been under-testing, something which we have lots of evidence for. On the other hand we have no evidence China is under-reporting.
To address (2.) "Most Western countries won't impose the type of strategies that China undertook; they simply can't." Why not? Why can't they?
To address (3.) "Most of the world doesn't have good healthcare." But most of the world has soap, most of the world understands what it means to self-isolate, most of the world can implement quarantining. "If the pandemic keeps growing exponentially with a doubling period of 4 days," Looks like mitigation strategies slow the doubling period to three weeks, why pick the worst case scenario?
To address (4.) "Simple math." Yes! Times an unknown mitigation factor of ? This outbreak is scary because it's exponential (highly lethal and highly infectious), but the total fatalities is also highly susceptible to interventions exactly for the same reason.
I have no ill feeling towards China other than the fact that they have a repressive, authoritarian government. Those types of government necessarily try to control and spin the news to maintain their authority. If a country is willing to censor Winnie the Pooh to make their leader feel better, than they'll naturally minimize the effect of SARS-Cov2.
I also agree that the US is underreporting due to inadequate testing. Estimates in the US should be closer to 9-10K. I think that we'll see a large spike in cases as soon as testing approaches levels in other countries.
My inclination regarding quarantine controls in Western countries stems from the willingness of these societies to restrict freedoms. Italy's quarantine is very basic, a 1 on a 1-10 level. Compared to what China implemented, it's not even close.
Soap isn't the ability to treat cases; it's a way of trying to mitigate the spread.
We might ballpark the number of global deaths – in the optimistic case† at between 20,000 and 30,000 souls. Not a global tragedy, on a scale of the recent Ebola outbreak, but warranting much more drastic action.
There's a huge sense of urgency. We could have a vaccine before the next flu season in the northern hemisphere.
† assuming not every country acts quickly when the time comes nor acts as effectively as China
I’m not sure about the overall efficacy of lockdowns unless:
- The US plays along. We are likely a hotspot now, whether we go the “undertest and live in ignorance” route, or not.
- We have an effective plan for rebooting out of the lockdown. Which, until we have an effective treatment or vaccine, to me means temperature scanning in most public places imaginable, continued vigilance around disinfecting, continued limits on public gatherings, and more.
From what the numbers are saying it looks like the USA is both under-testing and over-reporting simultaneously. Very odd state of affairs. I'm ignoring the total cases number from the USA at present because it is a clear outlier. The # of deaths is much more reliable but that number will lag as tests are performed.
(The # of deaths for Germany is suspiciously low, as is the # of deaths for S. Korea.) I actually think the Chinese data is fairly accurate. the Iranian data, well, who knows. I'd like to think the European data is reliable, but again, who knows.
If the USA becomes a hot-spot then other countries will undoubtedly institute a travel ban to/from there like is happening with parts of China, S. Korea, Italy, Iran, and so on.
This is impossible to contain. The purpose of the lockdown isn't to contain, it's just to spread out the infections over a larger period of time so that hospitals don't get overwhelmed. But there's likely not a plausible scenario at this point where we globally jump on this and only a few million or even tens of millions are infected. All we can do is slow it down.
China has demonstrated that it is in fact possible to contain the spread. Please use the links I provided to review the data. Do remember that the Chinese built two make-shift hospitals in something like 10 days. Once a couple of weeks pass we'll see if Italy is able to replicate what China did.
Here are my calculations based on current data[1]:
Country tot. deaths pop. (1m) tot. deaths/1m pop.
Italy 463 62 7.46
Iran 237 83 2.85
China 3120 1384 2.25
South Korea 53 51 1.03
Spain 30 49 0.61
France 30 67 0.44
USA 26 329 0.08
Italy has blown past China which is why they've locked down the country. Iran will surely do so next if they are not already doing so unless they want a national calamity. South Korea reacted quicker. Spain, France, will have to act next, possibly next week or the week after, the USA will have to act in about 3 or 4 weeks assuming things remain the same but by that time it'll be early April and the weather will be getting warmer so who knows.
China’s current status is impressive but it’s come at enormous cost which is unsustainable in the long run. And it’s unclear what’s going to happen in the long run as China opens up workplaces and public gatherings, and as international travel and commerce resumes. It may very well explode again. Some countries will get a handle on this for now, but many won’t, and it will continue to spread globally. It might take months, it might take years, but it’s not going away.
People can do great things when needed. Who says it is unsustainable? Can we not change our habits? Can we not provide the equipment and supplies (respirators, medicines, masks, disinfectant and sanitizers) that need providing?
With any luck we'll have a vaccine in 18 to 24 months. The flu season is halted by warmer weather. We can change our behaviour for a few years until we get it under control.
I really want to know if the people who appeared to catch it after recovering simply had the disease in remission or what, because being unable to develop an immunity screws up all the numbers until there is a workable vaccine.
I feel like it's less a matter of normalcy bias, and more that people reasonably distrust a Falun Gong newspaper written in a language they can't read.
For a while this Falun gong member [1] was one of the few persons who was publishing real news and videos of what was happening in Wuhan and in China as a whole.
Because news organisations like the FT or the BBC published the same news that she had published two or three days before.
Granted, she was not the only one publishing them on Twitter, but she was the one I was following the most. Also to add, news organisations like the FT or the BBC were only publishing news that could be taken for a political spin, like in the case of Li Wenliang, they were not publishing news about people committing suicide on their home as not to infect their loved ones or desperate phone calls made by people who were trying to get their loved ones into an hospital (which were already full by that point).
Also, many of the hospital scenes I was seeing on Twitter on her account are similar to what now surfaces from hospitals located in Northern Italy.
But you see the obvious concern, right? If news organizations publish some but not all of the same news she's reporting, that could mean that they're selectively skipping news to push a political angle - or it could mean that she's selectively adding fake news for her own political motivations. My inclinations are not to break the tie in favor of the person posting about a mystical connection between coronavirus and the shape of the Wuhan train station.
This is not surprising, even very common. The media can easily guide the direction of public opinion. After all, there are not many people who think independently (Fortunately, most of the people on the HN were able to make their own judgments).
Look at these two tweets from NYT, just separated by 20 minutes:
The biggest factor in what does or doesn't get upvotes is randomness, so you can't conclude anything from a single data point.
In that case (https://news.ycombinator.com/item?id=22274728) also, the article wasn't in English, which makes it off topic here (we deeply respect other languages, but HN is an English-language site).
>The opposite of normalcy bias is overreaction, or worst-case scenario bias, in which small deviations from normality are dealt with as signals of an impending catastrophe.
The question is to which one we are closer? That's what I think no one knows. Like how reddit says "2 million will die in the US" and some people say "it's just a flu" the truth maybe between the two half way there or so
It doesn't matter - what matters is the point when hospitals get overwhelmed. Past that points, fatality rate goes up just from lack of treatment. Societies have already proven they can put in sufficient containment practices to keep hospitals from getting overwhelmed, so it's a matter if other countries follow similarly effective practices or let themselves get overwhelmed.
I think this in and underdeveloped topic; as I see it this infection even if it is comparable to the flu in mortality require often more intense medical intervention.
I've been on this site for more than 10 years, I do not care about karma, I was using the karma number as proof that that news/story was being neglected/ignored.
It seems like these actions taken by governments will ultimately be futile, so the question is: can a vaccine or effective antiviral be developed fast enough to be worth the ~2-4 months of "slow spread" that can be bought in exchange for the economic and social slowdowns a country will sustain by creating massive quarantines like this?
While an authoritarian government may be better suited to positively addressing some very specific problems (such as a pandemic), I do not personally consider the benefits to be worth the costs of infringing on everyone's freedoms. A government built around liberty and individual rights simply cannot enforce a sufficiently useful quarantine here to contain something approximately as infectious as the flu.
Even China, which has severely curbed the spread of the coronavirus at tremendous expense, is still dealing with an exponential decay of new cases, at best. At the current rate (and assuming no incoming infections from abroad), it could take China a full year to go 14 days with no new cases. And if they let up restrictions sooner than that, perhaps they will lose ground to the virus once more. It does not seem sustainable.
Also note that most cases are not being tested and reported. Anecdotally, I have second degree connections who are mildly infected and being responsible (although still probably exposing some people who live near them), but see no point of getting tested because they don't need the hospital and it's just an extra trip out in public. Other seemingly sick people are out and about in the city in which I live, coughing without covering their mouths in busy areas, etc. Perhaps I am just noticing it more, but I suspect the official case numbers are still off by a factor of 10 or more, so considering roughly a million people are likely infected throughout the world, containment is a fantasy at this point.
Assuming that survival grants some level of immunity, if you can flatten the curve of the epidemic, you can make a limited supply of hospital beds, supplies, and personnel go a lot further.
This is a good point, and I think it is reasonable to start with the immunity assumption, since it is generally the case for respiratory viruses.
Still, I wonder what the math looks like. It has indeed been shown that flu outbreaks in ideal conditions are more intense, but conversely, the flu seasons are shorter [0]. If medical attention makes a significant difference in patient outcome, then the longer virus season is presumably preferable. However, the significance of medical attention needs to somehow be weighed against the total number of people who end up being infected and the costs of shutting down pieces of the global economy for longer periods of time (not to mention limiting individual rights.)
Consider that less vulnerable people may be more likely to become infected in their daily lives since they are more active and likely come into contact with more people. In this case, a faster outbreak with many mild cases may actually result in faster herd immunity, and therefore fewer total infections in vulnerable populations. Perhaps a partial quarantine of at-risk populations is the best solution.
If you look at highly infectious diseases that were effectively eradicated, most either ran their course and infected hundreds of millions (Spanish flu, swine flu), or were eradicated with both quarantine and vaccination (Smallpox, rinderpest). I would be very interested if you could find an example of a highly contagious disease that was stopped without a cure or vaccine [0].
You're measuring the wrong thing. Quarantine isn't an attempt to "eradicate" this disease. Like you say, it's likely to become a pandemic and infect hundreds of millions or more.
You quarantine to halt the rate of infection and give your health care facilities time to care for the seriously infected. And that saves lives. A lot. It can save a lot of lives.
That's the conventional wisdom, but as I mentioned in another comment on this thread, I'm not convinced that's the case, especially with a contagion that is most dangerous to less active people.
Then with all due respect, you really need to cite someone expert on the subject. Seriously public health policy folks are universally recommending social isolation (of which quarantine is the most expensive variant), and it has worked. Who exactly leads you to believe that this isn't working?
This is a poor time for armchair analysis when we're looking at worst case scenarios involving millions of deaths.
This is an online forum for technically minded people -- none of these comments result in prescribing public policy. Like you, I am only an armchair expert in this particular field, but it seems like a perfectly fine medium to discuss and debate new hypotheses. Not every idea needs to be put forward by someone with the right badge to be worth discussing, especially on an open forum, so please don't try to limit intellectual discussion simply because of fear.
I've never heard of 14 people dying in a 120-bed nursing home of the seasonal flu in a 3 week time span either, but the Coronavirus is making that happen in Kirkland, WA right now. Actually, about 30 people have died, but since they don't have enough tests, they can't say that it was Coronavirus.
My wife is an administrator at a Nursing facility that is much larger, and this many people DYING so quickly is terrifying.
I was able to look at the press release from this nursing home this morning, and the numbers are far worse than this.
The number is much higher than that, as there are an additional 12 deaths that haven't been tested for coronavirus yet. 26 have died in the last three weeks as compared to 7 in a typical month.
Another 26 are in the hospital, with the rest being quarantined at the home. Over 1/3rd of the staff there is showing symptoms ~70/180 people.
"The deaths associated with the facility, according to Killian, amount to 26 between Feb. 19 and March 7. That includes 15 patients who have died in local hospitals. Of those 15, 13 have positively tested for coronavirus."
Please do not consider this comment to be commentary on the ongoing coronavirus outbreak, especially considering the situation at the nursing home in Washington state.
Out of curiosity, I tried to find examples where many people died of a flu outbreak in nursing homes. Here are some articles I found:
I guess one thing would be, this was likely the first acute care nursing home hit which may be closer to taking a random sample of what it would do to any given one (though community spread wasn't known about yet, and later ones may have rapid tests available to limit spread and enforce quarantine). Whereas those are probably the worst hit of many. This one seems to be possibly 20 or so of 140 as well (testing not done yet), but the 9/60 case would still be worse.
I'm not OP, but it's a quick search. "Nineteen of those who died in King County were residents of Life Care Center, a nursing home in Kirkland, according to Public Health - Seattle & King County. Researchers say the virus may have been circulating undetected for weeks."[0]
I was referring to the fact that nobody died fothe flu the last time it was around. usually, at least over here, you don't conduct that level of testing.
Which indicates one really big issue. People are, for a large degree, scared by numbers now. Not because the nmbers look black death level bad, but rather because there are no numbers on stuf like, say, the flu or some other disease out there to compare them against. Not blaming people for it, that's just how numbers work, not just for diseases.
bad thing is, nobody is addressing this, or anything else related to testing, numbers and so on, in the public. Which includes TV, internet, papers... Instead we have fake news spreading. This fake news is then erroding trust in official information. And as a reult you have to sides, one that believes the virus is at most a flu and the other one believing it will at least be the spanish flu if not the black death. Both are wrong, but the true facts are not getting through. Also the official information is badly presented.
Yeah, they are saying now that there's a 5 day incubation period for COVID19.
Without widespread testing, we are going to have no idea how bad this is and how seriously fast we need to lock down facilities, particularly nursing homes, and this particular nursing home has shown that in a lot of places, the disease is going to strike and kill FAST.
Do people typically die of diagnosed flu? It's my understanding that most flu deaths are undiagnosed, which is why the CDC's ranges for flu deaths are always so broad; they're estimating how many pneumonia deaths they think were caused by the flu season.
That's why I said "diagnosed" because people die of pneumonia from time to time, and this can sometimes be a result of having the flu, but the pneumonia is apparent, but not necessarily that they previously had the flu.
> I've never heard of an entire country being shut down because of the flu.
H1N1 in Mexico [1], I was a Biology major during this time at a University in San Diego less than an hour away from the border. I recall this vividly and it still stands out in my mind just how corrupt Big Pharma is [2] and what control it wields, but Corona seems to be having a more political and economic destablizing effect than H1N! did, then again H1N1 was happening in the aftermath of the 2008 financial crisis. Still, given the wide-spread nature of this I can't help but draw parallels.
But the flu does kill a lot of people yearly. I tried to look up the mortality rate for Italy. The best I found is estimated 68000 attributed to flu over period from 2013-2017. And you will find similar high numbers in many other countries. Perhaps we are expecting it to be worse that this?
A political overreaction does not make the severity of a disease.
I am mostly following the french news on this and the doctors interviewed (some of whom seem to have impecable credentials) are calling this an irrational panic. It is a serious disease, one of many viruses around, not a particular dangerous one either. But mostly not something that calls for these drastic measures.
2. Possibly, I don't think Macron is immune to over-reaction
3. The economic damage is the damage caused by the reaction, not by the virus itself
4. I am not talking about some rural generalist. These are infectious diseases specialists, who from what I can tell publish in the likes of the New England, I give them more credit on that topic than the average TV anchor or newspaper editor
Individual risk is low, systemic risk is high. With the current the current numbers, the hospitalization rate is over 5% (critical cases). If the infection reaches 10% of the US population, it will require 1.5M hospital beds. Currently there are around 1M, at +60% occupancy.
"From a well respected friend and intensivist/A&E consultant who is currently in northern Italy:"
"Patients above 65 or younger with comorbidities are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest. Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed."
Then you'd get Wuhan, all over the world. A swamped medical system, 3+% death rates, infected population growing exponentially, thanks to nobody having an immunity.
I rather consider Wuhan to be the textbook case of a mass-panic in the face of an unknown virus. What I am primarily concerned about is the people's reaction and the economic effects which seem unprecedented (at least in recent decades). This has a much larger impact than the virus itself. Why is the effect so big compared to other pandemics? Is it because of the way infections and deaths are tracked (which might have some influence on the initial perception)? Is it social media and its newly-gained influence on policy? Or because it primarily affects aged population, which makes up a large share of the influential electorate and policy makers?
We will see how this entire issue will be treated in a year. I presume that even if it still prevalent, it will normalize in the eyes of the public and everyone will move on with their lives. And that point we will also have corrected and more accurate numbers and statistics, just like with every other outbreak.
>This has a much larger impact than the virus itself.
That's only because we're considering one branch in the multiverse though, right? If we get in our time machine and imagine that we didn't have the "mass-panic", then presumably the impact of the virus would therefore be much worse.
>Why is the effect so big compared to other pandemics?
Compared to the 1918 flu you mean? I guess I'm not sure what other pandemic we have had recently to compare with.
There aren't enough hospital beds available to treat everyone at the same time. There will be far far more deaths if you just let it run wild instead of slowing the spread.
The voting system on HN is being used to punish those that try to stay calm and put things into perspective.
Frankly, this actually surprises me. Either I always have had a distored view of the hacker culture, or some large scale manipulation is going on. Since I am not inclined to believe in conspiracy theories, I guess I was always wrong about the hacker culture and its people.
And now, let the donwvotes come. I am pretty done with this site anyway.
BTW, why doesn't HN allow me to delete my account? This seems worse then FaceBook. Even Twitter lets you delete your account and your posts. I smell bigotry, and that is why I want to run away.
The government is calling to unity, and the situation is tragic enough that no-one can ignore the call.
However the left wing (and the current ruling coalition) has some serious responsibilities here, and I hope they are held accountable once this mess is over. A few weeks ago we were told that 'the only virus there is, is racism', implying that people worried about the virus spreading were doing so because of an anti-Chinese sentiment. The other popular talking point was that there are more flu deaths every year, so one shouldn't worry.
I see a link between this attitude and the current disaster.
The situation is bad, though. I was particularly shocked by an ICU medic from Lombardia declaring that in his hospital they cannot treat all the patients, and that they have to select those that appear to have the highest survival chances, something you do in times of war.
(throwaway since my coworkers know my username here, and they wouldn't like my political opinions, I hope this is allowed, otherwise please remove.)
Since genome analysis has shown that the Italian strain came from Germany, they were right in denouncing racism against Chinese people living in Italy. Just like it's now incorrect to treat Italy like the European Wuhan.
I am not sure how you can say the government's response is worse than other countries, where other governments are doing absolutely nothing even after they reached a thousand cases.
(BTW the right spelling of your otherwise beautiful nick should be furioterzapi).
> they were right in denouncing racism against Chinese people living in Italy.
In my opinion there was no actual racism, just common sense measures. That work against any strain.
> I am not sure how you can say the government's response is worse than other countries
I am thinking of our prime minister, for instance. Two weeks ago he was on TV 16 times in a single day, to denounce the emergency. Then we went into the 'business as usual' phase, and the situation slipped out of hand. Today he was quoting Churchill, and I had the impression that it was more to inflate his ego, rather than to do something useful for the country.
All in all I see a very amateurish management of the crisis.
> furioterzapi
That's a debated point, on live versions of the song you can clearly hear "Fulvio". On the booklet they write "Furio".
Common sense measures include washing your hands, not avoiding Chinese restaurants. But yes, it wasn't perfect. At least there was no generalized denial.
It lessens the impact on the local economy. Restaurant workers are a generally vulnerable population in the US with little or no PTO and they often have poor access to health care.
> I think Italy is doing a bit worse that all other governments
It is the first western government to fucking react (even if forced to) and show everyone else the road ahead. And everyone else keeps acting like they hope it's not going to happen to them.
Could you provide a link to where "the left" has said the only virus is racism? I wasn't able to find anything, but admittedly my Italian is not great.
I find it hard to believe, and given Italy's recent problems with the far-right surge, it seems to be more fake news.
That makes a lot more sense to me. I do think both sides of the politcal spectrum are seeking to advance any parts of their agenda they can with this outbreak.
I just felt that if something that ridiculous was said (and I am a fairly liberal person!) it would have most likely made international news.
> I wasn't able to find anything, but admittedly my Italian is not great.
> I find it hard to believe, and given Italy's recent problems with the far-right surge, it seems to be more fake news.
So you don't speak enough Italian to verify, but still you got a hunch. And since we're at it, let's accuse whoever says things I don't like of spreading fake news.
What a constructive attitude!
Besides not speaking Italian well enough, you are not even well informed about Italian politics, because everyone even just skimming through headlines would know that a few weeks ago the President of the Italian Republic visited a primary school with mainly Chinese pupils as a symbolic gesture against discrimination and racism.
There was also a long article about racism and Coronavirus on Internazionale, but you could easily find tens of sources.
Get your facts straights (or just ask) before accusing people of spreading fake news.
> "The only virus there is, is racism", they told us.
That typically means that some specific person, one with power and influence, said the exact words (or something which can be translated to the exact words) "the only virus there is, is racism". If you just mean that some people are talking about racism caused by the coronavirus, that's a very misleading way to phrase it.
You asked for a source accusing me that I was spreading fake news because of some right-wing.
Anyway, I gave you a few pointers, look them up and you'll find everything you need. I am not spending more time for someone that immediately assumes my bad faith.
I do not believe it is left-wing or right-wing specific behavior. We are seeing the issue being handled the same way across the world. So, making a political statement does not contribute anything. If you remove the "left-wing", the point would be equally valid.
I don't think pointing out business connections between individuals belonging to particular nation states is an example of "casual racism". It's no kind of racism at all.
But the rest of the information you provided is very interesting! That the "Chinese capital" of Italy has no cases is very interesting, in particular.
The political situation in Italy has been an absolute powder-keg of not-even-casual racism for years now, not unlike some areas of the UK. The "political boss" of those two regional administrations I mentioned, Matteo Salvini of Lega Nord, tried to scapegoat Asian communities pretty brutally at the onset of the epidemic, with the usual result (Asian-looking people being shouted at in the streets etc).
We now know that the European "patient 0" was likely from Germany, so these right-wingers were left with egg on their faces and are now running around like headless chickens - just yesterday Lombardia asked for more rigorous lockdown measures, whereas Veneto was asking for the opposite. So I get pretty pissed off at the strenuous attempts to go back to the original talking points about discrimination of entire ethnic groups, particularly when Italians abroad (a category that includes me) have to suffer the same idiotic attitudes at the moment.
> so these right-wingers were left with egg on their faces
You could say the same of the left-wing, that promoted for weeks a reckless attitude, pushing the message that we just needed to do business as usual, and to "overcome the fear".
The secretary of the most prominent left-wing party, Zingaretti is now infected. About two weeks ago was posting picture of him drinking at a bar with other people. On top of the picture he wrote: "Our slogan is: normality. [...] Our economy is stronger than fear: let's go out and drink an aperitif, a coffee or have a pizza".
While I wish him a speedy recovery, it's undeniable the left wing downplayed the risks.
Read the whole thing, but this passage in particular is just chilling.
"5/ Patients above 65 or younger with comorbidities are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest. Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed."