Just curious, anyone have a plan, or preps for global pandemic?

[Sibiriak]

Holy Moses!

Edited April 1, 2020 by Sibiriak

[Ron Put]

And just to add:

Latest numbers from Germany show that the Covid-19 mortality rate has dropped to 0.01%.

And it's almost certainly lower, since testing for infections is limited.

Where re the headlines?

Edited April 1, 2020 by Ron Put

[mccoy]

1 hour ago, TomBAvoider said:

If top Italian scientists have no idea when this will be over in Italy, it means nobody in Italy knows

Tomb, right now it seems that Italy has hit a plateau in the spreading of epidemics. If we estimate that in May we may have a significant slump in contagion, then there arises the question: what to do now?  Most assuredly, life will not be the same as previously and all sorts of public meetings will continue to be banned. There is really little probability that by 8-10 June the virologists might have gathered together. Also, so far there continues to be a lack of protective masks. The restarting strategy will be critical but there are the examples of China and S korea now. Everything is still fuzzy and hard to foresee. 

[Dean Pomerleau]

24 minutes ago, Ron Put said:

And just to add:

Latest numbers from Germany show that the Covid-19 mortality rate has dropped to 0.01%.

And it's almost certainly lower, since testing for infections is limited.

Where re the headlines?

There are no headlines because everyone but you realize this is an asinine way of computing mortality rate, which I have clearly explained to you previously.

Come on Ron. You are a smart guy. And there are definitely cogent arguments that can be made regarding the tradeoff between saving lives and saving the economy, and the best strategy to optimize both. 

But claiming countries are overreacting based on comparing current infection numbers with current death numbers is just nuts. You can do better. 

--Dean 

[mccoy]

RE. fatality rates: the more I'm hearing the news, the more it seems that such a parameter can be totally unreliable.

The German number is way too low. Lower than the Diamond princess estimate, so there is probably some wrong procedure in identifying Covid19 deaths or some other unknown confounder. I might be wrong but that is an outlier which must be deleted or explained, in my little knowledge of data processing.

Another eloquent example: I would have never believed that, but in some small towns in Lombardy they showed that Covid19 deaths are probably being underestimated by sometimes an order of magnitude. How they did that? Simply by consulting the historical data on deaths for the month of March. In some towns, the March average in 2020 was by far larger than the historical average. No doubt, the difference is due to the largest anomaly that occurred in the latest decades, the SARSCOV2 pandemic. Of course, in those small towns, the population is largely made up of elders. The deaths have been grossly underestimated nevertheless. In oen instance, they cited 130 deaths not attributed to Covid19, but above the historical average. In a small town, that's a lot to understate it.

The above shows 3 general points:

• Reasonings based on CFRs may be very fallacious since there are so many confounding factors which govern the parameter
• If in some parts of Lombardy deaths have been so grossly underestimated, then CFR would approach 15-20% of confirmed cases and this can only mean that the persons which have really been exposed to the virus may be at least 1 to 2 millions, possibly more from my raw estimate (Lombardy has 10 million citizens).
• All the number published, even by apparently reliable sources, are most probably totally inaccurate, not even giving a first order estimates.

Bottom line: the only objective parameter to measure the seriousness of this Epidemic, in the western world seems to be the degree of saturation of the hospitals and ICUs, a parameter which varies according to the efficiency of individual states and regions.

Edited April 1, 2020 by mccoy

[TomBAvoider]

Those are crazy numbers, Gordo. I've been raising alarms about the economy very early on, but even I don't think we'll hit 30% unemployment. The worst case scenario I can see it's more like 18-20% which is of course still monstrous, but not quite on the scale of the Great Depression of 25%.

Here's a reality check - simple question: do you (or anyone) think that the COVID-19 Recession is going to be a deeper breakdown of the economy than the Great Depression? The answer is NO. The Great Depression was the result of a structural breakdown. COVID-19 Recession is a result of a non-economic factor - although, granted, it exposed structural weaknesses (such as excessive debt levels). Second, during the Great Depression, we did not do anything to mitigate (at least initially) - today we have many more tools and are far more responsive. Third, the Great Depression was a world of relatively low number of economic power zones - today the world is multipolar, and economic resources are distributed far more widely - see China.

So, if with all these disadvantages, the Great Depression resulted in a 25% unemployment in the U.S., why would the much milder COVID-19 Recession give us an unemployment level of 32%? I think that if they bungle this, and keep the economy shackled for longer than the end of June, you'll potentially, if everything goes wrong, maybe end up with unemployment as high as 18-20%, which would of course be catastrophic. I don't think it'll come to that. But 32% is outright scaremongering.

[mccoy]

In some parts of Italy, 20% is just the usual unemployment rate!!

[Dean Pomerleau]

Some hopefull news from a small study [1] on hydroxychloroquine as a treatment for mild to moderate cases of covid-19. The study had 62 patients evenly split between hydrochloroquine group and standard care group. After 5 days of treatment, 80% of the hydrochloroquine group saw improvement in their x-rays for pneumonia while only 54% of the control group did. Four patients in the control group progressed to severe illness while none in the hydroxychloroquine did.

Here is the main table from the graph, showing improvement in pneumonia x-rays:

--Dean

-----------------

[1] Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial
Zhaowei Chen,  View ORCID ProfileJijia Hu, Zongwei Zhang, Shan Jiang, Shoumeng Han, Dandan Yan, Ruhong Zhuang, Ben Hu,  View ORCID ProfileZhan Zhang
doi: https://doi.org/10.1101/2020.03.22.20040758
This article is a preprint and has not been certified by peer review [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.
AbstractInfo/HistoryMetrics Preview PDF
Abstract
Aims: Studies have indicated that chloroquine (CQ) shows antagonism against COVID-19 in vitro. However, evidence regarding its effects in patients is limited. This study aims to evaluate the efficacy of hydroxychloroquine (HCQ) in the treatment of patients with COVID-19. Main methods: From February 4 to February 28, 2020, 62 patients suffering from COVID-19 were diagnosed and admitted to Renmin Hospital of Wuhan University. All participants were randomized in a parallel-group trial, 31 patients were assigned to receive an additional 5-day HCQ (400 mg/d) treatment, Time to clinical recovery (TTCR), clinical characteristics, and radiological results were assessed at baseline and 5 days after treatment to evaluate the effect of HCQ. Key findings: For the 62 COVID-19 patients, 46.8% (29 of 62) were male and 53.2% (33 of 62) were female, the mean age was 44.7 (15.3) years. No difference in the age and sex distribution between the control group and the HCQ group. But for TTCR, the body temperature recovery time and the cough remission time were significantly shortened in the HCQ treatment group. Besides, a larger proportion of patients with improved pneumonia in the HCQ treatment group (80.6%, 25 of 32) compared with the control group (54.8%, 17 of 32). Notably, all 4 patients progressed to severe illness that occurred in the control group. However, there were 2 patients with mild adverse reactions in the HCQ treatment group. Significance: Among patients with COVID-19, the use of HCQ could significantly shorten TTCR and promote the absorption of pneumonia.

[TomBAvoider]

Here are some historic numbers:

Unemployment Rate by Year Since 1929 Compared to Inflation and GDP

"The highest rate of U.S. unemployment was 24.9% in 1933, during the Great Depression. Unemployment remained above 14% from 1931 to 1940. It remained in the single digits until September 1982 when it reached 10.1%.2 During the Great Recession, unemployment reached 10% in October 2009."

Again, I'm not saying 18-20% wouldn't be catastrophic - I just think it's very unlikely. It would be the worst since 1929, and if they handle this reasonably, there's not reason why the unemployment level has to be much worse than 12% - which I agree is still appalling.

[Ron Put]

1 hour ago, Dean Pomerleau said:

There are no headlines because everyone but you realize this is an asinine way of computing mortality rate, which I have clearly explained to you previously. ...

But claiming countries are overreacting based on comparing current infection numbers with current death numbers is just nuts. You can do better. ...

Dean, you are a smart guy, too. A headline could be "Covid-19 Death Toll Passes The Death Toll From 9/11!" or it could be "Covid-19 Death Toll Still Only 10% of Current Flu Death Toll!" It all depends on how the headline writer wants to make you feel.

And, I claim that there is a terrible overreaction by most countries. I understand that there is a lag between infection and resulting mortality, but I also understand that testing only suspected infections undercounts the number of infections dramatically, so even my "asinine" calculation likely results in a higher mortality rate. Moreover, the wave has not peaked in the US, so both detected infections and deaths are increasing, presumably at a similar clip. We'll know who is right in a few months, but I am fairly certain that the mortality rate of Covid-19 is shaping up to be comparable to that of the flu, based on the information I have.

1 hour ago, mccoy said:

RE. fatality rates: the more I'm hearing the news, the more it seems that such a parameter can be totally unreliable.

The German number is way too low. Lower than the Diamond princess estimate, so there is probably some wrong procedure in identifying Covid19 deaths or some other unknown confounder. I might be wrong but that is an outlier which must be deleted or explained, in my little knowledge of data processing....

mccoy, think about about the average age and health of the cruise passengers compared to the general population and you might realize why one would expect that the general German population is experiencing lower death rates.

The US mortality rate is moving close to where the German rate is, so I doubt that "wrong procedure" is the culprit. My guess is that Italy has a much higher infection rate than currently confirmed. Plus, Italy appears to generally have higher flu and general mortality rates, for whatever reasons so this should mirror past experience.

It's hard to admit that one is wrong, but I will make a prediction that the US death toll will be less than 100000, probably between 60000 and 80000, based on deadlier flu seasons. Hopefully lower.

The world's economy is another matter.

Edited April 1, 2020 by Ron Put

[Dean Pomerleau]

Ron,

Time will tell what the actual case fatality rate eventually turns out to be and what the total death count will be in various countries. Unlike most of the stuff we speculate about around here, we'll actually know the answer in a couple months, at least to pretty good approximation. 

1 hour ago, Ron Put said:

It's hard to admit that one is wrong, but I will make a prediction that the US death toll will be less than 100000, probably between 60000 and 80000, based on deadlier flu seasons. Hopefully lower.

The world's economy is another matter.

I'll stick my neck out and say I think it will be higher than 100k, but I'm hoping not dramatically so in this first wave. And I agree the economy is going to be very badly disrupted by all this. 

On a more personal note - I'd love to hear what things are like where other people live. Here is an update from western Pennsylvania, where things aren't too bad yet. My county (which includes Pittsburgh) has 356 confirmed cases and 2 deaths among a population of 1.2 million people (~300 cases per million). Schools have been closed for about two weeks and we've been on a stay-at-home order for about a week.

My wife and I went grocery shopping for the first time in 1.5 weeks today. Shelves were pretty well stocked, except for toilet paper. People here are finally starting to wear masks, but only about 5-10% of customers (including my wife and me). People were pretty good at social distancing and the clerks were wiping down the carts and checkout areas at our upscale grocery store, but not at low-cost Aldi. We bought enough that we shouldn't have to shop for ~2 weeks.

--Dean

[TomBAvoider]

The lockdown around here (Los Angeles) has some teeth at this point. The athletic park not far away from where I live - and is the place I jog (on the track) - has been closed down except for the dog park part of it. All the machines have been wrapped with yellow police tape, tennis courts locked, basketball courts closed, all indoor facilities closed, and so on. Stupidly, the dog park is in full swing, and it is now super crowded with people (and of course dogs), as people are now using it as an outlet for social gatherings - it kind of defeats the purpose to prevent people from exercising, but then having people socialize in large groups just a small distance away. 

My wife and I are reduced to jogging along local residential streets in our neighborhood - and apparently other people have the same idea, so that too is getting crowded. It's increasingly difficult to circle away from others whom you are passing, because there are now so many joggers. The saving grace is that car traffic is light, so less polution and fewer cars... but more bicycles - I fear that the number of accidents is going to go up... hope I'm wrong.

Trails and nature parks are closed in LA and surrounding areas. With gyms closed, you either exercise at home, or take your chances on the street. I suppose I could buy a treadmill, but I'm not a big fan, and prefer jogging out in the open air. We'll see. I have somewhat intensified my weightlifting and muscle exercises at home.

Can't say much about shopping, as we're not doing any - but when I jog past our local TJ's I see long lines in front of the store, 6 feet spaced. 

Edited April 1, 2020 by TomBAvoider

[KHashmi317]

Similar to Tom's experience here in LA (I'm in the South Bay). The streets still have quite a bit of traffic for a "lockdown".

The beaches, piers and (most unfortunately) the beach bike trails are closed. The city parks are "open", but their parking lots are closed. 

Supermarkets seem to have normal traffic, and I even (finally) noticed that TJs in my area did not have a metering line. The Hispanic supermarkets are the best option for groceries, IMO ... low traffic, very well stocked, clean, and folks practicing SDing, with many gloved hand and masked faces. I cycled thru some of the more affluent communities of Manhattan Beach, Hermosa Beach and Redondo Beach, earlier today, and saw more careless SD behavior than in less affluent ones. 

[Dean Pomerleau]

It is interesting to track the changes in the projections by the organization the US government is relying heavily on (IHME). Last Friday (5 days ago), I posted data here for NY and the entire US. The NY peak was projected for Apr. 11th at 550 deaths per day and a total of ~10,000 deaths between now and August.

Today in NY there were 505 deaths. So 10 days before the projected peak in NY the daily mortality rate is already very close to the peak death rate projection the IHME was making only five days ago (550).

Here are the same IHME graphs for NY as of today - peaking a day earlier (Nov 10th) at 845 deaths per day and a total of 16,000 deaths between now and August:

Five days ago the peak projected death rate per day for the entire US was 2300 and total deaths were projected to be 83,000. Today they are projecting a peak of 2600 deaths per day and 96,000 total deaths, with the peak coming two days later (April 16th).

I said in that post I thought the model was too optimistic, particularly as a result of assuming the half-hearted and spotty social distancing measure we're implementing in the US will have an impact similar to the draconian lockdown measures Wuhan took (and presumably assuming the Wuhan numbers China has given are accurate...). My skepticism seems to be bearing itself out already and the IHME is starting to increase their projections to compensate for their misplaced optimism.

--Dean

[Todd Allen]

4 hours ago, Ron Put said:

It's hard to admit that one is wrong, but I will make a prediction that the US death toll will be less than 100000, probably between 60000 and 80000, based on deadlier flu seasons.

I hope you are right but I sure wouldn't bet on it.  Covid-19 is not a deadlier flu.  It is a novel threat with very different properties.  A significant percentage of the infected develop severe respiratory distress.  Most are saved with appropriate intensive care.  But Covid-19 is brutal to hospital staff.  It creates massive surges in patient load in just a few weeks.  It infects and sometimes kills medical staff, even healthy young people without preexisting conditions.  When hospitals are overwhelmed patients die at much faster rates.  We got a small teaser of this in Wuhan, a much bigger repeat in Italy apparently plateaued but far from over, Spain following Italy's path and New York may become the worst example yet.  New hot spots are beginning to pop up in New Jersey, Michigan and many other states.  We don't have a unified approach so when a state implements very strict measures subduing the virus they will still be at high risk of reintroduction from others allowing the virus to propagate less restrained.  It looks to me like we are in for a long difficult year with repeated ugly surprises.

I don't like predicting the unpredictable but I expect this is going to accelerate China's ascendancy versus the declining US and the EU.

[Gordo]

1 hour ago, Todd Allen said:

I expect this is going to accelerate China's ascendancy 

I see the opposite, this is going to hurt China badly for years to come and counties will rely less on China going forward, and also have no tolerance for their abusive practices (endless state run cyber attacks on nearly every US tech company for example, forced tech knowledge transfer, IP theft, fraud, the China hustle, counterfeiting, etc.)

One result of the pandemic is a growing freedom/democracy movement in China. It would be fascinating if these events led to revolution there. There have been increasing numbers of “incidents” that are alarming to the CCP. I think the everyday Chinese people are getting fed up with their abusive, totalitarian communist overloads. The younger generation (students) in particular seem very much aware that their government is a joke and has to go.

[Sibiriak]

6 hours ago, Ron Put said:

I will make a prediction that the US death toll will be less than 100000....

 Ron, you're predicting exactly what Trump & co. are  aiming for.

But what about Dean's main point?

Quote

[Dean Pomerleau:] ...what you are really missing Ron is the fact that those coronavirus death numbers are what's likely to happen in Italy and the US with the very serious mitigation efforts both countries (but especially Italy) are taking. The number of deaths would be much higher if no social distancing measures were implemented.

 

Edited April 2, 2020 by Sibiriak

[Sibiriak]

39 minutes ago, Gordo said:

The younger generation (students) in particular seem very much aware that their government is a joke and has to go.

I wouldn't expect a "revolution" any time soon in China,  or the US.

Edited April 2, 2020 by Sibiriak

[Gordo]

8 minutes ago, Sibiriak said:

I wouldn't expect a "revolution" any time soon in China,  or the US.

Before the pandemic, revolution was already underway in Hong Kong, I think the same spreads to mainland China.

Speaking of spreading, it was just reported that China has locked down some new central county (population 600,000):

https://www.reuters.com/article/us-health-coronavirus-china-county-idUSKBN21J64X

 

Edited April 2, 2020 by Gordo

[Sibiriak]

24 minutes ago, Gordo said:

I think the same spreads to mainland China. 

I think not.   Time will tell. (The Western-backed Hong Kong "revolution" had no chance of succeeding anyway,  pandemic or not.  Hell,  the  massive --and massively repressed-- French "Yellow Vest"  protests didn't achieve much either.)

Edited April 2, 2020 by Sibiriak

[Sibiriak]

Economic crises are not simply a matter of material deprivation-- they can effect health and mortality as well.   Here's just one bit of evidence as an example,  (not that it is conclusive).  Of course, it doesn't have to be that way-- it depends on policy decisions.

Financial crisis caused 500,000 extra cancer deaths, according to Lancet study (2016)

 

[Ron Put]

1 hour ago, Sibiriak said:

 Ron, you're predicting exactly what Trump & co. are  aiming for.

But what about Dean's main point?

I already addressed it.

Actually, I am predicting a 2018 flu-like impact based on what I am seeing.

Anyway, here is some food for thought:

A fiasco in the making? As the coronavirus pandemic takes hold, we are making decisions without reliable data

[Sibiriak]

26 minutes ago, Ron Put said:

I already addressed it.

Sorry,  I don't see you addressing his point in that post, or in your latest one.

Quote

I am predicting a 2018 flu-like impact based on what I am seeing.

"Flu- like impact" based on a widespread  WHO-aligned response to the pandemic?

Quote

There is no denying the economic and social consequences of these containment efforts will be huge. But it is disingenuous of you to say that we shouldn't be doing them based on the fact that with the extreme distancing measures fully implemented the death toll might not to more than a couple times worse than the death toll during a very bad flu season.   --Dean

Edited April 2, 2020 by Sibiriak

[Gordo]

1 hour ago, Sibiriak said:

Economic crises are not simply a matter of material deprivation-- they can effect health and mortality as well.   Here's just one bit of evidence as an example,  (not that it is conclusive).  Of course, it doesn't have to be that way-- it depends on policy decisions.

Financial crisis caused 500,000 extra cancer deaths, according to Lancet study (2016)

 

I'm sure it will be very hard to quantify, but I think this pandemic will also end up causing serious and widespread health problems just from the stress and anxiety it caused alone (if anxiety levels could be measured for the country/world I bet it would be at an all time high).  The very fact that I keep hearing/seeing co-workers asking "are you alright?" tells me lots of people are NOT alright.  I've also seen many references to mental heath specialists offering free counseling and whatnot, people acting in strange ways, hysteria, etc.   Such an interesting time. 😉

[TomBAvoider]

I know it's wrong, and I chastise myself immediately, but my monkey brain slips in thoughts and moods I can't control. And those are often along the lines of "OK, that was a lot of excitement, but now it's getting boring"... "yeah, yeah, yeah, enough with the drama!"... "all this commotion, boy I'm over it, hard". I know it's wrong, and I immediately regret these thoughts/moods, but I wonder if more people won't start having them, and if they don't control themselves it might lead to acting out in unsafe ways wrt. social distancing and pandemic control measures (fortunately I would never act on such fleeting thoughts and momentary impulses).

So to Gordo's point about mental health, I suspect that if this goes on much longer, there will be a section of the population that will give in to various self-defeating impulses. People might break quarantine, visit friends, make illicit connections, socialize in unsafe ways etc. When all you hear around you is constant upbraiding and commands and reprimands and shaming, sometimes there's an impluse to say "F*** it all" and act out... I'm afraid it's part of human nature. People want to live fully, especially the young people, and constantly being shushed and cooped up and cautioned takes the fun out of life. I am confindent I can take it, despite my occasional non-PC thoughts, but what of those who lose their inhibitions - the longer this goes on, the bigger problem that may become. People will get tired and inured to it all and just screw off. YMMV.