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

[Dean Pomerleau]

Several comments/updates.

First, yes Thomas G, I know Josh and yes I agree that a major shock like this is likely to set off several geopolitical firestorms. I still am most worried about the stability of developing countries and the impact of a large wave of refugees in our already xenophobic climate.

Second, as I mentioned at the very beginning of this thread on January 26th (seems like a lifetime ago) that my only preparation going into this was a box of surgical masks I'd bought a few years ago during the MERS outbreak. Actually it was the avian flu scare in 2006, and when I dug out the box of masks I discovered I'd actually bought 800 of them, for something like $3 per box of 50. Since my wife and I are only going out to a public place (grocery shopping) every 1-2 weeks, we certainly don't need all those. So I contacted mask-match.com. They carefully vet the requests they get from healthcare workers, and I'm shipping out 7 packages of 50-100 masks each to hospitals in the Detroit and Chicago area where they have a serious need for them. Feels good to at least be to help, if only in a small way.

I kept 100 masks for me, my wife and daughter. Given the emphasis in the new guidelines on civilians using "cloth face coverings" rather than surgical (or N95) masks, I'm wondering if our wearing surgical masks in public will be frowned upon next time we venture out...

31 minutes ago, TomBAvoider said:

So all the Republicans - who are largely, though not exclusively responsible for these weaknesses - have to do, in face of such monumentally weak Democratic opposition, is to hold on fast and deflect all blame.

Speaking of politics. I heard an interesting theory today on a podcast I listen to (Robert Wright on bloggingheadsTV). He noticed that the "100-240k" US mortality estimate coming out of the Whitehouse is substantially higher than the IHME model (median 83k at the time of the WH projection) on which the WH claims to have based much of their projection. His speculation was that Trump and co. were attempting to exaggerate the death toll range and then declare victory and thereby attempt to redeem their botched response when the actual death toll comes in at or below the bottom end of their inflated range. 

It is an interesting theory. But as I said before, I thought the IHME projections were likely overly optimistic due to their rosy assumption about the speed and effectiveness of "stay-at-home" policies around the US. This seems to be bearing itself out, as the actual numbers seem to be coming at or above the IHME estimates, and even above the upwardly revised April 1st IHME estimate of 93k US deaths.

Speaking of revisions. On the IHME website, they had been prominently promising another update to their model on April 4th (yesterday) at the top of the page. That update still hasn't happened and they aren't even mentioning when/if another update will happen anymore. It's hard to know what to read into this missing update. Speculating, one possibility is that the IHME is reluctant to make another significant upward revision, or have been asked not to by the US government. Time will tell...

--Dean

[Sibiriak]

On 4/4/2020 at 12:02 AM, TomBAvoider said:

Sweden is unrepentant

But getting close to buckling under.  

Sweden prepares for possible tighter coronavirus measures as death toll climbs

 

[TomBAvoider]

The really discouraging thing is going to be if you cannot acquire reasonably durable immunity. I mean, if you can get at least 3 years, maybe it's bearable, but what if you only get a year or so? Then all the sacrifice that f.ex. Sweden and countries that count on toughing it out with "herd immunity" are willing to sustain will feel pretty hollow if all you get is 12 months at the cost of thousands of extra deaths. There's talk about a vaccine in 12-18 months, but I'll believe it when I see it. If CV becomes endemic, with low acquired immunity and a mutating virus, then that will be a terrible outcome.

[Gordo]

50 minutes ago, TomBAvoider said:

The really discouraging thing is going to be if you cannot acquire reasonably durable immunity. I mean, if you can get at least 3 years, maybe it's bearable, but what if you only get a year or so? Then all the sacrifice that f.ex. Sweden and countries that count on toughing it out with "herd immunity" are willing to sustain will feel pretty hollow if all you get is 12 months at the cost of thousands of extra deaths. There's talk about a vaccine in 12-18 months, but I'll believe it when I see it. If CV becomes endemic, with low acquired immunity and a mutating virus, then that will be a terrible outcome.

We may just end up wearing masks all the time when around other people, the masks may get more and more high tech over time, maybe eventually they will be so effective along with hand washing and not touching others that all the strains of this virus and others like it completely disappear. Wouldn’t it be amazing if the common cold and flu also got totally wiped out? We can dream...

Lots of encouraging signs this weekend with many European countries showing declines in daily new infections and deaths. It will be a relief when we see the same in the US. But I think the economic fallout is going to be long lasting regardless. We have entered a new deleveraging phase that will probably last 2-3 years and cause a lot of pain.

Regarding politics... if ever there was a golden opportunity for a third party candidate to have a legit chance at winning, this is it! Personally I’d really like to see the rise of additional parties. We’ve been stuck with “coke & pepsi” for too long. For this to work, the candidate would have to have broad appeal, drawing votes from both sides, plus the right personality and name recognition. Not sure who that might be. Mark Cuban was talking about running recently, but he definitely isn’t the right personality and would flop badly. Many are trying to get Cuomo to run, but he would simply split the Democrat vote and guarantee a Trump re-election. I’m sure there are some celebrities that could pull it off (similar to Arnold when he became governor of California).

Edited April 6, 2020 by Gordo

[Sibiriak]

10 hours ago, Dean Pomerleau said:

I still am most worried about the stability of developing countries

Cf. Primark and Matalan among retailers allegedly cancelling £2.4bn orders in ‘catastrophic’ move for Bangladesh

Quote

More than a million Bangaldeshi garment workers have been sent home without pay or have lost their jobs after western clothing brands cancelled or suspended £2.4bn of existing orders in the wake of the Covid-19 epidemic, according to data from the Bangladeshi and Garment Exporters Association (BGMEA).

Primark, Matalan and the Edinburgh Woollen Mill are among retailers that have collectively cancelled £1.4bn and suspended an additional £1bn of orders as they scramble to minimise losses, according to BGMEA. This includes nearly £1.3bn of orders that were already in production or had been completed.

[...] The BGMEA said the impact of the cancellations has already been “catastrophic” for Bangladesh. More than one-quarter of the country’s 4 million garment workers have already lost their jobs or have been furloughed without pay because of order cancellations or the refusal of brands to pay for cancelled shipments.

 

 

 

Edited April 6, 2020 by Sibiriak

[Ron Put]

3 hours ago, Sibiriak said:

But getting close to buckling under. 

Sweden prepares for possible tighter coronavirus measures as death toll climbs

 

Yep, political pressure. As we know, you can always find an expert to write a letter claiming that another expert is incompetent, or that "God did it."

Example: "Sten Linnarsson, a professor at Sweden’s Karolinska Institute, said the concern was that “there is really a lack of scientific evidence being put forward for these policies.”

Of course, we have lack of evidence that the lock down is impacting the spread much, since we have no idea how many are infected, but this has not stopped lock downs and economic shut downs.

Tedros from WHO first claimed that we should follow the China model because Covid-19 was stoppable, because it was not nearly as contagious as the flu. The flu, WHO stated, was too contagious to stop, so they don't attempt to contain it, even though it kills 600,000 to 1,200,000 each year.

And yet, we know that Covid-19 is considerably more contagious than the flu, so why are we following the China model, again? And the total Covid-19 world death toll is less than 1/20th of the 2017-2018 flu season, and is likely to remain lower.

Sweden is the nightmare for many a populist politician who got pushed for a lock down, so I expect enormous pressure is being exerted.

And Covid-19 will likely be coming back, joining the other four corona viruses endemic to human populations, 229E, HKU1, NL63 and OC43. And we'll learn to live with it, just like we have learned to live with the others, or with the flu. But this time, we shut down the world economy, and we'll reap the results for years to come.

Edited April 6, 2020 by Ron Put

[Dean Pomerleau]

Here is what I thought was a good from article the New York Times on how to manage the outbreak after the initial wave has passed but before a vaccine is available. It talks about balancing health care and the economy as well as people's individual psychological tolerance for continued isolation measures. 

--Dean 

[Sibiriak]

Exit strategies emerging:

Spain

Quote

In Spain, the daily number of deaths has declined for the fourth consecutive day, raising tentative hopes that the worst of the country’s outbreak is over.  [...]The Spanish government has said it is now studying the possibility of mass testing and isolating asymptomatic carriers of the virus.

 

Quote

Spain said on Monday it plans to widen coronavirus testing to include people without symptoms as a first step towards slowly easing a lockdown in the nation with the second highest death toll from the global pandemic.  [...]“We are preparing ourselves for de-escalation for which it is important to know who is contaminated to be able to gradually lift Spanish citizens’ lockdown,” Spanish Foreign Minister Arancha Gonzalez told TV station Antena 3.

While so far only those infected or suspected of having Covid-19 have been tested, now checks will focus on the wider population to try and find carriers who may not be displaying symptoms, Gonzalez said.

[...]Spain has been in lockdown since March 14 and prime minister Pedro Sanchez said at the weekend that would remain in place until April 26. However, Sanchez opened the door to easing some restrictions, such as keeping all non-essential workers at home, after Easter, even though shops and restaurants will stay shut.

 

Italy

Quote

Italy reported its lowest death toll in two weeks [...]  “The curve has started its descent and the number of deaths has started to drop,” said top Italian health official Silvio Brusaferro, adding the next phase could be a gradual easing of a strict month-long lockdown.

 

Germany

Quote

BERLIN (Reuters) - Germany has drawn up a list of measures, including an obligation to wear masks in public, limits on public gatherings and the rapid tracing of infection chains, that officials think should allow life to return to normal after lockdown’s scheduled end on April 19.

The proposals, contained in a draft action plan compilied by the Interior Ministry document and seen by Reuters on Monday, say the measures should be sufficient to keep the number of people infected by each person below 1 even as public life is allowed gradually to resume.

For this to be possible, mechanisms will have to be in place to track more than 80% of people an infected person had contact with within 24 hours of diagnosis. In return, schools will be able to reopen on a regional basis and strict border controls will be relaxed, the paper said.

Quote

In Germany, the Robert Koch is developing a similar app to that due to be introduced in Austria. It is being developed in conjunction with a European app which 130 researchers are currently developing, and will warn people if they might have had contact with infected persons. Its use is expected to be anonymous and voluntary, although surveys show a large number of Germans are prepared to use it if it leads to a relaxation of lockdown rules. The ultimate aim should be to have a single, Europe-wide tracking app.

Austria

Quote

The Austrian Chancellor, Sebastian Kurz, has said the country is planning to let smaller shops reopen next week, with the aim of reopening all shops and malls from 1 May. From then onwards, hotels and restaurants will open step-by-step from mid-May at the earliest, but a decision on that will come in late April. No events will be held until at least late June.  [...] Meanwhile general lockdown measures will be extended until the end of April, and schools will remain closed until at least mid-May.

Kurz also announced that from Monday, face masks will be compulsory on public transport.

Quote

The Austrian exit strategy will also include the introduction of tracking apps to trace citizens’ movements and ensure they are not breaking curfew rules. They should be used by the whole of the country. Those who don’t have a mobile phone will be required to wear a special key-ring style device, the chancellor said at the weekend. The majority of Austrians are said to be in favour of the measures.

 

Edited April 6, 2020 by Sibiriak

[Thomas G]

7 hours ago, TomBAvoider said:

If CV becomes endemic, with low acquired immunity and a mutating virus, then that will be a terrible outcome.

I'm re-reading the The Great Influenza about the 1918 pandemic and am about 70% of the way through it. One thing it mentions is that because the 1918 influenza was so deadly, as the virus changed through antigenic drift it actually got less deadly. So areas that didn't have a super bad first wave, but got a second or third wave, didn't have as high of a death toll.

There is no guarantee that will happen this time, but there is at least a chance that as time goes on and the virus shifts, it will shift to a more mild version.

6 hours ago, Gordo said:

We may just end up wearing masks all the time when around other people, the masks may get more and more high tech over time, maybe eventually they will be so effective along with hand washing and not touching others that all the strains of this virus and others like it completely disappear. Wouldn’t it be amazing if the common cold and flu also got totally wiped out? We can dream...

I'm a little bit surprised that we haven't seen more full-face masks (like a full-face snorkel mask) emerge as PPE. I'm expecting to see something like this emerge and be widely adopted. It has the benefits of covering the eyes, nose and mouth. It wouldn't even necessarily need to have a filter to be highly effective. Just wearing the face mask will stop people from touching their faces, and provide a material barrier for most droplets.

It would be fun to try to finally kill off the common cold just by denying it a host for a few years, but that seems very difficult. I do think that next year we will see an unusually high number of people get the regular flu shot and will develop some herd immunity against the seasonal flu at least for one year.

 

 

 

Edited April 6, 2020 by Thomas G

[Mike41]

Ha ha let’s go snorkeling!

Edited April 6, 2020 by Mike41

[Dean Pomerleau]

The IHME group has updated their model of projections for the US. Below are the graphs for New York and the entire US.

Their projection for NY hasn't changed much since the last update (discussed here). Peak on April 9th (April 10th last time) with a peak daily deaths of 878 (845 last time) and a total death toll of 15,600 (16,000 last time).

For the US as a whole, the current projection is a peak on April 16th (same as last time) with a higher peak daily deaths of 3130 (vs 2644 last time) but a quicker subsequent dropoff for a total death toll of ~82K (vs. ~96K last time).

So overall a bit of good news - slightly more optimistic projection than last time from the IHME for the upcoming several weeks in the US.

--Dean

 

[Sibiriak]

4 hours ago, Gordo said:

We may just end up wearing masks all the time when around other people, the masks may get more and more high tech over time, maybe eventually they will be so effective along with hand washing and not touching others that all the strains of this virus and others like it completely disappear.

That's actually not  so farfetched.    Most likely, though, people will revert to previous habits if serious danger recedes.

Modeling the Effectiveness of Respiratory Protective Devices in Reducing Influenza Outbreak (2018)

Quote

Abstract

Outbreaks of influenza represent an important health concern worldwide. In many cases, vaccines are only partiallvay successful in reducing the infection rate, and respiratory protective devices (RPDs) are used as a complementary countermeasure. In devising a protection strategy against influenza for a given population, estimates of the level of protection afforded by different RPDs is valuable. In this article, a risk assessment model previously developed in general form was used to estimate the effectiveness of different types of protective equipment in reducing the rate of infection in an influenza outbreak.

It was found that a 50% compliance in donning the device resulted in a significant (at least 50% prevalence and 20% cumulative incidence) reduction in risk for fitted and unfitted N95 respirators, high‐filtration surgical masks, and both low‐filtration and high‐filtration pediatric masks.

An 80% compliance rate essentially eliminated the influenza outbreak. The results of the present study, as well as the application of the model to related influenza scenarios, are potentially useful to public health officials in decisions involving resource allocation or education strategies.

 

Quote

Simulations revealed that a 20% compliance rate for people wearing RPDs showed some utility in reducing the spread of infection if the highest protection factor devices (e.g., PF > 7) were deployed, but overall did not have a big impact on the spread of infection due to the influenza virus. At a 50% compliance rate, however, the effect of the influenza outbreak was significantly reduced (prevalence cut by at least half) by all adult RPDs except the low‐filtration adult surgical mask. Similarly, the prevalence was reduced significantly for both children's masks when the compliance was 50% and the recovery rate was equal to or greater than the adult recovery rate.

At the 50% compliance rate for children, only the low‐filtration surgical mask and the reduced recovery rate result in a prevalence that is not cut in half relative to baseline.

At 80% compliance, an influenza outbreak is essentially prevented by all of the RPDs except the low‐filtration surgical mask, for both children and adults.

We conclude on the basis of the simulations that a roughly 50% compliance rate is recommended in order for RPDs that are likely to be used on an emergency basis to constitute an effective countermeasure. We also conclude that low‐filtration surgical masks (PF ⩽ 2) for adults would not provide an effective countermeasure even as a high rate of compliance, consistent with the fact that the masks were not designed for that purpose.

 

Respiratory virus shedding in exhaled breath and efficacy of face masks (April 3, 2020)

Quote

Abstract

We identified seasonal human coronaviruses, influenza viruses and rhinoviruses in exhaled breath and coughs of children and adults with acute respiratory illness. Surgical face masks significantly reduced detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols, with a trend toward reduced detection of coronavirus RNA in respiratory droplets. Our results indicate that surgical face masks could prevent transmission of human coronaviruses and influenza viruses from symptomatic individuals.

 

Quote

Our findings indicate that surgical masks can efficaciously reduce the emission of influenza virus particles into the environment in respiratory droplets, but not in aerosols¹². 

[...]We also demonstrated the efficacy of surgical masks to reduce coronavirus detection and viral copies in large respiratory droplets and in aerosols (Table 1b). This has important implications for control of COVID-19, suggesting that surgical face masks could be used by ill people to reduce onward transmission.

 

[TomBAvoider]

It seems there may be cardiac damage not just lung damge from this virus:

Mysterious Heart Damage, Not Just Lung Troubles, Befalling COVID-19 Patients

"While the focus of the COVID-19 pandemic has been on respiratory problems and securing enough ventilators, doctors on the front lines are grappling with a new medical mystery.

In addition to lung damage, many COVID-19 patients are also developing heart problems — and dying of cardiac arrest.

As more data comes in from China and Italy, as well as Washington state and New York, more cardiac experts are coming to believe the COVID-19 virus can infect the heart muscle. An initial study found cardiac damage in as many as 1 in 5 patients, leading to heart failure and death even among those who show no signs of respiratory distress."

[Sibiriak]

Thousands of NY COVID patients are being treated with anti-malarial drug [hydroxychloroquine]

Quote

As many as 4,000 seriously ill coronavirus patients in New York are being treated with the anti-malarial drug hydroxychloroquine, state health officials say .[...]Gov. Andrew Cuomo last month said health care providers in the state would be using the drug in combination with the antibiotic Zithromax, or azithromycin, for some last-ditch cases, based on potentially promising research.

“Time is of the essence,’’ Albany University Public Health Dean David Holtgrave, who is on the state’s research team, said in a statement.  A state Health Department official said the DOH has shipped doses of hydroxychloroquine to 56 hospitals across New York, distributing enough “to treat 4,000 patients to date.”

Patients have received doses as part of four- or 10-day regimens, officials said.  The University of Albany’s School of Public Health is observing the drug’s impact on the patients, and its preliminary study could come back in weeks instead of the usual months, officials said.

There are also clinical trials being conducted to see whether the drug can help block transmission. NYU Langone Medical School is conducting a random trial with a $9.5 million grant from the Bill & Melinda Gates Foundation [...]

 

 

 

[mccoy]

3 hours ago, TomBAvoider said:

It seems there may be cardiac damage not just lung damge from this virus:

Mysterious Heart Damage, Not Just Lung Troubles, Befalling COVID-19 Patients

"While the focus of the COVID-19 pandemic has been on respiratory problems and securing enough ventilators, doctors on the front lines are grappling with a new medical mystery.

In addition to lung damage, many COVID-19 patients are also developing heart problems — and dying of cardiac arrest.

As more data comes in from China and Italy, as well as Washington state and New York, more cardiac experts are coming to believe the COVID-19 virus can infect the heart muscle. An initial study found cardiac damage in as many as 1 in 5 patients, leading to heart failure and death even among those who show no signs of respiratory distress."

Lungs, heart and kidneys.... At the beginning, maybe even presently, it was uncertain if it was related to organs damage because of poor oxygenation. Also, possible neurological damage even to the CNS.

I don't know when we are going to have more detailed news.

Edited April 6, 2020 by mccoy

[Ron Put]

23 hours ago, Dean Pomerleau said:

... I heard an interesting theory today on a podcast I listen to (Robert Wright on bloggingheadsTV). He noticed that the "100-240k" US mortality estimate coming out of the Whitehouse is substantially higher than the IHME model (median 83k at the time of the WH projection) on which the WH claims to have based much of their projection. His speculation was that Trump and co. were attempting to exaggerate the death toll range and then declare victory and thereby attempt to redeem their botched response when the actual death toll comes in at or below the bottom end of their inflated range. 

It is an interesting theory. ...

It's a very partisan spin, but not much of a theory. It troubles me that I am finding myself defending Trump, but the fact is that when Trump tried to be optimistic and talked about this being about as deadly as a bad flu year, he was attacked for being out of touch, not listening to the social-media and mainstream media approved experts and downplaying the whole thing. This was the reason Cuomo and Newsom were hailed by the media as the embodiment of "leadership" when they shut down their respective economies (only to immediately start demanding a federal bailout).

Trump is a populist, so he changes his tune, depending on what's politically expedient -- just like Boris Johnson does. If the media wants doom and gloom, he can deliver. If the Democrats want to spend, he can outspend them. So, now we have no spending limits and grave warnings about the impending deaths to come. No matter that the death toll is likely to be lower than that of the 2017-2018 flu.

3 hours ago, TomBAvoider said:

It seems there may be cardiac damage not just lung damge from this virus:...

As more data comes in from China and Italy, as well as Washington state and New York, more cardiac experts are coming to believe the COVID-19 virus can infect the heart muscle. An initial study found cardiac damage in as many as 1 in 5 patients, leading to heart failure and death even among those who show no signs of respiratory distress."

Nothing new under the sun, except for sensationalist speculation. Viral infections can impact many systems, but adding "mysterious" to the headline makes it all so much scarier. Here is an old example of a variation from a different era: H1N1 flu can attack the heart

And to remind us how different the media coverage was back in less polarized times:

Apocalypse Not: Behind the Swine Flu Hysteria

Remember, in 2009 WHO did not even recommend testing for infections, they decided to treat the swine flu as another flu wave, even though it was much less infectious than the flu and thus possible to contain (which was the initial basis for the WHO recommendation why the world should follow the China model in the case of Covid-19). The Obama Administration was resisting calls to test at the time, and at the end it never did in the US, which is why there were never official numbers, just guesses. A repurposed vaccine became available after the wave of infections had peaked. But we had just had the market crash of 2008 and nobody even considered a shut down. Social media was not as inflammatory and the news media was generally sympathetic to Obama, so they were not searching for alternative "great leaders" to push in the headlines. 

The 2009 swine flu pandemic killed close to 700,000 people worldwide in only a few months -- as opposed to the 70,000 or so world deaths after months of Covid-19. It's clear that 2020 is a whole new political ballgame.

Edited April 6, 2020 by Ron Put

[Ron Put]

My guess is that we'll witness a major media push to paint Sweden as crazy and try to force the political class to override the recommendations of its own experts (ah, the irony...). I am noticing a growing crop of articles trying to stoke fears (even though the mortality rate is still much, much lower than that of the flu and is not dramatically different per capita than in the locked-down Scandinavian economies). Fear is contagious and I am afraid that at some point the media onslaught, exploited by political opportunists, will have the desired effect.

https://www.forbes.com/sites/gabrielleigh/2020/04/05/sweden-has-no-coronavirus-lockdown-but-can-it-last/#239a397a5f91

Bad, bad Sweden! And full of racists, in addition to being "irresponsible!"

[Todd Allen]

1 hour ago, Ron Put said:

The 2009 swine flu pandemic killed close to 700,000 people worldwide in only a few months -- as opposed to the 70,000 or so world deaths after months of Covid-19.

You keep comparing things which have run their course to something just getting started.  More than half of the covid-19 deaths have occurred in the last week.  Look at these graphs and try to imagine what the future could be.  Imagine how much worse this would look if it wasn't shut down in China with an aggressive containment policy.   Imagine how much worse it might be in Europe and the US without the extensive mitigation efforts.

[Dean Pomerleau]

Here is a rather disturbing Twitter thread by Mark Levine, chair of New York City Council health committee:

He later clarified that the "temporary interment" idea is only a contingency plan that he hopes won't be necessary, but the morgues and freezer trucks are nearly full.

It is troubling that he estimates nearly 200 excess deaths per day are occuring in NYC that are very likely coronavirus cases but aren't being counted because they are no longer testing people who die outside of a hospital setting.

It seems likely in places where the system is overwhelmed (or close to it) we may never have an accurate count on the number of CV-related deaths, or deaths from other causes that wouldn't have occurred had it not been for the CV-induced strain on the medical system. When this wave is over it will be instructive to look at total deaths around the peak to try to estimate the number of deaths in excess of what would be expected during normal times and thereby get a more comprehensive picture of the actual death toll.

--Dean

[Gordo]

One thing I noticed in my area today at the grocery/produce store is that almost EVERYONE is now wearing masks and gloves (including employees), that really happened suddenly, I guess when the CDC recommended them people took it seriously.  My Dad texted me a picture yesterday of himself in the mask my Mom sewed him, complete with protective eye wear (he is 80 and in good health).  I think (based on the study Sibiriak posted) this is going to help a lot.  Nice to see new deaths dropping in New York.  I still think when all is said and done this bad boy will end up killing fewer people than the flu did last year (both in the US and globally) but only time will tell - I do think the mitigation efforts (change in personal behavior) are an important reason for this.  I'm sure even in Sweden people are not behaving as if the pandemic didn't exist - it will be a valuable data point for future reference as to tight lock down / stay at home, vs. other types of strategies.  I think the anonymous contract tracing apps I've read about might be helpful with future outbreaks (and maybe with this one too).  I know some people will freak out about these and not trust them (reminds me of vaccines)...

The other aspect that fascinates me is the possiblity that total US and maybe global deaths will decline overall because of the pandemic.  Governor Cuomo even made some comments about this in his daily briefings - he said hospitals are seeing fewer non-coronavirus related patients (he mentioned traffic accidents are way down).  I expect all infectious disease deaths to decline this year, including the flu.  Although this may be offset by deaths related to people avoiding medical care either because they lost their health insurance or they are just paranoid about going to doctor's offices or hospitals due to coronavirus.

The stock market SOARED today (up 7% across the board pretty much) so investors seem to be betting on a more optimistic view as well (only time will tell how that works out, personally I think we have entered a new deleveraging phase independent of coronavirus that will result in a larger sell off over the coming 2 years but who knows that is just a guess).

Edited April 6, 2020 by Gordo

[Ron Put]

1 hour ago, Todd Allen said:

You keep comparing things which have run their course to something just getting started.  More than half of the covid-19 deaths have occurred in the last week.  Look at these graphs and try to imagine what the future could be.  Imagine how much worse this would look if it wasn't shut down in China with an aggressive containment policy.   Imagine how much worse it might be in Europe and the US without the extensive mitigation efforts....

Not really true. The "don't panic" Wired article was at the beginning of the swine flu epidemic, when it was considered to be particularly deadly and 5 months before a vaccine emerged. The media and social media did not relentlessly drive us to panic with hour by hour death rates and accusing the government of failure to act.

In 2020, things are much different and we have nonsense like this: After Grassroots Uprising, AZ Governor Issues Stay-At-Home Order To Prevent Spread Of COVID-19

"imagine" is the problem here. As John Ioannidis noted in the article I posted earlier, we are following a model of extreme measures based on apocalyptic, worse-case scenarios created out of bad or non-existent data. Politics and the media frenzy have closed the ability to have a reasoned discussion exploring all options, drumbeating all of us into an economic destruction with unknown social consequences.

And yes, we can guesstimate the number of dead in places like Italy, which is at less than 14,000 total as of today and dropping. Which means that it is unlikely to reach the mortality level of the 2017-2018 flu season. BTW, there is informed speculation that the mortality rate in Italy was so high because the flu season was had been so mild that a lot fewer of the "at risk" population died from the flu than usual, which left a lot more of them susceptible to Covid-19.

And it is far from clear that the lock down has any significant effect on the spread -- as WHO stated, we do nothing about the flu because it spreads regardless, with a reproductive number of 1.3 - 1.7. The estimated reproductive number for Covid-19 is 2.3, which means that it spreads even easier.

So, I'll ask again, if WHO and the rest of us do nothing about the flu because it is too easily transmissible, what is the logic behind the argument that we can contain Covid-19 by following Cina's example, when Covid-19 is even more easily transmissible?

Edited April 6, 2020 by Ron Put

[Ron Put]

32 minutes ago, Dean Pomerleau said:

... It is troubling that he estimates nearly 200 excess deaths per day are occuring in NYC that are very likely coronavirus cases but aren't being counted because they are no longer testing people who die outside of a hospital setting....

What's much more troubling is why the comparisons are always to 9/11 or the Vietnam War, aimed at purposely amplifying the public fear from the numbers, instead of comparing Covid-19 to mortality numbers of past flu seasons?

Because if we compare to past flu seasons, the numbers don't look dire. And the morgues have been full during past flu seasons, and we've had overwhelmed emergency rooms, too. And neither NY state, nor CA report flu deaths -- CA counts only flu deaths in hospital patients over 65.

Why are we all not troubled by any of this?

Edited April 6, 2020 by Ron Put

[Todd Allen]

17 minutes ago, Ron Put said:

And yes, we can guesstimate the number of dead in places like Italy, which is at less than 14,000 total as of today and dropping.

You probably believe in resurrection but the number of dead is not dropping.

According to worldometer Italy has 16523 dead with 636 having died today.  This is a tally of official figures which mainly counts those that have died in hospitals and misses most that have died elsewhere.  None of the flu figures you quote are rigorous tallies but rather calculated guesses computed afterwards.  You need to give covid-19 time to play out and for similarly calculated figures to be produced before your apples and oranges comparisons can have any meaning.  

Edited April 6, 2020 by Todd Allen

[Ron Put]

7 minutes ago, Todd Allen said:

You probably believe in resurrection but the number of dead is not dropping....

Huh?!!

Signs of hope in Italy as daily death toll falls again

And, I guess my questions above won't be answered.... Just a reminder: If WHO's argument is that we do nothing about the flu because it spreads too easily, but that we should follow the China containment model for Covid-19, because it doesn't spread easily, and if that argument is based on a false premise (because the fact is that that Covid-19 is even more transmissible than the flu), what is the logic behind arguing that we should still follow the China model?

Edited April 6, 2020 by Ron Put

[Todd Allen]

3 minutes ago, Ron Put said:

Huh?!!

Signs of hope in Italy as daily death toll falls again

And, I guess my questions above won't be answered....

You have confused death rates with the number of dead.  Despite a slowing of the death rate the number of dead is increasing.  The death rate is currently a noisy signal.  It is down from its peak but it is up by nearly 20% from yesterday.

Don't take the lack of answers personally, most of Fernando Gabriel's questions don't get answered either.