But I'm not hearing much talk about the next phase. Maybe you can point me to some articles on this subject. When do we reemerge? What are the possibilities? My rough understanding is that if we had not taken on this curve-flattening strategy, the virus would have hit like a tsunami. Trump used that water metaphor in his speech yesterday:
Some of the doctors say it will wash through, it will flow through. Interesting terms and very accurate. I think you’re going to find in a number of weeks it’s going to be a very accurate term.That made me think: So the same amount of "water" is going to get in, but it will hit much more gently, more slowly. And it would speed up again if we returned to normal life, I take it, unless we do social distancing until the flow-through process is complete. My unscientific sense of what needs to happen is that large numbers of Americans need to slowly get the disease and recover with acquired immunity before we can resume normal life. We just need to make that process happen slowly.
Perhaps we can't know how long social distancing will be needed until we see how much we've managed to slow the process down. Maybe the process will be calibrated by increments of ending social distancing. And some of the distancing may never end — should never end. I know I stopped touching doorknobs in public places decades ago. Thinking about what you are touching, washing your hands and not touching your face, covering coughs and sneezes, and getting 6 feet away from anyone who acts sick — these are things we will do well to make a permanent part of life.
Maybe social distancing will balance out in the next 2 months, with many precautions feeling normal and extreme aspects of social avoidance gradually seeming less important.
But I anticipate looking back at this post in 2 months — and I am planning to live — and thinking oh, if you only knew! 2 months?!! Ha ha. No wonder they didn't tell you how long this would take!
But there, now, I've said it. Message to future me: See? I wasn't naive. I knew.
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https://www.thelancet.com/action/showPdf?pii=S0140-6736(20)30567-5&mod=article_inline
Baseball is shutdown until June. That probably gives a good idea of the soonest we can emerge.
I am ashamed to admit it, but in the winter, I live in a gated community. Largely because I can leave my house at the turn of a key in the lock and come back next year and everything will be just like it was. I can’t believe that they still are doing valet parking though. There are so many elderly people who use it, because they can’t really walk very far, I can’t think of a more perfect vector to spread this around a vulnerable community like the people who are too feeble to self park and walk up the hill to the restaurant.
They should use the valet drivers to deliver meals to those people who can’t self park rather than put the drivers out of work.
I can tell you that the American Academy of Family Physicians has cancelled all meetings to the end of May. I myself am cancelling high risk patients and rescheduling in June, to keep them out of the office. I think the general feeling is three months, but this is subject to change.
I think it will matter what the actual results are. Remember: There are people telling us we were already too late, and we're going to be overwhelmed. We've been warned to expect Italy-like consequences when we hit the same amount of days as them.
If *nothing* happens, then social isolation will have mystery data. Was it needed? People will say yes, but other people will say no. A lot of other people will say: There's no real way to tell, but our best guess is X, Y or Z.
If something little happens, then there'll be a stronger argument to keep it going.
If people start dropping dead in the large numbers the doomsayers are claiming, well, then I'll be on ebay bidding for toilet paper.
Heh. Present Ann talking to Future Ann. I never thought of this blog as that, too.
"If *nothing* happens, then social isolation will have mystery data. Was it needed? People will say yes, but other people will say no. A lot of other people will say: There's no real way to tell, but our best guess is X, Y or Z.”
I spent three years working on various projects to minimize the impact of Y2K, like thousand of other programmers, and today it is a tag line for jokes about scares about nothing.
Maybe I missed a memo, but I thought there were issues about the extent to which a CV19 infection results in acquired immunity.
oh, if you only knew! 2 months?!! Ha ha. No wonder they didn't tell you how long this would take!
I assume this is what the toilet paper hoarders are thinking.
I don’t think anyone’s gaming out the next phase because it’s still too unknown. Here’s my fear....we come through this in 1-2 months and successfully transition back to normalcy, and the virus is dying out partly because of the social distancing measures and partly because of weather.
Then it comes roaring back next year, and the same people who are currently complaining say they’re not going to comply with self isolation again because they are convinced that it was all unnecessary this time. Isn’t that basically how things went in 1918?
Compared to Asians and Europeans, Americans already practice a sort of "social distancing".
We're less physically demonstrative [no incessant kissing on both cheeks like the Latins] and we tend to live farther apart due to the prevalence of single-family homes.
Maybe it'll help.
Order of magnitude estimate.
Need to drive down effective R0 for disease to less than 1. Course of disease is approx 14 days. If social distancing was perfect, then 14 days would be sufficient. If some slippage is allowed snd R0 approaches 1 then would need to double the time forsubsequent infections to run out.
So, IMHO, say 1 month.⁰
Most likely, it will peter out in the Northern hemisphere along with the flu and then next fall it will return with the flu and we will get inoculated as we do with the flu. I plan to take zero permanent measures, and when I get sick (which everyone does from time to time), I will stay home and feel like hell for a few days.
Check this out, Doctor from John Hopkins
https://youtu.be/ZhYcbo7rqEQ
as well as this
https://youtu.be/E9vIUtXa9ug
Based on my reading about the 1918 pandemic, which I'm finding really interesting, it seems that many cities back then kept the measures in place for about a month. But...there were additional waves of the flu that swept through and cities that had loosened up on the public gathering restrictions, etc., suffered more than they would have if they'd kept the measures in place for 6 months or so. This is assuming that they weren't already devastated by waiting too long the first time, which is what Philadelphia was guilty of, holding a parade, etc., and waiting over 2 week before implementing measures after the first case was diagnosed. My reading also reminds me how important good local government is, at the city/state level. Don't be waiting for the federales to show up.
Given that we now have much better hygiene products, better understanding of how things spread and no world war ending with the movement and chaos that brings, I'm thinking 3 months is more likely. Not that I know.
PJ said...
Maybe I missed a memo, but I thought there were issues about the extent to which a CV19 infection results in acquired immunity.
I've seen that, too. Maybe it is an artifact of testing. I hope so.
CStanley, respectfully, this is not 1918
Dan
Blogger Sydney said...
I can tell you that the American Academy of Family Physicians has cancelled all meetings to the end of May.
I wish they’d be as proactive about setting protocols.
My 10 year old woke up this morning with a low fever and cough. I’m not overly concerned and we were starting our 14 day isolation anyway, but I called the pediatricians office just to get guidance in case she worsens and find out if or when a test might be indicated (and of course trying to figure out if there’s a way to get tested yet that doesn’t involve exposure to ER waiting rooms.) The nurse asked “What would be testing for?”
I mean c’mon. I was perfectly calm, it’s not like she had reason to think she needed to downplay this to keep me from panicking. She also did not say one word about keeping her isolated. What is all of our public health funding for if primary care doctors and their staff aren’t even trained to make sure people know basics during a pandemic?
C Stanley's comment seems wise. Warmer weather should cause the virus to die out, possibly soon, possibly not until heat of summer. That's when we need to amp up the efforts for a vaccine before next fall/winter, and hope that the vaccine works to protect us from the virus as it has evolved.
Does anyone know anyone who has covid 19? I am seriously asking because I have asked all of my family, they have asked people and mo one knew of anyone even sick. Where we are, mo one is sick or even sniffling and no one here has heard of anyone being sick. We are not self distancing because most of us are laughing at you idiots for hoarding toilet paper. If anyone was sick we would know because news travels fast, but no one knows anyone sick. I will bet you a million dollars that by May, this will be fading from memory and you all will be left with years of toilet paper.
IMHO. Order of magnitude is approx. 2 times the quarantine period of 14 days. This allows for transmitting to others in limited cases (effective R0 < 1) since social distancing - "100% population quarantine" will be imperfect.
Blogger Dledhead said...
CStanley, respectfully, this is not 1918
Clearly true but human nature doesn’t change. My comment referred to what I assume played a role then, people being cavalier to risk after an incident when risks were mitigated to a significant degree.
Hopefully if my hypothetical plays out we’ll have a vaccine in time.
All of this flattening works, until you factor in real people's lives.
The ones who can afford to 'distance' themselves are a subset, not the whole: those well-off, retired, or have work where working from home is possible.
However, some will be out of a job, and that number will grow quickly in the weeks ahead. ( I know a few already affected -- cut hours -- and one stadium employee laid off). Those jobs will not all come back like the flick of a light-switch when the elite feel like they are safe. Or bored with the distance thing. Dominoes are falling.
And -- meanwhile -- many will be out working the jobs we will still expect to rely on: grocery clerks, gas station employees, maintenance, truck drivers, Amazon fulfillment people, delivery, etc.
Or are the ones preaching extensive measures willing to forego the needs for such services?
How many people were at risk in the production, delivery and sale chain that got that toilet paper to your home?
Take the challenge: go without toilet paper for two weeks to let us know you mean it.
Marie Antoinette understands.
I am Laslo.
I read a good case for the UK approach of just letting 'er rip, all at once, to build herd immunity quickly. Then it won't keep coming back.
It's somewhere on the net - against flattening the curve.
Maybe it was that useless Lancet link at the top here.
Megthered, where do you live?
I don’t know anyone personally but there are cases in the communities where we live and where my kids go to school. It’s not like a virus infects people in every community all at once.
I read a good case for the UK approach of just letting 'er rip, all at once, to build herd immunity quickly. Then it won't keep coming back.
It's somewhere on the net - against flattening the curve.
Maybe it was that useless Lancet link at the top here.
I read a good case for the UK approach of just letting 'er rip, all at once, to build herd immunity quickly. Then it won't keep coming back.
Yeah, I posted that the other day. The actual disease seems pretty mild unless you're a high-risk group, so I'd say the best overall strategy is for everyone else to avoid major changes in lifestyle.
It's not possible to stay 6 ft away from someone who is sick. People can't work or interact that way. The economy can't just be put on pause either, which means people will have to go forth and work hard like they do 5-7 days a week.
Althouse, this crisis is not bringing out the best in your personality. You’ll be right 2 months from now? Good grief. Being “right” about this hardly sounds like a glittering prize.
Does anyone know anyone who has covid 19?
Nope.Kind of surprising in that of a California population of a mere 39,500,000 there seems to be almost 250 cases.
The idea of flattening the curve is to attempt to have as many medical staff, bedrooms along with masks, ICU units and ventilators free for the people who are drowning in their own lung fluid. Double sided pneumonia is brutal.
And young people also are affected, it all depends if the infection stays in your throat or gets into your lungs.
If you had tonsils removed, beware.
How many sick people in Wisconsin? About 10 in Nebraska and they have been brought here for treatment!
Good news is, this situation will result in below average deaths from other flu.
With that in mind, I suggest, again, that it become a yearly practice world wide to close down and isolate for several months. Using this year as a learning experience, and building upon that experiance, it will become much easier as time goes on.
No need to rush out at last minute for TP. We will collect it during the year.
I Amazoned some cases to friends as a humorous Christmas present. While they complained about the quality then, they are thanking me now.
Living here in WA where 37 out of 47 USA deaths have occurred, I'll be your scout. When people start rejoining the world in person, I'll let you know.
we're flattening out the curve to lighten the load on the health system. But most of us will get the virus. Sooner or later. Its not a death sentence. You can argue the British are taking the right approach but in the USA everyone gets hysterical. its a good thing no major USA city was bombed during WW 2, you can imagine the mass panic and hysteria.
There will come a day when there is a preference cascade of people saying "Fuck this shit" and going back to their regular lives. Who knows when that will be?
Isn'tit fascinating that Sleepy Joe Biden, after cursing out autoworkers and putting on a bizarre 4 minute digital "townhall" where he wandered around aimlessly and couldnt remember when the next President would take office, STILL opposes travel bans!
Yep, gropey Joe would still have flights cranked up to bring in load after load of passengers from global hotspots as well as wide open borders with no enforcement.
My firm belief that all these models about overwhelmed hospitals, many sick and dead will be proven DEAD WRONG.
Dr. Anthony Fauci said models depend upon assumptions.
The warm weather is a key thing!
Maybe these WRONG.models and assumptions about Covid19 will wake people up about the CAGW scam. Same problems. Same people.
I went and grabbed 5 Guys burgers yesterday afternoon. The place was packed. As was Target.
The uncertainty is the main problem. There is actually a ways to fix that, but probably unthinkable as a political option in a western democracy-
(1) controlled inoculations with live virus- you start with the people most able to self-isolate for the two weeks necessary to account for the infectious stage, then inoculate the next wave, etc. You do this while, completely as possible, keeping the most vulnerable to death isolated for 10 weeks I would guess this approach would take;
(2) world-wide imposed isolation of everyone for a month in their homes. If you could get 90% compliance, you would probably force the virus to die down to unmeasurable by the end of the period- the Chinese did this Wuhan/Hubei, so we know it can work.
The problem with #2, though, is that there is still the uncertainty that the virus is actually vanquished. It might look dead at the end of the global quarantine, but then reappear next Winter, at which point you are right back where you started with little herd immunity, and with a lot more social resistance to the measures you took the first time. Additionally, you now start with even fewer economic resources with which to fight this because you are facing the reemerged pandemic in the middle of an economic depression.
I have written it many times- I think the virus was circulating long before the Chinese identified it- we are kidding ourselves that we are only 4 weeks behind the Italians/Iranians in the spread- the only difference is those two countries had the misfortune of having the outbreaks start inside the more vulnerable types of victims (sort of like a larger version the Kirkland, Washington critical care facility). The only difference between Italy and, let's say, Germany is that the Germans have done a better job of protecting the most vulnerable, and that the Germans probably have better medical facilities for treating such victims.
The point is to slow the spread and keep it manageable until the weather warms up and the humidity rises. Nearly all of us will get it at some point and most of us will think it’s a common cold or flu. But a certain percentage will need medical care and we only have so many beds, so the name of the game is to “flatten the curve” for the time being and hope our hospitals can keep up with the cases. Probably in late April or early May things will return to normal.
“Then it comes roaring back next year, and the same people who are currently complaining say they’re not going to comply with self isolation again because they are convinced that it was all unnecessary this time. Isn’t that basically how things went in 1918?”
Yes, that what I’ve been reading. The Spanish Flu lasted 15 months and in that 15 months 50 million died. I don’t think we will get anywhere near those numbers because of the mitigation techniques and modern medicine, but maybe because that’s how long it takes to develop herd immunity? I think we can get to the herd immunity point in a slower more controlled way (by flattening and prolonging the curve) than just letting it rip through unabated. At least healthcare systems could handle it better.
Expect it to pretty well disappear by summer then come back in the fall.
Isolation is impossible; all that can be done is limit the growth so that medical facilities can handle the load. A serious percentage of the population will get it. The level of isolation and control to slow it down is impossible to maintain over time.
I'd suggest instituting a rum ration for medical personnel. They are going to need it.
Worst case, “Between 160 million and 214 million people in the U.S. could be infected over the course of the epidemic, according to one projection. That could last months or even over a year, with infections concentrated in shorter periods, staggered across time in different communities, experts said. As many as 200,000 to 1.7 million people could die.”
There are 330 million in the entire US.
Projections use models and assumptions. Opinion!
All of this flattening works, until you factor in real people's lives.
The ones who can afford to 'distance' themselves are a subset, not the whole: those well-off, retired, or have work where working from home is possible.
However, some will be out of a job, and that number will grow quickly in the weeks ahead.
Yep, and many forced to miss work are living paycheck to paycheck, or have minimal savings. People with credit card debt, kids to feed, utilities and rent or mortgage, car payments, insurance, cell phone and cable bills. That stuff not going away.
I predict a month,maybe less. No more than six weeks before we get the all clear sign. Doesn't matter how good or bad the situation is, the message from above will be that danger has passed, although caution still advised.
Social distancing is fine but not sustainable. But when it is relaxed, we need to follow the lead of places like Taiwan and Korea, and just wear masks whenever we're in large crowds during flu season. Mask doesn't protect you, it protects other people. And it's not 100%, but it's enough that if everyone follows mask etiquette, you can reduce trasmission. And it is a lot cheaper than literally shutting everything down.
That and sanitizer in all public places, and more attention to the cleanliness of public spaces too.
Hopefully the USA will have enough masks for its population. Hopefully america will start making their own masks again. China makes 95% of masks for america. in hong kong, people are always wearing masks when they go out.
I think this will be the new normal for the next couple of months. MASKS!
If there are no major developments in the next two weeks I think you'll start to see people returning to their normal routines in large numbers.
If everything starts going to Hell then wait until at least May.
Random thoughts and observations...
Social distancing officially started at our house.
My company starting 2 weeks work from home.
Should not trust any info coming from China.
Federal and state authorities in uncharted waters - actions based on last crisis - consider their goals.
Kids played 2 hours of online quiz games with Amazon Alexa last night. Today she speaks with an Indian accent.....
It has started.....
I went and grabbed 5 Guys burgers yesterday afternoon. The place was packed. As was Target.
Musta been a heck of a line with everybody maintaining a six foot distance
Yeah, fuck the Chinese. They started it and then made it way worse. There should be a peasant revolt. With guns!
This seems like a panic to me, bordering on mass hysteria. The vast majority of those who catch it recover. If you are over 70 and have underlying medical conditions, then the recover rate is about 95%.
I agree completely with taking extra precautions. Wash your hands. Use hand sanitizer. Take some time to do an extra cleaning of frequently touched surfaces with a Clorox wipe.
But the entire country seems to be in race to see who can overreact the most.
There are no solutions, only tradeoffs. We accept the risk of driving, even though it kills tens of thousands every year. It's a tradeoff we make.
We are introducing a culture of fragility into our daily lives. Do we do this every flu season from now on? What about all those who can't "work from home". Do we destroy their lives to save ourselves the bother of getting sick for a week?
People are going to tire very quickly of this, and demand a return to something like a normal life very soon.
I love studying history, but honestly, its mostly bunk. Even the accurate history is mostly irrelevant, since essentially every variable beyond human physiology is different. Yes, Spanish Influenza '18, I'm looking at you. The useful flecks of knowledge we might get from studying the Spanish Flu are going to be obscured by the overwhelming avalanche of dross.
Generals always fighting the last war, blah blah
"large numbers of Americans need to slowly get the disease and recover with acquired immunity before we can resume normal life"
Yes. Particularly younger Americans. More particularly nursing and med students.
Althouse and Meade, stay away from the rest of us. I mean, physically.
Once the water really starts flowing, let it flow around the most vulnerable groups -- who need to quasi-quarantine to the extent possible.
I just checked. ZERO deaths in WI.
Is this worse than a two-month jail sentence? Nah. Much better. And you can do almost anything you want, including exercise. And let's face it: you are both guilty of something. Two months of home-detention for you--plus take those sunrise shots, but come right back. Promise?
We just canceled a much anticipated 10 day trip to England. The flight was yesterday; today we would have been on the ground. Shakespeare has gone home to Stratford. But we'll take the trip later this year.
I suspect, but will never be able to prove, that the messages "stay home if you are sick" and "wash your hands five times more often, every chance you get" effectively communicated would have been almost as effective in slowing this down as broader social distancing and closure orders, with less impact on the economy. But over-regulation is the order of the day.
"When do we reemerge?"
Such a silly question Professor. We reemerge only after the Zombie Apocalypse is over!
Does anyone know anyone who has covid 19?
I bet it's all those Nixon voters.
just wear masks whenever we're in large crowds during flu season
Wouldn't that be illegal in a lot of places?
I've already heard news stories about some businesses starting to lay people off. This should help slow things down quite a bit. Let's just hope some folks are left with jobs to provide Althouse and those with means the necessary goods and services to continue their self isolation.
Meh, this is America. Go forward a week, maybe two. Except for elderly and the frail, people who feel particularly endangered, self-isolation will be in direct proportion to the presence of the threat in that community. Fad panics cannot be sustained. After awhile, people need to see the bodies heaped up .
The neighborhood grocery store around the corner was jammed at 7:45 last night, and again at 8:15 this morning. The manager, with a smile on her face, says it has been going on like this for three days.
They had about 15 running feet of toilet paper stacked three levels high on display. But we have always known that Chicagoans are full of doo-doo.
Meg The Red asks: "Does anyone know anyone who has covid 19?" In the US, with a population of 330 million and with < 2000 cases of virus, If you know 1000 people, there is less than 1% chance that one of those people has the virus (0.6%). Here's the chart:
https://marginalrevolution.com/marginalrevolution/2020/03/covid-19-event-risk-assessment-planner.html
"200,000 to 1.7 million could die"
Fine. But this is not the best way to think about the trade-offs. The question should be, how many QALYs will be lost? How many QALY losses are we likely to prevent, and at what cost?
If 200,000 die, that is less than one-tenth of one percent; if most of those are very sick and over 80, the QALYs lost will be modest. 1.7M is a different story. But balance that against the losses caused by the containment impact. Hard to do, of course, but we should try.
So far, younger people seem to handle the virus well, which is encouraging. Going forward, that may mean selective isolation of particular groups, not universal social distancing.
The ones who have promoted this panic may not be so quick to call it off. Then it will only end when we revolt. What will that be like?
The really strange thing in the last few days. Democrat Governor Newsom praised Trump's response to the virus spread on Monday, and Democrat Governor Cuomo did the same later in the week.
Someone read them the riot act? Is there something being held over them? This is unprecedented Democrat behavior since election day 2016, Democrats praising or giving any credit to Trump and/or Pence. I can't help but think they've become privy to knowledge we don't yet have. That apparently has yet to be shared with Pelosi or Schumer.
"I bet it's all those Nixon voters."
PJ--that was a cruel blow.
That man was hounded from office for doing things that all his predecessors had done...
"Try this Lancet essay..."
Thanks.
From that I gather that there are too many variables to answer my question.
"This seems like a panic to me, bordering on mass hysteria."
How long before Dems will accuse Trump of going too far and doing too much?
And drawing any comparisons to the 1918 epidemic are absolutely idiotic, for reasons so obvious only an idiot would need them explained.
10:53 - agree with Balf.
We are past the containment phase where we try to stop the spread of the disease and are in the mitigation phase of an outbreak. There are currently two ideas on how to handle mitigation, the US based approach of social distancing/isolation which hopes to 'bend the curve' down as you have seen.
The second approach is the one taken by the UK and Singapore, that focuses on quarantine of sick people but does not implement social distancing, canceling events, or closing schools. The mathematical modeling used to inform that approach indicates that closing schools has only a very small impact on the timeline of the disease, whereas isolating sick people dramatically reduces the spread. For more on this second approach:
visual explanation: https://twitter.com/nickhassey/status/1238190817308807171
UK approach: https://www.theguardian.com/world/2020/mar/12/uk-governments-coronavirus-advice-and-why-it-gave-it
when I'm out and about, I am noticing that it is mostly Asians who are wearing masks. A few elderly folks. It must be part of their culture. Or they are really polite.
I think it's smart.
Re: PJ:
Wouldn't that be illegal in a lot of places?
True enough. Antifa and KKK thuggery isn't going to disappear just because of the Wuhan coronavirus. There's a tension. Right now I'd resolve that tension in favour of public health, but maybe not if the situation were less acute.
>>If there are no major developments in the next two weeks I think you'll start to see people returning to their normal routines in large numbers.
I think this is correct.
Here in Florida, it's already starting to get rather warm. When the AC fails, nobody is going to want to hear "Oh, I'm working from home. Disconnect your AC and bring it by and I'll fix it."
The panic should stop when people realize that they are destroying the lives of all the hourly service industry workers.
It will stop when the service industries are crippled, and everybody starts to realize how much we depend on the clerks, cashiers, plumbers and tradesman that keep this country running.
We live in Pine, Colorado, and have twice as many deer and elk as people. Living normally is the very definition of responsible social-distancing.
Laslo Spatula said... All of this flattening works, until you factor in real people's lives.................and
Or are the ones preaching extensive measures willing to forego the needs for such services?
How many people were at risk in the production, delivery and sale chain that got that toilet paper to your home?
Take the challenge: go without toilet paper for two weeks to let us know you mean it.
THIS...in spades!!! and everything else Laslo said at 10:14
Not everyone can just cavalierly stay home and self isolate. Not everyone can AFFORD to not work and have no income for a month...two months or have the financial reserves to last that long.
Yeah. Let them eat cake and get their own toilet paper.
Whether this turns out to be a real pandemic or not....people's "economic" lives are being destroyed. Some will never recover; lose their homes, cars, go bankrupt. Small businesses in particular are suffering and closing. Government help with unemployment isn't going to do anything to help the SELF employed.
Maybe it would have been better to let the curve be steep so we, as a society and an economy, can recover sooner. Stretching this out and creating a lingering event, may not be the best.
Whatever, though. It is what it is. Other than avoiding big crowds (easy to do for us,) not taking any more trips and using sanitary precautions (Lysol wipes are ubiquitous in every vehicle and in the house).... we haven't changed our life. Still working!!
It appears all the school closing set off another wave of panic. Welcome to instant food shortages.
reddit/Kroger employees
We deserve everything we get for being such a stupid populace.
To answer your question of how long, there are two general scenarios I see. First, without an effective anti-viral treatment the self isolation will be long. Back of the envelope, virus infections roughly double ever 7 days,starting from a base of 10k currently, we should see 80 million cases in 13 weeks. From other work I do, I've seen modeling of herd immunity that indicates ~35% immunity only reduces disease spread by <10%, so I think it's safe to say we will get to 35% infected pretty easily without intervention. We will likely get higher, maybe 50, 60%, but as the prevalence goes up herd immunity starts to slow the outbreak. If we slow the doubling by half with social distancing, then we push it out 26 weeks, so we will be at this for 3-6 months at a minimum.
The second scenario, we get evidence of effective anti-viral drugs, at which point I believe this will all blow over. If the anti-viral drugs are effective at reducing infections in severe cases, and 80% of people with infections will already be mild, the concern about spread and harm to at risk populations lowers. Remdesivir has been shown in animal studies to have an affect on MERS and SARS, and has been used in some of the early severe cases in Seattle, indications were positive but not definitive. It's currently in a clinical trial in China that should deliver data in early April. It's also in two clinical trials in the US, results will be latter this spring. If the April results are positive it will be a game changer.
What about all those who can't "work from home". Do we destroy their lives to save ourselves the bother of getting sick for a week?
People are going to tire very quickly of this, and demand a return to something like a normal life very soon.
Right on, and said with different words by several commenters.
Next up, MSM begins saying same thing and blaming Trump for over reacting and causing suffering among lower and middle classes. A big 180 from screaming he is not doing enough, just like them now saying it is racist to insinuate the virus is wuhan or Chinese..
@Amadeus 48 -- that was meant to be a Pauline Kael reference, Nixon was just a bystander.
Yet another news conference where the sole focus of our brave media is on whether Trump has a temperature. If only these people would self isolate.
David Begley said...
I just checked. ZERO deaths in WI.
Who cares!
We need everyone is Wisconsin tested so we can complete a math equation which is all that matters!
From what I understand about herd immunity, if I were President or a governor I'd be handling this thing much differently. I would tell anyone in the subset of the population that is exposed to the high risk of serious illness and death (those over 60 and people with compromised immune systems or lungs-smokers) to social distance, avoid travel, large gatherings, etc. For everyone else, treat this as every other flu virus. I would preserve the number of ICU beds normal populations need, and tell at risk groups the remaining beds are theirs, but no more than that.
I would not close colleges and K-12 schools or workplaces--those, like airline and mass transit are the preferred vector for spreading herd immunity. Isolate older teachers and professors, not the students. Have THEM skype lectures to the classroom. Same with operas, concerts and sports venues.
Dr. Fauci now.
China has radically slowed.
2226 total cases in the US.
I heard 50 deaths. Average weekend in Chicago.
"Take the challenge: go without toilet paper for two weeks to let us know you mean it."
Since I didn't actually believe people would decimate the toilet paper aisle, like locusts, I will now be practicing Laslo's challenge, whether I mean it or not.
At a presser- Trump should sneeze on the press.
PJ--but it also works well with the timeline: Nixon had a blow-out win in 1972, and all of us who voted for him (it was my first election)--and there were a lot of us--are getting to be, ahem, elderly. So it really is very witty. Nixon got blamed for everything else. Why not this?
Well done!
Yet another news conference where the sole focus of our brave media is on whether Trump has a temperature. If only these people would self isolate.
3/14/20, 11:37 AM
Of course. They are praying he tests positive so they can accuse him of selfishly exposing others.
As of yesterday South Korea had 7979 cases with 67 deaths, .008% of known cases. Surprise, I didn’t read that in the NYT. An interesting website: https://www.statista.com/statistics/1098721/south-korea-coronavirus-confirmed-and-death-number/
I like self isolation as a lifestyle, but this is getting to be absurd. Also Trump needs to get off the defensive. He’s actually doing well action-wise, but adding to the bullshit isn’t helping. The CDC got an historical increase in 2018, but appears the Obots and PCDeep Staters there didn’t put it to good use. Now they are trying to scare us to death to cover their asses and screw Trump.
Mass hysteria is easy in a country of godless idiots. My wife, La Senora, says this is mostly insanity. She also says, “Come Lord Jesus. Who cares.”
Meanwhile, I’m going to the store for green beans, mushrooms and steak. Hope something is left.
BTW, if everybody socially isolates, we’ll all die, won’t we?
The mathematical modeling used to inform that approach indicates that closing schools has only a very small impact on the timeline of the disease,
I think this is all about lawyers.
Our Secretary of Treasury is GREAT. Same for Pence!
One trick I learned from working at a hospital was to press all public buttons -- elevators, ATMs, etc. -- with your knuckle when possible. I also push doors open with the back of my hand and try to pull from the bottom of the handle where fewer people touch it.
They are praying he tests positive so they can accuse him of selfishly exposing others.
And even if he tests negative, they get to say he's benefiting from testing that -- because of him, dontcha know -- lots of ordinary citizens can't access. It's the sort of win-win they love.
The British plan (still to be seen whether they actually have the courage to implement it) is based on the simple observation that large-gathering cancellations- i.e, schools, businesses, sports and enterainment events- doesn't do much to stop the spread because the people involved simply displace to larger numbers of smaller gatherings- pubs, movie theaters, restaurants, playgrounds, malls, etc.- which are just as likely to help the disease spread.
These are basically the choices:
(1) isolate the most at-risk for death until the disease runs through the rest of the less vulnerable;
(2) Country-wide quarantine for a month or two to stop the virus spread in its tracks- this is what the Chinese did and claim has worked;
(3) Do #1, but with firm suppression of the total numbers of infected at any given time.
The British want to do #3, but I suspect there will be little actual control, but they at least have some hope to suppress the maximum number of infected at any given time.
The main problem with option 3 is that it will require a long quarantine period for the most at risk- the longer this period is, the less likely it will be efficacious in the end analysis- people will tire of it and go their merry way and the quarantine will be more likely to simply break down anyway because the longer period makes the probability of accidental breaks to increase.
I personally think the most rational approach is the competely isolate the most at-risk, and get the rest of the population through the disease as quickly as possible without allowing the breakdown of necessary services like food production/distibution and basic utilities and sanitation services.
What I think will happen is that we will take the most irrational and damaging top down approaches and end up in the exactly the same place we would have if we had collectively decided to do nothing at all.
How long until the plaintiff's bar starts advertising "Do you have coronavirus?" lawsuits?
We see these every year in Florida... hurricane lawsuits.
If toilet paper is out in your house, and you still have running water, then stock up on hand soap of any kind. You can always wipe your ass with your off hand after flushing down the shit and using the water in the bowl. This is how it is done in many third world locales, but without the hand soap.
14 days. 30 days to be sure.
Re: Laslo Spatula:
Take the challenge: go without toilet paper for two weeks to let us know you mean it.
The joke is on you, my friend. I have a Toto washlet bidet with a dryer function built in. I mostly don't actually need to use toilet paper, although I typically do because the dryer takes too long.
14-30 days with nearly 90% compliance. If compliance is more like 50%, then 6 months.
Does it blow hot air, Balfegor?
here are the idiots causing toilet paper panic at Costco
Here is the solution to the idiot problem
Isn't it odd when you're out in public now and someone coughs and it's a totally gross gurgly productive cough you are suddenly relieved?
Yancey--I am with you. But this is an election year. Every politician in America wants to say he or she did something, and those out of office want to say what was done was not enough. That is the fundamental dynamic at work here--to maximize the number of voters who know something was done (often by inconveniencing them) and to raise the stakes to do more.
The dynamic is somewhat different in Britain, where there won't be an election for four and one-half years and in China and Italy, where elections don't matter, for different reasons in each case. Illinois is more like China.
Compare to and contrast with 2009 and the swine flu pandemic, which in a follow-up study in 2010 was determined to be no more severe than the yearly seasonal flu. (DeNoon, Daniel J. "H1N1 Swine Flu No Worse Than Seasonal Flu". WebMD. Retrieved 13 March 2020.) Things were different for some reason.
7979 cases with 67 deaths, .008% of known cases.
That’s 0.8%, not .008%. There are also some open cases that are critical so deaths may increase closer to 1%. Even at 0.8% it’s 8 X more deadly than average seasonal influenza.
The 1918 flu. They'd have you believe that this one flu, the "Spanish Flu," was different from all other flus, viciously virulent, like the black plague. And then it disappeared, never to be seen or heard from again.
Another view is that Bayer invented aspirin in 1899, and by 1918 it was widely available and in everybody's medicine cabinet. People were encouraged to take it to alleviate their symptoms, and they did, but little was known about dosages. Coughs, sore throats, fever, people popped them like candy. Bottom line, it was the widespread chronic sustained overuse of aspirin exacerbated the effects of a normal seasonal flu.
Balfegor--
Oh, the Buttwasher! I had one of those in a hotel in Switzerland (but it was in Ticino. Does that count as Switzerland?) I felt clean but potentially chapped. Strange device.
Two guys in adjacent stalls in a mens' room.
Guy one: "Rats! There's no toilet paper. Do you have any over there?"
Guy two: "None here, either. Do what I do and wipe with a dollar."
A few minutes later, at the sinks.
Guy one: "What a mess! What a bad idea!"
Guy two: "Did you use a dollar?"
Guy one: "Yeah. Three quarters, two dimes and a nickel."
Howard--of all the trolls that hang out here, you (together with Freder and occasionally Inga) seem the most likely to be a real person.
Thank you for your comment.
TP is always a point of contention between people, and some even argue with themselves about the stuff.
Some insist 'this way round' others want the end folded, tucked, or not torn, others detest hanging the rolls up.
Then there is the never ending discussion about reasonable quantities, acceptable quality and and and.
Also, not to forget the power trips this can kick off, hiding TP (to teach a lesson) or buying the cheap TP everyone hates is quite common, since the confrontation is not so easily avoided and even otherwise calm people feel territorial about that area.
I think it's a form of stress relief and a way to release 'argument under currents' that build up in families. Some people are like cats --- they just love to fight, and the more trivial the problem, the fiercer.
But because TP is such a bone of contention, lots of TP being available is a good thing, it'll go a long way in taking the edge of some of the cabin fever coming up.
Of course, WaPo and the NYTimes can serve as TP in a pinch.
"Bottom line, it was the widespread chronic sustained overuse of aspirin exacerbated the effects of a normal seasonal flu.”
Worldwide? I kind of doubt that.
*** Waves Hands Frantically ***
"Mr. President!, Mr. President! Why do you continue to shake hands (a supposedly serious question as we busily destroy our economy)
My Answer:
1.) Who the fuck cares. You can wash your hands after a handshake.
2.) Like it or not, Trump is our President. He has a different role and different responsibilities. If he feels he needs to shake someone's hand for some reason, so be it. He isn't your fucking tax accountant.
3. Who the fuck cares.
DanTheMan said...
How long until the plaintiff's bar starts advertising "Do you have coronavirus?" lawsuits?
Why the schools are closing. No other good reason.
robother posted:
From what I understand about herd immunity, if I were President or a governor I'd be handling this thing much differently. I would tell anyone in the subset of the population that is exposed to the high risk of serious illness and death (those over 60 and people with compromised immune systems or lungs-smokers) to social distance, avoid travel, large gatherings, etc. For everyone else, treat this as every other flu virus. I would preserve the number of ICU beds normal populations need, and tell at risk groups the remaining beds are theirs, but no more than that.
I would not close colleges and K-12 schools or workplaces--those, like airline and mass transit are the preferred vector for spreading herd immunity. Isolate older teachers and professors, not the students. Have THEM skype lectures to the classroom. Same with operas, concerts and sports venues.
I'm guessing we are going to look back at some point and wish we had followed this advice.
Laslo Spatula said...
All of this flattening works, until you factor in real people's lives.
The ones who can afford to 'distance' themselves are a subset, not the whole: those well-off, retired, or have work where working from home is possible.
However, some will be out of a job, and that number will grow quickly in the weeks ahead. ( I know a few already affected -- cut hours -- and one stadium employee laid off). Those jobs will not all come back like the flick of a light-switch when the elite feel like they are safe. Or bored with the distance thing. Dominoes are falling.
And -- meanwhile -- many will be out working the jobs we will still expect to rely on: grocery clerks, gas station employees, maintenance, truck drivers, Amazon fulfillment people, delivery, etc.
Or are the ones preaching extensive measures willing to forego the needs for such services?
How many people were at risk in the production, delivery and sale chain that got that toilet paper to your home?
Take the challenge: go without toilet paper for two weeks to let us know you mean it.
Marie Antoinette understands.
I am Laslo.
This needs to be an option in Ann's stupidly sort list.
But self awareness isn't the only thing Ann lacks. Empathy is another thing.
Since SARS, I've heard the 1918 Flu is coming back at least during: SARS, Bird Flu, Swine Flu and then there was ZIKA.
Look, I get this is serious but that something bad happened in 1918, and that Italy is overwhelmed is not some sort of evidence or proof of what is going to happen now.
Bushman of the Kohlrabi said...
robother posted:
From what I understand about herd immunity, if I were President or a governor I'd be handling this thing much differently. I would tell anyone in the subset of the population that is exposed to the high risk of serious illness and death (those over 60 and people with compromised immune systems or lungs-smokers) to social distance, avoid travel, large gatherings, etc. For everyone else, treat this as every other flu virus. I would preserve the number of ICU beds normal populations need, and tell at risk groups the remaining beds are theirs, but no more than that.
I would not close colleges and K-12 schools or workplaces--those, like airline and mass transit are the preferred vector for spreading herd immunity. Isolate older teachers and professors, not the students. Have THEM skype lectures to the classroom. Same with operas, concerts and sports venues.
I'm guessing we are going to look back at some point and wish we had followed this advice.
The problem is, there is a political downside to that if things get bad.
If you shut everything down, there is no political downside -- the harm is all on individuals and small businesses.
"Does anyone know anyone who has covid 19?"
I'm related to a kid, under 15, who has it by way of that Biogen conference in Boston. I'm sure it will come out OK for the kid and I hadn't seen that family for months so I'm OK, too. In fact, I read on the ArsTechnica "don't Panic" site that there is no case of child to adult transmission. But it makes me feel that it is correct to have a lot of sites for testing as Trump was explaining yesterday that there would be; and makes me feel that people should and will test. If we could get tested in great numbers and could distinguish between sniffles, regular flu and this flu then we'd know how to act. We'd know if we'd had it and were immune; and we'd know if we got it and must stay home; and we'd know where it was spreading and how fast; and then we'd know how when to lift the general stay home order. And also I think the flu maps should be more like weather maps with areas of no flu of either kind joined by low pressure bars as they are on weather maps. Like in the south under the deadly-to-virus UV rays where flu might clear out next week whereas in the north it might linger for four weeks. These maps would show that there are flu and no-flu zones just like planting zones, at least I think so. Then other areas like O'Hare airport or the other big international airports should have tiny little circles of high-pressure bars with infections radiating out from them so that the O'Hare high pressure zone has circle of lower pressure bars around it touching Milwaukee. Then it would be seen I believe that flyover country is flu-over country even in the north within a few weeks, so lift the quarantine. Northern globo-land might take longer but no longer than it takes flu to clear out usually. And if a lot of people got tested then we'd also have a cadre that we knew had had corona.
PS. Should some testing stations be in the toilet paper aisles?
My wife and I are getting takeout tonight from our favorite Chinese restaurant. We don't feel this is risky behavior. You may disagree, but no matter how afraid you may be or whatever level of isolation you're practicing, try to find some way to support your local businesses and those that depend on them.
here are the idiots causing toilet paper panic at Costco
Here is the solution to the idiot problem
3/14/20, 12:16 PM
Small business shop at Costco, so maybe small grocery stores buying. On the other hand, have seen toilet paper for sale on Craigslist.
Later today, gonna start a social media rumor that local Target and WalMart has TP ,water, rice and beans. Figure I can head over to Safeway and get some groceries without having to wait in long lines..
" would preserve the number of ICU beds normal populations need, and tell at risk groups the remaining beds are theirs, but no more than that.”
Die old people, die in your MAGA hats!
Sure, that’s a viable option in a democracy.
If we could get tested in great numbers and could distinguish between sniffles, regular flu and this flu then we'd know how to act.
How should we act diff if it is cold or regular flu? OK then to go out in public or visit the old folks? OK to send the kid to school with regular flu? OK to go to work if it is just the regular flu?
Closing the schools makes no sense to me.
I'm still unclear why the rush to hoard toilet paper. Can someone please explain?
I'm still unclear why the rush to hoard toilet paper. Can someone please explain?
Michael asked: "Why the schools are closing. No other good reason."
Children are less likely to get it, but they are carriers, taking it home. In the same way that they infect each other with head lice and whatever other bugs can be shared etc. So home schooling is a good thing here.
There is also a huge problem what to do with the children of medical staff who need to work and rely on schools as day care --- if you run special creches just for them, you'll get a top notch petri dish of whatever variant Coronavirus there is floating about, from people with direct access to the latest version.
I hope this all is going to pass us by smoothly, but it also serves as a good rehearsal for whatever else that lurks and would be far worse.
Am going to venture out to Walmart and FoodCity to do this week's shopping here in Oak Ridge. Will update on the toilet paper situation. My mother and I have enough for the next month, at least.
MayBee said:
The problem is, there is a political downside to that if things get bad.
You're right of course. I'm looking at this from a common sense viewpoint, not a political one.
Rational and reasonable precautions. Physical distancing, you can still socialize, unless it normalizes a social contagion. Wear a condom... mask when symptomatic. Follow first-world sanitation standards. Do not share responsibility, but accept personal responsibility for your health.
So if we all hunker down for two months, who are we expecting to bring food to our houses? Does Amazon now employ only robots?
So you sit in your prepped house and expect other people to risk their lives so you can feel secure? Do the letters 'FO' mean anyting?
We all need to be careful, practice decent hygiene (like we already should be doing) and stop licking door handles and forget the essential oil bit.
I think the advice from the lady in Seattle who has recovered is germain - she said to stop panicing.
wildswan said...
"Does anyone know anyone who has covid 19?"
I think the story "The boy who cried wolf!" is going to come back in style soon.
The curve is tailing to 0 in China and South Korea.
2 orders of magnitude fewer deaths than the flu.
Meanwhile there will be thousands of jobs lost. World wide disruptions will lead to real reductions in quality of life for everyone on the planet.
There is a defacto hiring freeze right now.
Your panic has consequences.
PS. Should some testing stations be in the toilet paper aisles?
Make it a prerequisite..
We just got back from Wal*Mart. It was pretty normal except for absolutely no TP and some things were low, like dog food.
I'm sort of in a high-risk group and The Woman more so, but she said "I almost died twice this year, fuck it, I'm not going to hide. Another year of pain..." A bit cranky, eh?, maybe from the fever 'n' chills.
After that we stocked up on multi-purpose hand sanitizer.
I'm still unclear why the rush to hoard toilet paper. Can someone please explain?
I am beginning to think, without evidence, it started with a 4chan prank..
One big question is whether warm weather will interfere with the virus's transmission in the way it does with most current strains of f (but not the great 1918-19 pandemic). And we don't know.
And, how effective the limited, mostly voluntary quarantining will be for this specific instance.
Figure anywhere from one to six months. And don't be surprised if there is s second, probably smaller wave, a little later.
"Panicing" is a slippery slope.
“Also, not to forget the power trips this can kick off, hiding TP (to teach a lesson) or buying the cheap TP everyone hates is quite common, since the confrontation is not so easily avoided and even otherwise calm people feel territorial about that area.”
Funny and, absurdly, true. I’ve noticed that our Purchasing department has a markedly better quality of TP in their bathroom than the rest of the company, including Administration. It isn’t something I’d rock the boat about but it’s consistent with all those jokes about supply chain in any organization. Marie Antoinette paid triple for her cake. For whatever satisfaction there is in that.
Blogger Bilwick said...
I'm still unclear why the rush to hoard toilet paper. Can someone please explain?
Simple:
Guy thinks to himself "if there's going to be shortages, I'll be damned if I run out of toilet paper. Another guy sees this guy fill his cart, thinks to himself "he's onto something, I better stock up.
3rd person standing there watching this texts the family telling them there's a run on toilet paper. Family posts it on facebook, and here we are.
I'm waiting until next week and there's a glut of toilet paper because everyone has stocked up so much that they need no more - and it will be on sale cheap because no one is buying it.
The time to buy toilet paper is on weekdays.
Both Walmart and Krogers have a reasonable amount during the week, but tend to be out on weekends when working people do their shopping.
Just long enough to get Orange Man out of the White House.
Saw a video interview with a man who contracted the virus on one of the cruise ships. He is 67 years old. He ran high temperature (103) for a period of about 8 hours and came down with a dry cough. He still has a slight cough but no longer has a fever.
He said his experience with virus was more mild than flu.
There is actually a debate on Twitter right now about whether Trump was actually tested for coronavirus, coupled with a hopeful glee that he actually has it.
Trump Corona Truthers. People have lost their damn minds.
So how much of our TP supply comes from China?
Those commy rascals have us by the short hairs!;)
If it was as contagious as some say, Seattle would be overwhelmed by now
Vaguely on- topic ... lots of complaints about the lack of testing. But we should have rock solid proxy data: the number of cases of pneumonia admits to hospital ICUs and ERs. Are we seeing a big spike there, or really anything different than we would see with regular seasonal flu? I haven’t heard anyone mention this but I have avoided the news the last few days on purpose. We have data from other countries showing the pattern of infection and should be able to correlate to that to see where we are in this process. Anyone hear any experts talking about this? Thanks.
It's all irrational over-reaction to me. I expect that in two months we'll look back, laugh, and say 'what were we thinking'. If we aren't already on to the next get Trump scheme.
Via "Bing" from NHS- Coronavirus updates graph, it looks like there are about 700 new cases in the US from yesterday to today, and 13 more reported deaths. Not exactly rampaging through the population, However(!) from everything I read, we are way behind in our ability to test. I am hopeful that in the next couple of weeks we have a more comprehensive sample size.
In the meantime, I'm taking what I regard as appropriate precautions, short of self isolation.
Does anyone know anyone who has covid 19?
Nope. And here in Thurston County, WA - outside of the main, infected area, but still close enough - this has been going on for three weeks now. The epicenter, as it were.
Total number of cases in Thurston County as of today? Three weeks after all the hysteria started?
Three cases.
Three.
Gen Z kid nicknames COVID-19 "boomer remover"
CStanley: “That’s 0.8%, not .008%. There are also some open cases that are critical so deaths may increase closer to 1%.“
Thank you for the correction. My apology. I was evidently using MSNBC/NYT confirmation bias math. OTOH, if criticals recover deaths may decrease to below .8 of a per cent. Perhaps, confirmation bias cuts both ways.
The “10 times as deadly as seasonal flu” bit is useful to prolong the panic or, as in Dr. Fauci’s case, to encourage caution. For those whose goal is the former, WHO’s 3.4% figure is useful.
Fauci, who is trying to contain the outbreak, has a different charge than many researchers who generally seem to agree that it is too early to tell unless, of course, you’re a Democrat.
When shit gets real, toilet paper can be turned into a heat source.
"As late as 1972, Sanders was living in a shack in the woods with a dirt floor. Friends reported that to cook he deployed a coffee can at the bottom of which was a roll of toilet paper soaked in lighter fluid — “Berno.”
Just returned from Walmart and FoodCity here in Oak Ridge (I do two stops most weeks- big bulk items are significantly cheaper at Walmart, but FoodCity has a much better selection of prepared foods and with the discount card, better prices on smaller items).
There was zero toilet paper at the Walmart, and less than 10 rolls of the lower quality brands at the FoodCity. Don't Seize the Charmin, guys! In any case, we don't need any toilet paper until at least the middle of April when I suspect the madness might have started easing.
No bulk liquid hand soap anywhere to be found, all the iso-propyl alcohol was gone along with most of the hydrogen peroxide. The dishwashing liquid was gone at Walmart but for a lonely bottle of Joy I bought as a hand soap alternative for the next month.
Both stores were crowded for a Saturday afternoon, but not terribly so- I got in and out without waiting for anything, but then I use the self-service checkouts most of the time.
Re: Yancey Ward:
Does it blow hot air, Balfegor?
It does indeed. Well, warm, not really hot.
You can customise the heat (just low/mid/high).
TP is for savages.
Joan, I would think at this point that all admissions for respiratory distress are being tested for COVID-19, and that all home deaths from pneumonia are also being tested- this is one of the reasons the CDC rationed their resources early on- they need to be targeted to the highest value uses, not used so much for mild symptom victims who could just be ordered into self quarantine. However, the testing is really taking off now, and we will start getting some much more solid data by early this coming week.
A legal assistant working for Davis Wright Tremane (Bellevue, WA) died suddenly after self isolating/WFH. Went home with flu-like symptoms - dead a couple of days later. In her 50's. No word yet on what she died of - but if she did die of Covid-19 the fallout among law firms could be significant. I work for the HQ of another BigLaw in Seattle - they may shut down all other offices. I mean - if lawyers are the reason schools are closing I can only imagine the impact of a death like this.
"But we should have rock solid proxy data:”
Well, there are two strains of flu. going around, one of which wasn’t covered by the shot, and the other... well my SIL had the shot and still got it. She was pretty sick, but she tested positive for Influenza A. What we should be seeing is a spike in those who don’t test positive for any known causes if those scenarios like that bumpkin from Ohio proclaimed.
My wife and I probably had COVID-19. Her close colleague at work definitely did, and pneumonia, though already out of the hospital after a few days and feeling better.
The social distancing will continue until morale improves.
" Her close colleague at work definitely did,”
Tested positive at the hospital? Or negative for all known flu viruses?
stevew said...
It's all irrational over-reaction to me. I expect that in two months we'll look back, laugh, and say 'what were we thinking'.
I predict we will be doing no looking back and laughing. We don't seem to look back and wonder "what were we thinking" anymore. Instead, we will forget and then in 2 years there will be another virus that will join SARS, Avian Flu, Swine Flu, and Covid-19 as the next Spanish Flu of 1918 about which our entire country must panic.
Remember there are two different curves -- cases and deaths. The goal is to reduce the area under both curves.
1. Flattening the cases curve will undoubtedly reduce the area under the death curve as health care facilities will be less stressed.
2. Doctors are learning a lot every day. Every day you can put off getting the disease gives doctors more time to understand effective treatments-- and there are lots of treatments being explored.
3. Eventually there will be a vaccine. For those that can put off getting the virus until the vaccine is available that will benefit the area under both curves.
The "how long" question doesn't have a simple answer. To a large degree it will depend on your immediate environment. The answer for Madison, WI might be quite different than the answer for International Falls, MN.
Again, this is from the 1918 Spanish flu study* (https://qz.com/1816060/a-chart-of-the-1918-spanish-flu-shows-why-social-distancing-works/) comparing Philadelphia to St. Louis where St. Louis instituted social distancing quickly while Philadelphia waited until the flu was widespread.
The death rate in Philly was much worse, 250 per 100K, but the total event was over sooner -- about 2 months, from mid Sept. to mid Nov. In St. Louis the death rate was about 50 per 100K but the event lasted from end of Sept. to end of Dec.
Dr. Fauci said we'll have to wait and see how the infection rate goes, he estimated 8 weeks.
*The concept of “flattening the curve” is now a textbook public health response to epidemics ... says Richard Hatchett, a physician and head of the Coalition for Epidemic Preparedness Innovations in London, ...
“I think the critical lesson from both the modeling and the historical work is that the benefits of multiple interventions are greatest if they are introduced early (before 1% of the population is infected) and maintained,” wrote Hatchett, who has also directed medical preparedness in the Obama White House. Distancing measures are less effective once more people have contracted the virus, especially in cases where the vast majority of people are not sick enough to need medical attention...
China and Italy may have waited too long; both were forced to take drastic steps weeks after the first cases were discovered. ...
“Again, this is from the 1918 Spanish flu study* (https://qz.com/1816060/a-chart-of-the-1918-spanish-flu-shows-why-social-distancing-works/) comparing Philadelphia to St. Louis where St. Louis instituted social distancing quickly while Philadelphia waited until the flu was widespread.”
I’m glad to see several more people referencing the Spanish Flu besides myself.
"Remember there are two different curves -- cases and deaths. The goal is to reduce the area under both curves."
I think the important curve is neither of those things. It's the number of people who need intensive care.
The dead are gone. Nothing to be done anymore. The cases, per se, are not taxing medical care, because a large number of them are mild and can be handled with the kind of isolation we are already doing when we are not sick.
The goal is to keep the care-needing number below the line that represents medical care capacity.
Inga wrote: I’m glad to see several more people referencing the Spanish Flu besides myself.
Yes.
We learned a lot about contagion factors and mortality rates after it ran its course.
Not all the lessons from the Spanish flu apply 100 years later, but it is very important to understand that history does not begin anew each day.
The goal is to keep the care-needing number below the line that represents medical care capacity.
Exactly. So, why isn't there any reporting on this -- the currently available capacity, and intake of new cases day-to-day (or at least week-to-week)? This is data that is (or should be) available. It really doesn't matter how many cases there are now*, except to be able to spout statistics like a 3.4% mortality rate, and scare people into doing ridiculous things like buying a month's worth of TP. Obviously the best thing to do is to protect the most at-risk populations, and to do that, just do the things you're supposed to be doing anyway, like covering coughs, washing your hands, and staying home when you're sick.
Here in the suburbs of Phoenix, many school districts are extending their spring breaks by at least a week if not two. All three state universities and the local community colleges are switching to online classes only when their spring breaks end. The Diocese of Phoenix Catholic Schools (I work at one), are remaining open after consultation with the CDC and state officials. The infection rate in AZ is very low, and the Diocese issued a statement that closing schools now is not likely to be helpful, when it might be very helpful later on. In the meantime, the Diocese is sensitive to the amount of disruption that school closures have (epic child care disaster) and is seeking to minimize it. Our principal sent out a fantastic email to our entire school community detailing all this. I hope it helps everyone calm down a bit.
[FWIW, my 23-year-old son told me that the TP hoarding started in Japan because supposedly, surgical masks are made of the same material, and the run-up in manufacturing masks would necessarily reduce the availability of TP. This from one of the many random Twitter accounts he follows around the world. Who knows?]
*In the long run, it will be helpful to have the data for all sorts of analytical purposes. For now, it's just a cudgel to beat people with. I'm very concerned for the hourly and service workers whose income will be cut off. There are a lot of people who can't afford to be out of work for a day, never mind a week. The administration will win a lot of fans if it does something to help the people who are economically affected by "social distancing."
“We have data from other countries showing the pattern of infection and should be able to correlate to that to see where we are in this process. Anyone hear any experts talking about this? Thanks.”
I’ve heard different epidemiologists say we are about two weeks behind Italy.
Professor Althouse:
The goal is to keep the care-needing number below the line that represents medical care capacity.
Up to this point, I've not heard of hordes of people showing up to ERs or Urgent Care centers. THAT will be the definition of panic!
I think using graphs and math logically, then we should be able to extrapolate the ending of the curve, and i think that answer is like 5-1/2 or 6 months, and that is sorta an over kill guess on my part. It might only be 4 months, but i think it will be at least 4 months.
@MayBee,
"Since SARS, I've heard the 1918 Flu is coming back at least during: SARS, Bird Flu, Swine Flu and then there was ZIKA."
This is kinda sorta where I am.
My general thought is simply: (1) if you are elderly or already sick with something else, Yes, take every reasonable precaution and (2) if you are younger than 70 and generally healthy, well, take similar steps as you did during every flu season for the 3 or 4 decades.
Blogger Bay Area Guy said...
@MayBee,
"Since SARS, I've heard the 1918 Flu is coming back at least during: SARS, Bird Flu, Swine Flu and then there was ZIKA."
This is kinda sorta where I am.
My general thought is simply: (1) if you are elderly or already sick with something else, Yes, take every reasonable precaution and (2) if you are younger than 70 and generally healthy, well, take similar steps as you did during every flu season for the 3 or 4 decades.
I have noticed that comments here arising from the San Francisco/Silicon Valley Bay area are among the most reasonable, calm, intelligent and reassuring.
..as usual.
I suspect you are correct MayBee. Sadly.
The death rate in Philly was much worse, 250 per 100K, but the total event was over sooner -- about 2 months, from mid Sept. to mid Nov.
I skipped the qz article and just went to the paper:
... cities in which multiple interventions were implemented at an early phase of the epidemic had peak death rates ≈50% lower than those that did not and had less-steep epidemic curves. Cities in which multiple interventions were implemented at an early phase of the epidemic also showed a trend toward lower cumulative excess mortality, but the difference was smaller (≈20%) and less statistically significant than that for peak death rates.
The concern over "overwhelming the health system" per se is really a concern of the health system, not the general population; death rates are the important measure.
We live across from the Life Care Center and there are 15-20 ribbons each tied around a tree trunk for the people who’ve presumably died. Don’t know that any employees have died.
There are active and novel cases here, so a coworkers brothers classmate had it. I don’t know many more than that.
It’s getting a little weird and tense to visit the grocery stores, mostly because of fear and people stocking up.
The thing I can't get over is that last winter 35 Million Americans got the flu, and 34,000 people died from it, although most were either old or already sick, and, hence,vulnerable. But nobody panicked and no National Emergency was declared. Life seemed to work its way out.
But instead of comparing this flu season to last flu season, folks are jabbering about the Spanish Flu of 1918, which incidentally occurred during the midst of WORLD WAR 1, where millions of kids were sailing back and forth to Europe, shooting each other.
It seems inapt.
In 2013 I came back from Shanghai with what was very likely H7N9 bird flu. Seven people had died of it there in the previous week.
It was brutal. When I went to the ER in Arcadia, CA, I told them from where I had come, and about the deaths in Shanghai. After testing, they released me into the wild with the diagnosis "unknown viral infection" and a $3,000 bill for a complete waste of time.
No follow up, not the least bit of curiosity.
I self quarantined at my Dad's house. It was nearly two weeks before I could get on a plane home.
My wife is the more eager, and I the more reluctant social distancer. (Reluctant because I haven't seen an explanation for why this virus is vastly more dangerous than previous ones.) Yet we are doing our best. A key thing for us has been to figure out how to have church, where my wife is the pastor. Rather than just canceling, we have opted to open the sanctuary Sunday morning for people to come individually, pray quietly, and serve themselves communion. In times of anxiety, people need a connection to the divine.
I'm very concerned for the hourly and service workers whose income will be cut off. There are a lot of people who can't afford to be out of work for a day, never mind a week. The administration will win a lot of fans if it does something to help the people who are economically affected by "social distancing."
I have shared that my husband's income next year (which supports eight people including a daughter in college) will likely be about 1/3 less than it normally would be as a result of the reaction to the virus. Based on the comments I received in response from Meade and others, it is the position of this blog that people whose finances will be disastrously affected can just get bent, and God help them if they mention that they would rather have their money, than not.
I'm sure it's scary to be older, and vulnerable. It's also scary to have kids who depend on your ability to provide for them, and who need their activities and their educations and their normal lives. Young families are vulnerable too. Incidentally, this me-and-mine-first, you-and-yours-can-just-suck-it-up, crap is why people get tired of boomers and their nonsense. At least PRETEND to care about the people whose lives and futures you are bending for your own well being.
My social distancing is over.actually never started. Too busy playing tennis and Pickleball, and going out to eat with friends. Maybe I’ll catch it, maybe I won’t. Maybe I’ll catch the flu that’s killed over 20,000 so far, maybe I won’t.
But what’s for sure happening is tons of people’s livelihoods are being cut off, perhaps permanently because there are so many sheep in this country that believe everything the mediocrities in the media blare at them. You know, the tp hoarder mentally defective types. What’s even crazier is that they’re also buying all the bottled water too. Like the faucet will be turned on one day and nothing will come out.
This is 10X more deadly than flu, 1% (maybe, maybe not) and flu is .1%. Curse of small numbers. 1 is infinitely more than zero, but still only 1 more than zero. If I were over 65, already a couch potato or in poor health, I’d stay away from others, but should have already been doing that to avoid the flu that’s this year killed more people in this country than Covid-19 has killed on the entire planet.
This is hurting millions in their paychecks and retirement assets , some irreparably, so the Althouses can hide away.
Oh, by the way Althouse, you note that “the dead are gone”. Not in Italy, as one of your posts this week exposed.
So no, I don’t think we’ll be like Italy, folks.
I feel you, Pants.
If you are retired with a set income or a pension, or if you are salaried and your company has told you to work from home, I think it is very hard to remember that some people don't get paid if they can't just work from home. Or if clients are too scared to come to you. All kinds of people suffer if others are sitting at home, not going out to eat or going to the gym or to concerts.
And it isn't as simple as saying "Oh, the government is going to increase unemployment benefits". Not everyone is losing employment, per se, just losing the income that comes from large numbers of patrons.
The goal is to keep the care-needing number below the line that represents medical care capacity.
That is a function of the number of cases over time, assuming an even distribution among the population. It is clearly the case at this point that men are more severely affected than woman, older populations with certain diseases, and, potentially, smokers are the most likely to need the ventilators and the ICU. Children, for some unknown reason, are not transmitters.
We are FAR more likely to get it from someone sneezing or coughing very close to our face. The virus can survive for hours on surfaces from respiratory droplets under certain conditions. The idea is to try to avoid getting this virus if you are among those most likely to end up with a ventilator. Closely schools does not achieve that goal. Closely the bingo night at church probably will achieve that goal.
So, frankly, all this hysteria is causing far more harm than good. The economic harm is enormous and unnecessary.
At the top of this thread, commenter Diedhead posted these very excellent links to Dr. Amesh Adalja, an infectious disease expert at the Johns Hopkins Center for Health Safety. Both are very well worth the time. He makes clear that this virus is already endemic in humans, it cannot be contained, the R0 of this virus is in the same range as for the annual flu transmission, and it will become just another seasonal virus to add to the existing 4 coronavirus cold viruses. He says that the upper bounds of the fatality rate will be .6%, which is still higher than flu, but it is no catastrophe. At some point, anti-virals or even vaccinations will make this entirely manageable, but the other impacts from the panic are much worse.
Unless you and Meade are in a risk category (apart from gender and age) or currently have the disease, there is no point in this self-quarantine. Neither of you will be needing ventilators. By this time next year, half of the US population will have had it, so the only real goal is for people to stay away from clogging emergency rooms with the sniffles and tamping down the number of cases among the most vulnerable over time so that health care capacity is not overwhelmed.
https://youtu.be/ZhYcbo7rqEQ
as well as this
https://youtu.be/E9vIUtXa9ug
- Krumhorn
@Pants,
I'm with you. I think this whole thing is a gross overreaction. In California, population 39 Million, there are 2 Covid-19 deaths. Probably, if I bothered to look, it would be 2 old-timers at a nursing home, with 10 other maladies. There is a cost to this viral freak out. More precisely, a cost imposed by the massive social disruption in response to the supposed epidemic.
Misplaced pants, I hadn’t seen your post yet when I typed mine. I hope you and your family get through this ok, and the millions of others out there in similar straits.
I’m turning 76 in less than a month and am doing my best to counsel people to return to sanity. People who are at high risk should stay home. People who are just scared need to start thinking more critically about what they’re being spoon fed by people who don’t have the country’s best interest at heart.
That includes Althouse, who has the fitness for her early morning runs in mid winter Madison, but is afraid to be in the presence of others.
Yesterday, the Johns Hopkins Center for Health Safety reported these statistic from Korea:
"Females represent 61.9% of cases but only 41.8% of deaths. The unadjusted case fatality ratio for individuals aged 80 years and older is 8.30% (21 deaths out of 253 cases), and it is 4.74% for those 70-79 years old and 1.42% for those 60-69 years old. For cases under the age of 60, the case fatality ratio is only 0.12%. Notably, there have been only 2 deaths below the age of 50, despite 4,712 confirmed cases." 60% of the cases in Korea have been associated with the Shincheonji religious group.
Basically, cancelling Coachella or shutting down universities or public schools isn't going to help anything. An while shutting down the Masters might be reaching the right demographics, someone sneezing on the 12th fairway isn't going to affect anyone on the other side of the sand trap or around the green....and very possibly no one.
Meanwhile, caddies and vendors and valets are out of work.
- Krumhorn
The more the panic-ers panic, the more they make men like me feel other than impotent, previously my overwhelming feeling before the thrusting into the greatness I am now aware I am bound for, which is best for me.
Others?
Not so much.
In my defense, though I've never done a damn thing to earn my greatness thrusting(s), I've sure as heck been waiting my whole life for something to come out of nowhere and advance me somehow socially.
My wife thought this was a brilliant idea:
We're decimating the economy in order to protect - overwhelmingly - older people. Speaking here as an older person myself, who at this point is mainly concerned about the effects - on me - of decimating the economy.
Why don't we basically just command older people to radically isolate for a few months while we figure out a vaccine for this sucker?
Which, frankly, a lot of older people either are already doing anyway or they would happily take on the task?
There would be drawbacks. It's a paradigm shift.
My wife thought this was a brilliant idea:
She's right! Because that was also my idea, except for the "command" part.
"Why don't we basically just command older people to radically isolate for a few months while we figure out a vaccine for this sucker?”
That’s what the UK is doing. But I don’t think we have enough info just yet to decide, but if it were as it looks to be, then if I were a young man, I would live my life, take my chances, and help the old folks from afar.
Real men would make the lawyers pay.
Entertainment is anti-American; Americans entertain ourselves.
MayBee: If you are retired with a set income or a pension, or if you are salaried and your company has told you to work from home, I think it is very hard to remember that some people don't get paid if they can't just work from home.
No, it isn't. It isn't hard at all. If people are oblivious to this - or flippant about it - it's because they've get their heads up their asses. We all know people with heads up their asses, but I don't think most people who work for a living are oblivious to this, even if the direct economic consequences haven't reached their level yet.
It's not hard, because only the oblivious (or the unusually self-absorbed living in a very well-protected employment/pension situation) don't realize that some workers not getting paid very quickly starts to have a negative economic effect on workers who are still getting paid. *Anybody* who has retirement investments for themselves or educational investments for their children has already experienced the anxiety attendant to hits on those investments from the economic slowdown, with the likelihood of more to come. (I don't know where Pants gets the idea that the class of "workers who can work from home" are magically protected from the financial anxieties she's experiencing.)
In addition to the decline in the value of investments, even well-remunerated, well-credentialed white-collar workers have to worry about the lay-offs and job loss that *will* come if the economic slowdown is prolonged. Both older workers - who lived through the relentless lay-offs and career destruction of the aughties - and younger workers - who've had a tough employment environment for most of their working lives - are very much aware of this. As are Boomer retirees who don't fall into the Boomer Asshole class, which certainly exists, but is nowhere near as large and demographic-cohort encompassing as legend and comedy have it.
Angle, my husband works from home and has for years. You’re getting almost as overconfident in your insights as Farmer.
For Althouse and Meade and the rest of the isolators (not talking about the genuinely at risk sick and aged), Trump tested negative today for the virus, despite coming in contact, verifiably, with multiple infected people in recent weeks. That includes one sitting at the same dinner table with him.
He’s 73 and shakes hands and hugs more people in a week than you’ve done in your lives, most likely.
Stop being babies, support your fellow citizens. Quit scaring people.
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