COVID-19

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CS
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Re: COVID-19

Post by CS »

China's rulers will not learn from this, I'd wager. That regime is a danger to the world community. Replacing it would have the nice side effect of removing some serious human rights violations.

George the original one
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Re: COVID-19

Post by George the original one »

BeyondtheWrap wrote:
Mon Feb 24, 2020 10:19 pm
Stocks were down a bit today, apparently because of the virus. Will they keep going down?
Stock market is forward-looking, so as each dribble of information comes in, it will yo-yo badly. The seemingly bad news of yesterday is forgotten while a few bright spots appear today.

black_son_of_gray
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Re: COVID-19

Post by black_son_of_gray »

AnalyticalEngine wrote:
Tue Feb 25, 2020 9:47 am
If a single community got hit by a spike in "influenza" cases, the CDC would see it almost immediately. So if there is a sudden spike in people admitted for viral pneumonia to hospitals, the CDC would go on red alert.
I'm not sure that would ultimately be that helpful, unfortunately. Let's run some numbers. Assuming 85% mild, 15% turning into severe (and only the severe cases going to the hospital*), a sudden spike in viral pneumonia cases at a single hospital would be, what, 4 or 5 cases? Which would mean in reality that 4/0.15 or 5/0.15 or 27-33 people in the community already have a milder version. Throw in a lag time between testing (2-3 days because lack of test kits mean a flight to CDC), assuming patients are even tested as they might not meet CDC criteria including travel or contacts with someone from China (isn't that still the case?), and a conservative doubling time of a week (although initial numbers in Italy and S. Korea suggest it could be much faster), and you're looking at maybe 40-50 cases before you even start to do the contact tracing! Unless I'm super wrong about how these numbers stack up (maybe!), it would seem that the game is already lost at that point.

*The combination of the health insurance quagmire in the US, combined with it's inconsistent and generally more expensive cost of health care vs. other countries, and the fact that about half of the population couldn't afford a couple-hundred-dollar doctors visit, there is a huge incentive structure in place to avoid seeking medical care that is counter to best practice for tamping down outbreaks, i.e. precautionary principle, aggressive testing, early intervention. :roll:

TL;DR: By the time you detect a death (~2%, implying around 50 mild, and for at least a week or two) or a small cluster of seriously ill (~15%, implying at least 7 mild per seriously ill), it is already pretty bad. This is exactly why Iran's numbers are simply unbelievable, unless the virus has changed to become considerably more deadly...

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

@bsog - I agree with you that by that point, it would be too late for containment. However, that might not really matter because I believe we're already look at when the virus gets here, and not so much if.

If you take extreme sanitary precautions now (wash hands, assume everything you touch is contaminated), you're probably not going to be caught in the undetected first wave. Then once you know that community spread is happening, you enact stage 2 of the plan, which is to lock yourself in your house until the virus goes away.

I am curious/afraid of how woefully unprepared the citizens of America are for this. Between the bizarre insurance landscape, the "work while you're sick" culture, and paycheck to paycheck lifestyle of Americans, the virus may be able to wreck more havoc here than other developed nations. America is a weird place where we have pretty sophisticated quarantine and hospital systems based of previous fears of bioterrorism/ebola, and yet the average citizen is probably more individually vulnerable than someone in Europe would be due to the glitches in American culture.

chenda
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Re: COVID-19

Post by chenda »

@analyticalengine - would though the lower population density (on average) than Europe be an advantage in slowing down infection spread ? More isolated towns and cabins and the like...

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

@chenda - That's an instance where averages can be misleading. It doesn't matter what the average density across the country so much as what the density is in a given town or community. There's a huge number of cities that are just as densely populated as Europe.

Plus even rural areas have supply trucks and such coming in from bigger areas. So spread is still very much possible.

Another concern is that rural areas often have poorer medical facilities, and so they could be hit even harder from a surge in cases.

That being said, living somewhere like the suburbs does seem to be a boon for once. Since taking cars instead of public transit, not being jammed in, etc, does help your personal efforts of social distancing.

black_son_of_gray
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Re: COVID-19

Post by black_son_of_gray »

@AnalyticalEngine: Yup, sentiment shared.

While I'm at it, here are some more thoughts I'll throw out.

1. Quite a few stories have popped up in financial media pointing out the non-linearity of business supply chains, i.e. that if 5% of the parts to make your widget come from China, you don't simply make 5% less widgets, you could be stuck making no widgets at all because you are waiting for specific parts to complete the product. Most of this discussion has been tied to China, which has (according to their extremely-some might say questionably-smooth official numbers) started to make progress beating back their epidemic. But it's even more fragile than that, because pandemics roll around the globe in choppy waves. So just as the 5% comes back online from China, another supplier in some other place starts to flare up and consequently shut down. And on and on. So you could have a rolling small hit to supply chains that effectively shuts down 100% of production almost continually until structural workarounds are achieved. Of course, only certain businesses are affected by these kinds of issues, but the ones that are might be walloped.

2. A somewhat related issue that I haven't seen get much press is the overall productivity hit to businesses simply by the long timeline of the infection. Consider: most infections are mild, but that still means something like 0.5-1 week of illness, plus potentially a another week or two longer if you don't want them shedding virus at the workplace (at least, that's what they've discovered in China). For the approximate 1 in 7 that will have a serious case, that can mean 3-6 weeks before recovery (plus add the extra safety week). That is a long time for an employee to be absent from work. This is a rock-and-a-hard-place issue for everyone. If businesses want to maximize butts-in-seats for productivity reasons, they risk further spread among their employees. Do they just overtime the healthy employees to make up for it? That could be a lot of slack to take up. For employees, they better hope they have good insurance or an emergency fund or that they aren't paid hourly, because potentially 6 weeks of no pay = eventual bankruptcy for many, on top of just coming out of being really sick for a month (how much $$ is a couple weeks in the hospital?). Some businesses will be able to solve this through lots of telework... but not all businesses. At the national level, GDP can be broadly calculated as (# workers) * (productivity/worker). You can run some ballpark numbers of realistic assumptions of how many workers might be affected and how much of their yearly productivity might be reduced and easily come up with GDP hits that ding the economy down towards recession, and that's before considering the additional supply chain disruptions and the lateness of the business cycle.

3. In both 1 and 2, debt comes into play. For those that can still utilize debt, it will be increased to bridge funding gaps. For those that can't pile on more debt, you end up with the potential for cascading defaults. Central banks will do what they can with the hammer of liquidity that they have, but considering that this virus causes both supply and demand problems (leading to both deflation and inflation in different areas), they can't solve all the economic problems that come up. The longer this continues to roll around the world in waves, the worst the debt situation becomes (on top of it already being bad globally to begin with).

4. When it crops up in the US, Americans are going to freak out, largely because they are under/unprepared and because it is just human nature. Have you seen how Texans react when the weather forecast says they'll get a dusting of snow? (Nothing against Texans, I used to be one.) This over-reaction is predictable. There will also be the "I'm going to ride out the hurricane in my trailer" types too, who will act idiotically just to show everyone how not-scared they are. This under-reaction is also predictable. Neither are helpful, but the predictability of these behaviors is useful.

Thought-purge done for now.

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Dream of Freedom
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Re: COVID-19

Post by Dream of Freedom »

@AnalyticalEngine

Locking yourself up until it goes away may or may not work. Viruses can become endemic meaning it's just always present in a population and it's just too soon to tell if that will happen with this virus.

@black_son_of_gray
As for the American medical system, you can have fast, good, or cheap. Choose any two. We have fast and good. Other countries chose differently.

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

@bsog - The economic fallout you're describing is one argument you could make for just giving up and letting the disease run its course. Because at a certain point, the economic costs of containment are higher than the loss of life from the disease. This is the difficult balance the global leaders have to walk. They need to look like they're fighting the disease so their populations trust them, but they also can't let it derail the global economy because a recession hurts everyone.

This is why a certain amount of emergency fund money is so important. Your employer might tell you to come to work anyway because you're in the low risk group and the company risks going under. Being able to say "no" and have enough savings to weather the storm could be the difference between life and death.

To be honest, I think medical workers are going to have the worst share of the pie here. They're the ones who will be overworked and undersupplied.

@Dream of Freedom - At this point, I think the virus is very likely to become endemic, and we might even start to see "corona" season much like how we see flu season now. However, I'm not as worried about this outcome because endemic diseases can be fought using vaccines. If it became endemic, you can bet I'd be first in line to get vaccinated.

jacob
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Re: COVID-19

Post by jacob »

Dream of Freedom wrote:
Tue Feb 25, 2020 1:25 pm
As for the American medical system, you can have fast, good, or cheap. Choose any two. We have fast and good. Other countries chose differently.
Actually we have fast and good for those who can afford it and third-world standards for those who can't. This is just applied capitalism for private health issues like heart attacks, broken bones, or cancer. However, this arrangement changes the equation significantly when it comes to public health and issues like infectious diseases where the fragility is more determined by the lowest common denominator which in this case is scarily low. Basically, your risk of getting infected is not based on what you can afford but what your "neighbors" can afford.

theanimal
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Re: COVID-19

Post by theanimal »

@jacob/JP/anyone who stores water- How much water do you have in store per person?

GandK
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Re: COVID-19

Post by GandK »

We have 100ish gallons in the RV at all times, partly in the fresh tank and partly in bottles. We also have a Berkey.

On another note, we have a 7-week trip to Greece planned starting on April 15, tickets purchased and rental car arranged. Yesterday G came to me and said, "Do we still go?" We discussed it and agreed to take it week by week. I'm considerably less freaked out about coronavirus than he is. All 3 of us in the remaining household are reasonably healthy where something like this is concerned. G is something of a germaphobe though.

black_son_of_gray
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Re: COVID-19

Post by black_son_of_gray »

AnalyticalEngine wrote:
Tue Feb 25, 2020 1:51 pm
@bsog - The economic fallout you're describing is one argument you could make for just giving up and letting the disease run its course. Because at a certain point, the economic costs of containment are higher than the loss of life from the disease. This is the difficult balance the global leaders have to walk.
I'd flip that upside down, actually, with the distinction that I agree we should probably focus less on containment than on mitigation at the ground level. Or said another way, it would be a much better use of time for the people in charge of handling this situation to worry about mitigation. The best outcomes for everyone come from a lengthening and slowing of the epidemic curve*, which is best accomplished by huge efforts up front before problems arise. This is because all of the downstream effects aren't static, but change in severity with the speed of things. A long, slow ramp of infections means that hospitals aren't instantly overwhelmed. Death rate might go up 5x if you can't get a bed/ventilator/O2 when you get pneumonia. A slow squeeze of labor or supply-chain is much more manageable than a sudden disruption. Fast-spreading outbreaks cause panics, while slow creeping ones don't. Etc.

To me, the difficult question for leaders who want the best outcome (low and slow) is: how much preparation can they get away with politically? Huge preparations are expensive on the front end and if they work, the outcome makes it look like they "wasted" money or "caused a panic" when "not many people were affected in the end" or "it wasn't a big deal" (that's the point). Also, there are big egos involved that can't suffer looking concerned or incompetent or frantic or deferential to nerds in labcoats.

*even if this does put a squeeze on debt-laden companies. Zombies will have to die eventually, regardless of pandemics.

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

@bsog - Oh I agree with you. I think we should be doing more, not less, to try to slow it down now. It's just an incredibly difficult balance between shutting things down and keeping them going.

Oh and also, the CDC has officially said "it's not a matter of if but when" and that "Americans should be prepared for significant disruptions in their daily lives." The White House has also asked for a budget of $2.5 BILLION to fight/cope with COVID-19.

black_son_of_gray
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Re: COVID-19

Post by black_son_of_gray »

@ GandK - Speaking of deflation, prices for travel/tourism could come down a lot in the coming weeks. I would suggest doing a price check periodically as you approach your trip. It very well may be worth it to eat cancellation fees and re-book at dramatically lower costs.

black_son_of_gray
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Re: COVID-19

Post by black_son_of_gray »

@AnalyticalEngine - $2.5B is chump change. Singapore has spent more than that and it is tiny in comparison. Obama asked for $6B for ebola in 2014.

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

@bsog - Thanks for the clarification/references. Although now I can't help but feel we are truly doomed. :?

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jennypenny
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Re: COVID-19

Post by jennypenny »

2.3% death rate, 2.28 R0 http://www.cidrap.umn.edu/news-perspect ... death-rate


The problem with the slow but steady increase in cases means that there's no pivotal moment where the government can step in with draconian measures to slow the spread. If a hundred people died on the Diamond Princess, you'd see a lot more support for decisive action. As it stands now, at what point do they step in?

Besides, I could make an argument that if there's no containing the disease, we should let things go on as usual. People will decide on their own when to self-quarantine or curtail their activities to avoid exposure, which would be better than the government making an announcement that would prompt everyone to do it at once, guaranteeing a run on banks, stores, pharmacies, etc. At least supply lines aren't overrun when you let people (slowly) figure it out for themselves.


@theanimal -- 100 gal pp plus the biggest Berkey available

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Ego
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Re: COVID-19

Post by Ego »

Almost 2/3 of Americans don't have $500 for an emergency. Many have no one they can turn to for help. I would guess that many of the hourly service-industry jobs that are most vulnerable to disruption are staffed by these unfortunate folks. They need a constant flow of money to pay rent, eat and buy medications.

If we start seeing serious spread here I believe the government(s) will be forced to make a rather hard decision. Either downplay the risks of infection and keep the entire system rolling along -or- close it all down and declare rent/mortgage/healthcare jubilees where payments are delayed until we get back to normal. Thoughts?

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

Yikes, according to the study JP posted, the 80% of "mild" cases includes cases that only got "mild pneumonia." If even the mild version of this disease includes mild pneumonia, I'm gonna have to take a hard pass in contracting it. I can think of a whole bunch of better uses for three weeks than lying sick in bed with the flu from hell and mild pneumonia.

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