COVID-19

[Lucky C]

@jacob thanks for your estimate. I made different assumptions in my estimates - a bit higher spread rate not wanting to be too optimistic, and a higher localized infection rate vs. national rate since that is the case for the Greater Boston area. However since the spread is so rapid, my estimate vs. yours is only a shift of a few days over the next week!

In making my estimate, I was taking a stab at the question: "what are the odds that the average person in my area would get infected in the next week?" My plan was to isolate as much as possible as the odds for the average person getting infected started to exceed > 1% projected over the next week. We already don't go out much and I figure most of the cases in the next couple of weeks would be people ignoring the threat and going into the city, out to social gatherings, their 9-5 office jobs, crowded stores, etc. so our odds would already be much better than those of the "average" person.

Based on Jacob's numbers, I give the average person odds of infection of about 1% (if nobody changed habits significantly) over next week 3/16-3/22. Based on my previous estimate for Massachusetts (haven't updated it the past week), I was estimating those dates to be yesterday 3/13 through Thursday 3/19. With MA school closings next week, many large employers doing work from home, and people starting to take this seriously, the odds will probably be much lower. Obviously on the flip side someone working overtime bagging groceries in Boston next week could have a greater than 1% chance of infection.

We have a few things we need to go out for next week, but much fewer total hours of public exposure than the average family. In one week our self-isolation begins aside from maybe a couple of previously scheduled medical appointments the week after. So I'm estimating our odds of not getting infected, at least with this first big wave, as 99%+.

It's hard to predict how much all these closings and cancellations will help slow spread in the next couple of weeks, but if you want to keep your odds of being infection-free >90% I would estimate you would want to start isolation measures by the end of March. Especially if you normally come into contact with a lot of people who aren't taking any protective measures. You could also ease into it if needed as every potential reduction in exposure helps. It's not like a single trip to the store in the first week of April will give you a 10%+ chance of infection. But as all you smart people already know, it won't be long before it truly is everywhere.

[Dream of Freedom]

Apparently the kids these days are calling it 'boomer remover'.

https://news.google.com/articles/CAIiEH ... id=US%3Aen

[shemp]

@7wb5 - Also The Plague by Camus. It's amazing how the development in the book parallels what's happening now.

That plague was a metaphor for fascism in France and/or Nazi invasion of France.

This pandemic may cause the whole world to reengineer to reduce vulnerability to future natural pandemics as well as biological and other terrorism. (Such reengineering might also take concurrent global climate change into account.) Fewer bricks and mortar stores, more delivery services. Fewer in-person services, more teleconferencing delivered services. More working from home. Migration from big cities with expensive housing to small towns with cheaper housing. Travel industry may shrink then raise prices to provide cushion for expected future shutdowns whenever a pandemic arises.

Meanwhile, Spain is moving into lockdown mode. No panic yet here in the small city of Baza, where I am now. But I expect to be stuck here in this hotel for a long time. Hesitant to move on, since no guarantee hotels further on will have vacancies, or the police might stop all movement. I expect people to soon growed tired of the panic.

To put things in perspective, about 637 thousand people died in Italy in 2018, mostly from "old age", or over 1744/day. Meanwhile, corona virus has allegedly killed 1266 people in 3 weeks or so since the first death and is currently killing about 250/day. Most of those dying from corona virus are old, and in all likelihood would have soon died anyway from something else. Now granted, the corona death toll is increasing exponentially, but still, if it's mostly old people, it's people who were going to die soon anyway. Old people die of natural causes all the time, with flu being one of biggest of those natural causes. This whole corona virus thing feels to me like hysteria, though I'm not denying the reality or the seriousness of the disease.

[Ego]

The age distribution of deaths will influence a lot of individual decisions. This particular chart is for Italy. What are the chances that the younger deaths had comorbidities?



The fact that this data is being released publicly speaks volumes about public health planning in the same way that the supposed testing "mishaps" indicated certain intentions. If they really wanted *everyone* to isolate they would keep the age distribution secret.

[theanimal]

The views of the elderly as not full people have been one of the most interesting aspects of this virus. It's used as a justification for not really taking action on your own or a society as a whole as a major rebuttal until recently. After all "it's just old people." It is somewhat reminiscent of 19th century times when black people were considered 3/5th a person.

[jacob]

That plague was a metaphor for fascism in France and/or Nazi invasion of France.

Yeah, but that metaphor also works well as a metaphor for a real epidemic. The subtle evolution/emergence of the underlying change and the different responses/response-rates of "experts" and "ordinary people" work in both cases.

[AnalyticalEngine]

Definitely asking why officials focus on certain statistics over others is often more important than the statistics themselves. We have to look at what they say and what they do in combination.

If this virus truly just killed old grannies exactly like flu 2.0 then they wouldn't be canceling schools. Closing schools and shutting down the entire economy is extremely disruptive, and public officials aren't going to do that for fun. Italy went from business as usual to basically martial law in two weeks. So there's clearly more to the story here than some people giving into "hysteria" and buying TP.

(This is the real advantage to watching Clade X. It shows you how our leaders think!)

The reason the "only old people die" meme is trotted out is to quell panic by equating it to the familar. But there's clearly more to the story because Italy and China don't torpedo their own economies over granny flu.

And as theanimal said, the casualty of this propaganda tactic is dehumanizing the elderly.

ETA: I have a book called "Managing the Public Health Crisis" coming soon. I'm curious to see what lessons are in it and I'll share with you all what I learn.

[shemp]

The views of the elderly as not full people have been one of the most interesting aspects of this virus. It's used as a justification for not really taking action on your own or a society as a whole as a major rebuttal until recently. After all "it's just old people." It is somewhat reminiscent of 19th century times when black people were considered 3/5th a person.

The point is that old people are dying already. If they die a year or two sooner, well okay, that's unfortunate, but it's hardly some grand crisis of civilization. It just means fewer deaths of old people in the next few years. Old people die all the time.

Think about it. 1744 people/day were dying in Italy back on 2018, most of them old. Where was the panic? More people dying every single day, day after day, all year long, than have died in 3 weeks from corona virus. 637 thousand bodies to dispose of. Where did they put all these corpses? Why didn't anyone tell us of the mass deaths in Italy back on 2018?

[Bankai]

I knew trump was not handling this well but oh man...

https://amp.theguardian.com/world/2020/ ... e-trump-us

[theanimal]

@Shemp- Those were ergodic deaths. These are not.

[jacob]

@shemp - I couldn't find detailed demographic data, but 34% of the population of Italy is over 55+ and if we assume that everybody who can be infected will be infected within the next 6-8 weeks (40-60 days) under BAU and the average death rate of this crowd is 5%, then ... there are 60.5M Italians, so that works out to 0.34*0.05*60.5M/60 days = 17,000 deaths/day.

Even if the true death rate for the elderly is "only" 1%, that's still 3,500 deaths/day.

Yeah, they would have died anyway 0-30 years from now (that's also a lot of lost person-years if multiplied up), but I figure no country has the capacity to handle a sudden doubling spike of their death-rate.

[AnalyticalEngine]

@shemp - You're right, old people do die all the time. That's why the public health response in both China and Italy (and the UK and the US and others...) at the beginning of this outbreak was "let's ignore it and it will go away." Because hey, old people die all the time, the virus only kills old people, so what's the problem?

Then both China AND Italy went into lock down. Two very different countries with different cultures and governments. They tanked their own economies, something every public official as a strong incentive not to do. And most importantly, they did this only after trying the "let's ignore it and it will go away" strategy for weeks. Which proves the "just let it kill old people" strategy has failed twice now, and it wasn't for lack of trying.

So the point isn't that old people die normally. They do. It's also not that the virus is the end of the world, because it isn't. And it's also not a conspiracy. But government officials have a strategy in how they communicate with the public. It's up to us as citizens to look at the big picture and read between the lines. If they keep trying to reassure us with "it only kills old people" while closing everything and locking down the economy, there's a bigger picture that the average person consuming this soundbite may not understand.

ETA: The bigger picture is basically what @Jacob said, and also the fact the virus is killing 50-60 years old with shocking frequency, and that group isn't anciently old.

ETA2: What @Ego is saying is basically what I am trying to say too.

[Gilberto de Piento]

Iran's system for burying the dead isn't able to deal with the extra load:

Burial pits have grown so large amid a devastating coronavirus outbreak in Qom, Iran, that they're visible from space, satellite imagery shows.

https://www.businessinsider.com/coronav ... ace-2020-3

[Ego]

The views of the elderly as not full people have been one of the most interesting aspects of this virus.

My decade of Soylent Towers comments coming back to haunt me. This is neither new nor virus-specific and it is only going to get worse.

[Jin+Guice]

@shemp: I don't think the crisis is about current deaths. It's about 1) hospitalization rate and 2) infection spread.

I'm unclear on if COVID-19 is more infectious (much more infectious?) than the flu? If it "only" has 10x the death rate of the flu but infects twice as many people... There is also the lack of vaccine (again, not sure how much of an actual problem this is in terms of overall worldwide deaths vs. the flu).

20% hospitalization rate is fucking insane though. Hospitals don't have a ton of excess capacity, so a lot of other people are going to die who otherwise wouldn't have. Also the death rates appear to sky rocket wants hospitals are overrun. So hospital overrun is the real crisis.


Regarding response: I am impressed that the response has been so drastic given the low rate of death. Did anyone think ANY American politician would do anything before a single hospital collapse? U.S.A. is at 51 deaths. Personally I'm (pleasantly) surprised that any politicians are taking this seriously.

A potential problem with the European (non-Italy or Italy 2 weeks ago)/ American response is that we are just kind of half-assing it. I think this will have a large marginal impact (so a lot of lives saved), but if hospital overrun is the real issue (so there is a tipping point) we should either be 1) totally locking down or 2) accepting the deaths and doing business as usual. Instead we are opting for an intermediate response which will likely mean the lives saved are as expensive as possible and that many unnecessary deaths still occur.

I think we may be giving the U.S. government too much credit in terms of them conspiring against the elderly. I think a lot of their response can be explained by Trump denying this was a problem early on in an attempt to limit the effect to the U.S. economy, the media and his opponents saying he was wrong and Trump accepting that his original position was going to come down on the wrong side of (immediate) history.



There are a couple of things I don't understand. Is the situation under control in China? Have the restrictions been lifted? If this disease is as infectious as people say it is, isn't it much too early for that?

China was clearly able to take a regional problem and keep it from becoming nationwide, so what did they do? How have they been able to keep foreigners from infecting other regions?


Italy vs. S. Korea: WHAT THE FUCK? Italy's death rate is well over 5% (right?)? S. Korea is less than 1%? Is Italy's population really that much older? Was S. Korea really that much more prepared? Is it because S. Korea tested so much more? The difference is just fucking massive. Are these two just outliers that somehow saw epidemics develop 2nd and 3rd?

Iran and Spain: They are looking more like Italy, but not quite as bad? Do they tell us anything?

United States: Is this progressing as expected? I guess I thought there'd be more death/ hospitalization by now since the assumption has been that it's been running rampant and undetected for a few weeks. Does this imply that either the death rate is lower than thought or that it was not as widely spread in the U.S. as originally believed?

[Fish]

But there's clearly more to the story because Italy and China don't torpedo their own economies over granny flu.

I’m still seeking an explanation for this. Is this being done to prevent saturation of the healthcare system? That is, if the hospitals are full of C19 patients, then humans of all age groups can’t get proper treatment for other medical conditions. IOW, allowing C19 to saturate the system has a 2nd order effect of worsening outcomes for non-C19 patients so that they would experience disabilities and deaths that would not have otherwise occurred under normal circumstances.

[shemp]

... shutting down the entire economy is extremely disruptive, and public officials aren't going to do that for fun.... clearly more to the story here than some people giving into "hysteria" ...

From Merriam Webster online: "hysteria = behavior exhibiting overwhelming or unmanageable fear or emotional excess". Amd that's exactly what is happening, from what I can see: public officials (a job category more akin to charismatic actor/actress than steady hand on the tiller captain of a naval ship, for example) are falling prey to overwhelming fear of being blamed if things go bad, so they take drastic steps to avoid blame, and damn the consequences for the country, as long as it won't affect their pensions much.

Here's the thing. We have known for decades, if not centuries, that densely populated cities are breeding grounds for epidemics/pandemics plus they make a country vulnerable to terrorism. Back in the old days, we had no choice but to allow big cities for efficiency reasons. But after the invention of motor vehicles and telephones, it was possible to distribute things more. And the past few decades have seen huge advances in telecommunications such that we could get rid of big cities almost entirely and also greatly reduce long distance travel. Now if our so-called leaders had amy sense of public obligation, they would have been taking steps, starting about 1930 and accelerating in recent years, to distribute population, using some system of carrots and sticks to gradually push in that direction. We saw some such distribution post WWII in response to the these of nuclear war, but then in recent years the developed world has been crowding more and more back into big cities. Why?

Look at San Francisco and New York. Much of the value of work performed in those cities could be done remotely (software development, financial analysis and trading and investment banking, publishing, advertising). Medical work is more difficult to do remotely, but then a pandemic just exposes the craziness of concentrating medical work, because now the hospital becomes a focal point for disease transmission. We definitely want to keep people sick with contagious diseases as distributed as possible.

So why has nothing been done, other than building more skyscrapers in these densely populated urban conglomerations plus mass transit facilities (including airports) to ensure maximum vulnerability to pandemic? Answer: our public officials ALWAYS act at least borderline hysterical, because they always try to feel the political wind and react correspondingly, otherwise they don't get elected much less re-elected. And that political wind is nothing more than the rapidly shifting emotions of the crowd of voters, and such emotional reactivity is the definition of hysterical.

[AnalyticalEngine]

@Fish yeah it's to prevent healthcare saturation. Also it's disruptive to workplaces for all workers to be sick at once so it's to smooth supply chain and society disruption.

The weird focus on only old people dying is because the government is trying to quell fear. Undue panic doesn't help either

[shemp]

... there are 60.5M Italians, so that works out to 0.34*0.05*60.5M/60 days = 17,000 deaths/day.

I won't quarrel with the 5% fatality rate you propose, though it is very possible fatality rates have been overestimated because so many cases are asymptomatic. However, instead of dividing by 60 days, as you did, first look at the total: 1028 thousand extra deaths versus the 637 thousand of 2018 (and thus typical per recent year). So yes, a lot of old people would die a few years earlier than expected. Unfortunate, like I said before, though a much smaller tragedy, IMO, than someone dying from a drunk driver, something which happens very frequently everywhere and which has never caused the anger it deserves.

Packing all those deaths into 60 days does indeed create a big mess, but nothing we can't handle. Just dig some mass graves.

What the politicians correctly see, is that this surge of deaths followed mass graves to accommodate the bodies, even though it means nothing in the grand scheme of things, will be an opportunity for their opponents to blame them, and so they are desperately trying to get ahead of the curve and avoid such blame. If this causes other problems, so what? Job number one of a public official is always to get re-elected. (Even in non democracies like China, power is distributed among an elite class, and there is always a class of political opponents sharpening their knives and waiting for an opportunity to strike.)

[ertyu]

Is the situation under control in China? Have the restrictions been lifted? If this disease is as infectious as people say it is, isn't it much too early for that?

China was clearly able to take a regional problem and keep it from becoming nationwide, so what did they do? How have they been able to keep foreigners from infecting other regions?

Right now, Wuhan is still under quarantine but way fewer cases (field hospitals empty), and cases elsewhere in the country are mostly foreigners bringing it back in. They deal with foreigners by placing everyone in 14 day quarantine. People are being shipped from the airport straight into a quarantine hotel. If anything happens, they will treat you but you need to pay for any medical costs you may incur (unclear if you need to pay for the hotel stay). If you have alternative quarantine arrangements, you need to register those with the authorities. You can't go back to wherever via public transportation, either your employer needs to arrange a ride or you need to arrange your own and register it with the authorities. Once you arrive, local authorities monitor you. Idk how it is now, but I remember seeing pictures of people who traveled to Wuhan with cameras over their doors and a thing glued to the door where local officials sign that they've been to measure your temperature today + the result. Violating quarantine and hiding symptoms is a criminal offense. This is made possible becaue the state apparatus - officials, police, military - is way larger than it would be in a western country. Also the number of people flying to china at this time is comparatively small.