You're not used to the exponential nature of the spread, which makes the numbers look disproportionate, but we aren't being hit much harder. We were only hit earlier, and not that much earlier even.

Most other European countries are now at 20-40 cases per million inhabitants, where Italy was 5-10 days ago[1]. They will be in our situation or worse in a week, since Italy had already started putting (mild) containment measures in place in the last week of February.

[1] https://twitter.com/fagiolinux/status/1237059898304847874/ph...

How was the sentiment in the public before it hit the fan? Do you have politicians or celebrities who peddle the "It's only a flu" argument?

We did during the first week, i.e. 10 days ago approximately, including the opposition pandering to their base about how the government was incompetent. They have since backtracked, and the opposition leader (Salvini) has never been so silent.

It feels as if all these people were trained in a secret CIA guerilla training camp and spread across the world to champion the same bullshit. I find it creepy.

It wasn't a secret CIA camp; it was the Internet.

We created systems for like-minded individuals who were previously geographically separated to find each other and cross-communicate easily, asynchronously, peer-to-peer, and globally. What you're seeing that looks like organized planning by a central office is more the effect of these people all reading (and posting on) the same news sources and message boards regardless of country of origin.

The "it's only a flu" sentiment never died and nor has "it only kills elders", albeit more people are taking it seriously because hospitals may soon begin to select who has access to ICU. It feels like "I have nothing to hide" you know, or "if you have something to hide then you are a criminal"; some things are never taken seriously.

"The Lombardy outbreak came to light when a 38-year-old Italian tested positive in Codogno, a comune in the province of Lodi. According to his wife, he had met an Italian friend who had returned from China on 21 January, who subsequently tested negative.[20] On 14 February, he felt unwell and went to a doctor in Castiglione d'Adda. He was prescribed treatments for influenza.[20]

On 16 February, as the 38-year-old man's condition worsened, he went to Codogno Hospital, reporting respiratory problems.[20] Initially, there was no suspicion of COVID-19, so no additional precautionary measures were taken, and the virus was able to infect other patients and health workers.[21] Later, the patient, his pregnant wife, and a friend tested positive.[20] Three more cases were confirmed on the same day, after the patients reported symptoms of pneumonia.[22] Thereafter, extensive screenings and checks were performed on everyone that had possibly been in contact or near the infected subjects.[23]

The 38-year-old man was asymptomatic for weeks, reportedly led an active social life, and potentially interacted with dozens of people before spreading the virus at Codogno Hospital.[20][21] Afterwards, he was transferred to Policlinico San Matteo in Pavia,[24] and his wife to Sacco Hospital in Milan.[25][26] " [1]

[1] https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_I...

Bad luck. Ski season? All it takes is one person coming home from 6 weeks trying to ramp manufacturing in China taking a week's break to ski and unwind. Boom.

Total speculation on my part, but you can imagine a dozen similar scenarios that are just bad luck. Heck, in Germany, there was a cross-training event at an auto manufacturer, with Chinese workers visiting plant in Germany. Imagine: "Ok, let's all take turns at the controls of this metal press..." Boom.

The same thing has no doubt happened in the USA, we just don't know about it yet. I just looked at an annual event that I go to most Aprils, and.... not cancelled yet. I sure am not going this year -- I can't believe the organizers are not cancelling out -- knowing them, I suspect greed.

Edit: Typo's and grammo's.

- Older population

- lot of heavy smokers

- the typical european old people attitude (and i'm saying that as a european too): "you don't take me anywhere". My grandparents passed away long ago but they never went to doctor only in the very last minute all the time. It's a kind of mentality and you can see that in the Italy cases. When they take people to the hospital and they die the next day it means they had a heavy fever for a week or more already. They have been sick for a long time but no, we don't go to the hospital. That's why what South Korea does is important, 20k tests daily, and they have done 200k already.

All three may account for higher number of fatalities, but not for the speed of the virus spreading.

There is no real evidence that smokers or older people more easily get the virus, and of course if they stayed put at home they did not contribute to the spreading (they had no or however less contacts).

As bryanrasmussen pointed out physical contact is also more common on meeting, especially kiss on the cheek. Like that's how you greet everyone and the best way to spread viruses

I've never been to the US but I don't think kiss on the cheek is that common there.

I see a kiss on the cheek as a greeting in the US about once a year, usually between two visiting Europeans.

physical contact, kiss on the cheeks common.

> the a typical

Thanks for fixing.

I meant typical sorry

They did extensive testing and were finding cases other countries weren't. They changed this a bit over a week ago [0] to be more in line with other countries, so the numbers wouldn't increase quite as quickly.

> Italian health officials are making another change in their testing protocols that may slow the growth of new case numbers. The country expects to limit coronavirus testing to at-risk people showing symptoms of COVID-19, said Giuseppe Ippolito, scientific director at Italy’s National Institute for Infectious Diseases.

> Previously, Italy was testing anyone who visited certain towns in northern Italy or came into contact with someone infected with the virus but not necessarily showing symptoms.

> Ippolito said the shift corresponds with updated recommendations from the European Centre for Disease Prevention and Control,.

[0] https://abcnews.go.com/Health/wireStory/italy-virus-count-me...

Textile workers from Wuhan https://www.bbc.com/news/business-21350013 and

..."According to data published by the Italian Ministry of Labor and Social Policies, 309,110 Chinese people were officially living in the country in 2018, comprising 155,305 men and 153,805 women with an average age of 31 years. Lombardy and Tuscany emerged as the two regions that received the largest number. Specifically, several businesses producing or selling clothes, supermarkets, and technological-device stores have been concentrated in the city of Milan, boosting a vibrant multicultural environment in Lombardy."...

https://asiatimes.com/2020/03/on-being-a-chinese-in-italy-du...

Germany or France are only 4-5 days behind Italy in number of infected. (Germany 1100 : Italy 7300).

As for number of deaths in Italy - they are already in warlike conditions where patients are going through selection and some are simply left to die.

> Since there is, unfortunately, a disproportion between hospital resources, resuscitation beds and critically ill patients, not everyone can be intubated,” Salaroli said. “We decide based on age and state of health,” he added. [1]

[1 https://www.brusselstimes.com/all-news/belgium-all-news/heal...]

Heard it went through some winter sports locations. If you've ever been in such a place you know that you will at times be transported in jam-packed cable cars and buses. I can imagine one person can infect the whole car/bus, and they all leave in a few days (most people stay <10 days) and bring the virus to new lands.

All European countries are growing at the same rate. Italy just started first

Older population?

Correct. The average age of deceased in Italy from COVID-19 is 81.4. Which is mental and puts the current crisis in perspective.

14.3% Case Fatality Rate, 90+ years old

8.2% CFR, 80-89

4% CFR, 70-79

1.4% CFR, 60-69

0.1% CFR, 50-59

0% under 50

Source: https://www.iss.it/primo-piano/-/asset_publisher/o4oGR9qmvUz...

(Official Italian health service, 7 March 2020)

that's actually a very good answer.

Nothing. They're just one of the early hot spots.

This virus evolves somewhat slowly- up to 2 weeks incubation period plus another 3-6 weeks of illness. But because it spreads during incubation, and has a high R0 value, once it starts spreading it does extremely rapidly in dense areas, after the 1-3 week lull. It is allegedly aerosolized and one paper reported surface contamination for >1 week.

The us is in week ≈2 now. Week ≈3 is where the whole country lights up with outbreak and the government is pressed into extreme measures. This is based primarily on South Korea's timeline.

On the bright side, the sprawl of the US may make this easier to deal with, but you can probably expect some domestic travel restrictions soon. I don't know if states have authority to close borders but I won't be surprised to hear about it.

Where have you read that it spreads during the incubation time? So far Swedish epidemiologs have not seen any evidence of that fact.

I've heard 1-14 days with an average of 3 days, but I'd have to dig up sources. But even if the long incubation periods are rare, they'll still have an outsized impact.

>average of 3 days

That should be 'mean'

Mean is a type of average. And for communicating to the public, unless there's a strong reason otherwise, statistical jargon should absolutely be avoided in favor of more universally understood terminology.

Even worse, this is a total blunder, I meant 'median'.

Also, what would the mechanism be? Coughing is the ‘normal’ mechanism to move viruses out of your lungs.

If it spreads before the coughing starts, i.e. during normal breathing, doesn’t it get out of your body too easily?

The virus accumulates in digestive organs and sheds in fecal matter. Gastrointestinal (fecal-oral) infection route seems likely.

See:

- https://www.medrxiv.org/content/10.1101/2020.02.14.20022939v...

- https://www.medrxiv.org/content/10.1101/2020.02.20.20025601v...

> Compared with SARS, COVID-19 was transmitted in a more diverse way, from person to person, asymptomatic infected people and possible fecal-oral transmission, created the conditions for a large-scale spread.

- https://www.medrxiv.org/content/10.1101/2020.02.17.20023721v...

I've grown tired of pulling up sources on mobile but publications claim the virus accumulates in nasal passaged during incubation. Also thought to play a role in the high false negative rates for testing.

This is also true - digestive and respiratory organs appear to accumulate the virus most. Also heart and liver, which explains the high co-morbidity for people with damage to those organs.

See http://www.chinaxiv.org/abs/202002.00082

Looks like any organ with ACE2 receptors.

Lots of reports of this, for example: http://www.chinaxiv.org/abs/202002.00078

South Korea's timeline is very likely to be atypical, because a majority of the cases in the country are linked with one particular religious group.

Then why are countries like Germany, which were exposed earlier, not experiencing similar problems and lockdowns? I am deeply troubled by this sort of isolated authoritarian overreach and the eagerness with which people accept it.

If states in the US do try to lock down their borders, I might drive across a few just to reinforce the fact that such measures are unconstitutional and anti-American. This is all starting to feel like mass hysteria, considering how much reports vary from country to country and the whiplash speed at which the overton window is moving. How long until Congress passes the Pandemic-triot act to suspend the 1st amendment in the same way that the Patriot act suspended the 4th and 5th?

This happens every 5 years or so; SARS, swine flu, and H1N1 were all more severe, and we didn't destroy our societies over them. We just have more access to information and mediums of emotional contagion nowadays. I understand that most people disagree with me on this, but that's what happens with mass hysteria and emotional contagion. Know that not everyone buys into it, and if you are keeping calm you are not alone :)

Personally, I'm thinking of visiting Venice in a few weeks once the planes and trains are operating again. This seems like a great opportunity to avoid the crowds and get a good deal on seeing the city before it is submerged for good.

Of course every country has its own share of idiots. According to the latest Korean news, some elderly lady moved from Daegu to her daughter's home at Seoul, had a flu-like symptom, went to one of the biggest hospitals in Seoul and lied five times that she wasn't from Daegu. Now they have to quarantine the hospital.

Well, at least she didn't claim that it was her constitutional rights to barge into random hospitals carrying virus. Cultural differences, I guess.

> Then why are countries like Germany, which were exposed earlier, not experiencing similar problems and lockdowns?

Just wait a week or so.

Why would it be taking much longer for the virus to spread in Germany than it is in Italy, when Italy is implementing much stricter quarantine measures than Germany?

"Just wait a week" is the refrain of everyone who is panicking right now, as it has been for the past few weeks.

> Why would it be taking much longer for the virus to spread in Germany than it is in Italy

Because that's how the exponential function works. Italy started earlier so its numbers are still growing by thousands every day.

But the numbers for France and Germany are almost exactly the same as the numbers that Italy had 10 days earlier, and Switzerland trails Italy by only 5 days once you correct for the smaller population.

But Italy did not start earlier; France and Germany did. Here's an animated map:

https://en.wikipedia.org/wiki/Timeline_of_the_2019%E2%80%932...

So I ask again, if this is such a super-pandemic, why are Germany and France fine despite having looser quarantine measures and earlier outbreaks than Italy? And why do you expect them to get dramatically worse over the next week?

For the exponential phase of the epidemic to kick in, you need a cluster that goes undetected for a week or so. For example it can be a young local person that just shrugs it off as a bad cold and meets a lot of people while he's sick---which is exactly what happened in Italy. Italy found out after someone that "shouldn't have gotten sick" ended up in the ICU with pneumonia and a clever doctor decided to test him for COVID-19. That was in mid February, one week before 10 municipalities were the first to be locked down.

Looking back at the January data, however, there were already more cases of pneumonia than usual in that same area and many of those that survived now have antibodies. And in fact, the strain that is hitting Italy was actually already present in Germany in January based on genome analysis; for whatever reason the real outbreak started a bit later in Germany than in Italy, but that's expected because the initial phases of the epidemic are random.

Germany and France now have 1,151 and 1,209 patients, with latest daily increase of 31% and 27%, respectively. What do you mean they are "fine"?

I mean that they have not felt the need to take the extremely aggressive step of suspending their citizens' civil liberties for an arbitrary period of time, and rightly so.

Is this what you want in your community?

https://www.npr.org/sections/goatsandsoda/2020/03/03/8099657...

> ... they have not felt the need to take the extremely aggressive step of suspending their citizens' civil liberties ...

If that's your definition of "fine", then when you wrote this:

> why are Germany and France fine despite having looser quarantine measures ...

were you actually saying:

"why are Germany and France having looser quarantine measures despite having looser quarantine measures?"

/shakes head

I understand your point of view, but I would phrase it more like:

"Why are Germany and France not worse off than Italy despite having looser quarantine measures and an earlier start to their outbreaks?"

And I still haven't heard an answer which comes close to justifying Italy suspending its citizens' rights. But that's fine; it won't matter in a few months, and we're approaching an easy opportunity to make money and travel smart as the herds follow their predictable migrations.

I just wish that people were less eager to give our fundamental rights away over this; history shows that they are unlikely to come back once they are surrendered. I'm already tired of the CBP shutting down entire 80mph interstates to search every vehicle passing through; where does this end?

Anyways, arguing about it is just something to do while everything is shut down, eh? :)

So you say in 1 week Germany will turn into Italy? With multiple hundreds of deaths and states closed down?

I say at least two of France, Germany, Switzerland and Spain. Of course I'd be happy to be wrong.

> that such measures are unconstitutional and anti-American

You're wrong. The constitution explicitly carves out allowances for quarantines.

A "nobody is allowed to leave their homes starting now" type order would obviously be practically impossible to enforce, but that's a different matter.

>The constitution explicitly carves out allowances for quarantines.

Where? I could be missing something, but I don't see that:

https://constitutionus.com/

The closest I could find was the part that grants Congress the power to pass any law that it wants, but I don't think that the executive arm could unilaterally lock down interstate travel. It also says:

>The Citizens of each State shall be entitled to all Privileges and Immunities of Citizens in the several States.

We are citizens of the United States, not of one state in particular. We pull together, or we fall apart.

Gibbons v Ogden (1824) — states may pass quarantine laws under the interstate commerce clause.

That sounds like it involves the legislature passing a law, not an executive decision.

... but roving armed police cruisers are, obviously, a good start to such enforcement, and most American towns already know how to do that.

Normally I lean heavily libertarian and I agree with your concerns, but all of the literature out of China on lancet, pubmed, etc are demonstrating that this is far worse than SARS or anything else that's hit. At the very least the rate of spread is .25-4 times higher than the Spanish flu and lethality is comparable.

China shut down it's entire industry for two months. Knowing full well the risk of losing global business permanently. Perhaps it is time for drastic measures.

> At the very least the rate of spread is .25-4 times higher

See how China scientifically tracked spreading: https://news.ycombinator.com/item?id=22528245

> China shut down it's entire industry for two months

and kept everybody at home (and if you violate those restrictions, go to jail), and had masks for everybody... It's safer to be in China than EU now.

I don't understand how people can keep saying this with a straight face. It's been months since the infections started in Wuhan, people keep predicting imminent doom within the next week, and it keeps not happening.

I think we need to acknowledge that the worst-cast predictions are laughably inaccurate, and a little bit of fear of the unknown is not worth losing our civil rights over.

The thing that stopped the spread of coronavirus in Hubei after ~50k infections is the lockdown. The lockdowns began January 22-23rd, affecting about 59m people. Nobody is leaving their homes except a few essential personnel, to include medical personnel and food delivery. That works in China but it probably won't fly in most liberal democracies. At the time, less than 2k people were confirmed infected. Exponential growth continued for two more weeks, until hitting its inflection point. That's with the lockdown.

Coronavirus has begun exponential growth in the rest of the world. The rest of the world already has more cases than China did when exponential growth inflected.

As of today, it's not showing any signs of inflection. On February 26th, Trump said we had 15 cases in the US, and would be close to zero within a few days. 11 days later, we have 607 cases, 22 deaths, and 8 recoveries. That's a growth rate of 40% per day, and holding steady.

The scary number isn't 607. And it isn't even 22. Nor is it 22/607 or 22/(8+22). (which, tbh, is pretty scary)

The scary number is 40%.

Sure, it's "just" old people with a high probability of dying. But I have several elderly relatives. I'm not enthusiastic about losing any of them.

You are misinformed. This is literally starting now. Jesus man open your eyes. Multiple states have declared states of emergency. At the very least that means the virus is here.

Now do you honestly think China would shut down it's entire economy for 2 months over the flu? Have you actually read any published literature on the virus, or are you just watching people around you prepare and laughing at them? 8% of the Iranian parliament was infected last week - two were dead by Friday.

Because this is all unfolding slowly, we still don't even know if any of the following speculation is true:

1. Multiple Chinese sources report reinfection after recover

2. Multiple sources report positive tests after recovery

3. Hot weather may not stop the virus (see Singapore)

This is not SARS. This is not just another flu outbreak. Global markets are crashing because they see what's happened in 6+ countries now. It's time to get your head out of the sand.

Do you know that fucking Mecca is deserted right now? I don't think that's ever happened before.

Sure I believe that the virus is here and that it is serious. I wouldn't be surprised if my neighbors had it, and I might have had it a week ago judging from symptoms, but so what? I'm staying away from at-risk groups like the elderly and immune-compromised, I have enough food and water to last a few weeks, and I'm not running out to social gatherings. But I also believe that it is not an excuse to suspend the Constitution. Jesus man open your eyes, a lot of people died for those rights and it's insane to throw them away over a momentary panic.

The markets crashing is overdue IMO; things have been overheated for a long time now and a correction has been expected for awhile. It had may as well come as a result of herd behavior rather than market fundamentals, and I say let it ride. Like the old adage goes: be greedy when people are fearful, and fearful when people are greedy.

Also, the Hajj isn't until July this year; it's not surprising that Mecca is not crowded, and closing it for most business at this point in time is not beyond the pale in a global sense.

> what happened in Italy that they were hit so disproportionately hard relative to other countries?

Short answer: we don't know.

My hypothesis: Italy was the first G7 nation to join China's Belt & Road Initiative [1]. Its populist government also bet heavily on integration with Russia and China. That caused it, alongside Germany, to get hit early. Its sclerotic state then let it fester.

[1] https://en.wikipedia.org/wiki/Belt_and_Road_Initiative#Italy

I do not understand what Russia has to do with this? If you claim that there are more people traveling between China and Italy because some commercial interests why not say that? I have no idea about such people traveling but from what I see as an outsider a lot of US business people are traveling to China and Taiwan too.