Just wait until they actually start testing people in earnest; the infected numbers will skyrocket in a very short period of time, causing another stock crash and more mass panic.
It'll probably be at least another few weeks before it's time to buy with both fists, imo.
The President, while visiting the CDC, said that he would prefer not to let the Oakland cruise ship passengers disembark, because it would bring the numbers up. He'd rather keep the numbers down.
Based on that, I doubt that there will be testing in earnest, so that "the numbers" don't skyrocket.
Reported case =/= actual cases and pretty much everything I've read/heard from doctors and virologists says the numbers of reported cases attributed to the actual CFR has been bunk the whole time.
I would not be surprised if hundreds of thousands of people in the US have it right now.
- Inconvenient labour laws regarding sickness, people are and will be afraid to take sick leave
- A lack of public healthcare, the US system does not seem designed for a collective approach.
- A higher rate of diabetes compared to the rest of the developed world which seems to be affecting quite a lot the impact of the virus.
I find it fascinating that authoritarian regimes have an advantage in that they can rapidly implement lockdown.
Freedom has a price.
Culture does play a big role into that indeed though, if you can manage to close off events & cities and having your citizens obey all the health precautions, it has a big impact on how it spread.
It's also not clear what advantage "public healthcare" is supposed to have in this context. The CDC has the authority to test and quarantine people. For the majority of people infected the "treatment" is to stay at home and recover. A minority of people will require hospitalization, but most of those people will have health insurance. The vast majority of those requiring hospitalization will be elderly and eligible for Medicare. The large majority of the remaining minority of a minority will have private insurance. And the remaining minority of a minority of a minority who require hospitalization, aren't eligible for Medicare and don't have private insurance will presumably still get treatment and then have a bad day when the bill comes, which is a financial problem rather than a medical one.
Everyone always seems to forget about this. According to the Emergency Medical Treatment and Active Labor Act[0], any hospital that accepts Medicare must "provide an appropriate medical screening examination (MSE) to anyone seeking treatment for a medical condition, regardless of citizenship, legal status, or ability to pay." And if it's determined that treatment is required, or the patient's health may be in serious jeopardy, the hospital is required to treat them until they're stable.
In other words, if you show up at the ER, they're required to run tests to see if you have a life-threatening condition. If you do, they're required to treat you until you're stable.
Everyone makes it out like US hospitals will simply turn people away at the door; in fact, they can't (assuming they accept Medicare, which most do). They'll at least find out your status, and treat if necessary.
If you've ever been in an ER waiting room, you've seen this posted.
[0] https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...
In place and redeployable infrastructure.
What you'd want from a government is to have a surplus of portable infrastructure able to be deployed in an emergency, but that's the CDC and FEMA.
And what of that when the President doesn’t like the numbers he sees, stokes the many conspiracists among his supporters with distortions and outright falsehoods, and that segment of (likely well-armed) population that think the “deep state” is executing a coup, start resisting?
More people going to a doctor because they aren't scared of the bills means more people being properly tested, properly quarantined, contact-traced, and most importantly properly reported and reflected in the statistics, leading to better countermeasures and responses.
Are you familiar with sick leave policies in Korea?
> Higher rate of diabetes
Korea has 8% with Type-2 diabetes and 23% are pre-diabetic. The US does have a higher rate, but not by much: 10.5%
> lack of public healthcare
Just 8.5% of Americans are uninsured. So about 9 people out of 100. There may be capacity concerns, but no more than most other countries. If a surge of British citizens suddenly went to the hospital, they’d be overwhelmed as well.
My concern would therefore be that the people that cannot afford health care or quarantine are also the ones most likely to act as multiplier as they come in contact with hundreds of people a day. That's not a purely US problem, e.g. delivery drivers or Uber drivers also tend to be low wage and self employed in Europe.
But in the US the combination with the lack of health insurance could make this worse.
https://www.kff.org/uninsured/issue-brief/key-facts-about-th...
any "nationalistic flamewar" is an interpretation by others.
When either the authoritarian leader of China, or the elected government of Italy decide that the country needs to quarantine, they do it. Meanwhile nobody even believes it’s possible in the US because the system is set up not to allow any even mildly controversial law to pass without months of bickering (see Obamacare which would have been considered a relatively moderate reform in any European parliamentary system)
Sure you should stock up on essential medicines that you might need if you have to stay in for awhile, but I wish people would knock off the chicken little attitudes. It doesn't help, and it makes people stop listening to reasonable precautions when the sky consistently fails to fall.
Thank you for the example; please don't go spouting this stuff to your friends and family. Just tell them to wash their hands and keep their distance from others instead of advocating full-scale panic.
And for the record here is a 12 day old article that says Italy has had 650 cases and 17 deaths[1]. The CDC website currently has us at 647 cases and 25 deaths [2] and plenty of other places are reporting higher numbers[3]. I don't think I am raising a false alarm here.
[1] - https://www.npr.org/sections/goatsandsoda/2020/02/27/8099845...
[2] - https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html
[3] - https://www.nbcnews.com/health/health-news/live-blog/coronav...
Or the shoppers get better at math.
Or I have some personal pride. That one usually wins.
The best way to minimize the chance is to not leave the house. The best way to avoid leaving the house is to have enough supplies in for a few weeks.
That's exactly why you do it
Most European countries have already accepted that most will get infected at some point (see Merkel's statement yesterday). It's all about flattening the curve to make sure hospitals have capacity. If we manage that, mortality could stay at reasonable levels. But we have no idea how high mortality rates could go if people with severe symptoms would need to stay at home.
People really need to calm down. This isn’t Ebola but people are acting like it is.
Initially I was thinking its the testing part. If you test nobody then nobody is sick. But that's not the case because with such high level of mortality, we would know that people are dying from COVID-19.
So my take is - what I read via WHO, is that this virus has two or more strains, one more deadly than another. So its quite possible that one or more passengers from China traveled to Italy with that more deadly type in them.
Of course next logical question would be - is it only in Italy or we have those in other countries and perhaps incubation period is longer? That's probably a billion dollar question...
According to current trends, France and Spain will be where Italy is now in about week.
But since it is very contagious and dangerous to the elderly, it's still a good idea to distance yourself from at-risk groups. The panicked overreaction probably won't see the backlash that it deserves, because there is a kernel of truth that social distancing can help to protect a small number of the most vulnerable people.
Also, it's easy to point fingers in hindsight. A lot of the decision-making up to this point has been based on extrapolations from very incomplete information.
Thanks! Never knew that this role was sometimes contracted out.
TSA agents physically touched my passport and boarding pass at each one. I wonder what are the chances they've given it to me?
Shutting down schools is almost assuredly an effective measure to slow the spread of the disease. And slowing the spread is the overriding public health imperative. Even if the same number of people get infected, fast transmission means the healthcare system gets overloaded with all the patients at once.
A 5% reduction in the rate of transmission could plausibly reduce the number of fatalities by 50% or more. We need to do everything possible to institute "social distancing" to slow the process done.
First, like you very astutely pointed out, stop making school mandatory. Even encourage families to keep kids home if they have childcare available. That probably entails ceasing any academics, since parents will otherwise feel pressured to keep their kids in school lest they fall behind.
Second, we can keep kids isolated in small groups, so they're not intermingling as is typical during a school day. A child should be assigned to a single pod, and only interact with his assigned pod for the remainder of the epidemic. Obviously childcare workers should be assigned a single pod, and stay in that pod. The smaller we can sub-divide pods, the better.
Finally big common activities, like lunch or recess should be staggered so that kids aren't ever exposed to anyone else outside their pods. Other than that pods should stay confined to the same classroom for the duration of the epidemic. Pods should probably be assigned based on busing routes, so that kids only bus with their pod.
Here's a problem: what's the difference between state-provided daycare and school, from an infectious disease standpoint?
Both are a bunch of kids in one building, attended to by adults. Both will require busing kids to said building, with buses driven by adults.
Might as well just leave the schools open.
I don't have a solution, just pointing out that daycare == school for this situation, so closing schools but providing daycare in it's stead won't make a difference.
2. When it gets bad, schools will be closed anyways, and parents will need to figure out how to handle childsitting.
3. The longer we delay closure, the worse off everyone else will be.
Isn't this the underlying plot of Maze Runner, and a bunch of other books/movies?
A decade of young adult fiction dystopian worlds of only young adults, followed by an actual decade of dystopian world of only young adults.
If it's already out, how will stopping flights and closing schools really help? How long will you stop them? At best, this will just slow the spread, not stop it.
Each sick person will only, on average in unmitigated conditions, get two or three other people sick. If you consider just a single infected person that doesn't seem that infectious at all. Yet because this is an exponential process that won't slow down until a significant fraction of the population is infected or immune 2-3 is enough to go from a couple people sick to most of the world in fairly short order.
Yet if you can reduce that 2-3 down to 1 or below even with relatively half-assed measures like telling some people to stay in inside, isolating known-infected and likely-infected persons, closing down some major spreading venues, telling people to wash their hands or use surgical masks... presto chango the disease dies out and no more than a tiny percentage of the population will get infected.
If the half-assed measures reduce the exponent but don't get it below 1, eventually most people will still get infected but it will take a lot longer. That extra time means the hospitals get less overloaded and lots of additional lives are saved because many covid19 cases require serious medical intervention (forced respiration). It also potentially creates time for better treatments to be created/discovered.
The best time to start seriously addressing this would have been weeks ago when it became clear that it was spreading from unknown and non-isolateable sources inside the country-- at least to the extent that it could be done without major damage... before there were thousands (likely hundreds of thousands now; given the observed spreading rates) of cases circulating in the US. But so long as the vast majority of the people who could eventually be infected are not yet infected, it's STILL a good idea.
On top of the risk we're facing from hospitals overloading, there is also a lot of potential for widespread panic once testing catches up and the numbers go from a rounding error to "big and scary looking" overnight. Beginning countermeasures earlier should help reduce the panic both by decreasing the peak infected numbers and by making it clear that the issue is being addressed.
https://www.flattenthecurve.com/
Or if you want more math, here's why putting into place extreme measures even one or two days later can make outcomes significantly worse
https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
This animation helps understand the concept: https://thespinoff.co.nz/wp-content/uploads/2020/03/Covid-19...
We already know we don’t have enough ventilators or enough staff to care for the ill if we end up with a similar growth curve to what they’ve seen in Italy.
Yes, it will.
One thing that tends to get neglected is that in a lot of diseases, most people don't pass the disease on very well (maybe infect one other person) but a small number of people (superspreaders or superinfectors) pass it on EXTREMELY effectively.
If you can block the superinfectors by quarantines, that is like putting control rods into a nuclear reactor--you slow the progress dramatically.
The problem is there are only so many ICU beds available. If we self-isolate and slow the spread, then we can keep the number of dangerously ill people below our capacity limits, and make sure that everyone who needs care gets it. This is what Japan and South Korea have done. Italy did not react fast enough and now the fatality rate there is approaching 8%(!!).
With very strict measures, we might even stop the epidemic in its tracks. So far, only China is on track for doing that.
I'm usually the doomssayer, but that's 15% of people who are diagnosed. Usually people who are asymptomatic or nearly asymptomatic don't get diagnosed.
Only a few countries have testing programs widespread enough to start estimating case vs infection rates... and certainly not the US, where there are plenty of people who have been obviously infected who are still not included in the official counts because of god-knows-what-the-CDC-is-doing.
What is clear enough is that whatever the rate of serious cases are, it's more than high enough to overload the hospitals-- just as is happening now in Italy. So I fully agree with your point, I just don't want to see if lost in the noise because some people will notice the 15% claim is almost certainly an overestimate.
The difference matters because it's likely that 60-70% of the population or so will eventually be infected. But it won't be 15% of that which need intensive medical care but some lesser number because some infections will be asymptomatic or nearly so.
If you want you can calibrate against the Diamond Princess numbers.
Literally nobody is saying that. Please stop spreading misinformation.
Now under normal circumstances this intervention is not life threatening--that's the smaller "critical" category. But without access to common hospital equipment, the symptoms do become critical. Basically the patient becomes unable to breath normally, and without access to a breathing machine they'll suffocate themselves.
Most "severe" cases are treatable with access to a hospital. But if we peak at once and that equipment is all occupied by other patients... that 15% of severe cases become fatal.
Slowing the spread gives vaccine and antiviral researchers a fighting chance to win the race, gets us to summer where if we’re lucky enough that this virus is seasonal it’ll go away, and, most importantly, “flattens the curve”, as your parent commentator already pointed out.