We have to face the truth that the quality of people we vote for government is not where it needs to be and that science has too long been discredited and ignored.
Some of asia learned from SARS but that's it.
Madrid was hosting marches, political rallies and soccer games with 10.000-100.000 people a week ago because people did not want to make the hard choices needed even as Korea was burning and Italy started to.
Excuses that China is authoritarian do not cut it - this was a huge fail of governance and doing what people are elected to do
Science is supposed to mitigate the shortcomings of our natural intuitions and cognitive biases. The problem is that most people are not scientists. When a non-scientist is asked to trust a scientist, he or she is subject to all of the usual suspects: arguments from authority, confirmation bias, Bulverism, appeal to emotion, etc. What this means in practice is that scientists are generally not trusted over the word of one's friends and family.
This layman has read that we intuitively think of numbers logarithmically, which makes him wonder if we human beings do, in fact, intuitively understand exponential growth.
Exponential growth is like dynamite. It's absurdly fast, compared to anything people see in daily lives.
The only truly exponential example that comes to mind is milk souring. But that's too slow, unless you keep notes.
The real sad part of all this is that this is simply human nature. And we are next gonna go down the same path with climate change. And then not even lock downs will help.
Having seen the cutting of rural hospitals over the last two decades it will be a shitshow
It's also not necessarily an indictment of democracy- Taiwan clearly has been on the ball here. But it is absolutely an indictment of our current state of affairs in many western countries.
I did my numbers back in December. In January was already pretty worried, but I'm not an expert I thought. Maybe there's something I'm not taking in account.
So I kept reading about models and stats. Not that difficult. Ran my numbers again and again, yep it seemed pretty bad no matter what I cheated myself with parameters etc.
Then it came to Spain. I was pretty nervous by that time, kept it cool, tried to warn to people that this was no joke, everyone thought that I was a bit crazy and alarmist. Days passed, government went absolutely erratic and irreposible, lost all my trust in the lead epidemiologist and the ministry of Healthcare, not to mention the HUGE amount of healthcare workers that were insisting that it was just a flu and some of us were alarmists for two month and turned 360 in a few days.
Too late. Now I'm in it.
I have to say that some time ago I had a course of applied statistics with epidemiology exercises so I was not really an alien to it, but not an expert either.
But as has been pointed out before most people think if you do something big and dramatic to fix an oncoming problem, and it does fix it, lots of people will stupidly assume that you did not need to do the big, dramatic thing because it wasn't really a problem. So any politician who reacted appropriately would run the risk of fixing the problem and losing power in doing so, I would prefer to fix a problem like this even if it meant I would not have the power to fix later problems as my calculation would be if I do not fix this problem now I probably won't have the power to fix later problems anyway.
"The number of lily pads on a pond double every day. If it takes 20 days for the lily pads to completely cover the pond, how long does it take to cover half the pond?"
I think you will be surprised by how many people say "10 days."
So if you explain to the politician, once you start getting cases in your country and give them the actual growth rates, and what slowing down the growth rates will mean, with nifty charts and so forth.
Like maybe they should do in the movie Outbreak where they have display of the red spreading across the country on its way to the White House, with a timeline animated below it, then the politician will understand the situation without intuitively understanding exponential growth.
I suppose reasonably competent data visualizers who have ever had to explain complicated things to non-technical people in an important meeting would know how to represent the concept in their particular domain without much problems.
on edit: changed our to your
Why is it relevant that people don’t correctly apply exponential reasoning automatically? Because when people encounter information in everyday life (outside of the specific job they’ve been trained to do) they tend to use intuitive thinking predominantly. This matters a hell of a lot when it comes to making political decisions of a technical nature, such as infectious disease planning and response. Lo and behold, this is the exact problem the Italians are trying to warn everyone about!
Relating this to the spread of the virus, people aren't carrying around an animation of this in their minds. Perhaps science communicators should do a better job of communication and produce such an animation? But then you're still not getting people to understand the concept. You're telling them "this is what it looks like, sort of, now just trust us." The problem is that people don't trust scientists (and mathematicians) as it is.
And I don't believe you should have to understand exponential growth to listen to clear government messaging about the severity of a problem. This is a failure of messaging by the relevant authorities.
And my snarky side says there will be plenty more targets to blame in the coming weeks - think of it as an investment.
People will grasp at any excuse to convince themselves "it'll be fine, it won't happen to me". The fact it started in China made it easy - the Chinese government must be overreacting because it's authoritarian, it's halfway across the world, my government must have gotten this figured out, my health care system must be better than China's, etc etc. And of course the classic "it's just a flu".
It's sad that so many will suffer and die because of this.
But now, on HN now we're mostly preaching to the choir...
I've been contacting the officials of my state and surrounding communities since February 28th urging action. If your community isn't taking action you should join in. Even if your politicians don't respond to math, they'll still respond to public outcry.
The best time to respond was a while ago, but today is still vastly better than tomorrow.
Exactly. Two weeks ago every coronavirus thread on Hacker News was full of deniers claiming this was no worse than the flu and this was all just media hysteria. Some probably still hold that opinion. I don't think they will be convinced until the hospitals start overflowing.
(Engineers to, too. I try hard to watch it and I still arrogantly show my ignorance sometimes.)
When Coronavirus appeared in Wuhan, I tended to the opinion that it would self-limiting in one fashion or another or that is would not be worse than the flu. Only people arguing with me and me investigating the facts changed that. And, yeah, changing your opinion is hard and imagining a force that will upend the world is hard so it's easy to imagine how people stay in their positions.
That said, we have a representative government with the aim of electing people who will think ahead and protect from purely reflex based views. And clearly that control has failed.
The potential for this kind of pandemic is something that the government was aware of and at least somewhat prepared for. It can be hard to imagine, but if all we had were the concerns of joe-everyman this would have caught us significantly more off-guard than it has.
Where I think we've faltered is in rapidly the hard decisions to trade-off short term economic impact vs long term health and economic impact. But there is still time to do a lot of good, and the level of our response seems to now-- finally-- be increasing exponentially along with the infection.
Interview: https://samharris.org/podcasts/190-respond-coronavirus
IE we should not allow people to take risks that are going impact all of society.
The virus has exploded the American myth that we can isolate individual behavior to individual rewards but also this myth means the country is going to seriously suffer.
There was no excuse because there was never a chance for another outcome. The WHO was screaming into the void.
After that point it is mathematically clear that you're going to have deaths, and that similarly situated communities who react days later will have a lot more deaths. At that point the political calculus you're arguing for flips the other way around and encourages an over-reaction. ... except innumeracy is so common, we're not seeing too much evidence of that happening.
I guess anything less would be a dummy.
You don't have to be a mainstream follower to appreciate a high-performance leader
>who definitely understands Math
>who definitely understands Math
In future centuries we will look back and recognize this leadership characteristic is what has always been most advanced compared to all other outstanding choices.
Especially at times when the stakes get unusually high.
Organizations, communities, citizens, civilizations, and populations have always gone by the numbers.
And there's always a mainstream of some kind, with attitude being a thing among the moving weighted moving averages.
Seems like those furthest from the mainstream can also be most sensitive by nature to an _idiot-in-charge_ across various types of idiocy, and multiple levels of government, corporations, and other organizations.
Strongarm conformance and/or manipulated populism are some things that can give rise to a mainstream with ineffective recognition & response to dummy leaders and their destructive outcomes.
Since even a slightly above average problem-solving ability can make relatively genius moves compared to a slightly below average performer, it's tragic when there's not enough mainstream force to elevate the most mathematically competent leaders to handle high-stakes responsibilities.
Even more tragic when the mainstream is less-aware, and settles on preference for the dummy ones.
We need to confront the fact that democracy in the West by now elects people who sell the most comfortable lies instead of people who help adaptation to reality.
I am hopeful that human civilization and ingenuity can invent or discover that. I am just not confident that it would be anytime soon.
Alternatively, they do, and the process of getting there makes them less likely to do the things they wanted to do.
Bring back sortition!
At least German politicians had the sense to step aside and hand the mess they made to the scientific experts to clean up.
There is a large faction of people in the USA who believe this a politically motivated hoax. This is the world we are living in. How can we vote in competent leaders when a large faction holds such strong influence?
This has nothing to do with the politicians.
It's super easy to retrospectively say "they should've done something else". You might think that even you would do the right choice, but you are wrong.
Such decision is hard for any authority. You may vote for any person in the whole world and the result would probably be similar. Lockdown delivered too early could send whole country into chaos.
Also China managed this so well that it actually could work counterproductive for other countries.
What I'm trying to say is: Don't judge others. You have little idea of the situation they are in, and saying retrospectively "you should've known better" is just childish. Just learn from their mistakes.
With your attitude, you can choose any party and will always be unhappy about the choice.
European governments were not the first to have to deal with the epidemic (China), nor among the first few (Taiwan, Hong Kong, South Korea, Singapore etc.). They were fully aware of what happened in Wuhan without early action. They literally just had to follow what Taiwan, Singapore, South Korea etc were all doing. Those countries had less information and less time to act, and yet they're riding this much better than much of Europe.
So why _shouldn't_ European governments have known better?
Wasn't until it got Italy hard that most people opened their eyes.
But the point I was trying to make was that saying that somebody should've done something differently is not helping anybody. That's just complaining and nobody needs that.
Also - doing nothing until it is too late - not even educating - is not even a choice. It's not a strategy. Its dereliction of duty.
Those are the conservative figures for influenza in the USA since 2019 November.
Where was your outrage last year and the year before. Couldn't we have prevented this influenza tragedy from happening all over again. Is this also dereliction of duty?
It is by observing others and judging their decisions and actions that we can learn and avoid other people's mistakes.
Is it not?
What you are asking about is just drawing conclusions. I wouldn't mix those up.
It might be worth revisiting top comments on HN threads relating to Covid19 in the past few weeks. Quite telling how much the 'know-it-all' folks actually know about the real world - makes you even more afraid that these are the same people who run countries and have an outsized influence in the public sphere.
There are scandals in the sciences too. Peer review rings, studies that tend toward positive bias due to the pressure to publish, some studies being paid by big companies that favors their vested interests, etc.
The leaders of the country, the people in power, and the populace are not math literate.
There are 1600 confirmed cases but the lack of tests hides how many real infections there are.
Put that all aside.
Remember-- the numbers we see now are a look at the PAST. The infection incubates silently for a median 5 days. Then symptoms present. Then a week goes by with relatively mild illness. THEN shit gets real. THEN comes the hospital visit, the fight for a test, the time it takes for the test results to come back (if it happens). THEN the number gets added. Then you see it on wikipedia or the news.
These numbers we're seeing today are a time machine view backwards to recognize infections from 14 days ago. So infections spreading TODAY will show up AFTER the current Italy-like situation has already taken hold in the United States.
If it is possible, STAY HOME.
And the "shit gets real" part only occurs 20% of the time, give or take - which means the virus might spread quite a bit while showing symptoms no more severe than a common cold. That also introduces some further unpredictable lag between any social distancing behaviors being introduced and their effects on the actual numbers.
We're using a cracked, dirty camera lens to film a small fraction of the tip of a rapidly growing iceberg.... And the photo processing time is two weeks.
Death rates by age range also assume ICU care. It's virtually unheard of for healthy middle-aged people if they have access to good medical care, but plenty of 30- and 40-somethings can and have died from it once the hospitals are overrun.
https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_I...
Source?
China plainly lied about the outcomes of the SARS epidemic and reported about half the fatality rate of nearly every other country. Hell, no Chinese person I've talked with recently believes the official numbers.
Essentially this was not in bad faith when it was published but it is now so out of date and misleading and sharing it now is dangerous in that it may cause people to ignore safety advice.
Given that people are making difficult choices right now that will impact the course of the epidemic we should be very careful sharing outdated information that could lead to people becoming infected.
China's numbers are a minimum. Many people are saying online they are a maximum. I.e. claiming that there are lots of hidden mild infections when there are not.
No, I am no. I am saying the study supercedes numbers reported by authorities. The point of the study was to scatter information on very opaque reporting.
> China's numbers are a minimum. Many people are saying online they are a maximum. I.e. claiming that there are lots of hidden mild infections when there are not.
That doesn't parse.
The way I interpreted that discrepancy is that in the presence of full testing and good ICU care, the death rate from COVID-19 is about 0.7-1%. When the hospitals get overloaded, as they've been in Wuhan and Italy, the death rate skyrockets to 5-10%. This also squares roughly with the number of people who need ICU care in places where the death rate is low. If you need ICU care and don't get it, presumably you'll be dead.
Well, substantially all of the cases that end up dying go to the hospital first, and many more besides that and up recovering. It shouldn't be surprising that the hospitalization rate is higher than the fatality rate.
This is a real issue, and I have no solutions. The only thing I've been saying to them is that all bars and restaurants will be closed here in 2-3 weeks and that their bosses will understand then. They are understandably worried that in the aftermath of all of this, there will be so many unemployed servers/bartenders/cooks/drivers that it will be difficult or impossible to get their job, or any other job, back, with no way to pay rent in April or perhaps May either.
The only thing that might help there is if warmer weather reduces the spread. But then it could very well come back in the fall.
People need to stay home, period. Unless you work in healthcare, a grocery store, or some essential service, or are going to one of the same, you need to stay home. I know there's lots of reasons people aren't staying home yet, like they don't have paid sick leave, but still, none of this overrides the sheer importance of stopping the pandemic.
So the phrasing should be "Stay home, period." Not "Stay home if possible".
But your point is right. "If possible" means "unless it's absolutely essential for your survival or the survival of others".
Pretending that the only disaster we are facing is medical is blinding yourself to the reality that we are trying to navigate our way between twin catastrophes.
[1] https://www.usnews.com/news/healthiest-communities/articles/...
[2] https://www.nytimes.com/aponline/2020/03/13/us/ap-us-virus-o...
[3] https://www.feedingamerica.org/sites/default/files/2019-04/2...
[4] https://www.theatlantic.com/health/archive/2017/07/how-job-l...
Plus, all the school districts that have shut down so far have continued to offer meals for students AFAIK.
Source: - https://www.buzzfeednews.com/article/lamvo/coronavirus-death... - https://www.santaclarausd.org/site/default.aspx?PageType=3&D... - https://www.sfgate.com/news/article/Bay-Area-school-closures...
The exposure network hasn't been trimmed to zero, but its branching factor has been radically cut down. This is going to have an effect.
You're kidding right? Under what conditions that things are fine are you preposing? If you're not taking this serious, and in the US, you're definitely part of the problem. That attitude, statistics aside, is going to get people killed.
Among the things you should have derived from reading more carefully is the fact that state I'm living in is taking it quite seriously. Personally, my hatches are battened down and I'm prepared to be isolated for at least a month, maybe two. (Have to admit it's hard to tell how far my supplies will go, I've never actually had to live on them before.)
You're talking to someone who specially prepped for this about seven weeks ago, in addition to the general prep I already had on hand. If you can match that, then maybe consider start lecturing me. I actually got a bit of flak from my wife for the amount of prepping I did, because it was before she'd hardly even heard there was a new virus. Now she's glad I did, because I bought all the things that are missing in the stores around here now long before it was "hoarding".
I'm in the top tier of taking it seriously. At the same time... Don't panic. Don't advise panic. Don't fall into the cognitive trap of modeling this as a zombie apocolypse or some other thing where the virus is intelligently seeking out victims. Isolation measures will slow the virus down. It isn't possible to keep it "out of the US" but it remains possible to keep it out of your county, or your city, or your neighborhood, with sufficient steps. Total doom is not yet inevitable, and even then, how you are impacted remains significantly under your control even if your government is feckless. Or, at least, it was, if you got your prep in before the panic rush... you may be a bit more at the mercies of your government now.
2,695 at the moment, per the NYT tracker
https://www.nytimes.com/interactive/2020/world/coronavirus-m...
[0] https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html
The fact that many people here and around the web are sharing stories of sick friends is are a set of anecdotes that would be nearly impossible if the reported numbers were correct.
I suspect by this coming weekend the US will feel very different. I wouldn't be surprised at all if a major update to official numbers came and completely changed the current state of where things are.
But one of those cases is the Prime Minister's wife.
Do we really think there are only 150 cases?
It's obviously way, way, way higher than that.
I still disagree with this, although I somewhat agree with your sentiment. The anecdotes I have seen range from extremely mild to nightmarish. A large fraction of those made me false, deliberately or by accident. I find the statistics still tell the most concrete story.
And this is with extremely limited testing.
The CDC is headquartered in Atlanta. Where do the COVID-19 tests from them come from? Where are they manufactured, what ingredients do they require, how much do they cost to make, how long does it take to make them? What's the hold up on getting "unlimited" tests from the CDC? Do the tests even come from the CDC? How many are they producing a day? What are their blockers?
[0] https://www.npr.org/2020/03/13/815522836/u-s-coronavirus-tes...
[1] https://www.statnews.com/2020/03/14/thermo-fisher-to-produce...
Edit: others seem to feel the same. See epistatis' comment
Similar anecdote here.
My SO texted me earlier this week saying how she will be taking the train from Madrid to Barcelona to go back to her family. She figured it will be empty on Sunday at 6 am.
I have been following the situation evolve in Italy and told her to get on the train right away and leave immediately before it gets worse.
Luckily, the next day she was on the train. The lockdowns started happening shortly afterwards.
If you love your family and you have some sense of responsibility your duty is to stay where you are for a while. You can embrace your family in the near future.
It is expected that even with thorough reliable testing and rapid clearance of the non-contagious from confinement, the spread among previously unexposed confinees would be vastly greater than among the unconfined, or further the _isolated clean_.
People should stay where they are. Lockdown is not a disaster. People fleeing lockdown are literally the carriers of this disaster.
Stay where you are, wait. Don't travel. Don't fight the locdown. Lockdown is the current, appropriate course of action. A very effective lockdown can eliminate the infection in, well, however long it took to eliminate it in Wuhan.
Fleeing the lockdown now is just going to another area that is going to be on lockdown later on anyway.
There will be test of this thesis in Poland soon. As government closed down universities, some of them told students that they have to vacate their dormitories and go back home (dormitories are usually occupied by students from countryside and smaller cities), and it caused massive migration. It is already confirmed that students in my city were infected for two weeks, but is not known yet how widespread it was. To make situation worse, some dormitories are now being turned into quarantine hotels, so students are told to come back and take their belongings with them (initially they were told they can leave their stuff behind).
I hate to put this harshly but... She may well be fleeing with a life threatening virus that will kill her family. This has happened already, even documented, in China.
We can't look to our own comfort at this point. All my family visits are postponed and my food is mostly stocked up.
And it's a hard situation where we won't all make the best choices but still want to pressure everyone to make the appropriate choices.
True.
>She may well be fleeing with a life threatening virus that will kill her family.
And true.
This is readily recognized.
And this can be motivation enough to relocate to a chosen area for upcoming lockdown, while some choice is still possible.
I gotta say this but I don't think we should put forward the position that total lockdown is an irrational position. Total lockdown seems fully rational, not a product of mere panic at all. Total lockdown worked in Wuhan. Absolute and complete isolation inherently results in exponential decline in the fashion that exposure result in exponential growh. It's a drag but it doesn't seem as much of a drag as millions of dead people.
And that is the bizarre thing I'm saying and hearing in the US - "Uh, just let it infect everyone" - "you know that promises to the largest loss of life on US soil ever" - "well, try to slow it down a bit". Jeesh.
on edit: saw your other comment, and you're correct, little over 2 million is the low but totally unrealistic estimate.
From what I'm aware, if hospitals are able to handle the patients, it shouldn't be up to that level.
And the "slow it down" plan is primarily about not overwhelming hospitals.
There are no countries with mass infections where the fatality rate is plausibly below 1%. Of course, when the health system is overwhelmed, the fatality rate can be 4-5%. But let's just look at a 1% fatality rate to start with.
The US population is 327,000,000. Seventy percent of that is 228,900,000. One percent of that 2,289,000; A little more than two million people if we assume 70% infection and an orderly health care system. But that horrible figure isn't plausible.
Because there's more. Claims you can avoid the overwhelming of the health care system are clearly false. Dividing, assuming, unrealistically that the event could be divided evenly through a year, that means that, that many people dying in a year (365) involves 6271 people dying per day and ten times that many people, ~62,000 people, arriving very sick at hospitals, per day throughout the year. And that is far, far more than could be handled by the US health care system.
Moreover, spreading the deaths evenly is inherently unrealistic, the situation of "flattening the curve" (a good thing in itself), can't stop exponential growth as such. If you decrease the doubling time of a exponential curve, you still have a situation where most of the area, most of the deaths in this case, is in the last double. So the even supposedly flattened curve won't let things go smoothly IF we assume "everyone will get this". And that promises not just 2 million but 10 millions (at the 5% death rate). If assume the US current has 10,000 infections, we approximately 12 "doublings" away from 228,900,000 infections (70% of the population). If we slow the progression to year, half the infection will still happen in the last month, with 10% of those "serious", that 763,000 needing attention per day. We're now talking corpses in the streets levels of horror. And we'd have further deaths from this breakdown situation.
And back to the lockdown scenario. My answer is that Lockdowns are absolutely necessary and thankfully it seems likely in most situations they are coming. The figures above should show that alternative is effectively going to be complete breakdown of the health care system and effectively society.
> If you decrease the doubling time of a exponential curve, you still have a situation where most of the area, most of the deaths in this case, is in the last double.
The closer you get to affecting the entire population, the less exponential your curve becomes. Especially if you're assuming that a significant chunk of the population doesn't get infected, you have to have a curve that spends a lot of time slowing down. The max infection rate will be a lot lower than an exponential curve that keeps accelerating until it slams into a brick wall and somehow instantly stops.
South Korea has dealt the infection extraordinarily well and they have a %1 fatality rate. But even halving my figures, you get an insane result, an overwhelmed health system and so-forth.
The closer you get to affecting the entire population, the less exponential your curve becomes.
True but that STILL bunches up the deaths a lot, until are at a significant fraction of the population, the growth will exponential (and another point of realism, it's city by city also but health care is also city-by-city). The parabola shaped curves in the "don't flatten the curve" articles are bullshit (but the "don't flatten the curves" actions still should be done. It's just the idea that these will be enough that is untenable).
Edit: And I know well there are experts putting forward these arguments. As far as I tell, this an expression of sleep walking, cognitive dissonance or similar phenomena where people don't notice that their mental tools lead them to untenable approaches since they have relied on these tools for quite a while.
Edit2: I think the standard approach of health departments is "when you go past containment, you go to mitigation" and that's what they have been taught. The thing here is nations quickly discover that the situation cannot be mitigated and they have to go to containment on a region or nation wide basis - the situation in Italy, what the situation is becoming in Spain, what literally the situation should be throughout the entire world.
With an absolute best case CFR of 0.6%, that's near 2 Million dead. I struggle to think of a larger loss of life on US soil.
Assuming hospitals reach saturation fairly early, yielding a 5% CFR, and we're looking at 16.5 Million dead. That is... a lot. Like we have nothing here to compare that to. To put it into perspective, the US only lost 400 THOUSAND in WWII....
Now more than ever we should look at the source of every information.
I know I'm going to get downvoted for saying this, but I think it is important enough.
Particularly not since none of the signatories could plausibly be accused of exaggerating the danger, in order to extract grant money. As goes the usual cynical claim of innumerate science-deniers.
South Korea has, at no point, made anything close to the country-wide “lockdown” we’re seeing in parts of Europe.
Korea’s reaction is amongst the most successful in the world, and involves contact tracing and isolation of the sick. When they have “locked down” anything, it’s been extremely small scale, on the order of a building or block. Similarly, Taiwan has had an immensely successful response, without resorting to these kinds of extreme measures.
This article is designed to scare, not to inform.
Path 2 is you fuck it up and Covid-19 is running rampant through your entire population. Of course at this point closing borders and contact tracing is 100% pointless. It's in this environment where lockdown is the only way you can accomplish anything.
https://www.euronews.com/2020/03/14/coronavirus-spain-bound-...
Please take it seriously. This is not sensationalism.
What the letter means is that if your country is not there yet, you might be DAYS away from widespread panic and total lock down.
I'm writing this from Barcelona, Spain. This last Sunday, 6 days ago, I went on a walk with my girlfriend, had a nice lunch, took beautiful pictures...
The virus was just some nagging news.. A couple of hundred people infected somewhere far away.
6 days later, we're at over 6000 infections, the country is in total lock down.
Same pattern as Italy (even faster), we're just a couple of days away before tens of thousands is reached. This is what exponential growth means.