I agree that having a more "realistic" model that simulates people's social interactions is important, especially as we look to predicting longer term effects. This is something that is on the long-term roadmap for our model here, although as of now its on the back-burner while we deal with more immediate concerns like hospital allocation.

yeah, it's hard to get to that out of a stock/flow differential model (that's what this is under the hood right?) but if we had some sense of effect of different measures on R we could at least build in different "presets" thanks for your work here! wasn't meaning to disparage it, just calling out a lack of anything clear I could offer friends to help that understand that point...

Yes, under the hood its a coupled set of ODEs with the ability to be stochastically sampled. But this means the entire susceptible population can interact with the entire infected population every time step w/ some small probability -- hence no structure. And no worries, not offense taken!

The Washington Post has a nice visualization. Not aiming at realism but easy to understand: https://www.washingtonpost.com/graphics/2020/world/corona-si...

I think japan has shown us one thing. The absolutely dominant effect of closing schools. 1-5000 people in close proximity with high levels of social mixing and a very low rate of symptomatic infection. It's absolutely perfect for incubating the virus.

The tough part being: our teachers are already vastly underpaid.

Luckily, every teacher I know is still being paid. Even those who are completely off and don't have to teach virtual classes.

Except they can work from home, and now that they’re actually required to their commute cost is way cheaper.

Some teachers CAN work from home (not PE, Home-Econ teachers, etc.), but it's a less-than-ideal situation.

Are children self-motivated enough to work from home? I know many adults who aren't. Without adults to keep children accountable a total work-from-home schooling is likely to create gaps in the kid's education. And which type of child is the least likely to have an adult around keeping them accountable? Impoverished children.

A counter argument is that keeping kids physically proximate often exposes them to violence which makes school a lot harder and tends to really mess people up.

Lots of modern jobs worth doing will end up remote (at least occasionally and often permanently) so it’s probably a good idea to start training them when they’re younger anyway.

Nassim Nicholas Taleb discussed how superspreaders have a big effect[1]

[1]: https://www.youtube.com/watch?v=LX_bqMQfWlw

Do you have a source that you could share on the topic? I have been trying to inform myself and balance my behavior and think it would be very helpful.

There is official health institute report from Italy: https://www.bloomberg.com/news/articles/2020-03-18/99-of-tho...

This is just a panic created on social media.

> This is just a panic created on social media.

Don't be ridiculous. You can discuss the distribution of deaths, but the deaths are real.

A 2% death rate is still 2%. That's huge. It still has the potential to overwhelm any country's health system.

The deaths were always real. Putting the whole planet on hold because some 80 years old with three associated illnesses died is a bit borderline SF and a bit borderline stupid.

It's not going to be 80 year olds dying if the hospitals are overwhelmed. 40% of people in ICU in italy are 19-40, basically, those who make up the majority of the workforce.

19-40 makes up 0.25% of the deaths (4 in total) [0]

In the US, of people aged 20-44, "only" 2.0-4.2% are admitted into ICU, significant, but making up only 12% of the ICU admissions, and 20% of the hospitalizations. [1]

0: https://jamanetwork.com/journals/jama/fullarticle/2763401 1: https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm...

I think you're confusing "dead" with "in the ICU". If you listen to the various interviews with Italian Drs, you'll learn that to make a recovery from the full-blown infection requires spending weeks on ventilation. So looking at the deaths count does not accurately capture the real problem, which is that you have an accumulated pile of people who are severely sick but will probably make some sort of recovery eventually. In the meantime your health system is offline.

> 40% of people in ICU in italy are 19-40, basically, those who make up the majority of the workforce.

Correction: 11.9% of people in ICU in Italy are 19-50; 51.2% are 51-70; and 36.9% are > 70 [1].

[1] https://www.epicentro.iss.it/coronavirus/bollettino/Bolletti...

I don’t believe that could possibly be true. The current ICU makeup in the US is 2-4% for ages 20-44. That’s a 10-20x increase you’re proposing. And yes, you can say that they’re triaging, but for this to be possible you’d need truly enormous numbers of infected individuals AND tons and tons of triaging going on which doesn’t feel accurate based on what news says.

I highly doubt that number. Do you have a reliable source for that?

It looks startling, but could be true. Reportedly, the health workers in Italy had to do some fairly brutal prioritisation in triage. If you have a lot more patients requiring ICU than you have stations, you end up with a high proportion of younger patients in ICU even if they are a low proportion overall.

The classic fake news model: post some shit with no evidence that is immediately validated by some other worried internet person.

Basically the current state of the internet in a nutshell right now. People assume any valid question of any data means that person is a denialist nutter or something. Fact is, we are working with very biased data and people, even the smart folks here, are misinterpreting it. The virus exists, but there is no data that tells us how widespread it is in the population. Odds are very good this sucker has been adrift for weeks or months and many of us already got it. But without good, random sampling we cannot prove or disprove that hypothesis.

About the only place I’ve seen where rational talk is allowed without getting flame to death is /r/covid19.

Hacker news, unfortunately, appears to have devolved into yet another place full of panic stricken people.

Your aggression is unwanted and unnecessary. I haven't validated anything; I speculated, with appropriate qualifiers.

I'm happy to defer to actual stats if you have any.

Page 5 of the recent well-respected Imperial paper on modelling approaches to managing the outbreak has statistics on hospitalisation that I imagine are the current best estimates.

https://www.imperial.ac.uk/mrc-global-infectious-disease-ana...

For example, 3.2% of cases aged 30-39 require hospitalisation. Could that rise to 40% after triage? I'm not sure, it seems high, but it depends on what pressures the system is under.

Can't find the Italy link, but here's an article talking about hospitalizations and young people including alarming ICU cases: www.washingtonpost.com/health/2020/03/19/younger-adults-are-large-percentage-coronavirus-hospitalizations-united-states-according-new-cdc-data/

Quote from the movie The Big Short: "Every 1 percent unemployment goes up, 40,000 people die, did you know that?". That is probably an exaggeration, but I really hope people in power know what they are doing at the moment.

>The deaths were always real. Putting the whole planet on hold because some 80 years old with three associated illnesses died is a bit borderline SF and a bit borderline stupid.

Unfortunately this approach doesn't work unless you somehow deal with the relatives of the millions of 80 year olds who are now pissed off that the government let them die and their bodies rot in the streets, and you arrange for the army for force medical providers not to try to treat some proportion of the dying.

"More than 75% had high blood pressure, about 35% had diabetes and a third suffered from heart disease."

I feel like a huge number of Americans have high blood pressure and heart disease. Seems like it will still be very serious for a large number of people.

>705 were aged 20 to 44, according to the Centers for Disease Control and Prevention. Between 15% and 20% eventually ended up in the hospital, including as many as 4% who needed intensive care.

That's not a shocking number to you? 15% - 20% of people aged 20-44 ended up hospitalized? Even if no deaths were involved, that many young people ending up in the hospital is concerning.

It really comes back to the testing. There could be a million people 20-44 who didn't get tested and didn't need to visit a hospital.

If you only test people who arrive at a hospital with serious symptoms, it's not surprising that many of them go on to be admitted.

maybe examine the prevalence of all those conditions in the US?

"More than 99% of Italy’s coronavirus fatalities were people who suffered from previous medical conditions"

What were the most common pre-existing conditions?

"More than 75% had high blood pressure, about 35% had diabetes and a third suffered from heart disease."

How common are those conditions in the United States?

High Blood Pressure - 1 in 3

Diabetes - 9 in 100

Heart Disease - 1 in 10

I would be careful not to confuse correlation with causation here. Most old people have medical conditions. For example, about 75% of older people have high blood pressure [1] so seeing a 75% rate in the virus fatalities should not mean much.

I suspect age and immune function drive mortality, and the other factors are merely along for the ride.

[1] https://www.uptodate.com/contents/treatment-of-hypertension-...

When I studied medicine 15 years ago 130-139 mm Hg was not considered high blood pressure. We were young students and we were toying everyday measuring our blood pressure. Most males had over 130.

It seems times are changing: https://www.cdc.gov/bloodpressure/facts.htm

We have "evolved"!

Your initial proposal was that most of the Covid related deaths were due underlying conditions.

Now you propose that the underlying condition most present isn't really a condition.

You made me curios about it so I did a quick internet search for what is considered high blood pressure in Italy.

I found https://www.epicentro.iss.it/ben/2002/settembre02/2_en (the same health institute that provided the study I was talking about above). I quote:

"The prevalence of borderline hypertension was calculated by determining the number of persons who had systolic pressures between 140 and 160 mm Hg or who had diastolic pressures between 90 and 95 mm Hg."

This is more inline with what I've been thought in med school in my time.