Clues about when the disease may overwhelm hospitals are valuable. Without such forecasts, local exponential growth gives hospitals only a few days advance warning.
By Wisdom Seeker, a WOLF STREET Commenter with a physical sciences Ph.D., San Francisco Bay Area:
The CoronaWar continues – how soon will social distancing turn the tide? Extending the caseload analysis from my article from last Saturday, this report assesses progress in the Bay Area, the six hottest US state battlegrounds, and the six hottest global battlegrounds. We focus on locations with the highest number of confirmed cases per million population – in epidemiologists’ terms, the “prevalence rate.”
To focus on major population centers, I’ve ignored any country with under 1 million people, except for Iceland (pop. 341,000) which is special as you’ll see. Apologies to the Vatican and San Marino, both tiny nations embedded in Italy, which are technically the world leaders in confirmed cases per person. These hot spots are not covered here. Intriguingly, the states and countries with the most cases per capita are not necessarily the ones making the most news!
The graphs below use the same basic analysis as in the earlier article, but with the updated Johns Hopkins University (JHU) ArcGIS COVID dataset from 3/19, representing cases confirmed through 3/18. National population data was taken from Worldometers.info, and U.S. state data from the Census website. The graphs use a log scale on the Y-axis (similar to stock charts). This type of plot turns exponential curves into straight lines, which makes it easier to look at the early behavior and also spot “bending the curve” effects of social distancing and other public health measures.
Finally, beware: these are only “confirmed cases.” Nations which haven’t tested widely are under-represented (hello, Turkey and Indonesia). Even where testing is widespread, many cases are undiagnosed. The actual spread of the disease is likely much wider (possibly 10-100 times) than the confirmed cases.
San Francisco Bay Area Compared to Italy, South Korea.
The first CoronaWar graph is an update for the San Francisco Bay Area, with Italy and South Korea shown for contrast with other hot-spot outbreaks. Through March 16, the Bay Area was tracking the same exponential “Trend Growth” (black dashed line), with a doubling time of 3.2 days. But since 3/14 the daily new cases have flatlined (48-59 per day) and so the growth has gone “sub-exponential.” That is, from 3/16 thru 3/19 the curve has begun bending slightly – from public health measures prior to the March 16 “shelter-in-place” order.
If shelter-in-place works like the Korean “Red Alert,” we should see stronger “bending of the curve” in about 5-8 days, maybe similar to the Korean data. The next few days will be very informative! Hopefully everyone keeps up the “social distancing” and shuts COVID down locally as fast as possible.
Italy is important because it provided the first empirical data on when hospitals get overwhelmed in an “alert” nation with active testing. Italy’s lockdowns came later than Korea’s, but the curve for Italy is falling away from the black Trend Growth exponential curve – the measures in Italy also appear to be showing some effect now.
However, hospitals in the Milan area were swamped with cases for the past 12 days, causing the death rate to surge. Mortuaries and crematoria have been overwhelmed (!), and the Italian Army has been called in to move coffins to less-impacted burial sites. Italian doctors have been forced into painful levels of wartime triage while scrambling to increase capacity. (Triage is a graceful euphemism for “saving the young and relatively healthy, and giving up on many of the old and infirm.”) Hopefully this is the worst of it for Italy and things begin to get better soon.
The top six US states.
Now let’s zoom out one level and look at the six US states with the most cases per person. For the US, the state-level data from JHU is only available from March 9, so the plot range is more limited. But the recent trends are most important in these battlegrounds. This graph is less hopeful than the Bay Area data. New York had a testing surge and has overtaken Washington State to become the most-impacted US state. The regional testing surge could also explain how nearby New Jersey has pulled into 4th place, but the others may be a surprise!
How did Louisiana get into 3rd? I’d love to hear from a local expert. Washington DC (5th) and Colorado (6th) are also surprises.
Massachusetts (not shown here) had been a contender, after reaping the bitter harvest of a super-spread incident involving, somewhat ironically, a biotech conference.
Colorado seems to be resurgent, after getting seeded by ski tourism, with a big cluster in Aspen. Washington DC is of course home to extremely social politicians, a group which globally has been at high risk. The Brazilian state visit appears to have had some impact on DC.
Meanwhile, California is missing (so far?), despite the Bay Area hot spot. The local hot spot is diluted by the large statewide population. And hopefully West Virginia, which just had its first case confirmed in the past couple of days, will stay off the list for good!
The top six countries.
Surprise – Italy isn’t the leader, it’s actually Iceland! (Who infected Iceland??) Iceland is going to be a really valuable test case because the small population (341,000) and well-organized epidemiology team makes it possible to do truly representative testing. Early indications are that half the confirmed cases were asymptomatic at time of testing. If they stay that way, it should support a lowering of the overall fatality rate estimates by WHO and CDC.
Italy, discussed above, is next on the list. Switzerland is in 3rd place, and Austria has risen to 6th. But Norway? Where did that come from?
Next is Spain, which reaped a bitter harvest from a major political rally in Madrid, but has downshifted since and is back to 5th.
Iran has been in the news a lot but did not quite make the cut here. They had been 2nd behind Italy, and were 6th a couple days ago, but have slipped to 7th due to Austria’s surge. The data for Iran is rolling over and I certainly hope they’ve truly managed to bend the curve, but given the apparent local chaos, it’s hard to tell from here.
In each of these CoronaWar battlegrounds, we don’t know how many actual cases are out there. Any clues about when and where the disease may overwhelm hospitals are valuable. Without such forecasts, local exponential growth only gives hospitals a few days advance warning.
By watching other hot spots, and seeing where on the curve the local ICUs begin to overflow, we might be able to forecast farther ahead. I used Lombardy as an example, and have seen similar stories for Seattle (just hitting their ICU capacity limit now) and Iran.
We want to avoid hospital triage, but those horror stories do help to wake people up and get them to fight the battle. Fighting this war is as easy as “just stay home,” and yet that is so hard! It’s never too late to bend the curve by getting everyone you know to Stay Home and Stay Healthy! By Wisdom Seeker, for WOLF STREET.
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Two very fresh updates to the text:
(1) The Bay Area reported today 135 new cases confirmed yesterday, far above the 50-per-day of the last 6 days. Not a welcome sign. But still below the South Korea curve.
(2) Iceland has a wikipedia page on their outbreak which says most of their early cases came from ski tourists returning from northern Italy and nearby Alpine hot spots.
The new community decided name for the Wuhan Coronavirus is “the CCP Coronavirus” or “CCP virus” for short.
Why blame the Chinese? The Chinese government merely tried the same tactics of denial and downplaying that Donald Trump used until a few days ago. If you want to play the blame game, are you going to name bacterial infections after countries where factory farms dosing all animals with antibiotics breed antibiotic-resistant bacterial strains?
Let’s get the fire put out, and then talk about how to get sprinkler systems in place to reduce the risks of future fires.
AGREE, like, totally RA:
Please stop now and ask all your friend and family to stop now with the ”blame game.”
This is the time for all of We the People of all countries in our now relatively small and very interconnected world to ask not to blame, but ask how We the People can learn and act to either prevent any such microbe, virus or bacteria, ever doing this again to We the People.
Keep in mind the old and true saying, “When the people lead, the leaders will follow.”
Thank you
The CCP is entirely 100% responsible because, they as a dictatorship encouraged consumption of exotic animals to promote the idea they are special and different and the CCP is only one capable of leading them. They promoted this and didn’t ever bring real proper sanitation, cooking standards or hygiene and they as the dictators are responsible for both education and law enforcement. They then covered up the epidemic for at least over 1 month and a half through Chinese New Year ensuring that it could never be contained without vaccines. So yes they are 100% percent responsible. By the time, the CCP announced the outbreak, Chinese people carrying it had already spread across the world. Meaning stopping it without large scale efforts and supplies would be impossible, but as the place where the factories are located, they took over everyone’s factories that are located in China and hoarded the supplies, preventing these efforts in most countries from being a possibly.
The government of the prc made a choice of social controls. If they’d given the same priority to lessening or eliminating the high-risk wild animal markets that’s given to dissent suppression via the “Great Firewall,” covid-19 would have been less likely, and might not have happened at all. If public health had the same priority as image protection, the early calls of the outbreak wouldn’t have been suppressed.
This isn’t a call to rename covid-19 as “Chinese Virus”–in point of fact, “Shi Virus” would be much more appropriate, since the Premier created the atmosphere that allowed the outbreak and worsened its early stages.
I’ve benefitted from tcm (Traditional Chinese Medicine), and use its herbal remedies, especially as prophilactic against colds and relief from arthritis. So on a personal level, the last thing on my mind is fostering anti-Chinese/Asian xenophobia. I do wish they’d stop with the use of organs from endangered species, though. That dovetails with closing the culpable markets.
Hmm, Fox News Virus has a ring to it, perhaps Covid-19 will be renamed after its rampage through the US. It is funny, China is the darling of the news media when the everyone is making tons of money off of labor arbitrage and the goat when convenient (and, like the Fox News virus, warned of the dangers of globalism in the good times but ignored until there is a crisis). We will see if we can have it both ways … or blame Vietnam for our problems when we offshore there as a result of the mad cow diplomacy (or is it crazy ivan).
Unfortunately every country was slow on this. When half the people in Iceland who tested positive were asymptomatic at time of testing, it really shows how impossible it is to stop the spread.
I was a bit disillusioned though when the Bernie-Biden debate question on how to punish China for being too slow led to reactions no better than Trump’s.
There is no question that China has been sacrificing a lot with their shutdowns. Blame games generally just impede solutions to problems.
The Chinese obfuscated their data. End of discussion.
Thank you very much for this analysis. IMHO the best graphs around, taking cases per million into account. I would be very grateful if you could update the curve over the next days. I must say that lack of testing in the US may be an issue making the numbers not fully comparable to South Korea. Anyway, there is a slight bend in the Bay Area curve but it is too early for the shelter in place effect. I assume it could be due to large amounts of people working form home early on. Let’s hope the best.
Yes, US testing is ramping up so we’ll be uncovering more cases. So the super-fast growth in confirmations in NY and NJ doesn’t necessarily represent the growth of the underlying virus. I hope we get to South Korea levels of per-capita testing soon.
Testing in Florida has been minimal at best. A state with 22 million people and a tourist haven.. Think of cruise lines, Disney, Snowbirds from Canada, Midwest and North East. European travelers from Italy, the UK, and Ireland. Then think of the elderly retirees going abroad for holiday. If they are not residing in AL facilities. Could not believe the number of residents infected from Egyptian Nile Cruises. And lets not forget the presidents 1000 people galas at Mir A Largo. And top it off with Spring Breakers partying hard like they will never do it again. We are a petri dish waiting to explode.
With that in mind Palm Beach county is pretty locked down. Sadly I thinK it is too late. Testing seems to be minimal since there seems no point in following an epidemiological trail.
Why were none of these measures taken for h1n1 when the majority of people dying were younger?
Why such pandemonium when 50% of cases OR MORE are asymptomatic?
What % of cases involve a sniffle and sore throat? Would this be considered “symptomatic”?
Wasnt this around here in US back in oct, nov, december? Why such panic now?
What is average age and condition of those that are dying here in US?
I am not really seeing much of these answers out there. All I see is panic…but then again I am not spending hours researching. Please respond WOLFERS!!
Due to C19, Lombardy’s total “daily death rate” (in northern Italy, around Milan) has doubled in 1 month! No wonder they are panicking.
Ask Italy. Then you’ll understand precisely why this is nothing like H1N1.
There was a vaccine for H1N1, a strain of the flu virus, already. I remember everbody in my family, all my kids, got the vacciene. The vaccine was given out free by the public health agencies, and the lines were super long
@Andrew:
(1) The available data, while uncertain, show that COVID is 10-20x more dangerous than H1N1 at all age levels.
(2) The pandemonium is because the symptomatic cases, when left unchecked, begin killing more people than most societies are comfortable with. (Wuhan and Milan are leading examples.)
(3) It’s not clear what fraction of cases involve sniffle and sore throat. But in countries with strong test data, 10-20% of cases require hospitalization at some point. Side note: When the epidemiologists define a case as “mild”, though, they just mean “anything up to pneumonia that doesn’t require hospitalization”. They have 3 levels: non-hospital (“mild”), hospital (“serious”) and ICU (“severe”). I had a non-hospital pneumonia last year and it was the worst illness I’d had in 15 years. Personally I don’t want to risk even a “mild” case of an unknown new virus.
(4) So far as anyone genuinely knows, it wasn’t in the US until January. CDC shows first US case developing symptoms on 1/15 after travel to Wuhan. Globally there are many documented cases emerging from Wuhan and nothing significant before then. The earliest known case was reported from China, person showing symptoms on December 1 in Wuhan. The notion that this was in the US before January is completely unsubstantiated and appears to be a Chinese “communist party” government trope, designed to sow confusion and distrust and deflect blame from their initial poor handling of the outbreak. At some point I hope all nations will have enough spare test capacity to do retro studies of fall flu samples and maybe more will become clear about the origins of this thing. But it’s infectious and severe enough that if it was anywhere else before Wuhan, it should have left a massive trail of death. (It’s a damned shame that China razed the marketplace where many (but not all, and not the first known) cases originated – that site might have been a gold mine of information.)
(5) Average age and condition of those dying: the early deaths are invariably the most frail and least able to fight the infection. There is also skew from the demographics of the early infects. (South Korea had many young women infected from a religious group; Washington State had it hit a nursing home first – that skews the early stats.) The early stats won’t be representative of the full course of the pandemic. More informative to look at locations where a large number of cases have fully resolved (either recovery or not). China CDC did a detailed study on their first 75,000 cases (or so). Italy should be able to tell us a lot soon. US CDC has a study on the US cases known through March 16, but at that time US had very few fatalities, so the statistics are poor and not representative of what to expect. But US has had fatalities in all age groups 20 and up.
(6) The panic reaction is natural, this is a huge shock to people who were not paying attention or simply in denial. I’m with you that more facts, and calm responses, will help with that. But downplaying the known severity of this will not be helpful, it will just enable further disease spread and more suffering over the long term.
China’s “poor handling” of the outbreak? You mean the same poor handling that resulted in fewer deaths than Italy (which is 1/30th the size of China) and has basically arrested the spread of the disease after an early peak? Please get back to me in one month when we see how the US does in comparison.
Great response WS. Thank you.
Really good WS, this old guy who was fortunate to have been trained by Ames and others of his ilk in real science, and in spite of the fact I have forgotten so much of that, really appreciate your fact based articles and comments here.
Only one question: When you say, ”first case known,” are you talking about the first case known back in Dec, or are you talking about the recent revelations indicating that patient 1, (not zero) has been traced, (as reported by the Chinese,) back to 17Nov?
Thanks again to you and Wolf for bringing to us all some clear fact based info on the medical as well as the financial aspects of this event.
Worldblee – “Initial Poor Handling” was referring to the period from Dec 15-January 22, when the entire outbreak could have been eliminated if the Chinese government had gone into “red alert” mode instead of “cover-up” mode. That one-month is going to cost the world dearly.
I should add, though, that we’ve seen the same sort of denial response play out in many places worldwide, throwing away precious time all over the world. I’m not trying to blame the Chinese for being human. But humanity is going to have to learn how to do better, if we want to stop the next pandemic threat.
I agree with you that China did a great job of suppressing the disease – once they appreciated the scope of the disaster they were facing if they didn’t act quickly. I’m not sure how much to trust the recent case numbers – there’s a lot of politics involved now – but it certainly seems like all the east Asian nations are doing better than Europe and North America at the moment.
worldblee
China actually jailed several physicians who had the audacity to publicly state that Wuhan had a SARS like coronavirus epidemic in the first few weeks. Automatically disqualified from any discussion of a prompt response.
Cursory review on h1n1 below- again, I was originally going off my gut as i dont recall 1/100th the amnt of media storm
https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemic.html
https://www.cdc.gov/h1n1flu/cdcresponse.htm
Summary:
-Most victims were under 60 yrs old. Children were dying
– Older people most likely had antibodies
– reports indicated that most cases, (57%) occurred b/w 5 – 24 yrs of age- Tjis to me would be SERIOUS cause for concern
– highest rate of hospitalization was children under 5 yrs of age
– First case was in April of 2009
– A vaccine was not available until Nov of 2009
– If coronavirus primarily affects older people, the higher death rate % is understandable
– h1n1 18k deaths in 2009
– flu deaths in US ’19 – ’20 (as of feb 1): 16,000
– covid deaths in US +/- 323
– What was h1n1 death rate % at beginning? Who knows? Testing wasnt available
– overall Wisdom Seeker it looks like the point u made abt governments not being comfortable with a high % death rate is the best point
In summary, I dont recall the media going this batshit crazy in 2009. But people also werent on their phones 24/7 and the game of mass manipulation hadnt been perfected down to a science like it ia now
Lets see what the death rate % of corona is in a year or so. Then we will know
“China CDC did a detailed study on their first 75,000 cases (or so)…..”
Interesting that Fox News shows Chinese countrywide cases reported at 68,000 and change, with deaths in the 3800 range….
Can only speak for myself, but I am convinced I had it over Christmas, along with many others here in our village. Interestingly, family that had moved six months earlier to the Gold Coast of Australia were reporting the same symptoms at the same time. After the initial illness, was left with lungs that constantly streamed liquid and took honey and lemon, (in my case, whole organic lemon cut up into mug with added teaspoon of honey), which cleared the lungs in three days. Am surrounded by others that also believe their symptoms then match the description of the virus symptoms now. So I for one do not believe that early cases were a conspiracy of the CCP. Again, look back to the opening article above, “The actual spread of the disease is likely much wider (possibly 10-100 times) than the confirmed cases.” Which will move the statistics for death back into a normal flue season.
Is this another “Tamiflu”?
The disease commonly takes a couple of weeks to kill, so the 10-100 times cases haven’t shown up on the mortality statistics yet. Also, in many places, deaths were ascribed to viral pneumonia, either to keep the numbers down for political and economic reasons or because no testing was done so that the viral pneumonia category was accurate but not instructive.
@Chris – Be sure to get a serum antibody test when those become available. You’ll know if you had it or didn’t. But my money is on “had the flu” – it’s indistinguishable unless you get the rampant bilateral pneumonia where COVID has a very distinct signature.
Chris Coles,
Everyone who had a cold or the flu over Christmas (I had a bad cold with a nasty cough) is now saying they had the Covid-19?? I mean, come on.
So far in Canada we’ve got 1300 confirmed cases and 19 deaths. The 19 deaths have mostly been elderly (70s,80s) in chronic care facilities so obviously not in great shape to begin with. 1 death was a man in his 50s with “underlying health problems”. Everything is pretty much locked down now so we wait and see how it goes :(
Things I read today:
1. The average age of victims in Italy is 79.5.
2. Nearly every fatal case has involved serious pre-existing health issues.
3. The WHO projected fatality range is in line with H1N1. A report in the New England Journal of medicine concurs, putting it below 1%. China’s rate has been revised down to .7%. (And dropping, says I)
4. Protests around the world have been basically made illegal.
5. Read Wolf for financial scandals being snuck through behind the smokescreen.
6. At least one mayor has decided to suspend the Constitution and halt gun sales.
I’ve not had time to verify all of this, so but beware. I’ll post links if desired though.
From a New Orleans respiratory therapist via Propublica who wants name withheld as not authorized to speak to media.
‘I see patients in their early 40s and, yeah, I was kind of shocked. I’m seeing people who look relatively healthy with a minimal health history, and they are completely wiped out, like they’ve been hit by a truck. This is knocking out what should be perfectly fit, healthy people. Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can’t breathe at all.’
He adds that he’s never seen fluid build up in the lungs so fast and that patients on ventilators ‘have to be restrained as the drowning reflex takes over’.
A large number of cases in Iceland and Norway indeed originated in the skiing areas of Tirol, Austria starting at the end of February. The local authorities were very slow to take measures. Even after Iceland alerted them that 15 people on a return flight from Tirol were infected, it took local authorities over 2 weeks to kick into action. The economics of the skiing season prevailed over health concerns. Now, the Austrian federal government has closed off some of the affected Tirolian villages from the oudste world.
It is interesting that the outbreak in northern Europe apparently did begin as a standard of living disease because of the timing at the moment when schools were closed for winter vacation and a lot of people traveled especially to the Italian and Austrian alpine resorts. These people returning combined with an apparent attitude of “the virus isn’t a problem here, it is far a way in China and southern Europe” were seemingly an efficient combination.
In addition when you look at how people currently are flocking to our domestic ski resorts up north and how they’re celebrating and boozing as usual for those places, well …the “bold and beautiful” apparently have no thoughts to spare for tomorrow …
I hope I’m wrong, but I suspect that Sweden is the next hotspot due to reports of health care and hospitals being overburdened for years already, reports on shortages of everything beginning with hand desinficants, and rising number of cases although they’re claiming that only hospitalized people are being tested any longer, not even staff being tested currently. In Stockholm the 2 main hospitals laid off 800 doctors and nurses recently due to acute lack of funding…
Something about ski resorts? Mexicans now call it the Vail virus. Some wealthy types were exposed on a ski trip there. Meanwhile the prez suggests some states do not need to shelter in. Being part of fly”over” America has its advantages, except when virus does arrive these places have limited hospital capacity, and patients are spread over a wider area. Also in winter people tend to huddle together in their houses (like ski resorts?). Maybe rural America needs the lockdown more? Bad advice has been the only constant in this pandemic.
And China was reporting zero new cases a few days ago.
Hmmmm… China locked down hundreds of millions with 800 confirmed cases and then sent everyone back to work with 80,000 cases. Only then did new cases start plummeting.
Ummmm… shouldn’t half of China be dead and dying by now?
Applying virus logic: shouldn’t we be locking down the entire country every Friday and Saturday night around 7pm? To save lives? (Drunk driving.)
Yes…. in case you haven’t figured it out yet, I’m a little upset that people are so willingly forfeiting the constitution here. Judges, governors and mayors don’t have the legal authority to trash the constitution.
Why would anyone find the recent Chinese numbers believable?
@911Truther – I hear you about the Constitution. We should not be panicking about this. There is a very real risk that power-seekers will abuse their powers here.
BUT – there are many public health laws on the books to provide authority, during a pandemic, for suspension of “freedom of assembly” and other civil rights. Individuals don’t have a fundamental right to endanger the lives of others (by spreading disease). It’s the same principle as how we curtail “freedom of speech” by not allowing people to endanger lives by shouting “fire” inside a crowded theater.
We’re all shocked to see the same playbooks being used that were followed in 1919, it’s been so long since we had to deal with anything like this. But there’s a sound principle and plenty of examples from 1919 about how effective public health measures can save thousands of lives. The canonical example compares Philadelphia (denial and failure) with St. Louis, with the latter having about half the fatalities in 1919-1920.
Exactly. Do a web search for Mary Mallon an asymptomatic carrier of typhoid. She changed public health policies.
911Truther,
We’re all in this together, and we’ll need to get through it together. And we will.
The issue is this: If you need a ventilator because your lungs don’t function anymore due to the coronavirus, and there are no ventilators available at the ICU because they’re swamped with cases, then, well, you’re likely to suffocate.
So the idea is to slow down the progression of this thing so that if you do get it and need a ventilator that there will be one available for you. And this goes for everyone. Otherwise it’s “triage,” and doctors decide who dies and who lives.
Wolf ,
The reality is bad.
Let me explain. In the hospital Reg n95 masks. – They do not want to give them for suspected cases.
When we want to test we are told they do not meet criteria. We are being asked to wear regular surgical masks for suspected patients. No protection for health care workers.
Imagine telling a soldier you have to go to battlefield without a vest or asked to wear a cardboard vest.
Sorry, but I can’t resist – “We’re all in this socially distanced.” Or we better be.
Wolf keep up the good work. Read a snippet on Karl Denninger’s site and don’t know if it’s true, but stated that in China 95% of patients who needed a respirator didn’t make it. His point being that adding respirators might not be the most important tactic at this point. Don’t know the answer. Thanks for a great platform to exchange ideas.
Thank you very much for this. You’re time and effort is very much appreciated.
colorado where my septgen mom is, is going frking nuts! wtf is going on in colorado; their infection rates is off the charts i dont understand
Tourist hotspot? Lots of skiers in Jan/Feb…
Agreed, and confirmed by media rpts – Vail had an early cluster of foreign tourists with C19.
I think I read somewhere that Italians like to ski in CO.
Winter ski resorts are usually wet, dark, where people spend more time inside closely huddled drinking alcoholic drinks, interspersed with going outside breathing cold-air, coming back in for more drinks, in dark, damp.
Lot’s of initial infection tourists are people who like to travel to ‘snow-spots’ as never having seen snow, but they mostly stay in the lodges.
Just like in Aspen, you’ll find more people inside than outside at any given time.
The worst place to be is a cold, damp, dark place. Just like the KTV ( karoke rooms ) in Japan/Korea, which are the main vectors, and also the ‘smoking boxes’ where guys go for a cig, are usually closed spaces, same damp, dark, smokey, perfect for the virus.
Same in Iceland, most people are indoor, highest rate of alcoholism on earth, ice-cold drinks, ice cocktails, cold damp rooms, usually dark, the worst place possible for the virus.
Also at ski-resorts people spend a ton of time in lines, lines for the lift, lines to rent, lines to fit equipment, return lines, and the lines at the bar. Lines to park the skis, lines to get them back. Social distancing at a ski-resort? Nada
…
If you don’t want the virus, seek low humidity, outdoors, and get some sunshine.
I’m a physician in the front range of Colorado. Lots of people from all over the world skiing here in the winter. The mountain counties here have some of the highest prevalence of COVID19 per capita in the United States. It traveled very quickly to the front range. People have been isolating here for about a week, but it’s pretty clear it was widespread the week before.I would wager the curve will start to bend in two weeks here.
I think per capita Louisiana is probably in the lead now, must be Mardi gras related. But the ski resort counties are close to one confirmed case per thousand people now. And Colorado has not updated their numbers since Friday, there are probably twice as many now.
Northern Italy = proximity to Alps and ski vacations (wealthier part of Italy)
Oops, missed your graph WS, ha ha, you’ve got all that per capita stuff, apologies…
NYC numerically is the biggest problem right now.
Take a look at where the hot spots are anywhere in the world. The clusters are where affluent travelers congregate, for business or pleasure. Soon to be in refugee camps where there is little possibility for modern sanitation.
I think closer to 8 days and above to start to bend the curve, from what I read it has a basically 11.5 day incubation until symptoms are observed. Louisiana == Mardi Gras
Median incubation period is about 5 days, with low end at 2 days and a long right skew out past 14 days.
We’ll see it soon.
Here we’ve been under various forms of lockdown since February 24 and full lockdown since March 7. It hasn’t worked on a national scale yet, but yesterday there was the first drop in new cases in my area (one of the worst affected): it may be just a statistical error but we’ll see it soon. The first area of contagion in Italy hasn’t reported a new case in over a week now, and they have been under the most stringent form of lockdown for almost a month now.
Incubation period is hence on the long side, at least with the two virus strains present in Italy (the genuine Chinese article and a mutation first discovered in Germany in February).
If new cases in the North of Italy start slowing down over the next few days we can safely say incubation is on the long side, meaning an old fashioned quarantine (40 days in lockdown) is the way to go.
If not… it means the virus spreads in a novel way because I can assure you that people are really staying home.
I wonder if one reason for so many elderly people catching it in Italy is the custom of several generations living in the same household ?
Excellent underdiscussed point, Realist.
Does not get more proximate than same HH.
That kind of household is pretty rare, at least up here: most elders live alone or with their spouses.
Epidemiologists are on the case, not just because of the high mortality among the elderly but because symptomatic cases under 50 are very rare in Italy and mostly limited to people with pre-existing conditions.
There’s something seriously weird going on here: average age of “official” Covid-19 victims in my province is 81 and in two weeks we’ve had a single person under 50 succumbing to the disease.
Yep, had to be Mardi Gras. Expensive party this year. Last weekend’s “one more fling” St. Patrick’s Day revelers are going to ring up a hefty bill too.
Yup, this will be the thing that gets Colorado. If everyone had just avoided bars, social gatherings, etc., last weekend, we may have been able to stave off a bad outcome. But of course, there were still quite a few people out drinking Saturday and Sunday, and now that might be what really does us in.
Sadly, this coronavirus is profiting from misinformation spread by our own government. I needed to pick up my relative’s repaired phone from a computer place in OC recently, and I was astonished that there was a line outside of people waiting to happily go shopping. Apparently, no one was taking the coronavirus seriously.
I was the only one with googles and a mask. One or two others in the store might also have had masks.
I tried to tell a 75+ year old man that the coronavirus can become airborne and stays in the air for thirty minutes (which was a mistake, because a later study reveals that it can stay in the air for three hours), so that going into a crowded store was not a good idea for him. After he responded that the president had said that this like the flu and an exaggerated, Democratic hoax, I told him that the president had not known what he was talking about.
He actually got furious at me. I wish that he or others who have become annoyed at my warnings for weeks saw now an online video of a Spanish doctor crying while talking about how ventilators are being taken away from 65+ year olds, who are given sedatives to die less painfully. From relatives, I have heard similar stories from other countries.
That is what is coming for us and the world. I studied to be a doctor for a while, before switching. Most nations are still flying blind due to insufficient testing and amazingly irrational decision making, e.g., in the UK, if they were truly serious about trying to get “herd immunity” (without vaccines or preventive measures) as the solution to the coronavirus.
E.g., the UK’s residents are still often ignoring social distancing and shopping without protection. I fear that the infection rate is likewise truly unknown in the US, because airplanes were virus incubators and travelers and their contacts cannot be traced anymore. Without masks or other protection (which a Hong Kong doctor recently recommended would work at least partially to reduce the infection rate), Americans are sitting ducks.
Most just do not understand the potentially explosive, exponential rate of growth of a virus with an R0 of 2 to 7. This administration is compounding its many, major mistakes by trying to get bailouts for the rich’s corporations and businesses, while not imposing the national lock down (including barring all non-essential travel) that more courageous, competent leaders in the EU have imposed.
Then there’s the strategy of having thousands of young people from all over the US congregate in a city in a nice warm southern state and shed their clothes with a lot of body contact. After a few days send them back to all corners of the US. Not a particularly wise plan.
Amen. Without very extensive testing a lockdown of all infected
states (stopping all non-essential travel) is now the only, remaining option with any chance to contain the spread.
Louisiana had Mardi Gras, but the major vector seems to be a large nursing home in uptown New Orleans with staff carrying it to other locations.
Testing is ramping up over the past few days, currently under 25% testing positive, but expect a spike in numbers over next 5 days due to testing.
im iranian i would not trust iran’s data, not just because of lying, they havent tested people & because of sanctions got no med supplies,
no one has, whatever number you see, for whichever country, multiply it by 3 or 4 times to get a handle on actual infected cases vs what is reported; it is literally the tip of the iceberg, you see the top and its not representative of the entire thing….china?
the curve looks better, is it real? maybe, will it hold? have they restarted too fast visavis 2nd/nth wave?
…this thing is infectious and higher infection rates mean in general higher mutation/resistance rates which can induce certain feedback loops
The only country that seems to have done enough testing to get at the bottom of the iceberg is, ironically, Iceland, as WisdomSeeker notes.
Reportedly, both North Korea and Russia still have their borders closed to China. If we are wise, we should not trust their numbers and keep our borders closed to them. Ditto for Iran, albeit we should relax the sanctions as to the export of medical supplies/equipment as to Iran, so that the massive mortality there does not continue: the innocent should not suffer due to their government.
The Chinese communists would love for a major epidemic to break out in the US– even greater than our dear leader has already caused through incompetence. On another subject, thank you for the excellent article!
It is not in our interest to have trade sanctions on anyone except direct military tech. Those infected Iranians and Venezuelans are not all going to stay in their present countries.
Aside from just the humanitarian decent thing to do for our fellow man is the observation that ‘if your next door neighbor’s house is on fire, it’s not just their problem, it is your problem too.’
There should be NO sanctions for food or medical care anywhere at this time.
Hey Wolf. Have you heard anything about how the disease is tracking in Japan. Just watched Stephan Molyneux. He said Japan had lowest rate in developed world.
I don’t know the numbers but they’ve been locked down to some extent for a while with “social distancing” having become a huge priority. Some of the initial panic has settled down. It sounds like they’re getting a grip on it.
Wisdom Seeker can probably provide updated numbers.
they social distance in normal times (see their pron) they literally have sex via video screen…
…also, Japan has a stock of I believe 2 million doses of favipiravir, which appears to be especially effective against the Covid.
sevensec,
“But a Japanese health ministry source suggested the drug was not as effective in people with more severe symptoms. “We’ve given Avigan to 70 to 80 people, but it doesn’t seem to work that well when the virus has already multiplied,” the source told the Mainichi Shimbun. The same limitations had been identified in studies involving coronavirus patients using a combination of the HIV antiretrovirals lopinavir and ritonavir, the source added.”
https://www.theguardian.com/world/2020/mar/18/japanese-flu-drug-clearly-effective-in-treating-coronavirus-says-china
Japan is putting up great (low) numbers. Only 1054 total cases so far, even lower than Singapore on a per-capita basis. The skeptics question whether they have been testing enough, whether political pressure relating to the Olympics might be skewing response, and so on. Other countries which thought they were doing well (Indonesia, Turkey) have started sprouting cases once they got serious about testing. But I’m not enough of an expert to have an opinion for Japan.
Just heard Japan isn’t testing due to wanting to keep the Olympics.
The confirmed cases flew out to another country who would test
Until now in Japan, very limited testing and almost no autopsies.
This is the kind of data/information/how-to/non-alarmism that should have been released over a week ago instead of everything that was sh/t out on us.
what alarmist agitprop were you subjected to?
We did, a week ago:
https://wolfstreet.com/2020/03/14/to-win-the-coronawar-defense-is-the-only-offense/
“us” meaning the country/world. Not everyone reads you. I didn’t mean that YOU were dishing out cr@p. I meant the MSM -AND- the pressers.
I was going to italicize the word “everything“, but hit “enter” and it posted quicker than I intended.
and by “over a week ago”, I should have said something like “several weeks ago”. I usually read over my posts to make sure they’re fully coherent, but hit “enter” by mistake!
Who was publishing exaggerated or untrue and alarmist stories? I don’t read all the newspapers so I may have missed some big offenders.
I think things will calm down this week. Last week was all about ramping up public health responses. Once the news folks grasp that the “new normal” is everyone staying home for a few weeks, and stop hyperventilating about the latest public health announcement, that will help a lot.
I’m seeing a lot of hysteria from people who were in denial and finally woke up. The scapegoating isn’t a healthy response, but it’s progress compared to the outright denial.
I’d like to see the news focusing on (a) helping to enforce the shelter-in-place by shaming offenders, and (b) helping folks figure out how we can take care of each other until we have the virus beat. There’s plenty of food, we just need to be patient.
I’ve been able to find lots of stuff on where the virus is and how to recognize symptoms. Not much about tests where I live though there are some drive throughs that had to shut down promptly because the tests ran out. That was four or five days ago.
In general, the stories I read, if anything, erred a little bit on underestimating the impact in the U.S. of this virus.
It would also be useful if public health officials were a little more explicit about exactly why/how social distancing/shelter in place works…by denying the virus a transport mechanism (us) and therefore derailing potential exponential growth.
Some people understand this implicitly, others may not – but it is easy to illustrate graphically, the whole point of visual media.
In aggregate, masses of people act with more focused resolve if they are given a clearly defined goal, and a rational/trustworthy reason for that goal. They will endure more.
W.S., funny, I think just the opposite will occur as the emotional impact of this thing becomes reality and the dying begins. This will be akin to seeing the Twin Towers go down, only this time it will be our for profit Healthcare System and the whole bogus house of cards that is our Financial System.
Another very good data point:
The Diamond Princess cruise ship… basically a floating petri dish of old people…had about a 20% infection rate and seven deaths (all elderly) out of 3,700 passengers.
The problem is very simple: ICU beds.
My chronic disease landed me in the ICU back in 2016. While healthcare quality was absolutely excellent do you know how many beds it had? Six, with room to add three more in case of an emergency. ICU capacity cannot be increased overnight like China claims to have done in Wuhan and elsewhere: it requires not merely infrastructures and equipment but a lot of medical personnel as well.
That’s the big problem: healthcare facilities get swamped in no time.
Northern Italy is where everybody is looking at right now because of the excellence of her medical facilities (at least in Lombardia; other regions are not so good) and large number of beds due to a rapidly aging population. If we got swamped, everybody will get swamped.
This also means that as resources get syphoned into expanding ICU operations the rest of the healthcare system grinds to a halt.
The big problem in Italy right now is very simple: what happens if the disease spreads South? So far there only appear to be some clusters there, apparently cause by people fleeing back to their homes just before the lockdown started two weeks ago, but the healthcare system there would collapse in no time.
Now up to nine deaths and a couple of dozen cases still in critical condition. I expect the death rate to end up around 2% and that’s with everyone getting excellent medical care because they were early to the party.
The sample skews elderly because cruise ship passengers skew elderly. Current trends show that the 20 to 50 yr group has more severe cases than originally thought.
Here is more info on Iceland https://www.buzzfeed.com/albertonardelli/coronavirus-testing-iceland
Excellent link, thanks!
RE: Louisiana… Consider Mardi Gras (February 25th this year), a giant celebration with massive social interaction in New Orleans, where most of the cases are now coming to light. People go there from far away to participate.
That would do it! Corona thrives on large intimate sustained social gatherings.
There is a large misconception regarding Mardi Gras in Louisiana. The celebration is not just in New Orleans, every county(parish) has its own parades and celebrations, they number in the hundreds and they occur over weeks. The problem of exposure to the virus is statewide.
Although the NY, NJ and CA went into lock-down, DC area cannot because, first the .gov. Unless whole government shutdown itself, even if DC locks down, people will be moving from MD to northern VA (NOVA) and so on.
Its worthwhile to mention, all the federal employees and contractors were given full work from home. Federal government is still open and they should not close under this situation.
As far as Louisiana, a video of cops requesting bourbon street to shut down was circulating in twitter. When was that mardi-gras? before or after this COVID?
Similarly, UK who believed in herd immunity shifted to quarantine in the last minute.
Well, now its a man and his immune system it seems.
UK is pretty far down the list in terms of cases per million population, maybe a week or 2 behind Italy. Might have to worry about hot spots, but if they get serious nationally this week, they won’t be any worse off than the EU nations. Missed an opportunity to nip it in the bud though.
To be fair the advice was quite clear.
But this virus has made it abundantly clear that a proportion of the population in the UK absolutely need nannying, being told explicitly what to do, and a law making to make them stop doing it too.
I’d have preferred UK gov to just pay old/vulnerable people to stay indoors for 3 months at a time.
It’d have been cheaper and had more effect in my view.
Yup. Disappointed at the response by many people in the UK. Law abiding, sensible and stoic many are not.
Anyway – Boris asked nicely, but now he has done what was necessary. Time to crack heads if people do not comply….
As far as DC, it is hard to do lock down. Government has forced telework on all government employees that can. The issue is that they have never tested at this scale which leads to user and security issues. Also, some of us work on systems that are remote. So, the government has instituted one week on and one week off with minimal manning. The issue is how do you lock down the mall and other open areas. My wife asked me to drive around the cherry blossoms and we did. It was packed. Some were like us and drove around but many were walking around. After a long drive, it was through D.C. and Georgetown. It was deserted due to closed stores. It is the travelers and tourists who are not isolating that are causing issues. To be honest, I would like some traffic issues as I would know things are getting back to normal. However, I have a feeling that it is like a hurricane has landed on your shore and that it will take some time. Keep safe everyone.
I still have to go in to work each day, and had to work Saturday and Sunday. I just don’t touch any surfaces at work when coming and going from the office. I wash my hands a few times. I’m only around two other coworkers and we’re separated by a distance.
I’m still not sure how it spreads host to host without coughing / sneezing?
Best commute ever. Doing 80^H^H60 MPH into work during what is normally rush hour all week.
Actually, government is still open, it should be maximum teleworking approval.
tell me where the ghost commodity doelars are (us money-center banks) and i will tell you where the renminbis are:
“China is committed to signing the Regional Comprehensive Economic Partnership Agreement (RCEP), proposed by 10 members of the Association of Southeast Asian Nations, by the end of this year, said Gao Feng, a spokesman for China’s Ministry of Commerce. All parties in the RCEP are working hard to finalize the agreement, he added.
China is also speeding up discussions about the establishment of a China-Japan-South Korea free trade zone and the signing of a free trade agreement with the Gulf Cooperation Council. It will proactively push forward the discussion about setting up free trade zones with Israel, Norway, Sri Lanka, South Korea and Peru.”
extra credit question: if you had 1Y or 1E, if i gave you 1$ , which one would you keep?
: )
‘Early indications are that half the confirmed cases were asymptomatic at time of testing. If they stay that way, it should support a lowering of the overall fatality rate estimates by WHO and CDC.’
I can think of several diseases that lie dormant for years before becoming acute. Are these corona viruses not like that, if you beat it for two weeks you are clear?
@Nick – this one is a new coronavirus, capable of further evolving, and against which human immune system has no training. While I think the data from the confirmed cases supports the idea that this evolves like a flu or like SARS for most people, there have been some odd stories – long disease courses, apparent reinfections, symptoms popping up in other parts of the body after the lungs have cleared. There’s a lot of “fog of war” here.
Wisdom Seeker: Just to note – evolution does not necessarily mean worsening of outcomes for humans from this virus, we just do not know. Evolution is not unidirectional in such outcomes.
Your comment that human immune systems have no ‘training’ in regard to this virus implies there is no carry over or evolutionary advantage from exposure to a wide range of pathogens including viruses unless they are completely identical. I doubt this is the case. We know in swine flu (which I caught in 2009) research found that those infected tended to develop long term immunity to the common cold viruses. I can attest to this as i did not suffer a common cold for about 5 years afterwards (from a usual rate of 2x per year as an estimate for myself).
Agreed, thanks for the comment.
A fact is that oldsters who did catch the Asiatic during the 60s did not catch the Swine flu.
This is a great analysis WisdomSeeker, and it’s great you’re not taking all data at face value but trying also to understand the context in each country, given vastly different levels of testing. One minor correction is that you’re looking at the incidence rate (per day/week) and cumulative incidence (since start of outbreak). The prevalence rate is number of people who have the disease at a given time, and that’s not a very useful number for a disease that’s short lived like COVID-19. If you were truly examining prevalence for a disease with such a short duration (days to weeks), you’d have to pick a very short period to measure prevalence, and you’d have to exclude all those who had recovered. Prevalence is much more useful for diseases like high blood pressure or rheumatoid arthritis that last for years and years. Sorry that’s a nitpick. And feel free to correct me if I’ve got that wrong.
You’re probably right. These graphs are just plotting cumulative confirmed cases for each date. At the moment, the number of confirmed cases is close to the number of active cases since the confirmed recovered (and dead) is relatively low for the countries listed. That’s partly because the growth rates are so high and partly because the accounting for “recovery” is poor. Getting at a true prevalence or incidence number is challenging. Even the confirmed cases numbers are suspect because of testing differences. Early on, the test protocols often excluded some obvious-in-hindsight community-spread cases (and not just in the US) because of lack of travel or exposure history. So, confirmed cases too low. Then, as clusters are spotted, the tests potentially ramp up faster than the disease. Later on, in the bigger outbreaks, the testing might be an undercount again, since overwhelmed hospitals may not be able to (or want to) test everyone who clearly has the viral pneumonia, since it often doesn’t affect treatment plans much and when the hospital is overwhelmed the docs and nurses have little time and too many lives to save. It’s a classic fog-of-war situation but we have to use the data we have while recognizing its limitations.
https://ncov2019.live/
Real. Time data
Thanks for this update WS,
Having been there once, Mardi Gras immediately came to mind as noted above for New Orleans,,, if at all possible, it might be helpful for all to see a graph of Louisiana by county; that info is available in FL, but don’t know about LA. (Though it may not help that much because so many come into NO just for the fat tuesday party and leave soon after.)
Next ”surge” IMO will be a week or two from now, after Spring Break this week, even though the usual huge and wide open parties have been relatively muted to start, and now more or less shut down now.
It is very clear so far that this virus can be carried and shared by folks with no symptoms what ever, the most dangerous of its characteristics, so with vastly increased testing now coming on line in USA, the next few days should add considerably to our knowledge.
Thanks again, please keep up the good work.
Look at NOLA.com there is no paywall, they are documenting the spread. There are hundreds infected, some dead, and massive layoffs.
New Orleans has a large homeless population. I don’t see any mention of how the homeless are being affected by this virus anywhere, not NY, CA, or NOLA. It would be strange if they are not infected because they are a huge at risk group.
That is a very good observation!
Petunia,
A homeless person died of Covid-19 in Santa Clara County (Silicon Valley) a few days ago. First known case here.
First death in SD county, 74 yr old man who had been treated in Santa Clara, after a trip to Hawaii. (so probably not homeless)
The media have been covering the homeless – there have been multiple stories – just Google.
I caught part of a Gavin Newsom (governor of California) presser about a week ago. In the segment I watched he ONLY talked about the homeless (mentioning there are about 60K in CA; I suspect the number is larger). I couldn’t tell if this was typical, bleeding-heart, liberal empathy (Note: /s), or he understands a rampant outbreak among the homeless has the potential to infect millions. My guess is a bit of both.
Whenever the number of people tested is reported in the US, the number of people with positive results has been very consistently around 10%. So the number of positives reported in most cases is basically the number of tests done, not the number of people infected. LA county has told doctors that patients with Covid 19 symptoms should be tested only “if it would affect the prescribed treatment”. Since treatment is usually based on the patient’s symptoms, e.g. pneumonia, very few patients will be tested and therefore not counted. The number of positive results is meaningless because the number of patients tested is rarely disclosed. Only in South Korea where asymptomatic and symptomatic people were tested in the 10s of thousands are the results true indications of the level of infection.
Wigner, do you have a link to data to document the “consistently about 10%” claim? I could see that being true during the early testing period, when contact tracing gave good reasons to suspect an infection. More recently, with the drive-thru testing and all, I don’t think it’s true anymore. I’d like to dig up some numbers and would love some community wisdom on where to find the data.
As of Thursday afternoon, the US had run 103,000 tests, with, at the time, about 11,000 positives. I remember at some point, when the number was about 8,000 tests, the positives were about 750 at the time. I saw some data from New York on Thursday that they had about 20% positives, but they had actually found a true hot spot and had focused a lot of testing on that hot spot.
I surveyed a number of the states individually, and Wigner is right- the ones that report testing results vary on either side of 10% positives. There was even a graph from University of Washington that demonstrated this pretty steady ratio of positives vs negatives regardless of how many tests you ran on a given day.
I think this testing data is demonstrating that the infected probably number 1 million plus- might even be 2 million plus. We have uncovered only a small fraction of them at any given time. If we can get testing up to 500,000/day, you might finally get a feel for how large that unknown actually is, but if you stay between 20K and 100K tests per day, then you won’t. Even worse, I think people will just stop being tested and soon. There just aren’t the people available to take the samples and actually run the tests.
Wisdom Seeker,
Good cumulative tracking stats at
https://covidtracking.com/us-daily/
– and click around, other good segmented data.
It looks like the 10 pct positive rate was roughly accurate until last couple of days …now edging closer to 15%…but that may be an artifact of increased testing…higher pct of backlogged people matching the symptom profile can now access tests.
The data tracking sites are very useful tools – various ratios and axes of segmentation can reveal potentially useful info. Too little cited so far in MSM.
I found a website which is doing its best to track test numbers:
https://covidtracking.com/data/
This one shows a 12% “confirmation rate” at the moment. If you dig into their data, though, it’s clear that the reporting for many states is pretty sloppy. So 10-12% is not unreasonable but I would be inclined to take it as an upper limit. Much more incentive to report a positive result; less reason to tally up all the negatives when some states ignore that data.
I retract my claim of 3% – although it was true in some places at some times – it’s clearly not true for US now.
Thanks wisdomseeker. I’ve shared and posted this link you use, repeatedly here, but it’s been repeatedly blocked or deleted. I’ve also shared it at my work at Johnson & Johnson and gotten very positive feedback from my co workers. One thing worth mentioning is Tiawan. Very few cases they don’t even show up yet, and because they learned from SARS, they have a well funded government public healthcare system fully supported by government, specifically for pandemic – in direct opposite of the U.S.
Yes, Taiwan has been doing even better than Singapore on this one, based on the reported numbers. IMHO Taiwan doesn’t get enough airtime because of the political tension with mainland China. WHO won’t even report Taiwan as anything other than a Chinese province, which is clearly a political rather than medical choice, because Taiwan is clearly not ruled from Beijing at the moment and has a different medical system as you say.
Discussed Taiwan early on in another thread.
Very interesting case, given huge level of commercial interaction pre-C19 explosion. China and Taiwan may hate each other politically, but they do a ton of work together commercially.
Even with gates slamming down tight, you would have thought that some (or more) earlier spreaders would have already visited/returned.
It may be that the internal surveillance system is very, very tight – like SK and Sing…where internal spreaders are id’ed very, very quickly and quarantined.
That internal health surveillance state is probably due to their first hand experience with SARS (and communicable diseases in general, having high population densities) and, less discussed, general surveillance states due to fear of Chinese infiltration of all stripes, given proximity and asymmetric sizes.
They are also a small island and can completely control cases from outside by shutting down an airport.
Also not a large-scale tourist destination like Italy.
Previous experience with SARS and a population with Confucian respect for authority are probably also factors, as they have been in South Korea and Japan.
As far as a comprehensive government funded health system being part of the success there, that may be the case.
However the fact that Italy and Spain with their comprehensive government funded health systems are doing so poorly suggests otherwise.
China is over its epidemic. They found chloroquine to be effective. The French found a combination of hydrochloroquine and azithromycin to be effective. Trump wants this combo approved by the FDA. It should be sped into emergency use.
The Chinese also used plasma from healed people to speed recovery in sick people. Convalescent plasma was also used to cure Ebola patients; ending that epidemic.
The Spanish Flu epidemic of 1918 infected 30% of the world’s population. It killed tens of millions.
David, does the plasma exchange mean in other words that people can donate their antibodies for this virus?
Yes, that’s how plasma therapy works. Healthy recovered person has antibodies in their blood which can help the newly infected.
For anyone who is interested, here is a link to a website that lists per capita testing by nation-state for COVID-19:
https://ourworldindata.org/covid-testing
It’s rather difficult to evaluate the relative differences across nation-states for total infected cases, total deaths, or currently active cases without knowing the number of people who have actually been tested for this virus and how it compares to the total population. As can be seen in some of the graphs, the differences between nation-states in this regard are quite large.
I can tell you why CA isn’t registering. They aren’t testing. My brother has the symptoms and asked to be tested. He was rejected. I’m pretty confident that he has it. He, like others, are not reported.
He was asked to return to work, by the way. Imagine this scenario x100,000.
Wash your hands.
Statistically, 97% of people who have been tested didn’t have it. The early stage symptoms are indistinguishable from flu (especially if you had the flu shot) or some other common viruses. There’s no real way to know until the testing becomes more widespread. Testing is ramping up fast, just have to be patient … which of course is the hardest thing to do when you’ve got an unexplained fever and a tiny dry cough but no sniffles!
I had those symptoms recently myself, and was pretty damned anxious until the fever subsided and nothing else happened. I’m keen to get a serum-antibody test when those become available, just to find out if I had a genuinely mild case (and might have immunity now). But statistically, given the caseload right now, it was much more likely I just had a touch of the flu and was shielded by the flu shot.
WisdomSeeker: “Statistically, 97% of people who have been tested didn’t have it.”
For the United States, that is not correct. So far, about 104,000 people have been tested for COVID-19 in the United States, and 27,000 of them have been found to infected with the virus. So that’s an infection rate of about 25%.
Ultra, that’s very interesting. I’ve seen 3% positive, someone else on the thread says 10%, and now you’re saying 25%. Clearly worth looking at more. Do you have a link to your total number tested? I was under the impression that negative tests, particularly outside of the CDC/State-Lab public health network, were not necessarily counted.
The data lags a bit- the new cases gets updated more quickly than the testing number does on the various sites. I did apples to apples- when we are at 27,000 cases, I estimate the tests run, based on the rate of change of tests is that the US next report for that 27,000 will be about 220,000 tests- we are surely over 50,000/day right now based on the data from Thursday. After tomorrow (Sunday), 270,000 with about 32,000 cases.
If you compare the data side by side, the new cases are roughly anywhere from 8-13% of the tests run on a give day- this goes back the very beginning.
Wisdom Seeker: Here is the link for the total number of people tested by nation-state, along with graphs showing the per capita testing per million people:
https://ourworldindata.org/covid-testing
The USA has tested about 103,000 people and about 27,000 people have been identified as infected by the virus, as indicated by this link:
https://www.worldometers.info/coronavirus/
So, dividing these two numbers produces a rate of 25% who are tested have been identified as infected.
Yancey, thanks and see my comment up above – Cover Tracking site shows ~12% as you indicate.
I retract my 3% / 97% claim, which is not true now for all US.
Although I hope we get enough testing soon to spot the virus efficiently enough to get back to 3%!
@Ultra – if you’re using numbers from two different sources, there’s a risk of doing apples-oranges comparison, particularly with something that’s growing fast. If the “tested” number from one site lags a few days compared to the “infected” number from the other site, that would badly skew the ratio.
As of yesterday Out of 3,031 patients tested for the novel Corona virus in Massachusetts 328 have been positive. Yet somehow the total number is 525 infected ppl!
So that’s between %10-%17 positive whichever number you consider.
The high % of positives might be do to the fact that they don’t test unless they are perty sure some one is infected and even after that it takes days to actually test him/her.
Assuming the virus eventually will spread in Africa and India, what would happen there considering that they don’t even have the ( now clear) limited resources that the developed countries have? How you end the virus in other part of the world if the virus keeps growing in India or any large part of the world population?
Right you are.
Shelter in place will bend the curve all the way to zero only if the infection dies out on its own or we develop a cure or vaccine.
Otherwise, the infection will come right back and circle around the world again, after everybody comes out to play again.
If you had chickenpox, for example, and sheltered in place till it was gone, you would not infect anyone when you came out, and you would have developed antibodies. What is your point?
Partly true. After the first round however there would be some herd immunity for the hundreds of millions of cases who were exposed but did not develop symptoms.The virus would have to have sufficient susceptible hosts to spread and if 20 or 30% of the population have already had it, it would not have the same effect the second time around.
That’s the hardest question to answer. It can take a year or more for a pandemic to run its global course without a vaccine. Africa and India may get hit bad, or they might not due to favorable climate and youthful demographics. But since we can’t convince 100% of the people to stay home 100% of the time for the next month, there will be pockets of the disease smoldering away in various parts of the world for a long time.
China is wrestling right now with exactly this problem – how much can they “turn the economy back on” without triggering another big outbreak? And how do they support international travel and trade when they end up importing a bunch of new cases from other nations? The whole world will have to sort that one out. I could see a “new equilibrium” where social interactions ramp up a bit, but not to the “pre-pandemic” level, and then we see what happens. Maybe no big parties or full-stadium sports events until there’s a vaccine?
” It can take a year or more for a pandemic to run its global course without a vaccine.”
Are you talking about the 70% or so percentage of immunity by antibody, before a virus stops spreading?
Gandalf
Wisdom Seeker
What do you think of the Idea that the virus won’t survive the warmer weather/summer months? If Florida is any indication it doesn’t seem the odds are in our favor.
Ghassan, I think the warm weather theory is BS. This particular virus is very hardy and long lasting on steel, plastic surfaces, etc. And in water, including sewage. No reason to think a slight change in temperature would affect it.
Auto mutation of the virus into a self vaccinating form, like cowpox was to smallpox, is really the only short term miracle – otherwise it’s a long slog to a vaccine or medical cure.
Gandalf,
Maybe not as long a slog to at least a treatment, translational medicine approach is having a moment,
https://www.sciencealert.com/a-treatment-for-covid-19-might-already-exist-in-old-drugs-we-just-need-to-unlock-the-right-combination
Also, since we are not certain why the flu is seasonal, I don’t know how much we can really say, good or bad, about C19.
On the other hand, there are C19 cases in more tropical countries, which is not great news…but I don’t think there is much transmission data from those countries yet.
I don’t think ‘warmer weather’ kills many viruses; outbreaks tend to lessen in the warmer months because people are less confined indoors with many others. The common cold isn’t called a ‘cold’ because you get it from cold weather, but because it’s more common in the cold weather months (some still don’t understand this).
California Bob,
I think the confinement angle is under-explored (especially confinement with others).
Hypothetically, this might relate to initial infection (proximity) and re-infection/continuous exposure (systemic stress elevation) due to continual confinement with other sick people.
If you look at some pictures of Spanish Flu victims, they tend to be in huge open floor plan *enclosed* spaces with many, many other sick people. Spaces like this can become an enormous “bath” of potential pathogens, to which already sick patients are continually exposed.
Such “packing” facilitates limited medical care but…it concentrates ambient pathogens.
I guess the operational theory is, “once infected…can’t get worse/amplified/re-infected/sick with something else”.
I would feel better if some experts were exploring the “distancing” of hospitalized patients. It would present operational challenges but those might be easier to address than the increased severity of hospitalized C19 patients.
In contrast, in 1919 there were a few “open air” hospitals that either were completely outdoors (they wrapped patients in blankets) or emphasized heavy, heavy ventilation of indoor spaces (with a lot of outdoor time too). There is some evidence to suggest these places did better.
Also interesting, when some of the top med researchers in 1919 got sick…they did not go to mass wards or even smaller hospitals…they went into complete self-isolation, kept well hydrated and took care of themselves.
I vaguely recall that one even went to Atlantic City to do this (open, sea air?)
He survived.
Of course, hugely anecdotal but interesting.
China is reporting lots of new cases coming in from abroad – their own citizens returning home infected with the virus, in Shanghai and other coastal provinces/cities that are major ports of entry.
I don’t see how we prevent re-infection from abroad in similar fashion, unless a cure or vaccine is developed. Instant nasalpharyngeal swab PCR screenings at ports of entry? What about trade from Mexico and Canada?
The virus has spread all over the world. It is highly infectious and asympomatic or minimally symptomatic in lots of people, so it hides easily in the human population. And yet lethal enough to strike fear.
It may mutate into something very benign that ends up accidentally vaccinating everybody, that’s really the only short term miracle to hope for until we come up with a vaccine or cure ourselves.
Greetings from India,
I am afraid that we will soon find out about Indian scenario. Just in the last two days government authorities of hotspot of corona like mumbai have implemented social distancing measures. One unintended sideffect was that poor day labourer rushed to their home in rural villages . This is because these day labourer are employed and paid on daily basis and the sudden halt of economy due to social distancing mesaure created lack of daily jobs from them. Thus the option for them is either starve in city or head home in their rural villages taking virus with them in this villages where there are no health care facilities (most of this villages does not even have basic facilities like sanitation or water pipeline ).
This article of for Mumbai railway station:-
https://www.thehindu.com/news/national/other-states/chaos-at-mumbai-railway-stations-as-people-leave-for-north-east/article31123658.ece
While this video from twitter is for pune railway station another covid hotspot:-
https://mobile.twitter.com/srivatsayb/status/1241223054425853952
I hope I am wrong but this does not bode well.
Desai, thanks for the update. That sounds too much like Wuhan shutting down just after sending half the population all over China to spread the disease!
India is likely to have a hard time of it, and I doubt the statistics will do it justice.
Many of us here in the Bay Area have friends or family back in India – any further information you can share would be welcome!
Jeebuz xmas, I live in Asia, and in Jan-Feb-March, the trucks had stopped, now in the last 5 days, I’m seeing 3x more trucks every hour, than I have seen in my entire life.
Stuff is shipping in Asia, is it shipping to USA, I doubt it, last of the lowest priority’s, to ship to USA.
Asia has this thing contained.
The west courtesy of Trump’s ‘base’ have downplayed the virus all along, while Asia declared ‘war’ back in Dec-2019
Also in Asia, anybody can be tested for free if you go to a gov hospital, the price at private hospital is about $200, a lot of money, but only those who are rich, go to private hospitals.
Normally they only test people with over 104F temp, and breathing problems ( the end of the line ), normal sore-throat and runny-nose will not get you a test.
On the other hand in the West, its impossible to get a test, because they don’t want to know.
Two months ago all eyes were on China, now all eyes are on SF, funny because the worst of worst is in Italy, but that has been ignored all along. Even the Italians ignored the virus in Lombardi for months.
hey Dude,,, yes, eyes/focus on SF on this site because Wolf and WS live there!
Yes, USA and so many other nations did not take this serious, at first,,, but now jumping on it with a ton of effort and resources, and, older than a boomer, I am very pleased with all the efforts of all of our medical services people everywhere in all countries,,, and only pray for them NOT to do what the doc in Italy is reported to have done, work without proper PPE; we need all our medical folks to stay healthy first and foremost.
And my thanks and prayers go out to all of our medical folks!!
Trump has a base in Italy? Who knew?
Hey asian dude, your perspective is fantastic counterpoint here.
I am focusing on Bay Area partly because I live here, partly because it’s a US hot spot, but most of all because it, and Lombardy in Italy, may be the first places outside of Asia to successfully “bend the curve” and set non-Asian examples for stopping the virus.
I personally love how Asia has managed to hold this thing off, and have many friends and family there. On the other hand, the prevailing “incomplete reporting” to avoid loss-of-face does give the West good reasons to be skeptical of the Asian data. Which is why the non-Asian examples are valuable.
For instance, someone posted SCMP article indicating China withheld info on ~40,000 additional confirmed-positive test cases because they were asymptomatic. That would bring the Chinese data in-line with the Corona Princess (Japan quarantine) and Iceland data.
I also want to mention that US testing has moved up several gears – now confirming far cases per day than anyone else. Bad that US has those cases but better to know than otherwise. US testing is now basically free and the range of eligible symptoms is widening every week as more tests get produced.
Infections are just starting to crank up in BC, mostly due to the fact that the virus hit a few senior care facilities 2 weeks ago. Plus, the second highest age group to contract the disease are in the 30-40 year old band, BUT this is due to their being seniors care home workers where the infections first took hold.
The medical community is sounding alarms and say we should be doing more. Schools, restaurants, bars, closed for a week now, anyway. People are staying home and are careful. Younger people are idiots, for the most part and don’t get it. Selfish and stupid. They are shaming them on the news, but…… can’t shame self-centered stupidity.
My father-in-law just went into hospital hospice, waiting for a bed in another dedicated local hospice facility. He is on his last legs but from old age/bad heart and not Covid-19. Here is the deal. He is allowed just 2 visits per day, but not at the same time. The hospital (brand new facility) seems to be empty as the local authorities are dropping the numbers in prep for an increasing infection rate. Elective surgeries have been canceled for a week and it seems we are on a wait regimen. Grocery stores are operating on reduced hours and have guards stationed at the doors and admitting just 50 people at a time. When fifty is hit, if someone leaves someone else can enter.
Our infections first hit Vancouver area, from WA State, China, and Iran returnees. Now, it is spreading around the Province. However, the health authorities do not divulge individual infection points as they do not want to promote complacency in areas not yet affected.
People are mostly staying home. I might leave our driveway gate closed as neighbours have been wandering over the past few days. My wife and I are depressed about it all, but I think it is because of the unknown and apparent collapse of the economy in addition to the pandemic. We stay home, anyway, so it isn’t that. I think we are both sensing a cataclysmic change and believe society will never return to prosperity. The depression issue must be very widespread as we are outside most of the day, can go for walks, have projects galore, and really all is good. But we feel sad, for lack of a better word.
regards and good luck.
One more thing…. after I read a new comment. Canada has adequate testing, for now. I believe we did just over 11,000 tests yesterday, which was more than the US, but per capita it is 10X. For the drive through facilities results come in the next day.
There is worry about ICU beds and ventilators, but there seems to be enough PPE stuff, for now. But if our care workers and medical staff go down, we are as screwed as anywhere else.
Paulo:. Yes, BC seems to be doing better than Ontario.
Ontario took Don’t Test, Don’t Ask, Don’t Tell approach. Daily briefings seem to have stopped?
Ontario is still trying to reach 1,000 tests per day. They are ignoring community spread. Sad.
Nobody who has it, like my kids or friends, is being tested, nor will they ever be tested!
So we are not part of anybody’s statistics!
My daughter has likely lost her summer job at a golf course. She will be O.K. with rainy day fund. Son at home so not sure about getting paid though. Again he will be OK. Has a rainy day fund! Too much time on his hands! Bought a used 10 year old 4 wheeler for $800!
Until warmer weather comes it is still pretty cold outside in Toronto so I have little desire to go outside yet! Last snowbanks still melting! So still hibernating!
Hopefully in another 6 weeks spring will finally arrive and I can go outside in the backyard with my daughter’s pet rabbit!
I do see authorities are starting to monitor and arrest isolation breakers in Quebec (but not Ontario). First it was polite, now maybe not so polite going forward! Hard to believe Quebec forced (shamed) Ontario to close schools and businesses!
Did see a US SARS study showing 43% of people did not isolate themselves as it interfered too much with their lifestyle! That included the top US SARS expert!
Cheaters will cheat, making it harder on the rest of us!
Good luck Wes. Thinking of you fellow Canucks from out here on the west coast. I think Ford has been doing as well as anyone else, but I don’t live there so……
Come on, Paulo, of all the people on here you are likely the most prepared, logistically at least. Now focus on the mental side. Don’t give into the fear. Save your strength for dealing with the upcoming father-in-law issues (just had to go through the same thing last year myself). Take care.
My understanding is that Norway’s infection is as a result of a military exercise. It’s going to be very interesting to see if this is a cold weather only virus and/or if it’s a long incubation/resurgent type.
On a totally different tack it’s interesting watching parents have to deal with their kids in these conditions.
Sweden, Norway, Denmark and Iceland (and Finland) all practice “sports holiday” where school pupils get one week off. These holidays fall during separate weeks for different parts of the country usually between the weeks 7-10. The majority of corona cases in all four countries stem (have been traced to) from families going on Sports holidays skiing in Italy. In Sweden, week 9 is the week that pupils in Stockholm get a week off for sports holiday, which is why Stockholm is the region of Sweden that is the hardest hit so far.
Also, the numbers for Sweden do not present an accurate picture of the situation: A severe shortage of some component required for testing resulted in the Stockholm region announcing that from then on, they could no longer test suspected cases unless the person was sick enough to be admitted to a hospital ward (hopefully that has improved now). I suspect something similar may be the case with Denmark, considering that both Denmark and Sweden shows significantly more deaths than Norway even though our numbers of confirmed infected in both cases are lower than the numbers Norway shows.
The cluster in Colorado can probably be traced to the Italian alps as well. Skiers are a globetrotting bunch.
Watch South Florida. It’s the perfect storm for COVID-19. Lots of really old people who love to travel and socialize. Lots of young healthy asymptomatic carriers who work for these retirees in one fashion or another.
Absolutely no way, SoFla can contain this thing.
Some are waiting to see if the summer would kill the virus spread but if Florida is any indication I would say it ain’t happening.
From what I have observed from the statistics online for different countries, the spread of COVID 19 has been minimal so far in Thailand, Vietnam, the Philippines, India and even Mexico, but that could be because not ax many people have been tested for the virus. Then again they are in warmer climates, so any spear will most likely be due to close gatherings of people in one place.
Florida is particularly one place to monitor greatly. Not only because it has a warm climate but also because it has a high population of at-risk people. It’s possible that it could exceed Washington and New York in coronavirus cases due to all of those spring break party hoppers frolicking on the beach when most states were heading for lockdown.
SE Asia is a hard comparison for most advanced countries because the Indochina wars from the 1950s-1970s means a lot fewer old people in those countries. So higher infection rate, lower mortality rate.
If anyone wants an interesting thought experiment, pull up the demographics of Nigeria. Only 3% of its population is over 65, vs 22% for Italy.
Oregon’s testing is a joke. The governor said they were finally receiving testing capability for 20,000 kits from Quest sometime in the near future, but have no swabs and sample containers and have no idea when those will arrive. Providence just started testing a few hundred healthcare workers on their own. The only way to get tested is to get admitted to the hospital with symptoms, according to healthcare worker friends. I wouldn’t count on Oregon numbers much.
Well imagine that. I don’t know about the rest of you, but I am totally disgusted with politicians,CDC, WHO and the medical community. Trumps early denial will probably be his undoing. The Dems are worthless also. And what’s with hospitals running out of PPE. They’re the medical experts. You would think they would have an abundance of equipment stockpiled for a possible epidemic. Pathetic. My bet is within a week or two we will be in a national lock down., not out of choice. It is why the White House is warning expats to get home now, It’s why everyone will be receiving $1000 from the government, because everyone will be unemployed for a month. It is why businesses are getting 0% loans to tie themselves over. And yea, the financial markets will be shut down also. Even a mortgage/rent moratorium. The writing is on the wall, so get your toilet paper ready folks.
The Dems are useless? The ones who set up a national level disease monitoring group reporting directly to the NSC? The one that the current president disbanded?
Biden, the one who published an article warning that it was serious back in January in the USA Today op ed section? Before the GOP senators could dump their stocks?
I think it is pretty clear that there is a party that deals with reality in a rational way and a party that is addicted to snorting its own stash. The party of ” I am not responsible for anything” is sending a signal, isn’t it?
The FDA just approved a 45 minute test for corona virus.
https://www.businessinsider.com/fda-approves-coronavirus-test-that-can-diagnose-in-45-minutes-2020-3
Good news if accurate…Biz Insider is not the most reliable of sources…it is not one to spurn clickbait
Just want to comment that the situation with testing in the USA is evolving daily, and generally improving. So if you heard something a week ago, or even three days ago, things are likely to have changed. We’re not used to facts shifting that fast! But we know that NY and NJ are absolutely doing many more tests than last week, because their case numbers are soaring.
Right now if there’s a strong medical reason it’s possible to get tested. There are enough test kits in many places now, and the CDC criteria have been loosened up from the dire situation 2 weeks ago. But since flu still outnumbers COVID and testing is not totally unlimited, the doctors won’t order the test just for a fever. The test is up to your doctor but CDC guidance includes checking unexplained pneumonias, people at high occupational risk, and known contacts of confirmed cases. Regardless of travel history (as of March 4).
COVID tests aren’t yet as common as, say, pregnancy test kits, but if I imagine a pregnancy pandemic, I’d bet those little blue strips would be hard to find on store shelves too!
Here’s the link to the current CDC testing guidance:
https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html
A few quotes from the CDC:
“Clinicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Most patients with confirmed COVID-19 have developed fever1 and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing). Priorities for testing may include:
1) Hospitalized patients who have signs and symptoms compatible with COVID-19 in order to inform decisions related to infection control.
2) Other symptomatic individuals such as, older adults and individuals with chronic medical conditions and/or an immunocompromised state that may put them at higher risk for poor outcomes (e.g., diabetes, heart disease, receiving immunosuppressive medications, chronic lung disease, chronic kidney disease).
3) Any persons including healthcare personnel2, who within 14 days of symptom onset had close contact3 with a suspect or laboratory-confirmed4 COVID-19 patient, or who have a history of travel from affected geographic areas5 (see below) within 14 days of their symptom onset.
There are epidemiologic factors that may also help guide decisions about COVID-19 testing. Documented COVID-19 infections in a jurisdiction and known community transmission may contribute to an epidemiologic risk assessment to inform testing decisions. Clinicians are strongly encouraged to test for other causes of respiratory illness (e.g., influenza).
Mildly ill patients should be encouraged to stay home and contact their healthcare provider by phone for guidance about clinical management. Patients who have severe symptoms, such as difficulty breathing, should seek care immediately. Older patients and individuals who have underlying medical conditions or are immunocompromised should contact their physician early in the course of even mild illness.”
A paramedic in my city tests positive. The city says no problem, he was asymptomatic.
” pregnancy pandemic”, LOL!
Dawn:. Don’t laugh! There will be a mini baby boom nine months from now!
Lock up a female and a male.
What do you think could possibly happen!
Divorce pandemic
Let’s guess. Divorce, murder, insanity?
My brother and his wife in Spain are locked-in their tiny apartment with a baby they made just before all of this -going totally nuts already!
Very strict ‘state of alarm’ lock-down in Spain.
Little sense to it, designed as it was to crush civil disorder not deal with a pandemic, as it even denies people a little solitary exercise and fresh air – with guess what consequences for the immune system……
Learn to overcome the crass demands of the flesh?
Or at least this is what I kept telling myself after getting one door slammed in my face after another.
In the end I reached wisdom and came to the conclusion ascetism was invented by somebody as ugly as me and so mind boggingly poor he could not afford any vice.
As the saying goes, make virtue out of necessity. ;-)
If this virus keeps the name of ”Boomer Remover,” then the cohort born 9 months plus from now will have to carry the name of ”Corona Boomer” eh?
My parents had two ”war babies” from the same experience behind the black out curtains in WW2,,, then, somehow, 3 ”boomers” after that with no more excuses except Love!
WS – pregnancy epidemic is 2-3 months away as some shelter-in-place folks increase bed exercise time.
Wolf, you have to compare new cases to tests run. It is probable that San Francisco’s sudden plateau had nothing to do wit the virus suddenly stabilizing in scope, but that it was the tests run that had plateaued.
I have looked at a lot data, and my conclusion for over 2 weeks now is that if the US ran a million tests tomorrow on people with flu-like symptoms, we would find 100,000+ new cases. If we ran 10,000,000, we would find 1 million new cases.
The body of infected at any point in time now and in the last 2 months has probably been 10 times or more the 27,000 cases we have right now. Containment is already a non-starter. Mitigation is all that can be done.
From today’s Telegraph (UK): “The way in which we {Italian hospitals} code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus,” according to Prof. Ricciardi. ‘On re-evaluation by the National Institute of Health, only 12 percent of death certificates have shown a direct causality from coronavirus, while 88 percent of patients who have died have at least one pre-morbidity – many had two or three,’ he says.”
This virus is really a winter storm, that howls through a wood, taking down the aged, the infirm, the poorly-rooted.
Now, as we would assign a greater value -wisely or not -to a human life than to a tree, the question must be how to protect those more vulnerable lives, young and old.
Total lock-down, crashing economies, might well halt or give pause to contagion, but is, perhaps, the equivalent of chopping down every tree so that none can be toppled by the storm. …
Physicians, expert in their own fields, to greater or lesser degrees, are ill-equipped to consider and evaluate wider issues appertaining to the economy and the functioning of society as whole.
We are crashing our very fragile economies -already heading for recession in late 2019 – for something which in earlier ages would -to be frank – hardly have been noticed (younger populations and other much more lethal diseases around).
The question is, when can we exit lock-down, as this will likely be back next winter, and maybe for another year yet?
A vaccine is most improbable and should not be relied upon.
In the meantime: Carpe Diem!
There’s been a lot of behind partially closed doors debate about the effectiveness of the lockdown here in Italy. This means it’s mostly confined to page 10+ of the newspapers, the stuff few read.
What we are asking ourselves is: why isn’t a full lockdown working while countries like Japan and Taiwan seem to have the situation under control with less drastic measures? How could people still get sick if they don’t leave their houses and have their essentials delivered at home by a guy dressed like a Chernobyl liquidator?
If new cases don’t start to drop (very) soon people are going to get really mad: so far they have behaved splendidly but they want results for their sacrifices.
MC01,
Realist had a possibly excellent insight above…the higher frequency of multi-gen households in Italy.
In that case, shelter in place may be somewhat counter-productive as it is adult children infecting their live-in parents.
And they are continually locked in together.
Difficult to fix if true…somebody has to move out…to where?
But very, very important to find out if true…
Wisdom Seeker, somebody somewhere should be tracking Italian victim residence data…if *both* parents living with adult children have gone down, that will be a strong, strong clue of interfamilial infection.
Potentially very important.
Depending on household size, you’ll get extra cases for a week or two as every member of each infected household gets it in turn.
Also, the Asian approach includes aggressive isolation of known infected, along with rapid testing of known contacts. The rapid-construction hospitals and commandeered stadiums were used to isolate the known sick in order to reduce further infection risk.
Hey people, I have been in the trenches for weeks now. I think I can tell a Wizz Bang from a Jack Johnson. ;-)
That kind of “multigenerational household” is not common here in the North: most elderly live alone or with their spouses, chiefly in smaller apartments.
Epidemiologists here are burning the midnight oil but an answer is not coming… and I am really starting to fear all our sacrifices so far have been for nought. Either the virus is propagating in a novel fashion that has eluded all tests until now or there’s something really wrong here.
I am beginning to fear this lockdown was an immense screwup: we should be seeing more than a few pockets of fleeting hope by now. We are getting slaughtered and we aren’t achieving any good, the worst possible combination.
Now back to our lovely war.
MCO1,
Do you know for a fact (or even via media rpt) that during the organizational chaos/incredibly accelerating stress on the Italian medical system, that patient home addresses have even been collected in a comprehensive fashion, centrally gathered, and then accurately correlated?
For your average bureaucracy, things do not work that smoothly/well on a normal day…let alone a two, three week siege.
I have not seen the intergen angle mentioned elsewhere…I will Google for it now.
MC01,
Oxford U has produced a paper discussing age distribution and intergenerational housing factors (data thru March 13th),
https://www.medrxiv.org/content/10.1101/2020.03.15.20036293v1.full.pdf
Multigenerational households are much more common in Japan than in Europe
“What is truth?” Pilate asked, washing his hands.
That one, and ‘sow the wind, reap the whirlwind’, are the most memorable passages in that book for me.
1) There is hope that the comatose SPX, after $1T injection, will be able to jump over the x3 huge gaps. Perhaps $2T will do a better job.// Europe stimulus is only $0.75T. // China M2 : GDP ==> infinity.
2) The fake buyback DOW breached the Feb 2018(L) to Dec 2018(L) support line, thank to Boing.
3) But NYA weekly closed above Feb to Dec 2018 lows support line.
4) SPX is well above this support line.
Thank you Wisom Seeker, for your wisdom and action. My guess is when all this negates there will be fury world wide on the exact origins of this virus.
Agree with you John, but most fury should be aimed at the lack of communication and preparations for dealing with it.
As Wolf has said, maybe this old guy too is being wishful, but I really do think there is some serious hope that one result of this event will be better standard protocols established and maintained throughout the world.
Gaia, by any name, is going to do what Gaia needs to do to protect itself from any species, especially humans these days, doing her so badly as we have apparently been doing the last fifty years or so. We, as a species must do better or Gaia will get rid of us sooner or later, and try again with dogs or porpoises or who knows, maybe a new ”designer” species.
Mother Nature is angry.
She warned us, bu we don’t listen.
Soon it will be time to smack our backsides, and send us up to bed – without our suppers…….
Just a bit of anecdotal information from Illinois. 2 days ago our Governor initiated a “stay at home order”. The list of “essential” businesses that were allowed to stay open was, what I thought, quite long. Anyway, wife and I got sick and tired of being cooped up on a sunny, cold weekend and went for a ride. I was kinda shocked. Lots of traffic. All the home centers parking lots were packed with cars, Sams club same thing. Long lines in restaurant and coffee shop drive throughs. Looked like a typical Saturday in the burbs of Chicago. Oddly, the local Chinese restaurant was empty.
Yeah, good to get out to forest preserves for a SOLO run, etc, but if the small businesses are limited / locked down for a over a month, then most will never open their doors again. No word about suspending property taxes. Old Man Potter (Pritzker, Ken Griffin, Stone Families, other local and connected Bug Money, etc.) will be buying the whole monopoly board in the Chicago Metro for 10 cents on the dollar.
I live northwest of you in Rockford, Illinois. I have been been working from home for about a week before the full shelter in place order was issued, and I went out to the grocery store early in the morning yesterday after seeing how people were rushing out to buy (hoard) groceries the day before on my local news. The streets were pretty empty for the most oart,but the parking lot at the grocery store was already loading up even at 9:00 am. So there was definitely some panic going on. Ironically, there was plenty of fresh bread and baked goods available in the bakery department yet the shelves of pre-packaged baked goods were almost entirely bare. The meat department had plenty of steak and roasts available, but pork chops, chicken breasts, and hamburger were hard to find, even though they had people trying to restock the shelves. I hadn’t even tried to go to Walmart or Sam’s Club, but I’m sure those places were packed even if all other retail other than Target, Home Depot, Lowe’s, or Menards looked like ghost towns.
Guy who works at Lowes says the paint desk is busy non-stop. Lots of salaried work/stay at home types who are finally getting around to paint the spare room. And retirees who are still getting their checks in the mail.
The class dynamics of the shutdown are fascinating.
1) The American people are resilient and strong.
2) The buyback SPX is fake.
3) NYA : from 2009(L) to 2020 peak = 10,000 pts.
4) Early next week $1T liquidity injection might send NYA sharply higher. $2T injection is better = TnT injection. Yes $2T this is war !!
5) NYA, SPX … DOW might pump muscles for a while.
6) If NYA will end up at around 7,000 :
[14,000 – 7,000] : 10,000 = 70%.
7) This is TA. Myopic vs cold numbers.
8) Changes are waiting for the American people.
9) America is strong, will adjust, will never be divided. No doubt about it.
10) Adam Smith, The Wealth of Nation : ” led by an invisible hand
to promote an end which was NO PART OF HIS INTENTION.”
11) I am not your enemy.
I work in a sector with large labor component and have had bizarre conversations in past week with folks who are responsible for large sums of money and large numbers of people.
Nothing is shutting down until a government agency says so.
There is a vast disconnect due to basic ignorance of science, math and exponential growth.
They think in linear terms and parrot the Trumpian administration pretzel logic “everything will be fine”.
Working where more than one subcontractor indicated a possible/probable case on his crew working there last week.
Open for work on Monday…
Keflavik International airport is a pretty big hub. Assume there are plenty of locals running the place and subject to passenger exposure from many parts of the world. Then they go home for dinner…..
Charts, especially when based on immature data, are fun. I wonder what the historic data on seasonal flu statistics would look like, if they were charted in similar fashion.
I’ll bet that a very significant number of people have had this C19 virus, assumed it to be the flu, recovered, and go on. Panic about being tested only serves to misplace scarce medical resources, on testing and treating those who are at little risk from C19. Panic will do that.
This event is typical of similar emergencies.
Just one measure being presented (by experts!) at such a range makes for a good example. Some experts say it’s hard to contract- just 10% chance if you are in the same home with an infected person. Other experts are saying it’s about a 100% chance that you will be infected during the pandemic.
Only 10%-40% of the tests are positive for corona virus infection. (Most who have symptoms do not have it.)
The decision makers have to err on the side of caution, so we have what we have.
Many of the cases in New Orleans are from Lambeth House – retirement community. Mardi Gras just ended Feb 25th. St Patrick’s day weekend Bourbon street was full of people drinking and partying. It was only this past Sunday that bars were shut down and restaurants are only take out.
French quarter is so quiet the sound of the leaves in the wind is now consider noisy.
If you are looking for Ground Zero for the coronavirus problem, start with Brooklyn, NY. To give you some background information, read this article: jpost.com/Opinion/Im-a-pediatrician-and-coronavirus-has-changed-my-life-opinion-621830 New York State, as of this morning, reported 15,168 cases. See nypost.com/2020/03/22/coronavirus-in-ny-cuomo-calls-for-javits-center-hospitals-as-cases-hit-15168/ of which 9,045 were in New York City. I have not seen any recent breakdown by borough, but everything I have read indicates that it is Brooklyn and more specifically, the Hasidic neighborhoods of Borough Park and Williamsburg, with Crown Heights, also a Hasidic neighborhood probably coming in third. Rabbinical leaders in the Hasidic neighborhoods were late in requiring their followers to come into compliance with local public health authorities’ efforts to limit the spread of the virus.
1) Suppose your customer have an Acc/ Receivable = $10,000. Its a good well known co. A very respectful customer. You are lucky to have such a customer…
2) Your customer became a very slow payer. After 90 days u collect zero.
3) You call them and beg a little, please send something. Never say fu..fu.
4) They send x5 post dated checks, but the first two bounce.
5) After 180 days u get an offer u :
a) take 1,000 now, write off 9,000.
b) Soon business will peak. We will make profit we send u 7,000. Its a promise.
6) You go for high risk b) because u are desperate. You will never see a dime. After few months the CFO became a CEO.
TM: Older MD doc told me years ago that VC was only thing he knew would help rebuild my immune system; when I asked why it was not commonly used for that and other health challenges, as reported by Linus Pauling, etc., he said there was no big or any profit for the pharmaceutical industry in VC, and also asked me not to tell anyone he had recommended it because he would be kicked out of the AMA if they found out…
Older than boomers, i am taking a maintenance dose of approx 12-14 grams per day, and planning for a therapeutic dose of 30-40 if needed, before I call for help,,, if not better in a day or so, then i will go ahead to hospital to triage, etc. This approach has worked for me with Every virus since 1970, as suggested by Pauling.
There’s something wrong with the security of this webpage, it keeps redirecting my browser to a suspicious site.
Sounds like malware on your web browser.
No problem here.
I cleared out that browser entire cash, links, etc. all back to factory defaults and still this site is the only one doing that.
So going forward I’ll just keep the add blocker.
Tried using another android device, same issue. Add blocker works great.
Mean Chicken,
This happened to me about 6 months ago. I had to uninstall the browser and reinstall. Never figured out the source of malware but that did eliminate the problem. As with you, I didn’t have a problem with other websites but that doesn’t mean I wouldn’t have if I tried enough other sites.
Clear the cache in your browser. That often helps. If that doesn’t help, there may be additional issues with your devices.
This is the only website posing the issue so far. Yes, lost all my saved info clearing out caches, etc. A PITA lost info for no benefit. Always “clear your cookies” has never worked for me, not once.
I’ll stick with the add blocker, it works.
The thing is set up be triggered by something.
Vitamin C is well absorbed orally and is dirt cheap. Linus Pauling used to take 15 grams/day (this indeed sounded nuts considering the MDR is just 100 mg., but the guy did win not just one, but two Nobel Prizes) Why on earth talk about an exceedingly expensive form of delivery that also adds an extraordinarily inconvenient layer of healthcare? (and whose insurance pays for it?)
There are a number of possible alternative/non-medical consensus treatment approaches – these would seem to take on much greater import if the number of people excluded from ventilator access due to triage factors grows very large.
That “ventilator-excluded” population might have little to lose in trying various non-consensus approaches (with someone very, very, very closely tracking subset results)
PubMed has almost 12,000 articles discussing ARDS (the C19 endpoint likely requiring ventilator use). Within that library, there are multiple options discussed.
And the new discipline of translational medicine (existing drugs for new diseases, since wholly/partially shared biochemical processes/pathways can exist) is generating a decent number of alternative drug candidates (I don’t know if they are also examining never-patent material as well…that is a very good question)
https://www.sciencealert.com/a-treatment-for-covid-19-might-already-exist-in-old-drugs-we-just-need-to-unlock-the-right-combination
NW Louisiana here. New Orleans and neighboring Jefferson Parish account for most of the cases. Mardi Gras lis a good guess. As someone noted, many towns in the state also celebrate Mardi Gras, but no tourists fly in for them. Spring Break may have contributed, and there’s constant level of tourism and conventions in NO.
NO will run out of ICU beds in a week or two. It will be especially upsetting because there will be capacity in the rest of the state. Some cases in hospitals can be moved, but critical patients will be stuck. It sounds like NY will have the same problem.
This is a mental disease, and it won’t be resolved properly unless a lot of people catch the disease. After a decade of extend and pretend empirical data is quaint, most Americans believe we can print our way out of anything, including the Fed.
Trump like Wolf, but webpage hate us all.
Who the f are they.
Shortest Engel post ever…and unnumbered!
Get that man a test!
Broken bot?
Thank you Wisdom Seeker. Thank you Wolf. And thank you to the many posters on this thread. This might be the most informative thread I have seen – on a site that has very high standards and useful information.