Coronavirus Sars-CoV-2/Covid-19 Megathread

[Legbiter]

Well those ICL projected figures for the worst-case scenario have confirmed what I already feared - we're talking Spanish flu levels of death worldwide potentially (total UK fatalities in that epidemic was 220,000) if this is not controlled soon. Certainly, if it takes hold in sub-Saharan Africa, millions will definitely die there. Even if we do try and spread it out, I can see this just prolonging the death rate but at a slower rate, so actual deaths may not lowered that much. Honestly, I think we're looking at 200,000 deaths in the UK regardless because of this.

Control measures will snuff it out. The Wuhan virus can not grow exponentially for long with strong measures. It would be a total disaster if no measures were taken. Iran is the poster boy for that scenario.

Here we have 200 confirmed cases but we're testing like crazy. We did 1500 tests yesterday, we'll have tested a large portion of the entire nation in a few weeks. Almost 2000 people are in quarantine.

[DGuller]

Interesting.  That sounds like a very stupid coverage to sell, since the nature of this coverage is such that if one of your insureds claims it, then probably most of them will.  That's the exact opposite of the whole point of insurance, which is based on the lucky most pitching in to make whole the unlucky few.

Isn't that what the reinsurance market is there for?  Massively costly black swan events?

I'm not an expert on reinsurance, but I don't think reinsurance can make uninsurable events insurable.  Reinsurance market is there to spread the risk between insurers.  If all insurers are on the hook for a pandemic, or war, or massive nuclear strike, then who do you spread the risk with?  There have been attempts to turn reinsurance into tradable securities, so that investors outside of insurance industry could take on some of the insurance risk, but as far as I know, the entire market is not even within the order of magnitude of size necessary to take on something like this.

[Sheilbh]

Incidentally that article's another issue with the media handling of this. Because it involves government this stuff is being written by political journalists. The embarassment for the UK government seems like a secondary issue about that report, and I feel like it'd be getting a more relevant write-up if it was science or health correspondents leading the reporting - even though it involves the government.

[mongers]

Incidentally that article's another issue with the media handling of this. Because it involves government this stuff is being written by political journalists. The embarassment for the UK government seems like a secondary issue about that report, and I feel like it'd be getting a more relevant write-up if it was science or health correspondents leading the reporting - even though it involves the government.

I don't disagree.

[Sheilbh]

Incidentally asked my researcher friend for his view. He said he'd expect to see a few stories about it, it's worrying because those scientists are very legit and he's wondering if he should go ahead with his house purchase now

[mongers]

What it it about Brazilian politicians visiting Florida and getting coronavirus?

Brazil's foreign trade secretary says he has coronavirus

Brazilian Foreign Trade Secretary Marcos Troyjo, who was part of the Brazilian delegation that recently visited Florida, has tested positive for the coronavirus, his office said in a statement on Monday.

Source Reuters

[katmai]

Borders are closed

US citizens still ok

fingers crossed it stays this way

[crazy canuck]

Borders are closed

US citizens still ok

fingers crossed it stays this way

I think it going to change.  The BC Premier is putting on a lot of pressure to keep folks from Washington State out

[katmai]

Fuck you Dix

[viper37]

There needs to be a cost benefit weighing the incremental value of the lives saved versus the cost. Lets start with a list:
-education: schools are emptied, perhaps for a while. not only does that mean an entire era of children falling behind, it is going to further ossify the social structure as wealthier children have access to internet learning resources.

false assertion.  from past experiences, schools has been disrupted due to servere hurricanes in many places, or as happenned over here in 1998, the major ice storms that shut down schools for over a month as they became refugee centers.
Yet, these kids didn't fall behind.  The department of education made the necessary adjustements.
right now in Quebec, schools are closed for 2 weeks.

-economic: the list is almost too extensive to put here. Small business owners will go bankrupt. Middle and upper middle class families are having their investments wiped out as we speak. Many people--and especially service workers who are the most vulnerable--are losing their jobs, either temporarily or permanently.

the virus was discovered in China on November 17th.  They did exactly as you suggest: nothing.   By mid january they imposed a strict quarantine for 50 days.

Your point here is exactly why doing nothing in the past has led to this point where small businesses are hurting and many will go bankrupt if the governments do not help.

The more you wait by doing nothing, the worst it becomes.

Had China acted on november 18th, the epidemic would have been contained by January and would not have escaped Wuhan.  We would have had a limited shock due to the falling oil prices, since a lot of people believe like you do, that nothing should be done unless you are absolutely sure about 100% success of the measure you take, because otherwise it creates an undue strain on your social life.  Therefore, instead of reducing our dependance on fossile fuel, we're still at the same point as of 25 years ago and are still at the mercy of Saudi Arabia.

Act before it becomes a crisis.  Then, it is manageable.  Wait too long, you get that 18 month drastic measure.  Again, I will point that, per capita, Canada has had a lot less cases than the US and UK and we have had a lot less deaths to.  So far, Quebec has been very pro-active, doing as much as it can within the constraints imposed by our Federalism cadre (where it is apparently racist and evil to even think about secession but it's perfectly fine to let people enter without any kind of control during times of pandemic) and we have had zero deaths.  That will not last, but in the end, we will do better than Ontario, our neighbour.

-social: suicide is already a leading cause of death. I'm sure those rates will skyrocket. That is of course only the tip of the iceberg. Children are having birthday parties and gatherings with friends canceled, in small towns where church is the only outlet for the elderly services are being canceled. Grandchildren are not visiting their grandparents due to social distancing.   

Of yeah, kids are heartbroken.  They won't be able to use their phone/table to play&chat with their friends...
I've just seen 3 kids today and got report on 2 others.  The first 3 were playing on their tablet and barely noticed me.  The other 2 were at home playing on their phone.

That is so, so different from the usual.  No wait...

-wellness: in a society already with a myriad of health problems due to inactivity, we are literally closing all the gyms. An excessively sedentary society will become even more sedentary. Absolutely no excess deaths will be caused there, I'm sure of that. 

Of course, you absolutely need a gym to exercise, and the people who regularly use a gym are the least active of the population... No wait, false again.
If you're already going to the gym, you can easily switch your training to run outside and do the Rocky IV training instead.
If you're not already going to the gym, what are you missing?
You are trying to tell me that all these overweight people in the US were the ones filling the gyms of the nations?

There's nothing that forces you to be sedentary without a gym, even in a city.  You can ski in a park, or use snow-shoes.  You can run in the streets.  You're still free to go outside the city and climb a mountain.  Or go train in the desert if it's nearer.

Despite having access to a modern gym, current SAS soldiers are unable to carry as much weight as a Roman legionary did.  Given they had no gym with modern equipement to train, how did they achieve that?  Afaik, the gymnasiums were reserved for athletes, not used by the soldiers.

That's bs, and you know it.

As for the suicide rate, well, if people chose to stay inside of walking outdoor on sunny days, I figure they would be unlikely to do so in regular times.

And since the stats speak for themselves, that with early confinement the death rate is much lower than without confinement, I would say that you clearly need to revise your college statistics manual to understand the concept of probability.

[PDH]

Santa Cruz County is now under a "Shelter in Place" order til April 7th at least.  I oversee the Mail operations at the University (as well as the moving and surplus there), and the Mail is considered important enough to allow to stay open.  My guys get to brave the trip to the University, work sorting mail (not delivering it as nobody else will be around), and then cough on one another.

Too important to let them not work, not too important to pay well.

[viper37]

Seeing journalists say it's entire strategy based on "false analysis" - I mean surely that's always going to be true about a new disease as we learn new things about it? The next big missing piece will be the backward looking test so folks can work out how many asymptomatic people there are, because that will, I think, also affect those numbers.

that's exactly like climate change.  The near totality of scientists say if you do nothing, things will be bad.  But then you find one scientist who says the others are totally wrong and he is right...  That is why the Johnson response to the pandemic was wrong, and what happenned in Italy was predictable.  I mean, we have had Wuhan as an example before.

The assumption that by imposing social distancing there will be another peak next winter assumes that there still would not be any vaccines (a few are in their test phases now and others are coming to a human near you) or drugs to cure the symptoms (there are many drugs available for other diseases that are currently being tested, like drugs for ebola, AIDS, and malaria).  Since it's a near certainty that we can have some of these approved by next winter, it will not be as bad as it is now, unless there are huge mutations in the virus.  Wich becomes an higher probability with an higher number of infected people.

Why does cold not kill that many people now?  Is it because of herd immunity?  Certainly not, as the number of cases were constant every season until we developped a vaccine.
And the number of deaths became lower once we found medications that would alleviate the symptoms.

The same will happen here, and that's why we must flatten the curve.

Social distancing does not mean staying barricaded in your appartment.  But it will come to that if we can't reduce the spread now.

[alfred russel]

Viper, you can think that the response in one place or another is proving something, but once it initially expanded the game was over. No matter how drastic any nation acts at this point, the virus is still out there. Cases will come back.

If you accept that the current status of lockdown is untenable in the long term, I don't see any way out of this without a general population spread or a cure/vaccine (which isn't imminent).

You think your government's response is better because you have less infections. Maybe you even take strong enough actions that the cases go to almost zero. The problem is that once you resume life as normal it will come back--even if in a theoretical world you drove them to zero a traveler would bring them back. You can go with rolling lockdowns - a month on lockdown and then when it seems under control open back up, only as cases start expanding you have to lock down again. I don't think that will be tenable either.

You can see the actual mortality rates from what Sheilbh posted. They aren't worth destroying society to avoid.

Btw, if you think we are just looking at a month of school closures you are deluding yourself.

[Sheilbh]

Act before it becomes a crisis.  Then, it is manageable.  Wait too long, you get that 18 month drastic measure.  Again, I will point that, per capita, Canada has had a lot less cases than the US and UK and we have had a lot less deaths to.  So far, Quebec has been very pro-active, doing as much as it can within the constraints imposed by our Federalism cadre (where it is apparently racist and evil to even think about secession but it's perfectly fine to let people enter without any kind of control during times of pandemic) and we have had zero deaths.  That will not last, but in the end, we will do better than Ontario, our neighbour.

Just to be clear on this - the report doesn't say act early and it's manageable, though it is better to act early. If it's right this modelling is valid for all countries.

It says there are two strategies: mitigation (flattening the curve/delay) or suppression (containment). Given the figures coming out of early UK cases and Italy, their model says mitigation will result in hundreds of thousands of deaths because the ICU will be overwhelmed. However as the early evidence is there's not re-infection in the same season there's unlikely to be a second peak.

Supression for about five months will reduce that, but will still overwhelm ICU just less so. But unless there's a vaccine you'll regularly be suppressing the entire country for, say eighteen months, by which point we'll hopefully have a vaccine.

The UK, with the possible exception of London, is still ahead of the rapid growth phase when it's introduced these measures. But if the model is accurate then the choice facing all of the world is going to be significant deaths this year, or prolonged lockdown and quarantine measures (and we don't know what the social and other health implications of this are - it's unprecedented).

The new tests on drugs will hopefully be positive and help reduce this. But this report is really grim if the model is accurate - it's by some distance the biggest challenge since the war and I wouldn't be enitrely shocked, once there's a new Labour leader, if we end up with a government of national unity and senior doctors and epidemiologists appointed as ministers.

The ending of the paper on this - and it is a UK and US paper but unless your healthcare system has huge capacity of spare beds (let's say 8-fold more than the UK/US), then it probably applies to your country too:

Perhaps our most significant conclusion is that mitigation is unlikely to be feasible without emergency surge  capacity  limits  of the  UK  and US  healthcare systems  being  exceeded many  times over.  In the most effective mitigation strategy examined, which leads to a single, relatively short epidemic (case isolation, household quarantine and social distancing of the elderly), the surge limits for both general ward and ICU beds would be exceeded by at least 8-fold under the more optimistic scenario for critical care  requirements that we  examined. In  addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US.

In the UK, this conclusion has only been reached in the last few days, with the refinement of estimates of likely  ICU  demand due  to  COVID-19 based  on  experience  in  Italy  and  the  UK (previous  planning estimates assumed half the demand now estimated) and with the NHS providing increasing certainty around the limits of hospital surge capacity.

We therefore conclude that epidemic suppression is the only viable strategy at the current time. The social  and  economic  effects  of  the  measures  which are needed  to  achieve  this  policy  goal  will  be profound. Many countries have adopted such measures already, but even those countries at an earlier stage of their epidemic (such as the UK) will need to do so imminently.

Our analysis informs the evaluation of both the nature of the measures required to suppress COVID-19and  the  likely  duration that these  measures  will  need  to  be  in  place. Results  in  this  paper  have informed policymaking in the UK and other countries in the last weeks. However, we emphasise that is not at all certain that suppression will succeed long term; no public health intervention with such disruptive  effects  on  societyhas  been  previously  attempted  for  such  a  long  duration  of  time. How populations and societies will respond remains unclear.

Edit: And even "adaptive suppression" which is what they're watching China for maintains household quarantine and case isolation at all time. It's just every 2-3 months they re-impose a shutdown of schools and universities plus social distancing of the entire population for 2-3 months.

Edit: But on deaths and mortality figures that model says for the UK it's basically around 5-600,000 for "do nothing"; best case mitigation so all the measures we're all taking now to delay/flatten the curve about 200,000; suppression (all the measures we're taking now, plus case isolation and schools and universities closing for at least 5 months) we're down to 20,000 - unless it comes back and we don't have treatment or vaccine in place yet.

Edit: One alternative (and slightly dystopian) proposal is that we use mobile phones to track an individual's interactions and movements which could then lead to more targeted suppression.

[viper37]

Interesting.  That sounds like a very stupid coverage to sell, since the nature of this coverage is such that if one of your insureds claims it, then probably most of them will.  That's the exact opposite of the whole point of insurance, which is based on the lucky most pitching in to make whole the unlucky few.

Isn't that what the reinsurance market is there for?  Massively costly black swan events?

yes, but that only works well when one geographical area at the time is touched.  Say, Lloyds will collect payments from lots of insurance companies over the world.  If there's a Tornado affecting Louisiana and Texas, the payments they receive from France and England will cover their costs.
When the claims are rising each year globally (say, as in forest fires in multiple countries/areas, tornadoes, multiple snow storms per winter, multiple strong wind storm during summer&fall), then they have limited options:
a) Raise their fees (been there, done that, our commercial insurance has seen 20% increase last year)
b) Exit the market (again, many re-insurers have lef the market since 2001)c) Declare bankruptcyd) Have the government bail insurance companies or take their place by directly indemnising clients