Coronavirus Sars-CoV-2/Covid-19 Megathread

[Admiral Yi]

I didn't know health emergency insurance was even a thing.

[PDH]

6 California Bay Area counties (maybe 7 million people) have gone to "shelter in place" now.  This doesn't include Santa Cruz (right below this), but it does include the UC Office of the President, UC Berkeley, UC San Francisco, and a bajillion other things.

I might be posting from home tomorrow...

[viper37]

Nope. The better analogy is that I'd let the titanic sink with people using the lifeboats available, rather than have the world stay inside for 12 months to somehow enable rowboats to reach the ship and save a handful more people.

The world will not stay upside down for 12 months, really worst case scenario, until fall.  Most estimates, things will pick up by june/july.
But still, letting only a few people aboard the safety boats is bringing a lot of inconvenience to everyone: first the staff has to work double-time to insure that only women and children get into the boats, prevent a riot from those who can't get into the boat, make sure the boats are filled to capacity - no more no less - that does throw you life upside down, rather than say, letting the boats go without anyone in it so nobody could reasonably get to it, unless they first jumped in the icy water and got onboard by their own means.

Or you could say that since there's a lot of probability that you will hit an iceberg that will sink your ship, you decide to navigate at full speed during the night anyway, since the probability of a dangerous accident is not 0 even if you reduce the speed of the boat.

Either way, you are negligent.  You are making a willing choice to sacrifice some people, but you prefer to let others do the picking, in this case, the death panels.  Wasn't this what would happenned with the Democrats in power, death panels?

[Barrister]

Alberta Provincial Court will adjourn all out-of-custody appearances, including trials, 10 weeks down the road.

We will attempt to run in-custody trials, though we kind of anticipate lots of witness issues in doing so.

Our Chief Crown doesn't think this will work however (reading between the lines).

No "work from home" orders for anyone with GOA.  I did work from home today though because of this cough.  It was amazingly easy - as soon as I hooked my laptop up to my home WiFi it immediately hooked right up to the GOA network.  It was like I was at the office.

[Sheilbh]

I quite like this summary issued by the Health Department:

[viper37]

Nobody could have ever imagined it.

The UK Only Realised "In The Last Few Days" That Its Coronavirus Strategy Would "Likely Result In Hundreds of Thousands of Deaths"
Scientists advising the government say an aggressive new approach adopted to attempt to "suppress" the virus may have to be in place for 18 months.

The UK only realised "in the last few days" that attempts to "mitigate" the impact of the coronavirus pandemic would not work, and that it needed to shift to a strategy to "suppress" the outbreak, according to a report by a team of experts who have been advising the government.

The report, published by the Imperial College COVID-19 Response Team on Monday night, found that the strategy previously being pursued by the government — dubbed "mitigation" and involving home isolation of suspect cases and their family members but not including restrictions on wider society — would "likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over".

The mitigation strategy "focuses on slowing but not necessarily stopping epidemic spread — reducing peak healthcare demand while protecting those most at risk of severe disease from infection", the report said, reflecting the UK strategy that was outlined last week by Boris Johnson and the chief scientific adviser Patrick Vallance.

But the approach was found to be unworkable. "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," perhaps by as much as eight times, the report said.

In this scenario, the Imperial College team predicted as many as 250,000 deaths in Britain.

"In the UK, this conclusion has only been reached in the last few days," the report explained, due to new data on likely intensive care unit demand based on the experience of Italy and Britain so far.

"We were expecting herd immunity to build. We now realise it's not possible to cope with that," professor Azra Ghani, chair of infectious diseases epidemiology at Imperial, told journalists at a briefing on Monday night.

See AR, you have the net result of UK's policy.  Instead of the 50 days containment in China, which was that long because they acted too late, the UK would now likely face 18 months of severe measures, or "turning the entire country upside down" because it failed to act in time.

Preventing a crisis is always better than managing a crisis.

[alfred russel]

Nope. The better analogy is that I'd let the titanic sink with people using the lifeboats available, rather than have the world stay inside for 12 months to somehow enable rowboats to reach the ship and save a handful more people.

The world will not stay upside down for 12 months, really worst case scenario, until fall.  Most estimates, things will pick up by june/july.
But still, letting only a few people aboard the safety boats is bringing a lot of inconvenience to everyone: first the staff has to work double-time to insure that only women and children get into the boats, prevent a riot from those who can't get into the boat, make sure the boats are filled to capacity - no more no less - that does throw you life upside down, rather than say, letting the boats go without anyone in it so nobody could reasonably get to it, unless they first jumped in the icy water and got onboard by their own means.

Or you could say that since there's a lot of probability that you will hit an iceberg that will sink your ship, you decide to navigate at full speed during the night anyway, since the probability of a dangerous accident is not 0 even if you reduce the speed of the boat.

Either way, you are negligent.  You are making a willing choice to sacrifice some people, but you prefer to let others do the picking, in this case, the death panels.  Wasn't this what would happenned with the Democrats in power, death panels?

"Scientists advising the government say an aggressive new approach adopted to attempt to "suppress" the virus may have to be in place for 18 months."

It would absolutely be a different story if various leaders said that we will try this for no more than three months and after that we will go back to our lives. If everything is just about spotting avoidable deaths and banning those things, we can save over a million lives a year just by getting rid of motor vehicles.

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.
-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.
-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.
-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. 

[Sheilbh]

It's worth reading the paper, this isn't UK specific it has implications for everyone and is, in part, why the UK is accelerating (maybe other countries too).

This is mitigation - or flattening the curve - what the UK has announced today is the blue line. Better but still way, way above ICU capacity:

This is suppression - flattening the curve plus quarantine and "care isolation", so Wuhan the country. You manage it now (but still exceed ICU capacity) but get another peak in the winter:


So you mitigate with a high number of deaths now, or you suppress which is the only way to avoid those deaths and manage ICU capacity, BUT there needs to be a vaccine by the winter.

Basically it's worse than the UK's models so far had predicted - the key factor (and reason they only realised "in the last few days") is the Italian cases indicate double the ICU requirement than was expected. On the flipside, the early evidence is that reinfection (in the same season) seems very low - though there are freak cases like the reinfection in Japan.

Again I don't see what's bad about a government making decisions on these models and the research behind their decision making being public. 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.

By the by the paper has the latest on expected mortality/infection rate:


Edit: The other key factor that is missing is there are over 30 drugs at different stages of research for this - if any of them show real success then presumably people can be moved out of ICU quicker which will have an impact. A big part of the UK's early expectations was that there would be a reasonably large amount of home-care possible - that looks less likely.

Edit: Paper is here, linke in article too:
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf

As well as pharmaceutical research being really important they also say observing China is key now - it's earlier than anyone else - and may be needing to introduce what they call "adaptive suppression" which is basically doing Wuhan again every time the epidemic starts to track upwards significantly. So probably every couple of months we'll go into lockdown for a couple of months - until there's a vaccine.

[DGuller]

Apparently Boris limiting his measures to "advising" people not to visit pubs or restaurants really screws over their owners, as they won't be able to claim insurance because there aren't any official bans in place.

If that's the case I imagine they'll change policy. But I think most business interruption insurance is already activated because covid-19 is a "notifiable disease" which the government's already declared, that allows business to claim for interrupted business because of that disease.

Flipside is I think because the government hasn't ordered businesses to close down, it will be more difficult to fire staff.

As I say I suspect the whole sectors - arts, hospitality, certain retail and possibly insurance will need a huge bailout.

Johnson said today that no-one should be worse off for doing the right thing. I think that also needs to apply to business.

Maybe I'm missing something specific about the insurance coverage discussed, but in general you can't just make a business interruption claim because your business was interrupted for whatever reason.  The business interruption coverage is part of commercial property insurance, and it is activated only if some property damage happens (i.e. fire burns down your business so you can't make any revenue while the damage is being fixed).  It's also likely that claims due to pandemics, just like claims due to war, are excluded, because they're simply impossible to insure.

[mongers]

They could have asked the Italian's earlier and have known then that the biggest problem is prolonged ICU occupancy; Ch4 news just had another interview with the man in charge of I think the largest provincial medical unit in Lombardy and they'd had 1,300 ICU patients, around 200 or 13-14% had recovered, 13-14%% had died, and yet 1000 of the patients were still occupying nearly all ICU units for a minimum of two week each.

[Sheilbh]

It depends - I understand there is "notifiable disease" extension to business interruption. This has been declared a "notifiable disease" by the government.

But as I say I kind of expect the issue to be solved either by a bailout or the government saying businesses must close if that helps them claim insurance.

[DGuller]

It depends - I understand there is "notifiable disease" extension to business interruption. This has been declared a "notifiable disease" by the government.

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.

[Admiral Yi]

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?

[PJL]

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. 

[mongers]

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.

I don't disagree, but would say as a minimum over the 2 or so years it might take to deal with this crisis.