• Member Since 28th Aug, 2011
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Cold in Gardez


Stories about ponies are stories about people.

More Blog Posts178

  • 2 weeks
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    Read More

    24 comments · 533 views
  • 4 weeks
    Back to a more normal posting schedule

    Hey folks,

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    Read More

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  • 10 weeks
    That drone strike in Afghanistan...

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    Read More

    13 comments · 851 views
  • 16 weeks
    On Afghanistan

    So, those of you following the latest from Afghanistan may have seen this item, reported by CNN:

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    Read More

    61 comments · 1,691 views
  • 22 weeks
    Ten years of Pony

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    Read More

    39 comments · 1,083 views
Mar
23rd
2020

A prediction about COVID-19, why I'm scared, and why you should be too · 11:14pm Mar 23rd, 2020

Update 4/10/2020: Yesterday was the first day in which deaths surpassed 2,000.

Update 4/7/2020: The US reported 1700 deaths over the past 24 hours.

Update 4/2/2020: The US hit 1000+ plus deaths today. We're on course to pass the lower end of my prediction for April 11 by April 4.

Update 3/31/2020: The US hit 800+ deaths and 24,000 new cases (positive test results) today. We're approaching the lower end of my projections a full 12 days in advance of the target date (April 11).


I’m going to talk about pandemics and math today, and why they have me very, very worried. I know most people on this website aren’t here to talk about disease. But there are a lot of people in the US, primarily older people with more conservative views, who think this whole ‘coronavirus thing’ is being blown out of proportion, and it will never be relevant to their lives. My message to them is simple: It will be soon.


It’s okay, Ponkers, we’ll get through this. Or, 99 percent of us will, anyway.

Ambrose Bierce once said that “War is God’s way of teaching Americans geography.” With apologies to him, I’d like to offer a modern take on that immortal phase:

Pandemics are God’s way of teaching Americans math.

I think most of you know I’m in the military. Two weeks ago, I had to return early from an overseas exercise because the country hosting us was starting to ban international travellers, and we didn’t want to get stuck in a quarantine. Back then (two weeks ago!) the coronavirus still seemed like a joke, something that happened in East Asia and was starting to cause trouble in Europe. Most US cases were still tied to cruise ships or recent arrivals from China.

What a long two weeks it has been. Anyway, without further ado, let’s jump into the math. If you don’t like math much, just skip to the bottom for my predictions.

Beware: Math Ahead.


Source: The REALamddude


One of the frustrating things about COVID-19 is that there’s a lot we don’t know. We don’t know how many people really have it. We don’t know the true fatality rate. We don’t know how fast it expands. We don’t know the best ways to stop it. All we can do is make reasonable, science-based estimates. A lot of this vagueness has led people to throw up their hands and declare that there’s nothing we can really do, the flu kills thousands of people every year anyway, the economic damage of trying to stop it would be catastrophic, etc. 

But there are a few things we do know rather precisely. And from those small bits of data, we can start to draw larger inferences. And so I offer you this:

According to Fox News, on March 23, over the past 24 hours, 156 Americans died of COVID-19. Regardless of whether you trust Fox News for political reporting, this is part of their straight news program and is based on data released daily by state health departments and the CDC. We can also trust that this number is fairly accurate because, while testing is still in short supply, deaths by respiratory failure and pneumonia are closely monitored, and anyone who died of those diseases or complications today in the U.S. was tested for COVID, and if positive, were reported to the CDC. In other words, we can be fairly certain that over the past 24 hours, 156 Americans died of COVID.

Fact 1: On March 23, 156 Americans died of COVID

Here’s another fact: Based on studies of the disease, mostly by Chinese doctors and scientists in the early days of the outbreak, we know that the mean time from exposure to the virus to death is approximately 18 days.

That’s two facts! We can now extrapolate and draw inferences.

Extrapolation: The 156 Americans who died on March 23 were first exposed to the virus 18 days earlier, on March 5.

For our first inference, we need to use some estimates, and we’ll start with the fatality rate for the virus. The WHO estimated earlier this month that it was 3.7 percent. Other studies have shown something closer to 1 percent. I think they’re both accurate: in a healthy society with good medical care, only 1 percent of patients will die. In an overwhelmed society with insufficient medical resources that have been swamped by patients, many more will die. We saw this in Wuhan where the fatality rate approached 4 percent, though the rate in the rest of China was around 1 percent. For the sake of this particular model, we’ll choose 1 percent as our estimated fatality rate.

Assumption: In a society with sufficient medical resources (which we are, for now) approximately 1 percent of COVID patients will die.

And now some math! If those 156 fatalities reported today represent 1 percent of the cohort, how many Americans were first exposed to the virus on March 5? It would be 156 / .01.

Inference: 15,600 Americans were exposed to coronavirus and contracted COVID on March 5.

You read that correctly. On March 5, back when coronavirus was still a joke and there were very few restrictions anywhere in the United States, approximately 15,600 people in the U.S. were infected with COVID-19 on a single day. If that number seems high to you, remember, it has to be that high in order for 156 people to die of the disease 18 days later. 

For kicks, I dug through some old news reporting. On March 5, the U.S. Government reported a total of 129 cases of COVID-19 in the United States. Not new cases -- total cases. And we thought they were isolated in a few retirement homes and in quarantined areas on military bases for people returning from overseas. This was, of course, before we’d begun widespread testing, or really any testing at all. 

"We have very low numbers compared to major countries throughout the world. Our numbers are lower than just about anybody."

President Donald Trump, March 6

Are you ready for the scary part? It comes next.


One of the many unknowns with the coronavirus is how fast it spreads. There have been many attempts to model its behavior, and how well attempts to slow the rate of increase have worked. This is one area where we will have to make a reasoned guess based on other countries. 

Assumption: In a naive population (no immunity, no attempts to slow the spread of any infection), the number of cases will double approximately every three days. 

By March 5, however, many people in the US were already taking steps to protect themselves. Purell was selling out from stores, along with toilet paper. People stopped shaking hands. A week later, the first major closures began. So we can assume that the true rate of increase is probably less than every three days. For the sake of this model, I will assume it was significantly slowed, and only doubled every six days.

Assumption: Due to initial precautions, the spread of coronavirus was moderately slowed in the U.S., and has been doubling every six days.

So what can we extrapolate from that?

We have already established that 15,600 Americans were infected on March 5. That was 18 days ago. Conveniently, 18 divides into six exactly three times. In other words, the 15,600 new infections on March 5 have doubled three times. 15,600 x 2 x 2 x 2 is equal to 124,800.

Extrapolation: Today, 128,000 Americans were exposed to coronavirus and infected.

For comparison, the CDC reported about 7,000 new infections today. You might notice that number’s off by a factor of about 19. But that’s actually a reasonable guess -- the test results coming back today are from people who were infected several days ago, recently started to feel symptoms of the disease, and sought testing, assuming they could get it at all. Frankly, I’m impressed that we even caught 7,000 of the cases. Remember, on March 5, the U.S. was reporting 129 total cases, when on that one day closer to 15,600 were newly infected. Frankly, only being off by a factor of 19 is pretty good.

Anyway, it gets worse. Keep reading.


Remember earlier, that second fact? The average COVID fatality progresses from exposure to death in 18 days.

So, what does 18 days from now look like? Before I go further, I want to introduce one of my favorite quotes, often attributed to statistician George Box:

“All models are wrong, but some are useful.”

It means exactly what it says. By this point in our model we’ve introduced several assumptions, which means we can’t be perfectly confident in our assumptions going forward. I would not feel comfortable building a bridge with this many assumptions. But our model can still be helpful by showing us the possibilities.

Assumption: The 1 percent fatality rate holds true.

Believe in the 1 percent rate? Then 18 days from now, April 11 looks like this:

That is the lowest end of our estimate. It assumes the virus spreads slowly, doubling only every six days, and the fatality rate will remain 1 percent. In reality, by April 11 hospitals will be overwhelmed in the outbreak areas, and there will be insufficient ventilators for the most critical patients. The fatality rate will rise.

If we run the model again, with worse assumptions. We get this:

Assumption: No controls are effective, and infections double every three days. Doubles a total of six times over 18 days

Assumption: Fatality rate rises to 2 percent

Again, you are reading that correctly. Using significantly worse assumptions about the virus’s infectiousness and mortality, we get nearly 20,000 Americans dying on April 11.

And that is how pandemics teach math.


I’m posting this as a blog because at work we’re dealing with coronavirus almost solely to the exclusion of other military matters. It's all we talk about. It's all we plan and prepare for. And many of the people I’m working with are still saying that this is overblown. That the damage to our economy from all these measures isn’t worth it.

Consider, instead, China’s example.

I don’t normally look to China as a leadership role model. But they instituted draconian measures on Wuhan, locking people inside their homes and only permitting one family member out every three days. They aggressively tracked every new case. And they did this when the region was recording only 400 new cases per day. As a result, China has essentially defeated the virus. They recently recorded zero new cases.

As a reminder, the U.S. recorded almost 7,000 new cases today (officially; the true number was closer to 128,000). And if you haven’t noticed, we have not implemented controls nearly as strict as China.

Other countries are starting to. Around the U.S., some governors are implementing stronger measures. Closing schools, closing public establishments, restaurants, banning gatherings, ect. They are doing so because they have seen the same math I just showed you.

So, our models have a pretty wide spread. Where do I think the real number lies?

Call me an optimist. I think the measures we’re taking so far have slowed the virus. I think new measures will be implemented as more people understand how serious this is, and as we see the example of Italy (which is about a week ahead of us on the curve). In particular, I think the rate of increase in infections will be closer to 4.5 days to double.

Run that, and you get this:

Again, that is not total deaths. That is the number of Americans who I think will die on April 11.

These numbers look impossible to us, in the comfort of March 23. We can’t imagine 2,496 people dying of a disease in a single day. But humans are subject to something called the Normalcy Bias. We like to believe that things will continue the way they always have. Tomorrow will be like today. When someone predicts something that seems impossible by today’s standards, we call it crazy. I would remind you that on Sept. 10, 2001, not many people would have predicted a terrorist attack that killed nearly 3,000 Americans and started a two-decade war.

What do you think, friends? What’s your prediction? Come back in 18 days and see how I did. Hopefully I was wrong.

But I don’t think I will be.

Comments ( 130 )

Anecdotally, cases are doubling less than every six days. In the UK we're down to a doubling ever 3-4 days. I am fairly certain the US, which is implementing similar measures with similar urgency and has had a similar initial spread, is on a similar track.

e: also, the median incubation period for covid-19 is a little over 5 days now, according to current studies.

RBDash47
Site Blogger

Posting this for the folks who get through the blog and still think social distancing/self-isolation/quarantine is dumb:

thespinoff.co.nz/wp-content/uploads/2020/03/Covid-19-Transmission-graphic-01.gif

I think that “Box” is a pretty good surname for someone who dedicated their career to math.

(Okay, actually: I’m doing social distancing at my university, where I’ll be isolated until the semester ends. I’m also incredibly dyscalculic, but your blog and other information have worked to make it clear things are bad.)

I will gladly revisit this blargh. Assuming I'm still alive and have a home.

As of last night, we had something like a thousand confirmed cases in Michigan, and I’d estimate that the actual infection rate is at least ten thousand, probably closer to 20,000. And Michigan has been taking steps to slow the spread; we shut down the schools over a week ago, shut down restaurants, bars, sporting events. Over the weekend, all non-emergency personal care locations (barbers, tattoo parlors, nail salons, etc.) were ordered closed, and today the governor announced shelter-in-place for all non-essential employees.

For better or worse, I am an essential employee with both of my jobs, so for now I’m still working six days a week, fighting the good fight, and hoping for the best. But I don’t know.

One of my jobs is in adult foster care homes for developmentally disabled adults. Some of them have chronic health conditions, and I can think of two that I’ve worked with in the last month who don’t have very good odds if they get infected. For that matter, some of the staff are also in the high-risk category. We’re doing as much as we can to prevent infection, but with a long lead to symptoms (if any), there’s a chance it’ll happen. There aren’t many known cases in the counties were I live and work, but of course the number of known cases is just a fraction of the whole.

Both the WHO and New York Times are publishing updates--WHO publishes daily, NYT publishes multiple times a day. If you (or anyone) wants to do some calculations, WHO has over 60 daily reports with known infections/deaths per country.

Well, crap. Uh, bright side, bright side... All the ongoing gang wars in major cities throughout the country are probably being put on hold because of this, reducing the number of deaths by gun violence. Yay.

Erie #7 · Mar 23rd, 2020 · · ·

Not going to lie, before I saw this I thought the Corona Virus was a little overblown. Now, I feel like more action should probably be taken to counter it.

Thank you for showing me some of the facts.

5226776

This is, in fact, the desired outcome. Please take this seriously. Please feel free to re-blog this or link to whoever you like.

5226775

Alternatively, my theory is that armed robbery, smash and grab, and highway hijackings will go through the roof as police attention is diverted to other enforcement priorities and the drop in witness density and the disappearance of natural traffic increases the rate of return for such crime, and reduces the level of risk for committing same. Likewise, the criminally inclined but normally employed will see a rise in free time as they're let go or taken out of the direct supervision of their nominal employers.

There's probably a reason why gun and ammunition sales spiked as the shutdowns rolled out. People are preparing for disorder.

On the plus side, the organized mafias which specialized in hijacking crews and so forth got swept up in the RICO prosecutions of the last thirty years, and aren't as organized as they used to be. If the Italian mafia was still a real thing, this definitely would happen; as it is, I suspect I'm talking about drug gangs and common grifters and small-timers getting into a business which requires some actual planning and organization in a decidedly not-organized fashion.

I don't think you are wrong, but I also think you may be overly optimistic even in regards to your worst-case scenario, especially as you pointed out that there are many in this country who aren't taking it seriously, and even continuing to believe it is a plot by "Liberals, Jews and the Deep State" to bring down the President. The fact is that President Trump recently tweeted that they may lift the isolation requirements at the end of the month, simply to get businesses back up and running as quickly as possible, which could exasperate the situation even further. And while my wife and I might not be in one of the high-risk groups, we are both needing to go to work, she as a community manager for an office-space company, I for a certain Semiconductor manufacturer. And both our parents' ARE in the high-risk group. So we are not worrying ourselves to death (yet), but we are also being as cautious as we can be, under the circumstances. Best luck and fortune to you and everyone else here.

Unfortunately, I don't think you're far off the mark, either, CiD. I'm hoping that the more common sense measures enacted by state and local governments as well as the DOD will help slow the spread and start to contain the virus. To me, that is the the most logical way to approach this situation.

It is not the most popular or most economic but it will work. As you said, the way China locked it down has proven this method to work.

My other hope is that the current administration is either quickly convinced to continue these policies (and if necessary, enact stricter measures) or that the state and local governments enact these measures on their own. Help from the Federal government will be required to keep small businesses and local governments solvent during and after this crisis, of course.
But the cost of that assistance will be far less than enacting Marshall law, locking the country down by force and still having hundreds of thousands perish.

Just my thoughts, though. Like you, I also served in the military and am currently in civil service. I do what I am asked. But I can see what is going on, as well.

Stay safe, please and good luck.

Very thankful that I've been told to work from home for the last week. On the other hand, that means the last time I was in the office was literally Friday the 13th...

Well, we'll see what happens, personally, nationally, and globally. Thanks for running the numbers in a chillingly accessible way.

5226775
Reduced for now, at least.

Given the rate at which guns are selling where I work (50+ daily), gun violence is going to rise dramatically in the months/years to come.

Scared people who acquire power don't become less scared, they just become more dangerous.

I'm sincerely a lot more scared of the economic implications. One prediction put peak unemployment at 30%, and a GDP loss of 50% in the US

Even if that wealth just goes into savings which get spent at the end of the quarantine- 100 - 50% = 50, 50 + 50% = 75%, a full quarter loss.

If it's only about 20%, a more optimistic projection, it'd be 5% end difference instead of 25%.

But, if you follow Piketty's projections, that regain isn't spread evenly across the population. After the 2008 recession, 115% of the income growth in that time period was captured by the top 10% of the population. Even if the economy only shrunk 20%, the 20% that comes back would only be funnelled upwards to the richest 10%.

And because so many people are going to try to be hired at once, wages will be pushed way down, and even the currently employed can be negotiated down to lower wages because of how easily they could be replaced.

"It's just money" though, right?

The only comparison we have for numbers like that is the period of economic shock therapy in the former soviet union. Life expectancy dropped 10% in 2 years - with no mention to the quality of those lives.

Quarantine is good, and necessary, and isn't the only or full reason for the above. But it's only the tip of the iceberg of the consequences of this disease.

Last night, I had the very uncomfortable conversation with my parents, where, if I caught the disease and ended up in the ICU, to not have them treat me- and instead give up the resources to someone else.

I have very very VERY bad asthma and allergies (and that doesn't include all my other health issues), and when I started to get 'sick' about two weeks ago- it ended up just being a rush of bad allergies... that took me out of commission for a week. When I got Swine flu, i was sick for over a month with an average fever of 103 [ice baths are so fun] and when I got bird flu even that took me out for two weeks. I'm not disillusioned to see what the hell this would do to me.

I can't get tested until I truly get sick, and I know that I could never afford the treatment if I needed it. (Cost estimates between $9k with insurance and $31k so far). I'm already in debt from school alone by $60k, if this illness takes costs me $10k to $30k... well, yeah.

Needless to say, both my parents were really distraught. Nevertheless, I've only been going out of my room to do laundry, or get food. And the washer/dryer are right outside my door. (I don't actually know who the other tenants in my flat/place thing actually are)...

Nevertheless, with the US Government being an absolute dumpster fire that it is, it is incredibly hard to be optimistic in any sort of fashion. Hell, I just hope I can actually pay my rent that is due in... 6 days.

This isn't gonna be pretty, and to be honest, I'm kinda nervous about being able to see 2021.

And if I die before I can see the Cleveland Browns win the Super Bowl, I will comeback and haunt everybody.

5226769
Exponential growth gets out of control fast.

Thanks much for the math exercise. Gotta say, seeing somebody else who's got a heavy respect for the shituation we're in (quietly or not-so-quietly) is somehow a pretty significant relief.

My state shut the capital down today, and I expect the entire state will follow shortly. The only things that'll remain open are grocery stores and pharmacies. Thankfully my wife and I are decently stocked up, but I was just temporarily laid off from my job a few days ago. I'm thinking about getting a temp job at a grocery store so that I'll have some form of income, even if it isn't as much as I was making before. I'm just glad for my one year old son's sake that children aren't getting it that often, and none have died, last I saw. I'm worried that if I do get a second job, I'll be exposed and bring that home.

Either way, no one is really going to come out on top with this one. Other than corrupt duckweeds, of course. I thought it would have all blown over by now, but at this point, I hope it will have slowed considerably by the end of next month. I've heard that Italy and China are slowing, though New York (where almost half of the US cases are) doesn't seem to be. I looked at a list of countries with confirmed cases, and a lot of them have fewer people dying, so that's obviously good. Hope it gets better soon. It will probably get worse before it gets better, though.

5226774
I'm in a mission critical position in my job as well. I also work part time at a local hardware store. No word on it closing but I'll definitely be working at my full time job. Many of the other people that work there are older and/or have health conditions that make getting infected much worse for them. Them have been, or will be soon, put on 'safety leave'; paid leave to prevent them from serious illness and potentially spreading the virus further. Other non critical jobs have been given administrative leave (still paid) with suggested self quarantine.

Ironically, most of these folks were at the hardware store this weekend. Buying plants and lawn care products. Not quite sure about their priorities.

I stayed outside and drove the forklift, by the way.

I'm afraid that's not the scary thing. :twilightoops:

I hesitate to mention this because I know it does little good, but I believe the situation may be dire due to the nature of the vector being a type of coronavirus. You know what else is a coronavirus? The common cold. You know, the thing we don't have a cure for even though it has plagued humanity for thousands of years, and is primarily caused by only four viruses... the thing you can't gain an immunity to because, for whatever reason, your body purges the resistance from your system in six to eighteen months.

If SARS-CoV2 is anything like other coronaviruses (which we're certainly hoping it isn't), it may very well be here to stay. Like, permanently. Any vaccine we develop could be short-lived and require an annual dosing schedule. The economic damage may be severe and sustained, leading to a global depression as the new normal. It's not the end of the world, but it may be the end of the world as we've known it, and our social order could soon be changing in irreversible ways. Millions of people would die, but most of them will be poorer and older, so this wouldn't lead to a gain in resources that would offset what we've already lost in production.

Doubtless there will be solutions we can't currently see, and hope always remains. At least some of the wealthy will pump money into researching this like we've never researched anything before. But money alone doesn't cure diseases.

So, yeah. I probably should have hesitated after all. :facehoof:

First, I love Ambrose Bierce.

Second, I'm especially worried as I live in Washington, not too far from Seattle. It seems Seattle is taking things seriously; almost everything is shutdown, it's eerie like a ghost town. Where I live, about 40 miles south, everyone is out and about. Sure, restaurants are take-out or curbside only, but people an't very good at following the 6' distance while standing in line. The whole state needs to be locked down. There are too many people just out doing stuff (not counting the people who are absolutely needed to be out).

5226795
I don't know why this got a downhoof. Yes, lives are more important than money, but without money people will suffer and die for other reasons. The lasting consequences are likely to be a bigger concern in the long run.

Good post.

The governor of Massachusetts today issued a "stay-at-home" order, mandating that any non-essential business close for the time being, and even though my workplace has been designated as critical manufacturing, I only wish he had done so a bit sooner. Boston, in particular, is particularly rough right now, what with the Biogen conference and all.

Thank you for posting this. In the current politicized environment in the US, it astounds me that so many people aren't taking this more seriously.

Although I knew some details before, this video is what really scared me. This disease is not some chest cold or flu. At worst case, it tricks your own body into destroying itself. And if you live from a serious bout, you will lose lung/breathing capacity for the rest of your shortened life.

How does Coronavirus (Covid-19) compare to Spanish flu?

And here's a live, detailed and constantly updated map of the spread of and death toll from the disease:

I am right in an age range (and have certain conditions) to be most affected by this. So if I stop bugging the crap out of you all as I seem to do, then you'll probably know for certain.

This really scares me, for myself, my family, friends, co-workers, and all of you and yours. Please take care of yourselves.

I was in a shop last week buying something for Mother's Day (UK one, US is at a different time), and in the shop I overheard two older ladies talking, one saying to the other something along the lines of "this response is overblown" and they think "this will all be for nothing".

I had to stop myself from shouting that she's 100% right, that this is for nothing. Because nothing happening is exactly what we want, and the alternative is people sick and dying.

I couldn't visit my mum on Mother's Day, because my immuno-compromised aunt is staying with her. Three hours ago PM Bojo announced Britain is on lockdown. All nonessential services are suspended, and gatherings of more than two people are banned.

God I hope this is all for nothing.

“All models are wrong, some are useful” is one of my favorite quotes.

That said, while this certainly is serious and we have a lot of damage already done from no major containment measures, a naive model is not actually an exponential growth curve. It’s a logistic growth curve. Now we might still be in the part of that curve that looks like exponential growth or we might not. I’d need to do more algebra than I’m willing to do right now to figure out what growth rate matches those numbers, with the population of the US as the limit. We’ll also have an inflection on the graph when more major travel restrictions etc come into place. If we were the cdc we could break down population in a granular way as a matrix of linked logistic graphs for local populations, but that’s also more than we need to get a general idea.

That said, it does indeed look like it’s going to be an ongoing problem. And the economic impacts are also going to be devastating. Not even in terms of lost business, but in terms of people who can’t work right now. At least ongoing measures for Covid will also make ongoing flu seasons less awful.

This is not the part of the twenties I wanted back.

5226811
Fortunately it’s not exponential growth, it’s logistic growth, because there’s no reinfection.

I am in full agreement with Mr Numbers on this. I am far more concerned about the economic impact this is going to have. Unless some rabbit is pulled out of the hat, the little guys are going to be annihilated in the coming weeks and months. Locally businesses are already letting all of their employees go and as time passes they will be unable to reopen as they continue to incur costs with no income.

Incidentally, I think I read something similar to what is going on now.

5226861

Fortunately it’s not exponential growth, it’s logistic growth, because there’s no reinfection.

Logistic growth tracks exponential growth pretty well when things are still heating up, though. It's only when you start hitting saturation that the two part ways in earnest. If we've reached saturation, things are way worse than anyone thinks.

SPark #30 · Mar 24th, 2020 · · 1 ·

5226837
Because that argument is already contaminated by association with idiots who are saying that we should just go on with life as usual and do nothing and let the millions who are going to die die rather than harm the economy. I'm not saying that it's a bad argument in and of itself, the economy does matter. However, there are some callous assholes out there who are saying it matters more than people's lives, and that creates a knee-jerk response against pro-economy statements just now.

Also, I find it sad that this and a collaboration between a kink educator and a doctor on Fetlife are the two best "explain what is going on and why it matters to the layman" articles on the current situation I've seen. Modern reporting is in a sorry state.

Math is our best representation of reality, and it is sobering.

5226833
Common colds are primarily rhinoviruses (though around 15% are coronavirus strains). There's no vaccine because there are hundreds of strains, and they rapidly mutate into new ones all the time.

"The greatest shortcoming of the human race is our inability to understand the exponential function."
-Albert Bartlett

I've been trying to tell people what you've just laid out for weeks, in most cases to no avail. I'm afraid you're right, especially with the mortality rate in an overwhelmed health system. Italy has one of the best healthcare systems in the world, and the mortality rate has climbed steadily and now is a nine percent. As it looks, they are managing to bend the curve now. Slowly.

Here in Denmark people have at least begun to take the situation seriously now after the government finally showed some leadership and gave clear and consistent instructions on how to proceed now as we're in lockdown.

They've bungled the testing though, as in they hardly have any test kits because they for some reason thought the disease would be kind enough to stay in Italy. It did, until 139 people brought a souvenir with them from their skiing holidays in Austria (they were able to track the source down to a single bar in a resort town). They're not even testing frontline health workers anymore, only people with symptoms. So we have zero idea how the situation is actually developing and where hotspots are emerging.

I have a history of respiratory illness, as in repeated severe bronchitis and pneumonia. So I'm getting a bit anxious by now, even if mainly for the sake of my three kids and my wife who depend on me... please, take this seriously. Don't panic, but take it seriously. At least I kinda got a little bit of pride out of the response of my fellow countrymen - there was only minor panic buying and compliance is good. Went to the pharmacy today, eerie silence in the streets. When you can hear the wind whistle in the city center on highstreet in the afternoon in the most beautiful spring weather and not much else.

Anyway. Good post, thank you for it.

So, related to economics and infection, last Tuesday Portland, Maine was mostly shut down. This was in hopes of stopping Saint Patrick's day from making things much, much worse.

Not a curfew though, and there were people out on the streets. I was one of them. (For something I won't need to repeat for a least a month, and they've already changed things so that it can be done over the phone instead of in person, so I'm not gonna have to repeat that excision any time soon.)

While the streets weren't empty, I'm pretty sure they were as depopulated as I've ever seen them, by far, and I've walked them in the worst weather the city has to offer. There was one exception though. The food pantry/soup kitchen had a giant crowd outside of it. (It always does.)

That disturbs me a great deal. Everyone else was (being forced to) take steps to avoid infection. The people who most definitely cannot afford to get sick are just as at risk now as they ever were, because not eating isn't really an option. (The only reason I'm not one of them is because I got on SSI. Even still, if we'd been able to arrange transportation, we'd have picked up some food there ourselves.)

I very much doubt this is limited to Portland, Maine.

Unless you're in a place where food pantries deliver (are there such places?), and everyone has somewhere for their food to be delivered to, the ability to keep away from others to avoid infection and avoid infecting isn't available to everyone. Sufficient poverty strips you of the ability to take reasonable precautions.

it would seem the percentile of deaths declines the more cases we find. you need to factor in the prevalence of herd immunity, people who recover can buffer a bit

I've been taking it seriously, sure, but my brain went "cases doubling in 3 days? Wow, that's fast," and then I looked at my county's stats for the day. (Take into account that I live in Phoenix, a city).

We're at 139 confirmed cases. Two days ago we were at 49 cases. It's almost tripled in two days. (and that's only the confirmed cases)

I... I need to go sit down somewhere. A city is not the place to be during a pandemic. I live in a house of 4 people, one of whom is more at risk. And we may need more food, and I need to go out and get food in a city where the rate is more than doubling every 2 days. This is scary. I don't want to roll a d-100 for my life, and I especially don't wanna roll it for the lives of my loved ones.

We have reports of COVID-19 in Wuhan as early as December but the government didn’t want to spread this information. It took nearly a month for the local government to do anything about it. We Chinese payed dearly for these mistakes so it astonishes me that most of the other countries don’t seem to have taken the tragedy happening in my country seriously. Now I only want to say, please stay in your homes and stay safe. Pretending the virus doesn’t exist doesn’t do any good for anybody.

Sorry but... being someone at risk (50, type 2, heart issues).... I do not get the panic about the beer virus.


Look flat out, Cancer kills 300,000+ people in the US a year, Car accidents alone kill 1.25 MILLION Americans a year. 20,000k is a blip, a statistical nothing.

We are getting all worked up over this, but do NOTHING about things like cancer, auto related deaths, and the vast other venues of death far far out in front of this little virus. Don't you think that is silly?

Thank you for pointing this out.

Also, and with a callousness worthy of Starlight Glimmer in her worst moods ...

... Every person who dies is a person removed from the economy. Yes, some of the people who die were so old and sickly that they weren't going to have any productive, or indeed much life left anyway. But not all, nor even most will be.

People 50-70 years old are quite vulnerable. (That's me, by the way. I'm 55). And a lot of those people, including me, work regularly.

If I don't die now, I can reasonably expect 15-25 more years of life, barring significant advances in medical technology. I can also reasonably expect to be able to continue working for around 10-15 of those years of life.

During the shelter-in-place in California, I (and the economy) is losing the productivity of my labor for ... a few weeks? A few months? Even if it's a year, that's not as bad as losing me for 10-15 more years. (And my wife has far less cold calculations involved and would much prefer me to live for at least 25 more years, preferably more!)

But it's worse than that. A lot of people my age are at the top of their fields (I'm not). That means a high death toll among expert workers -- top managers, scientists, engineers, doctors, and so on.

And it gets even worse than that. Some people who die will be in the prime of their lives, which means the loss of 20-40 productive years.

And ... the kicker ...

Do you want COVID-19 to mutate into a deadlier strain? Do you know how you get that?

Take a very large population of infected people, so that you have a far larger population of the coronavirus. Then have them try various anti-virals and other medicines against it.

Then let chemistry and radiation and natural selection do their wondrous magic work, and now instead of one strain you have many -- some of them even worse.

Pleasant dreams, everyone.

Or let's not allow this to happen. Let's stop it as fast as we can, before we're facing Spanish Flu or Black Death levels of fatality.

We need to act as fast as we can, because it's, as you demonstrated, growing exponentially.

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The only reason I can reasonably hope this won't happen is that our biotechnology has advanced a lot during my lifetime, and hence we have more resources to attempt a cure. Or at least a pan-vaccination against all likely strains.

When people compare this to, say, the flu, they are ignoring that this is much more lethal. Flu strains kill small fractions of a percent of sufferers (In part because we aren't virgin-field with respect to flus; for an example of what respiratory diseases can do to a truly naive population, look at the Colombian Plagues of the 16th-17th centuries).

When they compare this to, say, AIDS, they ignore that COVID-19 is much more contagious. AIDS requires blood-to-blood transfer (open wounds) under fairly low-oxygen conditions, which is why it's mostly a venereal disease. COVID-19 is airborne and -- worse -- able to survive for minutes or more on surfaces. AIDS mostly requires penetrative sex -- COVID-19 can be spread by a kiss, a shared cup, or even a breath.

This could get very bad, if we decide on "business as usual."

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True, but cancer is a kind of disease that few people fall victim to and has a high death rate. This, however, if you don’t take any precautions, can spread to every corner of the world and the 1% death rate is only applicable when the patients receive extensive treatment in hospitals. Imagine a world where 5% of its population dead all in three months.

5226925
I think your reading comprehension is slightly lacking here. That "blip" of nearly 20k deaths in a worst-case scenario isn't a yearly total, like the cancer and car crash deaths you're comparing it to. It's one day's worth of deaths. Multiply that times 365 and see where you get.

I mean, don't, because that's not how pandemics behave, they follow curves, not flat lines, but still.

According to Fox News, on March 23, over the past 24 hours, 156 Americans died of COVID-19

Not to throw rocks at Fox news, but the official numbers from the CDC updated twice daily, and which I actually trust, show the total C19 deaths in the US and associated territories to date is 400. To think that a third of them happened yesterday, is a little odd to say the least. Reported cases of C19 will continue to skyrocket in the US because the testing kit shortage is *finally* being resolved, despite the FDA's rather strange position of supposedly encouraging testing while screwing up by the numbers on the actual testing. This means the press will switch from reporting each death to reporting gross numbers of positive test results.

Italy should have everybody worried. They are proving the test case for "How can we possibly screw up a pandemic response in the worst way possible?"

As a result, China has essentially defeated the virus. They recently recorded zero new cases.

And if you believe those Chinese numbers, I have a bridge I'll sell you.

Back before it left Washington State I added ‘transmissible during an up to 14 day incubation period’ and ‘fatality rate at least an order of magnitude higher than influenza’ together and came up with ‘we’re fucked’. Didn’t feel like doing more math after that.

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Fair point. I didn't mean to imply that the cold was solely from coronaviruses, I just meant four coronaviruses are cold bugs that you lose immunity to quickly. This implies that people might not be able to develop a lasting immunity to SARS-CoV2, even if they've been infected previously (at least, not by natural means).

5226925
If C19 was allowed to spread completely unhindered, infecting a projected 60-70 percent of the population in a matter of months, a reasonable estimate for the death toll at 1% mortality rate is around 2 million. That's not counting those who'd die not because of the disease but because of an overwhelmed healthcare system. That's just math.

Italy introduced a full lockdown not that far into the pandemic and the curve is beginning to flatten now. They still have the army transporting bodies to quickly set up storage facilities because the system can't cope with all these people dying at the same time in their breaking healthcare system. Italy isn't a developing country. That's not scaremongering, that's simply what is happening now in a rich western nation with one of the best healthcare systems in the world.

The argument for keeping the economy intact is a valid one and I'm not discounting the fact that you might get a majority of people on board. Crashing the economy will also have dire effects. But you have to be honest about what this 'take it on the chin' approach means in practice.

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Despite what it says at the top of the CDC's website, they aren't updating it daily. And if you need more than Fox News, here's the Washington Post:

'It’s going to get bad’: As outbreak surges, nation faces tough start to a grim week

From the third paragraph: For the first time since the coronavirus pandemic reached U.S. soil, the country reported more than 100 deaths in a single day, pushing the death toll past 500 and the infection total to more than 41,000.

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I know "me too" is silly, but absolutely, what you just said. I've seen some ghoulish examples of that recently.

Mostly from young, rich men in the financial sector, oddly enough.

I'll give you a few numbers to think through.

On January 23rd Wuhan was put under strict quarantine, and after 2-3 days the whole China. Most communities even banned residents to go out door for grocery. There was almost no chance virus can spread from one person to the other. On that day, there were 771 cases.

After ~1 month of quarantine, China had seen less than 10 new cases per day a few days ago. The number is at 81000 now.

The infected cases is estimated to *1.4 everyday, and the mean onset period is at around 7 days. Even if you isolate everyone indoor immediately, you will have *10 cases 7 days later. (1.4^7)

Most population movement in Europe and US has not been restricted as did in China (and do, in Wuhan). It makes me cringe every time I think about it.

It is doubling every other day. It was every 2.5 days. Your math is sound, but the rate is faster. That said I think the measures taken won't even be bearing any fruit until partially into the data period. The death rate is also higher than 1%. That said, I am well up the ladder from you on what the death toll will be. I would be really surprised if fewer than 10,000 people died on the 11th of April.

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