coronavirus

[TheDrake]

A new medical facility in the city of Wuhan opened its doors to patients Monday after just 10 days of construction, marking the latest effort by Chinese officials to stymie the rapidly spreading coronavirus that has sickened more than 17,000 people in the country.

Huoshenshan’s swift construction was the product of a round-the-clock effort fueled by 4,000 workers and 1,000 construction machines, according to China Daily. Live-streamed video over the course of construction allowed people to follow its progress online.

Xinhuanet, another state-run news agency, reported that the hospital is staffed by 1,400 medical personnel from the People’s Liberation Army.

According to the Associated Press, the two-story, 600,000-square-foot hospital features doubled-sided cabinets and ventilation systems that essentially quarantine patients, allowing hospital staff to deliver supplies without entering their rooms. The building also contains infrared scanners that can detect if any employees have a fever — one of the coronavirus’s telltale symptoms.

That's pretty impressive. I'm sure it involved unsafe practices, a likelihood that the building won't survive long, and the ventilation system sounds a little dubious. I'm not sure how much testing they could have done, but its better than nothing.

Meanwhile...

All flights from China are being funneled to 11 U.S. airports.

State and county officials where the 11 airports are located said they received no notice about the quarantine order and are scrambling to figure out where to house people. Hotels, military bases and trailers are among the options, officials said.

I guess there's something to be said in favor of a state-run economy quasi-dictatorship. No, I'm not advocating one in any form. Just saying it works in this scenario.

[TheDeamon]

We'd probably just "field deploy" some of the mobile hospital facilities DOD has stashed away. Temporary structures for addressing a temporary need.

As to the "quarantine of patients" all you need to achieve that is a negative pressure gradient in the rooms the quarantined patients are in and positive air pressure in the areas immediately adjacent.

Challenge is dealing with all of the "return" air coming from the those rooms. Although intense UV light and some ionizers could likely help address that. Otherwise it's a "simple" matter of you place air supply in the hallways outside the patient rooms, and you put the "air returns" in the room the patient is in. However, you don't recirculate the air from those rooms for obvious reasons.

[Wayward Son]

It sounds like we are woefully unprepared for this outbreak.

In 2018, the Trump administration fired the government’s entire pandemic response chain of command, including the White House management infrastructure. In numerous phone calls and emails with key agencies across the U.S. government, the only consistent response I encountered was distressed confusion. If the United States still has a clear chain of command for pandemic response, the White House urgently needs to clarify what it is—not just for the public but for the government itself, which largely finds itself in the dark...

In the spring of 2018, the White House pushed Congress to cut funding for Obama-era disease security programs, proposing to eliminate $252 million in previously committed resources for rebuilding health systems in Ebola-ravaged Liberia, Sierra Leone, and Guinea. Under fire from both sides of the aisle, President Donald Trump dropped the proposal to eliminate Ebola funds a month later. But other White House efforts included reducing $15 billion in national health spending and cutting the global disease-fighting operational budgets of the CDC, NSC, DHS, and HHS. And the government’s $30 million Complex Crises Fund was eliminated.

In May 2018, Trump ordered the NSC’s entire global health security unit shut down, calling for reassignment of Rear Adm. Timothy Ziemer and dissolution of his team inside the agency. The month before, then-White House National Security Advisor John Bolton pressured Ziemer’s DHS counterpart, Tom Bossert, to resign along with his team. Neither the NSC nor DHS epidemic teams have been replaced. The global health section of the CDC was so drastically cut in 2018 that much of its staff was laid off and the number of countries it was working in was reduced from 49 to merely 10. Meanwhile, throughout 2018, the U.S. Agency for International Development and its director, Mark Green, came repeatedly under fire from both the White House and Secretary of State Mike Pompeo. And though Congress has so far managed to block Trump administration plans to cut the U.S. Public Health Service Commissioned Corps by 40 percent, the disease-fighting cadres have steadily eroded as retiring officers go unreplaced.

Public health advocates have been ringing alarm bells to no avail. Klain has been warning for two years that the United States was in grave danger should a pandemic emerge. In 2017 and 2018, the philanthropist billionaire Bill Gates met repeatedly with Bolton and his predecessor, H.R. McMaster, warning that ongoing cuts to the global health disease infrastructure would render the United States vulnerable to, as he put it, the “significant probability of a large and lethal modern-day pandemic occurring in our lifetimes.” And an independent, bipartisan panel formed by the Center for Strategic and International Studies concluded that lack of preparedness was so acute in the Trump administration that the “United States must either pay now and gain protection and security or wait for the next epidemic and pay a much greater price in human and economic costs.”

So Trump was able to dismantle another Obama bureaucracy and save millions of dollars in the budget.  And we have no central coordination for our various local health and safety agencies.  This may not go well.

[Fenring]

I don't think it would have gone well anyhow. I honestly don't think the U.S. is equipped for a *major* pandemic no matter what the President's policy is. It's one of these WWII type things where when the thing hits you then the massive mobilization begins in a hurry.

[TheDrake]

This just in, Trump isn't a globalist. None of that has to do with the ability to react within our borders.

I don't see anything in your quoted article, wayward, that reduces coordination between state, county, or municipal coordination. Unless I missed it.

The $15B "cuts" landed in CHIP, ACA, and other areas only peripherally related to pandemic response.

Doesn't mean I think any of those things are good policy. Just that they aren't that relevant to coronavirus.

[ScottF]

This virus keeps getting headlines and it's just stupid.

When compared to the flu on both communicability (15M flu illnesses reported in the US since just Oct 2019 vs 11 coronavirus) and lethality (flu can be over 150 a day, depending on the year) Coronavirus is a non-issue - something to keep an eye on, but that's about it.

I think we're probably good for another week or so of this and then they'll move on to the next thing.

[LetterRip]

That's pretty impressive. I'm sure it involved unsafe practices, a likelihood that the building won't survive long, and the ventilation system sounds a little dubious. I'm not sure how much testing they could have done, but its better than nothing.

Not likely a reasonable assumption.  5 years ago the Chinese did a 57 story skyscraper in 19 days,

https://www.theguardian.com/world/video/2015/apr/30/china-build-57-storey-skyscraper-19-days-timelapse-video

Buildings can be put up safely in extremely short time frames with proper coordination and planning.

[LetterRip]

This virus keeps getting headlines and it's just stupid.

When compared to the flu on both communicability (15M flu illnesses reported in the US since just Oct 2019 vs 11 coronavirus) and lethality (flu can be over 150 a day, depending on the year) Coronavirus is a non-issue - something to keep an eye on, but that's about it.

I think we're probably good for another week or so of this and then they'll move on to the next thing.

I think your metrics are wrong - coronavirus isn't spreading rapidly or killing many people today due to the isolation measures that have been taken.

We don't have an accurate gauge of the fatality rate or communicability at this point, see this discussion that goes into depth on fatality rate,

https://www.worldometers.info/coronavirus/coronavirus-death-rate/

Seasonal flu has a death rate of .01% (1 death per 10,000 infected).  Thus far it looks like Coronavirus has a death rate of 2% (200 per 10,000).  For comparison SARS was 9.6% (960 per 10,000).

[DonaldD]

And although the current corona virus is not as lethal as SARS on a case by case basis, it seems to be more highly contagious - there are currently more than 14000 reported confirmed cases of the current outbreak (2-month period) vs only about 8000 for SARS over a 9-month period.  And that is with aggressive worldwide quarantines in place.

[Crunch]

The problem with tracking this infection is that it’s occurring in a communist country. They’re going to lie about it. It’s just a reflexive thing in communism.

Last night, satellite imagery show a large fire near Wuhan.

[TheDeamon]

The problem with tracking this infection is that it’s occurring in a communist country. They’re going to lie about it. It’s just a reflexive thing in communism.

Just ask anybody under 30, we need more communism in the USA. 

[DonaldD]

There used to be a time when those in the USA could mock other countries for lying transparently.  Those days are long gone.

[Crunch]

Yeah, Schiff, Nadler, and Pelosi sure took us down the road on that.

[ScottF]

This virus keeps getting headlines and it's just stupid.

When compared to the flu on both communicability (15M flu illnesses reported in the US since just Oct 2019 vs 11 coronavirus) and lethality (flu can be over 150 a day, depending on the year) Coronavirus is a non-issue - something to keep an eye on, but that's about it.

I think we're probably good for another week or so of this and then they'll move on to the next thing.

I think your metrics are wrong - coronavirus isn't spreading rapidly or killing many people today due to the isolation measures that have been taken.

We don't have an accurate gauge of the fatality rate or communicability at this point, see this discussion that goes into depth on fatality rate,

https://www.worldometers.info/coronavirus/coronavirus-death-rate/

Seasonal flu has a death rate of .01% (1 death per 10,000 infected).  Thus far it looks like Coronavirus has a death rate of 2% (200 per 10,000).  For comparison SARS was 9.6% (960 per 10,000).

First off, the death rate for flu varies year to year but seems to hover around 1 per 1000, i.e .1%. Both the number and the percentage you present above are an order of magnitude off - your own link clearly shows this.

You also seem to be comparing historically recorded US flu data, which in general is trustworthy, with estimate/model data coming from China's NHC, which is... less so.

Media hype aside, I think the more interesting story here is speculation that this is an escaped virus from China's bio weapons program. Based on China's ambassador's answer to that direct question over the weekend, I'm leaning towards that being a distinct possibility.

[TheDrake]

Scott, don't know where your numbers are coming from but....

influenza mortality

14.3 per 100,000 = .014%

If they are coming from the website linked, all I can find them saying is less than 1 per 1000, not equal to.

As the the speculation about a weapons program, it's not exactly Captain Trips, is it? All of the experts have dismissed that anything about the virus looks engineered or intentional.

Elsa Kania, a fellow at the Center for a New American Security, said that while Chinese officials had expressed public interest in the potential weaponization of biotechnology, a coronavirus would not be a useful weapon.

“Hypothetically, a bioweapon would be designed to be highly targeted in its effects, whereas since its outbreak the coronavirus is already on track to become widespread in China and worldwide,” she said.

Vipin Narang, a professor at the Massachusetts Institute of Technology, wrote in a message on Twitter that a good bioweapon “in theory has high lethality but low, not [high], communicability” and that spreading such ideas would be “incredibly irresponsible.”

[Seriati]

TheDrake, the difference is 1 in 1000 deaths (on average) of those infected, and what you cited based on the population without regard to infection (in the US).  Both numbers are - very roughly - correct.  Sometimes the mortality is higher, a few years back it was 3-4 in 1000, but the infection rate may or not be higher in the population as a whole.

[TheDrake]

Okay, I get it. Thanks.

[LetterRip]

Sometimes the mortality is higher, a few years back it was 3-4 in 1000, but the infection rate may or not be higher in the population as a whole.

3-4 mortality per 1000? ?

https://www.cdc.gov/flu/about/burden/index.html

34,157 deaths/35,520,883 symptomatic infections is about 1 in 10,000 - .01% mortality.  The past 10 years give similar numbers.  The 1 in 1000 is off by two orders of magnitude.

[TheDeamon]

The other thing that will play havoc with the numbers involving the flu is the matter that there is a vaccine that is made widely available.

There is no vaccine for the coronavirus at this time, which means there is no herd immunity in play, and you're dealing with everything else on top of that.

[LetterRip]

TheDeamon,

The other thing that will play havoc with the numbers involving the flu is the matter that there is a vaccine that is made widely available.

There is no vaccine for the coronavirus at this time, which means there is no herd immunity in play, and you're dealing with everything else on top of that.

2004 and 2014 vaccines weren't very effective against the influenza strains for those years, and show similar mortality rates.  Herd immunity is at around 93-94%; flu vaccination rates are in the 30-40% range, so herd immunity really isn't a factor.  The death rate for elderly due to vaccination is probably a bit lower, but likely doesn't move the numbers too much.

If you want to calculate it out - the CDC provides averted burden due to vaccination,

https://www.cdc.gov/flu/vaccines-work/past-burden-averted-est.html

4,400,000 averted infections; 3,500 averted deaths.

(34,157+3,500)/(35,520,883 + 4,400,000) = .00094 so essentially the same .01% mortality I calculated above.

[ScottF]

34,157 deaths/35,520,883 symptomatic infections is about 1 in 10,000 - .01% mortality.  The past 10 years give similar numbers.  The 1 in 1000 is off by two orders of magnitude.

Maybe the error is within the link you posted (copy/pasted below)?

"Comparison with other viruses
For comparison, the case fatality rate with seasonal flu in the United Stats is less than 0.1% (1 death per every 1,000 cases)."

[Seriati]

Sometimes the mortality is higher, a few years back it was 3-4 in 1000, but the infection rate may or not be higher in the population as a whole.

3-4 mortality per 1000? ?

https://www.cdc.gov/flu/about/burden/index.html

34,157 deaths/35,520,883 symptomatic infections is about 1 in 10,000 - .01% mortality.  The past 10 years give similar numbers.  The 1 in 1000 is off by two orders of magnitude.

LR, I'm sorry, can you check your math.  I looks like you divided 34 thousand by 35 million and got 1 in 10,000. 

Millions are literally 3 zeros bigger than thousands.  Not four zeros.

You can just move the decimal point 3 places to see were talking about 34 deaths, for every 35,000 people, or 3.4 deaths for every 3,500 people and divide that roughly by 3.5 to see almost 1 death for every thousand people.  Unless I'm missing something, in which case I will feel much shame.

[cherrypoptart]

I don't want to dive head first down a rabbit hole regarding the Corona virus - bio-weapons lab connection... but "experts have dismissed that anything about the virus looks engineered or intentional" didn't quite cut it as far as putting the fears to rest.

I can agree with the professor that "a good bioweapon “in theory has high lethality but low, not [high], communicability”.

I don't think the idea here is that this virus was the bioweapon though. The idea would be that this was just something they were doing research on and maybe not even to weaponize but to help with developing vaccines for this and other viruses. The idea isn't that China purposefully let it loose either but that it escaped on its own despite their best intentions never to let that happen.

I had thought the argument against the virus looking engineered would have been based on its genetic structure which has been analyzed in detail and determined to have conformed with what could be expected to naturally occur in nature but if the argument is just because of the low lethality and high communicability that is unpersuasive since this wouldn't be a purposeful bioweapon but just a product of legitimate research that would span a wide range of different viruses and this just happened to be the one that got out.

Of course I have no idea if that's the case or not. It could be completely natural.

As for spreading such ideas being  “incredibly irresponsible", well it's just an idea. It seems like it would be important for those looking for a vaccine, treatments, and effective quarantines to understand everything there is to understand about the virus and that would include whether it was completely natural or a product of research.

Speaking of containment, here is something else to think about. Just interesting reading. Hopefully it doesn't represent an uncontainable infection vector.

https://medium.com/science-and-innovation/trillions-upon-trillions-of-viruses-fall-from-the-sky-each-day-b2dcc3c13219

https://www.sciencedaily.com/releases/2018/02/180206090650.htm

"Every day, more than 800 million viruses are deposited per square metre above the planetary boundary layer -- that's 25 viruses for each person in Canada," said University of British Columbia virologist Curtis Suttle, one of the senior authors of a paper in the International Society for Microbial Ecology Journal that outlines the findings.

"Roughly 20 years ago we began finding genetically similar viruses occurring in very different environments around the globe," says Suttle. "This preponderance of long-residence viruses travelling the atmosphere likely explains why -- it's quite conceivable to have a virus swept up into the atmosphere on one continent and deposited on another."

For purposes of full disclosure, I like disaster movies and novels both geologic as well as infection based. The Last Ship. The Walking Dead. The Day After Tomorrow. All of that. So I understand I have a predisposition for what may be wild speculation. It's just interesting.

[cherrypoptart]

More likely of course is that it's just another virus jumping out from the wet markets.

https://www.yahoo.com/news/men-represent-majority-coronavirus-cases-230600596.html

"SARS was also a coronavirus that jumped from animals to people in wet markets. It shares about 80% of its genome with the novel coronavirus, and like the current outbreak, it infected more men than women."

[ScottF]

Sometimes the mortality is higher, a few years back it was 3-4 in 1000, but the infection rate may or not be higher in the population as a whole.

3-4 mortality per 1000? ?

https://www.cdc.gov/flu/about/burden/index.html

34,157 deaths/35,520,883 symptomatic infections is about 1 in 10,000 - .01% mortality.  The past 10 years give similar numbers.  The 1 in 1000 is off by two orders of magnitude.

LR, I'm sorry, can you check your math.  I looks like you divided 34 thousand by 35 million and got 1 in 10,000. 

Millions are literally 3 zeros bigger than thousands.  Not four zeros.

You can just move the decimal point 3 places to see were talking about 34 deaths, for every 35,000 people, or 3.4 deaths for every 3,500 people and divide that roughly by 3.5 to see almost 1 death for every thousand people.  Unless I'm missing something, in which case I will feel much shame.

I was going to say something similar, probably with a bit of snark but then thought sh$t, what if I've suddenly forgot how to math...

[LetterRip]

LR, I'm sorry, can you check your math.  I looks like you divided 34 thousand by 35 million and got 1 in 10,000. 

Looks like I did indeed do a rounding error - doh!  Part of why I usually post my math and link my sources, just in case I miscalculate so others can check it.

So 1 in 1,000.  Thanks for correcting my error, hate it when I do that.

It looks like I misquoted the seasonal flu death rate as 1 in 10,000 when I first posted and it said 1 in 1000 also.  My bad.  (Hmm the table shows Swine Flu as .02% -and this source says the same thing https://www.reuters.com/article/us-flu-h1n1-pandemic/swine-flu-infected-1-in-5-death-rate-low-study-shows-idUSBRE90O0T720130125 - it looks like the Swine Flu is based on sampling of blood tests for antibodies; but the 1 in 1000 is based on symptomatic individuals - so they aren't an apples to apples comparison).

So .1% which is 20 times less dangerous than coronavirus (2%) and almost 98 (9.8%) times less dangerous than SARS on a 'deaths per symptomatic individual' rate.

Of course we also need to know how many people who are infected become sympotmatic vs only develop antibodies and fight off the infection before becoming symptomatic - and those rates could differ quite a bit.

[Crunch]

Reports are coming out that the Chinese government is welding people into their homes, sealing them in. Can that be accurate? Seems insane.

[Crunch]

So the guys that got those reports out, they’re gone.

HONG KONG — The beige van squatted outside of a Wuhan hospital, its side and back doors ajar. Fang Bin, a local clothing salesman, peered inside as he walked past. He groaned: “So many dead.” He counted five, six, seven, eight body bags. “This is too many.”

That moment, in a 40-minute video about the coronavirus outbreak that has devastated China, propelled Mr. Fang to internet fame. Then, less than two weeks later, he disappeared.

Days earlier, another prominent video blogger in Wuhan, Chen Qiushi, had also gone missing. Mr. Chen’s friends and family said they believed he had been forcibly quarantined.

Before their disappearances, Mr. Fang and Mr. Chen had recorded dozens of videos from Wuhan, streaming unfiltered and often heartbreaking images from the heart of the outbreak. Long lines outside hospitals. Feeble patients. Agonized relatives.

Weird, I wonder why?

The footage would have been striking anywhere. But it was especially so coming from inside China, where even mild criticism of the authorities is quickly scrubbed from the online record, and those responsible for it often punished.

What? Communists hiding inconvenient information? Punishing anyone that says anything critical of the government? I bet some of you are shocked!

China’s leader, Xi Jinping, said last month that officials needed to “strengthen the guidance of public opinion.

But Bernie would never do that! He’d never do what literally every other socialist or communist government has done! This time, it’s different.

Meanwhile:

The head of the U.S. Centers for Disease Control and Prevention says the new coronavirus, which has killed almost 1,400 people and is still spreading in China, could be around for at least another year. With the Chinese government reporting 121 more deaths and more than 5,000 new cases Thursday alone, the illness dubbed COVID-19 didn't even appear to have peaked.

Chinese health officials in the epicenter province of Hubei changed the way they officially diagnosed the disease this week, leading early Thursday to a sudden, alarming jump of about 14,000 new cases recorded in the region.

My guess is you could add a zero to those numbers and be closer to the reality of the situation.

[Crunch]

Back in the USA

An American biotech company says it created a coronavirus vaccine three hours after getting access to the virus' genetic sequence on Jan. 9, and now scientists are racing to get the vaccine on the market in record time.

"We have an algorithm which we designed, and we put the DNA sequence into our algorithm and came up with the vaccine in that short amount of time," Inovio's research and development director Dr. Trevor Smith told KVUE.

It’ll be ready for use by summer!

Buried all the way down in the very last paragraph:

Another U.S. company, Maryland-based Novavax, is aiming to make a coronavirus vaccine in as little as three months, although such vaccines can take years to develop.

Who’s gonna be first to inject that 3 hour vaccine into their body? I suspect a few hundred million Chinese will get this vaccine before summer.

[yossarian22c]

Reports of Corona virus outbreaks in Italy, South Korea, and Iran. Should this go the route of the 1918 Flu pandemic it would be bad but not civilization ending. The ease of infection with the seemingly long incubation period makes this thing ending up global seemingly more likely.

Realistic worst case scenario (IMO) based on rough back of the envelope calculations would put maximum spread of infection at 30-40% of the global population with a death rate around 1% (largely people who are already sick or elderly in some way). So around 200,000,000 people dead worldwide.

For reference 3-15% of the US population gets the flu annually, with ~0.1% dying. I set the worst case spread at approximately 2x that because of the lack of an effective vaccine (currently).

Also for reference the 1918 flu pandemic infected 33% of the world population and had a death rate of about 10%.

[Seriati]

Yossarian22c, interesting parallel.  Just had a fascinating read on the 1918 Flu.  A number of conditions that allowed the 1918 pandemic to spread and be so deadly are no longer present.  They had no anti-biotics, so a lot of the deaths were from secondary infections.  They really didn't understand a lot of how the body works, not that our knowledge is great but it's way past theirs.  They were in the midst of WWI and apparently trench warfare flipped the typical response to the illness (typically, very sick people stay home and may die, while less sick people continue working, which causes less deadly strains to supplant the more deadly, in the trenches the less sick people stayed in the trenches, but the more sick were shipped on crowded trains to crowded hospitals and areas that troops were constantly deploying through).

One thing that did cause me concern is that the current virus has such a long incubation time where it can effect, that means that even those infected with the deadly version will be interacting with a large number of people before they get sick enough to stay home.  That would interfere with the natural process that selects for the milder version.   

[yossarian22c]

Yossarian22c, interesting parallel.  Just had a fascinating read on the 1918 Flu.  A number of conditions that allowed the 1918 pandemic to spread and be so deadly are no longer present.  They had no anti-biotics, so a lot of the deaths were from secondary infections. 

Death rates will probably hold steady in the 1-2% range for countries with adequate medical care, so far below the 10% rate of 1918. The real disasters would occur if this got into places like Syria or refugee camps were the level of medical care is going to be lower and impeded by war.

[fizz]

Writing from Italy, not in the locked zone but pretty near, right now here there have been 229 confirmed cases and 7 deaths, all of them over 80 and suffering from pre-existing conditions.

Schools have been closed in about a third of Italy, and all manifestations canceled (we were about to finish the carnival celebrations right now so there were plenty).

In Lombardy, around Milan, also all cinemas, discos, pubs, churches and all similar activities have been closed.

People are quite calm for now, there have been some limited stockpiling, but apart for masks and hand sanitizers the food supplies are still fine, supermarkets are open and supplied if a bit bare, and no big queues.

The thing that could get ugly quickly is the economy: apart for the momentary slump of having to stop production because workers have to stay in their homes and parts from China and other countries stop arriving, and ofc tourism, travel etc., around here a disproportionate part of the economy is built around small specialized production companies.

This kind of companies always work quite on the razor blade with their financials: even with state help, if the situation goes on too much many of them could go down or at least seriously suffer.

[Grant]

Death rates will probably hold steady in the 1-2% range for countries with adequate medical care, so far below the 10% rate of 1918. The real disasters would occur if this got into places like Syria or refugee camps were the level of medical care is going to be lower and impeded by war.

I understand where people are getting the 1-2% mortality rate, but I think it's a myopic number.   

According to the info coming out from the Chinese CDC, the mortality rate per age group is as follows:

0-9            0
10-19       0.2
20-29       0.2
30-39       0.2
40-49       0.4
50-59       1.3
60-69        3.6
70-79        8
>79           14.8

NCOVID19 is mostly killing people above the age of 60.  81% of the fatalities from China are from those aged 60 or more.  Hypertension and CVD are major co morbidity factors. 

COVID19 is killing people with pneumonia.  So it's killing those people who are already vulnerable to pneumonia.  14.6% of cases among healthcare workers were classified as severe or critical.  COVID19's transmissiblity, or basic reproduction number, is from 1.5 to 3.5, which is roughly the same as the Spanish Flu, but without the horrible mortality rate. 

In the United States, the elderly, especially in nursing homes, will be most vulnerable.  But as you already stated, we have much better medicine than we did in 1918, and the cause of mortality (pneumonia) is easier to take care of. 

[TheDeamon]

Realistic worst case scenario (IMO) based on rough back of the envelope calculations would put maximum spread of infection at 30-40% of the global population with a death rate around 1% (largely people who are already sick or elderly in some way). So around 200,000,000 people dead worldwide.

For reference 3-15% of the US population gets the flu annually, with ~0.1% dying. I set the worst case spread at approximately 2x that because of the lack of an effective vaccine (currently).

Also for reference the 1918 flu pandemic infected 33% of the world population and had a death rate of about 10%.

Census.gov estimates 7.6 Biliion people(rounded down) on the planet.

40% of that gives us 3.04 Billion people infected.

1% of that gives you 30.4 Million dead, not 200 Million.

Even killing 1% of the total world population would "only" result in 76 Million dead. So your 200 Million number is off by rather a lot.

[Seriati]

Thanks Grant I hadn't seen those numbers and they are interesting, but I just don't trust anything reported by China.  Nor will I trust those reported out of the Middle East or third world countries.  I don't believe they have the medical care, testing facilities or culture to accurately track total infections, even with their death counts I'd expect them to be over inflated (by miscounting other causes of death) or under reported (either because or repression of information - China, or inability - most of the third world, where cases may not even come to a medical center).

The biggest risks are similar to the 1918 breakout, where conditions in the first world eliminate the infection in the first instance (meaning we don't catch the infection in great enough numbers to cause it to select for a less deadly strain) and one or more of the third world countries are in conditions that cause or allow the deadly strain to become predominant before it reinfects the rest of the world.  Not sure on this virus if previous infection provides immunity or just resistance.

[Grant]

Thanks Grant I hadn't seen those numbers and they are interesting, but I just don't trust anything reported by China. 

Of course you don't.  What is your preferred source of information? 

I don't believe they have the medical care, testing facilities or culture to accurately track total infections

Which one of these is China guilty of? 

[Seriati]

Depends on what's being reported.  Unfortunately for an outbreak, it's often the after action reports. 

I was mostly referring to China as having a culture of information repression (on the statistics).  But I do think that translates fairly directly into not having a culture or medical care to accurately track total infections, as well as more substantively to making bad decisions on medical care overall.  Initially, they suppressed information internally (they may still be doing so), at the level of reporting to the central government and also in reporting to the people as a whole.  That  information is necessary to formulate an effective response by the government, but also very significantly by their citizens.   If transmission can be significantly retarded with basic hygiene measures, that suppression of info has killed people.

There's pretty open speculation that they deliberately exposed medical staff that were trying to communicate information to the virus to permanently shut them down, they certainly silenced those voices.

At the point where the infection is already spreading, a lot of people start looking at the totalitarian measures a country such as China can impose on their citizens and see an "effective" way to stop the spread of a pandemic.  But I think that reflects a misunderstanding of what's going on, top down societies will always choose to cut off a branch or purge some "regrettable losses" to save the whole.  How can they not, very few people matter to them as individuals.  And if we presume it's a do or die that may be the only way to save everyone else.

But if it's not do or die, then that's a cynical decision that imposes massive costs on the few that may have been avoidable.  The west will almost certainly use far less draconian responses, and will almost certainly achieve better survival rates (hope those aren't famous last words).  But it may mean we end up with higher infection rates.

[yossarian22c]

Census.gov estimates 7.6 Biliion people(rounded down) on the planet.

40% of that gives us 3.04 Billion people infected.

1% of that gives you 30.4 Million dead, not 200 Million.

Even killing 1% of the total world population would "only" result in 76 Million dead. So your 200 Million number is off by rather a lot.

Derp you're right. I was off by an order of magnitude. I meant to say around 20 million. And as other people have reiterated the deaths fall predominately among the elderly and others with underlying conditions that leave them vulnerable.

[cherrypoptart]

I'm just curious how bad people think this will get.

The CDC is talking about closing down schools and teleschooling. To my knowledge that has never happened before.

I know we're already supposed to have enough food to last a while but to be honest I probably don't. I'm wondering if I should get some while the getting is good.

It looks like water, tap water anyway, and electricity aren't going to be issues and worst case maybe self-quarantining for one to three months might do it to give the vaccine time to get made and distributed. Maybe get some food and a water filter and that should about do it. And maybe nothing will happen either but I'm just wondering if anyone else is prepping a little bit, or not. Over-reaction or prudence at this point?

[fizz]

There are some difference in opinions between CDC and WHO from what I hear: WHO reccomends a more aggressive early containment strategy, while CDC seems to prefer softer social distancing strategies.
My country is adopting WHO strategies, and while likely they will not be sufficient as everybody seems to agree the virus will be with us till at least this summer, for the moment they are working: only very few cases are out of the lock-down hot-spots (they are about a dozen towns for a total population of about 50k people, to give an idea).
People that try to enter or leave the lock-down zones without good reasons and arranging it with the health department would be stopped and fined, but people at least for now are collaborating quite willingly in a disciplined way.

Anyway, in the meantime, all north of Italy schools are closed, and we are starting to deploy distance-learning tools.

In the region around the lock down zones (Lombardy and the Venetian, the most industrialized regions of Italy), all people-gathering activities have been closed, from pubs and restaurants to cinema to gyms to churches, but in the rest of Italy they are not yet, although attendances are way down.

Monday there were some limited supermarket runs, people wanted to be sure to have some "just in case" reserves of the fundamentals, but the only consequence were some bare shelves: food and resource distribution is going on regularly.
Some of the usual jackals tried to profit from the sudden scarcity of face masks and hand sanitizers with huge price gouging, but it did not last much, pharmacies are already getting fresh batches.

Public transport is still working everywhere, there are some delays as long distance trains get stopped for checks when entering or leaving the dangerous zones.

The companies in the lock-down zone have been temporarily closed, but outside they are only encouraged to shift any worker they can do telecommuting.
Syndicates and emergency government committees are studying all kinds of incentives and facilitations to help transitioning as many people possible to this form of work, and made a decree that ensure no liabilities for companies or workers for the measures taken in the meantime in this direction.
With my own company, we decided to take the chance to triage our "emergency response plan" to ensure the company functioning in case of disruption of our workplace. Its working well, and right now only few employees are working from the office, all the rests moved to distance work.

Right now, to give some numbers from a western country, we have tested around 5000 symptomatic or at risk people, finding a total 374 positive cases, and 12 deaths, all of over 60 (mostly 80+) and suffering from pre-existing conditions.
The official percentages told by WHO doctors on official public sources here are that 80% of infected are barely symptomatic, 15% develop serious symptoms, 5% develop life threatening symptoms, and a still unclear percentage of these if vulnerable for other reasons may die.

Of course in the media chaos there are also doctors that say that's barely more serious than normal flu and everybody is being too overdramatic and we should think of the economy, and pundits that predict the end of the nation if we don't kick out all immigrants immediately and close all our borders.

But most of the chaos (for the moment) is in the media: from what I can see and what I can infer reading between the attempts of the media to dramatize things, people seems to be taking things calmly and rationally, even more so than before these things happened.

[Grant]

I'm just curious how bad people think this will get.

Worst case scenario is kinda like what you are describing.  But a lot has to do with where you live.  Population density and public transportation is going to be a big factor.  Schools get shut down for 2-3 weeks.  I don't know about tele-education.  Not everybody has that capability.  Not everybody has someone at home to watch the kids.  Shutting down business for 2 weeks in major metropolitan areas.  Not sure how that is going to work either, since so many live paycheck to paycheck.  They can't afford to lose 2-3 weeks of work.

It's more likely that in America we just power through the thing.  That will mean plenty of people getting sick and having to stay home anyways, but at least then they get sick pay.  Some cases will get serious and develop into pneumonia.  As I mentioned before, it will hit the elderly the hardest.  There will be more deaths in nursing homes. 

Roughly 2.5 million Americans die every year.  My guess is that could double with a bad epidemic. 

It wouldn't be a bad idea to have 2-3 weeks of emergency rations.  Canned foods.  Powdered formula for infants.  Hey, get some N95 masks.  But I think that the worse case scenario is not extremely likely except for places like New York City, some areas of Los Angeles.  Like I said, places with high density and public transportation might get shut down. 

Of course, it will inordinately effect those in the poorest and most crowded areas and the elderly, with minimal access to healthcare.  So look for that new cycle to begin soon.  It may or not be connected to global warming by pundits. 

The best case scenario is that everybody is overreacting and that we're never even going to notice when coronavirus hits the US.  It's already dying down in China.  We're talking about the most populous and densest population on earth, and the epidemic lasted only a few months.  We'll probably get more epidemics in other countries, and then 2-3 months later, it will be over.  Social distancing, handwashing, masks, and some local quarantine have done the trick there in my opinion. 

[TheDrake]

Actually masks don't do f all for covid-19 in a public setting. Therefore CDC does not recommend it. Crazed people buying masks are putting them in scarce supply for the health workers who actually need them.

[Grant]

Actually masks don't do f all for covid-19 in a public setting. Therefore CDC does not recommend it. Crazed people buying masks are putting them in scarce supply for the health workers who actually need them.

Are you sure of that? 

I said:

Hey, get some N95 masks.

$1000 says N95 masks are effective against COVID 19.  Eagerly awaiting your response. 

Love,

Grant

[TheDrake]

Oh, they're effective. Just not useful for the average person. It decreases your chance of contracting the disease by some fraction of a percent at best.

“The main point of the mask is to keep someone who is infected with the virus from spreading it to others,” Brewer said.

CDC agrees, writing on its website succinctly: “CDC does not recommend that people who are well wear a face mask to protect themselves from respiratory diseases.”

Do face masks work? An expert explains.

Medical face masks are often used during flu season or a virus outbreak. Demand for masks has skyrocketed amid the coronavirus outbreak. (Elyse Samuels/The Washington Post)

Common surgical masks block the droplets coming out of a sick person from getting into the air, but they are not tight enough to prevent what’s already in the air from getting in.

There are specialized masks — known as N95 masks because they filter out 95 percent of airborne particles — that are more effective, and some online retailers are sold out of them. But there’s a problem: The masks are difficult to use without training. They must be fitted and tested to work properly.

“If you just buy them at CVS, you’re not going to do all that,” Brewer said. “You’re not going to get it fit-tested, and you’re not going to be wearing it properly, so all you’ve done is spend a lot of money on a very fancy face mask.”

[cherrypoptart]

What if you put a saniwipe over your N95 mask? You'd have to replace it as it dried out but a couple of them should give you time to get through the supermarket and you use some more to wipe down all the stuff you buy or spray it and hopefully that would do it.

[Grant]

What if you put a saniwipe over your N95 mask? You'd have to replace it as it dried out but a couple of them should give you time to get through the supermarket and you use some more to wipe down all the stuff you buy or spray it and hopefully that would do it.

No.  Use the N95 mask properly and use alcohol hand sanitizer religiously.  Like a religious fanatic.  Minimize contact.  No handshakes.  Minimize touching surfaces.  Do not put anything over the N95 that could make breathing through it more difficult. I wouldn't even wear the N95 unless I was on public transportation or someplace close to lots of people.  Jupiter's Rooster, COVID19 isn't even airborne like smallpox or measles.  It's water droplets.  Yeah, it's contagious.  If you shake hands with someone who has it, or they sneeze or cough within 6 ft of you, or you touch what they touch, you can get it.  But it's not nearly as contagious as smallpox and measels, and the human race survived those for thousands of years. 

[TheDrake]

Faust already has developed a workaround. If coronavirus arrives, Oakland County personnel will put surgical masks over N95s, protecting the underlying mask somewhat so it can be used again.

NYU is already working to conserve “personal protective equipment” — full-body “moon suits,” masks, face shields and other gear — for a shortage that Phillips considers inevitable. Many masks used in U.S. hospitals come from Hubei province in China, where the outbreak began. And when production in China resumes, equipment surely will be reserved for use in that country, he said. About 65 percent of N95 respirators are manufactured outside the continental United States, in China and Mexico, according to HHS data.

If you are using up an N95 mask to buy oranges, you're taking it away from a doctor, nurse, or janitor in a hospital. Don't. If you are immune compromised, I suggest you not go out in public.

[cherrypoptart]

I hadn't known they were in short supply. Well that's something new.

[Grant]

If you are using up an N95 mask to buy oranges, you're taking it away from a doctor, nurse, or janitor in a hospital. Don't. If you are immune compromised, I suggest you not go out in public.

There is a temporary shortage because everybody in the world is *censored*ting their pants at exactly the same time.  Production has increased, and demand will go down after every swinging richard has a box.  The hospitals and healthcare providers will get theirs first from providers.  If you can get a box, you're not taking away from healthcare providers.  But I wouldn't spend $400 on a box from ebay.   COVID 19 just isn't that serious.