Author Topic: How long can we wait while flattening the curve?  (Read 253682 times)

Kyle Schuant

  • Handlebar Stache
  • *****
  • Posts: 1297
  • Location: Melbourne, Australia
Re: How long can we wait while flattening the curve?
« Reply #50 on: March 17, 2020, 05:17:23 AM »
They're not testing much. Even if no further person got infected, the numbers would eventually go up as they got tested or, as is happening a lot in Italy, autopsied.

If only we lived in advanced countries like India.

https://www.abc.net.au/news/2020-03-17/india-is-containing-coronavirus-despite-dense-population/12059024

runbikerun

  • Pencil Stache
  • ****
  • Posts: 539
Re: How long can we wait while flattening the curve?
« Reply #51 on: March 17, 2020, 03:13:44 PM »
The Taoiseach is addressing the nation here in Ireland right now - the plan appears to be to 1) get people onto income support as quickly as possible, 2) keep things as they are for the next few weeks, and 3) at some point in the future, "cocoon" vulnerable people for a period of several weeks with full food delivery and on-call medical staff. It sounds as though the plan is to bring numbers as low as possible as quickly as possible, and then use the time that buys to let the virus rip through the population in a single sustained burst (although I am absolutely speculating here).

Telecaster

  • Handlebar Stache
  • *****
  • Posts: 2315
  • Location: Seattle, WA
Re: How long can we wait while flattening the curve?
« Reply #52 on: March 17, 2020, 03:19:37 PM »
If we had a great depression most people would suffer greatly both economically and in terms of their day to day lives.

But why would we have a great depression? The great depression was a time of deflation when we were still on the gold standard and the government was unwilling to deficit spend. I'm not afraid of deflation, we would helicopter money our way out of that if we had to. Which is to say that I'm not afraid of a depression.

Co-signed.  This isn't like 2008 when we had a system banking problem.   As far as I can tell the guts of the economy are fine. 

rocketpj

  • Pencil Stache
  • ****
  • Posts: 808
Re: How long can we wait while flattening the curve?
« Reply #53 on: March 17, 2020, 04:13:19 PM »
From a long-term perspective a crash like this can have a net positive financial effect, basically clearing out all the overleveraged doomed companies as they crash (i.e. Uber).  Better situated companies will be able to come in and buy up the good bits while discarding all the garbage and debt.  We saw something similar in the dot com crash - lots of debt to build out the infrastructure, crash and burn, infrastructure remains and taken up by stronger survivors.

That said, bad for shareholders of individual stocks, bad for employees.  This is going to be a tough decade.

All the critical weaknesses of capitalism as a system are on display.  We may end up with something else by the time the dust settles.  No, this is not an infantile binary capitalism vs Stalinism situation, but we may see some of the things that should probably be operated as common goods become just that.

The most obvious example is health care.  A health care system that is optimized for profit maximization and extraction is by design not going to be able to handle sudden surges in demand, especially if it is combined with strong individual disincentives to actually using the system (i.e. high costs).  If it breaks, which it looks like it will, I don't see it being replaced by more of the same with the same weaknesses built in.


PDXTabs

  • Handlebar Stache
  • *****
  • Posts: 2028
  • Age: 37
  • Location: Portland, OR, USA
Re: How long can we wait while flattening the curve?
« Reply #54 on: March 17, 2020, 06:12:11 PM »
Imperial College says that flattening the curve (ideally) will reduce the death toll from 2.2 million to 1.1 million in the USA. That is, they model that flattening the curve (enough) is worth 1.0~1.1 million US lives.

Viking Thor

  • Stubble
  • **
  • Posts: 119
Re: How long can we wait while flattening the curve?
« Reply #55 on: March 18, 2020, 05:53:41 PM »
We don't know for sure if it's 1m lives or 10k lives that could be saved or how much time period of quarantine/distancing is required. We also don't know the economic impact, there are estimates that up to 80m jobs in the U.S could be at some level of risk (looking at all the jobs in restaurants, travel, etc).
https://www.cnn.com/2020/03/16/economy/job-losses-coronavirus/index.html

No one i think is arguing against a period of social distancing now to begin with, but at some point if this continues you would see a period like nothing in modern times- i.e in the history of the modern world there has never been an example where huge portions of the entire economy were mandated to stop for 12-18 months.

There are already many layoffs now and we just started, in 3 months there would be an avalanche.

If handled poorly more people could die related to poverty and losing access to healthcare (to treat non-corona health issues) than are saved by social distancing for 12-18 months and driving the economy off a cliff.

American GenX

  • Bristles
  • ***
  • Posts: 482
Re: How long can we wait while flattening the curve?
« Reply #56 on: March 18, 2020, 08:01:58 PM »
No one i think is arguing against a period of social distancing now to begin with, but at some point if this continues you would see a period like nothing in modern times-

No one says it has to go on forever.  But it has to for now to prevent the healthcare system from being overwhelmed.  In fact, we may have not buckled down as quickly and significantly as we should have, but we have to ride this out for NOW.  The future will be arriving very soon.  Adjustments can be made then if and when they are needed.

Viking Thor

  • Stubble
  • **
  • Posts: 119
Re: How long can we wait while flattening the curve?
« Reply #57 on: March 18, 2020, 09:13:14 PM »
that I agree with, we didn't do enough (in the U.S.) to start with and didn't take it serious enough for a long time. My fear is that eventually switches to the opposite extreme, where we shut things down for way too long.

I know 3 people already that have lost their job. Some of the experts now saying it could take 12-18 months for the corona virus to be under control.

We can afford a couple of months of economic shut down but at some point the costs would be astronomic. We should also be looking at what other countries do - frankly we are handling it the worst other than maybe Italy. Other countries had high cases in the beginning and it's calmed down now. E.g. In Japan they did not have to shut down restaurants, gyms, etc but they did shut down schools early on.
« Last Edit: March 18, 2020, 09:15:50 PM by Viking Thor »

Jack0Life

  • Bristles
  • ***
  • Posts: 320
Re: How long can we wait while flattening the curve?
« Reply #58 on: March 18, 2020, 11:08:05 PM »
More and more, this thread makes a good point.
This country can maybe handle the shutdown till the end of April.
Things have to get rolling again or else economically the devastation maybe be worst.

American GenX

  • Bristles
  • ***
  • Posts: 482
Re: How long can we wait while flattening the curve?
« Reply #59 on: March 19, 2020, 04:59:07 AM »

How long?

The latest news is that the government is preparing for 18 months of waves of COVID-19.

https://www.cnn.com/2020/03/19/health/us-coronavirus-case-updates-thursday/index.html

ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1635
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #60 on: March 19, 2020, 08:23:02 AM »
John P.A. Ioannidis is professor of medicine, of epidemiology and population health, of biomedical data science, and of statistics at Stanford University and co-director of Stanfordís Meta-Research Innovation Center:

Quote
The data collected so far on how many people are infected and how the epidemic is evolving are utterly unreliable. Given the limited testing to date, some deaths and probably the vast majority of infections due to SARS-CoV-2 are being missed. We donít know if we are failing to capture infections by a factor of three or 300. Three months after the outbreak emerged, most countries, including the U.S., lack the ability to test a large number of people and no countries have reliable data on the prevalence of the virus in a representative random sample of the general population.

This evidence fiasco creates tremendous uncertainty about the risk of dying from Covid-19. Reported case fatality rates, like the official 3.4% rate from the World Health Organization, cause horror ó and are meaningless. Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. As most health systems have limited testing capacity, selection bias may even worsen in the near future.

Basically, we are making decisions with extremely shitty data.

https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/

runbikerun

  • Pencil Stache
  • ****
  • Posts: 539
Re: How long can we wait while flattening the curve?
« Reply #61 on: March 19, 2020, 08:36:38 AM »
People still seem unwilling to face just how dire this situation is. Infection rates in a situation where serious measures are not taken are running at perhaps eight days to multiply numbers by ten. Lombardy is running out of coffins. Its doctors are showing PTSD symptoms. The mortality rate is effectively 10% thanks to a completely overrun medical system.

Whatever your mental model is for how bad this is, forget it. It's far, far worse. See my mention of Lombardy above? They had their first coronavirus positive less than a month ago. There is a reason governments are mobilising on this scale; it's because left to its own devices, this will kill more people than the world wars, and it will do it in weeks.

If your state has a population of ten million, and isn't taking serious measures, here's a fairly likely trajectory.

Today: the first case in your state.
Eight days from now: the tenth case in your state.
Sixteen days from now: the hundredth case in your state, and the first few deaths.
Twenty-four days from now: deaths are now beginning to add up.
Thirty-two days from now: deaths at this point are running at close to one in ten, as your medical system becomes completely overrun.
Forty days from now, assuming still no measures being taken: about a hundred thousand cases by now, and almost ten thousand deaths. There is a shortage of coffins. Medical personnel are showing PTSD symptoms; some are dying. Decisions are regularly being made to leave patients to die because there are not enough ventilators.
Forty-eight days from now: close to a million infected. Almost one percent of the population has died of coronavirus in less than seven weeks. The medical system is effectively gone at this point. Corpses are being piled up in warehouses because there's no room left.
Fifty-six days from now: at this point, the infection rate is levelling off as 90% or so of the population has contracted coronavirus. There are thousands upon thousands of deaths on a daily basis. The piles of corpses lead to a secondary outbreak of bacterial and parasitical illnesses, a considerable number of which will end up killing their hosts as a result of an already weakened immune system. Of the ten million people in your state, close to a million are dead or dying. The hospital system will take years to recover, and the state faces a desperate shortage of doctors and nurses.

If this is not prevented, it will be the worst loss of life in Europe and America in centuries.

At this point, eight weeks have passed. In a little under two months, your state has lost almost 10% of its population, its support and safety structures have been utterly ruined, the economy is wrecked completely, and (assuming you survive) you'll be mourning your friends and family for years to come.

Telecaster

  • Handlebar Stache
  • *****
  • Posts: 2315
  • Location: Seattle, WA
Re: How long can we wait while flattening the curve?
« Reply #62 on: March 19, 2020, 09:12:40 AM »
People still seem unwilling to face just how dire this situation is. Infection rates in a situation where serious measures are not taken are running at perhaps eight days to multiply numbers by ten. Lombardy is running out of coffins. Its doctors are showing PTSD symptoms. The mortality rate is effectively 10% thanks to a completely overrun medical system.

Whatever your mental model is for how bad this is, forget it. It's far, far worse. See my mention of Lombardy above? They had their first coronavirus positive less than a month ago. There is a reason governments are mobilising on this scale; it's because left to its own devices, this will kill more people than the world wars, and it will do it in weeks.

If your state has a population of ten million, and isn't taking serious measures, here's a fairly likely trajectory.

Today: the first case in your state.
Eight days from now: the tenth case in your state.
Sixteen days from now: the hundredth case in your state, and the first few deaths.
Twenty-four days from now: deaths are now beginning to add up.
Thirty-two days from now: deaths at this point are running at close to one in ten, as your medical system becomes completely overrun.
Forty days from now, assuming still no measures being taken: about a hundred thousand cases by now, and almost ten thousand deaths. There is a shortage of coffins. Medical personnel are showing PTSD symptoms; some are dying. Decisions are regularly being made to leave patients to die because there are not enough ventilators.
Forty-eight days from now: close to a million infected. Almost one percent of the population has died of coronavirus in less than seven weeks. The medical system is effectively gone at this point. Corpses are being piled up in warehouses because there's no room left.
Fifty-six days from now: at this point, the infection rate is levelling off as 90% or so of the population has contracted coronavirus. There are thousands upon thousands of deaths on a daily basis. The piles of corpses lead to a secondary outbreak of bacterial and parasitical illnesses, a considerable number of which will end up killing their hosts as a result of an already weakened immune system. Of the ten million people in your state, close to a million are dead or dying. The hospital system will take years to recover, and the state faces a desperate shortage of doctors and nurses.

If this is not prevented, it will be the worst loss of life in Europe and America in centuries.

At this point, eight weeks have passed. In a little under two months, your state has lost almost 10% of its population, its support and safety structures have been utterly ruined, the economy is wrecked completely, and (assuming you survive) you'll be mourning your friends and family for years to come.

But that nice Mr. Trump assured us the cases numbers were going down and it would disappear like a "miracle." 

JGS1980

  • Bristles
  • ***
  • Posts: 435
Re: How long can we wait while flattening the curve?
« Reply #63 on: March 19, 2020, 09:13:29 AM »
John P.A. Ioannidis is professor of medicine, of epidemiology and population health, of biomedical data science, and of statistics at Stanford University and co-director of Stanfordís Meta-Research Innovation Center:

Quote
The data collected so far on how many people are infected and how the epidemic is evolving are utterly unreliable. Given the limited testing to date, some deaths and probably the vast majority of infections due to SARS-CoV-2 are being missed. We donít know if we are failing to capture infections by a factor of three or 300. Three months after the outbreak emerged, most countries, including the U.S., lack the ability to test a large number of people and no countries have reliable data on the prevalence of the virus in a representative random sample of the general population.

This evidence fiasco creates tremendous uncertainty about the risk of dying from Covid-19. Reported case fatality rates, like the official 3.4% rate from the World Health Organization, cause horror ó and are meaningless. Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. As most health systems have limited testing capacity, selection bias may even worsen in the near future.

Basically, we are making decisions with extremely shitty data.

https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/

Great Argument! Except that people are dying in droves in Italy because the medical system is overwhelmed.


bacchi

  • Walrus Stache
  • *******
  • Posts: 5017
Re: How long can we wait while flattening the curve?
« Reply #64 on: March 19, 2020, 10:00:15 AM »
People still seem unwilling to face just how dire this situation is. Infection rates in a situation where serious measures are not taken are running at perhaps eight days to multiply numbers by ten. Lombardy is running out of coffins. Its doctors are showing PTSD symptoms. The mortality rate is effectively 10% thanks to a completely overrun medical system.

Yes.

It's not about a 1-3% death rate for elderly people. It's about the number of hospital beds and ventilators needed all at once. Some people are going to get triaged to the morgue if hospitals are overwhelmed.

Think about it. There are only 160k ventilators total in the US. If only 5% in the US get coronavirus during the same 2 week span, and only 5% of them need breathing help (far less than what China saw), we're SOL.

GettingClose

  • Stubble
  • **
  • Posts: 108
Re: How long can we wait while flattening the curve?
« Reply #65 on: March 19, 2020, 10:35:27 AM »
It's wrong to assume that only older people are at risk: https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm6912e2_w  This report covers 508 COVID-19 cases in the US resulting in hospitalization.

Quote
Among 121 patients known to have been admitted to an ICU, 7% of cases were reported among adults ≥85 years, 46% among adults aged 65Ė84 years, 36% among adults aged 45Ė64 years, and 12% among adults aged 20Ė44 years (Figure 2). No ICU admissions were reported among persons aged ≤19 years. Percentages of ICU admissions were lowest among adults aged 20Ė44 years (2%Ė4%) and highest among adults aged 75Ė84 years (11%Ė31%)

48% of ICU admissions were in people < 65 years old.
From other data in the report:
55% of hospitalizations were in people < 65 years old.
20% of deaths were in people < 65 years old.

Interestingly no one under the age of 20 appeared to have been hospitalized or to have died.

There are various ways to pick the numbers apart, but it's clearly not a matter of "isolate everyone over 65 and let the disease take its toll on everyone else".  We're days away from a major healthcare crisis.  In my state all elective medical procedures, dental procedures, and veterinary procedures have been halted by order of the governor, to preserve PPE.

YttriumNitrate

  • Handlebar Stache
  • *****
  • Posts: 1055
  • Location: Northwest Indiana
Re: How long can we wait while flattening the curve?
« Reply #66 on: March 19, 2020, 11:01:13 AM »
It's wrong to assume that only older people are at risk: https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm6912e2_w  This report covers 508 COVID-19 cases in the US resulting in hospitalization.

Who is saying that only older people are at risk? I certainly haven't heard anyone argue that healthy 70 year olds need to isolate themselves while 40 year old cancer patients on chemotherapy should continue as normal.

PDXTabs

  • Handlebar Stache
  • *****
  • Posts: 2028
  • Age: 37
  • Location: Portland, OR, USA

nemesis

  • Bristles
  • ***
  • Posts: 259
Re: How long can we wait while flattening the curve?
« Reply #68 on: March 19, 2020, 11:32:37 AM »
48% of ICU admissions were in people < 65 years old.

In The Netherlands a full half of ICU patients are under 50.  https://www.washingtonpost.com/health/2020/03/19/younger-adults-are-large-percentage-coronavirus-hospitalizations-united-states-according-new-cdc-data/
The data is chilling.

This is far more serious than saving jobs / economy at this moment.  No wonder China reacted with such draconian measures that are unprecedented in history during times of peace.

I spoke with 2 friends last night by phone who still weren't getting it.  "Oh it's just the flu" "more people die every year than this by the flu" "My parents are healthy and have a great immune system"...

No you dummies (my friends) - get your head out of the sand and learn how serious this is.
« Last Edit: March 19, 2020, 11:34:13 AM by nemesis »

itchyfeet

  • Pencil Stache
  • ****
  • Posts: 925
Re: How long can we wait while flattening the curve?
« Reply #69 on: March 19, 2020, 11:41:02 AM »
Not just China.

The world has woken up this week and is taking very dramatic steps.

The next two weeks of global social distancing will see COVD-19 completely eradicated from some countries that donít really have social transmission within the country yet, and the growth of cases in other more affected countries will have been thoroughly wound back. From this point the world should be able to slowly start operating again in a cautious way, more prepared and more educated way. Look how fast China and Korea stopped the growth in cases once they got serious. Countries like Singapore have controlled the break out of the virus quite well.

There is hope. At least I choose to believe so.

Bloop Bloop

  • Handlebar Stache
  • *****
  • Posts: 2140
  • Location: Melbourne, Australia
Re: How long can we wait while flattening the curve?
« Reply #70 on: March 19, 2020, 04:29:34 PM »
I have no doubt that the current draconian social isolation measures in most countries will see the pandemic relegated to very handle-able proportions in most countries (and those in which it still rages will be cut off from other countries). Just have a look at how China and Japan and Singapore have been able to halt the spread of the virus. Even here in Australia, it's been weeks since the outbreak and we are still running in single figure deaths.

nereo

  • Senior Mustachian
  • ********
  • Posts: 13562
  • Location: Just south of Canada
    • Here's how you can support science today:
Re: How long can we wait while flattening the curve?
« Reply #71 on: March 19, 2020, 04:36:33 PM »
Iím not certain it would actually play out this way here, but lately Iíve been thinking that once an epidemic hits some critical psychological threshold [almost] everyone goes into full lockdown mode from panic, which in turn halts all further spread. 

Thatís why Iím still skeptical of any 7-figure mortality estimates for within the US.  People can shrug off 1,000 deaths or maybe even 10,000, but if/when the death toll starts being thousands per day Iím betting >90% of the population will lock themselves in their homes and not venture out.  Of course this will be in tandem with ever-more-strict governmental decrees.

...which is basically what happened in Wuhan Provence in Chaina. It got super-bad; hundreds were dying daily, and then transmission rates went to near-zero as everyone became afraid to be anywhere near another person not in their family.

...just some evening ramblings.

Buffaloski Boris

  • Handlebar Stache
  • *****
  • Posts: 2129
Re: How long can we wait while flattening the curve?
« Reply #72 on: March 19, 2020, 05:13:32 PM »
I believe that the debate is academic at this point. The schools are locked down, the tourism industry is crushed as is hospitality. The technical definition of a depression is a 10% drop in real GDP. We are where we are. Weíre going to have a depression.

The choice is whether we make the best of that, crush this pestilence, and go onto a better future next year, or do we get both a depression AND a lot of unnecessarily dead people due to half measures? And a worse depression as a booby prize?

 I see a lot of potential good and some great coming of this in the long run. It will suck extremely  mightily in the short term. Thatís the card weíve been dealt.


American GenX

  • Bristles
  • ***
  • Posts: 482
Re: How long can we wait while flattening the curve?
« Reply #73 on: March 19, 2020, 05:21:37 PM »
48% of ICU admissions were in people < 65 years old.

In The Netherlands a full half of ICU patients are under 50.  https://www.washingtonpost.com/health/2020/03/19/younger-adults-are-large-percentage-coronavirus-hospitalizations-united-states-according-new-cdc-data/

Yes, we need these young people to listen and stop congregating in large crowds.  They were told to avoid that to protect against spreading to the vulnerable, but many young healthy people will find they aren't so invulnerable, so they are protecting themselves as well by self-quarantining as much as possible.

AnnaGrowsAMustache

  • Handlebar Stache
  • *****
  • Posts: 1919
  • Location: Noo Zilind
Re: How long can we wait while flattening the curve?
« Reply #74 on: March 19, 2020, 05:31:48 PM »
I have no doubt that the current draconian social isolation measures in most countries will see the pandemic relegated to very handle-able proportions in most countries (and those in which it still rages will be cut off from other countries). Just have a look at how China and Japan and Singapore have been able to halt the spread of the virus. Even here in Australia, it's been weeks since the outbreak and we are still running in single figure deaths.

That's because it's slow right up until it explodes. This is exactly what happened in China and Italy. Hopefully, Aus implemented those measures in time.

Kyle Schuant

  • Handlebar Stache
  • *****
  • Posts: 1297
  • Location: Melbourne, Australia
Re: How long can we wait while flattening the curve?
« Reply #75 on: March 19, 2020, 05:42:28 PM »
Hopefully, Aus implemented those measures in time.
The people are ahead of government measures. The government wants schools to remain open, but 1/4-1/3 of children have been removed by their parents. The government is now saying that restaurants etc can have one person per 4m2 of venue - but the places are deserted anyway.

https://www.abc.net.au/news/2020-03-20/coronavirus-covid-should-kids-go-to-school/12071336

https://www.abc.net.au/news/2020-03-20/coronavirus-queensland-restaurants-cancellations-deliveries/12064292

RetiredAt63

  • Senior Mustachian
  • ********
  • Posts: 13951
  • Location: Eastern Ontario, Canada
Re: How long can we wait while flattening the curve?
« Reply #76 on: March 19, 2020, 05:57:28 PM »
An Air Canada gate agent told me they are seeing lots of domestic cancellations.  My domestic flight thst showed fully booked online had lots of empty seats.  Flights are being amalgamated because of lots of cancellations. Canadians seem to be taking it seriously.  Having a self-isolated Prime Minister probably helps this attitude.

OtherJen

  • Magnum Stache
  • ******
  • Posts: 3621
  • Location: Metro Detroit
Re: How long can we wait while flattening the curve?
« Reply #77 on: March 19, 2020, 06:23:05 PM »
I have no doubt that the current draconian social isolation measures in most countries will see the pandemic relegated to very handle-able proportions in most countries (and those in which it still rages will be cut off from other countries). Just have a look at how China and Japan and Singapore have been able to halt the spread of the virus. Even here in Australia, it's been weeks since the outbreak and we are still running in single figure deaths.

That's because it's slow right up until it explodes. This is exactly what happened in China and Italy. Hopefully, Aus implemented those measures in time.

Yes. The numbers in my state have increased by more than 10-fold in 9 days, and those are just the cases we know about. Weíve also seen our first 3 deaths in the last 24 hours. This is with a full shut-down of all schools and municipal buildings and many businesses.

nereo

  • Senior Mustachian
  • ********
  • Posts: 13562
  • Location: Just south of Canada
    • Here's how you can support science today:
Re: How long can we wait while flattening the curve?
« Reply #78 on: March 19, 2020, 07:00:20 PM »
I believe that the debate is academic at this point. The schools are locked down, the tourism industry is crushed as is hospitality. The technical definition of a depression is a 10% drop in real GDP. We are where we are. Weíre going to have a depression.


Maybe?  Iím far from convinced at this point.  Consider the 1918 flu coincided with the First World War. 
675,000 Americans died from the flu when the population was just 1/3 of present levels.  WWI killed an additional 115,000 a year beforehand.
Adjusting for inflation that would be 1.9MM deaths.  We are a very long way from that.

Yet what followed wasnít a depression but one of the greatest market run ups in history (which ended in a depression a decade later).

The US economy is incredibly complex and surprisingly resilient.  Some forecasts Iíve seen suggest lost economic activity around $900B this year, but some of that will be offset by governmental bailouts.  To drop 10% weíd need a net loss of around $2.2T. Businesses are shuttered right now, but some (much?) of that is simply delayed... for a few weeks at least, possibly for several months. Other losses are permanent and canít be replaced.


Buffaloski Boris

  • Handlebar Stache
  • *****
  • Posts: 2129
Re: How long can we wait while flattening the curve?
« Reply #79 on: March 19, 2020, 07:12:07 PM »
Hopefully, Aus implemented those measures in time.
The people are ahead of government measures. The government wants schools to remain open, but 1/4-1/3 of children have been removed by their parents. The government is now saying that restaurants etc can have one person per 4m2 of venue - but the places are deserted anyway.

https://www.abc.net.au/news/2020-03-20/coronavirus-covid-should-kids-go-to-school/12071336

https://www.abc.net.au/news/2020-03-20/coronavirus-queensland-restaurants-cancellations-deliveries/12064292

Thatís pretty much the case here. Restaurants are empty, schools are closed, traffic is Christmas holidays light. Even the bars that are still open seem quiet. And then you see some idiots hanging in groups close to each other. A mixed bag but better than I expected.

Paper Chaser

  • Bristles
  • ***
  • Posts: 323
Re: How long can we wait while flattening the curve?
« Reply #80 on: March 19, 2020, 07:17:55 PM »
Yes. The numbers in my state have increased by more than 10-fold in 9 days, and those are just the cases we know about. Weíve also seen our first 3 deaths in the last 24 hours. This is with a full shut-down of all schools and municipal buildings and many businesses.

I'd guess that a very large part of the recent increases comes just as much from people finally being tested as it does from the virus spreading. In other words, a bunch of those new confirmed cases probably had the virus 9 days ago when the numbers in your state were lower, we just didn't have a way to confirm it.

Acorns

  • Stubble
  • **
  • Posts: 103
Re: How long can we wait while flattening the curve?
« Reply #81 on: March 19, 2020, 08:05:55 PM »

If your state has a population of ten million, and isn't taking serious measures, here's a fairly likely trajectory.

Today: the first case in your state.
Eight days from now: the tenth case in your state.
Sixteen days from now: the hundredth case in your state, and the first few deaths.
Twenty-four days from now: deaths are now beginning to add up.
Thirty-two days from now: deaths at this point are running at close to one in ten, as your medical system becomes completely overrun.
Forty days from now, assuming still no measures being taken: about a hundred thousand cases by now, and almost ten thousand deaths. There is a shortage of coffins. Medical personnel are showing PTSD symptoms; some are dying. Decisions are regularly being made to leave patients to die because there are not enough ventilators.
Forty-eight days from now: close to a million infected. Almost one percent of the population has died of coronavirus in less than seven weeks. The medical system is effectively gone at this point. Corpses are being piled up in warehouses because there's no room left.
Fifty-six days from now: at this point, the infection rate is levelling off as 90% or so of the population has contracted coronavirus. There are thousands upon thousands of deaths on a daily basis. The piles of corpses lead to a secondary outbreak of bacterial and parasitical illnesses, a considerable number of which will end up killing their hosts as a result of an already weakened immune system. Of the ten million people in your state, close to a million are dead or dying. The hospital system will take years to recover, and the state faces a desperate shortage of doctors and nurses.

If this is not prevented, it will be the worst loss of life in Europe and America in centuries.

At this point, eight weeks have passed. In a little under two months, your state has lost almost 10% of its population, its support and safety structures have been utterly ruined, the economy is wrecked completely, and (assuming you survive) you'll be mourning your friends and family for years to come.

Posts like this are just fear mongering. Yes, coronavirus is scary and deadly, highly transmittable and certainly more deadly than the average flu, but the United States isn't Italy and we shouldn't expect our outcomes to be the same as theirs. How do I know this? In direct contrast to the projections in the above post, coronavirus has been circulating in my state for almost 2 months and only .001% of our population has died from it, and that is with zero preventative/social distancing measures until two weeks ago. There are likely thousands of unreported/untested cases but only .02% of the state's population has gotten sick enough from it to be tested for it. We are younger, healthier, fewer smokers, less "handsy" in general, don't practice kissing as a social greeting, etc.

I am practicing social distancing. Have been to the grocery store twice this week but that is the only time I have left the house. But if we are going to make this worth the huge economic toll this will take on our country, it has to be all in, a nation wide lock down if necessary. At some point (soon!) we all have to go back to work or else we risk a total economic collapse. My grandmother is 85 and figures she is going to die in the next 10 years one way or another, but she really doesn't want to die destitute.
« Last Edit: March 19, 2020, 08:13:10 PM by Acorns »

Bloop Bloop

  • Handlebar Stache
  • *****
  • Posts: 2140
  • Location: Melbourne, Australia
Re: How long can we wait while flattening the curve?
« Reply #82 on: March 19, 2020, 08:13:40 PM »
People still seem unwilling to face just how dire this situation is. Infection rates in a situation where serious measures are not taken are running at perhaps eight days to multiply numbers by ten. Lombardy is running out of coffins. Its doctors are showing PTSD symptoms. The mortality rate is effectively 10% thanks to a completely overrun medical system.

Whatever your mental model is for how bad this is, forget it. It's far, far worse. See my mention of Lombardy above? They had their first coronavirus positive less than a month ago. There is a reason governments are mobilising on this scale; it's because left to its own devices, this will kill more people than the world wars, and it will do it in weeks.

If your state has a population of ten million, and isn't taking serious measures, here's a fairly likely trajectory.

Today: the first case in your state.
Eight days from now: the tenth case in your state.
Sixteen days from now: the hundredth case in your state, and the first few deaths.
Twenty-four days from now: deaths are now beginning to add up.
Thirty-two days from now: deaths at this point are running at close to one in ten, as your medical system becomes completely overrun.
Forty days from now, assuming still no measures being taken: about a hundred thousand cases by now, and almost ten thousand deaths. There is a shortage of coffins. Medical personnel are showing PTSD symptoms; some are dying. Decisions are regularly being made to leave patients to die because there are not enough ventilators.
Forty-eight days from now: close to a million infected. Almost one percent of the population has died of coronavirus in less than seven weeks. The medical system is effectively gone at this point. Corpses are being piled up in warehouses because there's no room left.
Fifty-six days from now: at this point, the infection rate is levelling off as 90% or so of the population has contracted coronavirus. There are thousands upon thousands of deaths on a daily basis. The piles of corpses lead to a secondary outbreak of bacterial and parasitical illnesses, a considerable number of which will end up killing their hosts as a result of an already weakened immune system. Of the ten million people in your state, close to a million are dead or dying. The hospital system will take years to recover, and the state faces a desperate shortage of doctors and nurses.

If this is not prevented, it will be the worst loss of life in Europe and America in centuries.

At this point, eight weeks have passed. In a little under two months, your state has lost almost 10% of its population, its support and safety structures have been utterly ruined, the economy is wrecked completely, and (assuming you survive) you'll be mourning your friends and family for years to come.

OK, so in about six weeks' time, I should expect 10% of my state's population to be dead, and I will be mourning friends and family members.

Is that a 50th percentile EV, or is it a 99.9th percentile worst case scenario? Because the two are very different.

If you are particularly susceptible to something, you might run at 99.9th percentile survey. For the rest of us, this comes across as fear-mongering. Based on the available data, if the entire population got the virus a lot less than 10% would be dead, and most of the dead would not be young or healthy individuals.


lutorm

  • Stubble
  • **
  • Posts: 206
  • Location: A large island in the middle of the Pacific Ocean
Re: How long can we wait while flattening the curve?
« Reply #83 on: March 19, 2020, 08:20:20 PM »
In direct contrast to the projections in the above post, coronavirus has been circulating in my state for almost 2 months and only .001% of our population has died from it. There are likely thousands of unreported/untested cases but only .02% of the state's population has gotten sick enough from it to be tested for it.
I'm not sure you understand how this progresses. The absolute numbers are less important than how they change. An exponential is very flat at the beginning, but once it turns up it's breathtaking. The projections above were for no countermeasures. Social distancing will slow the increase, so the doubling time is longer. But I'd be very surprised if the case numbers won't keep on doubling for a while. I'd love to be wrong, but I think we are far from the peak. The social distancing is just getting underway and many people and businesses still seem to think it's nothing to worry about.

Viking Thor

  • Stubble
  • **
  • Posts: 119
Re: How long can we wait while flattening the curve?
« Reply #84 on: March 19, 2020, 08:31:25 PM »
The point everyone is overlooking is that the fatality rate is likely far lower than the calculated numbers, which are based on test confirmed cases. And by all expert accounts there are way more cases that are not reported both in the U.S. and places like China where it peaked already.

So the 2% mortality rate might easilly be 10 times lower, because most people that have it don't report it And recover in their own. And a 10% death rate is not something that is in any way supported by evidence and this has now been around for several months. Yes it's a serious problem and we should do social distancing but it seems like in the U.S. the pendulum has swung from initial denial/bury head in sand foolishness to fear mongering and representing a worst case scenario out to be 100%  certainty.

ender

  • Walrus Stache
  • *******
  • Posts: 5577
Re: How long can we wait while flattening the curve?
« Reply #85 on: March 19, 2020, 08:36:09 PM »
The point everyone is overlooking is that the fatality rate is likely far lower than the calculated numbers, which are based on test confirmed cases. And by all expert accounts there are way more cases that are not reported both in the U.S. and places like China where it peaked already.

So the 2% mortality rate might easilly be 10 times lower, because most people that have it don't report it And recover in their own. And a 10% death rate is not something that is in any way supported by evidence and this has now been around for several months. Yes it's a serious problem and we should do social distancing but it seems like in the U.S. the pendulum has swung from initial denial/bury head in sand foolishness to fear mongering and representing a worst case scenario out to be 100%  certainty.

This is where the Diamond Princess "experiment" starts becoming interesting from a percentages perspective.

It's a little tricky to fully represent given it was early enough that everyone was able to receive full medical care.

Viking Thor

  • Stubble
  • **
  • Posts: 119
Re: How long can we wait while flattening the curve?
« Reply #86 on: March 19, 2020, 08:40:39 PM »
Right, I wish the sky is falling crowd would read this article from a respected Stanford University Epidemiologist and researcher.

https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/

Bloop Bloop

  • Handlebar Stache
  • *****
  • Posts: 2140
  • Location: Melbourne, Australia
Re: How long can we wait while flattening the curve?
« Reply #87 on: March 19, 2020, 08:45:20 PM »
We can thus rule out the Italian approach as a useful solution.

We can certainly rule out "doing nothing". The lockdown instituted on the 8th of March in Lombardy and the 10th of March across Italy, though, may be working. It took eight days to go from 300 to 3,000 confirmed cases across Italy; it's now been thirteen days since 3,000 and the cases are not yet at 30,000 - it seems as though the rate of spread has slowed down, and that may be reflected more and more in the Italian numbers as days pass. The average daily growth in confirmed cases has slowed to below 20%, which is obviously still terrifying, but substantially better than it was.

Which is why I think newspapers talking about exponential growth are doing us a disservice. According to the WHO numbers, the rate of infection is nothing like an exponential function. Just because for a few days in a row there are more infections each day than in the day previous does not make a function 'exponential', otherwise in about 30 days everyone on earth would be infected.


ender

  • Walrus Stache
  • *******
  • Posts: 5577
Re: How long can we wait while flattening the curve?
« Reply #88 on: March 19, 2020, 08:46:57 PM »
We can thus rule out the Italian approach as a useful solution.

We can certainly rule out "doing nothing". The lockdown instituted on the 8th of March in Lombardy and the 10th of March across Italy, though, may be working. It took eight days to go from 300 to 3,000 confirmed cases across Italy; it's now been thirteen days since 3,000 and the cases are not yet at 30,000 - it seems as though the rate of spread has slowed down, and that may be reflected more and more in the Italian numbers as days pass. The average daily growth in confirmed cases has slowed to below 20%, which is obviously still terrifying, but substantially better than it was.

Which is why I think newspapers talking about exponential growth are doing us a disservice. According to the WHO numbers, the rate of infection is nothing like an exponential function. Just because for a few days in a row there are more infections each day than in the day previous does not make a function 'exponential', otherwise in about 30 days everyone on earth would be infected.

The limiting factor is actually testing too.

I'd be very curious to see numbers of tests administered/available vs these growth rate charts. I suspect they'd be oddly correlated.

Acorns

  • Stubble
  • **
  • Posts: 103
Re: How long can we wait while flattening the curve?
« Reply #89 on: March 19, 2020, 08:58:20 PM »
In direct contrast to the projections in the above post, coronavirus has been circulating in my state for almost 2 months and only .001% of our population has died from it. There are likely thousands of unreported/untested cases but only .02% of the state's population has gotten sick enough from it to be tested for it.
I'm not sure you understand how this progresses. The absolute numbers are less important than how they change. An exponential is very flat at the beginning, but once it turns up it's breathtaking. The projections above were for no countermeasures. Social distancing will slow the increase, so the doubling time is longer. But I'd be very surprised if the case numbers won't keep on doubling for a while. I'd love to be wrong, but I think we are far from the peak. The social distancing is just getting underway and many people and businesses still seem to think it's nothing to worry about.

My state had no countermeasures until 2 weeks ago, even now we are far from total lockdown. Cases in the state have gone from 1 to 1370 (probably many more untested). I don't know what rate of growth that is but it is way less than the 90% infection rate cited in the original scenario I responded to.

Boofinator

  • Handlebar Stache
  • *****
  • Posts: 1432
Re: How long can we wait while flattening the curve?
« Reply #90 on: March 19, 2020, 09:52:38 PM »
We can thus rule out the Italian approach as a useful solution.

We can certainly rule out "doing nothing". The lockdown instituted on the 8th of March in Lombardy and the 10th of March across Italy, though, may be working. It took eight days to go from 300 to 3,000 confirmed cases across Italy; it's now been thirteen days since 3,000 and the cases are not yet at 30,000 - it seems as though the rate of spread has slowed down, and that may be reflected more and more in the Italian numbers as days pass. The average daily growth in confirmed cases has slowed to below 20%, which is obviously still terrifying, but substantially better than it was.

Which is why I think newspapers talking about exponential growth are doing us a disservice. According to the WHO numbers, the rate of infection is nothing like an exponential function. Just because for a few days in a row there are more infections each day than in the day previous does not make a function 'exponential', otherwise in about 30 days everyone on earth would be infected.

The rate of infection for a novel virus in a virgin population is absolutely exponential. Technically, it is a logistic function, but at the lower limit it devolves to an exponential, which is what we're seeing. At some point, one of two things will happen to break the exponential growth: 1) the exponential growth becomes saturated by recovered individuals, and the disease falls off as the logistic curve, and/or 2) people change their behaviors in response to the disease (or perhaps the disease becomes less communicable due to the weather), so that the function stays exponential but the growth rate decreases significantly (in the case of China and a few other countries, they've managed to achieve a negative exponential growth rate). The current approach the world seems to have settled on is #2, though I doubt every country will be able to achieve a negative growth rate prior to a vaccine being implemented.

Here's an example of the derivation: https://math.stackexchange.com/questions/137087/rate-of-infection-in-a-population

lutorm

  • Stubble
  • **
  • Posts: 206
  • Location: A large island in the middle of the Pacific Ocean
Re: How long can we wait while flattening the curve?
« Reply #91 on: March 19, 2020, 10:13:47 PM »
The rate of infection for a novel virus in a virgin population is absolutely exponential. Technically, it is a logistic function, but at the lower limit it devolves to an exponential, which is what we're seeing. At some point, one of two things will happen to break the exponential growth: 1) the exponential growth becomes saturated by recovered individuals, and the disease falls off as the logistic curve, and/or 2) people change their behaviors in response to the disease (or perhaps the disease becomes less communicable due to the weather), so that the function stays exponential but the growth rate decreases significantly.
Exactly, countermeasures do not prevent exponential growth, they just make it slower, and a slow exponential is still pretty bad unless it gets a lot slower.

This was a pretty good article today on growth rates.

Reader

  • Bristles
  • ***
  • Posts: 458
Re: How long can we wait while flattening the curve?
« Reply #92 on: March 20, 2020, 04:36:31 AM »
My state had no countermeasures until 2 weeks ago, even now we are far from total lockdown. Cases in the state have gone from 1 to 1370 (probably many more untested). I don't know what rate of growth that is but it is way less than the 90% infection rate cited in the original scenario I responded to.

watch what is happening to the italians. their numbers should be reliable. in about a week, the state may reach 5000+ cases if the infection rate is similar to italy.

https://www.reddit.com/r/dataisbeautiful/comments/fhykic/oc_this_chart_comparing_infection_rates_between/

MayDay

  • Magnum Stache
  • ******
  • Posts: 4447
Re: How long can we wait while flattening the curve?
« Reply #93 on: March 20, 2020, 05:33:27 AM »
My state had no countermeasures until 2 weeks ago, even now we are far from total lockdown. Cases in the state have gone from 1 to 1370 (probably many more untested). I don't know what rate of growth that is but it is way less than the 90% infection rate cited in the original scenario I responded to.

watch what is happening to the italians. their numbers should be reliable. in about a week, the state may reach 5000+ cases if the infection rate is similar to italy.

https://www.reddit.com/r/dataisbeautiful/comments/fhykic/oc_this_chart_comparing_infection_rates_between/

I do not think we will see that growth in the US because there literally are not tests. So they are hoarding tests just like toilet paper.

If you aren't admitted to the hospital or a celebrity or healthcare worker, no test.

caleb

  • Bristles
  • ***
  • Posts: 313
Re: How long can we wait while flattening the curve?
« Reply #94 on: March 20, 2020, 08:33:36 AM »
@waltworks I'd be shocked if we last more than a month.  At some point, businesses are going to open their doors rather than go out of business.  Parents are going to insist that schools reopen, because they need to go to work and they need some relief from childcare.

I read an interesting piece in the NYT by an historian of the 1918 flu.  The part that stuck out to me was that even the army, in wartime, wasn't able to maintain effective quarantines for long enough to matter all that much.  We as humans just aren't wired for extended periods of isolation.  If a wartime army a hundred years ago couldn't do it, I highly doubt ordinary Americans in 2020 will be able to do it.

Boofinator

  • Handlebar Stache
  • *****
  • Posts: 1432
Re: How long can we wait while flattening the curve?
« Reply #95 on: March 20, 2020, 10:33:46 AM »
@waltworks I'd be shocked if we last more than a month.  At some point, businesses are going to open their doors rather than go out of business.  Parents are going to insist that schools reopen, because they need to go to work and they need some relief from childcare.

I read an interesting piece in the NYT by an historian of the 1918 flu.  The part that stuck out to me was that even the army, in wartime, wasn't able to maintain effective quarantines for long enough to matter all that much.  We as humans just aren't wired for extended periods of isolation.  If a wartime army a hundred years ago couldn't do it, I highly doubt ordinary Americans in 2020 will be able to do it.

As others have noted, there are major differences between 1918 and today.

  • There was a major war effort going on, which takes at least some precedence over quarantine.
  • The economy was mostly focused on maintaining the war effort, and therefore probably a strong majority of businesses would have been considered essential.
  • There were fewer "telework-eligible" jobs back in the day.
  • We currently understand disease transmission much better than we did then.
  • The government has much better stimulus options in place for people to remain unemployed and not starve.

I think the big question that remains to be answered is how far ahead of the pandemic were we able to get in the U.S. If things turn out that people are dying in the streets, businesses will remain closed for the foreseeable future, as people will be overly cautious. On the other hand, if we're able to contain it so that healthcare workers can manage the workload, we will get a false sense of security and there might be a push to end quarantine measures prematurely.

Cassie

  • Walrus Stache
  • *******
  • Posts: 6656
Re: How long can we wait while flattening the curve?
« Reply #96 on: March 20, 2020, 11:53:21 AM »
Nevada is shutdown. We are very tourist dependent but itís the right move. My kids will most likely have to move in with us. We are retired on small pensions so as a family will be fine.  We will do what families did during the depression. Families live together and make it work. For those without families it will be hell.

Buffaloski Boris

  • Handlebar Stache
  • *****
  • Posts: 2129
Re: How long can we wait while flattening the curve?
« Reply #97 on: March 20, 2020, 05:01:34 PM »
Nevada is shutdown. We are very tourist dependent but itís the right move. My kids will most likely have to move in with us. We are retired on small pensions so as a family will be fine.  We will do what families did during the depression. Families live together and make it work. For those without families it will be hell.
Yup. Kids *are* social security. As are parents.

Travis

  • Magnum Stache
  • ******
  • Posts: 3196
  • Location: South Korea
Re: How long can we wait while flattening the curve?
« Reply #98 on: March 20, 2020, 05:46:23 PM »
@waltworks I'd be shocked if we last more than a month.  At some point, businesses are going to open their doors rather than go out of business.  Parents are going to insist that schools reopen, because they need to go to work and they need some relief from childcare.

I read an interesting piece in the NYT by an historian of the 1918 flu.  The part that stuck out to me was that even the army, in wartime, wasn't able to maintain effective quarantines for long enough to matter all that much.  We as humans just aren't wired for extended periods of isolation.  If a wartime army a hundred years ago couldn't do it, I highly doubt ordinary Americans in 2020 will be able to do it.

There's some evidence (but nothing conclusive) that the 1918 flu started in a US Army camp and we brought it over to Europe. With millions of soldiers huddled in trenches and slugging it out, quarantine just wasn't an option.

On the flip side, the modern US military community is in a great position to force isolation.  Our bases have controlled access, we can be legally restricted from going to certain places, and being federal employees we're salaried.  I live just off base, but I get screened now every time I go through the gate. I was given specific orders that if I feel flu-like symptoms to stay away and call the hospital for instructions.  Having all of our plans upended and being told to sit and wait is something we get a lot of practice at.
« Last Edit: March 20, 2020, 05:52:00 PM by Travis »

mm1970

  • Walrus Stache
  • *******
  • Posts: 8314
Re: How long can we wait while flattening the curve?
« Reply #99 on: March 20, 2020, 06:06:09 PM »
My state had no countermeasures until 2 weeks ago, even now we are far from total lockdown. Cases in the state have gone from 1 to 1370 (probably many more untested). I don't know what rate of growth that is but it is way less than the 90% infection rate cited in the original scenario I responded to.

watch what is happening to the italians. their numbers should be reliable. in about a week, the state may reach 5000+ cases if the infection rate is similar to italy.

https://www.reddit.com/r/dataisbeautiful/comments/fhykic/oc_this_chart_comparing_infection_rates_between/

I do not think we will see that growth in the US because there literally are not tests. So they are hoarding tests just like toilet paper.

If you aren't admitted to the hospital or a celebrity or healthcare worker, no test.
Yeah, my BFF bailed on our walk last week because her kid woke up sick.  It was pouring anyway.  In the last week, she, both her twins, and her older child (all kids in elementary) have been down HARD with fever/ cough.  Could be regular flu?  She's not able to be upright for more than 30 min at a time.  Husband still going to work.

But they aren't testing her because she's under 50.  I have a running friend who also has all the signs, but they aren't testing her either.

Literally not testing anyone if you haven't been traveling, haven't been around a known case, or are under 50.