Let’s look at some numbers just to get a sense of COVID-19’s possible effects. This is not a prediction or an attempt to find precise numbers. Just something to wrap your mind around.
United States population: 329,000,000 (US census)
Number of deaths in 2017: 2,814,000 (CDC)
Deaths from influenza and pneumonia: 55,672 (CDC)
Cases of influenza: 9,300,000 to 45,000,000 (CDC)
That’s a wide uncertainty, no doubt because not everyone who has influenza goes to the doctor, much less is tested.
The numbers of cases of influenza are kept down by vaccinations and immunity in people who have had a similar strain of influenza in the past. COVID-19 has no such mitigating factors, which is why limiting people’s movement becomes important.
Don’t bother to try to make the numbers of deaths from influenza and pneumonia fit neatly with the cases of influenza. My purpose in this post is to provide a general sense of how COVID-19 might affect the United States and give some numbers for you to make sense of.
Right now, the death rate for influenza is generally agreed to be about 0.1%. For COVID-19, it’s about 2%.
If there are as many cases of COVID-19 as there are of influenza, that gives 186,000 to 900,000 deaths. That’s compared to 56,000 for influenza. Heart disease kills about 650,000 people a year, cancer 600,000 (CDC). And, without a vaccine or immunity from earlier infections, those numbers could be larger.
Hoodie
Isn’t the lack of a vaccine or previous infection already baked into the current estimate of fatality rate? My guess is that 2% is likely a bit high for countries with a minimum level of healthcare, but a rate similar to the 1918 flu seems plausible. Still a lot of deaths and a lot of economic stress, particularly considering the global nature of the supply chains.
Roger Moore
This is the part that really freaks people out. There’s a serious worry that the lack of immunity could result in a lot more cases of COVID-19 than we get of influenza in a typical year.
I also wonder how much the lack of any kind of existing immunity contributes to the higher mortality rate. I know the flu vaccine is not 100% effective, but that even a less than perfect imunization or prior exposure to a related strain can result in a less serious case than in a completely naive patient. If COVID-19 is genuinely novel so there’s no existing immunity, that might contribute to its comparatively high mortality rate.
chopper
@Hoodie:
but there is a certain critical mass which can be quickly achieved where hospitals become overwhelmed. in the case of a virus like this, death rate is also dependent on hospitalization rate; if 15% of symptomatic cases require hospitalization, then there’s not a whole lot to do to keep the CFR down.
Subsole
Informative and helpful. Thanks for posting this.
bluehill
Read on twitter that China and Singapore show how the spread of the virus can be slowed, but tradeoffs particularly in China is willingness to accept significant infringement of personal freedoms, economic harm, etc. The issue is the inflection rate coupled with the percentage of exposed people that suffer severe effects could overwhelm existing capacity at hospitals that can handle it, so the quick is quick and competent response when cases emerge.
hitless
@Hoodie: I would not rely on access to modern health care to lower the case fatality rate in the US. The US health care system has no surge capacity (such capacity is not cost effective and therefore eats into profits). An epidemic like in Wuhan would quickly overwhelm any comparable area in the US and most of the ill would not have access to modern health care. Moreover, it is doubtful that the US government could send additional healthcare workers and resources to the afflicted area as the PRC did in Wuhan. That is why it is vital to slow and limit transmission as much as possible in the US.
Barbara
The death rate in China seems to be a hotly contested subject. Chinese authorities believe that 2% is not an inflated rate due to the failure to identify people who don’t present themselves for evaluation or diagnosis. I assume the strategy for countries with public health infrastructure is to use containment to minimize infection until such point a vaccine is available, at least for the most vulnerable populations.
Hoodie
@Roger Moore: Wouldn’t seem to jibe with kids seem less susceptible, except a generally higher level of health. If that’s the case, you think mortality may be much worse in poor countries.
Nicole
Smithsonian Magazine ran an article in 2017 about the Spanish Flu (which many now think started right here in the heartland of the USA):
smithsonianmag.com/history/journal-plague-year-180965222/
One of the interesting, and really depressing parts in the article is that maybe, maybe the effects wouldn’t have been so terrible if the government and media had not, oh, lied to the public about it.
Mike in DC
Has there been any American deaths, on American soil, yet? My impression is that there has not.
Archon
My fiancé who is in health care kept telling me this seasons flu is worse then COVID-19.
She doesn’t think that anymore…
Hoodie
@hitless: I wasn’t basing it on response capability, but rather on a higher baseline health and nutrition level, albeit the US is not necessarily the best in that sense (EU would likely fare better). It is probably better than, say, Nigeria or even certain parts of China.
Major Major Major Major
@Mike in DC: At a 2% death rate you would expect one, so zero isn’t too far off.
Origuy
It appears there may be a link between COVID-19 mortality and smoking. China and Iran have two of the highest smoking rates among men, and are showing high mortality rates from COVID-19.
Barbara
@hitless: I think you are perhaps applying the concept of surge capacity in manufacturing (which China apparently has but the U.S. does not) to health care. I don’t think any country has “surge” capacity when it comes to complex health care treatment, at least not immediately.
Reading stories out of China, many people did not receive the level of services they needed. Many did, of course, but there was rationing as China tried to build additional capacity. They also grouped people by apparent state of need for purposes of quarantines.
Everyone seems to agree that “self-quarantine” within a single family group was a failure. Your relatives will almost certainly get the virus.
The real issue will be the availability of ventilators and associated care requirements — infection control, secondary infection risks, and so on. The U.S. health care standards are so high that I have no doubt there is insufficient capacity. The question is what kind of workaround or second best care would be acceptable or agreeable to providers and patients?
PeakVT
Assume 10% of the population gets infected (33,000,000) and 0.5% (also assume much better medicine in the US, a debatable proposition) die directly or indirectly = 165,000 deaths from COVID-19.
165,000 divided by 2,814,000 = 5.86% increase in the number of annual deaths.
165,000 divided by 703,500 (compressing the deaths into 3 months) = 23.45% increase in the number of deaths.
A bad but not worst case will really strain our health care system and economy.
Anecdote: a co-worked died at work a few weeks ago and because the hiring manager is also out recovering from surgery, I worked 66 hours last week. Now give the same problem to thousands of businesses across the country, most of which don’t have an employee able to do what I did, especially for weeks on end. The economy will be in recession pretty quickly.
The Dangerman
So, the only “expert” I’ve heard talk about how this thing will go away when the weather gets warmer is Donald Trump. Now, and I can scarcely believe I am typing these next few characters, but does this have even a minimal amount of truth and accuracy or is Trump just completely full of shit.
There is talk of postponing or cancelling outright the Tokyo Olympics and that is the height of Summer (late July, IIRC). So someone isn’t telling the truth here. Yeah, I’m shocked.
I still fear Trump using this thing to dick with the election somehow. I don’t know how but we can’t have an election that would be so unfair to Trump, right? He would have to even things out somehow. No idea how.
Repatriated
@Barbara:
The problem is that the US system triages by ability to pay, not medical necessity or optimal containment.
Not good.
Sebastian
@Origuy:
This is a great article. Thank you for sharing this!
Barbara
@Origuy: Some accounts suggest that the smoking rate helps explain the disparity in the death rate between men and women.
piratedan
other considerations…. with people who have other illnesses already in place, having to fight off the flu in addition to what their immune system is already in battle against, makes it extremely dangerous… sure, maybe you can attribute the death to something like emphysema or COPD, but coupled with the flu, you might have had a chance to survive one, but not both…. and there’s a good number of folks already in the country fighting a daily health battle, throwing this on top as a contributing factor is not going to be pretty.
Mary G
Cheryl Rofer
@Hoodie: The lack of immunity, one way or another, has to do primarily with the disease rate in these calculations.
And my point is not to argue whether the fatality rate is 2% or 2.3% or 1.5%. It’s to give a general sense of the numbers we’re talking about.
MazeDancer
Because there are no treatments for viruses and because older patients are at risk for Coronavirus – and BJ readership skews older – I thought I might report on 3 supplements that have helped me in my ongoing viral condition.
I have a chronic virus for which there is no cure. It flattens me. It nearly destroys me physically, mentally, and emotionally. But I fight it every day. And these safe and non-controversial supplements help me beat back the virus. In me, not saying they will in you. Or even work against this virus.
If you would like to know about the supplements I take, please contact me at PostCardPatriots at the google mail place.
One of them is currently under study against Coronavirus at a University in Singapore. Which is good, because double blind studies are not done in this country unless big bucks are the result of the process. Supplements are not expensive. Drugs are.
Wanted to remove the names of the supplements and replace my post because there are those on the blog that see no difference between proven supplements, which I heavily disclaimed, being taken under medical supervision, and the insanity of wacky anti-vaxxers.
I had forgotten the arrogance of those not open to possibilities. But as a BJ regular for well over a decade, I certainly do not want anti-vaxxers swarming the blog. Or open the door to their irresponsible ilk. Only wanted to help.
Back when I could work, I was a consultant to the Integrative Medicine Center at one of the nation’s leading hospitals. As one of my doctor clients would say, “There are patients we simply cannot help conventionally, So we have to be open to alternatives.”
if you, heaven forbid, find yourself in need from the virus, please email me, if you want to consider a possible alternative to no treatment at all.
edited
Major Major Major Major
@Origuy: Italy, too, has a much higher fatality rate than, say Singapore. The rate of smoking in Italy is significantly higher.
Immanentize
Sorry, but just a quick drive by. Best estimate for the absolute earliest availability of any type of effective vaccine is 18 months. Development, testing and finally gearing up manufacturing then followed by distribution will not under any circumstances happen this year.
Cheryl Rofer
@Mike in DC: No deaths attributed to COVID-19 in the US yet.
Elizabelle
@Nicole: Excellent Smithsonian article.
And: did the 1918 flu help set the conditions for WW2 (ie. the disastrous Versailles Treaty):
On April 3, 1919, during the Versailles Peace Conference, Woodrow Wilson collapsed. His sudden weakness and severe confusion halfway through that conference—widely commented upon—very possibly contributed to his abandoning his principles. The result was the disastrous peace treaty, which would later contribute to the start of World War II. Some historians have attributed Wilson’s confusion to a minor stroke. In fact, he had a 103 degree temperature, intense coughing fits, diarrhea and other serious symptoms. A stroke explains none of the symptoms. Influenza, which was then widespread in Paris and killed a young aide to Wilson, explains all of them—including his confusion. Experts would later agree that many patients afflicted by the pandemic influenza had cognitive or psychological symptoms. As an authoritative 1927 medical review concluded, “There is no doubt that the neuropsychiatric effects of influenza are profound…hardly second to its effect on the respiratory system.”
FWIW: After that third wave, the 1918 virus did not go away, but it did lose its extraordinary lethality, partly because many human immune systems now recognized it and partly because it lost the ability to easily invade the lungs. No longer a bloodthirsty murderer, it evolved into a seasonal influenza.
Barbara
@Repatriated: So I really do understand the role of money in health care, but I don’t think that the biggest financially related impact will be on the efficacy of triage, e.g., when someone shows up at the ER, whether they get tested or whether they get sent home. I think that where money is going to have a much larger impact is people deciding not to report symptoms so they don’t get sent home from work, or deciding not to seek care because they can’t afford it.
Elizabelle
@Major Major Major Major: WRT smoking: France is not going to fare well. Lotta smoking in Spain too.
Mon Dieu.
Another Scott
Thanks for this.
I’m no expert, just “thinking out loud” in the following.
Since we know a vaccine is 12-18 months away (according to Fauci), it seems like the most important thing for health care workers to do is figure out early on who will get infected and show no/minimal/mild symptoms and who will develop nasty life-threatening lung infections that require (weeks? months?) of being on a ventilator. If everyone who develops a fever shows up at an emergency room, then of course the system is going to be overwhelmed. :-( Are kids under 10 effectively immune? Are men at special risk? There are lots of anecdotes out there, how many are accurate?
Experts need to figure out how long the virus survives on surfaces, and the best way to quickly and cheaply disinfect it. What are they spraying in China? Ethanol? Is it effective? Should people be wiping down every surface they touch? How often? Are those efforts worth the cost and opportunity costs?
And there has to be a better way of controlling the spread than shutting the borders or shutting down cities. Rapid, accurate, cheap, testing is required. And that testing has to feed into more than – this person has the virus, lock them up for 14-days – 3 months. Not everyone who tests positive for the virus will develop life-threatening infections. Shutting down the economy for 3-6 months isn’t going to stop the virus if it lives on surfaces for weeks or months – it will stretch out the infection timeline, but there would still be a year before there’s a vaccine.
Lots and lots of questions, lots and lots that needs to be done.
I hope Fauci and his team are able to make progress in spite of all the nonsense and dangerous missteps by Donnie-Pence.
Cheers,
Scott.
MattF
We just don’t know. There are optimistic scenarios, pessimistic scenarios, and any minute now, there will be meta-anti-scenarios. One thing, I guess, to bear in mind is that rare events are not a good basis for statistical inference, and all the data we have outside China consists of rare events.
Cheryl Rofer
@The Dangerman: I have not seen any firm claims from an expert on how coronavirus will behave when the weather gets warmer. Some of the common-cold coronaviruses become less of a problem as the weather gets warmer, and I’ve seen some speculation in that direction, but my sense is that nobody knows.
Sebastian
@Elizabelle:
Neither is Russia.
Barbara
@Major Major Major Major: Don’t forget the impact of age as well. There is a major difference in the death rate, almost like a parabola, related to the age. No doubt, if you are 75 and a smoker you are at significantly higher risk, and you might as well start planning your funeral if you already have a smoking related lung condition.
Barbara
@Another Scott: It’s hard to survive weeks and months on a ventilator. Secondary infections are common.
Hoodie
@Cheryl Rofer: Agreed, whatever the actual rate turns out to be, it seems like it will be bad. One thing about this virus is that it seems to have a significantly higher transmission rate than influenza and orders of magnitude higher than SARS and MERS coronaviruses. You have to worry whether this will be a persistent thing with mutations of varying severity occurring every few years like influenza, and thus permanently adding to the baseline number of deaths from infectious diseases. The societal impact could be significant and chronic, lasting long past the initial crisis
Another Scott
@The Dangerman: I caught the flu in Nara, Japan the end of May last year. I was shocked that it was the flu (diagnosed via a throat swab at an urgent care place when I got back). I did have the flu vaccine ~ 6 months before, also too.
I don’t think we can count on the summer solving the problems…
Cheers,
Scott.
Goku (aka Amerikan Baka)
BNO Newsroom: Iceland reports first case of COVID-19
Didn’t we have a commenter on vacation to Iceland recently? And they were in their 70s? Oh shit.
BR
Great article on how to prepare sensibly for the virus:
blogs.scientificamerican.com/observations/preparing-for-coronavirus-to-strike-the-u-s/
Mallard Filmore
@The Dangerman:
A decade or two ago I learned from a forgotten source that cold winters cause people to cram close together in warm rooms. Warm weather allows people to disperse and lessen the need for closer contact.
Major Major Major Major
@Barbara: Not quite a parabola–I don’t believe anybody under ten has died.
MazeDancer
California has a Surgeon General that won’t have to filter through Pence. Here’s her Twitter: twitter.com/DrBurkeHarris
There may be other state officials who can lead the truth telling/
Barbara
@Major Major Major Major: Very true. I am exaggerating, but the difference in the death rate is fairly staggering when sorted by age.
Goku (aka Amerikan Baka)
@Sebastian:
The most disgusting part about Russia is they were trying to spread misinformation about the virus recently. I mean, JFC.
Viruses don’t care about national borders, Pootie Poot. Better get in that bunker and hope nobody has it that’s in there with you; he is in an at risk demographic
Major Major Major Major
I was going to read The Stand this summer but I think that plan’s on hiatus.
PeakVT
Smoking rate by country. According to this data, the male smoking rate in Iran is only slightly higher than in the US, though the female rate is drastically lower. The male rate in France is about 50% higher, and about 200% higher in Russia.
Goku (aka Amerikan Baka)
@Major Major Major Major:
M-O-O-N. That’s how you spell pandemic
Feathers
I found a bunch of good stuff here: news.harvard.edu/gazette/story/series/coronavirus/ . The Harvard Gazette, which is their newspaper for faculty and staff (and the rest of the world), has created a coronovirus roundup page. It was updated with a new article from when I read it to when I went back because I hadn’t copied the link correctly. I found it soothing because I knew it only had credible material, was written in a very straightforward style, and it filled my knowledge craving without freaking me out. Yeah, it’s plugging Harvard scientists and researchers, but they are doing so by sharing good information. I get the newsletter because I used to work there and missed it when I left.
Note: I just added this to Anne Laurie’s daily COVID-19 post as well.
Goku (aka Amerikan Baka)
Has anybody been having weird dreams lately? I keep waking up in a cornfield in Nebraska
Nicole
@Elizabelle: Right? I was totally blown away by the bit about Wilson.
I thought of you and the rest of us talking yesterday about the Spanish Flu as soon as I saw the article and was just waiting for a thread to post it in.
Matt
I think it would be interesting to estimate the probable fractional loss of life expectancy.
Another Scott
Relatedly, GovExec (originally at ProPublica): (CC license)
Emphasis added.
We can’t count on luck that the US infections aren’t substantial. We need good data. Soon.
Cheers,
Scott.
L85NJGT
So…
Wash your hands regularly.
Keep fingers out of nose, mouth and eyes.
Quit smoking.
Immanentize
@Feathers: That is a good source. I just sent t to the senior administrators at my University. Thank you.
Immanentize
@Goku (aka Amerikan Baka): Were you sent to the cornfield by an eight year old Billy Mumy?
Martin
The challenge with early outbreaks is who gets tested. How many people got Covid, shrugged off the symptoms and recovered, and never got counted in the denominator of that mortality rate? But the folks in the numerator – they always get tested, they always get counted.
That’s why you’re seeing high mortality in Iran. It’s not that they’re bad at healthcare, it’s that they’re bad at testing the people who didn’t die.
The other wildcard in all of this is the growing percentage of people who test positive a second time, after recovery.
So either the viral immunity of this disease isn’t strong, meaning it can keep getting passed around, or it might be biphasic meaning it has two distinct symptom periods. Leptosporosis is like that. The first week is flu-like. Then you get better. Then your kidneys shut down or you become paralyzed or some other horrible shit that will kill you. Catching it in the flu-like state is key to improving outcomes. If it is biphasic, that really complicates things. The 14 days may only be the first phase. The second phase isn’t necessarily worse, it’s just different. But you might still be contagious after your symptoms go away. Anthrax is also biphasic. Again, flu-like for a few days, then you get better, then system shock and you die.
Immanentize
@Nicole: It is slightly interesting about Wilson, but that Mofo was racist and plain long before 1918.
Martin
@Goku (aka Amerikan Baka): That’s not a dream, that’s aliens. How does your butt feel?
L85NJGT
@Martin:
NO PROBING
Mousebumples
I think 2%death rate might be a bit high, but I agree that age and smoking status play a large role. I’m on my phone but I’ll see if I can find an analysis of the infection and death rate from the cruise ship that enacted quarantine off Japan. Those numbers were under 2%and both deaths were in patients over age 80,iirc.
Major Major Major Major
@Martin: HIV also presents as flu-like at first (obviously I am not saying that coronavirus is like HIV)
Very unfortunate if reinfection is possible, or if it’s biphasic/contagious after discharge.
Martin
@Hoodie: Changing the transmission rate is key to knocking this down, even if we don’t have a vaccine. If you can get it down from 2-3 people per infectee to below 1, then you’ve set a course for the disease to burn itself out. That’s why quarantine achieves. That’s what China appear to be achieving with some success, thanks to some herculean efforts (which could have been avoided if not for their Trump-like handling of this in the beginning). My fear is that if we’ve similarly missed our window of opportunity, that we won’t have the policy/economic options to replicate that herculean effort.
Another Scott
@Martin: I’m not an MD.
There’s also things like being “colonized” with bacteria. E.g. my understanding is that just about everyone has MRSA on their skin these days, and even in their nose. But not everyone has a life-threatening MRSA infection, fortunately.
(I understand that bacteria and viruses are different. ;-)
I don’t know if this new coronavirus is like that or not. Presumably people are checking for things like that…
:-/
Cheers,
Scott.
Martin
@Mousebumples: 705 contracted it, and at least 5 died.
Mousebumples
cidrap.umn.edu/news-perspective/2020/02/study-72000-covid-19-patients-finds-23-death-rate
Not what I was looking for, but this references a JAMA paper so probably more accurate. Haven’t dug into the details though.
Another Scott
@Martin:
TheHill says 6 deaths from the Diamond Princess.
:-(
Few details, other than he was apparently an ex-pat UK.
Cheers,
Scott.
L85NJGT
@Martin
There also could be a not yet understood transmission vector (like Legionnaires) that leads to higher mortality.
Another Scott
TheHill summary posted today:
(Emphasis added.)
Cheers,
Scott.
Poe Larity
So there will be no party conventions. This could impact Trumps stadium campaigning.
Major Major Major Major
@Poe Larity: I’d like to snark that I encourage the MAGA crowd to pack themselves into stadiums… but they’re also probably the types to go outside after they become horribly ill, and one imagines they have families too.
Enhanced Voting Techniques
No, just the usual of being attacked by a monster in my bed while a dwarf in a tuxedo watches that everyone gets.
snoey
@Martin: Simplest explanation is that rectal tests show positive longer than oral tests. No evidence of fecal/oral trasmission though.
Roger Moore
@Martin:
I would be deeply skeptical of the numbers coming from China right now, almost as skeptical as I would be of numbers coming from Mike Pence.
Mai naem mobile
JaneE
Our flu numbers are bad enough with flu vaccines, built up immunity, and fairly effective treatment when caught early enough. Even if COVID-19 turns out to be just like the flu (which it isn’t) we have no vaccine, no built up base of immunity, and treatments that are of unknown effectiveness. That makes slowing it down pretty much our only course of action. At least we may learn about the effectiveness of current anti-virals pretty quickly. The rest, not in time to do anything about the current situation.
LuciaMia
Now thats gonna cause some hard core withdrawal for our Narcissist-in-Chief. Even Hannity cant provide enough ass-kissing to make up for that loss.
Feathers
From the twitters: Today’s the day Otomo warned us about in “Akira” in 1988: “147 Days to the Tokyo Olympics.” (Now ours is in similar danger of being cancelled, too, which is another eerie coincidence.)
twitter.com/Matt_Alt/status/1233219420589133824
Bill Arnold
@MazeDancer:
Also see “Table 1 | Selected repurposed drugs in clinical development to treat COVID-19” in this from yesterday.
Coronavirus puts drug repurposing on the fast track – Existing antivirals and knowledge gained from the SARS and MERS outbreaks gain traction as the fastest route to fight the current coronavirus epidemic. (Nature Biotech, news, 27 February 2020)
MazeDancer
@Poe Larity:
Let us hope. Because they’re all crazy enough to want to gather in a stadium to prove the media hoax.
Fortunately, Trump is a germaphobe and will know he, himself, would be a big risk, so he might have to switch to Pay Per View. Which would be so much easier for him to grift
Immanentize
@JaneE: That’s not entirely true — we are actually pretty good at dealing with secondary infections (like pneumonia) which keeps our flu death rates low. Those same protocols will likely be just effective with the secondary infections from Covid-19. Many of the people who have died from the virus have actually died from pneumonia. So that is where our medical experiences will be helpful in this country.
Cermet
There is some dramtic ignorce of facts here; not anyone one’s fault but here are the facts on this part of this illness being discused:
THIS IS NOT THE FLU! It has no relation to what is called the flu. The cornona virus is in the SARs family. It DOES NOT behave as do flu’s. People calling this the flu and indicating flu’s wan in spring are providing false information and need to study facts before posting.
Fact: NO ONE – zero – knows if this will or will not continue through warmer weather; currently, in Sinapore it is spreading and it is in the 80’s there. So, that does not look good.
This is NOT the flu and should NEVER be posted with that name combined nor directly used in place of the more common name Corona or its actual offical name (COVID-19).
edited to remove response to original comment that is no longer there.
MazeDancer
@Bill Arnold:
Here’s hoping they find a treatment that works. And is easy and affordable enough to administer.
Which is often tricky with anti-virals.
Anti-virals are tricky because even the “proven” ones don’t always work. Probably, because virusses are tricky. it’s like every virus works differently in every body.
I can’t take the drugs because the side effects are pretty close to life-threatening for me. And there is not even a guarantee they’ll work on my condition. So, weighed the risks, and both my doctor and I decided no. Which is why I am on a different regimen.
But they found something that helps stop AIDS, so it’s not impossible. And goodness knows there is an incentive. If they could figure out a “pill” – not an expensive infusion – that could work on a flu like virus: Gold mine.
ByRookorbyCrook
Anyone see Randall Flagg during the Nevada caucuses?
The problem is there is just too little confidently known about this virus. The possibility of it being biphasic would skew all the existing data. All we do know is that we do not have the best health care system to address this pandemic and can not count on our Federal government to assist in a positive fashion. So we need to have the best individual practices we can. The Nigerian Health release linked up above is a pretty good list of practices.
Major Major Major Major
@Immanentize: We’re good at dealing with secondary infections until we run out of hospital beds, masks & goggles & gloves, and antibiotics.
Nicole
@Immanentize: Yeah, but Wilson’s moral character doesn’t have anything to do with history attributing a stroke to what may likely have actually been the Flu. Last I checked, viruses don’t select hosts based on intrinsic moral worth. Anne Boleyn may have been a conniving man-stealer or an innocent victim of a despot (or both) but it doesn’t have anything to do with her contracting and recovering from the sweating sickness.
Although I guess one could claim to find some kind of ironic justice in it since Wilson, as the article also discusses, put a clamp down on any sort of “morale threatening” news during WW1, which was taken to include the Spanish flu. ;)
Barbara
@Immanentize: Pneumonia is as much a cluster of pulmonary symptoms as it is a specific pathogen, though there are certain pathogens that are closely identified with pneumonia (some of which have vaccines). The “pneumonia” associated with Covid-19 is the lung’s reaction to the Covid-19 virus. My understanding is that it is not a secondary infection (though no doubt, you could get a secondary infection, especially from the use of a ventilator).
JR
In some sense the original name for the virus (SARS-CoV-2) is informative. It is genetically quite similar to the original SARS virus, and has a fairly high mortality rate although nowhere near as high as SARS’ 9%.
What makes this virus so damned concerning is the long incubation time and the asymptomatic period where it is contagious.
Mike in NC
We can all sleep soundly knowing that a Nobel Prize winning scientist like Mike Pence is on the case, unless he needs to attend several fundraisers with fat cats and religious nuts.
Martin
@Barbara: Yeah, my understanding is that there’s viral pneumonia, bacterial pneumonia, and then pneumonia as a set of symptoms of other illnesses. I’ve had viral pneumonia, and my aunt developed pneumonia symptoms from her bout with West Nile.
Martin
@Major Major Major Major: We’re going to run out of hospital beds in a hurry. Many regions of the US were already running shortages.
germy
@Cermet:
Thank you.
Steeplejack
This situation still has an air of unreality about it. (I’m speaking on a personal level.) I had a long telephone conversation last night with my old friend in Las Vegas about a trip I’m making out there in mid-March (family business), and it didn’t occur to me at all until long after the conversation to wonder whether I should cancel the trip. (I don’t think I can—lots of moving parts.)
At the macro level, something else that occurred to me late last night that I don’t think I have seen addressed in the media or even in the back alleys of Twitter: As a hypothetical, what if you’re an elderly white male politician, maybe not in the best of health—sedentary with a dreadful diet, say, or perhaps recently had a heart attack of unknown severity—and you’re out pounding the campaign trail or doing mass rallies in the time of COVID-19? All that meeting and greeting, gripping and grinning . . . Makes you think.
For that matter, what about the Democratic convention? Probably it doesn’t matter if the Republican convention is canceled, because their candidate is already set (but see previous paragraph), but a COVID-19 pandemic, or even sub-pandemic “event,” could greatly complicate things if the Democrats need a convention to settle an unresolved candidate race.
And what about the primaries themselves? A lot of people out and mingling with a lot of other people. Or not, and thereby suppressing turnout.
Obviously, it’s not time to panic, but as I start to think about the situation I see that there are wheels within wheels within wheels.
And don’t get me started on the “supply chain.” The service industry is riddled with low-paying, bad- or no-insurance jobs where people can’t “work from home” or even afford to take time off if they get sick. What happens when you’re safely holed up in the bunker but you can’t get deliveries from Amazon because everybody’s drivers are out?
Barbara
@Martin: It’s highly specific to the locality. Many urban centers (and some states) have more beds than they need. Indeed, many hospitals are “licensed” for a certain number of beds but are only “operating” at a reduced capacity. Where it gets scary is in places that have had hospital closures. Arguably, these places are at lower risk because they tend to be more isolated, for instance, less likely to have tourists or commercial travel as a component of their economy. There is no doubt that if we have anything like what we see in China, there will have to be ad hoc conversions of existing hospital space under waiver of certification authorities
ETA: For instance, some places would likely need to cancel elective surgery or admissions to accommodate acute episodes of the virus.
burnspbesq
OT:
A panel of the Ninth Circuit upheld the District Court’s preliminary injunction against “remain in Mexico.”
hitchhiker
@Barbara:
I read that on TPM. In China almost half the men smoke, but only 1 or 2 % of women do. So if being a smoker exacerbates the degree of illness, you’d expect more men to get it worse.
Steeplejack
@L85NJGT:
LOL. This reminds me of the joke one of my dermatologists made to me about skin cancer: “Stay out of the sun 40 years ago.”
JR
@Mallard Filmore: That’s part of it, but rhinoviruses (which cause the common cold) lose a substantial part of the infectivity as humidity increases. I believe this is also true for influenza.
trollhattan
@MazeDancer:
Found this address by Ca Public Health Officer Sonia Angell yesterday, helpful laying out the facts and plans, going forward.
Good to see the governor there. Not playing golf or yelling at fans.
Subsole
@Goku (aka Amerikan Baka):
Huh. I woke up in Vegas.
germy
Here’s a photo from over 100 years ago:
Ca. 1918-1919. “Precautions taken in Seattle, Wash., during the Spanish Influenza Epidemic would not permit anyone to ride on the street cars without wearing a mask. 260,000 of these were made by the Seattle Chapter of the Red Cross which consisted of 120 workers, in three days.”
Subsole
@ByRookorbyCrook:
Flagg? Thought he was the king’s magician.
Martin
@Barbara: Yeah, I was thinking rural areas. Worth noting, Solano is considered to be relatively rural.
Baud
@hitchhiker: Second hand smoke may be just as bad.
wvng
I asked a doctor friend how quickly he thought a vaccine could be developed. He threw cold water in that by saying a successful vaccine was never developed for the closely related SARS virus. He hopes it goes better with this one.
Steeplejack
@Poe Larity:
Okay, just saw this.
Elizabelle
@Steeplejack: Great minds. My comment from Cheryl’s coronavirus thread yesterday.
You’re a leading Democratic candidate, elderly white male, recently a heart attack survivor (maybe not for the first time — who knows?), and your job requires constant mingling with
the great unwashedAmericans, in large groups, plus — apparently in your view — shouting constantly too.How will you fare with the coronavirus out there?
Good point about the Dem convention in Milwaukee. Great unknown at this point.
But also about volunteers not being able to make the voter contact, due to their own health or folks not being at the doors — or opening them.
Or people thinking twice about attending candidate events. C-Span might be your friend if the coronavirus is rampant in your community.
Uncharted waters.
germy
@Baud: That reminds me of the essays Pence wrote a few years back, claiming cigarette smoking was not linked to cancer.
comrade scotts agenda of rage
@Major Major Major Major:
My thoughts were along the same lines: I used to think it was a work of fiction.
EmbraceYourInnerCrone
@The Dangerman: I don’t know but the temp today in Singapore is 79. Hong Kong’s high was in the 70s. The UAE temp today is about 70. They all have active cases so I am going to guess warmer weather is not going to make this go away
Martin
@wvng: Ebola came together somewhat quickly once the right countries started to give a shit, but it was also a case where they could skip a number of the trials because, shit, you’re gonna die from it anyway.
They won’t do that with Covid-19. The trials will take 2-3 months each. And for Ebola they were only making thousands of doses. We may be looking at millions here. You have to grow vaccines. It doesn’t scale great.
?BillinGlendaleCA
@Baud: Then you wouldn’t have a wide difference in mortality rates between women and men in that case.
chris
Thread.
germy
The CDC designed a flawed test for COVID-19, then took weeks to figure out a fix so state and local labs could use it. New York still doesn’t trust the test’s accuracy.
Crashman06
Don’t worry, guys. Pence said there’s only one American with the virus still in the hospital. This is fine.
Baud
@?BillinGlendaleCA:
Ok, maybe not just as bad, but you would think women in China are around a lot more second hand smoke than here given the different smoking rates.
OTOH, you may have more women smokers here than in China.
trollhattan
@Martin:
Solano is agricultural but also has cities that are bedroom communities to the Bay Area and–ta-da–Travis AFB where they repatriated and quarantined the Americans from that cruise ship.
trollhattan
@Baud:
First visit with my current primary care doc, he’s running through the medical history checklist.
Do you smoke?
No.
Did you ever smoke?
No
Not at all?
No.
Did your parents smoke?
Yes, both, but mom eventually quit.
Okay, then you did smoke.
Sigh.
hitchhiker
@Baud:
Sure. This was more an observation about what might be causing the virus to be having a worse effect on men.
Of course, all of this assumes that we can trust data from China in the first place.
jl
Role of smoking is still uncertain, but seems to be something to it.
Very definite data on much higher risk for people with diabetes, uncontrolled hypertension, COPD, and pulmonary and cardiovascular disease, and very especially in people over 50. But all of those are related to long term smoking, so may be hard to untangle the different effects.
We also don’t know what the basic reproductive number will be in different countries. That number is not a constant fact of nature. It’s a function of probability of transmission per infected individual with a given rate contact per a given time interval and the rate at which infected individuals are removed from exposure to the susceptible population (through recovery, admission to hospital and presumably removal from contact, or self quarantine). And it assumes that everyone the infected person contacts is susceptible. Different variations on the basic reproduction number are what will drive actual spread in different communities, with different initial proportion of population, and different control measures. Hard to know how fast the disease will spread in the US from estimated made in Wuhan.
So, huge uncertainty in how the pandemic will play out in different countries. The worry about the uncertainty is hard to deal with, in terms of planing and mental stress.
Steeplejack
@chris:
This is a must-read.
Avalune
My coworker’s husband has the flu. I found my workplace patient zero! I asked Leto to pick up some dog food, a giant can of chocolate pudding and a crossbow.
I make jokes because … it’s the only way I can cope with things right now.
Mnemosyne
Serious question: I was going to take the subway to downtown LA this weekend. Should I drive instead?
LeftCoastYankee
I read about an example of the containment impact today.
There’s a multi-day bicycle race in the UAE which was cut short when two staff members on one team tested positive for Covid.
They’ve got the riders locked down waiting for test results, and they could be quarantined up to 14 days. It wasn’t clear to me what the criteria for the lockdown would be (e.g. testing positive or just exposure to someone who tested positive).
I don’t know if this is going to be the standard for containment, but that could be crazy disruptive.
Of course letting someone who could be infected run off to The Netherlands (or wherever) for the next race would be worse.
trollhattan
@Avalune:
They make giant cans of chocolate pudding?!?
Dogfood story: last time I picked up Rocco’s economy-size sack of kibble the trunk was full so into the passenger seat it went. Driving home a chime started up and it was the car telling me I had an unbelted passenger. No place to safely stop to belt the sucker in, so it was an aggravating drive.
And now I know where angry drivers come from. Stupid dogfood.
Martin
@trollhattan: Still rural by CA standards. Vallejo isn’t, but Vacaville looks like Iowa City without the university. It’s more urban/suburban, but the agriculture is still everpresent. The county has 1% of the state population. It’s got the same economic problems that would lead to rural hospital closures, as well as the same difficulty of community spread as other rural areas would have. The upside is that Davis/Sacramento anchors it on one side and Oakland/SF on the other, so it’s only an hour drive or so to a top flight hospital.
But if it can spread in a place like Vacaville (TBD) then it can spread anywhere that has seen rural hospital closures.
Mnemosyne
@MazeDancer:
An allergy warning: coconut oil can cause a cross-reaction for people who are allergic to milk. One of my coworkers found this out the hard way, but fortunately her EpiPen was nearby.
jl
Also important to remember that the control method of mass population quarantine of a whole city without much ability to limit spread within city (perhaps because prevalence of infection vastly underestimated) produces a much more intense and scary, and rapidly spreading epidemic inside the city. The control method makes things inside the city far worse, though for a shorter period of time.
The epidemic may look very different in other countries. Different control measures may produce as much damage, but less intense and spread out over a much longer period of time. If control measures really effective in the US, there is a danger of letting up on control measures too soon, if expected disaster is not as spectacular as expected. Which would probably lead to an unexpected very bad flare up in the disease.
As I said, best case is that the new virus is added to type of control for serious STDs and TB, permanently. It will always be with us, and we can never let up on control. And if we keep up an effective control program, won’t be too disruptive.
chris
@Steeplejack: I thought so.
Dorothy A. Winsor
Stock market down 350 points today. What a week.
Fair Economist
@Cheryl Rofer: The 2009 Swine flu shows summer won’t save. It kept on increasing through July, backed off a bit, then soared even higher in the fall.
trollhattan
@LeftCoastYankee:
When you think about it, a stage race is the ideal sporting event to expose riders and support staff, since they move from city to city daily for as long as three weeks (TDF). I’ll award second place to the NBA, who fly to a new city two or three times some weeks. Luckily they’re all charter or team planes, not stuck with riffraff like ourselves.
Martin
@trollhattan:
A) Yes. Worked in the cafeteria in college and got access to many giant cans of chocolate pudding (about a gallon, maybe a bit less) and institutional sized bags of jello mix – just add 5 gallons of water.
B) Japan has us covered, though. Sliced mayonnaise and sliced chocolate (like american singles in texture, but chocolate, so I think of it more as a heavily skinified chocolate pudding)
Orange Is The New White
@ByRookorbyCrook: He’s waiting for the conventions.
Fantastic novel, never wanted to live it in real life.
Mr. Kite
@MazeDancer: stop talking about herbs and supplements as antivirals ffs.
You say a doctor prescribed you this. Was it a GP or immune system or virology specialist?
Martin
@LeftCoastYankee: Exposure is the standard right now.
trollhattan
@Martin:
All true, and I’ll wager Vacaville’s (literally Cowtown) working population nearly all work at the Air Base or in the Bay Area.
Vallejo is effectively the Bay Area, being west of the coast range. They would be Contra Costa if it weren’t for the pesky river.
trollhattan
@Dorothy A. Winsor:
Just a third of yesterday? “Winning!” [every Trumper with a voice left]
Avalune
@trollhattan: Before it went really silly and frustrating, Walking Dead had a transitional scene with a character just enjoying this giant can of chocolate pudding and the other characters kind of doing semi normal things before all heck broke loose again. So when I think of zombie apocalypse, I think of a giant ass can of puddin.
tvtastic.files.wordpress.com/2014/02/carl-pudding.png
JR
@Martin: Also VHF like Ebola, and Marburg, and Rift Valley before it, are self-limiting in a way that COVID is not.
Steeplejack
@chris:
God, I’m still reading comments on that thread and getting PTSD from my time at Barnes & Noble. As people point out, it’s not just fast-food places, it’s retail (and service) in general.
Major Major Major Major
Unfortunately it is actually named after a Mr. Vaca.
LeftCoastYankee
@trollhattan: Yeah it sounds like the quarantine is in some luxury hotel in Dubai, so no riffraff like us.
The more I think about it professional cyclists at the World Tour level would be a nightmare for exposure and spreading it.
They can have 2 active races going, swapping team members and support staff at each race. They’ve already raced in Australia, China, Spain, Portugal, Columbia, Argentina, UAE, Saudi Arabia and Italy.
Then a good number of the racers are borderline anorexic and stress the hell out of their immune systems with racing.
The only good thing is the fans are usually less in number and spread out more.
Ok the “who to avoid” rabbit hole sucked me in.
trollhattan
@Avalune:
Great pic! I’m inspired. Looks like a young Raylan Givens enjoying watching the locals in Harlan County.
trollhattan
@LeftCoastYankee:
My go-to sports cringe is mountain stage summits where the crowd closes in and even chases the riders, to the point there are crashes and punches handed out. Nothing quite like a dude in Speedo, cape, and viking helmet toting a trident while escorting you up the mountain to let you know you’re not in Cannes.
Yutsano
@Avalune:
Can I come over?
Kathleen
@MazeDancer: My General Practitioner prescribed Taurine, Gabba, NAC and Green Tea Extract for my panic attacks and they have helped me. Thanks for the information
trollhattan
@Major Major Major Major:
Am sure the fine citizens of Manteca convince themselves they’re named for a misspelled “Mr. Monte.” :-)
trollhattan
@Kathleen:
“Gabba”? Like the Ramones? Hey.
LeftCoastYankee
@Martin: Thanks for the info.
This could get messy.
chris
@Steeplejack: Yep. I spent the last eight years of my working life in retail.It sucked, glad it’s over.
Don’t forget that child and elder care are also considered “service” and don’t pay much.
Peale
@wvng: Wouldn’t matter. Once there was a vaccine, there won’t be money to produce it and to create that money, Congress will need to ensure that no undocumented immigrants, lucky duckies who are above the poverty line, layabouts, residents of sanctuary cities and prisoners will receive one.
trollhattan
My congresscritter has words for our Corona Czar.
sacbee.com/news/local/health-and-medicine/article240731281.html
chopper
@Major Major Major Major:
okay, so it’s mr. cowtown.
Cheryl Rofer
LeftCoastYankee
@trollhattan: Ha ha! The Grand Tour mountain top finishes are awesome with some very silly fans.
My favorite is there always seems to be one guy (usually dressed like you described), who may have had a few cold ones waiting for the riders, who suddenly decides to run sideways up hill and gets overwhelmed by the effort/attempt, and lands on his ass.
Probably the only positive of the UAE race was no crazy speedo fans.
Steeplejack
@Cheryl Rofer:
About 61,200 people died in the “moderate” 2018-19 flu season. If COVID-19 wafts through the population like flu, with its higher (estimated) mortality rate, that’s 1.2 million deaths.
If doing a lot of work there, but sobering nonetheless. And a useful rejoinder to nitwits who quote Trump saying it’s “just like the flu.”
Argiope
@Mnemosyne: right now you’re at much higher risk from an auto accident than COVID-19, so I wouldn’t change that plan. Just move your seat if someone around you is coughing.
trollhattan
@LeftCoastYankee:
I’m incapable of not watching TDF, there’s something oddly mesmerizing about the peloton winding its way though the country, and then suddenly a race breaks out. Phil of course is an integral part of the experience (r.i.p. Paul) and some of the riders are true characters.
Upset there’s no Amgen Tour 2020 and hope to hell they can land a sponsor and bring it back next year.
ghost cat
Some odd news about the patient in northern CA who was the first one identified as possibly community-acquired infection. She wasn’t tested for COVID-19 several days after admission to hospital because she didn’t meet criteria:
latimes.com/california/story/2020-02-26/california-coronavirus-case-could-be-first-spread-in-u-s-com…
She was then transferred to UC Davis Medical Center and now moved to undisclosed location.
sfgate.com/bayarea/article/San-Mateo-county-coronavirus-repatriated-patient-15092052.php
Anyone know if this is a typical move by CDC under the current state of the pandemic? Or a way to hide what’s happening to this patient?
trollhattan
@ghost cat:
OMG, “Dr.” Dick Cheney and his undisclosed location/clinic. Run away!
It seems very a odd action by the CDC but we’re all left guessing what any policy might be ATM.
LeftCoastYankee
@trollhattan: I agree totally. It’s like getting a lightweight mellow travel documentary with sporadic athletic drama throughout. And there’s a new Episode every day for 3 weeks.
I hope the TOC comes back. I watched the Tour of Utah last year and it was a competitive race despite being second tier.
However, there were numerous routes through tacky suburban neighborhoods, which is pretty lame given all the natural beauty in Utah.
GC
From what I see, we don’t have a basis for a mortality rate. We have a fair sense of how many died, no way of knowing how many have been infected, other than a lower bound. If a significant number of asymptomatic cases were not detected then the mortality rate is lower. That would be nice.
I also haven’t seen anything that suggests an upper bound for the infection rate. Given that there is no vaccine, it would seem very challenging to limit the spread once it takes hold.
I appreciate the information that has appeared on this site. I’m old and not particularly vigorous. I expect to be spending more time at home as this develops.
evodevo
@Martin: Yeah, but when I was in Fairfield staying near the airbase a few years ago visiting the grandkids, Vacaville was the place to go for shopping at Wallymart and going out to eat, etc., only a couple miles north. Oh, and Solano prison is there too.
evodevo
@Fair Economist: Yes. Both the hubby and I caught it, probably from an airplane trip out to Texas, in May. We were still coughing horribly 2 months later. Not a pleasant disease…
jl
@ghost cat: Who knows? An innocent and common sense explanation would be that at UC Davis the patient was in high tech room that was expensive and may be needed for more important cases that might come in, or they felt the patient may need intensive treatment quick.
Now there is no problem with patient prognosis, and confident self quarantine in a lower tech place is OK. Just want to point out that there are innocent and common sense explanation.
Being somewhat hush hush about to not risk unjustified panic.
I trust career CDC and health professionals to do the right thing. We should worry about Trump and Pence and how far they can reach down into where the action is.
From utilization and cost estimates I’ve read, health people are very very (very) worried about health system overload and breakdown if we experience something even half as bad as what happened in Wuhan. So conserving adequate health care capacity is a very high priority. And if a full blown epidemic begins, timely placement of patients is of the essence. Having to wait even half a day to get a patient out of room they don’t need might be very costly and a big problem if people come in who need it.
Sister Golden Bear
@ghost cat Best guess is that they were moved to a big region Kaiser hospital, or more likely to be near the Stanford Medical Center. The Stanford hospital is in Santa Clara County, but Stanford opened a huge medical complex nearby (in SMC) which may a suitable containment facility.
Ruckus
@Mnemosyne:
I’m taking the metro system to West LA on Monday. I’m not terribly worried about it yet. I will talk to my doc there and see what else I might need to do, given my age and my current health status. Which isn’t bad in context but my age puts me in one of the more obviously bad groupings.
Fair Economist
@Martin: The clinical course of this disease does seem to be kind of biphasic. The first few days patients have flu-like symptoms. These fade and many patients even stop having a fever, although anecdotally many continue to feel bad. Then the pneumonia sets in.
Seems plausible that in at least some people it could be more genuinely biphasic, perhaps in those who have slow onset of frank pneumonia.
Mnemosyne
@Ruckus:
I still need to talk to my brother who lives with her, but we may be lucky that my mom with COPD is already a hermit who hates going out where people are. We should probably encourage that, for once.
Aaron
How do we have a population of 325M and an annual death rate of 2.8M?
doesnt a life expectency of <80years imply somewhere around 1.2% of the population would die each year? (3.9M/yr or ~10,600/day)
Are there just a lot of people dying who dont make it into CDC numbers?
Mnemosyne
@Argiope:
We already know that Covid-19 is in California and it’s going to spread pretty easily here since people travel within the state quite a bit, so it’s not a totally irrational question. It’s more a question of when it gets down here to the Southland, not if.
If I thought my surgical masks from Daiso might do any good, I would wear one, but it sounds like they wouldn’t. ?♀️
Martin
Second case from unknown origin in CA. This time in Santa Clara county – in Mountain View. This is 70 miles south and 2 million people away from the Vacaville case.
Santa Clara county is silicon valley, where a shitton of people fly to China on a regular basis.
My prediction holds – there are hundreds of cases in the state, but because we’re not testing people, they’re just running around doing their thing. The instructions I got last night indicated that I only needed to self quarantine if I’d flown to China in the last 14 days. That’s a good week out of date now. It should include South Korea, Japan, Iran, and Italy.
Mnemosyne
@Aaron:
Because people have babies. ?
Also because of immigration, both legal and illegal.
Martin
@ghost cat: A bit of both, I suspect. There’s a big uproar near me over moving the patients from Travis to a local facility. It’s about 90% NIMBYism (which we could win olympic gold at if it were a sport) but about 10% valid as the facility isn’t appropriate for those kinds of patients and there’s no component to change that. China built a ‘hospital’ in 2 weeks for this. It wasn’t a conventional hospital, it was just a negative pressure dorm with bare bones medical facilities, but that’s fine. But there’s no plan to even bring this existing facility to that same level. It would take 2-3 days tops.
But one of the things the CDC does need to do, which people won’t like, is to move them out of tier 1 facilities into basically a hospice like quarantine facility removed from general traffic. UC Davis medical center (which is in Sacramento, not Davis, in case people were confused about that) need to be available for intake, and for other medical issues that come up and can’t really afford to be a long-term Covid facility. They triage, stabilize, and ship out, and CDC should be tipping up suitable facilities as if they were on a war footing. That’s the part we’re not seeing.
Given that the feds have ZERO credibility on any of this, and don’t seem to be changing any time soon, I see no reason to give them the benefit of the doubt that this isn’t also to tamp down information as well. I mean, part of today’s urgent Covid legislation was tax cuts. Because the problem isn’t mass casualties, it’s the effect of mass casualties on the stock market.
Thats right, the GOP is going to tax cut our way through the pandemic.
Mnemosyne
@Martin:
Two people from our office were supposed to fly to Milan starting next week, but that ain’t happening anymore.
Martin
@Mnemosyne: I would suggest that paying more than $1.50 for surgical masks might be a thing to consider.
We love Daiso, but not for everything.
joel hanes
@ghost cat:
There is now a second case in the Bay Area who has no known link to anyone who travelled to China. This one’s in Santa Clara County.
Where I live.
Where I was planning to attend, with most of my family, the wonderful IFES February Crab feed tomorrow night, to eat Dungeness crab in cioppino with a thousand other people.
I’m reconsidering.
Ruckus
@Aaron:
Yes, yes there are. Boomers make up a large portion of the population and are, like me getting into our 70s. I’ve stated here before that over the last 3 yrs I’ve seen 12 friends pass who are all younger than me. Only 1 of them was not health related and 1 was suicide over life long health related issues he was born with. People alive today generally start dying of age/health related issues around 65. Those other 10 people were all in their 60s. I’ve known people over 100 as well, and known several in their 90s. Mom passed the day before her 95th birthday. Her daughter passed 4 yrs earlier at 66.
Fair Economist
@Aaron: We are not yet to a steady-state population distribution. The percentage of old people is less than it would be if we had had current birth and death rates for 100 years. So the observed death rate is lower than it “should” be.
Fair Economist
@Aaron: We are not yet to a steady-state population distribution. The percentage of old people is less than it would be if we had had current birth and death rates for 100 years. So the observed death rate is lower than it “should” be.
@Martin: I saw a convincing report of a third highly suspected case in Orange County on twitter yesterday. The report was supposedly coming from an examining doctor, and the doctor is real. It sounded like the patient wasn’t yet on respiratory support and was still in the general population. Since I live less than 10 miles from the clinic, yay for me.
The NIMBYism for quarantine facilities isn’t nuts. Patients do escape and obviously you don’t want that in your neighborhood. A military base is often a pretty good quarantine location precisely because it’s often hard to get away from, as opposed to an old dorm in the middle of a massive metropolitan area.
Ksmiami
@JR: because everybody dies. The end. I read the hot zone scared the crap out of me
Martin
@Fair Economist: No, I get that. But the thing with collective action problems is that you have to step into the solution even when it’s not clear you’ll benefit because if you don’t, and it’s you with the disease and you needing a bed and everyone else co-ops your arguments, then you’re fucked.
It’s hard. You have to be willing to sacrifice a bit of your own worth or safety or whatever. We used to be able to do this. People volunteered to fight the Nazis even though they might die because if nobody volunteered, then we’d possibly all die.
Fair Economist
@Martin: Yeah, I get that. I was OK with evacuees at March AFB out past Riverside. Costa Mesa seemed very inappropriate given that March was available.
ziggy
This has been a really interesting thread, lots to chew on. I appreciate all the new information and perspective. The upshot seems to be that there is a LOT we don’t know yet. It’s going to be critical to find sources of information that we can trust. For me, I’m not terribly concerned at this point (me and my husband are not in a bad demographic, our elders are already gone), but I can see how this could really do a number on others economically if not physically.
Martin
@Fair Economist: If this breaks out, that facility will be needed – so why isn’t the CDC getting on the ball and getting it upgraded?
The courts are going to have to STFU on issues like this if this breaks out – you can’t constantly second guess and back seat drive through an epidemic. It’s going to be hard enough to get this under control.
And this is why I’m pessimistic about our federal response. We don’t have the iron fist that China does or the technocratic responsiveness that Singapore does. We’re going to fumble through this. We separated kids at the border and then lost track of them. How on earth are they going to track tens of thousands of quarantined individuals, care providers, and all that across countless non-integrated systems. One benefit of single payer – you have a single central EMR you can use for this. We don’t have anything like that.
Martin
3rd case of unknown origin, this one in Oregon.
CA has over 100 nurses under quarantine for the few cases we already have. We’re going to have to hazmat up an intake facility at many hospitals to deal with this, and isolate it from the rest of the hospital. Apparently China had a real problem of people getting infected at the hospital because they were slow to do this.