Everyone knows that we're facing a real crisis from the coronavirus. But do you know how we got here and what we need to do next? Ron Klain, former White House Ebola Response Coordinator, breaks it down for us: pic.twitter.com/XRkIw2EzM4
— Joe Biden (Text Join to 30330) (@JoeBiden) March 21, 2020
Gideon Lichfield, at the MIT Technology Review, “We’re not going back to normal” includes a good explanation of the infamous Imperial College ‘Eighteen Months’ prediction:
… It’s now widely agreed (even by Britain, finally) that every country needs to “flatten the curve”: impose social distancing to slow the spread of the virus so that the number of people sick at once doesn’t cause the health-care system to collapse, as it is threatening to do in Italy right now. That means the pandemic needs to last, at a low level, until either enough people have had Covid-19 to leave most immune (assuming immunity lasts for years, which we don’t know) or there’s a vaccine.
How long would that take, and how draconian do social restrictions need to be? Yesterday President Donald Trump, announcing new guidelines such as a 10-person limit on gatherings, said that “with several weeks of focused action, we can turn the corner and turn it quickly.” In China, six weeks of lockdown are beginning to ease now that new cases have fallen to a trickle.
But it won’t end there. As long as someone in the world has the virus, breakouts can and will keep recurring without stringent controls to contain them. In a report yesterday (pdf), researchers at Imperial College London proposed a way of doing this: impose more extreme social distancing measures every time admissions to intensive care units (ICUs) start to spike, and relax them each time admissions fall…
What counts as “social distancing”? The researchers define it as “All households reduce contact outside household, school or workplace by 75%.” That doesn’t mean you get to go out with your friends once a week instead of four times. It means everyone does everything they can to minimize social contact, and overall, the number of contacts falls by 75%.
Under this model, the researchers conclude, social distancing and school closures would need to be in force some two-thirds of the time—roughly two months on and one month off—until a vaccine is available, which will take at least 18 months (if it works at all). They note that the results are “qualitatively similar for the US.”
Eighteen months!? Surely there must be other solutions. Why not just build more ICUs and treat more people at once, for example?
Well, in the researchers’ model, that didn’t solve the problem. Without social distancing of the whole population, they found, even the best mitigation strategy—which means isolation or quarantine of the sick, the old, and those who have been exposed, plus school closures—would still lead to a surge of critically ill people eight times bigger than the US or UK system can cope with… Even if you set factories to churn out beds and ventilators and all the other facilities and supplies, you’d still need far more nurses and doctors to take care of everyone…
And what if we decided to be brutal: set the threshold number of ICU admissions for triggering social distancing much higher, accepting that many more patients would die? Turns out it makes little difference. Even in the least restrictive of the Imperial College scenarios, we’re shut in more than half the time…
(Excellent graphs & full explanations at the link.)
For sewist volunteers: From the SmartAir Filters website, an in-depth dissection of “What Are The Best Materials for Making DIY Masks?”
(Short answer: Vacuum cleaner bags!)
From the Brisbane Times, “‘It’s a powder keg’: South-east Asian countries grapple with virus”:
South-east Asia’s response to the coronavirus had varied wildly, from world’s best practice in Singapore to possible disaster in Indonesia.
As of Thursday night, Indonesia (309 infections), Malaysia (900 infections) and Thailand (272 infections) had all recorded their largest single-day rises in case numbers. Vietnam (76 infections), Cambodia (37 infections) and the Philippines (217 infections) were recording steady daily rises in infections, while Laos and Myanmar still claimed to have zero cases…
The lessons for other countries to learn from Singapore, Hong Kong, Taiwan and South Korea are that “testing early and extensively, and effective isolation, contact tracing and quarantining has been key to bringing epidemics under control”.
“Any country that hasn’t been able to implement these measures quickly, for whatever reason, is at high risk of uncontrolled community transmission, as we’re seeing now in a number of European countries and the US,” Tam says.
On the face of it, the recent cases in Malaysia are a particular concern – it has recorded rises of more than 100 cases per day for five days in a row, and more than two-thirds of the cases were linked to a three-day mass prayer gathering of about 16,000 people at the Sri Petaling mosque complex in late February.
But Malaysia’s health system is relatively advanced, its doctors and professors well trained and competent. It is better equipped than many nations in the region to handle the outbreak, and the closing of its borders to foreigners – while perhaps belated – will stop more cases being imported…
It’s Indonesia, which has more than 50 times the population of Singapore and which has already reported 25 deaths – despite only confirming its first infection on March 2 – that is causing the greatest concern.
The national government has been in denial about the problem for weeks, with the country having tested about 1500 out of 270 million people, compared to more than 80,000 people tested in Australia and 250,000 in South Korea. Health Minister Terawan Agus Putranto claimed prayer had kept the country virus-free and a tourism campaign has been launched on social media to capitalise on the virus’ alleged non-spread to the nation…
Tam, the epidemiologist, says Malaysia, Indonesia and the Philippines face very specific challenges “because of their large and widely-dispersed populations and the fact that they have very sizeable migrant working populations”.
And while some countries do have the capacity to mount an effective response, “we can’t rely solely on our individual national capacities, because epidemics in other countries pose a continuing risk of re-importation and local transmission. This means that in order to have an effective, coordinated response, we need far greater investment in strengthening health systems region-wide.”
San Francisco has the best, most comprehensible “Stay home except for essential needs” notice I’ve seen so far:
What to do
The City issued a Public Health Order requiring people to stay home except for essential needs.
Vulnerable populations must stay home. People who are over 60 or have a chronic health condition are the most vulnerable to this virus.
Everyone else is required to stay home except to get food, care for a relative or friend, get necessary health care, or go to an essential job.
It is OK to go outside for walks or bike rides if you are not in a group.
Stay at least 6 feet apart when leaving your home for essential activities.
This order is in effect until April 7.
It may be extended depending on recommendations from public health officials…
What can’t I do?
You cannot engage in group activities in person with others.
You cannot have dinner parties. You cannot invite friends over to your home to hang out.
You cannot go to bars or nightclubs.
You cannot go to a nail salon or get your hair cut by a stylist or barber.
You cannot go shopping for non-essential goods.
You cannot take unnecessary trips on public transport or in your car or motorbike…
Something actually encouraging — from Bloomberg News, “The Virus Hunter Showing the World How to Fight an Epidemic”:
As South Korea’s coronavirus outbreak risked veering out of control, with infections rising thirty-fold in just ten days last month, the country’s health authorities got an unexpected break. The secretive religious sect whose meetings were early vectors for spreading the virus had agreed to disclose the names of all 212,000 members — critical information for figuring out where it would appear next.
The deal was brokered, in part, by Jung Eun-kyeong, the head of Korea’s Centers for Disease Control and Prevention, whose management of the response has made her something of a national hero, and a potential role model for virus-fighters elsewhere. Since the agreement with the Shincheonji Church of Jesus on Feb. 25, South Korea has tested more than 320,000 people, a diagnostic blitzkrieg that’s brought the daily tally of new infections to less than 100, compared with more than 900 two weeks ago.
A former small-town doctor who was deeply involved with the response to a 2015 epidemic of Middle East Respiratory Syndrome that killed 38 in Korea, Jung’s daily briefings have become must-see TV for many citizens. Social media buzzes with praise for her straightforward approach to pandemic communications: tell the public exactly what’s going on, but without over-promising about what’s possible…
Although it was one of the first countries outside of China to experience a large-scale epidemic, Korea’s response has been measured compared with the U.S. and Europe. Cities aren’t locked down, many workplaces remain open, and school is likely to resume in early April. The CDC’s aggressive early actions, centered on an enormous but focused testing operation that’s moved far faster than efforts in the U.S. and U.K., were a big part of why it was able to avoid more drastic measures…[I]t’s the approach to testing that’s given Korea its edge. The country approved its first coronavirus test on Feb. 4, just 16 days after the initial domestic case was confirmed. By Feb. 27, four different companies were manufacturing test kits, allowing the authorities to process as many as 20,000 people a day. Jung’s teams, meanwhile, worked on novel methods of administering the tests, from drive-through centers to compact stations that look like phone booths…
Please amplify this important request. https://t.co/dHuOIW4duw is providing critical help to the dedicated frontline healthcare workers who need protection so that they can care for their patients. https://t.co/APeITOaqZ0
— Dr. Angela Rasmussen (@angie_rasmussen) March 22, 2020