The three ideas you all are writing me the most about

1. Segregating old people, and letting others go about their regular business.  Given how many older people now work (and vote), and how many employees in nursing homes are young, I’ve yet to see a good version of this plan, but if you favor it please do try to write one up.  One of you suggested taking everyone over the age of 65 and encasing them in bubble wrap, or something.

2. Tracking and surveillance by smart phones.  Here is one story, here is another.  Here is an Oxford project.  Singapore is using related ideas, China has too.

3. Testing as many Americans as possible, or at least a representative sample, to get data.

I hope to analyze these more in the future.

Comments

You need to stop pretending to be a medical expert and STFU.

It’s hard to be in lockdown, isn’t it? Raises serious anger management issues.

+1 and makes ya so much less credible

Relax, Ray C.

No mention of South Korea regarding cell phone tracking/tracing/notification while linking to something with more than a whiff of vapor ware is pretty clear evidence that Tyler lacks more than medical expertise.

As for 3, that is a sad, sad joke, in light of these two pieces of info from the WaPo live updates -

1, The test has been designed to operate on the company’s automated GeneXpert Systems. There are about 23,000 of those systems throughout the world, of which 5,000 are in the United States, according to the company.

The firm plans to begin selling the test at the end of the month.

2. Health officials in New York, California and other hard-hit parts of the country are restricting coronavirus testing to health-care workers and people who are hospitalized, saying the battle to contain the virus is lost and we are moving into a new phase of the pandemic response.

As cases spike sharply in those places, they are hunkering down for an onslaught, and directing scarce resources where they are needed most to save people’s lives.

If you can not track the virus as it spreads, you have already completely lost any chance to keep the number of deaths down, by trying to ensure those infected effectively self-isolate, instead of going to work or shopping.

It's clear enough by now from watching Europe that containment via testing is impossible. At this point, continuing to suggest it is just more of prior's politically motivated disinformation.

Containment has not been even an imaginary option since mid-February or so.

Please try to keep up.

20% of the country will soon be unemployed and available to be trained for gathering tests, processing them, and operating ventilators

And they will have no problem being equipped with PPE in the next couple of weeks either.

A pandemic is not a Hollywood big budget movie, it is reality. Though as Poe knew, it can make for memorable stories.

This is an interesting example of the sort of testing that no nation has been able to perform. theguardian.com/commentisfree/2020/mar/20/eradicated-coronavirus-mass-testing-covid-19-italy-vo But in the last two weeks, a promising pilot study here has produced results that may be instructive for other countries trying to control coronavirus. Beginning on 6 March , along with researchers at the University of Padua and the Red Cross, we tested all residents of Vò, a town of 3,000 inhabitants near Venice – including those who did not have symptoms. This allowed us to quarantine people before they showed signs of infection and stop the further spread of coronavirus. In this way, we eradicated coronavirus in under 14 days.

While we believe it is too late to enact this approach in a city such as Milan, where infections are out of control, there could still be time to do this in the UK before the crisis gets even worse: the government could identify and isolate clusters, quarantine everyone affected, trace their recent contacts, and quarantine and isolate them, too – whether they had symptoms or not.

Our experiment came to be by chance. The Italian authorities had a strong emotional reaction to news of the country’s first death – which was in Vò. The whole town was put into quarantine and every inhabitant was tested. The tests were processed by us at the University of Padua. It became clear that this was a unique epidemiological setting – and an application was put in to keep the town in lockdown and run a second round of tests after nine days.

Ray,

I agree. There is a great deal of medical or virus related information in the comment section; Tyler has been careful in the post.

When people are hungry for information, they turn to what they are familiar with.

Unfortunately, this is not the place to get medical or epidemiological information.

So, this site should direct readers to Johns Hopkins site or Oxford Universities site for medically reviewed information.

This site can be perfectly fine when it discusses economics. But, when it discusses medicine, put your mask and gloves on so you or a neighbor you talk to becomes infected with misinformation.

Here are two sites that provide credible information

https://coronavirus.jhu.edu
https://ourworldindata.org/coronavirus

Unless you know a great deal of background context, and how to interpret the numbers, going to either of those sources could end up misleading you, FWIW. We do not give out medical advice, but social science has plenty to say about the listed plans.

!!!

This is exactly what one expects from a typical economist.

I have concluded this cannot be the real Tyler, but must be an imposter claiming that because "I understand numbers" and that sources created by epidemiologists, public health professionals and doctors for the public 'could end up misleading you."

Good impersonation.

I thought that Official Tyler Comments appeared bolded.

I would reformulate #3. It’s not just to get data, it’s to permit people to act in accordance with test results. Thus:

Rolling out test kits like it’s war production to allow as many Americans as possible to get tested.

"More testing" is what every expert has been saying since January. Unfortunately, the US/CDC completely botched this. Even now, there is no such thing as a "test kit" that can be produced at scale and distributed widely. There are "sample kits" and the samples have to be sent to labs, and processed. There simply aren't enough labs to do what needs to be done, at least in the US. Hopefully true "test kits" will be developed, manufactured, and widely distributed in record time.

Number 1 is suggested by people who still don't understand how many people under the age of 65 are being devastated by this virus. If the only real problem was people in this age group getting sick, this would not be the international event that it is. How on March 21, 2020 are there so many literate and reasonably intelligent people who haven't understood this yet. How can Tyler even entertain such an utterly stupid (sorry, "counterfactual") idea?

This is exactly what one expects from a typical economist.

Well why make the cutoff 65? Given what we know, what’s the highest possible threshold? 50?

In Finland, they have ordered a lockdown but only for 70-and-over population. As a starting point, only people who are both sick and old are admitted to hospitals for Covid-19.

The authorities believe that the virus cannot be contained and the most cost effective way to manage the hospital admissions is to confine the 70+ demographic in their own homes.

That sounds reasonable and doesn’t affect the economy. There’s the question of nursing homes as care workers must go in and out.
It’s amazing how every country is following a different path.

Small countries like Finland and Iceland have to be the world's pioneers. Large nations like the UK simply catch way too much flack.

Another reason to be against political unification into larger blocs. People talk about there being no benefits of divergent national policies, and so the right for a nation is always the one that gives larger unified markets. But we'll see about that.

One could have the care workers self-isolate or even live in the nursing home, or in trailers or something outside. A couple of months with added hazard pay doesn't seem too difficult to pull off.

Yes, it seems doable to me. Apart from the cost, it’s not clear Western style quarantines are effective are there are still many people are out and about.
The visiting Chinese medical team to Italy remarked that they didn’t think the Italian quarantines were good enough.

This sounds so much more reasonable than most of the globe's approach so far. Maybe Finland's world-beating education system has produced world-beating critical thinking skills at the population level.

Whereas here (in the states) they've decided to terminate the economy over a virus with a 98% survival rate.

One upside is we ought to emerge with lots of immune health professionals, which might help with the segregating old people thing.

How about paying people to volunteer to get infected? Do it now, and in a few weeks, you'll have an army of the immune.

One suggestion - not yet endorsed or implemented - is to have some type of I.D. like a wrist band or badge for those who are 'certified' as having had the virus and recovered.

Some fraction of people as young as 20s or 30s need to be intubated after exposure. We neither have the compensation system nor the capacity to pay for that.

Yes, we do. It's called health insurance. And the fraction is likely less than 1%.

1% of millions of people is a whole lot of people. And it might be a 1% very-serious-illness-with-permanent-disabilities rate for someone twenty years old, but it is much higher for those in their 30s, and higher still for those in their 40s, and so on. If we're talking about hundreds of millions getting this virus, we're talking about 10s of millions of permanent disabilities, and millions of deaths. And this if everyone over the age of 65 is somehow spared, which is frankly impossible.

Are the Chinese, South Koreans and Italians reporting that the recovered have permanent disabilities? Stop being hysterical.

"Chinese doctors say autopsies of coronavirus victims suggest the deadly illness is “like a combination of SARS and AIDS” that can cause “irreversible” lung damage even if the patient recovers."

"“The influence of COVID-19 on the human body is like a combination of SARS and AIDS as it damages both the lungs and immune systems,” Peng Zhiyong, director of the intensive care unit of the Zhongnan Hospital of Wuhan University in Wuhan, told the Global Times."

https://www.eutimes.net/2020/03/coronavirus-is-a-combination-of-sars-and-aids-that-causes-permanent-lung-damage-chinese-doctors/

Found the Russian troll. The eutimes.net is clearly Anti-Western propoganda.

Do you think your health insurance would be fine with for-profit exposure?

Well given that the ACA mandates coverage of pre-existing conditions, I'm pretty sure they couldn't legally say no.

The early recovered population is going to become invaluable. They will be a special class, with special responsibilities and privileges across the entire economy until more advanced responses are widely available.

1. Reinfection seems to be a real thing.
2. We have yet to secure good data on how much immunity is conferred and how long on the recovered.
3. Health care workers seem more susceptible to getting really sick. Possibly being exposed to the virus in large amounts puts you in a different class of risk.

In other words, before sending doctors and nurses who have recovered into the wards filled with sick patients on the theory they are wearing bullet proof vests, we may end up killing more of our health care force.

Hmmm... I suppose it is a real-life (or death) experiment. They are basically trading off a certain number of under-age-70 deaths for the hope of curve-flattening. And there will be those deaths.
Assuming, of course, that it is true that Finland has done this. Misinformation is all over the place right now.

To implement widespread testing would require going to war against the FDA, which is opposed always and everywhere to widespread testing for anything. The Deep State would chew Tyler up and spit him out on that issue.

#1) How about just reducing Social Security payments to help compensate those that are most adversely affected by social distancing? That would seem more feasible (logistically, not politically). If everyone must do their part to help reduce the risk to seniors, including forgoing income from not going about their regular business, does that include seniors themselves and their Social Security income?

I'll pass that idea along to Prof. Larry Kudlow (Ph.D. Television Science, Fox University).

I think one can make a good case that we don't listen enough to our seniors, with their decades of accumulated wisdom and experience. It would be informative to ask them how much of their Social Security they would be willing to sacrifice for various levels of risk reduction through social distancing. Everyone's voices should be heard in our society.

The single lowest hanging fruit is universal mask wearing. This is what saved HK, Taiwan, Japan, SG, etc. Sure, there's a shortage of N95 masks, but a homemade mask is almost as good at the critical task of preventing virus spread by the mask wearer. It is physically possible, right now, for every American to cut up a t-shirt or paper towel and put on a mask, reducing viral shedding by 3.5 times ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591312/ ).

We need to meme this into existence. Universal mask wearing, now!

There might be something to this, it's the flip side of the hypothesis that Italians' practice of close contact and kissing casual acquaintances is one reason for their high rates of infection.

It's also consistent with the story that people with the virus spread it by coughing, sneezing, (maybe exhaling?) and their virus-laden exhalations land on surfaces that people touch.

But how strong is the evidence that those are the main pathways to spreading the infection, as opposed to say touch-based ones (sick person uses a door handle to enter a room, uninfected person touches the same door handle)? Handwashing rather than masks is the key in that scenario.

I have read that surface-based spread is a minor vector

Paper towel masks are only 25% efficient. Better than nothing, but...
https://smartairfilters.com/en/blog/paper-towel-effective-against-viruses-diy-mask/

+1. I agree, simple but effective measures like this are not used much or encouraged much. Even in normal times, sick people ( with respiratory type infections) should wear masks. That’s more routine in Asia.

This story doesn’t even pass the bullshit. This woman has no job and no income.

She’s clearly covered under Medicaid as per Washington stage regs.

*bullshit test

Also, shoulda just washed her hands amirite fellas?

Have you ever added anything useful?

We already know "let them eat medical bills" was the right wing position in opposition to universal healthcare, in a two-step with "you have the Medicaid (we are also constantly opposing), what more do you want?"

See also "there are charities for that," charities now being hit by a tsunami.

Bottom line, unless the government enacts policies which reach down to the marginally employed and their medical bills, people are going to come out of this knowing some dead and knowing some bankrupt.

As cruise lines are bailed out.

Not a great advertisement for late-stage capitalism.

One idea to improve herd immunity:

Providing every invincible 18-24 volunteer on a caribbean island for 3 weeks with beer, music, wine, dancing, and free condoms. Transportation provided by a major cruise line.

Covid will be introduced to the population, which they will gladly accept, and, after suffering a small cold, and maybe a hangover, they, or most of them, will return and serve as the rods in the reactor so that everyone can go back to their life,

Those who are sick will be cared for on another island, recently vacated by a former math teacher hedge fund guy who, unfortunately, took his life.

The dead will be respectfully buried at sea.

Well played. Isn't this already happening right now, in Florida?

It could make Italy's mistakes look trivial. Though don't count out the Iranians, who are even now apparently doing a lot of traveling to enjoy their new year.

By the way, I heard recently that there is an evolutionary psychology explanation why those under family responsibility age (18-24) might believe they are invincible.

Societies needed young persons who believe they were invincible to fight the invader. So, those societies that survived had people in this age group whose brain structure supported beliefs in invincibility,

By the way, I didn't ask for the age of invincible from the psychologist who mentioned this.

Italy just blew the cover off. 793 deaths today. Hoo boy.

Are you looking at the WHO website? Having a hard time finding that statistic...or maybe it’s because I don’t want to :( Hoo Boy indeed.

Use Worldometers. It’s the best site I think

793 new cases today. Not deaths.

No 793 deaths In Italy, not cases see Worldometers

My bad. The article I read did say cases but it has since corrected itself.

I'd recommend BNO news:

https://bnonews.com/index.php/2020/03/the-latest-coronavirus-cases/

Brian: the population of Italy is more than 60 million.

Of those who died, what fraction are elderly smokers?

"And these elderly citizens are those who have become the sickest: people over the age of 70 represent more than 87 per cent of deaths there (Italy).

https://www.independent.co.uk/news/world/americas/coronavirus-death-toll-italy-south-korea-sex-update-cases-map-men-women-a9413271.html

A reasonable question: Did we just collapse the global economy on account of elderly smokers?

Of course, they’re old and a lot of them have comorbidities, etc... still Italy seems an outlier. They seemed to have been overwhelmed from the beginning Nothing was ever under control there.

Yes, If I recall correctly, haven’t they been struggling on and off with austerity measures?

Both of whom are still in the running to beat the Italians.

+1 Yes, this is one of the most salient points in the behavioral epidemiology of this pandemic. Unfortunately, the most vulnerable population-as far as population health-are those elderly folks with pre-existing pulmonary and/or respiratory conditions. This is widely known at this point. But many people will lose their loved ones, so it’s potentially devastating either way. No statistic could adequately capture this grief. The idea that Italy is also not land-locked and geographically exposed, if you will, making that boot a vulnerable target along with a unique climate. It’s a panoply of factors that manifest in a perfect storm. This has already been explored in the media.

Brian,

Here are some reliable sources that keep track of this information

https://ourworldindata.org/coronavirus
https://coronavirus.jhu.edu

They’re still in their death spiral. They had 5000 ICU beds when the infection started, Germany 25000. That was probably a factor.

FYI-USA has ~170, 000 ventilators

From https://www.cebm.net/global-covid-19-case-fatality-rates/

Some very significant factors that apply to Italy.

Italy

In Italy, there are several reasons why CFR might be higher: the age structure of the Italian population (2nd oldest population in the world); highest rates of antibiotic resistance deaths in Europe which might contribute to increased pneumonia deaths (Italy tops the EU for antibiotic-resistance deaths with nearly 1/3rd of the deaths in the EU). Smoking also seems to be a factor associated with poor survival – in Italy, 24% smoke, 28% men. In the UK, for instance, 15% are current smokers.

Update 20 March: Coronavirus: Is Covid-19 the cause of all the fatalities in Italy?

Sarah Newy reports that Italy’s death rate might be higher because of how fatalities are recorded. In Italy, all those who die in hospitals with Coronavirus will be included in the death numbers. In the article, Professor Walter Ricciardi, Scientific Adviser to, Italy’s Minister of Health, reports, “On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three.”

Recording the numbers of those who die with Coronavirus will inflate the CFR as opposed to those that died from Coronavirus, which will reduce the CFR.

+1 nice overview

I'd file this one under 'Cold Comfort'.

The Value of Disinformation

When Trump puts an uninformed Happy Face on, and states that a miracle drug is just around the corner, he is actually helping with compliance.

You see, people will find it fatiguing to sit at home, in fear. Fatigue (or what is called depletion) causes people to give up.

But, if they are told: there is a Miracle Just Around the Corner, they will hang in there some more.

So, Donald, keep misinforming, and we'll make social distance work, all the way till November, when we will meet to vote,

But it was the behavioral "experts" who, despite having little evidence of their own, gainsaid the original UK strategy and denied that any such fatigue would set in quickly. Are you suggesting that these "experts" were wrong? Where is your cite to some authoritative source?

No, actually not "behavioral experts". It was employees of the government who claimed to be BE folks. Show me the link to the behavioral experts who were not Boris Johnson government employees.

Folks

I am not surprised that Anon7 did not provide a link or respond. He is probably a disinformation specialist.

You know why?

There was an open letter from 600 English Behavioral Economists opposing the governments failure to impose social distancing and other matters.

Anon7 gets bad information. He should lose your trust.

"On Friday, a group of behavioural scientists penned an open letter to the U.K. government questioning the decision to not enact strict social distancing policies.

Social distancing measures, like closing restaurants and pubs, cancelling school and events, and working from home are being enforced across Europe. The U.K. government, however, has taken a decidedly different approach. At the time of publishing, around 1,400 cases of the virus had been detected in the U.K., up 1,000 from the week before.

The open letter raises questions about the behavioural science evidence that may have been used to justify this decision—though a lack of transparency from the government has made it hard to discern what the official policy is.

The letter has been signed by nearly 600 behavioural scientists from around the United Kingdom (at the time of publishing)."

Here is the link: https://behavioralscientist.org/why-a-group-of-behavioural-scientists-penned-an-open-letter-to-the-uk-government-questioning-its-coronavirus-response-covid-19-social-distancing/

Ignore Anon7 until he offers support for his claims with evidence.

Doesn't his comment say the same thing yours does?

No. Read the comment, and my challenge. "It was employees of the government who claimed to be BE folks. Show me the link to the behavioral experts who were not Boris Johnson government employees."

"it was the behavioral "experts" who, despite having little evidence of their own, gainsaid the original UK strategy and denied that any such fatigue would set in quickly. "

You seem to agree with this, don't you?

Trump's biggest challenge right now is the bureaucratic practice where time is not of the essence. Yes you can get a permit once the epidemic is finished.

What he did yesterday is showed up on site, saw that things were trudging along, and announced that the concrete truck is here in an hour.

We can't be ready, it will take days! Ok, two hours.

This is how the Empire State building was erected in a year and 45 days.

Assuming, of course, that there is such a thing as 'concrete' and that it comes in trucks.
If it isn't out there, words won't speed it up. Nor will impatient bullying to try to salvage one's own reputation.

There are 20 credible vaccine candidates out there. It typically takes two weeks for a vaccine to take effect and two weeks for see if the subjects get the disease after you intentionally expose them to the virus. First round, relatively small number of healthy young people (50ish). Second round, for vaccines that ace the first round, 1,000 people from general population. Total testing time two months.

But we can't do that because a handful of study subjects could die. So thousands of others have to die. And the economy has to die.

There's plenty of concrete.

If you really wanted to prioritize distancing elderly and high risk people...

I think you really have two issues. One is getting people to do it and the other is not allowing wide spread infections in the areas where they are. For at risk people who can quarantine themselves at home, this is easier. We subsidize this and have them download tracker apps, as mentioned before, and paying them to stay home. Another novel idea would be to ask streaming video and gaming services to ask you more often if you are watching, and use that data to get a feel for how much time people are actually spending in quarantine. I am sure that there are some other easy ways, and combinations of them would be best. For nursing homes, we could prioritize serology testing for immunity to SARS-CoV-2 and paying those people who test for antibodies a higher amount to encourage them to come work with those populations. That doesn't replace the hygiene practices going in and out, but it may reduce the risk of them bringing the virus in while being asymptomatic.

Since the travel industry isn't really booming, this could be a time to rent large amount of hotel rooms to help quarantine some of the high risk people that due to certain circumstances can't self quarantine. Cover a per diem of food food they eat each day being delivered.

Why has not government implemented 2. already? It is way cheaper and easier to implement than 1. and 3. . And I do not even want to think how costly full-scale lock-down is going to be.

As I understand it, surgical masks don't reduce your chances of getting sick. They reduce your chances of infecting others. If we were to ramp up production of masks 100x and legally required everyone to wear them while in public spaces (and suspended handshaking and hugs), would that reduce the rate of transmission? 3 billion masks wouldn't exactly be cheap, but it would be a lot less costly than shutting down the economy for 18 months.

It would certainly reduce transmission and be a lot cheaper. As it is. I don’t think Western democracies can do quarantines. Certainly they can’t do a Wuhan style lockdown.
I am in California and there are still a lot of people driving, and out and about.
What we might get is the worse of both worlds , an ineffective quarantine and a damaged economy.

Though driver in itself is any trouble. I have fired up my vintage convertible and have been driving it around (going nowhere) for entertainment this past week.

I am sure the climate activists love you.

This is incorrect--- surgical and even homemade masks are somewhat effective in protecting the wearer. Links are here:
https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-masks.html

They are also effective in protecting those around the wearer.

I wonder how useful it would be to do post hoc testing? By that I mean looking at the samples of blood (and other substances) that people (patients, blood donors, whoever) have been giving for the past month or two.

We would presumably find people who had the virus but didn't know it.

That's not as useful as testing new live patients. But maybe the information about infection patterns in the recent past could be useful for epidemiological modeling. I'm also presuming that this testing of old samples doesn't require using the scarce test kits needed by new live patients.

I now see that Helen Chu has already been doing this, as described in Tyler's post about EV prizewinners.

What's the point of testing? There's no medicine for it.

If you're feeling sick, you should take Vitamin C and self-quarantine anyway.

My son had the flu last month, it was pretty bad, my wife and I were around him the round clock. Did we get it too? No.

Many persons have immunities to various strains of influenza (if that is actually what your son had) and it is less infectious than Covid-19.
The reason this is called a novel coronavirus is because it is novel - new. Nobody on Earth had immunity when it began.

When I brought him in to the clinic, I asked the doctor if it could be the Corona Virus (this was about a month ago). He laughed me off. He laughed because, at the time, he was told that only people who had traveled to China (or closely exposed to someone who had) could contract the virus.

Actually, there is medicine for it. As well as respirators. But the importance of testing is to know where the infection is spreading and containment efforts are needed.

The point of testing is to identify who *else* needs to be quarantined. This virus has an incubation period of 2 weeks, during which it can be shared. If a person presents as ill, and tests positive, then we can test everyone else they came close to in the last 2 weeks and quarantine them before they can spread also. That's why testing is so critical.

Incubation period median is 5.1 days
https://annals.org/aim/fullarticle/2762808/incubation-period-coronavirus-disease-2019-covid-19-from-publicly-reported

Does anyone have a line to a non-corona denying Fox News host like Tucker Carlson? This story is Tucker Carlson bait if I ever saw it (Why doesn't our government endeavor to make the Taiwan-USA quasi-alliance work to save American lives instead of just enrich our military industrial complex):

Taiwan and other East Asian nations claim a mask shortage – despite having the bulk of world N95 and surgical mask productive capacity. Even the 23 million nation of Taiwan makes more masks than the US. The reason they claim a shortage is that their goal is to flood nearly every man, woman and child with a continual mask supply – not just health care professionals. To be clear I agree with the East Asian mask consensus and not with the CDC/WHO consensus that only Health-Care Professionals need them, but that is besides the point because our Health Care Professionals do not even have enough.
China and Taiwan have banned exports. We can expect China to do this – but Taiwan is supposed to be our friend and we have helped them for decades – to the point of risking war with China – to keep them independent. Yesterday Taiwan not-so-generously proposed to start supplying us with 100,000 per week. This is 1/700th or 0.14% of their production of 70 Million per week. Forget about their claimed mask shortages – we must remember that is only because they are attempting to nearly blanket every single person in their country of 23 Million with continuous masks. That is their right to try and is probably wise, but given our robust and necessary protection of their independent existence, why are we not firmly asking – arm twisting behind the scenes if you will – to get them to supply more like 1 million per day? We could pay dearly for them – almost no price is too high – so Taiwan can save face. Our health care professionals in a nation of 320 million should come before every man woman and child in Taiwan getting one. American lives are at stake.

An explanation for things aimed at Taiwan might be a Chinese disinformation campaign.

Check facts from reliable sources.

Bill,
Chinese disinformation campaigns are real and bad. I do encourage you to check facts from reliable sources. A Chinese troll farm wouldn't have time to come back and talk to you - I will just say I live in California and I am concerned with US lives. I am very pissed at China, more-so even, but I am trying to rant constructively about something it appears our politicians actually would have leverage over. If you have any other arguments I will respond.

Sources:
Taiwan Mask Output to Hit 10 Million per Day https://www.globalsecurity.org/security/library/news/2020/03/sec-200309-cna01.htm

"Taiwan puts a ban on exporting N95 and surgical masks due to China’s coronavirus"
https://thetaiwantimes.com/taiwan-puts-a-ban-on-exporting-n95-and-surgical-masks-due-to-chinas-coronavirus/1463

Taiwan Donated 100,000 Masks Per Week to Hospitals
https://www.washingtonexaminer.com/policy/foreign/taiwan-plans-to-donate-100-000-hospital-masks-to-us-per-week

"any explanation for things aimed at Taiwan" It is the US fault for not having masks. Blame goes squarely on the US!!! I am trying to find solutions and China and Taiwan both make hordes of them... Beg China all you want....we have Zero leverage over China, but Taiwan is our freaking protectorate! All it takes is one call from Trump and we have some masks until we can ramp up our production!!!!!!

Scott, Thank you for providing the information and links.

Bill, you are welcome!!!

Steve Sailor has a post about a town in Colorado that is testing everyone (who consents) for antibodies

this idea may be worth long term followup; analyze geographical density of fox news viewers wrt covid uptake.

Tyler, this is first time I've ever commented on an MR post. Though I am a long-time reader and grateful for what you and Alex do. Your frame for Idea #1 is just bananas though. You wrote, "Given how many older people now work (and vote), and how many employees in nursing homes are young, I've yet to see a good version of this plan..." I've yet to see a good version of any plan! It has to be more feasible to quarantine 15-25% of our population than 100%, right? What's the good plan you've heard for quarantining 100% of the world's population? The onus is on that before we tear down the plans for 15-25% of our population in quarantine. Here are a few basic ideas to "segregate the old people" from my pea-brain. I'm pretty sure smarter, more qualified people would have more and better ideas: 1) fast-track online voting to allow older Americans to vote from home 2) Immediately and for the next two years drop the age for collecting social security to 60 years old and include anyone of any age with a verified and relevant pre-existing condition (lung cancer survivor, asthmatic, etc.) 3) Require all of those people to stay home as much as possible and increase the social security payment to whatever it takes to make sure they can afford their lives 4) Hire a lot of the mass unemployed we just created with retail shutdowns as a sort of Peace Corps for delivering needed supplies to vulnerable populations, probably by subsidizing the likes Amazon 5) As for nursing homes, that's a tough one. Invest in increasing testing to a ludicrous, Manhattan-project extent for medical care workers (including those in nursing homes) and quarantine those who do test positive. Lastly, and most important, let everyone who's healthy and young-ish get back to work and life. We actually need people to run the economy IRL in-person. We can't just code the world from our bedrooms. The robots aren't there yet. We need people to make things and deliver them places. There are so many products and services essential to life (and mental health) that we risk denying to billions of people over the course of just a few months. Depending on how long our current lockdowns continue, the risks of our current approach become more and more unfathomable over time.

Very good. Don’t wanna offend 15% of population so lock every single person up and threaten the whole society those seniors labored for. Including perhaps capacity of that society to take care of them.

About nursing home workers, if that’s really what stands between us and Great Depression II, we owe it to ourselves and posterity to work something out.

Lest we forget...what was the price of getting out of the first Great Depression?

There are (or will be soon) three classes of people:

1. Those who have not been infected by the virus.
2. Those who are currently infected by the virus.
3. Those who have been infected and have recovered, or who show a good titer (immune resistance) to the virus.

While there are few class 3 people yet, the number will gradually increase as the months go by, particularly amongst health care workers. For suppression purposes, we will need to treat these three classes very differently:

Class 1: During outbreaks, these "virus virgins" need to be isolated to avoid over-burdening hospitals, ICUs, and ventilators
Class 2: Need to be quarantined until they recover (or die).
Class 3: No restrictions

We need COV-19 tests to separate Class 1 and Class 2, which is critical today. But we need to be run COV-19 titers, eventually on the whole population, to create Class 3.

When individuals pass a COV-19 titer, they need to be given a passport to allow them to move freely. This could be done with a smart phone app. It will be very helpful to the economy if we can quickly identify and issue passports to Class 3 people. They will be able to help the economy continue to function as the people still in Class 1 have to shelter in isolation, perhaps through several iterations. Having a Class 3 passport will become valuable.

Note that there may be a sizable group that already has COV-19 titer due to their natural immunity (or not, we don't know). It would be very helpful to test everyone for titer ASAP to identify if there is a significant minority that need not fear COV-19 exposure, even though they have not caught and recovered from it. Even if some small fraction of the adult population could be declared immune, that would help the country to continue to run.

Testing for the presence of virus in people is still important, but less so than it would have been if we could have tested widely a month ago. Widely testing for titer is very valuable, and will continue to be going into the future. Many will need to be tested several times. Ramping up titer testing is something the nation should be working on now.

Anybody figure out the flaw? - "Having a Class 3 passport will become valuable."

A class 3 passport will be valuable to an individual because it will allow them to work and circulate without fear of infection. Similarly, giving class 3 passports to those who are immune is valuable to society and the economy because we won't be needlessly isolating those who have no need to isolate.

Forging a class 3 passport for someone in class 1 or 2 is of much lower value. Until we institute strict limits on personal movement a la China, everyone is free to not isolate now. Not isolating while in class 1 is foolish for one's own health, and harmful to others, but we're mostly relying on good sense and the honor system anyway. Class 3 passports will allow those who are immune to move freely (and hopefully help others). It would be dangerous for those not actually immune. The demand for forged passports would therefore be limited.

Borders between most nations are currently closed. Would they be opened to class 3 passport holders? If so, then the value increases considerably.

That would require recognition of other country's COV-19 passports. There would be some bureaucratic and diplomatic delays, but if two country's trusted each other's public health system, I don't see why it wouldn't happen. If the passport exists, airlines may require it to allow you on a flight, particularly an international one. Letting Class 1 people on a flight is asking for a lawsuit.

Given that for 99% of people under 50 this is no worse than a bad flu I find it hard to justify shutting down their entire lives and throwing them out of work indefinitely. Surely the rights of the elderly don't extend to basically putting everyone else under martial law to protect them.

A sizable fraction of those infected under 50 are sufficiently ill that they need to be admitted to the hospital, Hazel, although relatively few die. That's a lot more serious than the flu, and the hospital bed that they occupy will be one fewer for those more likely to die.

So the chance that you might take a hospital bed away from an 80 year old justifies putting you under martial law and depriving you of an income?

Essentially.

It's not that black and white, by the way. There are 30-year-olds dying, as well as 50-year-olds and 80-year-olds. Overworked doctors in their 30s and 40s are dying, doctors whose workload includes a sizable number of young people who are unlikely to die, but only if they receive treatment.

It's not martial law yet. That will only happen if people don't isolate voluntarily.
The need for strict central control of a society is proportional to the threat to that society, whether than threat is a foreign enemy or a pandemic. Americans don't remember the civil liberties that were abandoned during WW1 and WW2, and no war against a foreign power has been fought on American soil since 1814. Yes, the nation will curtail you civil rights when there is a need. Don't kid yourself that the US is different than any other country.

The rights of the country to act to protect itself trump your individual rights; it has always been so.

People die all the time, in their 30s, 50s, and 80s. What is the threshold, exactly, at which martial law becomes justified to stop a contagion - apparently a 2% death rate is sufficient, so why not the flu?

Since last week, he’s been running ventilators for the sickest COVID-19 patients. Many are relatively young, in their 40s and 50s, and have minimal, if any, preexisting conditions in their charts. He is overwhelmed, stunned by the manifestation of the infection, both its speed and intensity. The ICU where he works has essentially become a coronavirus unit. He estimates that his hospital has admitted dozens of confirmed or presumptive coronavirus patients. About a third have ended up on ventilators.

His hospital had not prepared for this volume before the virus first appeared. One physician had tried to raise alarms, asking about negative pressure rooms and ventilators. Most staff concluded that he was overreacting. “They thought the media was overhyping it,” the respiratory therapist told me. “In retrospect, he was right to be concerned.”

"I have have patients in their early 40s and, yeah, I was kind of shocked. I’m seeing people who look relatively healthy with a minimal health history, and they are completely wiped out, like they’ve been hit by a truck. This is knocking out what should be perfectly fit, healthy people. Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can’t breathe at all.”

Read the whole thing, A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients. A free press is a good thing to have, after all.

Again, preventing deaths that would happen even under ideal treatment conditions is only part of the problem to be solved. Another part is getting treatment to people who develop complications but who can be saved if they receive proper care. The third is ensuring we have enough doctors and nurses so that if some of them get infected from these patients and themselves need treatment, we have enough backup capacity.

Italy is already bringing in doctors from China but if every country is hit at the same time and if China experiences a second wave in the next month, that won't be a sustainable option.

The rights of the country to act to protect itself trump your individual rights

Since when did "the country" become synonymous with the 60+ population? This isn't an existential threst to our way of life - but martial law IS.

And you know it is functionally equivalent to martial law, or will be soon enough if the government actually serious about enforcing it's stay at home orders.

“I work 12-hour shifts. Right now, we are running about four times the number of ventilators than we normally have going. We have such a large volume of patients, but it’s really hard to find enough people to fill all the shifts. The caregiver-to-patient ratio has gone down, and you can’t spend as much time with each patient, you can’t adjust the vent settings as aggressively because you’re not going into the room as often. And we’re also trying to avoid going into the room as much as possible to reduce infection risk of staff and to conserve personal protective equipment.”

Even if you survive ... it can also do long-lasting damage.

“But we are trying to wean down the settings on the ventilator as much as possible, because you don’t want someone to be on the ventilator longer than they need to be. Your risk of mortality increases every day that you spend on a ventilator. The high pressures from high vent settings is pushing air into the lung and can overinflate those little balloons. They can pop. It can destroy the alveoli. Even if you survive ARDS, although some damage can heal, it can also do long-lasting damage to the lungs. They can get filled up with scar tissue. ARDS can lead to cognitive decline. Some people’s muscles waste away, and it takes them a long time to recover once they come off the ventilator.

“There is a very real possibility that we might run out of ICU beds and at that point I don’t know what happens if patients get sick and need to be intubated and put on a ventilator. Is that person going to die because we don’t have the equipment to keep them alive? What if it goes on for months and dozens of people die because we don’t have the ventilators?

"existential threat" = a threat to existence
Yes, actually, dying is an existential threat. Martial law is not.

Ok, so, then martial law for the flu. The flu kills people too. So do traffic accidents. What's your threshold.

"Ok, so, then martial law for the flu."

One obvious response is that the threshold should be in between flu and covid-19 and should account for just how little we still know about the latter. Another response is that there is low-hanging fruit in the fight against flu. For instance, mandatory paid sick leave for all workers, policies to promote more widespread flu vaccination, and more spending on research on a universal flu vaccine.

"A sizable fraction of those infected under 50 are sufficiently ill that they need to be admitted to the hospital, Hazel". How do you know that?
We have no idea of the number of total cases, since only people with symptoms are tested. That number may be very high, and the fraction of persons under 50 that are hospitalized may very well be less that 0.1%

Not only people with symptoms, but people who traveled, people who had contacts- especially in places like South Korea.

We have data on deaths from Italy. Of 3200 fatalities only 1.1 % were under 50 and that’s from an overextended health care system.
If we assume the death rate is 2% overall. Then the death rate for under 50 is 0.02%. In this age bracket it is not worse than the usual flu.
https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_20_marzo_eng.pdf

That contradicts what I have read, that it is roughly 250x worse than the flu for the young- 0.1% as compared to .0004%

The data supports it. I really doubt that it is 0.1% for the under 40 ( 1000 per million). It’s probably actually less than 200 per million.
It might well be higher for a young but immuno compromised population ( 5% HIV prevalence in sub Saharan Africa for 19- 50)

Certainly the data you cited about Italy does not support it. Think about the % of Italy's population int he various age bands, for example.

0.1% is still not a very high number, worth throwing the 99.9% of other people who are not going to die out of work and shutting down the economy. 670,000 people die of heart disease every year. We havn't mandated martial law to prevent people from eating hamburgers. Why is this different?

"worth throwing the 99.9% of other people who are not going to die out of work and shutting down the economy"

You are being hysterical.

One obvious difference is that this is an epidemic with exponential spread where social distancing can do something, whereas heart disease is not.

Ok for the Italian data the deaths under 40 are 9/3200 = 0.28% of the total. This age bracket is 40% of the population, so age adjusted it’s 0.28 x 2.5 = 0.7% . If the incidence of death overall is 2%, then the death rate of the under 40 population is 0.014% or 140 per million. Now it’s possible that they put more efforts in saving the younger ones because they were overloaded.
Note that the men were double the women in that bracket and that there were zero deaths under 20

Why are you switching from under 50 to under 40?

On the other hand, South Korea arguably has better and more detailed data and shows death rates of 0.08% for 40-49 year-olds and 0.11% for 30-39 year-olds. No deaths so far for people below 30.

https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=0030

Without more and better data coming out of Italy, it is difficult to know what to make of their situation and not particularly responsible to draw firm conclusions.

You can resurrect

Your economy

But

You cannot resurrect

The Dead.

What do you do when your dead economy makes even more dead humans? This is not a flippant comment. We're looking at a possible global depression due to our actions in response to the virus. The last global depression brewed up a rather large war that killed 40-70 million. And that was with a far smaller global population and lesser weaponry. As you say, you cannot resurrect the dead. We must tread with caution.

O Yea of Little Faith.

Could you posit what the US would look like if it followed the path of Italy?

Part of the problem we are going to have as a society is going to be dealing with the following:

Say these plans to limit spread are successful. Someone will come back and say they were unnecessary. Say they were only partially successful, then someone will say they were not worth it.

But, did you notice: No one offered evidence of what if would be like and no one discussed what it would be like if we did nothing or did a small plan.

But, we can point to Italy, and start there to ask what it would be like if we did not respond to flatten the curve or go even further if necessary.

And, if it is a world depression, as it might be, we are only one part of the world, so maybe saving our lives is even a better result since it may be tough times ahead with a world depression.

I think we will see variations across states and countries and that may tell the story when it is all over, adjusting for density and demographics.

No life has infinite value. Actuaries know this. Alex T. calculated a year of extra life is worth $100k in the US.

What about 2.2 million dead, and those who they support.

You can value one persons life, but you can't include the value of having a parent who now is unable to take care of a kid, or a lost spouse, who makes it difficult for you to raise others.

2.2 million people worst case.
https://www.nytimes.com/2020/03/20/opinion/sunday/coronavirus-outcomes.html

Maybe you. How much do you value your life. Alex says it's only worth $100k.

Cat,

If you are interested in selling your life for $100k, I can arrange for that, you see, there is this medical experiment people are interested in doing...well, I guess I have to tell you this, I get a 10% commission if you say yes. I just want to say, its awfully sweet of you to participate.

What are your plans to do with the $100k when you are dead?

Bill, very weak arguments, as are most of yours, in normal tines, are just painful. When they are used to justify martial law and the use of violence against us, they are hateful.

Joel,

You are not my judge.

Earlier you said you were technically a doctor. What did you mean by that.

What country are you in and do they value life.

Also, Joel, to show how you do not know how to respond to an argument, I will note that you asserted that these proposals are " used to justify martial law and the use of violence against us, they are hateful."

Please identify the martial law and violence.

Post below.

My wife and I are 65 and 66 year olds with an 8YO foster son. He is isolated with us because school is out. I suspect school will reopen before they recommend that the elderly (that hurts) stop isolating.

You're going to have to decide whether you want to let your son return to school before next August, Tom. You may well decide that it is not worth the risk to you and your wife. His education will not suffer significantly, particularly with a little home-schooling, but he will go stir crazy without access to friends. Perhaps you could organize a group of families with similar aged children to isolate together (i.e. w/ playdates).

Oh yeah, educating our kids ... no big deal. keeping 80 year olds alive - that's where our social priorities need to lie!

Eat... our parents?

On your point #3, I am a diagnostics professional (many years in the business side), and it is vitally important that we understand the scope of the problem.

If you look here at the FDA site: https://www.fda.gov/medical-devices/emergency-situations-medical-devices/emergency-use-authorizations#coronavirus2019 all the EUA's to-date for SARS-CoV-2 testing are using high complexity, molecular reverse-transcriptase real-time PCR methodology.

As of this writing there are 13 of them, none of them are able to test for virus using blood serum for evidence of the virus using antibody technology.

I am aware of two companies that are preparing very simple ELISA or even lateral flow antibody-based tests (lateral flow is very inexpensive, the technology used in pregnancy tests) and under EUA consideration now. So this situation with testing limitations may be lifted over the next few weeks, at least to give us a scope of how wide-ranging the problem is.

As the laboratory work is much simplified (i.e. instead of a molecular workflow the ELISA and stick tests are very routine and simple) we may actually get the data we need in the US. (It would also help laboratories worldwide greatly.)

One thing in the US though that we do not do that I believe we should do is contact tracing and setting aside quarantine areas. It seems as if the national response is get physically distant, shut down cities and try to catch up on the testing, but is only part of the solution to holding down the infections (and deaths).

I was one of those who sent to Tyler and Alex the idea 3.b: "Testing a representative sample of Americans, to get data.". To be precise, to get a reliable estimate of the number of persons infected in a given area. We already have reliable estimates of the number of deaths, the number of people in ICU, and the larger number of people hospitalized. With an estimate of the number of cases, we could finally have a good estimate of the lethality rate, of the rate of hospitalization, etc. This would be extremely valuable to understand the epidemics.

There is a small difficulty in finding a "representative sample" since we know so little about this epidemics. Its geographic distribution is probably
extremely variable, and de we don't know it, so we should not try to find
an estimate of the number of case on the whole US, bur rather restrict to a relatively small, homogeneous locality. Say New York City, or the LA area or a small stale like RI.

I don't see any practical reason why this can't be done now, in a few days.
A test is apparently less than $50. A political poll for 1000 persons is about $25,000. Adding the price of the test, we get $75,000. This is a very low. Why are we not doing that? We just need to spare 1000 test kits from the hundred of thousand the country has.

In my email I suggested Tyler and Alex to use $75,000 of the money they have for the prizes to use it to buy such a poll.

I agree, it’s important to know. The cost even hardly matters considering we’re spending trillions on a lockdown. So do random sampling even in more than
a few areas. The positives would have to be retested due to the false positive rate as it is likely the infection proportion is low.

"We just need to spare 1000 test kits from the hundred of thousand the country has. "
I'm seeing cities and states in the news saying that can't test because tests aren't available. Where are those hundreds of thousands you refer to?

According this (found at random) article
https://www.cnn.com/2020/03/21/politics/us-coronavirus-tests-invs/index.html
170,000 persons have been tested in the US. What I am saying is that, even if there is a big penury of test kits, it would be worth it to spare 1,000 or 2,000 to test people at random (rather than because they have a particular reason of being suspect of a coronavirus infection. like symptoms or contact with known infected person). This will give us for a very minor cost, in terms of money and healthcare, of an information that would allow us to weigh decisions concerning, as Catinthehat reminds us, trillion on dollars (and perhaps million of lives.)

Either A. You are an epidemiologist B. Have delusions of knowing more than the experts or C. are just trolling.

I think it is time for bold action. Brazil's President Captain Bolsonaro has ordered the ramping up of chloroquine production.

1. 0ver 65 population

Economists value life; old people have low value.

So, creative destruction should be employed.

Euthanize any US resident over age 65. Non-citizens, especially illegals will instantly self deport. The US citizens are a massive burden on taxpayers because they get massive excessive welfare

If working, they are currently boomers who benefit still from the leftist policies of FDR like unions that got them high wages and benefits even if not in a union, while those who grew up under Reagan got low wages and no benefits, unless in the liberal elite class living in leftist coastal areas, working for leftist elite neoliberal corporations in tech, health care. They are still stealing the jobs from the Reagan generations, thus the high life.

If not still working, the get SS and Medicare.

And they are reaping the benefits of a boomer neoliberal ponzi scheme which takes money from Reagan generation workers by selling stock to live the high life, or by borrowing money they will never repay on houses with inflated prices because boomers hoard houses for a family of five to shelter one, maybe two people. They don't even take in roomers like the boomer's parents and grandparents did for them.

Their organ can be screened for disease and health, some benefiting from their leftist gift of good wages, health benefits, the ability to live in good areas free of pollution, in workplaces that kept them safe from harm, like offices with fitness centers, and their organs sold yo the younger elites now able to fill the good jobs paying high wages with good benefits, moving into the big houses the creatively destroyed boomers leave behind.

And the later will really halt the spread of disease, smaller population spreading out into millions of too big houses is social distancing. And the big houses the boomer elites live in have easy access to the big well funded health care providers.

Just a boomer elite who listens to conservatives and their economic arguments with amusement because while constantly talking about cutting costs, the costs of cutting costs are too high for conservatives to actually try to cut costs. In fact, any cost threat is met by conservatives borrowing and spending with abandon, for tomorrow they die, and won't need to deal with their creditors.

mulp, you're not funny.

You know there's going to be a large number of people out there who want their coffee and they're going to get increasingly pissed the longer Starbucks is closed. Can we declare coffee shops an essential life-sustaining industry?

Remote patient monitoring. I have family that works to manufacture and sell this out of Brisbane. There weren't a lot of buyers before, it was technology viewed as 'the future' rather than something to invest in today. That's changed.

1. It can free up hospital beds, with more mild cases monitored out of their homes.
2. It can protect health care workers who can monitor patients without entering infected areas as frequently.

They've adapted their devices from being comprehensive to monitor for temperature and a few other things both to be cheaper and for better patient adoption (since it's more comfortable when it does less).

Naturally the challenge they're facing right now is supply chain.

Has anyone asked 70-80 year olds if this is what they want? To shut down all the schools and the economy, possibly causing a depression that will throw millions of people out of work, possibly including their own children and grandchildren, to protect them from a disease that still gives them an 85% chance of living, even if they get it? Most of the people dying have co-morbitities. Do you think my 92 year old aunt who is on a respirator already wants to trade causing a depression that will impact her 24 children, grandchildren, and great-grandchildren, so she can live another year or two?

Let me ask the question in reverse.

"Has anyone asked the young if this is what they want? To recklessly kill millions of people including hundreds of thousands of young people, and leave many millions more with permanent lung damage, many of them their own parents, friends, and loved ones, to prevent a couple of months of economic downturn that will hardly be a blip on GDP growth charts in a few years? Do you think my 20-year-old daughter wants her grandparents to die so that she can keep her barista job for the next two months?

Anyone who wants to avoid spreading the virus is totally free to socially distance on their own.
Btw, your elderly parents have an 85% chance of living even if they do get it. Probably more. You can't predict it will only be a "couple of months" of economic downturn, and you might have read about the long-lasting effects of graduating in the middle of a recession on future earnings. Your 20 year old daughter might never find a real job and wind up being a barrista for the rest of her life.

Turnabout is fair play. You can't predict how many people will die and I can't predict how long the recession will last. You theorize that my daughter will never be anything but a barista and I theorize that Timmy will have permanent lung damage and never be able to play a sport. You say I'm free to stay home and I say you're free to be Typhoid Mary and wreck my attempt to bend the curve.

“It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy shit, this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube and out of his mouth. The ventilator should have been doing the work of breathing but he was still gasping for air, moving his mouth, moving his body, struggling. We had to restrain him. With all the coronavirus patients, we’ve had to restrain them. They really hyperventilate, really struggle to breathe. When you’re in that mindstate of struggling to breathe and delirious with fever, you don’t know when someone is trying to help you, so you’ll try to rip the breathing tube out because you feel it is choking you, but you are drowning.

“When someone has an infection, I’m used to seeing the normal colors you’d associate with it: greens and yellows. The coronavirus patients with ARDS have been having a lot of secretions that are actually pink because they’re filled with blood cells that are leaking into their airways. They are essentially drowning in their own blood and fluids because their lungs are so full. So we’re constantly having to suction out the secretions every time we go into their rooms.”

I do not want to catch this.

“Before this, we were all joking. It’s grim humor. If you are exposed to the virus and test positive and go on quarantine, you get paid. We were all joking: I want to get the coronavirus because then I get a paid vacation from work. And once I saw these patients with it, I was like, Holy shit, I do not want to catch this and I don’t want anyone I know to catch this."

You should turn this into an opera. Maybe something about a beautiful girl who gets COVID-19 and coughs up a lot of blood.

You don't cough up blood, you drown in lung fluids. Or your lungs are destroyed as the ventilator pressure is increased to keep oxygen being supplied to the rest of your body.

The article also explains why x.raying works as a diagnostic test, by the way.

And it is from New Orleans and written ion March 21 - is New Orleans considered one of the American hot spots? Because as it is right now, they are pretty much running at full capacity at that facility.

Hazel- you are afflicted with a limited imagination. The tsunami of COVID-19 patients will not only collapse the healthcare system leading to excessive deaths in COVID patients- it will severely 8mpact the care of all the other patients-young motor vehicle trauma patients will not ge5 an ICU bed & therefore die-40 year olds with MIs won’t get proper care-the list goes on. There will likely be a shortage of healthcare providers as the get sick or exhausted and can’t care for anyone. Even if you don’t care about the cost or lives of the elderly COVID patients the pandemic will affect numerous other patients-unless you plan to deny ANY care to COVID patients over 70.

Correct. Hazel is also exaggerating the "it's only old people" incidence of the disease. 38% of the American COVID-19 patients in hospitals are under the age of 55.
https://www.washingtonpost.com/health/2020/03/19/younger-adults-are-large-percentage-coronavirus-hospitalizations-united-states-according-new-cdc-data/

That's not the same as 38% of young people under 55 are hospitalized. In the US, according to statistics here: https://www.worldometers.info/coronavirus/country/us/

only 64 cases are listed as "serious or critical".
Maybe a lot of people are being hospitalized out of an abundance of caution.

That number has been stuck on 64 for over a week while hundreds of people have died, so I wouldn't give it much credence.

If you're going to measure severity as what percent of a group is hospitalized, then even 1% is a huge, catastrophic number, and moreover it's a number whose ceiling we don't know (in the US that is; China may be close it its ceiling).

But by whatever measure, the point is that you're overemphasizing the extent to which the epidemic affects only the old. As Mm says, the collapse of the health care system affects all of us. And for the young who get serious symptoms, the disease is deadly serious. And in New York, the latest figures show that 49% of the patients with COVID-19 are under the age of 45.
https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary.pdf

Hazel, correct that the effects are far milder on young people. Italy now has age group stats out and they are similar to the Chinese stats.

https://www.reddit.com/r/China_Flu/comments/fmdw3e/italy_reports_deaths_and_cfr_per_age/

0% deaths under 30

And what people fail to remember is that most of that 15-20% of the 70+ age group are people with comorbidities. A healthy 70 year old is going to have a better chance of living than that. That probably goes for all age groups - if you're in good health, this very likely isn't going to kill you. It's people who are already chronically ill or dying, who are just dying a little sooner.

Again Hazel- many younger people will be affected UNLESS you plan to deny care to all COVID-19 patients over age 70- ie no hospital admissions-no ICU care etc. if you do not the system will crash d/t excessive demand.

Hazel, please reduce the amount of melodrama in your comments, I just finished a binge session on Netflix and so could do without. The idea isn't that we save the elderly from the flu. The idea is that we don't stress our healthcare system to the point of collapse. Should they be overwhelmed with COVID hospitalizations the ICUs cannot take on the next patient. Suddenly all survivable illness or injury thereon takes a higher than usual mortality rate. The whole thing cascades. Do you now see the issue?

Why is 1) a problem?
Just pretend that every nursing home is an oil rig. You get there, you'll do your job for 10 days without leaving the home, you get 1 week off.
Maybe add a tent for transitioning personel to stay and get tested/show they're not sick for 1 day, before the shift change.
Daily testing for the employees whilst on the premise.
Medical personel is getting tested daily in Aachen, already. Once they can show an infection is detected, the viral load will be so low still, that we know they haven't infected anyone else yet.

Sure the work will have to be better paid, but it's not unimaginably hard to set this up.

Exactly. Set up some trailers so the staff doesn't need to leave the premises. Quarantine them with the elderly. Only people who need to enter and leave are delivery drivers and they can drop off packages without interacting with anyone.

What you propose is expensive but it sounds much less expensive than our current plan.

What if one state has the same percentage of population having covid as another state, and the other state does nothing, while the first state does.

Should resources (ventilators) be allocated to the state which acted to control the spread?

Here are the questions I want to find out more about over next few weeks.

(1) what % people are asymptomatic/undiagnosed

(2) what is actual CFR, factoring for (1).

(3) what's the distribution of R0? Do highly sociable people have higher R0 and spend more time together?

(4) Does R0 change with temperature/humidity? How much?

(5) What else reduces R0? Ban touch screen self checkout? Gyms+ offices? Masks? Temperature check+ detention? Related to this, why does a couple of weeks of apparent stricter Italian measures do less than Japan, without shelter at home? Is it mainly passing from office --> family --> office?

(6) what antivirals/other existing procedures can help in short run

(7) how quickly does death rate rise because of increased case burden?

(8) At what rate can treatment capacity grow?

(9) best estimate of date vaccine ready for health workers

(10) best estimate vaccine ready for all

(11) best estimate specially designed antivirals ready for all

"Segregating old people, and letting others go about their regular business. Given how many older people now work (and vote), and how many employees in nursing homes are young, I’ve yet to see a good version of this plan..."

It doesn't need to be a good plan. It just needs to be better than the current plan of quarantining EVERYONE, which is what we are currently doing.

I just became aware of your site. Just because something takes planning, organization, and effort doesn't mean you don't try. I've posted "A Plan to Move Forward" on my blog showing a road map out of this mess. There are only two ways out of this type of epidemic, a vaccine or herd immunity. As a vaccine is at best a year away, we are left with the latter. How we do this is the question. At the rate, we're going putting the vulnerable in bubble wrap will prove to be the world's greatest bargain.

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