34 ms·

Open letter from Italy to the international scientific community

1095 points by magoghm 7y ago

Ninjak8051 7y ago
The handwaving arguments in this letter are not convincing (especially the "You do also understand that, as long as the rate of increase is exponential, no linear solution to contrast it will work (I.e. increasing x times the number of ICU machines, etc.)" nonsense). The stats in this very letter indicate that 10% of patients require ventilators, which cost about $4000. So even if the entire population were sick at the same time, would need population * 0.1 ventilators, at a cost of $400 per resident. The fact that we haven't spent $400 per resident to stockpile ventilators is a failure of society and a failure of government. The economic damage over these next few weeks will be far, far greater than $400 per resident.
- cobookman 7y ago
  If you take every potential apocalyptic scenario and stockpile supplies. It’d add up to much more than 400$/resident. The real shame is globalization. If manufacturing occurred in Europe. In North America...etc. we’d all just quickly ramp up our respirator production. Instead the west outsourced this to China
  - stblack 7y ago
    This is only the first part of the problem. The second part is, optimized supply chains that are effectively as empty as possible, all the time. Here in Canada an 18-day rail blockade by native bands was enough to cause serious concerns in the supply of propane and other fuels in the eastern part of the country. It's shocking that eastern half of Canada, the majority of its population, faces winters with just 3-weeks supply of fuel. The reason? Nobody wants to carry inventory. So for many things, we outsource creation, AND we optimize-away buffer stock.
- scarmig 7y ago
  We've stockpiled some number of ventilators in the USA (though still likely insufficient for the task at hand). The bigger issue is the labor needed to staff them, which has very limited scalability. I wonder how hard it is, and how quickly a moderately intelligent person could be brought up to speed (at least enough to get better outcomes than just leaving the patient to die).
mensetmanusman 7y ago
As a physicist, it still feels odd to me they are talking about statistics with such confidence here. It seems only SK has earned that right and has tested enough people to get reliable statistics. If you only measure the sick in the hospital...
- soVeryTired 7y ago
  The pattern is fairly consistent across countries [0]: [0] https://www.ft.com/__origami/service/image/v2/images/raw/http%3A%2F%2Fblogs.ft.com%2Fthe-world%2Ffiles%2F2020%2F03%2Ftrajectory-mar14.png?fit=scale-down&source=next&width=700 https://www.ft.com/__origami/service/image/v2/images/raw/htt...
  - Animats 7y ago
    That is the most useful graph on this subject so far. Go look at it now. Most countries have exactly the same growth trajectory measured from 100 cases. That's solid data about how this behaves. Singapore and Hong Kong have been able to slow things down by strong measures, but it's still a straight line on a log graph, just with 1/3 of the growth rate. Italy is on the same line, just 8 days ahead of Europe and 13 days ahead of the US. Only South Korea shows flattening so far.
    - TeMPOraL 7y ago
      I still don't get how people - including apparently some governments - don't get or don't believe it. Getting this graph is as simple as 1) taking the daily measurements, and 2) plotting them on log scale (and technically 3) shifting the lines to overlap, but that's just cosmetics). The trajectory of the entire West being the same as Italy's is immediately apparent.
      - Animats 7y ago
        It's much worse than that. Italy's health system is already collapsing at 20,000 victims. The population of Italy is 60 million. That has to level off at some point due to saturation, but that's at somewhere in the millions or tens of millions.
spacephysics 7y ago
We don’t need military patrolling our streets just yet. Not saying it won’t come down to it, but the sentiment in the US is less, uh... flexible, towards being heavily locked down as compared to the aforementioned countries.
- hoka-one-one 7y ago
  I don't think there's any realistic situation that would justify caving to the isolationism and xenophobia that's been pushed by the Trump administration for the last four years.
  - w3mmpp 7y ago
    Are you making a parallel between isolate yourself to not catch and spread a disease with "isolationism and xenophobia"? I sure hope you (and people in general) can separate the 2 concepts or we're really doomed.
    - deleted 7y ago
      [deleted]
    - a9h74j 7y ago
      Agreed. Responding to these situations is in part a collective test of practical intelligence -- or of collective intelligence if you will. Part of practical intelligence is to be capable of precise language (and separating concepts, as you say).
- GarrisonPrime 7y ago
  Or at least, some people would like to believe that. I suspect an astonishing large number of them will discover differently, should those ideals be put to the test. Just a hunch.
  - 7177Y 7y ago
    Much of the herd will comply. Many others will make their stand, especially with the current state of sentiment In the right wing population.
itcrowd 7y ago
Not sure why this is on the number 1 spot currently. This is a letter signed by non-experts (albeit sometimes scientists/engineers). To me, it comes off as the climate-change denier letters or 9/11 "truthers" letters. Please let the experts do their job. Don't spread uninformed opinions backed up by Facebook posts and panicked researchers with expertise "relevant to virus spreading" such as electronics, architecture and art history. Be safe out there but don't let the fear and resulting panic of this virus be worse than the virus itself.
- mochomocha 7y ago
  Why do you believe this is misinformation? All it's trying to do is mobilize people who understand what an exponential is to act.
- freepor 7y ago
  The “experts” are not doing their jobs! In the US you would have expected the CDC under the President’s leadership to act decisively and promptly. Obviously this did not happen. The randos are providing much more value than the experts in the US. Other countries like South Korea and Singapore have experts who are doing quite well.
  - ComputerGuru 7y ago
    The CDC can’t dictate state policies. These are executive decisions that the CDC can only strongly advise on.
    - mcbits 7y ago
      The CDC effectively dictated who could be tested and what test would be used. But those tests were faulty and now there are supply chain issues with the new tests. That was the point when they gave up and admitted failure. "Mitigation" and "flattening the curve" are admissions of failure. The only hope now is that summer blunts the spread, which is possible but by no means guaranteed.
- rozab 7y ago
jakub_g 7y ago
> It’s hard for non-specialists to intuitively grasp the way an exponential rate increase can get out of control. The best way to explain the exponential growth (and shock people) is ask them about https://en.wikipedia.org/wiki/Wheat_and_chessboard_problem https://en.wikipedia.org/wiki/Wheat_and_chessboard_problem
- thedance 7y ago
  Or you could present them with the classic cognitive reflection question: A lake has one lily pad. Every day the number of lily pads doubles. After fifty days the lake is completely covered by lily pads. How many days did it take to cover half the lake with lily pads?
  - kspacewalk2 7y ago
    Is there some parable about getting too excited about exponential growth and taking the extrapolation game way too far?
    - fsckboy 7y ago
      Zeno concluded that all motion was an illusion, so that's taking things pretty far.
  - __s 7y ago
    That's a big lake to have room for 1125899906842624 lily pads
    - kspacewalk2 7y ago
      Nonsense. Nothing in the real world can impede the progress of endlessly extrapolating exponential growth and impressing your friends with Really Big Numbers.
    - sk5t 7y ago
      Fortunately, it will only require space for 1125899906842623 pads.
cknoxrun 7y ago
My co-founder and I are really struggling with the decisions ahead of us. We feel we should act quickly, and enforce our team to work from home, but the spread in our city is quite low for now. We also wonder how long this can go on, are we going to be isolated for months? We are at a critical point where we have just closed our seed round this past week. We have both put so much energy and time into this moment and we were ready to work harder and focus on scaling and growth. Of course, the more tragic situation around us makes our issues seem small. I think we will likely announce to our team to work from home starting Monday. How surreal.
- justusthane 7y ago
  Definitely do it. Way more people are already infected than we know. You can be proactive or reactive, and if you’re reacting it’s already too late.
- leppr 7y ago
  Take comfort in knowing the whole world will slow down, your competitors included.
  - pinkfoot 7y ago
    However, the rent on your offices, the interest on your mortgage, and your school fees will not.
- michaelchisari 7y ago
  If working from home is an option, then you should absolutely make everyone work from home. Not let, make.
- mjoin 7y ago
  what if you wait and your employees get sick? if you're in tech, just implement a work from home policy right now. don't wait for the gov to do so. it's a matter of time. - a French
- davidw 7y ago
  Here's what Paul Graham wrote on twitter: > When you're dealing with exponential growth, the time to act is when it feels too early. https://twitter.com/paulg/status/1237801364023017472 https://twitter.com/paulg/status/1237801364023017472
LeoNatan25 7y ago
Here in Israel, ministry of health wanted a full lockdown. But business won, so only a partial lockdown is enforced, and they are shutting down only clubs and restaurants. People will still be able to visit parks, roam freely, etc. Today there was an article [1] that some idiot that was in quarantine left it and was arrested on the street. There is no discipline. A hard lockdown is likely the best option everywhere. It works, as evident in countries that have enforced it. 1: https://www.ynet.co.il/articles/0,7340,L-5694758,00.html https://www.ynet.co.il/articles/0,7340,L-5694758,00.html
- davidw 7y ago
  That lasted for a few days in Italy and then they shut it all down anyway. But more people got infected in the meantime!
  - LeoNatan25 7y ago
    Exactly, they should have gone all-in and shut it down.
- zozbot234 7y ago
  > Today there was an article [1] that some idiot that was in quarantine left it and was arrested on the street. There is no discipline. Hopefully he/she was nabbed quickly, without spreading the disease to anyone else. Is Isreal using electronic tagging on those quarantined folks to ensure that they can't just leave their assigned place without anyone knowing about it?
  - LeoNatan25 7y ago
    They are starting to talk about it, but there are big privacy concerns of tracking citizens by intelligence agencies. Not sure what the status of this is, but will probably pass parliament because everyone is very scared. They can abolish it later, but we all know they probably won't. It is unclear of the idiot that evaded quarantine is sick or only precautionary, but that's just the people we have—morons. Very different from Hong Kong and Singapore.
iRobbery 7y ago
Just from the start already i dont get a scientific feeling. "In just 3 weeks from the beginning of the outbreak, the virus has reached more than 10.000 infected people." Does this mean only tested 10.000 people? Reads a bit odd though too, i assume they were not infected already when the virus reached them? "From our data, about 10% of patients require ICU (Intensive Care Unit) or sub ICU assistance and about 5% of patients die." Is this from 10% of the people actually going to the hospital, or 10% of all tested, or 10% of all people that got the virus?
- toyg 7y ago
  >Does this mean only tested 10000 people? Italian health services have tested more than 50k people (the number of tests is over 60k but some people got tested more than once). More than 12k were infected. This is likely to be an underestimate, since we know a lot of infections are asymptomatic.
- yelloweyes 7y ago
  Who cares. The point is to get people out of their comfortable complacency. Read this one: "We are now in the tragic situation that the most efficient health system of the richest area of the country (Lombardy) is almost at its full capacity and will soon be difficult to assist more people with Covid-19."
  - kspacewalk2 7y ago
    I care. These doom and gloom shrieks and exhortations for President Madagascar to Shut. Down. Everything are distracting from the real work governments have to do to tackle this severe and protracted crisis in a competent manner, i.e. following the advice of real, not collective-letter experts.
    - mtmail 7y ago
      The advise from real experts is also to shut everything down.
lbeltrame 7y ago
As an Italian, I raise my eyebrows every time China is mentioned as an example for the successful containment of this virus. It could do that because it could afford to take the economical hit and because it is an authoritarian state, which means you can get almost everyone to obey, in one way or another. Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world. Why on Earth is this a good model? Undoubtedly for the safety of citizens, but even with all the people shouting about a "fascist revolution" going on with the previous government, it only took three orders to strip everyone of most of their freedoms without anyone batting an eye (especially since no one knows for how long, the April 3rd date is a joke). Quarantining is probably inevitable (although it won't help the overloaded ICUs until two weeks from now, so more capacity will always be needed), but following rules in place in an outbreak does not mean one should not question their principles. And this letter should be sent to the media and the government, since both can't even understand an exponential, or basic statistics (even with the so-called "peak" reached, cases will keep on increasing until recoveries are due). Personally I'd like fast-tracking of anti-SARS-CoV-2 drugs instead (those are the ones which will get out of this mess, quarantining is just flattening the curve, although immensely beneficial), along with setting up place for non-intensive care COVID-19 patients. Every ICU bed freed is a victory.
- incompatible 7y ago
  "China could afford to take the economical hit" The faster and better that you deal with it, the smaller the economic hit is going to be. China is going to be the big winner here.
  - greedo 7y ago
    Although China has a large internal market, they still rely on exports. If those are curtailed due to slackening demand, quarantine and tariffs, how do they become the "big winner?"
    - incompatible 7y ago
      Well, smaller loser than they would have been if they'd allowed the virus to spread unchecked.
mirimir 7y ago
Maybe Italy is a worst case, both because it didn't quarantine early enough, and because greater population inversion. > It's now a well-established fact that older people and those with underlying health issues are more susceptible to succumbing to Covid-19. With 23 percent Italians aged 65 or above and a median age of 47.3, the Italian population is the oldest in Europe. This is chiefly responsible for the high fatality rate in Italy.[0] Also these articles.[1,2] And similar to the age effect in China. 0) https://www.ibtimes.sg/fatality-rate-7-16-why-coronavirus-death-rate-double-italy-rest-world-40975 https://www.ibtimes.sg/fatality-rate-7-16-why-coronavirus-de... 1) https://nypost.com/2020/03/12/heres-why-the-coronavirus-death-rate-is-so-high-in-italy/ https://nypost.com/2020/03/12/heres-why-the-coronavirus-deat... 2) https://www.theguardian.com/world/2020/mar/03/italy-elderly-population-coronavirus-risk-covid-19 https://www.theguardian.com/world/2020/mar/03/italy-elderly-...
- sorum 7y ago
  Italy isn't the worst case, they're just 2 weeks' ahead of most other countries. Looking at the latest SitRep from WHO, my home country (Sweden) has small no. infected (775), but grew 25% vs the previous day. If that rate keeps up, number of infected will keep on doubling every 4-5 days and in 14 days' time will be at what Italy is today (17k infected). And then another week later it'll break 100k. Exponential growth is a bastard in that sense.
  - mirimir 7y ago
    True. But still, maybe Italy is a worst case. Trying to be optimistic here, being >70 and all ;)
    - goatlover 7y ago
      Iran is likely the worst case, but it’s hard to know the full situation there.
  - elorant 7y ago
    I had the same worries for Greece when in just two days recorded cases doubled from 100 to 200, but since the government imposed partial lockdown measures the rate of infections slowed down significantly. My guess is the same will happen everywhere. It's just that it's easier to see the growth slowing when you have an order of magnitude less incidents than Italy. We have to trust the process.
delegate 7y ago
I've seen comments here trying to play down the message or discredit the signatories of this letter. Don't. Please take it seriously. This is not sensationalism. What the letter means is that if your country is not there yet, you might be DAYS away from widespread panic and total lock down. I'm writing this from Barcelona, Spain. This last Sunday, 6 days ago, I went on a walk with my girlfriend, had a nice lunch, took beautiful pictures... The virus was just some nagging news.. A couple of hundred people infected somewhere far away. 6 days later, we're at over 6000 infections, the country is in total lock down. Same pattern as Italy (even faster), we're just a couple of days away before tens of thousands is reached. This is what exponential growth means.
- rimliu 7y ago
  We (Lithuania) are going into more or less total lockdown since coming midnight. With 8 active cases (first confirmed case recovered and was released home). I only wish government would be more aggressive with testing.
- cl42 7y ago
  I believe you’re correct. The SK approach has been more focused on individual quarantines and aggressive monitoring: https://www.aljazeera.com/news/2020/03/italy-south-korea-differ-tackling-coronavirus-outbreak-200313062505781.html https://www.aljazeera.com/news/2020/03/italy-south-korea-dif...
- baby 7y ago
  Can we make sure we’re reading this kind of information when given by people who actually study and work in a relevant field? Now more than ever we should look at the source of every information. I know I'm going to get downvoted for saying this, but I think it is important enough.
  - everybodyknows 7y ago
    It is fair to observe that the expertise here is math rather than medicine. However, epidemiologists have already made these predictions. Don't see any harm in signalling broader academic support. Particularly not since none of the signatories could plausibly be accused of exaggerating the danger, in order to extract grant money. As goes the usual cynical claim of innumerate science-deniers.
Camillo 7y ago
This is not "from Italy", it's been organized by a far-left Italian magazine. Yes, they are "from Italy", but the title is disingenuous and misleading. Note that the page lists "the editors" (of the magazine) as the authors, and the first signature is by the magazine's publisher. The rest appear to be various academic personalities they have reached out to, many of them not from Italy or in Italy. As for the contents, I don't necessarily disagree with the advice, but this letter is not particularly well written, nor particularly authoritative. For example, this section: > The beginning of the outbreak had the exact same number of infections in China, Italy, and other countries. The difference is that China strongly and quickly locked down Wuhan and all of the Hubei region 8 days before Italy [3]. This is an exceedingly poor phrasing, almost seeming to suggest that the outbreak started with a few cases everywhere in the world at the same time. Inadvertently or not, this dovetails with China's PR push trying to claim that the epidemic may not have started there (something that is readily disproven by all epidemiological and genetic evidence). Even setting aside the potential for confusion, the claim on its face is clearly baseless. Maybe the outbreak started with ten people getting infected in the Wuhan wet market on the same day (if we go by the wet market theory), while in Italy it started with a single infected person entering the country. Or, vice versa, maybe in China it started from a single infected person, and in Italy it was brought in by ten different people carrying it into the country separately. Who's to say? At any rate, if you look at the source for that claim, you can see that it is shifting the timelines to align at some particular point in the outbreak, and it is comparing the time from that point when China imposed the Wuhan lockdown with the time when Italy imposed the whole-country lockdown. The source is certainly more interesting, and gives a better picture of the situation than the letter does (although we have seen similar and better analyses in English for a while). However, the "8 days" figure is somewhat arbitrary. For example, Italy imposed a partial lockdown on the areas of the country where individual cases were found days before they shifted to a whole-country lockdown. Maybe that date should have been compared instead? By the best information currently available, the first case in Italy came from a person who was infected in Germany. According to the letter's claim, the outbreak starts with "the exact same number of infections" (one, presumably), and then grows at the same speed. But then Germany's timeline should be ahead of Italy, yet it's not. Then there is the elephant in the room, of course. If you cannot rely on China's lockdown to contain the infection, then the rational and prudent thing to do was not to wait for outbreaks in other countries and impose lockdowns there. It was to restrict and heavily control international travel (cancel flights, test all passengers, force visitors to quarantine, etc.). Would that have been accepted by the public? Would that have been accepted by the authors of this letter? tl;dr: title is grossly misleading, please correct.
exegete 7y ago
The last part urges lockdowns like China and South Korea but my understanding is that South Korea has not been doing lockdowns and instead was able to ramp up testing quickly and isolate infected from others. Is that incorrect?
- Benmcdonald__ 7y ago
  Yes no lock downs and I believe minimal travel restrictions (only Wuhan, China?). They did extend the school holidays. Even in the center of the outbreak Daegu there was no lockdown in the city.
  - Benmcdonald__ 7y ago
    Other things people probably don't realise about Korea. Self isolating and monitoring for people entering the country. Also they aggressive tracked contact with infected people. Watching supermarket survalence video seeing who they were near and then publishing nationally the time and location of where they had been
    - pbourke 7y ago
      plus everyone is wearing a mask
  - dba7dba 7y ago
    S. Korea has a very aggressive investigation of movements of infected persons. Once a person is found to be infected, they go through CCTV recordings, cellphone location records, etc and warn people who were in the same location at same time. They also release to the press the location/time infected person was at, such as name of hospital/events. And these are reported to the public. So S. Korea does not do a carpet bombing type of lock down as China but more of a surgical strike type of lock down. But it is a lock down.
- klipt 7y ago
  Yes but Western countries are past the point where that is effective. https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop... > The lengths at which it went to contain the virus are mind-boggling. For example, they had up to 1,800 teams of 5 people each tracking every infected person, everybody they got interacted with, then everybody those people interacted with, and isolating the bunch. That’s how they were able to contain the virus across a billion-people country. > This is not what Western countries have done. And now it’s too late.
deleted 7y ago
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blondie9x 7y ago
One of the most important upvotes of our lives.
x__x 7y ago
This post does not feel like it rose naturally to the top of HN
- jacquesm 7y ago
  My upvote was entirely natural. If you have proof of vote brigadeering you should send it to hn@ycombinator.com, speculation is pointless and against the guidelines.
riazrizvi 7y ago
The time shifted rates of growth tell a compelling story, along with the fact that 1000 people out of 10000 required hospitalization. That is certainly statistically significant. I am now concerned that my birth country, the UK, has the wrong response. UK hospitals will not be able to handle that much traffic.
thehoomanist 7y ago
Also someone from Italy here: never, ever praise China as it is the same authoritarian state that caused all these deaths by silencing the truth when it mattered the most. Had they not violently censored doctors (like their own people or the current holocaust being carried on against Muslims), we would not be suffering through this devastation. This is also absolutely not an open letter "from Italy": it's a message from a minor—poorly written— publication.
mirrorlake 7y ago
Can anyone vouch for the legitimacy of the names on this list? Is this authentic? I've been running my own numbers, and it does not seem far fetched at all. Governments need to be taking this extremely seriously.
- dsqrt 7y ago
  For what it means, I know some of the people on that list and I can say that they are real scientists.
lowdose 7y ago
Why didn't more people die in China?
- jstanley 7y ago
  Because Wuhan started welding people's doors shut as soon as they passed 400 new known cases in a single day. That kind of behaviour is not acceptable in the West (nor should it be, anywhere), but we still probably need to be taking this virus a bit more seriously than we are.
  - devit 7y ago
    I think these claims of "this is not acceptable in the West" are absurd and one of the causes of the current catastrophe. All you need is to pass a law and enforce it with police and military, it's not hard. Since there is a good reason for the law, there won't be widespread resistance, and in fact on balance citizen are likely to help enforcement rather than hinder it.
stevespang 7y ago
Italy <may> have a mutated strain . . .
ausjke 7y ago
It's said Germany does not lock down cities and fatality remains to be extremely low, which gives British, even USA the confidence to practice herd immunity. I hope in US we will not see this exponential infected scenario, finger crossed.
- pedrocr 7y ago
  Germany seems to be doing the South Korea solution of very extensive testing and quarantine so that they end up with more confirmed cases that in other places would not even be found. That drives down their mortality rate just because the denominator is bigger. But that just means they're more days behind in the exponential than the confirmed cases number would suggest. It does not mean they have it under control.
- temac 7y ago
  Exp is the simplest, and works very well with this virus. To not get exp you have to basically eradicate it (can be done locally with strict lockdown measures, but one day or another you will have to lift them...)
- hesk 7y ago
  German cities are starting to lock down. Berlin has canceled any gathering with more than 50 people. If it's less than 50 people, you have to keep a list of everybody who's there for a month. Schools are closed. As are recreational places (cinemas, clubs, museums, gyms, baths). Restaurants have to enforce 1.5 meters separation between patrons. https://www.berlin.de/rbmskzl/aktuelles/rathaus-aktuell/2020/meldung.906890.php https://www.berlin.de/rbmskzl/aktuelles/rathaus-aktuell/2020... It's not quite Italy yet but it's close.
jyrkesh 7y ago
I've been using https://meet.jit.si/ https://meet.jit.si/ through OBS with family to share content/games and webcam chat. Works great on mobile with apps, desktop on web.
lazyjones 7y ago
The fact that growth rates seem very similar in all affected countries, baffles me. Surely lifestyles, social structure (number of families/kids etc.), hygiene habits differ slightly and testing rates/effectiveness of the health system varies greatly among them. If these factors aren't important, does social life even matter? The effectiveness of China's lockdown is a good argument for it, but perhaps they were just more effective at identifying and isolating spreaders? My point is that there's a chance that it spreads through the air or in some other way unaffected by curfews etc. (if you leave the windows open...).
- tim333 7y ago
  It's not true that they are similar in all affected countries. The ones in that graph are cherry picked for similarity. If you look at China, Taiwan, Singapore etc there are differences. eg Fujian https://mackuba.eu/corona/#fujian_china https://mackuba.eu/corona/#fujian_china Taiwan https://mackuba.eu/corona/#taiwan https://mackuba.eu/corona/#taiwan HK https://mackuba.eu/corona/#hong_kong https://mackuba.eu/corona/#hong_kong Taiwan is impressive in that they had thousands of flights a month to China, have only 30 active cases and no lockdowns. They had people ride on the planes from Wuhan to identify sick passengers during the flight and quarantine them on landing. As a Brit I'm embarrassed by our performance in comparison.
deleted 7y ago
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feral 7y ago
I work as Principal ML Engineer, and did a little epidemic modeling in my ML PhD. I wrote an analysis of how this is going to hit Ireland, including the best calculations I could find on fatality rate: https://medium.com/@fergal.reid/predicting-the-impact-of-coronovirus-on-ireland-bff1b6d00d6a https://medium.com/@fergal.reid/predicting-the-impact-of-cor... I think that left unchecked this could kill millions of Americans in a couple of months. I'd love to be wrong.
- hn_throwaway_99 7y ago
  I thought that was an excellent analysis. Thank you.
- masklinn 7y ago
  For people who don’t find that clear enough, here’s a bloke comparing the obits in L’Eco Di Bergamo between Feb 9 and Mar 13: https://twitter.com/benphillips76/status/1238854071509016577 https://twitter.com/benphillips76/status/1238854071509016577 February 9 is 1 1/2 pages. March 13 is 10 full pages.
- toohotatopic 7y ago
  >If that trajectory persists, and we don’t arrest it, in the 2 weeks closest to peak rate, we’ll have seen 75% of our cases emerge. vs >in a couple of months. Why months? If there are 75% of the cases within 2 weeks, won't 75% of the deaths also occur within 2 weeks?
  - bo1024 7y ago
    It says in the two weeks closest to peak rate. So if the peak is mid-May, those 75% would all fall in May.
bengalister 7y ago
Here in France even with the Italian experience relayed in the press, i.e doctors having to make many times a day a choices between the ones who will live or die, many people don't take it seriously. I am shocked but not surprised by the behavior of my fellow citizens. Many people still went out shopping, went to the restaurants, still think it is a simple seasonal flu and do not at all comply with the recommendations of avoiding contacts. The government decided at last today to close the restaurants and most of the shops except grocery stores and drug stores. Also I think in France at some point the army will have to be called to help, to let policemen enforce the rules and be used to secure sensitive sites. With the periodic social unrest that France endures since the last major "ethnic" riots of 2005 and the more recent and more social yellow vest protests, I am afraid that in France there will be also a lot of indirect deaths of the sars-cov-2 pandemic.
- rambojazz 7y ago
  > I am shocked but not surprised by the behavior of my fellow citizens. Many people still went out shopping, went to the restaurants, still think it is a simple seasonal flu and do not at all comply with the recommendations of avoiding contacts. This is what happened in Italy as well. 1. people are recommended to stay the fuck home and reduce physical interactions 2. most people don't care and carry on with their normal life 3. state now needs to enforce harsh rules because people don't seem to understand that it's serious 4. some people still don't care, go to parks, beaches, private parties
joshstrange 7y ago
Chris Martenson likes to say "If the facts scare you, the problem isn't with the facts". (also check out his COVID-19 updates, I think they are very well done! [0]) You may think "it's not here yet". It is. You may think "the numbers are low". They aren't. We are failing miserably in our testing, our numbers are easily off by a factor of 10 (for infections). You might not want to be "weird" and not want to practice social distancing. You need to. You need to act when it feels too early and honestly, in the US, that was a week+ ago so at least act now. I don't say these things to whip people up in a panic, I say them because we are about to get hit hard here in the US. If you know a nurse maybe send them a text and ask how they feel. I can tell you the nurses I know are freaking out because they know we are not prepared. A have a friend who works at a big hospital. They have 2 cases (at least as of a day ago) and they almost buckled under it. They don't have many masks, they don't have training, and the hospital itself has no plans in place. When asked "How many masks do we have?" the answer (on Thursday of this week) was "I don't know" from the head of infections diseases. Let that sink in. March 12th. I can understand not knowing the count off the top of your head in November 2019, I can understand it in December 2019, I can still wrap my head around not knowing it in January 2020 but damn it... It's March, you are in a meeting to discuss COVID-19 and you don't know how many masks you have on hand? The world has been warning us for months now and they had no plans for how to handle visitors. The nurses have not done n95 mask fit tests. They are not getting clear direction on how handle mask reuse. We are not prepared for this. If this hospital (which I would trust for any major procedure) is feeling the strain with 2 patients what happens when there are 4? 8? 16? 32? [0] https://www.youtube.com/playlist?list=PLRgTUN1zz_oeQpnJxpeaEkFimDeepqyWf https://www.youtube.com/playlist?list=PLRgTUN1zz_oeQpnJxpeaE...
- maremp 7y ago
  > they don't have training, and the hospital itself has no plans in place I have a difficult time grasping this part. It’s not like it’s something completely new. We encounter virus infections every year during flu season. The SARS outbreak was 18 years ago and MERS was 8 years ago. Did we not learn anything from it? Sure, it was not as severe as SARS-CoV-2, but we should know how to handle it. I agree we should take precautions to stop spreading. But from seeing what is going on around here in EU, I am thinking that the panic is over-inflated and is doing more harm than good. Maybe it takes panic and fear to scare the majority of people into taking all precautions to stop the virus from spreading?
RivieraKid 7y ago
Please also read this, I believe it's the right approach: https://medium.com/@jb_89278/the-11-day-plan-to-contain-covid-19-the-global-11-day-plan-99e324630de7 https://medium.com/@jb_89278/the-11-day-plan-to-contain-covi... The guy is tech enterpreneur and VC investor who has been advising our (Czech) PM.
- js2 7y ago
  It would be impossible to do this in the U.S. I'm not sure he appreciates the size of the U.S., the resistance among many Americans who don't like being told what to do, the denial by Fox et al, the distributed nature of our government and on and on. I can't even imagine it working in my county.
  - beatgammit 7y ago
    Yeah, there would be rioting pretty much immediately if anyone tried that here, and I'm sure the same would happen elsewhere. I'm personally a fan of controlled, opt-in infections to help speed up research for a vaccine along with moderate quarantine (cancel many public events, encourage self quarantine). It may not be as effective, but it's much less likely to end in riots.
    - RivieraKid 7y ago
      The alternative may be an explosion of cases and a complete collapse of the health care system. Because there is a good chance that mild social distancing measures are simply not enough.
  - fogleman 7y ago
    It also doesn't consider that many of the infected are asymptomatic, so they won't be "revealed" within the 11 day period.
- epicureanideal 7y ago
  Maybe we should do a Global 11 Day Quarantine every year. Stop the flu and common colds from spreading too. Time it so it happens before peak flu season. Or maybe even twice per year, for the northern and southern hemispheres, if they have different flu season schedules. (Edit: Or just do it once per hemisphere, but with restricted travel between hemispheres during the quarantine.) 22 days at home every year... okay, a bit boring, and the economy would take a small hit from that... BUT, there would also be far fewer people taking sick days, and workers would also get more rest and come back more refreshed. It may only be a net loss of a couple days of work, lets say 3 days of work, 1% of Global GDP. Global GDP grows at about 2-3% per year from what I can see. So a loss of 1% would set us back to the level of late 2019 or New Years' 2020, which was hardly the dark ages. Not to mention Work From Home policies would adapt so it's likely very little productivity would be lost.
meerita 7y ago
The left drove us to the same situation here in Spain. I cannot be more concerned with their politics, sadly, we should be prepared to a massive spread.
rosybox 7y ago
It's unlikely that other countries can do what China has done. As an example, China is able to do 200 CT scans a day at each fever station throughout the affected regions. In the US we can maybe do what 10 CT scans a day with a single machine? In China they were able to figure out within a short duration if someone needed to be quarantined. They built hospitals in days. It's not just about locking down. China has people taking temperatures of people entering their apartments or when they show up at work. There are drones patrolling the streets that detect people with a high temperature. I have a hard time seeing us in the US build out what China did in just a few days.
- tantalor 7y ago
  Do CT scans even help?
  - Osmium 7y ago
    They're an effective diagnostic, faster than testing for the virus directly. At least they seem to be effective at these fever clinics. NYTimes Daily podcast had a good explanation of how these fever clinics work.
  - assblaster 7y ago
    It's like artificially inflated GDP numbers from producing bad steel that nobody will buy. It does something, but in the end it's really nothing, and actually quite wasteful.
C19is20 7y ago
Lockdown resident: i fear our population will get bored off the lockdown, and/or fearful of shops running out of goods (part caused by sick workers, sick transporters, and people taking a risk and going shopping anyway), and by Wednesday there'll be reports of social unrest. This will be seen by other countries, who will impose more stringent curfews, and a cycle of restrictions will start. When the forces of law and order get sick, then the real fun will begin. Of three local food shops to me, one just got closed as a workers spouse has been hospitalised. Tomorrow, do i go get whatever food may be left in the other stores, play hide and seek with the police, then perhaps get sick, or let my family go hungry?
RivieraKid 7y ago
"Flattening the Curve" is a deadly delusion https://medium.com/@joschabach/flattening-the-curve-is-a-deadly-delusion-eea324fe9727 https://medium.com/@joschabach/flattening-the-curve-is-a-dea... "Flatten the curve" scenario requires r0 to between 1.0 and a small number above 1.0, like 1.1. In other words, it's not happening, you either contain the virus or let it explode.
- Medicalidiot 7y ago
  Flattening the curve is the only scenario a lot of countries can realistically do outside of a Wuhan style quarantine.
  - 7177Y 7y ago
    It's certainly effective propoganda to calm the Populus, from the government to the population and the population to itself. Hopefully leaders are sorting out more drastic measures in the meantime.
    - Medicalidiot 7y ago
      My attending went on the news to say that flattening the curve is our best bet at the moment. He's also considered to be one of the top physicians in the region. Y'all can sit here in a bubble, but the medical community has no hallucination that containment should have been done months ago and now it's past that.
- contravariant 7y ago
  It's also somewhat troublesome that for the 'flatten the curve' tactic the best case scenario is still infecting everyone...
  - ElderKorihor 7y ago
    No it isn't. The hope is that at some point a vaccine or lighter treatment becomes available. If that occurs before the end of the flat curve, that's a major change in outcome.
blululu 7y ago
Taiwan is probably the best model for how to handle a pandemic. The Chinese government took strong action well after the virus became a huge problem there. I suspect we will see a similar anti pattern repeated around the globe. I’m sure that Donald Trump will follow the CCP in talking up how he reacted decisively to the problem (a month late in both cases). This type of response hardly deserves praise. Taiwan was swift and proactive in its response, and acted intelligently before drastic measures were needed.
jMyles 7y ago
> From our data, about 10% of patients require ICU (Intensive Care Unit) or sub ICU assistance and about 5% of patients die. I think that we really need to understand precisely what conclusions these represent when we see statements like this. Exactly what does "10% of patients" mean? 10% of those who test positive? 10% of those who test positive and also show symptoms? It seems that a majority of people who contract the virus and test positive (let alone those who are exposed) do not show any symptoms at all.[0] Of those who do show symptoms, estimates regarding how many any seek out, receive, or require care vary widely, so much so that it's very difficult to draw any conclusions using any dataset that I've seen. So I ask: When the authors here say "From our data", exactly what dataset are they using and what operations are they performing on this dataset to arrive at this number? This is crucially important, because if this 10% is actually 10% of those who already seek treatment for respiratory illness, and also subsequently test positive for COVID-19, then the death rate is actually much, much lower than most of the published reports. It seems to me that we need to know the answer to this before proceeding with any other restrictive public policy solutions. I'm particularly concerned with the decision to close schools, which in many cases (at least here in the USA) is inevitably going to lead to kids being placed with grandparents for care, which is a terrible outcome if our goal is to reduce exposure to vulnerable populations. It is OK to question the panic. It is OK to believe, as I do given the available data so far, that the panic is more harmful than the virus itself. I have started a subreddit to gather data and opinions inclined toward using this as an opportunity to appropriately prepare rather than race to drastic solutions likely to hurt vulnerable populations.[1] 0: https://eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.10.2000180 https://eurosurveillance.org/content/10.2807/1560-7917.ES.20... 1: https://www.reddit.com/r/PrepareInsteadOfPanic/ https://www.reddit.com/r/PrepareInsteadOfPanic/
Medicalidiot 7y ago
I was downvoted here recently for sounding the alarm bells on how bad this is going to be and accused of trying to incite panic. Folks, COVID-19 is something that should be taken seriously. President Obama had great advice: "stay calm and listen to the experts". All the experts are saying this is going to be bad and we should be getting ready now for what will happen in the future.
willart4food 7y ago
"Everything we do before a pandemic will seem alarmist. Everything we do after will seem inadequate." - Michael Leavitt, former HHS Secretary under President George W. Bussh
liquidify 7y ago
Here in the U.S.A. in Indianapolis, my 60 year old dad is out at a club right now dancing with his old people girlfriends. He is a smart dude (on paper - tenured professor of finance), but he doesn't think he has a thing to worry about. I hope we get a lock down here. Many people are too selfish, arrogant, and stupid to make the right choices even when it is obvious.
- pinkfoot 7y ago
  I would argue that your father's actions are brutally rational: get the virus now, so he still has a shot at a ventilator before the system is swamped. He could be recovered and immune when the rest of you are figthing over the ICU. Not exactly neighbourly though.
throw7 7y ago
It's too late for the U.S. There isn't a clear, organized, unified direction of testing and action plan for all humans within its borders. That's the only way to get and organize an effective response. We're canceling/closing off large groupings of humans and basically hoping/praying? for the best for the next few weeks. It's sad. This type of haphazard response drives conspiracies and confusion that is then opportunistically taken advantage of by all sectors of power.
seles 7y ago
Lockdown is not a long term solution though. This virus isn't going to disappear anytime soon. It might be good for countries that are getting out of control, but for places where it isn't a problem yet it just delays when it his. Places without a problem yet should take reasonable sustainable precautions to flatten the curve instead. (https://www.flattenthecurve.com/ https://www.flattenthecurve.com/)
- soared 7y ago
  Lockdown is literally what flattens the curve. The slower the virus spreads, the flatter the curve gets. The virus still spreads in lockdown, just at a slower pace. We will likely see resurgences when the lockdown(s) are lifted, but the idea is to plan to do that when we can handle it.
anigbrowl 7y ago
I'm not too optimistic. Scnes like this at multiple US airports. https://twitter.com/JasonWhitely/status/1238986444615618561 https://twitter.com/JasonWhitely/status/1238986444615618561
thepra 7y ago
From Italy, don't trust the Italian media, they are the first that are making so much fuss and wrecking chaos, and especially making quite some money because as an industry it was starving for some time. Statics say clearly what strategy could have been followed to take care of coronavirus without much disruption of the working force. And the people at the government are mostly old farts, which says quite a lot why they panic.
heisenbit 7y ago
> Every minute is exceptionally important as it means saving lives. Don’t waste it! The fact that the US Senate did not speed up the emergency measure by staying is loosing 2 days. At that time the measures are in place the problem is twice as large. In normal times this is just a business day delay but in these times calendar days are the measure and weekends are counted too. We really need to start thinking and acting differently.
mleonhard 7y ago
My relatives will never open a "left" website. Is there a version of this letter with the graphs on another website?
mleonhard 7y ago
Mike Pence is not the right person to manage US response to the virus. We needs someone with different skills. If you live in US, please call your congresspeople and ask them to make a change: https://www.house.gov/representatives https://www.house.gov/representatives https://www.senate.gov/senators https://www.senate.gov/senators

1095 points by magoghm 7y ago

The handwaving arguments in this letter are not convincing (especially the "You do also understand that, as long as the rate of increase is exponential, no linear solution to contrast it will work (I.e. increasing x times the number of ICU machines, etc.)" nonsense). The stats in this very letter indicate that 10% of patients require ventilators, which cost about $4000. So even if the entire population were sick at the same time, would need population * 0.1 ventilators, at a cost of $400 per resident. The fact that we haven't spent $400 per resident to stockpile ventilators is a failure of society and a failure of government. The economic damage over these next few weeks will be far, far greater than $400 per resident.

cobookman 7y ago
If you take every potential apocalyptic scenario and stockpile supplies. It’d add up to much more than 400$/resident. The real shame is globalization. If manufacturing occurred in Europe. In North America...etc. we’d all just quickly ramp up our respirator production. Instead the west outsourced this to China
- stblack 7y ago
  This is only the first part of the problem. The second part is, optimized supply chains that are effectively as empty as possible, all the time. Here in Canada an 18-day rail blockade by native bands was enough to cause serious concerns in the supply of propane and other fuels in the eastern part of the country. It's shocking that eastern half of Canada, the majority of its population, faces winters with just 3-weeks supply of fuel. The reason? Nobody wants to carry inventory. So for many things, we outsource creation, AND we optimize-away buffer stock.
scarmig 7y ago
We've stockpiled some number of ventilators in the USA (though still likely insufficient for the task at hand). The bigger issue is the labor needed to staff them, which has very limited scalability. I wonder how hard it is, and how quickly a moderately intelligent person could be brought up to speed (at least enough to get better outcomes than just leaving the patient to die).

mensetmanusman 7y ago

As a physicist, it still feels odd to me they are talking about statistics with such confidence here. It seems only SK has earned that right and has tested enough people to get reliable statistics. If you only measure the sick in the hospital...

soVeryTired 7y ago
The pattern is fairly consistent across countries [0]: [0] https://www.ft.com/__origami/service/image/v2/images/raw/http%3A%2F%2Fblogs.ft.com%2Fthe-world%2Ffiles%2F2020%2F03%2Ftrajectory-mar14.png?fit=scale-down&source=next&width=700 https://www.ft.com/__origami/service/image/v2/images/raw/htt...
- Animats 7y ago
  That is the most useful graph on this subject so far. Go look at it now. Most countries have exactly the same growth trajectory measured from 100 cases. That's solid data about how this behaves. Singapore and Hong Kong have been able to slow things down by strong measures, but it's still a straight line on a log graph, just with 1/3 of the growth rate. Italy is on the same line, just 8 days ahead of Europe and 13 days ahead of the US. Only South Korea shows flattening so far.
  - TeMPOraL 7y ago
    I still don't get how people - including apparently some governments - don't get or don't believe it. Getting this graph is as simple as 1) taking the daily measurements, and 2) plotting them on log scale (and technically 3) shifting the lines to overlap, but that's just cosmetics). The trajectory of the entire West being the same as Italy's is immediately apparent.
    - Animats 7y ago
      It's much worse than that. Italy's health system is already collapsing at 20,000 victims. The population of Italy is 60 million. That has to level off at some point due to saturation, but that's at somewhere in the millions or tens of millions.

spacephysics 7y ago

We don’t need military patrolling our streets just yet. Not saying it won’t come down to it, but the sentiment in the US is less, uh... flexible, towards being heavily locked down as compared to the aforementioned countries.

hoka-one-one 7y ago
I don't think there's any realistic situation that would justify caving to the isolationism and xenophobia that's been pushed by the Trump administration for the last four years.
- w3mmpp 7y ago
  Are you making a parallel between isolate yourself to not catch and spread a disease with "isolationism and xenophobia"? I sure hope you (and people in general) can separate the 2 concepts or we're really doomed.
  - deleted 7y ago
    [deleted]
  - a9h74j 7y ago
    Agreed. Responding to these situations is in part a collective test of practical intelligence -- or of collective intelligence if you will. Part of practical intelligence is to be capable of precise language (and separating concepts, as you say).
GarrisonPrime 7y ago
Or at least, some people would like to believe that. I suspect an astonishing large number of them will discover differently, should those ideals be put to the test. Just a hunch.
- 7177Y 7y ago
  Much of the herd will comply. Many others will make their stand, especially with the current state of sentiment In the right wing population.

itcrowd 7y ago

Not sure why this is on the number 1 spot currently. This is a letter signed by non-experts (albeit sometimes scientists/engineers). To me, it comes off as the climate-change denier letters or 9/11 "truthers" letters. Please let the experts do their job. Don't spread uninformed opinions backed up by Facebook posts and panicked researchers with expertise "relevant to virus spreading" such as electronics, architecture and art history. Be safe out there but don't let the fear and resulting panic of this virus be worse than the virus itself.

mochomocha 7y ago
Why do you believe this is misinformation? All it's trying to do is mobilize people who understand what an exponential is to act.
freepor 7y ago
The “experts” are not doing their jobs! In the US you would have expected the CDC under the President’s leadership to act decisively and promptly. Obviously this did not happen. The randos are providing much more value than the experts in the US. Other countries like South Korea and Singapore have experts who are doing quite well.
- ComputerGuru 7y ago
  The CDC can’t dictate state policies. These are executive decisions that the CDC can only strongly advise on.
  - mcbits 7y ago
    The CDC effectively dictated who could be tested and what test would be used. But those tests were faulty and now there are supply chain issues with the new tests. That was the point when they gave up and admitted failure. "Mitigation" and "flattening the curve" are admissions of failure. The only hope now is that summer blunts the spread, which is possible but by no means guaranteed.
rozab 7y ago

jakub_g 7y ago

> It’s hard for non-specialists to intuitively grasp the way an exponential rate increase can get out of control. The best way to explain the exponential growth (and shock people) is ask them about https://en.wikipedia.org/wiki/Wheat_and_chessboard_problem https://en.wikipedia.org/wiki/Wheat_and_chessboard_problem

thedance 7y ago
Or you could present them with the classic cognitive reflection question: A lake has one lily pad. Every day the number of lily pads doubles. After fifty days the lake is completely covered by lily pads. How many days did it take to cover half the lake with lily pads?
- kspacewalk2 7y ago
  Is there some parable about getting too excited about exponential growth and taking the extrapolation game way too far?
  - fsckboy 7y ago
    Zeno concluded that all motion was an illusion, so that's taking things pretty far.
- __s 7y ago
  That's a big lake to have room for 1125899906842624 lily pads
  - kspacewalk2 7y ago
    Nonsense. Nothing in the real world can impede the progress of endlessly extrapolating exponential growth and impressing your friends with Really Big Numbers.
  - sk5t 7y ago
    Fortunately, it will only require space for 1125899906842623 pads.

cknoxrun 7y ago

My co-founder and I are really struggling with the decisions ahead of us. We feel we should act quickly, and enforce our team to work from home, but the spread in our city is quite low for now. We also wonder how long this can go on, are we going to be isolated for months? We are at a critical point where we have just closed our seed round this past week. We have both put so much energy and time into this moment and we were ready to work harder and focus on scaling and growth. Of course, the more tragic situation around us makes our issues seem small. I think we will likely announce to our team to work from home starting Monday. How surreal.

justusthane 7y ago
Definitely do it. Way more people are already infected than we know. You can be proactive or reactive, and if you’re reacting it’s already too late.
leppr 7y ago
Take comfort in knowing the whole world will slow down, your competitors included.
- pinkfoot 7y ago
  However, the rent on your offices, the interest on your mortgage, and your school fees will not.
michaelchisari 7y ago
If working from home is an option, then you should absolutely make everyone work from home. Not let, make.
mjoin 7y ago
what if you wait and your employees get sick? if you're in tech, just implement a work from home policy right now. don't wait for the gov to do so. it's a matter of time. - a French
davidw 7y ago
Here's what Paul Graham wrote on twitter: > When you're dealing with exponential growth, the time to act is when it feels too early. https://twitter.com/paulg/status/1237801364023017472 https://twitter.com/paulg/status/1237801364023017472

LeoNatan25 7y ago

Here in Israel, ministry of health wanted a full lockdown. But business won, so only a partial lockdown is enforced, and they are shutting down only clubs and restaurants. People will still be able to visit parks, roam freely, etc. Today there was an article [1] that some idiot that was in quarantine left it and was arrested on the street. There is no discipline. A hard lockdown is likely the best option everywhere. It works, as evident in countries that have enforced it. 1: https://www.ynet.co.il/articles/0,7340,L-5694758,00.html https://www.ynet.co.il/articles/0,7340,L-5694758,00.html

davidw 7y ago
That lasted for a few days in Italy and then they shut it all down anyway. But more people got infected in the meantime!
- LeoNatan25 7y ago
  Exactly, they should have gone all-in and shut it down.
zozbot234 7y ago
> Today there was an article [1] that some idiot that was in quarantine left it and was arrested on the street. There is no discipline. Hopefully he/she was nabbed quickly, without spreading the disease to anyone else. Is Isreal using electronic tagging on those quarantined folks to ensure that they can't just leave their assigned place without anyone knowing about it?
- LeoNatan25 7y ago
  They are starting to talk about it, but there are big privacy concerns of tracking citizens by intelligence agencies. Not sure what the status of this is, but will probably pass parliament because everyone is very scared. They can abolish it later, but we all know they probably won't. It is unclear of the idiot that evaded quarantine is sick or only precautionary, but that's just the people we have—morons. Very different from Hong Kong and Singapore.

iRobbery 7y ago

Just from the start already i dont get a scientific feeling. "In just 3 weeks from the beginning of the outbreak, the virus has reached more than 10.000 infected people." Does this mean only tested 10.000 people? Reads a bit odd though too, i assume they were not infected already when the virus reached them? "From our data, about 10% of patients require ICU (Intensive Care Unit) or sub ICU assistance and about 5% of patients die." Is this from 10% of the people actually going to the hospital, or 10% of all tested, or 10% of all people that got the virus?

toyg 7y ago
>Does this mean only tested 10000 people? Italian health services have tested more than 50k people (the number of tests is over 60k but some people got tested more than once). More than 12k were infected. This is likely to be an underestimate, since we know a lot of infections are asymptomatic.
yelloweyes 7y ago
Who cares. The point is to get people out of their comfortable complacency. Read this one: "We are now in the tragic situation that the most efficient health system of the richest area of the country (Lombardy) is almost at its full capacity and will soon be difficult to assist more people with Covid-19."
- kspacewalk2 7y ago
  I care. These doom and gloom shrieks and exhortations for President Madagascar to Shut. Down. Everything are distracting from the real work governments have to do to tackle this severe and protracted crisis in a competent manner, i.e. following the advice of real, not collective-letter experts.
  - mtmail 7y ago
    The advise from real experts is also to shut everything down.

lbeltrame 7y ago

As an Italian, I raise my eyebrows every time China is mentioned as an example for the successful containment of this virus. It could do that because it could afford to take the economical hit and because it is an authoritarian state, which means you can get almost everyone to obey, in one way or another. Also, the Chinese Party is what caused this mess to begin with, by allowing this virus to spread all around the world. Why on Earth is this a good model? Undoubtedly for the safety of citizens, but even with all the people shouting about a "fascist revolution" going on with the previous government, it only took three orders to strip everyone of most of their freedoms without anyone batting an eye (especially since no one knows for how long, the April 3rd date is a joke). Quarantining is probably inevitable (although it won't help the overloaded ICUs until two weeks from now, so more capacity will always be needed), but following rules in place in an outbreak does not mean one should not question their principles. And this letter should be sent to the media and the government, since both can't even understand an exponential, or basic statistics (even with the so-called "peak" reached, cases will keep on increasing until recoveries are due). Personally I'd like fast-tracking of anti-SARS-CoV-2 drugs instead (those are the ones which will get out of this mess, quarantining is just flattening the curve, although immensely beneficial), along with setting up place for non-intensive care COVID-19 patients. Every ICU bed freed is a victory.

incompatible 7y ago
"China could afford to take the economical hit" The faster and better that you deal with it, the smaller the economic hit is going to be. China is going to be the big winner here.
- greedo 7y ago
  Although China has a large internal market, they still rely on exports. If those are curtailed due to slackening demand, quarantine and tariffs, how do they become the "big winner?"
  - incompatible 7y ago
    Well, smaller loser than they would have been if they'd allowed the virus to spread unchecked.

mirimir 7y ago

Maybe Italy is a worst case, both because it didn't quarantine early enough, and because greater population inversion. > It's now a well-established fact that older people and those with underlying health issues are more susceptible to succumbing to Covid-19. With 23 percent Italians aged 65 or above and a median age of 47.3, the Italian population is the oldest in Europe. This is chiefly responsible for the high fatality rate in Italy.[0] Also these articles.[1,2] And similar to the age effect in China. 0) https://www.ibtimes.sg/fatality-rate-7-16-why-coronavirus-death-rate-double-italy-rest-world-40975 https://www.ibtimes.sg/fatality-rate-7-16-why-coronavirus-de... 1) https://nypost.com/2020/03/12/heres-why-the-coronavirus-death-rate-is-so-high-in-italy/ https://nypost.com/2020/03/12/heres-why-the-coronavirus-deat... 2) https://www.theguardian.com/world/2020/mar/03/italy-elderly-population-coronavirus-risk-covid-19 https://www.theguardian.com/world/2020/mar/03/italy-elderly-...

sorum 7y ago
Italy isn't the worst case, they're just 2 weeks' ahead of most other countries. Looking at the latest SitRep from WHO, my home country (Sweden) has small no. infected (775), but grew 25% vs the previous day. If that rate keeps up, number of infected will keep on doubling every 4-5 days and in 14 days' time will be at what Italy is today (17k infected). And then another week later it'll break 100k. Exponential growth is a bastard in that sense.
- mirimir 7y ago
  True. But still, maybe Italy is a worst case. Trying to be optimistic here, being >70 and all ;)
  - goatlover 7y ago
    Iran is likely the worst case, but it’s hard to know the full situation there.
- elorant 7y ago
  I had the same worries for Greece when in just two days recorded cases doubled from 100 to 200, but since the government imposed partial lockdown measures the rate of infections slowed down significantly. My guess is the same will happen everywhere. It's just that it's easier to see the growth slowing when you have an order of magnitude less incidents than Italy. We have to trust the process.

delegate 7y ago

I've seen comments here trying to play down the message or discredit the signatories of this letter. Don't. Please take it seriously. This is not sensationalism. What the letter means is that if your country is not there yet, you might be DAYS away from widespread panic and total lock down. I'm writing this from Barcelona, Spain. This last Sunday, 6 days ago, I went on a walk with my girlfriend, had a nice lunch, took beautiful pictures... The virus was just some nagging news.. A couple of hundred people infected somewhere far away. 6 days later, we're at over 6000 infections, the country is in total lock down. Same pattern as Italy (even faster), we're just a couple of days away before tens of thousands is reached. This is what exponential growth means.

rimliu 7y ago
We (Lithuania) are going into more or less total lockdown since coming midnight. With 8 active cases (first confirmed case recovered and was released home). I only wish government would be more aggressive with testing.
cl42 7y ago
I believe you’re correct. The SK approach has been more focused on individual quarantines and aggressive monitoring: https://www.aljazeera.com/news/2020/03/italy-south-korea-differ-tackling-coronavirus-outbreak-200313062505781.html https://www.aljazeera.com/news/2020/03/italy-south-korea-dif...
baby 7y ago
Can we make sure we’re reading this kind of information when given by people who actually study and work in a relevant field? Now more than ever we should look at the source of every information. I know I'm going to get downvoted for saying this, but I think it is important enough.
- everybodyknows 7y ago
  It is fair to observe that the expertise here is math rather than medicine. However, epidemiologists have already made these predictions. Don't see any harm in signalling broader academic support. Particularly not since none of the signatories could plausibly be accused of exaggerating the danger, in order to extract grant money. As goes the usual cynical claim of innumerate science-deniers.

Camillo 7y ago

This is not "from Italy", it's been organized by a far-left Italian magazine. Yes, they are "from Italy", but the title is disingenuous and misleading. Note that the page lists "the editors" (of the magazine) as the authors, and the first signature is by the magazine's publisher. The rest appear to be various academic personalities they have reached out to, many of them not from Italy or in Italy. As for the contents, I don't necessarily disagree with the advice, but this letter is not particularly well written, nor particularly authoritative. For example, this section: > The beginning of the outbreak had the exact same number of infections in China, Italy, and other countries. The difference is that China strongly and quickly locked down Wuhan and all of the Hubei region 8 days before Italy [3]. This is an exceedingly poor phrasing, almost seeming to suggest that the outbreak started with a few cases everywhere in the world at the same time. Inadvertently or not, this dovetails with China's PR push trying to claim that the epidemic may not have started there (something that is readily disproven by all epidemiological and genetic evidence). Even setting aside the potential for confusion, the claim on its face is clearly baseless. Maybe the outbreak started with ten people getting infected in the Wuhan wet market on the same day (if we go by the wet market theory), while in Italy it started with a single infected person entering the country. Or, vice versa, maybe in China it started from a single infected person, and in Italy it was brought in by ten different people carrying it into the country separately. Who's to say? At any rate, if you look at the source for that claim, you can see that it is shifting the timelines to align at some particular point in the outbreak, and it is comparing the time from that point when China imposed the Wuhan lockdown with the time when Italy imposed the whole-country lockdown. The source is certainly more interesting, and gives a better picture of the situation than the letter does (although we have seen similar and better analyses in English for a while). However, the "8 days" figure is somewhat arbitrary. For example, Italy imposed a partial lockdown on the areas of the country where individual cases were found days before they shifted to a whole-country lockdown. Maybe that date should have been compared instead? By the best information currently available, the first case in Italy came from a person who was infected in Germany. According to the letter's claim, the outbreak starts with "the exact same number of infections" (one, presumably), and then grows at the same speed. But then Germany's timeline should be ahead of Italy, yet it's not. Then there is the elephant in the room, of course. If you cannot rely on China's lockdown to contain the infection, then the rational and prudent thing to do was not to wait for outbreaks in other countries and impose lockdowns there. It was to restrict and heavily control international travel (cancel flights, test all passengers, force visitors to quarantine, etc.). Would that have been accepted by the public? Would that have been accepted by the authors of this letter? tl;dr: title is grossly misleading, please correct.

exegete 7y ago

The last part urges lockdowns like China and South Korea but my understanding is that South Korea has not been doing lockdowns and instead was able to ramp up testing quickly and isolate infected from others. Is that incorrect?

Benmcdonald__ 7y ago
Yes no lock downs and I believe minimal travel restrictions (only Wuhan, China?). They did extend the school holidays. Even in the center of the outbreak Daegu there was no lockdown in the city.
- Benmcdonald__ 7y ago
  Other things people probably don't realise about Korea. Self isolating and monitoring for people entering the country. Also they aggressive tracked contact with infected people. Watching supermarket survalence video seeing who they were near and then publishing nationally the time and location of where they had been
  - pbourke 7y ago
    plus everyone is wearing a mask
- dba7dba 7y ago
  S. Korea has a very aggressive investigation of movements of infected persons. Once a person is found to be infected, they go through CCTV recordings, cellphone location records, etc and warn people who were in the same location at same time. They also release to the press the location/time infected person was at, such as name of hospital/events. And these are reported to the public. So S. Korea does not do a carpet bombing type of lock down as China but more of a surgical strike type of lock down. But it is a lock down.
klipt 7y ago
Yes but Western countries are past the point where that is effective. https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop... > The lengths at which it went to contain the virus are mind-boggling. For example, they had up to 1,800 teams of 5 people each tracking every infected person, everybody they got interacted with, then everybody those people interacted with, and isolating the bunch. That’s how they were able to contain the virus across a billion-people country. > This is not what Western countries have done. And now it’s too late.

deleted 7y ago

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blondie9x 7y ago

One of the most important upvotes of our lives.

x__x 7y ago

This post does not feel like it rose naturally to the top of HN

jacquesm 7y ago
My upvote was entirely natural. If you have proof of vote brigadeering you should send it to hn@ycombinator.com, speculation is pointless and against the guidelines.

riazrizvi 7y ago

The time shifted rates of growth tell a compelling story, along with the fact that 1000 people out of 10000 required hospitalization. That is certainly statistically significant. I am now concerned that my birth country, the UK, has the wrong response. UK hospitals will not be able to handle that much traffic.

thehoomanist 7y ago

Also someone from Italy here: never, ever praise China as it is the same authoritarian state that caused all these deaths by silencing the truth when it mattered the most. Had they not violently censored doctors (like their own people or the current holocaust being carried on against Muslims), we would not be suffering through this devastation. This is also absolutely not an open letter "from Italy": it's a message from a minor—poorly written— publication.

mirrorlake 7y ago

Can anyone vouch for the legitimacy of the names on this list? Is this authentic? I've been running my own numbers, and it does not seem far fetched at all. Governments need to be taking this extremely seriously.

dsqrt 7y ago
For what it means, I know some of the people on that list and I can say that they are real scientists.

lowdose 7y ago

Why didn't more people die in China?

jstanley 7y ago
Because Wuhan started welding people's doors shut as soon as they passed 400 new known cases in a single day. That kind of behaviour is not acceptable in the West (nor should it be, anywhere), but we still probably need to be taking this virus a bit more seriously than we are.
- devit 7y ago
  I think these claims of "this is not acceptable in the West" are absurd and one of the causes of the current catastrophe. All you need is to pass a law and enforce it with police and military, it's not hard. Since there is a good reason for the law, there won't be widespread resistance, and in fact on balance citizen are likely to help enforcement rather than hinder it.

stevespang 7y ago

Italy <may> have a mutated strain . . .

ausjke 7y ago

It's said Germany does not lock down cities and fatality remains to be extremely low, which gives British, even USA the confidence to practice herd immunity. I hope in US we will not see this exponential infected scenario, finger crossed.

pedrocr 7y ago
Germany seems to be doing the South Korea solution of very extensive testing and quarantine so that they end up with more confirmed cases that in other places would not even be found. That drives down their mortality rate just because the denominator is bigger. But that just means they're more days behind in the exponential than the confirmed cases number would suggest. It does not mean they have it under control.
temac 7y ago
Exp is the simplest, and works very well with this virus. To not get exp you have to basically eradicate it (can be done locally with strict lockdown measures, but one day or another you will have to lift them...)
hesk 7y ago
German cities are starting to lock down. Berlin has canceled any gathering with more than 50 people. If it's less than 50 people, you have to keep a list of everybody who's there for a month. Schools are closed. As are recreational places (cinemas, clubs, museums, gyms, baths). Restaurants have to enforce 1.5 meters separation between patrons. https://www.berlin.de/rbmskzl/aktuelles/rathaus-aktuell/2020/meldung.906890.php https://www.berlin.de/rbmskzl/aktuelles/rathaus-aktuell/2020... It's not quite Italy yet but it's close.

jyrkesh 7y ago

I've been using https://meet.jit.si/ https://meet.jit.si/ through OBS with family to share content/games and webcam chat. Works great on mobile with apps, desktop on web.

lazyjones 7y ago

The fact that growth rates seem very similar in all affected countries, baffles me. Surely lifestyles, social structure (number of families/kids etc.), hygiene habits differ slightly and testing rates/effectiveness of the health system varies greatly among them. If these factors aren't important, does social life even matter? The effectiveness of China's lockdown is a good argument for it, but perhaps they were just more effective at identifying and isolating spreaders? My point is that there's a chance that it spreads through the air or in some other way unaffected by curfews etc. (if you leave the windows open...).

tim333 7y ago
It's not true that they are similar in all affected countries. The ones in that graph are cherry picked for similarity. If you look at China, Taiwan, Singapore etc there are differences. eg Fujian https://mackuba.eu/corona/#fujian_china https://mackuba.eu/corona/#fujian_china Taiwan https://mackuba.eu/corona/#taiwan https://mackuba.eu/corona/#taiwan HK https://mackuba.eu/corona/#hong_kong https://mackuba.eu/corona/#hong_kong Taiwan is impressive in that they had thousands of flights a month to China, have only 30 active cases and no lockdowns. They had people ride on the planes from Wuhan to identify sick passengers during the flight and quarantine them on landing. As a Brit I'm embarrassed by our performance in comparison.

deleted 7y ago

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feral 7y ago

I work as Principal ML Engineer, and did a little epidemic modeling in my ML PhD. I wrote an analysis of how this is going to hit Ireland, including the best calculations I could find on fatality rate: https://medium.com/@fergal.reid/predicting-the-impact-of-coronovirus-on-ireland-bff1b6d00d6a https://medium.com/@fergal.reid/predicting-the-impact-of-cor... I think that left unchecked this could kill millions of Americans in a couple of months. I'd love to be wrong.

hn_throwaway_99 7y ago
I thought that was an excellent analysis. Thank you.
masklinn 7y ago
For people who don’t find that clear enough, here’s a bloke comparing the obits in L’Eco Di Bergamo between Feb 9 and Mar 13: https://twitter.com/benphillips76/status/1238854071509016577 https://twitter.com/benphillips76/status/1238854071509016577 February 9 is 1 1/2 pages. March 13 is 10 full pages.
toohotatopic 7y ago
>If that trajectory persists, and we don’t arrest it, in the 2 weeks closest to peak rate, we’ll have seen 75% of our cases emerge. vs >in a couple of months. Why months? If there are 75% of the cases within 2 weeks, won't 75% of the deaths also occur within 2 weeks?
- bo1024 7y ago
  It says in the two weeks closest to peak rate. So if the peak is mid-May, those 75% would all fall in May.

bengalister 7y ago

Here in France even with the Italian experience relayed in the press, i.e doctors having to make many times a day a choices between the ones who will live or die, many people don't take it seriously. I am shocked but not surprised by the behavior of my fellow citizens. Many people still went out shopping, went to the restaurants, still think it is a simple seasonal flu and do not at all comply with the recommendations of avoiding contacts. The government decided at last today to close the restaurants and most of the shops except grocery stores and drug stores. Also I think in France at some point the army will have to be called to help, to let policemen enforce the rules and be used to secure sensitive sites. With the periodic social unrest that France endures since the last major "ethnic" riots of 2005 and the more recent and more social yellow vest protests, I am afraid that in France there will be also a lot of indirect deaths of the sars-cov-2 pandemic.

rambojazz 7y ago
> I am shocked but not surprised by the behavior of my fellow citizens. Many people still went out shopping, went to the restaurants, still think it is a simple seasonal flu and do not at all comply with the recommendations of avoiding contacts. This is what happened in Italy as well. 1. people are recommended to stay the fuck home and reduce physical interactions 2. most people don't care and carry on with their normal life 3. state now needs to enforce harsh rules because people don't seem to understand that it's serious 4. some people still don't care, go to parks, beaches, private parties

joshstrange 7y ago

Chris Martenson likes to say "If the facts scare you, the problem isn't with the facts". (also check out his COVID-19 updates, I think they are very well done! [0]) You may think "it's not here yet". It is. You may think "the numbers are low". They aren't. We are failing miserably in our testing, our numbers are easily off by a factor of 10 (for infections). You might not want to be "weird" and not want to practice social distancing. You need to. You need to act when it feels too early and honestly, in the US, that was a week+ ago so at least act now. I don't say these things to whip people up in a panic, I say them because we are about to get hit hard here in the US. If you know a nurse maybe send them a text and ask how they feel. I can tell you the nurses I know are freaking out because they know we are not prepared. A have a friend who works at a big hospital. They have 2 cases (at least as of a day ago) and they almost buckled under it. They don't have many masks, they don't have training, and the hospital itself has no plans in place. When asked "How many masks do we have?" the answer (on Thursday of this week) was "I don't know" from the head of infections diseases. Let that sink in. March 12th. I can understand not knowing the count off the top of your head in November 2019, I can understand it in December 2019, I can still wrap my head around not knowing it in January 2020 but damn it... It's March, you are in a meeting to discuss COVID-19 and you don't know how many masks you have on hand? The world has been warning us for months now and they had no plans for how to handle visitors. The nurses have not done n95 mask fit tests. They are not getting clear direction on how handle mask reuse. We are not prepared for this. If this hospital (which I would trust for any major procedure) is feeling the strain with 2 patients what happens when there are 4? 8? 16? 32? [0] https://www.youtube.com/playlist?list=PLRgTUN1zz_oeQpnJxpeaEkFimDeepqyWf https://www.youtube.com/playlist?list=PLRgTUN1zz_oeQpnJxpeaE...

maremp 7y ago
> they don't have training, and the hospital itself has no plans in place I have a difficult time grasping this part. It’s not like it’s something completely new. We encounter virus infections every year during flu season. The SARS outbreak was 18 years ago and MERS was 8 years ago. Did we not learn anything from it? Sure, it was not as severe as SARS-CoV-2, but we should know how to handle it. I agree we should take precautions to stop spreading. But from seeing what is going on around here in EU, I am thinking that the panic is over-inflated and is doing more harm than good. Maybe it takes panic and fear to scare the majority of people into taking all precautions to stop the virus from spreading?

RivieraKid 7y ago

Please also read this, I believe it's the right approach: https://medium.com/@jb_89278/the-11-day-plan-to-contain-covid-19-the-global-11-day-plan-99e324630de7 https://medium.com/@jb_89278/the-11-day-plan-to-contain-covi... The guy is tech enterpreneur and VC investor who has been advising our (Czech) PM.

js2 7y ago
It would be impossible to do this in the U.S. I'm not sure he appreciates the size of the U.S., the resistance among many Americans who don't like being told what to do, the denial by Fox et al, the distributed nature of our government and on and on. I can't even imagine it working in my county.
- beatgammit 7y ago
  Yeah, there would be rioting pretty much immediately if anyone tried that here, and I'm sure the same would happen elsewhere. I'm personally a fan of controlled, opt-in infections to help speed up research for a vaccine along with moderate quarantine (cancel many public events, encourage self quarantine). It may not be as effective, but it's much less likely to end in riots.
  - RivieraKid 7y ago
    The alternative may be an explosion of cases and a complete collapse of the health care system. Because there is a good chance that mild social distancing measures are simply not enough.
- fogleman 7y ago
  It also doesn't consider that many of the infected are asymptomatic, so they won't be "revealed" within the 11 day period.
epicureanideal 7y ago
Maybe we should do a Global 11 Day Quarantine every year. Stop the flu and common colds from spreading too. Time it so it happens before peak flu season. Or maybe even twice per year, for the northern and southern hemispheres, if they have different flu season schedules. (Edit: Or just do it once per hemisphere, but with restricted travel between hemispheres during the quarantine.) 22 days at home every year... okay, a bit boring, and the economy would take a small hit from that... BUT, there would also be far fewer people taking sick days, and workers would also get more rest and come back more refreshed. It may only be a net loss of a couple days of work, lets say 3 days of work, 1% of Global GDP. Global GDP grows at about 2-3% per year from what I can see. So a loss of 1% would set us back to the level of late 2019 or New Years' 2020, which was hardly the dark ages. Not to mention Work From Home policies would adapt so it's likely very little productivity would be lost.

meerita 7y ago

The left drove us to the same situation here in Spain. I cannot be more concerned with their politics, sadly, we should be prepared to a massive spread.

rosybox 7y ago

It's unlikely that other countries can do what China has done. As an example, China is able to do 200 CT scans a day at each fever station throughout the affected regions. In the US we can maybe do what 10 CT scans a day with a single machine? In China they were able to figure out within a short duration if someone needed to be quarantined. They built hospitals in days. It's not just about locking down. China has people taking temperatures of people entering their apartments or when they show up at work. There are drones patrolling the streets that detect people with a high temperature. I have a hard time seeing us in the US build out what China did in just a few days.

tantalor 7y ago
Do CT scans even help?
- Osmium 7y ago
  They're an effective diagnostic, faster than testing for the virus directly. At least they seem to be effective at these fever clinics. NYTimes Daily podcast had a good explanation of how these fever clinics work.
- assblaster 7y ago
  It's like artificially inflated GDP numbers from producing bad steel that nobody will buy. It does something, but in the end it's really nothing, and actually quite wasteful.

C19is20 7y ago

Lockdown resident: i fear our population will get bored off the lockdown, and/or fearful of shops running out of goods (part caused by sick workers, sick transporters, and people taking a risk and going shopping anyway), and by Wednesday there'll be reports of social unrest. This will be seen by other countries, who will impose more stringent curfews, and a cycle of restrictions will start. When the forces of law and order get sick, then the real fun will begin. Of three local food shops to me, one just got closed as a workers spouse has been hospitalised. Tomorrow, do i go get whatever food may be left in the other stores, play hide and seek with the police, then perhaps get sick, or let my family go hungry?

RivieraKid 7y ago

"Flattening the Curve" is a deadly delusion https://medium.com/@joschabach/flattening-the-curve-is-a-deadly-delusion-eea324fe9727 https://medium.com/@joschabach/flattening-the-curve-is-a-dea... "Flatten the curve" scenario requires r0 to between 1.0 and a small number above 1.0, like 1.1. In other words, it's not happening, you either contain the virus or let it explode.

Medicalidiot 7y ago
Flattening the curve is the only scenario a lot of countries can realistically do outside of a Wuhan style quarantine.
- 7177Y 7y ago
  It's certainly effective propoganda to calm the Populus, from the government to the population and the population to itself. Hopefully leaders are sorting out more drastic measures in the meantime.
  - Medicalidiot 7y ago
    My attending went on the news to say that flattening the curve is our best bet at the moment. He's also considered to be one of the top physicians in the region. Y'all can sit here in a bubble, but the medical community has no hallucination that containment should have been done months ago and now it's past that.
contravariant 7y ago
It's also somewhat troublesome that for the 'flatten the curve' tactic the best case scenario is still infecting everyone...
- ElderKorihor 7y ago
  No it isn't. The hope is that at some point a vaccine or lighter treatment becomes available. If that occurs before the end of the flat curve, that's a major change in outcome.

blululu 7y ago

Taiwan is probably the best model for how to handle a pandemic. The Chinese government took strong action well after the virus became a huge problem there. I suspect we will see a similar anti pattern repeated around the globe. I’m sure that Donald Trump will follow the CCP in talking up how he reacted decisively to the problem (a month late in both cases). This type of response hardly deserves praise. Taiwan was swift and proactive in its response, and acted intelligently before drastic measures were needed.

jMyles 7y ago

> From our data, about 10% of patients require ICU (Intensive Care Unit) or sub ICU assistance and about 5% of patients die. I think that we really need to understand precisely what conclusions these represent when we see statements like this. Exactly what does "10% of patients" mean? 10% of those who test positive? 10% of those who test positive and also show symptoms? It seems that a majority of people who contract the virus and test positive (let alone those who are exposed) do not show any symptoms at all.[0] Of those who do show symptoms, estimates regarding how many any seek out, receive, or require care vary widely, so much so that it's very difficult to draw any conclusions using any dataset that I've seen. So I ask: When the authors here say "From our data", exactly what dataset are they using and what operations are they performing on this dataset to arrive at this number? This is crucially important, because if this 10% is actually 10% of those who already seek treatment for respiratory illness, and also subsequently test positive for COVID-19, then the death rate is actually much, much lower than most of the published reports. It seems to me that we need to know the answer to this before proceeding with any other restrictive public policy solutions. I'm particularly concerned with the decision to close schools, which in many cases (at least here in the USA) is inevitably going to lead to kids being placed with grandparents for care, which is a terrible outcome if our goal is to reduce exposure to vulnerable populations. It is OK to question the panic. It is OK to believe, as I do given the available data so far, that the panic is more harmful than the virus itself. I have started a subreddit to gather data and opinions inclined toward using this as an opportunity to appropriately prepare rather than race to drastic solutions likely to hurt vulnerable populations.[1] 0: https://eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.10.2000180 https://eurosurveillance.org/content/10.2807/1560-7917.ES.20... 1: https://www.reddit.com/r/PrepareInsteadOfPanic/ https://www.reddit.com/r/PrepareInsteadOfPanic/

Medicalidiot 7y ago

I was downvoted here recently for sounding the alarm bells on how bad this is going to be and accused of trying to incite panic. Folks, COVID-19 is something that should be taken seriously. President Obama had great advice: "stay calm and listen to the experts". All the experts are saying this is going to be bad and we should be getting ready now for what will happen in the future.

willart4food 7y ago

"Everything we do before a pandemic will seem alarmist. Everything we do after will seem inadequate." - Michael Leavitt, former HHS Secretary under President George W. Bussh

liquidify 7y ago

Here in the U.S.A. in Indianapolis, my 60 year old dad is out at a club right now dancing with his old people girlfriends. He is a smart dude (on paper - tenured professor of finance), but he doesn't think he has a thing to worry about. I hope we get a lock down here. Many people are too selfish, arrogant, and stupid to make the right choices even when it is obvious.

pinkfoot 7y ago
I would argue that your father's actions are brutally rational: get the virus now, so he still has a shot at a ventilator before the system is swamped. He could be recovered and immune when the rest of you are figthing over the ICU. Not exactly neighbourly though.

throw7 7y ago

It's too late for the U.S. There isn't a clear, organized, unified direction of testing and action plan for all humans within its borders. That's the only way to get and organize an effective response. We're canceling/closing off large groupings of humans and basically hoping/praying? for the best for the next few weeks. It's sad. This type of haphazard response drives conspiracies and confusion that is then opportunistically taken advantage of by all sectors of power.

seles 7y ago

Lockdown is not a long term solution though. This virus isn't going to disappear anytime soon. It might be good for countries that are getting out of control, but for places where it isn't a problem yet it just delays when it his. Places without a problem yet should take reasonable sustainable precautions to flatten the curve instead. (https://www.flattenthecurve.com/ https://www.flattenthecurve.com/)

soared 7y ago
Lockdown is literally what flattens the curve. The slower the virus spreads, the flatter the curve gets. The virus still spreads in lockdown, just at a slower pace. We will likely see resurgences when the lockdown(s) are lifted, but the idea is to plan to do that when we can handle it.

anigbrowl 7y ago

I'm not too optimistic. Scnes like this at multiple US airports. https://twitter.com/JasonWhitely/status/1238986444615618561 https://twitter.com/JasonWhitely/status/1238986444615618561

thepra 7y ago

From Italy, don't trust the Italian media, they are the first that are making so much fuss and wrecking chaos, and especially making quite some money because as an industry it was starving for some time. Statics say clearly what strategy could have been followed to take care of coronavirus without much disruption of the working force. And the people at the government are mostly old farts, which says quite a lot why they panic.

heisenbit 7y ago

> Every minute is exceptionally important as it means saving lives. Don’t waste it! The fact that the US Senate did not speed up the emergency measure by staying is loosing 2 days. At that time the measures are in place the problem is twice as large. In normal times this is just a business day delay but in these times calendar days are the measure and weekends are counted too. We really need to start thinking and acting differently.

mleonhard 7y ago

My relatives will never open a "left" website. Is there a version of this letter with the graphs on another website?

mleonhard 7y ago

Mike Pence is not the right person to manage US response to the virus. We needs someone with different skills. If you live in US, please call your congresspeople and ask them to make a change: https://www.house.gov/representatives https://www.house.gov/representatives https://www.senate.gov/senators https://www.senate.gov/senators