First it came for Wuhan
Update (March 13): One day after I put up this post—a post that many commenters criticized as too alarmist—the first covid cases were detected in Austin. As a result, UT Austin closed its campus (including my son’s daycare), and at 3:30am, the Austin Independent School District announced its decision to suspend all schools until further notice. All my remaining plans for the semester (including visits to Berkeley, Stanford, Harvard, CU Boulder, Fermilab, Yale, and CMU) are obviously cancelled. My family is now on lockdown, in our house, probably at least until the summer. The war on the virus has reached us. The “1939” analogy that I mentioned in the post turned out to be more precise than I thought: then, as now, there were intense debates about how just serious the crisis would be, but those debates never even had a chance to get settled by argument; events on the ground simply rendered them irrelevant.
Scott’s foreword: This week Steve Ebin, a longtime Shtetl-Optimized reader (and occasional commenter) from the San Francisco tech world, sent me the essay below. Steve’s essay fit too well with my own recent thoughts, and indeed with this blog’s title, for me not to offer to share it here—and to my surprise and gratitude, Steve agreed.
I guess there are only two things I’d add to what Steve wrote. First, some commenters took me to task for a misplaced emphasis in my last coronavirus post, and on further reflection, I now concede that they were right. When a preventable catastrophe strikes the world, what’s always terrified me most are not the ranting lunatics and conspiracy theorists, even if some of those lunatics actually managed to attain the height of power, from where they played a central role in the catastrophe. No, what’s terrified me more are the blank-faced bureaucrats who’ve signed the paperwork that amounted to death warrants. Like, for example, the state regulators who ordered the Seattle infectious disease expert to stop, after she’d had enough of the government’s failure to allow corona tests, took it upon herself to start testing anyway, and found lots of positive results. Notably, only some countries have empowered lunatics, but the blank-faced bureaucrats rule everywhere unless something stronger overrides them.
Second, I’ll forever ask myself what went wrong with me, that it took me until metaphorical 1939 to acknowledge the scale of an unfolding catastrophe (on more than a purely intellectual level)—even while others were trying to tell me way back in metaphorical 1933. Even so, better metaphorical 1939 than metaphorical 1946.
Without further ado, Steve’s essay:
The most expensive meal I ever ate was in San Francisco at a restaurant called Eight Tables. As the name implies, the restaurant has only eight tables. The meal cost $1,000 and featured 12 courses, prepared by award-winning chefs.
The most expensive meal a person ever ate was in late 2019, in China, and consisted of under-cooked bat meat. It cost trillions of dollars. The person who ate it, possibly a peasant, changed the course of the 21st century. The bat he ate contained a virus, and the virus threatened to spread from this man to the rest of humanity.
I’m making up some details, of course. Maybe the man wasn’t a peasant. Or he could have been a woman. Or the bat could have been a pangolin. Or maybe, through a lucky accident (the guy was a loner perhaps), it could have not spread. That could have happened, but it didn’t. Or maybe sometimes that does happen and we don’t know it. These are just accidents of history.
I’m writing this on March 9, 2020. The good news is that the virus, in its current form, doesn’t kill children. I am so thankful for that. The bad news is that the virus does kill adults. The virus is like a grim reaper, culling the sick, the debilitated, and the elderly from the population. It attacks the pulmonary system. I heard a 25-year-old survivor describing how he became unable to control his breathing and could not fall asleep or he would die. Even for healthy young people, the prognosis is often poor.
There were Jews in Europe in the 1930s who sat around tables with the elders of their families and villages and debated whether to leave for America, or Palestine, or South America. Most of them, including my grandmother’s family, didn’t leave, and were largely exterminated. The virus of the time was Nazism, and it too attacked the pulmonary systems of the old and the debilitated, in that case with poisonous gasses.
When you grow up as I did, you are taught to have a paranoia in the back of your mind that there is a major disaster about to happen. That a holocaust, or something of that magnitude, might occur in your lifetime. And so you are never complacent. For your whole life, you’re looking and waiting for a history changing event. You try to ensure that you are willing to follow your thoughts to their logical conclusion and take the necessary actions as a result, unlike many of the Jews of 1930s Europe, who refused to confront the obstacle in front of them until it was too late, and unlike many politicians and world leaders today, who are doing the same.
And the conclusion we must now confront is clear. We are watching a once-in-a-century event unfold. Coronavirus–its mutations, its spawn–will change the course of human history. It will overwhelm our defense system and may kill millions. It may continue to mutate and kill millions more. We will develop painful social measures to slow its spread. We will produce vaccines and better treatment protocols. Some of this will help, but none of this will work perfectly. What will happen to society as this unfolds?
My favorite biblical verse comes from Ecclesiastes: To everything there is a season, and a time to every purpose under the heaven. A time to be born, and a time to die. A time to plant and a time to pluck that which is planted. And so on.
The season has changed, and the seven years of famine have begun.
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Comment #1 March 12th, 2020 at 8:56 am
You concede, but you persist in your insistence that “some of those lunatics” “played a central role in the catastrophe”. Pfui! The lunatics you have in mind have no effective authority over the bureaucrats, who constitute the vast bulk of the actual federal government, of the officials, officers of the CDC and so on. The “lunatics” can’t fire, promote or demote them, can’t discipline them except for the grossest possible violations of criminal law, can’t set compensation, often can’t or are very strongly not supposed to set policy* – and even when they do set policy, they have no mechanisms to enforce its execution. Career bureaucrats can afford to drag their feet and wait until the current set of lunatics are voted out of office. In addition, they can and do help the process through leaks to the press – who do you think all the unnamed officials are whose opinions are quoted in the articles? – and have the further advantage that almost everybody tends to think “those lunatics” when seeing the words “federal government”, thus automatically imputing blame to the “lunatics”, like you do.
* compare last year’s Congress hearings on foreign policy: career State Department people were flabbergasted that a mere President had the temerity to act contrary to established foreign policy. This isn’t news, either. I don’t take a position here on the substance of the policy disagreement. It may well be that Trump’s foreign policy was stupider than the permanent government’s, and it may be the opposite.
Comment #2 March 12th, 2020 at 9:02 am
While not trying to downplay the risks of coronavirus at all, I’m hopeful that this is painting a picture at least somewhat worse than reality (if not significantly worse).
While I think governments should *prepare* for the worst, I think there are legitimate reasons to think that the mortality rate isn’t as bad as it first appeared (e.g. South Korea), and the scenarios of mutations etc. sound scary, but at least should be countered with remembering that we’ll also have vaccines and/or better treatment protocols.
Comment #3 March 12th, 2020 at 9:27 am
Hi. I am deeply sympathetic to Steve’s overall point, on several levels.
But I can’t help but wonder at this part of the metaphor — isn’t it true that, through most of the 30s, most countries were either largely or completely closed to Jewish immigration, so that, in practice, the vast majority of those who did not flee actually could not have?
Someone more knowledgeable about this — please correct me.
Comment #4 March 12th, 2020 at 9:42 am
Candice III #1: I guess that, unlike you or (say) Mencius Moldbug, I’m a proponent of the wild, nutty theory that the President of the United States has some actual power. Right now I think there’s still a huge range of possible outcomes for the US, from ~250K deaths on the low end to ~10M on the high end. If we manage to hit the lower end of the range, it will be despite having a president who hollowed out the CDC, disbanded the White House pandemic response team, and publicly encouraged the belief that the threat was a liberal hoax.
Comment #5 March 12th, 2020 at 9:45 am
I can’t agree more with the comparison to the holocaust. We should learn from them how only the people willing to abandon their daily routine, realize the horror of the situation and do everything to survive, were the survivors.
Call me a conspiracy theorist, but I don’t think that the fact this happened right next to China’s most dangerous pathogen research facility a coincidence. What exactly happened there no one will know, but their silencing attempts, the fact they somehow knew from the start how deadly this is going to get before it barely killed anyone, the countless references showing researchers from that same facility researching bat corona viruses, everything seems to lead to this being a biological Chernobyl. The complete lack of information coming from china also leads me to believe they were building their research on existing research from that same facility. They otherwise would have no incentives to conceal their research from the rest of the world.
Comment #6 March 12th, 2020 at 9:50 am
Hi Scott
I’ve been reading your blog for a long time. I enjoy it tremendously, as well as the quality discussions in the comments. It’s bittersweet that my first comment is on this occasion, but here goes.
While Steve’s essay is well-written and evocative, I am surprised you chose to publish it. It provides only fear. No constructive prescription or ideas to improve one’s chances. It is one more way to induce panic, in a situation where panic is not going to help anybody.
This isn’t helpful. There are ways to slow this virus down, for long enough that the proper countermeasures can be prepared. The main ingredient is social distancing. Keeping people from social gatherings, from work, and so on.
Crying armagedon is of no help to anybody. In fact, it may actively hurt. I hope you can reconsider your choice, or at least provide links to sources of actual useful information.
Comment #7 March 12th, 2020 at 9:50 am
HIV might have crossed over into humans as a result of someone eating the meat of another primate species; that meal might have been more expensive than the one that introduced COVID-19 to humans.
Comment #8 March 12th, 2020 at 10:02 am
People, people. There is plenty of blame to go around! Trump has made some exceptionally stupid decisions! And faceless bureaucrats enforcing bad rules and regulations have caused untold damage! Does it really matter, right now, who deserves more blame? Or should we focus on fixing what we can and flattening out the curve, on being Max Starkloffs rather than Wilmer Krusens?
Comment #9 March 12th, 2020 at 10:30 am
According to the CDC, from April 2009 to April 2010, the H1N1 resulted in 12,469 deaths in the U.S.
Who was the president of US at that time?
Comment #10 March 12th, 2020 at 11:10 am
+1 to Jonahs comment – this is not helpful in any way.
Comment #11 March 12th, 2020 at 11:14 am
Mike Goldenberg #3: Yes, there were many, many European Jews who wanted or tried to flee in the 30s but couldn’t (including, famously, a few hundred who reached the US by ship, were turned away at port, and were mostly then sent to the death camps). There will also most likely be hundreds of thousands or millions, especially among the elderly and sick, who will perish over the coming months despite having taken all reasonable precautions. But that only makes the moral burden all the greater, for those of us whose actions will help determine their fate.
Comment #12 March 12th, 2020 at 11:35 am
@jonah #6
There are plenty of places where you can read advice on what to do given the current situation. This essay isn’t meant to be that. This essay is meant to be a description of the current situation. I’m sorry it comes off as alarming, but unfortunately the reality is alarming. If we confront that reality, we’ll be better prepared to deal with it.
“For a successful technology, reality must take precedence over public relations, for Nature cannot be fooled.” – Richard Feynman
Comment #13 March 12th, 2020 at 11:53 am
Jonah #6: There’s certainly such a thing as too much panic, but right now, it seems obvious to me that we in the US need more panic rather than less. Panic is sometimes a prerequisite for action.
At least among the readership of this blog, I assume people already know most of the practical steps to take. Frequent and thorough hand washing, avoiding face touching (I had several posts about the psychological aspects of exactly that), disinfecting surfaces (including your phone), cancelling events, working from home, staying far away from the elderly and at risk, totally quarantining yourself if you have cold symptoms (regardless of the cause), checking your temperature. Most of all, shaming our feckless leaders into ordering more tests (including drive-thru), emergency manufacture of masks and respirators, and the setting aside of regulations that impede progress, as if this was WWII (as, on a per-capita loss of life basis, it very plausibly will be).
I have the utmost gratitude and respect for the people who understood the threat from the beginning, and who’ve been working around the clock to figure out what else we can do. I’m trying to learn from those people just as the rest of us have been—Paul Graham’s Twitter (to pick just one example), which links to many of those experts, has arguably done more to communicate the reality of what’s happening than has the entire CDC. Only rarely do I imagine that I, a quantum computing theorist with no background in medicine or epidemiology, can improve on any aspect of what they say.
The trouble is that, while many of us intellectually understand what’s about to happen and what needs to be done, we still haven’t brought our actual behavior even a quarter of the way into alignment with it—indeed, I’m still struggling with the behavior part myself. That’s what interests me, and that’s the reason why I published Steve’s essay.
Comment #14 March 12th, 2020 at 12:01 pm
“The most expensive meal a person ever ate was in late 2019, in China, and consisted of under-cooked bat meat. It cost trillions of dollars. The person who ate it, possibly a peasant, changed the course of the 21st century.[…] These are just accidents of history.”
Uh, no, this was no accident. It’s no probably not a peasant either.
https://www.youtube.com/watch?v=TPpoJGYlW54
The CCP has known about the risks of wet markets for years!
The CCP refuses closing them for good, not because they’re feeding the poor, but because a rich minority is lobbying to keep them open because they’re a source of rare species used for their magical properties at curing limp dicks.
The CCP knew about warnings from local Wuhan doctors since end of November, but they were supressed/threatened/silenced… Then the CCP still encouraged ppl to gather in Wuhan for the New Year celebration (only after they decided to alert the public).
Now the CCP is already rewriting history.
The official media in China is calling the virus the “Italy virus”, or “Japan virus”, claiming that it came to Wuhan after some locals visited Italy, and/or Japan.
Another alternative narrative being pushed on the Chinese people as a scientific fact is that they have proof that it originated in US labs.
The WHO has been corrupted by China – since the beginning of the crisis their first priority has been to make Xi and China look good. Read the WHO and China’s reaction to the US initial travel ban. The WHO also decided to name the virus in a way that doesn’t reference its Chinese origin, but have no qualms naming other diseases after their origin, like MERS – Middle East Respiratory Syndrome… and much worse, they’ve played along China in trying to ban Taiwan from all meetings (when in fact Taiwan is one of the few countries that has effectively contained the virus).
https://www.youtube.com/watch?v=DFxmiV2_OHs
The CCP shouldn’t get away with this, but they are…
Comment #15 March 12th, 2020 at 12:02 pm
Oh, some power, to be sure. Neither me nor Moldbug deny that. But a good case for “central role” can be made only in the geographical sense. You’re saying that the lunatics have “hollowed out” CDC, but even Washington Post adduces only two actual instances: the hiring freeze in early 2017 (in force less than 3 months) and administration’s proposals to cut CDC budget in 2021 (subject to approval in Congress). Indeed, it is revealing that the main charges WaPo raises against the lunatics is that their messaging is inconsistent with the career people’s, and that the president and his “designated surrogates” are not discharging the role of the Hand-Holders in Chief. I do not doubt that for many people it is easier to stick with the antiquated idea of an all-powerful administration that can be blamed for things (and has few necks), because the alternative – that most of the actual governing government is the blank-faced bureaucrats who’ve signed the paperwork that amounted to death warrants – is too horrible to contemplate even for those relatively few people who are capable of contemplating it.
Comment #16 March 12th, 2020 at 12:09 pm
PS: you might find these UK pandemic guidelines from 2011 (long before Trump, Brexit etc.) instructive. Excerpted and discussed here.
Comment #17 March 12th, 2020 at 12:16 pm
I certainly wouldn’t concur confidently with the sentence: “We are watching a once-in-a-century event unfold.”
I live in an area (like many) where they used to talk about once-a-century floods… except that they now occur every 2-5 years. And those in the know have been warning for years about new viruses and resistant bacteria arriving in our near future… no reason to believe viral pandemics won’t be a part of our globalized world every decade or more often.
Comment #18 March 12th, 2020 at 12:35 pm
On a positive note…
First, humanity has gone through ups and downs constantly.
We’re part of a generation that’s been pretty lucky… my grandma grew up through WW1, she dealt with the Spanish Flu, then had to live through WW2 as an adult (my grandpa was a prisoner for 5 years in Germany).
Second, it’s in the nature of the universe that everything is transient.
We all live and die, everyone we care about lives and dies, we eventually lose everything we care about.
Humanity is no different, but on a different time scale.
Even our sun will die.
We have to embrace it all, otherwise we live in fear and miss on the miracle of being alive.
Some silver lining from coronavirus:
We’re all in this together, noone can dodge this (plus or minus the quality of your health insurance).
Science will put more emphasis on fighting viruses.. it’s the common opinion from experts that we’ve been too complacent after SARS, etc. We never bothered developing remedies for those.
The coronavirus, as bad as it looks, it’s still a dressed rehearsal (according to some experts). Things could be much worse. So we get a new chance at it.
As bad as a virus looks, it’s really nothing compared to the potential of global warming.
It’s an opportunity to reduce our carbon footprint. Expecting to fly hundreds of millions of humans around the planet just for entertainment is really bad idea. Most ppl really don’t need to commute to work.
VR is the right thing to push for. It not only weans us from the limited resources of the planet, but will let us all interact in more interesting and meaningful ways with one another (you can be whoever you want).
Comment #19 March 12th, 2020 at 12:42 pm
For anyone experiencing experiential angst, I really recommend reading this edition of “Meditations, by Marcus Aurelius”.
https://www.amazon.com/Meditations-New-Translation-Marcus-Aurelius/dp/0812968255/ref=pd_sbs_14_img_0/143-0091432-6852830?_encoding=UTF8&pd_rd_i=0812968255&pd_rd_r=8dad3cc9-1b38-44e2-b36b-44b0af635269&pd_rd_w=8jyla&pd_rd_wg=X1gqy&pf_rd_p=5cfcfe89-300f-47d2-b1ad-a4e27203a02a&pf_rd_r=XRMEBQ80QAMEACGSRKC3&psc=1&refRID=XRMEBQ80QAMEACGSRKC3
Humans two thousand years ago were really dealing with the same questions as we all are today (and probably dealing with them better).
Comment #20 March 12th, 2020 at 12:51 pm
Scott #13: I have to disagree that panic serves a useful role here. We have already seen that for many people, ‘panic’ means buy excessive amounts of household items to the point where people in need can’t get them (even things like baby wipes for daycare centers, not to mention the medical necessities like masks and other equipment). Needless to say, none of that is what any qualified, knowledgable person recommends to help in this situation.
Now, a ‘public intellectual’ of good repute such as yourself chooses to put out a piece like this, which can be shared in the twitterverses of the world. This can easily serve as more fuel to a flame that does not promote the helpful actions, but the panic that induces the unhelpful ones.
To better explain what I mean, here is a piece from an Italian doctor who is in the thick of one of the most urgent life and death situations on the globe at the moment, yet nowhere does she call for anything but common sense precautions (which are extreme only in the sense that they keep everybody but healthcare workers from work):
https://www.newsweek.com/young-unafraid-coronavirus-pandemic-good-you-now-stop-killing-people-opinion-1491797
Comment #21 March 12th, 2020 at 1:32 pm
Why should one suppose that, in the long term, the historical impact of this will be comparable to World War 2, rather than comparable to the impact of the 1919 Spanish Flu, which, until now, was practically a trivia question, known only to pandemic history buffs?
Comment #22 March 12th, 2020 at 1:46 pm
For anyone interested in the Spanish flu, I recommend this video – I learned a lot and it did put things in perspective (in those days healthcare was still very primitive):
Comment #23 March 12th, 2020 at 1:53 pm
This is nonsense: ” Even for healthy young people, the prognosis is often poor. ”
The risk group is 80+, and even there mostly with comorbidities. Below 60, only very few cases. This is clear from all data so far, China, South Korea, and Italy.
It is quite likely that the pandemic will not actually increase total all-cause mortality.
The biggest problem is the massive overreaction.
Comment #24 March 12th, 2020 at 2:15 pm
Andrew #23: Bullshit. (And unlike most bullshit in the history of this comment section, bullshit that will get people killed.)
According to this paper, the Covid19 case fatality ratio in Wuhan for my parents’ age group (60-69) is 9.4%, after adjusting for both delayed mortality and unidentified symptomatic cases. There is every indication that US hospitals will be more deluged than the hospitals in Wuhan were. My parents both have immune system issues. And there are two of them. And I expect about 2/3 of Americans to get this disease. Accounting for all of that, a reasonable estimate might give a ~20% chance that at least one of my parents will die of this disease in the next few months, in the absence of extreme isolation measures. And I’m overreacting?? Not even within an order of magnitude.
Comment #25 March 12th, 2020 at 2:45 pm
I have been reading your blog for five years. I’ve bought your book and read it, twice. I think you’re probably one of the smartest guys on the planet, and as a fellow writer, I envy your ability to explain complicated scientific concepts. But this post is so off-base, from my experience at work (adjacent to public health) and in the world at large, that I really, really wish you would consider retracting it.
Steve’s essay reminds me, as many things do, of a line from The Simpsons, as Kent Brockman covers an uprising at Bart’s summer camp: “Ladies and gentlemen, I’ve been to Vietnam, Afghanistan, and Iraq, and I can say without hyperbole that this is a million times worse than all of them put together.”
Comment #26 March 12th, 2020 at 2:50 pm
fred #14:
> The official media in China is calling the virus the “Italy virus”, or “Japan virus”, claiming that it came to Wuhan after some locals visited Italy, and/or Japan.
And the “Spanish” flu did not originate in Spain, but this deliberate misnaming did not cause damage comparable to that of the flu itself. The point of this post, for me, is to focus less on your righteous desire for the CCP (or Trump, or bureaucrats, or …) to pay for their crimes, and more on improving your personal chances of survival regardless of who is to blame.
Comment #27 March 12th, 2020 at 2:59 pm
Scott: Not true. Wuhan is not representative for many reasons, to begin with, they stopped testing and had extreme smog. Even the rest of mainland China had MUCH lower numbers.
Italy’s latest numbers: average age way above 80, and more than 2/3 with severe comorbidities. It is not even clear how many die of the virus, and how many of the comorbidities.
For the general population, the risk is clearly lower than a flu. In South Korea, even for the 80+, fatalities are low than the flu (10-20%).
What is people really getting killed prematurely and unnecessarily is the panic and economic collapse.
Comment #28 March 12th, 2020 at 3:00 pm
Let me add this: too many people simply have no clue what they are talking about. You should have in-depth knowledge of virology and epidemiology to even open your mouth.
Comment #29 March 12th, 2020 at 3:03 pm
@Scott: Regarding your parents: If they are over 60 and have immune issues, they are at risk with any flu, and yes, also the Covid-19. So yes THEY sould get isolated and protected. But it doesn’t mean we have to crash the economy and society because of this.
Comment #30 March 12th, 2020 at 3:07 pm
Finally, the mere number of “cases” (“infections”) is pointless, it is basically following the spread of a common cold for most of the population (which is also dangerous for chronically ill 80+ year olds).
Comment #31 March 12th, 2020 at 3:15 pm
Latest numbers from Italy, which is currently by far the hardest hit country: average age 81.4, 90% above 70, 98% above 60, and 67% with one or more severe comorbidities.
It is not even clear yet how many really died due to virus. In winter, many people die while also having the flu or a cold. That’s why the epidemic chief says these are “dead having tested positive”, not “dead due to the virus”.
Northern Italy is also a smog hot spot, by the way, with 10% of all deaths above 30 due to smog. The Wuhan pneumonia outbreak also happened during an extreme smog situation (indey 140 to 160).
Comment #32 March 12th, 2020 at 3:22 pm
These are more precise numbers but from a few day ago: 80% had more than two existing pathologies, 60% had more than three existing pathologies, only 2% had no preexisting pathology. Average age as mentioned above 81 years.
So most of us can and should relax. And the rest of us should get protected.
Comment #33 March 12th, 2020 at 3:25 pm
Andrew #27: The rest of China had much lower numbers because by the time it would’ve caught up with Wuhan, the country was on lockdown, so the r0 fell and the hospitals and ICUs stayed available for those who needed them. I see every reason to assume that the entire US will soon look like Wuhan or Lombardy, or much worse. We have a few factors in our favor, like geographic spread and a younger population than Italy and much less smog than China. But we also have massive factors against: no national health system, no paid sick leave, a significant part of the population that will take trollish delight in defying public health measures, and (incredibly) those same trolls now actually in the control room of policy, having locked the grownups out. At least northern Italy was frantically preparing its hospitals in advance of the deluge. Compared to that, we’re doing zilch, and it’s largely thanks to the worldview exemplified by your comments.
Comment #34 March 12th, 2020 at 3:32 pm
@Scott: China as a country was never on lockdown. I’m sorry to say, but you don’t know what you’re talking about in this case. I have given you the numbers, and they are clear. Flu is much worse for general society. Protect the high risk group and relax.
Comment #35 March 12th, 2020 at 3:41 pm
And again, the head of the Italian epidemics response team repeatedly emphasized that they don’t yet know who really died of the virus, and who (in this 80+ group) simply died of comorbidities.
Italy has an average *daily* mortality of 2000, and the *whole* number of deaths having tested covid-positive is currently at 50% of this. So the all-cause mortality rate probably won’t even increase.
Same for China by the way: they have pneumonia cases in the millions and pneumonia deaths about 150k per year. There will hardly be statistical difference to this number.
Comment #36 March 12th, 2020 at 3:58 pm
Bob Strauss #25: Thank you. If Steve and I didn’t have multiple commenters telling us that we were totally off-base, melodramatic, etc. etc., then I’d worry that we hadn’t been clear enough. And that therefore, this post would not have the effect on my readers that I wanted: namely, to induce them (yes) to panic, just enough that some will take reasonable precautions to protect their own lives and those of their loved ones. I now have well over a month of relative apathy and indifference to atone for.
For context, I should tell you that among my own friends, the ones who always struck me as the most levelheaded and data-driven are precisely the ones who are now “panicking” the most—selling off their investments, searching for places to hunker down, etc. To take just one example, I knew Steve Ebin mostly as a guy who’d email me to object if he felt like one of my blog posts went too far overboard! In joining him and my other friends, I realize that I’m now joining a wild-eyed company of “screamers”—one that also includes Bill Gates, Paul Graham, and many of the world’s public health experts.
The term “screamers,” incidentally, comes from Arthur Koestler, who wrote:
Clearly all this is becoming a mania with me and my like. Clearly we must suffer from some morbid obsession, whereas the others are healthy and normal. But the characteristic symptom of maniacs is that they lose contact with reality and live in a phantasy world. So, perhaps, it is the other way round: perhaps it is we, the screamers, who react in a sound and healthy way to the reality which surrounds us, whereas you are the neurotics who totter about in a screened phantasy world because you lack the faculty to face the facts. Were it not so, this war would have been avoided, and those murdered within sight of your day-dreaming eyes would still be alive.
That was written about the Holocaust while it was ongoing.
Comment #37 March 12th, 2020 at 4:08 pm
This is from the top level chinese officials on Twitter (what the hell are they doing spewing their disgusting propaganda on Twitter when the rest of China isn’t even allowed to access it?):
Spokesperson & Deputy Director General, Information Department, Foreign Ministry, China:
https://twitter.com/zlj517/status/1238111898828066823
“CDC was caught on the spot. When did patient zero begin in US? How many people are infected? What are the names of the hospitals? It might be US army who brought the epidemic to Wuhan. Be transparent! Make public your data! US owe us an explanation!”
From the Foreign Ministry Spokesperson:
https://twitter.com/SpokespersonCHN/status/1238003509510856704
“Dr. Robert Redfield: Some cases that were previously diagnosed as Flu in the US were actually COVID19. It is absolutely WRONG and INAPPROPRIATE to call this the Chinese coronavirus.”
Comment #38 March 12th, 2020 at 4:19 pm
@Scott: Your next logical error:
“For context, I should tell you that among my own friends, the ones who always struck me as the most levelheaded and data-driven are precisely the ones who are now “panicking” the most—selling off their investments, searching for places to hunker down, etc.”
Of course, because they fear the panic. But this has nothing to do with the *actual* medical situation for the normal population. It’s psychological. And it’s thanks to blogger like yourself.
This is the *real* Corona crisis.
Comment #39 March 12th, 2020 at 4:25 pm
Andrew #38: Nope, mostly because they fear the virus itself. I talked to them. You’re wrong.
Comment #40 March 12th, 2020 at 4:37 pm
Scott #39
It’s the same with Sam Harris.
He happens to know a group of guys in their 50s who had just come back from a ski trip in Italy, all caught the virus.
All are in top shape, very active, yet two of them are in serious condition – one connected to a respirator, the other in induced come because his cough was so bad.
So he’s really nervous about it.
The thing is that if something’s killing 10 times more than the flu, it’s not as if the ones who die just “drop dead” suddenly…
it means that there’s really a huge set of people having a tough time with it, struggling for days in ICUs, even if most survive in the end (and often will need a long rehabilitation).
Comment #41 March 12th, 2020 at 4:45 pm
@Scott#11- It’s still wrong to say that the Jews were mistaken not to leave. The majority of Jews that died in the Holocaust came from Poland, parts of the USSR, Lithuania, Latvia, Estonia, Yugoslavia, Greece, France, Belgium, the Netherlands, Luxembourg and Norway- countries that were invaded by the Nazis during the war. It’s not like the Jews of Europe could have known in advance what parts of Europe the Nazis could conquer.
Comment #42 March 12th, 2020 at 5:09 pm
Scott #36: I guess my question for you is, what, as an individual, can I possibly do to take this more seriously? My company (an international research firm) has already suspended all travel, and is encouraging people to work at home (I am guessing that will be mandatory by next week). My wife and kids and I have been talking about the Coronavirus over dinner, reliably, for the past two weeks. All I see is Coronavirus, all I hear about is Coronavirus, all people want to talk about is Coronavirus. What is it you mean, exactly, when you say you want to induce your readers to panic so they take this more seriously?
I’m not trying to be snarky about this, I’m just trying to figure out what you would take as a *positive” result of Steve’s post, beyond the stuff that everyone (as far as I can tell) is already doing: washing hands, avoiding crowds, not traveling, etc. And trying to remain calm and, yes, un-panicked. Panic does nobody any good.
Comment #43 March 12th, 2020 at 5:46 pm
In times like these, the virtues of a life spent studying eternal subjects like math and TCS kinda become apparent.
Comment #44 March 12th, 2020 at 6:08 pm
I’m compelled to go into biocomputing after reading about the virus. Is it just me?
It’s so much cooler than quantum computing. BQP is certainly contained in BPP in that department.
I would trade an asymptotic speedup for the bio kools.
By the way, i rolled my eyes at the biblical quote.
Comment #45 March 12th, 2020 at 6:23 pm
Surely during your Tel Aviv sabbatical you have come across the phrase “Asur lehashvot” meaning “One must not compare”.
Comment #46 March 12th, 2020 at 6:35 pm
Bob Strauss #42: It sounds like there might be little more you can personally do (assuming your elderly relatives are safe). Certainly there’s not much more that I’m doing, if we don’t count blogging (as I don’t).
Your comment perfectly illustrates the difficulty of writing for a diverse audience. See, it’s like this: Internet feminists spent years spreading the message that all men are potential sexual harassers, that if you’re not sure whether you’re a harasser then the answer is almost certainly yes, etc. etc. Many of the feminists probably had excellent reasons to do this, for example involving actual unrepentant serial harassers who victimized them or others who they knew. They either weren’t thinking about nerdy guys dealing with OCD, scrupulosity, or related issues whose lives could be ruined by that sort of messaging, or if they were, they regarded it as collateral damage in a bigger and more important battle, either laughably trivial or (the nice ones) regrettably unavoidable.
And then when, just once, I talked about the collateral damage part in this comment section, I got hundreds of messages of thanks from nerdy guys, about the hope I’d given them that they weren’t alone in the world, but was also condemned in magazines and social media by literally thousands of feminists, who thought my comment gave aid and comfort to entitled misogynists. In an odd bit of symmetry, I faced exactly the same problem as the feminists: I had no way of targeting my message only to those who desperately needed it, and withholding it from those for whom it would be counterproductive.
In the same way, no doubt there are people paralyzed with unproductive fear, hoarding toilet paper and N95 masks, etc. etc., for whom reading the remarks of me or Steve Ebin would only make things worse. But then there are also millions of people—indeed, probably the majority of people—in utter denial about the enormity of what’s about to happen. Scarily, one of those people is the President of the United States; another is the Director of the CDC. But we needn’t look nearly that far; we’ve seen such people right here in this comment section. One of them, Andrew, went so far as to tell me that my level-headed, data-driven friends, who’d just spent hours talking to me about such topics as quarantine locations and the DIY manufacture of respirators, must not have been worried about the virus itself, but only about the “panic” about the virus. When I pointed out that he was wrong, Andrew responded with an ad hominem attack that I’m leaving in moderation (as with all further comments from him).
At this point, inspired by the heroic doctors in Lombardy, I think we all need to engage in triage. Those like Andrew, who sneer at the silliness of others’ coronavirus “panic” even while Iran is digging huge burial trenches for all its corpses (and that while the world is still only 0.01% of the way up the exponential)—they’re simply no longer worth the time to argue with. Meanwhile, those like you, who are already taking the sensible precautions, don’t need to be frightened further. All our rhetorical ammunition ought to be aimed at those in the middle (except, again, how does one get the aim just right?).
Comment #47 March 12th, 2020 at 6:38 pm
Here are a few reasons that Covid-19 will not fulfill the apocalyptic fantasies of either the right wing preppers dreaming of the boogaloo, or the left wing progressives hoping that enough people die and that there’s enough economic disarray to bring down Trump.
1) The death rate is exquisitely connected to support therapy. There are a number of diseases where the secondary effects of the disease are what are deadly, more than the direct effects of the disease itself. The classic is cholera, which has a 50-60% mortality if untreated, but has a mortality of around 1% if electrolytes and fluids are replaced, with or without antibiotics. These flu-like illnesses are similar. If there’s good support, then mortality is very low. If there’s poor support, then mortality is very high. In Wuhan, the Chinese provided support therapy by putting forcing people in their homes and welding the doors shut. The United States is still not the kind of socialist utopia centered on providing uniformly marginal medical support therapy that folk hope for, and people in the US will tend to do better. As a side note, the infamous 1918 flu would not be the 1918 flu today. The reason that people died like they did was that technology for supportive therapy was amazingly primitive then.
2) The virus may be racist. The virus attaches to specific receptors, particularly in the lung. There have been some studies that show significantly increased numbers of receptors in East Asian populations (though there are manuscripts and preprints that dispute this). The receptors are also more highly expressed in smokers. They are also more highly expressed in people over 60. A population with a large number of older Asian smokers will likely do worse — like China. Also as an aside, the 1918 flu also showed racial predilictions.
3) The virus is competing with other viruses. A marginal increase in mortality is not measured by the number of people killed by Covid-19, but by the number of people killed by Covid-19 *who would not have been killed by the flu or other interstitial pneumonitis*. Since a number of more popular viruses target the same cohort, there will be a number of people who would have died of influenza or a different coronavirus or respiratory syncytial virus or bacterial pneumona or whatever who happen to get Covid-19 first. Those count as Covid-19 deaths, but they are not “excess” deaths.
4) The US population is different than the Italian population. As I remember, the average age of the Italian population is around 10 years older than the US population. There is a much higher concentration of people in the higher risk group (older smokers) in Italy than in the US.
5) In addition to better support therapy in the US, there are also indications that meaningful antiviral therapy will be shown useful shortly. Covid-19 has some similarities to HIV, and those protease drugs used for HIV have shown initial promise. While full trials have not been done, and so one cannot make blanket statements, it seems that drugs like lopinavir and ritonavir will be useful.
6) There will be a vaccine this fall. While the efforts such as travel restrictions and quarantine will not stop the pandemic, it will flatten the curve a little, which will likely buy time for the vaccine to come on board.
7) Summer is coming. A coronavirus is a coronavirus. It is very likely that things will slow down considerably come sunny days.
That is not to say that people should not be careful, and if I were a 65-year-old with COPD, I’d be scared to death. People should keep grandpa and grandma in a box. Prudent measures are prudent measures. There will be *some* excess mortality.
But these fantasies of “The Stand” and the apocalyptic prophesies that are going around are just not realistic. And this economic reaction is nothing more than hysteria.
Comment #48 March 12th, 2020 at 6:54 pm
Oy Vey #45: If anyone has the right “lehashvot” (to compare), surely it’s those like Steve who lost most of their families in the Shoah. Frankly, I might not have gone there on my own, as I’m also sensitive to the risk of trivialization. But inspired by Steve’s example, I think I’m going to stand my ground and say: we honor the memories of those who perished in the Shoah by suffusing our lives with whatever attitudes would’ve stood the best chance of preventing them (or at least some of them) from perishing, had we been alive then. And by not worrying too much about those who ridicule those attitudes as paranoid or panicky—for Arthur Koestler’s “screamers” were ridiculed as well.
Comment #49 March 12th, 2020 at 7:15 pm
I think this article here gives a very good overview over how the virus spreads under what conditions and measures, all based on numbers that we’ve seen so far in other countries:
https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca
Slightly scaring if current measures are not going to be adjusted, but also good to see that the situation is not futile.
Comment #50 March 12th, 2020 at 7:40 pm
Incidentally, whataboutery #9:
According to the CDC, from April 2009 to April 2010, the H1N1 resulted in 12,469 deaths in the U.S.
Who was the president of US at that time?
12k US deaths is minuscule compared to even the most optimistic forecasts for what’s about to hit us. More importantly, though, I don’t recall anything about Obama disbanding the teams whose job it was to respond to outbreaks like H1N1, or subjecting them to hiring freezes, or downplaying the threat on Twitter in a naked attempt to shore up the stock market. Nor is it remotely plausible that Obama would do such things: just because Trump has expanded by orders of magnitude our notions of what a president might plausibly do, doesn’t mean you get to back-project that expansion onto presidents who were relatively normal/competent human beings.
Comment #51 March 12th, 2020 at 8:38 pm
This social distancing thing is a great opportunity to:
* spend more time with our family, and certainly learn how to live with one another within the same space for long periods of time.
* catch up on books
* try a new hobby, particularly one that requires time and patience, I recommend:
– meditation (I recommend the Waking Up app).
– 3D printing (it’s hard to describe how addictive this is, but a decent print requires a bit of tweaking and around 10-15 hours).
– learn a new language.
* get into shape (I do all my workout in VR, an hour a day).
* save some money.
Comment #52 March 12th, 2020 at 8:45 pm
It’s encouraging that SK seems to have things under control, they have definitely passed the inflection point
https://www.worldometers.info/coronavirus/country/south-korea/
Comment #53 March 12th, 2020 at 10:52 pm
[…] First It Came for Wuhan 8 by richardfeynman | 2 comments on Hacker News. […]
Comment #54 March 12th, 2020 at 10:52 pm
billo#47: “7) Summer is coming. A coronavirus is a coronavirus. It is very likely that things will slow down considerably come sunny days.”
I wouldn’t count on that. The ‘M’ in MERS stands for Middle-East, and may have been transmitted by desert camels.
This is not a common cold (rhino virus) nor influenza.
Comment #55 March 13th, 2020 at 12:20 am
Slightly related note, WRT Jews in Germany and the Flee / No Flee decision in the late 1930’s: One families’ true story is published in “Nowhere_in_Africa”, written by the daughter, who was a little girl at the time. I still vividly remember the Movie version: https://www.youtube.com/watch?v=cbOQajcxKEM
Comment #56 March 13th, 2020 at 4:00 am
Sobering report from WHO team member on China in NYT:
And to think they were desperately poor just 30 years ago. That’s what I call work.
Comment #57 March 13th, 2020 at 7:56 am
GuyGordon#47
Coronaviruses make up about 15-20% of the common colds (rhinovirus makes up about half and the rest are scattered among respiratory syncytial virus, parainfluenza, adenovirus, influenza and others). Those coronaviruses that cause the common cold follow the same pattern as the other cold viruses. Of course this may have a different pattern, since it’s novel, but if it becomes endemic, it likely will act like a coronavirus.
It’s hard to say what MERS would do if it became common, because the number of cases is so small, with numbers in the single and double digits outside of Saudi Arabia and South Korea, and only in the triple digits in those two countries. It has a very different pattern of spread, and basically doesn’t get too far from it’s animal host. If this Wuhan strain spread like MERS, we wouldn’t be having this panic at all — certainly not outside an election year.
Comment #58 March 13th, 2020 at 8:03 am
Scott #48
Being roughly the same age as Steve Ebin I could easily play my own 2nd and 3rd generation holocaust card here but I won’t because it’s irrelevant and utterly repugnant, though I completely understand San Francisco “tech world” people who can (and more importantly, do) pay 1000$ for a meal having lots of not-unreasonable fears of persecution to project on this.
A pandemic, however deadly is just not in the same category as a premeditated mass murder – in a way it is diametrically opposite, if a rampant pandemic is a crisis brought about by governmental inaction and execution failures the holocaust was brought about by an unchecked government originally empowered to deal with an acute crisis, comparing Nazism to a virus is not just trivialising it’s fictionalizing – it recasts the holocaust as a Zombie apocalypse movie – but it wasn’t, everybody involved were all too sentient and agentic.
You probably had your own share of cringe watching a certain prime minister routinely invoking the holocaust in nakedly cynical political contexts, this is how Ebin’s “essay” reads like just without the appropriated clout.
I can only speculate where Ebin himself is coming from but Paul Graham et al. are not being paranoid or panicky, at least not about COVID19 itself – the situation really is dire and they are in no way original or unique in their takes on it, they are acting out their trade shlock “thought leadership” while being driven by the need to stay relevant and have their stake in the agenda of the economical and political aftermath that will inevitably arrive – a major crisis is always followed by social upheaval and they understandably do not wish to end up as the food supply for those seven years of famine.
Before COVID19 hit and took the markets with it there were and are things going on in the world far more reminiscent of the holocaust era (how are the Xinjiang camps doing with COVID19 ?) yet I don’t recall the Koestlerian screaming coming off the silicon valley twitter feeds, indeed if I was in the comparison game – Albert Speer and Alfred Krupp opportunistic vibes would come to mind.
And it’s about the markets alright, the burial trenches have not even been dug yet but there is already coordination signalling going on about the need for a bailout for the portfolio classes.
COVID19 will be bad, quite possibly really really bad and everyone should take all the precautions available to them and urge their friends to do the same. Still. Not. The. Holocaust.
Comment #59 March 13th, 2020 at 8:23 am
billo #47
“Summer is coming. A coronavirus is a coronavirus. It is very likely that things will slow down considerably come sunny days.”
I was wondering too, but Qatar, Bahrain, Kuweit, … aren’t spared. Of course you could say that’s because a lot of the population spends time within buildings, under AC, but it’s also the case in the US (at least in NYC).
Comment #60 March 13th, 2020 at 8:39 am
Some of your readers, Scott, are grandparents (grandmas or grandpas). Some are in their 60s, 70s, 80s. Some are both, and have “comorbidities” (full disclosure: I am one of them).
It’s all very well to suggest that we should be safely isolated, but at least some of these comorbidities require treatment, including ongoing treatment, e.g. dialysis, infusion chemotherapy.
I haven’t yet been successful in finding a reliable source for what underlying conditions make getting covid-19 particularly deadly for Boomers like me, and what not. Does any reader know of such a source? Here are some of the leading causes of death of older folk, ranked by my guess as to deadliness: lung conditions (asthma to lung cancer to TB), failing kidneys or livers, heart problems, stroke, Alzheimer’s.
Guesses are not reliable; who knows? maybe, counter-intuitively, having TB means that covid-19 will be far milder (on average) that not having it (cet. par.) …
Comment #61 March 13th, 2020 at 8:57 am
Scott, the predictions that you keep referring to are wild stabs in the dark. The fact is, even the experts are extremely bad at making predictions of this sort.
For example, in the Ebola outbreak a few years ago, the WHO’s initial projection for the number of cases was too low by a factor of ~100, and a later CDC projection was too HIGH by a factor of ~30. And this was for a virus that had been around for 40 years, with a number of prior outbreaks to study.
The issue is that, with exponentials, if the base is off by even a small amount, this gets amplified into huge errors in the final total. This is our very first time encountering the novel Coronavirus, and our understanding of the virus is rapidly changing. Add to that issues such as a lack of accurate testing in the U.S. and supposed data suppression by some other countries. Given that the experts were off by ~2 orders of magnitude in the Ebola case (in both directions), I would guess the projections for Coronavirus could easily be 100x off.
Comment #62 March 13th, 2020 at 9:35 am
Many people in this crisis are acting like there is nothing between death and full recovery, but there is growing evidence that patients who enter critical condition with this disease can be left with lasting problems, the most well-documented so far being chronic fatigue and lung damage. Given what we know about the original SARS-CoV (devastates lungs, brains, hearts, etc), as well as all the long-term problems caused by viruses that remain dormant in the system but are not eliminated (post polio, shingles, etc), I do not think we can assume that young people are safe; they may just take longer to succumb. Prepare your immune system. I have about 20 different supplements I’m taking; there are traditional herbs and remedies that helped people survive plagues before sanitation (I don’t have any forsythia though…). Get injectable / IV vitamin C if you can, it’s one of the best and the absorption rate is 10^4 times higher compared to oral vit C. And to any who scoffs at these things with a smug faith in double-blind studies, think of it as taking advantage of the placebo effect, or consider Pascal’s wager.
Also I’ve noticed no one here has brought up the possibility that the virus escaped from China’s only BSL-4 lab located at the Wuhan Institute of Virology 8 miles away from the wet market that is the presumed origin being discussed, which houses scholars who are well-published experts in bat coronaviruses. One of the factors that makes this more plausible to me is the CCP’s reaction, which (for them) is out of proportion with something causing 10,000 deaths. It doesn’t mean this was engineered, or that it even originated in China (they could have stolen or acquired it from anyone). No wonder the CCP is trying to rewrite history and accuse the US of originating the outbreak. This possible origin of the disease increases my concern over its virulence, and also increases the likelihood of war and the collapse of industrial civilization. If this is not under control in 6 months I am preparing to go off-grid.
Comment #63 March 13th, 2020 at 10:37 am
Good heavens. Is this sort of thing normal in SV-adjacent circles?
Comment #64 March 13th, 2020 at 10:43 am
As Andrew and others have mentioned, the fear and panic is way overblown. Latest numbers from Italy (Lancet study) show average age of deaths is 81 to 84, and almost all chronically ill. 14% were over 90. Only 2% of all deaths were healthy people. It’s strange how these numbers are rarely reported in the media. South Korea was even milder, they already reached the peak, and they didn’t even quarantine any cities. For the general population, this is a common cold, if at all. Total all-cause mortality by the end of the year will probably not have increased.
Comment #65 March 13th, 2020 at 11:29 am
I think I am inclined to agree with those saying that the level of fear and paranoia in this post is not helpful. I admit that it is hard to know the “right” response to an event that is once-in-a-lifetime and involves tremendous uncertainty– both of which are things that our instincts are extremely unsuited for.
Some questions I’d like to ask, without claiming that I know the answers:
1. How sure are you that the potential dangers of panic are negligible? Even in the face of a genuine threat, they can be responsible for a substantial part of the damage (I’m thinking of Hurricane Katrina, as one example among many).
2. You say that most of your most knowledgeable friends are freaking out about this. Are you sure that this is not the effect, so common on the Internet and elsewhere, that the loudest but unrepresentative voices are being amplified? And if so, how?
3. Both you are Steve have admitted that, like many people and especially many intellectuals (including me!) you are prone to catastophizing– in this case, comparing events immediately to the Holocaust. I appreciate the need to keep the worst as well as the best scenarios in mind, but the worst case is exactly that– not necessarily the case you should focus on. And the comparison to the Holocaust specifically seems extremely unreasonable to me here. There are no pro-covid armies.
Also, I appear to be the first commenter to actually have, right now, covid-19. At least, I think it is very likely. As I live in the United States I will probably never know for sure (your criticisms of our government’s high-level response I absolutely agree with). I don’t think it is something to be taken lightly. I am relatively young and very rarely get sick, and I’ve had a mild fever and aching for several days, for the first time in over a decade. Of course, I’m being extremely careful not to expose anyone else. But, I feel that if you are being responsible and following the public health guidelines it is not helpful, or reasonable, to despair. It is fair to say that the public mentality took awhile to catch up to the reality, and I think a warning like this might have been more justifiable a few weeks ago (as you said yourself, in metaphorical 1933). But now that everything is cancelled and every story in the news is coronavirus, I’m not sure what purpose it can serve or positive outcome it could have. Of course, this is your blog and you’re entitled to vent your thoughts no matter how unproductive they are, but if your interest is in doing your part to get people to react to this threat sensibly I think you’ve missed the mark.
Comment #66 March 13th, 2020 at 12:12 pm
#64
“the fear and panic is way overblown. Latest numbers from Italy (Lancet study) show average age of deaths is 81 to 84, and almost all chronically ill. 14% were over 90.”
First, and again, for each death, there are many many people in serious condition, in ICU for days or weeks.
Second:
https://www.theatlantic.com/ideas/archive/2020/03/respect-old/607864/
Comment #67 March 13th, 2020 at 12:17 pm
This type of epidemic can only be dealt with by over-reacting.
You can only beat a geometric growth process by acting swiftly and decisively.
The irony of course is that if it works, many will say “see! we over-reacted!”
Comment #68 March 13th, 2020 at 1:07 pm
Oy Vey #58:
I see you take issue with me bringing up the holocaust. I am comparing the current situation to the holocaust in two ways. First, I am arguing that these are both major history-changing events. Second, I am pointing out that many people, including my grandmother’s family, ignored the signs that the holocaust was about to occur, and suffered as a result. I make this comparison to argue that we can learn from their mistakes. I did not say, and do not think, that an epidemic is of the same category as a genocide. They are obviously completely different things. It is dangerous to say the only time one can draw lessons from the holocaust is in relation to Uighur camps, the Cambodian genocide, and other ethic cleansing. The lessons are broader and we can speak about them.
I also take issue with your characterization of my essay as panicky. My essay describes a situation. Panic is a reaction to a situation. For my own part, I think panic is reduced rather than amplified when there is broad understanding and acknowledgement of a situation. Downplaying the risk is what will lead to panic.
The issue is that there isn’t broad acknowledgment of the risk. If there were, we’d be building hospitals, manufacturing respirators, ventilators, test kits and more, with breakneck speed and wartime focus. That’s pretty much the opposite of what’s happening.
Comment #69 March 13th, 2020 at 1:19 pm
Woke up this morning (Queens, NY) with a cough and feeling run-down. Then took a nap that turned into a 3-hour deep sleep. So I am self-quarantining. However, I did have a chance to read the “Website” hooked to my name for this posting.
Comment #70 March 13th, 2020 at 1:23 pm
Also, claiming that this kills only the elderly and the weak is missing the point that, if uncontrolled, the number of serious/critical cases will swamp the hospitals, at which point it would be like we’ve seen in Wuhan (and are starting to see in Italy): parking the weak and the old in gymnasiums (and such) full of simple beds, waiting for them to die on their own…
Comment #71 March 13th, 2020 at 2:38 pm
Oy Vey #58: Your comment touches on a wide range of concerns that are interesting but orthogonal to the potential trivialization of the Holocaust. For simplicity, let me focus only on the latter.
What it comes down to, in the end, is that I have a fundamental trust in the readership of this blog to be able to make distinctions like “A is similar to B in respect X, but is not similar in respects Y or Z.” No, the coronavirus is not a Nazi; it’s just a mindless replicator. But when we shift our focus from perpetrators to victims, we see the same pattern recurring (on larger and smaller scales) all throughout human history.
Namely, people go on preparing their big annual picnic even while ominous storm clouds gather. It would simply be too disruptive to cancel the picnic, and no permission to cancel it was granted, and the meteorologists predicting a historic flood seem like smug techno-elitists, and what’s most important to stay calm and not panic, and—boom! thunderclap!—oh right, and not even a drop has fallen here yet, and why not wait until there’s at least a confirmed drizzle before taking any rash countermeasures?
This sort of denial runs incredibly deep in human nature; certainly I often notice it in myself. My own reaction to the coronavirus wasn’t far from it until 2-3 weeks ago.
That, at least, is one of the many lessons that I take from the Shoah, which (for better or worse) has been at the center of my mental and emotional life since approximately the age of 7.
Comment #72 March 13th, 2020 at 2:59 pm
I don’t often comment on this site but I thought I’d chip in a couple of comments on this occasion.
Firstly, coronavirus doesn’t present the same face to everyone. To most, it is an inconvenience, a fever for a few days accompanied by a dry cough. To children, mercifully it isn’t even that.
To doctors dealing with the problem in Lombardy, where the Covid 19 cases are concentrated, the view is quite different. Each individual coronavirus case can be treated but the numbers affected are so great that doctors are obliged to make decisions about who to save and who to let die. The Italian medical authority (SIAARTI) has gone so far as to publish a document to help doctors decide. Google translates it thus:
“Clinical ethics recommendations for admission to intensive treatments and for their suspension, in exceptional conditions of imbalance between needs and available resources – version 01
Posted on 06.03.2020”
It isn’t hard to imagine how difficult this is for all concerned and the possibility such situations will develop in other countries is very real and perhaps inevitable. The UK government has been quite frank about this and has developed a plan to mitigate the effects but there are many unknowns.
Secondly, there have been a few suggestions here that the virus may have originated in some government lab.
The Lancet, one of the oldest and most prestigious medical journals, in the world published the following statement by public health scientists on February 19, 2020.
“The rapid, open, and transparent sharing of data on this outbreak is now being threatened by rumours and misinformation around its origins. We stand together to strongly condemn conspiracy theories suggesting that COVID-19 does not have a natural origin. Scientists from multiple countries have published and analysed genomes of the causative agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and they overwhelmingly conclude that this coronavirus originated in wildlife, as have so many other emerging pathogens.”
You can read the full statement here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30418-9/fulltext
I appreciate that in our world of misinformation and high emotions a statement like this doesn’t stand too much of a chance, nevertheless it is important and should be read.
Comment #73 March 13th, 2020 at 3:20 pm
Regarding “panic,” I liked the way one of my Facebook friends put it yesterday: that most people have only two mental settings, namely “complacency” and “panic.” And to whatever extent one accepts that as basically unchangeable, it seems obvious that “panic” is the more appropriate setting for this moment.
Comment #74 March 13th, 2020 at 3:36 pm
mark #61:
Scott, the predictions that you keep referring to are wild stabs in the dark. The fact is, even the experts are extremely bad at making predictions of this sort.
I agree, but when stabs in the dark are all we have, and we need to make life-and-death decisions on the basis of them, we have no choice but to go Bayesian and try to distinguish between better and worse stabs.
10K deaths in the US seems to me like an extraordinarily loose lower bound, based on reasonable estimates for how many Americans already have the virus combined with the case fatality ratios observed elsewhere (even under a high standard of care).
Meanwhile, 10M deaths (3% of the population) seems even to me like a plausible upper bound, supposing we let the virus rip through the entire country unchecked with basically no countermeasures.
Between those there are 3 orders of magnitude. And as I said, I think that whether we hit the lower or upper end of that (logarithmically-scaled) range mostly depends on what we do right now.
Comment #75 March 13th, 2020 at 4:03 pm
This link has been circulating in the nerdosphere for a few days and the article looks really good:
https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca
It’s about the virus spread, how small delays in putting measures in place cause huge differences in infection and mortality, and it says social distancing is much more important than containment (regional lockdowns etc) at this point. Tons of charts and graphs but the underlying math is pretty simple. Caveat, the guy who did it is not a doctor or biologist and I don’t know if there has been any response to it from those types. So there may be significant errors. I still found it a big aid to understanding.
Comment #76 March 13th, 2020 at 4:13 pm
for a bit of perspective regarding your ‘plausible upper bound’: ~3M people die in the US per year (~2M due to illnesses), ~46M live in poverty (most likely without access to good or any medical care)
why would you think 10M is a plausible upper bound? what is the basis of your estimation?
and no, stabs in the dark is not all we have. we have science and good models. you claim we should refer to and rely on scientific studies when the topic is climate change. but right now you seem to assume that making uninformed guesses and uninformed suggestions for the management of the pandemic are fine (as e.g. everyone should be tested, which is clearly not feasible in any larger country and was indeed shown to have negative effects; switzerland e.g. only tests hospitalized people now, but i guess you deem them to be incompetent as well?).
Comment #77 March 13th, 2020 at 4:30 pm
There is also a very good reddit AMA by a UK NHS doctor treating covid-19 patients:
https://old.reddit.com/r/Coronavirus/comments/fgfspi/im_a_critical_care_doctor_working_in_a_uk_hcid/
It’s a few days old and maybe some events have overtaken it, but it’s informative about treatment, self-care, and the state of play in the UK as of then:
Comment #78 March 13th, 2020 at 5:29 pm
josh #76: From now on, all comments that sneer at guesstimates about coronavirus impacts, for being insufficiently justified, rigorous, etc., but that refuse to stick their necks out and put forward their own alternative predictions, will be left in moderation, and their authors banned from further participation in this thread.
I apologize if that seems rude or disproportionate or uncharitable. But we’re now living through an extraordinary event, when we’ll all need to make daily life-or-death decisions on the basis of incomplete information and guesstimates. And in these circumstances, the “defense attorney mindset” is precisely one of the central failure modes that will get people killed. By the “defense attorney mindset,” I mean any attitude that tries to stand above the fray—that imagines that it can “win,” demonstrate its own superiority, by casting enough doubt on what other people say, without ever needing to put forward its own theory of the case.
When it comes to (e.g.) debates over the feasibility of quantum computing, the defense attorney mindset is merely annoying. When it comes to the coronavirus, I believe such a mindset is lethal.
Think I’m exaggerating? OK then, what was the “reasoning,” on the part of the FDA and CDC, that’s now led the US to the brink of the abyss? Roughly, it was:
(1) You can’t conduct your own coronavirus tests, because you can’t prove to our satisfaction that they work.
(2) Because the tests haven’t been done, you can’t prove that there’s community spread; therefore you have no justification to insist on any drastic response.
In both steps, the authorities used “proof reasoning,” rather than Bayesian reasoning and maximization of expected utility. “Proof reasoning” is great for math papers and murder trials, but it’s catastrophically inappropriate to a rapidly evolving pandemic.
Comment #79 March 13th, 2020 at 5:46 pm
Candide III #15, try this:
https://fortune.com/2020/02/26/coronavirus-covid-19-cdc-budget-cuts-us-trump/
“…The cuts started in 2018, as the White House focused on eliminating funding to Obama-era disease security programs. In March of that year, Rear Adm. Timothy Ziemer, whose job it was to lead the U.S. response in the event of a pandemic, abruptly left the administration and his global health security team was disbanded.
That same year, the Centers for Disease Control and Prevention (CDC) was forced to slash its efforts to prevent global disease outbreak by 80% as its funding for the program began to run out. The agency, at the time, opted to focus on 10 priority countries and scale back in others, including China.
Also cut was the Complex Crises Fund, a $30 million emergency response pool that was at the secretary of state’s disposal to deploy disease experts and others in the event of a crisis. (The fund was created by former Secretary of State Hillary Clinton.)
Overall in 2018, Trump called for $15 billion in reduced health spending that had previously been approved, as he looked at increasing budget deficits, cutting the global disease-fighting budgets of the CDC, National Security Council (NSC), Department of Homeland Security (DHS), and Health and Human Services (HHS) in the process.
The effects of those cuts are being felt today. While the CDC announced plans to test people with flu-like symptoms for COVID-19, those have been delayed and only three of the country’s 100 public-health labs have been able to test for coronavirus. The administration’s request for additional funding came roughly two weeks after officials said HHS was almost out of funding for its response to the virus…. “
Comment #80 March 13th, 2020 at 6:17 pm
Sicko #65:
It is fair to say that the public mentality took awhile to catch up to the reality, and I think a warning like this might have been more justifiable a few weeks ago (as you said yourself, in metaphorical 1933). But now that everything is cancelled and every story in the news is coronavirus, I’m not sure what purpose it can serve or positive outcome it could have. Of course, this is your blog and you’re entitled to vent your thoughts no matter how unproductive they are, but if your interest is in doing your part to get people to react to this threat sensibly I think you’ve missed the mark.
Look, the fact that I offered such strong warnings only now, rather than a month ago, is a regret that I’ll take with me to the grave. (Throughout my life, again and again I’ve had this problem of sitting there paralyzed, failing to act quickly on information that I had and that predictably turned out to be incredibly important. Good thing that I became a professor rather than an investor! 😀 )
Having said that, you might be surprised by how many people I know who still aren’t taking this too seriously—even now, as the corpses are already piling up, and as all the disaster movie tropes unfold just the way it would in the disaster movie. (Yesterday, like many others, the President of UT Austin was still waiting for confirmed cases on campus, before making the final decision to cancel classes. Today, after he learned of such cases and made that decision, his own wife also tested positive.)
Comment #81 March 13th, 2020 at 7:40 pm
“Yesterday, like many others, the President of UT Austin was still waiting for confirmed cases on campus, before making the final decision to cancel classes.“
It is *precisely* this mindset which is going to get people killed. If people in positions of power only *react* to this based on the appalling amount of testing that is going on … then we have no hope.
Thankfully, in the last three days or so there have been some significant decisions made to really start the social distancing that is necessary. Unfortunately, even this is likely too late to prevent hospitals from getting swamped in areas of the country.
Comment #82 March 13th, 2020 at 8:25 pm
Scott 71
See my response to Steve above, Yes metaphorical holocaust is metaphorical and I wasn’t attributing him a literal equality here, it is specifically the aspect of relating the victims behavior to the outcomes here that I find a particularly poor analogy for the situation at hand, I’m sure you’re familiar with the “lambs to slaughter” accusations and the treatment of survivors in post-ww2 nascent Israel society.
You are in a far better position than me to have a model of your readership, what percentage of them do you think have updated towards taking additional active measures as a result of this post vs having reaffirmed their heavily motivated bias of believing this is all being blown out of proportions as a result of this metaphor ?
This is absolutely true as far as observation of human nature (also frog nature ?) is concerned, but attributing it specifically to the Shoah imo is an overfit – I actually consider the choices faced by 1930s Jews in central and western Europe (where majority of those who actually had choices resided) as being far from obvious when not looked at in hindsight, but this is not the time or the place for this discussion.
Comment #83 March 13th, 2020 at 10:13 pm
Oy Vey, you wrote:
“Being roughly the same age as Steve Ebin I could easily play my own 2nd and 3rd generation holocaust card here but I won’t because it’s irrelevant and utterly repugnant, though I completely understand San Francisco “tech world” people who can (and more importantly, do) pay 1000$ for a meal having lots of not-unreasonable fears of persecution to project on this.”
While I don’t want this to degenerate into a discussion about the holocaust, and while I should let your comment slide (https://xkcd.com/386/), I can’t, emotionally-speaking.
Here is a video of my grandmother, a living Auschwitz survivor who lost 10 siblings, countless cousins, and both parents, telling me how her family deliberated for so long about whether to leave Europe that it became impossible to leave. This is a video I recorded. Your family may have suffered during the holocaust as well and you are welcome to draw whatever lessons you want. But I will not ignore this lesson and I will not be hushed by you.
Comment #84 March 13th, 2020 at 11:07 pm
Steve E #82: I was totally riveted by your grandmother’s story, but then it cuts off in the middle (at 3:37). Was there more? Also, did you just make this today? Thank you so much for it.
Comment #85 March 14th, 2020 at 2:43 am
You shouldn’t be too hard on yourself for waiting to write about this until now. The epidemiology came into focus in January but Wall Street waited until late February before noticing any problems. And almost no one prominent (with a few exceptions like Scott Gottlieb) bothered writing about the bureaucratic testing mess in your NYT link except through Monday morning quarterbacking.
The problem I have with your post and exponential (rather than logistic) growth assumption is that it’s not inducing panic but fatalism. If we’re all gonna die anyway then I guess we’ve got to get on the train and into the shower stations. The reproduction number is getting smacked by distancing and closures, will get below 1 when amped up in response to wider spread, and other countries have already shown this will work.
Comment #86 March 14th, 2020 at 4:13 am
Just for clarification: I think you were underestimating not exaggerating. I think that was very clear from the numbers I provided. But sure, just silence me. You could have simply asked for my sources instead of writing such a sneering response to me. I will remove myself from your blog now. Bye Scott. It was very nice learning about QC from you. Thanks for that.
Comment #87 March 14th, 2020 at 6:16 am
josh #76: In Switzerland, the goverment introduced serious/reasonable measures regarding events, restaurants, schools, etc. only yesterday, after the number of confirmed cases had reached 1000. The scary thing is that even I could guess this timing in advance. So my conclusion is that waiting for the magical number 1000 had no professional ground (it’d be a weak excuse to say they hadn’t known until yesterday what was coming). I prefer the way it was done e.g. in Hungary (and some other countries too), where measures were introduced after about 13 confirmed cases (I know, the number 13 does have a meaning, but nevertheless I’m happy they don’t wait until it goes up to 1000).
Comment #88 March 14th, 2020 at 6:35 am
@Scott #33:
Actually we have that in Italy too.
Comment #89 March 14th, 2020 at 6:38 am
@Scott #46:
See also: https://slatestarcodex.com/2014/03/24/should-you-reverse-any-advice-you-hear/
Comment #90 March 14th, 2020 at 8:31 am
The UK is making a massive game based on same non-Bayesian reasoning that I contend is going to get a lot of people killed:
https://amp.cnn.com/cnn/2020/03/13/uk/uk-coronavirus-response-boris-johnson-intl-gbr/index.html
Comment #91 March 14th, 2020 at 10:42 am
Hi Scott,
I guess I’ll put it this way: if this posting is read by people in authority positions like your University president, and it helps to shake them out of complacency, then I 100% approve.
If, instead, the main reaction from readers is to go stockpile hand sanitizer and masks for their bunkers, letting them gather dust while the people who need them most (maybe medical professionals, but more likely people in supply line jobs) can no longer get them, that’s a problem.
The most noble reaction in these circumstances is not going to look at all like the Holocaust equivalent of sheltering Jews in our attics. It is going to be close to the opposite– being cautious and responsible, but also being responsive to directives from authority while resisting the temptation to think of only the people immediately around us. Because we’re all only going to be as healthy as the sickest in our societies.
Best wishes to all your readers– that we might go back to arguing about the important things, like quantum volume definitions, soon!
Comment #92 March 14th, 2020 at 10:56 am
Scott,
I’m glad you’ve changed your tune a bit. I stand by my comment a few days ago. I’m a little disappointed others interpreted it as pro-Trump, but I suppose that’s reasonable based on priors. I’m not pro-Trump in the least, but I do value an accurate assessment of our circumstances since this can lead to a correct response. The problem is much bigger than Trump (though I don’t deny he’s making matters worse, and that he is a symptom of the same class of problems).
I’ve honestly been quite depressed about all of this, since I correctly forecast the course of the epidemic back in January. Though I didn’t expect the US response to be quite this bad.
I do think we still have a window to avert catastrophe, and I see the main hurdles at this point as bureaucracy and personal complacency/selfishness (really almost the same thing). I actually have some hope that Trump might end up doing some good in the end (I’m reminded of Gandalf’s words), for example if he starts tearing down bureaucratic barriers to drug approval. I understand there are promising potential vaccines weeks away from development….and years away from approval.
Comment #93 March 14th, 2020 at 10:58 am
There are many comments that this one of mine is directly or indirectly relevant to, too many to call out.
The general models epidemiologists use are both widely, publicly, available, and easily understood by most readers of this blog. Further, one can whip up such a model in minutes on one’s laptop, using a spreadsheet or coding in Python (say). The input values for such models may take a bit of digging but they’re not too hard to find. So, frankly, the josh’s who’ve posted here are no excuses.
I’d like to present something a bit different.
What % of the US population would get covid-19 if exposed? Reasonable lower and upper bounds, please. I’ll take 40% and 80%.
What % of those who come down with covid-19 will die of it? Likewise, reasonable lower and upper bounds please. I’ll take 0.2% and 5.3%.
Take the geometric mean of each range, assume 330 million as the US population, turn the handle … 1.9 million deaths (range 260k to 14 million).
In my experience, this OOM (order of magnitude) or BOTE (back of the envelope) method works well. For just about anything and everything of practical use or value. I’ll leave it to other readers to explain why it is just so darn robust.
Speaking of robust: the ~2 million deaths estimate changes barely at all under changes in input values, unless they are truly dramatic changes. Don’t believe me? Go ahead, try it for yourself.
Caveats:
– a widespread, effective vaccine would, obviously, make a difference … but such a thing is unlikely for at least a year
– apparently successful containment – heroic, draconian, whatever – as in China would make a huge difference (except for the fact that the virus is now circulating globally)
– the behavior of the virus may change, in terms of what we know today (e.g. it could be highly “seasonal”); this could affect the numbers in either a “good” or “bad” way of course
– much more effective treatments become widely used, e.g. drastically reducing the number of “bad” cases which lead to death. I had not appreciated this when I wrote on the back of my first envelope.
I’ll close with this: Andrew wrote “It is quite likely that the pandemic will not actually increase total all-cause mortality.” I don’t want to pick on Andrew, nor this particular statement (there are lots of others I could have quoted). That may be true (and we’ll break out the champagne if it turns out to be), but unless this coronavirus is contained, in the US at least, mine may well be one of those deaths (see my #60). Kinda like this, from a different forum I hang out in, referring to people like me: “gonna die anyway“.
Comment #94 March 14th, 2020 at 11:22 am
Scott,
In hindsight do you think your weighting factor re the importance of long horizon problems eg global warming vs more immediate problems needs rebalancing?
I.e. everybody knows Greta but who’s championing pathogen research or asteroid apocalypse research etc.
Do you think we have gotten our priorities wrong in that context? Eg pre covid even quantum computing got more attention than voronaviruses?
Comment #95 March 14th, 2020 at 12:35 pm
#93 Jean Tate
Your calculations seem to agree with josh’s comment that 10 million deaths might be a too optimistic upper bound even by your own estimations for death rate and spread.
There are some studies suggesting that the death rates in the US could even be higher as 5% due to a significant portion of the population not having access to necessary hospital equipment (either by sheer distance to such facilities or by lack of insurance) and because of the prevalence of pre-existing conditions.
And, of course, we all hope that the current worst case calculations will not become reality and that by taking the suitable precautions ‘only’ the usual amount of people dies. But one mutation and things might look very very different. As Scott said himself he wants to explain the severeness of the current situation to people. This is why he should not downplay it by giving a too low upper bound estimation without justification. Don’t you agree?
Comment #96 March 14th, 2020 at 12:59 pm
Assuming the number of deaths is more indicative/reliable than the number of positive tests – I sorted countries by number of deaths per million of people:
Italy 24.01
Iran 7.54
Spain 4.06
China 2.30
Switzerland 1.62
S. Korea 1.41
Netherlands 0.70
Norway 0.4
Belgium 0.36
UK 0.32
Greece 0.27
Iraq 0.26
Sweden 0.2
France 0.18
Japan 0.17
USA 0.17
Denmark 0.16
Australia 0.12
Germany 0.10
Comment #97 March 14th, 2020 at 3:20 pm
@Scott #78: in case you were also referring to my comment, I don’t mean to sneer at the predictions. I think they serve a useful purpose when placed in appropriate context. For example, if you give give estimates under various response scenarios, it can help inform policy decisions. It also may help convince people to take the virus seriously.
However, I still think people need to be careful when quoting these numbers. Articles have been providing these estimates without the proper context. Many statements are of the form “up to x% could be infected”, without giving the low end of the projected range. Many sources fail to mention when predictions are worst-case scenarios under the assumptions of no preventative actions (which was the case in the U.S. a week ago, but not today).
Articles like these, failing to discuss the context around the estimates, are helping to fuel a harmful frenzy: hoarding of masks, empty grocery stores, etc. (aside: my local grocery store today was out of many *perishable* items. Why on earth would people stockpile bananas?)
I’m not expert on these things, so any guess I make is of course an even wilder stab in the dark than the expert estimates. But since you asked: I wold guess the range for U.S. deaths is 1,000 to 1 million. 1,000 sounds plausible under extreme measures such as a total lock-down. On the other hand, 1 million would correspond to about 10% of the population being infected, which seems a reasonable upper bound given that significant action is finally being taken.
Comment #98 March 14th, 2020 at 4:30 pm
@Rahul #94:
You are correct that it is important to compare threats to allocate worry and (ideally) resources. Some people have undertaken just such an analysis. I’m not quite at their level, but I’ll throw out a few thoughts on the topics you mention.
Even under highly pessimistic scenarios, a pandemic is unlikely to cause extinction, or the complete collapse of technological civilization. I’m not 100% confident in that, but it seems likely. In this case, barring a really unlucky mutation, the upper bound is probably on the order of a 5% global death rate. And even that is like the 1% worst case scenario. Really really bad, but not extinction.
Historically humanity has survived many pandemics. Some have had 1/3 death rates in historical societies. Probably the worst case was the native americans, where it was a dozen diseases at once, and death rates may have been 90%.
A big enough asteroid would simply wipe us out. We can get a rough lower bound on the frequency by looking at mass extinctions in the fossil record. Some smaller ones may have hit that don’t show up, but that still might wipe us out, or at least wreck our civilization. But we’re still probably talking about a rate of less than one in a million years.
Global warming is really difficult to forecast. I agree it’s happening, but I’ve heard reasonable argument for consequences ranging from mildly positive to extinction event. Really hard to assess — unlike pandemics or asteroid strikes, we can’t look at historical cases.
If you want a global risk that not enough people are talking about, I suggest dysgenic reproductive trends. Extrapolating current trends in developed countries leaves humanity incapable of maintaining a technological civilization in 200 years. That’s just a simple extrapolation of current events under standard science, no non-linear effects required. Pretty scary stuff.
Comment #99 March 14th, 2020 at 5:29 pm
Careful, those numbers can be flawed and depend on countries actually doing a post mortem to check whether the cause of death was the virus (and publishing this information). The death numbers coming from Germany, for instance, are known to be flawed, they have admitted they don’t analyse whether corona was the source of death.
Comment #100 March 14th, 2020 at 7:10 pm
@mark #97: You stockpile bananas to make banana bread! Quarantine in style.
All in all, I think Scott’s right, people need to be taking this way more seriously. Somehow, we all thought it wasn’t much to worry about when China shut down a city bigger than all of New York. Then we continued thinking it was no big deal when Italy also completely shut down. Now France and Spain are shutting down. We aren’t far behind. And yet, my peer group of 20-somethings are still commuting to the university to study because they “don’t like studying at home,” and workplaces are closing to the public but still requiring employees to come in if they want to be paid. Several countries have managed to curb the spread (Japan, Singapore, South Korea, etc) – and we are not following their model, not at all.
Comment #101 March 14th, 2020 at 7:48 pm
Thank you for writing this! In an epidemic getting one person to change behavior isn’t just a cliche but can save many lives in the next weeks and months. I believe we can get through this – when called by history our grandparents needed to storm beaches into machine gun fire and we mostly need to stay at home and Netflix binge. This is going to be tricky to do quickly with all the noise on Twitter and social media tools Silicon Valley has forced upon us, but it’s a Rosie the Riveter style communications problem to very quickly impart the right mixture of panic, hope, and inspiration to social distance like China until we’re victorious, and your posting helped on the panic side.
Comment #102 March 15th, 2020 at 12:36 am
@Jonathan
Agree with your assessment. However are we putting enough resources & effort into researching a 3% global near-term mortality catastrophe compared to the effort we are putting into long-run existential crisis.
One problem I have with Scott’s response is that he’s been complaining about the failures of *others* (CDC, Government, Trump etc.) But we really need to acknowledge that resources aren’t infinite. An extra dollar spent on global warming or quantum computing research can actually mean less allocation for another (more pressing) need.
We really need more introspection here. Even from a global warming perspective, isn’t Scott’s list of planned travel engagements (that he had to cancel due to Covid) obscenely long?
Comment #103 March 15th, 2020 at 2:37 am
To be more clear about how widespread the virus in a given area already is, do you think it would be a good idea to select, say, 100 people randomly and test them? (Because most of the infected people have no symptoms.) Or would it be just useless statistics?
Comment #104 March 15th, 2020 at 3:34 am
It is annoying to see Trump getting all the blame here.
This kind of pandemic can only be tackled by the society at large following protocols. The government cannot do much if the public are not cooperating. Compared to EU, Trump played
better role. German chancellor Merkel, who is a scientist and Johnson who is definitely smarter
than Trump are taking much more risk. And EU’s indecisiveness about imposing travel ban on China and other Asian countries is the major reason why it became global pandemic. Trump has nothing to do here. By focusing only on him, we are letting others go scott-free (pun intended).
Comment #105 March 15th, 2020 at 8:52 am
Annoyed #104,
Your annoyance is infuriating to others as your dear leader accepts zero responsibility for anything unless it is good news when alone is responsible for it. And don’t forget, your dear leader says all the responsibility is actually Obama’s fault for …. h1n1 forget that he has been in power for four years.
Like, if you are so annoyed Trump is getting blamed since he has been in power for four years, then I guess you are absolutely beside yourself that Obama is getting blamed by him, right? Right??
Or maybe you are just a hypocrite seduced by his cult of personality. Anyway, social distance your annoyance please.
Comment #106 March 15th, 2020 at 9:01 am
Also, maybe this will help with your annoyance… those of us who did not vote for this utter disaster of a President don’t just blame him for the lives that have and will be lost due to his incompetence and child-like lack of leadership… we also blame you guys who voted for him too. So maybe just hang your heads in shame and shut the *%# up about your annoyance while the rest of us live with the consequences of your collective colossal mistake.
Comment #107 March 15th, 2020 at 9:28 am
Please share the specific data-driven argument that convinced you to go into lockdown. I have locked myself down, but need to persuade my family members to take their social distancing to the next level. People have a false sense of comfort from the small number (3 confirmed cases, all from outside) in Austin, and while they theoretically know there is almost no testing in Austin, maybe the current lack of evidence means that there isn’t the degree of fear I think there ought to be. I have to confess the small number here gives me comfort even though it shouldn’t.
I am reading that restaurants and bars in NYC were packed yesterday. In at least at one U.S airport (Newark) my friend flew in to from Mumbai, India, there was no health screening today. What is driving this apathy? My own family is not willing to go into lockdown to the degree that I am.
Comment #108 March 15th, 2020 at 10:02 am
Annoyed #104,
Trump is unique in that he called the claim that the virus is worse than the flu to be a hoax perpetrated by the Democrats, and similar blather. This causes his legions of idiotic followers to not take it seriously.
There certainly is a lot of blame to spread around though. For me, one thing that stands out are the cruise ships. Take Japan’s reaction to the Diamond Princess. They let the virus spread throughout the ship to about 700 largely elderly passengers, and the passengers have now mainly gone home. The passengers from the US were all put on an airplane together by a decision of the US authorities, some infected and some not. Then there is the other cruise ship, the Grand Princess. Passengers who were on the cruise ship started testing positive or even dying, and it took some time for anyone to act. There was even a third cruise ship on the Nile which had similar issues. Only very recently have the major cruise ship companies stopped cruises.
Things like the above aren’t Trump’s fault… in the US and in other countries there have been so many incompetent decisions. Now we are in freakout mode where people like Scott are convinced half the country will get it. While I doubt that will happen while we are all hiding away (see S Korea or China’s experience), it seems that the current sentiment is a distinct improvement over where we were before.
Comment #109 March 15th, 2020 at 10:52 am
AdamT, no I don’t blame Obama for this. I am not a Trump supporter, neither I have voted for him. The point I wanted to make is by blaming only Trump, the others are not getting
highlighted. What about the enlightened citizens and politicians from EU, who callously shifted the epicenter from Asia to Europe?
Comment #110 March 15th, 2020 at 11:22 am
It still shocks me to see how many people seem to think this is going to just blow over. This isn’t going to be over, until there’s a vaccine. They point to China, to SK, where there’s been some reduction (temporary, of course). It strikes me that the UK government seems to be the only one willing to accept this – most people won’t bunker down till the end of this, and the ones that know they want to/are able to certainly don’t need the government to nudge them to do it. 2020 is going to be remembered for this, and *solely* this.
Comment #111 March 15th, 2020 at 12:02 pm
When it comes to the long term political fallout of this.
This mess started because of China but the CCP is already wasting no time rewriting history with an aggressive PR campaign.
Still, our main weakness in the pandemic is our reliance on China when it comes to critical supply chains.
But, once all of this is over, with possibly millions of deaths and a massive recession in the US and EU, what will the West attitude towards China be?
Welcome China as the number one economy in the world, with President Xi seen as a world hero? (especially if they manage to be the first to create a vaccine)
Tell China to get its act together and finally ban the wet markets for good? (how cute)
Ask China for reparations, or decouple the economies from China? (but with no leverage left whatsoever)
How do you think career politicians who’ve been soft on China (or even possibly corrupted by China) will look?
Comment #112 March 15th, 2020 at 12:52 pm
“Oh ye who emptied the supermarket shelves afore the elderly could arrive, may your fruits be riddled with the egg of Enterobius Vermicularis”
Comment #113 March 15th, 2020 at 1:09 pm
One of the many unfortunate results of the fact that the outbreak started in China is that the numbers we got from them are *totally* bogus, orders of magnitude below reality. This gave everyone a false view of the scale of the crisis.
The first signs of the outbreak was in November, when the CCP started suppressing the information about lots of new serious cases of pneumonia from local doctors.
The CCP waited after the Chinese new year celebrations to tell people in Wuhan about the new virus (a massive community new year banquet, with thousands and thousands of ppl attending, was given the go-ahead, a mere couple of miles away from the wet market of the outbreak).
Now we see that the number of deaths in Italy, with a couple of weeks, are already reaching half the official number of China!… do you seriously think that China had a mere 3,000 deaths?
There were reports of crematoriums in Wuhan working 24/7, for weeks.
Countless videos of hospital stacked with body bags.
Reporters disappeared.
They turned down help from the CDC, i.e. they wanted no foreign professionals to see the real scale of the disaster.
Back early February, friends of mine in HK (who aren’t even on the side of the freedom protests) were telling me that Carrie Lam (the HK governor) was refusing to block the Chinese border because Beijing wanted the virus to start spreading outside of China asap, in order to redirect the focus from the world media…
And now China can’t wait to call all this a victory:
https://www.theaustralian.com.au/nation/world/mysterious-delay-as-xi-jinpings-coronavirus-textbook-goes-missing/news-story/afc268ea49e7597f70fbdd46f0dc9988
Comment #114 March 15th, 2020 at 2:15 pm
One last thing:
In all the countries that have brought the virus under control, the population is wearing facial masks.
So, if you get the chance to get some, please do so and use them!
(for some reason ppl here seem reluctant to do so. A Chinese friend working in a NYC office brought several boxes for his coworkers, but they all non-Asians refused to take some).
You can reuse a single mask a few times by using a UV sterilizer (e.g. something like this https://www.amazon.com/gp/product/B07W7HSDPZ/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1 ), then store the mask for 3 days in a dry place (like a ziplock bag) before reusing it.
Comment #115 March 15th, 2020 at 2:37 pm
What I find interesting is that folks who espouse conspiracy theories about the origin of coronavirus (Elizabeth #62) use as evidence that the Chinese government made a strong, but in retrospect prudent and correct decision, based on limited data.
In this view, a government acting rationally is such a low probability event that a conspiracy theory is more likely. That’s projecting the US government behavior on governments everywhere.
Comment #116 March 15th, 2020 at 2:37 pm
Right now all over US airports there are scenes of hundreds/thousands standing in crowded small places and long lines standing around for HOURS bunched together while each gets “screened” for a fever. So what happens if one of them has a fever? I guess they get “quarantined” rather than allowed in and all the people who have been standing by them for hours and hours get into the United States.
All of this was Trump’s decision to close the air traffic from Europe on a whim to show he was “doing something” which no public health expert was calling for. None. Of course, he has muzzled the CDC by making it all classified.
Again, I dare anyone to imagine a worse response to this disaster than what Trump has given us all.
Comment #117 March 15th, 2020 at 3:56 pm
AdamT, show me a country that took proactive stance (except for some Asian countries).
In my opinion, the response in Europe is worse than US. Here, in Germany, people are yet to take it seriously. It seems Germany and UK have resigned to fate–accepting that 70 percent or eventually almost all would have it. If the history of this pandemic is written fairly, Europe should get the maximum share of blame.
Comment #118 March 15th, 2020 at 7:01 pm
Here is Trump lackey and US Representative telling people to go out to restaurants and bars *today* even while the head of CDC communication emphatically tells the country the opposite:
https://thehill.com/homenews/house/487666-nunes-urges-americans-to-stop-panicking-its-a-great-time-to-just-go-out-if?amp
Now, Nunes has no brain and probably has a diminished IQ, but he is just faithfully following Trump’s direction. And people are listening. There is a marked indifference among partisan R’s to this crisis and it is getting people killed all thanks to President Trump. He owns all the blame we can heap on him.
Comment #119 March 15th, 2020 at 7:41 pm
It’s worth pointing out that a time of extreme public fear/national crisis always makes the current POTUS stronger, because he’s the one in charge and calling the shots, and things are moving so fast that criticisms don’t really have the time to stick.
As an example, take a look at the evolution of the approval ratings for W Bush:
https://en.wikipedia.org/wiki/Public_image_of_George_W._Bush#/media/File:George_W_Bush_approval_ratings_with_events.svg
Comment #120 March 16th, 2020 at 12:52 am
fred #119: It is true that extreme emergencies people tend to make the leader stronger. But this is not like, say, Geo. W. Bush — this is an obvious and total idiot.
Comment #121 March 16th, 2020 at 1:16 am
Here is a large batch of data and graphs:
https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca
Comment #122 March 16th, 2020 at 3:21 am
See how it started in Italy.
https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Italy
If Italy and other EU countries banned travel from China, they could have avoided the disaster.
At that time, CNN was publishing articles on why travel ban is bad and racist and EU
was trying to be smart and considerate by not imposing travel ban.
I have friends in China and certainly want good for them. But to avoid a global pandemic,
travel ban from the epicenter was the only way.
Comment #123 March 16th, 2020 at 8:06 am
Marc #122
Italy got on board the “Belt and Road” initiative of China (which is basically soft colonialism), they didn’t want to offend their new overlords with travel bans.
Comment #124 March 16th, 2020 at 8:07 am
To those who say the reaction is overblown.
The more the virus is out there, the more likely it will survive summer, and the more likely it will mutate into a deadlier version (which happened with the Spanish flu of 1918).
Comment #125 March 16th, 2020 at 8:12 am
Marc#122, there’s very little evidence that travel bans are effective (see point 4.18 in https://www.gov.uk/government/publications/responding-to-a-uk-flu-pandemic and its references).
Comment #126 March 16th, 2020 at 9:06 am
Eric, it would have been effective if everybody (especially Europe) imposed travel ban/quarantine (of all people with travel history of visiting China in the last month) immediately (within a week) after the outbreak. This is common sense, but I know pundits from WHO downplayed it. If travel ban is completely irrelevant, why Germany and others are trying to close borders now? Even Trump delayed the ban to late January. Everybody who was trying to save economy would now have to pay the price.
Comment #127 March 16th, 2020 at 9:31 am
It has become blazingly obvious that there are only *two* purposes for the travel bans:
1) To give a country or an area more time to *actually prepare* for what’s coming including testing, stockpiling of medical supplies, getting hospitals/healthcare system ready, and preparing the public psychologically for what is coming and making plans on how to shut down society
2) To give the politicians some face saving gesture that they are ‘doing something’
The first purpose is the only legit one and it is without actually taking advantage of the time that travel bans might give the travel ban policies are worse than useless. See yesterday at US airports where the federal government made things worse than had they not done anything.
Trump and this administration deserves worse than an F grade. There response (and lack thereof) has been just short of criminal.
Comment #128 March 16th, 2020 at 1:30 pm
Scott,
Trying to look at some good in all this, any chance that classes being cancelled and everyone self-quarantining will result in a mini-boom of results from academics? Basically curious on your opinion if all the side-work largely distracts from the deep concentration needed for theory work, or if all the distractions promote diversity in thought and are therefore actually a necessary part of making interesting breakthroughs?
Comment #129 March 16th, 2020 at 5:28 pm
Hi Scott
We are being bombarded by so much information regarding this virus , I’m having a hard time figuring out how such a virus can spread so fast in so many places all over the world. As our resident computer science guru, you (or maybe another blogger) must have come across studies that try to use mathematical models to show how fast contagious diseases can spread. What is your understanding of such models and do they correlate with the phenomenon we are seeing in the world today ? If this is too big a question or off base, please just delete it, thanks.
Comment #130 March 16th, 2020 at 5:54 pm
William Hird #129: I’m no epidemiology expert, but granting a virus should arise like this one—spreads person-to-person and asymptomatically for days, r0~2, no one has any immunity—and granting that initial containment fails, isn’t perfectly natural and expected that the virus should quickly spread all over the world (although with its penetration of each region depending on that region’s response to it)? In other words, isn’t the mathematical model that you’re looking for simply exponential growth, N(t) ~ ct? 🙂 And if, as a bonus, you want to know why the growth should continue being exponential all the way up to the scale of the globe—why geography shouldn’t constrain it and make it polynomial long before that—shouldn’t you be looking toward the extreme interconnectness of the modern world, via air travel and so forth, which has made the social world more like what computer scientists call an “expander graph”?
Comment #131 March 16th, 2020 at 7:48 pm
@ Scott #130
I’m doubting your characterization of “extreme interconnectedness ” as being a big part of why it seemed to have spread so fast. Surely modern day air travel is ubiquitous but over the course of any given time frame only a tiny fraction of the global population is actually airborne. I’m not an expert either, but I think a cellular automata model would be a more “accurate” way to model the spread of a virus as opposed to your suggestion of an expander graph, unless they are equivalent ?
Comment #132 March 16th, 2020 at 9:14 pm
William #131: No. What the human physical connectivity graph really looks like, is mostly local connections but with a few long-range connections overlaid on top (e.g. because of international air travel). But a key realization of ‘network science’ from the 1990s (see e.g. Jon Kleinberg’s papers) was that even a small number of long-range connections are enough to make the graph more “expander-like”—and so, for example, decrease the typical number of degrees of separation, and make epidemics spread faster. So the math supports the intuitive conclusion that air travel really can matter here: viruses used to be able to get around only on horseback or by ship; now they can get around by jet.
Comment #133 March 16th, 2020 at 9:56 pm
This is what finally worked to convince my family they need to be as extreme as possible in social distancing. Now we seem to finally be able to get on the same page, able to talk about decreasing E and p and so on, and also that the UK’s policy assumes too much. Fantastic video by “Blue One Brown”:
https://youtu.be/Kas0tIxDvrg
Comment #134 March 17th, 2020 at 8:34 am
Scott #130
“isn’t perfectly natural and expected that the virus should quickly spread all over the world”
At first any contagious person has a vast pool of healthy people to contaminate.
But they can only pass it within a certain period, after which they can no longer pass it and can no longer act as intermediary to pass it from a sick person to someone who was never exposed (experts do think that one can’t get re-infected, i.e. you can only be an active carrier once).
So, as the number of people who got exposed to it (and build some immunity to it) increases, the available pool of healthy people to contaminate shrinks dramatically, and the probability of a sick person coming in contact with someone who never got exposed gets lower and lower.
Comment #135 March 17th, 2020 at 8:37 am
There’s also a high probability that the virus will mutate, for better or worse, before it contaminates everyone in a first wave (so things will reset).
It’s like the flu – everyone got the flu at some points in their life, but most likely from different strains (different waves).
Comment #136 March 17th, 2020 at 9:16 am
On the technical side, I had some ideas. Wonder if they made sense and if any of these tools (apps) already exist:
One of the big tools in the response is transmission tracking and isolation. Going ahead this seems a common part of the response to any pandemic.
But from reading the news this seems to be still done in a relatively primitive way. These days most everyone has a smartphone. With a combination of GPS and perhaps blue tooth shouldn’t it be possible to create a list of potential contacts? This way, the moment a positive for an infection is detected (through a symptomatic case, or random screening etc.) instantaneously a list of probables for infection transmission could be generated and then triaged. Not sure how much damage reduction we already can do but surely for future pandemics this sort of thing can squelch the spread right at the start?
Perhaps, GPS alone will generate a moving circle too large for this to make good use of; typical transmission tracking would want to only target other users in say a 4 to 6 feet radius. But assuming we turn on things like Blutooth, or even better NFC or maybe even ultrasonic sound pulses etc. couldn’t this be made more refined for short radii interactions? Other tweaks could be some sort of time integral of proximity to come up with probabilistic estimates of who could have been infected. Finally, I can even imagine doing more fancy stuff like estimate who used the same hotel room the next day or who sat in the same taxi cab etc. Using known databases of WiFi router names (thanks Google!) or Cellular IDs or things like Foursquare I suppose one could further refine such a tool?
Of course, this raises privacy implications and I see several options: (a) A strictly voluntary or opt-in app or feature on the popular phone OSs. I can see many people adopting it out of a sheer sense of doing what is good and right. This way post pandemic people can turn this off as well
(b) Some sort of smart way of integrating this into the OS where the close-contacts-data is gathered by the phone system and integrated only on demand where a certain decryption key is available. Of course, the master key concept has weaknesses so could this sort of thing be made on a voting model where during a pandemic when X% of users vote for it the decryption key is assembled. Sounds like some sort of cryptographic algorithm based on quorum sensing is needed. Not sure if realistic. But basically you don’t have to trust the government to use the tool only when needed but just trust some fraction of the user population.
(c ) Just to suppress privacy concerns right now since these are extraordinary times and in the interest of the greater good.
Fortunately, it does not have to cover the entire user-base. Even with relatively modest penetration one could ease epidemiological tracking efforts or make a dent into the transmission network. Furthermore the most likely spreaders, (e.g. globetrotters etc.) are the ones most likely to have smartphones all the time.
Is anything like this out there? If not, is this sort of tech intervention likely to be useful or a solution in search of a problem?
Comment #137 March 17th, 2020 at 10:25 am
The mutation risk is another good reason for drastic methods to slow the spread of the virus. The more copies of the virus there are in existence at any one time, the greater the chance of a “successful” (from the virus’s point of view) mutation.
I am waiting to get the virus and see whether I survive (having had breathing problems in the last few years). I kind of like where I am in life now (retired) but all good things end, and my main hope is that there is no form of reincarnation. I don’t want to go through all the angst and nonsense again. (Born under Truman and died under Trump–the arc has not bent toward justice, from my viewpoint, and I’ve been one of the luckier ones.)
Comment #138 March 17th, 2020 at 10:31 am
Finally, some good news: https://news.cgtn.com/news/2020-03-17/Favipiravir-very-effective-against-COVID-19-clinical-trials-show-OW28AySS1W/index.html
Comment #139 March 17th, 2020 at 11:29 am
For all the young folks out there you really don’t give a shit because this is just getting rid of the previous generations faster – keep in mind that it just takes a mutation of the virus to flip things around, and the more people get it the higher the chance of new mutations.
For example the flu of 1918 was deadlier in younger segments of the population ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734171/ )
Comment #140 March 17th, 2020 at 12:02 pm
Bill #138
Please, CGTN is owned and operated by China Central Television (CCTV), the national media organization of China, under the control of the Publicity Department of the Communist Party of China, i.e. the same people who claim the US is the source of the virus.
From the wiki
“CGTN has been registered as a foreign agent in the US.
In 2019, CGTN aired a pro-Beijing documentary about China’s actions in Xinjiang with regards to the re-education camps.”
Enough with the spreading of the CCP propaganda.
Comment #141 March 17th, 2020 at 12:33 pm
Fred #140: The drug is made by a subsidiary of Fujifilm (Toyama Chemicals) and is well-known in Japan. It was in the news a few weeks ago that Japanese government bought a large supply of it for Japanese hospitals. Just because this study was done in China, does not mean it is not reliable. The news has not spread in the English media, but ask your Japanese friends about news in the Japanese media.
Comment #142 March 17th, 2020 at 1:27 pm
some research results on the survival of the virus.
“Some studies on other coronaviruses, including Sars and Mers, found they can survive on metal, glass and plastic for as long as nine days, unless they are properly disinfected. Some can even hang around for up to 28 days in low temperatures.
[…]
Neeltje van Doremalen, a virologist at the US National Institutes of Health (NIH), and her colleagues at the Rocky Mountain Laboratories in Hamilton, Montana, have done some of the first tests of how long SARS-CoV-2 can last for on different surfaces. Their study, which has yet to be published in a scientific journal, shows that the virus could survive in droplets for up to three hours after being coughed out into the air. Fine droplets between 1-5 micrometres in size – about 30 times small than the width of a human hair – can remain airborne for several hours in still air.
It means that the virus circulating in unfiltered air conditioning systems will only persist for a couple of hours at the most, especially as aerosol droplets tend to settle on surfaces faster in disturbed air.
But the NIH study found that the SARS-CoV-2 virus survives for longer on cardboard – up to 24 hours – and up to 2-3 days on plastic and stainless-steel surfaces. “
(from https://www.bbc.com/future/article/20200317-covid-19-how-long-does-the-coronavirus-last-on-surfaces )
Comment #143 March 17th, 2020 at 1:50 pm
Bill #141
I’m not talking about that piece of news in particular, but the fact that the sole purpose of that website is to soften Westerners by spoon-feeding them CCP propaganda in the middle of what looks like normal news.
The Chinese dictatorship is using free press and social media in the West as “soft power” tactics to slowly build up their legitimacy.
Which is totally hypocritical since Chinese within China have no freedom of press and freedom of speech whatsoever… but they’re trying to make you forget about this by mimicking legit Western news media.
By reading that website you’re supporting a regime that is really no different from North Korea.
Comment #144 March 17th, 2020 at 1:56 pm
JimV #137
> my main hope is that there is no form of reincarnation
Unfortunately I think that’s unlikely. The worldview most closely associated with the belief in the non-existence of any form of afterlife is materialism/physicalism, so I will limit my reasoning here to that view, which I take primarily to mean that conscious experience is somehow produced by certain configurations of matter.
The fact that you experience existence is proof that there exist configurations of matter which generate this experience. Suppose that at time t0 this configuration breaks down (ie. you die) and your consciousness ceases.
In the absence of any strong reason to believe that the physical universe is finite, it seems likely (if not certain) that at t1 > t0 a configuration of matter will arise that is sufficiently similar to your current configuration that it will again produce your experience of existence.
It’s possible that an unimaginable amount of time separates t1 from t0, a time that could include the death and birth of countless new universes. This however is no comfort. During that time, no matter how long, you won’t experience anything, so from your point of view it will pass in an in instant.
Another way of looking at this is that if asked what it is like to be in a state of death a materialist is likely to answer that it’s like being in a state of pre-birth. Now what is the one thing we all know about our state prior to birth ? — It came to an end.
Comment #145 March 17th, 2020 at 2:31 pm
There seem to be a number of drugs we have reason to believe will work against COVID-19 (Sarah Constantin sums up the evidence here, though she doesn’t include favipiravir). The problem seems to be in spinning up production (remdesivir I believe in particular does not have a large supply at the moment but my understanding is Gilead Sciences is trying to make more as fast as they can) and/or getting government approval.
Although I’m not clear on why government approval is needed for, say, chloroquine — couldn’t a doctor just prescribe it off-label? Or is it being used in the US already and I’m just not hearing about it? If so why do I keep hearing people talking about trials for it?
Comment #146 March 17th, 2020 at 2:33 pm
I can’t let this pass because this will play a major role in the fallout of the virus, one way or another.
As soon as one criticizes the Chinese dictatorship for doing xyz on a massive scale through the use of force, they turn our freedoms against ourselves by claiming that our democracies are failing to pass some arbitrary purity test, which of course democracies will never pass because nothing’s ever perfect even with the best intention, especially when our freedom of speech/press insures that someone can always be heard about any injustice, whereas the Chinese dictatorship brutally suppresses any internal voice that doesn’t fit its narrative.
Like, comparing the admitted headache of Guantanamo and a few dozen detainees with the forced internment of millions of innocent Uyghurs in order to erase their culture.
The same with the corona virus crisis:
The “strong hand” of the Chinese regime in dealing with the crisis (supported by suspiciously low official numbers, backed by a corrupt WHO) is now being sold as a positive, and contrasted with the inherent weak response from democracies.
The CCP is wasting no time in using this as a big PR opportunity, they’re being very smart about it (Alibaba donating 500,000 masks to Belgium, etc).
Scott loves making WW2 analogies, and this is really the same as gushing all over the economic miracle of Germany, in 1939, praising them for looking strong and great in their big rallies, parades, and push at unification… and contrasting it with the pathetic attempts at appeasement from Chamberlain.
Again, the CCP is just like North Korea, except they have the resources of the number 2 economic power (soon number 1, thanks to this pandemic).
Comment #147 March 17th, 2020 at 3:29 pm
There’s a good animation in the washington post even though it looks like they repurposed it from a thermodynamics diagram. It shows a bunch of dots moving around randomly, and when a brown (“infected”) dot touches a grey one, the green one becomes infected and turns brown. Pretty soon all the dots are brown. Then they show it again with most of the dots not moving, and the infection dies out quickly. The phenomenon is because the number of free collisions goes up with the square of the number of moving dots.
https://www.washingtonpost.com/graphics/2020/world/corona-simulator/
Comment #148 March 17th, 2020 at 4:09 pm
This is supposed to be about DIY masks:
https://www.scmp.com/news/hong-kong/health-environment/article/3050689/how-make-your-own-mask-hong-kong-scientists
Article about why telling people not to wear masks backfired, by the very astute Zeynep Tufekci:
https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-masks.html
Why Telling People They Don’t Need Masks Backfired
To help manage the shortage, the authorities sent a message that made them untrustworthy.
Comment #149 March 18th, 2020 at 4:26 am
This is clearly a very serious situation. However I continue to think that the unintended consequences of our response could do more damage than the virus. Our societies are fragile and not resilient to mass disruption to supply chains etc., and this all depends on a great many people continuing to move around and do their jobs.
Basically we should follow the advice that we are given around social distancing, working from home where feasible, hygiene, protecting the old and weak, etc. And other than that maintain a cheerful and positive demeanour to the greatest extent possible. And. at the risk of being labelled a snob of some sort, better educated people who occupy more privileged positions in society (such as many of those who recreationally read quantum computing themed blogs, for example) have a greater obligation in this regard.
Comment #150 March 18th, 2020 at 6:23 am
This is the paper on the new corona virus survival in the air and on various surfaces.
“Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1”
https://www.nejm.org/doi/10.1056/NEJMc2004973
Comment #151 March 18th, 2020 at 9:10 am
@Rollo Burgess #149:
I am just reading this article by Ioannadis. Any comments? He seems to think the lockdowns etc. are too draconian? Maybe sort of what your comment was indicating. A more nuanced view?
https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/?utm_content=buffere08f7&utm_medium=social&utm_source=twitter&utm_campaign=twitter_organic
So normally, I’d have dismissed this sort of opinion as wacko / uninformed but coming from Ioannadis I must take it more seriously. Is it that he is just in denial? Or are these contrarian yet credible arguments?
I’m not convinced either way. Finding it hard to decide (given the totality of circumstances) what’s the lesser evil?
Comment #152 March 18th, 2020 at 10:41 am
The really amazing thing is that if everyone was really isolating themselves perfectly for 3 weeks, the virus would be totally extinguished, and we could really go back to a totally normal situation in 3 weeks…
Obviously that’s not gonna happen without a worldwide coordination… and it’s all pointless if 20% of the population is behaving as if it’s business as usual (the economy is taking a hit from lock-downs for basically nothing):
https://gulfnews.com/photos/news/photos-spring-breakers-throng-florida-beaches-despite-coronavirus-pandemic-1.1584527033617?slide=7
Comment #153 March 18th, 2020 at 10:53 am
On COVID-19 being of “natural” origin:
https://www.sciencedaily.com/releases/2020/03/200317175442.htm
Comment #154 March 18th, 2020 at 12:01 pm
fred #152
> The really amazing thing is that if everyone was really isolating themselves perfectly for 3 weeks, the virus would be totally extinguished, and we could really go back to a totally normal situation in 3 weeks…
If literally everyone totally isolated themselves for 3 weeks civilization would collapse and there would probably be billions of deaths.
The economy, or at least a significant portion of it, is our life support system on this planet. Power plants, water distribution systems, food production, the internet, all transportation including food distribution would shutdown. You can’t live for 3 weeks without water and after 3 weeks without food many would be in no shape to return to work. That’s not even considering hospitals and medical care.
Comment #155 March 18th, 2020 at 2:04 pm
Rahul #151
It’s also possible (probable?) that the regular flu also has a large percentage of asymptomatic cases, and that even if he were right this disease could still be 10 times as deadly as the typical flu. When you have situations like the nursing home in Washington state where 25 percent of the patients have died, and when the hospitals are being flooded with patients with severe respiratory symptoms, I don’t think people will change their attitude towards this virus because of this.
Comment #156 March 18th, 2020 at 5:03 pm
fred #14:
> The official media in China is calling the virus the “Italy virus”, or “Japan virus”, claiming that it came to Wuhan after some locals visited Italy, and/or Japan.
Everyone could speak for their politics. Only idiots use totally fake news.
Comment #157 March 19th, 2020 at 6:28 am
asdf #79:
Called, yes, but was the spending actually reduced? Fortune doesn’t say so and my guess is it wasn’t, because otherwise they and WaPo would hardly fail to mention that. Yes I’ve heard about CDC global team, although (a) it’s global and the question is about US internal response and (b) cutting China from CDC purview sounds reasonable.
Scott: here’s all-powerful lunatics vs powerless benevolent experts and scientists again:
Comment #158 March 19th, 2020 at 4:18 pm
More lunatics (h/t Cowen):
Comment #159 March 20th, 2020 at 11:47 am
#165
fake news?
The CCP totally controls the narrative on social media, not just WeChat, but they’re monitoring Twitter as well (whenever their citizens post something using VPNs).
https://www.vice.com/en_us/article/wxepem/heres-how-china-is-hunting-down-coronavirus-critics
https://www.vice.com/en_us/article/epgqpj/chinese-internet-users-have-some-ingenious-ways-of-getting-around-coronavirus-censorship
https://www.vice.com/en_us/article/qjdejp/a-chinese-citizen-journalist-covering-coronavirus-just-live-streamed-his-own-arrest
https://www.vice.com/en_us/article/939q35/heres-how-china-is-silencing-coronavirus-critics-in-the-us
It’s the bread and butter of the CCP to stir up internal nationalism against other countries whenever it suits them – about the only time “protests” are allowed:
https://www.theatlantic.com/photo/2012/09/anti-japan-protests-in-china/100370/
Comment #160 March 20th, 2020 at 11:58 am
Here’s more fake news for you
https://www.nytimes.com/video/world/asia/100000007024807/china-coronavirus-propaganda.html
Comment #161 March 20th, 2020 at 1:50 pm
For anyone looking for clue as to why Italy has been hit so hard and so fast, a piece from Dec 2019 on how a lot of the “Made in Italy” fashion industry is actually being manufactured in Italy by local factories owned by China, using a big community of migrant Chinese workers
Comment #162 March 21st, 2020 at 5:16 am
Michael #155: Here are the estimates for flu:
https://www.cdc.gov/flu/about/burden/index.html
In 2018/2019 season, there were estimated 490,561 hospitalizations and 34,157 deaths. Why people use the word “flooded” now when the number of covid patients and deaths is a small fraction of this?
Comment #163 March 21st, 2020 at 6:34 am
2018/2019 flu statistics (estimates) in the US:
Symptomatic (!) illnesses: 35,520,883
Medical Visits: 16,520,350
Hospitalizations: 490,561
Deaths: 34,157
Death rate among hospitalizations: 7%
Death rate among medical visits: 0.2%
Recent estimate from Wuhan about covid death rate: 0.8%. However, covid testing and medical visits have much stricter guidelines than flu, so 0.8% could easily become 0.2% if we allow for 16 million medical visits for covid. Also, flu 7% hospitalization death rate is not far even from the covid death rate in Italy, 8%, which is what it should really be compared to. Look at this article:
https://www.bloomberg.com/news/articles/2020-03-18/99-of-those-who-died-from-virus-had-other-illness-italy-says
The average age of people who died in Italy is 79.5, and 99% of them had other conditions like high blood pressure (75%), diabetes (35%), and heart disease (30%).
I think sceptics are being too generous when comparing covid with flu. I think it won’t be 10 times deadlier once compared accurately (i.e. in the imaginary control group where the world has not panicked). My guess it would not be worse than n1h1 outbreak.
Comment #164 March 21st, 2020 at 7:09 am
Let me guess one reason why at least doctors describe current situation as a “flood”. Imagine you are a university professor and suddenly you were asked to drop your usual research and teaching routine and supervise PhD dissertations of 10 students from a local community college. These students come to your office hours every day for 30 minutes each and you have to find and explain some projects to them. These students haven’t even taken basic undergraduate classes (analogous to visiting your family doctor). I bet most professors would complain like crazy and feel overwhelmed.
Comment #165 March 22nd, 2020 at 6:47 am
Does anyone understand what the long term game plan is?
The hope is that each country will be able to contain the spread within its border. But some countries are going to struggle with this (third world)?
Then we’ll keep restricting travel between countries at a minimum, with mandatory quarantines and testing at points of arrival?
But within a huge country like the US, isn’t it necessary to apply the same model recursively, i.e. isolate states/cities from one another (like China did with Wuhan)?
Identifying hot spots is important, but apparently NYC is at the top right now because way more testing is being done there.
So efficient testing is clearly important in the long term to detect new outbreaks of corona once things are under control.
Should the tech industry focus asap on improving dramatically the ease of use of the test(imagine if it was as simple as measuring insulin levels)? It’s probably as important as a vaccine itself.
What about the effects on the food supply chain? Is there a risk of food shortage?
Should we start focusing on making sure a few basic goods are produced in sufficient quantity (I have no idea which, but like bread, rice, beans, eggs, …).
Comment #166 March 22nd, 2020 at 6:55 am
Bill #164
sadly, we can’t trust the numbers out of Wuhan (they’re a lower bound).
Indeed, it’s easy to see that this isn’t like the flu:
we never saw Italian hospitals being totally overloaded with severe/critical flu cases, right? (it’s possible the media never really reported on this, or noone paid attention though).
This is an actual fact that doesn’t depend on how we do statistics.
Also, as the hospitals are dealing with a tsunami of serious cases of CCP virus, there is still the normal load of other illness/conditions coming in, and there are less resources for those as a result of the pandemic.
Comment #167 March 22nd, 2020 at 6:51 pm
Fred #165: A doctor who worked in a large hospital for decades told me that he has seen only once in his life a flu patient in ICU. So those 34,157 flu deaths in one season occur naturally outside of ICUs. Covid19 is treated like it’s out of a scary movie; that’s why hospitals are overloaded. But Italy is a strange case and the number of deaths is definitely very high. Seems like this virus is quite contagious and deadly for older folks who have other serious conditions, e.g. lifelong smokers. On average, it is worse than a typical flu, but is it 10 times worse? I just don’t see credible evidence for that. But my main point is that people should not panic. You have to be mentally strong and ready to fight back. If you panic, stop breathing properly, get weak mentally, you are not improving your chances. So I wish that media and everyone else stop scaring people and assume a more level-headed attitude.
Comment #168 March 27th, 2020 at 6:50 pm
To say that even for young adults, “the prognosis is OFTEN (my emphasis) poor” is a blatant lie! Yes, young people will die, and have died due to the corona-virus. Hell, even you and me might die. But a CFR is around 0.2 % does NOT qualify as OFTEN IMO. Is this typical of democrats? To use hyperbolic language to fear-monger people into social distancing? Yes, I am a bible-bashing right-winger, but I´m also a student of pure mathematics at Stockholm University. The IFR is estimated to be around 0.2-0.4 % by experts at Stockholm University.
Comment #169 March 27th, 2020 at 6:58 pm
And I´m not saying that just because I study pure math, or that an expert has said something, i´ts necessarily right, but I don´t think it helps anyone to use hyperbolic language when discussing this. Just report the facts (fatality rates for different ages) instead of using words like “OFTEN”. Being precise and truthful is incredibly important right now. And maybe I´m more a libertarian than right-winger, although I don´t know what I am, really. Sorry to use ad-hominem arguments, I just got really upset with your predictions, since I am a hypochondriac and have been feeling a bit unwell for the last few days.
Comment #170 March 28th, 2020 at 10:22 am
some of the Western media is actually calling out the CCP for what they’re doing
https://www.skynews.com.au/details/_6143711080001
interesting facts about what’s going on in China right now, in the context of all the accusations of racism
Comment #171 March 29th, 2020 at 6:00 am
Worth repeating again that wearing a mask (and glasses) is critical.
Here’s an excellent interview with a leading expert from SK.
He says masks are the reason why China, Japan, Singapore and SK got things under control and why Europe and the US are struggling:
Comment #172 March 30th, 2020 at 10:29 am
Steve,
It didn’t start off by someone literally eating a bat or a pangolin. At least we don’t yet know for sure. The scientists are still investigating into the matter. What we do know is that the coronavirus is genetically very close to certain viruses found in some bats and pangolins, or some other yet identified intermediate host. If you have watched the movie “Contagion”, the cause could be as arbitrary as someone consumed pork that contains the virus (as the pig had eaten fruits polluted by bat’s excretion).
Please do not spread fake news unless you have proof.
Comment #173 April 20th, 2020 at 5:41 pm
[…] honored to host another guest post by friend-of-the-blog Steve Ebin, who not only published a beautiful essay here a month ago (the one that I titled “First it came from Wuhan”), but also posted an […]