The editors of the Washington Post have advice for how we should deal with COVID-19:
Avoid large crowds. Workplaces should turn as much as possible to video conferencing. Avoid big meetings and food-sharing. If you can work from home, do so.
All nonessential large social gatherings should be reconsidered and if possible postponed. Sports games might proceed without fans, but concerts may have to be delayed. Political campaigns can proceed without rallies. A St. Patrick’s Day parade is a bad idea. Cruise ships are turning out to be virus incubators — don’t take a spring break cruise. Air travel poses risks of exposure to large numbers of people: If you don’t have to fly, don’t. If you’re sick, stay home so as not to expose others. If you’re an employer, keep paying your workers who do the right thing and stay home when they’re sick.
Voting is vital to the health of our democracy, but it can be organized to minimize the risks of infection. Schools are a difficult question. They could prove to be transmission grounds. But closing schools means cutting off meals for needy students and straining life for parents — including nurses, doctors and other health-care workers. If schools are kept open, rigorous migitation measures must be enforced.
Personal hygiene won’t solve everything, but is important. In addition to hand-washing, avoid face-touching, and follow good cough and sneeze etiquette. The elderly are particularly vulnerable, according to the early studies of the virus, so extraordinary efforts should be taken to protect them from possible infection.
I think the first thing we should do is not panic. I see lots of signs that people are, hoarding being among them. Even in the worst case scenario, COVID-19 will not be the zombie apocalypse. If it marks the end of civilization, it’s only because people have chosen to abandon civilization.
It would help if the media weren’t trying to whip people into a frenzy while other institutions attempt to minimize the problem. Yes, there is a problem and, if what I think is most likely to happen which is following a very large number of infections with consequently, about 1-2% of those becoming infected dying, the virus will become endemic in the population which in turn could change our behavior forever. Some industries may not survive a change in behavior but that just tells us they were fragile to begin with.
I learned the past couple of weeks – for many people, there is nothing in between “who cares†to “panicâ€.
Common sense applications would be worthy substitutions for all the panic being churned up by the media, various politicians and alarming but misleading statistics related to fatality percentages. It will definitely be a fascinating read to do an analysis of the COVID-19 programming and public reaction to it after the fact.
CO- I think we are polarized in more ways than just politics.
I cant tell how many people are actually panicking. We have developed these “just in time” supply lines and rely on distribution centers so that stores arent sitting on a lot of inventory. We are always being pushed to find ways to hold down inventory and I think medicine generally lags broader industry. So I doing think it takes much increased buying to have empty shelves. Our Wegmans will be out of toilet paper at 11:00 AM then be fully stocked at 2:00 PM.
All that said, I am sure some people are panicking. Some people are terrified of dying or of things they dont understand. We have always had preppers anyway.
Query- What would you consider an effort by the media to whip people into a frenzy? I am not seeing that but I dont consume a lot of mass media.
Steve
That’s true, many people don’t realize stores these days don’t have anything at all “in the back”.
So those truck drivers had better show up for work.
If you watched the White House Press Briefing yesterday – that pretty much is example #1 of the press trying to whip up hysteria.
It’s somewhat fuzzy right now. To my eye, there is not much difference in the initial reactions to outbreak between Italy and South Korea.
Yet South Korea contained the outbreak at something like 50 dead and 8000 infected. Italy went out of control – 100 dead a day…
It is not clear if the US will end up like South Korea or Italy.
I just bought 250 lbs of toilet paper, because I’m so full of…..
I gotta million of them.
This whole thing is silly. Of course take reasonable precautions, this is a serious public health issue, but that’s it. It’s somewhere between vanilla flu and H1N1, especially if steve is correct about reinfection. The 60 plus crowd needs to be more attentive, and consider prophylactic action, but the rest…..
Steve – if you don’t see the media hysteria, manufactured hysteria, just turn on CNN, MSNBC, WaPo etc. it’s irresponsible almost to a criminal level. It’s political, and they should be ashamed.
I guarantee that the number one longer term effect of this will be a re-evaluation of globalism and offshoring. Gee, I wonder who has been pushing each side of that issue……..
Just as an example, there are presently 120 some-odd diagnosed cases in New York State (population 20 million). No fatalities as yet, fortunately. That’s a page 10 story yet it’s getting practically non-stop coverage on the national news.
At any given time there are probably 120 cases of practically anything in New York State.
The main problem, as I see it, is that we don’t know what we don’t know. The CDC, in particular, grossly bungled the test development so the numbers we have really don’t mean much because no nearly enough testing has been accomplished. We actually don’t really have any idea of how bad the virus has spread here, but the signs don’t look good.
Research on lethality seems to be getting better but, again, is still highly uncertain. Considering my sister lives in an institutional environment and I have several relatives of an age where lethality appears to be a major concern, I’m really not in the mind to minimize the potential effects.
And in an environment where the powers-that-be appear to lack competence, and where there is a resulting lack of critical information (thanks to grossly inadequate testing), there will inevitably be some level of panic.
“Just as an example, there are presently 120 some-odd diagnosed cases in New York State (population 20 million). No fatalities as yet, fortunately. That’s a page 10 story yet it’s getting practically non-stop coverage on the national news.”
Yes, the problem is that there have only been about 5,000 tests performed in the entire US at this point. I don’t know what percentage of those were for New York, but the low number of confirmed cases is the result of a lack of testing.
And the CDC is still restricting conclusive results from state and local labs, so confirmation of cases is limited by throughput at the CDC and the limited number of authorized test kits.
We do know some of what we don’t know.
Some rough numbers — in South Korea, if one assumes they tested so much that they likely caught anyone who would test positive, they have 7500 infected and 54 dead.
By a rough approximation, the US has 27 dead, which corresponds to 3750 infected — and the US case count is only 763.
It is unlikely the number of deaths from coronavirus in the US is severely undercounted. The CDC and the States track deaths from respiratory failure (flu or otherwise), and there is not a detectable rise in deaths so far (outside of the Washington State Cluster).
We are different societies. South Korean outbreak centered around an offshoot Christian cult who’s leaders refused to release a membership list. Took authorities about half a day to take that list by force. Here, we’d have a court date somewhere in September.
“It is unlikely the number of deaths from coronavirus in the US is severely undercounted. The CDC and the States track deaths from respiratory failure (flu or otherwise), and there is not a detectable rise in deaths so far (outside of the Washington State Cluster).”
The CDC estimate for flu deaths alone for this season range from 20k to 52k. That’s 4k=10k a month for this flu season.
Last season there were 34k deaths from flu, the season before that 61k deaths. That’s just flu, ot all respiratory deaths.
There are probably people who have died from Covid that were never diagnosed – because there aren’t enough tests. I’d be willing to bet that authorities are not wasting the very limited and valuable supply of tests on dead people.
And, given these large numbers and the huge ranges, it takes a lot of deaths to detect a rise, especially since Covid has really only gotten started here over the last month.
Again, we don’t know. That is the problem. We shouldn’t assume that numbers are low based on the current state of testing, which everyone realizes is undercounting, at least, the number of cases.
And we also shouldn’t assume that the end of the world is nigh. We really need some data to make anything close to reasonable estimates and we simply don’t have it.
If we use the Italy numbers, then fatalities are much higher. Will we respond more like South Korea or more like Italy? I am thinking Italy, but that is just an opinion. Italy from just a few cases to thousands in a few days. By report, they are converting entire hospitals into ICUs and they are turning away non-Coved pts. Have a stroke? Too bad. And things are probably worse in Iran. So I would take South Korea as a best case scenario. They tested a lot and they tested early. We probably arent missing too many asymptomatic patients, but there are probably still some more who will die. Iran may be a worst case scenario even though I think they are much younger. Poor medical system. The part of Italy affected is the rich part. I think they are probably closest to what we should expect.
“At any given time there are probably 120 cases of practically anything in New York State.”
Thats true, but not that many illnesses of 120 that are showing exponential growth in the rest of the world.
I really dont watch that much TV. Turn it on to watch the 76ers underperform or the Eagles lose. Occasionally Netflix or Curiosity stream, we like history. Just saw Dont F&ck With Cats. Liked that. I guess I would be charitable and say this is like trying to cover a hurricane. It certainly looks like it could be awful, but maybe we swerve East. So on a professional level I have to prepare for the worst and hope for the best. On the personal level we made sure we have a month’s worth of our meds. We cook way ahead for large groups of people so we always have a couple of months worth of food in the freezer. We did buy some extra yeast just in case I need to make bread.
Steve
“globalism and offshoring”
I defer to your experience, but in my lifetime the race to the bottom price began with the rise of the bargaining power of the retailer, led of course by Walmart, but now everybody’s following suit.
My point being, cost is paramount, not quality. Consistent supply will be a lesson learned, companies making sure they have secondary suppliers. But cost is king. And the Chinese are in a unique position in the world to use force to ensure they are the low cost supplier.
Patriotism will never bring factories home. That’s hot air.
Nice piece. Takes a few, warranted, shots at Trump but makes a reasonable case that Italy is our model, but Italy has some advantages we dont have so hard to tell if we can perform as well.
https://thehealthcareblog.com/blog/2020/03/10/can-the-us-health-care-system-pull-an-italy/
As an aside, I have mentioned this in passing but never dwelled on it, the big increase in US health care spending over the last 30 years has been in outpatient care. We have moved lots of stuff out of the hospital, including surgeries. We have many fewer beds now, certainly less than Italy on a per capita basis. If Drew is correct and we reassess having so much of our manufacturing base offshore (I hope he is correct but I think he is way too optimistic. We quickly forget everything and go back to tree status quo.) maybe we reassess our allocation of medical resources.
Steve
According to medical personnel interviewed, a million test kits have been disbursed to all states, with many millions more sent out by the end of the week. The range of the virus’s severity varies from under-the-radar, mild to increasing cases of severity, mostly in older age groupings and those already having compromised health conditions. Most deaths have occurred in the vulnerable sectors identified. In the meantime, quarantines – voluntary and involuntary ones – are going on all over the country, with additional information being publicly distributed as more is gleaned about a virus making it’s way into the public consciousness only 2+ months ago.
I’m sure the virus has not peaked, especially with the expected explosion of new cases arising once unrestrained testing is fully implemented. Nonetheless, I think the massive amount of unsubstantiated, worst-case-scenario news and speculation has lent little assistance in getting past this serious medical event, without first injecting 24/7 hysterics that could render the unintended consequences of long term damage to our economy, along with upending an array of public rituals and routines for who knows how long.
I’m beginning to wonder if the problem is not what we don’t know but, as Josh Billings put it, what we do know that just ain’t so. The Italians attribute their outbreak to 15 Italian tourists who went to India. Given that India has reported so few cases that just doesn’t sound right.
Maybe this strain of coronavirus has been circulating in the population for a lot longer than we think and we’ve only just noticed it. If that’s the case containment would be utterly futile and testing not much better.
What if China is massively understating the number of cases and deaths? We could have the entire trajectory wrong. What if the number of false positives from the tests is higher than we think? I think we’ve got to not just figure out what we don’t know but check our assumptions. Start with the size and speed of the outbreak in Italy and go backwards from there.
I’m just going to point out that the Washington State cluster is detectable from what normal death surveillance.
Washington State has 7.5 million residents compared to 330 million US residents, 2.28%. If there are 4K flu deaths a month in the US, so for Washington State it is 91 deaths / month from flu.
25 deaths like the outbreak in Seattle (so far) would mean a rise of 30% from a normal month — that is detectable.
The CDC has granular enough data they caught the vaping deaths last fall and that was just 68 deaths over multiple states over a period of months.
It doesn’t really say as to the future course of coronavirus here in the US because of exponential growth potential.
By the way, has anybody given clear evidence why Italy is the US’s fate vs South Korea? Or why their outbreaks had such different outcomes?
At a high level, both countries have similar health care systems, and took similar approaches (Lockdowns of infected areas, rapid expansion of testing, etc).
I have 15, soon to be 16, critical care doctors (the ones who run an ICU). They have been following this with great interest since at least December. This acts differently than the flu, or at least it has everywhere else. In a bad flu season our ICU at our tertiary care hospital gets swamped, but that really means another 15-20 patients sick enough to need ICU who could benefit from that care. Maybe 4 or 5 go on ECMO. Looking at Italy, South Korea and China, a lot higher percentage of patients end up needing ICU care. That is what would likely overwhelm our system. We just dont have a lot of extra ICU beds sitting around.
“If that’s the case containment would be utterly futile and testing not much better.”
If we are willing and able to do it on the scale done in S Korea or even in China, we can probably cut the number of cases way, down. If we arent, then we are Italy. Nonetheless it is encouraging that testing, quarantine and isolation seem to have some effect, at least in South Korea.
“But cost is king. And the Chinese are in a unique position in the world to use force to ensure they are the low cost supplier.
Patriotism will never bring factories home. That’s hot air.”
I think it is just as likely that we end up farming out our factories to a second cheap foreign country, even a third rather than have them come back home. Agree that cost is king.
Steve
And:
https://www.msn.com/en-gb/news/coronavirus/stop-saying-its-a-bad-flu-doctor-fighting-coronavirus-shares-dramatic-account/ar-BB10YXEc
CuriousOnlooker:
I think that South Korea’s and Italy’s health care systems are pretty different. IIRC Italy has a capitation system. I also suspect there are major differences between the two countries in social views of illness.
“By the way, has anybody given clear evidence why Italy is the US’s fate vs South Korea? Or why their outbreaks had such different outcomes?”
I think this is an excellent question and one I hope that we can sort out when things are better. I have been guessing, but based upon some media coverage. For example, it leaked out early that Italy was going to quarantine. The response of the Italians? A lot of them left the area. They weren’t going to be stuck living in an area where they had to stay home. I haven’t read anything like that in South Korea, and I have looked. Doesn’t mean it isn’t there and I just missed it, but it wasn’t prominent in media coverage like the stories were about Italians running away.
My bias is that Americans act more like Italians than Koreans. We dont follow rules very well. We have a large number of people who are privileged and used to getting their way. But, we live in smaller units and tend to keep to ourselves a lot. Maybe video games will save us all. Lets hope that tilts things in our favor.
Steve
My daughter’s home from college on spring break, and now has been informed that there will be no in-person classes for two weeks following the break, at least. This seems to follow a previously stated policy that students who went to certain listed places during Spring Break, like China and Italy, would be required to quarantine themselves for two weeks on return. The previous policy didn’t seem to have any enforcement mechanisms or facilities available. I never saw it, but my daughter’s take is that it was entirely voluntary and was simply intended to discourage travel during Spring Break.
So she plans to return to her dorm after spring where I guess the lack of in-person classes will keep her from being infected by other students. She’s not certain whether her theatre activities are cancelled; it seems like sports continues — what is important and what is not important? I’m tempted to think teaching is not important, but is sounds like the professors are supposed to teach remotely and some are rising to the challenge and others are simply assigning reading.
Grey
You missed it by a hair. It’s not the retailer, it’s the consumer. It’s so easy to blame business and profits. No one wants to admit that the consumer is king. They will tell you what your business model needs to be with their purchasing decisions. Any other view is bias or naive.
I think Steve is flat damned right on American behavior. Don’t expect us to behave responsibly. Expect finger pointing in spades. So much easier.
It matters quite a lot to figure out if there are any differences between Italy and South Korea that are actionable now, not to be researched later. Could be the difference between a mortality of hundreds vs thousands.
For health care, both their systems seem more similar to each other than the US is to either — they are both universal access, almost single payer systems, with similar life expectancies. At first glance, neither availability of health care or the quality of health care explains the difference.
They both locked down their epicenters of outbreak 2 weeks ago — Italy a cluster of 5 towns with 50000 people. South Korea a city of 2.3 million. They were both pretty tight. But apparently Italy’s failed requiring a more drastic whole country quarantine while South Korea’s succeeded.
As to the US is more similar to Italy or South Korea –> Washington State is 8% Asian-American.
PD
My daughter is returning to same. She’s asking about stockpiling food etc.
Media has truly failed us.
If you read the stories on Italy you find quite a few saying something like this.
“There was chaos and confusion in the northern Italian city of Padua in the Veneto region as word spread late Saturday evening that the government was planning to announce the quarantine.
Packed bars and restaurants quickly emptied out as many people rushed to the train station in Padua. Travelers with suitcases, wearing face masks, gloves and carrying bottles of sanitizing gel shoved their way on to trains.”
https://www.gulftoday.ae/news/2020/03/08/16-million-quarantined-in-northern-italy-over-coronavirus
Compare that with stories about South Korea where it sounds like they went all out, including giving care packages to people who were quarantined.
Steve
You are referencing the Italian’s drastic countrywide quarantine issued on Saturday.
It is the quarantines initiated two weeks ago is the issue – and the results we see today.
South Korea did not cutoff public transport to the epicenter – or even enforce “social distancing†to the degree the Italians are trying.
https://www.google.com/amp/s/www.nytimes.com/2020/02/25/world/asia/daegu-south-korea-coronavirus.amp.html%3f0p19G=3248
Mini-quarantines are starting to happen. Colorado’s governor (where I live) issued a state of emergency today. The facility where my sister lives just barred visits by all non-essential personnel, including all family and friends and all the authorized people entering will be screened. I think most of the big assisted living corporations are doing the same thing.
I think it’s probably a prudent move considering the evidence of how lethal the virus is with elderly and compromised populations. And – repeating myself here – in the absence of a comprehensive set of hard data obtained and informed by a robust testing program, it’s better to be safe than sorry with vulnerable populations.
I think a big problem is that there’s a very limited amount that can be done to prepare without going all out.
So, stock up on nonperishables and OTC meds, make sure prescription meds are filled. Avoid large crowds. Ok, so far no problem. But you haven’t actually done much to mitigate your risk if the virus is already circulating in your community.
It apparently is in mine now (an employee at a Waffle House down the road tested positive and there are about a dozen cases scattered around my kids’ school locations.) So now what? As we keep going out into the community to school, work, stores and the like, will frequent hand washing do the trick? Who knows? And at some point if the prevalence becomes higher do we go into isolation mode? If we do it too soon we’ll go through the extra food supplies we’ve obtained should this become a prolonged problem, but you don’t want to be a hoarder. It’s really not easy to determine the right course of action between the extremes of unpreparedness and panicking.
Don’t you think, steve, that part of the issue in Italy is their high median age?
Separately, it has become clear that we as Americans won’t self police. We are a month away from widespread infection. The older crowd better get religion and take basic precautions. We have mass hysteria. We need sober but real precautions taken by the most susceptible. And I pointed out, and Steve probably more eloquently, the issue is going to become the US system being overwhelmed. You don’t design for rare events.
“Don’t you think, steve, that part of the issue in Italy is their high median age?”
I do. It would be interesting to know the average age in that part of Italy where it started. Still, I am just guessing about why it is worse in Italy. As CO keeps pointing out some of my guesses dont quite make sense. However, I am still betting that when analyzed afterwards we will mostly find that S Korea just took this more seriously, tested sooner and had better compliance. The article CO links to above is nicely written, but my take home from it is that even though S Korea did not impose mandatory travel bans right away, their voluntary bans worked very well. This may be because they are a more culturally cohesive society, the point (paraphrased) that I think Dave tries to make. Or maybe living next door to China this was just more real to them so they were scared enough to comply.
“You don’t design for rare events.”
Wish I had said that too. Maybe I will just quote you and Andy all the time. People really dont understand this at all. We actually do make general plans for stuff like this, but since you dont know ahead of time what you will face you cant plan the specifics. And, what you really cant do is staff for and have the equipment on hand to adequately handle these kinds of rare events. The costs of every hospital in the country staffing an extra 10 ICU docs, 20 ICU nurses and so on jus incase we have one of these events every 30-60 years is prohibitive.
Steve
The average age in Lombardy, where the outbreak was first detected, is 45.4. That’s actually younger than in much of the rest of Italy.
The stats are pretty confusing. If you look at the closed cases, the case fatality rate is still very high everywhere, including S Korea (though it is much lower than Italy.) I guess it’s too soon to use the technical CFR formula (# of deaths/# of deaths + # recovered) because there’s still so many active cases. I also wonder though if recoveries are being reported as thoroughly as deaths are.
I dont understand the differences in mortality rates very well and am not even sure we have really accurate data. Every time I come up with what I think is a decent assumption I find reasons to undercut my guesses. Anyway, link goes to a nice site looking at total cases and the rate of increase. It is increasing at an exponential rate and we are tracking Italy pretty closely.
http://earlywarn.blogspot.com/2020/03/covid-19-update.html
Steve
Keep it in perspective. South Korea tracked Italy (in some ways, it looked worse), until it didn’t.
I think the one thing the Federal Government should do right now is impose a complete ban on international travel. It doesn’t help anyone to export cases to other countries — and it is clear there is a lot of travel imported cases outside of the Seattle / California / New York clusters.
I think, Dave, the median age is, broadly, much greater. But now we are into the never never land of speculation.
Steve – it’s a generalized phenomenon. No one designs for worst case except people like airframe designers (they do, they really try). But costs interfere in most venues. I never promised you a rose garden…….
This whole thing is going to be a mess. It’s manageable if we try. But I’m ashamed for the media, politicians, and citizens and their hysterical and self interested reactions.
I think curious raises an interesting issue. Ban intl travel. Every liberty instinct in my body says no. But rational containment considerations may prevail.
I think it’s too late for a ban on international travel to be effective.
Thanks for the link, Steve, looks like a good site for analysis.
Re: the median age. 45.4 is pretty high and once you reach a critical # of people over 60 in a given area, the system is likely to become overwhelmed and more deaths occur. Would be interesting to see if there’s a correlation between # fatalities and % of people > 60 in a given area or more to the point a correlation between # fatalities and the ratio of people over 60 to ICU beds.
Seattle is closing its schools. Now that threshold is crossed by one major city — a lot of cities will follow.
No real evidence that kids are “super-spreaders” or at high risk of disease through.
I’m told, curious, that Villanova is shutting down.
Things are moving quickly here in Colorado due to the governor’s state-of-emergency order. CU Boulder, a campus with 30k+ students, is going online starting Monday. It’s likely that other schools will follow suit.
As far as I’m aware, all nursing homes and assisted living facilities are on a kind of lockdown, with non-essential personnel only allowed inside, and only after screening.
Public school districts are considering options. I know of several that are trying to figure out how to do online-only classes if need. There’s been talk of canceling spring break.
All these plans, which seem to also be taking place in other states, assume an internet infrastructure we don’t have.
My daughter changed her mind and she’s staying with us indefinitely now. She couldn’t be certain what would be open and the school doesn’t know what it will do because it doesn’t know how many students will be around to run things on and off campus.
More generally, some of this only makes sense to me if we assume there are seasonal affects that will play out and the abundance of caution now is simply what’s needed to get us out of the flu season.
It looks like we ares till short on testing ability. One of my docs felt sick today (he flew back from Canada through Chicago this weekend, and we know what an awful place Chicago is) so we had him, per protocol, go to the ED for risk evaluation. They sent him home for two days since he doesn’t have a fever and minimal respiratory symptoms. They didnt want to waste a test. Then later in the day we got an email blast saying that we just got notice from a couple of private labs that they can now do the tests so we will be able to test a lot more people. At his point we should be able to test anyone even remotely suspicious. This is very concerning.
“I think it’s too late for a ban on international travel to be effective.”
Agree. We need to concentrate on domestic solutions. Heard Trump on radio driving home. I didnt hear details but he said he was banning travel from Europe. Too late. On the plus side it sounds like there may be some positives on the financial side. We may get some tax cuts that will help a little, but it also sounds like they are going to try to do sick leave pay for those out of work and cover the costs of Covid treatment. Kudos to Trump and the Republicans if they come through on that.
Steve
“More generally, some of this only makes sense to me if we assume there are seasonal affects that will play out and the abundance of caution now is simply what’s needed to get us out of the flu season.”
It is a little more than that. Let’s say that no matter what we do we are going to face a million cases of Covid (random number pick). If we can just slow down the spread some it could mean caring for those million patients over 3 months instead of one month. That would mean a lot less stress on the system and we could, hopefully, save a few more lives.
Steve
On seasonality, this is a pre-print that argues that “there is a striking similarity in the measures of average temperature (5-11 degrees C) and relative humidity (RH, 47-79%)” in the areas most affected. The paper dated March 9, 2020, identifies similar conditions would come to exist in the Midwest (St. Louis) and the Northeast (New York) in the coming weeks.
“Although it would be even more difficult to make a long-term prediction at this stage, it is tempting to expect COVID-19 to diminish considerably in affected areas (above the 30 N) in the coming months. It could perhaps prevail at low levels in tropical regions similar to influenza and begin to rise again in late fall and winter in temperate regions in the upcoming year. One other possibility is that it will not be able to sustain itself in the summer in the tropics and Southern Hemisphere and disappear. Surveillance efforts in the tropics, as well as New Zealand, Australia, South Africa, Argentina, and Chile between the months of June through September may be of value in determining establishment in the human population.”
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3550308
Travel bans are necessary but not sufficient component for success.
Given how serious the situation is in Europe – I would treat treat every traveler from there as having a chance of being infected – and that implies they need to be self isolated on arrival. Why spend resources on self isolation, there is no gain from spending resources on that.
There are a couple of other points. We should not think that RNA based testing is a magic bullet. The Chinese found significant false negatives with RNA tests, that the latency (takes a day or two to get a result) was too long for decision making. They relied on CT scans during the height of the crisis to quickly make preliminary diagnosis.
We should be open to using CT scans for quick diagnosis purposes as well.
By the way, we should keep in perspective – China had 80000 cases — an outbreak of 1 million cases means the US would have an outbreak an order of magnitude worse then China, with only 1/4 of the population??
As to when the outbreak ends – assuming a peak is 2 weeks away, Farr’s law of epidemics suggests end of May. It can easily go into June/July.
I think steve hit the nail on the head with his last post. Although I’m disappointed with Monday Morning Quarterbacking on travel ban timing.
How many of you have been in a pure crisis management mode? I have. I bet Dave has. Steve, but perhaps patient specific, not organizational. Things are moving at the speed of light. You have to focus on the big issues first. People not in charge will second guess. In the post mortem you will realize the mistakes you made. The critics will have a field day, but that’s why they aren’t on stage, just in the critics section. Trump is doing fine. Go to OTB if you want to see rank pettiness on display, even by the blogging staff, who should know better.
I definitely have.
I had no doubt. Your blog posts over time told me so.