Coronavirus

[Jurgis]

https://emcrit.org/ibcc/covid19/ - medical info collection on Covid19

[SnarkyPuppy]

Imagine mocking this as "just the flu" or not taking it seriously at this point.

[thowed]

Report from the UK.  People are definitely starting to get twitchy - lots of stories about empty supermarket shelves, especially for hand sanitisers etc. 

 

Lots of people here get supermarket deliveries from online orders - you're looking at a week wait to get a slot in London.

 

There is more of a culture of closed-end funds in the UK, so you're starting to see decent discounts emerging, which could present opportunities.

 

The main UK index (FT-SE100) has been a dog of an index for the past 25 years, first being dominated by the 'hot' sector, which then gets wiped out (tech in the late 90s, commodities in 2008).  Since then, it's stagnated, so is still big oil and tobacco instead of all the 'disruptors' the S&P has.  Anyway, you can imagine what it's like today...

 

Anyway, I provide the supermarket info to show that perhaps a significant number of people here are behaving irrationally, so god help us for what could happen in the markets.

 

And also I wonder if this is all to come in the US?

[Read the Footnotes]

Gates-funded program will soon offer home-testing kits for new coronavirus

 

https://www.seattletimes.com/seattle-news/health/gates-funded-program-will-soon-offer-home-testing-kits-for-new-coronavirus/

 

Gates also funded the program that discovered the outbreak in Washington. Bill Gates has a very good chance at looking like a saint or hero when this is all over.

[Kaegi2011]

Imagine mocking this as "just the flu" or not taking it seriously at this point.

 

There's a reason why your question above on what precisely one needs to see to change their mind goes unanswered.

[orthopa]

I think at least three healthcare professionals have contributed to this discussion in the past couple of days, hopefully they and others are still with us and might be willing to respond to a couple of questions. So especially for the healthcare professionals or others well educated on the subject, would you be willing express an opinion on the following three questions?

 

1. My understanding is that "mild" in the case of COVID-19 is any case that ultimately was not hospitalized. That means that symptoms for "mild" range from almost asymptomatic, which is believed to be extremely rare, to something that survivors have described as being the worst experience of their lives and feeling that they couldn't breathe for extended periods of time, etc. I understand that other conditions that would be horrifying to experience are often graded as "mild" relative to the other outcomes, such as death, disability and coma. Could the general public be misunderstanding the medical usage of the term "mild" and that is creating a false sense that this virus is nothing to worry about?

 

2. I have heard there are concerns for the long-term outcomes and there has been some debate regarding long-term consequences for those that survive one of the worst cases of COVID-19, specifically those cases requiring hospitalization.

 

3. Finally, the triaging of patients and prioritizing patients with the greatest chance of survival would further bias the outcomes making COVID-19 look even more dangerous to older people and people with preexisting conditions and less dangerous to those who are younger and healthier. It seems this could create a sense of false confidence in some younger healthier people that they personally don't have to worry about their risk from this virus.

 

Thank you in advance for any feedback that could make this community more informed and safer.

 

 

1. I dont think the public is being misinformed about what mild is. Honestly I do not see any of the panic that anyone of this board, or social media, or media itself is portraying. The presentation of the disease will be and can be very different for different people. As always older people and immunocompromised are at higher risk, but they always have been and always will be. This is common knowledge in the medical community and a reality we deal with every day. This goes for nearly every disease, an especially those infectious. The vast, vast majority of people who contract the virus will have moderate to severe cold symptoms, some may feel like they have the flu. As always just as investing there can be a "black swan" event and a young or healthy person dies. 

 

2. Long term consequences for those who have had covid should be minimal to none...unless you have a restrictive or significant lung diagnosis such as severe asthma, COPD, Lung cancer, and then severe pneumonia. I would think of the long term consequences comparable to the worse cold or flu you have ever had, likely none.

 

3. Again I don't think that young people are being lulled into a false sense of security. Their expectation of the disease should be similar to the flu/mono/pneumonia, etc all of which happen on a daily basis to everyone. I cant remember the last time I saw a young patient that was worried about getting the flu and under estimating its effect. It just isn't pertinent.

 

Couple of other things I think is miss construed by non medical people esp on social media is the need for testing, testing, testing. For one testing is used to treat a diagnosis. Not prevent the spread of a disease. As I mention in another post we test for the flu every year like crazy. Does nothing to prevent the spread of the disease. What does? Standard precautions!!! Sure knowing someone has covid19 would allow a quarantine but by then its way, way too late. Its been spread on, or has had potential too multiple times. A reasonable understanding of incubation time, spread via respiratory droplets and close contact with others should make this quite clear.

 

FWIW I went down to the 20 bed ICU today. 8 beds are open. The ventilators are all ok and unused if not in a room lol. ER was slow too. Idk guys, believe what you want but there is no panic here. We will see I guess.

 

 

[Jurgis]

Gates-funded program will soon offer home-testing kits for new coronavirus

 

https://www.seattletimes.com/seattle-news/health/gates-funded-program-will-soon-offer-home-testing-kits-for-new-coronavirus/

 

Gates also funded the program that discovered the outbreak in Washington. Bill Gates has a very good chance at looking like a saint or hero when this is all over.

 

He has been looking as a hero to me for a while now.

 

Disclosure: I donate to Gates Philanthropy Partners sometimes.

[SnarkyPuppy]

I think at least three healthcare professionals have contributed to this discussion in the past couple of days, hopefully they and others are still with us and might be willing to respond to a couple of questions. So especially for the healthcare professionals or others well educated on the subject, would you be willing express an opinion on the following three questions?

 

1. My understanding is that "mild" in the case of COVID-19 is any case that ultimately was not hospitalized. That means that symptoms for "mild" range from almost asymptomatic, which is believed to be extremely rare, to something that survivors have described as being the worst experience of their lives and feeling that they couldn't breathe for extended periods of time, etc. I understand that other conditions that would be horrifying to experience are often graded as "mild" relative to the other outcomes, such as death, disability and coma. Could the general public be misunderstanding the medical usage of the term "mild" and that is creating a false sense that this virus is nothing to worry about?

 

2. I have heard there are concerns for the long-term outcomes and there has been some debate regarding long-term consequences for those that survive one of the worst cases of COVID-19, specifically those cases requiring hospitalization.

 

3. Finally, the triaging of patients and prioritizing patients with the greatest chance of survival would further bias the outcomes making COVID-19 look even more dangerous to older people and people with preexisting conditions and less dangerous to those who are younger and healthier. It seems this could create a sense of false confidence in some younger healthier people that they personally don't have to worry about their risk from this virus.

 

Thank you in advance for any feedback that could make this community more informed and safer.

 

 

1. I dont think the public is being misinformed about what mild is. Honestly I do not see any of the panic that anyone of this board, or social media, or media itself is portraying. The presentation of the disease will be and can be very different for different people. As always older people and immunocompromised are at higher risk, but they always have been and always will be. This is common knowledge in the medical community and a reality we deal with every day. This goes for nearly every disease, an especially those infectious. The vast, vast majority of people who contract the virus will have moderate to severe cold symptoms, some may feel like they have the flu. As always just as investing there can be a "black swan" event and a young or healthy person dies. 

 

2. Long term consequences for those who have had covid should be minimal to none...unless you have a restrictive or significant lung diagnosis such as severe asthma, COPD, Lung cancer, and then severe pneumonia. I would think of the long term consequences comparable to the worse cold or flu you have ever had, likely none.

 

3. Again I don't think that young people are being lulled into a false sense of security. Their expectation of the disease should be similar to the flu/mono/pneumonia, etc all of which happen on a daily basis to everyone. I cant remember the last time I saw a young patient that was worried about getting the flu and under estimating its effect. It just isn't pertinent.

 

Couple of other things I think is miss construed by non medical people esp on social media is the need for testing, testing, testing. For one testing is used to treat a diagnosis. Not prevent the spread of a disease. As I mention in another post we test for the flu every year like crazy. Does nothing to prevent the spread of the disease. What does? Standard precautions!!! Sure knowing someone has covid19 would allow a quarantine but by then its way, way too late. Its been spread on, or has had potential too multiple times. A reasonable understanding of incubation time, spread via respiratory droplets and close contact with others should make this quite clear.

 

FWIW I went down to the 20 bed ICU today. 8 beds are open. The ventilators are all ok and unused lol. ER was slow too. Idk guys, believe what you want but there is no panic here. We will see I guess.

 

Do you not understand the growth argument or are you just willfully ignoring it?

[Read the Footnotes]

I think at least three healthcare professionals have contributed to this discussion in the past couple of days, hopefully they and others are still with us and might be willing to respond to a couple of questions. So especially for the healthcare professionals or others well educated on the subject, would you be willing express an opinion on the following three questions?

 

1. My understanding is that "mild" in the case of COVID-19 is any case that ultimately was not hospitalized. That means that symptoms for "mild" range from almost asymptomatic, which is believed to be extremely rare, to something that survivors have described as being the worst experience of their lives and feeling that they couldn't breathe for extended periods of time, etc. I understand that other conditions that would be horrifying to experience are often graded as "mild" relative to the other outcomes, such as death, disability and coma. Could the general public be misunderstanding the medical usage of the term "mild" and that is creating a false sense that this virus is nothing to worry about?

 

2. I have heard there are concerns for the long-term outcomes and there has been some debate regarding long-term consequences for those that survive one of the worst cases of COVID-19, specifically those cases requiring hospitalization.

 

3. Finally, the triaging of patients and prioritizing patients with the greatest chance of survival would further bias the outcomes making COVID-19 look even more dangerous to older people and people with preexisting conditions and less dangerous to those who are younger and healthier. It seems this could create a sense of false confidence in some younger healthier people that they personally don't have to worry about their risk from this virus.

 

Thank you in advance for any feedback that could make this community more informed and safer.

 

 

1. I dont think the public is being misinformed about what mild is. Honestly I do not see any of the panic that anyone of this board, or social media, or media itself is portraying. The presentation of the disease will be and can be very different for different people. As always older people and immunocompromised are at higher risk, but they always have been and always will be. This is common knowledge in the medical community and a reality we deal with every day. This goes for nearly every disease, an especially those infectious. The vast, vast majority of people who contract the virus will have moderate to severe cold symptoms, some may feel like they have the flu. As always just as investing there can be a "black swan" event and a young or healthy person dies. 

 

2. Long term consequences for those who have had covid should be minimal to none...unless you have a restrictive or significant lung diagnosis such as severe asthma, COPD, Lung cancer, and then severe pneumonia. I would think of the long term consequences comparable to the worse cold or flu you have ever had, likely none.

 

3. Again I don't think that young people are being lulled into a false sense of security. Their expectation of the disease should be similar to the flu/mono/pneumonia, etc all of which happen on a daily basis to everyone. I cant remember the last time I saw a young patient that was worried about getting the flu and under estimating its effect. It just isn't pertinent.

 

Couple of other things I think is miss construed by non medical people esp on social media is the need for testing, testing, testing. For one testing is used to treat a diagnosis. Not prevent the spread of a disease. As I mention in another post we test for the flu every year like crazy. Does nothing to prevent the spread of the disease. What does? Standard precautions!!! Sure knowing someone has covid19 would allow a quarantine but by then its way, way too late. Its been spread on, or has had potential too multiple times. A reasonable understanding of incubation time, spread via respiratory droplets and close contact with others should make this quite clear.

 

FWIW I went down to the 20 bed ICU today. 8 beds are open. The ventilators are all ok and unused lol. ER was slow too. Idk guys, believe what you want but there is no panic here. We will see I guess.

 

Thanks for sharing your opinion. Hopefully we will get a few more medical professionals to comment, although I suspect no one with first hand knowledge will be chiming in here for quite a while. Plus, the market will likely be a bit distracting for a while.

 

I completely agree that testing is the number one most important thing. Hopefully something similar to S. Korean drive through clinics will be available soon in the rest of the developed world, or the Bill Gates back mail in testing program model would be another giant advance.

 

1. Regarding my first question, I didn't mean to imply that the public was being mislead, just that the resolution is not very fine. For the most part we have everything sorted in to three or four buckets, 1) did not require hospitalization, 2) hospitalized, 3) hospitalized with supportive oxygen, and 4) hospitalized with ventilation. Some reports indicate that the disease is largely binary, other reports indicate there is a large disparity of experiences within the non-hospitalized cohort.

 

3. Regarding my third question, I have heard reports from college teachers that undergraduates are openly saying that they will not comply with requests to isolate, that they can't be forced to not attend classes, that they will come to class whether they are sick or not, etc. I am looking for some way to explain that behavior. Is that simply the hubris of youth? Or are these students underestimating their risk and believing this only effects Boomers?

[merkhet]

3. Regarding my third question, I have heard reports from college teachers that undergraduates are openly saying that they will not comply with requests to isolate, that they can't be forced to not attend classes, that they will come to class whether they are sick or not, etc. I am looking for some way to explain that behavior. Is that simply the hubris of youth? Or are these students underestimating their risk and believing this only effects Boomers?

 

Schools are adjusting to this as we speak. Princeton just sent out a notice to students that they are encouraging their students to stay home after spring break and that the University will make sure they can meet their academic requirements remotely.

[orthopa]

Imagine mocking this as "just the flu" or not taking it seriously at this point.

 

What evidence do you have that its not the flu. Mainly looking for personal/observed, preferably not social media or media.

[StubbleJumper]

 

3. Regarding my third question, I have heard reports from college teachers that undergraduates are openly saying that they will not comply with requests to isolate, that they can't be forced to not attend classes, that they will come to class whether they are sick or not, etc. I am looking for some way to explain that behavior. Is that simply the hubris of youth? Or are these students underestimating their risk and believing this only effects Boomers?

 

 

Just as an observation, the automobile accident fatality rate for males aged 21-25 is about 40 per 100,000 in a given year.  The mortality rate from Covid-19 for people in that age range seems to be about 0.2%, or 200 per 100,000.  One is clearly higher than the other, but if you are in that age range and you aren't afraid of routinely using a car during the year, you probably shouldn't be too afraid of death from covid either.

 

 

SJ

[orthopa]

I think at least three healthcare professionals have contributed to this discussion in the past couple of days, hopefully they and others are still with us and might be willing to respond to a couple of questions. So especially for the healthcare professionals or others well educated on the subject, would you be willing express an opinion on the following three questions?

 

1. My understanding is that "mild" in the case of COVID-19 is any case that ultimately was not hospitalized. That means that symptoms for "mild" range from almost asymptomatic, which is believed to be extremely rare, to something that survivors have described as being the worst experience of their lives and feeling that they couldn't breathe for extended periods of time, etc. I understand that other conditions that would be horrifying to experience are often graded as "mild" relative to the other outcomes, such as death, disability and coma. Could the general public be misunderstanding the medical usage of the term "mild" and that is creating a false sense that this virus is nothing to worry about?

 

2. I have heard there are concerns for the long-term outcomes and there has been some debate regarding long-term consequences for those that survive one of the worst cases of COVID-19, specifically those cases requiring hospitalization.

 

3. Finally, the triaging of patients and prioritizing patients with the greatest chance of survival would further bias the outcomes making COVID-19 look even more dangerous to older people and people with preexisting conditions and less dangerous to those who are younger and healthier. It seems this could create a sense of false confidence in some younger healthier people that they personally don't have to worry about their risk from this virus.

 

Thank you in advance for any feedback that could make this community more informed and safer.

 

 

1. I dont think the public is being misinformed about what mild is. Honestly I do not see any of the panic that anyone of this board, or social media, or media itself is portraying. The presentation of the disease will be and can be very different for different people. As always older people and immunocompromised are at higher risk, but they always have been and always will be. This is common knowledge in the medical community and a reality we deal with every day. This goes for nearly every disease, an especially those infectious. The vast, vast majority of people who contract the virus will have moderate to severe cold symptoms, some may feel like they have the flu. As always just as investing there can be a "black swan" event and a young or healthy person dies. 

 

2. Long term consequences for those who have had covid should be minimal to none...unless you have a restrictive or significant lung diagnosis such as severe asthma, COPD, Lung cancer, and then severe pneumonia. I would think of the long term consequences comparable to the worse cold or flu you have ever had, likely none.

 

3. Again I don't think that young people are being lulled into a false sense of security. Their expectation of the disease should be similar to the flu/mono/pneumonia, etc all of which happen on a daily basis to everyone. I cant remember the last time I saw a young patient that was worried about getting the flu and under estimating its effect. It just isn't pertinent.

 

Couple of other things I think is miss construed by non medical people esp on social media is the need for testing, testing, testing. For one testing is used to treat a diagnosis. Not prevent the spread of a disease. As I mention in another post we test for the flu every year like crazy. Does nothing to prevent the spread of the disease. What does? Standard precautions!!! Sure knowing someone has covid19 would allow a quarantine but by then its way, way too late. Its been spread on, or has had potential too multiple times. A reasonable understanding of incubation time, spread via respiratory droplets and close contact with others should make this quite clear.

 

FWIW I went down to the 20 bed ICU today. 8 beds are open. The ventilators are all ok and unused lol. ER was slow too. Idk guys, believe what you want but there is no panic here. We will see I guess.

 

Do you not understand the growth argument or are you just willfully ignoring it?

 

Yes I do understand the growth argument (was that a serious question?). Your also aware that I believe there are already hundreds and hundreds of thousands of cases in the US correct? Why are you assuming they are all severe and will require the most intensive treatment? And in your exponential growth model how many are you assuming are severe? why? and what symptoms are you modeling that will be most severe? Are you concerned only about viral pneumonia? Bacterial superinfection? Nosocomial infection? How many are you assuming are symptomatic and recover with little to not treatment then otc meds?  Lets start there we can have an intelligent discussion.

[Viking]

orthopa, I see lots of people getting stuck in the weeds debating this theoretical detail or that detail. Sometimes it is useful to look at the big picture. And the real world. So what is actually going on in other parts of the world?

 

Not sure if you have watched this video. It is an example (Wuhan, China) of what happens when a government does not take this virus seriously, does not test and lets the virus rapidly spread in the first couple of weeks...

 

Similar thing in South Korea. Similar thing in Iran. Similar thing in Northern Italy. FYI, people in these countries are not stupid.

 

-

 

So let's have an intelligent discussion. What exactly is it the government in Wuhan should have done after the outbreak had happened? They chose lock down and a bunch of other draconian measures. Your solution (after hundreds of thouands of cases have already happened)?

[jfan]

The problem with COVID-19 is not the absolute number of deaths but the possibility of # of visits to the hospital by elderly patients and those with comorbidities that require hospital admissions or care.

 

If you are fortunate to live in an area with abundant hospital resources than you have the slack to absorb this potential influx. If you are unfortunate, then there will be significant stress on the system.

 

The place I practice, on a regular basis has 30-50 patients admitted to the ER with no in-patient beds. The hallways are always littered with patients. The hospital functions at >98-110% capacity (>90% equates to severe overcrowding with exponential downstream effects).

 

The impact will not only be taking care of these COVID ill patients, but the displacement of resources from all others in the community ill with other illness such as myocardial disease, strokes, renal dysfunction.

 

Furthermore, as healthcare workers get ill, and are isolated from work, who will be left to manage the departments for more patients? During SARS, healthcare workers would work then be off for 2 weeks due to exposure, then to repeat the cycle.

 

The end-goal of vigorous testing is to quarantine and delay the spread, protect the elderly, and buy time for the hospital system to not buckle under pressure.

 

Certainly, there is no proof that this thing will die out in the summer months. We are lucky that SARS and MERS had such a high mortality rate, so the infected can not spread it very far. The problem with COVID-19 is it allows healthy individuals to spread it widely because it doesn't make them very sick.

 

 

[orthopa]

https://abcnews.go.com/Health/early-mortality-rates-covid-19-misleading-experts/story?id=69477312

 

Something to chew on, sure there will be counter factual articles but time will tell I guess.

[Spekulatius]

https://abcnews.go.com/Health/early-mortality-rates-covid-19-misleading-experts/story?id=69477312

 

Something to chew on, sure there will be counter factual articles but time will tell I guess.

 

Yes, this seems to make sense and I think the author is correct and overall mortality rate will come down. The mortality rate varies a lot from country to country. Korea’s mortality rate  is fairly low while Italy’s is surprisingly high. I guess age distribution and the detection/testing rate account for the difference.

[orthopa]

orthopa, I see lots of people getting stuck in the weeds debating this theoretical detail or that detail. Sometimes it is useful to look at the big picture. And the real world. So what is actually going on in other parts of the world?

 

Not sure if you have watched this video. It is an example (Wuhan, China) of what happens when a government does not take this virus seriously, does not test and lets the virus rapidly spread in the first couple of weeks...

 

Similar thing in South Korea. Similar thing in Iran. Similar thing in Northern Italy. FYI, people in these countries are not stupid.

 

-

 

So let's have an intelligent discussion. What exactly is it the government in Wuhan should have done after the outbreak had happened? They chose lock down and a bunch of other draconian measures. Your solution (after hundreds of thouands of cases have already happened)?

 

I have not watched the video yet and responding without as I don't have the 45 minutes right now to do so. I don't think there is much a government can do against an novel airborne disease that has a 2-14 day incubation period, symptoms ranging from none to life threatening, was previously undiagnosed, tested, treated and studied. I think that is the problem many non medical people have a hard time understanding. Governments can't make viruses go away. Governments cant stop panic, hysteria, or fear. Governments can quarantine people but again they cant prevent humans from under reporting, being non compliant, sneezing, coughing, touching, etc.

 

It would be much simpler if the virus was visible to the naked eye and humans didn't panic. It would also be simpler if you had a population with more common medical knowledge but as we all know we dont.  We will probably never know the true mortality rate of the disease other then covid-19 specific antibody testing. Until then speculation will rage.

[orthopa]

The problem with COVID-19 is not the absolute number of deaths but the possibility of # of visits to the hospital by elderly patients and those with comorbidities that require hospital admissions or care.

 

If you are fortunate to live in an area with abundant hospital resources than you have the slack to absorb this potential influx. If you are unfortunate, then there will be significant stress on the system.

 

The place I practice, on a regular basis has 30-50 patients admitted to the ER with no in-patient beds. The hallways are always littered with patients. The hospital functions at >98-110% capacity (>90% equates to severe overcrowding with exponential downstream effects).

 

The impact will not only be taking care of these COVID ill patients, but the displacement of resources from all others in the community ill with other illness such as myocardial disease, strokes, renal dysfunction.

 

Furthermore, as healthcare workers get ill, and are isolated from work, who will be left to manage the departments for more patients? During SARS, healthcare workers would work then be off for 2 weeks due to exposure, then to repeat the cycle.

 

The end-goal of vigorous testing is to quarantine and delay the spread, protect the elderly, and buy time for the hospital system to not buckle under pressure.

 

Certainly, there is no proof that this thing will die out in the summer months. We are lucky that SARS and MERS had such a high mortality rate, so the infected can not spread it very far. The problem with COVID-19 is it allows healthy individuals to spread it widely because it doesn't make them very sick.

 

Is this the case where you practive? If so how well did the area handle H1N1 in 2008?

[orthopa]

https://newyork.cbslocal.com/2020/03/09/coronavirus-update-new-jersey-patient-speaks-out/

 

 

"Cuomo also made a surprise announcement. One of the latest cases is a top transportation official in charge of the airports: Rick Cotton, executive director of the Port Authority. Cotton is in his mid-70s and is asymptomatic."

[Gregmal]

Well some more anecdotal stuff, a story from a friend who works in one of the tri state area hospitals.

 

An existing patient, one that has been making news lately, is in quarantine and being administered remdesivir along with cocktails of other experimental stuff, mostly over the counter. It is not really working(yet at least), but he remains in somewhat stable condition. However there are now several additional people in quarantine because a confused old man wandered into his room, chased by his wife trying to corral him...

[Spekulatius]

Italy is now entirely locked down. I hope we can avoid this, but it may happen here too. I think it will happen in more European countries.

https://www.cnn.com/2020/03/09/europe/coronavirus-italy-lockdown-intl/index.html

 

How long needs a lockdown last in order to be effective? I guess longer than the incubation period which would be 20 days that Taleb has mentioned. If we lose 20 days, that would 20/260 work days or 7.6%. Even with a 2% base growth rate they would be an almost 6% negative GNP print this year. Ouch!

 

I was a buyer today. So I hope we can avoid this, but I am not sure. I don’t think that -6% GNP is priced in.

[jfan]

The problem with COVID-19 is not the absolute number of deaths but the possibility of # of visits to the hospital by elderly patients and those with comorbidities that require hospital admissions or care.

 

If you are fortunate to live in an area with abundant hospital resources than you have the slack to absorb this potential influx. If you are unfortunate, then there will be significant stress on the system.

 

The place I practice, on a regular basis has 30-50 patients admitted to the ER with no in-patient beds. The hallways are always littered with patients. The hospital functions at >98-110% capacity (>90% equates to severe overcrowding with exponential downstream effects).

 

The impact will not only be taking care of these COVID ill patients, but the displacement of resources from all others in the community ill with other illness such as myocardial disease, strokes, renal dysfunction.

 

Furthermore, as healthcare workers get ill, and are isolated from work, who will be left to manage the departments for more patients? During SARS, healthcare workers would work then be off for 2 weeks due to exposure, then to repeat the cycle.

 

The end-goal of vigorous testing is to quarantine and delay the spread, protect the elderly, and buy time for the hospital system to not buckle under pressure.

 

Certainly, there is no proof that this thing will die out in the summer months. We are lucky that SARS and MERS had such a high mortality rate, so the infected can not spread it very far. The problem with COVID-19 is it allows healthy individuals to spread it widely because it doesn't make them very sick.

 

Is this the case where you practive? If so how well did the area handle H1N1 in 2008?

 

I was still studying at the time so I was a bit sheltered from the H1N1 outbreak, so it is hard for me to comment.

 

However, this is the current situation that I work in everyday with worsening year by year. The Canadian hospital system is stretched beyond all imagination on the best of days.

 

Here is a twitter feed from Italy

 

Obviously, I'm not an expert in calculating GNP, but I don't think the loss of productivity will be as dramatic as -7%. The chances are the working age group will have mild symptoms but be able to recover and return to work (if workplaces allow them).

 

But the working age group could contribute to protecting your healthcare resources by not exposing yourself to the elderly, wear a surgical mask if mildly ill (it won't protect you, but it will protect others from you), don't go to your local hospital for very minor coughs, sore throats and runny noses, and hopefully your employers won't need a doctor's work note to explain your absent if you are away ill.

 

 

[Read the Footnotes]

Italy is now entirely locked down. I hope we can avoid this, but it may happen here too. I think it will happen in more European countries.

https://www.cnn.com/2020/03/09/europe/coronavirus-italy-lockdown-intl/index.html

 

How long needs a lockdown last in order to be effective? I guess longer than the incubation period which would be 20 days that Taleb has mentioned. If we lose 20 days, that would 20/260 work days or 7.6%. Even with a 2% base growth rate they would be an almost 6% negative GNP print this year. Ouch!

 

I was a buyer today. So I hope we can avoid this, but I am not sure. I don’t think that -6% GNP is priced in.

In the worst case scenarios, -6% GNP annually is too optimistic, and a year is even more likely to be too short. Maybe a really bad outcome is not likely and only a possibility that lies in the tail of the distribution, but it is easily imaginable for me, while it does not even seem to be considered as a possibility by most. Leadership and preparation will be what prevent that, and so far we seem to be lacking in both. I expect the response will improve substantially in the coming days.

 

US Federal officials in the last 24 hours have started acknowledging that we are going to be dealing with this for more than a year. So modeling some sort of ongoing impact for 24 months might be prudent.

 

I bought some today too. I mainly bought because the range of imaginable outcomes is too broad to ignore the possibility that we could see one of the best possible scenarios, in which case I would regret not buying. Most of my dry powder is still dry.

[meiroy]

Italy is now entirely locked down. I hope we can avoid this, but it may happen here too. I think it will happen in more European countries.

https://www.cnn.com/2020/03/09/europe/coronavirus-italy-lockdown-intl/index.html

 

How long needs a lockdown last in order to be effective? I guess longer than the incubation period which would be 20 days that Taleb has mentioned. If we lose 20 days, that would 20/260 work days or 7.6%. Even with a 2% base growth rate they would be an almost 6% negative GNP print this year. Ouch!

 

I was a buyer today. So I hope we can avoid this, but I am not sure. I don’t think that -6% GNP is priced in.

 

1. Some consumption/production is delayed, it doesn't just vanish.

2. Some companies might BK, careers damaged etc. Long term damage.

3. Apply to other countries and you get similar hit on demand so there is some long term impact.

4. The virus might mutate and we get a second wave.

5. There could be an early vaccine.

6. It's far more serious than the Flu, including for non-fatalities.

7. If things get really bad,  maybe this will be the time that Germany adjusts, starts massive stimulus and saves the Euro zone.

8. How effective is a "lockdown" in one European country? Open borders, mix of nationalities.