Coronavirus

[Guest cherzeca]

our entire focus is ass backwards. we should be exercising special precaution for elderly and immunosuppressed.  they should be subject to social distancing irrespective of whether or not they have infection. they should be ring fenced. the rest of us should just go about our business and if we get the flu, we get the flu.

[Libs]

Isn’t the modelling fairly basic here? Cases double every week, 10% get hospitalized,  1% die in 4 weeks. The rest are cured.  Let’s start with a thousand cases today, and only count deaths of these cohorts. You could vary any of these assumptions. Why did I choose 1%? It’s the only estimate I heard which came with a 95% confidence interval of [0.4%, 3%]. Here at minute 16 in this academic lecture. https://m.youtube.com/watch?v=mYTQI2DvAfo,

 

Ok, so let’s run this simple model. Not saying it’s right, but I’d like to hear which assumption to change here, and even better if there is a prediction model developed by epidiomologists which actually can be compared to future outcomes. According to this model, deaths should match the flu in 18 weeks.

 

Week 1: 1000 cases

Week 2: 2000

Week 3: 4000

Week 4: 8000 cases, 10 deaths (1% of the 1000 from week 1)

Week 5: 16000 cases, 20 deaths

Week 6: 32k cases, 40 deaths

Week 7: 64 k cases, 80 deaths

Week 8: 128k cases, 160 deaths

Week 9: 256k cases, 320 deaths

Week 10: 0.5 million cases, 640 deaths

Week 11: assume a miracle and no new cases, 1280 deaths

Week 12: no new cases, 2560 deaths

Week 13: 0 new cases, 5000 deaths

Week 14: happy days

 

Total cases ~1 million

Total deaths ~ 10k

Hospitalization~ 150k total

 

Seems very manageable at this point. Hopefully the infections start decreasing around here, but I have no idea when that will happen, so i’ll just extend this simple model until there are almost no humans left to infect.

 

If the miracle doesn’t happen for 5 more weeks , deaths double every week as well, following the infections with a four week lag. So deaths continue as 10k, 20k dead, 40k dead, 80k dead, 160k dead. Now the total deaths cross the flu at 320k approx, and the infected number are about 32 million (100 times the dead, remember this model is with a 1% mortality assumption). Doesn’t seem too bad compared to the flu. But hospitalization is now, 3.2 million, so outcomes may be worse than 1%(or whatever number you assume, as long as a 10% hospitalization rate holds).

 

Another 4 weeks without a miracle and you get, deaths per week of 320k, 640k, 1 million.

But now the deaths are 2 million total, and infected are 200 million. The series cannot go on much longer as there aren’t many un infected humans left in the USA. Let’s bookend the worst case at 1% mortality at 3.2 million deaths. Lower if some people escaped infection.

 

Very basic model, but tells me some numbers I can track in the future. If anyone has seen a published  predictive model like this somewhere, please share. To be clear, I am not making a prediction, just modelling outcomes with numbers that get thrown around. I’ve tried to use the best estimate for those numbers that I remember, but please correct them if I got them wrong.

 

Economic costs:

In 1918-19, there were no long term economic effects. As per a fed study. https://www.stlouisfed.org/~/media/files/pdfs/community-development/research-reports/pandemic_flu_report.pdf

Of course there were permanent effects on certain people, but society as a whole bounced back.

 

 

Extinction:

 

I see a lot of people got riled up by my extinction joke in the jokes thread. You guys are way to serious if you can’t take a joke. I obviously don’t believe this is the extinction event. But I do find reasoning of this type funny: “if something has never happened so far, it can never happen in the future.” To me it’s as funny as “I won’t join any club which will have me”. Others in this class are “house prices never go down”, “I don’t believe I can die, show me”, “humans will not go extinct. I won’t believe it until I see it”.

 

On the possibility of extinction by some other pandemic: we have been lucky so far as all the viruses that emerged so far are not that deadly, or not easy to spread, or turned out to be easy to contain. I certainly hope there is some natural law that prevents the emergence of a virus that spreads like measles and kills like Ebola.

 

Yours sincerely

Extinction dude

Signature: “Cold never bothered me anyway” /

 

Good post. Thank you.

[Gregmal]

I think this will ultimately be an effort that succeeds or fails because of action(or inaction) at the local levels. Trump literally has nothing to do with this. He is not capable of really impacting anything any more than he does when he whines about the Fed. He s just a mouthpiece who behaves in a predictable way.

 

Most states immediately declared state of emergency, Trump has yet to do so. People I think are conflating Trumps actions with the responses. Sprinkle in a little media narrative and social media effect, and its easy to see how people think this is Italy. But on a local level, I think the work has been solid. And I again say this giving credit to politicians like Murphy and De Blasio, guys I generally think are shleps.

 

Some stuff is just preposterously priced right now. Other stuff, not so much. But thats almost always the case.

 

Greg, i could not disagree more about Trump. This guy is a control freak. And an image freak. And he has really bad judgement. People who disagree are punished. He has surrounded himself with yes men. The US response is severely handicapped. He sets the tone for the whole response and he is toxic.

 

45% of the people in the US think he is a god...

 

At the top sure. But from what I’ve seen that states are basically ignoring him and moving ahead and even somewhat surprisingly, companies are taking the initiative as well. Trump is only so powerful. He is a figurehead. Which worked until it lost confidence. Cuomo the other day basically said, they don’t care what Washington is doing.

 

Death rates, ex the nursing home, aren’t that high. If, and this is a big if, there have already been cases for months, I think that’s a pretty good indication that at least for now, it’s more manageable than what we see in Italy. I think we will have a microscope on Hanks and the basketball player. Two small cases but having a spotlight on how these unfold could be a little reassuring(or devastating).

 

Here is one of 100 examples from just the past week: When he spreads his misinformation people listen to him and this hurts local efforts. FYI, do you think Trump calling the Governor of Washington State a snake was helpful? Did that help Republicans in Washington State get behind the Governors requests? No. That matters.

 

Honestly, maybe its just me(always possible) I think he's lost a lot of credibility. The same reasons the market sells the news with him now, I think a lot of people, even his supporters, understand this. Of course just local observations, but Im in Trump country, and theres big macho men rushing up to the hand sanitizers at Home Depot. My larger point is that I think people, even in a lot of the extreme cases, have begun discounting a lot of things with the guy. The awareness is the preventative, not some guy with little back ground on the subject talking about how a scientist recently told him he would have been a great doctor...

[Read the Footnotes]

For Trump's sake, I hope that doctor wasn't lying about Trump's health.

 

On Monday, Trump met with someone who has tested positive.

 

Governor Rick Scott of Florida and the Mayor of Miami announced self-quarantines as a result of meeting.

 

https://www.nbcmiami.com/news/local/florida-sen-rick-scott-in-self-quarantine-after-potential-contact-with-brazilian-official/2204541/

 

Hopefully Trump will set a good example for the country and self-quarantine.

[KCLarkin]

But on a local level, I think the work has been solid. And I again say this giving credit to politicians like Murphy and De Blasio, guys I generally think are shleps.

 

https://www.cnbc.com/2020/03/12/new-york-gov-cuomo-bans-gatherings-of-500-or-more-amid-coronavirus-outbreak.html

 

Why is this not 100 people or 50 people? Local leadership needs to be much more aggressive in these hot spots.

 

[RichardGibbons]

I would invite everyone to go back and read my first post in this thread. I dont have time look now, then read the yahoo article gregmal posted.

 

That being said realize in this thread I have been called "ignorant", a "cabbage brain", "blind", and have had very little offer.

 

Orthopa, the problem is that what you're saying doesn't seem to align with evidence.

 

It seems fairly clear that a bunch of people have died in Italy, Iran, and China as a result of COVID-19.  You seem to be claim is that millions in the USA have been infected a long enough time ago that we'd already be seeing lots of deaths if COVID-19 were a big deal.  But USA has not seen lots of deaths.

 

So, to be credible, you need to make it simple for us to understand this disconnect.  Are Americans just more robust than the Italians, Iran, or Chinese? Do Americans have some sort of herd immunity that makes them less likely to die?  Are Italy, Iran, and China simply pretending to have all these deaths, when really, they don't?  Is there something about American culture that allows millions to catch COVID-19, but nobody to die?

 

If you don't have some explanation for this disconnect between your hypothesis of millions infected but nobody dying, the most reasonable thing for people to believe is that your hypothesis is wrong.  Particularly considering that there doesn't actually appear to be any evidence for your hypothesis except "some people got sick this flu season and didn't die, and it's conceivable that those people had COVID-19".

 

(That said, I don't think you're ignorant.  I think you've got the "I'm smart and know a lot about the topic, so my hypothesis unsupported by evidence must be right, and I'll defend it unto death" thing going.  Pretty well all smart people make that mistake occasionally.)

[ERICOPOLY]

Reports are that Trump still won't talk with Pelosi.  His personal wounds are paramount.

 

https://theweek.com/speedreads/901409/trump-reportedly-wont-meet-pelosi-coronavirus-bill-reason-because-hes-mad

 

"You know, Bill Clinton built part of his political narrative by saying 'I feel your pain,'" former Rep. David Jolly (R-Fla.) told Wallace on Tuesday. "Donald Trump is asking the nation to feel his, and it is a weird leadership quality in a moment of crisis."

 

 

[Read the Footnotes]

I would invite everyone to go back and read my first post in this thread. I dont have time look now, then read the yahoo article gregmal posted.

 

That being said realize in this thread I have been called "ignorant", a "cabbage brain", "blind", and have had very little offer.

 

8)

I have said it before, and I'll say it again. I think it is very easily explained that there are multiple sides to this and each side is right. I'll explain in a moment.

 

First a question.

 

Orthopa, what percentage of the beds in your hospital are available on an average day?

What about ventilators?

 

Also, how many total patients have you personally seen that you believe have COVID-19? Were any diagnosed as COVID-19?

 

I just called the hospital and talked to the charge nurse on each floor. Hospital is ~ 85% full but that is very fluid and changes by the hour as people are admitted and discharged. Ventilator only used in ICU. 80% full. Don't know any of the diagnoses though. Now mind you this is a suburban hospital in town with 9 other hospitals within 20 miles. That could vary in each one.

 

In that data I suggested I saw 165 of those patients. None were tested for corona. All in the group looked at were diagnosed with viral illness.

Thank you Orthopa for the response and for going above and beyond and getting us up to date numbers.

 

Orthopa's stats match what I have heard from numerous doctors around CAN and USA.

 

First a note in case anyone is incredulous. Many doctors I spoke with said they tend to operate close to 90% all the time. From operations management, you might think that operating at 90% sounds insane and you never want to operate at that level, but the real limiting factor under normal conditions is the practitioner error. Under the best case scenario, you want your doctor to seem mildly bored or slightly engaged. The best case possible is that your doctor is skipping to work and experiencing flow, but has seen it a million times. If you think of things that way for a while operating at 90% capacity starts to make more sense.

 

Here's a simply capacity model using the numbers Orthopa provided to us:

 

If we adjust the number of beds and ventilators to reflect the actual capacity rather than the total number, things make more sense.

 

Inputs for the USA:

2.8 beds/1,000 people

333,000,000 total population

20 full featured ventilators per 100,000 people

 

Orthopa's Utilization Rates:

85% bed occupancy

80% ventilator utlization

 

Experience in China:

15% were hospitalized

5% were put on ventilation

 

American Hospital Association Assumptions:

5% of cases require hospitalization

1% require ventilatory support

 

Simple point estimate of capacity:

 

2.8 beds/1,000 people * 330,000,000 total population = bed estimate for the USA = 924,000 beds in the USA

 

15% free X 924,000 beds = estimate of beds currently available in USA = 138,600 beds available

 

20 ventilators/100,000 * 330,000,000 total population = ventilator estimate for the USA = 66,000 total full featured ventilators

 

20% availability rate of ventilators * 66,000 total ventilators = 13,200 available ventilators

 

Using Experience in China:

 

138,600 beds available/15% hospitalization rate = 924,000 cases before we run out of beds

 

13,200 ventilators/5% on ventilation = 264,000 cases before we run out of beds (this is not good and US have more per capita than most)

 

Using Experience in China and Orthopa's utilization rates:

 

138,600 beds available/15% hospitalization rate = 924,000 cases before we run out of beds

 

13,200 ventilators/5% on ventilation = 264,000 cases before we run out of beds (this is not good and US have more per capita than most)

 

If we have 1,319 cases as I write this and the number is doubling every three to four days, how long before we have 264,000 cases? What if today's real number of cases is more like 20,000? We will be above the number of cases in which we would have to ration resources in less than three weeks.

 

Now why wouldn't this look bad at this point from Orthopa's perspective on the front lines?

 

If he has seen 160 cases so far, and it is doubling every three to four days, then three weeks ago he would have seen less than 20 COVID-19 patients. With serious cases representing 15% of cases and serious cases frequently taking multiple weeks to progress to hospitalization, it becomes very believable that Orthopa has seen 165 diagnosed COVID-19 patients, none of whom have required hospitalization, yet. This simple model would indicate he only saw his hundredth patient within the last week, and that 88% of the patients he has seen were not in that cohort of the first 20 I mentioned who have had the most time to present with serious cases.

 

I think this makes explains why it is very believable that Orthopa is seeing lots of COVID-19 patients. That they will increase every day, and that in a couple of weeks, Orthopa's hospital and surrounding hospitals may be overwhelmed with returning patients who have deteriorated very quickly. Reports are that this disease progresses very slowly compared to the flu. Being sent home doesn't mean that a number of them wont return very ill in a few weeks.

 

I'd be interested to see someone else play around with growth rates patients, and play around with other assumptions. I provided the AHA's assumptions from a presentation. Feel free to use other assumptions.

[Castanza]

I would invite everyone to go back and read my first post in this thread. I dont have time look now, then read the yahoo article gregmal posted.

 

That being said realize in this thread I have been called "ignorant", a "cabbage brain", "blind", and have had very little offer.

 

Orthopa, the problem is that what you're saying doesn't seem to align with evidence.

 

It seems fairly clear that a bunch of people have died in Italy, Iran, and China as a result of COVID-19.  You seem to be claim is that millions in the USA have been infected a long enough time ago that we'd already be seeing lots of deaths if COVID-19 were a big deal.  But USA has not seen lots of deaths.

 

So, to be credible, you need to make it simple for us to understand this disconnect.  Are Americans just more robust than the Italians, Iran, or Chinese? Do Americans have some sort of herd immunity that makes them less likely to die?  Are Italy, Iran, and China simply pretending to have all these deaths, when really, they don't?  Is there something about American culture that allows millions to catch COVID-19, but nobody to die?

 

If you don't have some explanation for this disconnect between your hypothesis of millions infected but nobody dying, the most reasonable thing for people to believe is that your hypothesis is wrong.  Particularly considering that there doesn't actually appear to be any evidence for your hypothesis except "some people got sick this flu season and didn't die, and it's conceivable that those people had COVID-19".

 

(That said, I don't think you're ignorant.  I think you've got the "I'm smart and know a lot about the topic, so my hypothesis unsupported by evidence must be right, and I'll defend it unto death" thing going.  Pretty well all smart people make that mistake occasionally.)

 

Orthopa's general point is this. (correct me if I'm wrong)

 

As testing is rolled out nationwide what statistic will compound at a higher rate of discovery?

 

A.) Terminal cases

 

B.) Mild cases

 

The correct answer is B

[Guest Schwab711]

I would invite everyone to go back and read my first post in this thread. I dont have time look now, then read the yahoo article gregmal posted.

 

That being said realize in this thread I have been called "ignorant", a "cabbage brain", "blind", and have had very little offer.

 

Orthopa, the problem is that what you're saying doesn't seem to align with evidence.

 

It seems fairly clear that a bunch of people have died in Italy, Iran, and China as a result of COVID-19.  You seem to be claim is that millions in the USA have been infected a long enough time ago that we'd already be seeing lots of deaths if COVID-19 were a big deal.  But USA has not seen lots of deaths.

 

So, to be credible, you need to make it simple for us to understand this disconnect.  Are Americans just more robust than the Italians, Iran, or Chinese? Do Americans have some sort of herd immunity that makes them less likely to die?  Are Italy, Iran, and China simply pretending to have all these deaths, when really, they don't?  Is there something about American culture that allows millions to catch COVID-19, but nobody to die?

 

If you don't have some explanation for this disconnect between your hypothesis of millions infected but nobody dying, the most reasonable thing for people to believe is that your hypothesis is wrong.  Particularly considering that there doesn't actually appear to be any evidence for your hypothesis except "some people got sick this flu season and didn't die, and it's conceivable that those people had COVID-19".

 

(That said, I don't think you're ignorant.  I think you've got the "I'm smart and know a lot about the topic, so my hypothesis unsupported by evidence must be right, and I'll defend it unto death" thing going.  Pretty well all smart people make that mistake occasionally.)

 

Orthopa's general point is this. (correct me if I'm wrong)

 

As testing is rolled out nationwide what statistic will compound at a higher rate of discovery?

 

A.) Terminal cases

 

B.) Mild cases

 

The correct answer is B

 

Duh.

 

The counterpoint has been that widespread testing will reduce the number of illnesses at any given time and that Orthopa's ranting is in complete contradiction to every health oversight agency

[Read the Footnotes]

Duh.

 

The counterpoint has been that widespread testing will reduce the number of illnesses at any given time and that Orthopa's ranting is in complete contradiction to every health oversight agency

I agree with you in spirit, but take a look at my post above and tell me if I'm missing something.

I think we're just a bunch of blindfolded analysts feeling around an Elephant. Orthopa may have just been too busy hanging around down there by the tail to get around and explore the other parts.

[Castanza]

I would invite everyone to go back and read my first post in this thread. I dont have time look now, then read the yahoo article gregmal posted.

 

That being said realize in this thread I have been called "ignorant", a "cabbage brain", "blind", and have had very little offer.

 

Orthopa, the problem is that what you're saying doesn't seem to align with evidence.

 

It seems fairly clear that a bunch of people have died in Italy, Iran, and China as a result of COVID-19.  You seem to be claim is that millions in the USA have been infected a long enough time ago that we'd already be seeing lots of deaths if COVID-19 were a big deal.  But USA has not seen lots of deaths.

 

So, to be credible, you need to make it simple for us to understand this disconnect.  Are Americans just more robust than the Italians, Iran, or Chinese? Do Americans have some sort of herd immunity that makes them less likely to die?  Are Italy, Iran, and China simply pretending to have all these deaths, when really, they don't?  Is there something about American culture that allows millions to catch COVID-19, but nobody to die?

 

If you don't have some explanation for this disconnect between your hypothesis of millions infected but nobody dying, the most reasonable thing for people to believe is that your hypothesis is wrong.  Particularly considering that there doesn't actually appear to be any evidence for your hypothesis except "some people got sick this flu season and didn't die, and it's conceivable that those people had COVID-19".

 

(That said, I don't think you're ignorant.  I think you've got the "I'm smart and know a lot about the topic, so my hypothesis unsupported by evidence must be right, and I'll defend it unto death" thing going.  Pretty well all smart people make that mistake occasionally.)

 

Orthopa's general point is this. (correct me if I'm wrong)

 

As testing is rolled out nationwide what statistic will compound at a higher rate of discovery?

 

A.) Terminal cases

 

B.) Mild cases

 

The correct answer is B

 

Duh.

 

The counterpoint has been that widespread testing will reduce the number of illnesses at any given time and that Orthopa's ranting is in complete contradiction to every health oversight agency

 

I'm not disagreeing that there is value to testing (probably only relevant to immediate treatment at this point). Testing is hindsight at this point. You're not skating to where the puck is going. You're not skating to where the puck is. You're skating to where the puck was.

[Jurgis]

Duh.

 

The counterpoint has been that widespread testing will reduce the number of illnesses at any given time and that Orthopa's ranting is in complete contradiction to every health oversight agency

I agree with you in spirit, but take a look at my post above and tell me if I'm missing something.

I think we're just a bunch of blindfolded analysts feeling around an Elephant. Orthopa may have just been too busy hanging around down there by tail to get around and explore the other parts.

 

I don't think your post (which is good IMO) contradicts what Schwab711 is saying.

 

 

The problem is that we cannot prove the "more testing does not help" people wrong, since we don't have two parallel universes where US tested in one but not tested in another and results are clear. (Even if we had, they'd say "it's a different universe! Testing won't help in ours!")

 

We can point to S. Korea, but the answer from no-testing-benefit camp is "but that's not US... and they all gonna die/recover anyway".

[KJP]

My home county in the Philly suburbs (Montgomery County, Pennsylvania) has just been partially locked down by the Governor.  All schools, universities, gyms, entertainment venues and community centers ordered closed until March 26:  https://www.msn.com/en-us/health/medical/coronavirus-updates-pa-orders-montgomery-county-schools-to-close-state-has-22-cases/ar-BB116dhZ

 

There are currently 13 confirmed cases in Montgomery County out of population of roughly 825,000.  Of course, we don't know how many actual cases there are. 

[Gregmal]

My home county in the Philly suburbs (Montgomery County, Pennsylvania) has just been partially locked down by the Governor.  All schools, universities, gyms, entertainment venues and community centers ordered closed until March 26:  https://www.msn.com/en-us/health/medical/coronavirus-updates-pa-orders-montgomery-county-schools-to-close-state-has-22-cases/ar-BB116dhZ

 

How long did that take?

[Read the Footnotes]

Duh.

 

The counterpoint has been that widespread testing will reduce the number of illnesses at any given time and that Orthopa's ranting is in complete contradiction to every health oversight agency

I agree with you in spirit, but take a look at my post above and tell me if I'm missing something.

I think we're just a bunch of blindfolded analysts feeling around an Elephant. Orthopa may have just been too busy hanging around down there by tail to get around and explore the other parts.

I don't think your post (which is good IMO) contradicts what Schwab711 is saying.

 

The problem is that we cannot prove the "more testing does not help" people wrong, since we don't have two parallel universes where US tested in one but not tested in another and results are clear.

 

We can point to S. Korea, but the answer from no-testing-benefit camp is "but that's not US... and they all gonna die/recover anyway".

I don't think it contradicts what what Schwab is saying. I wholeheartedly agree with Schwab.

 

Orthopa has told us he is an ER Doc. His job is basically to stabilize patients. To the best of my knowledge he's not an epidemiologist, or specialist in infectious diseases, or a specialist in infectious disease surveillance. There is a fascinating literature on the difficulties of infectious disease surveillance. Statistics nerds will enjoy a trip down that rabbit hole. The problem is that the sample size tends to be too small for each individual doctor. When the data is aggregated and in the hands of a specialist, that helps a lot. Frequently in the past, we have gotten lucky when several otherwise healthy patients with severe, troubling illnesses present to the same doctor with the same symptoms at the same point of progression at roughly the same time. If you don't have a lot of those qualities present at the same time, a single individual will usually miss the signs of an outbreak because the number of observations is too small to catch their attention.

 

In Orthopa's case, if he does not take this seriously enough it could be because he does not believe the reports of disease progression from China or elsewhere and is discounting the risks if 15% of his patients return in three weeks with serious symptoms and the population is doubling every three to four days or less.

 

[Dalal.Holdings]

What is the cost of widespread testing? Low. The benefits? Tremendous as people who know they have it more likely to quarantine/reduce further spread.

 

This is NOT a theoretical, abstract discussion. At this moment you see countries who took aggressive action seeing the end of this crisis and those that stood by and let cases go undetected stuck in a rut. There are several controlled experiments running right now that we can learn from.

 

Taking single anecdotes of people who recovered (N=1) is not a useful way to study this. You can look at countries (N=10s of thousands) to better get an idea of what happens when you either intervene or do not. It ain’t pretty if you sit by and let this build (Iran, Italy).

[LC]

 

I'm not disagreeing that there is value to testing (probably only relevant to immediate treatment at this point). Testing is hindsight at this point. You're not skating to where the puck is going. You're not skating to where the puck is. You're skating to where the puck was.

 

Gretzky didn't play hockey with a blindfold on. You need to know where the puck is to know where it is going.

 

Testing is preferable to not testing. It really is that simple.

[Guest Schwab711]

For every disease I can think of, outcomes are improved if you actually know what disease you have as opposed to just treating symptoms. I don't understand not wanting to know the diagnosis.

 

It's possible we are all talking about different things when we say "testing".

 

Maybe Orthopa thinks I mean test every person everyday. All I'm saying is more broad testing for anyone with symptoms or that has been in contact with someone sick/traveled is probably more prudent than the current "have you been in contact with someone with CV or do you have severe symptoms + travel to an affected country". I truly do appreciate that testing does not prevent illnesses in many cases when many don't have immunity. What I am saying is that we can easily improve outcomes. We should do it.

 

Men and woman get colonoscopys and mammograms all the time as preventative screening. It's good to know early what you have. As Orthopa has pointed out, some are asymptomatic early on. If you know you have CV but without symptoms, you would know to escalate care quickly if they appear. Common sense stuff.

[KJP]

My home county in the Philly suburbs (Montgomery County, Pennsylvania) has just been partially locked down by the Governor.  All schools, universities, gyms, entertainment venues and community centers ordered closed until March 26:  https://www.msn.com/en-us/health/medical/coronavirus-updates-pa-orders-montgomery-county-schools-to-close-state-has-22-cases/ar-BB116dhZ

 

How long did that take?

 

Is now the time to do this nationwide?  Should Trump issue that recommendation to all governors?  Or is that an overreaction? 

[Read the Footnotes]

My home county in the Philly suburbs (Montgomery County, Pennsylvania) has just been partially locked down by the Governor.  All schools, universities, gyms, entertainment venues and community centers ordered closed until March 26:  https://www.msn.com/en-us/health/medical/coronavirus-updates-pa-orders-montgomery-county-schools-to-close-state-has-22-cases/ar-BB116dhZ

 

How long did that take?

 

Is now the time to do this nationwide?  Should Trump issue that recommendation to all governors?  Or is that an overreaction?

Some local people where I am are acting like idiots and not taking it seriously. In these situations you don't want people to panic, but there are plenty of people who still are anchoring to the "it's just the flu" statements from weeks ago. Maybe we have not yet reached an appropriate level of fear.

[Read the Footnotes]

What is the cost of widespread testing? Low.

Korea is spending less than $15/test.

 

Korea's tests are provided by Roche. In testimony before the oversight committee yesterday, the CDC head was loathe to acknowledge we could likely have just bought the test from Roche, or even who the maker was. Eventually he mumbled some stuff about Roche and having to get back to them.

[alwaysdrawing]

Is now the time to do this nationwide?  Should Trump issue that recommendation to all governors?  Or is that an overreaction?

 

Yes, it's time.  Wait until you see what happens in Seattle in the next two weeks.

 

We can't have that happen all over the country.

[KJP]

Is now the time to do this nationwide?  Should Trump issue that recommendation to all governors?  Or is that an overreaction?

 

Yes, it's time.  Wait until you see what happens in Seattle in the next two weeks.

 

We can't have that happen all over the country.

 

I'm far from a medical expert, but it seems to me that the virus is probably all over the place by now.  Based on that assumption, locking down small areas for two weeks seems like a half-hearted solution, because new cases will just come in to the small area after the two weeks are up, even if transmission is substantially slowed within the small area during the local partial lockdown. 

[alwaysdrawing]

Is now the time to do this nationwide?  Should Trump issue that recommendation to all governors?  Or is that an overreaction?

 

Yes, it's time.  Wait until you see what happens in Seattle in the next two weeks.

 

We can't have that happen all over the country.

 

I'm far from a medical expert, but it seems to me that the virus is probably all over the place by now.  Based on that assumption, locking down small areas for two weeks seems like a half-hearted solution, because new cases will just come in to the small area after the two weeks are up, even if transmission is substantially slowed within the small area during the local partial lockdown.

 

Totally agree.  Must be done all over now, so we can assess how bad the problem is, and to prepare our health system for things to get worse.

 

I only mention Seattle because that is almost certainly the worst hit place currently, and where within two weeks, we may see their health care system become overwhelmed.