Coronavirus

[ERICOPOLY]

But, if any 40 year-old is fussing about his own prospects of mortality, it's worth reflecting on the existing likelihood of death in the actuarial table before getting too worked up about a 0.2% chance of dying if you are part of the 60% or 70% who catch covid.

SJ

 

Totally!

 

It's like a 40 yr old should panic about the odds of reaching age 42.

 

[ERICOPOLY]

Once 60%-70% of 40 yr olds get COVID-19, those that will die will die, and then for several years thereafter the life expectancy of the survivors will increase.

[Liberty]

[Liberty]

No, but if you return to your psychology courses that you took from university, you would see that they are classical defence mechanisms:

 

https://www.simplypsychology.org/defense-mechanisms.html

 

 

The use of callous terms is designed to actually enable a clinical analysis.

 

 

SJ

 

So what you wrote was callous, but you had good reasons. Ok.

 

Personally I prefer neutral terms when talking about the death and illness of people.

 

I still think the point I made generally applies. There's way too much casual and accepted discrimination against whole groups of people based solely on their age, which is just as out-of-their-control as their gender or color of their skin or sexual orientation or whatever.

[Jurgis]

No, but if you return to your psychology courses that you took from university, you would see that they are classical defence mechanisms:

 

https://www.simplypsychology.org/defense-mechanisms.html

 

 

The use of callous terms is designed to actually enable a clinical analysis.

 

 

SJ

 

So what you wrote was callous, but you had good reasons. Ok.

 

Personally I prefer neutral terms when talking about the death and illness of people.

 

I still think the point I made generally applies. There's way too much casual and accepted discrimination against whole groups of people based solely on their age, which is just as out-of-their-control as their gender or color of their skin or sexual orientation or whatever.

 

Investor [inˈvestər]

NOUN

A person who would sell their own mother if it gave 2bp outperformance. (Also see: rational behavior)

 

I should move this to jokes thread perhaps.

[StubbleJumper]

  It will, however, clean out the 80+ year-old cohort (but 5.77% of them were destined to croak in 2020 from some other cause anyway).  Now, people might not like this comment, but I will make it anyway.  Is a family/community/nation/country economically worse off or better off when an 80 year-old dies?  The panic and lock-downs are what cause economic damage more than the morbidity and mortality.

 

I hope someday what happened to racism and sexism happens to ageism.

 

People are people, with inherent worth and dignity, they are not worth less because their bodies are sick and frail and they have had many birthdays.

 

Now I know you said "economically", but the tone still got to me. Maybe you didn't mean it to come across this callous with the lives of people who often already have tough lives.

 

 

No, I had intended to use a clinical tone to deal with that age cohort.  I have several family and friends who are in that cohort and I fully expect to lose more than a few from Covid.  When that happens, it will be sad for me and those around me.  But, when dealing with the aggregate question, you need to remain distant, clinical, and ideally, objective.

 

 

SJ

What is sad is that if there is quick decisive action the financial costs can remain low. That unfortunately did not happen in China and this virus may now be with us indefinitely.

 

And it also did not happen in the USA, which may increase the ultimate costs. It's kind of like levering the heck out of a bunch of businesses and telling everybody everything is going to be great. The costs of the leverage will be minimal until they aren't.

 

 

Well, that might be true, but there are a few underlying assumptions that have not been articulated.  Some of us disagree with the unspoken assumptions, which occasionally has resulted in a few sparks in this thread over the past couple of weeks.  The conversation usually degenerates into a statement about how some people are stupid and can't do math, when the reality is that they disagree about how the math is to be done.  So I will speak of a few of those assumptions where our respective views probably depart.

 

An enormous issue is the question of asymptomatic cases, or mild cases that never end up seeking medical attention and a second enormous issue is the lengthy incubation period.  Decisive action can be taken against known cases but you can't do too much about the undiagnosed.  Nobody knows for sure, but it is quite likely that 50% of cases are asymptomatic (does anyone actually believe the stats that children are not infected?) and another perhaps 30% are mild symptoms that do not require a doctor visit.  So, if ~80% of your cases are happily going on with life, hammering out their R0=3, you've got a problem.  You can deal with the 20% who are actually sick enough to go to a doctor, and you can quarantine them and try to do some trace-backs, but there's a limit to do that.  Meanwhile by the time your 20% have taken their trek to visit their doctor, they have already had the virus for 2 weeks as it incubates and were happily going on with life hammering out a smaller R0...perhaps they infect only 1.5 other people before they realize that they need to visit a doctor?

 

So are we "stupid" for holding our assumption that the reported cases are the tip of the iceberg?  Or are other interlocutors "stupid" because they are assuming that the only cases out there are the reported cases and you can take the same approach with Covid as you do with Ebola?  In my book, neither are stupid, they are both just operating under uncertainty.  Ex post, we will know whose assumptions were correct, but the invectives that are sometimes hurled around strike me as a sign of overconfidence of one's view.

 

 

SJ

[StubbleJumper]

No, but if you return to your psychology courses that you took from university, you would see that they are classical defence mechanisms:

 

https://www.simplypsychology.org/defense-mechanisms.html

 

 

The use of callous terms is designed to actually enable a clinical analysis.

 

 

SJ

 

So what you wrote was callous, but you had good reasons. Ok.

 

Personally I prefer neutral terms when talking about the death and illness of people.

 

I still think the point I made generally applies. There's way too much casual and accepted discrimination against whole groups of people based solely on their age, which is just as out-of-their-control as their gender or color of their skin or sexual orientation or whatever.

 

 

Are you in need of a "safe space" or are you just looking for something to scrap about?  My sense is that it is the latter....

 

 

SJ

[alwaysdrawing]

Just in economic terms, how many industries have already been hit?  Airlines are furloughing staff and flying planes half full at best.  Conventions are being cancelled, sports games are being cancelled, people are going out to the movies/restaurants/museums less, theme parks are hurting.

 

THE METEOR HASN'T EVEN HIT.  Feel like the only dinosaur with a telescope out here, and the other dinosaurs saying the trees still have leaves.

 

I don't know...maybe we can invest at tangible book value in banks.  Interest rates plunging, oil plunging definitely won't affect credits, to say nothing of an entire economy potentially locking down within weeks.

[Read the Footnotes]

 

Well, that might be true, but there are a few underlying assumptions that have not been articulated.  Some of us disagree with the unspoken assumptions, which occasionally has resulted in a few sparks in this thread over the past couple of weeks.  The conversation usually degenerates into a statement about how some people are stupid and can't do math, when the reality is that they disagree about how the math is to be done.  So I will speak of a few of those assumptions where our respective views probably depart.

 

An enormous issue is the question of asymptomatic cases, or mild cases that never end up seeking medical attention and a second enormous issue is the lengthy incubation period.  Decisive action can be taken against known cases but you can't do too much about the undiagnosed.  Nobody knows for sure, but it is quite likely that 50% of cases are asymptomatic (does anyone actually believe the stats that children are not infected?) and another perhaps 30% are mild symptoms that do not require a doctor visit.  So, if ~80% of your cases are happily going on with life, hammering out their R0=3, you've got a problem.  You can deal with the 20% who are actually sick enough to go to a doctor, and you can quarantine them and try to do some trace-backs, but there's a limit to do that.  Meanwhile by the time your 20% have taken their trek to visit their doctor, they have already had the virus for 2 weeks as it incubates and were happily going on with life hammering out a smaller R0...perhaps they infect only 1.5 other people before they realize that they need to visit a doctor?

 

So are we "stupid" for holding our assumption that the reported cases are the tip of the iceberg?  Or are other interlocutors "stupid" because they are assuming that the only cases out there are the reported cases and you can take the same approach with Covid as you do with Ebola?  In my book, neither are stupid, they are both just operating under uncertainty.  Ex post, we will know whose assumptions were correct, but the invectives that are sometimes hurled around strike me as a sign of overconfidence of one's view.

 

 

SJ

Last time I looked, WHO and others were saying that they believe asymptomatic cases were extremely rare. That seemed to be the direction that the opinion of most professionals was headed.

 

I admit some statistics do strain credulity for me a bit. So maybe there is some agreement there. Your comments would make a lot more sense to me if you can substantiate your assumptions with references.

 

By the way, it wasn't clear if you were saying I had said something offensive. One thing I should clarify is that when I have said "most people" in recent posts I was referring to people who aren't paying attention and those people certainly aren't reading the Coronavirus thread on CoB&F.

[Liberty]

Are you in need of a "safe space" or are you just looking for something to scrap about?  My sense is that it is the latter....

 

 

SJ

 

You're trolling me now?

 

¯\_(ツ)_/¯

 

I just dislike ageism/sexism/racism and try to call it out when I see it.

[Guest Schwab711]

https://www.ssa.gov/oact/STATS/table4c6.html#fn1

 

I think there is a lot of misinformation backing the gut feelings that this is a low risk event or 'a worse flu'.

 

The average 40yo has a 0.24% chance of dying from all possible causes, including self-inflicted. A 40yo with COVID-19 has >5% chance of severe respiratory illness and 0.4% chance of death. The flu generally doesn't kill or cause serious illness to an otherwise healthy 40yo. When we change our hypothetical person to 55yo, the numbers become pretty startling.

 

The thing about being skeptical is it is a no-lose opinion. Either the disease is contained and you can say everyone overreacted, despite not knowing how much of the preventative containment was necessary vs excessive, or the disease is widespread and with us for a prolonged period. Then you can move goalposts/change your mind/blame new causes for the change in trajectory during that time. At any point, you get to maintain superiority over those "freaking out", without acknowledging that someone does need to "freak out" for you to be right. If everyone was skeptical or ignorant, then we are back to the era of frequent plagues and pandemics.

 

There's also the political aspect to many changes in opinions of late. Within this thread we can see some that were previously concerned about the virus when it was in China are now not as concerned. We can see the opposite. How much of the increased awareness and concern around the disease is reporting vs changes in facts/spread of the disease? I'd argue the stats and guidance from WHO support increased concern. We can see evidence within daily situation reports and history of prior pandemics supporting an underreporting of 10x-20x right now. 3 years after Swine Flu ended, WHO estimated that 15x more people actually were infected by Swine Flu than were confirmed by laboratory testing. How much of changes to lower concern is due to Trump's comments as opposed to factual reporting? The lack of citations makes me question the thoughtfulness of some.

 

In general, I think folks are way too confident in defying guidance from CDC/WHO when there's plainly not enough information available to have a contradicting opinion at this time.

 

 

https://www.nbcnews.com/health/health-news/live-blog/coronavirus-updates-live-u-s-europe-brace-infection-spread-italy-n1153801/ncrd1154211

[Liberty]

https://apnews.com/921ad7f1f08d7634bf681ba785faf269?utm_medium=AP&utm_source=Twitter&utm_campaign=SocialFlow

 

NEW YORK (AP) — The White House overruled health officials who wanted to recommend that elderly and physically fragile Americans be advised not to fly on commercial airlines because of the new coronavirus, a federal official told The Associated Press.

 

The Centers for Disease Control and Prevention submitted the plan as a way of trying to control the virus, but White House officials ordered the air travel recommendation be removed, said the official who had direct knowledge of the plan. Trump administration officials have since suggested certain people should consider not traveling, but have stopped short of the stronger guidance sought by the CDC.

[undervalued]

I know a lot of people in the US has high blood pressure. I think the death rate for people with this condition is greater than 50%.

 

https://www.bloomberg.com/news/articles/2020-03-09/top-virus-doctor-says-high-blood-pressure-is-major-death-risk

[Guest]

Are you in need of a "safe space" or are you just looking for something to scrap about?  My sense is that it is the latter....

 

 

SJ

 

You're trolling me now?

 

¯\_(ツ)_/¯

 

I just dislike ageism/sexism/racism and try to call it out when I see it.

 

You should be more tolerant and accepting. Your evolutionary instinct of disliking those things is neither more "right" or "wrong" than those folks who like those things. The folks have just as much insight into the right way to live as anyone else does. Why force (by "calling it out") your arbitrary values on others?

[StubbleJumper]

 

Well, that might be true, but there are a few underlying assumptions that have not been articulated.  Some of us disagree with the unspoken assumptions, which occasionally has resulted in a few sparks in this thread over the past couple of weeks.  The conversation usually degenerates into a statement about how some people are stupid and can't do math, when the reality is that they disagree about how the math is to be done.  So I will speak of a few of those assumptions where our respective views probably depart.

 

An enormous issue is the question of asymptomatic cases, or mild cases that never end up seeking medical attention and a second enormous issue is the lengthy incubation period.  Decisive action can be taken against known cases but you can't do too much about the undiagnosed.  Nobody knows for sure, but it is quite likely that 50% of cases are asymptomatic (does anyone actually believe the stats that children are not infected?) and another perhaps 30% are mild symptoms that do not require a doctor visit.  So, if ~80% of your cases are happily going on with life, hammering out their R0=3, you've got a problem.  You can deal with the 20% who are actually sick enough to go to a doctor, and you can quarantine them and try to do some trace-backs, but there's a limit to do that.  Meanwhile by the time your 20% have taken their trek to visit their doctor, they have already had the virus for 2 weeks as it incubates and were happily going on with life hammering out a smaller R0...perhaps they infect only 1.5 other people before they realize that they need to visit a doctor?

 

So are we "stupid" for holding our assumption that the reported cases are the tip of the iceberg?  Or are other interlocutors "stupid" because they are assuming that the only cases out there are the reported cases and you can take the same approach with Covid as you do with Ebola?  In my book, neither are stupid, they are both just operating under uncertainty.  Ex post, we will know whose assumptions were correct, but the invectives that are sometimes hurled around strike me as a sign of overconfidence of one's view.

 

 

SJ

Last time I looked, WHO and others were saying that they believe asymptomatic cases were extremely rare. That seemed to be the direction that the opinion of most professionals was headed, although it does strain credulity for me a bit.

 

Your comments would make a lot more sense to me if you can substantiate your assumptions with references.

 

By the way, it wasn't clear if you were saying I had said something offensive. One thing I should clarify is that when I have said "most people" in recent posts I was referring to people who aren't paying attention and those people certainly aren't reading the Coronavirus thread on CoB&F.

 

 

No, you in particular have not said anything offensive that I am aware of.  When I note that some participants have hurled around invectives, I was attempting apply the principle that we ought to criticize by category and praise by name.  I most certainly did not intend to direct any criticism specifically at you.

 

We are all making assumptions about a known-unknown, and there are no references to provide (the one thing that has puzzled me, but does not really constitute "evidence" is the lack of children reporting symptoms).  Some portion of the cases are symptomatic and severe enough that people seek medical attention and those people end up in the stats.  Some portion do not seek medical attention and those cases do not appear in the stats.  As you noted, what exists at this stage are opinions, and I don't doubt that the WHO has provided an opinion, just as the WHO has provided an estimate that the mortality rate is 3.4%.  There are different people out there operating with different assumptions.

 

There are a few interlocutors in this thread who have launched accusations about people in being incapable of doing math, but the reality is that everybody is doing the math with different assumptions.  So, anyone who is interested can create a Mickey Mouse spreadsheet to model infections under the assumption of there being those two groups, one which has mild symptoms and the R0=~3, and one which seeks treatment and perhaps has a R0=~1.5 (because they stop infecting people after they are instructed to self-isolate).  If you assume that a large percentage of cases seek medical attention, then you might legitimately hold the view that you can meaningfully control and slow the outbreak.  On the other hand, if you assume that a large percentage of cases do not seek or require medical attention, you might reasonably conclude that your focus should instead be on augmenting health system capacity.  Your assumptions about the relative size of those two groups and the R-naught for each of those two groups will be a key driver of your attitude about the outbreak.

 

But, we are all still grappling with a known-unknown.

 

 

SJ

[Read the Footnotes]

https://apnews.com/921ad7f1f08d7634bf681ba785faf269?utm_medium=AP&utm_source=Twitter&utm_campaign=SocialFlow

 

NEW YORK (AP) — The White House overruled health officials who wanted to recommend that elderly and physically fragile Americans be advised not to fly on commercial airlines because of the new coronavirus, a federal official told The Associated Press.

 

The Centers for Disease Control and Prevention submitted the plan as a way of trying to control the virus, but White House officials ordered the air travel recommendation be removed, said the official who had direct knowledge of the plan. Trump administration officials have since suggested certain people should consider not traveling, but have stopped short of the stronger guidance sought by the CDC.

The article you have posted is from March 7. The CDC's recommendations have changed in the three days since then. The CDC website now recommends:

 

Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships.

 

https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html

 

Also, their definition of "older" seems to be above 60 years old.

 

This is a great example of how the costs are higher than they needed to be due to panic. When the messaging is poor, slow, inconsistent or people believe they are being lied to, it will likely lead to panic and will increase the costs through various action.

[rogermunibond]

BMJ letters posit theory that ACE inhibitors (prescribed for HBP) could be the factor.  Studies show that ACE inhibitors upregulate ACE2 expression in cardiac tissue.  Could also be upregulated in lungs thus giving SARS-COV-2 more binding targets.

[Kaegi2011]

BMJ letters posit theory that ACE inhibitors (prescribed for HBP) could be the factor.  Studies show that ACE inhibitors upregulate ACE2 expression in cardiac tissue.  Could also be upregulated in lungs thus giving SARS-COV-2 more binding targets.

 

Could you kindly translate this for us, please?

[KJP]

BMJ letters posit theory that ACE inhibitors (prescribed for HBP) could be the factor.  Studies show that ACE inhibitors upregulate ACE2 expression in cardiac tissue.  Could also be upregulated in lungs thus giving SARS-COV-2 more binding targets.

 

Could you kindly translate this for us, please?

 

A class of drugs commonly prescribed for high blood pressure may (just a theory) increase susceptibility to COVID-19.  There is, of course, a correlation between age and high blood pressure medication.

[alwaysdrawing]

WASHINGTON POST - Gov. Andrew M. Cuomo (D) on Tuesday announced schools and places of worship within a one-mile zone of the city of New Rochelle will close their doors for 14 days, and National Guard troops will help deliver food and disinfect common areas inside the zone.

 

I wonder if the National Guard can deliver food to every town?

 

Does anyone know if there are any neighborhood banks in New Rochelle trading at Tangible Book Value?

[Kaegi2011]

BMJ letters posit theory that ACE inhibitors (prescribed for HBP) could be the factor.  Studies show that ACE inhibitors upregulate ACE2 expression in cardiac tissue.  Could also be upregulated in lungs thus giving SARS-COV-2 more binding targets.

 

Could you kindly translate this for us, please?

 

A class of drugs commonly prescribed for high blood pressure may (just a theory) increase susceptibility to COVID-19.  There is, of course, a correlation between age and high blood pressure medication.

 

Gracias.  :)

[StubbleJumper]

WASHINGTON POST - Gov. Andrew M. Cuomo (D) on Tuesday announced schools and places of worship within a one-mile zone of the city of New Rochelle will close their doors for 14 days, and National Guard troops will help deliver food and disinfect common areas inside the zone.

 

I wonder if the National Guard can deliver food to every town?

 

Does anyone know if there are any neighborhood banks in New Rochelle trading at Tangible Book Value?

 

 

It's not just a question of whether the National Guard has the capacity to deliver food to every town, but a question of whether we should even want them to.  We have a very efficient food retailing system in North America based on grocery stores which provide a typical American with a choice of more than 40,000 stock keeping units per store, refreshed regularly and with due care for food safety through effective cold-chain management.  As long as you can keep those stores open, it strikes me that you wouldn't want the military to be delivering food baskets that probably don't have the assortment of food that most people want and that probably focuses on non-perishables (due to the need for a cold chain).

 

The reason why a grocery store might need to close would be if a large portion of its employees refused to go to work out of fear of getting infected by colleagues or customers.  I am convinced that there will definitely be some of this.  There are some employees who work in a grocery store as a retirement job, but if I were 65 years old and just working at Safeway for something do do, I would be looking at the Covid mortality numbers and questioning how badly I really need that $10/hour.  Similarly, a husband and wife making a family income of $200k who have a 17 year-old daughter working part-time at a grocery store, might naturally question how badly the family needs the daughter to earn the $10/hour.  But, by and large, I can't see labour shortages (work refusals) being so severe that the existing supply chain would need to be replaced by centrally controlled food distribution.

 

 

SJ

[LC]

The reason why a grocery store might need to close would be if a large portion of its employees refused to go to work out of fear of getting infected by colleagues or customers.  I am convinced that there will definitely be some of this.  There are some employees who work in a grocery store as a retirement job, but if I were 65 years old and just working at Safeway for something do do, I would be looking at the Covid mortality numbers and questioning how badly I really need that $10/hour.  Similarly, a husband and wife making a family income of $200k who have a 17 year-old daughter working part-time at a grocery store, might naturally question how badly the family needs the daughter to earn the $10/hour.  But, by and large, I can't see labour shortages (work refusals) being so severe that the existing supply chain would need to be replaced by centrally controlled food distribution.

 

Who could have imagined this effect of income inequality?

[orthopa]

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.

 

And then someone from another part of the world drives in/flies in or walks in after 20 days and starts it all over again. It doesnt work this way.

[orthopa]

Here are mortality rates for any given age:

 

https://www.ssa.gov/oact/STATS/table4c6.html

 

Before accounting for COVID-19, an octogenarian was facing anywhere from a 4.2% - 11.6% chance of dying in any given year.

 

All I'm saying is I was already fearful for my father as it was.  The Chinese CDC is saying that COVID-19 is killing 14.8% of 80+ yr olds (and this number may be high). 

 

I am looking at this as basically knocking two years off of their life expectancy, and that might be exaggerated due to its propensity to kill the weakest.

 

What's scary is that even if you don't die, it sounds like complications from lung fibrosis can have long-lasting/permanent deleterious effects in at-risk populations like the elderly.

 

Its even more scary for the 1B+ smokers who are probably 10,100,1000x times more likely to die due to smoking related complication. Funny I never heard anyone worrying about them.