Coronavirus

[Viking]

I listened to the press conference and came out impressed about the mindset change underway. Finally, leadership and teamwork 101!

 

The doctors in the team were finally being listened to, the measures to create capacity in hospitals for COVID and via Telemedicine for non-COVID care were sincere. Testing in bulk will be available soon, drive-in is the appropriate method of testing in a lean and high throughput manner and will be helpful in longer term control - there were many pharmacy retailers who put their reputation on the line by being involved. If anyone can be trusted to build a website efficiently (and be able to track locations of those signing up for testing) it's Google. On another front, CDC and IDSA were conducting a nationwide webinar brainstorming best implementation of infection control measures which is the next frontier on the horizon.

 

Overall while COVID and other opportunistic risks remain I feel the tone of administration's approach has changed. Now looking for actions to match words. It may take 7-10 days before it makes an impact, and the near term news flow will remain dismal. But there seems to be hope at the end of the tunnel...

 

Doc, i was the same. And then the more i read it looks like the whole event was pretty much staged by Trump. Bottom line, US is pretty much in the same situation it was 10 minutes before the presser started. And what impeccable timing right before markets closed. Trump got what he wanted: The stock market averages up 10% and lots of ’busy’ press.

 

Yes, what was discussed looks promising. The big news for me is how the Federal Government seems getting out of the way and essentially letting states handle their own response. Sports/businesses are also taking the lead. Trump had no choice, the train was leaving the station and he needed to get on. Better late than never.

 

I am shocked with how fast the ex-Federal Government response has been. The NBA annoucement was a game changer. Washington State is also moving fast; great because their case count is looking it might be ready to shift into the next gear.

[Dalal.Holdings]

He'll choose Haley to recruit the vote of suburban moms.  Pence is holding the coronavirus bag.  Trump is NEVER responsible for his failures.  Never.  He was raised spoiled and cannot handle blame because of it.

 

https://www.bloomberg.com/news/articles/2020-03-13/-i-don-t-take-responsibility-trump-says-of-virus-test-shortage

 

President Donald Trump said he doesn’t accept responsibility for a scarcity of coronavirus tests available in the U.S. after state officials complained patients with symptoms couldn’t get screened.

 

“I don’t take responsibility at all,” Trump told reporters at the White House on Friday. “We were given a set of circumstances and we were given rules and regulations and specifications from a different time -- it wasn’t meant for this kind of event with the kind of numbers that we’re talking about.”

 

Right on the money.

 

[Spekulatius]

He’s insane

 

 

You can’t make this up. I am certain it is timed to get the stock market to close up, as the news conference started late at around 15:20 or so. Another positive news, I got this email today, which eases many of my concerns. Got to love NH - Boston is shut down, MA schools are shut down, the grocery stores are a zoo and overrun by the mob, but the NH liquor stores remain open:

Dear Friends,

 

For more than 85 years, the New Hampshire Liquor Commission has maintained a steadfast commitment to ensuring the health and safety of our NH Liquor & Wine Outlet customers and employees. We are closely monitoring the Coronavirus (COVID-19) situation and implementing recommendations from the Centers for Disease Control and Prevention (CDC).

 

All 77 NH Liquor & Wine Outlets are open for business and we have bolstered our thorough cleaning and disinfecting practices to ensure that our Outlets are safe for customers and employees.

 

It’s critical we do everything we can to prevent the spread of COVID-19 and other illnesses. That’s why we have reinforced the CDC’s everyday preventative actions to prevent the spread of respiratory diseases and encouraged employees who aren’t feeling well to stay home as a precaution. We extend those recommendations to our customers as well.

 

While the situation remains fluid, we have comprehensive plans in place to address the changing conditions and are committed to keeping you informed each step of the way.

 

We thank you for your business and we look forward to continuing to serve you.

 

Sincerely,

 

 

Joseph W. Mollica

Chairman

[LC]

While the situation remains fluid

 

;D

[Dalal.Holdings]

I think I've found the country that is likely to have the worst outcome from all of this:

 

https://www.ft.com/content/38a81588-6508-11ea-b3f3-fe4680ea68b5

 

Britain’s chief scientific adviser stoked controversy on Friday when he said that about 40m people in the UK could need to catch the coronavirus to build up “herd immunity” and prevent the disease coming back in the future.

 

Defending Prime Minister Boris Johnson’s decision not to follow other European countries by closing schools and banning mass gatherings, Patrick Vallance said it was the government’s aim to “reduce the peak of the epidemic, pull it down and broaden it” while protecting the elderly and vulnerable.

 

But Sir Patrick told Sky News that experts estimated that about 60 per cent of the UK’s 66m population would have to contract coronavirus in order for society to build up immunity.

 

“Communities will become immune to it and that’s going to be an important part of controlling this longer term,” he said. “About 60 per cent is the sort of figure you need to get herd immunity.”

 

Unbelievable.

 

[Jurgis]

I think I've found the country that is likely to have the worst outcome from all of this:

 

https://www.ft.com/content/38a81588-6508-11ea-b3f3-fe4680ea68b5

 

Britain’s chief scientific adviser stoked controversy on Friday when he said that about 40m people in the UK could need to catch the coronavirus to build up “herd immunity” and prevent the disease coming back in the future.

 

Defending Prime Minister Boris Johnson’s decision not to follow other European countries by closing schools and banning mass gatherings, Patrick Vallance said it was the government’s aim to “reduce the peak of the epidemic, pull it down and broaden it” while protecting the elderly and vulnerable.

 

But Sir Patrick told Sky News that experts estimated that about 60 per cent of the UK’s 66m population would have to contract coronavirus in order for society to build up immunity.

 

“Communities will become immune to it and that’s going to be an important part of controlling this longer term,” he said. “About 60 per cent is the sort of figure you need to get herd immunity.”

 

Unbelievable.

 

No, it's totally British approach to things.  ::)

[Jurgis]

Our supermarket was emptied today. No toilet paper. (As another indication of our idiosyncratic tastes, almost everything we needed to buy was available.)

 

Walked by neighborhood restaurant in the evening. It was still pretty full.

 

I don't think we have a serious panic (yet).

[Viking]

Ok. So now, in North America, we start the next phase: lock down. Coming soon to a state/province near you. Washington State is in the lead. Washington State is closing all K-12 schools from March 17 until at least April 24. So 5 weeks to start. (By ‘lock down’ i mean measures that Washington State is taking right now... there are lots more than just school closure).

 

My question: how long will states, once it gets serious, remain in lock down? 6-8 weeks? The benefit of slowing the spread is heath care can cope. This also lengthens time needed to contain the outbreak.

 

Same for international travel: banned for 8 weeks?

 

And then what measures are necessary to ensure the virus does not re-cluster? How long are they needed? Like one person per table at a restaurant. Or at work, 6’ between people.

 

I am trying to understand the eventual economic impact on each country the virus will have.

 

Here are two summaries of how the virus has been handled to date:

- South Korea: https://www.scmp.com/week-asia/health-environment/article/3075164/south-koreas-coronavirus-response-opposite-china-and

- Germany: https://www.spiegel.de/international/germany/inside-germany-s-piecemeal-response-to-corona-a-f376b3f9-625f-4a6a-8e7d-04bd48be20b2

 

PS: has anyone aware of web sites that cover the economy in China? I would like to understand how quickly they are ramping back up.

[ERICOPOLY]

All the schools around Sacramento shut down today for 3 weeks, my kids' school included.

 

Even my step-son's ONLINE school shut down.  You've got to be kidding!!!  It's a friggin' online school!

 

 

[Read the Footnotes]

I think I've found the country that is likely to have the worst outcome from all of this:

 

https://www.ft.com/content/38a81588-6508-11ea-b3f3-fe4680ea68b5

 

Britain’s chief scientific adviser stoked controversy on Friday when he said that about 40m people in the UK could need to catch the coronavirus to build up “herd immunity” and prevent the disease coming back in the future.

 

Defending Prime Minister Boris Johnson’s decision not to follow other European countries by closing schools and banning mass gatherings, Patrick Vallance said it was the government’s aim to “reduce the peak of the epidemic, pull it down and broaden it” while protecting the elderly and vulnerable.

 

But Sir Patrick told Sky News that experts estimated that about 60 per cent of the UK’s 66m population would have to contract coronavirus in order for society to build up immunity.

 

“Communities will become immune to it and that’s going to be an important part of controlling this longer term,” he said. “About 60 per cent is the sort of figure you need to get herd immunity.”

 

Unbelievable.

Dalal,

I hate to break it to you, but this is the USA's plan too. Britain is being honest. Trump is giving us bread and circus. I suggest you listen to their plan if you want to know what the true plan is here. It's the best we can do given that the federal gov't squandered what time we have. All they can do is try to manage the rate at which people become infected through social distancing.

 

You are thinking about testing from the perspective of the individual. At this point, it's about the herd, not the individual.

 

If I had to choose who would do better? All else equal, the country that communicates honestly, openly, clearly and with one voice would get my vote. On the federal level, My money is on Britain for having better outcomes.

[Read the Footnotes]

Ok. So now, in North America, we start the next phase: lock down. Coming soon to a state/province near you. Washington State is in the lead. Washington State is closing all K-12 schools from March 17 until at least April 24. So 5 weeks to start. (By ‘lock down’ i mean measures that Washington State is taking right now... there are lots more than just school closure).

 

My question: how long will states, once it gets serious, remain in lock down? 6-8 weeks? The benefit of slowing the spread is heath care can cope. This also lengthens time needed to contain the outbreak.

 

Same for international travel: banned for 8 weeks?

 

And then what measures are necessary to ensure the virus does not re-cluster? How long are they needed? Like one person per table at a restaurant. Or at work, 6’ between people.

 

I am trying to understand the eventual economic impact on each country the virus will have.

 

Here are two summaries of how the virus has been handled to date:

- South Korea: https://www.scmp.com/week-asia/health-environment/article/3075164/south-koreas-coronavirus-response-opposite-china-and

- Germany: https://www.spiegel.de/international/germany/inside-germany-s-piecemeal-response-to-corona-a-f376b3f9-625f-4a6a-8e7d-04bd48be20b2

 

PS: has anyone aware of web sites that cover the economy in China? I would like to understand how quickly they are ramping back up.

 

Britain is saying some form of lockdown for 9 months. They are a little behind us, but they are saying it will take 3 months to reach peak once the lockdown and that they won't start for another couple of weeks.

 

They will likely increase international travel at the point that on average the US population has equal or greater herd immunity and equal or greater presence of infectiousness.

 

The breakpoints for some of these decisions are probably something like 40% and 60% herd immunity. That will take time and suffering.

[james22]

Scientists around the world have worked overtime to get a handle on Covid-19, yet one great unknown remains. We still don’t know for sure whether this is only a medical crisis, or also a medical system crisis.

 

The distinction matters for the novel coronavirus for the same reason it matters for other “natural disasters” that aren’t entirely natural. It is now widely understood that famines arise from local political failures in the trade and distribution of abundant global food supplies, not from local crop failures. Floods devastate communities not because the local rivers are unusually watery but because poor zoning and subsidized flood insurance encourage people to build homes in flood plains.

 

This is the context for a conspicuous feature of Covid-19: It is not untreatable, but many health systems are struggling to deliver effective treatment. Nowhere is this more so right now than in Italy, where nightmarish reports are emerging from hospitals in the hardest-hit areas.

 

Doctors in Italy know what to do to treat severe cases, such as using ventilators in intensive-care units. But hospitals lack the beds and equipment for the influx of patients and Italy doesn’t have enough doctors even to make the attempt. Ill patients languish in hospital corridors for want of beds, recovering patients are rushed out the door as quickly as possible, and exhausted (and sometimes sick) doctors and nurses can’t even muster the energy to throw up their hands in despair.

 

Is this more a result of the severity of Covid-19, or of long-term failures to invest in the Italian health-care system? One starts to suspect the latter.

 

Italy lags other large European countries in provision of acute-care hospital beds, furnishing 2.62 of them per 1,000 residents as of 2016, according to the Organization for Economic Cooperation and Development. In Germany it’s 6.06 and in France and the Netherlands it’s 3.15 and 3 respectively. That year, Italy devoted around $913 per capita to inpatient acute and rehabilitative care, compared with $1,338 in France, $1,506 in Germany, and $1,732 in the U.S.

 

U.K. policy makers understand what such analyses portend—because underinvestment in Britain’s creaking health-care system is even worse. The U.K. spent the princely sum of $901.70 per capita on acute care in 2016, according to the OECD. British data don’t distinguish acute-care beds, but a comparison of available beds overall isn’t any more favorable to the U.K. (or to Italy). In 2017, when Germany provided 8 beds per 1,000 residents and France offered 5.98, Italy managed 3.18 and the U.K. only 2.54.

 

https://www.wsj.com/articles/europes-coronavirus-fate-is-already-sealed-11584025664

[thefatbaboon]

 

Does anyone know where i can find data for hospitalization by age cohort?

 

And within hospitalization the split between oxygen and intubation also by age cohort.

 

Thanks

 

 

[Liberty]

 

The testing situation in the richest country in the world with months of advance warning is a disgrace

[Dalal.Holdings]

I think I've found the country that is likely to have the worst outcome from all of this:

 

https://www.ft.com/content/38a81588-6508-11ea-b3f3-fe4680ea68b5

 

Britain’s chief scientific adviser stoked controversy on Friday when he said that about 40m people in the UK could need to catch the coronavirus to build up “herd immunity” and prevent the disease coming back in the future.

 

Defending Prime Minister Boris Johnson’s decision not to follow other European countries by closing schools and banning mass gatherings, Patrick Vallance said it was the government’s aim to “reduce the peak of the epidemic, pull it down and broaden it” while protecting the elderly and vulnerable.

 

But Sir Patrick told Sky News that experts estimated that about 60 per cent of the UK’s 66m population would have to contract coronavirus in order for society to build up immunity.

 

“Communities will become immune to it and that’s going to be an important part of controlling this longer term,” he said. “About 60 per cent is the sort of figure you need to get herd immunity.”

 

Unbelievable.

Dalal,

I hate to break it to you, but this is the USA's plan too. Britain is being honest. Trump is giving us bread and circus. I suggest you listen to their plan if you want to know what the true plan is here. It's the best we can do given that the federal gov't squandered what time we have. All they can do is try to manage the rate at which people become infected through social distancing.

 

You are thinking about testing from the perspective of the individual. At this point, it's about the herd, not the individual.

 

If I had to choose who would do better? All else equal, the country that communicates honestly, openly, clearly and with one voice would get my vote. On the federal level, My money is on Britain for having better outcomes.

 

It’s a good thing then that we will still be able to travel to/from Britain. It’s like handcuffing the two slowest kids at school to each other for the big race.

[Dalal.Holdings]

 

The testing situation in the richest country in the world with months of advance warning is a disgrace

 

Yes, tests are being rationed due to shortage. Pence’s 1M tests is over a week late now and we are nowhere close. This increases the probability that we may end up like Italy and be rationing ICU beds and vents eventually as well... :-\

[petec]

I think I've found the country that is likely to have the worst outcome from all of this:

 

https://www.ft.com/content/38a81588-6508-11ea-b3f3-fe4680ea68b5

 

Britain’s chief scientific adviser stoked controversy on Friday when he said that about 40m people in the UK could need to catch the coronavirus to build up “herd immunity” and prevent the disease coming back in the future.

 

Defending Prime Minister Boris Johnson’s decision not to follow other European countries by closing schools and banning mass gatherings, Patrick Vallance said it was the government’s aim to “reduce the peak of the epidemic, pull it down and broaden it” while protecting the elderly and vulnerable.

 

But Sir Patrick told Sky News that experts estimated that about 60 per cent of the UK’s 66m population would have to contract coronavirus in order for society to build up immunity.

 

“Communities will become immune to it and that’s going to be an important part of controlling this longer term,” he said. “About 60 per cent is the sort of figure you need to get herd immunity.”

 

Unbelievable.

Dalal,

I hate to break it to you, but this is the USA's plan too. Britain is being honest. Trump is giving us bread and circus. I suggest you listen to their plan if you want to know what the true plan is here. It's the best we can do given that the federal gov't squandered what time we have. All they can do is try to manage the rate at which people become infected through social distancing.

 

You are thinking about testing from the perspective of the individual. At this point, it's about the herd, not the individual.

 

If I had to choose who would do better? All else equal, the country that communicates honestly, openly, clearly and with one voice would get my vote. On the federal level, My money is on Britain for having better outcomes.

 

It’s a good thing then that we will still be able to travel to/from Britain. It’s like handcuffing the two slowest kids at school to each other for the big race.

 

British response seems rational to me. If you shut schools kids (carriers) go to grandparents (vulnerable) which is dumb. And if you lockdown too early people get bored and you create a worse issue later. We are in uncharted waters, and a lot depends on behavioural “science” which is far less precise than medical science, so who knows what’s right, but at this point I don’t have an issue with Britain’s approach.

 

What does annoy me is certain elements of the press stoking panic because it’s good for their Twitter reputations. But then we have long said that countryside is the act of killing Piers Morgan.

[Dalal.Holdings]

 

British response seems rational to me. If you shut schools kids (carriers) go to grandparents (vulnerable) which is dumb. And if you lockdown too early people get bored and you create a worse issue later. We are in uncharted waters, and a lot depends on behavioural “science” which is far less precise than medical science, so who knows what’s right, but at this point I don’t have an issue with Britain’s approach.

 

What does annoy me is certain elements of the press stoking panic because it’s good for their Twitter reputations. But then we have long said that countryside is the act of killing Piers Morgan.

 

Closing schools has already been shown to drastically reduce the spread of viruses like influenza. Any parent with young kids know that school/daycar is where infections spread from one child to another and then that illness is introduced to a new household. People who don’t use daycare don’t have that problem until school starts. This stuff has been proven over and over again in medical literature. Nothing rational about refusing to close schools.

 

Relying on behavioral economics over much harder science is sure to prove unwise.

[petec]

 

British response seems rational to me. If you shut schools kids (carriers) go to grandparents (vulnerable) which is dumb. And if you lockdown too early people get bored and you create a worse issue later. We are in uncharted waters, and a lot depends on behavioural “science” which is far less precise than medical science, so who knows what’s right, but at this point I don’t have an issue with Britain’s approach.

 

What does annoy me is certain elements of the press stoking panic because it’s good for their Twitter reputations. But then we have long said that countryside is the act of killing Piers Morgan.

 

Closing schools has already been shown to drastically reduce the spread of viruses like influenza. Any parent with young kids know that school/daycar is where infections spread from one child to another and then that illness is introduced to a new household. People who don’t use daycare don’t have that problem until school starts. This stuff has been proven over and over again in medical literature. Nothing rational about refusing to close schools.

 

Relying on behavioral economics over much harder science is sure to prove unwise.

 

Let’s see. This thing seems rare to me in how it doesn’t harm kids as much as the elderly. I think the risk is not how many get it - it is going to spread no matter what we do - but limiting intra-family interactions to protect the elderly. But that’s it from me. If you disagree I’m not going to argue, because I don’t hold my views as strongly as you clearly do. Only time will tell.

[minten]

Does anybody have any data on spread on a regional level in Italy by any chance?

 

Italy placed certain parts of Lombardy on lockdown from February 22nd. If those measures were effective, the statistics should show it. It's the ultimate test case, as all other serious containment measures in Italy and the rest of Europe were only taken five days ago at the earliest, so won't show in the new case statistics for five/seven days. If the lockdown was succesful here, it seems more likely it will be succesful elsewhere.

[Dalal.Holdings]

 

British response seems rational to me. If you shut schools kids (carriers) go to grandparents (vulnerable) which is dumb. And if you lockdown too early people get bored and you create a worse issue later. We are in uncharted waters, and a lot depends on behavioural “science” which is far less precise than medical science, so who knows what’s right, but at this point I don’t have an issue with Britain’s approach.

 

What does annoy me is certain elements of the press stoking panic because it’s good for their Twitter reputations. But then we have long said that countryside is the act of killing Piers Morgan.

 

Closing schools has already been shown to drastically reduce the spread of viruses like influenza. Any parent with young kids know that school/daycar is where infections spread from one child to another and then that illness is introduced to a new household. People who don’t use daycare don’t have that problem until school starts. This stuff has been proven over and over again in medical literature. Nothing rational about refusing to close schools.

 

Relying on behavioral economics over much harder science is sure to prove unwise.

 

Let’s see. This thing seems rare to me in how it doesn’t harm kids as much as the elderly. I think the risk is not how many get it - it is going to spread no matter what we do - but limiting intra-family interactions to protect the elderly. But that’s it from me. If you disagree I’m not going to argue, because I don’t hold my views as strongly as you clearly do. Only time will tell.

 

I am confident about stuff that has a lot of evidence backing it. Every year in the United States, new flu cases (also spread by respiratory droplets) drop drastically around end of December. Why is that? Winter break for all K-12 kids. In January, infections ramp back up.

[Dalal.Holdings]

Does anybody have any data on spread on a regional level in Italy by any chance?

 

Italy placed certain parts of Lombardy on lockdown from February 22nd. If those measures were effective, the statistics should show it. It's the ultimate test case, as all other serious containment measures in Italy and the rest of Europe were only taken five days ago at the earliest, so won't show in the new case statistics for five/seven days. If the lockdown was succesful here, it seems more likely it will be succesful elsewhere.

 

We have data from places like China—question is if you can trust it. Based on this data, Locking down Hubei had a major impact on spread throughout the other provinces. Turns out there are actions you can take to nip this in the bud instead of infecting 60% to achieve “herd immunity”.

[Liberty]

 

The testing situation in the richest country in the world with months of advance warning is a disgrace

 

Yes, tests are being rationed due to shortage. Pence’s 1M tests is over a week late now and we are nowhere close. This increases the probability that we may end up like Italy and be rationing ICU beds and vents eventually as well... :-\

 

Meanwhile:

 

[minten]

We have data from places like China—question is if you can trust it. Based on this data, Locking down Hubei had a major impact on spread throughout the other provinces. Turns out there are actions you can take to nip this in the bud instead of infecting 60% to achieve “herd immunity”.

 

I trust China's numbers to some extent, but it's not clear to me how draconian their Hubei lockdown really was, and if that's even doable here.

What Italy has been doing has been much more transparent for us in the West, they're ahead of everybody else in both number of infections and their containment response, and their measures are being copied to some extent in every European country (and soon the US), so their statistiscs are a great forward looking indicator. If their "new cases" stop going up (and they seem to have stopped going up over the last three days, altough it's too soon to be sure), or at the very least stop going up exponentially like was predicted in many doomsday scenario's, that's good news. I was just looking for some confirmation of a region which is even further ahead than Italy as a whole.

[petec]

Does anybody have any data on spread on a regional level in Italy by any chance?

 

Italy placed certain parts of Lombardy on lockdown from February 22nd. If those measures were effective, the statistics should show it. It's the ultimate test case, as all other serious containment measures in Italy and the rest of Europe were only taken five days ago at the earliest, so won't show in the new case statistics for five/seven days. If the lockdown was succesful here, it seems more likely it will be succesful elsewhere.

 

We have data from places like China—question is if you can trust it. Based on this data, Locking down Hubei had a major impact on spread throughout the other provinces. Turns out there are actions you can take to nip this in the bud instead of infecting 60% to achieve “herd immunity”.

 

Don’t misunderstand British policy. Britain will lock down. But it’s at an earlier stage than many other countries and locking down too early is potentially catastrophic. Plus, as your flu/Christmas example demonstrates, the problem comes when you *lift* the lockdown. That’s why herd immunity matters.

 

For interest: