Coronavirus: Are You Scared?
- Thread starter probyn
- Start date
O
OnTheWayOut
It is free for all who have a Sirius or XM radio, no need to be a subscriber. Rather nice of them I'd say. I listened a bit today, it is doctors with common sense advice and facts which should calm folks down a bit. Factual information is what folks need to know what to do without freaking out.
The ace 2 receptor racial component was debunked weeks ago. That’s just one point that was inaccurate.
Italy plans to lock down Milan area, nation’s financial hub, in effort to contain coronavirus
PUBLISHED SAT, MAR 7 20207:16 PM EST
Reuters
KEY POINTS
The new rules include telling people not to enter or leave Lombardy, which is home to some 10 million people, as well as 11 provinces in four of Italy’s 19 other regions, according to a draft decree.
The head of the civil protection agency said on Saturday the decree would be presented later in the day, after data showed the number of coronavirus infections jumped by more than 1,200 in the past 24 hours.
However, at midnight Prime Minister Giuseppe Conte had still not signed off on it, after the leaked draft prompted pushback from the governors of Lombardy and Emilia-Romagna, another region affected.
https://www.cnbc.com/2020/03/07/ita...ial-hub-in-effort-to-contain-coronavirus.html
Latest data:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
It's one of the most alarming charts I've ever seen because
1. Trend has been very stable for weeks even with Italy mitigation measures
2. If it continues health system collapses within 2 weeks
https://twitter.com/epsilon3141/sta...ic-party-tests-positive-covid-19-live-updates
Added new data point on the exponential italian ICU trend (doubling every 2.6 days)
PUBLISHED SAT, MAR 7 20207:16 PM EST
Reuters
KEY POINTS
The new rules include telling people not to enter or leave Lombardy, which is home to some 10 million people, as well as 11 provinces in four of Italy’s 19 other regions, according to a draft decree.
The head of the civil protection agency said on Saturday the decree would be presented later in the day, after data showed the number of coronavirus infections jumped by more than 1,200 in the past 24 hours.
However, at midnight Prime Minister Giuseppe Conte had still not signed off on it, after the leaked draft prompted pushback from the governors of Lombardy and Emilia-Romagna, another region affected.
https://www.cnbc.com/2020/03/07/ita...ial-hub-in-effort-to-contain-coronavirus.html
Latest data:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
It's one of the most alarming charts I've ever seen because
1. Trend has been very stable for weeks even with Italy mitigation measures
2. If it continues health system collapses within 2 weeks
https://twitter.com/epsilon3141/sta...ic-party-tests-positive-covid-19-live-updates
Added new data point on the exponential italian ICU trend (doubling every 2.6 days)
I hope so!
Cannot says he 100% immune to it. There more then one strain out there. Who know?
This disease have too many unknown variables! Even US CDC said that.
Hope there a vaccine soon next year. I figured with my N95 mask I pray I wouldn't catch it. I also hope you have N95 mask too.
I will be the first one in line for the vaccine . Guess I figured you will be right behind me & please don't push ahead of me. I glad you read my post and prep for food and adjust your investment portfolio. If you thought the last two week the stock market was wild. Wait until the shit hit the fan! In the coming weeks and months when the hospitals get overwhelmed.
One slide in a leaked presentation for US hospitals reveals that they're preparing for millions of hospitalizations as the outbreak unfolds
https://www.businessinsider.com/pre...aring-for-millions-of-hospitalizations-2020-3
Hospitals are bracing for millions of Americans to be hospitalized as part of the novel coronavirus outbreak.
The American Hospital Association, which represents thousands of hospitals and health systems, hosted a webinar in February with its member hospitals and health systems. Business Insider obtained a copy of the slides presented.
The presentation, titled "What healthcare leaders need to know: Preparing for the COVID-19" happened February 26, with representatives from the National Ebola Training and Education Center.
As part of the presentation to hospitals, Dr. James Lawler, a professor at the University of Nebraska Medical Center gave his "best guess" estimates of how much the virus might spread in the US.
Lawler's estimates include:
4.8 million hospitalizations associated with the novel coronavirus
96 million cases overall in the US
480,000 deaths
Overall, the slide points out that hospitals should prepare for an impact to the system that's 10 times a severe flu season.
To read further go to link: https://www.businessinsider.com/pre...aring-for-millions-of-hospitalizations-2020-3
Here's the slide:
https://www.businessinsider.com/pre...aring-for-millions-of-hospitalizations-2020-3
Hospitals are bracing for millions of Americans to be hospitalized as part of the novel coronavirus outbreak.
The American Hospital Association, which represents thousands of hospitals and health systems, hosted a webinar in February with its member hospitals and health systems. Business Insider obtained a copy of the slides presented.
The presentation, titled "What healthcare leaders need to know: Preparing for the COVID-19" happened February 26, with representatives from the National Ebola Training and Education Center.
As part of the presentation to hospitals, Dr. James Lawler, a professor at the University of Nebraska Medical Center gave his "best guess" estimates of how much the virus might spread in the US.
Lawler's estimates include:
4.8 million hospitalizations associated with the novel coronavirus
96 million cases overall in the US
480,000 deaths
Overall, the slide points out that hospitals should prepare for an impact to the system that's 10 times a severe flu season.
To read further go to link: https://www.businessinsider.com/pre...aring-for-millions-of-hospitalizations-2020-3
Here's the slide:
Expect Up To 40% Of Tehran's Population To Be Infected In 2 Weeks: Iranian Health Official
With the daily soaring infection rate and death toll inside Iran officially at 124 deaths amid 4747 confirmed cases as of early Friday — though true numbers are believed much higher — all eyes are on the largely unprepared country given it's the biggest outbreak epicenter outside the virus' origin country of China.
Health officials worry that Iran could be a sign of things to come in the much of the rest of the world — a deeply alarming prospect given a member of Iran's National Committee for Influenza and specialist in infectious diseases, Dr. Masoud Mardani, has just issued a stark warning for the capital city of Tehran, brimming with about 9 million people and over 12 million in the greater metropolitan area.
Dr. Mardai said he expects 30 to 40 percent of Tehran's population to be infected with coronavirus within the next two weeks.
He was quoted in state media as saying: http://english.alarabiya.net/en/vie...ehran-s-population-within-next-two-weeks.html
“Coronavirus is rapidly spreading … we estimate that 30 to 40 percent of Tehran’s population will be infected by the end of this (Persian) month.”
The current Persian month is the last month of the Persian calendar and ends on March 20, Al Arabiya English notes.
According to a summary of his statements given to an Iranian newspaper, he said further:
...an infected person could transmit the virus to four people at the same time. Therefore it is expected that 30-40 per cent of Tehran’s population will be infected with the virus by March.
He pointed out that many Iranians visit health centers and hospitals when they have regular flu, believing it is a coronavirus.
Dr. Mardai is urging people who think they're sick to stay home instead of potentially infecting overcrowding medical clinics and hospitals.
nerd
@nerd_hawk
Mar 6
#coronavirus Iran: Population seeking help in hospitals for coronavirus. "We estimate that 30 to 40% of Tehran's population will be infected with COVID-19 by March 20," says Dr. Massoud Mardani, member of Iran's National Influenza Committee. Tehran population: 12 million.
https://twitter.com/nerd_hawk/statu...-be-infected-2-weeks-health-official-predicts
According to a summary of his statements given to an Iranian newspaper, he said further:
With the daily soaring infection rate and death toll inside Iran officially at 124 deaths amid 4747 confirmed cases as of early Friday — though true numbers are believed much higher — all eyes are on the largely unprepared country given it's the biggest outbreak epicenter outside the virus' origin country of China.
Health officials worry that Iran could be a sign of things to come in the much of the rest of the world — a deeply alarming prospect given a member of Iran's National Committee for Influenza and specialist in infectious diseases, Dr. Masoud Mardani, has just issued a stark warning for the capital city of Tehran, brimming with about 9 million people and over 12 million in the greater metropolitan area.
Dr. Mardai said he expects 30 to 40 percent of Tehran's population to be infected with coronavirus within the next two weeks.
He was quoted in state media as saying: http://english.alarabiya.net/en/vie...ehran-s-population-within-next-two-weeks.html
“Coronavirus is rapidly spreading … we estimate that 30 to 40 percent of Tehran’s population will be infected by the end of this (Persian) month.”
The current Persian month is the last month of the Persian calendar and ends on March 20, Al Arabiya English notes.
According to a summary of his statements given to an Iranian newspaper, he said further:
...an infected person could transmit the virus to four people at the same time. Therefore it is expected that 30-40 per cent of Tehran’s population will be infected with the virus by March.
He pointed out that many Iranians visit health centers and hospitals when they have regular flu, believing it is a coronavirus.
Dr. Mardai is urging people who think they're sick to stay home instead of potentially infecting overcrowding medical clinics and hospitals.
nerd
@nerd_hawk
Mar 6
#coronavirus Iran: Population seeking help in hospitals for coronavirus. "We estimate that 30 to 40% of Tehran's population will be infected with COVID-19 by March 20," says Dr. Massoud Mardani, member of Iran's National Influenza Committee. Tehran population: 12 million.
https://twitter.com/nerd_hawk/statu...-be-infected-2-weeks-health-official-predicts
According to a summary of his statements given to an Iranian newspaper, he said further:
Coronavirus in U.S.: More than half of all states have reported COVID-19 cases
March 7, 2020, 3:12 AM EST / Updated March 7, 2020, 2:48 PM EST
https://www.nbcnews.com/news/us-new...-half-all-states-have-reported-covid-n1152076
:ambivalence:
March 7, 2020, 3:12 AM EST / Updated March 7, 2020, 2:48 PM EST
https://www.nbcnews.com/news/us-new...-half-all-states-have-reported-covid-n1152076
:ambivalence:
What Went Wrong?
March 6, 2020 12:30 p.m.
https://talkingpointsmemo.com/edblog/what-went-wrong-2
:ambivalence:
March 6, 2020 12:30 p.m.
https://talkingpointsmemo.com/edblog/what-went-wrong-2
:ambivalence:
This wouldn't be necessary if they just all stop kissing.Italy might shut down 11 provinces. They're in serious trouble now
https://twitter.com/WarsontheBrink/status/1236399730596478976
Maybe this is karma for Iran shooting down a civilian plane.Expect Up To 40% Of Tehran's Population To Be Infected In 2 Weeks: Iranian Health Official
With the daily soaring infection rate and death toll inside Iran officially at 124 deaths amid 4747 confirmed cases as of early Friday — though true numbers are believed much higher — all eyes are on the largely unprepared country given it's the biggest outbreak epicenter outside the virus' origin country of China.
Health officials worry that Iran could be a sign of things to come in the much of the rest of the world — a deeply alarming prospect given a member of Iran's National Committee for Influenza and specialist in infectious diseases, Dr. Masoud Mardani, has just issued a stark warning for the capital city of Tehran, brimming with about 9 million people and over 12 million in the greater metropolitan area.
Dr. Mardai said he expects 30 to 40 percent of Tehran's population to be infected with coronavirus within the next two weeks.
He was quoted in state media as saying: http://english.alarabiya.net/en/vie...ehran-s-population-within-next-two-weeks.html
“Coronavirus is rapidly spreading … we estimate that 30 to 40 percent of Tehran’s population will be infected by the end of this (Persian) month.”
The current Persian month is the last month of the Persian calendar and ends on March 20, Al Arabiya English notes.
According to a summary of his statements given to an Iranian newspaper, he said further:
...an infected person could transmit the virus to four people at the same time. Therefore it is expected that 30-40 per cent of Tehran’s population will be infected with the virus by March.
He pointed out that many Iranians visit health centers and hospitals when they have regular flu, believing it is a coronavirus.
Dr. Mardai is urging people who think they're sick to stay home instead of potentially infecting overcrowding medical clinics and hospitals.
nerd
@nerd_hawk
Mar 6
#coronavirus Iran: Population seeking help in hospitals for coronavirus. "We estimate that 30 to 40% of Tehran's population will be infected with COVID-19 by March 20," says Dr. Massoud Mardani, member of Iran's National Influenza Committee. Tehran population: 12 million.
https://twitter.com/nerd_hawk/statu...-be-infected-2-weeks-health-official-predicts
According to a summary of his statements given to an Iranian newspaper, he said further:
Maybe there was something on that plane that necessitated bringing it down? They did shoot 2 missiles at it 30 seconds apart. Right beside the airport. They had to know it was a passenger jet. Why would they do that?
There are no coincidences.
There are no coincidences.
Well this doctor has the real solution:
https://www.washingtonpost.com/opin...s07C8umVi_ohN_GhrYz4JXP8KbuWHjKyWONyTpKqQRDDQ
I've heard good things about this Doctor T.
He provides free prescriptions for Trump Derangement Syndrome to the homeless.
God bless America.
:yo:
An excellent post, enjoyed reading it very much. Thanks for sharing.
On the same topic, it is about paranoid people. Remember that joke?
Ask any paranoid person, why are you paranoid?
The automatic reply from the paranoid would be: "It keeps me alive".
Rationally speaking, there is no way we can argue with that.
Survival is a basic instinct. The fight/flight response.
This is reality: All US Hospital Beds Will Be Filled With Patients 'By About May 8th or latest May 20' Due To Coronavirus: Analysis
A sobering analysis of how coronavirus is likely to impact the US healthcare system suggests that hospitals will be quickly overwhelmed with patients, and that all available beds will be filled by around May 8th if the virus tracks with Italy's figures and 10% of patients require an ICU.
Of note, the Straits Times reported last week that thousands of people were waiting for hospital beds in South Korea as the disease surges.
https://www.straitstimes.com/asia/e...-reports-516-new-cases-bringing-total-to-5328
Liz Specht, a PhD in biology and the associate director of Science and Technology for the Good Food
https://www.linkedin.com/in/liz-spe...issionId=29c953ac-9952-fa15-7189-50e2776b5067
Institute laid out her concerns in a lengthy Twitter thread on Friday, which you can see here on Twitter, https://twitter.com/LizSpecht/status/1236095180459003909?s=20
or continue reading below.
Liz Specht
@LizSpecht
I think most people aren’t aware of the risk of systemic healthcare failure due to #COVID19 because they simply haven’t run the numbers yet. Let’s talk math. 1/n
Liz Specht
@LizSpecht
Let’s conservatively assume that there are 2,000 current cases in the US today, March 6th. This is about 8x the number of confirmed (lab-diagnosed) cases. We know there is substantial under-Dx due to lack of test kits; I’ll address implications later of under-/over-estimate. 2/n
Continued:
*We can expect that we’ll continue to see a doubling of cases every 6 days (this is a typical doubling time across several epidemiological studies). Here I mean *actual* cases. Confirmed cases may appear to rise faster in the short term due to new test kit rollouts.
*We’re looking at about 1M US cases by the end of April, 2M by ~May 5, 4M by ~May 11, and so on. Exponentials are hard to grasp, but this is how they go.
*As the healthcare system begins to saturate under this case load, it will become increasingly hard to detect, track, and contain new transmission chains. In absence of extreme interventions, this likely won’t slow significantly until hitting >>1% of susceptible population.
What does a case load of this size mean for healthcare system? We’ll examine just two factors — hospital beds and masks — among many, many other things that will be impacted.
*
The US has about 2.8 hospital beds per 1000 people. With a population of 330M, this is ~1M beds. At any given time, 65% of those beds are already occupied. That leaves about 330k beds available nationwide (perhaps a bit fewer this time of year with regular flu season, etc).
*Let’s trust Italy’s numbers and assume that about 10% of cases are serious enough to require hospitalization. (Keep in mind that for many patients, hospitalization lasts for *weeks* — in other words, turnover will be *very* slow as beds fill with COVID19 patients).
* By this estimate, by about May 8th, all open hospital beds in the US will be filled. (This says nothing, of course, about whether these beds are suitable for isolation of patients with a highly infectious virus.)
* If we’re wrong by a factor of two regarding the fraction of severe cases, that only changes the timeline of bed saturation by 6 days in either direction. If 20% of cases require hospitalization, we run out of beds by ~May 2nd.
* If only 5% of cases require it, we can make it until ~May 14th. 2.5% gets us to May 20th. This, of course, assumes that there is no uptick in demand for beds from *other* (non-COVID19) causes, which seems like a dubious assumption.
* As healthcare system becomes increasingly burdened, Rx shortages, etc, people w/ chronic conditions that are normally well-managed may find themselves slipping into severe states of medical distress requiring intensive care & hospitalization. But let’s ignore that for now.
* Alright, so that’s beds. Now masks. Feds say we have a national stockpile of 12M N95 masks and 30M surgical masks (which are not ideal, but better than nothing).
*There are about 18M healthcare workers in the US. Let’s assume only 6M HCW are working on any given day. (This is likely an underestimate as most people work most days of the week, but again, I’m playing conservative at every turn.)
* As COVID19 cases saturate virtually every state and county, which seems likely to happen any day now, it will soon be irresponsible for all HCWs to not wear a mask. These HCWs would burn through N95 stockpile in 2 days if each HCW only got ONE mask per day.
* One per day would be neither sanitary nor pragmatic, though this is indeed what we saw in Wuhan, with HCWs collapsing on their shift from dehydration because they were trying to avoid changing their PPE suits as they cannot be reused.
*How quickly could we ramp up production of new masks? Not very fast at all. The vast majority are manufactured overseas, almost all in China. Even when manufactured here in US, the raw materials are predominantly from overseas... again, predominantly from China.
* Keep in mind that all countries globally will be going through the exact same crises and shortages simultaneously. We can’t force trade in our favor.
* Now consider how these 2 factors – bed and mask shortages – compound each other’s severity. Full hospitals + few masks + HCWs running around between beds without proper PPE = very bad mix.
* HCWs are already getting infected even w/ access to full PPE. In the face of PPE limitations this severe, it’s only a matter of time. HCWs will start dropping from the workforce for weeks at a time, leading to a shortage of HCWs that then further compounds both issues above.
* We could go on and on about thousands of factors – # of ventilators, or even simple things like saline drip bags. You see where this is going.
* Importantly, I cannot stress this enough: even if I’m wrong – even VERY wrong – about core assumptions like % of severe cases or current case #, it only changes the timeline by days or weeks. This is how exponential growth in an immunologically naïve population works.
* Undeserved panic does no one any good. But neither does ill-informed complacency. It’s wrong to assuage the public by saying “only 2% will die.” People aren’t adequately grasping the national and global systemic burden wrought by this swift-moving of a disease.
* I’m an make biochemical & molecular engineer also. This is what my mind does all day: I run back-of-the-envelope calculations to try to estimate order-of-magnitude impacts. I’ve been on high alarm about this disease since ~Jan 19 after reading clinical indicators in the first papers emerging from Wuhan.
*Nothing in the last 6 weeks has dampened my alarm in the slightest. To the contrary, we’re seeing abject refusal of many countries to adequately respond or prepare. Of course some of these estimates will be wrong, even substantially wrong.
*But I have no reason to think they’ll be orders-of-magnitude wrong. Even if your personal risk of death is very, very low, don’t mock decisions like canceling events or closing workplaces as undue “panic”.
* These measures are the bare minimum we should be doing to try to shift the peak – to slow the rise in cases so that healthcare systems are less overwhelmed. Each day that we can delay an extra case is a big win for the HC system.
*And yes, you really should prepare to buckle down for a bit. All services and supply chains will be impacted. Why risk the stress of being ill-prepared?
* Worst case, I’m massively wrong and you now have a huge bag of rice and black beans to burn through over the next few months and enough Robitussin to trip out.
* One more thought: you’ve probably seen multiple respected epidemiologists have estimated that 20-70% of world will be infected within the next year. If you use 6-day doubling rate I mentioned above, we land at ~2-6 billion infected by sometime in July of this year.
*Obviously I think the doubling time will start to slow once a sizeable fraction of the population has been infected, simply because of herd immunity and a smaller susceptible population
*But take the scenarios above (full beds, no PPE, etc, at just 1% of the US population infected) and stretch them out over just a couple extra months.
*That timeline roughly fits with consensus end-game numbers from these highly esteemed epidemiologists. Again, we’re talking about discrepancies of mere days or weeks one direction or another, but not disagreements in the overall magnitude of the challenge.
*This is not some hypothetical, fear-mongering, worst-case scenario. This is reality, as far as anyone can tell with the current available data.
*That’s all for now. Standard disclaimers apply: I’m a PhD biologist but *not* an epidemiologist. Thoughts my own. Yadda yadda. Stay safe out there. /end
Liz Specht
@LizSpecht
Mar 7
Addendum: to anyone who found this useful or interesting, highly recommend you follow
@trvrb
who actually does modeling and forecasting for a living. This thread is a great place to start: https://twitter.com/trvrb/status/1236097553520660483?s=21
Trevor Bedford
@trvrb
·
Mar 6
Replying to
@trvrb
Using forward simulation, with a doubling time of 6.2 (5.1, 8.2) days, we estimate the prevalence of active infections on Mar 5 is 620 (90% uncertainty interval 120, 1600). 4/7
Trevor Bedford
@trvrb
·
Mar 6
If growth continues unabated, this cluster alone may be responsible for 1100 (210, 2800) active infections by March 10 and 2000 (370, 5000) by March 15. 5/7
https://twitter.com/trvrb/status/1236097553520660483?s=21
A sobering analysis of how coronavirus is likely to impact the US healthcare system suggests that hospitals will be quickly overwhelmed with patients, and that all available beds will be filled by around May 8th if the virus tracks with Italy's figures and 10% of patients require an ICU.
Of note, the Straits Times reported last week that thousands of people were waiting for hospital beds in South Korea as the disease surges.
https://www.straitstimes.com/asia/e...-reports-516-new-cases-bringing-total-to-5328
Liz Specht, a PhD in biology and the associate director of Science and Technology for the Good Food
https://www.linkedin.com/in/liz-spe...issionId=29c953ac-9952-fa15-7189-50e2776b5067
Institute laid out her concerns in a lengthy Twitter thread on Friday, which you can see here on Twitter, https://twitter.com/LizSpecht/status/1236095180459003909?s=20
or continue reading below.
Liz Specht
@LizSpecht
I think most people aren’t aware of the risk of systemic healthcare failure due to #COVID19 because they simply haven’t run the numbers yet. Let’s talk math. 1/n
Liz Specht
@LizSpecht
Let’s conservatively assume that there are 2,000 current cases in the US today, March 6th. This is about 8x the number of confirmed (lab-diagnosed) cases. We know there is substantial under-Dx due to lack of test kits; I’ll address implications later of under-/over-estimate. 2/n
Continued:
*We can expect that we’ll continue to see a doubling of cases every 6 days (this is a typical doubling time across several epidemiological studies). Here I mean *actual* cases. Confirmed cases may appear to rise faster in the short term due to new test kit rollouts.
*We’re looking at about 1M US cases by the end of April, 2M by ~May 5, 4M by ~May 11, and so on. Exponentials are hard to grasp, but this is how they go.
*As the healthcare system begins to saturate under this case load, it will become increasingly hard to detect, track, and contain new transmission chains. In absence of extreme interventions, this likely won’t slow significantly until hitting >>1% of susceptible population.
What does a case load of this size mean for healthcare system? We’ll examine just two factors — hospital beds and masks — among many, many other things that will be impacted.
*
The US has about 2.8 hospital beds per 1000 people. With a population of 330M, this is ~1M beds. At any given time, 65% of those beds are already occupied. That leaves about 330k beds available nationwide (perhaps a bit fewer this time of year with regular flu season, etc).
*Let’s trust Italy’s numbers and assume that about 10% of cases are serious enough to require hospitalization. (Keep in mind that for many patients, hospitalization lasts for *weeks* — in other words, turnover will be *very* slow as beds fill with COVID19 patients).
* By this estimate, by about May 8th, all open hospital beds in the US will be filled. (This says nothing, of course, about whether these beds are suitable for isolation of patients with a highly infectious virus.)
* If we’re wrong by a factor of two regarding the fraction of severe cases, that only changes the timeline of bed saturation by 6 days in either direction. If 20% of cases require hospitalization, we run out of beds by ~May 2nd.
* If only 5% of cases require it, we can make it until ~May 14th. 2.5% gets us to May 20th. This, of course, assumes that there is no uptick in demand for beds from *other* (non-COVID19) causes, which seems like a dubious assumption.
* As healthcare system becomes increasingly burdened, Rx shortages, etc, people w/ chronic conditions that are normally well-managed may find themselves slipping into severe states of medical distress requiring intensive care & hospitalization. But let’s ignore that for now.
* Alright, so that’s beds. Now masks. Feds say we have a national stockpile of 12M N95 masks and 30M surgical masks (which are not ideal, but better than nothing).
*There are about 18M healthcare workers in the US. Let’s assume only 6M HCW are working on any given day. (This is likely an underestimate as most people work most days of the week, but again, I’m playing conservative at every turn.)
* As COVID19 cases saturate virtually every state and county, which seems likely to happen any day now, it will soon be irresponsible for all HCWs to not wear a mask. These HCWs would burn through N95 stockpile in 2 days if each HCW only got ONE mask per day.
* One per day would be neither sanitary nor pragmatic, though this is indeed what we saw in Wuhan, with HCWs collapsing on their shift from dehydration because they were trying to avoid changing their PPE suits as they cannot be reused.
*How quickly could we ramp up production of new masks? Not very fast at all. The vast majority are manufactured overseas, almost all in China. Even when manufactured here in US, the raw materials are predominantly from overseas... again, predominantly from China.
* Keep in mind that all countries globally will be going through the exact same crises and shortages simultaneously. We can’t force trade in our favor.
* Now consider how these 2 factors – bed and mask shortages – compound each other’s severity. Full hospitals + few masks + HCWs running around between beds without proper PPE = very bad mix.
* HCWs are already getting infected even w/ access to full PPE. In the face of PPE limitations this severe, it’s only a matter of time. HCWs will start dropping from the workforce for weeks at a time, leading to a shortage of HCWs that then further compounds both issues above.
* We could go on and on about thousands of factors – # of ventilators, or even simple things like saline drip bags. You see where this is going.
* Importantly, I cannot stress this enough: even if I’m wrong – even VERY wrong – about core assumptions like % of severe cases or current case #, it only changes the timeline by days or weeks. This is how exponential growth in an immunologically naïve population works.
* Undeserved panic does no one any good. But neither does ill-informed complacency. It’s wrong to assuage the public by saying “only 2% will die.” People aren’t adequately grasping the national and global systemic burden wrought by this swift-moving of a disease.
* I’m an make biochemical & molecular engineer also. This is what my mind does all day: I run back-of-the-envelope calculations to try to estimate order-of-magnitude impacts. I’ve been on high alarm about this disease since ~Jan 19 after reading clinical indicators in the first papers emerging from Wuhan.
*Nothing in the last 6 weeks has dampened my alarm in the slightest. To the contrary, we’re seeing abject refusal of many countries to adequately respond or prepare. Of course some of these estimates will be wrong, even substantially wrong.
*But I have no reason to think they’ll be orders-of-magnitude wrong. Even if your personal risk of death is very, very low, don’t mock decisions like canceling events or closing workplaces as undue “panic”.
* These measures are the bare minimum we should be doing to try to shift the peak – to slow the rise in cases so that healthcare systems are less overwhelmed. Each day that we can delay an extra case is a big win for the HC system.
*And yes, you really should prepare to buckle down for a bit. All services and supply chains will be impacted. Why risk the stress of being ill-prepared?
* Worst case, I’m massively wrong and you now have a huge bag of rice and black beans to burn through over the next few months and enough Robitussin to trip out.
* One more thought: you’ve probably seen multiple respected epidemiologists have estimated that 20-70% of world will be infected within the next year. If you use 6-day doubling rate I mentioned above, we land at ~2-6 billion infected by sometime in July of this year.
*Obviously I think the doubling time will start to slow once a sizeable fraction of the population has been infected, simply because of herd immunity and a smaller susceptible population
*But take the scenarios above (full beds, no PPE, etc, at just 1% of the US population infected) and stretch them out over just a couple extra months.
*That timeline roughly fits with consensus end-game numbers from these highly esteemed epidemiologists. Again, we’re talking about discrepancies of mere days or weeks one direction or another, but not disagreements in the overall magnitude of the challenge.
*This is not some hypothetical, fear-mongering, worst-case scenario. This is reality, as far as anyone can tell with the current available data.
*That’s all for now. Standard disclaimers apply: I’m a PhD biologist but *not* an epidemiologist. Thoughts my own. Yadda yadda. Stay safe out there. /end
Liz Specht
@LizSpecht
Mar 7
Addendum: to anyone who found this useful or interesting, highly recommend you follow
@trvrb
who actually does modeling and forecasting for a living. This thread is a great place to start: https://twitter.com/trvrb/status/1236097553520660483?s=21
Trevor Bedford
@trvrb
·
Mar 6
Replying to
@trvrb
Using forward simulation, with a doubling time of 6.2 (5.1, 8.2) days, we estimate the prevalence of active infections on Mar 5 is 620 (90% uncertainty interval 120, 1600). 4/7
Trevor Bedford
@trvrb
·
Mar 6
If growth continues unabated, this cluster alone may be responsible for 1100 (210, 2800) active infections by March 10 and 2000 (370, 5000) by March 15. 5/7
https://twitter.com/trvrb/status/1236097553520660483?s=21
