[News] Coronavirus

A place to discuss the now-global coronavirus outbreak.

So my travel group has officially canceled the April trip to Italy.
So when do we start calling this a pandemic? Seems to me that it's there already.

Pence on meet the press Sunday morning talking about the 1 US death and how it was a tragedy. But the guy had underlying conditions, blah, blah, everything is fine.

36 hours later and we're up to 6 US deaths.

WizKid wrote:

So my travel group has officially canceled the April trip to Italy.
So when do we start calling this a pandemic? Seems to me that it's there already.

And when do we stop canceling travel? I mean if it is everywhere then traveling or not traveling to places won't really do anything, correct?

I guess places with no cases could prevent all travel to and from the location but is it really possible for say Iowa (with no confirmed cases as of now) to stop all travel in and out of the state?

@farley

It's more non-necessary travel. If there is a high chance of you getting sick or, even worse, being sick while on vacation that is no fun for anybody involved.

I can kind of get that. But at some point the risk of getting sick on the vacation will be equal to the risk of getting it from going to the local grocery. When that equilibrium is reached then I think canceling stuff becomes pointless.

Part of the mindset behind it is to prevent getting stuck somewhere thousands of miles from home if the sh*t really starts to hit the fan.

farley3k wrote:

I can kind of get that. But at some point the risk of getting sick on the vacation will be equal to the risk of getting it from going to the local grocery. When that equilibrium is reached then I think canceling stuff becomes pointless.

I go back to my own bed and have access to local resources if I get sick at home. Health plan networks aren't international so insurance won't cover anything including meds (at least any that I have used).

Also, I came back from the Naples area less than a year ago. If the hospitals are anything like their airports and public transportation, efficiency is not Italy's strong suite

That feeling of how f*cked we all are when Trump thinks he can negotiate how quickly a coronavirus vaccine can be developed, tested, and deployed.

It's also a testament to how unprepared Trump is when he rolls into meetings. Clearly no one gave him briefing materials that explained the vaccine development process or they did and he didn't bother reading them.

WaPo wrote:

After Leonard Schleifer, the founder and chief executive of Regneron, said his company aimed to have 200,000 doses ready by August, Trump asked him, “That means you’d be able to use the vaccine that early?” He added, “So that process would be faster than John’s?” referring to another CEO.

After another CEO took a turn, Trump asked him, “So you’re talking over the next few months, you think you could have a vaccine?"

The CEO clarified that it would be ready only for phase two of testing at that point. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, added, “Yeah. You won’t have a vaccine. You’ll have a vaccine to go into testing."

“And how long would that take?” Trump asked. The CEO said it would take months and then head into phase three. “All right. So you’re talking within a year.”

“A year to a year and a half,” Fauci again clarified.

“Well, but, Lenny is talking about two months, right?” Trump said, incorrectly referring to Schleifer’s August estimate.

“A little -- a little longer,” Schleifer again clarified. “A little longer.”

“A couple of months, right?” Trump pressed. “I mean, I like the sound of a couple of months better, I must be honest with you.”

That’s when Health and Human Services Secretary Alex Azar cut in, again emphasizing the difference between being ready for testing and ready to deploy.

“But when you say June phase one initiation, though -- right? -- in June, it’s not a completed vaccine,” Azar said.

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What’s remarkable about these exchanges is that Fauci has explained all of this -- in front of Trump and publicly. At a White House briefing on Thursday, Fauci laid out a detailed timetable for clinical testing and concluded, “So although this is the fastest we have ever gone from a sequence of a virus to a trial, it still would not be applicable to the epidemic unless we really wait about a year to a year and a half.”

Trump on Monday eventually relented and set the goal posts at about a year from now. “So can you have it ready for next season, any of you?” he asked. “I mean, would you say, for the next season?”

Several CEOs said they hoped to, but Paul Stoffels, Johnson & Johnson’s chief scientific officer, stepped in to clarify, saying: “Yeah. But, like many people said, we have to be very careful here. If you vaccinate several hundred million people … "

“You’ve got to make sure it works,” Trump said.

“Works and is safe,” Stoffels said. "Yeah."

“And it doesn’t hurt,” Trump said. “Right.”

Eventually Trump turned to the efficacy of the potential vaccines, and again he seemed unfamiliar with how much we know at this point. He mentioned that seasonal flu vaccines are different every year, but that they are often somewhat ineffective.

“And yet, I hear numbers that are better than that with respect to corona,” Trump said. “You think you can really knock it out and that’s because you know specifically what it is, I suspect. So that’s impressive.”

Schleifer clarified that there’s still so much we don’t know. And that’s when Trump asked about whether they could just use the flu vaccine.

“But the same vaccine could not work?” he said. “You take a solid flu vaccine -- you don’t think that would have an impact or much of an impact on corona?”

“No,” Schleifer replied.

“Probably not,” Fauci added, charitably.

Soon, Trump returned to his preferred months-long timetable. Asked by a reporter about whether he’s comfortable with this taking longer than that, Trump again sounded as if he hadn’t heard everything the CEOs and experts had just told him.

“I don’t think they know what the time will be," Trump said. "I’ve heard very quick numbers -- a matter of months -- and I’ve heard pretty much a year would be an outside number.”

Again, Fauci had said a year to 18 months.

“But if you’re talking about three to four months, in a couple of cases, and a year in other cases -- wouldn’t you say, doctor, would that be about right?” Trump said.

When a reporter pressed on whether Trump really thought the months-long timetable was viable for a vaccine, Fauci cut in. And he actually asked that the president be educated on the timetable -- despite it having been told to him repeatedly.

“Would you make sure you get the president the information that a vaccine that you make and start testing in a year is not a vaccine that’s deployable,” Fauci said. “So he’s asking the question, ‘When is it going to be deployable?’ And that is going to be, at the earliest, a year to a year and a half, no matter how fast you go.”

Trump, though, was still skeptical.

“Do you think that’s right?” he asked.

Azar emphasized that treatments but not vaccines could be available sooner, and Trump suddenly seemed more interested in that.

“Well, I think treatment, in many ways, might be more exciting,” Trump said, adding: “So the treatment, I mean, just for the media -- so the treatment element of it goes faster than the vaccine element of it, which, in my opinion, in this case, would be better.”

Supposed to be going to a conference for work next week that will have dozens of international attendees. They've already disinvited anyone from Italy, South Korea, and Japan. There aren't typically attendees from China but they would be barred as well obviously. There would still be people from all over the world - Singapore, Greece, Turkey, Saudi Arabia, Oman, probably half a dozen others. I can't decide whether to go and be extra vigilant, or just skip it this year. I'm simultaneously glad to see they're not succumbing to hysteria but also a little surprised they haven't just canceled it outright.

That meeting is the perfect encapsulation of how Trump plus a pandemic is the perfect storm. His brain only works in terms of winning and losing. He can’t conceive of mitigating and reducing risk.

Right now the White House could be leaning into companies to offer sick time or incentivizing it. They could be doing anything but having a pointless on camera meeting where he demonstrates his ignorance while he tries to prove the whole thing is going to be completely cured shortly.

ClockworkHouse wrote:
Badferret wrote:

I'm guessing that the virus is pretty much nation wide at this point.

I think you're right.

Thirteen states confirmed as of right now:

WaPo wrote:

Arizona, California, Florida, Illinois, Massachusetts, Nebraska, New Hampshire, New York, Oregon, Rhode Island, Texas, Wisconsin and Washington state have reported cases of the coronavirus.

With it having been in the wild undetected for six weeks, and with the US being such a mobile society, it has to have spread everywhere.

Yeah, I'm in King County, WA where the virus has killed 6 and we have lots of cases with unknown origins, so it's got to be all over here now. There's absolutely no containment. I ride the bus every day. Pretty much boned, as is the rest of the US eventually.

(This has been my fatalistic tag-in to the thread so it appears in my activity finally )

farley3k wrote:
WizKid wrote:

So my travel group has officially canceled the April trip to Italy.
So when do we start calling this a pandemic? Seems to me that it's there already.

And when do we stop canceling travel? I mean if it is everywhere then traveling or not traveling to places won't really do anything, correct?

I guess places with no cases could prevent all travel to and from the location but is it really possible for say Iowa (with no confirmed cases as of now) to stop all travel in and out of the state?

Chris Hayes had a good Twitter thread on this. The key is to think about an epidemic from more points of view than just if you get sick. You getting sick has more of an impact than just you getting sick.

I've seen a lot of comparisons of COVID-19 to the flu and I think it's worth talking through why COVID-19 poses a larger systemic risk even though it will almost certainly kill far far fewer people this year than the flu.

There are a few things that seem clear from the early data we have on COVID-19
1) it is more transmissible than the flu
2) it has a higher fatality rate
3) the fatality rate goes up *staggeringly fast* for older patients and the immuno-compromised.
4) many of folks in those populations are going to require hospitalization, intensive medical care and ventilators in order to recover.

So those are the individual risks to patients, but the best way to think about the *systemic risk* of COVID-19 is to consider that there is essentially a fixed supply of medical care available at any one time in any one place: a certain number of doctors, nurses and hospital beds

The season flu unfolds over time in a fairly predictable manner, and increases in vaccination rates, means that the current system can handle the flow of those patients with high risk as they come through.

But we've seen in places like Wuhan, and Iran and Northern Italy to a certain extent, is that if the disease transmits quickly enough in one place, it produces a need for intensive medical care **that outstrips the supply**. That's the full-blown crisis everyone wants to avoid.

One way to avoid that is through fairly dramatic mitigation efforts like we've seen in Japan: canceling school for a month, or massively restricting travel/public events.

All of that is undertaken with an eye not to snuff out the virus, but to slow its transmission so that the hospital/healthcare system can manage the flow of patients. But in order to avoid a kind of "run on the hospitals" you absolutely need to know the scale of the problem.

And here in the US we simply do not know the true scale because we are testing nowhere at the level we need to be.

I'm pretty sure the numbers are low now only from the lack of testing. China tested over 65k as of last week. The US hadn't tested 500 people yet. Then consider the cost is in thousands in the US and free in other country or less than $20.

Given his first three points, why does he think far far fewer people will die from covid-19 than the flu this year?

This is not the correct thread for these musings.

Now the Primary thread has infected the Coronavirus thread!

Stengah wrote:

Now the Primary thread has infected the Coronavirus thread!

There’s no containment.

Burn the thread with fire.

Stengah wrote:

Given his first three points, why does he think far far fewer people will die from covid-19 than the flu this year?

My guess is that it has to do with how long the virus has been around. From a John Hopkins article comparting COVID-19 to the flu:

Infections
COVID-19: Approximately 90,279 cases worldwide; 100 cases in the U.S. as of Mar. 2, 2020.
Flu: Estimated 1 billion cases worldwide; 9.3 million to 45 million cases in the U.S. per year.
-
Deaths
COVID-19: Approximately 3,085 deaths reported worldwide; 6 deaths in the U.S., as of Mar. 2, 2020.
Flu: 291,000 to 646,000 deaths worldwide; 12,000 to 61,000 deaths in the U.S. per year.

Coronavirus Diaries: I Had the Coronavirus. This Was the Worst Part.

On Feb. 14, the first flu symptoms came. I remember it pretty well because it was Valentine’s Day, and now for fun I say that I got a “crown” from my valentine [in Italian, corona means crown]. I felt weak, I had a cough, and I was particularly tired. On Feb. 16, the symptoms got worse. I took my temperature, and it was 101.3 Fahrenheit. I made an appointment with the doctor—I wanted to know what was going on. I went to his clinic, and after the visit he gave me the usual prescription for the flu. His only advice: “Stay home.” The first outbreak of COVID-19 had not yet exploded. Doctors were on alert, but nothing compared to now.
On Feb. 21, my 59th birthday, I had chills, and, instead of getting better, the cough only got worse. It was a kind of cough that I didn’t like. I’ve had pneumonia three times in the past, and I could tell from the sound that it wasn’t good. That was the same day the newspapers reported patient No. 1 was hospitalized, in Codogno, near Lodi. It was the beginning of the infection—or, better, the beginning of the chaos. I started to worry. I tried to call the two emergency numbers dedicated to COVID-19. I called and called back, but it was always busy, the lines were blocked, stormed by panicked people. I managed to connect with them a day and a half later. They told me they would call me back from the ministry of health, but they never did.

I called Sacco, Milan’s hospital specialized in infectious diseases, but they were full and had no more rooms for isolation. They told me to go to the hospital in Treviglio, smaller and closer to my home. I live alone, my son is far away, and I didn’t know whom to ask for help. [The phone number] 112, our 911, was not responding. I felt really sick at this point, and I decided to go to the emergency room by car. There they scolded me, I shouldn’t have gone, but I didn’t know what to do. I knew it was banned, but I had no other choice.

I told them about my symptoms, and I also told them I had contact with people from Asia (even though in hindsight I realize I could have gotten it anywhere). A lightbulb went on over their heads, and I was hospitalized. They took some X-rays, and they confirmed that I had pneumonia. There were no rooms in isolation, though, so they put me on a stretcher in an unused office that lacked even a bathroom. Every two hours they would come to check my vitals. They gave me the swab, and the results came back a day later: positive for COVID-19.

When they told me about it, I wasn’t afraid for myself. I had figured I had it, and I was actually doing better—it was like having a bad flu. I was afraid for everyone else. I thought back to whom I had seen, whom I had come in contact with, and I hoped with all of myself that no one had contracted the virus. I had to call my friends, family, and co-workers and explain the whole story.

They transferred me to the infectious diseases department at a bigger hospital in Bergamo. There, they were more prepared to handle this emergency. I was in isolation; no one could visit me. Since there is no cure, they could only give me Tylenol. They took another X-ray and saw that my condition had improved. They let me out five days ago and put me in what is called “voluntary isolation”: For two weeks I must stay at home, I can’t come in contact with anyone—that’s why my groceries will have to be delivered and left at the door. I’m better, much better. I still have a little cough, but I’m healed. I speak with my son and my sister via Skype. I’m very bored, but that’s how it goes for now.

The thing that hurt me most about this whole ordeal was the people from my city, who treated me as if I had the plague. I live in Truccazzano, a town of 5,800 inhabitants, 15 kilometers east of Milan. They accused me of going to the doctor and risking infecting everyone, but who could have imagined such a thing three weeks ago? They made up a lot of lies, even that men in hazmat suits came to my house to sanitize it. It’s crazy. I needed their support—instead I was humiliated.

More than the virus, it’s the ignorance that frightens me. I feel sad about the gossip. I’m sad seeing people empty food from supermarkets. Not because I don’t understand panic—I understand it very well—but because nobody thinks of the others. If you take everything, it may be that the one after you, who may need it more, would find nothing. It’s a complicated time; we need rationality. Not for us, but for the most vulnerable, the first victims of COVID-19

Jayhawker wrote:
Stengah wrote:

Given his first three points, why does he think far far fewer people will die from covid-19 than the flu this year?

My guess is that it has to do with how long the virus has been around. From a John Hopkins article comparting COVID-19 to the flu:

Infections
COVID-19: Approximately 90,279 cases worldwide; 100 cases in the U.S. as of Mar. 2, 2020.
Flu: Estimated 1 billion cases worldwide; 9.3 million to 45 million cases in the U.S. per year.
-
Deaths
COVID-19: Approximately 3,085 deaths reported worldwide; 6 deaths in the U.S., as of Mar. 2, 2020.
Flu: 291,000 to 646,000 deaths worldwide; 12,000 to 61,000 deaths in the U.S. per year.

I dunno, I think by the end of the year Covid-19 will have caught up.

Jayhawker wrote:
Stengah wrote:

Given his first three points, why does he think far far fewer people will die from covid-19 than the flu this year?

My guess is that it has to do with how long the virus has been around. From a John Hopkins article comparting COVID-19 to the flu:

Infections
COVID-19: Approximately 90,279 cases worldwide; 100 cases in the U.S. as of Mar. 2, 2020.
Flu: Estimated 1 billion cases worldwide; 9.3 million to 45 million cases in the U.S. per year.
-
Deaths
COVID-19: Approximately 3,085 deaths reported worldwide; 6 deaths in the U.S., as of Mar. 2, 2020.
Flu: 291,000 to 646,000 deaths worldwide; 12,000 to 61,000 deaths in the U.S. per year.

How can anyone cite statistics for the US when we don't have testing deployed? Those US numbers are completely brown.

Trump is really not giving up on the "two months" notion he has lodged in his head. This really is Sharpiegate all over again.

Stengah wrote:

Given his first three points, why does he think far far fewer people will die from covid-19 than the flu this year?

I assume because in the US 32 million people have already had the flu this season and at least 18,000 people have died from it. Worldwide, it causes 290,000 to 650,000 deaths each year.

COVID-19 is currently at 6 dead in the US and an unknown number of people infected. Globally, there are only 92,312 confirmed cases and 3131 deaths, so it's currently a tiny fraction of the spread of influenza.

The US probably has thousands of people infected with COVID-19 at this point, but it's still a drop in the bucket in comparison.

There's too many unknowns to be able to say for sure what will happen, of course. Will warm weather dampen it? Will it return with a vengeance next flu season?

The WHO has a page about current myths being spread about the coronavirus.

Gremlin wrote:

COVID-19 is currently at 6 dead in the US

I don't trust that number. Again, how do we know without the widespread availability of testing? Not only that, but the current political climate is not conducive to factual statistics.

BadKen wrote:
Gremlin wrote:

COVID-19 is currently at 6 dead in the US

I don't trust that number. Again, how do we know without the widespread availability of testing? Not only that, but the current political climate is not conducive to factual statistics.

Which is fair, but even if 60 people have died from it in the US that's still 0.003% of the influenza deaths that have already happened.

COVID-19 is bad. By all accounts even if you survive a severe case it's a nasty experience. I'm probably one of the more vulnerable people. And the long incubation period means that it's going to spread pretty far. But we're not at red alert time...yet.

Wash your hands.

I'll readily admit I rolled my eyes at the Coronavirus hype for quite a while, largely because I expected there would be an organized, well-planned process for containment and testing. I forgot the nature of the idiocy of this country these days; I was wrong.

So, the kids are supposed to go on the big Spring Break trip to France in a few weeks; tool around southern France, stay with a family for a few days, big deal for them. While they were doing that, the wife and I were going to take a trip to London; our 20th anniversary was right before Thanksgiving (pro tip; this is a really inconvenient time to get married down the road), so we were finally taking some time together while the kids were off doing their thing.

We're not going to London, and the expectation is the Spring Break trip will be canceled; it seems pretty logical the virus will continue to spread, and, at some level, somebody in the school district is going to sit down and realize that, if one of these kids comes down with it, they're responsible, and nobody wants that. I'm not vaguely worried from a health perspective at this point, as we're all reasonably young and/or healthy comparably speaking, but exposure means quarantine, and the wife and I just couldn't take two weeks out of our life to be quarantined in London while waiting for the infection to show up or not.

Sigh.

At the opposite end of the United State's head-in-the-sand approach is Singapore and Hong Kong. Singapore's government released enough public data that people have built a dashboard showing the known transmission network graph. Which is somewhat alarming from a privacy standpoint.

Gremlin wrote:
BadKen wrote:
Gremlin wrote:

COVID-19 is currently at 6 dead in the US

I don't trust that number. Again, how do we know without the widespread availability of testing? Not only that, but the current political climate is not conducive to factual statistics.

Which is fair, but even if 60 people have died from it in the US that's still 0.003% of the influenza deaths that have already happened.

COVID-19 is bad. By all accounts even if you survive a severe case it's a nasty experience. I'm probably one of the more vulnerable people. And the long incubation period means that it's going to spread pretty far. But we're not at red alert time...yet.

Wash your hands.

The thing about disease response is that you want to call a red alert and put containment and treatment positions in place well before we hoi-polloi start thinking there should be a red alert. That this hasn't happened is a damning indictment of Trump and Pence and their CDC.

Tanglebones wrote:
Gremlin wrote:
BadKen wrote:
Gremlin wrote:

COVID-19 is currently at 6 dead in the US

I don't trust that number. Again, how do we know without the widespread availability of testing? Not only that, but the current political climate is not conducive to factual statistics.

Which is fair, but even if 60 people have died from it in the US that's still 0.003% of the influenza deaths that have already happened.

COVID-19 is bad. By all accounts even if you survive a severe case it's a nasty experience. I'm probably one of the more vulnerable people. And the long incubation period means that it's going to spread pretty far. But we're not at red alert time...yet.

Wash your hands.

The thing about disease response is that you want to call a red alert and put containment and treatment positions in place well before we hoi-polloi start thinking there should be a red alert. That this hasn't happened is a damning indictment of Trump and Pence and their CDC.

We have toddlers in charge. This is one of the worst-case scenarios everyone has feared. It requires pure leadership, built on a foundation of trust. Trump's first reaction was to violate that trust, because he feared the truth would hurt his election chances. It's the same thing over and over.

I mean, if this was a TV Network movie in the 80's, this would be too predictable of a plot. Politician games systems and gets idiots to rally around him. True disaster requiring leadership occurs, and his failure to respond causes everyone to turn on him.

Of course, the difference here is that the idiots won't turn on him, even as they are dying. We are in the dumbest timeline.