Coronavirus: The Hammer and the Dance
When all of this is over, this man should earn a Nobel Prize for his writing.
"Can" is also an important word. If treated, mortality does seem fairly low, and I wouldn't be surprised if it approaches that of flu when all the numbers are in. If the healthcare system is overwhelmed, however, there can be little doubt now that it becomes a very dangerous virus for some. So flattening the curve is the key, but we must also be careful how that is done. The vulnerable and people in healthcare must be protected, and at the same time business must continue with the least disruption possible.
Exactly, and I think that is one of the most important messages. The virus does not have some intrinsic transmission coefficient or mortality rate. Both depend on how we respond to it. Its potential to cause widespread death and suffering is extremely high if everyone did nothing. But humans are intelligent. Many are changing their behaviors rather than doing nothing, and that helps mitigate the risk.
This is an extremely serious situation here, and thats why whole states are being shut down. We're going to be out of hospital beds and ventilators in 2 weeks. Also, as researchers have shown, just because the majority of people dont die, doesn't mean it wont cause serious damage. Research has shown that even younger patients have gotten lung damage from this virus, akin to years of heavy smoking. I've also seen research that shows that it's causing CNS (Central Nervous System) damage. This is far far worse than the flu and just looking at mortality numbers isn't enough."Can" is also an important word. If treated, mortality does seem fairly low, and I wouldn't be surprised if it approaches that of flu when all the numbers are in. If the healthcare system is overwhelmed, however, there can be little doubt now that it becomes a very dangerous virus for some. So flattening the curve is the key, but we must also be careful how that is done. The vulnerable and people in healthcare must be protected, and at the same time business must continue with the least disruption possible.
The economy doesn't matter at this point. The actions taken might seem too aggressive but that's precisely what makes them the right actions- we are behind the curve right now (talking about curves) because the amount of people we think are sick is actually an underestimation. That's why you need to be so aggressive right now.Exactly, and I think that is one of the most important messages. The virus does not have some intrinsic transmission coefficient or mortality rate. Both depend on how we respond to it. Its potential to cause widespread death and suffering is extremely high if everyone did nothing. But humans are intelligent. Many are changing their behaviors rather than doing nothing, and that helps mitigate the risk.
How much action is too much? Previously we've been taught to flatten the curve (reducing R to something closer to but still greater than 1, so the virus still spreads but not so quickly), and I too thought it was the most reasonable thing to do. It is intuitive that going so far as reversing the curve would only cause unnecessarily greater economic damage.
But after reading The Hammer and the Dance article, and thinking about it... I found the arguments for a shorter term but more aggressive solution very persuasive. Even if the author is not an expert in epidemiology or economics, I agree with him. I think flattening the curve was the right starting point, as it was easier to enact and have the public adjust while also putting us in the right direction of slowing the virus down. Then the idea of the hammer is "let's act further now, and go through a rough few weeks instead of a rough few months, which will then make the following year much easier." In fact the WHO is also now recommending suppression rather than just mitigation. If enacted carefully, it appears it can reduce the cost in both lives and economies, limit the opportunities for the virus to evolve new strains, and buy us more time and capacity to better manage the virus in the long term until vaccines are ready.
People should get the vaccine for pneumonia...I saw that recommendation also. Also saw some emerging researching showing how the virus impacts the CNS. 40% of the people hospitalized are under 50 and 70% of the fatalities in Italy occurred in males.It also has a tendency to directly go for the lungs and result in pneumonia, fibrosis (scarring), and permanently reduced lung capacity. For some, recovery does not necessarily mean back to 100%, and that is also not always limited to the elderly or cases with the most severe symptoms. I've seen some sad medical reports of healthy people in their 20s and 30s having no prior symptoms suddenly collapse, CT scans then discovering the extent of the damage done. There's also the problem that the immune system itself can be a killer when the infection is in the lungs (cytokine storms). Modern medicine can treat that, but not if hospitals are overwhelmed.
This can be a very nasty virus.
It's 10x more deadly than the flu and spreads twice as fast. But mortality isn't the whole story because it can cause permanent lung and CNS damage even among those who recover.“It had only killed 41 people” isn't a good metric. A virus that’s infected, say, 500,000 people and killed 41 is quite a different thing from a virus that’s infected 42 people and killed 41.
The mortality rate of this virus is 41 in 4,000 cases, or about 1%. Doesn’t sound like a lot, right?
By way of comparison, the mortality rate of influenza A is 0.1%, hepatitis A is 0.3%, anthrax is 0.6%, smallpox is 3.0%, and Lassa fever is 1.1%.
So we’re talking about a virus with comparable mortality to smallpox and Lassa fever, that’s easily transmitted (it has an R0 of somewhere between 1.4 and 2.5, meaning each infected person can be expected to transmit it to 2–4 others). By way of comparison, the R0 of influenza is 1.4 to 1.6, and Ebola is 1.5 to 2.0.
It’s as lethal as smallpox and spreads as fast as or faster than Ebola.
Remember that there is a percentage of the population that is alive thanks to a well economically developed society, and we can't allow that to change. We need to be pragmatic. We want to avoid triage in healthcare, and trade that for temporary triage in the economy but we do triage. Food and goods still need to be distributed and that part of the economy can't stop. Infrastructure needs to be maintained. For the most part things need to go on, but in a more "undercover" way.
It does expose the dangers of privatizing healthcare though. The two things I've always stated should not be privatized even in a capitalist nation are healthcare and education. You can layer private healthcare over public healthcare for elective procedures, but everyone should have access to life saving healthcare (income should not determine longevity.) Companies are price gouging NY for hospital beds, masks and ventilation equipment. They are charging NY $4 per mask when it normally costs only 0.70! As far as education is concerned, not having access to free college exacerbates income inequality. We have both these things now in NY (and a longer life expectancy than other parts of the nation as a result.)Remember that there is a percentage of the population that is alive thanks to a well economically developed society, and we can't allow that to change. We need to be pragmatic. We want to avoid triage in healthcare, and trade that for temporary triage in the economy but we do triage. Food and goods still need to be distributed and that part of the economy can't stop. Infrastructure needs to be maintained. For the most part things need to go on, but in a more "undercover" way.
I've heard this too Wat. Also the reason that NY has by far the most infected is that NY has done the most testing. 60,000 tested and 15,000 found infected in the state as a whole with 10,000 in NYC and 100 dead in the cityAlarming (but not yet robustly verified) news. It appears that the strain of the virus spreading through the US might be more dangerous in younger age groups:
I'm hoping that this could be due to biases in terms of people who have the most travel and contact with others, and that more elderly may have already socially distanced themselves in the US. But we'll see how the expert review goes.
I agree with this however America's really bad processed diet is going to play a big part in what happens. MSNBC had a health special last night talking about how billions of our tax dollars go towards corn farmers who are contributing towards America's obesity and diabetes epidemic by producing high fructose corn syrup. I stopped eating processed food years ago, but I have relatives who have bad immune systems and/or diabetes and/or high blood pressure because of it- I worry about them.Remember that there is a percentage of the population that is alive thanks to a well economically developed society, and we can't allow that to change. We need to be pragmatic. We want to avoid triage in healthcare, and trade that for temporary triage in the economy but we do triage. Food and goods still need to be distributed and that part of the economy can't stop. Infrastructure needs to be maintained. For the most part things need to go on, but in a more "undercover" way.