Lunchtime Pandemic Reading, 18-Mar-2020
Lunchtime COVID19/SARSCoV2 (coronavirus) reading.
Standard disclaimer: this is a roundup of informative pieces I've read that interest me on the severity of the crisis and preparations for it. I am not a qualified medical expert in ANY sense; at best I am reasonably well-read laiety. ALWAYS prioritize advice from qualified healthcare experts over some person on Facebook.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.
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The economic impact is just beginning. Via Politico: "Employers are slashing jobs at a furious pace across the nation due to mass shutdowns over the coronavirus, slamming state unemployment offices with a crush of filers facing sudden crises. In New Jersey, 15,000 people applied for unemployment benefits on Monday, a twelvefold increase over normal levels. In Connecticut, nearly 8,000 applications arrived over the weekend, an eightfold increase over the norm. Rhode Island officials reported Tuesday a five-day rise in claims due to the coronavirus from 10 on March 11 to 6,282 on March 16. According to an NPR/Marist poll conducted Thursday and Friday, 18 percent of households already reported someone being laid off or having hours reduced because of the coronavirus outbreak, with women hit harder (21 percent) than men (16 percent), and people who earn less than $50,000 hit harder (25 percent) than those earning $50,000 or more (14 percent)."
Source: https://www.politico.com/news/2020/03/17/coronavirus-layoffs-america-unemployment-134819
http://maristpoll.marist.edu/wp-content/uploads/2020/03/NPR_PBS-NewsHour_Marist-Poll_USA-NOS-and-Tables_2003151338.pdf#page=3
Treasury Secretary Steven Mnuchin warned Republican senators that US unemployment could hit 20% without stimulus.
Source: https://www.cnbc.com/2020/03/18/mnuchin-warns-senators-of-20percent-us-unemployment-without-coronavirus-rescue-source-says.html
That's likely U-3, the official unemployment rate. Bear in mind that the alternative measure many of us economics nerds follow is U-6, which is the total amount of underutilized labor (out of workforce, part time instead of full time, etc.), and is usually double what U-3 is - meaning up to 40% of the population may be underutilized.
Two things will make the pandemic a serious problem: healthcare system overload, and economic system failure. The former we address with social distancing, but the latter is caused by social distancing. In the short term, we are trading livelihoods for lives, but as documented in the Imperial College of London paper yesterday, we may need to be doing it for up to 18 months, or until a vaccine is deployed broadly, whichever comes first.
Source: https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf
The economic downturn is already here. If you haven't secured a business line of credit for your company, now is the time to do so before credit markets over-tighten. For both people and businesses, trim your expenses as best as you can, and look for additional sources of income, especially digital. If you run a business, do what you can to secure longer-term contracts and boost your sales activities before the impact causes everyone to turtle. If you market a business, acquire audience as quickly as you can while being fiscally responsible.
Finally, regardless of your political affiliation, contact your elected representatives and urge them instead of bailouts for Wall Street and big companies, bail out Main Street with direct stimulus to citizens so people can make rent and eat.
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NIH validates the SARS-CoV-2 on surfaces pre-print study. "The virus that causes coronavirus disease 2019 (COVID-19) is stable for several hours to days in aerosols and on surfaces, according to a new study from National Institutes of Health, CDC, UCLA and Princeton University scientists in The New England Journal of Medicine. The scientists found that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detectable in aerosols for up to three hours, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel. The results provide key information about the stability of SARS-CoV-2, which causes COVID-19 disease, and suggests that people may acquire the virus through the air and after touching contaminated objects. The study information was widely shared during the past two weeks after the researchers placed the contents on a preprint server to quickly share their data with colleagues."
Source: https://www.nih.gov/news-events/news-releases/new-coronavirus-stable-hours-surfaces
Wash those hands, wash surfaces that may be contaminated. Remember that any alcohol solution of 61% strength or better will do the job, as will a hydrogen peroxide solution of 1% or better.
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The Lancet reiterates high mortality rates for severe cases of COVID19. "We tend to hear more about the most severe cases in the early stages of a new disease, as these are the ones first brought to the public's attention and are associated with deaths. However, it is important to bear in mind that the current best estimate is that about 81% of people with COVID-19 have mild disease and never require hospitalisation. In-hospital mortality was high (28%), much higher than in other reports that had incomplete follow-up data and was very high among the 32 patients requiring invasive mechanical ventilation, of whom 31 (97%) died. This might reflect a higher proportion of patients admitted with severe disease in the early stages of the outbreak. In another report from Wuhan, mortality was 62% among critically ill patients with COVID-19 and 81% among those requiring mechanical ventilation. While the world awaits further information from other locations, including from outside China, the current message is that mortality is high among the minority of people with COVID-19 who get severe disease."
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30633-4/fulltext
This study is the essence of why social distancing is vital. COVID19 appears to be very binary - if it's mild, it's mild. If it's bad, it's bad. Not a ton of middle ground. Without social distancing, we will not be able to provide care to those who need it, and because it's bad when it's bad, those hit hard by it will die.
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Via STAT News, more perspective on why social distancing and mitigation methods will be "the new normal" until a vaccine is available: "To stop an epidemic like that permanently, nearly half the population must be immune. While the exact number of people infected in each population is unknown, current estimates are that for every symptomatic case there is about one asymptomatic or very mild case. In populations with good ascertainment of symptomatic cases, the number of infections is perhaps double what is observed (in the U.S., where testing is limited, true cases are a much higher multiple of reported cases). In well-tested countries, we can be nearly certain that no population has reached anywhere near half of its people infected. That means that when each country lets up on control measures, transmission will increase and the number of cases will grow again."
Source: https://www.statnews.com/2020/03/18/we-know-enough-now-to-act-decisively-against-covid-19/
Keep that figure in mind. Half the population needs immunity before an epidemic can be turned. We are far from that number now, which means that we are still a dry forest waiting for the sparks to light fires. Keep your distance.
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What happens when citizens ignore government warnings? This from Iran, via Al-Jazeera: "Dr Afruz Eslami said if people begin to cooperate now, Iran will see 120,000 infections and 12,000 deaths before the outbreak is over. If they offer medium cooperation, there will be 300,000 cases and 110,000 deaths, she added. But if people fail to follow any guidance, it could collapse Iran's already-strained medical system, Eslami said. If the "medical facilities are not sufficient, there will be four million cases, and 3.5 million people will die," she said."
Source: https://www.aljazeera.com/news/2020/03/coronavirus-pandemic-kill-millions-iran-200317135500255.html
The situation in Iran is absolutely tragic in the truest sense of the word. Hubris caused leaders and citizens to ignore the words of scientists, and now the country is paying the price dearly.
Listen to public health authorities. Follow shelter-in-place orders. Whether or not you're personally at risk, someone near you is.
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The WHO has open, free courses for governments and healthcare professionals for dealing with COVID-19, such as operational planning guidelines, infection prevention and control, clinical care, and more. If you live in a place without world-class training and talent, forward this resource onto your local healthcare institutions.
Source: https://openwho.org/channels/covid-19
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A reminder of the simple daily habits we should all be taking.
1. Wash/sanitize your hands often. Have a bottle of hand sanitizer on your belt, bag, purse, whatever and use it when out and about in public every 15 minutes whether you need it or not.
2. Wash/sanitize before touching any part of your face for any reason.
3. Avoid large crowds. Period. Any group over 25. Stay home as much as practical.
4. Avoid in-person interaction with anyone at risk, without exception. Video call instead of visit.