Lunchtime Pandemic Reading, 22-April-2020
Lunchtime pandemic reading.
Standard disclaimer: this is a roundup of informative pieces I've read that interest me on the severity of the crisis and how to manage it. I am not a qualified medical expert in ANY sense; at best I am reasonably well-read laity. 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 Lancet outlines risks for increased suicide during the pandemic, along with other hardships: "Loss of employment and financial stressors are well-recognised risk factors for suicide.6 Governments should provide financial safety nets (eg, food, housing, and unemployment supports). Consideration must be given not only to individuals' current situations but also their futures. For example, many young people have had their education interrupted and are anxious about their prospects. Educational institutions must seek alternative ways to deliver curricula and governments need to be prepared to offer them financial support if necessary. Active labour market programmes will also be crucial. The pandemic could adversely affect other known precipitants of suicide. For example, domestic violence and alcohol consumption might increase during lockdown. Public health responses must ensure that those facing interpersonal violence are supported and that safe drinking messages are communicated. Social isolation, entrapment, and loneliness contribute to suicide risk and are likely to increase during the pandemic, particularly for bereaved individuals. Providing community support for those living alone and encouraging families and friends to check in is helpful. Easily accessible help for bereaved individuals is crucial. Access to means is a major risk factor for suicide. In the current environment, certain lethal means (eg, firearms, pesticides, and analgesics) might be more readily available, stockpiled in homes. Retailers selling such products should be especially vigilant when dealing with distressed individuals. Governments and non-governmental organisations should consider temporary sales restrictions and deliver carefully framed messages about reducing access to commonly used and highly lethal suicide means."
Source: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30171-1/fulltext
Be checking in with the people you know and care about, on a regular and frequent basis. Listen carefully for signs that they're not okay despite them saying otherwise. Ensure they make use of services, especially telehealth services, so that they don't feel they have no place to turn.
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Changing case definitions may have led to underdiagnosis of COVID-19 in China, according to the Lancet. "From Jan 15 to March 3, 2020, seven versions of the case definition for COVID-19 were issued by the National Health Commission in China. We estimated that when the case definitions were changed, the proportion of infections being detected as cases increased by 7·1 times (95% credible interval [CrI] 4·8–10·9) from version 1 to 2, 2·8 times (1·9–4·2) from version 2 to 4, and 4·2 times (2·6–7·3) from version 4 to 5. If the fifth version of the case definition had been applied throughout the outbreak with sufficient testing capacity, we estimated that by Feb 20, 2020, there would have been 232 000 (95% CrI 161 000–359 000) confirmed cases in China as opposed to the 55 508 confirmed cases reported."
Source: https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30089-X/fulltext
Many of the early models of the disease were based on China's data. Now that the pandemic is widespread, it's time for all modelers to update their models with the latest, global data and discontinue China-specific models.
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The risk of misinformation will grow. "We anticipate that critiques will only become louder as citizens increasingly question the overall benefits, for example, of physical distancing. The risk of misinformation spreading will probably increase, as these tensions between public health authorities and the public increase. Social media provides an important platform to ensure that citizens have a voice and promote public trust in the transparency and accountability of policy making.9 As public health practitioners, we must ensure that measures strike an ethically appropriate balance between protecting speech and preserving and promoting public health."
Source: https://www.thelancet.com/journals/landig/article/PIIS2589-7500(20)30084-4/fulltext
Protect yourself against misinformation. Vet everything, even when it comes through sources and people you trust. Vet everything, even this newsletter, to ensure that the underlying sources are real and verifiable. One of the reasons I include source URLs for every article is so that you can read it in its entirety and judge for yourself whether my interpretation and commentary is valid or not.
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First steps towards a vaccine published in a pre-print paper by Sinovac Biotech in China, with accompanying data. "A purified inactivated SARS-CoV-2 virus vaccine candidate (PiCoVacc) confers complete protection in non-human primates against SARS-CoV-2 strains circulating worldwide by eliciting potent humoral responses devoid of immunopathology."
Source: https://www.biorxiv.org/content/10.1101/2020.04.17.046375v1.full.pdf
This is excellent news on the long trail towards a vaccine. That a company was able to create an inactivated candidate and see any kind of results in non-human primates is good; had they done the test and seen no impact, we'd be looking at a much, much bigger problem.
To give you a sense of where this is, this is essentially step 1 of the process, to verify that a vaccine is even possible. This is the first 100 feet of the marathon; if you never get past this point, the rest of the marathon doesn't matter - but you know you still have 26.19 miles to go.
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Nobel economist Joseph Stiglitz took the United States to task about its coronavirus economic response. "“The numbers turning to food banks are just enormous and beyond the capacity of them to supply. It is like a third world country,” Stiglitz said. “The public social safety net is not working.” “The inequality in the U.S. is so large. This disease has targeted those with the poorest health. In the advanced world, the U.S. is one of the countries with the poorest health overall and the greatest health inequality.” When asked if the country was heading toward a situation similar to another Great Depression, Stiglitz responded in the affirmative. “Yes, is the answer, in short,” he said.
Source: https://www.theguardian.com/business/2020/apr/22/top-economist-us-coronavirus-response-like-third-world-country-joseph-stiglitz-donald-trump
For planning purposes, assume a defensive financial position for yourself and the people or organizations you care about. Cut costs as much as possible, find revenue wherever you can find it, and aim to build up a war chest if you can of cash. In any economic downturn, cash is king, and cash flow is the throne the king sits on. To the extent you can, get to and stay at positive cash flow as quickly as possible. Defer non-essential purchases, and use the power of the Internet to reduce your own costs as well as find new sources of income.
For the United States specifically, assume that the federal government will do little to nothing to help the average household beyond a few dollars here or there. Most assistance will go towards large corporations. If you're running a business in B2B, focus your sales efforts on those companies that are likely to survive because they have huge cash reserves; publicly-traded companies are required to disclose this in their SEC filings.
Most of all, focus on what doesn't change. People fundamentally need food to eat, water to drink, air to breathe, and places to live. Anything above that is up for grabs in terms of stability and the ability to forecast, but if you can find a way to tie your business to the basics, you have a better chance of making it through.
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A reminder of the simple daily habits we should all be taking.
1. Wash/sanitize your hands every time you are in or out of your home for any reason. Consider also spraying the bottoms of your shoes with a general disinfectant (alcohol/bleach/peroxide) when you return home.
2. Wear gloves and a mask when out of your home.
3. Stay home as much as possible.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Donate any PPE you can. https://getusppe.org/give/
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Common myths debunked. There is no genomic evidence at all that COVID-19 arrived before 2020 in the United States and therefore no hidden herd immunity:
Source:
There is no evidence SARS-CoV-2 was engineered.
Source: https://www.washingtonpost.com/world/2020/01/29/experts-debunk-fringe-theory-linking-chinas-coronavirus-weapons-research/
Source: https://www.nature.com/articles/s41591-020-0820-9