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 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 unemployment numbers this morning were unsurprising if you're using real-time data to calibrate against unemployment inquiries. "Americans displaced by the coronavirus crisis filed unemployment claims in record numbers last week, with the Labor Department reporting Thursday a surge to 3.28 million. The number shatters the Great Recession peak of 665,000 in March 2009 and the all-time mark of 695,000 in October 1982. The previous week, which reflected the period before the worst of the coronavirus hit, was 282,000, which was higher than expected at the time."
Source: https://www.cnbc.com/2020/03/26/weekly-jobless-claims.html
If you are considering a job change, now is not the time. If you are in the hiring process, get it in writing as quickly as possible. If you have been laid off, this is just the front of the tidal wave, so make job search - if possible - your full-time job. If you're employed, update your documentation anyway to prepare for further impact.
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Here's the twist on layoffs. It takes time to rehire. How much time? Under normal circumstances, the time to rehire averages about 24 days in the United States, from submitted job application to final offer.
Source: https://resources.workable.com/tutorial/time-to-hire-metrics
The lag in hiring means that when we do take the restrictions down, we will have a gap of about a month when production is seriously impaired because no one can staff up fast enough. That's why networking is so important now if you're laid off or at risk of being laid off. Once restrictions are eased, you want to be at the front of line and top of mind of hiring managers.
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The #1 question people have is, how long is this going to go on for? A study from Oxford University estimates the major wave of infection is approximately 4 months. "Our simulations are in agreement with other studies that the current epidemic wave... in the absence of interventions should have an approximate duration of 2-3 months, with the numbers of deaths lagging behind in time relative to overall infections. Importantly, the results we present here suggest the ongoing epidemics... started at least a month before the first reported death."
Source: https://www.dropbox.com/s/oxmu2rwsnhi9j9c/Draft-COVID-19-Model%20%2813%29.pdf?dl=0
If we use historical data, we really first started to become aware of COVID19 in late February/early March, even though it was likely present before then. Thus, if we consider March to be month 1, we have April, May, and very possibly June under significant restrictions in order for this thing to make its way through the population.
A paper in The Lancet confirms the same; if Wuhan had kept restrictions longer, they would be reducing risk further.
Source: https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30073-6/fulltext
If governments are prudent, the new normal will be measured in months, not weeks.
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What's happening with social distancing? An excellent read in Science Magazine. "Recent data from Hong Kong and Singapore suggest extreme social distancing is hard to keep up, says Gabriel Leung, a modeler at the University of Hong Kong. Both cities are seeing an uptick in cases that he thinks stem at least in part from “response fatigue.” “We were the poster children because we started early. And we went quite heavy,” Leung says. Now, “It's 2 months already, and people are really getting very tired.” He thinks both cities may be on the brink of a “major sustained local outbreak”."
Source: https://www.sciencemag.org/news/2020/03/mathematics-life-and-death-how-disease-models-shape-national-shutdowns-and-other
Response fatigue in cultures like Singapore and Hong Kong, which have strong communal values that supersede individual liberty, is a warning sign for people in Western democracies, particularly America, that social distancing is likely to only slightly slow down the pandemic. In terms of outcomes, we should prepare for the worst case scenarios in America - Americans are known for individualistic streaks, disobedience to central authorities, and a culture of personal liberty, all of which run counter to what's necessary to maintain social distancing for months, like the pastor in Louisiana who defied shelter-in-place orders and convened over 1,000 attendees with 27 buses to church gathering.
Source: https://www.nbcnews.com/news/us-news/louisiana-pastor-defies-coronavirus-order-draws-over-1-000-people-n1168501
The best we can do is keep hammering the message to stay home.
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The Atlantic has a thoughtful piece on how the pandemic will end. "Aspects of America’s identity may need rethinking after COVID-19. Many of the country’s values have seemed to work against it during the pandemic. Its individualism, exceptionalism, and tendency to equate doing whatever you want with an act of resistance meant that when it came time to save lives and stay indoors, some people flocked to bars and clubs. Having internalized years of anti-terrorism messaging following 9/11, Americans resolved to not live in fear. But SARS-CoV-2 has no interest in their terror, only their cells. Years of isolationist rhetoric had consequences too. Citizens who saw China as a distant, different place, where bats are edible and authoritarianism is acceptable, failed to consider that they would be next or that they wouldn’t be ready. (China’s response to this crisis had its own problems, but that’s for another time.) “People believed the rhetoric that containment would work,” says Wendy Parmet, who studies law and public health at Northeastern University. “We keep them out, and we’ll be okay. When you have a body politic that buys into these ideas of isolationism and ethnonationalism, you’re especially vulnerable when a pandemic hits.”"
Source: https://www.theatlantic.com/health/archive/2020/03/how-will-coronavirus-end/608719/
Who we are after this depends on how we are during this. The whole piece is an excellent, worthwhile read.
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Economist James Galbraith notes what the governments around the world must do next. "Maintaining vital civilian supplies, especially food, medicines and fuel, is the second big need. This is a two-part problem. The first part is to make sure that there are goods in the stores and pharmacies, and that gas stations and drive-through restaurants can remain open. The second part is to ensure that those at home have the means to pay, and that local distribution remains orderly. A shortage economy may arrive anyway, with long lines to get into stores, empty shelves inside, and black markets all around. This would be a health disaster. Lines are already a byproduct of mandatory social distancing rules. Some shortages have been reported – sanitizer and toilet paper, notably. The solution is to limit sales per customer, and if necessary to control prices and ration basics like rice, potatoes, flour, pasta, eggs, milk and cooking oil and staple meats. Rationing and price controls can be run by local authorities under a general hold-the-line order, as was done in World War II from April, 1943 onward. Put up signs with the allowed prices. Civilians will enforce them."
Source: https://www.ineteconomics.org/perspectives/blog/what-the-government-needs-to-do-next
Supply chains are still extremely fragile, and if we lose complete control of the pandemic, many of the consequences detailed by Galbraith may come to pass.
What should you do about it? Continue to maintain, responsibly, your shelter-in-place supplies. Venture out as necessary to replenish what you use and augment it. If you're rationed, as many grocery stores are now doing in the US, to 2 of an item, get 2 of the item for key staples. Where I live, our local grocery stores still have shortages depending on the suppliers. If we end up with a massive system shock - meaning tens of millions of cases and millions of fatalities, supply chains may break.
Keep stocked up.
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A paper in the Health in Humanitarian Crises Centre identifies low income and displaced populations as especially at risk: "In Ebola epidemics, isolating the ill into a contaminated ‘red zone’ is mainly needed to protect the healthy. In COVID-19, this paradigm is upturned: from the perspective of at-risk groups, the red zone is everywhere, unless they can be shielded from transmission and cared for when isolating. Whenever vaccines or improved therapeutics for COVID-19 become available, these must be allocated equitably to low-income and crisis-affected populations. Until then, it is imperative that low-resource countries and humanitarian responses plan and roll out evidence-based, long-term strategies to mitigate their COVID-19 epidemics, starting now."
Source: https://www.lshtm.ac.uk/research/centres/health-humanitarian-crises-centre/news/102976
The idea of creating "green zones" of high-risk populations makes a lot of sense. The world is the red zone right now, and we may need to relocate the highest-risk folks to protect them from the rest of us.
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The Centre for Mathematical Modeling of Infectious Diseases has rolled out a modeling technique for estimating under-reporting of COVID19 cases by using estimated case-fatality rates.
Source: https://cmmid.github.io/topics/covid19/severity/global_cfr_estimates.html
By these estimates, which are time-delayed two weeks, we had detected only 10-20% of COVID cases in the United States. CMMID's web apps update regularly with data, so tune back in from time to time to see how the models have changed.
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A reminder of the simple daily habits we should all be taking.
1. Wash/sanitize your hands often, and 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 appropriate protective equipment if you have it when out of your home in any enclosed airspace (stores, etc.).
3. Stay home. Just stay home.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Donate any PPE you can. https://getusppe.org/give/