Lunchtime Reading 13-Mar-20
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.
You are welcome to share this.
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What should you worry about when it comes to shortages? Not toilet paper. According to the US Census Department's International Trade in Goods and Services data, the top 5 things we import into America are:
* Pharmaceutical preparations
* Passenger cars, new and used
* Crude oil
* Other parts and accessories of vehicles
* Cell phones and other household goods
Source: https://www.census.gov/…/P…/current_press_release/index.html
These are the goods that will be most heavily impacted; all things pharma are most important. Amazon is still delivering for a lot of OTC medications. If there's stuff you will need for spring allergies, etc. get it now. Don't go crazy, but go get it.
Other stuff like basics should be okay. We're going to have additional panic for the next couple of weeks in America, as testing finally gets ramped up and we discover just how far the pandemic has gotten.
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Dr. Anthony Fauci from NIAID advises that America will need mitigation strategies including up to 8 weeks of social distancing, on Good Morning America. "It's going to be at least several weeks, to up to 8 weeks".
Source:
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A new study published in The Lancet posits the mortality rate of COVID19 is much higher than initially estimated due to the time lag of infection. "We re-estimated mortality rates by dividing the number of deaths on a given day by the number of patients with confirmed COVID-19 infection 14 days before. On this basis, using WHO data on the cumulative number of deaths to March 1, 2020, mortality rates would be 5·6% (95% CI 5·4–5·8) for China and 15·2% (12·5–17·9) outside of China. Global mortality rates over time using a 14-day delay estimate are shown in the figure, with a curve that levels off to a rate of 5·7% (5·5–5·9), converging with the current WHO estimates. Estimates will increase if a longer delay between onset of illness and death is considered. A recent time-delay adjusted estimation indicates that mortality rate of COVID-19 could be as high as 20% in Wuhan, the epicentre of the outbreak.6 These findings show that the current figures might underestimate the potential threat of COVID-19 in symptomatic patients."
Source: https://www.thelancet.com/…/PIIS1473-3099(20)30195…/fulltext
This is deeply concerning and if it were in any publication other than NEJM or the Lancet, I'd disregard it as scaremongering BS.
But it's not. The mathematical model that the researchers used is eminently sensible, shifting the infection and mortality rates to be aligned by time. A mortality rate of 5.7% is substantially higher than what WHO or CDC have been working with, and that's millions of additional casualties.
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The National Guard has been activated in four states to help with pandemic logistics: Florida, New York, Rhode Island and Iowa. Expect more of this.
Source: https://www.stripes.com/…/more-than-150-national-guard-troo…
The best thing we can do is stay home and avoid putting burdens on the system. Start following procedures that worked well in China - having one person in the household going out weekly for errands and such.
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NEJM reminds us that epidemics and pandemics occur in three stages. "Epidemics unfold as social dramas in three acts, according to Rosenberg. The earliest signs are subtle. Whether influenced by a desire for self-reassurance or a need to protect economic interests, citizens ignore clues that something is awry until the acceleration of illness and deaths forces reluctant acknowledgment. Recognition launches the second act, in which people demand and offer explanations, both mechanistic and moral. Explanations, in turn, generate public responses. These can make the third act as dramatic and disruptive as the disease itself. Epidemics eventually resolve, whether succumbing to societal action or having exhausted the supply of susceptible victims. "
Source: https://www.nejm.org/doi/full/10.1056/NEJMp2004361
This is important because it presages when the pandemic will come to a logical conclusion: when we've exhausted the supply of susceptible individuals.
There's a very useful simulation by the New York Times that lets you see the potential timelines and outcomes for COVID19.
Source: https://www.nytimes.com/…/o…/coronavirus-trump-response.html
With this simulator, and interventions beginning now and over the next two weeks, we might be able to constrain COVID19 to 320,000 deaths, as opposed to an unchecked spread of 1 million deaths.
Social distancing. Do it. Encourage everyone you know to do it. Hundreds of thousands of lives are at stake.
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The state of Ohio estimates that 100,000 residents are infected with COVID19.
Source: https://thehill.com/…/487329-ohio-health-official-estimates…
Social distancing has to be a team game, otherwise we don't get the benefits from it.
California has released an executive order allowing the state to commandeer hotels and medical facilities for additional space to treat victims.
Source: https://www.latimes.com/…/california-governor-gavin-newsom-…
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What's coming next are the second and third order effects from the pandemic. Seoul has banned short selling on its stock market.
Source: https://en.yna.co.kr/view/AEN20200313005800320
We know the economic effects will be substantially greater than the pandemic and take longer to recover. In 2008-2009, the trigger event of the Great Recession was a credit collapse that only lasted a short time, but the effects were felt for close to 3 years. The pandemic will certainly cause business and consumption to be seriously impacted for 3-6 months, but according to Johns Hopkins University's Center for Health Security, a pandemic like COVID19 will have repercussions lasting up to a decade.
Be prepared. Consumer spending will be down and only recover once the pandemic is behind us. Lending and credit will tighten. It will look a lot like the Great Recession, only worse. Prepare now for a sustained downturn.
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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 and public gatherings, especially in places where international travelers are concentrated - airports, trains, public transit, etc. Don't dare set foot on a cruise ship or attend a conference. Cancel all non-essential travel.
4. Avoid in-person interaction with anyone at risk. Video call instead of visit.