Tomas Pueyo: Coronavirus: Why You Must Act Now https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca: 'For the Bay Area, they were testing everybody who had traveled or was in contact with a traveler.... I looked at that ratio for South Korea... 86%.... With that number, you can calculate the number of true cases. If the Bay Area has 86 cases today, it is likely that the true number is ~600.... France claims 1,400 cases today and 30 deaths. Using the two methods above, you can have a range of cases: between 24,000 and 140,000.... Spain has very similar numbers as France.... So the coronavirus is already here. It’s hidden, and it’s growing exponentially.... The World Health Organization (WHO) quotes 3.4% as the fatality rate.... This number is out of context.... It really depends on the country and the moment: between 0.6% in South Korea and 4.4% in Iran. So what is it? We can use a trick to figure it out.... Deaths/Total Cases and Death/Closed Cases. The first one is likely to be an underestimate.... The second is an overestimate, because it’s likely that deaths are closed quicker than recoveries.... Hubei’s fatality rate will probably converge towards 4.8%. Meanwhile, for the rest of China, it will likely converge to ~0.9%.... Iran’s and Italy’s Deaths / Total Cases are both converging towards the 3%-4% range. My guess is their numbers will end up around that figure too.... The last relevant example is the Diamond Princess cruise: with 706 cases, 6 deaths and 100 recoveries, the fatality rate will be between 1% and 6.5%. Note that the age distribution in each country will also have an impact: Since mortality is much higher for older people, countries with an aging population like Japan will be harder hit...

...Countries that are overwhelmed will have a fatality rate between ~3%-5%. Put in another way: Countries that act fast can reduce the number of deaths by ten.... Around 20% of cases require hospitalization, 5% of cases require the Intensive Care Unit (ICU), and around 2.5% require very intensive help, with items such as ventilators or ECMO (extra-corporeal oxygenation).... A few years ago, the US had a total of 250 ECMO machines.... That is without taking into account issues such as masks. A country like the US has only 1% of the masks it needs.... Countries like Japan, South Korea, Hong Kong or Singapore, as well as Chinese regions outside of Hubei, have been prepared and given the care that patients need. But the rest of Western countries are rather going in the direction of Hubei and Italy....

What Should You Do? Flatten the Curve.... The more we postpone cases, the better the healthcare system can function, the lower the mortality rate.... Social Distancing: There is one very simple thing that we can do and that works: social distancing. If you go back to the Wuhan graph, you will remember that as soon as there was a lockdown, cases went down. That’s because people didn’t interact with each other, and the virus didn’t spread. The current scientific consensus is that this virus can be spread within 2 meters (6 feet) if somebody coughs.... The worst infection then becomes through surfaces: The virus survives for up to 9 days on different surfaces such as metal, ceramics and plastics. That means things like doorknobs, tables, or elevator buttons can be terrible infection vectors.... Learning from the 1918 Flu Pandemic: You can see how Philadelphia didn’t act quickly, and had a massive peak in death rates. Compare that with St Louis, which did. Then look at Denver, which enacted measures and then loosened them. They had a double peak, with the 2nd one higher than the first....

On average, taking measures 20 days earlier halved the death rate. Italy has finally figured this out.... Hopefully, we will see results in the coming days. However, it will take one to two weeks to see. Remember the Wuhan graph: there was a delay of 12 days between the moment when the lockdown was announced and the moment when official cases (orange) started going down.... Containment is making sure all the cases are identified, controlled, and isolated. It’s what Singapore, Hong Kong, Japan or Taiwan are doing so well.... China.... The lengths at which it went to contain the virus are mind-boggling. For example, they had up to 1,800 teams of 5 people each tracking every infected person, everybody they got interacted with, then everybody those people interacted with, and isolating the bunch. That’s how they were able to contain the virus across a billion-people country.

This is not what Western countries have done. And now it’s too late. The recent US announcement that most travel from Europe was banned is a containment measure for a country that has, as of today, 3 times the cases that Hubei had when it shut down, growing exponentially. How can we know if it’s enough? It turns out, we can know by looking at the Wuhan travel ban.... The Wuhan travel ban only delayed the spread in China by 3–5 days.... The US administration’s ban on European travel is good: It has probably bought us a few hours, maybe a day or two. But not more. It is not enough. It’s containment when what’s needed is mitigation....

Mitigation requires heavy social distancing. People need to stop hanging out to drop the transmission rate (R), from the R=~2–3 that the virus follows without measures, to below 1, so that it eventually dies out... cclosing companies, shops, mass transit, schools, enforcing lockdowns… The worse your situation, the worse the social distancing. The earlier you impose heavy measures, the less time you need to keep them, the easier it is to identify brewing cases, and the fewer people get infected.... This is what countries like Iran, France, Spain, Germany, Switzerland or the US need to do. But they’re not doing it.... One approach is to gradually increase measures. Unfortunately, that gives precious time for the virus to spread. If you want to be safe, do it Wuhan style. People might complain now, but they’ll thank you later.... This is an exponential threat. Every day counts. When you’re delaying by a single day a decision, you’re not contributing to a few cases maybe. There are probably hundreds or thousands of cases in your community already. Every day that there isn’t social distancing, these cases grow exponentially...


#noted #2020-03-12

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