Thursday, March 12, 2020

Recommended Read: Coronavirus--Why You Must Act Now

This coronavirus thing is enormously important. I found this article to be very impressively researched and reasoned. Personally, I wonder whether our spacing here in the US will help us gain time to get a handle on this. But that's my totally inexpert ... hope. Here's what I wrote to my family this morning--again, non-expert opinion. Challenge the reasoning if you wish:

Here's why Covid 19 is so much more dangerous than the flu. 
The Spanish flu of 1918 eventually petered out because so many people got sick that a natural immunity was eventually developed. That has continued to this day. Every new strain of flu arrives at populations now in which most of the population has developed varying degrees of immunity through exposure to various strains of the flu over a lifetime. In addition, many of them have been vaccinated. As a result, the still large number--but low percentage--who die from the flu are mostly people whose immune systems are compromised in one way or another, who have other vulnerabilities, or have not been vaccinated--or two or even three of the above. Flu is still a killer if it can find unprotected victims. 
For those reasons, the overall average mortality rate for flu is typically .1%.
In stark contrast, Covid 19 enters populations that have no immunity whatsoever--as far as anyone can tell. 
The lowest estimated mortality rate for Covid 19 that I've seen is about 1%. A few estimates are lower, many are higher--often much higher. That means that the mortality rate for Covid 19 is likely 10x higher than what it is for flu these days. In some countries the rate seems much higher--much depends on preparedness. 
Another factor. Nowadays, people with a bad case of the flu can be treated without being admitted to an ICU. Flu doesn't overwhelm our hospitals. Serious cases of Covid 19 require intensive medical intervention. That's a big difference, because we know that the mortality rate for Covid 19 spikes drastically when hospitals are overwhelmed, as in Italy. 
It's also known that Covid 19 is many times more easily transmitted than is flu and the ability of humans to develop an immunity is still in doubt--reinfections have been reported. 
To allow a virus like that--so deadly, so easily transmissible--to enter a population that has no immunity is the height of irresponsibility. If it were allowed to peter out like Spanish flu the death toll would be catastrophic. 
Right now the outbreaks within the US appear to be highly localized. That will change if we're complacent about this. If the rate of increase once becomes exponential, we're in huge trouble.

In the meantime, do yourself a favor and read this article. Think about it. I've pasted in the bare intro. As you can see, it's a 24 minute read:

Coronavirus: Why You Must Act Now

Politicians, Community Leaders and Business Leaders: What Should You Do and When?

Tomas Pueyo

Mar 10 · 24 min read

Updated on 3/11/2020

With everything that’s happening about the Coronavirus, it might be very hard to make a decision of what to do today. Should you wait for more information? Do something today? What?

Here’s what I’m going to cover in this article, with lots of charts, data and models with plenty of sources:

  • How many cases of coronavirus will there be in your area?
  • What will happen when these cases materialize?
  • What should you do?
  • When?

When you’re done reading the article, this is what you’ll take away:

  • The coronavirus is coming to you.
  • It’s coming at an exponential speed: gradually, and then suddenly.
  • It’s a matter of days. Maybe a week or two.
  • When it does, your healthcare system will be overwhelmed.
  • Your fellow citizens will be treated in the hallways.
  • Exhausted healthcare workers will break down. Some will die.
  • They will have to decide which patient gets the oxygen and which one dies.
  • The only way to prevent this is social distancing today. Not tomorrow. Today.
  • That means keeping as many people home as possible, starting now.

As a politician, community leader or business leader, you have the power and the responsibility to prevent this.

You might have fears today: What if I overreact? Will people laugh at me? Will they be angry at me? Will I look stupid? Won’t it be better to wait for others to take steps first? Will I hurt the economy too much?

But in 2–4 weeks, when the entire world is in lockdown, when the few precious days of social distancing you will have enabled will have saved lives, people won’t criticize you anymore: They will thank you for making the right decision.

Ok, let’s do this.


  1. Europe has been hit bad because they have lots of old people. Italy has the oldest population in Europe. China and other Asian countries are the same way. That is why this looks more lethal. 2 years ago the flu killed 80,000 people and the swine flu in 2009-2010 affected 60 million people and hospitalized 300,000. The panic can make it look worse than it real is, due to our irresponsible press. The best weapon we have is to wash our hands and use lysol to keep common areas clean.

    Rob S

    1. I didn't dig deeply but 29% of the US population is 55 or over. That's a lot of people.

      I've also heard that on the cruise ships--a real lab environment, since the air is recirculated-- the infection rate for <20 and >20 is the same. The reason the rate seems lower has to do with living/social environment.

      Beyond best health practices I would hope our less crowded conditions may help isolate cases more easily.

    2. From an ex-pat living in Italy:

      "And finally for those who say that this is just something that happens to old people, starting yesterday the hospitals are reporting that younger and younger patients – 40, 45, 18, are coming in for treatment."

  2. Hi Mark, the link didn't work for me. Looks like it double copied the URL.

    1. Tx, greencork. I have a persistent problem of doubling pasted things when I middle-click. I should check more often.

  3. South Korea found the death rate to be 0.6%. I expect the US to be similar. The young are not getting sick. This is overblown IMHO.

    1. 1. At .6% that rate is still multiple times higher than the usual flue rate--very bad news if this thing is allowed to spread.

      2. South Korea didn't "find" that death rate. Through extraordinary preparedness and aggressive measures they were able to keep the death rate lower. Why would you expect the US rate to be similar to South Korea when the US has none of the preparedness and relatively little of the aggressive approach?

      3. South Korea was also greatly helped because their outbreak was highly localized (a bit like the one nursing home near Seattle that accounts for so many of our deaths) at one church.

      4. The article makes a persuasive case that the mortality rate in most country tends toward 4%.

      5. The BI article you linked is a good article and makes most of the same points that the author of the article I linked made. Including that part of the reason for the low death rate in South Korea has to do with the extraordinary preparedness and super aggressive investigation and testing. BI notes that that is all very different from most countries, except Taiwan and Singapore.

    2. @Mark

      "Why would you expect the US rate to be similar to South Korea when the US has none of the preparedness and relatively little of the aggressive approach?"

      Well, one reason that I might have expected the South Korean death rate to be higher than the US death rate is that male South Koreans apparently have the highest rate of smoking in the OECD! And my understanding is that smokers are a high risk category...

      But my point isn't that I know that smokers are at higher risk of dying or, in fact, that I know anything at all about the subject.

      My point is that this is such a sensible website, supervised by such a sensible person...we should probably all try to avoid pontificating about stuff (like mortality rates) for which virtually no reliable data is available and that we really know very little about!

    3. The issue of the high smoking rate among Oriental men was addressed by Michael Osterholm. Osterholm pointed out that we Occidentals have a far higher rate of obesity and that the side effects of obesity in fact mirror in many respects those of smoking when it comes to respiratory diseases. Osterholm also goes into the disparity of death rates among Chinese men and women (who don't smoke at the same rate). The point is, Osterholm, a true expert, is well aware of the role of smoking in all this, but points out other factors for elevated risk that are very prevalent in the US.

      My point re the role of preparedness stands.

  4. Mark, thanks for this clear-eyed presentation. I’ve been making this case for the last few days and am shocked at the pushback. God help us!

    For the past month and a half I’ve found the daily analysis of Chris Martenson at Peak Prosperity to be among the best. Here is a link to yesterdays update:

  5. Week by week, we are avoiding group gatherings and trips to medical facilties and doctors’ offices. We are hunkering down for a while to see what comes next… We will eat home-cooked food, while skipping restaurants and delivered prepared food/meals. (The epidemic in Northern Italy was said to have been tracked to a Pakistani who was cooking and delivering Chinese food!) And Dr. Mom here will keep her eye on things. She is not given to panic, nor is she foolhardy. We are not kids; said to be in the “vulnerable” population. The toughest thing for DH will be the folding of numerous sports events he usually enjoys on TV. This won’t last forever. We plan to sanely, calmly ride it out...

  6. At what point do measures to contain the Coronavirus, like shutting down large parts of our society/economy, outweigh the actual effects of the Coronavirus? At risk people, which include the elderly and those with existing conditions, and maybe their caregivers should be isolated regardless.

    In my opinion, the low US death rate does not justify the hysteria and measures taken to this point. I understand the idea is to get ahead of this, but thanks to Trump, it appears we already are. If we take targeted actions toward protecting those at most risk, the end result probably wouldn't be drastically different, less the severe economic devastation.

    1. "In my opinion, the low US death rate does not justify the hysteria and measures taken to this point."

      The article I linked goes into great detail re what numbers like 'death rate' mean in terms of the likely progression of the disease in a given society. I'm guessing you didn't digest what he was saying. For various reasons "death rate" is what you might call a 'lagging indicator.'

      "I understand the idea is to get ahead of this,"

      In fact, the idea is to play catch up as fast as we can. Again, the article provides data to back up the author's contention that the US is way behind and has no real idea at this point of the situation. Except that it will get worse, as CDC keeps telling us. Based on the experience of others countries, also covered in detail, that is a totally warranted view.

      "At risk people, ... the elderly and those with existing conditions"

      I did address the issue of "at risk people," who by your definition comprise well over a third of the US population. Speaking as an old white guy, old white people are a very disproportionate percentage of that group.

    2. My usage of "rate" is probably confusing the point. The low number of deaths caused by Coronavirus, period, and low risk of death for the vast majority doesn't justify the ongoing overreaction.

      We suffered many more deaths due to the 2009 swine flu (12,000), which had a comparable transmission rate, but I don't remember anything shutting down or crashing like we see today.

      I read your assessment, but only read through parts of the article you linked. It makes perfect sense that it will get worse before it gets better. I just don't understand how this is very different from 2009 at this point.

    3. If you were inventing a virus as a bioweapon a 'low' death rate would be a feature, not a bug (!). A high death rate, as with Ebola, can end up limiting a viruses ability to spread because the hosts are all killed--thus resulting in far fewer deaths than a highly transmissible virus like the new coronavirus which is less lethal. The result in the case of Covid 19 is more deaths will result than if it were more deadly.

      But the death rate is not so clear cut. The great success of the Koreans and some other Asian countries was to quickly locate all infected person, even those who were asymptomatic, and get them effective treatment. That aggressive and well prepared approach is what kept their death rate so low. The Chinese weren't so lucky, nor have other unprepared or less aggressive countries been--like Iran and Italy. The indications are that most of Western Europe is rapidly heading toward the Italian situation, even though the death rates haven't spiked yet.

      The reason for the lower deaths in Spain and France (compared to Italy) is that the virus incubates for a very long period. They will catch up. And when there is a widespread infection in a society the health services are overwhelmed. When that happens the death rate spikes well into the teens. Preventing that situation is what justifies "the ongoing overreaction."

      Re nothing shutting down during the 2009 swine flu, I just looked that up and learned that

      "during the swine flu pandemic of 2009, 1,300 schools in the U.S. closed to reduce the spread of the disease, according to a 2017 study of the Journal of Health Politics, Policy and Law. At the time, CDC guidance recommended that schools close for between 7 and 14 days, according to the study."

      Here's an article comparing the swine flu of 2009 to Covid 19:

      Among much else, the author notes:

      "... in South Korea, which has done the best job of keeping up with the spread of the virus through testing, the fatality rate so far is about 0.7%. But even that is 35 times worse than H1N1 in 2009 and 2010. Multiply 12,469 by 35 and you get 436,415 — which would amount to the biggest U.S. infectious-disease death toll since the 1918 flu. Hospitalization rates are also many times higher for Covid-19, meaning that if it spread as widely as H1N1 it would overwhelm the U.S. health-care system.

      "That’s one very important reason governments (and stock markets) around the world have reacted so much more strongly to Covid-19 than to the 2009 H1N1 pandemic."

      I really recommend you read the whole very long article I linked.

    4. "But the death rate is not so clear cut."

      According to Lancet, we tend to overestimate the fatality rate at these early stages. We need more data before we can make a proper assessment regarding the death rate. Please see the article linked below. Here's an excerpt from it:

      "Medical journal The Lancet warns any estimates should be “treated with great caution because not all patients have concluded their illness (ie, recovered or died) and the true number of infections and full disease spectrum are unknown”.

      It adds: “Importantly, in emerging viral infection outbreaks the case-fatality ratio is often overestimated in the early stages because case detection is highly biased towards the more severe cases.”"

      Coronavirus vs flu: how do they compare?

      Even the Bloomberg opinion piece you cite admits it's "still unknown" how much deadlier Coranvirus is compared to the swine flu.

      "Re nothing shutting down during the 2009 swine flu, I just looked that up and learned that . . ."

      I said "I don't remember anything shutting down . . . *like* we see today." I didn't say nothing shut down. However, there's really no comparison.

      "during the swine flu pandemic of 2009, 1,300 schools in the U.S. closed to reduce the spread of the disease, according to a 2017 study of the Journal of Health Politics, Policy and Law. At the time, CDC guidance recommended that schools close for between 7 and 14 days, according to the study."

      The CDC recommendation was for schools with a confirmed or probable case of swine flu. Targeted action like that makes perfect sense.

      Today, we see whole states closing all K12 schools. Ohio, Maryland, and Michigan are the first states to close all of their K12 schools. Nothing like that happened during the '09 swine flu, even though it directly affected the young, unlike Coronavirus. It seems we're overreacting with devastating results.

    5. "I really recommend you read the whole very long article I linked."

      I read the whole article and remain unconvinced we need to take the broad measures that have taken place and that the author irresponsibly recommends.

      Some observations:

      * China is not the US, and we can't reliably extrapolate their experience and assume the same will happen here. How can we trust what comes out of China anyway?

      * We may have a high number of unknown cases, but risk remains low for the general population.

      * The amount of known and unknown cases will vary by country and region, yet the author seems totally comfortable using the Chinese numbers to make predictions elsewhere.

      * We probably can't reasonably compare the 1918 flu to modern times. There was likely much less hygene and people were probably much less educated on how to prevent spreading it, not to mention the more effective treatments we have now. We've learned a lot in 100 years.

      "So the coronavirus is already here. It’s hidden, and it’s growing exponentially."

      Yet we have a relatively low number of deaths. There's reason for concern, but not the panic we're seeing.

      "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 . . ."

      For some reason, the author seems to forget Trump was way ahead of this when he banned travel from China on January 31. No mention of the China travel ban at all in the article, yet that was probably one of the most effective measures we've taken to stop the spread here.

      "These measures require closing companies, shops, mass transit, schools, enforcing lockdowns…"

      That is dangerous and hysterical. No one reasonable is suggesting a total shutdown of our country, yet the author views this as critical to saving us. It's just not that serious, at this point, and I doubt it ever will be.

  7. Short of locking grandma and grandpa in the attic and having contact with them via dumb waiter, I don’t see how any thinking person can envision their being able to be totally isolated. Thus, if this relatively unknown virus can ramp up in the general population, how do we keep it from grandma and grandpa?

    A few weeks of shutting down obvious high risk venues for contagion cannot be a bad idea until more is known and our own good testing is in place. Somehow business as usual while waiting to evaluate the death toll doesn’t seem quite right to me...

  8. The writer of that article is well-meaning, I believe, but he has a huge blind spot in the story he tells. He is assuming COVID-19 first appeared in Wuhan in the last week of December- indeed, everyone makes this assumption, and I don't see any support for it other than the fact that it was the first place that the virus was isolated and identified as a novel coronavirus.

    Given the sheer numbers of people who die from pneumonia each year, it is very, very unlikely that the first infectee was in Wuhan, or was infected in the month of December 2019. It is far more likely that hundreds or maybe even thousands of people died of COVID-19 related pneumonia before anyone even bothered to take a closer look at what turned out to be linked cases. The odds greatly favor the assumption that the virus was circulating in China for months before the first diagnosed case.

    In other words, the writer, with his nifty models, is all but certain to also be vastly underestimating the numbers of people who have been infected, and who are infected as I write this. I think a conservative estimate on the number of infected in the US right now is 1/2 million, and I wouldn't be surprised to learn retrospectively that the true number of infected right now were 5 million.

    Now, my question for you is- would this be alarming to you- that everyone is greatly underestimating the numbers of people who have been infected already?

    1. Re the time of origin, Osterholm believes it was some time in November, 2019.

      Not per se. What I mean is, regardless of the actual total number infected, we know that if it becomes widespread in the general population the health care system WILL be overwhelmed.

    2. Are you sure of that last statement?

      Osterholm, by the way, bases that belief about November 2019 on nothing other than the fact that it was found in Wuhan and sequenced in early January of 2020- he is then giving a fudge factor that is certainly too small.

      What will eventually be done is to start testing samples from people who died of pneumonia or other respiratory failures throughout 2019, and we will find the people started dying in the early Fall or late Summer of last year- a lag time like that is what is normally found with every new strain of influenza- it is out there for a half year or longer before someone actually "discovers" it. There is absolutely no reason to think COVID-19 is any different in this regard.

    3. Of course Osterholm is guesstimating, based on his own vast experience but based on facts that aren't completely known to us. On the other hand, the analogy to influenza is also limited. This ain't yer flu.

    4. Every influenza strains begins with a single point infection, and then spreads through the population by the tens of millions (in just the US) within a year or so.

      It is silly to think this first infection occured within a month of identification and sequencing. I will also point out that all of Osterholm's guesstimating is from the numbers of the tests and their results- this particular test will miss everyone who isn't sick, who doesn't submit for the test, or who isn't sick now but had already fought off the virus weeks or months previously. Just for the sake of argument, let's assume Osterholm is off by a factor only a month- then using his own arguments, his estimates are a magnitude too low already. If he is off by two months, then two magnitudes too low. You get the picture, right?

      My argument might seem a bit obtuse- I realize this- but deaths by pneumonia are the noise from which someone had to pick out COVID-19 deaths in the first place, and the fact is that everywhere, more people died of influenza A and B related pneumonia in the last 2 1/2 months than did from COVID-19, including China, Italy, and Iran. Picking up this signal isn't an easy thing to do, and it would a shocking, fortuitous event if it happened just 4-5 weeks after the first infectee- it would be like winning a $1000 scratch off.

    5. The key point that most people are ignoring is what one of the CDC guys(?) harped on Wednesday evening; "we don't know the denominator."

      And given the evidence that is accumulating that suggests there have been many more people infected that we don't know about (because their symptoms are hard to distinguish from an ordinary cold, or they have almost no symptoms at all,) this implies our current attempts to estimate the denominator are likely way too small.

      This is good news I two respects: a vastly larger denominator divided into the number of deaths means the mortality rate is much lower than it appears to be at present with our undercount of total infections.

      The other good news is that if CV-19 has spread much further through the population than we think it has, it means we are that much closer the peak infection date, after which the increasing lack of infectables in the population will cause the total current infections to enter the declining phase of the epidemic. We will turn the corner sooner.

  9. Roughly 50,000 people/yr die of pneumonia linked to influenza A/B strains that are constantly cycling through the population each year, and this is in the United States alone. People don't pay attention much to such deaths because there isn't actually much that can be done about it as a practical matter. My paternal grandmother and my grandfather both died this way, though maybe not linked to influenza directly, both died of pneumonia at very advanced ages (early 80s and mid 80s respectively).

    In a large city like New York, for example, such deaths each year probably numbers about 1 to 2 thousand, or about 100-200/month. Now imagine a world where these 100-200/month appear out of nowhere because this hypothetical world had never seen influenza strains A and B, but now has them circulating around, and few months after arrival in the city, someone gets interested because three elderly people in the same family died of pneumonia, and this starts running tests to identify whether or not these patients had some sort of common virus, and he finds, for example, H1N1, swine flu 2009 variety.

    That is where Wuhan was at the end of December. Have the researchers back-tested all cases of pneumonia-caused deaths that happened, let's say, going back to August 2019? I can answer that for you- no, they haven't. Someone will eventually do this. Additionally, someone will eventually sample the population using ELISA to look for anti-bodies to see how wide-spread the infection really was, of course, this needs to be done before there is a vaccine.

    All I am saying in these two comments is that the true number of infected is completely unknown at this point, but it is all but certain that the number is far higher in every country on the planet than the diagnosed/test numbers show. However, I am also pointing out that it is also unknown when the virus started circulating- the article writer is assuming it started in late December in Wuhan, but that is very unlikely to be the case- it would a great coincidence that a doctor would get curious enough about the very first actual cases that led to the discovery of COVID-19- it is far more likely that the thousands or millions had already been infected and recovered by the end of December, and that thousands had already died from it before the first death was assigned to the disease.

    1. I agree with your overall point. However, in fairness to the author, I think he does understand the unknown element in this. He's extrapolating the best he can, I think, based on what we know for sure, but with the caveat you make. Again, Osterholm, who has a vast amount of experience with all this, believes that November was probably the origination date. And, in fairness to the Chinese medical people (as opposed to the politicians) from what I've read they were actually pretty alert.

  10. And the medical systems in Italy and China got overrun because a large fraction of the population panicked and showed up in the ERs and clinics overburdening the system.

    A good policy at this point would be to sequester the elderly from the general population- if Italy had done that early on, the death toll would be much more like South Korea.

    I do think this disease is measurably more fatal to such people- maybe as high as 3-5% fatal to someone over the age of 70, so they need to be protected with extra vigilance on the part of everyone. I would probably put most of my effort in testing to using it on a continual basis on healthcare personnel- they are at the highest risks of infection, and their patients are at the highest risk of dying. I think that explains all the differences in the mortality rates we are seeing- some countries got this part right at the beginning, or close enough of the beginning to minimize the deaths. I take some comfort from the low rates of serious/critical patients in the US, but will feel better a week from now if the rates on that remain low.

    1. "sequester the elderly from the general population"

      Oh, thanks! Now I know--you just wanna shut my blog down! Are you some kinda Google operative?

    2. "And the medical systems in Italy and China got overrun because a large fraction of the population panicked and showed up in the ERs and clinics overburdening the system."

      Wait a minute--you're saying that the whole population panicked, ran to the hospitals, and the hospital staff put them all on ventilators without, like, taking their temps and other basic steps?

  11. Are there much larger numbers of people with pneumonia of any kind right now in Italy and Iran? Based on the reported numbers, no. Are they suddenly putting more people on ventilators in a panic, perhaps- the precautionary "principle" drives a lot of irrational behavior at times.

    I wonder what the normal procedure for an 85 year old Italian with run of the mill viral pneumonia would have been prior to COVID-19. What would the families have demanded before COVID-19?

  12. Any minute now I expect to hear that an 85 year old with symptoms of pneumonia - or COVID-19 - should be sequestered - out in the woods with a bottle of water, some crackers and a thin blanket…and buh-bye...

  13. Calculated Risk has a post, on an article by folks mostly from the U. Maryland Institute of Human Virology, on how
    their virus path map shows its spread (so far) limited mostly to places w/ similar weather patterns, of 47-79% humidity, and 5-11 OC (41° - 52°F), all well south of Gt. Lakes area.
    If this is so, the guess is, that the virus' spread in most of the U.S. should abate in May, and return in the Fall.
    See .

    1. Thanks, very interesting. He specifically addresses something I wondered about--why some areas with very large overseas Chinese populations seem not very much affected. I caution that I did some research on the seasonality thing and, while it's a reality, it's one that's not understood. Nevertheless, it does appear to be a factor with Covid-19, which gives hope that we can get ourselves much better prepared by the time the worst flu season arrives in October. If the pattern
      demonstrated here is correct, that should coincide with a return of some form of Covid-19.

    2. OTOH, very troubling is the fact that one of the Brazilians who recently visited the WH tested positive. Looking at the map, Brazil should be one of the last places the virus would reach. Of course he could have traveled and picked it up. Including in the US!

    3. Another caution with the blog is that all of the places most affected have close ties to China--NW US, N. Italy, Iran, etc. Is climate part of the equation? The whole issue does need more attention.

  14. Here is an excellent article that tells us - from doctors dealing with the disease - what the virus does to the body. What they know and what they do not know. It was too long to be copied here. From the New York Times, it is available from another site where there is no paywall.

    What Does the Coronavirus Do to the Body?

    1. Tx, Bebe. Not a pretty picture. It's easy to see why the extreme transmissibility (from greater distances) and mortality rate that's low compared to SARS or Ebola--but very high compared to flu--are factors that have health authorities very worried. If 20% of a huge number of infected persons need treatment then health systems will be strained. Preparedness world wide varies wildly, including in the West.

  15. CoronaVirus Scenarios - A Few SWAG's

    Best Case Below, with my guess on chance of it actually happening.

    1. A miracle happens, and testing in the US is increased by X100 and it results in the CoronaVirus being contained within a month as is happening in South Korea. The current attitude seems to be it's in the community spreading stage. Chance of this happening, 5%.

    2. A vaccine is produced for general use within 6 months and approved. To much bureaucracy by the FDA and CDC will delay this. Traditional methods for vaccine production take a while. Recombinant technology may allow much faster production. 20% chance.

    3. A vaccine is produced within 12 months. 50% chance.

    4. DARPA treatment to increase immune system for CoronaVirus is released within 3 months - 30% chance

    5. Warm Weather stops spread of CoronaVirus, as happens with regular flu. Flu season in the US is October through May. 60% chance.

    6. K-12 schools are closed to stop spread in US. 30% chance of happening in US.

    7. Vaccine is produced within 18 months - 95% chance.

    8. Everyone in US starts wearing masks, that stops spread of virus, which stops the spread. Lots of follow up is done with those with Coronavirus to stop spread. The US just does not have the production. And the CDC does not seem to have the ability to trace deceases anymore. 10% chance of happening.

    9. CoronaVirus does poorly in hot, humid areas.

    10. An instant results test is created.

    11. Some type of treatment works for those that catch CoronaVirus (current in clinical trial). Rumors of anti Viral, Aids Type medicines working

    12. China actually has Wuhan Virus under control, and gets back to full industrial production,100%, and US starts receiving stuff within 60 days. 50% Chance.

    13. Iran Government Collapses due to Corona virus, and Shiite Arc across the Middle East is stopped. 20%

    14. North Korea Collapses due to Coronavirus and lack of imports from China. Reunites peacefully with South Korea 10%.

    15. Saudi Arabia and Russia come to agreement within a month, saving major hurt to US Fracking Industry. 30%

    1. Lots of useful speculation. Let me single out one, #6. That is actually more feasible right now than you might think, in a limited sense. Instead of complete closures, an extended Spring break of maybe 3 weeks could be a significant help in stopping the spread. Children, while apparently less affected, can often become spreaders.

  16. It's a good article, the math models are useful and should get a lot of play in Silicon Valley, and associated techies.

    Areas that could be improved in the article:

    1. Affect of pollution, Wuhan seems to have been heavily polluted.
    2. Affects of smoking. People who smoked seem to have lung damage, that leads to a higher death rate.
    3. Explanation of why Korea's death rate is so much lower than Italy.
    4. Explanation of why Korea is in so much better shape than Italy (my take is Korea has done lots of testing with quaranteening, and Italy did not).
    5. Data on temperature and humidity of areas affected.
    6. Cultural closeness issues (my guess on why Iran is being cratered). There should be some data on social distance.
    7. A table of testing per millions by country vs. detected vs deaths would be interesting.
    8. Age range of people who died
    9. Noting that data out of China is highly suspect...
    10. Affects of living space (sq ft) vs. Corona Virus Data
    11. Comparisons of other viruses, and why they were not the threat that CoronaVirus is (SARS, MERS, Ebola). I wrote up something like that in a post somewhere. I got tired of poorly researched comments.

    1. In fairness, the author would have had to write a book--on incomplete data--to cover all that. There have been discussions of at least some of those topics, some referred to above. For example, Osterholm addresses the smoking issue, but argues that lower rates here are no reason for complacency, since other risk factors for sever respiratory illness are present. I think the Korea situation has been addressed--high preparedness in terms of infrastructure and supplies coupled with aggressive identification of possible spreaders. That has worked in Taiwan, HK, and Singapore as well. I linked to an article comparing Covid-19 to swine flu which, while not in depth, is very informative. I have seen comparisons to SARS and Ebola, and one of the factors always raised is that a high mortality rate tends to slow the spread by killing off hosts too rapidly. This is why the long incubation, slow onset, and a mortality between flu and more extreme viral diseases makes Covid-19 so worrisome.

      Thanks for the thoughts.

    2. China, presumably where it all began, is a highly air-polluted country full of smokaholics, male and female, all the way up to grandma and grandpa. They finally passed a law years ago to make public hawking and spitting illegal, but if some didn’t do that wherever they are, they would surely choke. I once saw the dissected lung of a heavy smoker in an anatomy lab. Rather than looking soft and pliable, it was hard, dark, very firm. Didn’t look as though it had any “give” left when its owner passed on.

    3. Yes air quality generally in China is a huge issue. Mask wearing is very common for certain times of year and in any of the major industrial areas.

    4. "6. Cultural closeness issues (my guess on why Iran is being cratered). There should be some data on social distance."

      Here's a video where some mullah or imam in Iran is exhorting his followers to "hug, shake hands, and do the traditional kiss on both cheeks, in order to spread the disease more, thereby creating some natural immunity. Social distancing is what the devil Westerners want to break down their culture.
      No comment is possible...

  17. Here is another thing to consider with this Flu. The main areas that are badly affected all have Nationalized health care systems. Italy actually has death panels. So could this fact be skewing the results upward with more deaths to seniors? This also could be death of socialized medicine.

    Rob S

    1. It varies from one country to another. Ray - SoCal has linked an article from today's WSJ that discusses some numbers for Western Euro countries--mostly beds available, spending per capita, stuff like that. While England and Italy have fine doctors, their resources are very limited. Germany and France, otoh, do much better. It's partly a cultural/political thing. I'm not sure where the US ranks in that mix.

    2. Then again I remember when France had a very hot summer and 30K+ died because of it.

  18. Wow - thanks for link

    Maps of temperature and humidity are amazing!

    One of the most useful things I have seen on CoronaVirus.

    And in Wuhan, temperature has been going up, and # of cases down.

    1. Much of China is considered humid subtropical as a climate zone, except that it's just far enough north to have seasons. It has happened before that countries have thought they had some disease licked and let up on counter measures too soon.

  19. Europe’s Coronavirus Fate Is Already Sealed
    One reason Britain and Italy are struggling: Their medical systems are too dependent on government.

  20. Lots of good points and information. It is wise to not do as Obama did and wait a long time to declare a national emergency.

    It appears a chief architect of Obamacare, bioethicist Ezekiel Emanuel aka "Zeke" is gettIng his wish and, if want to be cynical like me, explains Obama's lack of action on the flue pandemic on his watch. Oh, Zeke is an advisor to Biden on Public Health in Biden's campaign.

    From an October 24, 2014 opinion in the Atlantic (note, Zeke asserts this is just his view and is not trying to influence, but the very reason for this opinion piece is inherently to influence. Gist, old folks just should die. Betcha this does apply to Biden)

    "Why I Hope to Die at 75


    I am sure of my position. Doubtless, death is a loss. It deprives us of experiences and milestones, of time spent with our spouse and children. In short, it deprives us of all the things we value.

    But here is a simple truth that many of us seem to resist: living too long is also a loss. It renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived. It robs us of our creativity and ability to contribute to work, society, the world. It transforms how people experience us, relate to us, and, most important, remember us. We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.


    I take guidance from what Sir William Osler wrote in his classic turn-of-the-century medical textbook, The Principles and Practice of Medicine: “Pneumonia may well be called the friend of the aged. Taken off by it in an acute, short, not often painful illness, the old man escapes those ‘cold gradations of decay’ so distressing to himself and to his friends.”


    What about simple stuff? Flu shots are out. Certainly if there were to be a flu pandemic, a younger person who has yet to live a complete life ought to get the vaccine or any antiviral drugs. A big challenge is antibiotics for pneumonia or skin and urinary infections. Antibiotics are cheap and largely effective in curing infections. It is really hard for us to say no. Indeed, even people who are sure they don’t want life-extending treatments find it hard to refuse antibiotics. But, as Osler reminds us, unlike the decays associated with chronic conditions, death from these infections is quick and relatively painless. So, no to antibiotics."

    Zeke's piece is a plea for quality of life, but who decides what's quality or not? This has much, much greater implications than just the elderly and their health care.

    If you were a strapping 20 year old Marine almost fatally injured in Iraq and now have severe physical and mental impairments and get the flue or corona flue, do we as a society say tough luck, go die? I have some friends in that category.

    Do we tell the parents of a new born baby that while there are life saving techniques, but it may mean a suffering of quality of life later on including possible mental issues to just the baby die? That's me. My son had open heart surgery at 5 months old.

    Why do bioethicists appear to welcome the death of soo many people?