Sorry for ranting, you do not need to read this. I hope writing this down helps me sleep.
There’s this new virus Covid-19 (formerly known as 2019-nCov), that is rapidly spreading. It will not be the end of humankind, there have been much worse pandemics in history, but it *will* kill and it *will* change our world.
- Mortality is around 1% (averaged over all age groups) *if and only if* you have access to intensive care units.
- Mortality increases to 3-5% if no intensive care is available
- Without severe restrictions, the number of cases doubles every 2-3 days. Each affected individual infects ~ 2 others(Unfunny fact: 2 is at least twice as large as 1…)
- No effective treatment available: patients are ventilated for > 2 weeks
- Spread *can* be controlled – see the two Chinas, South Korea, Japan
Actual numbers might be different(difficult to get now due to incubation time, severe undertesting, many mild cases that are never reported), but do not be too optimistic: On the diamond princess cruise ship 696 cases were diagnosed. 7 of them have died at the time I’m writing this with the best medical care a developed nation can offer.
Now with some basic math you can run the numbers and, well, it’s not pretty.
For Germany, this would mean more than two million people dead (of 80 Million) and hospitals *way* overrun – The ~6000 free ICUs available are not that much different from 0 if you need hundrets of thousands.
We should do something, or better, should have done something long ago.
There’s an excellent analysis here, by someone more knowledgeable. And there’s more out there, for every detail level you want. A word of caution though, if you do these calculations, it gets kind of depressing.
Best way: Just copy what Taiwan(Republic of China) is doing. So far it works *amazingly* well. It seems to be a combination of simple measures:
- Early partial shutdown: Taiwan extended the lunar new year holidays. Enables getting all the measures in place
- Face masks: They may not protect you, but should you have been infected, they reduce the spread and protect others. So in the end, everyone wearing one protects you.
- Lots of checks: Taiwan has fever checkpoints everywhere, so no fevery persons in the businesses, no coughing (social control)
- Movement tracking: This is certainly invasive, a *lot* of work, but it helps to find possibly infected others
- smart way to test enough people.
The last two are tricky, but the others are quite low-hanging fruits.
Note Taiwan is not part of the WHO and therefore some dashboards do not report it. South Korea has a very similar strategy, and if it had not been for that cult(of which there are too many, but that’s another story) they would likely have succeeded as well.
Also, China(ProC) has recovered very well with a harsh strategy: Full lockdown of 60 Million people at just 400 cases. But now they have very few cases, and are doing a similar strategy with even more tests. Soon they will have eradicated it *in China*.
Travel restrictions can be useful for control. But you should do it the smart way. The smart way might also not be nice: When China locked down Wuhan, it was few days before lunar new year – everyone was planning to visit their families. That was enormously unpopular
In the end, until effective treatment becomes available, varying degrees of this are the only non-evil option. It needs to be made sure that an outbreak quickly dies out and does not spread exponentially over vast areas.
“It’s a pandemic. 60-70% of people will get infected. We just need to make it slower so it does not overwhelm our hospital system.”
That is something I’ve read quite often. And apart from the defeatism(East asian countries can do this, why can’t other developed nations?) it does not match with the numbers, just too many hospitalizations required (see Italy).
Also, once you reduce the spreading enough to not overwhelm the medical system(each one infected infects less than ~1.1 others), why not go the extra mile and make it so that each sick person infects less than 1 other person? Presumably not that much harder, and then you just stop it. If you had started early, very few would have died.
But alas, “We cannot convince the people a lockdown is needed”. So, we wait until thousands will die and terminally ill patients are rejected from hospitals and medical staff collapses from exhaustion? And then we do the full lockdown. For longer than if we had lockeddown earlier, with more impact on the precious economy. That is dumb. Let me remind you you can still go shopping in Taiwan. With a mask, but still.
Not learning is idiotic
China falls, then gets up.
Numbers are out, but are ignored.
South Korea falls, then gets up.
Italy falls. I really hope they managed to turn around.
Numbers are out, but are ignored.
Spain falls, Germany and the US will follow soon (alea iacta est – would need a miracle to prevent thousands of deaths).
And if we look at poorer countries, numbers get much worse quickly.
Really, more decisive action would have been nice in each case. And the more often this happens, the more idiotic it gets to hear politicians state that “the situation is under control”, “we are well prepared”, “We will not do X”, and then do X(travel ban, lockdown, ban gatherings…) 2 days later when the number of confirmed cases has *surprisingly* doubled.
A no-prewarning lockdown prevents a last-minute exodus. Compare that to the perfect virus storm created by the US border closure with prewarning and getting everyone home in crowded flights and have them wait several hours in crowded airports. The European union looked at this, complained, and then *did pretty much the same*.
Minus the long airport wait, but: Instead (at least in germany) without even the most basic fever control. Seriously, you could travel from Iran to Germany yesterday without any quarantine or having your fever checked.
Also, travel warnings for travelling to much safer countries.
And let’s not forget the poor iranian minister’s press conference.
Where is the solidarity?
Serioulsy, why isn’t a large detachment of medics of every single european army in northern italy? It would really have helped. Bonus points for getting actual experience which will be needed in spain tomorrow and in germany and france the next week. Or maybe a call for volunteers, or fly out some patients. China sent some medical aid and personell, but Germany managed to lock urgently needed medical equipment sent from China to Switzerland (piracy, really?). And closing the borders in such an uncoordinated fashion, and blaming each other is not helping:
Travel restrictions have their use, but should not at least Europe as whole decide where to draw spread-specific borders?
This is a worldwide problem. It’s a disease, it’s neither the fault of china nor of Italy that the problem is now in the world. The disease just is. It stays.
Why do we fail?
There have been some comments this virus will end populism – but probably not. The responses in Germany,
What to learn from this?
We will be wearing facemasks for a while.
Also, we really should not let idiots run our countries.
And, we should learn more from Asia.