All posts by nouyang

COVID19: For mortality rate, cases/day is everything

Over the last few days my attitude on COVID-19 has totally flipped (as I’m sure it has for many, but not enough, people).

1) Cases per day matters

Earlier, I thought COVID19 is less problematic than the flu since the flu kills so many (more) people every year. But unlike the flu, this is going to result in a ton of severe cases all in a very short window. This can lead to nightmare scenarios where there is not enough intensive care equipment for the sudden influx of patients. These patients will sometimes need to remain on it for up to 2 or 3 weeks, since all we can do is wait for the body to heal itself.

Doctors then have to choose who to give lifesaving equipment to. If everyone got care, the fatality rate of COVID-19 can be low (but still 3x that of the flu), ~0.5%. But when the ICU is overrun, then we start getting 5% fatality rates or more. 10x difference in death rate.

2) Escalation

The other point I learned is that Wuhan has a population of 60 million, roughly the size of Spain or France, and went into lock-down with 400 confirmed cases. This involved canceling lunar new years celebrations, which are culturally kind of like 4th of July, New Years, and Thanksgiving all in a single holiday. I’m sure the decision was not made lightly, but still made swiftly. In fact Lunar New Years contributed to the urgency since everyone travels at that time.

In reality, since it takes 1-2 weeks to show symptoms, and the number of infected people (when not in lockdown) roughly doubles every 2 to 5 days, there were already thousands of cases which would soon lead to tens of thousands of cases.

3) Notify locals

I’ll follow-up in the morning with sources for all this in the morning, but basically the summary is that we all need to behave as if we are in lockdown already, even if the politicians are slow to act. Otherwise, we are going to see the grim scenarios of overworked doctors and nurses, reusing equipment, having to choose who lives and dies.

I’ll further run numbers to show just how bad the situation is.

Hopefully, by adapting these numbers to a local level, we can encourage local authority figures (church leaders, employers, etc.) to act. Or at least stop making people go in to work who don’t absolutely need to.

Todo: make list of places to send letters to, e.g. local (county-level) newspapers, state newspapers. Needs to come from person with ties to feel authentic. Identify people who can decide to close things down.

(I suppose this is easy for me to say, since I do not have kids and have a stable income and can WFH).

COVID19 in Boston: Reasons to *not* panic

A little mental checklist here.

1) This was from China a few weeks ago. Sounded dire but wasn’t sure if it was real. However now three weeks later appears China has come out from worst of it. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30065-6/fulltext

It sounds a lot like italy right now (https://translate.google.com/translate?hl=&sl=it&tl=en&u=https%3A%2F%2Fbergamo.corriere.it%2Fnotizie%2Fcronaca%2F20_marzo_07%2Fcoronavirus-bergamo-medico-humanitas-facebook-situazione-drammatica-altro-che-normale-influenza-4fdf6866-6088-11ea-8d61-438e0a276fc4.shtml), and society didn’t collapse in China, and things are improving there for sure (based on my friend who just moved to Shenzhen two weeks ago).

2) Someone pointed out that Wuhan is ~11 million people, roughly like NYC (which is maybe 9 million?), and it had maybe 80k cases.

So that’s 80000 / 11000000 = 0.007 likelihood in Wuhan of being coronavirus positive. And that had maybe 3,000 deaths (though that will increase). Meanwhile, measles killed about 100,000 people in 2019.

3) In terms of panic, I will also say that, on Wed. 4pm at work I got a screenshot sent by a friend of a friend of a friend saying roughly  “positive at csail, i’m in self quarantine, staff grads not allowed back”. And at 9pm the official email went out, and it was just “one person, briefly contacted another positive case not at CSAIL.” And we are not physically locked out of campus or anything.

I am writing this down now, because I’m getting a different kind of panic (more local to Boston) going through my social circle now. And my instinct is to share it, even though I know that emotionally that’s because it’s panicky news and we’re starved for anything useful or relevant, and also rewarded for being in the know and letting our friends know first.

Commentary

  • Of course, the measles kids dying are mostly poor people in places with bad health infrastructure, so that doesn’t freak us out since we’re so much better off and our situations are not comparable…
  • I guess the news is in English now and less censored so there’s a constant influx of panic that’s hard to fight. It kinda reflects and bounces in everywhere — it’s hard not to panic when my entire family is panicking
  • I feel upset that we have clearly badly hurt Iran’s health infrastructure, and they’ve back militants now that killed a US soldier. Now US is missile striking back. It’s like… virus induced unrest. I wish the lesson from that was recognizing that when we hurt others we hurt ourselves too. But I’m sure the older generation which is in charge will learn a different lesson from this.