Originally Posted by LapLap

The U.K.’s last minute realisation of what has arrived (it’s no longer on the way) has been published
....
Apparently (it’s in the FT but I can’t access it) they had been working under the assumption of 80% mildly ill, 15% Hospital ill and 5% needing ICUs.

What Italy found, what Spain has found is what England is finding. That the reality of what they have to deal with is double those percentages needing Hospital Beds and ICUs.

Originally Posted by shallowdrift

Fair enough - I only checked the current weather. I don't think Lombardy has had an especially chilly winter either though.

Originally Posted by Loren Pechtel

Any word on whether people on ACE inhibitors for high blood pressure should be switching to something else?

Originally Posted by trueblu

Sadly, the West fiddled away for two months of 'this is just the flu' instead of ramping up the necessary resources (e.g. high capacity testing, pandemic preparedness protocols and strengthening infrastructure) to mitigate spread. Almost the entire West Coast US outbreak is due to lack of complete contact tracing of the very first US case (as by genetic phylogenetic tracing of cases).

About 4 weeks back, I said it may take $100B dollars for the US to try to really mitigate COVID-19, and most people on the thread were skeptical that the actual disease impact if we don't do anything will cost that much...it will now be trillions of dollars for the US alone.

The problem is that everyone except the UK, still thinks this is a "winnable" war...by the way we're going, it's not. UK at least gets that. I still think we need to mitigate as much as possible to prevent healthcare infrastructure collapse. What we're seeing in Italy is horrific, but even extrapolating number of cases 10-fold, they only have 200k cases...they have another 30 million to go before things start to get better.

China is basically closing its borders in all but name, and will need to do so for 12 months. However, if it does so, it can actually revert to almost normal economic activity within a couple of months. It will have basically lost 10-20% of its annual GDP for the next year. Most countries will lose much more, and will have millions of lives lost to boot.

The problem with the 'cure is worse than the disease' is that infrastructure collapse is usually the worst possible outcome that any nation can imagine. So any costs to prevent that become justified. I have no idea what our hospitals will look in the West by late May. If they basically become non-functional, that will have knock-on effects for other services in time, although I don't anticipate total collapse of infrastructure in any worst case scenario: just a lot of (what could have been prevented) unnecessary deaths.

It's likely we'll adjust to the new way of life, I'm sure we will: the human spirit is incredibly resilient.

Many businesses will go bust, and that will have huge consequences, including, as has been alluded numerous times, on health disparities and so on. Having said all that, I don't expect this to last more than a year from now (as per UK predictions). So the hit will be terribly hard, but it won't last long, unlike e.g. 2008 (although I'm not an economist: but generally, rebuilding after a disaster promotes economic stimulus). There will be other positive consequences as well, but unfortunately, they have morbid connotations.

Be well!

tb

Originally Posted by ricardojrsousa

Please note I am note advocating for "this is the flu", l"just go on the street and keep about normal lives" or "f*ck isolation" – and this isn't even about "when can I fly and mileage run again?" - this is more a genuinely interested question of someone that not only doesn't know what will happen (as most of us) but also doesnt have many ideas / guesses on what will happen and how governments and even individuals are going to handle this. i.e. what is moderate success after draconian measures we are all pushing for? How will businesses survive and things ever go back to normal?

​​​​​

Originally Posted by narvik

Milan has had similar temps as Qom: a few degrees above freezing at night.

Originally Posted by HKTraveler

There is light at the end of the tunnel. Look at how China and South Korea have been able to manage the crisis and dramatically reduce the number of new cases even after severe outbreaks. But it will take time and effort. Unfortunately for small businesses, all Governments are pretty much saying we will take the economic cost of stopping the virus to avoid a worst case outcome of total collapse in healthcare systems.

Originally Posted by LapLap

The U.K.’s last minute realisation of what has arrived (it’s no longer on the way) has been published

https://www.imperial.ac.uk/media/imp...16-03-2020.pdf

Apparently (it’s in the FT but I can’t access it) they had been working under the assumption of 80% mildly ill, 15% Hospital ill and 5% needing ICUs.

What Italy found, what Spain has found is what England is finding. That the reality of what they have to deal with is double those percentages needing Hospital Beds and ICUs.

Originally Posted by GinFizz

Just to add though that I also cannot access the FT, but at least in the the Imperial College data (to my reading in any case) they are still using numbers around the 10-15% and 5% values for hospital care (as a fraction of all symptomatic cases). Taking their data from Table 1 (for percentage of symptomatic cases needing hospital care stratified by age), and combining that with similarly stratified 2018 census data gives population-normalized average values of around 10% for hospitalization, and 30% of hospitalized cases needing ICU (which matches the statement in their study ("We assume that 30% of those that are hospitalized will require critical care")

Note that I am not posting this to downplay the seriousness of the situation - if anything the contrary, as if the reality on the ground in Spain and Italy is a much higher fraction needing hospital care, then either the numbers in the paper are out of date (they include a caveat that they will need to be updated over time), or there is a significant age-bias attack rate of symptomatic cases (which make the predictions in the Imperial study even starker).

Originally Posted by Imperial

These estimates were corrected for non-uniform attack rates by age and when applied to the GB population result in an IFR of 0.9% with 4.4% of infections hospitalised (Table 1). We assume that 30% of those that are hospitalised will require critical care (invasive mechanical ventilation or ECMO) based on early reports from COVID-19 cases in the UK, China and Italy (Professor Nicholas Hart, personal communication)

Originally Posted by nk15

"Spiking U.S. coronavirus cases could force rationing decisions similar to those made in Italy, China"

(excerpts)

"By many accounts, the United States is ill-prepared for a such a situation.

A 2005 federal government report estimated that in the event of a pandemic like the 1918 flu, we would need mechanical ventilators for 740,000 patients. Currently 160,000 ventilators are available for patient care, with at least an another 8,900 in the national stockpile, according to a February estimate by the Center for Health Security at Johns Hopkins."

(From NYS triage plan):

"The plan’s basic outlines are simple and “fairly draconian,” Rosoff explained. “If you are in respiratory failure and there is a ventilator available and an ICU bed, and you meet certain medical criteria, you go on the ventilator. You have a certain amount of time to get better. If you don’t, we’ll take you off and give it to someone else.”

(Other random excerpt)

"Some state recommendations do not set specific age cutoffs for ventilators during rationing, while others explicitly exclude access for older people, with access barred to those ranging in age from 65 to 85. A Minnesota panel, for instance, recommended prioritizing children over adults, and young adults over older adults, while the New York group did not use age as a criteria in itself."

https://www.msn.com/en-us/news/us/sp...?ocid=primedhp

Originally Posted by trueblu

You're right, I've been caught out by how amenable COVID-19 is to containment by aggressive measures, but those aren't being implemented.

Sadly, even if the warm weather thing is real, which I think it will be, it won't help if the baseline numbers are huge: if we have doubling every 3 days, the UK will have e.g. 2M cases in a month when the weather is appreciably warmer. Slowing doubling to 10 days, i.e. a third of the current growth rate, will result in 30M in the UK being infected by end of May...not much help. EVEN if COVID-19 all but disappears with the warm weather, it will just come back in the Autumn to a largely susceptible population.

What we need to do is to minimise the growth rate now, and the count on the warm weather to incrementally increase cases until we get 30M infected by November...and then so many will be immune that the growth rate won't shoot up in the Autumn...

tb

Originally Posted by JNelson113

I read something somewhere that the virus's ideal temperature is around 48 degrees F/9 degrees Celsius. So that temp is pretty close to what helps it survive.

Originally Posted by ezefllying

So: How is it that China has, arguably, managed to defeat the virus without achieving anything close to herd immunity? There are 1.4 billion Chinese citizens. 80K were infected. That’s 1 in 20,000.

As I see it, the only explanations are: (a) China somehow squelched every single case of the virus domestically, (b) China’s reporting highly inaccurate numbers, (c) there will be flare-ups in the coming weeks and China will have to re-lock down whole regions, or (d) some other epidemiological dynamic is at play that’s preventing resurgence.

Originally Posted by notquiteaff

I believe Wuhan and Hubei province had stricter lockdown rules and isolation from the rest of the country. Most of the infections where within Hubei and probably specifically in Wuhan. I think the same is true for deaths, too.

Going by https://gisanddata.maps.arcgis.com/a...23467b48e9ecf6

China: 81050 infections and ???? deaths
Hubei: 67799 infections and 3111 deaths

Instead of 1.4b, just the population of Hubei (Wuhan?) would be the basis for the 67799 people infected and the 3111 deaths. Taking Hubei, it’s about 60 million. Same as Italy.

Originally Posted by ezefllying

But there was still substantial spread outside of Hubei -- on the order of 13,000+ infections, going by your numbers. Is it really the case that the Chinese government stamped out every one of those non-Hubei infections? If not, wouldn't the exponential-growth models we've seen suggest that the disease would just flare right up again?

Originally Posted by ezefllying

But there was still substantial spread outside of Hubei -- on the order of 13,000+ infections, going by your numbers. Is it really the case that the Chinese government stamped out every one of those non-Hubei infections?