Covid (3/n)
Mar. 16th, 2020 08:46 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
jackI've read a lot of persuasive contradictory articles about the current situation and I think I'm finally fitting them together into some sort of shape.
Look at numbers. Out of a 1000 people in a country like the UK. If they all get infected, estimates I'm seeing guess that 80% of people will experience a cold or mild flu that they recover from on their own (so even in the worst predictions, we should be able to make deliveries keep coming). 15% will experience bad flu, but recover. 5% will need need serious hospitalisation, 1% will die even with a hospital.
For 1000 people, there are 2 hospital beds. And less than 0.1 ventilators, which most people hospitalised will need.
If the infection isn't contained (either grows unchecked as in some countries, or slow growth as in countries that have it sort of contained but not eliminated), then something like 80% of people will get it depending on how effective measures are taken. But those hospital beds and ventilators are ALREADY FULL. So I'm going to temporarily not think about both those things and just pretend that on average everyone gets it.
Then, out of 1000 people, 50 need treatment, in one of those 0.1 ventilators. For two weeks or more likely a month. So if we "flatten the curve" enough to treat everyone who needs it, the situation will go on for forty years.
The death rate for over 70s is more like 10%-20% and the death rate for younger people is more like 0.2%. I assume the hospitalisation rates follow a similar proportion. If everyone who's vulnerable is kept safely isolated, that might reduce the numbers above by a factor of 5. So... less than a decade. Maybe more if we got serious about protecting everyone who was vulnerable.
So when we talk about three months, that could mean, "we successfully contained it, almost everyone infectious has stopped spreading it, the rates are all going down". Or it could mean, "it's run through the whole population". Those are quite different pictures. But I and maybe a lot of people weren't thinking about that.
But surely...
I really really hope that those numbers above don't come to pass. Plausibly we'll reach the same point as China "we should have contained it earlier, but now we're going to contain it as much as possible". If the situation drags on another year, hopefully we WILL manufacture 10x or 100x the number of ventilators. And find a vaccine. And realise which containment measures help and which just make people sad but don't help.
On Thursday it seemed like the government was ignoring this. On Friday they hinted they'd get serious about helping protect vulnerable people. On Sunday they said they would, and also started saying, "hey can we maybe get some war-footing ventilator production." Today I'm hearing, "the situation might last until next year." We should have been doing some of that planning three months ago, but I admit I wasn't thinking about it then either. So hopefully, even if the politicians are a bit bumbling, they HAVE been taking the advice from the epidemiologists, so they will do the right things, even if a bit inconsistently and late. Hopefully they will also not react TOO much (e.g. "banning going outside" is probably counterproductive, encourage walks, discourage gathering).
Those articles
"Flatten the curve". This says, spreading out the infection reduces the load at once on the health care system. Which is true. But (probably deliberately, to avoid getting people to despair), it didn't mention that in some cases, that might mean, "reducing 100s of people per ICU bed to 50s of people per ICU bed".
"The curve is a lie" Several people wrote angry articles pointing out the flaw in the curve theory.
"Herd immunity something" Talking about, if it does spread unchecked
"Act NOW!" My instinct would be act now to contain the problem when it's as small as possible, in the hopes of finding the best lockdown politicy to eliminate it while still allowing normal life to continue, expanding hospital capacity, giving time for other breakthroughs. But it's also true, knee-jerk "lock down the entire country" probably isn't correct.
"Choose the right time to act" Pointing out that "act now" is wrong if you want to soften the peak rather than slow the growth. But maybe not emphasising that that would soften it only a small proportion.
I think I misread a lot of these articles through not seeing what they weren't saying.
I think a lot of people knew all this already but weren't laying it out like that, but I think a lot of people didn't understand that.
What are you doing?
I'm not that scared for me, but I'm doing what I can to slow the spread (if at some point I will get it and have several days of being infectious without knowing) because I can do so without much hardship and I think that's the socially responsible thing. I don't know if that's right, maybe that doesn't help. Probably in a week or two, we'll know which scenario we're in :(
Look at numbers. Out of a 1000 people in a country like the UK. If they all get infected, estimates I'm seeing guess that 80% of people will experience a cold or mild flu that they recover from on their own (so even in the worst predictions, we should be able to make deliveries keep coming). 15% will experience bad flu, but recover. 5% will need need serious hospitalisation, 1% will die even with a hospital.
For 1000 people, there are 2 hospital beds. And less than 0.1 ventilators, which most people hospitalised will need.
If the infection isn't contained (either grows unchecked as in some countries, or slow growth as in countries that have it sort of contained but not eliminated), then something like 80% of people will get it depending on how effective measures are taken. But those hospital beds and ventilators are ALREADY FULL. So I'm going to temporarily not think about both those things and just pretend that on average everyone gets it.
Then, out of 1000 people, 50 need treatment, in one of those 0.1 ventilators. For two weeks or more likely a month. So if we "flatten the curve" enough to treat everyone who needs it, the situation will go on for forty years.
The death rate for over 70s is more like 10%-20% and the death rate for younger people is more like 0.2%. I assume the hospitalisation rates follow a similar proportion. If everyone who's vulnerable is kept safely isolated, that might reduce the numbers above by a factor of 5. So... less than a decade. Maybe more if we got serious about protecting everyone who was vulnerable.
So when we talk about three months, that could mean, "we successfully contained it, almost everyone infectious has stopped spreading it, the rates are all going down". Or it could mean, "it's run through the whole population". Those are quite different pictures. But I and maybe a lot of people weren't thinking about that.
But surely...
I really really hope that those numbers above don't come to pass. Plausibly we'll reach the same point as China "we should have contained it earlier, but now we're going to contain it as much as possible". If the situation drags on another year, hopefully we WILL manufacture 10x or 100x the number of ventilators. And find a vaccine. And realise which containment measures help and which just make people sad but don't help.
On Thursday it seemed like the government was ignoring this. On Friday they hinted they'd get serious about helping protect vulnerable people. On Sunday they said they would, and also started saying, "hey can we maybe get some war-footing ventilator production." Today I'm hearing, "the situation might last until next year." We should have been doing some of that planning three months ago, but I admit I wasn't thinking about it then either. So hopefully, even if the politicians are a bit bumbling, they HAVE been taking the advice from the epidemiologists, so they will do the right things, even if a bit inconsistently and late. Hopefully they will also not react TOO much (e.g. "banning going outside" is probably counterproductive, encourage walks, discourage gathering).
Those articles
"Flatten the curve". This says, spreading out the infection reduces the load at once on the health care system. Which is true. But (probably deliberately, to avoid getting people to despair), it didn't mention that in some cases, that might mean, "reducing 100s of people per ICU bed to 50s of people per ICU bed".
"The curve is a lie" Several people wrote angry articles pointing out the flaw in the curve theory.
"Herd immunity something" Talking about, if it does spread unchecked
"Act NOW!" My instinct would be act now to contain the problem when it's as small as possible, in the hopes of finding the best lockdown politicy to eliminate it while still allowing normal life to continue, expanding hospital capacity, giving time for other breakthroughs. But it's also true, knee-jerk "lock down the entire country" probably isn't correct.
"Choose the right time to act" Pointing out that "act now" is wrong if you want to soften the peak rather than slow the growth. But maybe not emphasising that that would soften it only a small proportion.
I think I misread a lot of these articles through not seeing what they weren't saying.
I think a lot of people knew all this already but weren't laying it out like that, but I think a lot of people didn't understand that.
What are you doing?
I'm not that scared for me, but I'm doing what I can to slow the spread (if at some point I will get it and have several days of being infectious without knowing) because I can do so without much hardship and I think that's the socially responsible thing. I don't know if that's right, maybe that doesn't help. Probably in a week or two, we'll know which scenario we're in :(