COVID19: U.S. Officials Warn Americans to Brace for Likely Outbreak
nytimes.comIt's been a little bit frustrating watching the evolution of this. Even today a lot of people are very unaware of whats coming and the preparations, at least from what we can see on the outside, are woefully inadequate in the US and other countries.
Back on Feb 10th the CDC had done 398 tests, it's now Feb 25th, 15 days later and they've only done 426 tests. The surveillance testing that was meant to be set up totally failed to work and still hasn't started.
The virus is 3+ generations on in Italy where it's gone from no cases to 322 cases and 11 deaths in a few days, and now cases are showing up in neighboring countries. Expect a similar kind of surprise "outbreak" to appear here in the US once we eventually get testing capabilities up to speed.
Probably the biggest disappointment has been the deliberate and dangerous misinformation that was spread online and on the news saying the flu was more dangerous. Most people I've spoken to have been under this false belief.
Part of this is terrible communication on the part of the US government, specifically the CDC.
* Watching their press conferences I have no idea how the average American comes away with concrete steps for preparation. The pressers seem mostly focused on laying out everything the HHS / CDC doesn't know and describing that the CDC "is assessing its own preparation" - suggesting they're still not prepared even though the situation has been building for weeks.
* The COVID-19 section on their website is still focused on China even though the virus has obviously spread at this point to several countries.
I suspect the virus itself is unavoidable at this point unless you're willing to walk around with eye protection, rubber gloves, an N95 respirator, etc. But it's critically important to suggest what counter measures (if any) the US can expect to employ, like imposed travel restrictions and curfews in affected areas, so Americans can adequately prepare supplies.
One of my close friends works at the CDC and volunteered to join the Covid-19 response, which requires her to work 100 hrs/wk.
I know HN is not supposed to be a political place, but you can't talk about Covid-19 without talking about politics. Elected officials in the US have an enormous amount of power over how an outbreak spreads here. They control budgets, budget allocations, and all the preparedness/response bureaucracies that are supposed to be ready for situations like this[1].
Per my friend, the Trump administration has been replacing mid-level appointees with political donors who have absolutely no idea what they're doing -- at best. In some cases, they're actively anti-government, so they're both malicious and incompetent. The CDC's response has been crippled by many of these appointees.
This is most evident at the State Department. Despite CDC employees screaming at them not to let the Japanese cruise ship passengers into the country, they did it anyway[2].
And then you have the usual propaganda and denialism, such as Larry Kudlow claiming today that Covid-19 is contained[3].
There are a thousand ways Trumpism has fueled this crisis, and I can't summarize them all here, but there is a bipartisan outcry[4] over this issue that has had mixed success.
I apologize again for the baldly politics-related post, but I think this issue highlights the limitations of HN's anti-politics moderation. It's very difficult to divorce issues of science, business, or (especially) society when politicians are major forces in all of them.
1. https://thehill.com/blogs/congress-blog/healthcare/483320-wo...
2. https://www.livescience.com/coronavirus-cruise-ship-us-passe...
3. https://seekingalpha.com/news/3545343-kudlow-says-u-s-contai...
4. https://foreignpolicy.com/2020/01/31/coronavirus-china-trump...
> enormous amount of power over how an outbreak spreads
Given what we're seeing in other countries, that seems doubtful.
And based on the science we're hearing, it sounds like the most that can be hoped for is spreading the epidemic out over time some, which might allow resources like hospital beds to be better utilized.
> Given what we're seeing in other countries, that seems doubtful.
Do you have a source for this? You're waving away the work of hundreds of thousands of people in public health. Do you know something about epidemiology (and interventions) that epidemiologists don't?
You can't understand a complex scientific field by reading headlines as a layperson. You don't know what people are doing to prevent the spread and you don't know what they could be doing if elected officials were cooperating with scientists.
Here are some obvious things that reduce the spread of viruses, some of which were mentioned in the articles I linked, which you seem not to have read.
- Free health care. In countries where primary care, patients will submit themselves for testing sooner, allowing precautions to be taken before they infect anyone else.
- Not allowing the Japanese cruise ship passengers into the US, as the CDC recommended.
- Discouraging hoarding of masks, especially by healthy people. Cloth masks are most useful when worn by people who are already infected, not by healthy people.
- Deploying testing kits quickly and providing support for the clinics getting them up and running.
- Quarantines, which also need human administration.
Nothing you've written contradicts my original thesis, which is supported by actual experts and bipartisan officials in the US: that this illness will kill more people and have greater economic impact because the Trump administration (and Xi regime, for that matter) mishandled the preparation and early response.
The awful truth is that there's not that much professionals can do about this. Singapore is reputed to have one of the best systems in the world, and they're suffering like everyone else.
(And for what it's worth, Trump was apparently outraged that those passengers were allowed into the US.)
I'm sorry, I don't at all follow your last sentence. The flu IS more dangerous. Upwards of 45 million people get the flu every single year, hundreds of thousands of those are hospitalized, and tens of thousands of those are killed by Influenza. I'm not at all seeing the "deliberate and dangerous misinformation."
My last sentence is referring to exactly what you're saying, your statement is dangerous and irresponsible because it is designed to make people think SARS-CoV-2 is less dangerous than regular seasonal flu. Comparing annual deaths from an established virus to the current deaths from an emerging virus is on the face of it absurd. You need to compare mortality rates, the rate of spread, and projected infections. You can come back and compare total deaths in two years after it has become endemic everywhere like the flu already is.
If I gave you the choice tomorrow of being infected with this seasons flu or the coronavirus, which would you pick? Hopefully you're smart enough to understand the difference between a 0.1% mortality rate and a 2% mortality rate.
Leading people to believe the flu is more dangerous has slowed (and is still slowing) the response, reducing preparedness, increasing the spread, and as such will have a part to play in loss of life from this virus.
No, the flu is still more dangerous. We're not talking about whether I have the choice of being infected with "this year's strain" or Covid-19. We're talking about risk assessment and realistic chances of catching them. The mortality rate of covid-19 outside Wuhan is 0.7% [1]. In the U.S. it's zero so far. I have a MUCH higher chance of getting influenza and dying where I and most people live. This could change and I certainly reserve the right to modify my preparedness and anxiety appropriately.
Alarmism and panic do far more harm in situations like this than the actual virus itself.
[1]https://www.marketwatch.com/story/coronavirus-update-79339-c...
I think the OP intended dangerous to mean: likelihood of death if you catch the disease. Of which case, COVID19 is still looking to be ~20x more dangerous to catch than the flu.
That certainly depends on where you are and your general health. But as it stands at the time of this writing, the mortality rate for COVID19 and Influenza are both about 2-3%.
https://www.worldometers.info/coronavirus/coronavirus-death-...
Unless I'm reading this wrong, this is incorrect. The nih paper says that influenza deaths represent ~2% of all respiratory deaths, not a death rate.
The CDC estimates the death rate of influenza is at most 0.65% (61k deaths and 9.3MM infected) and at least 0.026% (12k deaths and 45MM infections)
Important to remember that older and immunocompromised people are not always the only vulnerable ones. The Spanish flu had an unusual mortality pattern of killing young adults [1]. It also had an overall morality rate around 2%, which caused multiple years of health catastrophe around the entire world. We don't have enough information to say whether COVID19 will match the characteristics of something like the Spanish flu, but the signs are ominous.
[1] https://en.wikipedia.org/wiki/Spanish_flu#Patterns_of_fatali...
Are you listening to yourself? 45 million people get the flu and tens of thousands die.
COVID19 is both more transmittable and has a fatality rate an order of magnitude larger.
Except that's not true. The fatality rate is similar to influenza. Influenza ranges between 0.1% and 10% rate, depending on seasonal epidemics. A generous estimate for COVID19 so far is ~3%
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815659/
https://www.worldometers.info/coronavirus/coronavirus-death-...
The only influenza outbreak that approached 10% death rates was the infamous 1918 "Spanish Flu". In the US specifically, one of those most severe flu seasons caused 61000 fatalities and 45 million infections, or a fatality rate of approximately 0.14%. https://www.cdc.gov/flu/about/burden/index.html This is an order of magnitude lower than the 2-3% fatality rate estimate for COVID 19. Had that particular flu season had death rates of even 2%, the deaths would reach almost a million people in the US that year.
Furthermore vaccination is available and there is some herd immunity for influenza. Proven antiviral therapies exist for the flu like Tamiflu or amantadine (depending on specific flu subtype). COVID 19 only has experimental options currently, with no vaccines yet available.
Considering that COVID 19 has a far longer incubation period than influenza, it also has a greater potential for spread. Spread potential to a greater proportion of the population (due to less herd immunity and longer incubation) would mean fewer severe cases would get the proper resources to be treated, which further increases the morbidity and mortality going forward. There is potential for the health system to be overwhelmed. All these factors make it a very serious disease - far more so than the flu.
We just got the first confirmed case in Switzerland today: https://www.telegraph.co.uk/global-health/science-and-diseas...
Since the main GIS tool died I was using to monitor this outbreak I have been using https://news.ycombinator.com/item?id=22409640
This one still seems to be working:
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...