You mention exponential spread, working from home, and avoiding travelling after March.
But what is the endgame here? How long do we need to stop travelling for? Should we apply these measures, as far as possible, starting in April and keep them up until a vaccine is available in 1-2 years? Will the number of cases level off eventually?
I assume there is no scientific consensus on these questions. If the virus is here to stay, then there might be little value in adopting extreme individual precautions for just one or two months. Afterwards, when you stop taking these extreme measures, there will be an even higher risk of infection. Under these circumstances, it seems better to adopt measures that can plausibly be sustained for one year or even longer.
I know next to nothing about this stuff, but I was thinking that it would be good to at least avoid the virus in the period when there might not be enough hospital beds and the health system is very overwhelmed. So it might make sense to take more extreme precautions in that time.
Chief Medical Advisor in the UK, Professor Chris Whitty, “told MPs on the health and social care committee that half of all coronavirus cases in the UK are most likely to occur in just a three-week period, with 95% of them over a nine-week period.”
All good questions. I don’t have great answers, but here are a few things.
The disease CAN burn itself out:
When the density of susceptible individuals is low enough (either because many are recovered and immune or because of social distancing) the disease is predicted to burn out. Google “SIR model” for more info. It is really hard to guess when this will be, obviously. It does look like the social distancing measures taken by China, even after alleged number fudging and diagnostic shortages, made the disease spread much more slowly (and MAYBE would have burned it out if China was completely isolated from the world- very dubious though)
Re extreme individual precautions and the long game
I don’t expect this to blow over in 1-2 months, and I wouldn’t advocate that view to anyone else. The recommendations I made are intended to be risk-reducing in the medium- long term as well as the short term. If you have food stock for 1+ month, then you can choose the safest time to go to the grocery store, or leave your food delivery for 10 days to sanitize, and thereby reduce your risk. Likewise, each time you avoid travel or work from home is reduced risk.
You definitely do want to avoid sheltering in place, only to desperately need food or other supplies later when the risk is higher. But as I said above, having food stocks and taken other precautions means you have more options.
It’s also not the case that you will always be at higher risk if you wait. While the exponential doubling is a good approximation in the short term (and important IMO for people to wrap their heads around), things like safe delivery infrastructure, overall proficiency treating the disease, and availability of medical countermeasures like remdesivir will probably improve in the medium term.
I’m curious what you’re thinking of when you say “adopt measures that can plausibly be sustained for one year or even longer”?
Thanks for the explanation on extreme individual precautions, that made things clearer.
I’m curious what you’re thinking of when you say “adopt measures that can plausibly be sustained for one year or even longer”?
I’m thinking of simple, low-cost changes to habits and my living environment that reduce chances of infection with Coronavirus and other illnesses. For example: improving personal hygiene practices (how to handle laundry, when to desinfect hands, how to keep the kitchen super clean, desinfecting electronic devices), changing workout times (to hit the gym at times when it’s empty), invite my friends to use hand sanitizer when eating together, going to smaller events instead of mass gatherings, keeping a 1-month food supply at home.
These would be easy to sustain for a year or even longer. On the other hand, “not leaving the house” or “cancel all events” incurs significant cost, so I would not be willing to do that for an entire year unless the risk was very high. (Of course, the risk might become “very high” if >10% of the population becomes infected).
This makes sense. To say the obvious, it is sensible for everyone to judge their risk individually and adjust precautions as we have more info. A particularly large factor is your age and comorbid conditions, as well as those of people who you would have the opportunity to infect (who may have higher risk and lower risk tolerance).
I think it is likely enough that most people will consider the risk “very high” at some point before we get a treatment to recommend preparing for that eventuality.
There will not be a vaccine soon, but anti-viral drugs are currently in an FDA approved Phase 3 trial, and from what I have heard could be both approved and available in May.
There is evidence that higher temperatures will limit the spread: Africa has so far been mostly spared, and warm places like Singapore are doing much better than Japan or South Korea.
Too early to have confidence on higher temperatures limiting spread IMO (although some reason to hope, certainly); cases in japan are only <2.5x higher than singapore (234 vs 102 last I saw, and IIRC it got to japan slightly earlier); surveillance and testing in African nations unlikely to be as extensive as e.g. Japan/SK; likely less volume of travel going through african nations than some of the Asian hubs.
Singapore also ranked lower on lists published in late January on “most at risk countries” compared to Japan and Korea. Thailand (first on that list) would be a better example for a warm location being hit less badly than predicted. It reported a lot of cases initially, but it indeed seems like the virus hasn’t spread as much as in some other locations. Warmth could be the decisive factor, but there might also be other reasons.
Singapore is also one of the nations that appears to be dealing most effectively with their coronavirus outbreak (rate of new cases is comparatively low). The country also had a very effective response to SARS in 2003. (Although by Western standards the extent to which they gather information on the population might be uncomfortable).
I just read (surprisingly to me) that Thailand ranks extremely high in pandemic preparedness and early detection. This makes me downshift the warmth hypothesis a bit.
FWIW I now think that warm conditions very likely do slow down transmissions by a lot. Mostly because there are many cold countries where outbreaks became uncontrollable quickly, and this happened nowhere in a hot country so far.
This blog post suggests (based on Google Search Trends) that other coronavirus infections have typically gone down steadily over the course of March and April. (Presumably the data is dominated by the northern hemisphere.)
You mention exponential spread, working from home, and avoiding travelling after March.
But what is the endgame here? How long do we need to stop travelling for? Should we apply these measures, as far as possible, starting in April and keep them up until a vaccine is available in 1-2 years? Will the number of cases level off eventually?
I assume there is no scientific consensus on these questions. If the virus is here to stay, then there might be little value in adopting extreme individual precautions for just one or two months. Afterwards, when you stop taking these extreme measures, there will be an even higher risk of infection. Under these circumstances, it seems better to adopt measures that can plausibly be sustained for one year or even longer.
I know next to nothing about this stuff, but I was thinking that it would be good to at least avoid the virus in the period when there might not be enough hospital beds and the health system is very overwhelmed. So it might make sense to take more extreme precautions in that time.
Chief Medical Advisor in the UK, Professor Chris Whitty, “told MPs on the health and social care committee that half of all coronavirus cases in the UK are most likely to occur in just a three-week period, with 95% of them over a nine-week period.”
https://www.bbc.co.uk/news/uk-51759602
All good questions. I don’t have great answers, but here are a few things.
The disease CAN burn itself out:
When the density of susceptible individuals is low enough (either because many are recovered and immune or because of social distancing) the disease is predicted to burn out. Google “SIR model” for more info. It is really hard to guess when this will be, obviously. It does look like the social distancing measures taken by China, even after alleged number fudging and diagnostic shortages, made the disease spread much more slowly (and MAYBE would have burned it out if China was completely isolated from the world- very dubious though)
Re extreme individual precautions and the long game
I don’t expect this to blow over in 1-2 months, and I wouldn’t advocate that view to anyone else. The recommendations I made are intended to be risk-reducing in the medium- long term as well as the short term. If you have food stock for 1+ month, then you can choose the safest time to go to the grocery store, or leave your food delivery for 10 days to sanitize, and thereby reduce your risk. Likewise, each time you avoid travel or work from home is reduced risk.
You definitely do want to avoid sheltering in place, only to desperately need food or other supplies later when the risk is higher. But as I said above, having food stocks and taken other precautions means you have more options.
It’s also not the case that you will always be at higher risk if you wait. While the exponential doubling is a good approximation in the short term (and important IMO for people to wrap their heads around), things like safe delivery infrastructure, overall proficiency treating the disease, and availability of medical countermeasures like remdesivir will probably improve in the medium term.
I’m curious what you’re thinking of when you say “adopt measures that can plausibly be sustained for one year or even longer”?
Thanks for the explanation on extreme individual precautions, that made things clearer.
I’m thinking of simple, low-cost changes to habits and my living environment that reduce chances of infection with Coronavirus and other illnesses. For example: improving personal hygiene practices (how to handle laundry, when to desinfect hands, how to keep the kitchen super clean, desinfecting electronic devices), changing workout times (to hit the gym at times when it’s empty), invite my friends to use hand sanitizer when eating together, going to smaller events instead of mass gatherings, keeping a 1-month food supply at home.
These would be easy to sustain for a year or even longer. On the other hand, “not leaving the house” or “cancel all events” incurs significant cost, so I would not be willing to do that for an entire year unless the risk was very high. (Of course, the risk might become “very high” if >10% of the population becomes infected).
This makes sense. To say the obvious, it is sensible for everyone to judge their risk individually and adjust precautions as we have more info. A particularly large factor is your age and comorbid conditions, as well as those of people who you would have the opportunity to infect (who may have higher risk and lower risk tolerance).
I think it is likely enough that most people will consider the risk “very high” at some point before we get a treatment to recommend preparing for that eventuality.
There will not be a vaccine soon, but anti-viral drugs are currently in an FDA approved Phase 3 trial, and from what I have heard could be both approved and available in May.
There is evidence that higher temperatures will limit the spread: Africa has so far been mostly spared, and warm places like Singapore are doing much better than Japan or South Korea.
Too early to have confidence on higher temperatures limiting spread IMO (although some reason to hope, certainly); cases in japan are only <2.5x higher than singapore (234 vs 102 last I saw, and IIRC it got to japan slightly earlier); surveillance and testing in African nations unlikely to be as extensive as e.g. Japan/SK; likely less volume of travel going through african nations than some of the Asian hubs.
Singapore also ranked lower on lists published in late January on “most at risk countries” compared to Japan and Korea. Thailand (first on that list) would be a better example for a warm location being hit less badly than predicted. It reported a lot of cases initially, but it indeed seems like the virus hasn’t spread as much as in some other locations. Warmth could be the decisive factor, but there might also be other reasons.
The information Singapore is gathering, collating and making available is fascinating.
https://twitter.com/RyutaroUchiyama/status/1234616723615166465
Singapore is also one of the nations that appears to be dealing most effectively with their coronavirus outbreak (rate of new cases is comparatively low). The country also had a very effective response to SARS in 2003. (Although by Western standards the extent to which they gather information on the population might be uncomfortable).
I just read (surprisingly to me) that Thailand ranks extremely high in pandemic preparedness and early detection. This makes me downshift the warmth hypothesis a bit.
Where did you read this?
I don’t remember the exact source, sorry.
FWIW I now think that warm conditions very likely do slow down transmissions by a lot. Mostly because there are many cold countries where outbreaks became uncontrollable quickly, and this happened nowhere in a hot country so far.
This blog post suggests (based on Google Search Trends) that other coronavirus infections have typically gone down steadily over the course of March and April. (Presumably the data is dominated by the northern hemisphere.)
Update: this blog post is a much better-informed discussion of warm weather.