Contributor Post Created with Sketch. Coronavirus Overreaction

 

Out of over 367,000 COVID-19 cases reported as of noon March 23, 2020, 16,000 people have died, a rough increase of about 9,500 from the past week. China has contributed about 3,500, a figure that is holding relatively stable — if we are to believe the reporting coming out of the People’s Republic of China — as is Iran’s total of 1,812 deaths (another potentially dubious total). In Spain, the death toll is 2,206. Italy has taken the lead with 6,077 deaths, 85 percent of which are of people over 70, which stems, it appears, from a conscious decision not to supply ventilators to anyone over 60. These four nations make up close to 13,000 deaths or about 82 percent of the total. Taken together, these four countries account for over 13,595 of the 16,097 deaths. The good news here is that the growth rates in both Italy and Spain have turned downward in the past 48 hours.

In my column last week, I predicted that the world would eventually see about 50,000 deaths from the novel coronavirus, and the United States about 500. These two numbers are clearly not in sync. If the first number holds, the total US deaths should be about 4 to 5 percent of that total, or about 2,000–2,500 deaths. The current numbers are getting larger, so it is possible both figures will move up in a rough proportion from even that revised estimate. Indeed, the recent run-ups in Italy and perhaps Spain suggest that those countries have yet to turn the corner.

Locally, the United States is high on cases (~35,000) but low on deaths (471). The conversion and expansion rate of COVID-19 are much in issue, and the breakdowns show a high variation across states, and within states. The state that continues to experience the most significant upward movement in fatalities is New York, at 122 as of March 23; its first death was reported only one week ago on March 14. Add in Washington State with 98 deaths, and now close to half of the fatalities are accounted for. California is at 33, with Georgia at 25.

The question is — what should we make of these data? The standard model sees a slow rise in cases until mid-July when it predicts that the United States shall have, for a period of several weeks, close to 10 million cases per day, with an ultimate death total that could reach one million deaths. A recent, thorough study by Aaron Ginn (which itself has been heavily attacked), takes a much more cautious view. A second article by David Katz also indicates that the global totals and that of the United States could be even higher than the numbers I suggested, perhaps by two- or three-fold. These estimates are almost two orders of magnitude lower than the common estimate. Ginn’s study uses the term “hysteria” to describe the response to COVID-19, and, sadly, he is right, given the dangers of drawing hasty inferences from Italy to the rest of the world. Unfortunately, the most common visuals of the virus spread, large red dots to indicate the number of cases in a given area, are alarmist and suggest a more severe crisis than the raw numbers indicate.

The key element in all these cases is the extrapolation from existing cases. The implicit assumption behind Ginn, Katz, and my earlier column is that the worst way to model growth in deaths from the coronavirus is through a geometric progression that runs rapidly through a large number of cycles, each of which generates more cases than the cycle before. If the exponent at each of these stages is greater than one, the model will quickly explode. Thus, if we assume that each infected person infects 2.3 other persons, a world that starts with 100 infections in the first period will have about 2,800, infections by the fifth period, and the rate would grow even more rapidly after that. If the periods are close together, it is easy to see how the fearful analyst could conclude that the world will be soon consumed.

Thus this statement from Tomas Pueyo captures the modern conceit: “Now, use the average doubling time for the coronavirus (time it takes to double cases, on average). It’s 6.2. That means that, in the 17 days it took this person to die, the cases had to multiply by ~8…. That means that, if you are not diagnosing all cases, one death today means 800 true cases today.”

But there is no reason to assume that the doubling is a constant, and therefore there is no reason to accept the ratio of 800 to 1 for true cases compared to deaths. The situation in South Korea alone should dispel that narrative, where pervasive COVID-19 testing has revealed 8,897 cases against only 104 deaths, a ratio of approximately 80 to 1, an order of magnitude less than Pueyo’s representation of the situation. Political leaders predict rising rates of infection, running perhaps for three months, while more cautious analysts think that the cycles turn down far sooner than the doomsday models predict. All of the stay-at-home orders that we see assume that the growth of cases (and of deaths) will be exponential, which is the sole justification for imposing the draconian measures that have wrecked both the economy and upended the lives of millions of people.

Our governors all believe in long-term positive duplication rates, some even subscribing to the 2.3 figure posited by The New York Times. To see the magnitude of these predictions, note that Gavin Newsom, governor of California, has indicated that in the fullness of time, he believes that 25 million people in California will, without intervention, suffer from the virus, meaning that 250,000 people in his state alone will die given the conversion rate. J. B. Pritzker, the governor of Illinois, asserts that his stay-at-home order will prevent “the loss of potentially tens of thousands of lives” within the state. He claims that he consulted with all the right experts before reaching this conclusion. Similarly, New York Governor Andrew Cuomo has issued an executive order that puts “New York State on PAUSE,” with the exception of a long but limited list of essential services, while leaving schools, universities, restaurants, sporting events, and hotels shuttered for the foreseeable future. He thinks that the epidemic will be in force for nine months and claims that his experts expect “that between 40 and 80 percent of New Yorkers will be infected with coronavirus, however, authorities hope to spread out the rate of infection in order to not overwhelm the state’s health system.”

These projections are far more drastic than any sensible extrapolation from the data. If one assumes that there were just a 50 percent exposure rate in California (39.9 million, Illinois (12.7 million) and New York (19.4 million), the number of cases would equal 36 million that would translate into about 360,000 deaths in those three states alone. The current numbers of cases and death of those three states is: New York (15,168 cases, 122 deaths), California (1849 cases, 33 deaths), and Illinois, (1,049 cases, 9 deaths). The total cases are roughly 18,000 or 0.000050 of the projected totals, and the 155 deaths represent 0.00043 of the projected totals.

The governors’ numbers are hysterical and sloppy. None of them have released any detailed study that purported to support their extreme decrees. There was no opportunity for the many critics of their proposals to have their voices heard. The emergency mentality created a one-man gubernatorial dictatorship in each state.

We need a public debate on the political response to COVID-19, and we need it now. I fully understand the need for immediate responses to immediate threats, like fires, but not for crises that may last for three months or more. At this point, everyone knows that people who are elderly, especially those with chronic conditions, should stay out of harm’s way. But that prohibition is self-enforcing because those people know that it is in their best interest to self-quarantine, at least in place of high incidence, but by no means nationally. But for low-risk groups, a different set of precautions may fit the bill — an emphasis on thorough hand washing, reduced work hours, reducing workers per shift, and better availability of ventilation equipment.

The central Hayekian principle applies: All of these choices are done better at the level of plants, hotels, restaurants, and schools than remotely by political leaders. Our governors have failed to ask a basic question: When all the individual and institutional precautions are in place, what is the marginal gain of having the government shut everything down by a preemptive order? Put otherwise, with these precautions in place, what is the extent of the externalities that remain unaddressed?

Progressives think they can run everyone’s lives through central planning, but the state of the economy suggests otherwise. Looking at the costs, the public commands have led to a crash in the stock market, and may only save a small fraction of the lives that are at risk. In addition, there are lost lives on both sides of the equation as many people will now find it more difficult to see a doctor, get regular exercise, stay sober, and eat healthily. None of these alternative hazards are addressed by the worthy governors.

It is critical therefore to get some perspective on this issue, which is perhaps done by taking a quick look at the now-forgotten H1N1 pandemic that ran for about a year from April 2009 to April 2010. The similarities between the two pandemics are evident. Both were novel strains for which there were no available vaccines. Both viruses hit people over 60 the hardest. During the year that H1N1 raged, the CDC estimates that “there were 60.8 million cases (range: 43.3-89.3 million), 274,304 hospitalizations (range: 195,086-402,719), and 12,469 deaths (range: 8868-18,306).”

These figures are in flat contradiction to the wildly high estimates that supposed experts give to support their current doomsday scenario, and they suggest that a far more modest program of containment—and allowing the virus to run its course—is a better path forward for the economy. Our government fiats will probably save very few, if any, lives saved over what we can obtain through more focused voluntary precautions. All the while, the United States is entertaining hopeless stimulus negotiations that shift dollars around, but do nothing to make up for the trillions that will inevitably be lost as a result of the economic shutdown. There is only one cure to the current malaise, which is to reverse these self-destructive policies before it is too late.

© 2020 by the Board of Trustees of Leland Stanford Junior University.

Published in Economics, Healthcare, Law
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  1. James Gawron Thatcher
    James Gawron Joined in the first year of Ricochet Ricochet Charter Member

    Richard Epstein: There is only one cure to the current malaise, which is to reverse these self-destructive policies before it is too late.

    Dr. Epstein,

    Agreed.

    Regards,

    Jim

    • #1
    • March 23, 2020, at 6:02 PM PDT
    • 5 likes
  2. Unsk Member

    Richard: “these figures are in flat contradiction to the wildly high estimates that supposed experts give to support their current doomsday scenario, and they suggest that a far more modest program of containment—and allowing the virus to run its course—is a better path forward for the economy.”

    Yep. Undeniably true. South Korea beat back this disease without going to these incredibly harmful lockdowns. Yes, it is advisable to encourage prudent measures such as self quarantines but the incredible scope of these lockdowns will actually prevent us for fighting this disease. We need farms, most construction, trucking, most engineering and most manufacturing activities to continue pretty much as they were just to name a few industries that must keep producing to fight this disease, not to mention all the people who will be throw out of work and will lose their jobs permanently. 

    • #2
    • March 23, 2020, at 6:57 PM PDT
    • 11 likes
  3. iWe Reagan
    iWe Joined in the first year of Ricochet Ricochet Charter Member

    Complete agreement. Quarantine the at-risk. Release and promote the drugs that have shown results. Put everyone else back in full circulation.

    • #3
    • March 23, 2020, at 7:17 PM PDT
    • 10 likes
  4. Zach H. Coolidge

    Mr. Epstein has the ear of the White House and I hope his arguments are very closely scrutinized. If his relative sanguinity is misguided and leads to a softening up of containment measures the upshot could be terrible not only for our healthcare system but for the very thing he hopes to preserve, our economy. As Scott Gottlieb has pointed out on Twitter: “So long as covid-19 spreads uncontrolled, older people will die in historic numbers, middle aged folks doomed to prolonged ICU stays to fight for their lives, hospitals will be overwhelmed, and most Americans terrified to leave homes, eat out, take the subway, or go to the park.” “The only way to return to a stable economy and restore our liberty is to end the epidemic spread of covid-19.”

    A week ago Mr. Epstein was predicting 500 dead in the USA from Covid-19–total. Today the number dead is already 585. For reasons I can’t apprehend, he compares the H1N1 outbreak (due to an orhthomixovirus), citing its relatively low hospitalization rate and death count, to that of the Coronavirus (in a different family of viruses altogether), which from what we can see so far behaves, unsurprisingly, very differently. Data in the US are early (2049 cases in this instance), but between February 12- March 16, the hospitalization rate in this country was between 20-31% and ICU admission 5-10%, case-fatality between 1.8 and 3.4% (18-34X that of the flu).

    Mr. Epstein somewhat casually mentions the need for ventilators. I sometimes wonder whether people grasp the invasive nature of this potentially life-saving device. It ain’t a nasal cannula, folks, nor is it a sure win. Basically, you have a plastic tube shoved down your windpipe forcefully pumping air into and out of damaged, fluid-filled lungs. Acute Respiratory Distress Syndrome, which Covid-19 causes in a startling percentage of its victims, young and old, is survivable (mortality rate: about 35-50%) but also a nightmare, and one that requires a lengthy recovery (we don’t yet know to what degree severe cases of Covid-19 recover lung function).

    This is not H1N1. This is not the flu. Right: The cure musn’t be worse than the disease. We must balance difficult cost-benefit questions. But the disease is plenty bad. I suspect Mr. Epstein is again drastically low-balling the final death count (2000-2500 is his current estimate). It seems likely to me that we will be passing those numbers within a week or two. I would love, love, love to be wrong.

    • #4
    • March 23, 2020, at 9:03 PM PDT
    • 8 likes
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  5. Danny Alexander Member

    If the virus — as I strongly suspect — emerged, however accidentally, from the virology lab in Wuhan, all bets are off.

    In China at present, all evidence points to continued ravages at least in Wuhan (and elsewhere in Hubei province?), notwithstanding the Xi regime’s fiat that victory be proclaimed. (See reporting in The Daily Caller as well as Helen Raleigh’s latest column at The Federalist.)

    Prior to said fiat, the CCP/PLA dictatorship engaged in a containment campaign that effectively trashed wide-ranging segments of the PRC economy, and unhesitatingly condemned a significant number of Wuhan/Hubei denizens to their premature demise through drastic lockdown of the populace there (and elsewhere in the country for a period of time). Personally, I find it next to impossible to accept that this is anywhere remotely a garden-variety SOP response to a naturally occurring virus, however strong.

    I made the abrupt decision in mid-February to relocate from Tokyo to Boston — notwithstanding the valuable 2.5 years of validity I had left on my Japanese work visa — with this concern top of mind. Of course, my hopes of finding refuge in Fortress America proved misplaced — so I’m left with praying that my assessment of the nature of the virus also proves spectacularly wrong.

    • #5
    • March 23, 2020, at 9:19 PM PDT
    • 3 likes
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  6. Zach H. Coolidge

    Danny Alexander (View Comment):

    If the virus — as I strongly suspect — emerged, however accidentally, from the virology lab in Wuhan, all bets are off.

    Usually, I would brush off such an idea as conspiracy mongering, but in this case I don’t know why people are dismissing it. There is a Biosafety Level 4 Virology Lab (that is, maximum containment; most danger) in Wuhan, miles away from the wet market where the virus putatively emerged (I’ve read between 4 and 20 miles away). For perspective, there are fewer than 60 BSL-4 facilities worldwide. The lab in Wuhan has published research in–guess what?–Coronavirus, particularly those strains emerging from bats. (This is all on Wikipedia.) So one BSL-4 Virology lab with a special interest in zoonotic coronaviridae happens to be smack at the center of ground zero of this pandemic. Huh.

    Moreover, in my understanding, zoonotic diseases do not leap from animal to human at breakneck speed and become almost instantly virulent. They have to stew around relatively harmlessly in different hosts for a while before mutating into something that can sustain the environment of its hosts. Most die out relatively quickly. Has a zoonotic disease ever blown up as quickly as Covid-19? This is not my speciality. I would like to know.

    The long and short of it is: No one should trust the numbers or explanations coming from the CCP. Neither should we take the wet market claim at face value. Not at all.

    • #6
    • March 23, 2020, at 9:53 PM PDT
    • 8 likes
    • This comment has been edited.
  7. J. D. Fitzpatrick Member
    J. D. Fitzpatrick Joined in the first year of Ricochet Ricochet Charter Member

    fivethirtyeight surveyed a bunch of epidemiologists. 

    https://fivethirtyeight.com/features/infectious-disease-experts-dont-know-how-bad-the-coronavirus-is-going-to-get-either/

    • #7
    • March 23, 2020, at 10:12 PM PDT
    • 3 likes
  8. Scott R Member
    Scott R Joined in the first year of Ricochet Ricochet Charter Member

    We’re a continent-size country of 330 million people with varying population density, climate, and exposure to travel. It might well be that an aggressive temporary lockdown in NY represents the least bad trade-off there, while less severe restrictions strike the better balance in TX. 

    We need to be more nimble.

    • #8
    • March 23, 2020, at 10:30 PM PDT
    • 6 likes
  9. Ontheleftcoast Member

    Richard Epstein:

    In my column last week, I predicted that the world would eventually see about 50,000 deaths from the novel coronavirus, and the United States about 500. These two numbers are clearly not in sync. If the first number holds, the total US deaths should be about 4 to 5 percent of that total, or about 2,000–2,500 deaths. The current numbers are getting larger, so it is possible both figures will move up in a rough proportion from even that revised estimate. Indeed, the recent run-ups in Italy and perhaps Spain suggest that those countries have yet to turn the corner.

    Locally, the United States is high on cases (~35,000) but low on deaths (471). The conversion and expansion rate of COVID-19 are much in issue, and the breakdowns show a high variation across states, and within states. The state that continues to experience the most significant upward movement in fatalities is New York, at 122 as of March 23; its first death was reported only one week ago on March 14. Add in Washington State with 98 deaths, and now close to half of the fatalities are accounted for. California is at 33, with Georgia at 25.

    Since 473 is close enough to 500 for government work and we are nowhere near done yet, Professor Epstein’s predictive model of last week clearly needs some work.

    Case fatality rate is deaths per number of diagnosed cases; the US CFR, now crudely estimated from the current data is about 1.3. How you define “diagnosed cases” is going to vary a lot with the availability of accurate testing. US testing has been heavy enough that test supplies are running out; that supports President Trump’s call to test the symptomatic but doesn’t do much for comprehensive statistics. Reports from China are that by the time pneumonia sets in in Kung Flu, the radiologic appearance of CT is pretty characteristic; accurate, but by then they’re likely to die.

    But let’s be optimistic, and anticipate that, like in South Korea, a bit over 3% of the population is infected, call it around 11,000,000 people. The US Surgeon General has estimated that about 20% will need hospitalization; most of that 2 million will be people with preexisting conditions. The US has about 900,000 hospital beds, many if not most of which are occupied day in and day out anyway, for which that additional patients will be competing. Uh oh.

    Or let’s be really optimistic and say that for that 11 M patients, the CFR will be 1.3%ish. That’s “only” an excess mortality due to COVID-19 of 125,000; a guesstimate based on other countries’ experience will be, including the dead, a mere excess demand for 750,000 hospital beds over the course of the epidemic.

    That appears to be the best case scenario. We shouldn’t bet the farm on it. Not yet.

    • #9
    • March 23, 2020, at 10:53 PM PDT
    • 2 likes
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  10. Steven Seward Member

    Ontheleftcoast (View Comment):

    But let’s be optimistic, and anticipate that, like in South Korea, a bit over 3% of the population is infected, call it around 11,000,000 people. The US Surgeon General has estimated that about 20% will need hospitalization; most of that 2 million will be people with preexisting conditions. The US has about 900,000 hospital beds, many if not most of which are occupied day in and day out anyway, for which that additional patients will be competing. Uh oh.

    I’m not sure where you got that figure of 3% of South Koreans being infected with the virus. If you do the math, South Korea has a population of 51 million people, and as of today they have catalogued 9,037 cases of infection. That would be an infection rate of about .00017 or .017%. Expressed in a different way it would be nearly one person in six-thousand.

    I have been struck by all the estimates that 30% or even 10% of the population is going to be infected, when we are seeing such low actual infection rates. Even if you were to multiply South Korea’s cases by one-hundred, it would still only be one person in 600, or about .16%. Italy has by far the highest rate of infection for a major country (if you exclude places tiny places like San Marino). Even their infection rate is only one in a thousand, or .1%. You would have to multiply this by 100 times in order to reach 10% infections. And their infection rate is ten times the U.S. rate (so far).

    Have I done the math wrong? Are these numbers misleading or is this virus not as contagious as everyone thinks? What am I missing?

    • #10
    • March 24, 2020, at 8:00 AM PDT
    • 1 like
  11. Ontheleftcoast Member

    Richard Epstein: China has contributed about 3,500, a figure that is holding relatively stable — if we are to believe the reporting coming out of the People’s Republic of China

    If indeed. In the absence of trustworthy reporting, there are tea leaves to try to read. The Epoch Times (obviously no friend of the CCP) reports that there are 21 million fewer cell phone accounts and 840,000 fewer land lines in China than the month before, and then discusses the various possibilities. One possible explanation for some of the decrease in a previously constantly increasing statistic is the economic downturn, another is “CCP virus” deaths not reported to the world.

    Lacking data, the real death toll in China is a mystery. The cancellation of 21 million cellphones provides a data point that suggests the real number may be far higher than the official number.

    The Epoch Times refers to the novel coronavirus, which causes the disease COVID-19, as the CCP virus because the Chinese Communist Party’s coverup and mismanagement allowed the virus to spread throughout China and create a global pandemic.

    • #11
    • March 24, 2020, at 9:41 AM PDT
    • 1 like
  12. Ontheleftcoast Member

    Steven Seward (View Comment):
    I’m not sure where you got that figure of 3% of South Koreans being infected with the virus. If you do the math, South Korea has a population of 51 million people, and as of today they have catalogued 9,037 cases of infection. That would be an infection rate of about .00017 or .017%. Expressed in a different way it would be nearly one person in six-thousand.

    You’re partially right. By early February, South Korea had tested over 50,000 people, 3.3% of whom tested positive. The most recent number, 9,037 was detected in testing 348,582 South Koreans. That’s about 2.5%. That’s probably pretty accurate; they’ve been doing a lot of non-clinically driven testing. I’m thinking that this is a pretty good value for the percentage of the entire population which is infected.

    The comparable statistics being produced in the US are not nearly as good for now. Unfortunately, now is when we have to make critical decisions. While you can, maybe should, quibble with the Surgeon General, he’s got access to better data than I do and “20%” came from him. If your planners can say “X% of infected people will need hospitalization” and you know how many people in your country are infected, you can plan pretty well. If the best you can say is that “20% of the people who test positive will need hospitalization” but you don’t know how many people that actually is, why, you’re living in the U.S. of A.

    So I’ll revisit my numbers based on 2.5%:

    In the US, at 2.5% of the population infected, that’s 8,250,000 or so infected people. Per the Surgeon General, 1,650,000 hospital cases due to COVID-19, not 2 million.

    We still only have about 900,000 beds. Not new beds, total beds. For everything.

    • #12
    • March 24, 2020, at 12:36 PM PDT
    • 2 likes
    • This comment has been edited.
  13. Steven Seward Member

    Ontheleftcoast (View Comment):

     

    In the US, at 2.5% of the population infected, that’s 8,250,000 or so infected people. Per the Surgeon General, 1,650,000 hospital cases due to COVID-19, not 2 million.

    We still only have about 900,000 beds. Not new beds, total beds. For everything.

    As bad as that 2.5% infection rate sounds, we would still have to multiply what we’ve got so far (50,000 cases) by 165 times in order to reach that level.

    • #13
    • March 24, 2020, at 12:58 PM PDT
    • 1 like
  14. Ontheleftcoast Member

    Steven Seward (View Comment):

    Ontheleftcoast (View Comment):

     

    In the US, at 2.5% of the population infected, that’s 8,250,000 or so infected people. Per the Surgeon General, 1,650,000 hospital cases due to COVID-19, not 2 million.

    We still only have about 900,000 beds. Not new beds, total beds. For everything.

    As bad as that 2.5% infection rate sounds, we would still have to multiply what we’ve got so far (50,000 cases) by 165 times in order to reach that level.

    That’s 5 doublings away. 

    1. 100,000
    2. 200,000
    3. 400,000
    4. 800,000
    5. 1,600,000

    I read that NY state is doubling its reported cases every 2-3 days. There are regional differences, and other countries have reported a week or so when in the throes. Let’s hope the lockdowns are impeding transmission and slowing down the spread the way they’re supposed to. 

    • #14
    • March 24, 2020, at 3:23 PM PDT
    • 1 like
  15. Gumby Mark (R-Meth Lab of Demo… Thatcher

    Steven Seward (View Comment):

    Ontheleftcoast (View Comment):

    But let’s be optimistic, and anticipate that, like in South Korea, a bit over 3% of the population is infected, call it around 11,000,000 people. The US Surgeon General has estimated that about 20% will need hospitalization; most of that 2 million will be people with preexisting conditions. The US has about 900,000 hospital beds, many if not most of which are occupied day in and day out anyway, for which that additional patients will be competing. Uh oh.

    I’m not sure where you got that figure of 3% of South Koreans being infected with the virus. If you do the math, South Korea has a population of 51 million people, and as of today they have catalogued 9,037 cases of infection. That would be an infection rate of about .00017 or .017%. Expressed in a different way it would be nearly one person in six-thousand.

    I have been struck by all the estimates that 30% or even 10% of the population is going to be infected, when we are seeing such low actual infection rates. Even if you were to multiply South Korea’s cases by one-hundred, it would still only be one person in 600, or about .16%. Italy has by far the highest rate of infection for a major country (if you exclude places tiny places like San Marino). Even their infection rate is only one in a thousand, or .1%. You would have to multiply this by 100 times in order to reach 10% infections. And their infection rate is ten times the U.S. rate (so far).

    Have I done the math wrong? Are these numbers misleading or is this virus not as contagious as everyone thinks? What am I missing?

    Yes, you are missing things. In addition to the point raised by @ontheleftcoast, the Korean situation is not comparable. The outbreak there started in one city and the quick reaction by the government allowed for widespread testing, identification, and containment of infected individuals before it became widespread. We are way past that point in the U.S. where we could have a half million infected by now.

    My understanding is that Italy is not doing widespread testing and has also taken countrywide restrictions way beyond those of any area in the U.S. in order to try to stem virus spread so it is difficult to draw any conclusions at this point that are applicable to the U.S.

    I don’t know if we will end up with several million cases or not. No one does. But it is a plausible, not worst case, scenario and it will have consequences for our ability to treat the ill. Although those below 50 have a much lower mortality rate than those older, it is still significantly higher than for flu and, more importantly the % of those younger people infected who require hospitalization is also higher than for the flu. The higher the denominator, the more stressed the system will be, even if the percentages remain low.

    • #15
    • March 24, 2020, at 4:17 PM PDT
    • Like
  16. Instugator Thatcher
    Instugator Joined in the first year of Ricochet Ricochet Charter Member

    Richard Epstein: Our governors all believe in long-term positive duplication rates, some even subscribing to the 2.3 figure posited by The New York Times.

    The US doubling rate has held pretty steady at 1.75 days.

    Study here.

    Additional chart – note the slope of the US data is steeper than the other countries, this too argues for a doubling rate in excess of other countries.

    • #16
    • March 24, 2020, at 4:24 PM PDT
    • Like
  17. Steven Seward Member

    Ontheleftcoast (View Comment):

    Steven Seward (View Comment):

    Ontheleftcoast (View Comment):

     

    In the US, at 2.5% of the population infected, that’s 8,250,000 or so infected people. Per the Surgeon General, 1,650,000 hospital cases due to COVID-19, not 2 million.

    We still only have about 900,000 beds. Not new beds, total beds. For everything.

    As bad as that 2.5% infection rate sounds, we would still have to multiply what we’ve got so far (50,000 cases) by 165 times in order to reach that level.

    That’s 5 doublings away.

    1. 100,000
    2. 200,000
    3. 400,000
    4. 800,000
    5. 1,600,000

    I read that NY state is doubling its reported cases every 2-3 days. There are regional differences, and other countries have reported a week or so when in the throes. Let’s hope the lockdowns are impeding transmission and slowing down the spread the way they’re supposed to.

    I don’t know what the relevance of doublings is. I could just extend your chart to 13 steps and the entire country would be infected, but I don’t think that is how infections spread in practice. Just as a for instance, 60% of all the infections are in a tiny geographical area in New York and New Jersey. The rest of the country’s infection rate is lagging staggeringly far behind. Throughout the world, a few select places are spreading quickly, mainly just in Europe, while Africa, Central and South America, and nearly all of Asia (with the exception of China) remains largely unaffected.

    • #17
    • March 24, 2020, at 5:05 PM PDT
    • Like
  18. The Reticulator Member

    Steven Seward (View Comment):
    I don’t know what the relevance of doublings is. I could just extend your chart to 13 steps and the entire country would be infected, but I don’t think that is how infections spread in practice.

    Actually, they do spread that way in practice, at first, and then the doubling time gradually slows down. So in a bad case, we could get to 160,000 cases in 12-13 days. (If current doubling time is 2.5 days, and it stays that way.) If it slowed down to 5 days (where Italy is now) it would take 25 days. Of course, it slows gradually, so it would really happen in less than 25 days if it slowed down no more than that. 

    • #18
    • March 24, 2020, at 6:46 PM PDT
    • 2 likes
  19. The Reticulator Member

    The Reticulator (View Comment):

    Steven Seward (View Comment):
    I don’t know what the relevance of doublings is. I could just extend your chart to 13 steps and the entire country would be infected, but I don’t think that is how infections spread in practice.

    Actually, they do spread that way in practice, at first, and then the doubling time gradually slows down. So in a bad case, we could get to 160,000 cases in 12-13 days. (If current doubling time is 2.5 days, and it stays that way.) If it slowed down to 5 days (where Italy is now) it would take 25 days. Of course, it slows gradually, so it would really happen in less than 25 days if it slowed down no more than that.

    South Korea is currently at 13 days and Japan is at 10 days. If we could magically be at South Korea’s rate tomorrow, it would take a little over two months to get 5 doublings. But we have a lot of slowing to do before we get down to that rate.

    • #19
    • March 24, 2020, at 6:53 PM PDT
    • 2 likes
  20. Steven Seward Member

    The Reticulator (View Comment):

    Steven Seward (View Comment):
    I don’t know what the relevance of doublings is. I could just extend your chart to 13 steps and the entire country would be infected, but I don’t think that is how infections spread in practice.

    Actually, they do spread that way in practice, at first, and then the doubling time gradually slows down. So in a bad case, we could get to 160,000 cases in 12-13 days. (If current doubling time is 2.5 days, and it stays that way.) If it slowed down to 5 days (where Italy is now) it would take 25 days. Of course, it slows gradually, so it would really happen in less than 25 days if it slowed down no more than that.

    Good point, though what I was getting at and probably should have phrased it better, is that doubling doesn’t just continue ad infinitum. So far it hasn’t gone very far in any country, including Italy. After two months, Italy’s infection rate is still only .001, or .1%. Even if you account for inadequate testing and multiply that by ten times it would only be 1%.

    • #20
    • March 24, 2020, at 7:14 PM PDT
    • 1 like
  21. Ontheleftcoast Member

    Steven Seward (View Comment):
    Good point, though what I was getting at and probably should have phrased it better, is that doubling doesn’t just continue ad infinitum. So far it hasn’t gone very far in any country, including Italy. After two months, Italy’s infection rate is still only .001, or .1%. Even if you account for inadequate testing and multiply that by ten times it would only be 1%.

    1% of a population of 330,000,000 = 3.3 million cases. Let’s say it’s not 20% of the cases that need hospitalization, it’s only 10%. That’s 330,000 “excess” hospitalizations due to COVID-19 putting pressure on the existing 900,000 beds we have.

    • #21
    • March 24, 2020, at 7:32 PM PDT
    • 1 like
  22. The Reticulator Member

    Ontheleftcoast (View Comment):

    Steven Seward (View Comment):
    Good point, though what I was getting at and probably should have phrased it better, is that doubling doesn’t just continue ad infinitum. So far it hasn’t gone very far in any country, including Italy. After two months, Italy’s infection rate is still only .001, or .1%. Even if you account for inadequate testing and multiply that by ten times it would only be 1%.

    1% of a population of 330,000,000 = 3.3 million cases. Let’s say it’s not 20% of the cases that need hospitalization, it’s only 10%. That’s 330,000 “excess” hospitalizations due to COVID-19 putting pressure on the existing 900,000 beds we have.

    And maybe not everyone will need a bed at the same time. (I think the practice of multiple patients in a hospital bed at one time went out a long time ago.) But still, there is plenty of potential for serious difficulty.

    • #22
    • March 24, 2020, at 7:52 PM PDT
    • 2 likes
  23. James Gawron Thatcher
    James Gawron Joined in the first year of Ricochet Ricochet Charter Member

    The Reticulator (View Comment):

    Ontheleftcoast (View Comment):

    Steven Seward (View Comment):
    Good point, though what I was getting at and probably should have phrased it better, is that doubling doesn’t just continue ad infinitum. So far it hasn’t gone very far in any country, including Italy. After two months, Italy’s infection rate is still only .001, or .1%. Even if you account for inadequate testing and multiply that by ten times it would only be 1%.

    1% of a population of 330,000,000 = 3.3 million cases. Let’s say it’s not 20% of the cases that need hospitalization, it’s only 10%. That’s 330,000 “excess” hospitalizations due to COVID-19 putting pressure on the existing 900,000 beds we have.

    And maybe not everyone will need a bed at the same time. (I think the practice of multiple patients in a hospital bed at one time went out a long time ago.) But still, there is plenty of potential for serious difficulty.

    Guys,

    My point would be why are you only talking about the total number of beds (or ventilators) available. The key factor is how long they will be staying? With no real treatment (nothing that kill the virus already spread inside the patient) they will either slowly manage to fight their way through or linger until death.

    A course of something that kills the virus would reduce the stay down to one week. Once you get the hang of telemedicine they could be given the drug and constantly be monitored remotely. No bed stays at all.

    Of course, if Fauci won’t relent and he insists that anything less than a full Phase II study is unacceptable, all solutions must wait at a minimum of 1 year. We are setting ourselves up for a resource shortage. This is where somebody at the top must take a risk or we will really have a double catastrophe. The virus will kill many no matter how many times you wash your hands each day and the economy will be destroyed.

    A real full scale lose lose proposition.

    Regards,

    Jim

    • #23
    • March 24, 2020, at 8:05 PM PDT
    • 3 likes
    • This comment has been edited.
  24. Gumby Mark (R-Meth Lab of Demo… Thatcher

    James Gawron (View Comment):

    The Reticulator (View Comment):

    Ontheleftcoast (View Comment):

    Steven Seward (View Comment):
    Good point, though what I was getting at and probably should have phrased it better, is that doubling doesn’t just continue ad infinitum. So far it hasn’t gone very far in any country, including Italy. After two months, Italy’s infection rate is still only .001, or .1%. Even if you account for inadequate testing and multiply that by ten times it would only be 1%.

    1% of a population of 330,000,000 = 3.3 million cases. Let’s say it’s not 20% of the cases that need hospitalization, it’s only 10%. That’s 330,000 “excess” hospitalizations due to COVID-19 putting pressure on the existing 900,000 beds we have.

    And maybe not everyone will need a bed at the same time. (I think the practice of multiple patients in a hospital bed at one time went out a long time ago.) But still, there is plenty of potential for serious difficulty.

    Guys,

    My point would be why are you only talking about the total number of beds (or ventilators) available. The key factor is how long they will be staying? With no real treatment (nothing that kill the virus already spread inside the patient) they will either slowly manage to fight their way through or linger until death.

    A course of something that kills the virus would reduce the stay down to one week. Once you get the hang of telemedicine they could be given the drug and constantly be monitored remotely. No bed stays at all.

    Of course, if Fauci won’t relent and he insists that anything less than a full Phase II study is unacceptable, all solutions must wait at a minimum of 1 year. We are setting ourselves up for a resource shortage. This is where somebody at the top must take a risk or we will really have a double catastrophe. The virus will kill many no matter how many times you wash your hands each day and the economy will be destroyed.

    A real full scale lose lose proposition.

    Regards,

    Jim

    What are you talking about? New York just received, with FDA approval, a large amount of these medicines to try.

    • #24
    • March 24, 2020, at 8:08 PM PDT
    • 1 like
  25. Steven Seward Member

    Ontheleftcoast (View Comment):

    Steven Seward (View Comment):
    Good point, though what I was getting at and probably should have phrased it better, is that doubling doesn’t just continue ad infinitum. So far it hasn’t gone very far in any country, including Italy. After two months, Italy’s infection rate is still only .001, or .1%. Even if you account for inadequate testing and multiply that by ten times it would only be 1%.

    1% of a population of 330,000,000 = 3.3 million cases. Let’s say it’s not 20% of the cases that need hospitalization, it’s only 10%. That’s 330,000 “excess” hospitalizations due to COVID-19 putting pressure on the existing 900,000 beds we have.

    Not to be rude, but you are doing what the majority of “doomsdayers” do and that is to expect the U.S. to follow the worst case country on Earth, Italy, instead of just an average or better case country , like Japan or Thailand. On top of that you are multiplying the worst case by ten. With the best medical system in the World and the drastic measures we have taken, I would predict that we will not end up like Italy or most of the European countries.

    • #25
    • March 24, 2020, at 8:12 PM PDT
    • 1 like
    • This comment has been edited.
  26. Gumby Mark (R-Meth Lab of Demo… Thatcher

    Steven Seward (View Comment):

    Ontheleftcoast (View Comment):

    Steven Seward (View Comment):
    Good point, though what I was getting at and probably should have phrased it better, is that doubling doesn’t just continue ad infinitum. So far it hasn’t gone very far in any country, including Italy. After two months, Italy’s infection rate is still only .001, or .1%. Even if you account for inadequate testing and multiply that by ten times it would only be 1%.

    1% of a population of 330,000,000 = 3.3 million cases. Let’s say it’s not 20% of the cases that need hospitalization, it’s only 10%. That’s 330,000 “excess” hospitalizations due to COVID-19 putting pressure on the existing 900,000 beds we have.

    Not to be rude, but you are doing what the majority of “doomsdayers” do and that is to expect the U.S. to follow the worst case country on Earth, Italy, instead of just an average or better case country , like Japan or Thailand. On top of that you are multiplying the worst case by ten. With the best medical system in the World and the drastic measures we have taken, I would predict that we will not end up like Italy or most of the European countries.

    Our measures are significantly less drastic than those in Italy.

    • #26
    • March 24, 2020, at 8:24 PM PDT
    • 1 like
  27. James Gawron Thatcher
    James Gawron Joined in the first year of Ricochet Ricochet Charter Member

    Gumby Mark (R-Meth Lab of Demo… (View Comment):
    What are you talking about? New York just received, with FDA approval, a large amount of these medicines to try.

    Gumby,

    Really, then what was Fauci talking about the day before. Could you link the article that says NY has full FDA approval?

    Regards,

    Jim

    • #27
    • March 24, 2020, at 8:32 PM PDT
    • 1 like
  28. Gumby Mark (R-Meth Lab of Demo… Thatcher

    James Gawron (View Comment):

    Gumby Mark (R-Meth Lab of Demo… (View Comment):
    What are you talking about? New York just received, with FDA approval, a large amount of these medicines to try.

    Gumby,

    Really, then what was Fauci talking about the day before. Could you link the article that says NY has full FDA approval?

    Regards,

    Jim

    Here you go. Trials started today.

    • #28
    • March 24, 2020, at 8:34 PM PDT
    • 2 likes
  29. James Gawron Thatcher
    James Gawron Joined in the first year of Ricochet Ricochet Charter Member

    Gumby Mark (R-Meth Lab of Demo… (View Comment):

    James Gawron (View Comment):

    Gumby Mark (R-Meth Lab of Demo… (View Comment):
    What are you talking about? New York just received, with FDA approval, a large amount of these medicines to try.

    Gumby,

    Really, then what was Fauci talking about the day before. Could you link the article that says NY has full FDA approval?

    Regards,

    Jim

    Here you go. Trials started today.

    Gumby,

    I know the trials started today but I wasn’t aware that FDA had approved the whole thing. Fauci was still talking about his “anecdotal evidence” the day before making Trump look foolish. The next day Cuomo got 500,000 doses of the stuff Trump only said he was “hopeful” about plus complete FDA approval.

    This is the most massive radical fast-tracking ever done. Somehow I suspect the inference of efficacy was really rather evident. Fauci just wanted to pooh pooh Trump to the very last minute. Fauci you see is a man of science and Trump is just some wishful thinker. What a lot of [email protected]

    Regards,

    Jim

     

    • #29
    • March 24, 2020, at 8:49 PM PDT
    • 2 likes
  30. Steven Seward Member

    Gumby Mark (R-Meth Lab of Demo… (View Comment):

    Steven Seward (View Comment):

    Ontheleftcoast (View Comment):

    Steven Seward (View Comment):
    Good point, though what I was getting at and probably should have phrased it better, is that doubling doesn’t just continue ad infinitum. So far it hasn’t gone very far in any country, including Italy. After two months, Italy’s infection rate is still only .001, or .1%. Even if you account for inadequate testing and multiply that by ten times it would only be 1%.

    1% of a population of 330,000,000 = 3.3 million cases. Let’s say it’s not 20% of the cases that need hospitalization, it’s only 10%. That’s 330,000 “excess” hospitalizations due to COVID-19 putting pressure on the existing 900,000 beds we have.

    Not to be rude, but you are doing what the majority of “doomsdayers” do and that is to expect the U.S. to follow the worst case country on Earth, Italy, instead of just an average or better case country , like Japan or Thailand. On top of that you are multiplying the worst case by ten. With the best medical system in the World and the drastic measures we have taken, I would predict that we will not end up like Italy or most of the European countries.

    Our measures are significantly less drastic than those in Italy.

    Are you insinuating that the U.S. will end up equal to the worst case country on Earth, Italy? If so, please explain why you think so.

    • #30
    • March 24, 2020, at 8:56 PM PDT
    • 1 like