Hard Coronavirus Suppression is Needed For A Few Weeks

Tomas Pueyo makes the case that far stronger coronavirus measures are needed today and they should only last a few weeks. There shouldn’t be a big peak of infections afterwards, and it can all be done for a reasonable cost to society, saving millions of lives along the way. If we don’t take these measures, tens of millions will be infected, many will die, along with anybody else that requires intensive care, because the healthcare system will have collapsed.

We need to have testing, case isolation and social distancing at the same time for a few weeks. This could prevent the medical system collapse. We then ramp up our medical drugs and build up ventilators and capacity at a rapid pace, for the next surge which would be expected in October or November. We buy time but we have to use the time to fully prepare for the next time that will be coming.

If we know where the virus is, we can target these places only. This is the basics of how East Asia Countries were able to control this outbreak without national social distancing that is increasingly essential in other countries.

We have social distancing now but we need abundant testing, contact tracing and case isolation.

Brian Wang also believes that hourly hand washing -hand cleaning is needed at places that cannot shutdown like hospitals, military bases, prisons etc… An MIT Study model indicates that cleaning hands every 82 minutes would reduce disease spread from a global airport model. Hourly handwashing-sanitizer cleaning with announcements at any public places that need to stay open would be simple to follow.

Niel Ferguson and the Imperial College of London COVID-19 Response team have a 20-page paper that describes the need for suppression.

If it does run out of control, suppression is still the attempt to take the edge off of the medical system overrun. Try to keep the death rate at 0.6% instead of 5.0% where none of those needing ventilation die.

Suppression would get us:
Fewer total cases of Coronavirus
Immediate relief for the healthcare system and the humans who run it
Reduction in fatality rate
Reduction in collateral damage
Ability for infected, isolated and quarantined healthcare workers to get better and back to work. In Italy, healthcare workers represent 8% of all contagions.

For individuals, practice hourly hand cleaning when you are anywhere there might be infected surfaces or infected people. You now must assume other people are infected for the next 2-3 weeks.

Sign a Whitehouse petition to get hard suppression implemented.

SOURCES – Tomas Pueyo, Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand – Imperial College of London, Risk Analysis – Hand‐Hygiene Mitigation Strategies Against Global Disease Spreading through the Air Transportation Network
Written by Brian Wang, Nextbigfuture.com. Brian Wang is working with a startup working on coronavirus mitigation

37 thoughts on “Hard Coronavirus Suppression is Needed For A Few Weeks”

  1. if the incubation time is around 3 weeks, keep twice that time isolation and the virus is gone, its simple
    why twice because someone could have been infected just the day it started, or shortly after, this gives him time to get sick and recover. Its best to do it at summer time so people live less indoors 
    (no locked up particles in home/work/cafe/etc)

  2. I used to take chloro quinine when I lived in Malaysia. Do you have a link showing they are using it widely in Korea?

  3. This sounds grim, but compare that to the 120,000 people who WILL DIE this week because of hunger. Suddenly, those numbers don’t look so bad.

  4. This kills people with other health issues. Many people in Africa have health issues from other infections, and nutritional deficiencies. One positive is lower smoking rates. The 2 countries with the highest cigarette consumption: Andorra and Luxembourg both have higher rates of infection than Italy. https://en.wikipedia.org/wiki/List_of_countries_by_cigarette_consumption_per_capita#2016_rankings
    Andorra 1462/1m
    Luxembourg 1275/1m
    Italy 886/1m

  5. Models are only as good as the assumptions put into them.

    Yes. That’s why models are created, models allow us to predict future behaviors and results. To project the outcomes based on certain initial assumptions, so you can avoid or adopt the initial conditions if you like or don’t like the end results.

    In the (unlikely) absence of any control measures or spontaneous changes in individual behaviour, we would expect a peak in mortality (daily deaths) to occur after approximately 3 months(Figure 1A). In such scenarios, given an estimatedR0of 2.4, we predict 81% of the GB and US populations would be infected over the course of the epidemic… -Imperial College COVID-19 Response Team

    If it would make you feel better if the projected results were correct for your country, you will have to convince your countrymen to adopt the model’s initial assumptions and do nothing to mitigate the problem.China took action to mitigate the problem and thus avoided the out comes of the model’s initial assumptions. Our technological civilization is built upon the scientific method and the predictions models allow.

  6. The problem with any country that can’t contain and limit the spread is that they become a large reservoir of the virus. So either they have to be put under complete isolation from the rest of the world, or they end up reinfecting it repeatedly.

    For poor countries, isolation can be a problem. Even for rich countries it’s difficult to carry. And complete isolation may not even be possible, because if just one country allows a leak from the isolated source, people can find less direct routes to everywhere else.

  7. The silver lining for the poor countries is that they have much lower percentages of elderly. In the UK, Boris Johnson’s proposal to let the virus run, to develop herd immunity, and isolate the vulnerable for three months or so, was calculated as likely to cause more deaths than WW2. The difference is that most of the war deaths were for the young, so years of life lost were much greater.
    If the poor countries can’t afford heroic measures, but don’t have so many old people, people with transplants, etc, they’ll probably fare much better than with a disease like Aids that strikes the working age groups.

  8. The good thing is that people when facing existential problems are much less concerned about the stock markets. You locked in quarantine but you worry less did you are already if kissing you job because the sky has fallen…

  9. ummm… not sure about that… those wet markets are really unsanity… i’ve seen some of them in guandong province…. if they did something like that in the United states they would be shutdown within 2 hours by the health department…. imagine the worst pet store you can imagine filled with dirty animals in cages… then on top of that …picture a filthy table with the butch throwing meat piece slaughers that day onto a table without any wrapping or refrigeration….just thrown on an old table… in the middle of a hot day… ohh ;;; i think… i’ll buy a peice of pig snout… and there it is … a chopped off pig shout just laying all bloody on a table…laying next to bloody chopped pieces of pig… and god knows what else ….

  10. The analogy is that in the early days of AIDS there appeared to be a lot of “cheap, existing” drugs that showed great promise against HIV.
    But once they were properly tested they turned out to be merely suppressing symptoms temporarily and stuff like that. No actual treatment that solved the problem until new drugs were developed many years later.

  11. Would you model the USA as one country, or 50 independent state economies with mostly independent health systems?

    Or you can probably map out the economic and health system linkages and end up with some intermediate number.

  12. I suppose there are a lot of people who “love the smell of panic in the morning.” Save the quotes everyone, they will make for interesting reading later. Pueyo in particular.

  13. You’re one zero short on the total deaths: 10^4 * 10^2 = 10^6 = 1,000,000.

    Also, your initial assumption is industrialized countries, but many countries aren’t industrialized / well developed, and may be hit harder.

    But other than that, I agree, ~100K confirmed cases per country in the badly hit ones – given appropriate measures are taken. If left alone, it can be worse.

  14. It hit countries with more travelers first, which tend to be wealthier. Those wealthier countries are more capable of shutting down things. Poor countries must go on as they otherwise will not have enough to eat. That means the spread could be dramatic in these least developed countries.
    The reality is that this virus is more lethal. The deaths could be quite high globally, if we don’t create good vaccines and get them to nearly everyone.

  15. I doubt that is what happened. There was probably someone in China collecting bat guano in caves to sell as fertilizer. Some farmer probably bought it, and used it in his fields. Steps beyond this, it probably spread to Wuhan probably from some delivery or person making the delivery.
    Though the bat to pangolin to people path is clearly still a viable hypothesis.

  16. At least we will know if it slows down global warming?

    Weather here is getting so strange. Yesterday was 20 C. Today strong winds are blowing like crazy(very ususual for where I live, since more than half country is forest), tomorrow snow and under 0.

  17. I think the Coronavirus could actually result in less loss of life in the US than otherwise, if we can delay to the point that we have a vaccine. That is because there will be far less people dying of flu. Because what shuts down the spread of coronavirus will also shutdown the spread of flu. As long as we loose less than 10k to Coronavirus, I suspect, we will have lost less than we would have lost to the flu.
    If we can’t get a vaccine to people in the next few months, well, that projection is probably out the window.
    And people, you do not want to be going to the hospital in the next few months, so drive very carefully. Do everything carefully. Turn on the lights if you are entering a room and you can’t otherwise see 100%. Don’t let your big dogs trip you. Better to put their food where they can’t get it until you open a door or a gate…rather than trying to walk with it as they get excited. Get in better physical shape. Stay away from fried food. Get plenty of sleep. Remove any tripping hazards. Don’t just drink, smoke, eat junk food, and stay up all night. Stopping smoking now may save your life. This thing is killing smokers: https://www.healthline.com/health/effects-of-quitting-smoking#quitting-timeline

    There could be more deaths from domestic violence, suicides related to the stock market, failed businesses, inability to pay the rent or other bills… People could even run out of money for food.

    And people you can’t flush other stuff used as toilet paper.

  18. who knows what’s different this time

    The other deadly things don’t have the potential to spread uncontrollably to a large fraction of the population. And the things that can spread (like the flu), are comparatively much less deadly.

    For comparison, the leading cause of death in the US is heart disease, with ~700K deaths per year. Out of US’s 330 million people, that’s 0.2%.

    If this virus spreads to 70% of the population as some experts warn, even with a conservative death rate estimate of 0.5%, it would overshoot heart disease and become the leading cause of death.

    But Italy’s death rate is currently 8.6% of confirmed cases, so potentially it can be much worse. (If adjusted for total infected population, the death rate is lower, but still likely much more than 0.5%.)

  19. Ventilators aren’t the answer. If you need a ventilator due to this disease you have a 95% chance of dying. Hospitals are stockpiling chloroquine (anti-malarial) due to South Korea’s raging success with it fighting the virus. It is currently opt-in only until the FDA approves it.

  20. Select and copy the url from the top of the browser, and paste that into the Facebook comment

  21. 99 percent of deaths are age 70+ in Italy.
    Voter turnout for 18-29 is 35 percent.
    Voter turnout for 65+ is 65 percent.
    Want to calculate how many politicians are 29 and younger and how many 65 and older? Massively bigger skew.

  22. If the US economy truly tanks the nationwide death rate is going to be a lot more than 2-3% and not due to the virus.

  23. The worry is not the dead bodies its the amount of people who will get sick and get things like failing kidneys or Permanent lung damage.

  24. The future is large rooms filled with beds and 4 people over the age of 60 hooked to the same ventilator…All because people in China like to eat gamey bat meat for lunch From a wet market with bats pissing and shitting all over the floor…

  25. Sure, more people die from other preventable causes but economic concerns usually still takes precedence, who knows what’s different this time. You know what’s bad for elections, economic problems. What’s worse for elections, high visibility problem + 2-3% fatality rate if the system is overwhelmed + highly contagious. Can’t exactly do nothing and call it a Chinese hoax or claim the flu pandemic in 1918 killed more people so that proves there is nothing to worry about now, all while still expecting to do well at the polls.

    It’s new and scary, give it some time and it will fade a bit into the background and become just another semi managed problem that stems from personal choices. If you don’t pay close attention and spread it around a bit in time and space, society can abide a lot more new dead bodies among the existing chronic supply streams.

  26. Watch what happens in Iceland as a benchmark for other countries. They are testing more than anyone, including non-symptomatics (!), are isolated, have a good healthcare system and are on lockdown.

  27. Hydroxychloroquin is being used all over NYC now, according to one oncologist at NYC’s Lennox Hill Hospital, where he says over 100 patients have the virus. The biggest danger is that they are running out of that too. See here 3 minutes in: https://www.youtube.com/watch?v=j64-FlVFezs
    There are other treatments showing good effect too. Of course, we are going to have to rely on China to produce the bulk of this, maybe even to develop the cure.
    China has ramped up production of N95 masks from 20m/day to 100m/day in just a few days. Their production of ventilators has similarly sky-rocketed.
    Meanwhile, we DO still have some pretty good research companies, but the FDA has to get out of the way, and people like Dr. Fauci who keep adhering to the old school model of 3-phase trials over 12-18 month have to go away too. 12-18 weeks is more like it, and we are well into that already.
    It’s a different age now. There are mapped genomes, sophisticated computer models, and global sharing of data on an instant basis (the medical journal model of peer-review is too slow too).
    The diagnostic tests aren’t even very good; false positives and false negatives both. China abandoned them mid-stream, which is why their confirmed cases shot up then suddenly leveled off in mid-february.
    The economy can’t a year off. We’ll be in the second Great Depression, except there’ll be riots and a black market for people who need to earn a living. This will kill far more people than the virus.

  28. The Imperial College study has very negative assumptions which guarantee really bad outcomes. Millions will not die in the U.S. Here is Bill Gates answer about that model: Fortunately it appears the parameters used in that model were too negative. The experience in China is the most critical data we have. They did their “shut down” and were able to reduce the number of cases. They are testing widely so they see rebounds immediately and so far there have not been a lot. They avoided widespread infection. The Imperial model does not match this experience. Models are only as good as the assumptions put into them. People are working on models that match what we are seeing more closely and they will become a key tool. A group called Institute for Disease Modeling that I fund is one of the groups working with others on this.

    It’s bad that people will die, but we are doing more economic harm than needs to be done because of the panic mentality.

  29. I would make a case for looking at a simple metric that I don’t think has been figured and may be critical. Right now S. Korea has a 3% infection detection rate for their screening and coming down. We need to find out historically what their rate was after daily infection number went down sustainably from the peak to a reasonably small number to a country their size, probably 300 new infections a day while keeping their country relatively open as they did. We need to bring our country to their level of openness when we reach a similar detection rate and proportional daily infection numbers while continue ramping up inspections and pinpointed isolations. Before that we need to issue very careful calculated social distancing guidelines.

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