Flattening The Curve

Guest Post by Willis Eschenbach

I’ve been following the many changes in the IHME coronavirus model used by our very own most incompetent Dr. Fauci. (In passing, let me note that he’s been wrong about most everything from the start—from first saying it was not a problem, to predicting 200,000 deaths in the US (based on an earlier version of this model), to advising people to NOT wear masks, to opposing chloroquine. But I digress …)

The IHME model is here, and it’s well worth a look, although not worth too much trust—it’s been wrong too many times. To their credit they’ve put the results online here.

Another problem with it is that the presentation of the data is so good. It’s good enough that it’s hard not to take it as fact.

The model historically has predicted numbers that were too high. The latest incarnation of the model is predicting 81,766 COVID-19 deaths in the US by August 4, 2020. That’s down from 93,000 in the previous incarnation of the model. Are they finally right? History makes one cautious. There’s a discussion of the upgrade of the model here.

However, despite their past high estimates in absolute numbers, I figured that their estimates of the shapes of the responses is likely pretty close to realistic. So I thought I’d take a look at the projected daily deaths, to see what I could learn. In particular, I wanted to investigate this idea of “flattening the curve”.

What does “flattening the curve” mean? It is based on the hope that our interventions will slow the progress of the disease. By doing so, we won’t get as many deaths on any given day. And this means less strain on a city or a country’s medical system.

Be clear, however, that this is just a delaying tactic. Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period. Valuable indeed, critical at times, but keep in mind that these delaying interventions do not reduce the reach of the infection. Unless your health system is so overloaded that people are needlessly dying, the final numbers stay the same.

Now, the model lists three kind of interventions on a state-by-state basis. The interventions are:

• Stay at home order

Educational facilities closed

Non-essential services closed

I figured I could take a look to see if imposing those restrictions would make a difference to how flat the curve is. Of course, to do that, I had to figure out a variable that would represent the “flatness” of the curve. After some experimentation, I settled on using the highest daily death number as a percentage of the total number of deaths. For convenience I’ve called this number the “peak factor”, and the larger it is, the more peaked the curve is.

So to start with, here are a couple of states with very different peak factors from two ends of the scale. The graph shows the shapes of the curves, but not the actual sizes, of the daily death counts in the two states.

Figure 1. The shapes of the curves of daily deaths for West Virginia and Missouri. Both have been scaled to a mean of 0 and a standard deviation of 1, and then aligned to zero. Both datasets slightly smoothed (Gaussian filter, FWHM = 3 days). For purposes of illustration of curve flattening, I’ve adjusted them so the total number of deaths are the same in both states.

Note that the area outside the blue line but still under the yellow line (bottom center) is equal to the amount of the peak above the yellow line. It’s the same total amount, just spread out over time.

Now, that looks like interventions are working … except for one detail. West Virginia imposed all three restrictions. Missouri only imposed two. And for those two, Missouri imposed them both later than did West Virginia.

So that pair certainly doesn’t say much for the effectiveness of our interventions. Why are they so different? Unknown, but presumably because of things including the density and distribution of the population.

So that’s what the effect of the interventions should look like. It should take a peaked curve and transform them, stretch them out over a longer time with a lower peak. And more interventions should flatten the peak even more.

Intrigued by all of this, I returned to the IHME model. One interesting discovery that I made was that for all of the states, the number of deaths before the peak is very close to the number of deaths after the peak. This was true for states with a high peak factor as well as a low peak factor, across the board. This should allow us a rough-and-ready rule of thumb to estimate the total deaths once the peak is passed. 

Note that this rule of thumb is true no matter when the lockdowns are removed—all that will do is change the date of the deaths, not the total number calculated by the rule of thumb.

For example, Italy. Let me go look it up at Worldometer … OK, the peak was on March 28th, at about 10,000 deaths. That would make me think that total deaths in Italy will be on the order of 20,000 deaths. 

To check that prediction, I just now looked for the first time at the IHME model country page for Italy. Until this latest update, they didn’t cover other countries, just the US. OK, the IHME model says 20,300 deaths projected for Italy. So my rule of thumb appears to work quite well. Let me test it with Spain. First, Worldometer. It says there had been 9,400 deaths by the time of the peak daily death in Spain. Rule of thumb says that the total should be on the order of 18,800 deaths. Turns out when I got there that the IHME model page for Spain says 19,200 deaths. So it seems that the rule of thumb works well, at least according to the model. Whether it works in the real world remains to be seen …

Next I looked at the peak factor for all the states versus the number of interventions, to see if the interventions tended to lower the peaks and flatten the curve. Figure 3 shows that result.

Figure 2. Scatterplot, “peak factor” showing how peaked the curve is, versus the number of interventions imposed on the populace. Red “whisker” lines show one sigma uncertainty of the median. Since there are only two states with zero intervention, no uncertainty calculation is possible.

As you can see, the total number of interventions makes no statistically significant difference in the flattening of the curve. 

So I thought, well, let me look at the dates of each of the three types of interventions—stay at home, close schools, close businesses. Maybe there is relationship there. First, here are peak factors of the various states versus the timing of their “stay-at-home” order. Over time, the intervention should lead to lower peak factors, with early adopters getting greater benefit. Here’s that result.

Figure 3. Scatterplot, peak factors of the states versus the date on which they imposed the “stay-at-home” order. The yellow line is a “robust” trend, one which downweights any outliers. The trend is not statistically significant.

What that says is the opposite of what we’d expect—in this case, the later the intervention happened, the flatter the curve. Should be the other way around, earlier interventions should lead to more effect on the outcome.

Next I looked at the closing of non-essential services. Here’s that result.

Figure 4. Scatterplot, peak factor versus the date of closing of all inessential services. Again, the yellow line is a “robust” trend, one which downweights any outliers. This time the trend is statistically significant (p-value = .028)

However, despite the statistical significance of the trend line, it’s going the wrong way. The early adopters should be less peaked by now, not more peaked. Finally, here is the school closure data.

Figure 5. Scatterplot, peak factor versus the date of closing of all schools. Trend is not statistically significant.

It’s sloped the wrong way again, but I saw that graph and I thought “Hang on … that one data point is influencing all the rest”. So removed that point, which happened to be Iowa, and took another look.

Figure 6. Scatterplot, peak factor versus the date of closing of all schools. Trend is not statistically significant. 

At least this one is going slightly the right way, although the trend is still not significant. That lack of a clear result may be a result of the bluntness of the instrument and the small size of the data sample.

Despite the lack of significance, I suspect that of all of the actions taken in the Western world to slow the spread of this illness, closing the schools could be the only one to have an actual measurable effect. Don’t get me wrong, any intervention has some effect however small. But I mean a real significant effect.

I say closing schools could have this effect because schools, particularly grade schools, could have been designed to be a very effective way to spread an infection. Consider. You not only have the kids packed in close together indoors for five days out of the week. Worse, it’s the same kids every day, so they have multiple chances to infect each other. Worse yet, they all go back home at the end of the day to infect the rest of the family, or to bring in new fun illnesses for “show-and-tell-time” at school to start the process over.

And finally, as all kids do, they wrestle and kick and cough and grab each other and sneeze and spit on the ground and trade clothing and eat bits of each others’ lunches … it’s a perfect petri dish.

So if you want to slow an infection, closing the schools at least makes logical sense.

On the other hand, stay-at-home orders where people still go out for groceries as well as to either work in “essential” jobs or purchase other essentials (and non-), that seems like a joke to me. The virus is sneaky. The Fed-Ex driver just dropped off a couple of packages here … there are still loads of people out and about. It’s all around. It can live on surfaces. It is transported by coughing, sneezing, or even talking. Yes, if you do a full-on surveillance state detecting, tracking, and contact tracing like South Korea has done, that will work. But you need to give your phone GPS data to the government to make that work. There’s no way Americans, or most westerners in general, would do that.

The western style style of quarantine leaks virus like a “closed” Senate hearing leaks classified information, and then the virus is transported everywhere. There’s really no attempt being made to track contacts. I suspect it would be futile at this point.

Overall? I see little evidence that the various measures adopted by the western nations have had much effect. And with the exception of closing schools, I would not expect them to do so given the laxness of the lockdown and the vague nature of “essential business”. I’ve mentioned before, here in Sonoma Country California, the local cannabis retailer is considered an essential business … strange but absolutely true.

Finally, I want to talk about that most mundane of things, the humble cost/benefit analysis. Draw a vertical line down a sheet of paper, label one side “Costs” and the other “Benefits”. Write them down on the appropriate side, add them up. We’ve all done some variation of that, even if just mentally.

Unfortunately, it seems Dr. Fauci doesn’t do cost/benefit analyses. It seems he only looks at or cares about the benefits. He called millions of people being thrown out of work “unfortunate” … unfortunate? It is a huge cost that he doesn’t want to think about. He’s not going to lose his job. His friends won’t lose their jobs. Meanwhile, at the same time that he’s saying “unfortunate”, the mental health hotlines and the suicide hotlines are ringing off the wall. People are going off the rails. Domestic violence calls are through the roof, and understandably. Forcibly take the jobs away from a wife and a husband, tell them that they are under house arrest, that’s stress enough … and meanwhile there’s no money coming in, rent and electricity bills are piling up, can’t put gas in the car, kids bouncing off the walls from being cooped up … of course domestic violence and suicides and mental health problems are off the charts.

Which brings me to California where I live. If California were a country it would have the fifth-largest economy in the world. Fifth. Just California. The annual GDP (Gross Domestic Product, the total value of everything we produce) of California in round numbers is three trillion per year. We have no hard figures, but it would not surprise me if 2020 was only seventy percent of normal, not from the virus, but from the government pulling the wheels off of the economy. That’s a loss of Nine. Hundred. Billion. Dollars. That’s bigger than the GDP of most countries, up in smoke.

And that’s not counting the cost of partially offseting the governmental destruction. First, the government pulled the wheels off of the economy. And now, they’re pumping out taxpayers’ dollars like water to try to ease the pain that they’ve just inflicted. That $1,200 check people are talking about? That a cost, not a benefit as the chatterati would have us believe. It comes out of our pockets. And there are all kinds of other associated expenses, lost wages, the list goes on and on.

So overall, here in California alone we’ve lost pushing a trillion dollars of value, with millions out of work, tens of thousands of businesses shuttered forever, discord and dismay abounding … and for what? For what?

Well, it’s for the following. Here is the IHME model projection for coronavirus deaths in the fifth largest economy in the world …

Figure 7. Projected coronavirus deaths, California.

That’s it? That’s all? Eighteen hundred dead? That’s less than California murders. It’s less than California gun deaths. It’s a third of our drug overdose deaths, for heaven’s sake, and guess what?

The trillion dollars we lost from the government shutting down the California economy?

It won’t save one of those 1,783 people. Not one.

It will just delay their deaths by a week or two.

A trillion in losses are on the cost side of the cost/benefit analysis. And on the benefits side, all we have is a two-week delay in eighteen hundred unavoidable deaths? That’s it? That’s all that a trillion dollars buys you these days?

Ah, you say, but more people might die if the medical system is overwhelmed. Are there enough beds and ventilators?

Well, glad you asked. Here are the figures, again from the IHME model. Unfortunately, as with the number of deaths, all the previous incarnations of the model have overestimated the need for hospital resources … but with that caveat, here are their California numbers.

No bed shortage. No ICU bed shortage. And we just shipped some ventilators to New York. We should peak in a week.

And while we’re waiting for the peak, we’ve just spent about a trillion dollars to delay 1,783 deaths by a few weeks. Not to save anyone’s life, I say again. Just to delay a couple thousand deaths by a couple weeks … look, it still wouldn’t be worth a trillion dollars even if we could actually save that many lives and not just delay their deaths. If it helps your conscience you could give the family of each person who could have been saved a million dollars, that’s only 0.2% of your trillion dollars, and the economy could keep humming along.

But it’s simply not worth totally wrecking the lives of 30 million Californians just to save eighteen hundred lives. That’s madness, that’s a terrible deal.

I have opposed this from the start. I don’t do a one-sided “benefits” analysis like Dr. Fauci does. I do a COST/benefit analysis, and we’ve just looked at it. Here’s the conclusion of that analysis:

Even if your hospital system is going to get overloaded, even if more people are going to die, put the trillion dollars into making the medical system the strongest and most resilient imaginable. Spend it on field hospitals and stocks of disposables, buy ventilators, buy hospitals, buy medical schools, buy beds and gowns, that’s what will save lives. I don’t care, shut down the grade schools if you have to although with a solid medical system you likely won’t have to … but whatever you do …

DO NOT SHUT DOWN THE ECONOMY, STUPID!! The costs are far, far too great.

Just the human costs are beyond measure. Lives ripped apart, suicides, endless worry and concern, running out of money to feed the kids, there’s no end to it, lying in bed at night wondering when they’ll let you out of jail. 

And that’s all before we even get to the economic costs and the ripple-effect costs and the loss of productive capacity and the canceled contracts and the lawyers’ fees and finally, the start-up capital required, and the businesses that will have gone elsewhere, and the need to rehire or replace people and overhaul idled machinery, etc. etc. once this monumental stupidity is over.

So this is a plea for all you women and men at the top, the ones deciding when to call off the madness, I implore you—get up out of your offices, look around you, go to a small town and talk to some unemployed businesswoman whose local enterprise is now belly-up, understand what the loss of that business means to that small town, and GET AMERICA WORKING AGAIN TODAY! Not tomorrow. Today. Every day is endless pain and worry for far too many.

Here’s how crazy this lockdown is. You folks who decide on this for California? You are costing us trillions of dollars, and you are literally killing people through increased suicide and depression and domestic violence, and it’s all in the name of delaying a couple of thousand deaths. Not preventing the deaths, you understand. Delaying the deaths.

Killing people to delay death, that sounds like a charmingly Aztec plan, it comes complete with real human sacrifices …

Sheesh … it’s not rocket science. Further delay at this point won’t help. End the American lockdown today, leave the schools closed, let’s get back to business.

And yes, of course I’d include all the usual actions and recommendations in addition to leaving the schools closed—the at-risk population, who are those with underlying conditions, particularly the elderly, should avoid crowds. And of course continue to follow the usual precautions—wash your hands; wear a mask at normal functions and not, as in your past, just at bank robberies; only skype or facetime with pangolins, no hootchie cootchie IRL; refrain from touching your face; sanitize hard surfaces; y’all know the drill by now … the reality is we’ll all be exposed to to coronavirus sooner or later. And like the Spanish Flu and Hong Kong Flu and a host of diseases before and after them, after a couple of years the once-novel coronavirus will no longer be novel. It will simply become part of the background of diseases inhabiting our world like the Swine flu and the Bird Flu, all dressed disreputably and hanging out on every street corner in every town waiting for someone to mug …

My regards to all, and my profound thanks to the medical troops who are on the front lines of this war. The wave is about to break in the US, dawn is approaching, it will be over in a month. And hopefully, long before then. these insane regulations will go into the trash, we can stop paying trillions to delay a few deaths a few weeks, and we can get America up and working again.

w.

A REQUEST: If you know someone who makes the decisions on one of the lockdowns, or if you know somebody who knows one or more of the women and men making that decision, please send them a link to this document and ask them to read it and pass it up the chain so that we can all get back to work sooner rather than later.

To facilitate this, I’ve put a copy of this post for anyone to download as a Word document here, and as a downloadable PDF document here. Send a copy to someone who might make a difference.

MY USUAL REQUEST: When you comment, please quote the exact words that you are referring to. Only in that way can we be clear about what you are discussing.

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stinkerp
April 8, 2020 10:16 am

This study just published in Lancet says school closures have only a minimal effect:

https://www.thelancet.com/pdfs/journals/lanchi/PIIS2352-4642(20)30095-X.pdf

Systematic reviews of influenza outbreaks suggest that school closures are likely to have the greatest effect if the virus has low transmissibility (R<2), particularly if attack rates and transmission are
higher in children than in adults. Although our information on SARS-CoV-2 remains incomplete, this appears not to be the case with COVID-19 outbreaks. Reported R values for COVID-19 are high (≥2·5). Although children appear to contract infection at the same rate as adults, they largely have mild or asymptomatic forms of the disease and appear to be less likely to spread the virus through coughing or sneezing

Reply to  Willis Eschenbach
April 8, 2020 10:46 am

There are not only the kids, but also teachers involved.

Rocketscientist
Reply to  Willis Eschenbach
April 8, 2020 10:58 am

Asymptomatic for Covid-19 perhaps, yet sneezing coughing and drooling from other causes and spreading the virus regardless.

Nicholas McGinley
Reply to  Willis Eschenbach
April 8, 2020 11:33 am

Plus they are far less likely to be conscientious about the fact that there we got this a’here virus dealio goin’ around.

Rick
Reply to  Willis Eschenbach
April 8, 2020 4:48 pm

Kids and middle agers mostly get it, give it, and get over it. This is the best way to build that ‘herd immunity’. Of course the elderly and frail need to be protected. All retirement homes must be closed for this 3-4 wks of nastier virus season. All these other measures are truly flattening the curve but at some point we need to get back to living – then with only ?50% of the herd immunized – here comes the next bump this fall.

DM
Reply to  Rick
April 9, 2020 6:12 am

The following confirm Rick’s point.
https://www.doh.wa.gov/Emergencies/Coronavirus 93% of deaths w/ C19 in WA state occurred amongst those age 60 & older.
https://digg.com/2020/coronavirus-death-rate-italy-spain-elderly The results are similar in Italy, Spain & S. Korea.

Changing perspective helps support the results of Willis’ analysis. Healthy people 59 & younger have less chance of dying with C19 than of winning a $100+ million lottery. So, preventing such people from carrying on their normal daily routines will NOT significantly affect deaths with C19. Worse, ordering these people to stay home WILL INCREASE deaths from anxiety related causes (suicides, overdoses, heart attacks … _) and by murders.

The consequences for hospitalizations are similar. 50+% of those 59 & younger w/o complicating health conditions are asymptomatic when infected, or they feel only slightly subpar. So, they will NOT seek hospital care. The others can be sent home because they do NOT need hospital care.

Willis, another point you make is worth emphasizing. Flattening the curve FAILS to reduce the # of deaths with C19, unless it reduces deaths caused by rationing health care services. I will add: A more effective way to allocate health care service is to give priority to those KNOWN to be most vulnerable to dying with C19.

Time to wrap up: The KEY public health issue is how to better protect the most vulnerable to dying with C19. Another key issue is how to minimize the adverse consequences such measures have for the rest of society.

Philip George Hayward
Reply to  Willis Eschenbach
April 8, 2020 6:34 pm

The more I learn, the more I am convinced that it is co-infections that are responsible for making COVID-19 deadly for a tiny minority of the infected. It has very high rates of asymptomatic and mild infection. Is it not plausible that besides “pre-existing” health conditions, a determinant of deadliness is another common and sometimes-deadly pathogen?

Kids spreading COVID-19 and the other pathogen or pathogens, would be a plausible explanation for your finding.

But the thing I am most convinced about is the “housing and environment” factor. New Zealand is an outlier; it had to have had COVID-19 spreading as early as anyone else did because China is a major trading partner and source of tourists, immigrants and arrivals. Lockdown only started after the first death in late March. Testing has been slow and late, quarantining based on tracing contacts (like Singapore) is non-existent, and border triaging extremely lax even now.

The fact that there is one death and 14 hospitalized in total so far is NOT due to any inherent POLICY superiority. Lockdown can’t be the reason that there is no sign of previously infected people still ending up in intensive care during the early days of lockdown!!! (Like there is in every other country).

Confirmed cases of “community transmission” is “two”! The other 1100 total confirmed infected, only 14 of whom are in largely-empty hospitals, are explained by known contact with infected people from overseas. The experts need to be excited about studying New Zealand to discover what factors make its people so “immune”. Plenty of experts are pointing out that COVID-19 is an infection with a high rate, 40 to 60%, of asymptomatic cases, and of the rest, most are mild illnesses only. The true rate of infection on average everywhere is around 100 times “confirmed infections”. New Zealand obviously has the highest rate of asymptomatic or mild infection anywhere in the world!

I say it is obvious, self-evident, that the factors are low urban density, clean air, the elderly being predominantly in good suburban housing, the fact that it is not flu season in the Southern Hemisphere (hence absence of the co-infections that actually result in deaths “with” rather than “of” COVID-19), and NZ’s climate itself (ambient humidity, temperature etc at this time of year). See this paper for guidance on environmental and seasonal factors:

https://www.annualreviews.org/doi/pdf/10.1146/annurev-virology-012420-022445

Obviously there can be quite different environmental conditions from region to region even within States and countries. All else being equal, one would expect rural regions to have lower death rates and yet there are exceptions, suggesting that their environmental and housing conditions should be investigated.

Phoenix44
Reply to  Philip George Hayward
April 9, 2020 1:34 am

My bet is that countries with these very low rates have already “had it” and so have some immunity. There’s no reason why South Korea, Taiwan and Japan should be so lightly hit. I note Japan had a very early flu season and Korea and bad flu season. Could easily have been COVID.

ak in vt
Reply to  Willis Eschenbach
April 10, 2020 4:25 pm

Actually, from what I recall regarding the study on the Princess cruise ship,when testing positive for the “dreaded virus,” the older you were the more asymptomatic you were by percentage: obviously, the older you were and symptomatic, the worse it was for you. Thought I had read another study on http://www.swprs.org/a-swiss-doctor-on-covid-19 (which was linked from WUWT awhile back) which stated that children with the “dreaded virus” were more symptomatic.

Regards
ak

Jeffery P
Reply to  stinkerp
April 8, 2020 11:59 am

No surprise there is little effect from closing schools. Most students are not in any high-risk categories.

Nicholas McGinley
Reply to  stinkerp
April 8, 2020 12:09 pm

The way I see it, schools are germ factories…really efficient ones.
And kids are germ fountains…not like a gently flowing kind of fountain, but the kind that sends out high pressures jets in every direction…willy-nilly-like.

David L Hagen
Reply to  stinkerp
April 8, 2020 1:02 pm

Willis Eschenbach how do a very high R0 and high asymptomatic fraction affect the analysis?
High SARS-CoV2 Infection rate
CDC has calculated each person’s R0 reproductive number at very high 5.7 of new persons infected per newly infected person. This China Virus has a very rapid spread of 20%-31%/day or doubling every 2.3 to 3.3 days. The Communist Party’s refusal to quarantine Wuhan before the annual Spring Festival New Years celebration caused this pandemic to very rapidly seed cross China and thence to the world.
If asymptomatic cases are 2-3 times those with symptoms, that causes it to spread unannounced very rapidly. That suggests what some thought was the “flu” could have been COVId-19.
High Contagiousness and Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2

the threshold for combined vaccine efficacy and herd immunity needed for disease extinction is calculated as 1 – 1/R0. At R0 = 2.2, this threshold is only 55%. But at R0 = 5.7, this threshold rises to 82% (i.e., >82% of the population has to be immune, through either vaccination or prior infection, to achieve herd immunity to stop transmission)….
we estimated the growth rate of the early outbreak in Wuhan to be 0.21–0.30 per day (a doubling time of 2.3–3.3 days), suggesting a much faster rate of spread than initially measured.

https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article
https://twitter.com/QTRResearch/status/1247873179391012864/photo/1

Guest
Reply to  Willis Eschenbach
April 8, 2020 4:13 pm

This is true. And reading this paper in more detail is somewhat laughable. There was a study in Oregon where a serum tested positive had the disease in December. Their 5.7 R0 is based on the assumption that only 4,000 people in Wuhan had in on Jan. 18th. That doesn’t jive.

Again, the CDC, Imperial College and and initially IHME were all using IFR north of 1% and high R0, that they do not adjust. This throws out millions of dead even though the majority of evidence suggested otherwise. A highly transmissible virus floating around in China since Nov/Dec and only 4,100 Wuhan residents have it? Just that modeling alone should show the fallibility of those projections. It was more likely in the millions or 10 of millions, where the majority of people that have little ability to pay or access healthcare are low/no symptom patients.

Case counts are super irrelevant because they are biased and CFR is then rendered meaningless until testing is random and large – please ignore case counts on TV and Worldometers for your own good. IFR can be estimated other ways until large scale serum testing is done (Diamond Princess was a perfect example).

Nicholas McGinley
Reply to  Guest
April 9, 2020 8:12 am

jibe.

Guest
Reply to  David L Hagen
April 8, 2020 3:57 pm

This is a good link, though a bit primitive. I have seen several private models and public ones. First thing:

1. NYC has easily the highest R0 outside Wuhan. Probably 4.0 or something. Europe 2.5-3.0, rest of US 2.0-2.2. Its very density driven
2. Once people are aware of a virus R0 drops, so NYC drops from 4.0 to 2.0 quickly
3. Distancing drops is further. Lockdown maybe is 0.5
4. R (which is R0 adjusted for the amount of people immune) drops very quickly as people are infected, especially if R0 is high.

By definition the higher the R0 the lower the IFR – the chances you die if you get it. If both were high the death toll globally would already be millions and maybe 10’s of millions. Oxford has the IFR at 0.1%-0.25% which is 1-2.5x a bad influenza year. Those numbers feel right to me, even a little high.

A friend of mine who does modeling for COVID has been saying NYC is already >50% infected and recovered by next week – almost herd immune. It all happened before the lockdown. As of now its the safest place to be if you are high risk. There will be no second peak.

Chaswarnertoo
Reply to  Guest
April 8, 2020 11:38 pm

There are 2 things affecting Kung flu spread.
1) Population density
2) Density of that population….

Nicholas McGinley
Reply to  Chaswarnertoo
April 9, 2020 8:13 am

You left out the obvious connection to the prevalence of people with the Flu Manchu style of facial hair.

Joe Born
Reply to  David L Hagen
April 8, 2020 6:33 pm

Actually, there’s a subtlety in the relation between R0 and percentage immunity. See that plots I posted at https://twitter.com/JosephHBorn/status/1247823025602465792?s=20

Brian Jackson
April 8, 2020 10:20 am

Absolutely what I have been saying re the lockdown here in UK. Well said Willis. I dont have your analytical skills but common sense says that wrecking an entire economy so that a relatively small number of people very sick with this virus are not turned away to die somewhere else. Tragic but necessary.
There will be far more deaths and suffering as a result of wrecking the economy than would occur from the virus – and the economic effects will last a much time.

Teewee
April 8, 2020 10:22 am

Can we rely on the total number of virus deaths given by the government? I don’t believe we can. As noted in other articles posted on WUWT, a large number of patients in Italy and other countiies were old or very old. Many had serious underlying health conditions. Some had more than one serious underlying condition. According to one of the doctors on the Federal task force, if a person with the virus dies, their death is counted as a virus death. The presence of virus may have been a contributing factor however, we should not just assume that all deaths were caused by the virus. A person may have died of a heart attack, cancer, or some other pre-existing or unknown condition however, that death is counted as a virus death. Do we really know how many people actually died of the virus and not some other cause?

icisil
Reply to  Teewee
April 8, 2020 11:08 am

Iatrogenic deaths are counted as COVID deaths also, and it’s starting to look like that may be responsible for a lot of mortality.

The protocol-driven approach mentioned below is the ARDSnet protocol of high PEEP (pressure) with low oxygen that COVID patients are subjected to when placed on ventilators. The proposed physiological approach that resulted in 0% deaths at one European hospital is low (as possible) PEEP with high oxygen.

Anecdotal evidence has increasingly demonstrated that this proposed physiological approach is associated with much lower mortality rates among COVID-19 patients, he said.

While not willing to name the hospitals at this time, he said that one center in Europe has had a 0% mortality rate among COVID-19 patients in the ICU when using this approach, compared with a 60% mortality rate at a nearby hospital using a protocol-driven approach.

Is protocol-driven COVID-19 respiratory therapy doing more harm than good?
https://www.the-hospitalist.org/hospitalist/article/220301/coronavirus-updates/protocol-driven-covid-19-respiratory-therapy-doing

Phoenix44
Reply to  icisil
April 9, 2020 1:50 am

Some German doctors have said they were shocked by images from Italy of the use of ventilators. They avoid using them as they say they cause a lot of lung damage.

Derg
Reply to  Teewee
April 8, 2020 11:38 am

I have the same question

Nicholas McGinley
Reply to  Derg
April 8, 2020 2:52 pm

I read somewhere that whenever there is a headline with a question…the answer is no, 100% of the time.
The headline of the article was “Are headlines with a question in them always false?”
Hmmm…

icisil
Reply to  Teewee
April 8, 2020 2:35 pm

COVID19 Death Certificates are Being Manipulated According to Montana Physician with 30 Years Experience

https://healthimpactnews.com/2020/covid19-death-certificates-are-being-manipulated-according-to-montana-physician-with-30-years-experience/

icisil
Reply to  Teewee
April 8, 2020 2:36 pm

CDC Tells Hospitals To List COVID as Cause of Death Even if There are No Test Results Confirming it

https://healthimpactnews.com/2020/cdc-tells-hospitals-to-list-covid-as-cause-of-death-even-if-there-are-no-test-results-confirming-it/

LdB
Reply to  icisil
April 8, 2020 6:32 pm

They have a different code so if you don’t like the stat being used don’t be lazy and filter out the one you want to present.

icisil
Reply to  Teewee
April 8, 2020 5:04 pm
Brian Jackson
April 8, 2020 10:22 am

…not turned away from hospital ….. and last a much longer time.

ren
April 8, 2020 10:23 am

The data in this report reflect events and activities as of April 8, 2020 at 9:15 AM.
All data in this report are preliminary and subject to change as cases continue to be investigated.
These data include cases in NYC residents and foreign residents treated in NYC facilities.
https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-04082020-1.pdf
The peak of the Spanish flu occurred in autumn.

stinkerp
Reply to  ren
April 8, 2020 11:09 am

There is a scenario not many are mentioning: the next wave. In 1918, the mortality rate in the first wave of the Spanish Flu from (6/29–7/27) was one fifth the mortality rate of the second wave that started in October. There are reasons to be optimistic about a second wave because warmer temperatures will likely reduce the spread, but come fall we’d better have effective treatments and health care capacity for the most serious cases or we’ll be right back where we are now. It is hard to imagine going through another period of self-induced economic destruction later this year.

Some hopeful news about a possible broad-spectrum vaccine:

https://medicalxpress.com/news/2020-04-successful-mers-vaccine-mice-covid-.html

And a potentially effective treatment for the most severe cases:

https://medicalxpress.com/news/2020-04-coronavirus-patients-benefit-blood-recovered.html

Reply to  stinkerp
April 8, 2020 1:55 pm

re: ” in the first wave of the Spanish Flu from (6/29–7/27) was one fifth the mortality rate of the second wave that started in October.”

Case sample of one; are there other examples where the flu (etc) has come in ‘waves’?

Rob Bright
Reply to  _Jim
April 8, 2020 9:47 pm

This one. Social distancing and school closures are credited – at least in part – with causing 2 additional waves, the third one being the worst.

“Social distancing and school closures can create multiple outbreaks… when examined in detail, the “waves” result from the aggregation cases occurring non-uniformly with respect to location and time (Fig. 8). In addition, the multiple “waves” do not occur because of differences in the recovery time or susceptibility to infection due to geographical factors. These results provide strong support to the hypothesis that a combined effect of local transportation, social distancing, and school closures can produce multiple macroscopic (whole-country) “waves” for the same epidemic; as observed in Mexico during 2009 (Fig. 2)…

The “waves” in the cases considered here occur because the implementation of social distancing and school closure measures pause, but not stop, the spread of the disease.

https://www.aimspress.com/fileOther/PDF/MBE/1551-0018_2011_1_21.pdf

https://www.ncbi.nlm.nih.gov/pubmed/21361398

Nicholas McGinley
Reply to  stinkerp
April 8, 2020 2:11 pm

“There is a scenario not many are mentioning: the next wave. ”

Doh!
I knew I was forgettin’ sumptin’!

John Tillman
April 8, 2020 10:23 am

Well done. But, despite continued exodus of citizens, there are 40 million Californians, with an unknown number of illegal aliens.

Gjende
April 8, 2020 10:24 am

I have noticed for some time that the death rate of coronavirus in both Hong Kong and Singapore is about 0.5%. These places are more densely populated than New York, have closer tie to China and their outbreak was earlier. Also, the death and infected numbers are quite reliable and believable. How come that their death rates are so low and different from those in Europe and USA? They seem to test suspected cases only.

Rocketscientist
April 8, 2020 10:24 am

Thank you for doing the maths.
I have been arguing this very point for days, but now the numbers are showing.

Vuk
April 8, 2020 10:25 am

The UK’s curve is far from flattening but there is an encouraging deviation downwards of about 35% from the longest persistent trend line. In the absolute numbers the divergence is some 3800 cases from 10905 (trend line) to 7097 actual recorded deaths as shown here

n.n
April 8, 2020 10:26 am

Are there “Unintended Consequences (a la polio)” of flattening the curve?

a charmingly Aztec plan, it comes complete with real human sacrifices

One-child? That is so Pro-C… I guess it depends on how you define “human”, “sacrifice”, and “real”.

Scissor
April 8, 2020 10:29 am

Not only is Fauci wrong, he’s dangerous and at the very least, he’s allowing politics to cloud his judgement’s. In the extreme, he’s acting as a Chinese operative. That video recently posted by kenji, is eye raising.

https://youtu.be/eglF0BFkkrQ

Robert Stewart
April 8, 2020 10:30 am

Willis, thanks for putting forth a clear and understandable explanation of the need to consider the unintended consequences of actions that are often taken to address the symptoms without understanding fully the benefits, let alone the costs. Your point about the constancy of the total deaths is a very important one. You also nailed the need not to overload our healthcare facilities as that could lead to an increase in fatalities. It does no good when the Governor of New York demands 37,000 ventilators, when the actual number they apparently will need is less than 10,000. My only caution is that the data is really not very good, particularly given the large number of asymptomatic infections as well as the possible undercounting of COVID-19 deaths given the shortage of test kits over the past two months. That said, you have done this as well as possible at the moment, and I certainly hope your analysis is considered by our decision makers.

Shawn Marshall
Reply to  Robert Stewart
April 9, 2020 4:48 am

I haven’t seen any mention that the malaria meds are prophylactic and curative. Isn’t that the real deal – we took malaria pills in VN – give the quinines to medical staff and the +60 crowd with underlying morbidities – tell old folks to shelter as much as possible – and have everyone else get back to work?

Reply to  Shawn Marshall
April 9, 2020 6:32 am

re: “I haven’t seen any mention that the malaria meds are prophylactic and curative. ”

You must have missed the postings in previous threads; I think the group has ‘moved on’ …

Stephen Lindsey
April 8, 2020 10:33 am

Flattening the curve does reduce the death count. If there is a high peak there are no ventilators available at all and clearly more people will die.

Scissor
Reply to  Stephen Lindsey
April 8, 2020 10:48 am

Even besides that, how valid is the premise that, “Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period.”?

Is this generally true of pandemics; is it accepted principle?

Andrew S Krause
Reply to  Scissor
April 8, 2020 1:22 pm

The area under the curves is the same. It’s a function of mathematics.

John Tillman
Reply to  Stephen Lindsey
April 8, 2020 10:57 am

If Drs. Gattinoni in N. Italy and Kyle-Sidell in NYC are right, then too many COVID patients are on ventilators, and the machines are set too high.
They have concluded that many Covid patients shouldn’t be ventilated under high pressure because they don’t have ARDS.

https://www.the-hospitalist.org/hospitalist/article/220301/coronavirus-updates/protocol-driven-covid-19-respiratory-therapy-doing

If they’re right then some deaths have been iatrogenic, caused by assuming the patients suffered from ARDS. Had we known more about the illness, by being let into China, US and European doctors might have discovered this sooner, if it in fact be the case.

Andy Pattullo
Reply to  John Tillman
April 8, 2020 11:03 am

John this is an excellent point. I work in the health system and I see every day how health providers feel far more enthusiasm for doing something rather than watching and waiting. The underlying sentiment seems to be “it can’t do any harm” and that sentiment is always wrong. Everything we do can have both benefits and detrimental effects. Not considering both possibilities when doing anything to a patient is a grave mistake.

John Tillman
Reply to  Andy Pattullo
April 8, 2020 12:16 pm

Of course, the dictatorship might not have wanted the sainted Dr. Li to survive.

Nicholas McGinley
Reply to  Andy Pattullo
April 8, 2020 2:56 pm

All the more reason to try to not get it for as long as possible.
Reason #$1,201: Learning curve of the medical teams caring for COVID-19 patients.
🙂

John Tillman
Reply to  Nicholas McGinley
April 8, 2020 4:29 pm

That’s some reason, that Reason #22!

icisil
Reply to  Nicholas McGinley
April 8, 2020 5:30 pm

That’s a really good point.

John Tillman
Reply to  John Tillman
April 8, 2020 12:11 pm

https://www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/

If your only tool is a hammer, everything looks like a nail.

It’s a novel virus, so docs are learning on the job. Again, being in Wuhan hospitals would have sped up the learning curve. Maybe 33 year-old hero Dr. Li, who reportedly received ECMO (although can’t believe anything ChiCom regime says), might have survived.

John Tillman
Reply to  John Tillman
April 8, 2020 12:34 pm

To find more asymptotic survivors is a reason for wide antibody testing. Not all plasma donors are created equal:

https://news.yahoo.com/plasma-treatment-being-tested-york-213100838.html?

DHR
Reply to  John Tillman
April 8, 2020 12:55 pm

I have sleep apnea and use a CPAP machine. It can be set to a constant pressure, a bilevel pressure (lower when exhaling, higher when inhaling,) or forced breathing mode where if you stop breathing, it will increase pressure until you do . There are attachment for these machines if additional oxygen is needed.

Compared to hospital ventilators, they are cheap. Perhaps these are all that’s needed for COVID patients having trouble breathing.

John Tillman
Reply to  DHR
April 8, 2020 2:49 pm

Maybe for many or most, except those liable to die anyway.

icisil
Reply to  Stephen Lindsey
April 8, 2020 11:15 am

Ventilators are probably killing more people than they’re saving. Most COVID patients need O2, not pressure.

https://rebelem.com/rebel-cast-ep79-covid-19-trying-not-to-intubate-early-why-ardsnet-may-be-the-wrong-ventilator-paradigm/

icisil
Reply to  Stephen Lindsey
April 8, 2020 11:17 am

Ventilators are probably k!lling more people than they’re saving. Most COVID patients need O2, not pressure.

https://rebelem.com/rebel-cast-ep79-covid-19-trying-not-to-intubate-early-why-ardsnet-may-be-the-wrong-ventilator-paradigm/

gringojay
Reply to  Stephen Lindsey
April 8, 2020 11:43 am

Survival is not guaranteed by putting Wuhan Virus patient on a ventilator. The older person’s chances are, generally speaking, not as good relative to a younger person. Then too, the individual’s underlying condition also impacts their chances. If my memory is correct about a USA medical professional’s statement at this data stage the average survival rate is less than 75%.

Chaswarnertoo
Reply to  Stephen Lindsey
April 8, 2020 11:42 pm

Yep. It’s the availability of intensive care beds that must be maintained. Cheaper to add more beds IMHO.

JohnM
Reply to  Chaswarnertoo
April 9, 2020 10:53 am

It isn’t the beds….it’s the staffing…..

commieBob
April 8, 2020 10:33 am

Flattening the curve does not reduce the total number of cases or deaths. … Unless your health system is so overloaded that people are needlessly dying, the final numbers stay the same.

The whole rationale for flattening the curve is to keep the health system from becoming overloaded. The poster child for an overwhelmed system is probably Ecuador. They can’t even pick up the dead bodies fast enough.

You may think America has the best medical system that has ever existed anywhere, and it probably does, but the bottleneck is ICU beds. How many of those are available in your community? The probable answer is probably, not enough … unless you can sufficiently flatten the curve.

You can ask the Ecuadorians about the wisdom of partying hardy in the face of a pandemic.

Bob boder
Reply to  commieBob
April 8, 2020 12:49 pm

Except Willis shows the number of ICU beds in his neighborhood against the projections. There are plenty

commieBob
Reply to  Bob boder
April 8, 2020 3:52 pm

So, suppose that you have two cities in 1950. How do you know how many long distance phone circuits to run between them? Ultimately, you have to decide how much of the time you are willing to have all the circuits filled with the result that some customers won’t be able to make a connection. You can’t afford to have one long distance circuit per subscriber. Not only that, but most of the time most of the circuits will be unoccupied which seems like a waste. Your boss’s boss’s boss will lay down policy on how much of the time you’re willing to put up with all the circuits being full. You will then tell him how big the cable has to be. erlangs

The ICU bed problem is similar. In 2005, the national ICU bed occupancy was 68%. link That means that a distressing amount of the time there was an ICU bed shortage in some communities even without any sort of emergency.

Bob boder
Reply to  commieBob
April 9, 2020 4:18 am

Even in NYC they haven’t run out of ICU beds or Ventilators, that’s per Governor Cuomo just yesterday.

commieBob
Reply to  Bob boder
April 9, 2020 9:00 am

It’s not nearly as clear cut as you think.

As hospitals have teetered on the brink of being overwhelmed, they have sent home people whom they would have admitted just a few weeks earlier, several New York doctors said in interviews. link

Has NY peaked? When will it peak? Anyway, it sounds like things aren’t that rosy as it is, and people aren’t getting the care they need.

jabre
Reply to  commieBob
April 8, 2020 1:13 pm

+++I appreciate this comment.

For most of the posts across the internet I see the same, fundamental assumption. I do not understand how this point can be overlooked. I am starting to think that it is purposeful oversight as I see it so often and as often refudiated.

If there are more people requiring medical assistance than the system can accommodate at that time it is very likely that their prognosis will be *significantly* worse.

Derg
Reply to  jabre
April 8, 2020 2:41 pm

Jabre do you think people are refusing to go see a Dr?

I know I am…I am assume a physical will not be scheduled, because they are fighting Corona

TimTheToolMan
Reply to  commieBob
April 8, 2020 2:36 pm

The whole rationale for flattening the curve is to keep the health system from becoming overloaded.

And when a vaccine comes along then those yet to be exposed won’t die either. Of course if the vaccine is say a year away then it would seem irrelevant.

TimTheToolMan
Reply to  Willis Eschenbach
April 8, 2020 7:37 pm

Willis writes

In other than heavy surveillance states like Korea and China, the various measures taken to “lower the curve” have not been shown to be effective

I’d say its being effective in Australia. Infection rates have stayed low and so far each Australian State appears to be on top of tracking the infections.

Personally I think that’s an excellent initial strategy but without a vaccine, leaves the country in an even more difficult position going forward.

commieBob
Reply to  Willis Eschenbach
April 8, 2020 7:43 pm

Should they “party hardy”? I never said that.

You did not and I apologize if I left that impression.

From the reports I have read, ‘party hardy’ pretty much describes what the people did. Perhaps I exceeded my poetic license. It might be more technically correct to say that they displayed a cavalier attitude to the looming threat.

There are two things about the situation in Ecuador.
1 – It seems to be the worst case scenario and, IMHO, an object lesson.
2 – Although much of Ecuador has malaria, the city with the coronavirus doesn’t have it. That accords with Roy Spencer’s observation that places with malaria don’t have coronavirus and vice versa. link

Bob boder
Reply to  commieBob
April 9, 2020 4:13 am

This is the greatest epidemic that we have seen in a long time and even in NY city the hospital system is keeping up. Yes its a strain and yes we should learn from this and yes we need to be more prepared, but no we don’t need to bankrupted the entire country over this.

chemman
Reply to  commieBob
April 8, 2020 3:46 pm

There was a comment from a poster that actually lived in the city that generated that information about bodies laying in the street. He actually said it had to do with the way they deal with the dead and the government had closed down most of the mortuaries as being non-essential. Place on top of that the shuttering of wood mills which supplied wood for the coffin building and all the people could do is put the bodies out in the streets. Many of the bodies were from the average daily death rate and not primarily from covid-19.

zack
Reply to  commieBob
April 13, 2020 10:54 am

Yes their medical system is overloaded, but it probably always is. Life expectancy there is likely lower all the time.

But Ecuador’s covid “reported” death toll is currently a mere 20 per million population. Much, much, lower than half the states in America.

Italy, Spain 300, NYC 500+ Whereas CA is 15. I doubt many dispute that mitigation buys time and spreads the case load across a limited resource base. Nowhere in America It also simultaneously allows better medical practice outcomes to circulate. The question is at what cost to the rest of everything else.

We have a luxuriated population because of modern healthcare access. We have “cheated” our way around natural selection. Taking for granted that we are owed, that we have a right to x years on the planet is the default presumption in our policy. The presumption needs challenging.

If we reduce US productivity to Ecuadorian levels we’re going to have an Ecuadorian level health system.

Phil.
April 8, 2020 10:33 am

So it seems that the rule of thumb works well, at least according to the model. Whether it works in the real world remains to be seen …

It’s the standard feature of the logistic curve which does work rather well in the real world.
You focussed on grade school closures, one thing that concerned my university was that all our students would leave campus during spring break and disperse all over the country for a week (many by air) mix with many others then return to campus and spread any infections around campus. Consequently we decided to close campus for the rest of the semester and go to virtual classes. Several years ago we instituted a fall flu vaccination program free to all students and faculty and it has definitely had a good effect on the usual outbreak in flu after the fall break.

zack
Reply to  Willis Eschenbach
April 13, 2020 2:43 pm

Willis, thank you.

“.. I’d expected that the disease would ramp up more quickly than it would taper off…”

Seems the NYC numbers agree more to that then IMHE projections of two weeks back.

New hopsitaliztions are lower than peak,
but not dramatically so. Perhaps midpoint is much farther to the right.

Spain Italy similar.

Clyde Spencer
April 8, 2020 10:33 am

Willis
Kudos! Now, you just have to convince Monckton.

LdB
Reply to  Clyde Spencer
April 8, 2020 7:22 pm

And over 90% of the population 🙂
In Monckton’s backyard support is running at 93%.

Chaswarnertoo
Reply to  Clyde Spencer
April 8, 2020 11:46 pm

Good luck with that. Milord is stubborn.

Reply to  Clyde Spencer
April 8, 2020 11:49 pm

Monckton is right.

Phoenix44
Reply to  Dave Burton
April 9, 2020 2:04 am

He’s wrong. He doesn’t even understand the basic problem, which is the data is useless. Thus using data to prove your argument immediately fails.

We have some basic data, totally all-cause deaths, and that’s about it. Look at that and nothing shows up. There’s now a great deal of argument about the resource claim, with doctors saying that ventilation is a mistake both medically and ethically, and simply putting everyone in ICU and on a ventilator is a mistake.

Wim Röst
Reply to  Phoenix44
April 9, 2020 6:27 am

Phoenix44: “We have some basic data, totally all-cause deaths, and that’s about it. Look at that and nothing shows up.”

WR: The basic data: totally all-cause deaths in the Netherlands in week 13 showed that there were1300-1600 more deaths than ‘normal’. Normal in a week: 2700-3000 deaths in this time of the year.

Official Corona count for week 13: 592. Missing (!) 700 to 1000 extra deaths: probably Corona. Which means that the general number of all-cause deaths shows that the situation is two to two and a half times as serious as the official numbers show.

The Netherlands only show tested cases and in nurseries and at home people dying people are not tested and so not counted as corona deaths. The same in Flanders (Belgium) until recently and in France (until recently). The situation in many countries is more serious than official numbers show – that is what shows up when you look at basic data.

Mike McHenry
April 8, 2020 10:34 am

I don’t see how you can model it. Population is unevenly distributed in the states. In New Jersey where I live it’s concentrated in the NE corner. Here is today’s report for New Jersey with a map https://www.nj.gov/health/cd/topics/covid2019_dashboard.shtml?fbclid=IwAR13y6aoFPeQh8J2pvON509usNwP8Og_Qr9riyvIAoTZ35EEdhB1VN4ODlg

John Tillman
Reply to  Mike McHenry
April 8, 2020 11:02 am

It’s not just the NYC metro area. In most states, it’s concentrated in a few urban and suburban counties.

Reply to  John Tillman
April 8, 2020 2:26 pm

John, absolutely correct. In Oregon 65% of cases are in three counties that represent 40% of population.

John Tillman
Reply to  Mike McHenry
April 8, 2020 1:34 pm

Although the NYC mayor and health commissioner did pursue especially idiotic policies, as did the mayor of New Orleans and governor of LA.

Mr.
April 8, 2020 10:38 am
Clyde Spencer
April 8, 2020 10:39 am

Willis
You said, “Of course, to do that, I had to figure out a variable that would represent the “flatness” of the curve.”
Kurtosis?

Joe Born
April 8, 2020 10:41 am

“That $1,200 check people are talking about? That[‘s] a cost, not a benefit as the chatterati would have us believe. It comes out of our pockets.”

No brief for the bailout here, but that doesn’t seem quite right. No, I don’t like the way they did it it, but in principle it could be done in a way that makes some sense. Consider the following hypothetical:

Suppose the treasury issued everyone $3000 in income taxable at 100%: the $3K they get this year would be added to everyone’s tax bill next April. Politically impossible, of course, but what if it weren’t? Administrative friction and tax non-compliance would probably end up costing us something, of course. But a lot of folks will get income shifted from next year, which they can plan for, to now, when they really need it.

Does that make us poorer? Maybe, but not by nearly $3K x population.

Nicholas McGinley
Reply to  Joe Born
April 8, 2020 11:31 am

They are gonna have to monetize it this time.
Some are calling for a period of very high inflation, something we have not seen in many decades, coming to a theater near you this Fall. Or so.

Toto
April 8, 2020 10:43 am

“Flattening the curve does not reduce the total number of cases or deaths”

Everybody repeats this; few can backup that statement. Is it true?

I’m skeptical. I can think of situations where it is true and I can think of situations where it is not.
For example, a theoretical (impossible?) case where the whole world goes on a total perfect lockdown and the virus dies out in 14 days and the world goes back to what it was last year as far as the virus is concerned, which is billions of people with no immunity but no virus.

markl
Reply to  Toto
April 8, 2020 11:01 am

Toto: The virus will not disappear because we no longer have carriers. Without eventual immunity it will go on infecting. Consider polio, the plague, ebola, etc. …. once thought eradicated but still pop up on the radar.

Toto
Reply to  markl
April 8, 2020 12:52 pm

If there are no human carriers, the virus is gone from humans, no? So this problem would be solved until next time. There will be other viruses and more pandemics.

You mention polio. Polio is a good example. Once common, now mostly gone. And any herd immunity is gone with it. There is a vaccine for polio or else it would still be a pandemic.

One thing that flattening the curve does is give more time to develop vaccines, antibody tests, and other things that could limit the contagion and the issues of lockdowns. Like we do for malaria — there is a pill to prevent getting it. More time to do research on what works and what doesn’t. Meanwhile, take more zinc.

If flattening the curve could get us back into the initial stages where we had few carriers, we could do it better for the second wave. More testing, more contact tracing.

A lockdown done poorly is one that needs to go on forever because it doesn’t get the job done.

Michael Jankowski
Reply to  Toto
April 8, 2020 11:37 am

Yes, there are situations where it would reduce cases and deaths (e.g., vaccine or treatment discovery).

But most experts seem to assume this is going to stick-around and eventually become seasonal (albeit not nearly so destructive).

From my experience, “everybody repeats” that flattening the curve will bring things back to normal sooner, too. Sometimes the curves are right there in front of their eyes to tell them that is not the case…and sometimes the curves are truncated (seemingly intentionally) so that you can’t see that to be the case.

Greg
Reply to  Toto
April 8, 2020 12:17 pm

I like Willis’ in depth look at the effect when measures are introduced etc. Once our expectation of what seems “obvious” turns out not to be the case at all. We need a lot more fact checking examining whether our assumptions are correct.

However, I think Toto, like another person above has put his finger on a flaw in Willis’ logic which explains why this all looks pointless.

He deftly demonstrates that flattening the curve in California , where according to current models it is already flat enough it TOTALLY pointless. The whole point of flattening is to avoid health service saturation. If that is not likely, it makes no sense and is doing immense harm for nothing.

However, he stops there and seems to make an unsubstantiated jump to concluding this is automatically can be generalised to the whole USA and pleads “End the American lockdown today”

I’m generally in agreement and I’m sure most states should not be in this insane shutdown. Europe should get out of it as quickly as possible.

It is not clear from this article that would apply to NY.

Toto
Reply to  Greg
April 8, 2020 1:08 pm

You bring up a good point. If the US borders were closed on New Years day, there would be few if any cases in the US. But they weren’t. So cases popped up in the big cities with international airports. And then it spread to smaller areas and so on. If only there was a way to set up green zones and red zones.

So we are left with keeping distant from others. Is it working? If not, try something else.
BTW, there is police type enforcement and there is social pressure type enforcement.
The former generates backlash. The second is more effective.

Reply to  Willis Eschenbach
April 8, 2020 2:05 pm

Why do you say NY has a huge ICU shortage when admissions have been stable for the past 14 days and the hospitals are still managing? They are now well into their peak and don’t seem to be overrun. The plateau has also happened too soon to put it down to the lockdown.

Loydo
Reply to  Willis Eschenbach
April 8, 2020 2:27 pm

“I don’t do a one-sided “benefits” analysis like Dr. Fauci does.”

Thats exactly what you are doing. On the one hand you are railing against the economic cost for the saving of a disproportionately small number of lives but ignore the fact that without the economic cost many more would have succumbed. You say “not a guarantee but a chance” but that is plainly incorrect. Not just from Fauci but senior epidemiologists worldwide. In countries where shuttering was done early the death toll has been insignificant. In Australia and NZ for example community spread has been neglible as a result of EARLY shuttering, testing, social distancing, etc,.

Zig Zag Wanderer
Reply to  Loydo
April 8, 2020 4:01 pm

We are outliers. Both Oz and NZ have very spread out population centres. Even our capital cities are very small and sparsely populated compared to most other countries. My town has no significant nearby towns for 500km.

Greg
Reply to  Loydo
April 8, 2020 6:25 pm

as a result of EARLY shuttering, testing, social distancing, etc,.

You are making the same fallacy as Monckton. Spurious temporally coincident change is not correlation and is no reason for jumping to your conclusion of attribution.

You start from expecting a certain effect and then jump to confimation bias to claim it’s happening.

Global CO2 has increased since the 14th March , that must be the cause of the reductions in new COVID cases. You seem to think it causes every other change on Earth, why not this one?

The danger is with the shutdown CO2 may begin to drop and we’ll have a “second wave” of COVID.

Stop the shutdown ! We must act now!

Richard M
Reply to  Loydo
April 8, 2020 7:27 pm

Loydo, I live in a state where the count of cases is very low. Even in my medium sized city only 5% of those who think they are sick have been positive for the virus. You are assuming that after some period of shutdown we will all be just fine.

Will we? We still live in a very mobile society. Seems to me this will just allow the virus to gain entrance again and up jumps another curve. Only this time there’s no way to shutdown the economy. All that happened was the problem was delayed.

That’s why the only hope is for a miracle treatment or vaccine. Otherwise, we are damaging our economy for almost no benefit.

China is loving it.

Loydo
Reply to  Loydo
April 8, 2020 10:50 pm

ZZW, I agree to a point that we are generally spread out but cities of 1-5 million with avid travellers, international airports and cruise ship ports are at equal risk world-wide. The only US states to have a higher population than Australia California and Texas. You have to run down the list of US states to Minnesota before you find one with fewer deaths than the entire country of Australia. If New Zealand was a US state it would rank 25th in population behind Alabama, but only Wyoming would rank lower in deaths. It’s a lot more than just population density.

“you start from expecting a certain effect and then jump to confimation bias to claim it’s happening.”
Fair enough Greg, what strategies/circumstances/timing would you say have made such a huge difference in outcomes between certain countries?

Bob boder
Reply to  Willis Eschenbach
April 9, 2020 4:16 am

Just yesterday Cuomo stated that the situation is stable and there are enough ICU beds and ventilators.

Joe Born
April 8, 2020 10:49 am

“Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period.”

As I explained, that’s not technically true:

https://twitter.com/JosephHBorn/status/1247823025602465792?s=20

Doug
Reply to  Willis Eschenbach
April 8, 2020 3:13 pm

Ventilators cost about the same as a small car and have about the same useful life. Imagine asking the car companies too tool up production to double the total number of cars on the road in the next few months. Its laughably impossible. Its the same for the few companies making ventilators.

Joe Born
Reply to  Willis Eschenbach
April 8, 2020 3:30 pm

Pro tip: just saying it’s technically true doesn’t make it so.

For the benefit of any lurkers, I’ll mention that I did the math and plotted the results at the Twitter link above. The math shows that flattening can indeed reduce deaths even if we have all the ventilators and ICU beds we need.

Guest
Reply to  Joe Born
April 8, 2020 4:19 pm

Agreed you can reduce deaths if:

1. Herd immunity is achieved through disproportionate exposure to low risk people
2. The virus burns out before infecting to herd immunity (in this case its probably 55-60% requirement)
3. The virus is delayed to a vaccine/virus weakens (as the tend to do)/treatments improve (as they tend to do)

It won’t save lives if the end result is herd immunity uniformly achieved with no medical treatment changes or viral decay.

Joe Born
Reply to  Guest
April 9, 2020 6:06 am
Joe Born
Reply to  Willis Eschenbach
April 8, 2020 5:45 pm

Pro tip: Just saying that something is technically true doesn’t make it so; the oh-yeah-so’s-your-old-man response is not compelling. Please try to tighten up your game.

For the benefit of any lurkers, I’ll mention that I did the math; it shows that flattening the curve can indeed reduce the number of deaths even if we have enough ventilators and ICU beds and even if we come up with no improvements in treatment. The Twitter link above gives plots the results. And I’m not the only one who came up with that result.

Joe Born
Reply to  Willis Eschenbach
April 8, 2020 7:41 pm

Look, I admire your facility with data sets, and I find your “thermostat” hypothesis quite insightful and the data you’ve marshaled in support compelling. I freely admit that I wouldn’t have had the capacity to come up with it myself. So please don’t take this the wrong way.

But we all have our limitations, and your failure to recognize yours has led you consistently to reject help with math from the half dozen or so of us at this site who can provide it and have attempted to do so.

I explained on Twitter why I disagree with your statement that “Delaying deaths does NOT necessarily reduce deaths.” I’ve done the math and plotted the results for you. I’ll even comment the script I used and send it to you. If you can provide a reasoned explanation as to why you disagree with it, fine.

But you haven’t so far, and, frankly, nothing in my experience suggests that you can. That’s okay. We all have our limitations; I certainly have mine.

Just try to entertain the possibility that maybe, just maybe, some of us actually know what we’re talking about.

Greg
Reply to  Joe Born
April 8, 2020 6:38 pm

Sorry Joe. That twatter link’s mess, I see 1/5 and 2/5 then a load of junk.
I gained nothing from reading what was there.

Twatter is an awful media for anything but the plus banal in life.

Joe Born
Reply to  Greg
April 8, 2020 8:00 pm

Sorry about that; you’re among the few who probably could have understood the concept (although I see above that you haven’t yet).

I don’t know what to tell you except to try using Twitter’s search feature with my name and clicking on “Tweets & replies.” There should be five of my tweets on this subject, with two plots.

Unfortunately, I have no way of sending you what I’ve sent Mr. Eschenbach: the underlying scripts with extensive comments. (His other gifts notwithstanding, my sending it to him is no doubt casting pearls before . . . someone who wouldn’t appreciate them. But, hey, I tried.)

Greg
Reply to  Willis Eschenbach
April 8, 2020 6:28 pm

Then consider that there’s no evidence I’ve seen that shutting down the economy makes any significant reduction in the curve

comment image

ZERO PIONT ZERO.

Scissor
April 8, 2020 10:51 am

I have that question also. Good example.

Henry Pool
April 8, 2020 10:54 am

“put the trillion dollars into making the medical system the strongest and most resilient imaginable”

Too late, the pandemic is already here. Might have worked if you did it last year.

“wrecking the lives of 30 million Californians just to save eighteen hundred lives. ”

So, are you saying that $1,000,000,000,000 / 1800 is your dollar value on a human life?

Bob boder
Reply to  Henry Pool
April 8, 2020 12:55 pm

Yes, in fact my value is a lot less. Just fricking stupid, if you found out that you could save ten lives for 100 trillion dollars would you spend it? Those dollars your dismissing are people’s lives, many many peoples lives.

Paul Penrose
Reply to  Henry Pool
April 8, 2020 1:04 pm

Henry,
Strawman argument. What he is saying, if I may Willis, is that wrecking the lives of 30 million people will cause far more loss of life than the 1800 the virus is predicted to take. If you disagree with that, fine, then state your case. As distasteful as you may personally find it, our elected leaders must make these kind of calculations all the time. Resources are always limited are almost always less than the perceived need. So sometimes, yes a human life is reduced to a value of some kind to help make a particular decision. It can’t be avoided, and you are naive if you think it can be.

Henry Pool
Reply to  Paul Penrose
April 8, 2020 2:36 pm

“wrecking the lives of 30 million people will cause far more loss of life than the 1800 the virus is predicted to take”

Sorry, there is no evidence that this is the case, it’ just you assuming so. PS, my argument is not a “strawman” it is derived by the implicit dollar valuation that Willis has placed on a human life.

John Tillman
Reply to  Henry Pool
April 8, 2020 4:43 pm

Henry,

I don’t have data for the US, but in Italy, 85% have been over 70 years of age. Assume US is similar. Ballpark figures here.

We are going to spend far more than two trillion dollars to compensate for Wuhan virus economic losses. Assume, wildly unrealistically, that the economic catastrophe from shutdown will save 100,000 lives (probably ten times too high). That’s $20 million per life, or at a minimum two million per year of remaining life. The real figure could easily be ten times that high.

Weigh end of life expense vs. cost of early in life enjoyment and productivity. All is not absolute, but relative. Many great grandparents would willingly give up a year of bedridden, painful, drugged life for more time for their young descendants.

I know I gladly would, although that’s easy for me to say, lacking great grandkids.

Chaswarnertoo
Reply to  John Tillman
April 8, 2020 11:52 pm

This 👍

Paul Penrose
Reply to  Henry Pool
April 9, 2020 10:05 am

Henry,
No assumptions necessary. Just look at Venezuela or any poor third world country for that matter. Need something more concrete? In the state I live in there has been a spike in motor vehicle deaths since the shut-down because people are driving a lot faster since there are not as many vehicles on the road. Stupidity? Of course, but still a consequence of the shut-down. Also trending up are suicides, robberies, and assaults. Which will all get worse as time goes on.

CptTrips
Reply to  Henry Pool
April 8, 2020 2:37 pm

Henry, are you saying that spending one half of a billion dollars of someone else’s money to buy an extra 5-10 years, on average, for a person is a reasonable idea?

The real problem here is some people’s demand for “safety”. Safety, like dry land, is a myth. It does not exist in and of itself, only as a relative comparator between two or more things. What we have is risk. And risk is different for each and every individual.

Let’s use COVID-19 as an example. I’m in my mid 40s and due to health issues am in the high risk group, I probably have 1 chance in 5 of dying if I get this. My kid sister is in her upper 20’s and in perfect health. Her chance of dying is much less than 1%. In economics, I make a comfortable living, have decent savings, own my home, have a job in an “essential” industry, and can work from home/in isolation. She makes less than half what I do, is currently laid off due to the lockdown, can’t work from home, has little savings, and rents. While my risk from the shutdown is very low, it is putting serious risk on her.
My example is essentially the statistical pattern you will find in the general public as well. While the older are at higher risk for COVID, the younger are at higher risk from the economic shutdown. This leads us back to the $1/2 billion dollar question: Why is it okay/a good idea to transfer so much risk from the older population unto the younger? More importantly, why would anyone be for taking away one’s choice on which risks they are willing to accept? Is it just to eliminate the responsibility on people to mitigate their own risk?

Every day we all make decisions that risk our life and limb based on what we perceive the risks to be, whether we are good at calculating them or not. Now instead of giving people guidance on what their risks are and methods to reduce them, then allow them to make their choices and live with the consequences, we are taking the decision out of their hands and imposing a different set of risks to reduce this one particular risk. But, I suppose it’s an easy decision to make when the risk isn’t yours to bear.

Henry Pool
Reply to  CptTrips
April 8, 2020 3:31 pm

You are free to make decisions that risk your life and limb based on what you perceive the risks to be, whether you are good at calculating them or not. You are not free to make those decisions for me, or for anyone other than yourself.

Bob boder
Reply to  Henry Pool
April 9, 2020 4:23 am

Henry

its your job to make the decisions for you to protect your self, but its you that thinks you should have the power to alter everyone else’s life to protect yours.
If you are high risk you can self isolate.

paul courtney
Reply to  Bob boder
April 9, 2020 8:28 am

To readers: This Pool isn’t worth another keystroke.

BrianB
Reply to  Henry Pool
April 9, 2020 11:02 pm

That’s a rather poor argument.
Every decision in this involves making decisions for other people. And they can be life and death decisions on both sides of the equation. It’s not simply suicides. Wealth of a society by itself is highly correlated to lower mortality rates. Destroy trillions in wealth and more people will die earlier. Destroy enough and the number will be rather high.

Doc Chuck
Reply to  Henry Pool
April 10, 2020 2:11 am

C’mon guys, credit virtue when it’s due. Henry is signaling, admittedly indirectly, that he sufficiently feels for human life that he would welcome deductions from his own savings in the effort to extend lives even for some months. I respect his generous decision to devote his own hard won resources instead of further burdening generations to follow with a soaring indebtedness to effect his wishes.

Eustace Cranch
April 8, 2020 10:56 am

Looking at the virus maps, it’s blindingly obvious that population density is *everything*. No other risk factor even comes close. And New York City is, unfortunately, is the outcome of a “perfect storm” of risk factors (27,000 people per square mile!) and absolutely criminal policy decisions. Is anyone really surprised what happened there?

This pandemic is not even close to homogeneous. Federal and statewide one-size-fits-all lockdowns are idiotic policy. Some states still only have case counts in the low double digits. Many, many counties in the U.S. have not recorded a *single* case. Zero point zero zero. Why can’t people living there go back to work?

This is outrageous.

Reply to  Eustace Cranch
April 8, 2020 1:36 pm

Yep! Respiratory disease transmission requires 2 people, the infector and the infectee to be in some relatively close proximity. Thus it is analogous to a “2nd order” chemical reaction for which the rate varies as the square of concentration. So the disease transmission models should have rates that vary as the square of the population density! Do they? I don’t think so and if this is the case, no amount of curve fitting and “updating with better data” will allow them to make better “predictions”! So yes, most of the country is not in any danger of local outbreaks that would overwhelm their normal health systems… and we are finding this to be the case!

Richard M
Reply to  Eustace Cranch
April 8, 2020 7:52 pm

Large cities with high populations densities also have mass transit systems. They also have tall buildings with lots of elevators. Both of these are excellent vehicles for disease transmission. As a result the virus moves quickly through these area. The disease was already well up the curve before mitigation policies could have an effect.

Smaller population densities are not as easily infected. However, I think they will eventually go through a curve because of schools and other public transmission areas. They just look flat now because the mitigation took place before the disease got a good foothold.

I fully expect less populated areas to see a large increase in infections once the shutdowns end.

April 8, 2020 10:56 am

A great start, Willis. I like your approach of trying to fingerprint the effects of particular policies. You in the US have a great advantage over us Europeans; you have 50 laboratories trying different cures! Here, we have only 12 or so, with the French (at least) having screwed up their data. And if the EU had its way, we’d have only one…

In Europe, things are looking up with regard to new cases. (Though not in the UK, yet). Unclear (to me at least) whether it’s the result of lockdowns, or of herd immunity starting to kick in. The latter would require that the virus has been around a lot longer than anyone has told us. We shall see.

Greg
Reply to  Neil Lock
April 8, 2020 6:53 pm

At what point would you expect herd immunity to “start” to kick in?

I’ve seen 60-70% figures suggested as needed to it stop the virus, not for it to “kick in”.

Herd immunity maybe starting to have an effect as is the attrition of the supply of vulnerable octogenarians in poor quality care homes and those on ACE inhibitors.

What we have seen in Europe seems like the normal progression of any epidemic. I can not see the slightest effect of confinement. If it helped it is not slapping us in the face ( unlike the costs of doing it ).

comment image

Joe H
Reply to  Neil Lock
April 9, 2020 1:53 am

‘And if the EU had its way, we’d have only one…’

You are gone from the EU, Neil, but yet still continue complaining about it! You can have all the curved bananas and laboratories you want now – but the tooth fairy ain’t going to pay for them….

ossqss
April 8, 2020 10:57 am

One would wonder that the societal permeation factor would be associated with one infection transfer. How exponential would that be over a 1 week period in an uncontrolled environment. Let’s say with an R0 of 3 per day as an example. I get the possibility of 2,187 infections in one week generated from such. Just pretending to be a model 🙂

Andy Pattullo
April 8, 2020 10:58 am

Very interesting discussion Willis. You do a great service by introducing aspects of the response that need attention. I am a practicing infectious disease physician and have similar concerns but would not state some of the conclusions as forcefully, as much is still not known. I agree the decisions about how to respond should rightly be cost-benefit. They appear however to be CYA decisions (i.e. cover your ass by doing anything possible to reduce infections) – all “benefit” no cost. That is they are focused on one benefit that is of primary interest to decision-makers who will later crow loudly about how they saved everyone. This is contrary to the medical dictum of “first do no harm”. Even if cost benefit is calculated purely on lives lost or saved the idea that the precautions taken don’t cause loss of life is negated repeatedly by many examples such as increased violence, increased suicides, and decreased access to appropriate care for other serious conditions.

The one conclusion I am more uncertain of is that flattening the curve is just delaying but not preventing cases. It may well be true, but there is at least theoretical potential for measures to actually reduce the long term burden of infections if effective. That is the issue at the center of this discussion. Are the measures actually reducing the number of people who will ultimately get infected – we don’t know, but we should get a much better idea towards the end of this outbreak by doing comparisons similar to those undertaken by Willis.

Delaying deaths is a much more reasonable goal than preventing them since immortality is not an option. That is to say the death rate is always 100% if you do long enough follow-up. While the elderly and chronically ill are much more at risk of dying from or with CoVID, they were at more immediate risk of death even without CoVID. We will need more refined analysis to determine how much COVID contributed to an increased rate of early death. Seasonal increased mortality such as is tracked yearly during the flu season may give a better indication.

If, as Willis suggests, the measures we are taking are in error and have much higher costs than benefits, then faulty modeling based on incorrect assumptions is likely a major contributor to that outcome. Sounds a lot like global warming to me all over again.

With respect to the negative correlation of measures taken versus steepness of the curve there is an alternate possible explanation. Those jurisdictions starting off with the steepest case increase may be more persuaded to adopt coercive measures because of the steepness – i.e. the causation is reverse of what was theorized. One day we will have a much better understanding but it is critical that these contrary discussion points get a hearing and that honest analysis take place so that any mistakes made today need not be repeated in future.

Nicholas McGinley
Reply to  Andy Pattullo
April 8, 2020 12:05 pm

I was thinking something very similar…the places that took steps first were the places that were getting impacted harder at the outset. IOW…people were reacting to what was being seen, not what they thought might be coming.

Reply to  Andy Pattullo
April 8, 2020 12:06 pm

If in the meantime, while delaying new kwowledge about treatment (no ventilators f.e.) surges, than you saved live by winning time!

Richard Petschauer
Reply to  Andy Pattullo
April 8, 2020 1:11 pm

Andy’s excellent comments made me think. We need a metric that, estimated by a doctor, for each person whose death was claimed to be caused by COVID19 would have lived if the person had not been infected.

Richard Petschauer
Reply to  Richard Petschauer
April 8, 2020 1:16 pm

Correction:
I meant to ask how much longer they would have lived if they had not been infected.

Andy Pattullo
Reply to  Richard Petschauer
April 8, 2020 6:28 pm

Yes that is exactly the point. A better metric for “cause of death” is attributable years of life lost. That is the amount of life lost due to a particular contributor. For CoVID it would be how much longer and individual would have lived on average had they not contracted CoVID. A few hours doesn’t count for much, a few days?, but many months to years would be more impactful.

Reply to  Andy Pattullo
April 8, 2020 1:34 pm

re: “Delaying deaths is a much more reasonable goal than preventing them since immortality is not an option.”

AS I wrote on FreeRepublic on this subject, the number of deaths has been “front loaded” for this year due to the deaths of the ‘weak and infirm’ to date, and the stats for the rest of the year should reflect this.

chemman
Reply to  Andy Pattullo
April 8, 2020 4:05 pm

“The one conclusion I am more uncertain of is that flattening the curve is just delaying but not preventing cases.”

I think that is a valid question. I do know that flattening the curve was sold as having the same area under each curve but the flattened curve spread it out. That is the same number of infections are presumed in either curve while the flattened one reduced the stress on the medical system. So I’m not going to fault Willis for arguing based on the model assumptions sold to us.

Gareth Roberts
April 8, 2020 10:59 am

1. It’s not feasible to spend a trillion dollars beefing up the healthcare system in just one month.
2. In Wuhan and in Italy the hospitals did get overloaded and the mortality rate increased. London has got very close to that point, and so has New York.

Tonyb
Editor
April 8, 2020 11:00 am

I am completely mystified as to how locking up people in small houses for weeks, passing the virus from one person to another is a good idea. I am also baffled as to why the enormous repercussions in terms of people’s physical, mental and financial health seem to be ignored, not forgetting the impact on personal relations. Or on our freedoms.

Panic of the first order. The madness of crowds forcing the politicans to do ‘something’ whether or not that ‘something’ is at all logical.

Scissor
Reply to  Tonyb
April 8, 2020 1:03 pm

In most nursing homes, residents are being forced to stay in their rooms. They can’t leave even to go outside for a little fresh air and sunshine. They can’t see family, friends or enjoy any outside pleasures. The resulting grief will kill some.

Marc
April 8, 2020 11:01 am

The problem is that all your analysis uses absolute date… but those states that were hardest hit will have the earliest intervention dates, which completely messes up your ability to tell if interventions work. Preferably, you would use “intervention date RELATIVE to the date at which deaths exceeded X” (where X might be 5/million inhabitants, or something like that).

I also think it is fairly evident that if New York had NOT shut things down hard, they’d be hiring refrigerated trucks just for the excess dead… oh, wait, they already are. It would have been EVEN WORSE THAN THAT.

And all of these curves assume continued actions to halt spread. If we hadn’t locked down at all, California wouldn’t have peaked earlier but had the same number of deaths… instead, that curve would have skyrocketed up, and kept on going. If we assume a 0.5% mortality rate, we’d be looking at 150,000 deaths for California, not 1800. (likely the mortality rate would be much higher since hospitals would be overwhelmed, but probably some percentage of the population wouldn’t get infected even under no-lockdown, so I’m assuming those cancel out).

-Marc

Roger Caiazza
April 8, 2020 11:03 am

Check out the numbers for New York to see an example of a shortage of beds and ventilators. Then throw in the concerns that ventilators may not be the best solution: https://blogs.webmd.com/public-health/20200407/coronavirus-in-context-do-covid-19-vent-protocols-need-a-second-look and we are floundering for answers.

I have been thinking that I have not heard any politicians offer a plan to end this and I am leaning to an approach such as the one you proposed. Unfortunately, you offer a nuanced solution in a sound-bite society that views things in politicized black and white so it would be headlined as a plan to let people die.

markl
April 8, 2020 11:05 am

The more I read and witness the more I believe herd immunity is the answer. More months of lock down would destroy the world’s economy to the point it would cause more deaths than the virus. The fact that overall flu deaths are below normal doesn’t seem to get traction with the scaremongers.

MJB
April 8, 2020 11:08 am

Hi Willis, I’m a fan of your work but I find this post lacking in your trademark critical thinking.

1) You say: “Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period.”

Is it not possible that flattening the curve could indeed reduce the total number of deaths, in that a less stressed health system may lead to better outcomes for some fraction of serious cases? If not why even put people in hospital or ICU.

2) In this post (and previous) you use count of the number of interventions as a metric, but this treats all interventions as equally effective in their design and implementation. Intervention is not a standard unit of measure so a poor choice for things like Figure 3.

3) Also related to Figure 3, you seem to be missing the possible (likely?) correlation between number of interventions deployed and prior severity and risk factors for the local situation.

4) Figures 4 (typo: labelled as 3), 5, and 6 are by calendar date so confounded by date of local onset, which appears to have varied significantly across the country. Should this not be normalized to some factor (time since: first case, first death, first 100 cases, etc) to have any comparability? For example 2 jurisdictions may have closed schools on the same calendar day but one was a late adopter having 1000+ cases already, and the other was an early adopter having no reported cases. Date of adoption relative to the progression of the local outbreak could significantly influence effectiveness of the adoption.

MJB

MJB
Reply to  MJB
April 8, 2020 11:58 am

Figure numbers seem to have been corrected. In the above comment point 2) and 3) should refer to Figure 2, and point 4) should refer to Figures 3, 4, and 5. Thanks. MJB

Eliza
April 8, 2020 11:11 am

At last some real common sense. Dr Knut Wittkowsky a top coronavirus epidemiologist posted this yesterday a must see totally concurs 100% with this posting and explains why flattening the curve prolongs the viral problem plus the trillions lost suicides ect Thank you. This is the link first posted by H/T to Robert yesterday https://www.youtube.com/watch?v=QO1fvhksSoI BTW Sweden has not lockdowned and has same incidence a low rate countries with extreme lockdowns

Henry Pool
April 8, 2020 11:15 am

it still wouldn’t be worth a trillion dollars even if we could actually save that many lives

So at each life valued at about $0.5 Billion ($1T/1800), and with the death toll now greater than 14,000, we have lost $7 Trillion in value, and the death toll keeps rising.

Derg
Reply to  Henry Pool
April 8, 2020 12:31 pm

And more and more people are losing their jobs, their friends and family members are losing their jobs added to the fear of losing their jobs. People won’t go to the doctors for fear of getting the virus too 🙁

D. J. Hawkins
Reply to  Henry Pool
April 8, 2020 12:37 pm

I’m sorry, but no human life is worth $500,000,000 at least from an economic perspective. The range is about $130,000 (will insurance provide coverage for a new procedure?) to $9,000,000 according to the US EPA. So at $9 million a pop, CA shouldn’t be employing measures costing more than $16.2 billion. For the US, that’s $126 billion. We are so screwed.

Henry Pool
Reply to  D. J. Hawkins
April 8, 2020 12:53 pm

Some will argue that putting a dollar value on a human life is immoral.

Bob boder
Reply to  Henry Pool
April 8, 2020 1:04 pm

“Some people will argue putting a dollar value on human life is immoral”
RealLy so how much will you spend to “save” a life? $1, $10, $100, $1000, how about a trillion dollars? The money your are willing to spend is people’s lives, it’s their life savings from all their years of work and sacrifice. How many family businesses should we flush down the toilet? How many people that worked their whole lives scrimping and saving and fight to get ahead should we force back to square one? How much earlier will they die because they can’t enjoy the fruits of their life’s work? And how much will you spend to extend their lives?

Henry Pool
Reply to  Bob boder
April 8, 2020 2:39 pm

What dollar figure do you place on a human life? Is a teenager’s life worth more than a 50-year old? Is a male worth more than a female? Is an Asian worth more than a Spainard? What is your life worth?

Bob boder
Reply to  Bob boder
April 9, 2020 4:26 am

Henry

How much suffering of other peoples lives is OK to protect your life?

Rich Davis
Reply to  Henry Pool
April 8, 2020 2:05 pm

Henry, I know that you frame this in religious terms, but consider that every action (including the refusal to act) has multiple effects. Surely the decision to take an action motivated by profit should not be considered licit because the cost of deaths caused that might need to be compensated is less than the profit made. Any action that directly causes another person’s death is illicit, regardless of how lucrative. But that gets muddied if the deaths are not predictably and directly caused and everyone enjoys the benefits while everyone remains at a slight risk. For a small group to benefit while a large group only risks death is clearly immoral. But when burning fossil fuel for example, society as a whole benefits greatly and many more lives are extended than may be lost from pollution effects. In a just society we may still wish to compensate those who are negatively impacted, even though they also benefited from the positive effects. In such a case we must set a value for fair compensation. It is not the value of a life, it is a value of a compensation for a reduction in lifespan.

When we compare the harmful effects of overspending on mitigation of one problem, we can’t just look at the lives putatively saved by the mitigation. We have to look at costs and benefits of all the effects of our action. If in avoiding one death we unintentionally cause another person to die, then no cost can be justified.

Henry Pool
Reply to  Rich Davis
April 8, 2020 3:03 pm

Rich, can you explain in your framing of this discussing, why do we execute death row inmates, when it is less expensive to keep them incarcerated for the rest of their natural lives? This is an illicit action motivated by the opposite of profit.

Rich Davis
Reply to  Rich Davis
April 8, 2020 5:12 pm

Henry,
The death penalty is a question of justice and of deterrence and also not as you assert the unjust taking of innocent life. Personally, I hold as a matter of faith that human life has an intrinsic value and would prefer to see the death penalty minimized or eliminated, because in my judgment, there is not much deterrent value. On the other hand, some heinous crimes cry out for justice. Reasonable people may disagree on this, and we obviously do.

It doesn’t enter into my calculus at all as to which choice costs less. Having said that, the cost of incarceration or execution is largely a matter of policy. I am sure that China’s extensive use of the death penalty is far cheaper under their policy choices than incarceration would be. Indeed they may profit greatly from organ harvesting. If we sink to that level of indifference to the value of human life, we can certainly make slaughter pay.

Again that is not validly a question of cost, but of justice.

Henry Pool
Reply to  Rich Davis
April 9, 2020 11:29 am

OK Mr. Davis, you argue that you cannot place a dollar value on a life because of “justice.” I’m arguing that you cannot place a dollar value on a life because of “morality.”

Rob Bright
Reply to  Henry Pool
April 8, 2020 10:33 pm

The Court system is forced to value lives in wrongful death cases all the time. Expert witnesses are called by both sides to testify to various aspects of the person’s life, the loss, pain and suffering to the widow, etc… And the jury comes to a verdict on the valuation of that life.

Whether it’s “moral” to do so or not misses the point, IMO. If it’s “immoral” to value a life, then would you take the position that when a life is lost due to wrongful death, the widow should receive no compensation because it would be immoral to calculate the compensation?

It’s not something anyone WANTS to do. But it has to be done anyway.

And as to your question, “Is a teenager’s life worth more than a 50-year old?”

It depends. Here are some of the factors used to determine it:

“Placing a monetary value on a life is incredibly difficult. There are, however several factors which may be considered to help reach a amount. These include:

The age of the deceased person
The deceased’s earning capacity
The deceased’s state of health
The deceased’s income at the time of death
The age and circumstances of the deceased’s dependents
The deceased’s education and training
Medical bills and other expenses incurred for the deceased
Funeral expenses
Value of lost benefits (e.g. pension, health insurance)

The damages amount must not be merely a ballpark estimate, but must be supported by objective evidence. Economists and other expert witnesses can look at the deceased person and their circumstances and consider the various circumstances to determine an amount.”

https://www.askadamskutner.com/wrongful-death/calculating-wrongful-death-settlements/

Point being… whether it’s “moral” or not, sometimes you’re forced to give a life a valuation. And when you do that, you have to have a metric to do so. Most metrics value lives at no more than $25 million dollars, and often a lot less than that.

Chaswarnertoo
Reply to  Henry Pool
April 8, 2020 11:58 pm

Obviously never had to make healthcare funding decisions then. Bill Gates pays $15,000 pcm premium for the best available healthcare. Do you see the problem?

D. J. Hawkins
Reply to  Henry Pool
April 13, 2020 6:18 am

In a world of limited resources and infinite wants, valuation is imperative. Not doing so is immoral, as every compensation paid means funds not available to clean the water and air and render medical care to those less fortunate. At any point in time, there’s only so much cash available.

Henry Pool
Reply to  D. J. Hawkins
April 8, 2020 12:55 pm

Are you implying that if my uncle was on death row in CA, I could free him for $10 million?

Rich Davis
Reply to  Henry Pool
April 8, 2020 5:15 pm

No, but if your uncle accidentally killed someone, it might be considered to be a just compensation to the family.

pouncer
April 8, 2020 11:15 am

The “expected” flu (s, several varieties) for which we vaccinated and prepared, should be just as slowed from social distancing and masks as any other contagion. The US CDC measures annual effectiveness of the seasonal vaccine against each season’s flu to find vaccination is rarely much more that 50% effective. Before the Covid crunch, this season was typical, and there was a modest rise in “Influenza Like Illnesses” (ILI). Possibly some unspecified ILIs were CV-19.

Is there a data source pooling and segmenting ILIs, seasonal flu, and CV-19 incidence and fatalities, over time, such that we can see the effects of various measures? The “pool” should show all such contagions flatten. The seasonal stuff should flatten less, because the vaccine provides the herd immunity we are looking for. And the mysterious ILIs may, or may not, be or include CV-19 but if the curve — flattened or otherwise — parallels CV-19 that would be indicative. Of something.

Curious George
April 8, 2020 11:18 am

Until we know what percentage of the population is naturally immune and what percentage simply shows no symptoms, all models are shots in the dark – that’s why graphs with uncertainty ranges bear a depressing similarity to IPCC models.

Given how little we know, whatever approach we take is playing a roulette. Of course, we will put a scientific veneer on the approach taken. In four weeks or so we may compare results from Sweden and Denmark and other countries. Then we can evaluate approaches in hindsight.

I am not blaming anybody for the lack of knowledge, but I blame officials who ban potential treatments for questionable reasons.

Scott Gates
April 8, 2020 11:19 am

Excellent insight as always Willis …

The IHME Model has seen a major revision yet again … just a few days after the last one. Yesterday’s projection update:

Total Projected US Deaths:
60,415 COVID-19 deaths projected by August 4, 2020

Last week:
93,000 COVID-19 deaths projected by August 4, 2020

Last Sunday:
81,766 COVID-19 deaths projected by August 4, 2020

California projected deaths down also – now:

1,611 COVID-19 deaths projected by August 4, 2020

https://covid19.healthdata.org/united-states-of-america

zack
Reply to  Scott Gates
April 11, 2020 1:50 am

Scott Gates
The 30x disparity between NY known rates and CA assumed is what strikes me as odd in the IMHE. Avocado toast?

Also, Willis accepting the peak death day as being the halfway point may be off. Seems more likely that halfway will be farther along on the downslope with the tail long and fat. If NY, Spain and Italy aren’t at halfway yet then just doubling the 300 deaths per million now may be optimistic. That said, even .0008 or .001
is still quite low against other existing morbidities, which it will also lower.

Toto
April 8, 2020 11:19 am

“Here’s how crazy this lockdown is.” Human costs, economic costs, all too true.

It’s a war and the generals are incompetent.

“The western style style of quarantine leaks virus like a “closed” Senate hearing leaks classified information, and then the virus is transported everywhere. There’s really no attempt being made being made to track contacts.”

Incompetent and inexcusable.

To fight the virus, “we” have decided on social distancing, and “we” decided until recently that masks don’t work. Look at the photos from China yesterday as their big lockdown was ended. The photos show massive crowds, tightly packed, living outdoors and in the streets again — wearing masks. Clearly the Chinese people (as opposed to their government) think that masks are enough. They may be right. We will see.

And “we” decided that some malaria drug (and don’t forget to take zinc with it) doesn’t work and might kill somebody’, just because Trump mentioned it. Good thing Trump didn’t mention tonic water!

And “we” decided not to do aggressive contact tracing? That would be a worthwhile job creation program.

Let’s not do anything that works, let’s just do the symbolic (but damaging) stuff. /sarc

I don’t know who “we” is, but it doesn’t include me.

d
April 8, 2020 11:21 am

I fear that we are all still attempting to reason from quite bad data.

Henry Pool
April 8, 2020 11:21 am

Willis, the problem with what you propose is summed up as follows….. The economy will recover from this, but the dead people won’t.

Tropical Lutefisk
Reply to  Henry Pool
April 8, 2020 12:10 pm

You’re assuming the lock down will make a difference and you’re assuming no one loses a life due to suicide. Sadly, economic despair and isolation have a human cost as well. Many people, young healthy people, may choose to end their lives because of the bleak future they perceive.

n.n
Reply to  Henry Pool
April 8, 2020 12:42 pm

Planned People… Persons? Maybe, but not a given.

Eustace Cranch
Reply to  Henry Pool
April 8, 2020 12:52 pm

Hmm… Henry, are you one of the “if it saves just one life” crowd? Is one life worth a multi-trillion dollar hit to the economy? Or ten lives? A hundred? Just where is your cutoff point?

And hey, since we’re playing this game already, why not outlaw private ownership of automobiles? Use of alcohol? Air travel? Backyard swimming pools? Think of all the lives it would save. We’d get used to it, I’m sure. Freedom is highly overrated.

Henry Pool
Reply to  Eustace Cranch
April 8, 2020 2:13 pm

Cranch, you choose to ride in an automobile. You choose to drink alcohol. You choose to board an aircraft. You also choose to swim in a pool. You don’t choose to be infected.

John Tillman
Reply to  Henry Pool
April 8, 2020 4:01 pm

Actually, to a large extent, you do, based upon your own actions.

Bill Taylor
Reply to  Henry Pool
April 8, 2020 4:19 pm

henry, you choose to write very strange moronic posts.

Rich Davis
Reply to  Henry Pool
April 8, 2020 7:17 pm

You do not choose to be run over by a speeding car. You don’t choose to be beaten up by a rowdy drunk. You don’t choose to have an airplane crash into your neighborhood. An infant crawling into a pool doesn’t make a choice. If you carelessly go around risking infection maybe you are making a choice.

But Henry, how is it that you refuse to acknowledge that every action has multiple effects? Multiple effects that must be balanced.

Bob boder
Reply to  Henry Pool
April 8, 2020 1:12 pm

Henry

The money lost is very much other people’s lives! The economy may recover but how many small business won’t and how many people does that equate to? All the people losing their jobs and there lively hoods has a direct effect on their life spans, so how are you to give those people their life span back? Life stress is the number 1 contributer and indicator of early death.

Henry Pool
Reply to  Bob boder
April 8, 2020 2:17 pm

Bob you can resuscitate a failed business, you can’t do so with a dead person. People lost their jobs during the Great Recession, they got new ones. Dead people can’t get a new life. Stress is a part of life, it’s been here before the virus showed up. Business and economic endeavors are transient, they come and go, but death is final.

Bob boder
Reply to  Henry Pool
April 8, 2020 3:12 pm

Henry

So since it’s clear that less people will die from the flu because of the shut down, should we just stay shut down for ever to save those lives?
Being someone who lost his business during the 2008 recession and most of his life’s savings and has spent the last 12 years trying to get back some of those saving I can say without a doubt you have no fracking clue what your talking about. I lost 30 years of sweat and sacrifice, I don’t have another 30 years to get back that let alone what you think is so easily sacrificed now and there are many others that depend on me as well. People die, that’s part of life and matter how much of other people’s lives you are willing to sacrifice people are still going to die. Cars kill let’s get rid of them. Trains kill let’s get rid of them. plains kill let’s get rid of them. Peanut butter kills let’s out law that. Going to work is dangerous let’s out law that. Fighting wars against evil people takes lives let’s never do that again.

Henry Pool
Reply to  Willis Eschenbach
April 8, 2020 2:25 pm

“So are you claiming that it would be worth it to shut down the entire economy to save one person from death?” No, I didn’t say that, I said you cannot place a dollar amount on the value of a human life because it is immoral to do so. The problem you have in doing so is that you create a “market” for human life. You are in effect enabling trafficking and exploitation of people when you do so. Answer the question I posed: “if my uncle was on death row in CA, could I free him for $10 million?” $500 million? $20 billion?

Guest
Reply to  Henry Pool
April 8, 2020 4:23 pm

Insurance companies value human life all the time. Its literally one of the largest industries on earth. You can estimate that value by the premiums on life insurance. Its hardly immoral. Its also not very high, especially when you are older.

On a pure cost/benefit check here, its better to due minor distancing measure not lock downs. And its not particularly close.

damp
Reply to  Willis Eschenbach
April 8, 2020 5:31 pm

Willis (forgive the informality) I think a lot of people are forgetting the undeniable fact that people in rich countries are healthier and live longer than people in poor countries, generally speaking. The US has been intentionally making herself a poor country for about a month now. That will yield the cost in lives that you’re speaking of, I believe.

The potential deaths now can be seen on the news, whereas the potential deaths later may never be connected to their cause: lack of societal resources and personal resources brought on by panic and shortsightedness (not to mention love of power). Our children’s and grandchildren’s lives will be diminished in quantity and quality, but they’re not on the radar of the “compassionate” elite who only care about some deaths, not all deaths.

Thank you for your efforts.

rbabcock
Reply to  Henry Pool
April 8, 2020 1:42 pm

Henry, people die. Most of those in every country that died of COVID-19 are the old and infirm. COVID-19 is just one of many that visit every year to do the job and we really can’t change it very much. These viruses are opportunistic and ubiquitous and have been around since humans have.

The best we all can do is try to eat healthy and keep our weight down. Exercise and don’t smoke. We all have some personal responsibility in this. And even if we all do our best, sometimes nature has other ideas.

Henry Pool
Reply to  rbabcock
April 8, 2020 2:32 pm

Do you have either elderly parents, or grandparents? If you do, do you consider them expendable for the economy? How about if your wife is old and diabetic? Oh, another “issue” you have is that you used the word “most” which of course we all know means that young people are also susceptible to this virus. I agree every year the flu takes out a lot of folks, but consider this….right now in NYC they are using refrigerated trailers to hold the dead bodies that have overflowed from the mortuaries. They are even going to temporarily inter them in a park.

rbabcock
Reply to  Henry Pool
April 8, 2020 3:27 pm

Where did I post I consider anyone “expendable”? People just don’t live forever and the Flu and other diseases kill tens of thousands of people in the US every year, most of them old and infirm. We don’t shut the place down for them.

Please explain what makes this one different?

BTW I don’t have elderly parents. They have passed on. I’m a 69 yr old male. But I can say this. I have a resting heartbeat of 48, bike 15+ miles almost every day and have been in great shape all my life. I might get CV-19 and not make it through, but more than likely will because I chose a healthy lifestyle. There will come a day as I age where I will be old and probably infirm. It’s inevitable. But when it’s time to go, I will have no regrets.

Bob boder
Reply to  Henry Pool
April 8, 2020 3:41 pm

Henry

Neither my elderly father or mother would ever want someone to sacrifice their future for them. They know that their lives are their responsibility, they would make what ever sacrifice they would need to make to safe guard themselves and if that wasn’t possible then they would accept that outcome. They would never put the burden on others. As would almost anyone from their generation.

Guest
Reply to  Henry Pool
April 8, 2020 10:44 pm

“Do you have either elderly parents, or grandparents? If you do, do you consider them expendable for the economy?”

My parents are 67 and 70. I don’t consider them expendable.

On the other hand, I value the (estimated) 60-70 years of life that my children have left more than the (estimated) 5-15 years of life that my parents have left. And the quality of life for those 60-70 years of life my children have left is important.

You can say “the economy will recover” but you don’t know that to be a fact (especially the “when” part). We could be headed for a great depression that will result in lots more deaths than this virus will cause due to a variety of factors. And that would certainly make life much less pleasant than it was before this virus or even is now.

Your idea that this is a “lives vs. economy” situation is incorrect. It is a “lives vs. lives” situation. GDP has a direct correlation with lifespan and overall health.

As to my parents, what I would do is encourage my parents to self-isolate/social distance while the virus is around in order to protect the remainder of their lives. If they refuse to listen to reason, then there are consequences for bad choices.

But I do not think shutting down the economy to “save my parents” is either wise or necessary. They can be reasonably protected without shutting down the economy.

Rich Davis
Reply to  Henry Pool
April 8, 2020 5:32 pm

Again Henry, you are unfortunately blind to some of the corpses. The ones who lose their jobs, despair and die of substance abuse, who commit suicide, who through stress develop diseases and succumb to them. The ones k!lled in domestic violence. Why do you avert your gaze from them?

There is a balance which imho neither you nor Willis have gotten correctly. Just as rash to take no action and hope for the best.

Nicholas McGinley
April 8, 2020 11:28 am

Stay at home orders are not as important, it seems to me, as how people are voluntarily modifying their own behavior.
Look at pictures of the roadways and interstates, of the sidewalks in downtown.
People are not doing much more than going to work (if they have to, but many are working from home), or to a store.
These modifications in behavior started long before any edicts directed it to be so.
The NBA cancelled their season when one player tested positive.
Major League Baseball did the same shortly thereafter.
Concerts were cancelled.
Theme parks were closed.
Movie theaters were first almost empty, then just closed up.
Schools closed, and University’s closed and told everyone to go home, even though many people lived on campus.
Businesses told people to work from home if they could, then told everyone to work from home unless it was some sort of essential business.

I think the stay at home orders came after most people were already doing that, and a few people who were flagrantly defying what had become the norm. And in a short span of time the norm came to be do not congregate in crowds or even large groups.

I for one am not focused on modelling or analyzing a comparison of different locales.
What it seems like to me is a more or less haphazard convergence towards a large segment of the populace deciding they did not feel like getting this particular disease, and taking person steps to protect themselves.
And a large component of that is the most obvious one: Do not go near anyone who might have the virus if it can be avoided. And since basically anyone could possibly have the virus, that winds up at the logical conclusion of self imposed isolation. As much as possible.

Look at it this way: If tomorrow morning some official who you trust says all the movie theaters and ball games and concerts and theme parks and airports and vacation spots and everything else is going to open and everyone needs to pretend this virus is not a thing…would that still be someone you trust?
I for one would not do anything different than I have been doing: Not worrying about it, but also not doing anything I absolutely do not have to do that could or would cause me to spin the COVID 19 roulette wheel.
Here is the layout of the roulette wheel, as I see it: About 80 of the 100 slots on the wheel are either nothing at all happens, or the spinner of the wheel gets a dry cough for a few days, perhaps a fever, and a few that are like being sick like in a usual bad cold or case of the flu; 10 to 20 of the slots though, say “Get really darn sick, so sick you go to the hospital for the first time in your life because of a virus”; about 5 to 10 of those 10 or 20 say “Get really really REALLY sick, so darn sick they put you in the intensive care unit at the hospital, where you will remain for as much as FOUR TO FIVE WEEKS! Thanks for playing!; and somewhere between one and three of the slots say “Go to the cemetery. Go directly to the cemetery. Do not pass Go, do not collect $1200”.

Even without knowing that many of the people who do not get a cemetery slot on the wheel, will nonetheless having somewhere between long term organ damage to the lungs, and never being anything like healthy ever again…even without knowing that…I for one have no desire to spin that wheel and play that particular game of chance.
Heck…I am not even anywhere close the stage of hating this that I make myself pretend I am stuck in a mountain cabin in the Arctic in November… with no chance of rescue until Spring.

Instead, I am at the “Dang! This sucks, and I wonder how it is gonna end?” stage, personally.
As soon as I see some solid scientifical evimadence of a treatment with a very high rate of promising a good outcome, I will be at the “Who the hell cares about corona virus!” stage.

James Allen
Reply to  Nicholas McGinley
April 8, 2020 12:16 pm

Unfortunately for you, you’re spinning the wheel whether you want to or not. Statistically, sooner or later, your spin is coming regardless of your behavior, since you’re still connected to everyone else through at least the need to acquire food you don’t produce yourself from time to time.

Nicholas McGinley
Reply to  James Allen
April 8, 2020 2:08 pm

But fortunately for me, I am far more informed, equipped, resourceful, fastidious, and careful than everyone else (everyone else in the collective sense, not EACH everyone else).
IOW…I know how to protect myself, and intend to.
Can I get it anyway?
Yup.
Will I get it from fomites on a box delivered by Amazon or Walmart? Nope…not unless they can survive being sprayed with Lysol, sitting in the direct Florida Sun, and/or the type of hand washing I am doing.
I have N-95 masks and a whole bunch of cheaper ones, I have and know how to use eye protection, disposable gloves, Hibiclens, povidone iodine, 93% isopropyl alcohol, every cleaning product known to man, 50 pounds of calcium hypochlorite (a few ounces makes a gallon of extra strong bleach), and all sorts of other stuff, plus I know a lot about nutrition, have been a lifelong swimmer and biker, have never smoked, take no drugs, do not drink even a little bit EVER, and all sort of other stuff that I figure maybe just might give me a slight edge.
By the way none of that stuff did I purchase this year.

And…if I do become infected anyway, I am angling for a low infectious dose.
Luck and fate favor the well prepared.

In the end, my not wanting to get it will not necessarily prevent me from getting it, but it does not have to.
All that has to happen is I do not get it before whichever of the treatments that work, are well understood so I do not get some crap that will not help if I have an unlucky spin, or a vaccine comes along, or whatever.
And if I do get it and get real sick, oh well, I did everything I could think of.
No point in worrying about anything out of your hands.
I can tell you I do know what hospitals where are having clinical trials, and I know these places have a far higher level of patient care than some other places.
I aint gonna just go wherever.
And doctors tend to like me…I speak their lingo.
At this point, I think the virus has infected somewhere in the single digits percentage of the population…so just giving yourself an edge will go a long way.
Fortunately.

c1ue
April 8, 2020 11:31 am

Willis,
I agree with you in general – but I think New York and its neighbors are clearly a different story.
California nCOV deaths are low – presently under 100 per 10M pop – but New York just passed 3000 per 10M pop.
New Jersey, Louisiana, Michigan also appear to be a different story: 1669, 1393 and 850 respectively.

Erik Magnusin
April 8, 2020 11:32 am

Seems to me that the IHME model was originally tuned for the west coast states, had to be updated to take NY/NJ into account (NJ was way under counted in first model), and further tweaked when hospitalizations were nowhere near forecast. I was also amused at the projections for Wyoming, which has yet to report a COVID related death and my eyeballs estimating a 2 week doubling time for confirmed cases.

One thing missing from the model was the fraction of people taking mass transit as that would have a huge impact on the effectiveness of stay at home policies.

Based on the drastic changes between updates, the models should not be used for policy decisions more than a week in advance. (Sounds a bit like long term weather forecasting) Based on the experience of the last two months, for next winters repeat of the pandemic the US should implement closing of ski areas, and a ban on travel from high risk areas.

Bill Treuren
April 8, 2020 11:36 am

Emotionally the decision makers need a cure.

Hydroxy Chloroquine and some mixers looked like a possibility it need do only help 80% of people well and it would be fine.
Problem is political BS has hit it and that is sad. politics and ego, big problem.

good article thanks again.

MrGrimNasty
April 8, 2020 11:38 am

If the proportion of all infections that reach the serious (i.e. ventilation required) ICU stage is very low, but the proportion of those that subsequently die is very high, then it is definitely a waste of time, as resources overwhelmed or not, the number of deaths will be little different. Also as it tends to take the infirm, the death rate from all other causes after it has passed will drop for a while.

comment image

‘That does not mean there will be no extra deaths – but, Sir David says, there will be “a substantial overlap”.
“Many people who die of Covid would have died anyway within a short period,” he says.’

https://www.bbc.co.uk/news/health-51979654

The important data no one knows is the total number of infections – millions of which have probably had negligible symptoms.

It would be ‘scary’ if the media did a running count/commentary in any average flu season of people that died from any cause that happened to also have flu. e.g. If the worst hit area in Italy is notorious for atrocious winter air quality and normally has 100,000 excess winter deaths, then suddenly things look very different.

ren
April 8, 2020 11:38 am

If you think you can control the epidemic, you need to talk to doctors from New York.

Henry Pool
Reply to  ren
April 8, 2020 12:08 pm

+1

LdB
Reply to  ren
April 8, 2020 7:04 pm

I don’t see people like Willis saying that won’t be a problem and won’t happen they are just placing a higher value on the Economy. It’s the classic problem how much is one human life worth and there are multiple answers to that and who gets to decide?

Michael in Dublin
April 8, 2020 11:40 am

I have a son, an engineer, who has a keen interest in Mathematics, Statistics and Computer Modeling. From the first reports, he has closely followed details of the spread of the virus. He has been frustrated that crucial questions should have been asked ages ago but were not. To make matters worse the media and politicians keep fanning the flames of alarmism with their ignorant assertions. The consequences of their foolhardy responses will cause considerable economic damage. Will there be any accountability?

JoeShaw
April 8, 2020 11:43 am

I strongly agree that COVID-19 mitigation methods must be based on a realistic assessment of costs as well as benefits, However, the assertion that flattening the curve can not reduce overall mortality is almost certainly wrong. This would only be correct if access to health care and the efficacy of COVID-19 treatments don’t matter, or will not improve over time.

There is plenty of anecdotal evidence that overloading of hospitals in some areas (e.g., northern Italy) degraded standards of care and contributed to increased mortality, particularly among groups that were de-prioritized for treatment. Buying time to increase hospital, ICU, and critical equipment capacity can save lives. This is very hard to quantify in real time, but we should ultimately be able to make estimates of the case fatality rate and infection fatality rate over time and by group.

While the media and authorities have made much of the capacity issue, the more significant factor is the likelihood of improving treatment effectiveness over time. If any of the drugs current being assessed are shown to be effective in reducing the severity of the infection, or if protocols for supportive treatment can be improved, this could substantially reduce the number of deaths as well as the number of patients who are permanently impaired. Delaying COVID-19 infections by even a month or two could make a big difference.

c1ue
Reply to  JoeShaw
April 8, 2020 12:31 pm

Given that New York has passed both Italy and Spain – and continues to display a much higher rate of death curve – is hospital overload really the main concern? Are NY hospitals worse than the eponymous Italian ones? Because now the NY outcomes are worse…

JoeShaw
Reply to  c1ue
April 8, 2020 2:29 pm

C1ue,

I don’t understand your comment that New York continues to display a much higher rate of death curve then Italy or Spain.

The number of reported COVID-19 cases in New York state (150697) is comparable to Italy (135586) and Spain (140511). However the number of reported deaths in New York state (6268) is substantially less than Italy (17669) or Spain (14673) – at least so far.

I also do not think this is the relevant question when assessing the utility of mitigation measures or whether flattening the curve can save lives even if the total number of infections is not reduced. New York City where many hospitals are said to be nearing or at capacity is reporting 55% of the cases in New York state, but 73% of the deaths. The situation in Lombardy where hospitals were overwhelmed. The reported case fatality rate in Lombardy is 18.2% according to this source:
https://github.com/pcm-dpc/COVID-19/blob/master/schede-riepilogative/regioni/dpc-covid19-ita-scheda-regioni-20200408.pdf

c1ue
Reply to  JoeShaw
April 8, 2020 4:59 pm

You can’t compare absolute numbers – Italy has a population of 60.8 million people while New York State has a population of 19.4 million.
Spain’s population is 46.4 million.
What matters from an epidemiological perspective is the number of deaths per unit of population.
The numbers above are for 10M population – a typical flu season might see 1000 to 2000 flu deaths per 10M – which is what Willis has noted in the wattsupwiththat COVID-19 graphs page.
However, Spain, Italy and New York have long since exceeded the 2000 deaths per 10M point – and they’re still increasing. New York, in particular, is increasing a lot faster than Spain and Italy.
So: if the nCOV mortality rate is so bad in Italy and Spain because the hospitals are overwhelmed – what then do you say about New York where the mortality rate is higher and increasing faster than either Spain or Italy?

Rich Davis
Reply to  JoeShaw
April 8, 2020 5:56 pm

Excellent point. It is now increasingly clear that hydroxychloroquine and zinc is a safe and effective treatment. Supplies have been deployed widely. We are at most approaching the top of the bell curve. We could hope that 80-90% of the remaining projected deaths could now be avoided. At this moment the US is at 14,668 deaths with a model projection of 61,000 deaths. If 80% of the projected remaining deaths were avoided, the US would end up with under 25,000 deaths.

I hope that Trump Derangement Syndrome doesn’t sentence 36,000 people to a needless death. Come on media, you can pretend that Biden told Trump about HCQ and Trump stole the idea.

Tom Abbott
Reply to  Rich Davis
April 9, 2020 8:06 am

“I hope that Trump Derangement Syndrome doesn’t sentence 36,000 people to a needless death. Come on media, you can pretend that Biden told Trump about HCQ and Trump stole the idea.”

You know, I saw something that I would consider strange on Fox News Channel this morning and it is possibly related to your question.

Two nights ago, Tucker Carlson was interviewing Dr Seigel on Fox News Channel and at the end of the conversation, Dr. Seigel mentioned that his 96-year-old father had been infected with the Wuhan virus and had gotten to the point where he thought he was on Death’s Door, and asked Dr. Seigel to get him some hydroxychloroquine, which he did, and Dr. Seigel said in a very short time his father had recovered. So, naturally, I thought this was significant. Not only because it is another example of people being very ill with Wuhan virus, and taking hydroxychloroquine, and being back to normal in a matter of hours or days, but also because it happened to a high-profile doctor who is a contributor to Fox News about the Wuhan virus pandemic.

So now the strange part: I was watching Fox & Friends this morning and they interviewed Dr. Seigel about the Wuhan virus situation, but they never even mentioned his father, or the fact that he had such a good experience with hydroxychloroquine!!! Not one word.

And I thought to myself: Is the leftwing smear campaign against hydroxychloroquine affecting even how Fox News Hosts are addressing, or in this case, not addressing the promise of hydroxychloroquine?

Not one word about it. Unbelievable.

Reply to  Tom Abbott
April 9, 2020 8:09 am

re: “And I thought to myself: Is the leftwing smear campaign against hydroxychloroquine affecting even how Fox News Hosts are addressing, or in this case, not addressing the promise of hydroxychloroquine?
Not one word about it. Unbelievable.”

Almost as bad as mentioning Dr. Mills and Hydrinos on various forums; “not done in polite company” eh?

Tom Abbott
Reply to  _Jim
April 10, 2020 5:07 am

Since that interview on Fox & Friends yesterday, I saw Dr. Seigel interviewed three more times on Fox by various hosts and again, not one mention of hydroxychloroquine or what it did for his father.

You would think the hosts would at least be congratulating Dr. Seigel on his father’s good fortune, but no, not one mention.

I’m beginning to wonder if corporate at Fox has put out a message to their hosts to stay away from the subject. They do seem to be pushing Fox to the Left a little. They focus on the meme’s the Leftwing media create and treat them like they are legitimate instead of being skeptical about everything coming out of the Leftwing media. That’s my biggest problem with Fox. If it appears in the New York Times, then Fox has to talk about it, giving the Fake News legitimacy.

Rich Davis
Reply to  Tom Abbott
April 9, 2020 10:40 am

What I found dumbfounding was that at yesterday’s WH press briefing, there was no mention of the American Thoracic Society’s guidance. Not surprising that there was no question from the Democrat political activists (assembled in the guise of reporters), but usually Trump would be crowing about such a development. Why the silence?

https://www.thoracic.org/about/newsroom/press-releases/journal/2020/ats-publishes-new-guidance-on-covid-19-management.php

I’m not so naive as to believe HCQ-Zn is a cure for every case, but the anecdotes are sure building up.

Tom Abbott
Reply to  Rich Davis
April 10, 2020 5:32 am

Yes, I would think that deserves mention.

From the link you posted: “to consider extracorporeal membrane oxygenation (ECMO) in patients who have refractory hypoxemia, COVID-19 pneumonia (i.e. ARDS), and have failed prone ventilation”

It looks like they are not only allowing for the prescribing of hydroxychloroquine, they are also recommending the use of the ECMO which eliminates the requirement to shove a tube down a patient’s throat. I would want this kind of machine doing my breathing for me, if I had a choice. 🙂

Rich Davis
April 8, 2020 11:47 am

I’m still holding to the view that without having a parallel universe in which to run experiments, you do not have a control and it is unknowable what would have happened absent mitigation attempts.

It’s not valid to compare the actual shape of one state’s curve to the actual shape of any other state’s curve. They are not equivalent test subjects receiving different treatments. Each state has different population density, demographics, etc.

Then there are randomly different initial conditions. I suppose more people travelled between Wuhan and Chinatown in NYC than travelled between Wuhan and West Virginia. But it’s also unpredictably possible that somebody from WV took a trip to NYC to observe Chinese New Year festivities and then returned home asymptomatic and infected a great many people. Another state might have had a patient zero who didn’t interact with many people and who was quickly diagnosed. Every state is different.

As we all acknowledge, there has been nothing approaching a true lockdown. It has been very porous. The degree of compliance is also different for each state. Many people in states with no formal government interventions may be behaving almost the same as in states with the strictest mandates.

I am not willing to criticize Trump or the Governors for attempting to take steps to affect a pandemic in a situation where we do not have adequate information and millions of lives MAY be at stake. After this event provides lessons learned, if the inevitable errors being made now (which can only be confirmed after the fact) are repeated then I will be happy to criticize.

Tom Abbott
April 8, 2020 11:50 am

The reduction in numbers of new cases and the reduction in the need for ventilators and ICU beds might have something to do with how well the population is maintaining their distance from one another, and, although I’m not sure how you would do it right now, the number of patients receivng hydroxychloroquine and other treatments for the Wuhan virus ought to be figured into the mix, too, assuming they are actually having a beneficial effect on the disease.

I heard this morning that the virus models are predicated on using an estimation that 50 percent of the population would abide by the social distancing request, and some are saying that the reduction in numbers of new cases in the lastest estimates is a result of Americans doing better than 50 percent.

So there are two things that are not being taken into consideration when doing these calculations.

I’m curious: Does anyone contend that the 2.2 million dead figure is wildly inaccurate if we had done nothing to slow the spread of the Wuhan virus? I wonder what infection rate they were using to get that figure. You know, we still don’t know the real infection rate.

There are a lot of things we don’t know about this virus. People should keep that in mind.

Rich Davis
Reply to  Tom Abbott
April 8, 2020 1:31 pm

At the very least, 2.2 million is a phantasy number, because it assumes people will go on, business as usual, stepping over the corpses. Long before 200k deaths, people, especially vulnerable people, would certainly modify their behaviors.

Steven Mosher
Reply to  Rich Davis
April 9, 2020 8:56 pm

“At the very least, 2.2 million is a phantasy number, because it assumes people will go on, business as usual, stepping over the corpses. Long before 200k deaths, people, especially vulnerable people, would certainly modify their behaviors.”

Yup.

The problem is nobody knows how long it would take people to voluntarily figure out
that social distancing was what they needed to do.

https://www.theweek.co.uk/76088/what-was-black-death-and-how-did-it-end

Nicholas McGinley
Reply to  Tom Abbott
April 8, 2020 2:29 pm

Here is what I was wondering: Let us suppose that everyone in the entire USA reads this article, becomes convinced that the number of deaths and even who exactly will die is chiseled into stone and nothing can change that.
Convinced as in a mathematical certainty…and so everyone just tosses up hands, says “oh, well…what the hey!” and trudges on back to doing exactly what we were all doing last year at this time…just put it out of our minds.
I have a hard time believing that there are not a whole bunch of more people this virus would just love to infect, sicken, and kill…whenever it can swing it.
How many is a whole bunch of more people?
Well, everyone in the country except people who are already exposed…assuming this is like most diseases and no one can get it again anytime soon after getting it and recovering. A fair assumption I think.
Some people no doubt have a strong enough immune system and general constitution that this virus cannot do jack to ’em.
Right now a cruise ship off the coast of Uruguay has 60% of people on board testing positive.
Might that be an approximation of how many people will contract the virus?
It was in the case of the people on that ship.
If so many people get sick that all our hospitals are overwhelmed, it is not just people with COVID who will die but that would have lived with proper care…it is a large number of the people that normally inhabit our hospitals on an ongoing base…in addition to the excess COVID dead.

Or so it seems to me.

Nicholas McGinley
Reply to  Willis Eschenbach
April 9, 2020 8:23 am

I was not trying to be devious, and I am nothing like unprincipled.
I did not say that that conclusion, if it were reached by everyone in the country, is what you have said.
Clearly you did not say that.
But people can misinterpret.
What I did was, and I think I said so, just wonder what would happen IF everyone decided to just forget about the virus…as many people, but not you i do not think, have suggested we ought to do.
If everyone just woke up this morning and forgot about the whole series of events and went back to business as usual…what would happen?
Thought experiment.
I did not say you advocated this.
I am just going to ignore that you have put words in my mouth and accused me of blaming the whole thing on you.
I think you just do not like me, at all, and are not really reading only what I have said.

Nicholas McGinley
Reply to  Nicholas McGinley
April 17, 2020 9:28 am

Hi Willis,
I am just getting back to this thread after all this time because for some reason my browser was unable to see any threads on WUWT older than two days old, for a while, but that seems to have been resolved.
So, regarding this:
“And yes, I get grumpy when, after hosts of requests, you imply that your total misrepresentation is actually my message without quoting one word of mine. I am touchy about being blamed for something I never said, and I never said that.””

In retrospect, I could have and should have made my point without including this small snippet, ” in the entire USA reads this article” in the first sentence.
This would have left you out of it.
I was thoughtless and careless to include this in my comment.
If I could erase it I would.
You did not say any of the things I mentioned.
I caused you angst by dint of my carelessness, and I want to tell anyone who reads this that I should never have said or implied any such thing.
I was wrong, and I regret it.
I am very sorry for my carelessness and the implications of that carelessness.
It is not my intention to have antagonized you in any way, but this is beside the point that I did, and it was not a result of anything you said.
I apologize to you unconditionally.

Nicholas McGinley
Reply to  Willis Eschenbach
April 9, 2020 11:07 am

I am still trying to figure out what it is that made you say these things, Willis?

Or how on Earth you came to some conclusion I was “blaming” anyone for anything?

I was pretty clear in what I said in my direct comment that was not a reply to anyone.
I said, basically, that it is my view that this whole mess was not ordered from the top at it’s origin, but was at the beginning a series of reactions from various individuals.

I also said I do not think at this point that anyone is waiting for someone to tell them they can go back outside.
I may be wrong about that, but it is what I think.
I am not at all clear of even any theoretical basis anyone could possible credibly blame any of this on anyone!
So for you to make the statements you made, I think you must just have some deeply simmering anger at anyone you perceive as contradicting you.
I have not contradicted you…I do not even accept that what is happening can be modeled.
And all I was even thinking about when I asked the thought experiment question was the idea that once a peak was reached, the ultimate number of deaths is somehow predetermined.
I am not disputing the math, or even saying it is not true.
I am saying that my understanding of how many people get sick and die is completely dependent on how 320 million individuals behave.
And I am no where close to egotistical enough to think I or anyone else, including you, have much influence on how 320 million American citizens conduct themselves.
I think people are focused on not getting sick with something that may turn out to be really incredibly unpleasant.
I have said very little about orders or whether they should be lifted.
What I have done is express surprise at the whole thing.
But more than anything else, what has occurred in my view is that a large number of personal decisions, many of the most consequential and almost all of the early ones, were made by people in charge of various businesses, like the NBA, Baseball, Disney, the big tech companies and banks and such…when they closed their gates and/or told people to work from home.
I said in another comment here, very clearly, that IMO not too many people are waiting for an all clear from anyone to be issued by edict.
I could be wrong, but that is what it looks like to me.
Frankly I do not know whether to be amused or offended at your anger.
Amused that you somehow think you are so influential that this essay, or anyone’s opinion of it, could be construed as determination of what happens next.
You must be very egotistical.
I for one am not even remotely thinking of anything relating to blame or fault, so how could I deviously be trying to pin this whole thing on you?
That s about the most nonsensical thing I have ever heard you say. Clearly you are really mad at me for my comments. Maybe you could tell me why?

And offended…because you have, from where I am sitting, pulled some complete BS out of nowhere and pinned it on me.

Here is what I was responding to:
“I’m curious: Does anyone contend that the 2.2 million dead figure is wildly inaccurate if we had done nothing to slow the spread of the Wuhan virus? I wonder what infection rate they were using to get that figure. You know, we still don’t know the real infection rate.

There are a lot of things we don’t know about this virus. People should keep that in mind.”
Tom said that, and it seems like a sensible question to me.

And I was responding to this:
“At the very least, 2.2 million is a phantasy number, because it assumes people will go on, business as usual, stepping over the corpses. Long before 200k deaths, people, especially vulnerable people, would certainly modify their behaviors.”
Which is what Rich said in response.
I was following up on that and using the result you found, that by some confluence of factors, once the curve has peaked, the final number of deaths can be closely approximated to be double what occurred at the time of the peak. I specifically did not comment on this directly, because it is baffling to me, and yet you cited some stats that seem to confirm it.

So, I agree with what Rich says in his response…people react to what is happening, not to what some politicians are saying.
No one is going to do what I asked in my thought experiment. Or, rather, everyone collectively will not forget and just act like nothing happened.
It was a rhetorical question…is that happened, everyone would have to have either went insanely fatalistic, or else developed a case of TV show amnesia.
It was an IF hypothetical question!
If they did, lots more people would die because the virus does not care what people think or believe…it just infects.
Everyone knows that, and we know we need to protect ourselves.
The world has changed forever, and the Genie will not go back in the bottle.
Pandora’s box is opened, and this is the world we now have, incredible as it is.

Look, I never directly disagreed with you about the Japan cruise ship statistical analysis you did on another article. Like other people have said, I do not know how to do what you do in that regard.
But I was not entirely convinced it was a worst case scenario. It seemed to me some people probably did a very good job of not getting themselves infected. Some might have been dumb and got infected by not being careful. Or maybe no one was dumb, and the virus was spread to them through the air vents, or the food deliveries, etc.
Unknowable, in my opinion.

But now we have this ship off the coast of Urugauy.
New development. New information. Reports are that 60% of the people on the ship are infected. 60%!
Damn!
I am not shocked, and I am not nodding my head saying “of course” either.
I am absorbing it as new information…because I FOR ONE AM TRYING NOT TO THINK I KNOW WHAT WILL HAPPEN NEXT.
Maybe I could guess, but I do not see the point. I would get no satisfaction by being a good guesser at something like that.
Other people want to, fine with me.
I am sitting here figuring I will have more surprises just like I have had plenty already.

But that 60% ship is really something.
It may be a BS stat.
It may be true, or the number may be higher.
I do not know.
Why are 40% not testing positive?
I do not know.
Maybe they are locked up in their cabins.
Maybe they are immune somehow.
Maybe they just have no virus in their nose.

And maybe there is something unusual about that group.
But without assuming anything, we now have an examples which suggests that if left to it’s own course, this virus will infect as many as 60% of humanity.
What is the death rate if that happens?
I do not know.
I know one thing…it is not my fault, it is not your fault, and I am not blaming anything on anybody!
I just erased a final thought that I am sure would have got be banned for life, so that is all I have to say.

tistical thinned skinned buttmunch.

Rob Bright
Reply to  Tom Abbott
April 8, 2020 10:56 pm

“Does anyone contend that the 2.2 million dead figure is wildly inaccurate if we had done nothing to slow the spread of the Wuhan virus?”

Yes. For example:

Dr. Paul Offit (UPenn Virologist, Vaccinologist, Pediatrician, co-developer of Rotavirus vaccine).

Dr. Knut Wittkowski (epidemiologist, 35 years of modeling epidemics).

The Oxford team that created their own model of the virus.

The Dark Lord
April 8, 2020 11:50 am

this whole flattening of the curve stuff got me to thinking about the annual flu cure, which flattens all on it own … my assumption is a combination of herd immunity building up and just plain old geographic friction eventually stops the spread of the virus …

the geographic friction would be roughly the same for flu vs covid … now with the lock downs the travel during covid19 will eventually be felt more than with the flu but it takes weeks and geographic friction is never enough to stop a virus, that takes the herb immunity kicking in …

so as far as herd immunity … it starts building the first day a virus presents itself to the country … and builds over time until its big enough to severly reduce the spread … and the big enough number must be some % of the population …

so if covid19 is so much more infectious than the flu as we are told, then the population will build up herd immunity much faster than the flu … and its herd immunity that peaks a viral spread … the goegraphic friction is constant but never enough to stop the growth by itself … its the herd immunity reaching a certain threshold that nails a virus (thus the bell curves with sharp peaks) …

So the flu peaks in about 3 months … covid19 should peak in less time … we are at about 2 months right now …

Uzurbrain
April 8, 2020 11:55 am

I reached the same conclusions as above weeks ago. All of the curves a Gaussian. And normally shaped Gaussian curves have equal numbers on either side of the peak. The curve showing total deaths is the Gompertz curve or Gompertz function, which is simply the integral of the area under the curve showing the peak. All that “Slowing” the problem does is decrease the slope of the two curves. The only benefit is that it reduces the impact on unprepared medical facilities, and thus can, possibly, lower the deaths.

It has been 55 years since I got my degree in Applied Mathematics and went on to joining the Navy and becoming a Nuclear Engineer, SO, some of my conclusions and assumptions may be incorrect.

Tom Abbott
Reply to  Uzurbrain
April 9, 2020 8:43 am

“The only benefit is that it reduces the impact on unprepared medical facilities, and thus can, possibly, lower the deaths.”

It also gives us more time to develop treatments and vaccines. Medical supply shortages will soon be a thing of the past, and there lots of promising treatments being tested along with new vaccines, and new, much faster methods of mass testing are coming online. All these things, plus lessons learned will help us deal with the Wuhan virus and viruses that come along in the future.

We’ll be ahead of the next pandemic. Now, we just need to get this current Wuhan virus pandemic behind us, and as the president said, there is a little light at the end of the tunnel.

Supposedly, the rescue package Trump and Congress have passed will keep most people and businesses solvent for the next eight weeks, which is about June 1. Maybe by May 1, we can start opening things up. So everyone relax for a couple of more weeks and maybe we’ll get lucky and work ourselves out of this mess. Lots of testing, like in every building can get us back to work, and if drugs like hydroxychloroquine can prevent people from dying if they get the disease, then we should be good to go. Even better would be if hydroxychloroquine can serve as a preventative, which it looks like it does. We’ll know soon, there are several trials going on right now.

Wouldn’t it be nice if you could tell people that if they catch the Wuhan virus, they can take hydroxychloroquine, or something similar, and it will prevent them from dying, in most cases. Then people could walk around with confidence and not worry about being infected.

Of course, we have to guard against wishful thinking, but this looks like the direction we are heading to me. There’s no doubt we can produce enough testing equipment and tests to do everyone in the U.S. And I have heard nothing but good things about hydroxychloroquine. Trump says there are no bad reports he’s seen. Every day we see more positive results from hydroxychloroquine.

Dr. Oz is asking anyone who is taking hydroxychloroquine to treat their lupus to email him at DrOz.xxx if you have contracted Wuhan virus while taking this medication. He is trying to find out if hydroxychloroquine will prevent a person from being infected by Wuhan virus.

Dr. Oz and several federal agencies are looking into the medical databases and are trying to find the number of people who are currently taking hydroxychloroquine, and then looking to see if any of them have contracted the Wuhan virus.

One New York Hospital Director said his hospital was giving hydroxychloroquine to every patient that tested positive for Wuhan virus. I’ll bet you all those hospitals are doing that, especially when they are hearing about the good results, and there are a lot of medical people who are taking it in hopes it will prevent them from being infected. There’s a lot of hydroxychloroquine going around!

It couldn’t be that easy, could it? Maybe. Let’s hope so. We’ll know before too long.

ren
April 8, 2020 11:57 am

The economy will bounce back quickly. Ko will lose his life, he will not get it back.

Josh Postema
Reply to  ren
April 8, 2020 1:04 pm

Why is such optimism about the economy acceptable while any optimism about this virus is treated like heresy?

old engineer
April 8, 2020 12:02 pm

Willis-

I certainly agree that we should end the lock down, and you have done a good job of showing why.

However, I think you are being too hard on doctors. A doctor’s measure of success is lives saved, period. Years ago when I was in college, my machine design prof said “We can teach anyone to design [here insert any machine you want designed], an engineer’s job is to design it within a budget. Doctor’s aren’t taught this. They are taught save lives at any cost. Thus you are right, because of his training, Dr. Fauci only looks at the benefit (save lives) side, he is hardly aware that there is “cost” side.

Our politicians make the mistake of listening to the wrong people. They listen to the doctors. So their actions are designed to save lives at any cost. They should be listening to economists.

yarpos
Reply to  old engineer
April 8, 2020 2:29 pm

Doctors work within a budget, its called triage

KvS
April 8, 2020 12:03 pm

Just an observation:. The high population density cities of NY and Milan have death counts of about 600 per million residents. In places outside of these the count is about 125 per million residents.

A counter to this:. Japan is has very high population density cities but has not experienced high death counts. Japan has done much better than S Korea so far and with little testing.

I could use some help in understanding these observations.

Rich Davis
Reply to  KvS
April 8, 2020 1:24 pm

Just a thought, but although densely populated, Japanese culture tends to be very formal compared with more high touch cultures. Also extremely conformist. If masks are prescribed, masks WILL be worn. They have a saying that the nail that sticks up will be pounded down. Western cultures are far less conformist or compliant. Cleanliness is also highly valued. My thought is that culture will be the main differentiator.

Korea is far more like Japan than China in these respects.

Nicholas McGinley
Reply to  KvS
April 8, 2020 1:43 pm

Japanese are notorious germophobes.

T _Buzzard
Reply to  KvS
April 8, 2020 2:00 pm
Eliza
April 8, 2020 12:04 pm

If this had happened 40 years ago you would not even know there was a virus. The internet is 100% responsible for this. Forty years ago headlines would have been >severe flu in some european countries this winter season> Again I reiterate that about 170000 people die per day mostly old and half with cardiorespiratory, influenza and flu problems apart from traffic accidents. Willis is 100% correct. This is just a normal flu virus pumped up by the internet to a terrible pandemic and multiplied by human ignorance/stupidity as affirmed by Einstein. BTW this virus will infect everybody as it is airborne transmitted probably by birds animals insects and humans all over the world. By flattening the curve you are not allowing natural immunity to take place which is actually the purpose of theses viruses to protect our lungs from future disease! Death rates are complete within the range of normal coronavirus flu viruses every year. In fact if you look at general mortality rates they probably have fallen for this year as there are no more accidents ect.

Henry Pool
Reply to  Eliza
April 8, 2020 3:45 pm

“This” happened about 100 years ago without the Internet. They called it the “Spanish Flu.” The death toll was pretty high.

Rich Davis
Reply to  Henry Pool
April 8, 2020 6:05 pm

This is thank God, nothing at all compared to the Spanish Flu. Orders of magnitude less death now.

But to be fair, with 1917-18 medical standards, who can be sure.

Michael F
April 8, 2020 12:05 pm

I’m very surprised that there has been no analysis of the benefits of contact tracing. Those countries, South Korea, Singapore, and Taiwan that put a lot of effort into this exercise seem to have better results and returned to normality much sooner.

April 8, 2020 12:05 pm

Any truth to the rumor that deaths (stats) due to (attributable to) ‘simple’ pneumonia are down?