I am not a doctor.

[catsidhe]

But here are my thoughts on Covid-19, because "thought" seems to be a vanishing rare thing on that topic:

• Q: Is it really that dangerous?
  A: We don't know yet. It's likely that its total mortality rate is going to end up lower than you might expect, because many, most, maybe even almost all cases are mild to unnoticeable. If you've got a mild sniffle, or no symptoms at all (as has also been reported), then you're not going to go report to the ED unless you're already there or you're really cautious. The mortality rate looks high, at the moment, because the people being reported are the ones who are really sick, and they are more likely to die. But they're being reported because they're really sick, so that skews the population you're measuring. But this is still early days, and we haven't had time to collect and analyse the data. But we will eventually have a pretty good idea what's going on, because
  
• Q: Is it going to be endemic?
  A: It already is endemic. Covid-19 is already out in the world, and it's not going to go away. It's got a long, symptom-free, contagious incubation period, so by the time it was noticed, it was already outside China and spreading. It's now thoroughly endemic in China, Iran, Italy, Japan, Korea, and the USA.
  
• Q: Why hasn't it spread so quickly into the US?
  A: It almost certainly is already endemic in the US, and has been for a long time (as this sort of thing goes). It's just that the US doesn't have a Health System, it has fifty-mumble of them (fifty states, Washington DC, Puerto Rico, plus the Federal system.
  Except... even those aren't systems, so much as weakened bureaucracies trying to keep health insurance companies and their associated service delivery locations (also known as "hospitals") under some sort of co-ordination, with no noticeable success.
  And the Federal system is under the control of a demented sociopath, who is more concerned that the numbers make him look good than that the situation is actually under control, and that he has flunkies fighting for his approval than that there is anyone actually competent in control of anything. Do not expect any useful, or even correct, information out of the White House. The sorts of people who will be getting information out there in the US system will be doing so at Li Wenliang levels of personal risk.
  
• Q: If it's already out there, then aren't the quarantines and travel restrictions just a waste of time then?
  A: Yes and no. Yes, in that it's coming anyway. In fact, it's already here. If there's been travel somewhere, they should expect to have been exposed. No, it's not a waste of time, because that's what the authorities are buying: time. Time to build up information, time to determine treatment regimes, time to get emergency measures in place, time to spread out the initial wave of cases, so they don't all turn up at the ED at once.
  
• Q: So I should be worried?
  A: Yes, but probably not as much as you think you should. It's looking to be worse than the usual flu, but probably not 1919 worse. And if you're relatively young, then you might not even notice it. But the older you are, the worse it seems to be, so you probably should be worried for your elderly parents or grandparents, and for god sake don't go to a retirement village or nursing home if you've got a sniffle.
  
• Q: Do I need to hoard gather supplies?
  A: No.
  
• Q: So why can't I get toilet paper or hand sanitiser?
  A: "A person is smart. People are dumb, panicky dangerous animals and you know it." (— Agent K, Men in Black)

This is not medical advice. See your doctor if pain persists. Do not exceed recommended dose.

Comments

[motg]

Well, yes... but.

This came from Sir Seb. Who, when he isn't being a much-loved Knight, is also an incredibly senior doctor who goes to international conferences:

https://medium.com/@amwren/forget-about-the-death-rate-this-is-why-you-should-be-worried-about-the-coronavirus-890fbf9c4de6?fbclid=IwAR2aEp8kp3hgUMsuazbry3eZAkCrY-hNr5CUbMggyNPGjIOvlCvoULdKBSY

Your comments about the USA are, alas, all too true.

[catsidhe]

Given a choice, always listen to the actual doctor over me.

I think the point stands that the reports on case mortality have ranged from "eh you'll be fine" to "OMFG WE'RE ALL GOING TO DIE", depending on which vested interest you're listening to, and the best medical information is "look, we don't know yet, because the data's saying all sorts of things, and there all sorts of confounding factors".

But it's definitely worse than the usual flu (which is, don't forget, also still circulating), and the next question is "are we looking at 1919 bad?". To which the answer seems to be "no, but possibly only just, and the patterns are different, so the young will likely not be too badly affected, but the old are going to get it hard."

What that article said about what happens when the emergency departments get full is also apposite to remember.

I don't know that a full separation quarantine protocol is going to help for long, though: first because we've probably already been exposed (six degrees of separation has its bad side), second because the sort of extended isolation may not be possible at scale (what happens when households run out of food, and don't have anyone who can deliver more?), third because the incubation period means by the time one person in a family feels ill, the whole family has been infected. So any one person getting sick means the whole family goes into lockdown, and everyone they've interacted with for at least a week has to get checked. And probably everyone they've interacted with, which to a first degree of approximation is basically "everyone".

And no-one knows what the procedures are for going into quarantine. (Indeed, if there are any, they've been communicated so badly beyond "just don't go outside or interact with anyone, yeah?" that they might as well not exist.) So people apply common sense in inappropriate ways: they go into isolation via the supermarket, because the alternative is to starve. They have to balance incommensurate absolutes.

Also, the advice about soap and alcohol sanitiser is all well and good, if you can get your hands on the stuff. The supermarket shelves for soap are just as empty as the shelves for TP. So there exist many people who would love to be able to keep up with the recommendations, but are literally unable to do so.

The lockdowns and quarantines are not going to stop Covid-19. Nothing will at this point. The best they can hope for is to slow it down enough for the health system in emergency mode to be able to cope with it until the peak of the wave has passed.

Ironically, I suspect things will get better after a while, because people who've had it and recovered will be able to more easily help those in lockdown, but the sort of controls which are needed are not possible to be implemented, even in a totalitarian dictatorship like China. (Well, maybe if China were several orders of magnitude smaller.) And even then, we probably don't want to know what's happening in North Korea. Because they don't have the health system, they don't have the healthy baseline population, and they have a nasty habit of murdering the bearer of bad news which tends to stop anyone from reporting the actual severity of the situation to anyone in a position to be able to do anything about it until its too late.

[motg]

Yes to all of the above.

[catsidhe]

Oh, and also: Yay for Scotty from Marketing and his deep and abiding concern that the markets might suffer, and that businesses might get hurt.

As opposed to the people who are going to get hurt, and the people who don't care how much their employer gets for a tax break because they have to take leave they don't have to be in quarantine, or simply aren't paid for that period, and have no assistance. Never mind those people who are going to die.

Heaven forfend the market might suffer, though. Gotta keep our priorities straight.


I mean, is it actually compulsory to at least pretend to be a sociopath to be in the parliamentary Liberal Party now? He might at least pretend to care about the human suffering without qualifying how it's bad for the Consumer Confidence Index and smirking like he just thought about pushing grandmothers down the stairs or something.

Sociopaths

[motg]

Look, it really seems so!

If S-from-M understood anything at all about business, he would know that The Market (All Hail The Mighty Market!) was ridiculously overvalued anyway. Especially energy stocks and banks. Which have now crumbled. In the former case, because hey: investing in Yesterday always works, doesn't it? Now if you tried investing in Tomorrow you might make some money. In the latter case, because the halfwits allegedly in charge of the Reserve Bank don't understand monetary policy, and so the banks' margins are getting hammered. (Pro tip from the stable: any cuts in the reserve rate below 3% are ineffective. All they do is produce housing bubbles. Yet they keep on doing it because hey: that's all we know how to do, apparently.)

I am surprised to discover today that my super fund (a mixture of conservative and Socially Conscious - surprise, not) is still $7K ahead of the game this year. Because we invest in tomorrow.

But the moronic creeps who purport to rule over us don't understand what business is. They fetishize it, but they don't know anything about it.

So we have the absurd spectacle of a government which is only worried about The Markets, even though the last week's hammering was nothing more than a long-overdue correction; while the possibility that thousands of elderly Aussies stand in danger of death in overcrowded hospitals doesn't even seem to have occurred to them. Or that casual workers who get quarantined will be expected to fend for themselves and/or starve picturesquely in their hovels.

There is leadership, and there is S-from-M. An actual human might be urging businesses to let as many workers as possible work from home. After all, you don't need to be on-site for so many businesses. If you don't know what your staff do all day then you shouldn't be managing anything or anybody. That might be thing which could seriously take off. You want more productivity in the economy? Let them work from home!

But then: this would imply a leader who knew how to tie his own shoelaces....

*exit, mumbling in beard*