Preparing for Coronavirus?

[Cheerful]

During a conference call with reporters today, a CDC official reportedly (CNBC.com) said:

"We are asking the American public to work with us to prepare for the expectation that this is going to be bad," she said. "Now is the time for businesses, hospitals, communities, schools and everyday people to begin preparing."

Are you doing anything to prepare?  What are your thoughts?

[spork]

http://thefora.org/index.php?topic=1033.0

[mythbuster]

https://www.cdc.gov/mmwr/volumes/69/wr/mm6908e1.htm?s_cid=mm6908e1_e&deliveryName=USCDC_921-DM20815

Here is today's CDC update from MMWR. 53 cases so far in the US. Most had traveled to China, or lived with someone who had.

[mamselle]

Could these two threads be merged, mods?

M.

[Caracal]

During a conference call with reporters today, a CDC official reportedly (CNBC.com) said:

"We are asking the American public to work with us to prepare for the expectation that this is going to be bad," she said. "Now is the time for businesses, hospitals, communities, schools and everyday people to begin preparing."

Are you doing anything to prepare?  What are your thoughts?

It is always sort of hard to figure out how to respond to public health messaging because so much of it is about trying to deal with panic. Obviously, the whole thing is concerning, but as someone who has a lot of anxiety about health and disease, I'm trying to keep it in perspective from a personal level. Obviously the whole thing is bad from a public health level, but the vast majority of people who get this don't get very sick. The people at really high risk are the elderly and those with pre-existing health conditions. Right now the death rate in China for people under 50 is less than half a percent, and it seems likely the real rate is probably lower since a lot of people with mild cases are probably not going to hospitals. Children don't seem to get sick at all which is good...

The point is personally I'm trying to keep in mind that the personal risk is relatively low even though the low thing makes me pretty anxious. Since I'm not in charge of anything, I'm not totally sure what steps I could be taking to prepare. If classes move online, I guess I'll just figure it out. The only think I've been considering is whether it might be a good idea to stock up a bit on non-perishable food, just in case everything shuts down for some period of time.

[pigou]

Are you doing anything to prepare?  What are your thoughts?

No. So far, the 2019-2020 flu season has lead to 280,000 hospitalizations and 16,000 deaths. But we can't get people to wash their hands and get a flu shot. Most "prep" is basic hygiene, not hunkering down for the zombie apocalypse.

[hmaria1609]

Earlier today, I got an e-mail announcement from Avalon Waterways about the coronavirus. (I'm taking Avalon's river cruise of the lower Danube in April so it's how I got the notification) Anyone who has traveled through China, Hong Kong, and Macau in the past 21 days can't go on their upcoming trip with any of Globus family brand company.

[namazu]

This guide from the US CDC was written with pandemic flu in mind, but may be useful in this situation as well.  (Just bear in mind that certain aspects of the actual illness are different.)

[Hegemony]

Well, I think that the folks who are saying it's no worse than the flu are being a little rosier than the facts warrant. The flu kills somewhere between 0.1% and 0.015%. The generous estimates of the coronavirus fatality rate are that it kills 2%, which is significantly higher. And 20% of cases are severe, severe meaning requiring hospitalization for a matter of weeks. That's more than our hospital system can handle, even given that the cases will not all occur simultaneously. The idea that "Those most in danger are old" is not especially reassuring to me, given that I am in the over-50 category to which the greatest number of deaths happen. I nearly died from the flu in two separate years — despite flu shots — and so I am not sanguine about the coronavirus. My immune system is poor and I'm squarely in the vulnerable category.

Unfortunately, neither am I sanguine about the ability of the U.S. government to make the most effective choices to contain this. I imagine it will be chaos, just as in nearly every other natural disaster. Our healthcare system makes the problem worse, as people without insurance or with inadequate insurance may be reluctant to see a doctor or go to an emergency room until things are desperate and they have infected many others.

I am also not sanguine about my own university's plan for dealing with something like this. We had "emergency contingency planning" a few years ago — they were envisioning an earthquake or a flood — and everyone could see that the plans were unrealistic and left out very obvious things. If the coronavirus became a threat locally, they should have a plan to quarantine infected students and not have them in their regular room in the dorms, and to move classes online. In fact they should have had this plan up their sleeve years ago. But those in the know say they aren't even thinking about it.

Personally, I'm making sure I have a good supply of groceries that will mean I don't have to go grocery shopping for a few weeks, if the virus should hit the town. And I'm thinking whether I should simply refuse to come in to campus if coronavirus is rampant, or whether I should outright quit my job (which is something I'm tempted to do almost weekly anyway!) Easier for me to think of desperate strategies because I am almost at retirement age anyway. For younger folks, the options are tougher, although you younger folks can relax in the assurance that "It's the old people who are at risk anyway."

[Caracal]

Well, I think that the folks who are saying it's no worse than the flu are being a little rosier than the facts warrant. The flu kills somewhere between 0.1% and 0.015%. The generous estimates of the coronavirus fatality rate are that it kills 2%, which is significantly higher. And 20% of cases are severe, severe meaning requiring hospitalization for a matter of weeks.

I'm not an expert, and I'm not trying to diminish the risks, which seem high from a societal level, but my understanding is that the fatality rate is probably under two percent, possibly well under.

Basically, the rate has been much higher in and around Wuhan, than in the rest of China, where it has been about 1 percent. That seems to largely be about the impact of the draconian containment measures and the inadequacy of the hospital systems. It also could partly be that people without really severe symptoms are not being counted in Wuhan because they are deciding, given how bad things are at hospitals and quarantine areas, that if they are sick they should just stay at home and they only get counted if they get really sick or die.

The other things is that most experts seem pretty sure that there along with the mild cases that get reported, there are also a lot of really mild, or even totally asymptomatic cases that aren't being counted at all. They are pretty sure this is what is happening with kids, but it is probably happening with other people as well. There are probably a lot of people who have Coronavirus, but have symptoms that never progress beyond those of a mild cold, or don't even get that far.

There are a lot of unknowns obviously and even if it just turned out to have a fatality rate 7 times higher than the flu or something, that would still be really bad, but it is worth having a clear sense of risks. I also wouldn't worry that much about going in to teach if there's an outbreak. If you have community transmission going on in the area, I'm sure your school will close. People are much more inclined to overreact than under react to this sort of stuff.

[clean]

My PhD school classmate wrote me about 10 days ago about the reported rates.  The reported rates are problematic.
"
For Hubei for Feb 18, there are 9128 recoveries and 1921 deaths for a total of 11049 resolved cases.  The death rate for these resolved cases is 17% (1921 deaths divided by resolved cases 11049), and similarly the recovery rate is 83% (9128 divided by 11049). 

The total number of confirmed cases is 61682.  The confirmed cases 61682 minus the resolved cases 11049 equals the number who remain sick 50633.  For the 50622 who remain sick, we do not yet know what might happen (recover or die)."

subsequent articles have noted similar results with other new diseases.  There is a problem identifying the less severe cases (adding to the denominator), but given the ability of this illness to spread, a 2% rate would be catastrophic should it widely spread. 
For comparison, SARS had a reported death rate of closer to 10% but was far less contagious.  The one i looked at, for comparison was the Spanish Flu of 1917.  It had a lower death rate, but disproportionately killed the younger populations.   

On another front, my friend also tried to buy gloves to get ready for the spring gardening season. He wears the plastic/rubber gloves over gardening gloves because the neighborhood cats also appreciate his garden!  He tried to order some and they were all 'sold out'.  When he called the company he said they told him that the CDC has been allocated their supplies!

[Caracal]

Heres what the former CDC director said about the death rate of 3 percent

That's a substantial over-estimate; many patients weren't tested, many infected people don't have symptoms and hospitals were overwhelmed. The proportion could be as low as less than 1 in 1,000 -- 30 times lower -- and is unlikely to be more than 1 in 100

[fast_and_bulbous]

It is becoming likely that I will be eating my upcoming 3 week trip to Italy, starting in Genoa (the work related part), and then Rome (the vacation part), in less than two weeks.

Worst case scenario is being stuck in a large city under lockdown in a foreign country and then being quarantined when you get back home.

I'm not confident the work related part is going to happen anyway - the university is already shut down, supposedly to open next week.

[nebo113]

It is becoming likely that I will be eating my upcoming 3 week trip to Italy, starting in Genoa (the work related part), and then Rome (the vacation part), in less than two weeks.

Worst case scenario is being stuck in a large city under lockdown in a foreign country and then being quarantined when you get back home.

I'm not confident the work related part is going to happen anyway - the university is already shut down, supposedly to open next week.

A friend just cancelled her Italian jaunt, and another friend worried about France in April.  Her biggest fear is that King Kong will close the US borders, and she won't be able to get back home.  I hadn't even thought of that, but given his lack of impulse control.....

[pigou]

I can't imagine the US closing its border. There are over 300,000 people entering the US every day...

The reason I'd nonetheless cancel European vacations isn't so much the coronavirus itself, but how governments respond. If tourist attractions are closed and events are canceled, the trip won't be all that much fun. If you have an opportunity to cancel the flight, I'd go ahead.

On the other hand, if you're not going for anything touristy, there are great sales on flights to Europe right now. NYC to Rome roundtrip in March is $350.