The only way to win with surgical strikes is to know where to strike. In general warfare, you use intelligence agencies to gather the necessary information. In virus warfare you need testing. Without knowledge due to a lack of testing, the only option is a full war.

South Korea and Russia tested early on and were able to contain the outbreak and use surgical strikes. Many western countries only started systematic testing when the virus was already spreading in communities. Unfortunately, you can't reverse time although I'm sure many governments would like to reverse their calendar a few months back.

During the H1N1 pandemic, a virus more deadly than COVID-19

You might not realize that in Italy and Spain the capacities of hospitals are overflown and they can no longer handle all the cases, and have to prioritize some patients and let other die ...

In these countries, there is now several hundreds of dead per day, from the covid-19.

Same can happen in the next weeks in France and Germany.

I know that this is a common opinion, I have spoken to many people that share this view, most of whom are at low risk and feel a sense of resentment for being forced into isolation.

There is so much wrong with this article, I will focus on one:

The data from South Korea, where tracking the coronavirus has been by far the best to date, indicate that as much as 99 percent of active cases in the general population are “mild” and do not require specific medical treatment. The small percentage of casesthat do require such services are highly concentrated among those age 60 and older, and further so the older people are. Other things being equal, those over age 70 appear at three times the mortality risk as those age 60 to 69, and those over age 80 at nearly twice the mortality risk of those age 70 to 79.

Calling this a small percentage is misleading. Sure 1 is a much smaller number than 100, but 1% of a large population is not a small number.
Using nice round numbers:
US population = 300M
Estimate of population that could be infected by Covid19 = 15% (note: this is a number I have heard or read but I do not have a source for)
%of people hospitalized given that they have Covid19 = 1% (from NYT article)
300M * 15% = 45M
45M * 1% = 450k
Number of hospital beds in the US = 924,107

The time to reach 45M cases is less than 40 days
10,000 [current num of cases] * ( 1 + 0.25 [estimate growth rate {we forum website}]) ** 40 = 75M

I don't know what the average hospitalization duration is, but my understanding is that it is long. Let's, for the sake of this exercise, assume it is 20 days. Now over simplifying the math, This would suggest that roughly 225k beds taken by Covid 19 cases or 1/4 of the hospital capacity. How much excess capacity do you US hospital have? Not much certainly not 25%.

So what does Dr Katz suggest we do with the young car crash victim that is brought to the hospital, that is filled with elderly patients fighting for their lives with Covid 19. I guess unplug the old person and save the young one. No! the young was drinking, let's save the old person and let the young one die. Wait but a pregnant woman just showed up, certainly she gets the bed. But now a TV personality has a stomach ulcer.

The math above is based on the current growth rates that are the result of all the social distancing efforts. Do away with those efforts and one can expect the situation to be far worse.

The question to ask is, are these efforts actually effective? Are we slowing the rate of propagation? The statistics (WE Forum) would suggest that there appears to be a difference between some countries, Japan, Singapore and South Korea are clearly ahead of the rest. But simply looking at a graph is not sufficient to be sure. There are other factors that could be at play. WE Forum graph shows the progress of infections in days since the 100th case reported and what jumps out is that as time goes on the rate eventually decreases. Is this due to the population realizing the severity of the crisis and isolating more, or some other fact?

I certainly hope that there is a team at the CDC, WHO or elsewhere studying this, validating.

The WE Forum article is really excellent, the lead graph is really great, fully interactive, you can pick countries and time ranges and follow the progress over time.

[aha.org...]
[weforum.org...]

The surgical strike is protect/isolate the aged/elderly as they are the ones at most risk. Mortality is based on the age of a population (Italy is heavy on aged and short on youth).

When doing math, adjust for the age of population to arrive at a more valid projection.

Herd immunity will arise as the population afflicted with the "mild" version recovers and this will reduce the effect/spread as well.

Indeed it is a war and we, pretty much the entire human race has been attacked. A stealth attack in that it is not known for ~5 days whether any particular individual is a victim.

That delay in overt symptoms is the kicker; while less contagious than other previous the spread is far more pernicious.

A common comparison I heard before this month/week, especially from Americans, is that only a few thousand died in China of Covid-19 while tens of thousands die of flu in the US annually without anywhere near the anxiety/hype.

The flu has a typical mortality rate of one in a thousand; Covid-19 is somewhere between one to two in a hundred.

Not everyone gets the flu and there is vaccine that works more often than not yet 30,000 to 60,000 Americans die of it or complications from it annually.

The current best data says at least 70% of people exposed contract Covid-19 and there is no vaccine extant. Therefore, left to run its course in the US unchecked:
330,000,000 * 70% = 231,000,000
231,000,000 * 1% = 2,310,000

Best case, given current knowledge is over 2-million dead Americans. Best case. That is almost double all US combat deaths in all conflicts ever.

Now add in overwhelmed hospitals with medical staff casualties... and mortality increases as those who should, given medical support, have lived do not. Plus additional millions with scarred aka decreased capacity lungs.

Yes, it is a war. Against a microscopic foe.
What is the economic cost of at least 2-million+ dead? Which is why the UK suddenly switched from pretty much ‘herd inoculation’ (a cruel crass calculation that might maybe have worked if instigated 2-months ago but the virus is now too far spread in general population) and let the chips aka dead fall where they may to active fighting much as other countries.

The Trump administration have sort of come around to similar conclusion this past week although it’s still mostly individual states on the frontline calling for federal action.

I’d like to believe that intervention will be cause for asking, after the fact, if it was all worth it. Unfortunately, I believe that too few did too little for too long so that unnecessarily far too many will die and suffer.

<just-for-webmasters tangent>
As a user, I detest sites that break up their story with “Related Articles” or “You Might Also Be Interested In” because it makes me think I’ve read to the end and I am likely to close the tab and miss three-quarters of the article.
</tangent>

Doubling rate really is a useful metric. It looks like the US is currently on the same trajectory as Italy and Iran. At one point yesterday, the US was within 20 (twenty) cases of passing Iran to be #5 on the Total Count list, but today Iran has surged ahead. (There are other possible explanations, but we need not go there.) Another useful one is COVID deaths as a proportion of all deaths. At one point, Italy’s numbers were something like 1/4. Obviously some of those were people who would otherwise have died next week of what used to be classed as “old age” ... but not 1/4 of everyone. (By this metric, the US is still doing well. Sigh.)

The South Korea numbers do not align well with Italy's or most other European countries. South Korea worked early and hard to shut it down with measures most democracies wouldn't take kindly to. Theirs is a textbook case of how it can be beat so using them as a baseline is silly.

Don't forget that today's numbers are not some actual total. They can only count those who have been tested. There is currently a backlog in the reagents supply needed to evaluate tests. Not to mention that if you are not in a large, urban area your local heath resources are not the same. Health workers are being pushed into quarantine because they lack PPE and have been exposed. The numbers reported for the US to date do not include all of the infected, only those who have been tested and whose test results have been returned which is a tiny percentage of the population. There are still US International airports that only scan for overtly infected passengers - if they scan at all. This is a weak "war effort" with little ammunition.

Small risks are still risks. If someone passes you the chips and tells you that 3 or 4 are laced with poison, would you take your chances or pass? How about if the next step was to pass those chips to someone you care about?

During the last 24 hours, 800 dead in Italy because of the covid-19...

In Italy, 1750 people die on an average day of all causes together. With the virus still mainly concentrated in the northern part of Italy, one doesn't want to imagine what happens if it gets even more widespread over the country and/or infects a higher percentage of people within the already highly affected regions.

The reality though is that we will probably soon find out. :(

With the virus still mainly concentrated in the northern part of Italy, one doesn't want to imagine what happens if it gets even more widespread over the country

Yikes indeed. There are things Milan can handle that Naples can’t.

I read a quote from an Italian doctor who said there are no longer any surgeons or urologists or, or, et cetera: there are just doctors.

Edit: Less than three hours ago I wrote

At one point yesterday, the US was within 20 (twenty) cases of passing Iran to be #5 on the Total Count list, but today Iran has surged ahead.

The latest figures [coronavirus.jhu.edu] show the US at #4, having passed both Iran and Germany. Frankly this is not a race anyone wants to win.

The critical problem when comparing the various national impacts of Covid-19 (besides the reliability of the data) is twofold:
1. the variability of testing; too often the media is focussed on absolute number of tests done rather than the more telling tests per million population.
2. the variability of positive results; this carries over from (1) above. Indeed it is likely that infections are exponentially greater than published.

There is one statistic that tends to be more concrete: deaths. So, using the same Johns Hopkins dataset, but graphing deaths against the line of Italy’s results:

As of yesterday, 20-March:
* Canada is: day 4, 0.3 deaths/million.
* Germany: day 7, 0.8 deaths/million
* Sweden: day 7, 1.6 deaths/million
Note that Germany is half Sweden at same point.
* USA: day 9, 0.7 deaths/million
* UK: day 10, 2.7 deaths/million
Note that UK is currently running above Italy’s graph line and US running below.
* Spain: day 14, 22.2 deaths/million
* France: day 15, 6.7 deaths/million
* Switzerland: day 16, 6.4 deaths/million
Note that Spain is running well above Italy’s graph line, France and Switzerland somewhat below.
* Italy: day 25, 67.3 deaths/million

Note: I see no point in including Iran as I am sceptical of all their reported numbers.
Note: I am restricting to some EU, UK , US, and Canada as reasonably comparable; more interested in differences compared to extant example of Italy. The variability even in this subset is fascinating.

@Iamlost great points. But I think you need to add a #3. In this situation testing is not discreet, ie: test once get a positive or negative outcome. A person may test today and be found negative, but become positive at some point in the future. The only relevant metric is then the number that tested positive. So the number of tests done, be it in raw numbers or expressed as a percentage of the population is not relevant.

The other troubling thing for me is that I am also reluctant to focus on deaths, as the number of death in addition to being a measure of severity it also a measure of the ability of a nations medical system to cope. Compare US to Germany, number of cases is similar, but the number of deaths in the US 3X of Germany. This is made far worse when you adjust for population size, where the US population is ~4X Germany's. So infection rate per capita in the US 1/4 that of Germany while the death rate 3X (that is death given that the person has the disease). Such a staggering difference can only be explained by difference in treatment.

So the number of tests done, be it in raw numbers or expressed as a percentage of the population is not relevant.

On the contrary, it’s highly relevant. If you test the entire population--or some randomly selected portion of the population--your results will include asymptomatic carriers, leading to an extremely low death rate by the numbers. If you test only people who meet some narrow set of criteria, the people who end up dying will represent a far higher proportion of those who tested positive.

At this stage of the game all (and I mean ALL) countries are cooking to books. Iran's numbers are likely three times greater in all metrics, China's could be up to eight times greater. The lack of new cases is they stopped testing for it and the number of reported PNEUMONIA DEATHS (covid-19 or not) has quadrupled.

This is moving into "ordinary" politics for the countries, etc. etc. etc.

Nations with a higher percentage of aged population (such as Italy) will have more deaths than those with a lower percentage ... assuming the rate of INFECTION remains equal across all metrics.

Deaths is the concrete factor that can (and should be, bless their souls) be a most valid number.

@Lucy24 True, I'm not saying testing is not important. What I'm saying is that using a ratio like number of people tested is not relevant, as people could be tested multiple times and more importantly, as mentioned above, the probability of catching the disease does not change whether a person has tested negative or has not been tested. This fact is often overlooked in how the media portrays testing, which is typically "lets test everyone and then we can separate the positive people from the negative people". But this is wrong, you can separate the positives, that part is easy, but the group that remains still has the potential of becoming positive, so would be better described that group as "the not yet positives". Obviously if one could test and separate everyone at the same instant and separate them immediately, then yes testing would be 100% effective.

@Tangor

Nations with a higher percentage of aged population (such as Italy) will have more deaths than those with a lower percentage ... assuming the rate of INFECTION remains equal across all metrics.

That is a common claim, but unfortunately it is not supported by the fact.

Italy's +65 population is about 21%, Germany is 22% and Japan is 25%
Germany's deaths are 2% of Italy's with about half the cases.
Japan's death rate is about half of Italy's with only about 1000 cases and with double Italy's population.

This virus is an unbiased test (and potentially destructive test) of a nation's medical system.

Spain, 1326 dead because of the covid-19 during the last 24 hours...

Fixating on the number of deaths per whatever metric you want to use diminishes the importance of this: the strain on the world's health care system. If COVID-19 has demonstrated anything is that we, as a race, are not prepared to deal with a disaster of this magnitude. It is our own arrogance that is exasperating the problem more than anything else. And we can sit and speculate all we want. The fact is is that it is here and we as "the human race" need to deal with it as one, not 195 separate entities playing the blame game.

WE ARE DOOMED!

YOUR NUMBERS ARE WRONG!

WE CAN'T FIGHT THIS!

(and meanwhile ordinary flu, which is not being tracked as carefully by the mainstream press or cable news, is routinely thinning the population as it does every year)

That is not to say COVID-19-SARS-2 is not serious, it is, just as every other disease. I suppose what bothers me most is the hysteria attached to this flu (and it is a flu) is so disproportionate, especially when compared to previous flu pandemics of a far more serious nature which went largely unreported/covered.

As for medical facilities being overcome, that is more a statement regarding infrastructure and early response (or lack of) by various localities. Meanwhile, new testing with 45 minute results will be rolling out shortly. A number of human subject tests using well-known and SAFE malarial drugs are on-going (with good initial results!), and at least three countries are within weeks of starting human testing of vaccines.

Real data can be found here:
[cdc.gov...]

And note that 2009-2010's flu season was far more serious (that's during H1N1) than present.

All flus have the potential to harm/kill the very young or the very old ... and all of the flus out there (we even have a name for it: "flu season") are equally capable.

Avoid those with it. If you have it don't share it. Meanwhile...

Wash your hands with soap and water!

And note that 2009-2010's flu season was far more serious (that's during H1N1) than present.

You compare a season, 4 months, to a shorter period.

The covid-19 appeared in December, in China, but, it really arrived in Europe one month ago, and may be one week or 2, in the USA. so it's sure that in the USA, in one or two weeks it caused less harm than a 4 months of flu.

If you want to compare, wait 3 months and a half from now.

Virus appeared in NOVEMBER 2019 so the period is longer than reported. Was in Europe a month earlier than reported. Arrived USA in January. Travel bans began February. Lockdowns started March.

Sadly, the carriers had already been "everywhere" before most of the events above were done.

Protection of those most at risk would concentrate care and resources rather than a broad effort that dilutes resources.

The reason for the broad effort is because of the lack of resources. There is not much concentrating to be done when the effort for PPE is just now beggining to gear up.

Too much stupidities. Farewell.

Comparisons update, as of 21 March
Note: zero day for each is date passed 1.0 death per 10 million.
Note: d/m == deaths/million

* Italy: day 26, 80.4 d/m up from 67.3 yesterday.

* Switzerland: day 17, 8.8 d/m up from 6.4 yesterday
* France: day 16, 8.4 d/m up from 6.7 yesterday
* Spain: day 15, 29.3 d/m up from 22.2 yesterday
Note: Spain graph is increasingly far steeper than Italy’s; Switzerland noticeably below, France slightly below Italy’s graph line.

* UK: day 11, 3.5 d/m up from 2.7 yesterday.
* US: day 10, 0.9 d/m up from 0.7 yesterday.
Note: UK running slightly above, US running slightly below Italy’s graph line.

* Germany: day 8, 1.0 d/m up from 0.8 yesterday.
* Sweden: day 8, 2.0 d/m up from 1.6 yesterday.
Note: Germany is right on Italy’s track, Sweden is slightly above; Sweden’s death rate continues double Germany’s.

* Canada: day 5, 0.5 d/m up from 0.3 yesterday.
Note: right on Italy’s track.

(and meanwhile ordinary flu, which is not being tracked as carefully by the mainstream press or cable news, is routinely thinning the population as it does eveyh as ry year)

Not a valid comparison ... ordinary flu is bad, but it's not doubling every few days.

During the H1N1 pandemic, a virus more deadly than COVID-19, society was not put on hold and no general panic was created.

Again, not a valid comparison. H1N1 did not spread nearly as easily, and was not at any point running amok in the world population at large.

[edited by: buckworks at 8:29 pm (utc) on Mar 22, 2020]

There is far too much politicizing of the pandemic happening in countries within an election year AND if that country is a western country then the entire west is apparently trying to impose a singular message(in media) on the entire west. We saw that when the EU criticized the US(for border closure) only to follow suit to some degree a few days later. In the middle of a pandemic I think it should be illegal to make it political in the media, time is wasted debating.

Race, class and other "cards" are being used politically.... as if the average person thinks the virus cares about these. Too much about virus media coverage/message has political roots right now. If you want half the population to ignore quarantine measures, for example, alienate them with a biased message. "He said x so y is better" type stuff should not be happening between media and leadership. Sorry but media needs to fall in line and be supportive during a pandemic, not push political conflicts in every article.

"OMG he called it such and such that's so racist we're all going to die" is something I read a moment ago. Very unhelpfull and to be discussed AFTER, not during the pandemic, imo.

Happens every outbreak. You'd think we'd learn and have a response vector already in place by now. Our political fighting is worse than the disease right now, it knows no limits.

Not a valid comparison ... ordinary flu is bad, but it's not doubling every few days.

Chuckles. Historical v hysterical ... It is correct to state that corona does not yet have a year of data for comparison. Ordinary flu has only been around for a few thousand years, and each of those years the numbers remain fairly consistent.

However, if corona does wipe out the human race I will have egg on face and be forced to apologize for begging reason and commonsense.

(Where was all the panic during H1N1? MERS? SARS?)

What is obvious is the kids aren't going to play stay home and kill an economy. They are out partying, and even coughing in the faces of old folks. Politics won't mean anything if the population (particularly the kids, as in 18-35) won't conform.

As one of the 70+ critters, I DO keep track of all, practice the ordinary sterile protocols, and avoid large congregations, but that is for ME and my family, not anyone else. It is on me to protect myself and family, not a third party who may really not have my best interests at heart.

YMMV

Comparisons update, as of 21 March

Here’s the bit I’m having trouble with, mathematically.
#1 Spain has had COVID for the same number of days as the US. (Source: weforum graph.)
#2 Spain's doubling time is significantly shorter than the US. (Source: same.)
#3 In the past 24 hours, the US has overtaken Spain to become #3 worldwide in number of confirmed cases. (Source: continuously updated page at Johns Hopkins.)

What’s the discrepancy?

What’s the discrepancy?

The virus can be transmitted by air. I blame the air condition systems in buildings that recirculate the air. In theory, you could get the virus from the person in the next room without having been near them. Just my opinion.