This piece started out as a way for me to conduct some research and synthesize my thoughts on COVID-19. You’re probably not going to learn anything new reading it, but I thought it might be worth sharing anyway.
As COVID-19 spreads in America, society has split into two main camps.
- The YOLO crowd
- The PRSI crowd (Panic-Ridden & Stress-Induced)
The YOLO crowd is standing their ground as they laugh in the face of the meme-worthy Coronavirus. They are reluctant to give up their travel plans. They are “LMFAO-ing” at the Tom Hanks, Rudy Goberts, and Sophie Trudeaus of the world. This stance is softening day by day.
The PRSI crowd is freaking out about the lack of toilet paper in Costco, making large batches of hand sanitizer at home, and spending hundreds of dollars on N95+ masks on Amazon. This stance is strengthening day by day.
I’d like to extend an invite to anyone looking for a third camp: The Thoughtfully Over Reactive crowd.
This is where I currently reside. Although, if things get much worse, I may join the PRSIs.
Here are a few cultural & business (macro-level) highlights from this past week alone (3/8/20-3/14/20):
- The NBA, MLB, MLS, NHL, & PGA are either postponed or suspended
- NYC Broadway Shows, Disney Themeparks, & The Met are all closed for 30 days
- Trump restricts travelers from Europe (Except UK)
- The IRS is expected to push back the April 15 tax payment deadline
- Many states are prohibiting gatherings of 500 people or more
- Many schools (all grade levels) are either closing or transitioning to online only
- Italy went from locking down towns, to regions, to the entire country
- Tentpole movies push release dates: Mulan, FATF9, James Bond, A Quiet Place II
- Monday (3/9) was the worst day for stocks since the financial crisis. Thursday (3/12) was the worst day for stocks since 1987. Friday (3/13) was the best day for stocks since 2008.
Here are a few personal (micro-level) updates from this past week alone (3/8/20-3/14/20):
The labor & delivery center we selected for BabyShak sent a notice that only one support person will be allowed to enter the hospital with Dia until further notice. No one else will be allowed into the building, not even in the waiting room. That means I’ll have to 1) play the role of empathetic husband / punching bag and 2) fill Dia’s mom’s emotional support shoes. The second part seems impossible.
One of my oldest friends cancelled his bachelor party in Las Vegas later this month. I couldn’t go because we’re so close to our due date, but I feel sorry for him. I hope he has an opportunity to make up for it before his big day this summer. Every man (& woman) signing up for marriage deserves a proper send off.
Some ignorant teenager in the Rockaway, NJ ShopRite straight up accused a Korean-American friend of being “the reason why we [White Americans(?)] have to deal with this whole Coronavirus thing”.
What in the actual fuck?!
So upsetting.
Let’s Back Up
I’m not a fan of keeping up with the News. I actively avoid it at all costs. Except for my Morning Brew subscription.
Coronavirus, however, made its way through the cracks. Mainly because my parents had plans to travel to Thailand, Cambodia, & Vietnam from Feb 15 - Feb 29, 2020.
Chinese officials reported first cases to the WHO (World Health Organization) on December 31st, 2019. I didn’t start really paying attention to it until 3 weeks later. January 20th, 2020: The day the United States reported its first case in Washington state.
Knowing my parents trip was on the horizon, I monitored COVID-19 as close as I could without getting sucked into the fear mongering.
We waited for a “cure” or “vaccine” to surface, but it didn’t come. So on Sunday, February 9th 2020, I asked them to pull the plug on their trip. I couldn’t justify the risk of letting my parents go to Southeast Asia.
The pitch was simple: “Dad, all your friends are still going to go and probably have a great time. Chances are no one will get infected and they’ll return home safely. But you guys are old and have pre-existing conditions... The baby is coming soon after you guys return. I don’t want to say no to you visiting because you might be infected. Dia and I just don’t want you to go.”
That one conversation was all it took for my parents to back out of a 2 week trip they had sunk thousands of dollars into. Luckily, we recovered most of the heavy ticket items.
Finally, It’s worth mentioning all their friends went, had an amazing time, and came back healthy. But that doesn’t mean it was a good decision to go. Using the result to judge the decision making process is called Resulting. I wrote about Resulting extensively here.
Fast Forward To Today
I feel confused, misinformed, and scared. I don’t really trust the government because I truly believe it’s in their best interest to lie to us and downplay the effect this virus is having on our country.
After all, China started out by doing the same thing. Instead of simply being transparent, China used a quadratic regression model to publish their results to the WHO.
Please read the excerpt below from the Body Count article:
>>>> START
In fact, China reported a total of 491 cumulative deaths from nCov2019 through Feb. 5th. If you applied my incredibly rough and cartoonish model, then, of 15% new deaths on Feb. 6th, and 14% new deaths on Feb. 7th, and so forth and so on, you’d end up with the following daily data points on new and cumulative deaths:
Feb. 6: 74 new deaths & 565 cumulative deaths
Feb. 7: 79 new deaths & 643 cumulative deaths
Feb. 8: 83 new deaths & 720 cumulative deaths
Feb. 9: 87 new deaths & 810 cumulative deaths
Feb. 10: 89 new deaths & 901 cumulative deaths
And now here’s what China and the WHO actually reported:
Feb. 6: 73 new deaths & 564 cumulative deaths
Feb. 7: 73 new deaths & 637 cumulative deaths
Feb. 8: 86 new deaths & 723 cumulative deaths
Feb. 9: 89 new deaths & 812 cumulative deaths
Feb. 10: 96 new deaths & 908 cumulative deaths
I mean … c’mon, man.
I just gave you a ridiculously naive and idiotic model of “Progress in the War against Coronavirus!”, and it’s incredibly predictive for the reported data on a daily basis for a nation of 1.4 billion people in the throes of an unimaginable public health crisis.
>>>> END
After reading this, I knew I couldn’t rely on the government numbers or any media channels that are politically biased. I would have to curate my own news.
Research:
Source: Dr. Jennifer Nuzzo as Guest on Public Health On Call Podcast
- Hand hygiene is extremely important. Wash your hands!
- Hand Sanitizer is a convenient alternative to soap & water, but not a sufficient replacement.
- We can expect this virus to expand into all communities across the USA
- Additional risks to pregnant women have not yet been proven, but it’s a huge unknown.
- I read a conflicting argument saying Coronavirus cannot be passed on to a fetus.
- Face masks are best used by those that are already sick & healthcare workers
- There’s no strong evidence to say this virus will disappear in warmer months
- Get a flu shot if you haven’t already! Vaccination will not prevent you from getting sick, but it can reduce serious illness, hospitalization, and death. Need to reduce the number of flu cases in the health system in order to better focus on COVID-19 cases.
- Droplet Transmission: sneezes and coughs are the main forms of transmitting this virus. Safe distance is considered to be ~6 feet. The droplets do not float in the air. They fall to the ground. The droplets can live on surfaces anywhere from a few hours to a few days depending on the surface.
Source: Infectious Disease Expert Michael Osterholm as Guest on Joe Rogan Experience Podcast
- In the span of just 3 weeks, Italy went from being completely normal to basically shutting down the country. These infectious diseases spread incredibly quickly.
- Primary risk factor for dying from COVID-19 is old-age, but that doesn’t mean it’s an “old person’s disease”.
- Other primary risk factors are:
- smoking, obesity, comorbidities, compromised immune system
- Incubation Period is ~4 days.
- Incubation Period: Time that passes between the moment the virus is contracted and a patient starts showing symptoms
- In China, only 2.1% of cases were children under 18 years of age. One study shows children are getting infected with the virus, but aren’t getting sick.
Source: Twitter: @HelenBranswell, @YaschaMounk, @Missy_Ryan, @tferriss
- The coronavirus fatality rate in China for those over 80 is an estimated 21.9 percent, per the WHO.
- Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care Medical Document:
- A week ago, Italy had so few cases of corona that it could give each stricken patient high-quality care. Today, some hospitals are so overwhelmed that they simply cannot treat every patient. They are starting to do wartime triage.
- After 18 days of strict quarantine, the city of Codogno, epicenter of the red zone, registers 0 (yes, zero) new cases.
- Safest social distance may be isolation
- Mass testing, alerts and big fines: the strategies used in Asia to slow coronavirus
My Approach:
The single most important practice for me across all fields of life is differentiating what’s in my control and what’s not. In a truly viral situation like this, the only thing I can control is how I respond.
I need to identify the risks, create an action plan, and behave accordingly. I won’t be foolish enough to believe I can be the exception, or my family will be spared.
At the same time, no single individual can accomplish “flattening the curve” by themselves. We must collectively act right. Only then, will any difference be realized.
I hope you join me in the Thoughtfully Over Reactive crowd. Here’s what I’ll be doing for the following few weeks:
- I’ll consider COVID-19 "more dangerous until proven safe," not "safe until proven more dangerous."
- I’ll do my best to follow social distancing guidelines set forth in this article.
- I’ll encourage my friends, family, and colleagues to avoid traveling, public gatherings, etc.
- I’ll encourage my parents and grandmother to stay at home as much as possible over the next few weeks.
- I’ll curate my own news.
- I’ll be vigilant about keeping my hands clean, not touching my face, and sneezing or coughing into tissues or napkins.
- I’ll cancel or postpone events, or make them remote if possible.
- I won’t waste this time. Staying at home for a few weeks is a good excuse to be unproductive. I’ll focus on being more creative.
- I won’t panic. I’ll continue to self educate and rely on trusted resources.
- I’ll try to help others in more precarious situations.
- Finally, I’ll prepare for the worst. Dia and I stocked up on 30 days worth of food and supplies. If I’m wrong, we’ll laugh and make our way through these resources over the coming months.
The cost of being prepared and wrong is much less than the cost of being unprepared and wrong.
More Reading Material:
Coronavirus by Tomas Pueyo: This article has been read 24M+ times in the past week. Great for understanding and visualizing the data.
Response to COVID-19 in Taiwan by C. Jason Wang, MD, PhD: Taiwan is 81 miles off the coast of mainland China and was expected to have the second highest number of cases of (COVID-19). It didn't turn out that way.
Why ‘Flattening the Curve’ May be the World’s Best Bet to Slow the Coronavirus by Helen Branswell:
“On any normal day, health systems in the United States typically run close to capacity. If a hospital is overwhelmed by Covid-19 cases, patients will have a lower chance of surviving than they would if they became ill when the hospital’s patient load was more manageable.”
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