Coronavirus is Here

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Coronavirus
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Even in the best case scenarios, things are going to get a lot worse from here before they get better.

Please, please, please, do not rely on me here to tell you what is going on or what to do. Even more than that, please, please, please, do not take this as saying that you shouldn’t do a lot more than the things I’m saying here.

This is me doing what various stupid reasons prevented me from doing earlier, deciding that saying something is a lot better than saying nothing, and hoping it will do some good.

This is not a model of what is happening, or an attempt to justify what you should do, because attempting to do that would cause me to continue to say nothing, and that seems worse.

If you already are taking the situation seriously and making serious preparations, this probably won’t tell you anything new. I am totally fine with that.

This is me seeing something and saying something.

If you need some sort of permission to yourself to acknowledge that this is happening, and that you need to take action now to prepare, this is one more instance of that. You have it.

It will be important that you retain the ability, when things get bad, to keep your head on straight. Prepare now, including mentally, as best you can, for people you know and care about getting sick and dying, because this might well happen to you regardless of what actions everyone involved takes.

Here is an article describing the symptoms, if you are not yet familiar with that. It’s primarily dry cough and pneumonia.

From the statistics I have seen, with super wide error bars, overall risk of death if you do get infected could be up to about 2%. But that is only an average. It varies wildly based on age and prior health, and presumably access to health care. I’ve also seen reasonable claims that initial degree of exposure matters here.

Risk of death chart by age:

Age Death Rate
80+ years old    14.8%
70-79 years old 8.0%
60-69 years old 3.6%
50-59 years old 1.3%
40-49 years old 0.4%
30-39 years old 0.2%
20-29 years old 0.2%
10-19 years old 0.2%
0-9 years old no fatalities

Co-morbidity is very high for conditions such as heart attacks, cancer and diabetes. If you are elderly and/or have conditions such as cancer, a prior heart attack or diabetes, you are at much greater risk, and should take all precautions more aggressively.

If you have not yet prepared for quarantine in place for at least several weeks, and ideally longer than that, you need to do at least that much now. Get a three month supply of any medications you need. Make sure you are stocked with the necessary food and water, soap and toilet paper and so on. Here is a quick LessWrong post on quarantine preperations.

Decide now what would make you impose this quarantine on yourself rather than waiting for an authority figure to do it for you, and what would cause you to impose other lesser restrictions. Decide what would cause you to stop going to restaurants, stop going to work, stop going outside for any non-emergency reason, and so on.

Figure out what news sources, including people who you trust, you are going to be willing to trust for information going forward.

If you are not prepared, including mentally, for approximately everyone around you to freak the hell out about this in various ways, you need to do that now.

If you have any plans to fly or attend conferences or sporting events or other major gatherings of people, at least beyond the next few days, cancel them. Period. Where and when you draw the line is up to you, but draw a line and adjust it quickly as news comes in.

If you can do your job from home rather than a crowded office, do your job from home. If you have to commute, don’t do it on crowded subways or buses.

Do not shake hands or otherwise make other unnecessary physical contact with anyone.

If you are not yet doing your best to get good hand washing practices or avoid touching your face and other similar basic hygienic actions to avoid infection, get on that. Here is a post on how to properly wash your hands.

Remember that the virus can survive on surfaces for days, that it takes people several days of incubation to show symptoms, and that it takes two weeks to play itself out.

If there are people you care about who don’t know that this is happening or aren’t taking it seriously, fix that.

Here is a practical advice post that seems good that has detail. Biggest impact actions from its perspective are avoiding people in general, avoiding people who seem potentially sick in particular (at least 2 meters away at all times), frequent proper hand washing and keeping a reasonable stock of supplies.

Here is the LessWrong advice thread where people offer advice and justifications for potentially ‘weird looking’ actions. One piece of advice is to stock electrolyte drinks in case someone is unable to eat due to illness. They recommend copper tape be placed on commonly touched surfaces and the backs of phones, you can buy some here. Also they endorse a pulse oximeter. One interesting suggestion is Vitamin D supplements since you might be unable to go outside.

Here is a basic ‘the CDC expects this is happen’ thing from a few days ago in case anyone needs to share something that basic with someone, otherwise ignore.

If you live in a major city, and leaving that city is practical, it is at least reasonable to do so, especially if you are at greater risk.

Do not take this as anything like a complete list of things to do or consider doing. Seriously consider doing more things to prepare, and avoiding more things more aggressively, based on what you believe to be helpful.

Again, DON’T PANIC. Let’s all stay safe as best we can.

 

Coronavirus3
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16 comments, sorted by Highlighting new comments since Today at 12:22 AM
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My wife has a friend in California who works in medical. She points out that:

  • COVID-19 throws flu-like symptoms
  • It's still flu season
  • Our lab tests for the flu are pretty poor
  • Therefore: lots of cases of "you obviously have the flu, lets just treat it like it's flu and move on" in the last little while could plausibly have been COVID-19 and we would have had no good way to know

It's entirely reasonable to expect that it's out there in the community, at least on the west coast, and we just haven't found out yet. Any place close to a travel hub is suspect now. We should assume that most of us have at least had the opportunity to be exposed by now.

Above all, keep you hands washed (and lotioned because cracked and bleeding knuckles from lots of washing could be an infection vector, if not for COVID-19 then for other stuff) and keep good cough/sneeze hygiene!

Coronavirus is where? The west coast of America? The UK government is being moderately competent as far as I can tell. (They haven't banned the test)

Can you provide a citation for the breakdown of deaths by age? There was at least one confirmed death of a 2 year old in China a month ago. It's certainly negligible, but not 0.

[This comment is no longer endorsed by its author]Reply

Although the original comment is now marked unendorsed, I also want to note that the breakdown of deaths by age has been circulating for a long time, and is presumably not especially up-to-date based on current global figures (it's based entirely on China, as far as I know.) It would be good if someone could find more recent numbers.

I seem to be missing the statement that the 2 yo died. The link seems to be about a study of a group of patients, of which two were children, 2 an 15 years of age.

Near the send the like states: " As of February 4, 2020, all the patients recovered, but 12 were still being quarantined in the hospital."

Am I missing something of did you intend to provide a different link?

It's hard to rationally support the burden that would accrue from that high level of precaution if you're not in a vulnerable class[1]. The mortality rate of the 2019 coronavirus for twenty-somethings is not much higher than the mortality of influenza [2]. The financial burden of the activities you're proposing, namely moving to another location are out of proportion to the minimal risk. Unless you've already taken other safety precautions (e.g. cryonics, longevity supplements) that have higher expected utility/cost, it is hard to justify the level of action you're proposing for the risk coronavirus poses.

I understand that this post isn't meant to explain why taking coronavirus precautions is a good idea, but rather to explain what precautions one should take assuming that taking precautions is rational. I think there should at least be a link to an explanation for why the precautions you suggest are rational. There is already a pinned post for users to post their advice on coronavirus and this post should be located there as an answer. Posting in a separate thread seems like an attempt to get around the justification requirement while still writing something that should probably be in that pinned thread.


  1. The mean and median age of LW users is well without the older class that is vulnerable to coronavirus deaths. https://www.lesswrong.com/posts/j9kxNcm2bM7A8XAc6/coronavirus-is-here ↩︎

  2. https://www.nejm.org/doi/full/10.1056/NEJMe2002387?query=recirc_curatedRelated_article ↩︎

I think some of your points are good, but I downvoted you specifically for the statement "not much higher than the mortality of influenza", which appears to me to be extremely misleading. The linked reference notes that the currently-reported CFR is around 1.4%-2% (this ignores the WHO's recent figure of 3.4%, but it's not crucial either way), and that the CFR of seasonal influenza is around 0.1%. It then speculates that, under certain assumptions, the true CFR of COVID-19 "may be considerably less than 1%". So, under certain speculative assumptions, the CFR "may" be less than ten times that of seasonal flu. I don't think that reasonably justifies a declaration that it's "not much higher."

(I do think there's a reasonable argument to be made here that the absolute rather than relative risk of death is still quite low, for young and healthy people. There are other risks worth considering, such as the risks to people who aren't young and healthy; the risks to people who have close contact with people who aren't young and healthy; and the risks of outcomes other than death, such as pneumonia, poorly-treated pneumonia due to an overwhelmed medical system, and possible long-term consequences which aren't yet well-characterized.)

I was comparing mortality figures for the 20-29 age group. 2019 coronavirus mortality for 20-29yo's is 0.2%.[1][2] Meaning that's a worst-case statistic for the current situation. Mortality for seasonal influenza for confirmed cases in the same age group is .05%.[3]

You're comparing the overall mortality rate when I specifically stated that I was only comparing the mortality rate for twenty-somethings. You then use that mistaken analysis, and a blatantly out-of-context quote, to conclude that I'm being extremely misleading.


  1. https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/ ↩︎

  2. http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51 Look to Table 1. ↩︎

  3. https://www.cdc.gov/flu/about/burden/2018-2019.html ↩︎

Can you help me understand where in your link (3) I can derive your 0.05% figure? I do not see any figures for the 20-29 age group. The closest thing I see is "18-49", and when I divide "deaths" by "symptomatic illnesses" for that group, I get 0.02%, which would presumably be an overestimate for the youngest decade of that wide range.

EDIT: Also, none of that was anywhere in your citation for that claim (not that I think claims are obliged to be cited, but since your post contained no numbers, I think it was completely reasonable of me to assume that the numbers in your own citation were the ones you were using.) Also, to be clear, if the relevant multiple is actually 4x, I still dispute that 4x is "not much higher."

You can derive the .05% figure from deaths/medical visits for 18-49yo's in 2018-2019 (2450/4,407,885 = .056%). That's the same metric they use for COVID-19. There's nobody that's being counted as a confirmed coronavirus patient that's not going for a medical visit. I couldn't find data specifically about 20-29yo's for seasonal influenza. You can argue that .05% to .2% is a massive difference if you want to, but it's hardly extremely misleading to say that it's not much higher.

I do not want to continue the pointless back and forth where you find potential inconsistencies in my claims, I explain why there are no inconsistencies, and then you find more potential inconsistencies. I rather just bet.

By end of spring 2020 COVID-19 will have caused no more deaths in the US than H1N1 had by end of summer 2009 (4,000 according to Wikipedia). I'll take 1:1 odds on that. If you want to bet money I'll go up to $50.

Well, this comment sure seems to not have aged well. Did this bet ever pay out and resolve?

No, a bet was never made and accepted. You can see my reply to him as to why I didn't accept his offer. He never replied to my counteroffer.

Well, my level of annoyance at you for making misleading and poorly-sourced claims is definitely coming to a middle.

Mildly annoying is your vague specification of "end of spring" as the endpoint. More annoyingly, after spending some time investigating your newest vaguely-sourced claim, I found that Wikipedia tells me -- on the page https://en.wikipedia.org/wiki/2009_flu_pandemic_in_the_United_States -- that the US had 593 deaths, as of September 3, 2009. Someone else helped me find https://www.cdc.gov/media/transcripts/2009/t091112.htm, which gives an estimate of 3,900 as of October 17, which is still under 4,000 and implausibly late for "end of summer". (I don't think this is really material to the outcome of the bet, but it is a demonstration of exactly the same sorts of issues I've had with your previous comments.)

However, if you're still willing to make the bet, still 1:1, using the actual figure of 593, and let's specify May 31 as what seems to be the consensus last day of spring, I am happy to do that. $50 is fine, but it has been pointed out to me that betting on the coronavirus is considered to be in poor taste, which seems fair enough. So I ask that, if I win, my winnings be in the form of a donation to the Against Malaria Foundation, or another GiveWell top charity of your choice, with receipt provided. For your side, I would suggest something similar, but I will pay cash if you so desire.

Deal?

Posting in a separate thread seems like an attempt to get around the justification requirement while still writing something that should probably be in that pinned thread.

Zvi posted this on his own blog, and the post was then crossposted here, so only posting it there was not an option with the current crossposting setup. 

There's an argument that hospitals will quickly be overwhelmed, and that without hospital beds and staff and equipment available, the fatality rate is much higher, at least 2% for young adults, and even higher still for other demographics. Do you disagree with that? If you accept that part, avoiding at least 2% risk of death is plausibly worth suffering months of disruption over I think, right? Not to mention that plenty of readers may not be young or healthy...