What We Can Do About Coronavirus

The time to be brave, and act, is now.

Introduction

Coronavirus places us in the midst of a Black Swan event. It’s gone from highly unlikely, to likely, to happening. No one has perfect models of how it will unfold, exactly. But, we can identify possible worst-case scenarios and take action to minimize the negative impacts if those scenarios do occur. The most rational thing that we can do is to bound the downside.

Here are the downsides we can minimize:

1. Minimize the chance of getting infected in the first place.
2. Minimize the downside if we do get infected.
3. Bound other downsides, including financial.

For each of these questions, there are experts who have great advice. This article gathers that advice together into a (hopefully) digestible format. It reports what actions that can be done now A) as individuals, B) as governments, and C) as civic-minded citizens, grouped according to the downsides given above.

Doing some of these actions will feel weird, because they are unfamiliar. If you recognize that uncomfortable feeling, get past it, and take action. Get past the cognitive dissonance. We need to get serious, and we need to get courageous in taking these actions.

A. Individuals / Families

Here’s what we as individuals and families can do.

1. Individuals: Minimize your chance of getting infected

• Here’s the CDC recommendations on prevention. Below is a summary.
• Keep your hands clean. Most importantly, wash your hands (20 seconds!). Also, use hand sanitizer, wipe off surfaces, and wear latex gloves when in public.

• Minimize the chance of the virus getting into your body (mouth, nose and eyes). Wear a mask. Even simple DIY masks help a lot; here’s a starting point. Ignore social stigma on mask-wearing; you’re doing the right thing to help keep you and those around you safe.

• Also, don’t touch your face. It’s harder than it sounds. You can start practicing by simply monitoring yourself to see when you do touch your face. It’s a weird feeling, but you can make it a game to yourself. Not touching your face is easier if you’re wearing latex gloves or a mask. The NY Times has more tips. Also, steer clear of anyone showing any symptoms (a couple meters!).
• Avoid groups of people beyond those you live with: work from home, avoid public gatherings, don’t travel, don’t take face-to-face meetings. If you need to go shopping, do it when stores are as empty as possible (even better: get the food you need and self-quarantine).
• Teach those around you the same.

2. Individuals: Bound the downside if you get infected

• Here are the CDC’s recommendations. Below is a summary.
• You first need to know if you’re infected. The main symptoms to watch for are fever, cough and shortness of breath. Onset is 2–14 days after infection. Here’s a more thorough list of symptoms and the likelihood of each. Alas, many of these symptoms are shared with a usual flu or cold. The following helps.

• To bound your downside, the best defense on infections is your body itself. So maximize the strength of your immune system: help it help you. Stay healthy: eat well, exercise, sleep well. Eat foods that boost the immune system, such as citrus fruits and garlic.
• Be ready to seek medical attention if you get infected, but seek it appropriately. First, know that hospital waiting rooms are more likely to have the virus. And, since hospital space will be scarce, it’s best used by the seriously sick (including non-coronavirus patients that still need care); if that’s not you then ask how you can avoid burdening the system. We need to protect frontline medical personnel too. So call first; try to get the doctor to visit you if possible; and only then, visit the hospital. CDC link.
• You also want to bound the downside of those around you. So minimize your chance infecting others. Wear a mask. Keep your distance from others. Self-quarantine from even loved ones on your way to the hospital.

3. Individuals: Bound other downsides

• In case of a quarantine: have food supplies and medical supplies (including essential pharma, first aid) ready. An amazingly thorough list is at theprepared.com by @jonst0kes.
• Bound your financial downside. Have cash ready. Make sure your assets are diversified. If the worst does happen, will you have the resources to keep eating?
• Learn, and adapt. The first part is to pay attention. There is a lot of misinformation, so have a skeptical eye and follow people you trust. For me, Ryan Selkis’ Google Doc has many excellent references, and the coronadaily newsletter’s steady updates are very helpful. Focus on real data. This NYT interview of WHO’s Bruce Aylward, and these key learnings by WHO in China are good snapshots to start with. For dynamic data, see dashboards like this or these (survey). Coronavirus spread and impact is exponential; therefore once we get into the thick of it, every month could feel qualitatively different than the last. We could see more change in the next six months than the last ten years.

Dashboard of avatorl.org/covid-19/, snapshot taken Mar. 9, 2020

4. Individuals: Have courage

• Many of the steps above will feel weird, because you haven’t done them before. Get past it, and do it: your safety depends on it. Over time it will feel normal. You need to do them consistently with vigilance. I’d rather be super uncool and healthy, than super sick.

Be brave. [Photo by Benjamin Davies on Unsplash]

B. Governments

1. Governments: Minimize the spread of infection among your citizens

• Tedros Adhanom Ghebreyesus, Director-General of WHO, lists these key measures for countries on containment & preparedness. (Thanks coronadaily!) Below is a summary.
• Make it easy for your citizens to avoid groups of people. Minimize their downside if they work from home or stay home from work (no penalties, financial aid, etc). Disallow public gatherings. Turn off airports and train stations.
• Help your citizens help themselves: have an education campaign on how to minimize infection by washing hands, not touching their face, etc. Fast-track production of more hand sanitizers, wipes, masks, and the like.
• And everything else that governments like Taiwan, Singapore, and Hong Kong did! (Links below.)

2. Governments: Bound the downside for citizens that do get infected

• Do aggressive testing. Have a huge supply of testkits. Scale up manufacturing of more testkits. Train more medical professionals to test, and train even more people beyond that. Make it convenient and free for anyone to get tested. Proactively test, versus waiting for citizens to come to get tested. Have doctors with testkits in cars around the city/region who can visit patients instead of patients visit the hospital. Reduce turnaround time in testing. Help citizens administer self-tests (this will really help scale!) A gold standard: drive-through testing in South Korea. Another gold standard: big data analytics in Taiwan to identify at-risk persons.

Drive-through testing in South Korea. [Image source]

• Get the medical capacity to treat all the infected. This starts with freeing up as many beds as possible, and related medical equipment. This won’t be easy with the exponential rise of cases, so aggressive action must be taken. The downside to not being ready is severe: case fatality rate jumps or more if the medical system becomes overburdened. A gold standard: China building new hospitals in just two weeks. They also converted sports arenas and more into hospitals. Berlin Tempelhof, here we come?
• Have an education campaign to teach citizens to know when they might be infected, and what to do if they might be. Be transparent about the spread of the virus.
• And everything else that governments like Taiwan, Singapore, and Hong Kong did! (Links below.)

3. Governments: Bound the downside, generally

• Bound the economy’s downside. The drop in stocks so far might be only the start of a much greater economic stress test; what can you do to minimize the chances of economic catastrophe?

4. Governments: Have courage

• Do the right thing. Be transparent and honest. Make the data accessible, like HK or Singapore. Have a hotline up and running 24/7 with information or health questions. Have an easy to understand website. It’s key that citizens do not lose faith in the system; so show them a government to be proud of with your assertive actions.
• Look to best practices of other governments. Taiwan was first to activate emergency measures in mid-January. They did 124 specific things, and it’s been working for them. Singapore & Vietnam activated measures next, in late-January; and Hong Kong shortly thereafter. Importantly, China also did many amazing things that could be replicated in the west.
• This is not the time to let politics get in the way, or to blame slowness on bureaucracy. Find a way to make it happen. If you need to, approach it from a monetary standpoint by comparing the cost of a two month quarantine, versus years of fighting and potentially many deaths. Find a way.

C. Civic-Minded Citizens

This section is a mashup of individual (citizen) and government roles in “what can be done”. I was worried that some regions, including where I live, were not responding quickly enough. So I made a model asking: when would hospital capacity get exceeded? The model’s answer was that we have about 3 weeks max.

So now I’m asking what can be done, either by helping our governments, or citizens working in a grassroots fashion:

• How can we scale up diagnosis? We need higher throughput of tests, with lower latency. The benefits: treatment of infected happens earlier, and to proactively identify at-risk people earlier.
• How can we scale up treatment? We need more beds, more ventilators, and whatever else is needed to treat the patients; and more training to administer the treatment.

I don’t have great answers yet. If anyone has ideas for either, please reach out! My DMs on Twitter are open.

Conclusion

I hope that readers will find this compilation of possible actions useful. The time to be serious is now. The time to act is now.

Acknowledgements

Thanks to Balázs Némethi, Eric Anderson, Jan Krizan, Jennifer Zhu Scott, Emad Mostique, and Bruce Pon for the extremely helpful feedback / reviewing this piece.

And thank you to everyone out there who is taking action! There is now great information, and I really appreciate it.

Edits / Notes

[1] Added “masks” action on Mar 31.