Horror stories from Italy: The Nightmare on Coronavirus St is coming to America on Friday the 13th! A preview of horror that the United States will be facing within the next 1–2 weeks.
In this article I’ve collected 7 Horror stories from Italy (7 revelations!) Following those will be frighteningly good sources, horrifying facts, numbers that indicate horrifying forecasts, a wicked debate over the numbers, and finally the best arguments. After you absorb this information you may conclude that we should be telling people to worry more and self isolate now, not to be calm and go to meetups and gatherings with other people like its not real.
A news analysis of coronavirus topic by Micah Blumberg, Neurohacker, Journalist, and WebXR A-Frame Software Architect at Silicon Valley Global News http://svgn.io http://vrma.io
A couple days ago I posted this on social media:
“In my humble opinion the messaging that I should be transmitting to other people in all situations “right now” is to minimize all non-essential and non-necessary in-person human contact. No meetups. That is the most socially responsible message. Feel free to disagree. #coronavirus ”
Then I began think about the increasing flood of people insisting that the Coronavirus was no more dangerous than the flu.
Hardly anyone in my city (I live and work in San Francisco) seemed to be taking this seriously. I saw a flood of “don’t panic” and “be calm” messages online, and I realized that the most ethical thing to do was to get people to worry a lot more. I’m going to address why people, including famous people mistakenly think the coronavirus is less dangerous than the flu, and argue why we should still worry before the article is finished so scroll way down for those arguments.
First some introductory images to set the mood for this story.
Rational worry, rather than blind hysteria and panic, ideally translates into rational actions by those who receive that information, actions that may not otherwise be taken if irrational calm was promoted.
The point I’m making is that what one person calls hysteria may actually be rational worry, and that not being worried in a house fire for example is irrational and probably harmful.
Influenza is coming to a theater near you on Friday the 13th
Coming March 13th, 2020 if our numbers are right.
The streets are empty. Is it a dream or a nightmare?
So what is happening it Italy really? To begin our story I’m going to share six true horror stories from Italy separated by dots like this . . .
#1. The first horror story is the Quarantine of the entire nation of Italy, with riots reported in prisons there, people frustrated about the restriction on their movement. Italian officials seem to be terrified as well, they begged the infected to not come to their towns.
‘Don’t come down here’
Italy’s leaders panic.
“I speak to you as if you were my children, my brothers, my nephews and nieces: Stop and go back,” Michele Emiliano, Puglia’s president, said on Facebook Saturday.
“Get off at the first train station, do not catch planes for Bari and Brindisi, turn back in your cars, get off your buses at the next stop. Do not bring the epidemic that has hit Lombardy, Veneto and Emilia-Romagna to your Puglia,” he said, appealing to the region’s citizens stuck in the affected areas.
#2. The 2nd horror story is from Dr. Giacomo Grasselli on the front lines in Italy:
Dr. Giacomo Grasselli, a doctor at epicentre of the Italian COVID-19 outbreak, says “coronavirus like a bomb that exploded”
“This is like a Tsunami you know that its coming”
Coronavirus ‘worse than a bomb’ on Italy, says doctor coordinating response.
The Hospital system is incredibly stressed with nurses and doctors working 24/7. (Dr. Giacomo Grasselli is a senior Italian government health official who is coordinating the network of intensive care units in Lombardy — explains the “critical” situation in Italy, brought about by the Covid-19 outbreak (Subscribe: https://bit.ly/C4_News_Subscribe))
#3. “With no clear sign of when the epidemic will spike, anesthesiologists and doctors are being called on to make increasingly tough calls on who gets access to beds and respirators when there are not enough to go around.”
#4. The 3rd horror story is from Jason Van Schoor on Twitter
“Excerpt “6/ My friends call me in tears because they see people dying in front of them and they can only offer some oxygen. Ortho and pathologists are being given a leaflet and sent to see patients on NIV. PLEASE STOP, READ THIS AGAIN AND THINK.”
When I read Jason Van Schoor’s post on Twitter that was the tipping point when it really clicked for me that we need to be telling people to get worried and self isolate. In this scenario promoting rational fear and rational conduct will save lives.
From a well respected friend and intensivist/A&E consultant who is currently in northern Italy:
1/ ‘I feel the pressure to give you a quick personal update about what is happening in Italy, and also give some quick direct advice about what you should do.
2/ First, Lumbardy is the most developed region in Italy and it has a extraordinary good healthcare, I have worked in Italy, UK and Aus and don’t make the mistake to think that what is happening is happening in a 3rd world country.
3/ The current situation is difficult to imagine and numbers do not explain things at all. Our hospitals are overwhelmed by Covid-19, they are running 200% capacity
4/ We’ve stopped all routine, all ORs have been converted to ITUs and they are now diverting or not treating all other emergencies like trauma or strokes. There are hundreds of pts with severe resp failure and many of them do not have access to anything above a reservoir mask.
5/ Patients above 65 or younger with comorbidities are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest. Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed.
6/ My friends call me in tears because they see people dying in front of them and they con only offer some oxygen. Ortho and pathologists are being given a leaflet and sent to see patients on NIV. PLEASE STOP, READ THIS AGAIN AND THINK.
7/ We have seen the same pattern in different areas a week apart, and there is no reason that in a few weeks it won’t be the same everywhere, this is the pattern:
8/ 1)A few positive cases, first mild measures, people are told to avoid ED but still hang out in groups, everyone says not to panick
2)Some moderate resp failures and a few severe ones that need tube, but regular access to ED is significantly reduced so everything looks great
9/ 3)Tons of patients with moderate resp failure, that overtime deteriorate to saturate ICUs first, then NIVs, then CPAP hoods, then even O2.
4)Staff gets sick so it gets difficult to cover for shifts, mortality spikes also from all other causes that can’t be treated properly.
10/ Everything about how to treat them is online but the only things that will make a difference are: do not be afraid of massively strict measures to keep people safe,
11/ if governments won’t do this at least keep your family safe, your loved ones with history of cancer or diabetes or any transplant will not be tubed if they need it even if they are young. By safe I mean YOU do not attend them and YOU decide who does and YOU teach them how to.
12/ Another typical attitude is read and listen to people saying things like this and think “that’s bad dude” and then go out for dinner because you think you’ll be safe.
13/ We have seen it, you won’t be if you don’t take it seriously. I really hope it won’t be as bad as here but prepare.
#5. The 5th Horror story is shared by Silvia Stringhini also via twitter it is “The English translation of a post of another ICU physician in Bergamo, Dr. Daniele Macchini.”
“Cases are multiplying” “Suddenly the E.R. is collapsing.” “For others it’s too late…Every ventilator becomes like gold”
“The staff is exhausted. I saw the tiredness on faces that didn’t know what it was despite the already exhausting workloads they had.” “Nurses with tears in their eyes because we can’t save everyone,” “We no longer see our families for fear of infecting them.” “Some of us have already become infected despite the protocols.” “Some of our colleagues who are infected also have infected relatives and some of their relatives are already struggling between life and death.”
These are quotes that caught my attention inside a longer thread posted by Silvia Stringhini on twitter @silviast9 https://twitter.com/silviast9/status/1236933818654896129
“I may be repeating myself, but I want to fight this sense of security that I see outside of the epicenters, as if nothing was going to happen “here”. The media in Europe are reassuring, politicians are reassuring, while there’s little to be reassured of. #COVID19 #coronavirus”
“This is the English translation of a post of another ICU physician in Bergamo, Dr. Daniele Macchini. Read until the end “After much thought about whether and what to write about what is happening to us, I felt that silence was not responsible.”
“I will therefore try to convey to people far from our reality what we are living in Bergamo in these days of Covid-19 pandemic. I understand the need not to create panic, but when the message of the dangerousness of what is happening does not reach people I shudder.”
“I myself watched with some amazement the reorganization of the entire hospital in the past week, when our current enemy was still in the shadows: the wards slowly “emptied”, elective activities were interrupted, intensive care were freed up to create as many beds as possible.”
“All this rapid transformation brought an atmosphere of silence and surreal emptiness to the corridors of the hospital that we did not yet understand, waiting for a war that was yet to begin and that many (including me) were not so sure would ever come with such ferocity.”
“I still remember my night call a week ago when I was waiting for the results of a swab. When I think about it, my anxiety over one possible case seems almost ridiculous and unjustified, now that I’ve seen what’s happening. Well, the situation now is dramatic to say the least.”
“The war has literally exploded and battles are uninterrupted day and night. But now that need for beds has arrived in all its drama. One after the other the departments that had been emptied fill up at an impressive pace.”
“The boards with the names of the patients, of different colours depending on the operating unit, are now all red and instead of surgery you see the diagnosis, which is always the damned same: bilateral interstitial pneumonia.”
“Now, explain to me which flu virus causes such a rapid drama. [post continues comparing covid19 to flu, link below]. And while there are still people who boast of not being afraid by ignoring directions, protesting because their normal routine is”temporarily” put in crisis,”
“the epidemiological disaster is taking place. And there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us.”
“Cases are multiplying, we arrive at a rate of 15–20 admissions per day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the E.R. is collapsing.”
“Reasons for the access always the same: fever and breathing difficulties, fever and cough, respiratory failure. Radiology reports always the same: bilateral interstitial pneumonia, bilateral interstitial pneumonia, bilateral interstitial pneumonia. All to be hospitalized.”
“Someone already to be intubated and go to intensive care. For others it’s too late… Every ventilator becomes like gold: those in operating theatres that have now suspended their non-urgent activity become intensive care places that did not exist before.”
“The staff is exhausted. I saw the tiredness on faces that didn’t know what it was despite the already exhausting workloads they had. I saw a solidarity of all of us, who never failed to go to our internist colleagues to ask “what can I do for you now?””
“Doctors who move beds and transfer patients, who administer therapies instead of nurses. Nurses with tears in their eyes because we can’t save everyone, and the vital parameters of several patients at the same time reveal an already marked destiny.”
“There are no more shifts, no more hours. Social life is suspended for us. We no longer see our families for fear of infecting them. Some of us have already become infected despite the protocols.”
“Some of our colleagues who are infected also have infected relatives and some of their relatives are already struggling between life and death. So be patient, you can’t go to the theatre, museums or the gym. Try to have pity on the myriad of old people you could exterminate.”
“We just try to make ourselves useful. You should do the same: we influence the life and death of a few dozen people. You with yours, many more. Please share this message. We must spread the word to prevent what is happening here from happening all over Italy.””
“I finish by saying that I really don’t understand this war on panic. The only reason I see is mask shortages, but there’s no mask on sale anymore. We don’t have a lot of studies, but is it panic really worse than neglect and carelessness during an epidemic of this sort?”
#6. The 6th Horror story is from a surgeon working in Bergamo
“The war has literally exploded and the battles are uninterrupted day and night.”
Testimony of a surgeon working in Bergamo, in the heart of Italy’s coronavirus outbreak
“One after the other the unfortunate poor people come to the emergency room. They have far from the complications of a flu. Let’s stop saying it’s a bad flu. In these 2 years I have learned that the people of Bergamo do not come to the emergency room at all. They did well this time too. They followed all the indications given: a week or ten days at home with a fever without going out and risking contagion, but now they can’t take it anymore. They don’t breathe enough, they need oxygen.”
Full text: “Testimony of a surgeon working in Bergamo, in the heart of Italy’s coronavirus outbreak
“«In one of the non-stop e-mails that I receive from my hospital administration on a more than daily basis, there was a paragraph on “how to be responsible on social media”, with some recommendations that we all can agree on. After thinking for a long time if and what to write about what’s happening here, I felt that silence was not responsible. I will therefore try to convey to lay-people, those who are more distant from our reality, what we are experiencing in Bergamo during these Covid-19 pandemic days. I understand the need not to panic, but when the message of the danger of what is happening is not out, and I still see people ignoring the recommendations and people who gather together complaining that they cannot go to the gym or play soccer tournaments, I shiver. I also understand the economic damage and I am also worried about that. After this epidemic, it will be hard to start over.
“Still, beside the fact that we are also devastating our national health system from an economic point of view, I want to point out that the public health damage that is going to invest the country is more important and I find it nothing short of “chilling” that new quarantine areas requested by the Region has not yet been established for the municipalities of Alzano Lombardo and Nembro (I would like to clarify that this is purely personal opinion). I myself looked with some amazement at the reorganization of the entire hospital in the previous week, when our current enemy was still in the shadows: the wards slowly “emptied”, elective activities interrupted, intensive care unit freed to create as many beds as possible. Containers arriving in front of the emergency room to create diversified routes and avoid infections. All this rapid transformation brought in the hallways of the hospital an atmosphere of surreal silence and emptiness that we did not understand, waiting for a war that had yet to begin and that many (including me) were not so sure would never come with such ferocity (I open a parenthesis: all this was done in the shadows, and without publicity, while several newspapers had the courage to say that private health care was not doing anything).
“I still remember my night shift a week ago spent without any rest, waiting for a call from the microbiology department. I was waiting for the results of a swab taken from the first suspect case in our hospital, thinking about what consequences it would have for us and the hospital. If I think about it, my agitation for one possible case seems almost ridiculous and unjustified, now that I have seen what is happening. Well, the situation is now nothing short of dramatic. No other words come to mind. The war has literally exploded and battles are uninterrupted day and night. One after the other, these unfortunate people come to the emergency room. They have far from the complications of a flu. Let’s stop saying it’s a bad flu. In my two years working in Bergamo, I have learned that the people here do not come to the emergency room for no reason. They did well this time too. They followed all the recommendations given: a week or ten days at home with a fever without going out to prevent contagion, but now they can’t take it anymore. They don’t breathe enough, they need oxygen. Drug therapies for this virus are few.
“The course mainly depends on our organism. We can only support it when it can’t take it anymore. It is mainly hoped that our body will eradicate the virus on its own, let’s face it. Antiviral therapies are experimental on this virus and we learn its behavior day after day. Staying at home until the symptoms worsen does not change the prognosis of the disease. Now, however, that need for beds in all its drama has arrived. One after another, the departments that had been emptied are filling up at an impressive rate. The display boards with the names of the sicks, of different colors depending on the department they belong to, are now all red and instead of the surgical procedure, there is the diagnosis, which is always the same: bilateral interstitial pneumonia. Now, tell me which flu virus causes such a rapid tragedy.
“Because that’s the difference (now I get a little technical): in classical flu, besides that it infects much less population over several months, cases are complicated less frequently: only when the virus has destroyed the protective barriers of our airways and as such it allows bacteria (which normally resident in the upper airways) to invade the bronchi and lungs, causing a more serious disease. Covid 19 causes a banal flu in many young people, but in many elderly people (and not only) a real SARS because it invades the alveoli of the lungs directly, and it infects them making them unable to perform their function. The resulting respiratory failure is often serious and after a few days of hospitalization, the simple oxygen that can be administered in a ward may not be enough. Sorry, but to me, as a doctor, it’s not reassuring that the most serious are mainly elderly people with other pathologies. The elderly population is the most represented in our country and it is difficult to find someone who, above 65 years of age, does not take at least a pill for high blood pressure or diabetes.
“I can also assure you that when you see young people who end up intubated in the ICU, pronated or worse, in ECMO (a machine for the worst cases, which extracts the blood, re-oxygenates it and returns it to the body, waiting for the lungs to hopefully heal), all this confidence for your young age goes away. And while there are still people on social media who boast of not being afraid by ignoring the recommendations, protesting that their normal lifestyle habits have “temporarily” halted, the epidemiological disaster is taking place. And there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us.
“The cases multiply, up to a rate of 15–20 hospitalizations a day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the emergency room is collapsing. Emergency provisions are issued: help is needed in the emergency room. A quick meeting to learn how the to use to emergency room EHR and a few minutes later I’m already downstairs, next to the warriors on the war front. The screen of the PC with the chief complaint is always the same: fever and respiratory difficulty, fever and cough, respiratory insufficiency etc … Exams, radiology always with the same sentence: bilateral interstitial pneumonia. All needs to be hospitalized. Some already needs to be intubated, and goes to the ICU. For others, however, it is late. ICU is full, and when ICUs are full, more are created. Each ventilator is like gold: those in the operating rooms that have now suspended their non-urgent activity are used and the OR become a an ICU that did not exist before. I found it amazing, or at least I can speak for Humanitas Gavazzeni (where I work), how it was possible to put in place in such a short time a deployment and a reorganization of resources so finely designed to prepare for a disaster of this magnitude. And every reorganization of beds, wards, staff, work shifts and tasks is constantly reviewed day after day to try to give everything and even more. Those wards that previously looked like ghosts are now saturated, ready to try to give their best for the sick, but exhausted. The staff is exhausted. I saw fatigue on faces that didn’t know what it was despite the already grueling workloads they had. I have seen people still stop beyond the times they used to stop already, for overtime that was now habitual. I saw solidarity from all of us, who never failed to go to our internist colleagues to ask “what can I do for you now?” or “leave that admission to me, i will take care of it.” Doctors who move beds and transfer patients, who administer therapies instead of nurses. Nurses with tears in their eyes because we are unable to save everyone and the vital signs of several patients at the same time reveal an already marked destiny. There are no more shifts, schedules.
“Social life is suspended for us. I have been separated for a few months, and I assure you that I have always done my best to constantly see my son even on the day after a night shift, without sleeping and postponing sleep until when I am without him, but for almost 2 weeks I have voluntarily not seen neither my son nor my family members for fear of infecting them and in turn infecting an elderly grandmother or relatives with other health problems. I’m happy with some photos of my son that I look at between tears and a few video calls. So you should be patient too, you can’t go to the theater, museums or gym. Try to have mercy on that myriad of older people you could exterminate. It is not your fault, I know, but of those who put it in your head that you are exaggerating and even this testimony may seem just an exaggeration for those who are far from the epidemic, but please, listen to us, try to leave the house only to indispensable things. Do not go en masse to make stocks in supermarkets: it is the worst thing because you concentrate and the risk of contacts with infected people who do not know they are infected. You can go there without a rush. Maybe if you have a normal mask (even those that are used to do certain manual work), put it on. Don’t look for ffp2 or ffp3. Those should serve us and we are beginning to struggle to find them. By now we have had to optimize their use only in certain circumstances, as the WHO recently recommended in view of their almost ubiquitous running low. Oh yes, thanks to the shortage of certain protection devices, many colleagues and I are certainly exposed despite all the other means of protection we have. Some of us have already become infected despite the protocols. Some infected colleagues also have infected relatives and some of their family members are already struggling between life and death. We are where your fears could make you stay away. Try to make sure you stay away.
“Tell your family members who are elderly or with other illnesses to stay indoors. Bring him the groceries please. We have no alternative. It’s our job. Indeed what I do these days is not really the job I’m used to, but I do it anyway and I will like it as long as it responds to the same principles: try to make some sick people feel better and heal, or even just alleviate the suffering and the pain to those who unfortunately cannot heal. I don’t spend a lot of words about the people who define us heroes these days and who until yesterday were ready to insult and report us. Both will return to insult and report as soon as everything is over. People forget everything quickly. And we’re not even heroes these days. It’s our job. We risked something bad every day before: when we put our hands in a belly full of someone’s blood we don’t even know if they have HIV or hepatitis C; when we do it even though we know they have HIV or hepatitis C; when we stick ourselves during an operation on a patient with HIV and take the drugs that make us vomit all day long for a month. When we read with anguish the results of the blood tests after an accidental needlestick, hoping not to be infected. We simply earn our living with something that gives us emotions. It doesn’t matter if they are beautiful or ugly, we just take them home. In the end we only try to make ourselves useful for everyone. Now try to do it too, though: with our actions we influence the life and death of a few dozen people. You with yours, many more. Please share and share the message. We need to spread the word to prevent what is happening here from happening all over Italy.»”
#7 The Seventh Horror story from Italy: Luca Franzese reports on youtube:
“8 MARCH 2020 — NAPLES — FOUR HOURS AGO, LUCA FRANZESE, VOLUNTARILY STARTED IN QUARANTINE BECAUSE HIS SISTER DIED IN THE HOUSE PROBABLY DUE TO THE CORONAVIRUS — LUCA IS NOW CLOSED AT HOME WITH HIS SISTER YESTERDAY DEAD —
“The man in the video says that his sister felt bad yesterday afternoon and that she suffered from epilepsy. In the apartment, in addition to Luca and his deceased sister, the elderly parents also live, another sister with her husband and two children. «We have been waiting for 24 hours for the outcome of the Coronavirus swab, no one has let us know anything and we are completely abandoned to ourselves. My sister, she felt bad yesterday afternoon and she never regained consciousness I started practicing a cardiac massage and we called the 118. After the arrival of the 118 team, no resuscitation maneuvers helped my sister, and then at our insistence they carried out the swab.
“Since yesterday we have self-insulated ourselves in the house, we would just like to know what to do and who is taking care of us »Luca is outraged because he asked that the swab be made also to him and his family with whom he shares the apartment, but the doctors have refused to do so, telling them that it would only be done if the deceased sister tested positive for coronavirus. Meanwhile Luca and the rest of the family have been quarantined without anyone being asked to do so. 🔴🔴🔴Meanwhile, a local journalist showed up at the Franzese home to interview the family and the state of unease that they were experiencing abandoned by the doctors and all the institutions. 🔴🔴🔴According to the latest published updates, Teresa Franzese tested positive for the coronavirus, as well as the whole family and the journalist who went to interview them at home. ErTeresa is still forced into her bed until an equipped ambulance comes to collect her infected corpse; without receiving the last farewell from friends and relatives, nor the blessing of a priest and a worthy burial as a Christian (for now) … 🔴🔴🔴NB: LUCA ASKS A FAVOR FOR ENTIRE ITALY, OR SHARING HIS VIDEO WHY BECOME A VIRAL SOURCE OF SCANDAL FOR FULL ITALY! HEALTH AND GOVERNMENT ARE NOT WORKING ENOUGH WITH PEOPLE! 🔴🔴🔴PS: WE DO NOT ALLOW GOVERNMENT AND DOCTORS TO TREAT US AS SHIT! TOMORROW IN PLACE OF LUCA YOU COULD BE ME OR YOU READING — PLEASE,” the source video is in Italian https://www.youtube.com/watch?v=9x8S1QZ8Hkc
So now that the Horror Stories from Italy have been told lets dive into the numbers. As of Tuesday today we have over 10,000 cases of Coronavirus in Italy. 631 Deaths, an exponential infection case rate, and an exponential death rate at 5%.
Italy Coronavirus update with statistics and graphs: total and new cases, deaths per day, mortality and recovery rates…
What does an exponential infection rate look like and what’s the worst case scenario?
Published on March 8th, In a video titled “Exponential growth and epidemics” A math expert, 3Blue1Brown, illustrates how a billion people could have the Coronavirus in 81 days past March 6th 2020, or how if we isolate ourselves from one another, and our governments make serious mitigation recommendations (ie close schools, events etc) the virus might fizzle out much sooner than that.
If you want to see another cool video that compares the Coronavirus to other virus’s watch this.
Think about that first video for a second; imagine the worst case scenario:
1 billion people may be infected by May 26th,
If the 5% death rate in Italy somehow carried over to the United States that could mean
50 million of those 1 billion infected people could die in the month of June.
Do you know how 50 million people die from this?
In the worst case scenario 50 plus million people die if the Government and Individuals fail to react correctly to this, when we the individuals for example fail to self-isolate and we all end up at the hospital at the same time, overwhelming the medical system, and we can’t get the necessary treatment.
If we tell everyone don’t panic, don’t worry, be calm, and then no one does anything different we die. I’m still getting invites to meetups from people I know, why? It’s because we are telling people the wrong thing. We need to tell people to get worried understand!? You need to share the fear and worry over what’s happening in Italy and how its coming to your country soon with your friends and family to reduce the risk to everyone’s life capisce?!
Those numbers that I cited are not even a big deal, that would only put the Coronavirus on par with the flu of 1918 at that point, 50 million people died in 1918 from Spanish Flu, so it’s happened before in the past, it could happen again in June, but that’s just the beginning.
But are these numbers actually correct?
Here are some graphics to consider. First is that the Hospitals are attempting to prepare for 96 million cases, with a doubling time of 7–10 days.
This is American Hospital Association “Best Guess Epidemiology” for #codiv19 over next 2 months:
1,900,000 ICU admissions
vs flu in 2019:
49,000 ICU admissions
Via @sethbannon / twitter
If the doubling time is real, then charts will predict exponential increases in case numbers until we either self isolate, or we have state enforced quarantines which is what happened in Italy.
The more we slow down the virus, by going into self isolation, the less overwhelmed the hospitals get, and the more lives are saved. Thats what the next two charts illustrated.
Here is another reference to someone crunching the numbers.
“I’ve removed the outlier countries for clarity. The doubling time is fairly consistently 2–3 days. It seems to increase slightly over time.”
“I’m fairly confident that, left unchecked, COVID-19 will increase at a doubling time of 2–3 days. When containment in breached in a location this is the rate that the growth occurs at over the first few week or so.”
Next let’s talk math with Liz Specht:
“We’re looking at about 1M US cases by the end of April, 2M by ~May 5, 4M by ~May 11, and so on. Exponentials are hard to grasp, but this is how they go. 4/n” https://twitter.com/LizSpecht/status/1236095183332114432?s=20
“I think most people aren’t aware of the risk of systemic healthcare failure due to #COVID19 because they simply haven’t run the numbers yet. Let’s talk math. 1/n
“Let’s conservatively assume that there are 2,000 current cases in the US today, March 6th. This is about 8x the number of confirmed (lab-diagnosed) cases. We know there is substantial under-Dx due to lack of test kits; I’ll address implications later of under-/over-estimate. 2/n
“We can expect that we’ll continue to see a doubling of cases every 6 days (this is a typical doubling time across several epidemiological studies). Here I mean *actual* cases. Confirmed cases may appear to rise faster in the short term due to new test kit rollouts. 3/n
“We’re looking at about 1M US cases by the end of April, 2M by ~May 5, 4M by ~May 11, and so on. Exponentials are hard to grasp, but this is how they go. 4/n
“As the healthcare system begins to saturate under this case load, it will become increasingly hard to detect, track, and contain new transmission chains. In absence of extreme interventions, this likely won’t slow significantly until hitting >>1% of susceptible population. 5/n
“What does a case load of this size mean for healthcare system? We’ll examine just two factors — hospital beds and masks — among many, many other things that will be impacted. 6/n
“The US has about 2.8 hospital beds per 1000 people. With a population of 330M, this is ~1M beds. At any given time, 65% of those beds are already occupied. That leaves about 330k beds available nationwide (perhaps a bit fewer this time of year with regular flu season, etc). 7/n
“Let’s trust Italy’s numbers and assume that about 10% of cases are serious enough to require hospitalization. (Keep in mind that for many patients, hospitalization lasts for *weeks* — in other words, turnover will be *very* slow as beds fill with COVID19 patients). 8/n
“By this estimate, by about May 8th, all open hospital beds in the US will be filled. (This says nothing, of course, about whether these beds are suitable for isolation of patients with a highly infectious virus.) 9/n
“If we’re wrong by a factor of two regarding the fraction of severe cases, that only changes the timeline of bed saturation by 6 days in either direction. If 20% of cases require hospitalization, we run out of beds by ~May 2nd. 10/n
“If only 5% of cases require it, we can make it until ~May 14th. 2.5% gets us to May 20th. This, of course, assumes that there is no uptick in demand for beds from *other* (non-COVID19) causes, which seems like a dubious assumption. 11/n
“As healthcare system becomes increasingly burdened, Rx shortages, etc, people w/ chronic conditions that are normally well-managed may find themselves slipping into severe states of medical distress requiring intensive care & hospitalization. But let’s ignore that for now. 12/n
“Alright, so that’s beds. Now masks. Feds say we have a national stockpile of 12M N95 masks and 30M surgical masks (which are not ideal, but better than nothing). 13/n
“There are about 18M healthcare workers in the US. Let’s assume only 6M HCW are working on any given day. (This is likely an underestimate as most people work most days of the week, but again, I’m playing conservative at every turn.) 14/n
“As COVID19 cases saturate virtually every state and county, which seems likely to happen any day now, it will soon be irresponsible for all HCWs to not wear a mask. These HCWs would burn through N95 stockpile in 2 days if each HCW only got ONE mask per day. 15/n
“One per day would be neither sanitary nor pragmatic, though this is indeed what we saw in Wuhan, with HCWs collapsing on their shift from dehydration because they were trying to avoid changing their PPE suits as they cannot be reused. 16/n
“How quickly could we ramp up production of new masks? Not very fast at all. The vast majority are manufactured overseas, almost all in China. Even when manufactured here in US, the raw materials are predominantly from overseas… again, predominantly from China. 17/n
“Keep in mind that all countries globally will be going through the exact same crises and shortages simultaneously. We can’t force trade in our favor. 18/n
“Now consider how these 2 factors — bed and mask shortages — compound each other’s severity. Full hospitals + few masks + HCWs running around between beds without proper PPE = very bad mix. 19/n
“HCWs are already getting infected even w/ access to full PPE. In the face of PPE limitations this severe, it’s only a matter of time. HCWs will start dropping from the workforce for weeks at a time, leading to a shortage of HCWs that then further compounds both issues above. 20/n
“We could go on and on about thousands of factors — # of ventilators, or even simple things like saline drip bags. You see where this is going. 21/n
“Importantly, I cannot stress this enough: even if I’m wrong — even VERY wrong — about core assumptions like % of severe cases or current case #, it only changes the timeline by days or weeks. This is how exponential growth in an immunologically naïve population works. 22/n
“Undeserved panic does no one any good. But neither does ill-informed complacency. It’s wrong to assuage the public by saying “only 2% will die.” People aren’t adequately grasping the national and global systemic burden wrought by this swift-moving of a disease. 23/n
“I’m an engineer. This is what my mind does all day: I run back-of-the-envelope calculations to try to estimate order-of-magnitude impacts. I’ve been on high alarm about this disease since ~Jan 19 after reading clinical indicators in the first papers emerging from Wuhan. 24/n
“Nothing in the last 6 weeks has dampened my alarm in the slightest. To the contrary, we’re seeing abject refusal of many countries to adequately respond or prepare. Of course some of these estimates will be wrong, even substantially wrong. 25/n
“But I have no reason to think they’ll be orders-of-magnitude wrong. Even if your personal risk of death is very, very low, don’t mock decisions like canceling events or closing workplaces as undue “panic”. 26/n
“These measures are the bare minimum we should be doing to try to shift the peak — to slow the rise in cases so that healthcare systems are less overwhelmed. Each day that we can delay an extra case is a big win for the HC system. 27/n
“And yes, you really should prepare to buckle down for a bit. All services and supply chains will be impacted. Why risk the stress of being ill-prepared? 28/n
“Worst case, I’m massively wrong and you now have a huge bag of rice and black beans to burn through over the next few months and enough Robitussin to trip out. 29/n
“One more thought: you’ve probably seen multiple respected epidemiologists have estimated that 20–70% of world will be infected within the next year. If you use 6-day doubling rate I mentioned above, we land at ~2–6 billion infected by sometime in July of this year. 30/n
“Obviously I think the doubling time will start to slow once a sizeable fraction of the population has been infected, simply because of herd immunity and a smaller susceptible population. 31/n
“But take the scenarios above (full beds, no PPE, etc, at just 1% of the US population infected) and stretch them out over just a couple extra months. 32/n
“That timeline roughly fits with consensus end-game numbers from these highly esteemed epidemiologists. Again, we’re talking about discrepancies of mere days or weeks one direction or another, but not disagreements in the overall magnitude of the challenge. 33/n
“This is not some hypothetical, fear-mongering, worst-case scenario. This is reality, as far as anyone can tell with the current available data. 34/n
“That’s all for now. Standard disclaimers apply: I’m a PhD biologist but *not* an epidemiologist. Thoughts my own. Yadda yadda. Stay safe out there. /end
“Addendum: to anyone who found this useful or interesting, highly recommend you follow @trvrb who actually does modeling and forecasting for a living.”
Not everyone believes Liz Spect, Dr. David Robert Grimes wrote a pretty good rant on twitter that you can read here:
Thread by @drg1985: This thread on #COVID19 by an engineer is doing serious numbers. It's…
Thread by @drg1985: This thread on #COVID19 by an engineer is doing serious numbers. It's projecting millions of…
It’s a pretty good read but I think you can summarize it in the following two images. Liz is not proposing constant exponential growth, nor am I.
“Trump’s former pandemic adviser: ‘We are 10 days from our hospitals getting creamed’” (I would be that he believes in exponential infections. Lets see 10 days, Friday the 13th? okay maybe his calculation is better well see.)
Trump’s former pandemic adviser: ‘We are 10 days from our hospitals getting creamed’
Confirmed cases of the novel coronavirus are swiftly ballooning across the United States, and President Trump’s former…
So who else doesn’t believe us and why not?
The two issues I tend to see from folks I speak to are that exponential growth doesn’t go on forever, and that the fatality rate is over stated.
March 7th on Twitter
Elon Musk wrote:
“The coronavirus panic is dumb”
“Virality of C19 is overstated due to conflating diagnosis date with contraction date & over-extrapolating exponential growth, which is never what happens in reality. Keep extrapolating & virus will exceed mass of known universe!”
“Fatality rate also greatly overstated. Because there are so few test kits, those who die with respiratory symptoms are tested for C19, but those with minor symptoms are usually not. Prevalence of coronaviruses & other colds in general population is very high!”
On this point: “over-extrapolating exponential growth, which is never what happens in reality.” I don’t think we are proposing exponential growth that is greater than the Spanish Flu. Not seeing any serious researcher propose that right now. That’s sort of a main point that Dr. David Robert Grimes tried to use to take down Liz Specht with but she didn’t propose that.
This point seems to stem from the thread I keep hearing from folks that the coronavirus is not more dangerous than the regular seasonal flu. A thread that I think is motivated reasoning, a desire to downplay numbers to reduce feelings of worry, panic, and or fear that might cause correct action such as isolation (hiding). You want to hide from this virus, its a monster.
Another researcher writes: “Current best estimates expect that covid-19 will kill 10 times more people this year than the flu (and modeling by Elena Grewal, former director of data science at Airbnb, shows it could be 100 times more, in the worst case).”
Covid-19, your community, and you - a data science perspective
We are data scientists-that is, our job is to understand how to analyze and interpret data. When we analyze the data…
Covid-19 - What is the Real Risk vs. Flu
Summary Executive Summary: (See tabs for calculations and sources) - The US Population is ~328M and each year about…
The fatality rate debate:
Elon Musk wrote: “Fatality rate also greatly overstated. Because there are so few test kits, those who die with respiratory symptoms are tested for C19, but those with minor symptoms are usually not. Prevalence of coronaviruses & other colds in general population is very high!”
How am I sure, based on what evidence, that the Coronavirus lethality is not less lethal than the flu? Is the lethality 5% like in Italy right now. 3.4% like the WHO reported recently?
To start with I’ve seen similar arguments in the Matrix of knowledge group, my friend Shashkes shared one in the Viral Exploration group, Dr. David Robert Grimes sort of made a similar argument, and the argument sort of appeared in a Worth.com article.
How Mass Hysteria Is Making Coronavirus Worse Than It Actually Is - Worth
The fear pandemic about the coronavirus is driving market sell-offs, stockpiling of provisions and other…
My take is that the article (and these folks) are saying that we can’t compare the lethality of the coronavirus and flu numbers because it’s like comparing apples and oranges.
Bruce wrote: “The death rate is wildly overstated. this is because there are many many cases that are not tested nor reported unless they are serious. The only number that make sense is that rates are somewhere well below 3.4%, but exactly what that number is will not be known any time soon.”
Bj wrote: “Thousands if not millions have already had it” seems to me like a good argument, and it seems to be supported by the relative mortality rate between wuhan and neighboring provinces, and the relative mortality rate between January and February in China. In those relative cases, the major difference seems to me to be the denominator. Identified cases.”
Shaskes wrote: “”We found that at least 59% of infected cases were unascertained in Wuhan, potentially including asymptomatic and mild-symptomatic cases. CONCLUSIONS Considerable countermeasures have effectively controlled the Covid-19 outbreak in Wuhan. Special efforts are needed to protect vulnerable populations, including healthcare workers, elderly and children. Estimation of unascertained cases has important implications on continuing surveillance and interventions. This seems like pretty good news that validates my previous analysis that mortality rate and hospitalization rate are actually much lower because nearly 60% of infections were undetected (more sick people then the official cases detected means overall less % of people die). Mention of children is confusing because until now seemed children seemed to not be getting sick.”
Evolving Epidemiology and Impact of Non-pharmaceutical Interventions on the Outbreak of Coronavirus…
BACKGROUND We described the epidemiological features of the coronavirus disease 2019 (Covid-19) outbreak, and evaluated…
Ian wrote “The primary claim here, that from an emotional management perspective it doesn’t make sense to compare the flu death rate (dead/presumptive positive) to the COVID19 death rate (deaths/tested positive) is valid.(…)”
An emotional management perspective!? Is that another issue dividing people I thought? Is motivated reasoning at play, are people trying to play down the numbers for an emotional management agenda. Is that a hidden reason for why this debate exists?
The key they all seem to argue in one way or another is that if we calculated the Flu numbers the same, which include numbers of people who are estimated to have the flu but didn’t attend the hospital, then the real fatality rate comes down and isn’t as high. That idea only works if the the coronavirus really spreading much further than is being tested without causing folks to come to the hospital.
“The WHO Estimated COVID-19 Mortality at 3.4%. That Doesn’t Tell the Whole Story” As Time Magazine reports the 3.4% isn’t the whole story. The flu’s death rate is adjusted by the total number of cases estimated that didn’t come to a hospital.
The WHO Estimated COVID-19 Mortality at 3.4%. That Doesn't Tell the Whole Story
The World Health Organization said coronavirus COVID-19 has a mortality rate of 3.4%, but the actual number may be much…
Times magazine and all these folks seem to be backed by this credible looking research paper that says “Its overall impact, however, is uncertain and highly dependent on the number of asymptomatic cases.”
Epidemiology and Transmission of COVID-19 in Shenzhen China: Analysis of 391 cases and 1,286 of…
Abstract Background Rapid spread of SARS-CoV-2 in Wuhan prompted heightened surveillance in Shenzhen and elsewhere in…
So how many people didn’t go to the hospital but were sick? China decided to find out.
From the NYTimes: “Do we know what this virus’s lethality is? We hear some estimates that it’s close to the 1918 Spanish flu, which killed 2.5 percent of its victims, and others that it’s a little worse than the seasonal flu, which kills only 0.1 percent. How many cases are missed affects that.
“There’s this big panic in the West over asymptomatic cases. Many people are asymptomatic when tested, but develop symptoms within a day or two.
“In Guangdong, they went back and retested 320,000 samples originally taken for influenza surveillance and other screening. Less than 0.5 percent came up positive, which is about the same number as the 1,500 known Covid cases in the province. (Covid-19 is the medical name of the illness caused by the coronavirus.)
“There is no evidence that we’re seeing only the tip of a grand iceberg, with nine-tenths of it made up of hidden zombies shedding virus. What we’re seeing is a pyramid: most of it is aboveground.
“Once we can test antibodies in a bunch of people, maybe I’ll be saying, “Guess what? Those data didn’t tell us the story.” But the data we have now don’t support it.
“That’s good, if there’s little asymptomatic transmission. But it’s bad in that it implies that the death rates we’ve seen — from 0.7 percent in parts of China to 5.8 percent in Wuhan — are correct, right?
“I’ve heard it said that “the mortality rate is not so bad because there are actually way more mild cases.” Sorry — the same number of people that were dying, still die. The real case fatality rate is probably what it is outside Hubei Province, somewhere between 1 and 2 percent.”
Is the debate about the fatality rate over? No its not. Here is another article that muddies the water again:
“China’s Decision to Leave Asymptomatic Patients off Coronavirus Infection Tally Sparks Debate”
China's Decision to Leave Asymptomatic Patients off Coronavirus Infection Tally Sparks Debate
China's decision to exclude individuals who carry the new coronavirus but show no symptoms from the country's public…
We don’t know the real death rate, and even if we did that number may not be that useful, just as the R0 is not that useful as a number. These numbers can be indicators to help us predict the size of the monster.
We need other indicators: This report from Bloomberg News confirms that the consequences of getting infected are much more serious than seasonal flu
Yes that’s horrible and different what else?
“Coronavirus can travel twice as far as official ‘safe distance’ and stay in air for 30 minutes, Chinese study finds
“Authorities advise people to stay 1–2 metres apart, but researchers found that a bus passenger infected fellow travellers sitting 4.5 metres away
“The scientists behind the research said their investigation also highlighted the importance of wearing face masks because of the length of time it can linger
““The coronavirus that causes Covid-19 can linger in the air for at least 30 minutes and travel up to 4.5 metres — further than the “safe distance” advised by health authorities around the world, according to a study by a team of Chinese government epidemiologists.
“The researchers also found that it can last for days on a surface where respiratory droplets land, raising the risk of transmission if unsuspecting people touch it and then rub their face.
“The length of time it lasts on the surface depends on factors such as temperature and the type of surface, for example at around 37C (98F), it can survive for two to three days on glass, fabric, metal, plastic or paper.”
Coronavirus can travel twice as far as official 'safe distance', study says
Health authorities advise people to stay 1-2 metres apart, but researchers found that a bus passenger infected fellow…
And the best argument: Why is the Coronavirus not like the flu:
“Since from various parts, some also with important scientific roles, it continues to be argued that Covid-19 is completely comparable to a flu syndrome, as a National Association of Biotechnologists, we feel it necessary to underline again that this is NOT the case.
“For example, if we analyze the latest complete data available for the flu (2018–2019) we can observe 812 serious cases , which required hospitalization in intensive care, and 205 deaths (for technicians the data are reported to J10–11). However, this report covers all 33 weeks affected by the disease, with a peak of cases in the 5th week of the year, in which there were 93 hospitalizations in intensive care and 23 deaths.
“What we are recording for coronavirus instead tells a completely different story. In fact, 351 cases requiring intensive care and 131 deaths have occurred in this week alone . It is worth pointing out: in just 7 days . That’s because there is a doubling of severe cases, which require intensive care, every 2.5 days, a sign that the disease is spreading very quickly.”
Ecco perché il Coronavirus non è una semplice Influenza
Poiché da diverse parti, alcune anche con ruoli scientifici di rilievo, si continua a sostenere che la Covid-19 sia del…
What’s next after the virus kills 50 million people by June 2020 is next phase of the global economic horror story, supply chain disruptions, world war 3, and basically the apocalypse.
Reference: “Trump Coronavirus Incompetence ‘Like Its Own Natural Disaster’: Warren | Rachel Maddow | MSNBC”
The situation gets worse: You are not going to want to be in the United States at the end of next week when all this exponential shit hits the fan I think: “An annual intelligence report that has been postponed without explanation by President Donald Trump’s administration warns that the U.S. remains unprepared for a global pandemic,”(…)“The United States will remain vulnerable to the next flu pandemic or large-scale outbreak of a contagious disease that could lead to massive rates of death and disability, severely affect the world economy, strain international resources, and increase calls on the United States for support.”
The Trump Administration Is Stalling an Intel Report That Warns the U.S. Isn't Ready for a Global…
An intelligence report postponed by President Trump's administration warns the U.S. is unprepared for a global…
I’ve been monitoring the Coronavirus (SARS-CoV-2, which causes the condition COVID-19) situation…
Written by Nell Watson and reprinted here with permission.
Are we really without any hope? Nope there is hope. There is hope if we do the right thing, if we spread fear and worry, if you share my article, and if the government acts more quickly to set up more quarantines, more hospital beds, and gets testing up to scale quickly to match testing in South Korea for example.
Heroes like Bill Gates and Mark Zuckerberg are pitching in to help solve the problem with their money. Zuckerberg is like Batman now with all his cool technology if you think about it, and he’s doing the right thing most importantly. He may not be the hero Gotham wanted, but maybe he is the hero Gotham needed (humor).
Mark Zuckerberg's philanthropy groups will fund a quadruple increase in Bay Area coronavirus…
Facebook CEO Mark Zuckerberg is funding a significant increase in coronavirus testing in the San Francisco Bay Area…
Bill and Melinda Gates Pledge $100 Million to Coronavirus Response
The coronavirus outbreak has been declared a global public health emergency by the World Health Organization. The…
Thank you Mark Zuckerberg, and thank you Bill Gates for helping all of us!
Did you see this one? We need to be doing what Hong Kong did
“A Tale of Two Outbreaks: Hong Kong & Italy”
A Tale of Two Outbreaks: Hong Kong & Italy
Up until two weeks ago Italy had but 3 known COVID-19 cases. Today theECDC reported they had in excess of 2,500 cases…
Hong Kong’s coronavirus response leads to sharp drop in flu cases
Winter influenza season ends more than a month earlier than usual
Hong Kong's coronavirus response leads to sharp drop in flu cases
Hong Kong's extreme measures to combat the spread of the coronavirus, including school closures and working from home…
Yobie Benjamin may have the solution to the testing problem in the United States and beyond, check it out.
Now if you are faithful believer in the messiah Donald Trump you might be surprised to find out that there is a coronavirus infection explosion that is predicted to happen soon in the United States. Medical professionals will probably describe it as being in a war zone.
It’s going to happen because of a phenomenon called undetected “community spread” something that happens when your country fails to do the right amount of coronavirus testing surveillance on people coming into the country. Something I wrote about there in this article:
Here’s another example of CPAC in the United States getting infected with the Coronavirus:
“5 members of Congress who recently spent time with the president, including Doug Collins and Matt Gaetz, are in self-quarantine after coming in contact with an infected CPAC attendee.”
If you want to increase the chances of living (with your friends also) share it with as many people as you can to get your friends worried enough to self-isolate, and feel free to follow and or subscribe to all my social media channels.
Some of my sources (but not all) including science links for this article came from twitter and from the hidden Viral Exploration group on Facebook created by Andre Watson. If you are working on the coronavirus you should be talking to Andre Watson https://twitter.com/nanogenomic
Andre Watson is part of the Global taskforce fighting spread of coronavirus, COVID-19. A task force that I support whole heartedly.
Global taskforce fighting spread of coronavirus, COVID-19
Ritu Jha- It was mid-January when Dr. Prasun Mishra, founder of the American Association for Precision Medicine (AAPM)…
The COVID-19 Risk App may need your technical skills with this Covid Risk app. I’ve heard that we might need someone from Apple to contact the team leaders working on this app. There webpage is below.
Collaborate - COVID-19 Risk App
We've grown from a pair of researchers from Stanford and the University of Waterloo into a small, interdisciplinary…
About the author of this page: Micah Blumberg
I’m a neurohacker. I study this topic, neural lace, I have a group focused on it with 2,400 members. Its called Self Aware Networks: Computation Biology: Neural Lace and the idea is that your computational biology is rendering a volumetric video stream, a simulation, when your awake, and that we can tap into that with medical imaging technologies for two way data transmission, downloading what your eyes see, what your ears hear, and bringing AR VR like experiences without glasses via direct brain stimulation. I also have a podcast called the Neural Lace Podcast and I hosted Neurotech SF meetups for two years where I led a team that brought eeg into Webxr. My latest project is a webxr magazine for a news channel I started called Silicon Valley Global News intended to be on the front lines of science and technology. I’ve been self studying biology and computer science related topics for 14 years or so I estimate. Example of my software
Tech demo video reel #2 how it works on Oculus Go
Tech demo video reel #3 how it works on Oculus Quest
Tech demo video reel #4 how it works on an Android Phone in AR mode.
Here are 12 groups that I support as an admin.
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