March 27, 2020

THE PRINCIPLED UNCERTAIN:

Are many more people infected than we think? (Tyler Cowen, March 27, 2020, Marginal Revolution)

 Icelandic data -- they are trying to sample a significant percentage of their population -- suggest an asymptomatic rate of about 50 percent.  To be clear, none of those results are conclusive and they all might be wrong.  (And we should work much harder on producing better data.)  But so far there is no particular reason to think those estimates are wrong, other than general uncertainty.  You would have to argue that the asymptomatic cases usually test as negative, and while that is possible again there is no particular reason to expect that.  It should not be your default view.

Marc Lipitsch put it bluntly:

The idea that covid is less severe than seasonal flu is inconsistent with data and with the fact that an epidemic just gathering steam can overwhelm ICU capacity in a rich country like Italy or China.

So I give this scenario of a very low fatality rate some chance of being true, but again you ought not to believe it. 



MORE:
A South Korean Covid-19 Czar Has Some Advice for Trump (Wired, 3/27/20)

AS AMERICA'S FIRST week of social distancing drew to a close, I called Dr. Min Pok-kee, who heads up the Covid-19 response in Daegu, the South Korean city hit hardest by the epidemic. Though Min usually works as a dermatologist, he has spent the past six weeks as a volunteer civil servant, commanding an aggressive public health strategy that is now seen as a national model for slowing transmission of the coronavirus. In fact, on Tuesday, President Trump called his South Korean counterpart, Moon Jae-in, to request medical equipment and support.

Min has been following the situation in the United States, where his daughter attends college. But he seemed surprised, and alarmed, by what I told him--especially about the shortage of diagnostic tests and hospital beds. We spoke in Korean; his account has been translated, edited, and condensed. [...]

The United States is very late to this. And the president and the officials working on it seem to think they aren't late. This has both national and global repercussions. It isn't enough for Korea alone to survive. In the US, Trump is talking about taking care of his own, but the entire world has to respond in sync.

The key to keeping mortality low is very quickly differentiating between mild and severe forms of the virus. Those who are young or have no underlying disease should be separated from those who are older or have an underlying disease, and this latter group must be tested and given a chest x-ray as a matter of course. There is one category of young people, in their 40s or younger, who are asymptomatic but lose their sense of smell or taste. They should be examined for the coronavirus.

Trump has spoken dismissively about testing because of his ego. As we scientists see it, he's motivated by pride. The doctors in the US all know that this sort of testing is appropriate.

How are existing facilities in the US going to handle all the infected patients? They can't. So then it's inevitable that you become like Italy. Korea also could have become like Italy, but we assessed the situation very quickly. What should the United States do? For now, social distancing must be instituted comprehensively, and field hospitals must be built.

The UK offers a cautionary tale. Its first response was to say that people would develop herd immunity, though it switched course a few days later. I'd already been concerned about the capacity of the British system, and this made me very worried. Herd immunity only works if you have a vaccine and 85 to 90 percent of the population is inoculated. Right now, in the face of an infectious disease with such a high mortality rate, for the UK to resist acknowledging the reality of the virus could translate into tens of thousands of deaths. It was unthinkable for a government to put out such nonsense. We in Korea were thinking, "Are these people in their right mind?"

Posted by at March 27, 2020 8:21 AM

  

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