I am posting this so my loved ones can make a self-quarantine plan. The end has concrete suggestions and a shopping list. Please share with those you love
It's time to talk about COVID-19. I've been in several groups following the progression of the virus with an eye toward evidence-based, non-sensationalist news concerning the virus's properties and trajectory.
We are definitely facing a major public health threat. You can panic, or you can prepare. It is time to prepare.
Here are things I find relevant. I am not providing citations out of space/time constraints but let me know if you want sources for anything. If anyone has reliable contradictory information, I'm happy to edit - I certainly don't claim expert knowledge and the situation is very fluid.
Mental health PSA: The best thing you can do for panic is make a plan + put it in place + pick a point at which you will execute it. Then live your life.
Shopping list and self-quarantine instructions below.
- WASH YOUR HANDS AND DON'T TOUCH YOUR FACE -- outside of self-quarantine, that's the best best thing you can do.
- People think linearly. The virus acts exponentially. Adjust your thinking.Recession and supply chain disruption is another major issue.
- The possibility of ICUs being saturated could increase the impact.
- Those over 70 are most at risk and must have a self-quarantine plan as well as access to oxygen.
- It's infectious and deadly enough (2%+) to worry about, but the world will not end.
- The coronavirus will come to the US / is almost certainly already here, likely at the same scale it did in China. It has the potential to infect up to 2/3. of the global population.
Some properties of the virus:
For every one person infected, it infects between 2.7-3.3 people, which makes it quite contagious. This number is hard to estimate and people have been known to infect up to 40 people each.
What makes it super hard to contain is that the virus can spread in people without symptoms, and people are asymptomatic for up to 14 days. This means someone can spread it to a lot of people before they even know they have it, and containment measures like temperature checks are only about halfway effective.
Death rate is between 2% and 8%. Data from China has been hard to interpret, and we won't know until we have better ability to test for the virus. Death rate is over 8% for people over 70 and 14% for people over 80, so the older generation is the one with most cause for concern. 20% of people infected (and 75% of people over 70) are given oxygen. If the ICUs are overwhelmed by this, beds may not be available and the mortality rate could rise.
Kids are pretty resilient, adults as well, though it may cause some damage to lungs.
So it's not terrible. It's not the black plague. But a 2% death of 2/3 the global population isn't good either.
The virus is almost certainly already spreading in the U.S. fairly widely. Significant numbers of cases in Japan, Singapore, and South Korea already, and no real barriers to entry from those countries to the U.S., with multiple flights per day.
We don't really know how many cases there are in the US because the CDC has only tested 426 people. There are stories of people coming into hospitals with pneumonia and not being tested, etc.
Epidemiologists have speculated (very hard to know these things) that it could hit 40-70% of the global population.
Another thing to consider: the number of reported cases in the US is not the relevant number. You can assume those cases are controlled and unlikely to light the fire. It's the cases that likely have been spreading undetected.
Data from China cannot be trusted. We know that they have changed their diagnostic criteria twice, they have limited testing capacity, and they aren't counting people who haven't been explicitly tested (i.e. if someone dies in their home of pneumonia, they are not tested.)
Ridiculously, the data has an R\u00c2\u00b2 of .99 for a several week period!
Once a bunch more cases are reported, greater runs on stores are likely. So I suggest you prepare as noted below sooner, so you can be comfortable you have a plan. (That being said, in China food delivery is still happening.)
- 10 actual cases in the US on Jan 23 when they shut down flights from Wuhan = 160 now
- 5k by April 1
- 82k by May 1
- 1.3M by Jun 1
If you scale the known cases in countries that are testing to adjust for the US population, we could have as many as 800 now.
I expect the CDC testing capacity to increase this week, and reports come out about how many people are actually infected in the US. Media attention may bring panic, but the actual impact on your life will happen very slowly at first. This isn't likely to affect you personally for a few months.
I plan to self-quarantine when there are between 1-5k confirmed cases in the US (a lower threshold if a high proportion of cases are in California.)
This would mean that a more widespread situation is nearly locked in.
I have made the plan, so now I am not going to worry for myself as the news gets more crazy. I recommend preparedness over panic!
So What to Do?
== PREVENTION ==
A. WASH YOUR HANDS, don\u00e2\u0080\u0099t touch your face, try to avoid close quarters with crowds, and avoid public restrooms if you can. Get lots of sleep and drink lots of fluids. This helps strengthen your immune system.
Now is the time to start practicing this.
B. Work from home if you can. Cutting down the number of person-to-person interactions significantly slows the spread of the disease
C. If you have elderly relatives or friends, particularly those who smoke, encourage them to stay in and avoid person-to-person contact as much as they can (even contact with you - you may carry it with only mild symptoms but pass it on!) Tell them to wash their hands often, avoid eating out or take-out food, have caregivers wear masks around them (in case caregivers are infected).
== Self Quarantine Plan ==
Note: this is my plan, I am not sourcing it from anyone. Your suggestions would be very helpful.
- Pick a location for self quarantine. This should be a place where you can comfortably live for 1-3 months without much contact with the outside world. Have a way to get to the spot, and make plans with loved ones.
- If you need to fly to the spot, plan to go sooner than if you need to drive there or already live there.
- Pick a time at which you will self-quarantine and stick to it. Once you have a plan and you know when to execute it, there will be less reason to worry.
- Setup of self-quarantine:
For the first 14 days, isolation: everyone goes into their quarantine zone and don't come out for 14 days. (This means that for two weeks, most people won't have access to a stove.)
- As much as possible, each person should be physically separated from each other. This means that everyone gets one bathroom. You'll want to duct tape air vents to prevent spread of air.
- Once the two weeks are passed, anyone who isn't sick can freely roam the house. If people need to leave the house, when they return they go back into self-quarantine (depending on your risk tolerance and what they did.)
I KNOW this list may sound crazy to some of you. It's money, which can be hard to spend on something that seems so remote. Most of the things below are things you'll already have or will eventually use. Some are things that are smart to have around anyway in case of earthquakes, other emergencies, etc. And you can sell the oxygen machine... But think about if you were in a situation like they are in Wuhan, what you would want -- and if there's a small probability of that, don't you want to be prepared for less than the cost of a month of health insurance?
- 1-3 months food supply
- Some water supply
- 3mo supply of medications
- 3mo toilet paper
- Extra toiletries
- Contact lenses / glasses
- Lots of hand sanitizer, soap
- Oxygen machine (if you have older people in your family)
- Toiletries (extra toothbrushes and toothpaste)e
- Cold and cough medicine
- Pain & nausea relief
- Some vitamins to consider: Ester C, NAC, Glutathione, Zinc, Magnesium (not oxide), Vitamins D, B6, B12
- You may want to buy Chloraquine (90 x 500mg tablets) from an online store.
- Internet Access
- Portable battery
- Duct tape
A note on oxygen: for people over 70, 75% need oxygen and 25% need ICU, so that is a solid 50% of people who may be fine with oxygen and telemedicine. For younger people it's still an issue, but less so.
Also, I recommend preparing for supply chain disruption and markets to continue to take a major hit. Personally, I would be out of most markets to play it safe. Chinese road traffic is down to 1-3% of what it normally is; imagine that in 40 other countries at once. For people under 70, the panic, supply chain, and market effects will make more of an impact.
If this post turns out to be alarmist, I will happily take the hit. I just encourage you all to think in terms of rare and black swan events. Don't look at yesterday to imagine how tomorrow will go -- look at today.
This post was put our purely out of love for you, my friends. I want us to stay friends for a long time.
Good luck out there, it's a crazy world! :-D