PSA: The Coronavirus picture in the USA

Get ready for things to go bonkers for a little while.

Tl;dr

• The US is handling this as poorly as a nation could
• The government still has the ability to change the way they respond. A change now would make a drastic difference in future outcome. If you have any leverage with government, encourage them to take strong measures.
• We should be doing everything we can to flatten the curve and slow spread
• Prepare for self-isolation, hoarding, and disorder
• Those over 60 and with health conditions are highly at risk and should start self-isolation now
• It will happen more quickly in the US than in countries with better response and be more deadly
• People who cannot make money in a self-isolation situation (service workers, deliverers, people who do events, are at financial risk. If you can start community funds, take care of your neighbors, and keep paying service workers, you will be helping people pull through this.
• Panic is not helpful. As best as you can try to prepare with calmness, to support each other, and to remember that others are having feelings.
• For quality information and conversation on Covid, head to the Coronavirus Discussion Space
• For jokes, head over to the Coronavirus Dank Meme Stash

The situation today

Given the range of possible responses, we are responding about as poorly as a developed nation could. There has been almost no testing done (around 2000 tests to date?) and the CDC has actually stopped releasing numbers. We had a law that only the government can create tests, and they made hundreds of thousands which were faulty. The law was just lifted last week. New testing is coming online from individual labs, and the CDC has actually said they won't track how many people are being tested. I'd guess we can expect solid testing capacity in a few weeks.

Anecdotal reports are everywhere: everyone in a prison getting sick in the past week, people arriving in hospitals textbook symptoms for the past several weeks and not being tested, upticks in ER visits. Without widespread testing, deaths and anecdotal evidence are the best data points we have.

The papers are not reporting well on this. In our fake news climate, well-reputed papers are reluctant to post anything that seems like conjecture, so they aren't saying what is obvious to many: this is accelerating rapidly.

You can assume that for every death, there are about 1000 cases of community spread. 22 deaths means 22,000 cases. (If this is off by even an order of magnitude that's not a big deal as this changes by an order of magnitude every few days.)

Where this will go

We can look to other countries to see where we are headed in the next few weeks.
First off, when looking at the situation in other countries, it' important to consider the context. How a country or community responds determines how quickly or whether the virus spreads and how many people die.

For example, exponentially accelerating spread has leveled off in Hubei province because the government has kept everyone in their apartments, sprayed disinfectant over the entire city over and over, and conducted the most extreme measures you can expect. In Singapore, where they are testing carefully and tracking and isolating everyone who is found to have it (contact tracing) there have been almost no deaths. Meanwhile, the death rate is 4% in Italy (numbers subject to change and likely go down.)) The R0 (number of people who catch the virus for each one infected) on the Diamond Princess cruise ship was far higher than in most other places due to close quarters and poor quarantine.

Slowing the spread is important because it flattens the spike -- half as many people needing ICU beds means people can be treated much more importantly.

A small difference in doubling time makes a huge difference in speed of spread -- if the doubling time changes just from 4 to 5 days, that's a difference of 15x in the number of cases after three months.

The US has almost completely unchecked community spread, so you can expect us to be on the low end of doubling time -- let's say 4 days. At that rate, it will burn through the population in about three months, by the end of May. So it will happen faster here, but it will also be more deadly. Note that spread will slow, but that won't begin until it hits about 1% of the population. And if doubling time is 6 days, we're talking about end of July.

We're also looking at a tremendous strain on workers. As events are canceled, as people move around less, some peoples' livelihood and ability to pay rent is being threatened. Depending on how long people are in self-isolation, this could lead to widespread defaults on rent, etc. We are a country that doesn't believe in social safety nets.

Take care of the people around you. Keep paying people who are unable to come into work. As we hurt financially, we should hurt collectively and together, and not abandon the people who have enriched our lives with their work.

The two roads ahead

It may seem as if we the genie is out of the bottle, but the government still has the ability to decide how this goes. It has spread far, but there is much more to go and the decisions made today can still drastically change the course of future events.

If we continue business as usual, we are looking at a very quick escalation and a lot more pain. If Italy is in its current situation when 1/10,000 people are infected, imagine what our country will look like when 1/100 or 1/10 have it.

If the government does lockdowns, massively expanded testing, and contact tracing / community health measures, IT WILL make a huge impact.

IF YOU HAVE ANY LEVERAGE with any level of government, please do what you can to get them to take this seriously.

Supply chains and systems failures

We can look to Italy and Iran to imagine where our country may be in a matter of weeks. Unfortunately, we can't look anywhere to imagine where our world may be as this happens to every country at once. It may be totally fine, and major things we depend on could become less reliable. Prepare for a degree of mayhem. The upshot is this will all be over in 3-10 months.

A note about likelihood of having Covid

With the case prevalence so low, right now there is only about a 5-10% chance that you have Covid if you have the symptoms -- there's a lot of other sicknesses going around that are currently more prevalent. As the prevalence goes up, people with symptoms will be more likely to have it.

What you can do

• WASH YOUR HANDS! Use soap. Use hand sanitizer if it's available.
• Avoid holding large gatherings. If you are holding gatherings, encourage hand-washing, prohibit hand-shaking and kissing, and be sure there is a good amount of distance between people.
• If you think you might have it, practice social distancing. If you have a fever, stay home.
• If you are over 60 or not healthy, practice social distancing or self-isolation.
• For your loved ones over 60 or not healthy, sit them down and be sure they understand the risks they are taking (8% death rate over 70, 14% death rate over 80!) and are acting accordingly.
• PAY WORKERS who can't work. Create community funds. This is America and unfortunately we are the safety net we seek...-
  Stay calm. Prepare for the worst, show up for those who need you, practice responsibility. It's going to get bonkers, and this will be over in a few months.
• Oh yeah...vote out assholes who care more about their re-election chances than the lives of their constituents.