Many big headlines since the last time we talked about it, but the two biggest ones in my opinion are:
1. In my Feb 24 post, I suggested there are already numerous Corona clusters all over the US, Europe, and elsewhere, due to the disease’s ease of spread and its having a long incubation period.
Trevor Bedford, on March 1:
The team at the @seattleflustudy have sequenced the genome the #COVID19 community case reported yesterday from Snohomish County, WA, and have posted the sequence publicly to http://gisaid.org. There are some enormous implications here. This case, WA2, is on a branch in the evolutionary tree that descends directly from WA1, the first reported case in the USA sampled Jan 19, also from Snohomish County, viewable here. This strongly suggests that there has been cryptic transmission in Washington State for the past 6 weeks. … I believe we’re facing an already substantial outbreak in Washington State that was not detected until now due to narrow case definition requiring direct travel to China.
As I said, the cat is out of the bag. The US has neither the political will nor the social self-discipline to confine tens of millions of its people to their homes. And there aren’t many Americans who would take sick days out of their meager vacation days,
2. I also suggested that a recession is close to inevitable this year. In the week since I wrote that post, the ElectionBettingOdds.com tally of betting sites measuring the chances of a US recession in 2020 has skyrocketed from 32% to almost 50%.
As I said, I don’t think there’s much chance of stopping Corona from infecting a large % of the world population. There are now more new daily COVID-19 cases outside China than within China, which remains largely locked down (and at an economic standstill that is unsustainable in the long-term). Epidemics are one of those things where you either go big or go home. And Harvard epidemiologist Marc Lipsitch’s prediction that “go big” means a large percentage of the world population is looking increasingly realistic.
Lipsitch predicts that within the coming year, some 40 to 70 percent of people around the world will be infected with the virus that causes COVID-19. But, he clarifies emphatically, this does not mean that all will have severe illnesses.
So perhaps governments’ main task should no longer be about trying to contain it as such, but keeping infection rates steady to prevent surges that overwhelm healthcare systems. That is because mortality rates seem to be around ~1% when there’s access to modern healthcare (e.g. ventilators), it goes up to as high as 4% when they are overwhelmed (e.g. Wuhan a few weeks back – and, as seems plausible, Iran right now)*. So the main focus should be on trying to push as much of the population as possible into the phase state where they have 1% aggregate mortality from Corona as opposed to 4% aggregate mortality from Corona. The most obvious way to do that seems to be to stretch out the infections, e.g. by tightening up and relaxing quarantines at timed intervals.
Even radical and counterintuitive ideas, such as paying to get infected earlier so as to spread out the morbidity burden over time – as suggested by controversial economist Robin Hanson – should not be off the table. My own idea, or “powerful take,” involves paying out money to young people to get infected, which should produce very few casualties and will also push the overall r0 way down because they are generally much more active out on the streets than the elderly.
In other news, today also marks Russia’s first “real” case – that is, an ethnic Russian with a coronavirus infection within Russia (there were two Chinese coronavirus patients about a month ago, but they don’t seem to have spread it further). He was a Muscovite who had returned from vacationing in Italy on February 23, and reported into a clinic with symptoms of pneumonia on February 27 (according to a comment on /r/coronavirus, he was put in a ward with six other people before they discovered that he was infected with coronavirus). This is consistent with reports that Russian clinics have been testing pneumonia patients for Corona since the last third of February. But pneumonia patients are edge cases – there is no mass testing of travelers, or random testing of the population to gauge the approximate strength of the epidemic (as is now starting up in the UK). Considering Moscow’s links with China, Korea, and Italy, I would be very surprised if there weren’t already at least a hundred cases within the Russian capital as of the time of writing.