This post shares and comments on quotes from Hold the line, a coronavirus article by an infectious disease epidemiologist.

First, we are in the very infancy of this epidemic’s trajectory. That means even with these [social distancing] measures we will see cases and deaths continue to rise globally, nationally, and in our own communities in the coming weeks. This may lead some people to think that the social distancing measures are not working. They are. They may feel futile. They aren’t. [...] We need everyone to hold the line as the epidemic inevitably gets worse. This is not my opinion; this is the unforgiving math of epidemics for which I and my colleagues have dedicated our lives to understanding with great nuance, and this disease is no exception. I want to help the community brace for this impact. Stay strong and with solidarity knowing with absolute certainty that what you are doing is saving lives, even as people begin getting sick and dying. You may feel like giving in. Don’t.

I agree.

While social distancing decreases contact with members of society, it of course increases your contacts with group (i.e. family) members. This small and obvious fact has surprisingly profound implications on disease transmission dynamics. Study after study demonstrates that even if there is only a little bit of connection between groups (i.e. social dinners, playdates/playgrounds, etc.), the epidemic trajectory isn’t much different than if there was no measure in place. The same underlying fundamentals of disease transmission apply, and the result is that the community is left with all of the social and economic disruption but very little public health benefit. You should perceive your entire family to function as a single individual unit; if one person puts themselves at risk, everyone in the unit is at risk. Seemingly small social chains get large and complex with alarming speed. If your son visits his girlfriend, and you later sneak over for coffee with a neighbor, your neighbor is now connected to the infected office worker that your son’s girlfriend’s mother shook hands with.

This is a key point. If a family is staying home together, then if anyone in the family takes a risk, it's similar to your whole family taking the risk. That’s because one infected family member is likely to infect the rest of the family.

Also, if everyone in your family individually thinks they can get away with small risks, the risks will add up. Suppose you have 5 people each taking 3 tiny risks in a month. That's less than one risk per week. And suppose they’re 2% risks (1 in 50 odds of getting infected). Then the total risk for the family is a 26% chance of getting infected. That means over 1 in 4 families get infected from taking those tiny risks – every month. It doesn’t take many families doing this to keep the disease spreading. People acting anything like this scenario are part of the problem, not part of the solution.

In contrast to hand-washing and other personal measures, social distancing measures are not about individuals, they are about societies working in unison. These measures also take a long time to see the results. It is hard (even for me) to conceptualize how on a population level ‘one quick little get together’ can undermine the entire framework of a public health intervention, but it does. I promise you it does. I promise. I promise. I promise. You can’t cheat it. People are already itching to cheat on the social distancing precautions just a “little”- a playdate, a haircut, or picking up a needless item at the store, etc. From a transmission dynamics standpoint, this very quickly recreates a highly connected social network that undermines all of the work the community has done so far.

He's right. Don't cut corners.

Coronavirus: The Hammer and the Dance explains what everyone should know about governmental and societal policies for dealing with Coronavirus. Millions will die needlessly unless we change policies. (Some Asian countries have good policies. North American and European countries don't.)

Summary: Absolutely don't give up and intentionally let everyone get the disease. And we don't need total lockdown for 18+ months to wait for a vaccine, either. Instead, we must immediately do roughly 4-6 weeks of lockdown to get the disease under control (every day counts against an exponential pandemic). Once it stops spreading exponentially, we can manage it using testing and contact tracing, and ongoing mild and cost-effective lockdown measures while awaiting a vaccine. Any time spent on half-measures right now is condemning people to die and hurting the economy without solving the main problem. If we don't get this right, the hospital system will be overwhelmed and millions will die as hospitals turn them away. We're already on course for disaster, in a matter of days, if we don't make this policy change.

Do we really need to take drastic measures? Yes. Read about how harmful the disease is: A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients (the article is about a hospital in New Orleans, in Louisiana, in USA).

In Wuhan, the disease peaked a month after they did a full lockdown. In Italy today, despite the ongoing disaster (they've passed China in deaths), their lockdown is still inadequate.

We can stop the pandemic if we slow it down plus heavily ramp up testing. We don’t need to give up and accept that everyone will get it. And we don’t need to stay home for over a year until there’s a vaccine. We just need to do enough testing to figure out who to quarantine. Once we mostly know who has it, the rest is pretty easy, and we’ll be able to manage it when a few cases initially sneak by us. Until testing gets things under control, we must do a lot of social distancing. We can probably get this under control in one month if we take it seriously, which will save hundreds of thousands of lives in USA alone.

To prevent exponential growth of the pandemic, the average person needs to avoid around 70% of their regular contact with other people. That’s a reasonable, achievable number even if most people keep their jobs and go to the grocery store. (70% is a rough estimate based on several sources. Maybe the correct number is actually 80%, but it’s not 99%, it’s something achievable.) People who can isolate extra are a big help who will bring the average down. They’ll make up for some people, such as medical workers, who stay in contact with a lot of people. I’m staying home now.

Don’t go outside for non-essential reasons. Don’t congregate in groups. Stay home as much as you reasonably can. Do your best to leave public spaces for people who need them, e.g. utility workers who keep the water, sewers, power, internet, and phones working. Some people have really good reasons to go outside like healthcare workers, police, firefighters, delivery people, grocery workers, and pharmacy workers. Everyone needs to stop going out for entertainment, luxuries or socializing.

If you can cut down your going out just to work (if you can’t work from home and are in a bad situation to take a break from work), getting medicine and getting groceries when you actually run out (stay home and get stuff delivered if you can), it’ll be a big help to everyone. Get more food at once and eat non-perishables so that you have to shop less often. If you go out, shower when you get home and put all your clothes in the laundry. And don’t place unimportant orders for deliveries right now.

Once the pandemic is under control – we stop it from spreading exponentially, most currently infected people stop being contagious, and we do a lot more testing to find out who has it and who doesn’t – then we can go out more.

Remember: You can spread the disease before you have symptoms or even if you never get symptoms! This appears to be common and is part of why the disease is spreading rapidly.

The best time to get things under control is now, not after the bodies start piling up like they are in Italy.

More Info

Slow the coronavirus spread so we can test way more.

Coronavirus info thread (multiple updates per day; anyone can share info or ask questions)

My Coronavirus video

I tweet coronavirus info. Follow me or read my tweets directly at @curi42.

There is a coronavirus channel on the Fallible Ideas Discord

Johns Hopkins March 17 Coronavirus update:

The researchers concluded that efforts to mitigate the effects of the COVID-19 epidemic in each country—defined here as slowing transmission to reduce the peak of the epidemic—would be expected to still result in hundreds of thousands of deaths and overwhelmed health systems. Subsequently, they argue that efforts to suppress the epidemics—defined here as lowering transmission to bring R0 less than 1—are necessary to ensure the continued functioning of health systems. These measures, however, would likely need to be implemented for 18 months or longer. The study considered multiple interventions, both alone and combination with others: case isolation at home, voluntary quarantine of those living with cases, social distancing for individuals over the age of 70, social distancing of the entire populations, and school closures. The model indicates that a combination of these measures would be sufficient to suppress the epidemic and preserve the health system, but the disease would be expected to “quickly rebound” after the interventions are lifted. In order to maintain their impact, the measures would essentially need to be maintained until a vaccine becomes available, which could be 18 months or longer.

Study link. And FYI R0 means the average number of people that an infected person infects.

This info is dangerously wrong. Specifically, the 18 month claim is very discouraging (the rest is fine). People, including policymakers, will give up and think stopping the disease is hopeless. We're not all going to stay home for 18+ months (and there's actually no guarantee we'll have a working vaccine in 5 years – unpredictable scientific progress is involved). That won't work. But we shouldn't be planning to wait for a vaccine. That's the wrong plan.

We need to buy time to do way more testing to see who's infected. When we test enough, we can control the disease. Proof is logical and explanatory thinking about how diseases work (if we know who's infected, we can isolate them), as well how well heavy testing is working in e.g. South Korea and Vo, a small Italian town which got the disease completely under control with lots of testing.

See also my coronavirus info thread with multiple updates per day. You can share info there, too.

And see What To Do About Coronavirus

This is a discussion topic for posting info and questions about the CCP Coronavirus. Check back regularly for updates and share important info. This is a serious pandemic and we all need to educate ourselves and stay home. Don't go out for non-essential reasons. A lot of people are going to die, and our behavior today (March 15, 2020) will still dramatically affect how many die.

March 23 update: Although diseases are commonly named after locations, I edited the post title from The Wuhan Coronavirus to The CCP Coronavirus to reflect the fact that the fault lies with the Chinese Communist Party (CCP), not the city of Wuhan.

Below is the original post.

I'm not a medical expert and I haven't given my full attention to the Wuhan Coronavirus. But I've looked into it some and I have a few guesses, below. Summary: It's a real danger, which might kill millions, and China is lying about containment.

• Coronavirus is spreading in mainland China outside of Hubei province.
• The Chinese government is lying heavily.
• China reports fake coronavirus data.
• Experts could and should have known the above points a month ago.
• There's a significant chance, let's say >= 20%, that coronavirus kills a lot of people, let's say over a million.
• If the virus infects 25% of the world and has a 1% mortality rate, that's 19 million dead. The 25% and 1% figures are both plausible. Worse is not unreasonable.
• Things might not turn out all that bad, but people ought to be concerned and take it seriously.
• The virus is a bigger threat than the government measures to contain the virus.
• Many measures to stop or slow the virus' spread are being done too late to have a large benefit.
• Many people with coronavirus show no symptoms, but can still be contagious.
• Individual quarantine measures are frequently inadequate. Self-quarantined persons are told e.g. to keep their distance from their spouse ... who can still live with them and go to the grocery store.
• A 14 day quarantine is inadequate for a person who is around healthy family members or roommates. E.g. they could infect a family member on day 6. Then the quarantine ends too soon (8 days, not 14) after that person got sick.
• Although we may still slow the spread down, we can't realistically expect to stop the virus from spreading to most of the world. It may not spread that much, but if it doesn't, that will be luck more than skill. We don't know all the details of the virus and how good it is at spreading. Also, the potential exception would be if someone comes up with a major medical breakthrough to protect us.
• Politicians and others still going around shaking the hands of dozens of people are fools or bastards.
• The people mocking those who do "social distancing" like not touching other people (e.g. no handshakes) are second-handers disconnected from reality, and they will be responsible for many deaths.
• Literal life and death threats are inadequate for most social-reality-oriented persons to start focusing on facts, science, details and logic. They can't snap out of it and will continue to be dangerously careless, and to make decisions based on e.g. not wanting to show weakness. People deal with situations by social dynamics like acting tough instead of fearful, and not wanting to be reactive or high effort, and it doesn't matter if coronavirus has no social behavior and cannot act on social interpretations. People will e.g. stock up on supplies if and when other people stock up, and do whatever they think others are doing; they don't want to be different and that matters more to them than their lives.

The goal is to live a life guided by good ideas. Good ideas come from ongoing improvement – learning new things and error correction – while avoiding systematic blockers. So the goal of life is unbounded progress for your ideas.

Discuss below. Ask questions, express objections, try to elaborate on what this means or how to do it.

Topic for discussing Eli Goldratt ideas.

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