I’m sure that within a few weeks all the skeptics will be convinced, though too late.
The situation in the US is shaping up to be far worse than Italy.
I could not agree more. The cultivation of deliberate willful ignorance in the populace, the utter incompetence of leadership, and the culture of blind selfish greed, is going to create hardships the like of which few living have ever seen in the United States. And it will be sudden.
The question is not, will they be convinced, it is who they will blame.
Obama and Hillary. Any maybe Matt Damon.
Stranger
I disagree. Only because the USA is 32x the land mass of Italy with only 5x the population. As a population, we tend to be a lot more spread out than European countries and cities. That helps.
The exception is in highly dense urban areas like New York City or Hudson Country, NJ just over the river (where I live). We don’t seem to be fucking around with the “social isolation”. For the past week in both NY and NJ, schools have closed, everyone who is able is working from home, bars and restaurants are closed to all but takeout and delivery and most non-essential businesses are closed.
As of 3/20, there are 55 positive cases of COVID-19 in Hudson County:.
25 in Jersey City (pop 270,000)
13 in Hoboken (pop 55,000)
2 in West New York (pop 54,000)
2 North Bergen (pop 63,000)
2 Kearny (pop 42,000 )
1 Bayonne (pop 67,000)
1 Secaucus (pop 20,000)
9 don’t know
Plus you have around 4,000 in New York City (pop 8.5 million)
Within my apartment building they have shut down all public areas (gym, playroom, lounge). The management office is closed to in-person visits and the concierge’s desk has a fancy rope marking off around a six foot perimeter.
Still, it’s very difficult to maintain complete quarantine with a family of four. We still have our nanny come in to watch the kids and help with my son’s schoolwork while my wife and I work from home. About once every two days I venture out for supplies (the grocery store stocks have more or less normalized at this point). Lots of hand washing and Clorox wiping.
Fortunately we also live on the water with a number of large green spaces around us. So there are places to go out and walk around with the kids where we can also keep our distance from other people.
So to be honest, I can’t really understand people who live in suburban houses bitching about “working from home” or “social distancing”. In NYC and Hoboken, we practically live in our local bars, restaurants and coffee shops. The people I feel bad for are those who work for those bars and restaurants and small businesses whose jobs are affected by this virus.
I don’t live in a big city like NYC, but I was thinking the same thing this morning while I was walking through the park and my neighborhood. There was hardly anyone around. It would be much harder to maintain outdoor social distancing while walking around in a place like NYC, but in most places it’s pretty dang easy.
Currently 5,151 in NYC, and 7,845 in New York State, up from 5,367 yesterday.
Exponential growth is a thing.
Certainly population density is a big factor, but…
This. The sister of a friend lives in NYC. She doesn’t own a car, but she does own a dog. Public transportation is too risky, she feels (she’s over 60), but she can’t even maintain much distance from others while walking her dog. I can walk my dog around here without coming closer to anyone than half a block.
Except for the millions of us even out here in “flyover country” who live in apartment buildings that don’t allow us to get outside without being funneled through narrow common areas. 
What made the response to 9/11 a dangerous overreaction is that it led to more driving. Fear of (relatively safe) flying led us to go by car instead – and there were many more deaths in car accidents than there were in the terrorist attacks. There are about as many deaths in car accidents in the U.S. in the average month as there have been deaths in terrorist attacks in all of U.S. history.
The reaction to the virus has been to stay home, or at least go somewhere close or in the middle of the day. At what are normally peak commuting times, the roads are as empty as they are at those times on a weekend. The decreased use of the roads will save lives. We don’t know how many virus deaths would have happened if everyone went to school or work and will be prevented by staying home – but we know that there are about 100 car accidents on the average day of a normal day, and those won’t happen if we stay home.
So wear food service gloves to avoid touching door handles, railings, etc.
As someone who really loves outdoor recreation, this hits me in the gut.
Lombardy region bans outdoor recreation, even individual activities
During this whole week of social distancing, I’ve been so grateful that the weather has been nice enough for walking and riding around on my electric scooter. Doing these things has helped me to feel grounded during this crazy times.
I hope the things we’re doing now are flattening the curve enough so that we don’t have to face such a draconian measure. I fear they aren’t.
Honestly, given that the lockdown in Italy doesn’t seem to be bending the curve at all so far … what if this just doesn’t work? Like, what if this disease mostly spreads through some means other than casual social contact, and doubling down on stricter and stricter lockdown rules doesn’t actually do a damn thing to stop it? How long would it take us to figure that out?
Honestly, I’ve wondered about that myself.
We really don’t know that. They instituted these measures so very late that it was going to be bad in any event. It could well have been even worse. It’s the kind of thing you can’t tell until after the fact.
Then you will win the Nobel Prize.
I think lockdown rules only work if people have been following them. According to what I have read, a lot of Italians have been ignoring the rules. So I’m worried that people will assume that social distancing isn’t effective when really the problem is poor compliance with social distancing.
I think the super big question is to what extreme are we willing to enforce lockdown rules. We’re just at week 1 of this thing. Right now we are satisfied with just talking shit about those spring break kids partying on the beach. By week 10 of this thing, will we just be talking shit? Or will we be OK with state-sanctioned violence being directed towards anyone who doesn’t follow the rules, since flouters will be blamed not just for deaths but for the continuation of the lockdown?
There’s a kneejerk tendency to say this wouldn’t happen here in the US. But that’s what I said two weeks ago about lockdowns. Two weeks ago I had no idea we’d be where we are now. So ten weeks from now, who the fuck knows where we will be psychologically and thus politically.
Yeah, but shouldn’t the number of deaths and new infections be starting to flatten at least a little bit by now, ten days or so after lockdown, instead of going up and up and up? I know some of the lack-of-bend in the infection one might be due to increased testing, but it’s worrying me that there doesn’t seem to be any sort of difference in the trend line at all (and there have been more new infections and more deaths today, not yet reflected in these graphs, than on any day so far).
Admittedly, I’m doing this very imprecisely, just clicking through the days until I reach a day that is equal to or greater than double the number from a specific previous date, but it appears that Italy’s lock down slowed their doubling rate from every 4 days to every 5 days. Greater compliance might make that better.
Plus, lockdown was March 9. The results of it won’t really be seen until 5 days later. So, March 14. We are barely at the beginning of seeing the effects of it.
A podcast I listened to suggested that perhaps even more than the lockdowns in China and South Korea, a big difference may have been made by some drastic measures that were taken in separating the infected (or even suspected) from their households so that every time one person was infected it did not automatically mean the infection of their whole family. Vigilance, fever clinics, rapid diagnosis (often based on CT-scans of lungs rather than PCR tests, and separation of anyone referred for testing until they were cleared.
No. The SARS-CoV-2 seems to have a long latency period—maybe as long as 7-10 days—prior to expression, and it appears that many people may be asymptomatic or marginally symptomatic, so even with social distancing, people may be living with asymptomatic carriers. And the lack of effective testing means that we actually have do not have a good basis to make a qualified statistical estimate of how widespread the contagion may be, although the number of asymptomatic people who have tested positive indicates that the current estimates of the R[SUB]0[/SUB] value are probably way too low.
FWIW, I build a very simple dynamical system model of the virus distribution based upon the publicly available data as of last Saturday, and even using the most conservative assumptions about transmission and dispersion, I got an R[SUB]0[/SUB] of at minimum 4, and possibly higher than 6. Now, I’m not a virologist or epidemiologist so I could have made some unlikely assumptions that a professional would dispute, but as I’ve been watching the R[SUB]0[/SUB] estimates creep up I get the feeling that people were trying to make optimistic projections rather than realistic ones.
At this point, there is a minimum of a two week lag between the institution of distancing and isolation measures and seeing any measurable effects; realistically it might even be three weeks given the potential latency of onset of COVID-19 and undiagnosed asymptomatic carriers. We will almost certainly have the same type of situation that Italy has had except with a larger population and an even more fragile medical system, combined with the reluctance that uninsured people and undocumented immigrants may have in reporting early symptoms and seeking treatment.
And by all measures this is a love tap in comparison to an aggressive influenza or viral hemorrhagic fever pandemic could be in terms of lethality. While it is not correct to say that only the elderly and immunocompromised are experiencing critical illness, it is disproportionally affecting the elderly and not exhibiting the kind of effects like meningitis or cytokine release syndrome that would affect old and young alike. An occurrence of a InfA/H1N1 pandemic similar to the 1918 Spanish Flu could run through the population like a hot knife through butter with mortality rates exceeding 20% across all age groups. And by the way, we are particularly vulnerable to a co-incident influenza pandemic, so even if distancing is too late to directly affect the distribution of SARS-CoV-2 throughout the population it is still valuable in preventing a secondary epidemic that might dwarf this one.
The short answer is that right now we shouldn’t assume that we have the full picture on anything, and that the most ‘extreme measures’ (of which this is not) should be on the table in order to forestall even worse outcomes than what we are already facing. And after this is over—which won’t be for at least a few months—there should be some hard questions asked about how the nation was not better prepared for this (as epidemiologists have been warning for decades), why we do not have an organization with as much power and authority as the Department of Defense which has the mission to fight global pandemics, and why our economic and health system is so fragile that we can’t even weather what is really just a bad cold epidemic much less a major influenza or other epidemic that is coming as sure as spring follows winter.
PBS NewsHour: ”Why another flu pandemic is a likely just a matter of when”
Stranger
Thanks for the detailed answers, Stranger and eschroedinger! I don’t know if that’s comforting or … very very not.