You need to read this great article now. Not later today. Not tomorrow

This post was put up on my other blog on Saturday, March 14.

Dr. Roger Alexander of Schweitzer Engineering Labs sent me this link about 20 hours ago, describing it as “sobering”. I didn’t even look at it until 1 ½ hours ago. It’s a long article that took me an hour to get through (carefully), but there’s a very real possibility that this saved my life. You need to drop everything and read it, certainly before you leave your home for any sort of trip that isn’t absolutely essential.

Here are the main points I got out of the article; but – again – I want you to read the whole thing. There’s a lot of stuff that I’m not including here, which is almost as important. Don’t get intimidated by the fact that it’s filled with a lot of graphs. I’m one person who will often skip over a graph if I think I already know what it says, but you need to ponder each of them carefully (none of them require any sort of advanced statistical background to understand. The author is an entrepreneur, not a scientist or medical professional).

First: The number of actual Coronavirus cases in the US, and in almost every community (unless you live somewhere where nobody has traveled beyond the city limits since January), is without doubt a big multiple of the reported cases (and if there are zero cases now, there won’t be for long); this can be easily computed by looking at the total reported cases later and extrapolating back, since symptoms take about a week to appear. For example, in the Bay Area - as of March 10, when the article was written – there were 86 reported cases, and probably 600 true ones. In France, where there were 1,400 reported cases, there were likely between 24,000 and 140,000 true cases. In the Communidad de Madrid region of Spain, there were 600 reported cases and between 10,000 and 60,000 true ones.

Second: Countries that aren’t prepared for the big onslaught (which will probably hit parts of the US in the next 1-2 weeks) will have death rates that are 5-10 times higher than those of countries that were prepared – but still had a significant number of cases.  The biggest determinant of fatality rates will be whether or not the hospital system is overwhelmed, forcing doctors to triage all serious cases (whether due to coronavirus or anything else, like regular flu), as is happening in Italy now. So is the US hospital system prepared or unprepared for this?...OK, stop your cynical laughter. Yes, the US is woefully unprepared. For example, we have only one percent of the masks for healthcare workers that will be needed.

Some countries have done a great job of preparation. For example, Taiwan – which is of course very tied to China – had fewer than 50 cases as of 3/10, and Singapore and Hong Kong were also very well prepared for Covid-19. Interesting enough, China outside of Hubei Province (where Wuhan is) used the month or so before the onslaught to thoroughly prepare, and came out of it very well, relatively speaking. This is partly because of their experience with fighting SARS, which is also a Corona virus. The US, on the other hand, also had a month’s notice, yet we as of today have only tested about 10,000 people (with 16,000 tests, since it usually takes more than one test to get a good reading); while South Korea has been able to test over 10,000 people a day for several weeks.

Third: Given that there’s no way the US healthcare system can be made ready for a devastating surge of cases (which could happen in weeks, not months), the only remedy is social distancing, practiced ruthlessly, both on a community-wide and an individual level. The author graphically illustrates this by using data from the 1918 flu pandemic, when cities that instituted social distancing (like St. Louis) had much better outcomes than ones (like Philadelphia, where I was born) that didn’t. In comparing those two cities, the author says that instituting social distancing 20 days earlier in St. Louis led to halving the mortality rate.

Fourth: It’s too late for containment – where the country knows every case within its borders and tracks contacts for all of them, putting those people into isolation. Or for prevention – closing the country’s borders to inward travel. As the author sarcastically points out, “The recent US announcement that most travel from Europe was banned is a containment measure for a country that has, as of today, 3 times the cases that Hubei had when it shut down, (and) growing exponentially.” The enemy is here, folks. The author shows data that estimate the Chinese ban on people leaving Hubei only slowed the spread in China as a whole by 3-5 days.

So what’s to be done in the US? Social distancing is the only good option. It’s already being put into place in various places (Illinois just closed all of its schools), but it needs to be draconian (the author provides a list of measures taking by the Italians as an example of that. They were taken late, but at least they’re being taken).

The author concludes with the most powerful chart, which he created himself but which is loosely based on the experience in Hubei. It shows that, without social distancing, the cases will continue to increase exponentially. And then there are two cases, one with social distancing starting 20 days after the first infections, and one that starts 21 days after the first infections. What is amazing is the difference that literally one day makes – one day leads to literally 40% fewer cases. So in Hubei (which declared the lockdown on Jan. 23), if the lockdown had taken place just one day earlier, it would have led to 20,000 fewer cases! (BTW, Hubei is a big province, for any country other than China. It has about 40 million people).

So social distancing is the only answer, and it needs to be implemented as soon as possible. And that might mean in hours, not days. Of course, most of us can’t directly influence local authorities, but we can certainly influence our companies, churches, synagogues, schools and other organizations, as well as ourselves. There’s no time to waste!

I think Thomas Pueyo, the author, has done everybody a great service in writing this article. The only issue I have is that I think he should change the second sentence of his short bio, which reads “Creator of viral applications with >20M users.” Somehow, ‘viral applications’ seems to be a poor choice of words at this point. I'm not sure we need more viral anything!