The time to shut the country down is now. The infection rate just increased 5-fold in 4 days; if that continues, by Wednesday – 4 days from now – there will be 125,000 confirmed cases.

A week from tomorrow there will be 625,000.

Four days later 3 million of us will be infected.

By mid-April, 20 million will have tested positive for coronavirus, and hundreds of thousands will be dead.

Think that’s nuts?

If anything, the actual infection rate is higher than reported – because we still don’t have enough testing capacity.

We do not have the medical facilities, staff, or supplies to handle several million COVID-19 cases simultaneously.  Our government has failed catastrophically, leaving every medical provider from the VA to major hospitals to nursing homes desperately short of everything.

No cure, medication, or vaccine exists – and none will be here until this time next year at the earliest, there’s been lots of media from irresponsible blowhards.

The latest – chloroquine – has been touted as a “cure” despite a) extremely thin evidence that it is effective in humans; b) it can be fatal; and c: according to National Institute for Allergy and Infectious Diseases Director Anthony Fauci MD, None of the evidence has been collected through a controlled clinical trial, “so you really can’t make any definitive statement about it.”

This guy is NOT a medical doctor, he is NOT an “adviser” to Stanford University, the “research” was self-published and does not meet ANY standards for credibility.

All this is why we have to flatten the curve. If not, tens of millions more will be infected, the death rate will rapidly increase, and over a million will die.

If you detect more than a bit of anger here, you’re right. Two family members are nurses, both desperately struggling to prepare for the coming tsunami of cases. One is quarantined because there isn’t enough protective equipment, the other exhausted from days of overtime. And both know it will get a whole lot worse before it gets better – and that is terrifying.

The government won’t take responsibility, so we have to. Stop socializing. Go out only when you absolutely have to – and then act like everyone else has Ebola.

Wash your hands. Check on your neighbors, shop for those who are high-risk, call your family members and friends, and don’t panic.

It’s not all bad.  The response from regular people looking to do whatever they can to help out has been nothing short of wonderful. A local business here is using 3-D printing to manufacture face shields because there aren’t enough in emergency stocks (the owners are good friends).

And keep working at your regular job. It’s hard to focus…it’s also essential.

Quick take – we don’t know.

Before you read this – don’t freak.  Yes this is worse – much worse – than I thought, but panicking and reacting without thinking is NOT helpful.

First, the facts.

• 6,496 people have tested positive for coronavirus; it is in all 50 states
• In the US, 114 of those who tested positive have died.
• We do not know the death rate for three reasons.
  • The death rate I (and others) have been quoting is likely misleading – and may be too low

That’s because the number of cases is expanding rapidly but people don’t die immediately.  This from the Lancet, based on data from China (as with any early assessment the numbers are rough)

patients who die on any given day were infected much earlier, and thus the denominator of the mortality rate should be the total number of patients infected at the same time as those who died. [emphasis added]

The blue line is the more accurate figure and indicates a death rate of 5.7%.

But…

• Because of the lack of testing (especially early on in China and for far too long in the US), there are a lot of people with mild symptoms or no symptoms that are undiagnosed. Therefore, the denominator (the number on the bottom) is too low. This means the estimated death rate quoted above is likely too high.
• Anecdotally, I’ve heard from healthcare workers that some patients dying of respiratory failure were not tested for coronavirus – thus these deaths aren’t counted as related to COVID-19.  Anecdote is NOT data…that said due to the lack of tests, I’m betting the actual number of deaths is higher than reported.

Okay, pretty scary stuff.

What’s scarier is doing stupid stuff – and there is nothing stupider than hoarding toilet paper.

Coronavirus will NOT destroy the supply chain – it will lead to disruptions and delays, but anytime people hoard stuff, that means they won’t need to buy it for a long time. So, while shelves may be empty today, when the supply chain catches up – which it will – there will be lots of pasta, rice, canned food, and yes, TP on those shelves.

What does this mean for you?

Let’s take a lesson from our friends in Italy; be kind and thoughtful, smile at everyone, say hello, and remember we are all in this together.

Oh, and do a lot of takeout and tip generously!

This is way worse than we thought even a week ago. The death rate remains much higher than the flu, while we continue to get confusing and contradictory messages from the White House.

Facts.

• In the US, the number of diagnoses has tripled over three days.
• The death rate is just shy of 2 percent – about 20 times greater than the regular flu.
• Italy remains the worst-affected country, with almost 25,000 confirmed cases and 1800 deaths – a death rate of 7.2 percent.
• Contrary to what you may have heard, Italy’s population is NOT the oldest in Europe – Germany’s people are slightly older – and many other countries are almost as old as Italy.

What will protect us?

Not this…

• face masks.  those regular face masks are useless. Unless the facemask is specifically designed to eliminate most airborne moisture – and you have been trained specifically in how to fit the mask – it won’t protect you.
• Unless you are already ill – in which case those regular masks help limit others’ exposure.
• A vaccine. There will NOT BE A VACCINE for at least a year.
• Drugs – THERE ARE NO MEDICATIONS TO TREAT COVID-19.

This.

Wash your hands. Use alcohol-infused wipes.

Stay home.

Avoid any close contact with anyone you do not KNOW.

Sorry, grandma…I didn’t mean to kill you.  For anyone younger than 30  or older than 60 reading this – forgive me for generalizing, but please stop doing stupid stuff. Going to St Patrick’s Day events, senior dance parties, concerts, beach parties, and bars won’t hurt you much (unless you are diabetic, asthmatic, have pulmonary issues, are obese, or have an immune deficiency (which you may find out the hard way) – but it will kill others who get Covid-19 from you.

Finally, what’s with this obsession with toilet paper? 

If this is the beginning of the zombie apocalypse – which it most definitely is not – I’m thinking we should be ensuring there’s enough nutrition to go into our bodies – if there isn’t, we will not have to worry about taking care of what exits our bodies.

Okay, after ten days of nothing but Covid-19 blog posts, we’re going back to our regularly-scheduled focus on healthcare, healthcare policy, and workers’ comp stuff.

Here’s where things sit today.

What we know:

• Italy is getting hammered, especially the northern regions. The death rate is over 7%, healthcare facilities are overwhelmed, and there aren’t enough ventilators and oxygen to go around.
• The number of reported cases in the US hasn’t increased much overnight – but that is likely due to complete failure by the government to get testing started quickly, and to develop an accurate test to begin with. And, yes, even now there aren’t enough test kits – thank goodness the Chinese are going to send us a half-million.
• It looks like test kit availability will ramp up in the coming days – but we are weeks behind when actually needed them. Without testing, officials have no idea what’s actually happening, can’t allocate resources, make intelligent decisions about closures and travel bans.
• Our healthcare “system” is uniquely problematic; there are north of 18 million who don’t have insurance, and among those who do, folks with high deductible plans will have to pay for treatment and many don’t have adequate funds to do so. The result – the disease will spread in part because victims can’t afford testing or treatment.
• Social isolation and basic handwashing are the cure for the pandemic. 
• My beloved Syracuse rowing teams won’t be racing this year; my heart goes out to the men and women who have trained like the champions they are for 8 months only to be sent home.  Same goes for every other athlete in every other sport at every other institution.

Please – be thoughtful, don’t travel or mix in with large groups, and don’t panic.

And, you now have time for an “at home date” with your significant other, hang with the kids, catch up on those home chores, read those books stacking up on your night stand, clean the windows, finish your taxes, and be forever grateful for important stuff.

Finally, I encourage you to read this – and thanks to reader Paul Meyer for the tip.

That – along with social distancing – is the phrase that will mark 2020.

So here’s where we are – typed as I wait to board a plane home.

This is from Johns Hopkins University; best site I’ve seen for current infection rates and locations.

What we know about Covid-19:

• It is most dangerous for the elderly and those with underlying health conditions such as COPD, asthma, and other chronic conditions.
• It is MUCH less dangerous for the rest of us.
• The overall fatality rate appears to be between 1% and 2% – but may well be lower as we do NOT know how many of us are walking around with the disease and no symptoms
• Most of the deaths in the US occurred in a nursing home in Washington state.
• The epidemic appears to have peaked in parts of China, with fewer and fewer new cases appearing
• Italy is hardest hit; the death rate appears to be about 8% – again that may be distorted due to inadequate testing.

What works

Social distancing – defined as staying a few feet away from others wherever and whenever possible.

Washing hands, covering coughs and sneezes, using sanitizers containing alcohol.

What we have to do

Be realistic. There’s a ton of happy talk out there about how this isn’t that bad, it’s a made-up crisis, and somehow all will be fine and it will disappear in April and a vaccine will be here shortly and .

That’s crap. A vaccine won’t be here for at least a year, hot and humid Singapore has a persistent outbreak, and Covid-19 is much deadlier than the flu.

But, Chill. This isn’t Ebola, SARs, or MERs. Yes it may be 10+ times worse than the flu, but it isn’t the black plague.

Tip service workers. Baristas, Lyft drivers, Uber Eats and Instacart workers, bartenders, maids are getting crushed financially. Help them out.

Be kind and thoughtful and nice.  We will get thru this, and we’ll be wiser for it.