It’s Here, It’s Severe, and It’s Time to Batten Down the Hatches

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I arose this weekend morning thinking I would be going to “wake-up” tennis clinic, held at 8:30 A.M. every Saturday at Sun Oaks. I’m well aware of the calls for social distancing to minimize the risk of infection by COVID-19, but my attitude has been somewhat cavalier. I’ve been practicing social distancing myself to a certain extent, but my wife is an Assistant Principal at a local junior high school, and my daughter (who lives under our roof) works with the public all day long as a Shasta County planner. In general, I’m going to get whatever they get, so my attitude has been somewhat fatalistic.

My oldest daughter delivers babies at the Kaiser hospital in Roseville, where the first COVID-19 fatality in Northern California occurred. The levels of social distancing and personal/household hygiene she’s been advocating have struck me as Katie being Katie, even though I respect her professional expertise immensely. But last night she re-posted a Facebook post by a statistician and software developer—the CEO of a company that consults to companies like Google and Starbucks (in other words, a high-powered no-bullshit analytics guy). I read his post this morning, and I’m not going to tennis clinic. Instead, I’m adapting his post (which he encouraged sharing) to make it far shorter and more applicable to our community.

I’ll start with two take-home messages.

1. It’s already too late for this essay—ideally, it would have posted a week ago.

2. Start social distancing now, and do it aggressively, to the greatest extent that your circumstances permit.

Issue #1: We live where we live.

This is Shasta County. We’re a conservative community, and skepticism about analytics and academics is the norm. We’re inclined to view what we’ve been advised to do in the face of the pandemic by “so-called experts” as over-reaction. We’ll believe it when we see it. “The flu kills more people than COVID-19!” Or, “This is just another way to undermine President Trump!” If you haven’t heard these types of sentiments voiced, you’re already social distancing sufficiently, and this essay probably isn’t for you (but please read on).

Issue #2: Our brains don’t work the right way.

The reason that extreme social distancing feels like an overreaction is that most people overweigh the currently reported cases (there aren’t that many!) and under-weigh the math of how the virus is spreading, and where we’ll be in 30 days. We tend to think linearly, not exponentially. It’s the same reason many people don’t start saving early for retirement or understand compound interest. We’ll do a quick math exercise later to underline this, and if you’re thinking this essay is already dragging on, I encourage you to skip to that math exercise—it makes the whole point.

Issue #3: Maybe you don’t care about at-risk people.

We’ve all heard that the elderly and those with pre-existing conditions are most vulnerable, and indeed, one of the insidious characteristics of COVID-19 is that many people who have it are asymptomatic or have very mild symptoms. These people are carriers—the COVID-19 equivalents of Typhoid Mary. This gives some young people a sense of complacency—I’ve encountered many comments on social media to that effect. If that’s your thinking, I strongly encourage you to look at the now-ubiquitous “flattening the curve” graph above and gain an understanding of why it’s important to slow the spread of the virus, even if it’s a given that most of us are eventually going to get it. Unless you’re absolutely callous about the fates of others, you owe it to people who may need hospitalization.

But know this, “me-first” people under 60: A generalization is not an absolute. One of the eye-openers for me regarding this pandemic was watching video reports from Italian hospitals. Two things were apparent:

  1. When hospitals get slammed and overwhelmed, it gets ugly—extremely ugly.
  2. What the hell? Quite a few of those people on respirators are in their 30s and 40s!

Bottom line: If not you, someone in your family or close to you is at risk. But maybe you.

Okay, here’s the math.

There has been one confirmed case of Covid-19 in Shasta County. According to many epidemiologists, we can assume there were actually 10 times that many infected people at the time that case was confirmed on March 8, six days ago. Fifty times that number if you believe Harvard Medical School’s epidemiologists—but to be conservative, let’s stick with 10x.

The number of infected people doubles every ~3 days as the infection spreads. So take that conservative 10 infections and multiply by 2. Then do it again nine more times, for 10 times in total. You’re doing it 10 times to simulate where we’ll be in a month. It’ll take you 30 seconds to do the calculation on your phone’s or computer’s calculator, but I’ll save you the time. 2 to the 10th power is 1,024. Multiply that by the assumed 10 infected people six days ago, and in 30 days ~10,240 local people will have contracted COVID-19. At an estimated 2% mortality rate, over 200 people will have died…in the first month.

And remember, assuming that the one confirmed case 6 days ago was really the first, there are likely 40-80 people spreading it around town today—right now. Ten times that if we assume the earlier 10x multiplier (400-800), and 50x that if we go with Harvard’s estimate (2,000-4,000).

Divide 10,240 infected people by the population of Redding (~92,000) and you have ~11%. That’s the approximate percentage of people that you know personally who will have been infected 30 days from now.

Now take 15% of the 10,240 total infected people—that gives you 1,536, an approximation of the serious cases that will require acute medical care locally. Mercy Medical Center has about 270 beds, Shasta Regional Medical Center about 225. Total beds: ~495. And realize, those beds are not sitting empty now, and many will be needed over the next 30 days for other serious issues. Heart attacks, emergency surgeries, births, and other medical procedures requiring hospital beds aren’t going to magically be put on hold.

Too many patients, insufficient numbers of hospital beds, and a shortage of ventilators—the most serious problem of all—if we don’t immediately ramp up the social distancing. Major social distancing.

Yeah, I know.

Again, we live in Shasta County, which I sometimes affectionately call “Shastanistan.” We’re surrounded by people who just ain’t buyin’ it. They’re not going to do the social distancing thing. Maybe your job makes it impossible. Maybe your boss will tell you to get your ass to work or you’re fired. Maybe you’re self-employed, and you’ll go broke if you avoid people. Some of the people you know will mock social distancing. If enough of us do the social distancing thing diligently enough over the next 30 days, maybe the local impact of the disease won’t be as severe as the numbers we calculated. If that happens, those same people who benefitted from your diligence are going to call the whole thing a hoax, and call you a chump. Be an adult and don’t worry about that. Do whatever you can—the OCD hand washing and all. This is serious.

Lastly, I’m fairly handy with these sorts of analyses, but I don’t profess to be an epidemiologist or communicable diseases expert. The last thing I want to do is spread misinformation—there’s enough of that going around. If any medical experts read this and detect flaws in the argument, please weigh in.

(I thank Jason Warner of Bend, OR for the inspiration for and bones of this essay.)

Steve Towers
Steve Towers is co-owner of a local environmental consultancy. After obtaining his Ph.D. from UC Davis and dabbling as a UCD lecturer, he took a salary job with a Sacramento environmental firm. Sitting in stop-and-go traffic on Highway 50 one afternoon, he reckoned that he was receiving 80 hours of paid vacation per year and spending 520 hours per year commuting to and from work. He and his wife Elise sold their house and moved to Redding three months later, and have been here for more than 20 years. His hobbies include travel, racquet sports, taking the dogs on hikes, and stirring pots. He can be reached at towers.steven@gmail.com
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73 Responses

  1. Avatar Katie says:

    I’m the Katie in the article. For the sake of people who have to leave the house — the things we are currently doing and that i recommend are: if you must leave the house, wipe down EVERYTHING you touch with a disinfectant. Your debit card, the button you push at the gas station (and the handle), the outside of your Starbucks cup…Everything. When you get home — shoes stay outside, immediately walk to your laundry room and strip. Clothes get washed in hot water. Then wash your hands for at least 20 seconds (find a video online to show you how to do it right…my 4 year old has got it on lock — you can too). Then put on clean clothes to wear inside your home. Clean “high touch areas” like kitchen knobs and bathrooms daily. Groceries that are non-perishable either sit in bags for 5-7 days in a place where people won’t touch them to ensure no living germs on them OR get wiped down with disinfectant wipes before they are put away. Veggies get washed with soap or a veggie wash and then, ideally, cooked before eating.

    • Avatar Linda Cooper says:

      Thank you, Katie, for taking the time to provide this direction. I admit that I am using paper towels more (tearing them in half) for after I hand wash, in order to not fret over towels. Right now it seems like a “one-use” item is needed.

      • Avatar Katie says:

        We’ve been using hand towels in the house but washing them daily!

        • Avatar Linda Cooper says:

          Hi Katie, oh, small hand towels, and washing daily in hot water. Yes. Good idea. I’m still acclimating after “losing it all” in the Carr Fire. I will replace my small hand towels for sure.

    • Avatar don says:

      Thanks for the advice on food handling. Do you know of a safe way of handling frozen food, fresh meat, or poultry.

    • Thank you, Steve, and thank you, Katie, for this important information.

      Such a smart family. I’ve often thought that conversation around your family’s dinner table must be extremely lively and interesting.

    • R.V. Scheide R.V. Scheide says:

      Thank you Katie for the information on non-perishable food items. I wear rubber gloves to the grocery story, not I know what to do when the groceries come home.

    • Greg Greenberg Greg Greenberg says:

      The best evidence thus far is that COVID-19 can live on surfaces for up to 24 hours. You can make it 1-2 days!

    • Katie, you and your dad are a good team. I love his math breakdown, and I love your practical suggestions. Thank you for this information, and for your service as a medical provider. Here’s to continued good health to you and your loved ones.

    • Steve Towers Steve Towers says:

      Thanks, Katie. We’ll try to implement at least half of those in our household. 😉

  2. Avatar Richard Christoph says:

    Thank you, Steve, Katie, Jason, and Doni for this excellent piece and its vital information.

  3. Avatar Linda Cooper says:

    Thank you, Steve, for making it real. I really don’t want to get political here, however, it’s hard to restrain myself. Your Issue#1 was intriguing to me. I do have Trump people in my family. I have noticed that they are laying low on FB. I also have “you create y0ur own reality” people in my life. Boy, howdy, it does get confusing to me. And then I have dear husband in my life, whose perspective is that we “will get it, statistically.” I hang onto his follow-up, that this means we will have symptoms along with everyone else. “Doesn’t mean we will die.” We went to farmer’s market today in Chico. Saw the agent that sold us our house here (we are getting warmer, but I still can’t write “home”) after 26 years in old Shasta. The agent reached out to hug me, and I held up my hands, smiled, and said, “social distancing.” Boy, howdy.

  4. Avatar Candace says:

    I didn’t think about the shoes staying outside or the strip, wash, change your clothes. Thank you for this Steve, I just shared your daughter’s advice with my friends and family on FB.

  5. Avatar Eric Morton says:

    Thanks for the info Steve.

  6. Avatar bruce vojtecky says:

    Good article Steve, hope this means you’re back submitting articles.
    I thought about writing a COVI article but as things change hourly I figured it would be out of date before I hit submit button.
    My sense of “bravado” has changed in just a week. My wife and I are staying home today, instead of being at the Sportsman Show in Scottsdale watching our daughter from Wyoming and her Dock Diving team. My wife and I are in the high risk elderly, we moved to Phoenix because my wife had breathing problems in Wyoming. Plus her spring allergies are leading to bouts of sneezing, like our daughter-in-law who also is staying home. No other symptoms, as recommended go to the doctor before rushing into the overwhelmed ERs.
    My Facebook friends in Shastainia post a lot of comical messages of COVI, but it is their way of coping with the issue, not a denial of it. We can’t all be in a the sky is falling group, life has to go on. Just be careful, wash hands, avoid contact.
    With four grandkids living with us school safety is a high issue. Springbreak starts next week and many schools are deep cleaning and have not decided whether to reopen or not. Things could change dramatically in the next week, for good or bad.
    And as most of our toilet paper is made in Mexico a border wall won’t help.

  7. James Montgomery James Montgomery says:

    Interesting analysis. Mark me down as one who mistrusts such sorts of statistical prognostication, but you may be right. The virus is real and serious, no doubt, but so far the panic is far worse.
    Write it on the wall- Steve Towers predicts 10,000 people in Shasta County will have the virus by April 13, of which 1500 will require hospitalization.
    Can we go farther and predict that 200 to 300 people will die of the virus in that same time period? Grim stuff. We shall see.

    • Steve Towers Steve Towers says:

      No, James—those were *not* my predictions. Those hypothetical outcomes are what could happen if the preliminary data about attack rates, morbidity, and lethality are correct AND we fail to react with effective preventative measures like social distancing. Here is what will happen: Many people will take the pandemic and the guidance seriously, and many others will blow it off. As with vaccines and herd immunity, the ones who blow it off will benefit from the cautious actions of those who take it seriously.

      I’m not a praying man, but I hope to hell enough Americans take the pandemic seriously enough that we avoid a large-scale catastrophe like the ones occurring in Italy, Spain and France. I wrote the column quickly this morning and asked Doni to publish it promptly specifically to do my vanishingly small part to ensure that it’s not as bad in the end the modeling suggests it could be. If that positive outcome occurs, the skeptics can go ahead and feel smug as they point out that I and others were wrong. I’ll happily take that hit rather than being able to say with zero fear of contradiction, “I told ya.”

      • James Montgomery James Montgomery says:

        Ah. Just a hypothetical addition to the panic attack, not a prediction. Yeah, ok.

        • Steve Towers Steve Towers says:

          I’m curious, James. Are you even vaguely aware of what’s going on in several European countries that are only 2-3 weeks ahead of us on the scale of their COVID-19 outbreaks? Have you read any first-hand accounts of what it’s like in those countries at the moment—how it will be here if we fail to take preventive measures? And there are reportedly satellite images of people being buried in mass grave trenches in Iran.

          The other day, Trump said he accepts zero responsibility for the shortage of test kits in this country, even though his failure to take the pandemic seriously and logistical bungling were a direct cause of that shortage. You want a prediction from me? Here’s my prediction: If/when this pandemic explodes in America in large part because guys like you regard the proposed mitigations as a “panic attack,” you’ll deny any culpability. There’s my prediction—write it on the wall.

          • Avatar bruce vojtecky says:

            Steve, where did James say there was no outbreak? He disagreed with the future prediction, from whomever, and he, like many are not in panic mode. This illustrates the divide in America, both sides twist what the other side says.
            I have disagreed, voiced many times, my differences with your use of statistics to “prove” your opinions.

          • Steve Towers Steve Towers says:

            Bruce — I think you’re misunderstanding the gist of the disagreement. I never said anywhere that James had claimed I said there was no outbreak.

            What I took issue with was his suggestion that we should mark my predictions down, implying that if we don’t hit those numbers, I was wrong.

            Here’s what I said at the conclusion of my “here’s the math” section: “Too many patients, insufficient numbers of hospital beds, and a shortage of ventilators—the most serious problem of all—IF WE DON’T IMMEDIATELY RAMP UP THE SOCIAL DISTANCING.”

            We *are* ramping up the social distancing. Bethel has called off all big worship assemblies. By next week, I doubt any local public school districts will be open. How far people go independently and in private business is the big wild card.

            But partial social distancing and partial success are not proof that my estimates were wrong. I hope and expect they’ll be wrong. The whole point of the essay was to contribute in some small way to *making* them wrong.

    • Avatar Randy says:

      During the 1918 ‘Spanish’ flu pandemic the US decided to hide the truth from the people so as not to ‘lower morale’ and in the end the US death toll was 500,000-675,000. Scientists have been predicting for decades now that one of the great threats from AGW are new viral pathogens. Good time to rehearse procedure.

  8. R.V. Scheide R.V. Scheide says:

    In addition to social distancing, Shasta County must begin testing in earnest. The HHS website currently just lists the one positive test, not the number of people who’ve been tested. It might be too late for hot zones like Seattle and the Bay Area and New York where community spread is prevalent, but we might still have a chance to stop it here, if we take more extreme actions. I for one stopped substitute teaching last week until we get a clear picture of coronavirus in Shasta County.

    • Steve Towers Steve Towers says:

      I woke up this morning with a cough after a couple days of muscle soreness and fatigue. Ordinarily I’d just ride it out, but I went to Hilltop Clinic owing to the circumstances. Negative test for flu. The diagnosis was acute bronchitis, and now I’m on antibiotics. I’m not 100% convinced I have a bacterial infection, but it’s probably the better side of caution—if you get COVID-19, you don’t want to already be fighting a respiratory disease.

      Anyway, they didn’t test me for COVID-19 because I didn’t have a fever. I suspect they would have given me the COVID-19 test (as they did for flu) if the new tests weren’t still in short supply. When the history of this pandemic is written, our nation’s abject bumbling of the development and systematically implementation of widespread testing will be a big part of the story.

      • Avatar Hollis Pickett says:

        You are so right!

      • R.V. Scheide Jr. R.V. Scheide Jr. says:

        In my opinion, it’s unconscionable that you weren’t tested. I understand if they don’t have the test.

      • Avatar Anne Thrope says:

        So with every possible indication that you are not in the 20% requiring medical intervention you thought it was still a good idea to go to a place where the chance of contracting the coronavirus is much higher or, if you’re already infected, potentially spread the coronavirus to an at risk population?

        Unprotected High Five! 😀

        • Steve Towers Steve Towers says:

          As the medical experts advise, I phoned ahead, described my symptoms, and was told to come in. I was diagnosed with acute bronchitis. CORVID-19 was *not* ruled out—I wasn’t tested, so it couldn’t be—and I was told to go home and stay put until my symptoms subside. I’m pretty sure, since they tested me for flu, they’d have tested me for CORVID-19 if the tests weren’t in short supply.

          Had they been able to test me, I could probably go back to my normal routines in a couple of days. Multiply that by tens of millions of others, and the hit to our economy is going to be in the hundreds of billions. My daughter Katie (mentioned above) has a cough, and has been sent home until it goes away. There aren’t even enough test kits for front-line medical practitioners.

  9. Avatar Hollis Pickett says:

    Sensible…..what a breath of fresh air! Glad I’m retired and can mostly just stay home. I live with a COPD (oxygen 24/7) partner. These are scary times. Also glad that I have some “viral knowledge” and some vital hepatitis testing supplies – possibly things that might still be available for purchase in stores? Single-use alcohol swabs. Follow Katie’s excellent advice. Great article – thank you!

  10. Avatar Kate Barker says:

    Thanks for this great relevant article, Steve, and thanks Doni for publishing it!

  11. Avatar Claudia Hastings says:

    Why are many schools still open?

    • Steve Towers Steve Towers says:

      That’s likely going to change very quickly. An exceptionally smart young guy in these parts, Joe Bowers, predicts that no Superintendent is going to want to be the guy who didn’t err on the side of caution and as a result has an outbreak on his hands. Nobody is going to want to get caught holding that bag. Career ender, as Joe put it.

  12. Avatar C.C. Miller says:

    Thank you. Been staying home since last Thursday. Closed my business and urge all to practice the suggested rules and save lives. This week will be a bad one.

  13. Avatar bruce vojtecky says:

    Just received notice from Dysart School District, where my granddaughters go, that they will be closed until April 3rd as a caution. No COVI cases have been reported and Arizona is not a hot spot area but we have a lot of visitors this time of year and many are not returning to their hot spot areas, Seattle for one. The news is full of cafes wiping down their counters, doors etc.
    Summer school may be packed this year, lots of sub work.

  14. Avatar Candace says:

    C.C. My nephew just took the lead and made the difficult decision today of temporarily closing his Portland business’s doors to the public. He’ll still offer delivery (waiving delivery fee for all) and will also be delivering food for free to some for as long as he financially is able . On a “sort of bright side” my niece, a doctor in Seattle, who’s been struggling with “glass half full” feelings just today connected with other moms to coordinate home-schooling. She sent away for math books, etc., cleaned her house, made some home-made sanitizer and said “today was a good day”. What with all the Covid-19 info coming at us 24/7 it’s important to disengage from the “loop” now and again and do something, anything, which makes us feel as if we have some semblance of control in an mostly out-of -our-control situation.

  15. Avatar Gayle says:

    My son has been traveling the country interviewing for PhD programs and works in am immunological lab at UCSF after graduating from UCBerkeley, coming home and loosing everything to the Carr Fire. He now is presenting with symptoms of Covid-19 and has been quarantined. I am extremely worried about him. There are not enough test kits there-are there sufficient supplies here? Is the medical community in Shasta County complying with the Surgery General in stopping all elective surgeries to ramp up for the coming cases here? We are an aged and (hate to say it) obese, diabetic and infirm community.

  16. Avatar Candace says:

    Wanna support your local bartender or server through the pandemic? Zelle and Venmo work great. Possibly killing them not so much. Jam packing bars is not helping anyone.

  17. Avatar Candace says:

    Gayle, if I were you I’d be screaming from the rooftops to any and every local government, health official, doctor, hospital in ear shot regarding your son. I’m so very sorry you and he are going through this. I hope he gets better soon.

  18. Avatar Eleanor Townsend says:

    Steve, thanks for this ‘wake up call’. Really made me do some thinking. Am gonna make changes starting today!

  19. Avatar Shelly Shively says:

    I’ve been germ conscious most of my adult life, with sister Doni’s reference to my no-shoes-in-house policy in her anewscafe article.
    Thanks for this article as a sobering, as Eleanor pointed out, “wake-up call”.
    I’ve got a box of disposable gloves in my car: I wear them when I’m in public places, & remove them after opening my car door, disposing in a closed container on the floor of my car, wiping down my car keys with alcohol wipes, then I slather on hand sanitizer before driving.
    Friends in Norway sent me this text yesterday:
    “In Norway, almost everything is shut down now. No schools or gatherings are allowed. We have to keep at least one meter distance from everyone we meet, but the government want everybody that does not work, to stay home. I can’t even visit my parents now. The girls get to do a lot of cross country skiing in our garden these days.”

    I think it’s best to err on radical precautions, than risk being a carrier to those medically vulnerable, or passing it to those who aren’t taking precautions.

  20. Steve Towers Steve Towers says:

    The simulations depicting the spread of COVID-19 under various scenarios in the linked article are fascinating. Of the four, we’re probably closest to the third.

    https://www.washingtonpost.com/graphics/2020/world/corona-simulator/?fbclid=IwAR0FFOCiFW2iCkhrZp7HiD-mk8crn5j1ok1LvdDIyyfgIDLCl78OERu5acY

    • Avatar Karin W. says:

      Do you think simulations with every contact resulting in disease transmission are valid when less than 20% of high-risk cruisers contracted the virus on the floating petri dish Diamond Princess?

      https://www.foxnews.com/us/cruise-ship-data-helps-reveal-coronavirus-death-rate-researchers

      • Avatar Steve Towers says:

        1. It’s clearly stated that the simulations are of a fake disease in which the attack rate is 100%. The point of the simulations is to compare the shapes of four different quarantine/social distancing scenarios. The difference between 100% and 20% is how long each scenario would take to unfold—the shapes of the distributions should be robust.

        2. I don’t put too much stock in the currently estimated transmission rates, especially in the United States. In order to make that calculation, you have to test EVERYONE in a closed population. We’re barely testing anyone due to a shortage of test kits, despite President Nero stating that everyone who wants to get tested can now get tested—a flat-out lie. We have almost no idea how many people are walking around asymptomatic or with mild symptoms.

        I went to an urgent care facility yesterday (I phoned first to ask if I should) with dry cough, aching muscles, fatigue, and aching chest. But I didn’t have a fever and no recent travel to a hot spot, so they tested me for flu, wrote me a prescription for antibiotics (bronchitis), told me to go home and stay put, and call back if I develop a fever.

        I definitely have a respiratory infection—but no COVID-19 test for me. Not enough test kits for people who don’t have fevers or documented exposure. If they’re not testing me, they’re certainly not testing enough people to have any idea how many people locally are infected and asymptomatic, and what the transmission rate is.

  21. Frank Treadway Frank Treadway says:

    The team of researchers that will come up with the vaccine to slow and cure VOVID19, and hopefully tomorrow, can be from an obscure place like ReddingCA. I understand there’s a local R&D facility right here in ReddingCA.; not to mention UC Davis. What can they do to make this happen ? Meanwhile, let’s follow all the advice we’re peppered with on a daily basis. But, not to the point that we isolate ourselves into frantic immobility. Call/email someone, keep the dialog going.

  22. Hal Johnson Hal Johnson says:

    Thank you for this, Steve, and thanks to your daughter.

    Like you, I’ve been a bit offhanded about getting the virus; my wife spends several hours a week in a courtroom, and it seemed more likely that she would bring the virus home than I would get it playing a gig or hosting an open mic.

    But, your article has me reconsidering. I’d already half-decided that this coming week would be the last for playing music for awhile, but now I’m wondering if the only decent thing to do is bail out of my music activities *this* week–and the next happening is tomorrow (Monday).

    I went ahead with my open mic at Cedar Crest Brewing last Friday, and the night was a success, although it seemed to have just a wee bit of the flavor of a party scene from “On the Beach.”

  23. Avatar Lori Cahill says:

    “In the end, it will be impossible to know if we overreacted or did too much, but it will be quite apparent if we under reacted or did too little”.

    -A school superintendent’s quote when closing his district for three weeks

  24. My entire family and I appreciate your impeccable essay addressing certain spread. I use the word certain because the word potential allows disregard for the projection in its entirety. The question is how much will prove out, not if it will. It could be worse. What you say is extremely timely, well-qualified, and highlights the key high-level factors we need to address individually and collectively going forward.
    Readers should respect and understand that the projection model you use is fully grounded in experience elsewhere globally. It should also be understood, as you say, that the extent to which the disease spread may turn out to be less dire in reality, will be largely, if not completely, the extent to which individuals and our institutions act proactively to mitigate the spread. On every level possible. We agree, it’s that bad. And the vaccination paradigm applies, as you say.
    And for me, I also agree that leaving Ava Gardner behind in Australia is hard to understand.

  25. Avatar Gary Solberg says:

    I do not agree that the Steve Towers essay is impeccable. In particular, the portion after here is the math includes many unsupported assumptions. We do not know the mortality rate nor do we know the rateof transmissions. We may never know the exact mortality rate or the rate of transmission. It may take years to even get a half-way reliable estimate of either. To get the data needed would require widespread diagnostic testing, and that is unlikely to happen any time soon. Many, many people who have been infected exhibit only mild symptoms. Some infected persons do not exhibit symptoms at all. They are not tested. Even many with obvious symptoms who present to a medical provider are sent home to self quarantine and are not tested. The mortality rate is estimated by the number of confirmed cases compared to the number of confirmed deaths. The suggestion of a 2% mortality rate is not realistic. Also, if there have been 10x or 50x unconfirmed cases for every confirmed case, this means that the mortality rate is reduced by a similar factor of 10x or even 50x. This is good news. However even a .2 percent mortality rate would be horrific and justify aggressive actions to slow or reduce the spread of the infection. the above essay suggests as fact that the disease spreads exponentially, doubling every three days. A Washington post article suggests the same thing. This cannot possibly be true. That would mean the entire population of the world would have been infected after less than 100 days, or three weeks ago, as the disease can be traced at least as far back as mid-November in China. I agree this is a very serious national and international situation requiring aggressive action, perhaps long term. But I do not agree that we should misrepresent the mortality rate or the rate of transmission. creating greater anxiety, fear and stress will add confusion and exacerbate the problem.

    • Avatar Linda Cooper says:

      Gary Solberg, I appreciated what you posted. Thank you so much. I’m taking some comfort here from your perspective. My only reservation, is that I have yet to read an “impeccable” essay. From anybody. Yet, that could be my judging mind.

    • Steve Towers Steve Towers says:

      Gary — Thanks for weighing in. I was careful to conclude with a disclaimer regarding my expertise and invite others to examine the estimates, and I’m glad you did. Given the uncertainties, the assumptions that I used are absolutely tentative, but I did my best to glean them from legitimate sources, but they’re necessarily squishy.

      I agree with you that I should have been clearer about mortality rates. I should have used case fatality ratio (CFR). That’s the ratio of deaths to confirmed cases—where testing is scant, as in the U.S., that’s very difficult to nail down. Nevertheless, the latest CDC calculations that I’ve seen for China—where the dust is starting to settle—is that about 1.4% of confirmed cases died. In areas where hospitals became completely overwhelmed at the epicenter of the outbreak, it was more than 10%, including alarming numbers of medical personnel (e.g., the doctor who first announced the outbreak). Clearly, if a large number of people are walking around asymptomatic and are never tested, the true percentage is lower. But you’re absolutely right—even if the true CFR is an order of magnitude less than 2%, that’s still going to be a horrific loss of life (up to 350,000 a year in the United States, which is about 10 times our yearly car accident fatalities), and should motivate us to act.

      As for the exponential growth of the disease if left unchecked, I’m standing by that. I’ve looked at the growth curves of confirmed cases for many countries and the world as a whole, and they’re exponential, not linear. Alarmingly, the curve for the United States most closely maps onto that of Italy—another country that was slow to respond. But of course exponential growth doesn’t go on until everyone gets it—the curves eventually trend downward. If the mortality rate is high enough for a disease, that’s because >90% of the population is dead, as when bubonic plague decimates all the prairie dog colonies within a hundred-mile radius of an outbreak. But more typically, people who got it just start recovering. And the steepness of the growth curve depends quite a bit on what we do to slow it. If we don’t do anything, it’s going to be steep and ugly, and a lot of people will die unnecessarily for lack of resources. If we act decisively, maybe we can make sure we don’t get overwhelmed—as they are in Italy and Iran—and far fewer people will die. As I pointed out up above, the whole point of this essay was to do my small part to ensure that my calculations turn out to be wrong.

      With all such analyses, errors in either direction are possible. With biomedical issues, the question is often: Which type of error is most tolerable? In the case of this pandemic, I would argue that it’s better to err on the side of caution. If it’s true that 40-70% of us are eventually going to get it and the lethality of confirmed cases is 1.5% (CDC estimates), that’s serious, and I don’t want people I love to be in intensive care tents in the parking lots outside of California’s hospitals, being treated by overwhelmed and depleted providers, lacking the proper equipment because there isn’t enough to go around. Call me an alarmist, but I think we should err on the side of doing what we can to flatten the curve.

      Or, if the doom-and-gloom estimates aren’t compelling, chase down the anecdotal stories coming out of Italy where the response was too little, too late.

      • Avatar Gary Solberg says:

        Steve Towers – Thank you for your thoughtful response. I appreciate your comments and disclaimers. I agree we should do what we can to “flatten the curve.” The case fatality rate is gloomy enough. I suspect determining an overall mortality rate has to be a very complex calculation, and probably differs greatly among varying populations based on demographics, including age, population, overall heath, access to health care, and even local customs. I would hate for fear levels to rise so high as to create such a level that anyone who feels ill with has a cough or fever, thinks he or she is going to die. Stress and anxiety can impair the immune system.

  26. Avatar Semi-Retired says:

    Channel 7, KRCR, is reporting that the Kool April Nights administrators plan to hold the car show this year and provide plenty of hand washing stations. Will somebody please explain to them exactly what social distancing is, and why it is a bad idea to encourage people to come here from out of town in the middle of a pandemic!

    • Avatar Candace says:

      Semi- retired, I’ve reached out to our Mayor regarding those two very same things ( although one being further out). His office (Barry Tippin) promptly replied to my email. His answer was basically that they’re keeping in close contact with County and State Health Dept. recommendations and realize the situation is fluid and can change in a moment. I imagine it’s easier to cancel at a later date than cancel too early and then try to re-organize. That said, I do think it sends a lot of mixed messages as to what’s “ok” and what’s “not”. I personally think KAN should not get the green light this year but I get no pleasure from saying that. Many, many people will be disappointed. As far as the “money” thing of course that’s a factor, those events are big boons to our local economy, no-one wants to be the one to take the hit for canceling those events; understandable. Still, I encourage people to reach out to your local representatives (in a respectful manner) when you have a concern or question (being respectful doesn’t mean you need to sugar-coat your concern). It only takes a moment and while you might not like (or be satisfied with) the answer you get, I’ve found that they do indeed take the time to answer. Public outcry can be very persuasive at times but they have to actually hear your cry first-hand. They’re people like you and I trying to navigate this rapidly changing landscape. I hope they do the right thing and shut these things down for all our sakes, theirs included.

  27. Avatar Semi-Retired says:

    Redding Rodeo and Kool April Nights have both announced that they will go forward and hold their events this year. Will somebody please explain to these people and city officials why this is a bad idea? Social distancing will not be achievable and why would anybody encourage lots of out of towners to come to town in the middle of a pandemic?

  28. Avatar Semi-Retired says:

    Silly me. It’s the money they bring!

    • Avatar Doug Cook says:

      There is the possibility that by mid April the situation would be much improved. If not, I wouldn’t expect much participation
      Most of those with classic cars are at the age they need to self quarantine….but yes, it is all about the money

  29. Avatar Richard DuPertuis says:

    Wow. Thanks Steve, Katie, all involved in this article. It lays things out in necessarily stark terms. I’ve shared with family and a few receptive friends, emphasizing the comments. Can’t tell you how much I appreciate this tool to inform.

  30. Avatar Dr. Leo says:

    The flattening of the infection curve is the first thing I’ve seen that makes some sense to save medical resources. The other thing to keep in mind is that even if the Corona virus mortality rate is the same as the flu, most people don’t get the flu (vaccinations, etc). Being a somewhat new virus, “most” (?) of us or half of us are going to get the Corona virus. That is another huge factor to calculate the effect on the population as a whole.

    Lastly, don’t forget about the butterfly effect. When you change people’s behaviour, you change everything. Our 25 year old farm worker was in near panic mode yesterday. Car wrecks likely will increase or road rage or ?…

    • Steve Towers Steve Towers says:

      I would suspect that the butterfly effect will have net beneficial effects, as more people stay home.

      China says that <3,500 have died of COVID-19 so far. They’ve said that owing to the resulting air pollution holiday in the hardest hit areas, more people than that have *not* died from respiratory ailments, for a net mortality benefit. I don’t know if I’m buying that math, but I’m buying the beneficial impact on air quality and the relief to those with lung issues.

  31. Avatar Common Sense says:

    It’s not 27 days like some experts said a month ago. Now they are saying it stays in the body UP to 37 days now! Oh Shit!

    https://www.cbsnews.com/news/coronavirus-can-live-in-your-body-for-up-to-37-days-according-to-new-study/

  32. Avatar Common Sense says:

    The More He lies….. more that Die! Now saying that the states and Governor’s better be “Nice” to him or the might not get any help?

    WTH.

    https://twitter.com/RepKatiePorter/status/1242610583859593218

  33. Avatar Common Sense says:

    At this point I am not sure what is worse….having a Malignant Narcissist in office that down played the Virus for two weeks AFTER it hit our Country and after having an Intelligence Briefing a Month Earlier thus resulting in hundreds perhaps thousands of deaths OR the People that still Vigilantly defend this 5150?

    His is Incapable of taking real action based on his Pathology! Actions speak louder than words!

    https://www.yahoo.com/huffpost/new-york-city-coronavirus-healthcare-workers-trump-easter-183638991.html

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