Coronavirus - essential information that you probably don't know

After some recent reading I feel obligated to do my bit to make people more aware about the Coronavirus - specifically just how severe it could be and how important it is that we all use our efforts and networks to protect ourselves and others.

Please take me seriously because I wouldn't take time to do something this unless I was very worried. I wouldn't be so worried if there wasn't i) an abundance of strong evidence and concerned experts but also ii) a huge number of people who appear to be relatively unaware, misinformed or unconcerned about this [1,4,] 

Here are some very relevant quotes that will probably shock you as much as they shocked me - I don't think that I really understood how serious things might be until now:

There is a non-negligible chance that there will be a lot of cases - probably millions by June

"In The Atlantic, Marc Lipsitch, a leading epidemiologist at Harvard reported that “that within the coming year, some 40 to 70 percent of people around the world will be infected with the virus that causes COVID-19”. This was last week and while ridiculed at the time, his assumptions are now the generally accepted position among epidemiologists." [4]

"while the number is relatively small right now, cases outside of china are doubling roughly every 5 days. The reported rate of infection in China is lower, but China has taken drastic quarantine measures, including welding people inside apartment buildings." [4] (I found out that the welding claim may not be true - however it is generally agreed that the measures have been drastic)

"Each year the flu infects between 2 to 11% of the population. The infectiousness of a disease is measured by its R0 value. R0 is a measure of how many people will catch a disease from one infected person. The R0 value of the flu is 1.28. The R0 of COVID-19 is assumed to be between 1.4–3.8. Dr Marc Wathelet, research leader at the only institute in the world dedicated exclusively to research on respiratory disease transmission wrote an article this morning claiming that the R0 is being severely underestimated and the real value could between 4.7 and 7." [4]

There is a non-negligible chance that these cases will overload our health systems

Current rates mortality are 2% when there good healthcare [4]. However, that might not be available for long because we might run out of the treatments required:

" 5% of people who are diagnosed with Covid require artificial respiration. Another 15% need to breathe in highly concentrated oxygen - and not just for a few days. The duration from the beginning of the disease until recovery is 3 to 6 weeks on average for these severe and critical patients (compared to only 2 weeks for the mildly ill)" [1]

Here is a good example that shows just how much this might overload a health system:

"We think the virus might be much more infectious than the flu, but let’s assume that only 8% of the UK population gets infected, the same as a severe flu season. The UK population is 67 million people, that’s 5.4 million infected. Current predictions are that 80% of the cases will be mild. If 20% of those people require hospitalization for 3–6 weeks? That’s 1,086,176 People. Do you know how many beds the NHS has? 140,000" [4]

Of course most of those beds are already filled...

There is a non-negligible chance that Coronavirus will kill several million people, maybe even many million

For insight into why this may occur, see this comment from Wei Dai, a computer engineer known for contributions to cryptography and cryptocurrencies [3], who is widely respected in the LessWrong community for his impressive success at past predictions related to cryptocurrency and the the stock market. When asked what happens if >10% of population is infected with coronavirus [2], he responded:

" The world is probably going to lose 2.5-10% of its population (190-760 million[...]), worse than the Spanish flu even on a percentage basis. I didn't realize this until now (or rather, these facts didn't become salient until now), but the current CFR estimates for COVID-19 are based on hospitals not being overwhelmed, whereas Spanish flu CFR was based on hospitals being overwhelmed (plus they didn't have the life-saving technology we have today anyway, like oxygen concentrator and mechanical ventilator). If hospitals are overwhelmed, which seems very likely at this point, most of the people needing to be hospitalized (10-20% of infected, which will themselves be ~50% of world population according to epidemiologists) will probably die.

"An examination of 44,672 infected people in China showed a fatality rate of 3.4%. Fatality is strongly influenced by age, pre-existing conditions, gender, and especially the response of the health care system." [1]

"If just 25% of the US over 80’s cohort get infected, given current mortality rates that’s 466,200 deaths in that age group alone with the assumption that the healthcare system has the capacity to handle all of the infected." [4]

Many cases who survive may have long term complications 

"reportedly the [Corona]virus does serious damage to people’s lower respiratory systems — supposedly it can take “…at least six months for patients to recover heart and lung function.” [5,6]

An extrapolation from effects observed in past outbreaks/similar conditions:  

"I chose a similar but more severe virus, SARS, which was successfully contained in 2003. Out of 208 Canadian survivors of SARS, 22 (10%) appear in this study of subjects "who remained unable to return to their former occupation" with "clinical similarities to patients with fibromyalgia syndrome". [5, 7]

What to do now? 

Please read the information in [9], follow the recommended steps, share it with everyone you think needs to know - particularly those who are older or unwell. Vitamin D supplementation may help [8].

Start paying attention. Make serious preparations for potential bad outcomes - better to be too worried and look a little stupid in the eyes of some than to regret your complacency for the rest of your life. Do you need that holiday enough to risk your life? Do your parents know how serious this is? Do you really think that you should commute to work each day?

Your decision on these matters may determine whether people you love (or just that other people love) will suffer or die. This is that serious. Humanity has suffered greatly from underestimating epidemic risks - don't be a data point in a future case study. Most of the smartest people I know are very worried and taking serious precautions. Be like them.

Please also tell me why I am probably wrong if you are better informed - it would be a relief to know that I am over reacting!

References

1: https://www.reddit.com/r/China_Flu/comments/fbt49e/the_who_sent_25_international_experts_to_china/

2: https://www.lesswrong.com/posts/RukXjEvMfqDKRJaup/what-will-be-the-big-picture-implications-of-the-coronavirus

3: https://en.wikipedia.org/wiki/Wei_Dai

4: https://medium.com/@amwren/forget-about-the-death-rate-this-is-why-you-should-be-worried-about-the-coronavirus-890fbf9c4de6

5: https://www.lesswrong.com/posts/h4GFHbhxE2pfiadhi/will-ncov-survivors-suffer-lasting-disability-at-a-high-rate

6: https://www.cassandracapital.net/post/coronavirus-the-status-of-the-outbreak-and-4-possible-scenarios

7: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3071317/

8: https://www.bmj.com/content/356/bmj.i6583?fbclid=IwAR1pRvjWcve95gMp-euEBSLGgDni_TSJqohE1K1VsAsQ7VibRRYK8kZ3eNc

9: https://docs.google.com/document/d/1vumYWoiV7NlVoc27rMQvmVkVu5cOAbnaW_RKkq2RMaQ/mobilebasic