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Showing posts from April, 2020

March 12: Health care system capacity

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The graph below has been around, but I want to put it up again, because it really explains well the most important issue we are dealing with, and that is the capacity of our medical system. I have posted about the problem of grasping the effect of exponential growth and I have posted how that has already affected Italy, and I how we expect the same to happen here. The question I want address now is: when does the exponential growth stop and how? The growth stops when there are no more bodies left that can be infected. That can be because most people have already been infected and have acquired immunity or new possible "hosts" have become unreachable (possibly because they are staying home...or 6 feet away from infected folks). This "flattens" the curve, and, as the virus runs out of new hosts the curve goes back down. So where are we on the curve? We are on the left bottom side and we have a choice. Without adequate measure we'll go up the red cur

March 11: How many people around you?

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I just don't get it! You don't need 1000 people to get the virus... One is enough! Granted the probability of finding "the one" is greater if you have 1000 people around you... the problem is that we really DON'T know how many people may be shedding the virus around you. Avoiding large crowds doesn't cut it. We need to practice social distancing from everybody! Starting now! Recommended distance is from 3 to 6 feet! Amazing to see Italians lined up to enter supermarkets, all lined up 2 meters away from each other. The line goes around the block... quite a sight for people who are generally viewed as "undisciplined"! You can get fined or get jail time right now for not respecting the distance. "If it doesn't seem unreasonable... it won't be effective"

March 11: What's happening in Italy

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From the Italian Ministry of Health: here are the numbers from Italy as of today starting on Feb 22 (that's only 3 weeks ago)... Deceduti = dead Guariti/Dimessi = recovered Attualmente positivi = tested positive The chart starts with about 15 case in Northern Italy on Feb 22. This is the kind of "mathematics" I've been talking about (numbers doubling every few days). They started testing folks by the thousands immediately to know exactly what was going on... (how much testing has been done here?). There was only ONE case in the town of Codogno on Feb 21 and on Feb 23 they quarantined the whole town. How many cases do we already have in the Bay Area and what has been done? ONE PIECE OF GOOD NEWS FROM ITALY in the town of Codogno, the first one to be quarantined, there were NO NEW CASES yesterday for the first time. That means that drastic measures eventually work. Please stay home if you can, or practice "social distancing" if you abso

March 10: "Just like the flu"?

CDC estimates that so far this season (in the US) there have been at least 34 million flu illnesses, 350,000 hospitalizations and 20,000 deaths from flu. So why are we freaking out about 29 deaths from the corona virus? Here are the reasons: First of all the flu is a killer as well and measures such washing our hands will work for that too, and we do have a vaccine that increases our safety. However, it is a "known quantity", we know roughly how many people will be affected, and what the death rate is (around 0.1% and 0.05% this year -- certainly not a joke). Also, the health system has "adapted" to it. We have an adequate number of hospital beds and ICUs to take care of the worst cases. So, what's the difference with COVID-19? The difference is that with COVID-19 we are only at the beginning of the exponential curve (in my previous chess-board example we'd be on the 4th or 5th square) and the numbers (if left unchecked) can easily get la

March 9th: The math of epidemics

The problem with epidemics is that our brains were not "wired" for exponential mathematics. There is a story about an ancient king who was bargaining with a merchant about a payment in the form of rice. Finally the merchant asked for a chess board. He said: "all I want is a grain of rice on the first square, 2 on the second square, 4 on the third ...and so on, doubling the amount on each square." "That's all?" Said the king... "granted!" Unfortunately for him it turned out t hat there was not enough rice in the entire kingdom to pay the merchant! So what's the lesson? The lesson is that if every infected person infects 2 you have the same mathematics... and the time to stop the process is when the numbers are still so small that the problem is not yet obvious, So effective action will always seem premature and alarmistic. Any action needs to be proportional NOT to the present numbers but the numbers to be expected in a wee

Feb 19: epidemics and universal insurance

My previous post on the virus epidemic was "hijacked" by considerations on whether or not to "panic". That was not my intent. I wanted instead to bring up a point that, until now, has been absent from discussions on whether to have a "universal" health care system, or retain some form of the present volunteer, or employer based, system that still leaves some millions of people uninsured. I made the point by comparing the actions taken by Italy, that has universal care, to t hose taken and forthcoming in our country. The problem (regardless of how prevalent and dangerous the epidemic will be) is that we are not safe until EVERYBODY is safe. If even a small number of people will be unable to get immediate care and testing because of money or insurance restriction issues, we are ALL endangered, whether or not we have insurance. All democratic candidates want to get there, the differences are in how, and how quickly, and in what they view as &q

Feb 28: The start

One person was found positive for the COVID-19 in a town south of Milan. Extensive testing was done immediately of all contacts, and the whole town was put in quarantine. Milan to the north remained "open" but all public events and schools were closed. Italy has universal health care. They had thousands of tests kits available, and affected people were put in the best specialized hospitals. Medical authorities have been regularly speaking to the media. Politics has been out o f the picture. Let's compare with what's happening here... We have a first case in Solano county that appears to be "community" spread. We appear to have no large scale testing (any testing?). The Bay Area seems oblivious to the potential seriousness of the problem. How many "insured" folks will go to less capable hospitals because of the restrictions of their insurance companies. How many uninsured folks will not seek care or testing (when finally available) beca