It’s Coming (It’s Already Here): COVID-19 (or Coronavirus)

I’ve kept silent on this matter for far too long.

And even now I’m hesitant to say anything publicly—I want to write this piece before I no longer have the courage to do so as my instinct to preserve whatever respect that some of you might have for me is being ever-so slightly beaten by a strange mix of logic and reason, a very-large helping of compassion and my overwhelming sense of duty to say something to those that I love and cherish the most.

🛑— I believe that COVID-19, otherwise known as coronavirus, is serious enough for everyone to start preparing for the worst.

Yes, I know. That makes me sound like a crazy-person. Mhmm. Yes.

I hope I’m wrong. I hope that this public post here will forever embarrass me until the internet blows up. And I will eat these words and the public ribbing for the rest of my life. I’m ready.

I really don’t give a shit about my “personal brand” or the hit that my reputation will take by saying these things publicly (and most of you already know that). I simply care about too many of you too much to say absolutely nothing, especially since this is something I believe.

“Well, how do you know all these things? Why are you so confident?”

That’s a really great question! First-off, I’m a little ashamed to admit that I’ve become a “closet virologist” since December of last year, mostly because the amount of disruption that this is causing was something that I simply could not ignore.

Secondly, as I dove into the data and built a foundation of reliable, vetted sources, I began to connect with more folks in the scientific community who are dedicated to informing the public with facts.

The amount of energy that some have committed to throwing at this, despite any (and every) negative, personal consequence, has given me courage to use the small platform(s) that I have to inform you, my dearest friends and readers, that it’s time the wake the fuck up.

[But remember, I’m not panicked and neither should you. Level-heads and a simple plan will prevail! Just don’t be the last to try to jump on-board!]

Like data visualizations? Me too.

This post isn’t meant to be comprehensive justification of my position or in any way, shape, or form an attempt to “beat you” with information. You all know me, I want to get right to the point: I don’t want you to spend time reading and digesting material; I want you to act.

[You can always read more but I’m trying to give you permission to not read those things and just take me at my word. Get your basics covered and then read more!]

So, if you’ve ever found me to be a reasonable and trustworthy person, I’d like to “cash in” on any relational equity that we may have and tell you this plainly: Now is the time to get at least 30 days of food, water, shelter, and fire for everyone in your family or who’s under your direct supervision and care.

In my case, that’s ~150 gallons: 1 gallon per day per adult, for 30 days and a lot of beans, rice, and other non-perishable items (bigger list at the bottom of the post). We have 5 humans and we drink a lot of water:

It doesn’t feel like much. I feel we need more.

But the reason I want you all to get at least the bare minimum (30 days of food, water, shelter, and fire) is because it is your civic duty as a co-owner and inhabitant on this planet—it is our collective responsibility to care for one another, especially for the elderly and sick who are the most vulnerable to COVID-19. I agree with this article very heavily:

Forget all that. Preparing for the almost inevitable global spread of this virus, now dubbed COVID-19, is one of the most pro-social, altruistic things you can do in response to potential disruptions of this kind.

We should prepare, not because we may feel personally at risk, but so that we can help lessen the risk for everyone. We should prepare not because we are facing a doomsday scenario out of our control, but because we can alter every aspect of this risk we face as a society.

That’s right, you should prepare because your neighbors need you to prepare—especially your elderly neighbors, your neighbors who work at hospitals, your neighbors with chronic illnesses, and your neighbors who may not have the means or the time to prepare because of lack of resources or time.

via Scientific American

I have not stopped thinking about my neighbors, both my literal ones on the street and then everyone else that I care about who may not have adequately prepared.

My neighbors, like yours, are not geographically-bound. They are everywhere and we need to be ready and available to help them, especially if they can’t (easily) help themselves.

There are local trackers available, like this one for SF / CA.

You see, for those who are capable, able, and willing, we do our part to minimize the load that is going to overrun our current weak and unprepared medical systems, here in the US and already abroad.

This isn’t just an epidemic, it’s officially apandemic, something that threatens our entire world. This is from our very own CDC:

The fact that this disease has caused illness, including illness resulting in death, and sustained person-to-person spread is concerning. These factors meet two of the criteria of a pandemic. As community spread is detected in more and more countries, the world moves closer toward meeting the third criteria, worldwide spread of the new virus.

via CDC, Risk Assessment (March 1)

It will be just a matter of days before the CDC updates this statement to include the third criteria since it’s already happening here in California, Oregon, and now Washington.

I mean, in just 2 months it’s gone from one (1) country (China) to over 60 countries with confirmed cases. It’s just paper-napkin math, but, 60 out of 195 countries is just north of 30%. I’m using these numbers for a point: Countries that had zero plan a week ago now have to come up with one “from scratch”. No one seems to be adequately prepared.

If all of this sounds alarming then, good. Most of us have only begun to even think about preparations let alone scheduling a time to go do it.

Genomic Epidemiology—say that 3 times fast.

Truth be told, even I’ve been guilty of that since I did not have full preparations ready for a catastrophic event here in San Francisco! Most folks know about the San Andreas fault-line, but the fact is that that’s just one of seven fault-lines that criss-crosses below my family’s feet!

It’s taken a global pandemic for me to shore-up our own baseline (again, 30 days!) because… well… I’m… just… like… you! I don’t want to be “that guy” that’s standing in line after raiding the water and bean aisle.

Guess what, I did that this week—multiple times! Even brought my kids along on a few of them. We’ve also had candid chats with them about the real possibility of their school closing down (it’s already happening), their soccer teams not practicing or playing for a while, and even the chance that basic utilities and civil services turning off or being rationed (water, power, and gas).

The point is that we’re preparing for the worst while hoping and praying that this will be a big joke in the end (and I can be the willing the “butt” of every single one here on out).

It’s also worth noting that epidemic diseases have not just one “wave” but two. In the first, the initial infection happens followed by governments tightening movements, shutting schools, and anything that helps slow the growth and spread of disease.

Then, unfortunately, the “controls” are eventually relaxed (people need to work, kids need to get back to school, etc.) and then the second wave hits, usually infecting a subset of the folks who didn’t catch it the first time.

You need to prepare for both waves—think of it like the first earthquake and then the after-shocks, some of which can oftentimes be more damaging than the initial quake!

Finally, I’ve said almost nothing about the global economic instability that is already happening. Millions of small businesses will close and go bankrupt because no one is eating out or going shopping. What will happen to all of those people and their families? Are we even prepared as a global society to serve and support these people when the inevitable crisis comes?

In addition, how do we begin to even account for the psychological and emotional (i.e. trauma) impact on millions who have been forcibly moved and “quarantined” with very little humanitarian review, accountability, and/or oversight? Civil liberties are being systematically ignored and our world will have to respond to that impending cultural crisis!

Millions will need therapy, counseling, and more!

Okay. So, that’s a lot.

I’m not sharing any of this to scare you or make you panic. In fact, I’m very level-headed and feel emotionally in control. But, I’m concerned enough to share these thoughts and feelings with you candidly because thousands are suffering and it doesn’t appear that this will stop anytime soon. I love and care about my friends, family, and readers. I want you to get to the other side of this with me. Please, be prepared, for you, for me, and for every-freakin’-body on the planet!

I’ve added a few notes and graphics below as well as an overall timeline—I hope this can provide some helpful and useful overview.

But, if you’re still reading and not getting out of your chair and making a list of the things you need, then, this blog post has been insufficient to get you to act. For that, I’m truly sorry.

Quick Overview and Timeline:

In December of 2019, cases of a new respiratory virus emerged in Wuhan, China, a major city of over 10 million residents in the Hubei region. Although information on this disease was initially suppressed by the Chinese government, the WHO (World Health Organization) was contacted on December 31, 2019 and a new virus was officially recognized and identified on January 7th, 2020.

The first cases outside of China were identified on January 13, 2020, first in Thailand and then 3 days later on January 16, in Japan. On January 23rd, Wuhan was placed on forcible lockdown by the Chinese Government. The virus, now globally recognized as a coronavirus (which is a family of viruses that cause SARS and MERS but not flu). Humans have at least 4 coronaviruses already that cause 10-30% of all seasonal colds and many of us have had them!

Currently, as of this post’s original publication (March 1, 2020), there are over 80,000 people are infected with the new COVID-19 virus and over 2,700 have died. Many epidemiologists believe these numbers from China are grossly underreported by at least 10x, or 800,000 infected.

More wonderful data via Johns Hopkins CSSE

Confirmed are major outbreaks in Korea, Italy (lockdown 50k in 12 small  towns), Japan (Prime Minister asking folks to telecommute and a marathon (38,000 participants) cancelled (and possibly the Olympics), Iran (deputy health minister infected and cases spread across middle east), and many more countries (60+ and climbing).

Despite WHO’s assurances, most epidemiologists believe (and now with confirmation) that the virus has broken out of China and is spreading around the world at a significant pace. Many believe that 20% (or more) of the planet will be infected. For comparison, the 2009 H1N1 flu infected ~16% of all humans.

Data on the virus is limited but growing by the day (although our primary source, China, may never give the medical community accurate data). Here’s what we know so far (primary data here):

  1. Mild, in Most Cases. E suggest 80% of COVID-19 cases are mild and feel like a typical flu. Estimates suggest that roughly 10-15% of cases will be more significant and may require a hospital visit (see also) with 1-3% potentially needing an ICU. The concern of many governments is the peak number of cases that occur in a given moment. For example, if 1,000 sick people show up overnight to a hospital that hospital would be overwhelmed. Many of the social engineering policies (shutting schools etc.) are focused on spreading infectious cases out over time, so hospital infrastructure can deal with all the sick. The higher death rate in Wuhan versus rest of China may reflect a local collapse of healthcare infrastructure.
  2. Death rate: The reported death rate has hovered around 2% but may in reality be 0.2% to 1% depending on country and healthcare system. Many estimates tend indicate an overall expected mortality rate of ~0.5% globally.  The current existing fatality rate is biased upwards by Wuhan cases dominating the mix (which are closer to a 3-4% death rate and make up most cases). It is more than possible the virus is being under-tested for in China / rest of world driving the real death rate down (as many more people are infected than is reported).
  3. R0 value: The spread rate of the virus seems to be well over 2 and likely ~3. There are estimates that climb even higher. This means for every person infected at least 2 to 3 more get the disease. This compares to the flu at 1.5 or so.
  4. Incubation period. Realistically, the incubation period (time from infection to symptoms) appears to be under 14 days and likely 5 to 7 days for the majority of people. People appear to be infectious rapidly after infection, potentially as soon as 12-24 hours. Many experience only mild conditions early, which increases spread rate of the disease as people go to work or otherwise continue with life unchanged.
  5. Elderly & pre-existing conditions. The elderly and people with preexisting conditions appear especially susceptible to disease and severity or death. It is possible the elderly are susceptible largely because they are more likely to have pre-existing conditions. In contrast, very few cases have been reported in young children.

Stay Healthy, Prepared:

I like this video, so, here you go:

  1. Stay home when possible, avoid planes, buses, trains, queues, busy areas.
  2. No visitors, avoid close contact with symptomatic people or potential carriers, don’t share cups.
  3. No handshakes, kisses, hugs. Don’t kiss babies. All outside surfaces, money.
  4. Gloves and meticulous hand hygiene, don’t touch eyes, nose mouth.
  5. Wash hands, warm water and soap or hand sanitizers.
  6. Catch it – bin it – kill it.
  7. Coughs and sneezes spread diseases.
  8. Fecal contamination, meticulous hand and surface hygiene.
  9. Wear a quality medical mask or n95.
  10. Wrap around glasses.
  11. Avoid hospitals, limited visiting.
  12. Good nutrition, vitamin D.
  13. Keep warm, sleep, family life.
  14. Thoroughly cook meat and eggs.
  15. Avoid public spaces and wear a mask at home if you start to feel ill with fever.

Here are the symptoms. Staying safe is simple, but, you must do it.

One page simple guide? Sure, I got you fam:

Don’t respect me? Perhaps Bill Gates can provide some cogent thoughts (oh, he did!):

Now, in addition to the perennial challenge, we face an immediate crisis. In the past week, COVID-19 has started to behave a lot like the once-in-a-century pathogen we’ve been worried about. I hope it’s not that bad, but we should assume that it will be until we know otherwise.

There are two reasons that COVID-19 is such a threat. First, it can kill healthy adults in addition to elderly people with existing health problems.

The data so far suggests that the virus has a case fatality risk around 1%; this rate would make it several times more severe than typical seasonal influenza and would put it somewhere between the 1957 influenza pandemic (0.6%) and the 1918 influenza pandemic (2%).

Second, COVID-19 is transmitted quite efficiently. The average infected person spreads the disease to two or three others. That’s an exponential rate of increase. There is also strong evidence that it can be transmitted by people who are just mildly ill or not even showing symptoms yet.

This means COVID-19 will be much harder to contain than Middle East Respiratory Syndrome or Severe Acute Respiratory Syndrome (SARS), which were only spread by those showing symptoms and were much less efficiently transmitted. In fact, COVID-19 has already caused 10 times as many cases as SARS in just a quarter of the time.

via Bill Gates

I love you all and we’ll talk soon.