Here’s what I think you’ll find if you track things for the next week. The number of cases will go up by 500-1000 cases per day for the next couple of days. Then the increase will start to decline. The number of deaths will also go up, but modestly. I suspect that by the end of this coming week the total number of cases will be around 6000, the total number of deaths 100-150.
I bet that the number of cases by the end of this coming week will be more than double his estimate.
Consider the following math problem:
You observe a petri dish for 24 hours. The amount of bacteria is doubling every hour. At the start, there is only a microscopic amount of bacteria. Right at the end of 24 hours, the petri dish is filled with bacteria. When do you suppose that the petri dish was half filled with bacteria?
Many of my readers will arrive at the correct answer after a few seconds. I would bet that Roger Kimball would not be able to answer the question correctly within five minutes. And if you cannot do that, you should keep your views on the virus crisis to yourself.
In his own way, Nassim Taleb tries to explain why it is unethical not to pay attention to the exponential.
In a more easily-understood way, these physicians make the point.
If our health care system fails, then we will all suffer. If the hospital is choked with COVID-19 patients, people with appendicitis, heart attacks, broken ankles, and so on will not be able to be treated. This is the picture of systemic risk. Everyone is at risk if there is a systemic failure of our health care system, not just those with COVID-19.
The challenge is this: By following the appropriate recommended social isolation measures, you will be saving lives of not just those at increased risk who are infected, but also those who need other critical health care services, including potentially yourself. You will be saving the lives of people you will never meet.
Who should follow our suggested social isolation measures? EVERYONE. If you do not need to go out for a mission-critical purpose, do not. Again, you WILL be saving the lives of at-risk members of your own family, as well as people you will never have the pleasure of meeting.
This reinforces to my thought process.
Both the United States and Canada are at critical junctures. The key is whether clusters of community spread are stopped or allowed to grow unchecked. Wuhan had 6 weeks of uncontrolled community spread. The United States had pockets of community spread and the question is whether those pockets are growing undetected. At first I thought they were but my confidence is growing that the message of “social distancing” is finally getting through, possibly because of fear and panic, and that any uncontrolled spread will be due to new imported cases that refuse to adhere to common sense (perhaps after reading Roger Kimball).
The cases in both the U.S. and Canada are growing exponentially (the high growth part of the Bell Curve) but these are echoes of the uncontrolled community spread occurring worldwide and captured in local “travel” cases. Its harder to see in the U.S., but the Canadian numbers so far are pretty clear: large numbers of travel cases mostly self-isolating, partial Close Contact spread (e.g. spouses), hints of community spread that don’t take hold. The U.S. and Canada have many shared cases that we are forgetting: the early evacuation flights from Wuhan, the Diamond Princess quarantine and repatriation, the Grand Princess, CPAC conference, BioGen conference, etc.. As long as a decent effort to communicate potential new clusters, isolate people exhibiting new symptoms, and do Contact Tracing, even imperfect execution seems to slow then reverse the spread.
We need to be terrified of people like South Korean Patient 31 and her church. This is a moment for microeconomic thinking rather than macroeconomic modelling. Focus on individual interactions, homes, families, communities, shared spaces/transportation, and hospitals. I’m hopeful but not irrationally so: the U.S. is in for a tough battle but a very winnable one.
I spoke too soon, I should have checked my news feed before posting. It is now assumed that community spread of COVID-19 is occurring in Ottawa. I’m trying to be charitable but I’m struggling not to rant about stupid people ignoring simple messages.
It is the mindless Patient 31 types that will be our doom.
I wish we could require all columnists to bet on their predictions on everything before publishing…
That is a great gimmick for someone trying to break into the business.
Whatever one thinks of recent market actions, I think the plunging stock market has played an absolutely crucial role in getting people to take social distancing seriously (both individuals and elites). This is actually a “big win” for capitalism and the decentralized information aggregation mechanism it represents. At a minimum it is sending an incredibly loud signal to people to alter their behavior, whereas without a clear numerical signal people could go on saying its “well, just like, your opinion, dude.”
This will be tough. I live alone and often go to my local coffeeshop to do work and be around people. Don’t know if I can stay indoors for long…
Arnold, where is YOUR prediction of what “will” happen?
“Panic”/prudence becomes a self-negating prophecy, and because many folks ARE afraid of the exponential growth, they DO change their behavior, so the exp. growth does NOT happen.
I think, because of the “premature panic”, enough people are changing their behavior so that the casualties will be closer to Kimball than to … what is your estimate? 1000? 10k? 100k?
BECAUSE of Trump’s excellent early stopping of flights from China, and fairly early National Emergency, the USA is likely to have fewer deaths than China, listed by wiki (link below by RAD) as 3199. I also believe US reports, but do NOT believe China. I’m pretty sure more have died, sadly.
I think this Wuhan virus justifies “maximum prudence”, but not “panic”.
It’s not always clear where TP saving (10 rolls? 100 rolls? 1000 rolls?) goes from prudence (2 or 3 times your normal saving) to panic (10-20 times your normal saving).
We buy 8-packs; I usually have 1 saved, now it’s at 2-3 packs (time to buy tomorrow).
It will become an interesting discussion, afterwards, about what is/was prudence, and what was rude panic vs silly panic.
Like a 5.6 earthquake, big, somewhat damaging, but not “the Big One”. A good wake up call. The news media will look even worse, after this.
Also, how do we know when the emergency is over? Will things ever get back to normal? Did the government just expand its power again? Is a dictatorship on the way?
The new infection cases form a bell curve like the yellow barsin this graph.
The first step is to keep the peak below the health system capacity. Return to normalcy is a bridge to be crossed once we get into the downward slope far to the right of the peak.
Yeah I get that. I’m just worried we may be crossing a government power threshold, one where they will not go back on even if the crisis is over.
The petri dish is always a nice model story, but reality never actually works like that- the bacteria in a circular dish infected at the center can double at the beginning at a constant rate, but the bacteria start to inhibit themselves as more and more of the plate is taken over. Think of the petri dish as the world population- the infection will follow a bell curve of some kind, the only question is the area of that curve.
The people who think the infection can be stopped well short of saturation should think Kimball could be right- that the knowledge of the danger will alter behavior enough, all by itself, to have reduced R naught to less than 1 already. It might not show up soon enough for Kimball to be right, but he could have been right if he made the appropriate prediction 3-4 weeks from now. Right now, we are just in the phase of counting the people who were mostly already infected last week.
Even though I am pessimistic that the virus can be stopped short of saturation, the US will probably be in the most optimal position of any of the major western countries in that we aren’t as packed in closely together in most of the territory. If I lived in a high density city, I would probably take a nice 6 month vacation to the country. Europeans don’t really have that option since their dispersal to the boondocks will just turn the boondocks into cities.
Nassim Taleb’s essay seems to imply that social distancing is individually irrational, especially at the early stages of an outbreak. I’m not quite sure that’s true, especially if one includes concern about infecting one’s elderly loved ones (as opposed to unknown strangers) as an individual, private interest. Also, one might consider that the private consequences to individuals (or their elderly loved ones) getting sick is higher if there is the potential that, when they do get sick, the health care system might be overloaded. That’s a little different than the collective interest in not overloading the health system to begin with. Taleb of all people should understand that individuals have a private interest in managing black swan tail risks.
Related, on the collective interest of not overloading the health system, although many have pointed out such interest, I have yet to read anyone explain how such interest has arisen. There are very few, if any, other goods/services where we have somehow developed a collective interest in preventing demand spikes. Why? Is it because there is no market for reserving hospital/ICU/ventillator capacity in the event of an outbreak? Such a market, if it existed, would seem to allow us to rely on individual interest to get people to socially distance rather than on exhortations to consider collective interests. Tragedy of the Commons, shortages, and hoarding are all solved by property rights and flexible prices. Is hospital capacity an exception? Also, has regulatory capture in some way prevented emergence of health care innovations to allow for more flexible capacity to meet demand spikes? These are questions about how our healthcare system should evolve in the long term. In the present crisis, we have to deal with the healthcare system that we actually have. Somehow, though, I don’t get the sense that this pandemic — and the heavily regulated healthcare system’s inability to deal with it without resorting to calls for collective action — is priming us to consider market-based reforms in the future. That would be truly immoral and unethical.
Yes, hospital capacity is an exception as are seatbelt laws and speed limits. These are cases where we have to rely on empirical data to make optimal decisions in the aggregate. I think what is common in these cases is a lack of a feedback loop that matches our natural institutional memory.
Market prices incorporate empirical (and all other types) of data and provide for not only feedback loops but also predictions about future surpluses and shortages. My question is whether there is something about hospital capacity that doesn’t allow information about it to be communicated through market prices.
BC, I think I’ve tried to answer your question directly. Markets, and other emergent systems, work based on tight feedback loops. We have to also design systems with rare or non-linear (different variables that dominate in different phases) signals. If you are designing a city’s sewer system you need a 100-year storm value which is based on empirical data, including the timeframe based on the systems involved.
The health system is more of a non-linear system with many different variables that are dominant in many difficult scenarios.
One would have thought social media experience for chattering class types would have thoroughly trained everybody by now in viral dynamics and the exponential growth curve that occurs when something gets contagious and passes from person to person.
Also, all those pandemic and zombie horror movies have done a lot of unrecognized pubic education.
I am more concerned that a large majority of people have stumbling block psychological trouble thinking in terms of the prudence and desirability of active measures that, while they are certain to cause a lot of gross harm, are the lesser evil and reduce net harm, and yield a superior outcome to the passive harm counterfactual.
This is also something I would have thought Hollywood would have educated the public about, excruciating hard-call “least worst option” decisions of this nature being the running theme of shows like “24”, but apparently not.
Yeah, except my mechanistic-mind reels when confronted with the fact that the vast majority of very smart people, like the community built around this site, fully understand exponential curves but can’t seem to recognize systems that are clearly not behaving exponentially.
It was reasonable to make 40-70% infected population estimates before we understood the details of this specific disease and how our societies would behave during an epidemic but the learning phase is over. The data is imperfect but it’s good enough, in the engineering sense, to decide a strategy and a set of tactics given our current resources.
Our social systems collapse long before the infected population reaches an immunity level that has any impact on limiting further outbreaks. The bell curve is very shallow, relative to the total poulation, when it exceeds health system capacity and forces the economy into total lock down.
We will be facing a never ending series of shallow sinusoidal bell curves until we learn to focus on the newly ill and calmly backtrace their previous contacts with an emphasis on the time since first symptoms appeared or 5-14 days if you treat every infected person like a Byzantine General.
I like Roger Kimball, but I believe he is wrong on this.
It is difficult to find the correct response to an exponential or potentially-exponential event. If you go draconian before the “knee” in the curve, it looks like overreaction to a nothing-burger. If you hit after knee, you could easily get 10x or 100x the fatalities you might otherwise have gotten. Add in the long asymptomatic infectious period, and you are working with badly out of date data.
In terms of govt response, facilitating drive-through testing, closing borders, encouraging social distancing, seems correct at this point in the curve. martial law with jail time (like Italy) does not seem correct, perhaps ever for this country. I am very impressed with the response from sports leagues, which made it inevitable that schools, libraries and other public facilities would close.
If you haven’t read this:
https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca
You should do so.
Pueyo makes it clear in Chart 7 that a definite lag exists between the measured (confirmed) cases and the true number of cases. The lag approximates the incubation period. What this means is that the number of new cases keeps growing fast after the imposition of quarantines or self isolation.
I’m guessing that after a week or so of “self isolation” and shutdowns in the US, people will still see large numbers of new cases and begin to believe that the activities to curtail the growth aren’t working. The ability to sustain these policies will weaken and/or disappear and we’ll really be in trouble.
One counter to this is event is continual reminders to the public that the measures will work but we will not see the effects for some time and plea for patience. I don’t hear any of those reminders now.
You’d have won big. Nearly 2oK cases as of now (Friday evening).