updates/day2.R

In eeholmes/CoV19: Eli's package for figures and data on CoV-19 epidemic

More reflections on what to expect and why officials are implementing the changes that they area. Reminder, this is just my personal reflections as someone with training in epidemiological modeling (which includes modeling mitigation) and who has been closely following the epidemic spread around the world. Listen to our public health officials and follow their instructions. We know from China that the epidemic can be stopped if we follow extreme social distancing. Compared to other disasters, like a hurricane or a tornado, what we have to do is fairly easy and not dangerous. Practice good hygiene AND stop getting close to people outside your family. If you are working or shopping, keep your distance. This is the only thing that is working in other countries. Either we do it voluntarily or the government must enforce it.

Ok. Update. The lockdown (shelter in place) is having an effect in Lombardy. For the 2nd day in a row, the number of new cases dropped. Yes, cases are going but the goal is to stop the number of new cases going up each day. Exponential growth is when the number goes up each day. This is what was seen in China: lockdown works. 

In WA, our new cases continue to go up. Do not freak out but do do more distancing. If we look at the rate of growth over the last week, it has dropped. Our interventions are working! But a growth rate of 1.22 is still too high. That's back of the envelope 12 days to hit 10000 cases, which is about what Lombardy's heath care system could handle (roughly). Do not let up. Eliminate any non-essential social contacts. If you are working or volunteering to help, take seriously the instructions from health officials about how to do this. And keep your distance from others while you work! We know from other countries that extreme social distancing is necessary to stop the epidemic.

Realistically lockdown is coming. In addition to Italy, France, Spain and Lebanon (and probably more countries) are in a 'shelter in place' lockdown. Parts of California are too. I have been texting with friends in lockdown in Spain and Lebanon. Prepare, relax and follow instructions from health officials. Groceries and pharmacies will stay open. 

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Bigger picture. We now have Italy and the rest of Europe as guidance for what is coming. We also have China which shows us that the epidemic can be stopped, but it will take extreme measures. The 'Uh oh' moment has come watching Italy and Europe. The doubling rate in Europe has been 3-4 days not 6-8 like was thought it would be. We have seen that across Europe that countries have been unable to stop an epidemic with normal measures, even what would normally be extreme measures. 

Why are countries like Singapore and Japan able to keep the rate so much lower? Because people are social distancing much, much better. They went through SARS (much, much scarier than CoV-19) and know the drill. They were like, 'Um, nope not doing that again!' And everyone took it seriously but they also had been through this and knew what to do. With lower rates also give public health departments more options, like contact tracing and individual quarantines work.



Lombardy's health system really started feeling the strain at 10000 cases, so let's use that as a bench mark. Through shutting down schools, remote working, stopping all groups over 250, etc, WA has gotten the growth rate down to about 1.22. That gives us back of the envelope a little over 12 days to 10000 cases. Unfortunately it'll keep going up from there but getting the rate down to 1.22 from 1.3 gave us an extra 3 days of time. We still need to get the rate below 1.0.

The bigger picture. 

Why do we have to do this when the death rate is low? Let say death rate is 1% (which is best case scenario). The rate that the disease has spread in Europe means we have 14-21 days before the health system is overwhelmed. At 10000 cases, the Lombardy region's health case system was really strained.