Friday, March 13, 2020

Zombieing along in Japan

This is the Ministry of Health's page. They have a full breakdown of cases and outcomes.
https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/newpage_00032.html
This Kyodo news page has nice graph of detected cases and testing numbers over time.
https://english.kyodonews.net/news/2020/03/c35480d9a1eb-coronavirus-outbreak-latest-march-12-2020.html
What this tells you is that what Japan has done so far has been fairly effective but it hasn't been enough. The schools have been closed for 2 weeks, events have been cancelled and still, the number of daily new cases is rising. If it was truly effective, the numbers would be going down by now. In South Korea they have been going down sharply for a week (and they are still testing like crazy).
Japan's only doing 200 tests/day in some cases. That means they're still just reactive - find a case, track the contacts, test them all. That's almost enough but not quite. You'll never find every contact, ever person who used the same shopping basket or rode the same bus. With a less transmissible virus that wouldn't matter but with this one it seems to be just enough for the virus to be winning.
I was really worried that the low testing was masking massive numbers of undiscovered infections but if that was the case, I think by now, we would see a much higher proportion of critical cases and hospitalization than we do. So we're still far away from an Italy style crisis (also our cases are spread widely, not concentrated in one small region).
The problem is that this almost-containment is not enough. Even if it stays kinda-safe, it never ends.
Japan is great at enduring pain and could probably keep this up for months but the cost would be huge. Something needs to change to turn that gradual increase into a decrease.
Two things give me hope:
  1. Abe desperately wants the Olympics and they cannot happen with the status quo (forget about the crowds, the athletes are all over one-another - filthy beasts!).
  2. It won't be long before South Korea's and China's daily new cases are lower than Japan's. Hopefully that's a pain Japan's government won't want to endure for long.









Wednesday, March 11, 2020

TL;DR I'm staying home until I have reason to believe Japan is in control of Corona virus. I urge anyone else who can work from home to do so. Please avoid crowds in your social life, especially indoors. Corona virus is not that lethal when treatment is available but it doesn't take much for hospitals to be overwhelmed, at which point things become far more dangerous.

There's a huge difference between us all getting this eventually and us all getting this at the same time.

The difference is in the death-rate. Wuhan had a death rate of 5% - "but that's Wuhan", yeah and now it's Lombardy too and it flipped in a matter of days. There was nothing especially bad about Wuhan or Hubei, they didn't have low standards of care. They were just overwhelmed.

I'm reading articles about hospitals in Lombardy that do not have enough ventilators, they are allocating them to the ones with best chances of survival. To be clear, they are picking people to live or die. That is what happens when the number of cases goes over capacity. We need to keep away from that situation. Also, the hospitals have shut down many of their other services to try deal with corona virus. People will suffer and even die due to other unrelated problems because corona is taking up resources.

The mortality rate appears to be < 1% when resources are available and 5% when they're not.

Italy had 21 cases on Feb 21, now it has a national crisis. Ireland has 34 today with a fraction of the population of either Italy or Lombardy.

Everywhere is different but nowhere is special. What happens next comes down to people's behaviour and until you know that your country really has this under control, the responsible thing to do is to play it safe. Wait until credible, independent medical experts are saying it's under control, not politicians. It's critical that we avoid the kind of spike in cases that overwhelms the system. The government has no magic wand, it might be able to build make-shift hospitals but it cannot pull doctors and ventilators out of thin-air. It can make things much worse but it's too late for them to make things much better.

You don't have to panic, you don't have to hoard. You don't need masks and litres of hand-sanitizer if you're staying in. Masks are for sick people, medical staff and people who deal with lots of customers every day and have a decent chance of getting sick and not knowing it yet. If you can, support your local businesses, because either way, this is going to suck economically.

A few links

3 small concert venues in Osaka led to at least 40 infections over a few days
https://japantoday.com/category/national/japan's-live-music-clubs-emerge-as-new-coronavirus-transmission-sites

Italy's situation
https://www.politico.eu/article/coronavirus-italy-doctors-tough-calls-survival/

Flattening the peak
https://thespinoff.co.nz/society/09-03-2020/the-three-phases-of-covid-19-and-how-we-can-make-it-manageable/