COVID-19 Update: April 5th, 2020

26,553 new confirmed cases in the US today. This is the first day in which there were fewer new US cases than the previous day. Here are the number of new cases per day for the past five days:

March 31st: 24,240
April 1st: 26,000
April 2nd: 28,239
April 3rd: 32,979
April 4th: 33,767

The US has now had over 330,000 total confirmed cases. It took over one month to get to 100k cases; 5 days later there were 200k, and 3 days later, 300k (exponential growth is a bitch). Over 23k people in the US are currently hospitalized, and over 5,400 are currently in ICU. 9,498 people have died. The mean rate of growth in new cases per day over the past 14 days has slowed to x1.13 (contrast this with a much scarier rate of x1.4-ish in the first part of March).

The US is slowly flattening the curve. This is good news, but there will probably still be spikes in new cases over the coming weeks for three main reasons. One, there are huge backlogs at labs for the processing of tests (California apparently has 59,500 of 94,800 tests still pending). When these samples are finally analyzed, we’ll see artificial “surges” in new cases. Second, many spirited citizens (including the now-infamous spring breakers) ignored initial government recommendations to go into voluntary self-isolation during third week in March. The infections they picked up and spread are just now making it through the testing pipeline. Third, stay-at-home orders weren’t applied evenly or everywhere at the same time. Some states and cities applied measures much later, or have yet to apply them. 8 of 10 US counties are currently on some form of isolation orders.

Spain and Italy had terrifying trends in early March, which they have now arrested. It looks like the US is starting to do the same. However, both Spain and Italy are still seeing a steady 4k-5k new cases per day. It appears that, at least so far, their nationwide lockdowns (Spain’s started March 14th, Italy’s, March 9th) haven’t completely stopped the spread of the virus, just slowed it down. This may be because many people in western countries continue to “cheat” or evade lockdown rules, especially as the temptations of spring weather beckon. This isn’t helped in Italy by a famously low-trust culture in which he who follows the rules is know as fesso (a gullible chump), while he who breaks the rules to get ahead is seen as furbo (sly or street smart).

US society probably has its fair share of furbos (think spring breakers), which might preclude the implementation of a Sweden-style solution to this crisis. Sweden has relied on its high levels of horizontal and vertical social trust (i.e. people trust their neighbors and trust the government) to ensure widespread compliance with social distancing recommendations without the need for enforced lockdowns. So far, the current administration in Sweden is maintaining this policy despite criticism from rival political parties and some public health experts, but there is talk of implementing more restrictive measures similar to other European nations.

New York continues to be the epicenter of the US crisis, with over 122k confirmed cases, over 16k hospitalized, and over 4k in ICU. Mayor De Blasio said in a press conference today that there are not enough medical supplies there to last through the coming week. While the curve is flattening out in New York, there are probably still several tough weeks ahead where the medical system will be stretched thin.

After coming down with “a dry cough, some wheezing and a small decrease in appetite,” Nadia, a tiger at the Bronx zoo, tested positive for COVID-19. The 4 year-old Malayan tiger has potentially also spread the virus to other tigers at the zoo.

Hong Kong now requires pets of coronavirus patients to be quarantined, after two dogs and a cat tested positive.

With very few people driving or flying, global oil prices have dropped dramatically. A Russian-Saudi oil production face-off has added to the decline. There may not be enough storage space for all the oil now sitting around. The world may see $10/barrell oil — a price last seen during the Asian financial crisis of the late 90s — or even negative prices.

If oil was down, alcohol consumption was way up, spiking by 55% as people prepared for virtual happy hours.

Crews of cargo ships seem to be stuck at sea for the duration, as travel restrictions make it very difficult to get replacement crew to ports to relieve them, and they are necessary to keep global supply chains open (also, apparently 1/4 of the sailors in the world are Filipino).

North Korea insists that it has zero coronavirus cases (while asking for medical aid thru diplomatic back-channels).

This pandemic is turning out to be a stress-test for the internet, as more people use cloud-based web services for longer than ever before. Xbox Live experienced a system-wide crash, frustrating gamers, and Microsoft’s cloud-based service has experienced service disruptions. Apparently AWS (Amazon Web Services) learned from a previous massive crash in Feb 2017 — which took 148,213 websites offline for four hours — and has fared much better during the coronavirus crisis.

There is a new paper out from Imperial College which estimates an R0 for COVID-19 at 3.9, meaning the virus is much more contagious than previously thought. The paper also estimates that there are probably tens of millions of actual cases in the 11 European nations studied, versus the 300k or so confirmed cases there.

These findings, in combination with growing confidence that asymptomatic carriers often spread the virus (originally not thought to be common, based on a WHO report from Feb), that a large number of carriers (up to 50%) are asymptomatic, and that the virus spreads via breath alone, rather than just coughs or sneezing, has led to governments recommending the universal use of facemasks, previously thought not to help.

The example of a choir practice in Washington State illustrates the extremely contagious nature of the virus. 60 members attended on March 10th, all feeling healthy — “during the entire rehearsal, no one sneezed, no one coughed, no one there appeared to be sick in any way,” a member said. After many members fell ill, 28 tested positive. 2 have died.

The US is far from over the hill yet, but it seems that the worst possible catastrophe will likely be narrowly averted. Over the next two weeks, the “what next” conversation will probably take center stage. Will the US be able to implement some kind of test/trace/quarantine regime? That seems a very distant possibility now, given the current dire state of testing. Will a “rush vaccine” be possible? How long will it take for the economy and society to return to normal? 3 months? 6 months? Over a year? It is hard to imagine large parts of society, from airlines to working families, surviving that long without any income. In the absence of a vaccine, can some other creative solution be found that would allow at least a partial opening up of society?

Things I want to learn more about:

1. What’s the real deal in China? Did the virus originate in a lab and not the seafood market? Did China cover up deaths on a vast scale? Is the virus still spreading there, or have they managed to essentially eliminate it? What did China do that the world can learn from (both good and bad)? It is harder to get unbiased reporting on this topic because both China and the US are engaged in an all-out narrative war over it right now.
2. More details on how Taiwan did such a good job containing the virus. They’ve arguably handled it better than any other nation, including South Korea, and they did that with very close proximity and high exposure to travelers from mainland China.
3. Terminology: we seem to lack good terms for what we’re doing. “Shelter in Place,” “Lockdown,” “Quarantine,” “Self-isolation,” are all used essentially interchangeably. A Wuhan lockdown is not a Milan lockdown is not a Los Angeles lockdown. We need more precise terms to describe what policies are in place.
4. What the heck is going on in Russia?
5. What the heck is going on in Iran?
6. Why did Japan seem to have it under control and then they didn’t?
7. What is going on with immigrants held by ICE right now? What is going on at the US-Mexico border?
8. What has been the performance of prediction markets and “Superforcasters” on coronavirus-related predictions?
9. What is the up/down of government choices on this going to look like in terms of the value of QALYS saved vs the economic damage?