Greetings!
This is a message I wish I didn't have to write, but I feel a sense of responsibility to inform you of my concerns about the coronavirus situation so you can get ready for what could be very trying times, especially as media and authorities have been downplaying or sending mixed messages about the virus.
I once penned an article about black widow spiders for an Air Force base newspaper in Nevada. I had found them living in our home on base under the couch and thought it would be good to inform neighbors, so they would be careful to prevent toddler-spider interactions. I emphasized that the spiders are not aggressive, rarely bite, and not all that deadly for the most part. But the newspaper chose not to publish it, for fear of scaring the residents.
Today I see the press doing the same thing on a much larger scale, with the coronavirus. But that's not right. We need to face the reality of the situation so we can mount an effective response for our families and communities. We need to face the shock and grief and uncertainty, and then get over it, and get to work.
Over the past few weeks, I've been trying to prepare my family, while also doing my best to lead programs in the field and administer. I'm sorry for not alerting you sooner, but here at least, is a rough attempt.
Just to preface - I do have a B.S. in Biology from Georgetown and an M.S. in Environmental Science from UNLV, but I am by no means any kind of expert or authority in health science. But I think it's fair to consider me an informed observer, and one that is not constrained by the kinds of political considerations that authority figures must contend with. This is not intended to be authoritative, but to raise your awareness and encourage you to research, and to draw your own independent judgment.
The situation:
For the time being, much of the public is still either blissfully ignorant, or is just getting nervous, about the rapid approach of the outbreak, and there is probably still at least a small window of opportunity to get food and protective equipment, etc. for your family.
I assess the situation is considerably worse than readily apparent from mainstream coverage or the official Chinese numbers, and that it could be a matter of hours or days before panic buying hits a neighborhood near you (like we've seen in Italy over the last few days). CDC just reported a new case with no known origin... I expect a lot more of that whenever they actually start testing people in earnest, with kits that work.
It is arguably true that the US authorities had an opportunity to slow, or temporarily contain, the spread of the virus. However, for reasons that are unclear, it does not appear that they have made a meaningful effort to do so. Instead, our authorities appear to be following the Chinese government's playbook, including acceptance of that country's absurdly low numbers that are not congruent with the draconian measures being adopted there or with civilian leaks on social and alternative media - which support a very different story.
What I gather from scientific papers (mostly preprints), is that about 30% of infected people are contagious but asymptomatic, about 56% get mild symptoms, 10.5% get severe, and 3.5% get critical symptoms, with about 2.1% of people dying (i.e. 60% of critical patients). As I understand it, all these numbers are for patients that receive advanced hospital care.
However, most hospitals have limited capacity, and maybe have room/gear/staff to deal with only a small fraction of the people that have severe/critical symptoms. In the absence of intensive hospital care, mortality is presumably much higher than 2% - possibly as high as 10%+, with much higher ranges among people middle-aged and older. Thankfully, younger people seem much less vulnerable to the disease, with minimal cases reported for children, and good survivorship among young adults. But conversely, the mortality among older people is quite high and alarming.
This interpretation seems more consistent with the draconian measures taken in China, and with the alarming leaks by Chinese citizens. In other words, it appears that all of these people that never see a hospital or a test kit are simply not included in the Chinese numbers that our media echoes, largely uncritically. There are many reports and anecdotes to this effect, e.g.:
"At least 19 people, mostly seniors, died in a senior center in Wuhan. As of last Thursday, 11 seniors died from respiratory failure after recurrent fevers, a nurse at Wuhan Social Welfare Institute told Caixin Global, a Chinese business newswire. She said the facility didn’t have Covid-19 testing capability and many medical workers have had fever symptoms. Other symptoms include a dry cough and gasping for breath. If not tested, then the person is not counted by Chinese public health leaders as being a coronavirus patient. (Forbes article)"
Over the coming days and weeks, I expect the data from South Korea and other more transparent countries to give us a significantly better understanding of this virus, but overwhelm of medical facilities due to a large number of severe cases seems to be the major concern at this point.
Meanwhile, here in the US, the CDC has set strict criteria for who can be tested: only those who have been to Wuhan themselves or been in close contact with those known to have been infected. Since most of the spread is by asymptomatic individuals, we really have no idea how widespread it already is within the US. All we know is that the CDC is not making a serious effort to learn or to tell us, what is really going on, and are leaving everybody in the dark. They report testing only 400 people. Meanwhile, there are some 8000 people on self-quarantine, who are not receiving tests. People with suspicious symptoms, perhaps sick and dying, but not meeting those criteria, are likely not being tested either.
This is not consistent with the official narrative that this virus will be contained in our country - it more closely resembles the catastrophic approach taken in China.
Ultimately, we have very little idea (or data) on how widespread the virus is at this time in the US, but anecdotal evidence suggests states are not being very transparent about it, and the statistics are not in our favor. Hundreds of thousands of Chinese people came here before the travel ban, and there are no screening tools that can reliably detect this virus in the asymptomatic.
The problem is that the virus has been reported to double every 2.5 days, with infected people reportedly being very infectious for several days before symptoms appearing. With that kind of exponential growth things start slow, but then very rapidly get big. In order to contain the spread of virus like that, it is critical to have excellent surveillance so that one can pounce on, and eliminate any outbreaks before they get too big.
It seems to me, therefore, that our health authorities have already missed the boat on containment, and that we will soon see virus break out in multiple parts of the country with unstoppable and undeniable force, likely followed by a heavy-handed response by the government, especially in metropolises.
Strategic incompetence?
Late last year there was an "Event201" pandemic simulation by various authorities (find on YouTube or here), who concluded that a pandemic cannot be contained over the long term, and only social and economic conditions can be managed. So perhaps they have decided at a high level that it is preferable to have an acute pandemic that strikes hard and passes by faster, than to have a drawn-out restructuring of the entire economy in an ultimately futile attempt to avoid it. That is just my speculation… but we do need to understand that a pandemic offers no good options, only brutal trade-offs.
Preparing:
I would suggest stocking up on food staples and necessities TODAY, because an outbreak in our area, or even just the widespread awareness of its possibility, could lead to very rapid and extreme measures (and a run on the stores) as was observed in parts of Italy and S. Korea for example this past week. We are rapidly approaching a turning point in public awareness that may lead to a run on food and supplies.
Make a trip to the store TODAY and get at least some high-calorie staples like: rice, beans, flour, oil, sugar. If possible get extra medications important to your family.
Research and practice behaviors and diet to keep your immune system strong - like getting sleep, some sunlight, vitamins etc.
You should also start strategizing on how and when to begin social distancing. Can you work remotely and live off savings? What about your church, local hospital, work-place, condo/HOA, etc - how can you minimize interactions and risk?
Above all, we need to think and talk openly about the situation, and be creative in coming up with solutions.
You have the opportunity now to save lives in your family and community by facing this threat proactively.
For more recommendations on specific preps I would refer you here and here, along with the aforementioned YouTube channel of Ethan Galstad. You can also join the Peak Prosperity group and find tips and a forum there for $30/mo. There may well also be better sources out there, but these folks seem to have some useful tips.
Caveat and conclusion:
Let me end by saying that I readily imagine worst case-scenarios - it's part of my survivalist wiring - and that things usually play out much better than I expect. Part of being a problem-solver is that I am sensitive to threats that can be purely hypothetical and never come to pass. I hope that is true again in this case. My analysis is based on incomplete information, and hopefully the more reassuring narrative of the authorities do prove to be correct and this outbreak proves merely a "really bad flu season." If you work in the healthcare field or government and you have good information that you believe supports, or undermines my analysis, please feel free to share privately or in the comments on my blog or Fb.
However, I also believe that planning for the worst, and being proactive in confronting a threat, makes better outcomes much more likely. If each of us works hard to protect our families, and then start leading in our communities, we can make a major difference in how things play out.
Sincerely,
Nick
----
Nick Grenier
Director
Natural Leaders
571-244-3793
naturalleaders.com
https://www.facebook.com/naturalleaders/
P.S. Having already written the above, I just discovered a scientific paper that just came out, which also considers a 10% case fatality rate, and much higher Chinese numbers to be very plausible and consistent with non-official data:
He, Mai and Dunn, Lucia F., Evaluating Incidence and Impact Estimates of the Coronavirus Outbreak from Official and Non-Official Chinese Data Sources (February 18, 2020). Available at SSRN: https://ssrn.com/abstract=3540636 or http://dx.doi.org/10.2139/ssrn.3540636
These are my sources on the number of asymptomatic infected people - about 30%:
Estimating the Asymptomatic Ratio of 2019 Novel Coronavirus onboard the Princess Cruises Ship, 2020. Kenji Mizumoto, Katsushi Kagaya, Alexander Zarebski, Gerardo Chowell (here)
Clinical Characteristics of 24 Asymptomatic Infections with COVID-19 Screened among Close Contacts in Nanjing, China. 2020. Zhiliang Hu et al. (here)
I used the 30% figure from the studies above to correct the numbers provided in the study below for symptomatic patients (80/14/5 for mild/severe/critical respectively) by multiplying these numbers by 70%, the number of infected people that are symptomatic.
The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) — China, 2020[J]. China CDC Weekly, 2020, 2(8): 113-122. (here, See table 1)
This is a message I wish I didn't have to write, but I feel a sense of responsibility to inform you of my concerns about the coronavirus situation so you can get ready for what could be very trying times, especially as media and authorities have been downplaying or sending mixed messages about the virus.
I once penned an article about black widow spiders for an Air Force base newspaper in Nevada. I had found them living in our home on base under the couch and thought it would be good to inform neighbors, so they would be careful to prevent toddler-spider interactions. I emphasized that the spiders are not aggressive, rarely bite, and not all that deadly for the most part. But the newspaper chose not to publish it, for fear of scaring the residents.
Today I see the press doing the same thing on a much larger scale, with the coronavirus. But that's not right. We need to face the reality of the situation so we can mount an effective response for our families and communities. We need to face the shock and grief and uncertainty, and then get over it, and get to work.
Over the past few weeks, I've been trying to prepare my family, while also doing my best to lead programs in the field and administer. I'm sorry for not alerting you sooner, but here at least, is a rough attempt.
Just to preface - I do have a B.S. in Biology from Georgetown and an M.S. in Environmental Science from UNLV, but I am by no means any kind of expert or authority in health science. But I think it's fair to consider me an informed observer, and one that is not constrained by the kinds of political considerations that authority figures must contend with. This is not intended to be authoritative, but to raise your awareness and encourage you to research, and to draw your own independent judgment.
The situation:
For the time being, much of the public is still either blissfully ignorant, or is just getting nervous, about the rapid approach of the outbreak, and there is probably still at least a small window of opportunity to get food and protective equipment, etc. for your family.
I assess the situation is considerably worse than readily apparent from mainstream coverage or the official Chinese numbers, and that it could be a matter of hours or days before panic buying hits a neighborhood near you (like we've seen in Italy over the last few days). CDC just reported a new case with no known origin... I expect a lot more of that whenever they actually start testing people in earnest, with kits that work.
It is arguably true that the US authorities had an opportunity to slow, or temporarily contain, the spread of the virus. However, for reasons that are unclear, it does not appear that they have made a meaningful effort to do so. Instead, our authorities appear to be following the Chinese government's playbook, including acceptance of that country's absurdly low numbers that are not congruent with the draconian measures being adopted there or with civilian leaks on social and alternative media - which support a very different story.
What I gather from scientific papers (mostly preprints), is that about 30% of infected people are contagious but asymptomatic, about 56% get mild symptoms, 10.5% get severe, and 3.5% get critical symptoms, with about 2.1% of people dying (i.e. 60% of critical patients). As I understand it, all these numbers are for patients that receive advanced hospital care.
However, most hospitals have limited capacity, and maybe have room/gear/staff to deal with only a small fraction of the people that have severe/critical symptoms. In the absence of intensive hospital care, mortality is presumably much higher than 2% - possibly as high as 10%+, with much higher ranges among people middle-aged and older. Thankfully, younger people seem much less vulnerable to the disease, with minimal cases reported for children, and good survivorship among young adults. But conversely, the mortality among older people is quite high and alarming.
This interpretation seems more consistent with the draconian measures taken in China, and with the alarming leaks by Chinese citizens. In other words, it appears that all of these people that never see a hospital or a test kit are simply not included in the Chinese numbers that our media echoes, largely uncritically. There are many reports and anecdotes to this effect, e.g.:
"At least 19 people, mostly seniors, died in a senior center in Wuhan. As of last Thursday, 11 seniors died from respiratory failure after recurrent fevers, a nurse at Wuhan Social Welfare Institute told Caixin Global, a Chinese business newswire. She said the facility didn’t have Covid-19 testing capability and many medical workers have had fever symptoms. Other symptoms include a dry cough and gasping for breath. If not tested, then the person is not counted by Chinese public health leaders as being a coronavirus patient. (Forbes article)"
Over the coming days and weeks, I expect the data from South Korea and other more transparent countries to give us a significantly better understanding of this virus, but overwhelm of medical facilities due to a large number of severe cases seems to be the major concern at this point.
Meanwhile, here in the US, the CDC has set strict criteria for who can be tested: only those who have been to Wuhan themselves or been in close contact with those known to have been infected. Since most of the spread is by asymptomatic individuals, we really have no idea how widespread it already is within the US. All we know is that the CDC is not making a serious effort to learn or to tell us, what is really going on, and are leaving everybody in the dark. They report testing only 400 people. Meanwhile, there are some 8000 people on self-quarantine, who are not receiving tests. People with suspicious symptoms, perhaps sick and dying, but not meeting those criteria, are likely not being tested either.
This is not consistent with the official narrative that this virus will be contained in our country - it more closely resembles the catastrophic approach taken in China.
Ultimately, we have very little idea (or data) on how widespread the virus is at this time in the US, but anecdotal evidence suggests states are not being very transparent about it, and the statistics are not in our favor. Hundreds of thousands of Chinese people came here before the travel ban, and there are no screening tools that can reliably detect this virus in the asymptomatic.
The problem is that the virus has been reported to double every 2.5 days, with infected people reportedly being very infectious for several days before symptoms appearing. With that kind of exponential growth things start slow, but then very rapidly get big. In order to contain the spread of virus like that, it is critical to have excellent surveillance so that one can pounce on, and eliminate any outbreaks before they get too big.
It seems to me, therefore, that our health authorities have already missed the boat on containment, and that we will soon see virus break out in multiple parts of the country with unstoppable and undeniable force, likely followed by a heavy-handed response by the government, especially in metropolises.
Strategic incompetence?
Late last year there was an "Event201" pandemic simulation by various authorities (find on YouTube or here), who concluded that a pandemic cannot be contained over the long term, and only social and economic conditions can be managed. So perhaps they have decided at a high level that it is preferable to have an acute pandemic that strikes hard and passes by faster, than to have a drawn-out restructuring of the entire economy in an ultimately futile attempt to avoid it. That is just my speculation… but we do need to understand that a pandemic offers no good options, only brutal trade-offs.
Preparing:
I would suggest stocking up on food staples and necessities TODAY, because an outbreak in our area, or even just the widespread awareness of its possibility, could lead to very rapid and extreme measures (and a run on the stores) as was observed in parts of Italy and S. Korea for example this past week. We are rapidly approaching a turning point in public awareness that may lead to a run on food and supplies.
Make a trip to the store TODAY and get at least some high-calorie staples like: rice, beans, flour, oil, sugar. If possible get extra medications important to your family.
Research and practice behaviors and diet to keep your immune system strong - like getting sleep, some sunlight, vitamins etc.
You should also start strategizing on how and when to begin social distancing. Can you work remotely and live off savings? What about your church, local hospital, work-place, condo/HOA, etc - how can you minimize interactions and risk?
Above all, we need to think and talk openly about the situation, and be creative in coming up with solutions.
You have the opportunity now to save lives in your family and community by facing this threat proactively.
For more recommendations on specific preps I would refer you here and here, along with the aforementioned YouTube channel of Ethan Galstad. You can also join the Peak Prosperity group and find tips and a forum there for $30/mo. There may well also be better sources out there, but these folks seem to have some useful tips.
Caveat and conclusion:
Let me end by saying that I readily imagine worst case-scenarios - it's part of my survivalist wiring - and that things usually play out much better than I expect. Part of being a problem-solver is that I am sensitive to threats that can be purely hypothetical and never come to pass. I hope that is true again in this case. My analysis is based on incomplete information, and hopefully the more reassuring narrative of the authorities do prove to be correct and this outbreak proves merely a "really bad flu season." If you work in the healthcare field or government and you have good information that you believe supports, or undermines my analysis, please feel free to share privately or in the comments on my blog or Fb.
However, I also believe that planning for the worst, and being proactive in confronting a threat, makes better outcomes much more likely. If each of us works hard to protect our families, and then start leading in our communities, we can make a major difference in how things play out.
Sincerely,
Nick
----
Nick Grenier
Director
Natural Leaders
571-244-3793
naturalleaders.com
https://www.facebook.com/naturalleaders/
P.S. Having already written the above, I just discovered a scientific paper that just came out, which also considers a 10% case fatality rate, and much higher Chinese numbers to be very plausible and consistent with non-official data:
He, Mai and Dunn, Lucia F., Evaluating Incidence and Impact Estimates of the Coronavirus Outbreak from Official and Non-Official Chinese Data Sources (February 18, 2020). Available at SSRN: https://ssrn.com/abstract=3540636 or http://dx.doi.org/10.2139/ssrn.3540636
These are my sources on the number of asymptomatic infected people - about 30%:
Estimating the Asymptomatic Ratio of 2019 Novel Coronavirus onboard the Princess Cruises Ship, 2020. Kenji Mizumoto, Katsushi Kagaya, Alexander Zarebski, Gerardo Chowell (here)
Clinical Characteristics of 24 Asymptomatic Infections with COVID-19 Screened among Close Contacts in Nanjing, China. 2020. Zhiliang Hu et al. (here)
I used the 30% figure from the studies above to correct the numbers provided in the study below for symptomatic patients (80/14/5 for mild/severe/critical respectively) by multiplying these numbers by 70%, the number of infected people that are symptomatic.
The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) — China, 2020[J]. China CDC Weekly, 2020, 2(8): 113-122. (here, See table 1)
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