By delaying the "pandemic" designation, the WHO has inadvertently cost more lives. They will strongly need to reevaluate their role and policies going forward, because this was a monumental process and leadership failure.
The messaging from the media (who are laypersons) and the politicians (who are economically motivated laypersons) has been that this is "just the flu". Weak messaging from both the WHO and the CDC has only reinforced this in the public's perception.
The WHO should have taken the decisive move to encourage greater caution by employing the "pandemic" label. That label comes with real power. While there is danger in crying wolf, it was evident months ago from the growth rate of the virus and the lack of quarantine procedures being put in place that this virus would reach the pandemic stage.
If the role of the WHO is to stave off pandemics and not just to monitor them, then elevating the risk profile of the virus should have been a top priority. Since people look to the WHO for guidance, their actions have direct impact to sequestration and bringing the outbreak under control.
Both the WHO and the CDC were too afraid to take early action. Their wait and see approach will ultimately result in more human deaths and suffering.
I was under the impression that the Pandemic label was a response to objective criteria, not subjective decision of leadership.
In particular, one of those factors was sustained duration of the outbreak. My understanding is we finally crossed the time threshold for declaring this a Pandemic.
From the definition: A pandemic is an epidemic of disease that has spread across a large region; for instance multiple continents, or worldwide. We knew and saw that weeks ago.
Declaration of official pandemic means world bank pandemic
relief fund program gets activated as long as many other clauses in different contracts and agreements. There is an influence on WHO and the people behind it didn't want pandemic to be declared too soon. If it was declared 3-4 weeks earlier there could be many lives saved in countries like Iran, what is happening in Africa is not known at all due to no testing but situation is probably bad.
This really highlights the critical design flaw of the World Bank's Pandemic Emergency Financing Facility (funded by the pandemic bonds). By the time the conditions are triggered and funds distributed, it's already way too late into the pandemic. These fund should be made much earlier and more should be diverted into proactive measures to maximise effectiveness.
That's kind of the purpose, if its standards were too low, it would be triggerred too many times that we won't have any of it left to do anything honestly. The World Bank's Program is always suppose to be an emergency backup we hope never to use instead of substitute for a proper government planning in times of pandemic.
Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country [Italy|Iran] in a different WHO region [Europe|Eastern Mediterranean] in addition to Phase 5 that is characterized by human-to-human spread of the virus into at least two countries [China & South Korea] in one WHO region [Western Pacific]. No threshold of cases or deaths triggers the community level definition and is left to discretion of the WHO.
So the WHO has done everything right. It is the hallmark of professionalism to follow rules even under pressure. And the WHo is under a tremendous amount of pressure right now.
As I said there is probably no official WHO definition or criteria due to big economic impact of such declaration and it is decided on a case by case basis.
Yes, it is. Parent never asked for WHO definition in the first place, I wonder if there is any at all, probably a commercial secret. Pandemic in WHO definition is when Director General of WHO declares it a pandemic, probably after confirming with member states who contribute, they were criticized in 2009 for declaring too early too, so criteria might have changed.
This definition has too much room for subjectivity. It needs objective criteria. Or maybe WHO might need to have a numerical metric that says high large the impact of a virus or its associated disease is, just like the earthquake magnitude.
Wow, what is the source of this outrageous claim??
If anything, African states are going to be hit the hardest. South Africa for example, a country I am in, has the world's highest HIV cases. Pneumonia is a death sentence for HIV patients. Also, our infrastructure to manage a spike in infected arriving at state hospitals is abysmal. Right now, we sit with 7 infected (officially) but these are all index based with vectors from recent visits to Italy. If this changes to non-index based vectors, and this disease spreads to the townships, we are done for. If anything, COVID-19 is likely going to hammer Africa the hardest.
By and large improved health care won't affect population resistance all that much, it just improves survival rate. In an earlier time you would have been right, European germs caused more Native American deaths than Europeans themselves when they first colonized, but nowadays with global trade we all end up sharing the same diseases for the most part.
Sedentary lifestyles enabled by modern lifestyles as opposed to a hunter-gatherer lifestyle can contribute to decreased overall health but thats not the issue here since almost nobody is a hunter-gatherer anymore.
When it comes to new viruses, all of us are in the same boat immunity-wise.
First of all "there is still natural selection" in literally all life, so I think you're meaning something else. But to what your point actually is, do you have any source on that?
I know several people that would have not been able to reach adulthood 100 years ago but have now reproduced and have passed on their diseases to their offspring. There is no doubt that natural selection in humans is much weaker now then in the past.
That's not what natural selection means... medical innovations are still natural selection factors. It doesn't stop, we just naturally figure out how to get better at it.
To take you at your intent, all humans will be exposed to this virus with more or less the same chances of suffering. I imagine there may be pockets of resistance within certain gene pools, but it's a crap-shoot who and where.
For H1N1 as far as I remember the pandemic designation happened far earlier and that was a joke of virus compared to covid-19 comparing the mortality rates.
This is exactly right. Disease response can be very paradoxical.
An extreme and early response, can turn a disease into a trivial event. Which raises questions about whether such an aggressive response is necessary.
It can be, in many ways, like using an umbrella in a rainstorm. You get to the destination, and you're totally dry, so what was the point of the umbrella?
With these disease outbreaks, there's no counterfactual we can run to see what would have happened if we didn't respond early.
H1N1 was not successfully contained at all, it infected 15-20% of the world's population and ended up just being a bad flu strain, not a world ending pandemic as only 575k people died (for a mortality rate of around .05%)
>H1N1 was serious and compared to this, well handled.
The current COVID-19 epidemic caused by SARS-CoV-2 is many times more fatal than the 2009 H1N1 epidemic. The current epidemic has similar a fatality rate to the 1918 Spanish Flu.
But this is in the middle of the pandemic and is likely to be revised downward as many cases are undiagnosed.
The 2009 H1N1 outbreak had a inital case fatality ratio of 0.4%, but revised downwards to 0.026% afterwards due to new evidence of more spread than thought -
> COVID-19 currently has a 3.4% case fatality ratio according to the WHO last week -
This number will likely go down to below 1% because:
- S. Korea have implemented large scale tests on asymptomatic cases and their death rate is 0.77%
- the "Princess Diamond" cruise, which can be considered a closed experiment, has had a 1% death rate for people that were not ventilated
- in China if you exclude the Hubei province, the mortality rate is 0.88%
In Italy the mortality rate is 6% but the explanation is quite simple — they stopped testing asymptomatic cases, even people with fever are sent home without a test and instructed to return in case the fever doesn't go away in a few days and they are overwhelmed. At this point they are only admitting people that have trouble breathing.
And northern Italy has really good hospitals, so the only reasonable explanation for the huge disparity is that they have more than 10 times the reported total cases.
In other words, the virus has infected many more people than official numbers.
Remember that those "total cases" are cases that have been discovered via tests, it does not include people that stayed at home and weren't tested, either because the symptoms were too mild or because they were sent home.
“Princess Diamond” deaths are excluding people who died in their home countries that where infected on the cruse ship. They had 6 deaths as of February 28th and then excluded all future deaths and cases “cases found after disembarkation” from the total.
Edit: A Hong Kong national from the ship died on 6 March which is being included as the 7th death. So, this may simply be fragmented rather than explicit exclusions.
I don’t know about the cruse ship, but it seems like it’s double counting a death in Australia on both the cruse ship and an Australian death. I would double check the totals.
I really wish everyone was doing the random-sampling-of-general-population thing. Even if they could only do it on a fairly small scale, I suspect it'd give a much better picture of where we're really at than the "confirmed cases" floor.
In S. Korea the mortality rate is 0.77%. In China outside of the Hubei provence where things have gotten out of control the mortality rate is 0.88%.
People in Italy are only admitted in hospitals if they have difficulty breathing by themselves. People that only have a fever or other mild symptoms are sent home, with no test administered. When the outbreak started they were testing asymptomatic cases, trying to be proactive in identifying infected people, but they stopped doing that once things have gotten out of control. And we will see this pattern repeating.
What's dangerous is spreading nonsense like a 6% death rate, which is factually not true.
South Korea have a lot of early stage cases in those numbers (haven’t died, haven’t recovered), and a very young population on the whole. An undetermined number of those cases will die rather than recover.
Multiple sources have looked for these large majorities of asymptomatic cases and did not find them. There is no evidence other than our collective hunches that these cases exist in significant numbers.
Taking Johns Hopkins numbers (at time of me writing this):
Not sure what the demographics of S. Korea is, whether they have a younger population or not, but it's irrelevant.
At least 80%-85% of all Covid-2019 cases have mild symptoms. We are not talking about completely asymptomatic cases, we are talking about a majority of cases that could pass for a mere cold or flu.
Many of those will not go to a hospital or be tested, especially if the system is overwhelmed.
Italy could easily have more than 10 times the number of reported cases because they stopped testing proactively. Only people with difficulty breathing are now tested and these represent a small minority of cases.
I gave S.Korea as an example because AFAIK they are the only ones doing large scale testing of the population and they aren't China (whom we may or may not trust to be transparent).
The data we have points to a mortality rate that's less than 1%.
When you see a mortally greater than that it is because people aren't tested unless they reach the ICU.
A couple of things I’m not sure are correct there though.
The 80-85% mild cases comes from confirmed cases that we know about. They’re included in the current 6.45% death rate from the JH data.
China may or may not be transparent, but if they have an incentive to hide anything, it would be a higher death rate rather than a lower one.
The data is the data. In any case it’s now global and the 6.45% is actually higher than it was before the virus started growing exponentially outside of China (it was 5.7% from this dataset then).
Those numbers aren't terribly useful since so many cases are mild or even asymptomatic. Most organizations are estimating 2-3% mortality, and are quick to point out that this is probably an overestimation due to the lack of testing in asymptomatic individuals.
Basically we are counting every case severe enough to cause death, but only some of the cases that aren't very severe, and that latter group is already a much bigger piece of the pie even among confirmed cases.
The table in the "comparisons to other pandemics and epidemics" section gives a point estimate for the case fatality rate of 0.03%. If we assume that the final rate for covid-19 is somewhere in the 1-2% range that's what I last heard, that would mean that "10X as fatal" is an understatement - more like 30-70x as fatal.
You've claimed this three times already. Do you have a substantiating link? Furthermore, saying "six point oh one percent" instead of just "approximately six percent" gives a false air of precision that could not possibly hold -- even you admit the estimate is still in flux.
Is there some guarantee that containment measures which are actually too early or too aggressive are "much, much better than the alternative?" It seems to me that such a claim is ignoring that there are actual costs to containment measures instead of actually comparing the costs of containment measures with the costs of delaying them.
H1N1 was declared a pandemic but was not handled at at all and a huge amount of people got it, but luckily it was a joke of virus with 2 orders of magnitude less deaths than covid-19.
Was it? Maybe my perception is skewed from being in one of the earliest countries hit, but my memory of H1N1 is that we pretty much gave up everything but vaccine development once we realized it was uncontainable.
The reason people are trying to downplay H1N1 is because they hate the flu comparison. People understand the risks and accepted deaths, from the flu. That bothers the doom and gloom folks.
I was telling someone the other day that H1N1 is seen as being not that big of a deal, and if another one or two pan out that way, then the next one after that will kill a lot of people because they start thinking that it was a 'cry wolf' sort of situation.
Look at the situation with vaccines. Your grandparents getting vaccines was a no-brainer. They heard stories of people getting polio or the measles and it was serious shit. Three generations later we have conspiracy theories about vaccines, I think because so few iminently deadly diseases have gotten a vaccine lately. We are down to the tricky ones, and cultural memory of the others is starting to crack.
Also, what's hard to remember is that we already had (or were very close) to a vaccine candidate for H1N1 by the time it was declared a pandemic in April 2009. Even before the U.S. declared a national state of emergency, more than 11M+ vaccine doses had been produced for the U.S alone: https://www.cdc.gov/h1n1flu/vaccination/updates/101609.htm
AFAIK, scientists are still trying to develop a covid-19 vaccine candidate. And after they have one, there will be many months before millions of doses can be produced and distributed.
I've heard they were counting off countries with cases. My wife told me the other day that she read that "4 more countries with coronavirus and WHO will call it pandemic".
> Pandemic label was a response to objective criteria
Modeling the causal impact of their criteria in light of data from the COVID-19 pandemic could reveal how different messaging strategies applied at different thresholds impact the spread of the virus.
The leadership could have done this months ago and estimated how proactive versus inactive quarantine efforts would impact morbidity. They have to know their role in persuading the public and government officials.
You don't have to stick to a rigid and inflexible criteria when thousands of human lives are at stake. When you define the criteria, you can also change them.
I don't understand what you think is to be saved by inciting panic. There's plenty of coverage, all this classification does is open up money from the IMF I believe. A Pandemic classification doesn't change most people's behaviors, but it does cause toilet paper/hand sanitizer shortages.
At least in the US, companies and other organizations are hesitant to be the first ones to stick their necks out and cancel events/encourage remote work. Our federal government's incompetent/evasive/opaque response to the crisis has let the burden fall on local governments in the hardest-hit areas.
Labeling this a pandemic would have given cover to organizations that wanted to be more cautious but were afraid of "looking stupid".
Months ago? The first cases were identified in Hubei on 29 December. The first cases of COVID-19 outside of China were identified on January 13 in Thailand and on January 16 in Japan.
They also have to be careful about credibility. It wasn't clear how well the global containment efforts were going to work until very recently. Let's say a week or two ago there's a 33% probability of global pandemic: that means if they call it such then, 2 times out of 3 they're crying wolf and causing people to listen less carefully to the WHO. You already see people claiming all manner of conspiracy theory nonsense and not taking it as seriously as they should; they have to be careful not to amplify that, and balance that against acting too late when it's clear there is a high probability of global community spread.
Other than their censorship in China (they give different advice on their website served to China, even on English-language pages, involving the effectiveness of traditional Chinese medicine against the virus), I think they're doing a mostly okay job so far, from what I can see in the current reporting.
What are you are dismissing as "conspiracy theory nonsense" includes calls to calm from infectious diseases experts and health authorities. When we will look back with hindsight, the conspirary theory nonsense may end up being the unecessary panicking, armchair epidemiologists, "the numbers are worse than we are told", etc.
They were asked about this in their briefing a few days ago and made a multi-point response:
1) There are no objective criteria for calling something a pandemic.
2) They did not feel they knew enough about the propagation pattern to make the subjective call.
3) They were deeply worried that calling it a pandemic would switch government strategies from containment to mitigation, resulting in higher contagion and loss of life.
They especially emphasized the last point. The only question in my mind is whether (1) they decided containment was no longer viable or (2) they decided not calling it pandemic would be seen as unserious, even if containment could still potentially have benefits.
The WHO's entire purpose is to act as health diplomats and coordinators. They have been ringing the alarm bell for weeks now, saying that countries need to take things seriously.
Whether the WHO uses the term "pandemic" is honestly just semantics. You should direct the majority of your criticism at short-sighted governments who have prioritized the economy (or, even worse, markets) over health.
It was incumbent on local authorities to take the WHO's message seriously, especially after their expedition to China released its report.
I think it's easy to criticize their leadership from the outside, but I would assume that they make their decisions with great care, and aren't going to throw around "pandemic" or other words easily. If they do that, people stop listening.
It's akin to people not caring about a major hurricane barreling towards them because they've heard the doomsday scenarios before and nothing has happened.
Declaring pandemic requires data which the WHO simply can't have if its member states do not submit or further, do not test for it. People like to think that international organizations like the UN, WTO, WHO is somewhat superior, or above the states, but they are not.
> By delaying the "pandemic" designation, the WHO has inadvertently cost more lives.
... why?
I mean, it's not like the word of the WHO is a binding thing, where anyone is mandated to take action on any level because of a binary designation in a taxonomy. This whole this is just bureaucratic wheels turning; everyone who needs to take action has all the information they need to do so.
This is just the WHO doing what it does best -- having committees meeting endlessly to decide whether to apply a certain meaningless designation and then announcing the conclusion of that exercise.
Their actual job, of collating and disseminating information and trying to coordinate any large-scale responses, is actually hard, so nobody wants to do it, but having a meeting to decide IS IT A PANDEMIC is an easy bikeshedding meeting that all the MBAs and ex-McKinsey people can attend and offer their stupid opinion on what the definition of a word is.
EDIT: I said "everyone who needs to take action has all the information they need to do so", and that could be interpreted as saying that we know enough to determine what actions to take. But what I mean is that we have enough data to start to make a range of predictions and bound the uncertainty to some degree; having a more precise metric for any aspect of COVID-19 should not affect the response since those metrics are essentially made up and not comparable even on a per-hospital level, much less a per-country level or even a per-test-kit-type level. Uncertainty is part of the game here, and understanding the risk profiles is how people and organizations and governments have to tune their response.
If it is a political and subjective decision as you say, then they have to balance the benefits of the declaration against the risk of the counter-narrative overwhelming it. Too early and even more people would dismiss the problem than are doing so now. And there's no "we said 'pandemic' before, well, it's 'really a pandemic' now" label that can be used.
And leaving aside the immediate difficulties...let's save this kind of retrospective criticism for after, when we're closer to being out of the woods.
If you have prospective criticism -- what should be done now and going forwards -- that would be worthwhile.
But months ago they really couldn’t have known. We still don’t know how many will be infected. All we can do is take precautionary measures. The WHO messaging should have been stronger and earlier, but it isn’t their fault for not labeling a pandemic months ago. Granted, there was enough data and research done to squarely label this as a pandemic, and that’s really where I assign blame on them.
To be fair, China already delcared state of emergency months ago, but for the WHO to declare pandemic and recognize it as a international problem, it has to be that other countries has also done that. WHO cannot predict things, and they can't declare Pandemic when what they have is mere suspicion, it has to be an actual pandemic to declare. I'm pretty sure numerous experts have warned about the pandemic thing.
I'm pretty sure WHO is involved early on along with the Chinese authories when they first spotted it. They are already helping.
WHO is merely declaring matter of fact about the virus's spreading. Which is kind of it's primary function, to declare things and publish reports so the governments can act on them. They can't really do much beyond that.
Wuhan was probably a lot further up the curve of exponential spreading before China took any action than a superficial reading of the stats would suggest. Their reported cases were basically rate-limited by how fast they could test people with the most obvious and serious symptoms at the point they locked down Wuhan. It's not clear exactly how bad it was - I don't think there's much data out there - but there's a couple of alarming numbers quietly tucked away in the WHO joint mission's report. Apparently they went back and tested samples taken from people in Wuhan with influenza-like symptoms at the start of January. 1 out of 20 samples from the first week of January tested positive and 3 out of 20 samples from the second week. That's... not good. (No numbers are given for subsequent weeks.)
There's no particular reason to assume it would take the same path in other countries took some sort of action, even if the actions weren't nearly as forceful as a complete lockdown. Especially since that lockdown was basically a blind and desperate shot in the dark based on incomplete and dubious information.
in Germany in January people talked about:
- well, it's China, you know, they don't have nice hospitals there
- the flu is killing people too and you're not vaccinated!
- our democratic society will be much better at containing that, people are mord open
- the methods in China are soooo stoneage, we are good at contact tracing.
So: no, there was no objective reason to think it would not go global, but it was faaaar away...
As a layperson, I'm not sure I agree with your layperson perception analysis. To me, calling it an epidemic meant that efforts should be focused on containment in order to slow it down or stop its progression. That signaled just how dangerous it was. Calling it a pandemic essentially means that we've given up on that and just like the common flu, most people will catch it. Basically, it's time to just "deal with" it instead of attempting to contain. I'd rather they had kept the epidemic label a bit longer.
I believe it was declared a PHEIC - Public Health Emergency of International Concern - and this should be the signal that governments need to take measures for containment to prevent it from spreading.
I believe the pandemic label is when containment has failed and governments need to go into mitigation mode. Seeing as it had been relatively contained in China, South Korea, Singapore, Hong Kong, Taiwan, etc., it seemed reasonable that taking measures would be sufficient to prevent further escalation.
The WHO defines a pandemic as the worldwide spread of a disease[1]. So the disease only becomes a pandemic after it has spread everywhere; it wouldn't make sense to call a disease a pandemic before it becomes one.
The delayed message of the WHO was really more like a very slow reaction at the cost of potentially millions infected with several thousands dead. By the time it spread to Europe and the US, it was essentially game over.
Perhaps the 'doomsday clock' was right all along but didn't see this one coming.
You must not be watching a lot of TV. I constantly hear and see "experts" and talk show hosts claiming "don't panic, it's just a bad flu", or "nobody speaks about the dead of flu, why do you care now" and some such nonsense. The "wash your hands" meme is also spreading around.
This may be a regional thing. I haven't seen anything like that in Ireland except from true crackpots (the actual insane people seem divided on whether COVID19 is imaginary or a bioweapon). Certainly not on any respectable news source.
To be honest, it is a bad flu, as what we call as flu is also most commonly caused by coronavirus. Though its death rate is 200% worse than a common flu with proper hospitalization.
No; what we call the flu is caused by the influenza virus. What we call the common cold is sometimes caused by a coronavirus (about 25% of cases). And while actual mortality rates are unclear, even the most optimistic figures (South Korea, for instance), are far more than 200% normal seasonal flu rates.
Hygiene is important, of course, but I've seen several people say that if you wash your hands, the likelihood of being infected is zero. That is absolute nonsense, bordering on irresponsible. Coronavirus spreads through air particles. For this virus, washing your hands has no particular benefit.
Every mainstream news outlet in Canada. Followed by National, local polical leaders of all groups. On the advise from health official. Who get directives from the WHO.
Genuine question: What do the alt-right have to gain by dismissing the potency of COVID?
I know the South Korean government took that exact position because of their pro-China stance. They tried really hard to downplay the dangers of the virus simply because of its Wuhan origins. knowing that the Trump administration is on the other side of the fence regarding China, what do they have to gain by dismissing the situation?
They get to excuse their government’s new Katrina. They also tend to be distrustful of science, and of our ability to change anything through centralized action.
Mortality rate for COVID-19 is about 2-3% with medical care, and maybe 10% without. For common flu it's roughly 0.1% depends on when and where of the outbreak.
Most mild cases are reported as they perform temperature check for everyone who enters and exit most if not all enclosures, so unless those people self-quarantined and never go out, they are likely be included in the statistics.
Asymptomatic cases are extremely rare, if they infects multiple others, they will likely be identified through retrospection. Overall, I'd say those cases are unlikely to result in significant difference in the estimate.
Not sure if it makes sense worldwide given that there are a lot of 3rd world countries, but in US the flu has a mortality rate 2 orders of magnitude less than covid-19.
According to the CDC, "between 291,000 and 646,000 people worldwide die from seasonal influenza-related respiratory illnesses each year" [1].
This is likely exacerbated by many countries not having ready access to flu vaccines and/or proper hospitalization for those that need it.
Compare this to America-specific numbers, where 34,000,000 – 49,000,000 Americans catch a flu-related illness each year, yet only 20,000 – 52,000 result in death [2].
I misread parent comment but this was exactly my point. A lot of people die from flu although there is vaccine and mortality rate is at least one magnitude lower than Covid-19 and hospitals are not overwhelmed.
I don't follow. Per the CDC link, seasonal flu hospitalizations result from 1.0% to 1.5% of flu infections. COVID-19 is currently at about 20%. That's a significantly higher hospital load for COVID-18 than for seasonal flu.
There's also the political backlash if the WHO accurately says, "this is a pandemic," early enough to flatten the curve and save lots of lives.
Do you expect politicians to actually think? Especially when they can point at the "fakenews WHO." (I don't know how Trump would actually say it but you get the picture.)
If the WHO declares a pandemic early, they _do_ save lives. But they take the political beating because "nothing happened."
If the WHO declares a pandemic late, they don't save lives. They take a mild wrist slap because "they were late to declare it," which will not be remembered in about a month.
> I don’t know what “media” you’re referring to, put the idea that it’s being dismissed as “just the flu” by anyone except the US government and their alt-right propaganda channels strikes me as blatantly wrong.
Are you sure you've been paying attention longer than a week or two? The virus was being downplayed all of January and February by the media and other people not named Trump as "not a big deal" because "the common flu kills way more people."
America is so polarized politically it depends on which side you're on. If you're a fan of the current administration then they're doing their best and handling things in a realistic pragmatic fashion. If you're not, then the admin is doing everything wrong at every turn. Also, the media is everyone's bogey man because some media sides with the administration and some doesn't.
And, as leader of the Executive Branch of the government, what exactly will he do to change the private media so that it's not serving private interests?
Well, if 30 years of public service Bernie has performed are any indicator, absolutely nothing. Bernie's full of these big, revolutionary, expensive ideas, but he's really accomplished very little in his career. Look at Vermont... second thought, don't look at Vermont (hint: business abandoned the high taxes of Vermont decades ago). Economically, VT is a basket case, do you want Bernie to work his magic on a national level?
It's about what we're saying, it's about sending a message. That we won't be bullied by the corporations and special interest groups, and we'll divert our aid to those who are in need and struggling. There is nothing radical about that.
What country are you in? Both the media and government in my country (US) have been sending the exact opposite message of "just the flu". As with anywhere, there are a few local outlets and politicians trying to downplay it, likely for economic reasons, but I haven't seen it downplayed on the Federal level at all. In fact, there's been an overabundance of information and caution.
The president himself severely downplayed it and gave the opposite advice as his own health officials (including [paraphrasing] "it's just the flu" and "go to work.")
I think the right way to model 45's behavior is an evolutionary feedback loop, where the success condition is pushing the buttons (positive and negative) of the public, for narcissistic attention. He's a paperclip maximizer for outrage and fervor, a Facebook engagement algorithm made flesh.
Because this "skill" has been honed from a lifetime of obsession with media, he's exceptionally good at bypassing anything resembling rational thought, and hitting emotional triggers, resulting in otherwise intelligent people engaging with Frankfurtian Bullshit even when they should know better (opponents and supporters alike).
You are correct. However, the point the previous commenter was making was that it wasn't being downplayed at the federal level.
The president has been visibly out-of-step with the rest of the federal government messaging on this. One voice, no matter the position, doesn't evaporate what the hundreds of others have been saying.
> The president has been visibly out-of-step with the rest of the federal government messaging on this. One voice, no matter the position, doesn't evaporate what the hundreds of others have been saying.
The President has been accusing the "Bureaucrats" of not caring about average Americans, fear-mongering the virus, and claims the Deep State is after him.
The President's followers do NOT believe the government experts. As per the sitting President's plan. The sitting President has cultivated an "Us lay people vs Them bureaucrats" atmosphere.
Case in point: My own Mother believes that the Coronavirus is a Chinese conspiracy to attack the President. And nothing I say could sway her opinion. Unfortunately, the voters of the President support, and believe in him more than even family.
I really don’t understand why the guy can’t keep quiet and let people who obviously know more about the topic do their job. I don’t understand what he is trying to achieve constantly contradicting experts. He should support them.
I really don’t understand why the guy can’t keep quiet and let people who obviously know more about the topic do their job.
What, and let someone else “hog” the attention and the spotlight? I’ve been reading about 45 since the 80s (most of the time, not by choice). “All eyes on me” seems to be far more important to the sitting president than “do the right thing”. I’m not saying “do <what he thinks is> the right thing” isn’t on the list, it’s just way down that list.
I don’t understand how even the people who might agree with you aren’t bored of seeing formulaic offtopic Trump bashing that could be produced by a script polluting every discussion they view on the web.
Assuming you were honestly looking for an explanation: not bored because they don't participate in the same discussions as you might, where the conversations turn to being "formulaic". In my world, and I assume in the world in which the OP lives, it's not immediately obvious why someone would run their mouth about things they know little about when an expert is standing right next to them.
He's a narcissist. This approach gets him far more press (very, very bad press, of course, but he seems broadly okay with that), so it's the obvious route, from that point of view.
”It's not unique to the current administration. Most presidents have done this. ”
I couldn’t imagine any of the presidents of the last decades to stand up and openly contradict his experts on something like this. Maybe behind the scenes but not in the open. He doesn’t seem to understand that he can only lose doing this.
His surgeon general has echoed his sentiment although not so tersely. Yes, they are only two people, but if you can't believe either of these two people, who can you trust, particularly when they are making exclusive claims? Besides, he has made a cult of personality around himself and many people do listen to him.
If you're paying attention you know he's wrong. But there are large swaths of people who when it comes to believing the CDC or the president choose to believe the president. Just this weekend a group of relatives was making fun of the coronavirus as a hoax.
Even scarier, a lot of the people who believe him have been paying close attention the whole time. Trump sounds more like what they expect the truth to sound like than any competent person who is trying to do their job possibly could.
I disagree - the role of president in the USA is quickly marching towards "only voice of the government." This has been clear from many politicians acquiescing to the whims of that One Voice, sometimes to their own detriment, oftentimes to their benefit.
Correct; but the WHO is an international organization, and could easily have made this declaration sooner. The fact that the Trump administration was so clearly downplaying it for PR, only makes it that much more vital for health professionals to read the numbers and set appropriate expectations.
I'm very worried (and in Texas) but when people hear me talk they somehow walk away with "just the flu" anyway. My theory is that people feel cognitive dissonance between the seriousness of the situation and the mild-seeming precautions that are recommended. Cancel nonessential international travel, wash your hands. For most people (talking about the U.S. here) international travel seems extraordinary and optional, if not downright weird, so it's really just wash your hands. It's hard for people to understand that there's a crisis and all they're supposed to do about it is wash their hands, no matter that I say things like "unprecedented mortality and disruption in our lifetime."
Other obstacles to perceiving it as a big deal:
- Not grasping that a fraction of a percent mortality can be a big deal. Numbers under one percent make it sound indistinguishable from flu, even if it's 10x as deadly as flu.
- Having AIDS and Ebola as your mental prototypes for dangerous infectious diseases and feeling relieved when you hear COVID-19 is nothing like either one.
I've heard that from my direct manager. I'm sure that's influenced by who he reports to. He was potentially exposed last week but still comes into the office, and we're discouraged from working from home. We're told to use our "best judgement" but the subtext is pretty clear...
What? The Federal Government has been saying exactly that -- that the flu is far worse, it kills more, and that Covid19 is no big deal. They've said it repeatedly from Day 1 - Up through two days ago when Trump tweeted:
> So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!
Basically the entire GOP leadership structure has decided that people are only worrying as much as they are to damage Trump politically. Essentially the only top level official giving the straight story is Dr. Fauci and he's immediately contradicted by others in the cabinet who seemed to be completely preoccupied with the stock market and the election.
I'm in WA state, where until last week testing wasn't being conducted on anyone that wasn't traveling from a level 3 country or in contact with a known infected person, EVEN IF THE WOULD-BE TESTEE WAS SHOWING SYMPTOMS. We keep talking about the count of infected (and relying on it to decide who to test) but it's unarguably low if we've not been testing, particularly as we apparently have introductions via Europe as well as China, plus community transmission.
Trump just a few days ago said that everyone who wants to be tested can get tested. According to the doctor's offices, that's still false.
Trump himself has a NUMBER of downplaying statements. So many I won't bother to list them. But lots of statements along the lines of "just the flu", among others.
> there's been an overabundance of information and caution
Hard to judge "overabundance" (see other article about how everything with a pandemic is premature until it is too late)
Today's headlines: "The White House has ordered federal health officials to treat top-level coronavirus meetings as classified, an unusual step that has restricted information and hampered the U.S. government’s response to the contagion, according to four Trump administration officials."
Note this prevents any expert who doesn't have clearance from attending.
A few days ago: "US health officials wanted to recommend that elderly Americans avoid flying amid the coronavirus crisis. The White House overruled them"
Are you serious? At the Feb. 26 press conference [0], President Trump literally said: "This is a flu. This is like a flu."
The president tweeted this 2 days ago [1]:
> So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!
This is what the Surgeon General said on Sunday [2]:
> "If we had massive numbers of cases we would be seeing more deaths. And so we actually feel pretty good that some parts of the country have contained it just like when you look at the flu," Adams said on CNN's "State of the Union" Sunday. "When we look at the flu tracker, some parts of the country are having much more severe flu seasons. Some are having very mild flu seasons. The same thing for coronavirus."
Once again HN Civility disease strikes, if you blame anyone specific in politics for anything, expect heavy down voting because somehow that's not "civil", no matter how true it is.
I suppose that depends on your local feeds; if you are in NA you probably have a hard time getting correct information/governance/leadership at this time. (hence your question) It used to be 'good enough' or even 'fine' over there, i.e. with HIV or malaria issues or even H1N1.
But even with the research on pandemic readiness showing that neither capacity nor governance has been up to the task people are still pretending it's just a political choice and the results will be fine. If I remember correctly it as CSIS thing: https://healthsecurity.csis.org/final-report/
80-something percent of the time yes. The remainder is divided between "you need hospital, but will be fine" and "serious intensive care needed".
The trouble is that (1) the people who need hospital to be fine need hospital. They won't be fine if it isn't there, and (2) by being a selfish ass and treating it like just the flu, when it's a disease that grows exponentially in a no-immunity population, people are amplifying the speed and height of the peak, which means not enough hospital places.
If you get a situation where effectively nobody who needs hospital can get it - then those 20-ish percent just drop dead. And then there's your godly death rate.
It's not selfish to treat something like the flu. This means I wash my hands, get vaccinated yearly, and take other common-sense precautions. That's not "being an ass", it's being rational.
And which vaccine were you considering getting for this, precisely?
That's part of the problem; even if it was "just like the flu" (it is not; in particular the percentage of cases requiring advanced medical treatment is much higher, which will lead to a rise in mortality as that treatment is oversubscribed), the flu would be pretty scary if the annual vaccine didn't exist.
Common sense precautions here are much more stringent than the flu. Nobody is immune. There is no vaccination. Herd immunity is nil. And it's very infectious.
This is a new thing and you should treat it as a new thing. There has not in living memory been one this bad, against which we had no defense except to avoid catching it and spreading it.
Except the statistics have been so wildly different across sources it'd be very unwise to follow any of them, and instead check the stories where possible. Only yesterday someone posted the accounts of people in Italy being overwhelmed. Last time I checked, a regular flu doesn't smash through a hospital's capacity so hard they have to ask doctors to change focus.
I think you're referring to a Twitter thread where a doctor relayed descriptions of hospital conditions from another doctor in Lombardy. It was a horrifying story (and scared me, I admit), but I would suggest caution.
Unless there's information that's not making it out of Italy, the death statistics reported today don't seem to align with the picture painted by those tweets.
The thing is, that infrastructure already prepared yearly for the flu. They have capacity designed around it. It is "normal" for thousands to die from the flu yearly, and nobody says anything. (Except that you should obviously be vaccinated.)
There were an estimated 44,000,000 flu cases in the US in 2017-2018. Assuming a worst-case-with-current-data death rate of 3.5%, that's about 1,500,000 deaths. Not millions.
It is remarkable, it's just not civilization destroying. Lots of old and vulnerable people will die. The healthcare system will be taxed for many months to come.
Also the economy will get beaten up, with lots of people finding themselves suddenly in financial distress, and generally almost everyone will have it worse than it would be if the virus never happened.
Something doesn't have to have 25% death rates to be dangerous. Your way of thinking is quite frankly not only flawed but also incredibly harmful to the actual dangers of the coronavirus.
Which is that entire communities can be infected in a very short amount of time, overwhelming local medical infrastructure and resulting in deaths and harm because the doctors simply can't keep up. What was originally something that could be treated then becomes life threatening.
I think it is too early to say much about the mortality rate. 4% is an upper bound, since that is how many lab confirmed cases have resulted in death, but that doesn't account for all of the minor cases where people didn't even know they had it.
4% might be an upper bound under normal situation when there is sufficient availability of intensive care places. When these places become saturated then % of mortality will approach % of people needing intensive care.
Please also note that many people who require intensive care but survive are left with huge chronic damage to their lungs that will affect their quality of life for the rest of their lives.
“Earlier in the epidemic, there was hope that 3.5 percent was grossly overestimated, however as evidence continues to emerge, there is dwindling support for that hope.”
It's collapsing health care systems every where it breaks out. It doesn't take a high hospitalization rate before the CFR jumps way up. Italy's is 4% because they're just letting older people die because they don't have the resources to treat them.
I am an Italian and live in Bergamo, the Italian town that is so far the most affected. The impression that Italy is letting older people die is false, at least at the moment [1]; however, there are people that suggest this might be a guideline to be followed, should the virus continue spreading. I believe that the somewhat higher mortality rate in Italy could partly be due to the fact that our mean age is higher than in other European countries [2].
The messaging from the media (who are laypersons) and the politicians (who are economically motivated laypersons) has been that this is "just the flu". Weak messaging from both the WHO and the CDC has only reinforced this in the public's perception.
The WHO should have taken the decisive move to encourage greater caution by employing the "pandemic" label. That label comes with real power. While there is danger in crying wolf, it was evident months ago from the growth rate of the virus and the lack of quarantine procedures being put in place that this virus would reach the pandemic stage.
If the role of the WHO is to stave off pandemics and not just to monitor them, then elevating the risk profile of the virus should have been a top priority. Since people look to the WHO for guidance, their actions have direct impact to sequestration and bringing the outbreak under control.
Both the WHO and the CDC were too afraid to take early action. Their wait and see approach will ultimately result in more human deaths and suffering.