Sunday, March 15, 2020

Coronavirus and US

I first wrote about coronavirus and China on January 26. At that time the Chinese were admitting to about 2,700 cases and 80 deaths. At that time, there were 5 confirmed cases in the United States, all from people who had recently returned from Wuhan, China.

The most recent numbers in the United States (as of noon Sunday, March 15) are 2,952 cases and 57 deaths. By the time you read this the numbers will be higher.

In that post I wrote that the most effective way to stop an outbreak of a virus such as this one is to aggressively isolate and quarantine those that are ill so as to not infect other people. They need to be identified, treated aggressively by medical professionals, and isolated.

China failed in that effort in Wuhan by not closing down travel in and out of that city quickly enough. Millions left the city to travel during the Chinese New Year holiday. That allowed the virus to spread to other areas in China and ultimately all over the world.

This caused the Chinese to implement a massive and draconian quarantine program involving tens of millions of people in major population centers around the country. The Chinese locked down everything in the heavily affected areas and confined everyone but essential personnel to their homes. I wrote at the time that if there was anywhere on earth where that could be done successfully it was in Communist China.

If there is any place on earth where a quarantine and mass mobilization can be carried out to combat this disease it is in China where the totalitarian government has total control of the population.

This strategy appears to have worked for the Chinese but the virus had already escaped the country. Other countries that allow their citizens far more freedom are now faced with balancing individual rights and economic calamity with the need to curb the virus. There are no good choices.

Europe has now become the epicenter for the outbreak in the world. There have been over 8,000 new confirmed cases in Europe in the last day. 3,590 of those are in Italy alone.

Credit:, 3/15/20, 18:22 GMT

To say that all of this is unprecedented in our lifetimes in an understatement. All sporting events cancelled. Schools closed. Cruise lines shut down. Flights from Europe shut down. Major retail stores announcing closures for several weeks (Apple and Nike). Runs on food and essentials at Costco and grocery stores.

Here are a couple of pictures I took at my neighborhood Kroger this morning.

Bread aisle at Kroger, March 15, 2020

Meat counter at Kroger, March 15, 2020

I did not bother taking a picture of the toilet paper and paper good aisle. It would be no surprise to you that it was empty.

What do I think is next?

I can't imagine we are far from banning all international flights into the country. It would not surprise me if domestic flights are suspended as well for some amount of time. At a minimum, flights to and from major areas of the outbreak---Seattle, California, New York City Metro---may be suspended. We may eventually see all travel in and out of hot spot areas suspended except for shipments of goods  and travel that is absolutely essential.

I would expect large shopping malls will close soon. Bars do not have much justification for remaining open right now. Restaurants are more essential but the question is how many can stay open with ever declining customers? (Ed note-since I wrote this earlier today Ohio and Illinois have announced the closure of all bars and restaurants. California is forcing bars and clubs to close. It is becoming a challenge making predictions of what is to come and staying ahead of the new realities.)

Of course, if restaurants are closed what additional pressure does that mean to the grocery store supply chain? I can guarantee that it will not be helpful.

The bottom line is that we may be getting to the point that only essential services will remain open for a period of time in many parts of the country.

The news is bad and it is likely to get worse.

Of course, the news has been a big reason that we have seen the public reaction and panic buying we have seen involving some items.

I thought this was an interesting chart that compares coronavirus coverage with other similar health-related stories.

Do you think that might have something to do with why there is no toilet paper and many food shelves are bare today?

Credit: Data Is Beautiful

Is there any good news?

In the United States, we have the advantage of being behind where Europe is right now in the pandemic. We will be able to watch and learn from them just as we have learned from China and South Korea.

Some have pointed out that the United States is following a trend line on new cases that is running about 11 days behind where Italy is.

For example, the chart below was published last Wednesday and shows cases in Italy and projects where the United States will be 11 days later. Notice that it projected the U.S. would be at around 3,000 cases today when we were at just 1,135 on Wednesday. This is very close to the 2,952 I saw reported earlier today.

Based on Italy's experience, it suggests the U.S. will be at 12,500 next Sunday 3/22. Keep an eye on this to see if this trend continues. We will undoubtedly see a spike in numbers in the U.S. if for no other reason than increased testing.

Notice also that Italy's cases have doubled (from 12,500 to 25,000) since Wednesday if you refer to the chart of the current cases above. If we stay on the same trend line, that would suggest the U.S. would be at 50,000 cases by the end of the month. I am going to keep that number in mind to see if we are bending the curve in any way with the most recent actions that have been taken.


Bear in mind that Italy's population is only 60 million compared to the 330 million in the United States. The U.S. would need to have over 60,000 cases by next Sunday to be in the same position as Italy was last Wednesday on a per capita basis.

The most recent data from Italy also confirms that this virus is most dangerous for the elderly. These are the statistics of the first 780 deaths in Italy by age.

Credit: @ClayTravis

In light of  this data, the UK is said to be considering requiring all people over age 70 to stay in strict isolation at home for the next four months in keeping with a "wartime-style" response. This is being considered in order to prevent the government-run health service from "falling over" from cases among the elderly.

The primary reason the United States is concerned about the outbreak is also the potential pressure it will put on hospital beds, and in particular, critical care beds. While 80-85% of those who catch the virus will have mild symptoms, a large portion of the remainder may need intensive medical intervention in the ICU with ventilators, respirators, etc.

This is a capacity constrained resource in all countries.

Fortunately, the United States is also better equipped in this regard than most countries but it is not an unlimited resource. The system can quickly become overwhelmed as did China, Italy and Iran.

The other big advantage the United States has in the battle to combat the coronavirus was in evidence on Friday when President Trump showcased the public/private partnerships to deal with the crisis in a Rose Garden press conference.

President Trump announcing public/private initiative regarding Coronavirus testing

There is simply no other country in the world than can match the technological, pharmaceutical and medical resources that the United States can deploy in this fight.

If I am sure about anything it is the fact that we will meet the challenge because of these unique and unmatched intellectual and innovative resources that are the foundation of our free enterprise system.

As you consider your own personal interactions in the coming days, I thought the graph below was interesting in that it gives you an idea of your risk profile by attending a variety of events based on different infection rates that might be present in the population.

This graph was done for Colorado but it should be generally applicable to any population group. It clearly shows the wisdom of avoiding large gatherings.

One final amusing tweet that I saw yesterday in my Twitter feed.

Why in the world would Charmin think that they need to be advertising toilet paper right now?

I see that this ad was originally posted on February 21 but I would think those marketing and advertising experts at Procter & Gamble would have been a little more nimble in pulling this ad spending in light of recent events, don't you?

Do they really need to sell more product right now?

Stay safe...with or without toilet paper.

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