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Coronavirus PANIC news

I just canceled a cross-country trip I was going to take, replacing face-to-face meetings with videolink which I think will be just about as good.

In other news, Cass Sunstein writes about “the cognitive bias that makes us panic about coronavirus”:

At this stage, no one can specify the magnitude of the threat from the coronavirus. But one thing is clear: A lot of people are more scared than they have any reason to be.

Wha….? Let X be the magnitude of the threat and Y be people’s fear. If you can’t specify X, and you have no measure of Y, then how can you be so clear that Y > X?

Also this:

Many people will take precautionary steps (canceling vacations, refusing to fly, avoiding whole nations) even if there is no adequate reason to do that. Those steps can in turn increase economic dislocations, including plummeting stock prices.

Jeez. I cancel one flight, and all of a sudden the stock market crashes. Could I just do my civic duty by donating $400 to the stock market, without actually having to fly?

Just don’t call me Stasi.

P.S. More on this topic here.

P.P.S. Jazz, pictured above, doesn’t seem to be panicking about anything!

85 Comments

  1. Actually you can donate considerably less than $400. The profit on a $400 ticket is probably like $20, so if you just send me $20 I’ll invest it in a broad market index for you.

  2. Benjamin C Kirkup says:

    When you read coronavirus news, know these things: the tests have had serious issues in the US and in China, most non-symptomatic people aren’t tested but may have been infected, people have been in quarantine through the course of the illness unreported, and not all deaths have been reported for a variety of reasons (chaos, in quarantine alone without health and wellness checks, etc). So when you hear an analysis of the second derivative of unknowns…

    • Hans says:

      Seems to be the most plausible explanation of the available information. Will be difficult to be sure until in a few weeks.

      Particular aspects of currently available data: high differences in mortality per diagnosed case across countries. Highly reduced rate of reported infections in China.

  3. Jordan Anaya says:

    I don’t know why people are so alarmed, but it does seem some people are worried. My labmate today revealed he thinks there’s a 5% chance of dying if you get the disease and he’s ready to work from home for a couple months. I told him I don’t plan on making any changes whatsoever. Famous last words!

    • somebody says:

      Your labmate is wrong unless he’s already in bad health or much older than I’m imagining. However, that doesn’t mean that everyone behaving as if there were a 5% chance of dying if you get the disease is not the right thing for the sake of society as a whole.

      Nobody is concerned about a bunch of 23 year old college graduates catching a severe cold for a week and a half. It’s about the elderly being infected en-masse by a highly transmissive, vaccineless new disaese, then flooding into an already understaffed and overburdened health care system, making the hospitals unusable for a month. That’s the catastrophe.

      tl;dr, think about the tail risk to all of society

      • Annalisa says:

        I wouldn’t be so sure that on 23 year old this virus will at most produce a “severe cold”.
        At this point it is enough clear that there is a concrete risk of respiratory distress (pneumonia) requiring intensive care unit for people of any age, and I can’t see any reason to play with fire even at young age.

      • Dzhaughn says:

        Why should we not be concerned about the 23 year olds being sick for a week? That’s 2% of a year of the best part of their lives. (Just kidding about it being the best part, youngsters!) If we prevent 52 infections we gain a whole QALY. Some implicitly price a QALY at $50K, although its dubious.

        On the other hand, I guess we all have to binge watch Netflix sometime or another.

        Consider Wuhan: How many QALYs have been lost among those quarantined that won’t even get sick?!? A 10% degredation in the lives of 12 million for a month is 100K QALY, roughtly the suden death of 2000 23-year olds. I pulled the 10% figure out of the air, I really don’t know what to use there. Maybe it’s a 10% gain for those who learn something important. (The counterfactual loss from no quarantine maybe greater. Maybe we serious owe one to Wuhan.)

        Still, it’s enough to make one reconsider the wisdom of eating a freshly-killed bat. Freshly killed anything. Although that lamb dosa was pretty good.

    • Hans says:

      Look at the data before speculating! At least in this blog.

  4. Thanatos Savehn says:

    Hospital-acquired infections kill 100,000 Americans annually and sicken more than a million but nobody much cares because they’re mostly old, or have cancer or some socially unacceptable disease. So when the first paper on the Wuhan outbreak was published it was no surprise that 40% of the infected were healthcare workers and of the rest most had been infected not by neighbors but in hospital/clinic environments where viruses have long been known to survive for days on stainless steel surfaces, chrome-plated IV hangers and plastic phones/screens/bed rails.

    Kill on contact surfaces, better sanitizing tools and better cleaning procedures are available (though expensive) but alas 171 years after Dr. Ignaz Semmelweis was run off (and later institutionalized) for pleading non-stop for better hand washing procedures among healthcare workers and better sanitation in hospitals the tendency of healthcare systems to magnify and propagate infections still remains an enormous burden on public health. Maybe this time we’ll do something about it.

    • Dzhaughn says:

      Interesting and plausible. Can you offer studies showing elevated infection rates among healthcare workers compared to their peers in other cases?

      If they (who are thoroughly informed and trained in clinically proven methods) haven’t come to the point of avoiding contracting and communicating diseases, can we credit public information efforts in the same direction?

      • Thanatos Savehn says:

        Here’s a newly published study the results of which were reported at an industrial hygiene meeting last year. It shows the prevalence of respiratory viruses in an American hospital setting: https://t.co/HkdWb6r2my?amp=1 . As for higher rates versus other occupations the paper characterizing the first victims was typical – of the 57 infected in hospital 40 of them were healthcare workers: https://tinyurl.com/wlxrkfr It makes sense to me that working in a facility with lots of people shedding viruses increases the risk of infection.

        Regarding training for hand washing there are many papers out there that test various claims of improved hygiene among healthcare workers but my sense, for years, has been that follow up studies tend to show that the effect doesn’t linger much beyond the day the researchers’ cameras are turned off. Surveillance and immediate termination for violations seems to work but they lead to the sort of endless and expensive litigation in which my profession engages and so are largely avoided.

    • What a disaster the hospital-acquired infection rate is. Those Wuhanese hospital workers infected by other hospital viruts were probably younger.

  5. jim says:

    Until the outbreak in Korea I thought it might be contained, but now there’s no hope of that. The mortality rate is low and it’s mostly older people getting impacted, so for myself I’m not especially worried, but if I was an older person or had respiratory issues I’d be taking it very seriously and cancelling travel etc.

    It’s irritating that authorities here in the PNW aren’t acting more aggressively. From the economic standpoint better to take a week off and find out it’s not an issue than to wait two weeks and try to confront a major problem. But I think the fact that it affects mostly older people is a factor in that.

  6. Dzhaughn says:

    Will ship our stash of canned beans, pasta, and toilet paper to you later, once when we calm down and it’s your turn. (But, still plenty lentils de Puy in the stores, happy to say. No poblano chiles. Except in the asian market, lots of stuff there, and no lines. I was among the 25% (+/- 10%) in that market without a mask. I do kid a lot, but this was my actual experience yesterday here in King County.)

  7. Martha (Smith) says:

    Being in the fourth quarter century of life, and living in Austin: I have signed the petition to cancel SXSW this year*. I doubt that the petition will succeed, but it appears that there have indeed been quite a number of individuals and organizations that have cancelled: https://www.statesman.com/entertainment/20200303/sxsw-2020-and-coronavirus-herersquos-whos-not-coming

    (To be honest, I wish it would cancel permanently, just because it has messed up Austin so much.)

  8. Terry says:

    Getting quarantined a long way from home sounds like a very big deal even if you don’t catch it. Italy has quarantined twelve towns including Milan and Venice, so the possibility is very real.

  9. Yuling says:

    “Let X be the magnitude of the threat and Y be people’s fear. If you can’t specify X, and you have no measure of Y, then how can you be so clear that Y > X?”
    I guess if people are believed to be minimax optimal, then they are also alsmot surely over-prepared/over-panicked on average.

  10. Renzo Alves says:

    People in Japan got big props for not panicking during the 2011 quake (I was there, it was true, no one freaked out), but this time, based on nothing more than a fake internet rumor that there was a toilette paper shortage, confirmed to be false by the suppliers, people (some) panic-bought up every roll on every store (at least in my Yokohama suburb). Panic-buying-hoarding is called kaishimeru 買い占める if you’re interested. I have seen this process in action. A bar owner mentions that he heard a rumor, customer says he will stock up on way home. Person complains about empty shelves of product A, then mentions that they bought up all the product B, which soon enough becomes scarce. So it goes. Fear is a good motivator, but sometimes creates self-fulfilling predictions.

    As wife comments, we’ll soon be back to being monkeys.

    Just anecdotal, of course.

  11. Mark Palko says:

    Looks like Sunstein had a “probability neglect” column sitting around.

  12. Nick Adams says:

    Almost everybody in the world will be infected with this novel Coronavirus.
    Hand sanitiser and face masks will not prevent this.
    Many of those infected will be asymptomatic.
    Some will develop a fever and non-specific symptoms.
    A few will develop pneumonia.
    Some of those with pneumonia will require hospitalisation and a proportion will die.
    The majority of deaths will be in the elderly and those with pre-existing serious cardiovascular disease.
    A very small proportion of healthy adults will die from cytokine storm.
    Children are likely to be fine.
    These clinical effects are fairly typical of a viral disease.
    The only novel aspects are that it will affect a lot of people simultaneously because it is highly infectious and no-one has pre-existing immunity.
    The major risk is societal disruption due to panic/hysteria/hoarding etc, so just chill.

  13. Anon says:

    It’s far from clear Sunstein is right about what’s rational for the individual regarding the coronavirus

    But even if he were, everyone acting individually rationally about it might be worse in aggregate than if people were more cautious. I mean, it could go either way. He’s not quite reminding people to defect in the prisoner’s dilemma. But economic and psychological impact of fear might outweigh the reduction in infections from cautious behaviour.

  14. Anoneuoid says:

    Wuhan’s infection rates are the highest for any region afaik, which is why I chose those numbers. So I don’t think these containment measures can be called successful.

    From what I read they were forcing people to wear masks in public even if they were already wet from rain or breath which probably made it easier to get sick. Other suspected cases were getting put in “hospitals” with no barriers between patients and nearest bathroom the equivalent of 2 blocks away.

  15. > more scared than they have any reason to be.
    Well more scared than its in their best interests to be.

    There is no certainty about containment, degree of transmission, mortality rates, how that will vary across the population and whether it will be here for months or years. Surprise, surprise.

    However, we are more informed of this one than probably any other other in the past and the mortality rates at present are well below what should be causing wide spread panic which might well result in higher mortality.

    Why should those currently working in health care not head for the hills? Or those now working on the vaccine?

    So far, in Canada we seem to be faring better, given we went through the SARS crisis and the small panics then.

    • Hopefully folks here won’t neglect the second and third lines here:

      Get Prepared
      Have supplies on hand so you do not need to leave your home if you become ill. Add a few extra items to your grocery
      cart every time you shop. This places less of a burden on suppliers, and can help ease financial burden on you as well.

      https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/diseases-conditions/covid-19/covid-19-be-prepared-factsheet-eng.pdf

      • jim says:

        There’s no pressure on suppliers so far of anything other than hand sanitizer.

        The sooner you stock up the less often you go to the store and the fewer infected people have handled the things you buy and the less likely you are to catch or become a vector.

      • jim says:

        Keith,

        Your advice above is pretty sensible, but what’s happening here right now is just damned amazing. I wish I had a huge freezer!

        Today I was at a Kroger (major national chain) store. Not only are the shelves well-stocked – everything but hand sanitizer – Kroger is having the biggest sale on meats I’ve seen in at least a decade. Ground beef is a stunning $2.50/lb! Eggs $0.99! OMG! The store wasn’t empty, but it was pretty quiet in a store that’s usually extremely busy.

        Will be interesting to see what this is all about. Is there – shockingly – a food glut? Everyone’s staying home and not shopping, but stores probably put in their orders weeks ahead – could it be that product is poring in and there’s no one there to buy it? Or maybe suppliers are worried about having too much on hand and are cutting prices to move stock before it goes bad? Very interesting!

  16. Steve says:

    Can we now officially stop treating Cass Sunstein like a public intellectual? And, can we stop all of the “it’s just the flu” talk? I have been trying to tell people since mid January that there was a pandemic on it’s way. The WHO is now saying the mortality rate outside of China is 3% –30 times as deadly as the flu. That likely means that the mortality rate in China is much higher than reported. It kills middle age people who are otherwise healthy. The seasonal flu doesn’t do that. We are about to see a big outbreak in Seattle and it is starting here in NYC. NYC is not prepared. The subways might as well be recategorized as a disease vectors. Good luck to everyone. Also, please use soap and water — hand-sanitizer only when no other options are available. It gives a false sense of sense of security. Soap and water.

    • Andrew says:

      Steve:

      Of course Cass Sunstein is a public intellectual. From wikipedia: “The term public intellectual describes the intellectual participating in the public-affairs discourse of society, in addition to any academic career.” John Yoo and Niall Ferguson are public intellectuals too! We could perhaps categorize public intellectuals in some way:

      – Mainstream intellectuals promoting their particular academic subfield as a way to understand many of the world’s problems: Cass Sunstein, Jill Lepore, Tyler Cowen, Brian Wansink, Matthew Walker, David Spiegelhalter, Mary Beard, Steven Levitte, etc. Just to be clear, I’m not equating serious thinkers such as Lepore, Cowen, etc., with trimmers like Wansink and Walker; my point is that all these people are working within their academic subfields and promoting the relevance of these subfields to the outside world.

      – Political or politicized intellectuals: Paul Krugman, John Yoo, Niall Ferguson, Roxane Gay, Elizabeth Warren (before she became a politician), Thomas Franks, etc. By circumstance or by choice, these people have been identified with particular political positions, and they are public intellectuals in the role of advocate. They’re not just advocating an intellectual stance or some particular policies (in the way that Sunstein advocates nudging); they’re 100% taking sides.

      – Outsiders: Camille Paglia and Jordan Peterson are good examples of public intellectuals who’ve gained prominence by taking provocative positions. They have what my friend Seth called the insider-outsider perspective, using their academic credentials to push against mainstream views.

      The above categorization is not complete. For example, I’m not sure how Steven Pinker fits in to those categories, and I’m not sure how I fit in either! Each of us in our own way is some mixture of mainstreamer and outsider.

      • Steve says:

        I think you need a graph instead of categories. The x-axis is the degree to which the public intellectual is willing to take controversial positions. The y-axis is the degree to which they adhere to the professional rigor of at least their field. So, the top right quadrant has people like Taleb Nassim and Pinker (I think he stays on the positive side of rigor more than not). The bottom right quadrant has the Jordan Petersons and Niall Fergusons of the world, bomb throwers who are full of it. The bottom left quadrant has the Wansinks of the world (nothing particularly revolutionary, but almost certainly wrong) and the top left quadrant is filled with people who know what they are talking about but never say anything provocative so I don’t know their names.

    • jim says:

      Can you expand on hand sanitizer?

      I was wondering about it because the active ingredient is alcohol which I’m sure is effective against microbes but I don’t know about viruses. Also it depends on how much you use. The quantity delivered by an automated dispenser doesn’t seem like enough, IMO it should be about 3-4x that, so your hands and lower wrist are temporarily coated.

      but against microbes I presume it would be more effective than soap. Is that wrong?

      • Steve says:

        Caveat, I have no expertise, but I am repeating what infectious disease experts have told me. Alcohol may kill it, but if the virus is encased in material like, you won’t get rid of it unless you dissolve that material. A quick rub of alcohol won’t dissolve many fats and oils. Mucus is composed of proteins and fats. If that is what is on your hands, alcohol won’t work. 20 seconds of rubbing your hands with soap and water will. Stay safe.

        • jim says:

          OK, cool, that does make sense, soap removes the offending feature regardless, while HS attempts to kill it in place, which may fail.

          It does depend on how much you use though bcz I’ve used HS as an all-purpose solvent many times and it works great, even on nasty stuff like gobs of tree pitch, so a little longer application with more volume should cut through those protecting agents.

      • Martha (Smith) says:

        This question is moot if you can’t even get any hand sanitizer (a lot of stores have run out).

      • The mechanism of hand sanitizer as far as I know is that it damages proteins (“denatures” them, meaning their shape changes and they don’t work the way they’re supposed to) and it dries things (ie. carries away H20 during evaporation). Those two factors seem important to inactivation of viral particles. The alcohol based hand sanitizers seem to work better on “enveloped” viruses that have a lipid based envelope, which COVID does AFAIK. They work less well on viral particles that are not enveloped (have just a protein capsule, like noroviruses)

        I found this: https://www.webbertraining.com/files/library/docs/78.pdf

        which is a little annoying but as you get down past the first 10 pages or so, has specific examples of viruses.

        Slide 41: “Enveloped viruses are easy to kill” (this is the category COVID-19 is in)

        Slide 42: “Non-enveloped viruses are more difficult to kill… alcohols are more effective than medicated or nonmedicated soaps.”

        Soap and water should work well, especially thanks to the lipid envelope, if given enough time. Don’t just quickly wash your hands (see slide 15-16), spend 30 seconds rubbing the soap in and another 30 seconds rinsing. Do this first thing, *every time you enter a building* and you’ll be reducing the spread from location to location.

        note that those hand-washing slides are for *bacterial* contamination not viral. It’s hard to measure viral effectiveness.

        Washing has the advantage of actually removing the material as it goes down the sink… though viruses being very small can more easily cling to you than bacteria.

        The summary? Best thing is probably to wash your hands thoroughly about 5 times a day, using the entry to a building as a good trigger, and to use alcohol hand sanitizers to increase the frequency of hand-hygiene without relying entirely on them, mix and match.

        • jim says:

          Thanks Daniel, that was helpful. Mix and match is my regular approach anyway.

          I guess I still think though that slathering on the HS – if you get the full squirt from a standard dollar store bottle that’s a lot – should be pretty effective.

    • Zhou Fang says:

      “The WHO is now saying the mortality rate outside of China is 3% –30 times as deadly as the flu. That likely means that the mortality rate in China is much higher than reported.”

      Absolute nonsense. The high mortality rate outside of China is a sign of the patchy testing and therefore the prevalence of cryptic infections. Apparent death rates are low in countries with widespread testing, like South Korea, and high in places where testing is a clusterfuck, like the US.

  17. Steve says:

    Just because you don’t know X doesn’t mean you’re not reasonably sure that some other number, Z, is bigger than X. I think the idea is that it’s pretty reasonable to think that the risk of dying of, say, the flu is much greater (given what we know now anyway) in the US than the risk of dying of covid-19. And yet people’s actions reveal that they’re much less concerned with the flu than with covid-19 (e.g. how many people have not gotten a flue shot this year?).

    • The Real Steve says:

      Nonsense, as a middle age man who is not suffering from another serious illness my risk of dying of the seasonal flu is approximately zero. However, we know that SARs-Cov-2 has claimed middle age people and even younger people who were relatively healthy. So, my relative risk of dying from SARs-Cov-2 is orders of magnitude higher. It is silly to say people are panicking when they are trying to reduce a relative risk that so substantial. Why is absolute risk relevant? My chances of dying by drunk driver are low, but I would not get in a car driven by someone who has been drinking.

  18. Steve says:

    You should check your numbers, “Real Steve.” Between 12,000 and 60,000 people die of the flu every year. Your chances of dying from it are not zero.

  19. jim says:

    this is obviously a fertile topic for future statisticians.

    It’s pretty clear to various experts are at odds with the general public on how to handle this situation. It’s not just Cass Sunstein.

    I get why officials are warning against panic. But I don’t get why they are disinclined to action. Some have said that China’s quarantine was a bad idea “because it might not work”. Huh?? I’m curious how that wouldn’t “work” to slow the spread of the disease. Will or did it contain the disease 100%? No, and probably no one expected that.

    The topic brings up larger questions of “expert” forecasting on major issues – and highlights just how shitty we are at it. “Peak Oil” is a good issue to examine in this regard. A number of “experts” forecasting “peak oil” were completely ignorant of fundamental concepts about resource reserves (and still are). The were also ignorant of untapped kinds of resources. Shale oil was discovered in the 1970s and gas hydrates have been known for a long time too. Ultimate the “experts” didn’t get that their “peak oil” forecasts were forecasts about extraction technology and the price of oil, not about the volume of oil (gas) in the ground which isn’t close to exhaustion.

    When covid19 is done, we’ll need an exhaustive review of health official’s response to it to discover what measures were most effective and least costly.

  20. Kaiser says:

    Someone here must be able to help me resolve this question that came from a reader of my recent blog post about this coronavirus debate. I found thie CDC doc (PDF) that says there were ~ 56K deaths from “influenza & pneumonia” last year with a fatality rate of 17 per 100,000. (Page 17, Table 1). That seems to say over 300 million infections a year, concentrated during flu season. Given media reports of 30 to 50K deaths due to common cold each year, most of these cases are likely influenza, not pneumonia. The reader thinks it is implausible that on average everyone gets the flu each year. What do we think?

  21. joshua pritikin says:

    No idea if it would help with coronavirus, but you can improve lung function by avoiding milk, https://nutritionfacts.org/video/is-milk-and-mucus-a-myth/ ; Good idea to avoid dairy anyway for health reasons.

    • Andrew says:

      Jeez . . . poor guy had to deal with Stasi replication terrorists and now he has to tangle with mean people on the internet who screenshot his old posts. I’d say that Sunstein is the real victim here.

      I really enjoy the luxury of writing a blog where I can just say I’m uncertain and acknowledge my errors when they occur. It’s not so easy for Sunstein being a celebrity columnist: he has to come to a strong conclusion with everything he writes, and he can never admit error. That’s just a recipe for self-contradiction. I’d say it’s a recipe for self-contradiction and embarrassment, but given that Malcolm Gladwell, David Brooks, etc., never seem to show any embarrassment about what they’ve written, I guess there’s no reason that Sunstein should either.

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