The realistic perspective

My university has closed all face-to-face classes until 1 April, when, I presume, they’ll reassess what should be done. I hope no one thinks everything will be over then, because it won’t be. We’re just getting started. I expect April is when the pandemic in the US will be just roaring into action.

Some experts agree.

40-70% of the US population will be infected over the next 12-18 months. After that level you can start to get herd immunity. Unlike flu this is entirely novel to humans, so there is no latent immunity in the global population.
[We used their numbers to work out a guesstimate of deaths— indicating about 1.5 million Americans may die. The panelists did not disagree with our estimate. This compares to seasonal flu’s average of 50K Americans per year. Assume 50% of US population, that’s 160M people infected. With 1% mortality rate that’s 1.6M Americans die over the next 12-18 months.]
The fatality rate is in the range of 10X flu.
This assumes no drug is found effective and made available.
The death rate varies hugely by age. Over age 80 the mortality rate could be 10-15%.
Don’t know whether COVID-19 is seasonal but if is and subsides over the summer, it is likely to roar back in fall as the 1918 flu did

There is no guarantee that this will be a replay of the 1918 pandemic, but we should prepare as if it is. I’m teaching cell biology in the fall, I’m going to spend the summer getting organized for possibly having to teach it online.

I hope that’s all I have to do, and we’re not going to end up preparing by digging trenches for mass graves.

This next recommendation is personally bothersome. My wife flew to Colorado before the extent of the crisis became unavoidably obvious. She was supposed to fly back next week. Flying is out of the question anymore, so we’ve been trying to come up with alternative methods of getting her back home.

We would say “Anyone over 60 stay at home unless it’s critical”. CDC toyed with idea of saying anyone over 60 not travel on commercial airlines.

Right now we’re considering that instead maybe she should stay in Boulder with my daughter for some indefinite period of time. Safety apart is smarter than travel together that maximizes our chance of infection.


  1. Akira MacKenzie says

    There is no guarantee that this will be a replay of the 1918 pandemic, but we should prepare as if it is.

    Yeah, considering the attitudes of a large chunk of the population, good luck with that. My father and sister (who is a fucking infection control nurse and really ought to fucking know better) are clearly in the “This so-called pandemic is all hype generated by the liberal media and the Democratic party to and sully Dear Leader’s flawless reputation and ruin our economy” camp.

  2. Badland says

    Sophie’s Choice writ small, family after family, all over the world. What do we sacrifice/risk for our descendants, beloveds, parents, grandparents.

    It’s fun living in interesting times

  3. mathman85 says

    You know, I’d always heard that that line—“May you live in interesting times”—isn’t actually a Chinese malediction, but as the times in which I live grow more and more “interesting”, I find myself thinking that there might just be something to the idea that it is a curse after all.

  4. ruth/stl says

    Had an argument with my sister, who is 62 and a transplant survivor who thinks this is overblown. I’m willing to skip crowds to help GOP tools who won’t help themselves.

  5. blf says

    A doctor in the UK, Rachel Clarke, writing in the Grauniad, has some sensible suggestions for those dealing with elderly relatives in denial about the Covid-19 pandemic, How to give your elderly relatives coronavirus advice: a doctor’s view:

    In order to keep our loved ones safe, remember it’s not just the advice we give, but how we say it

    […] My conversations this week with a few family and friends in their 70s revealed at best a laissez-faire approach to infection, at worst a seemingly wilful defiance of current medical advice. The notion of self-isolation was scorned. Twenty-second hand washes were seen as neurotic. Phrases such as blitz spirit, over-reaction and the young today cropped up. I wanted to tear my hair out.

    Clearly, this experience is only anecdotal. In no sense am I suggesting that all (or even the majority) of those over 70 are cavalier about the current pandemic, or that the young are somehow smarter, kinder or more sensible. The last thing we need at a time of national crisis is the stoking of division between generations.


    If you, like me, have much adored older relatives who are meeting your pleas to self-isolate with amusement or intransigence, you may be feeling increasingly desperate. In these circumstances, simple advice is effective: the vital message to convey is the importance of self-isolation and good hand hygiene.

    Ideally, I would argue, those over-70 should now be self-isolating for their own protection. Perhaps you can enable a parent or loved one to do so more easily by delivering their groceries, setting up Skype links, downloading box sets, or boosting their morale with simple phone calls and messages.

    If your relative insists on going out (or has essential appointments that they cannot postpone), try to ensure they understand that the first thing they should do on returning home is wash their hands for 20 seconds with soap and water. No ifs, no buts, no excuses. This will reduce the risk of bringing live coronavirus into the home. More generally, hand-washing before eating or drinking, and after coughing, sneezing or touching their face, will also reduce the risk of contamination.

    If your loved one puts on a stiff upper lip or dismisses you as paranoid, it is worth remembering that there is nothing more infuriating than a high-handed know-all who insists they know what’s best for you. Moreover, we are all vulnerable to using denial to cope with the things that frighten us. Knowing how at risk you are, it might just feel safer to accuse your grown-up child of patronising you than to confront the nebulous, looming threat of a virus with apocalyptic potential. Equally, every adult son and daughter knows how effortlessly we can regress into our stroppy teenager behaviours of old when faced with an implacable parent. Just as doctors learn to develop their bedside manner, we could all, perhaps, benefit from listening to our elderly relatives’ concerns. Mirror their humour, if that’s the way they cope with adversity and, most important, communicate your love and concern for them.

    Ultimately, the most powerful motive for effecting change is, of course, our shared feelings for one another. Young, old, credulous, cynical — the best way to reach out to one another is to be open and honest about our fears and vulnerabilities. Statistics can be downplayed or disputed. Projected mortality rates can be dismissed as fake news. Yet who can deny the heartfelt plea: “I love you, Dad, and I don’t want to lose you. Do it for me, not you. Do it so we have more precious time together — please?”

  6. numerobis says

    A question: since you’re teaching remote anyway, why not get in the car and drive yourself to Colorado, rather than having Mary go home? Then you’d be with your family.

  7. malleefowl says

    1% mortality? Where did that figure come from. Figures from several countries have indicated a mortality rate at around 2% though this could be skewed by the rapid rise in cases. ie some of those already infected are not dead yet. Others using mathematical modelling programs suggest the mortality rate is somewhat higher at around 3% or more.
    Then consider Wuhan, China, which is seeing a drop in cases due to their stringent procedures and so should be much less skewed; there the mortality rate is running at 4.9%.
    In addition the World Health Organization (WHO) has estimated the mortality rate from Covid-19 is about 3.4%.

  8. epawtows says

    South Korea and Singapore’s mortality rate may well be below 1%: that mostly goes to show how much good prep work and a competent response can do.

  9. neroden says

    Strong evidence that mortality rate is higher in places with polluted air and high smoking rates. The US may do better for that reason (low smoking rate, low air pollution). On the other hand, our public health response has been awful (though it’s getting better in SOME STATES now).

  10. lotharloo says

    Based on what I read mortality rate also depends on how overwhelmed the health care system is. So in the worse case it could be as high as 4%.

  11. says

    @#13, lotharloo:

    And the degree to which the health care system is overwhelmed is determined by how much people isolate and quarantine themselves. Wuhan province had mortality which briefly went above 6% of known cases (although it eventually went down to 4.something as the number of known cases grew), other provinces in China which cracked down before things got out of hand never even reached 2%.

    (South Korea is apparently a special case — they locked down, but had a sort of Typhoid Mary case who was repeatedly reported to be feverish and ill but refused to even go home, let alone to a doctor, and came into contact with about 1500 people in approximately 24 hours.)

  12. DanDare says

    I don’t know how these death rate figures are being calculated. The sensible way is to only consider those that have recovered and those that have died, not those currently alive but infected. Back of envelope gives me around 8%.