Tomas Pueyo

> Spain went into lockdown a week before the UK, and still did worse? Germany later than the UK, and is doing better? Not relative to number of cases: Germany locked down later than UK, but a week earlier on the exponential growth curve. I'll post this link again, because it's the best articulation of this point that I've found: https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-di… Timing, with respect to where a country/region is on the exponential growth curve, is critical. In almost every place you see the same outcome, it's crazy.

You actually can't assume that will be the case, based on longevity data from the Great Depression[1]. If Covid runs rampant and collapses the medical system the U.S. is facing anywhere between 500,000 to 10 million dead based on current understanding of the numbers[2]. 1. https://www.history.com/news/great-depression-economy-life-expectancy 2. https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be…

I think the problem is bigger. We can't do now what SK is doing. They are tracing cases and aggressively quarantining everyone who tests positive. Obviously you cannot do that if you cannot test enough people to get a complete enough picture of the invected population. We also probably now have too many infected to make that strategy workable at this point, even if we had the tests, tracing probably would be the new bottleneck. This great write-up suggests to shut everything down to get cases back to a manageable level and then move to the SK and Singaporean model: https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be… Strongly recommend the read.

Garcetti, the Mayor of Los Angeles, covered this in his address last night. We are buying time to get more tests, more hospital beds set up, more ventilators, more medicine. The Navy is talking about turning Aircraft Carriers into hospitals. China is getting things under control and switching factories to produce medical supplies. It takes time to build these logistics chains, and we are buying that time by slowing our economy down and implementing social distancing. I agree that this information is not well-circulated right now. EDIT: another commenter posted this great link which I will also share: https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be…

Certainly: locking down the populace and the economy, without any plans to take advantage of the resulting respite, is unacceptable. Giving up and attempting to resume normal activity is also unacceptable, full stop. The best/latest explanation I've seen is https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be… Please read it (everyone, not just parent) if you haven't already. Then if you're frustrated that your political leaders aren't moving to make best use of your sacrifice... let them know!

I believe this model was created by Tomas Pueyo. His full article is well worth a read: https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-di…

Here is a great breakdown of the curves and the risks[1]. Scroll to the heading "Risk-based model" or go directly to the spreadsheet[2]. Fill in the numbers for your area. [1] https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-di… [2] https://docs.google.com/spreadsheets/u/1/d/17YyCmjb2Z2QwMiRRwAb7W0vQoE…

I am slowly coming to the realization that a quarter to a half of a percent of people who are alive on Earth today may not be in one year. Please send the following links to your employers, especially if you work with the public: https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-di… https://www.theatlantic.com/ideas/archive/2020/03/coronavirus-cancel-e… The only way we will avoid swamping the healthcare system in the US is by enacting widespread measures before it seems necessary/imminent. NOW is the time to act, not later.

I wouldn't put an idea on Twitter or Facebook. That's where I put a short joke, or a pun, or some political troll meme. Then I watch the mentions and likes roll in. That's not to say that it never happens, but they aren't really well made platforms for it, outside posting a link to an actual blog. Personally, I think the blogosphere is covered pretty well for me by the likes of Medium. I'm not sure how I feel about that, but they've made a damn good job at cornering that part of the market for those more serious posts that were previously relegated to the blogosphere. That's a place I'd put a more well-formed idea. A great example is the article, "Coronavirus: Why You Must Act Now" by Thomas Pueyo.[1] Outside that, blogs still exists! I still even have my own. I think the complaint is rather that they're hard to index or search. And to that end, there are many solutions and ways around it that still exist, such as syndication or even RSS. [1]: https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-di…

Since you want to discuss, and clearly looked into this: I do not agree on any single one of your numbered points. 1) "eradication is not possible" just does not follow from "this is a highly transmissible respiratory virus". "Eradication will be difficult" follows; but several countries have shown us that "eradication is entirely possible if proper measures are taken" 2) The purpose of lockdowns is to eradicate the virus. https://medium.com/@joschabach/flattening-the-curve-is-a-deadly-delusi… 3) See 1. So my position is that eradication is possible, and - given the possibility of multiple waves if the virus becomes endemic (large virus population --> increased chances of dangerous mutations) - it is vital that we give it a really good try. The discussion should re-focus on how we go about eradicating the virus, while minimizing the damage to the economy. This article outlines an appropriate path forward: https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be…

It looks like you need to find someone who can help make your post feel more professional - perhaps Ask HN for help or just directly email one of the clued up people here that are open to cold emails (patio11?). I almost didn’t read it because the title sounds too generically woowoo, and the domain you are using seemed unprofessional. Then on reading the article, you didn’t give your background, an irrelevant picture of a painting opens the article, and the sidebar of your article topics are all over the shop. Sorry for being so negative: it is much easier to find reasons why something doesn’t feel right, and I’m not a fantastic marketer so I can’t offer you fixes I could predict would help. It seems like a really good idea (are there others that have suggested it?), but I suspect it needs to be more convincing with a bit of repackaging if you want to push it. Maybe add comments to those 2 papers with an “elevator pitch” or a request for other relevant info, and link to an improved post, and it should bubble up and find the right people to evaluate it. Edit: also perhaps get your idea onto the various Covid daily link sites: good ideas should bubble up. Use Twitter to relevant people. Pass the idea to this guy who writes fantastically and has audience: https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-di… Good luck, we need some!

The issue with is the word "scientist". In academia, science is the pursuit of postulating a falsifiable theory, then gathering facts to verify that theory, and then going through a process of intensive peer review that either confirms, dispels or amends those findings. The formality of the academic process is a necessity. The value of scientific findings entirely depends on the trustworthiness of the research. That is, how were the results obtained, which line of thinking was followed, did the research exclude crucial biases, etc.? The importance here is that academic research is used as a pillar to produce products and services we all use in daily life. For instance, if you need a hip replacement, you want to be sure that prosthetic was designed based on rigorous scientific findings and studies that can vouch for safety and comfort. The difference then with "data scientist" is that they often they don't apply the same rigorous research practices. It's easy to pick a dataset and bang off visualizations; it's a different story to actually come up with relevant questions, assert the quality of the data at hand and publish your findings towards a community of domain experts who are actually able to review your findings. One needs in-depth domain knowledge to do that. Good data scientists will understand this limitation. They often work in a specific domain in a supporting capacity: bringing technical skills and capabilities to domain experts that don't have those…

Lots of people in these coronavirus threads have been confusing "confirmed cases" as reported by various countries, vs the actual number of cases, and using this to propose various conspiracy theories about governments downplaying or suppressing information about the situation. Here is an interesting analysis including analyses done by Chinese health officials to estimate the actual number of cases in the past on a given day, based on symptom data collected from confirmed cases. https://www.youtube.com/watch?v=mCa0JXEwDEk Other countries should follow suit. Chart: https://miro.medium.com/max/5376/1*r-ddYhoUtP_se6x-NOEinA.png Commentary: https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-di… > This is one of the most important charts. > It shows in orange bars the daily official number of cases in the Hubei province: How many people were diagnosed that day. > The grey bars show the true daily coronavirus cases. The Chinese CDC found these by asking patients during the diagnostic when their symptoms started. To be precise, even the grey bars are an underestimate of the true cases in reality, since they would exclude unreported cases as some people were turned away from hospitals. (In the UK they are advising people with non-severe symptoms to stay at home, where they can't be tested.) It's encouraging that a retrospective analysis confirmed that the Wuhan lockdown had the intended effect however, to reduce the true spread of cases.

>>> "We might see something that vaguely resembles what you are describing." No, there's a 100% chance we will see it if we don't take measures. Watch the news from Wuhan, Italy - it's apoplectic. It's really bad, and if they didn't shut everything down, it would be a zombie movie. We know that 'shutting things down' works because in China, the virus is contained, at least for now and medical facilities are starting to be able to cope. >>> "The morbidity rate is far less than 3%" Source? Because every credible source and the data coming out of various countries puts the rate at somewhere near 3%, not 'far less than' 3%. Some facts [1] Even a 1.5% death rate is existentially problematic, we're still talking millions of people dead. Moreover, if you bother to look at the data, you'll see that morbidity rates are a function of access to care, meaning that when Hospitals are 'overwhelmed' - people die at much greater rates. In Italy, it's 5%. But there's a bigger issue: 20% of people who get it requires specific medical intervention, and at least 5% of them 'intensive care'. COVID is totally overwhelming medical the medical system in 100% of the areas wherein the contagion has let loose; people getting zero treatment, medical staff getting infected, people dying in the hallways, in their homes. FYI 20% of 330M Americans is 66M people, only a fraction of whom need to be infected for 'zombie apocalypse' in the Hospitals, again: see Italy, Wuhan for what will happen. >>>…

That story and his individual points fall apart upon analysis. The below is the best current analytical distillation I've seen of where we are: https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-di… The upshot is: a) there is a huge diff between localities that act aggressively and prepare and those that dont b) the ones that prepare and act aggressively to reduce exposure see death rates below 1%. This is still 5-10x more deadly than the flu, and is best case c) the ones that dont see death rates above 5%. This is 50-100x worse than the flu. In the US Washington and San Fran are failing to act aggressively enough in time. The article doesnt discuss NYC, where I live, which has similar levels of infections as Washington tho far fewer deaths. The piece explains how the difference in death rate indicates NYC is in a far better position than Washington, and my own analysis is that we may still have time to stop the worst case, but it is really about what happens in the next several days. Even in worst case, most people will themselves be fine, but everyone knows at least someone immune compromised or elderly or otherwise much more significantly at risk. So everyone's social or familial network will be impacted. In terms of the future, it seems likely that even in best case, there will be subsequent waves that hit pockets that were missed the first time around. The difference in impact again will be in how overwhelmed the local hospital…

Well, for example, deaths being down instead of going down. Get the active cases down to a manageable number, then switch to test and trace while gradually opening up as advocated for in The Hammer and the Dance [1]. 1: https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be…

https://medium.com/@tomaspueyo/coronavirus-how-to-do-testing-and-conta… This article argue why it's not very likely to be good, compared to manual contact tracing. I don't agree with all the points, but it is a valuable read. There is a lot of other good things there as well.

> or they need to remain at current levels indefinitely until an effective vaccine or other treatment is available It isn't quite so bad. Lockdowns are a continuum of measures, and you can modulate them over time. We're having to do such strict lockdowns because we were so slow in responding. Once the R is below 1 you can release measures to keep it at that threshold and modulate it over time to match your health care capacity. Merkel seems particularly well informed about this, having even explained what the curve of healthcare capacity versus R looks like for Germany. This was a good discussion on this at the beginning of the lockdowns: https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be…

Hasn't that always been everyone's argument? That's the crux of Pueyo's "dance" [1], that as long as you've contained the initial outbreak, you can pretty much go back to normal if you track movement and have the capacity to test everyone who comes in contact with an infected person. [1]: https://medium.com/@tomaspueyo/coronavirus-learning-how-to-dance-b8420…

Here is an explanation of why the graph used by Tao on his blog is highly misleading: https://medium.com/@joschabach/flattening-the-curve-is-a-deadly-delusi… A few days after Joshua Bach posted the above critique, the original "flatten the curve" blogger, Thomas Pueyo, basically echoed Bach's points and called it "the hammer and the dance." https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be… The damage and confusion done by Pueyo's original graph is moot at this point, but it's been interesting to see how the FTC phrase has lived on. https://miro.medium.com/max/1340/1*PZesaMfoPxgYJBoQVtpmjQ.gif

> I've had people argue that this is containment > rather than flattening the curve, but I think it's > both, it's containment, which is roughly > the limit condition for flattening the curve. I suppose that's one way of looking at it. But using the "hammer and the dance" metaphor, if you start the dance (containment) early enough, there is no need to bring the hammer (because no big spike to flatten). https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be…

"The dance" will continue until there is widespread vaccination https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be…

Tomas Pueyo published an article: https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-di… He wrote a model that roughly estimates infection rates in a population based on either deaths or confirmed cases: https://docs.google.com/spreadsheets/u/1/d/17YyCmjb2Z2QwMiRRwAb7W0vQoE… The model is oriented around companies, but could be applied to any gathering of people. There may be more sophisticated or accurate models out there, but I found his relatively quick to understand and apply.

The hammer and the dance article covers in depth what you described. We need near very high test availability, and intense tracking of cases. The lockdown just buys time. https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be…

1. What happens in the middle, between a lock-down bringing down the infected numbers and vaccine. I've read a few things from epidemiologists, but there seems to be little discussion in the wider media. https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be… 2. What's going on with the PCR reagent shortage? Where are they produced? Why is it hard to make it quickly? etc.

I'd like hear an expert speaking on evolution and how that might effect immunity and the behavior of the virus. So far I've only read [1] that wrote about Nextstrain. While he clearly did his homework with a group of people, you can read in the comments that experts think his conclusions about the mutating genome are a bit too strong. Too strong as in: it could be the case but you can't state that it is the case. [1] https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be…

That's true and I think it's irresponsible. Even if the spread would be perfectly controlled and kept so that the number of patients in ICU stay below capacity, I don't think we can manage to get 60% of the population infected in 12 months because we would be moving at a slower rate. And it would be very surprising if the spread can be perfectly controlled. This article also makes some very good arguments for why it's not the right strategy: https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be…

The death curve is also quite steep. Seven days ago we were at 57 total deaths, now it's 276. Daily deaths has gone from eight people seven days ago to 49. https://www.worldometers.info/coronavirus/country/us/ Here's a good article on estimating current number of cases from number of deaths: https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-di…

> point I keep hearing from knowledgable people is that rapid spread is inevitable at this point. The point I keep hearing from every reputable epidemiologist, virologist, and public health expert around the world is that people need to stay the fuck at home because this virus is extremely dangerous and if left unchecked will completely overwhelm every hospital system in the world. Some public officials didn’t believe it when it was just Hubei, but after seeing the same happen in Lombardy, a rich region in Europe with a strong healthcare system, the situation became clearer. Edit: here’s a nice summary written by a Bay Area marketing executive (based on work by epidemiologists and others) https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-di…