Energy Prospectus

I have updated the COVID-19 spreadsheet and posted it to the EPG website.

181,580 Confirmed Cases
-78,943 People fully recovered and released. It really looks like the U.S. and Europe are not letting fully recovered people leave the hospital.
- 7,138 Death < 92.2% in just 4 of the 157 countries with confirmed cases
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95,499 Active Cases < Considering how tiny of a percentage this is of the global population 0.001229%, is the hype justified?
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What jumps out at me is that the number of active cases in China is now 9,046 compared to over 42,000 just 20 days ago. 68,763 out of 81,038 confirmed cases have totally recovered in China. Someone told me that the big spike in deaths in China at the beginning of February was a lot of very old people in Wuhan. Has China found a cure? Do they have a effect treatment plan?

Italy with 23,073 active cases is now the #1 "Hot Zone". China + Italy account for 5,387 of 7,138 worldwide deaths. < 75.5% Add Iran at 853 deaths and Spain at 342 deaths and four countries have 92.2% of all deaths. Of the 85 deaths in the U.S., 48 are from the state of Washington; most if not all are from the same nursing home. Followed by 10 in New York and 7 in California. No deaths in Texas so far. 85 active cases in Texas, which is low for a state of this size. Could it be our warm weather? I hope so.

Spain moves up over South Korea into the #4 spot and the number of people recovering in South Korea has also picked up.

You ask, "Is the hype justified?"

Here is one NJ community hospital CEO's answer.

https://www.roi-nj.com/2020/03/14/opini ... -outbreak/

Maron said the past week has been unlike any other in his more than four-decade career.

“I can fall back on my cholera experiences in Haiti, which was devastating, considering the lack of basic medical supplies after the earthquake — and then the other things that came here, everything from MERS and SARS, and even when we ramped up for Ebola — this is unprecedented,” he said.

“I can tell you, it’s real.”
...

Maron wants to get the word out. He wants to let everyone in the state know how bad this can be. His team is living it. And his reality, he said, is not matching what he’s seeing in the media.

“I’ve seen a bunch of headlines. Some people are out there saying: ‘They’re overplaying this. It’s not that contagious. It’s a little bit like the flu.’ It’s not.

“What we’ve seen in the patients who ultimately are positive is that things can turn very rapidly. We had a patient that we were thinking about releasing — he seemingly was recovering — and then, two days later, he was put in the ICU. The flu isn’t like that. People need to know this.”
...

“One of my employees, who is a beloved guy here, got it in the community and came in,” he said. “We had him in our ER in isolation. We were monitoring him, and the decision was: ‘He seems to be doing a little bit better. We think we’re going to discharge him home under self-isolation and monitor him from there.’ But we wanted to wait another hour or two because we were just seeing a little indication that something’s not right.

“In that two hours, he decompensated so fast. He is one of the ones in the ICU on a ventilator. He’s fighting for his life. It goes that quick.

“That’s what people aren’t seeing. The flu doesn’t do that to you. These people are going from being moderately OK to being on a vent. And the next thing that happens is they start to decompensate, and then you get into organ failure.”

Here's an updated set of statistics (U.S. only).

Total cases: 4,727
Active cases: 4,560
Closed cases: 167 (recovered: 74; deaths: 93) (these numbers do not reflect the estimated mortality rate, which most experts expect will be far lower, on the order of 1 or 2%)

As a percentage of the population, the numbers are obviously quite small.

Now look at the charts for the US here: https://www.worldometers.info/coronavirus/country/us/ Note the curves. Now go back to the world statistics and look at the numbers for Italy, Spain and France, and their curves.

What is concerning is what happened in countries that were late in aggressively implementing containment and mitigation measures, most notably Italy and Iran, and to a lesser extent Spain and France. Italy's health care system is on the verge of collapse (in the north), with many stories of life or death triage decisions (denying some patients who go into ARDS needed ventilatory care) having been necessary based on factors such as the patient's age and underlying condition. Spain and France are still TBD. And the shortages are not limited to just ventilators and ICU beds, as the ranks of doctors and nurses are being strained by their own contraction of disease (taking some of them out of the trenches) and fatigue.

So the issue is not just the number of deaths or cases (recovery, by the way, may not always be complete, but with residual pulmonary scarring). Rather, it is the ability of the available health care infrastructure to handle the volume of cases at any given point in time.

The U.S. health care system was not designed for a pandemic of a highly contagious virus whose lethality has been proven to exceed that of the flu (some experts estimate 10x or more), whose penetrance (R0) is now known to exceed that of the flu, for which there is no vaccine (unlike the flu), and for which there is no acceptably proven therapy, especially during flu season. We do not have the quantities of ICU beds, ventilators, necessary other equipment such as personal protective equipment for health care workers, and skilled personnel that would be needed if the penetrance in the U.S. mimics that which has occurred elsewhere. And our system is already somewhat burdened because we are in flu season.

"Flattening the curve," in effect delaying over time (and hopefully also reducing somewhat the number of) transmission in our population so that our health care system is not swamped to the degree that Italy's has been, is the only way we will avoid the unthinkable. If ventilators/ICU/isolation beds have to be rationed in this country and some patients die as a result, because people selfishly refuse to curtail their social activities and thereby facilitate natural transmission/penetrance rates, that would be a very tragic commentary on what our society has become.

We all dislike the economic consequences of social isolation and social distancing, including the shutdowns that will temporarily slam our economy. But our health care system, including its unselfish professionals who are putting their lives on the line, and our elderly and others most at risk for bad outcomes when they become infected, deserve whatever measures we can muster, despite the economic pain we will all share.

This is not hype. It is an unfolding train wreck of unprecedented (at least since about 100 years ago) proportion that can still be significantly mitigated IF we care enough about each other to alter our lifestyle temporarily. Some (hopefully very few) of us are eventually going to become infected with COVID-19, unfortunately. We should hope that if/when that happens, it's far enough into the future that an effective treatment is available and that adequate numbers of needed facilities, equipment and healthcare workers for all similarly situated patients are, as well.

Swine Flu was MUCH WORSE and civilization survived.
Just in the U.S.
> Over 60,000,000 cases of Swine Flu in 2009
> Over 274,000 hospitalized
> 12,000 to 18,000 death < Wide range is because a lot of the people that died had other serious illnesses

One way or another the human race goes on. BTW over 160,000 people died yesterday and only a tiny percentage were from COVID-19.

At some point the Gloom & Doom must give way to positive updates on how many people are recovering (looks like over 97%).
Updates on progress being made on ways to treat it would be nice. < As of this morning, over 80,000 people who had the virus have TOTALLY RECOVERED.
Updates from medical research teams on finding a vaccine would be nice.

My primary concern is that our government will use this to gain more control over our lives, like taking over the healthcare system. That will kill many more people.

Remember: FEAR is a powerful human emotion. Throughout history it has been used by dictators to take control of many countries.

Somebody should point out that the Johns Hopkins site, as a statistician should know, is an imperfect instrument. It tells us that it is based on only public sources. Given the lack of testing materials, we have no definitive number all of the active infections in the US. It may be early days in the epidemic. We don’t yet know.

In the meantime this is typical of EPG propaganda:

<<My primary concern is that our government will use this to gain more control over our lives, like taking over the healthcare system. That will kill many more people. >>

The screeching ideology is counterproductive and potentially dangerous.

Overstating/misstating the issues does not advance, but detracts from, the discussion.

"Swine Flu was MUCH WORSE and civilization survived." No one is questioning whether civilization will survive. Of course it will. Also, Swine flu statistics are largely irrelevant to the public policy issues we face.

"One way or another the human race goes on." No one is questioning whether the human race will go on. Of course it will.

"Gloom & Doom must give way to positive updates on how many people are recovering" No one from the scientific community is preaching "Doom and Gloom;" rather, they are stating known facts and the epidemiologists'/others' best understanding about a new (in humans) disease's expected course if various public policy alternatives are and are not taken. Recovery statistics are a necessary part of the analysis and are being reported (though a fact often omitted is that recoveries are not always complete, with residual pulmonary scarring even in young adults).

"Updates from medical research teams on finding a vaccine would be nice" Reports about progress in developing a vaccine (for prevention) are all over the news media, though unfortunately it takes an extended time (over a year) to conduct the trials needed to assure a vaccine would be safe and effective. During that period is when, without the public policy measures necessary to contain/mitigate spread and to "flatten the curve," the U.S. healthcare system would risk being overwhelmed. Reports about progress in developing therapies (for treatment) are also all over the media (and are encouraging, but still months away from yielding something that can be widely used).

"My primary concern is that our government will use this to gain more control over our lives, like taking over the healthcare system. That will kill many more people. Remember: FEAR is a powerful human emotion. Throughout history it has been used by dictators to take control of many countries."

Agree, fear is a powerful emotion. Your expressed fear, that the U.S. "government will use this to gain more control over our lives" has no chance of being realized. The public policy measures being urged and in some instances imposed will be limited to what the scientific facts justify and, in any event, will be temporary. Implying that those measures will result in a government takeover of our healthcare system is a use of unwarranted fear that distracts from the discussion of what public policy measures are immediately needed and how they can best be implemented.

Your "primary concern" might instead be whether you and others like you will have the necessary medical treatment available when it is needed (in the event you become infected) if Americans don't adopt the measures they are being asked to take. You might also be concerned about the many selfless healthcare professionals who are working very hard (and risking their health) 24/7 to treat those of us who need care.

While we are talking about "concerns," we might also think about the consequences of our having become so dependent on China for the manufacture of both API (active pharmaceutical ingredients) and medical equipment, all in pursuit of maximizing quarterly profits. Surely you will support efforts by our government to encourage/require our manufacturers to diversify their supply chains.