Bogleheads community discussion - Coronavirus

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Bogleheads community discussion - Coronavirus

Post by LadyGeek » Thu Feb 27, 2020 10:17 pm

Like Hurricane Sandy, flooding in Calgary (Canada), the US East Coast Blizzard, and Hurricanes Matthew and Michael, let's consider the coronavirus an event that affects all Bogleheads.

This thread is now open to discuss the effects of the coronavirus (Covid-19) on the Bogleheads community.

You are welcome to share your concerns, but please be cognizant of the Forum Policies. No politics, conspiracy theory (virus origins), or medical advice is permitted. Epidemiology should point to official sources.
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Re: Bogleheads community discussion - Coronavirus

Post by Mactheriverrat » Thu Feb 27, 2020 10:33 pm

Is this Coronavirus being over blown by the media.

See news about the 2019 - 2020 season has done just in the US.

https://www.cdc.gov/flu/about/burden/pr ... imates.htm
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Re: Bogleheads community discussion - Coronavirus

Post by Atomic » Thu Feb 27, 2020 10:44 pm

This might be a good excersize. If this pandemic is only an average 2% <0.15% for flu> morbidity rate, it might prompt us to get national public health system act in gear for the next pandemic. Sorry if you happen to be older, or in poor health, the dice roll gets worse.

<edit 3/21> oh, how wrong I was. Cascading issues in an overwhelmed healthcare system can make 2% look good. This is the one we should have been preparing for. It will take a level of coordinated discipline we have yet to summon.
Last edited by Atomic on Sat Mar 21, 2020 2:03 pm, edited 1 time in total.

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Re: Bogleheads community discussion - Coronavirus

Post by GeoffD » Fri Feb 28, 2020 6:44 am

Atomic wrote:
Thu Feb 27, 2020 10:44 pm
This might be a good excersize. If this pandemic is only an average 2% <0.15% for flu> morbidity rate, it might prompt us to get national public health system act in gear for the next pandemic. Sorry if you happen to be older, or in poor health, the dice roll gets worse.
The data is incomplete but it looks like 80% of people who contract the virus don’t have severe symptoms. The other 20% mostly go down the pneumonia path. Influenza typically only kills people with co-morbidly problems. If a strain not in this year’s flu vaccine gets into a nursing home, it kills most of the residents. Healthy adults with the flu usually don’t die. This virus is different. The pneumonia wipes out people with co-morbidly issues but it also kills healthy adults. The immune system starts attacking lung tissue and people have pulmonary failure.

If millions of Americans get severe pneumonia, it’s going to overwhelm the health care system. I think the United States will be the worst of the first world countries to contain it. Why? Because half of the country has been trained to avoid the for-profit health care system at all costs since any engagement runs the risk of thousands of dollars in bills. You can’t contain it if you have no idea who has the disease.

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Re: Bogleheads community discussion - Coronavirus

Post by Dantes » Fri Feb 28, 2020 6:56 am

GeoffD wrote:
Fri Feb 28, 2020 6:44 am
If a strain not in this year’s flu vaccine gets into a nursing home, it kills most of the residents.
Where does that come rom?

A review of 206 published infectious outbreaks in elderly care facilities across 19 countries over 40 years identified 37 different pathogens, but influenza viruses caused the largest number of outbreaks (23%).17 In the 49 outbreaks caused by influenza, the median attack rate in residents was 33% (range 4‐94%), and 23% (range 3‐58%) among staff, with a median case‐fatality rate for residents of 6.5% (range 0‐55%)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5596516/

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Re: Bogleheads community discussion - Coronavirus

Post by Cognitive_Squeeze » Fri Feb 28, 2020 9:23 am

GeoffD wrote:
Fri Feb 28, 2020 6:44 am
Atomic wrote:
Thu Feb 27, 2020 10:44 pm
This might be a good excersize. If this pandemic is only an average 2% <0.15% for flu> morbidity rate, it might prompt us to get national public health system act in gear for the next pandemic. Sorry if you happen to be older, or in poor health, the dice roll gets worse.
The data is incomplete but it looks like 80% of people who contract the virus don’t have severe symptoms. The other 20% mostly go down the pneumonia path. Influenza typically only kills people with co-morbidly problems. If a strain not in this year’s flu vaccine gets into a nursing home, it kills most of the residents. Healthy adults with the flu usually don’t die. This virus is different. The pneumonia wipes out people with co-morbidly issues but it also kills healthy adults. The immune system starts attacking lung tissue and people have pulmonary failure.

If millions of Americans get severe pneumonia, it’s going to overwhelm the health care system. I think the United States will be the worst of the first world countries to contain it. Why? Because half of the country has been trained to avoid the for-profit health care system at all costs since any engagement runs the risk of thousands of dollars in bills. You can’t contain it if you have no idea who has the disease.
See highlights above, first, note statement data is incomplete. Perhaps, you could expand on the incomplete data.

Then, please provide sources to indicate why is this virus is different.

How are you basing the statement that "millions of Americans will get pneumonia"? How many Americans currently get pneumonia each year, particularity during the flue season.


I think may help tame misinformation and fear.

Thanks,
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Re: Bogleheads community discussion - Coronavirus

Post by Atomic » Fri Feb 28, 2020 10:12 am

I agree, data is incomplete. Hopeful news that the CDC is figuring out testing. I'll be looking for morbidity numbers coming in from studies that include populations that show no symptoms.

Source for my initial "2%" http://www.cidrap.umn.edu/news-perspect ... death-rate

The latest from CDC https://www.cdc.gov/mmwr/volumes/69/wr/mm6908e1.htm

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Re: Bogleheads community discussion - Coronavirus

Post by Atomic » Fri Feb 28, 2020 10:25 am

Here's more on "2%" and co-morbidity / respiratory issues mentioned by another poster. https://www.thelancet.com/journals/lanc ... X/fulltext

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Re: Bogleheads community discussion - Coronavirus

Post by Cognitive_Squeeze » Fri Feb 28, 2020 11:36 am

A word of caution. I hope this helps.


At present, it is tempting to estimate the case fatality rate by dividing the number of known deaths by the number of confirmed cases. The resulting number, however, does not represent the true case fatality rate and might be off by orders of magnitude [...]

A precise estimate of the case fatality rate is therefore impossible at present.

https://www.worldometers.info/coronavir ... ographics/

https://www.worldometers.info/coronavir ... eath-rate/

https://smw.ch/article/doi/smw.2020.20203
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Re: Bogleheads community discussion - Coronavirus

Post by mc7 » Fri Feb 28, 2020 11:47 am

I checked my asset allocation today and was surprised to find it still in range. It seems the effect on international stocks has been much more muted. I try to stay roughly 50/50 US and international. For now, my actionable conclusion is to take no action, in true Boglehead form.

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Re: Bogleheads community discussion - Coronavirus

Post by DonCamillo » Fri Feb 28, 2020 10:24 pm

Atomic wrote:
Thu Feb 27, 2020 10:44 pm
This might be a good excersize. If this pandemic is only an average 2% <0.15% for flu> morbidity rate, it might prompt us to get national public health system act in gear for the next pandemic. Sorry if you happen to be older, or in poor health, the dice roll gets worse.
I think there are 4 primary factors to consider in estimating the death rate:

(known deaths + unknown deaths)
————————————————————-
(known cases + unknown cases)

At this time, it appears that deaths from coronavirus attributed to other causes are probably limited, while cases of coronavirus that are not known are probably significant, the numerator is reasonably fixed while the denominator should probably be increased. That makes is likely that the WHO 2.9% estimate is probably a good upper bound.

Secondary factors affecting the estimate are mostly related to timing. If we have a thousand cases with no deaths today, and a thousand deaths tomorrow, today’s mortality rate would obviously be incorrect. If there is a significant delay between diagnosis and death, then early estimates would be low. But that does not appear to be the case.

2.9% seems to be a good working hypothesis.
Last edited by DonCamillo on Sat Feb 29, 2020 9:41 am, edited 1 time in total.
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Re: Bogleheads community discussion - Coronavirus

Post by AlphaLess » Fri Feb 28, 2020 11:46 pm

Atomic wrote:
Thu Feb 27, 2020 10:44 pm
This might be a good excersize. If this pandemic is only an average 2% <0.15% for flu> morbidity rate, it might prompt us to get national public health system act in gear for the next pandemic. Sorry if you happen to be older, or in poor health, the dice roll gets worse.
Statistics on deaths.

https://www.bbc.com/news/health-51674743

I think access to ICU + breathing machine in time would probably cut death rate (in any category) by half.
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Re: Bogleheads community discussion - Coronavirus

Post by AlphaLess » Fri Feb 28, 2020 11:48 pm

DonCamillo wrote:
Fri Feb 28, 2020 10:24 pm
2% seems to be a good working hypothesis.
When there is such variability in terms of (age, gender, and co-morbidity), I think it is important to talk mortality / fatality rates per sub-group.

According to this BBC article:
- fatality of male vs female: 1.5 to 1,
- for every 10 years after 30, death rate doubles,
- morbid vs healthy: 5 to 10 times.

So, a 30 year old health female could be 0.2%.
A 72 year old male who has diabetes and breathing problems: 1.5 * 2 * 2 * 2 * 5 * 0.2% = 12%.
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Re: Bogleheads community discussion - Coronavirus

Post by curmudgeon » Sat Feb 29, 2020 2:11 am

AlphaLess wrote:
Fri Feb 28, 2020 11:48 pm
DonCamillo wrote:
Fri Feb 28, 2020 10:24 pm
2% seems to be a good working hypothesis.
When there is such variability in terms of (age, gender, and co-morbidity), I think it is important to talk mortality / fatality rates per sub-group.

According to this BBC article:
- fatality of male vs female: 1.5 to 1,
- for every 10 years after 30, death rate doubles,
- morbid vs healthy: 5 to 10 times.

So, a 30 year old health female could be 0.2%.
A 72 year old male who has diabetes and breathing problems: 1.5 * 2 * 2 * 2 * 5 * 0.2% = 12%.
There's a lot of questionable data out there that I don't fully trust. Even the standard testing is not terribly reliable, and with limited testing capability there can be a temptation to suppress bad news. It can be pretty easy to point to standard influenza or pneumonia as a cause of death. I would really be interested if there are significant jumps in those is some other Chinese provinces (or Africa, even). At one point I thought I read (but don't have the reference to verify), that in much of China they only test for COVID if the patient has a direct link to Hubei. Shanghai province had an initial burst of ~300 cases but has only been reporting 3/4 per week since which seems dubious to me (but then media reports a really high degree of lockdown in Shanghai too, so maybe it's really under control there). I have been dismayed at the limitations of the US testing process, though it seems to be getting better now.

The Diamond Princess is one source of data that I think is really valuable on outcomes, though a little fuzzier now since many of the passengers and some crew have been repatriated to their home countries. Everyone leaving the ship was tested, so you have a fairly clear picture of the population (still a few more positives coming in during later quarantine). It's a little tricky, because passengers on a 2-week cruise will skew a lot older, but over the next couple of weeks we should get a better picture of outcomes. There are a bit over 700 cases, most of which are still under quarantine/care in Japan, and so far six deaths and 36 in serious/critical condition.

With the widespread Korea/Iran/Italy outbreaks, I think it's becoming clear that containment can only slow, but not prevent, further spread. It seems like Korea is able do about 5-6K tests per day, and has been hitting something like 13% positives (that one large church/sect has been a focus for testing; it's possible that the infection rate will be much lower in general in Daegu). Given the known spread from Iran, and the reported deaths, I have to think that Iran is widely infected. Italy also feels like it must have several thousand active infections, and since it is such a travel destination, a significant spread beyond was pretty much a given.

Improved treatments and/or vaccine seem to be the keys. And there will be plenty of noise from ambitious biotech companies along the way.

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Re: Bogleheads community discussion - Coronavirus

Post by vested1 » Sat Feb 29, 2020 6:45 am

I plan to come back to this thread periodically to determine who here has the humility necessary to, shall we say, reevaluate their position.

Comparisons to the flu are nice talking points but unrelated to this virus. Suffice it to say that a much larger number of people are infected every year with the common flu, and that fatality rates are between .1% and .15% of those infected. These are estimates because actual diagnosis only comes after the flu becomes severe enough to require a trip to the doctor. In 2019 the mortality rate was .148% for the common flu with over 35 million reported cases, and the mortality rate for COVID-19 has yet to be determined because it's too early to have reliable data. However, most estimates hover around 2.5%, about the same as the mortality rate for the Spanish flu pandemic of 1918-1919. So far infections of COVID-19 are at about 85,000 worldwide with about 2130 deaths, or 2.5%.

https://www.cdc.gov/flu/about/burden/index.html
https://wwwnc.cdc.gov/eid/article/12/1/05-0979_article

Comparisons to other forms of coronavirus, such as SARS, MERS, or even the common cold, which have little in common with COVID-19 other than general category, are pretty misleading. Very few die from the common cold. SARS has a mortality rate of 9.6% and MERS has a mortality rate of 34.4%, but each have resulted in a miniscule amount of infections in comparison to those already infected with COVID-19. This is due to the fact that COVID-19 is far more communicable (infectious) than both SARS and MERS. In the 2002-2003 worldwide infection of SARS 8,098 people were infected of which 774 died. Since 2012, the number of people infected with MERS was 2,494 of which 858 died.

https://www.cdc.gov/coronavirus/types.html
https://wwwnc.cdc.gov/eid/article/12/1/05-0979_article
https://www.cdc.gov/sars/about/faq.html
https://www.who.int/emergencies/mers-cov/en/

The conclusion is that we should be humble in our assumptions, and not scoff at news reports that are simply providing the numbers. A possible pandemic should not be politicized. As of last night another case of apparent community infection was discovered in Santa Clara, Ca. As of last night one new case of community infection was reported in Oregon. As of last night two more cases were reported in Washington State, one of which was travel related and the other community related. Who knows how many other cases exist which haven't yet been diagnosed.

In my opinion, for what that's worth, the rapid deployment of accurate testing kits should be the number one priority.

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Re: Bogleheads community discussion - Coronavirus

Post by Dude2 » Sat Feb 29, 2020 7:04 am

https://www.cbsnews.com/news/coronaviru ... -positive/
As humans throughout the world grapple with the widespread outbreak of the novel coronavirus, a pet dog has been found to have a "low level" of the virus, a spokesperson for the Hong Kong's agriculture, fisheries and conservation department said in a statement Friday.
https://www.imdb.com/title/tt0068408/plotsummary
In 1983 (several years after the end of 'Escape from the Planet of the Apes'), an interstellar disease kills the world's cats and dogs, leaving humans with no pet animals. To replace them, humans began keeping monkeys and apes as household pets. In time, humans notice the apes' capacity to learn and adapt; thus they train them to perform menial household tasks. By 1991, the former United States of America and most of the North American continent has become an oppressive and fascist police superstate culture of uniformed classes and castes, based upon ape slave labor. The different apes are divided into similar caste systems; gorillas wear red jumpsuits; chimpanzees wear green jumpsuits; and orangutans wear orange jumpsuits.

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Re: Bogleheads community discussion - Coronavirus

Post by Cyclesafe » Sat Feb 29, 2020 8:46 am

Had planned to leave for a six week trip to Tuscany April 15. Not worried about losing money as the agent has committed to "doing the right thing", the airlines (BA) will (IMHO) give refunds if flights are cancelled, and anyway I won't put DW and dear me in harms way for this relative pittance.

Yesterday, the state department increased the travel advisory warning for Italy from level 2 (exercise increased caution) to level 3 (reconsider travel). It is very possible (IMHO), in lieu of comments from Trump also yesterday, that the warning will be increased to level 4 (do not travel) if there is anything other than a sustained improving situation in the country.

https://travel.state.gov/content/travel ... isory.html

April 15 is still 6 weeks from now and no decisions are possible. In the interim one can only do one's bit and cough and sneeze into one's sleeve, wash hands thoroughly and often, keep hands away from one's face, and if sick, stay home. Sorta what we all should be doing anyway.
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Re: Bogleheads community discussion - Coronavirus

Post by LadyGeek » Sat Feb 29, 2020 8:52 am

I removed a post suggesting an approach for quarantining people infected with the coronavirus. The discussion will become derailed.
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Re: Bogleheads community discussion - Coronavirus

Post by Chicken Little » Sat Feb 29, 2020 8:56 am

DonCamillo wrote:
Fri Feb 28, 2020 10:24 pm
while cases of coronavirus that are not known are probably significant
This is where I'm at. If you haven't counted all the cases, your rates aren't going to be very accurate.

There may also be two enormous silver linings to this;

1. It doesn't appear to be effective at killing kids.

2. It doesn't appear to cause lasting damage in those that recover.

That doesn't help someone over 80 with COPD, but at least it's something.

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Re: Bogleheads community discussion - Coronavirus

Post by Mr.BB » Sat Feb 29, 2020 9:06 am

I think it's way overblown. I've talked to a very good internist and ER nurse, they both say it's just an over reaction. It's weird that tens of thousands of people died in the US last year from the flu but that caused no panic.

I think one of the biggest issues of why it's so widespread in China is the flu bug attacks people with compromised immune system. China has horrible pollution, they smoke a lot and their health care is not that great.
What this has shown us is how our economy is so interdependent we are with China.
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Re: Bogleheads community discussion - Coronavirus

Post by DonCamillo » Sat Feb 29, 2020 10:03 am

I changed my earlier post from 2% to 2.9% in line with the most recent estimate from the World Health Organization.

It does appear that there is a timing issue with reported deaths. The deaths from the Diamond Princess took long enough after diagnosis that early estimates were misleading. So far, with 6 deaths and 700 cases, that looks like 1%. But it is very possible that there will be more deaths among those seriously ill.

This morning’s Wall Street Journal, page A9; “Experts say the high mortality rate in Iran May be due to underreporting of milder cases.”
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Re: Bogleheads community discussion - Coronavirus

Post by mancich » Sat Feb 29, 2020 10:19 am

I am strongly considering going on a no-news, no-looking at Yahoo Finance diet for a week or two, then reassessing how I feel about the constant drumbeat of news on this topic. I did some low-level market timing in my 401k yesterday, and then felt stupid today for doing so.

I am sure that constantly looking at what the market was doing during the week was what drove me to do so, and I am normally pretty calm about drops (example: December 2018 didn't faze me a bit). I have over 7 years before I am 59 1/2, was at 50/50, and know intellectually that I should have left my AA as it was, but I moved some (relatively small percentage) of 401k money from stocks to bonds. Knowing that the market would be down at the closing bell. Dumb. It didn't change my AA much, but I felt I had to take action, violating what Jack Bogle would have said ("Don't do something, just stand there!"). I sold shares low. Again, very dumb.

I had a good talking-to-myself-moment today. I am not doing this going forward. If I lose another chunk, then so be it. I will adhere to my IPS and stop staring at the Internet and reading every story on Coronoavirus, including on Bogleheads (but I will still read other topics on the board).

Good luck to everyone in the coming weeks and stay healthy and safe. Control what you can control (eat well, sleep well, exercise, maintain a disciplined approach to investing, a prudent cash cushion, practice smart hygiene, hug your family, enjoy life) :beer

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Re: Bogleheads community discussion - Coronavirus

Post by btenny » Sat Feb 29, 2020 10:27 am

I live in Phoenix and would normally go to 2-3 spring training baseball games in March. The weather is great right now and it is a really fun event. We also go grocery shopping and to the gym and similar activities several times a week. I am also older and have some medical issues. So now I am wondering if this Corona thing is reason to sort of stay home and self quarantine.

I also have already bought and paid for airline tickets and hotels for my kids and grand kids to come visit me later in March. We are having a mini reunion. We are planning on lots of activities. All the young people seem like they are at low risk. But my wife and I and some cousins are old so we have more risk. Any suggestions????

Now I need Good Luck.....

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Re: Bogleheads community discussion - Coronavirus

Post by Cousin Eddie » Sat Feb 29, 2020 10:36 am

DonCamillo wrote:
Sat Feb 29, 2020 10:03 am
I changed my earlier post from 2% to 2.9% in line with the most recent estimate from the World Health Organization.

It does appear that there is a timing issue with reported deaths. The deaths from the Diamond Princess took long enough after diagnosis that early estimates were misleading. So far, with 6 deaths and 700 cases, that looks like 1%. But it is very possible that there will be more deaths among those seriously ill.

This morning’s Wall Street Journal, page A9; “Experts say the high mortality rate in Iran May be due to underreporting of milder cases.”
The Diamond Princess should be a good case study for the death rate. At 0.85%, it is thankfully much lower than 2%, but there are 36 who are still in serious/critical condition, so the number will probably rise. However, I think it's safe to say that the average age of the passengers is greater than the general population so that should reduce the estimated death rate.

Containment is going to be critical as well, the world is engaged in a delaying tactic against the virus, trying to get to the summer and buy more time to better understand the disease and come up with effective treatments.

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Re: Bogleheads community discussion - Coronavirus

Post by curmudgeon » Sat Feb 29, 2020 11:23 am

btenny wrote:
Sat Feb 29, 2020 10:27 am
I live in Phoenix and would normally go to 2-3 spring training baseball games in March. The weather is great right now and it is a really fun event. We also go grocery shopping and to the gym and similar activities several times a week. I am also older and have some medical issues. So now I am wondering if this Corona thing is reason to sort of stay home and self quarantine.
People will be all over the map on this type of thing. Some are still booking cruises, others stocking up on masks.

For now, I'm mostly trying to trim exposure around the edges. Things like wiping down the handle of shopping carts and consolidating the trips a bit. Avoiding handshakes and embraces. Being a bit more aware of health of those around me (and ourselves). Whether it will do much good is hard to say.

We are fortunate in that we didn't have much in the way of hard plans for travel this year. We did three cruises last year, but for us, cruises are less a destination in themselves and more of a pleasant add-on to a trip; we usually book them at last minute. We were actively considering an Alaska cruise this year for a family gathering, but have decided to skip that; it would be different if the Diamond Princess were clearly a one-off situation like the Costa Concordia, but illness spread on cruise ships has a significant history. For air travel, I'm not dropping it, but am trying to be aware of exposure and will start doing some things like wiping down seat arms and tray tables with sanitizing wipes.

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Re: Bogleheads community discussion - Coronavirus

Post by quantAndHold » Sat Feb 29, 2020 11:34 am

Cyclesafe wrote:
Sat Feb 29, 2020 8:46 am
Had planned to leave for a six week trip to Tuscany April 15. Not worried about losing money as the agent has committed to "doing the right thing", the airlines (BA) will (IMHO) give refunds if flights are cancelled, and anyway I won't put DW and dear me in harms way for this relative pittance.
We’re going to Spain at the same time. Walking the Camino, which usually involves staying in hostels in close quarters with a lot of other people. We’re waiting and watching right now. The only action we’ve taken is to change the one reservation we had for a hostel to a private apartment. Except for the plane tickets, most of the money we’ve spent is refundable. We verified that our US health insurance will cover us in Europe, and we have medical evacuation insurance, although I would expect it to not work in this situation.

We decided that if the airlines offer refunds (we’re on 4 different flights on 3 different airlines), we’ll take them. If Spain or France go to State Department level 3 or 4, we will also reconsider, even if it means losing the plane ticket money.
Yes, I’m really that pedantic.

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Re: Bogleheads community discussion - Coronavirus

Post by quantAndHold » Sat Feb 29, 2020 11:48 am

One of my friends who is ethnically Chinese but born and raised in the US said that when she is walking down the street, people are now crossing to the other side. We realized that local Chinese businesses must be hurting, so we went out for Chinese food last night. Great meal, and lots of personal attention. Except for the owner and her family, we were the only ones in the restaurant on a Friday night.
Yes, I’m really that pedantic.

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Re: Bogleheads community discussion - Coronavirus

Post by F150HD » Sat Feb 29, 2020 11:48 am

Washington Post article from 2/28....interesting. This person was on the Diamond Princess.

I have the coronavirus. So far, it isn’t that bad.

-

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Re: Bogleheads community discussion - Coronavirus

Post by AlphaLess » Sat Feb 29, 2020 11:52 am

curmudgeon wrote:
Sat Feb 29, 2020 2:11 am
AlphaLess wrote:
Fri Feb 28, 2020 11:48 pm
DonCamillo wrote:
Fri Feb 28, 2020 10:24 pm
2% seems to be a good working hypothesis.
When there is such variability in terms of (age, gender, and co-morbidity), I think it is important to talk mortality / fatality rates per sub-group.

According to this BBC article:
- fatality of male vs female: 1.5 to 1,
- for every 10 years after 30, death rate doubles,
- morbid vs healthy: 5 to 10 times.

So, a 30 year old health female could be 0.2%.
A 72 year old male who has diabetes and breathing problems: 1.5 * 2 * 2 * 2 * 5 * 0.2% = 12%.
There's a lot of questionable data out there that I don't fully trust. Even the standard testing is not terribly reliable, and with limited testing capability there can be a temptation to suppress bad news. It can be pretty easy to point to standard influenza or pneumonia as a cause of death. I would really be interested if there are significant jumps in those is some other Chinese provinces (or Africa, even). At one point I thought I read (but don't have the reference to verify), that in much of China they only test for COVID if the patient has a direct link to Hubei. Shanghai province had an initial burst of ~300 cases but has only been reporting 3/4 per week since which seems dubious to me (but then media reports a really high degree of lockdown in Shanghai too, so maybe it's really under control there). I have been dismayed at the limitations of the US testing process, though it seems to be getting better now.

The Diamond Princess is one source of data that I think is really valuable on outcomes, though a little fuzzier now since many of the passengers and some crew have been repatriated to their home countries. Everyone leaving the ship was tested, so you have a fairly clear picture of the population (still a few more positives coming in during later quarantine). It's a little tricky, because passengers on a 2-week cruise will skew a lot older, but over the next couple of weeks we should get a better picture of outcomes. There are a bit over 700 cases, most of which are still under quarantine/care in Japan, and so far six deaths and 36 in serious/critical condition.

With the widespread Korea/Iran/Italy outbreaks, I think it's becoming clear that containment can only slow, but not prevent, further spread. It seems like Korea is able do about 5-6K tests per day, and has been hitting something like 13% positives (that one large church/sect has been a focus for testing; it's possible that the infection rate will be much lower in general in Daegu). Given the known spread from Iran, and the reported deaths, I have to think that Iran is widely infected. Italy also feels like it must have several thousand active infections, and since it is such a travel destination, a significant spread beyond was pretty much a given.

Improved treatments and/or vaccine seem to be the keys. And there will be plenty of noise from ambitious biotech companies along the way.
The data provided by me is from a large scale study of around 20K infected in Hubei.

Again: I am not making a claim about the absolute value of fatality. I am merely claiming about the relative value of fatality.
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Re: Bogleheads community discussion - Coronavirus

Post by AlphaLess » Sat Feb 29, 2020 11:53 am

F150HD wrote:
Sat Feb 29, 2020 11:48 am
Washington Post article from 2/28....interesting. This person was on the Diamond Princess.

I have the coronavirus. So far, it isn’t that bad.

-
That does not mean anything.

The 3% dead are not writing those types of editorials, are they?
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Re: Bogleheads community discussion - Coronavirus

Post by F150HD » Sat Feb 29, 2020 12:41 pm

AlphaLess wrote:
Sat Feb 29, 2020 11:53 am
F150HD wrote:
Sat Feb 29, 2020 11:48 am
Washington Post article from 2/28....interesting. This person was on the Diamond Princess.

I have the coronavirus. So far, it isn’t that bad.

-
That does not mean anything.

The 3% dead are not writing those types of editorials, are they?
Ironically, your post doesn't mean anything either.

I didn't write the article.

You can read and panic in a different thread, there are 1000s to choose from.

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Re: Bogleheads community discussion - Coronavirus

Post by curmudgeon » Sat Feb 29, 2020 12:50 pm

AlphaLess wrote:
Sat Feb 29, 2020 11:52 am
The data provided by me is from a large scale study of around 20K infected in Hubei.

Again: I am not making a claim about the absolute value of fatality. I am merely claiming about the relative value of fatality.
I would agree that the age and health condition relation to fatality is pretty clear (and not surprising). Flu has a very similar pattern. I would expect these to generally hold across the world population. I think there is still a lot of unknown as to whether the apparent sex correlation is instead a secondary correlation to smoking and/or workplace environmental factors.

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Re: Bogleheads community discussion - Coronavirus

Post by stumpy » Sat Feb 29, 2020 1:07 pm

Word of advice if you r going to travel I would bring over the counter cold and flu medications. We were on an Alaska cruise and got sick the first day. The boat had none and only 1 town we stopped at was I able to find any. And I underestimated how much we needed.

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Re: Bogleheads community discussion - Coronavirus

Post by ram » Sat Feb 29, 2020 1:19 pm

What will be the ratio of:

People 18 to 64 years/ people >=65 years

on Dec 31 of this year as compared to Jan 1 of this year. a) worldwide, b) In USA.

My best guess is it will be statistically insignificant for both a) and b).

If there is a change it will most likely be an increase in the ratio.

What will be the economic impact by 2030:
i) If statistically insignificant change: status quo.
ii) If increase in the ratio: probably economically favorable.

Contrast this with the early days of the AIDS epidemic which was expected to cause more deaths in the younger population and actually had that impact in some countries.
Ram

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Re: Bogleheads community discussion - Coronavirus

Post by Cousin Eddie » Sat Feb 29, 2020 2:04 pm

Here's an editorial from the New England Journal of Medicine on the coronavirus.
https://www.nejm.org/doi/full/10.1056/N ... 7?query=RP

" If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively."

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Coronavirus - Business Travel

Post by Kenkat » Sat Feb 29, 2020 2:17 pm

I would like to get others opinions on business travel and the Corona virus. I am a fairly infrequent business traveler (2-3 times per year) but it just so happens that I’ve got a trip already scheduled for the end of March. I also see potential for second likely trip in March, a possible third trip in May for a conference (my boss has already suggested I go) and I can see a possible 4th trip in the April timeframe for a project kick off. These would all be business trips in the domestic US.

I saw today that Amazon announced that employees forgo non-essential business trips and I am curious what others have heard / not heard from their own companies as well as thoughts and plans outside of that. I can wait and see for April/May as well as wait to see if my company announces anything in the next week or so but do I even want to book anything right now given the current uncertain environment?

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Re: Bogleheads community discussion - Coronavirus

Post by AlphaLess » Sat Feb 29, 2020 4:19 pm

Washington State death is the canary in the coal mine.

Once death count is high enough to have some statistical meaning, we can infer the iceberg of actual cases.

Iran, for example, as a lot more deaths than their cases would suggest.

https://www.worldometers.info/coronavirus/#countries

43 deaths would imply 1500 or so infected.

Also, death rate is lagging, as deaths occur days after initial infection.

So Korea, on the other hand, is ahead of the curve:
- testing,
-investigative work

We shall see where the USA is. But I am not optimistic, as the US response has been slow and sloppy.
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Re: Bogleheads community discussion - Coronavirus

Post by AlphaLess » Sat Feb 29, 2020 4:24 pm

F150HD wrote:
Sat Feb 29, 2020 12:41 pm
AlphaLess wrote:
Sat Feb 29, 2020 11:53 am
F150HD wrote:
Sat Feb 29, 2020 11:48 am
Washington Post article from 2/28....interesting. This person was on the Diamond Princess.

I have the coronavirus. So far, it isn’t that bad.

-
That does not mean anything.

The 3% dead are not writing those types of editorials, are they?
Ironically, your post doesn't mean anything either.

I didn't write the article.

You can read and panic in a different thread, there are 1000s to choose from.
I am not panicking. But I am not in the business of collecting anecdotal information, either.
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Re: Bogleheads community discussion - Coronavirus

Post by nps » Sat Feb 29, 2020 4:24 pm

Cousin Eddie wrote:
Sat Feb 29, 2020 2:04 pm
Here's an editorial from the New England Journal of Medicine on the coronavirus.
https://www.nejm.org/doi/full/10.1056/N ... 7?query=RP

" If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively."
This is from the WHO - China joint mission report:

https://www.who.int/docs/default-source ... report.pdf

"Asymptomatic infection has been reported, but the majority of the relatively rare cases who are asymptomatic on the date of identification/report went on to develop disease. The proportion of truly asymptomatic infections is unclear but appears to be relatively rare and does not appear to be a major driver of transmission."

So who knows. It's early.

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Re: Bogleheads community discussion - Coronavirus

Post by AlphaLess » Sat Feb 29, 2020 4:27 pm

curmudgeon wrote:
Sat Feb 29, 2020 12:50 pm
AlphaLess wrote:
Sat Feb 29, 2020 11:52 am
The data provided by me is from a large scale study of around 20K infected in Hubei.

Again: I am not making a claim about the absolute value of fatality. I am merely claiming about the relative value of fatality.
I would agree that the age and health condition relation to fatality is pretty clear (and not surprising). Flu has a very similar pattern. I would expect these to generally hold across the world population. I think there is still a lot of unknown as to whether the apparent sex correlation is instead a secondary correlation to smoking and/or workplace environmental factors.
Extremely astute comments!

The apparent sex correlation can be broken down to two things:
- probability that a person smoking in China is a male is huge, as females almost don't smoke,
- probability that a person working in construction or other dust hazard jobs in China is a male is also huge.

Thus, the virus is not somehow exploiting some inherent immune disadvantage of males. Rather, it is a simply case of co-morbidities that are not accounted for in that study.
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Re: Bogleheads community discussion - Coronavirus

Post by AlphaLess » Sat Feb 29, 2020 4:55 pm

Washington state case details:
- man in his 50s died,
- lived in an adult care facility,
- 27 patients, and 25 staff showing symptoms.

Only 2 are diagnosed so far (presumably due to shortage of test kits).

Situation fluid and developing.
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Re: Bogleheads community discussion - Coronavirus

Post by curmudgeon » Sat Feb 29, 2020 5:36 pm

AlphaLess wrote:
Sat Feb 29, 2020 4:55 pm
Washington state case details:
- man in his 50s died,
- lived in an adult care facility,
- 27 patients, and 25 staff showing symptoms.

Only 2 are diagnosed so far (presumably due to shortage of test kits).

Situation fluid and developing.
I'd say odds are this will be like the Italy outbreak; it's been simmering along under the surface for a while and only becomes visible when there is an unusual death. I expect they will have test results for more of the staff soon, but the surface of exposure with staff at the facility (and to some degree staff at the hospital) has to be quite broad. Probably a similar situation in Oregon and SF area where there are also cases with unknown origin.

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Re: Bogleheads community discussion - Coronavirus

Post by veggivet » Sat Feb 29, 2020 5:41 pm

Oh, to be an epidemiologist these days. Fun, fun and more fun. Confidence is not inspired when the President misstates the sex of the deceased, and misspells the name of the virus in a tweet. Can anybody provide a link that shows the actual number of test kits that are available at this time? I believe the CDC was in the process of distributing them to a few states, but have heard nothing with respect to details. The nursing home is extremely concerning, as the resident population there is at a much higher risk of death. One has to wonder how many more staff have been infected, but are not showing clinical signs yet...
If you watch your pennies, your dollars will take care of themselves.

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Re: Bogleheads community discussion - Coronavirus

Post by AlphaLess » Sat Feb 29, 2020 5:42 pm

curmudgeon wrote:
Sat Feb 29, 2020 5:36 pm
AlphaLess wrote:
Sat Feb 29, 2020 4:55 pm
Washington state case details:
- man in his 50s died,
- lived in an adult care facility,
- 27 patients, and 25 staff showing symptoms.

Only 2 are diagnosed so far (presumably due to shortage of test kits).

Situation fluid and developing.
I'd say odds are this will be like the Italy outbreak; it's been simmering along under the surface for a while and only becomes visible when there is an unusual death. I expect they will have test results for more of the staff soon, but the surface of exposure with staff at the facility (and to some degree staff at the hospital) has to be quite broad. Probably a similar situation in Oregon and SF area where there are also cases with unknown origin.
Read about the South Korea case.

It is quite staggering how prepared they were to track so much information so well.

It is a case study in preparedness.

https://graphics.reuters.com/CHINA-HEAL ... index.html
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Re: Bogleheads community discussion - Coronavirus

Post by AlphaLess » Sat Feb 29, 2020 5:45 pm

veggivet wrote:
Sat Feb 29, 2020 5:41 pm
Oh, to be an epidemiologist these days. Fun, fun and more fun. Confidence is not inspired when the President misstates the sex of the deceased, and misspells the name of the virus in a tweet. Can anybody provide a link that shows the actual number of test kits that are available at this time? I believe the CDC was in the process of distributing them to a few states, but have heard nothing with respect to details. The nursing home is extremely concerning, as the resident population there is at a much higher risk of death. One has to wonder how many more staff have been infected, but are not showing clinical signs yet...
I would say that it is safe to assume that the USA has ZERO test kits.

As in: it is a statistically unimportant number at this point.

Given one or two untraced cases, you need to test THOUSANDS of people on short notice, possibly retesting a sub-sample using a DIFFERENT test.

This would require dozens of thousands if not hundreds of thousands of test kits.

Whether the USA has 100 or 1000 test kits: that is basically a zero.
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Re: Bogleheads community discussion - Coronavirus

Post by veggivet » Sat Feb 29, 2020 5:47 pm

Thanks, AlphaLess, then the question becomes how fast can they be manufactured and distributed.
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Re: Bogleheads community discussion - Coronavirus

Post by AlphaLess » Sat Feb 29, 2020 5:49 pm

veggivet wrote:
Sat Feb 29, 2020 5:41 pm
I believe the CDC was in the process of distributing them to a few states, but have heard nothing with respect to details.
It has been widely reported that the CDC test kits were faulty, or unavailable.

I read two things that was hard to understand:
- original criteria identified for deserving a test were setup in such a way that they prevented the person in NoCal to be tested for over a week,
- counties and states had their own test kits; however, they were not approved to be used.

I don't work in the industry, so I don't understand the legality and other things involved, but the information available is not inspiring.

A lot of people get on TV and talk, but I am going to go on a limb and say that the BSDs who were selling the whole week know a lot more than we do.

China claimed that manufacturing capacity was back online to 70-80% level of the pre-breakout, but hedge fund analysts came out and flat out caught the lie. Neither the smog levels, nor travel from the provinces to the tier 1 and tier 2 cities helped support that. Essentially, manufacturing capacity was at most 30% restored.
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Re: Bogleheads community discussion - Coronavirus

Post by AlphaLess » Sat Feb 29, 2020 5:56 pm

veggivet wrote:
Sat Feb 29, 2020 5:47 pm
Thanks, AlphaLess, then the question becomes how fast can they be manufactured and distributed.
I have no idea.
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Re: Bogleheads community discussion - Coronavirus

Post by veggivet » Sat Feb 29, 2020 5:59 pm

Yes, you are correct about the NorCal patient. Same thing happened with a US citizen returning from Japan who felt ill shortly after arriving back here. She went to her doctor, and they both thought she had COVID-19. Doctor recommended going to the ER, and the patient actually called them up and told them her suspicions and was told not to worry; come in the usual entrance, take an Uber, etc. No precautions taken whatsoever! The doctor evaluating her case in the ER told her she didn't meet the qualifications for COVID testing, so home she went. They ran around 25 other tests that were negative. On the bright side, she said she isn't feeling that bad (she is in her 30's), but can't help but think how many people she may have exposed to the hospital, in the hospital, and back home from the hospital.

If you want more details, just google "Suspected Coronavirus patient with recent travel to Japan sent home without testing in NYC".
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Re: Bogleheads community discussion - Coronavirus

Post by AlphaLess » Sat Feb 29, 2020 6:00 pm

quantAndHold wrote:
Sat Feb 29, 2020 11:48 am
One of my friends who is ethnically Chinese but born and raised in the US said that when she is walking down the street, people are now crossing to the other side. We realized that local Chinese businesses must be hurting, so we went out for Chinese food last night. Great meal, and lots of personal attention. Except for the owner and her family, we were the only ones in the restaurant on a Friday night.
That is very sad.

I interact with Chinese people daily. Many of them have relatives in Wuhan, Shanghai, Shenzen, Beijing, and Guangzhou.
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