Why We Are Not Doing Enough to Stop the Pandemic (in Simple Math), by Jason S. Warner by 30Seconds Health
(This post by Jason S. Warner is only a 5-minute read from here, and then a 25-minute more detailed explanation for those who want to learn more about how this COVID virus is creating so many issues and all over planet earth.)
First, COVID is one tricky virus. It tricks us into thinking it’s no big deal and it won’t affect where we live. I didn’t see and understand the danger until last week. We think, “Well, all the restaurants and stores are closed and most of us are all working from home so what happened in Seattle and Italy and New York is not going to happen where I live…”
Nothing could be further from the truth.
I will explain it in simple math.
We all need a simple way to understand how the pandemic is already advancing where we live, even if we have few or even zero reported cases. That’s why this virus is so tricky, and why it’s so dangerous. That’s this article.
My hope is by carefully considering this 5-minute read and doing one simple but revealing 30-second math exercise, in 5 minutes you will understand everything that is happening with the Pandemic and clearly see what we all must do next.
Finally, I have talked personally with the nurses in Seattle and California and had other members of the medical community contact me with their support and their stories. To the five brave women in Seattle and California to whom I spoke, and to all the healthcare workers who have reached out, I have not forgotten you and will tell your stories in a future post as soon as I am able.
Part 1: [5-minute read] WHY EVERYONE IN AMERICA, EVERYWHERE, NEEDS TO ELIMINATE ALL NON-ESSENTIAL CONTACT WITH PEOPLE AND REST IN PLACE FOR 20 DAYS, STARTING NOW:
In one sentence, it’s because of math:
EXPONENTIAL GROWTH MAKES THE VIRUS EXPLODE LIKE A BOMB IN YOUR TOWN & MINE, BEFORE WE CAN EVEN SEE THAT IT’S HAPPENING, BECAUSE WE CANNOT IDENTIFY THE COUNT OF INFECTED PEOPLE, DUE TO A LACK OF TESTING AND SYMPTOMS.
The COVID virus is stopping the world because it’s one very tricky virus. It’s tricking us into thinking it’s no big deal in a lot of different ways which I explain in this post.
But the virus is already in your town and it’s going to cause major problems and kill a lot of people you know if we don’t work together to stop it starting today. It sounds like hype I know. I assure it’s not hype, it’s math.
And the good news is that there is a simple solution: everyone in America needs to “rest in place,” except for grocery shopping and other essential trips, for 20 days. Simple solution, but very hard to do because it means not going to work and literally, wherever you are, even if you aren’t at home, staying put for 20 days. But everyone must do it, because there is no other way to stop the virus.
This is an open letter to every citizen of the United States of America and to any citizen of any country regarding the COVID-19 pandemic:
I am not a journalist or a media company. I am the CEO of a SaaS software company focused on data and analytics, who also happens to be good at math. But as I have said before, I am no BS. I am a left brain, analytical guy and not one for histrionics, politics or hype. I tell the truth, and I use math to prove that what I am saying is the truth.
Finally, once you’ve read this, then you must inform your friends, family, followers and the community where you live, today, by imploring them to read this post.
If you are an influencer, please carefully consider this post, as you are in a unique position to help the citizens fully understand, and also save lives. If you wish to speak to me before sharing the post, media contact information is at the bottom of this post. Kindly DM me on Facebook if this is you.
Let’s dive in, you may wish to grab a calculator.
Where We Are and What’s Next – Pandemic Math
A lot of friends, family and complete strangers thought I was crazy on Thursday 3/12 when I posted this on Facebook. I wrote the post because I had an epiphany when I realized that almost everyone I knew and cared about wasn’t understanding several key things about the pandemic: the exponential nature of pandemic math; the absolute imperative that we immediately establish extreme social distancing; and the social norms that were causing inaction and delay. That’s why I wrote the post last week – to sound the alarm for my friends and family. Since then the post has been viewed over 4 million times on Medium and shared on Facebook over 200,000 times.
Since the original post (only seven days ago), everything has changed – U.S. schools and restaurants are closed. France and Spain locked down. Seven million people in California have been ordered to “shelter in place” which is a fancy of way of saying, “No really, you need to stop all non-essential contact with other people.” The stock market imploded even more than we expected. Other states are considering rest in place mandates. As is always the case with exponential math, the COVID outbreak is moving faster than we realize.
This virus is one tricky virus and tricked a lot of us into thinking it’s no big deal. I didn’t see it until last week. But once you understand, what happens next is clear.
It’s not complicated, it’s not hype, it’s math.
HOW MATH SHOWS US THAT WE ARE NOT DOING ENOUGH, AND WHAT WE NEED TO DO NEXT (WHICH IS REST IN PLACE, STOP AIR TRAVEL AND HELP OTHERS UNDERSTAND)
“I’ll say it over and over again,” Dr. Fauci said. “When you’re dealing with an emerging infectious diseases outbreak, you are always behind where you think you are if you think that today reflects where you really are.” – Dr. Anthony Fauci [Source}
Remember this quote. Read it 10 times and burn it into your brain. We need to think about this quote EVERY SINGLE DAY until we get through the pandemic. This is why Dr. Fauci says, “I’ll say it over and over again”.
Despite everything that has happened in the last 6 days to “lockdown” America we are not doing enough because of the exponential way that COVID-19 spreads. I’m sorry to say the worst is yet to come.
I know what you are thinking: there’s hardly any cases in my area. That’s what I thought, but this is one tricky, and very deadly virus, which I’ll explain.
The virus is really good at tricking us because it doesn’t kill very many people, and symptoms are mild so it seems like you are safe in your town. So it tricks us into thinking it’s no big deal. But as you’ll see in this post, COVID will be catastrophic to your town if we don’t stop it starting today. None of this is cause to panic, and none of this is hype. The math will show us that this is a call to respond.
Here’s why: As I said in my first post: the nature of exponential math is that COVID infection rates seem to start slowly, and then explode like a bomb and absolutely overwhelm the hospitals and society in a way that is difficult to even fathom. Despite exponential math being super predictable, the virus continues to use exponential math against all of us in a very tricky way: one of the biggest problems is all of our brains are designed to process information logarithmically (linearly), as opposed to exponentially, which is the way the virus spreads and why it has kicked our butt as a planet.
SIMPLE MATH EXERCISE TO UNDERSTAND HOW THE VIRUS TRICKS US:
It takes one minute. If you want to understand the danger, and how we’ve all been tricked by the virus, you have to do this step. Grab a calculator:
- Part A: Logarithmic Math (regular math): Visualize yourself walking out your front door and taking 20 steps, and each step is 3 feet. After 20 steps, how far do you travel? Answer: 20 x 3 = 60 feet. Super easy. I bet you actually visualized it in your head, how far out from the front door you’d be when you stopped, and your estimation would be pretty accurate. That’s because all of our brains are designed to process information in a linear fashion.
- Part B: Exponential Math (the reason the virus is stopping the whole planet right now and is so tricky): Now, visualize yourself walking out your front door and taking 20 steps, but in this scenario every step is twice as far as the previous step. So the first step is 3 feet. The next step is 6 feet. The third step is 12 feet and so on. Now, after 20 steps, how far do you travel? This is impossible for anyone to answer, because it’s exponential math. Our brains can’t process the information on exponential math. They weren’t designed to. That’s why calculators were invented.
Like many enemies, this COVID virus is using one of our weaknesses as humans to hurt us: that we our brains can’t process how fast the virus is spreading because it’s growing exponentially. To make matters worse we can’t use a calculator to see how fast it’s spreading because we don’t have COVID tests to tell us how many are infected.
Math tell us the answer to Part B is 3 feet multiplied by 2 to the 20th power. 2 to the 20th power is 2 x 2 twenty times. Everyone who read my first post knows that 2 to the 10th power is 1024. We will all probably never forget that number actually.
Here’s what those 20 exponential steps looks like:
2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2
And then multiple by 3 feet per step. Simple right?
Grab your calculator and run the math. Seriously. Plug in all those 2s. It’s a lot of 2s I get it. But do it on the calculator, and at the end multiply by 3 feet for each step. That’s the answer to Part B.
2 x 2 twenty times is 1,048,576. So the answer to Part B is 1,048,576 x 3 feet or 3.1 million feet. Almost 600 miles. In only 20 exponential steps. Exponential math makes it impossible for human being so see patterns in numbers, even when they are as simple as taking 20 steps.
The virus spreads exponentially. 2 people give it to 2 people, and then three days later those 4 people have spread it 8 more people, and so on until it’s this 30 days later:
2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 = 1024
But we can’t see it because the virus is spreading and most people have mild symptoms and there are no tests. But then the bomb goes off and overwhelms every hospital in every town in America. Because the virus is already here, and it’s spreading (even with social distancing, which I explain below).
So the first concept you have to understand is that exponential growth makes the COVID Virus explode like a bomb where you live, because the virus is tricking us with exponential math. It’s doubling every 3 days, but we can’t see all the cases because there is no testing and our brains can’t calculate how fast it’s growing. But now the world is shutting down and Italy is in catastrophe because they waited to long to rest in place and stop the transmission of the virus – because this is one tricky virus.
This is also why almost everyone didn’t see the impact and danger of the COVID virus coming, despite the virus being in plain sight (and why I sounded the alarm on Facebook last week). Now that we understand, the knowledge helps us all understand what comes next. But it’s super easy to lose sight of how the virus behaves because the virus has been spreading exponentially and our brains don’t process it correctly. This aspect of our brain is why it seems like things are “not that serious” and that our current Social Distancing seems to be “okay” because we have so few cases in our town.
THE BIG PROBLEM WITH THIS PARTICULAR TRICKY VIRUS NAMED COVID (there’s a few big problems, unfortunately, but this is a key concept):
- The virus is spreading, and has been spreading in your town, doubling the number of infected people every 3 days, for approximately the last 30 days. Maybe longer. Even if you have few cases compared to your population. The bomb is ready to go off and we must stop the transmission of the virus today.
- But we cannot see the spread of the virus, or count it because we don’t have enough tests and the symptoms are mild. So it doesn’t show up in any of the reports. And it’s mild in most people, so even if we did have tests, maybe we wouldn’t even catch them. So every few days the count of infected people doubles. This virus really likes to spread.
- It’s been in your town, probably for at least a month, maybe longer. Maybe 8 weeks. My 16-year-old daughter may have had it in early February. We will never know. She got a fever, then it turned into this gnarly chest cold. The kind where she coughed and it was the deep, pneumonia-like sound. But 2 days later she was fine. She laid in bed for 2 days but didn’t even go to the doctor. Sat on her iPhone all day. She’s 16. It was no big deal. This is another way the virus tricks us. It seems like no big deal. Despite everything going on in Asia and Europe, and all the pandemic news, when she developed these mild symptoms, we didn’t even connect the dots. But in hindsight, now that things are totally hitting the fan across the world, and with math….I think it might have been COVID. Most people have mild symptoms. And we only have 6 counts of CONFIRMED cases in Bend as I write this. But it’s been here since early January I’m guessing. One tricky virus.
This is a made up, fictitious story, to illustrate what this tricky virus is doing in your town, right now: So let’s say COVID came to Bend (and also to your town) exactly 30 days ago, doubling every three days like the math suggests it does. We don’t know because there are no tests and the virus tricks us into thinking it’s no big deal because the symptoms are so light. So Bend went from having the first 2 people infected 30 days ago, to a whole lot more infections, none of which showed symptoms until the last few weeks. But even when people in Bend showed symptoms, they are mild and we only test the really sick people because there are few testing kits available. Since there are ten 3 day periods for the virus to double over the course of 30 days, Bend likely developed cases in the last 30 days like this:
2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2 x 2= 1028 infections in Bend (and your town) all in the last 30 days. And there are very few symptoms and few tests so we can’t even see the virus spreading. Exponential math makes the virus explode like a bomb.
Now, as of March 20, we only have 6 identified cases, and have put some social distancing in place, so the virus can’t double every 3 days. Seems like no big deal, only 6 cases. But, because a lot of people have to work and some people haven’t been socially distancing themselves and people are still traveling, let’s say the virus is only spreading only 25% as much as it did with no lockdown. 75% of those infected aren’t spreading COVID now, but 25% still are. Which is 1/4 the transmission rate. So it takes 4 times longer for the virus to double.
So instead of taking 3 days to double the count of infections, we have slowed the virus with “semi-lockdown” maybe it’s now taking 4 times longer = 12 days to double. Under current “semi-lockdown” conditions in Bend (and your town) the virus now doubles only every 12 days, with semi-lockdown but it’s still exponential and it’s still going to explode like a bomb.
Exponential growth makes the virus explode like a bomb so we have to stop it now.
That’s the problem: exponential growth causes the virus to explode, even with semi-lockdown conditions. And when the virus explodes, a lot of people are killed by the virus like we are seeing in Italy.
- Exponential math is always a big problem: in 12 days from now there will still be 2 x 1028 = 2056 cases in Bend (and where you live) and then 12 days later the number of infected will be 2 x 2056 = 4,112 cases in Bend (and where you live). See the problem? Semi-lockdown doesn’t work because the virus is spreading exponentially.
- The only way to stop it, as proven by Wuhan, Spain, France and by Italy, is full rest in place with only essential trips for groceries and similar essential trips. The virus can’t spread if there is no human to human contact. We must all do our part and stay home for 20 days.
If you read this far, and say, “I still don’t understand why this is a big deal, hardly anyone dies from COVID, it’s like the flu.” I explain everything below in Part 2. So keep reading if you really want to understand why the whole world is shutting down from this one tricky virus. It takes some time to explain it all, but if you follow along carefully and really read and do the math exercises, you will fully understand by the end.
If you’ve read this far, and you understand the math and why so many people will die if we don’t stop this really tricky and dangerous virus immediately, you can probably stop reading and go to the end where I explain what everyone must do to stop the virus.
But please share this with all of your followers, friends and family and when you share it, let people to know why it’s important that they read it today – we have information overload on the pandemic, so you have to explain why they should read this one post.
We all have information overload on this virus: there is a lot of hype and news about this virus, which is another way the virus tricks us into thinking it’s no big deal – we stop paying attention to all the news about it because it doesn’t seem like a big deal in our town. I’m sure that’s what Italy thought, too.
PART 2 (25 MINUTE READ) – THE DETAILED ACCOUNT OF WHY SEMI-LOCKDOWN DOESN’T STOP THE VIRUS AND WHY COVID IS SHUTTING DOWN PLANET EARTH:
I have fact checked the math and assumptions. If you are a data person you should check them yourself. I have had credentialed experts in sophisticated quantitative analyses and scientists with degrees from MIT (Massachusetts Institute of Technology, one of America’s most prestigious universities) confirm the inputs and conclusions, and I’ve included some of their work at the bottom of this post and will continue to do so. But I like to keep it simple.
WHAT TO EXPECT NEXT BASED ON THE MATH:
Despite the recent lockdown and measures, the COVID bomb is going to explode in Seattle and other epicenter markets this week, as predicted by math. But it’s also going to explode where you live and also where I live, despite what we are doing today with regards to Social Distancing. I’m going to focus on Seattle, as I lived there and went to University of Washington. But the bomb is exploding in other areas like New York and California just as badly (or worse) but choosing one city helps to narrow the focus to one city to explain what’s going to happen next so we can all understand more clearly.
We don’t have good data for a whole lot of reasons, including not enough COVID tests (still) but here’s what is going to happen next based on the math. It varies by market because every geography locked down differently and at different times. Some did it well, others did it poorly. Some may still be doing it poorly, I don’t know. Also, some markets started sooner, some started later. Some started immediately, others eased into it. We will only be able to ascertain this in hindsight once we are through the pandemic.
How do you really think the social distancing is going in your community? Are people still gathering? Are some people still working? I still see on Instagram and Facebook that not everyone is getting the message. I am here to tell you, and as usual back it up with math, that we need to shelter in place starting today. Not tomorrow. Today.
WHAT THE MATH REGARDING THE OUTBREAK IN WUHAN, CHINA REVEALS ABOUT WHAT COMES NEXT:
We have varying degrees of confidence in the current data, data sources, and not enough COVID tests in the United States (so we cannot even track actual cases), I’m sticking with this chart data which shows the outbreak from Wuhan because it makes it easy to explain in simple, inarguable terms and this data has been around the longest, since Wuhan is where the virus started. But because math is predictable (100% of the time, that’s why I keep using it to understand what is happening), I’m choosing to use the oldest data (it may be more accurate than real time data unfolding daily as we are in the middle of a crisis and not testing). In simple terms, it is common sense to use data from the original outbreak because it has not been refuted, and it’s been around since January. The new data that is flying at all of us from some more sources every day, could be good data or bad data. There’s no way to verify.
Anyone, from anywhere can use any other valid data source they want, the math will be the same. I have supplied fancier charts below, which come from a credentialed quantitative analysis expert who spent his whole career doing math (yuck) and has his MBA. This person contacted me with the same conclusions I have come to after conducting his own independent analysis pulling data from the CDC. I’ve also had a scientist and graduate from MIT check all of these assumptions and math because I understand the gravity of what I am saying and because there is a lot of hype and fear regarding the pandemic. The math is correct.
The chart above shows the outbreak in Wuhan and was pulled together after the crisis was mostly past. I’ve never met Tomas Pueyo, it’s creator but we all owe him a lot after we get through this. He is one of the people who identified the math the earliest and put up his concern on Medium at the link below the chart. He is smarter than me: 2 Masters of Science in Engineering and he is a Stanford MBA and he runs a billion dollar business. As an HR executive I can tell you with authority that his credentials are the best there are. He has been sounding the alarm for a month.
Here’s what to look at on the chart above given where we are today. This is important to understand and not the time to just glance at the chart, here’s what to really look at:
There’s two key things: The first key thing is to see the peak of COVID Actual cases in Wuhan (these are orange bars). See how the peak happened 12 days after complete lockdown? It’s the orange mountain shaped trend.
This peak is when new cases per day started to diminish. Put another way, once lockdown happened, it took 12 days for the counts of diagnoses (new COVID cases) to peak and then start to diminish. This means that caseloads in hospitals continued to increase after the lockdown for 12 days. I won’t go too deeply into why this is, but it’s because of the exponential nature of how the virus spreads, and the fact that it takes multiple days of incubation before COVID patients show symptoms (last I checked 50% of patients show symptoms by day 5, and 99.7% of the other patients identified symptoms by Day 14). A simple way to understand is that all patients that were infected right before the “extreme social distancing” point in your community – some will not show symptoms for 12 to 14 days days. In addition, it often takes a few days more before they discover they need to go to the hospital because it takes awhile to feel really sick. So some of the really sick COVID patients don’t head to the ER until Day 20 or Day 22. But they are coming and show you the math in a minute.
So new cases are still going to be identified where you live, despite the recent attempt at “extreme social distancing.” But what you need to know is that there are still a lot of new cases that are going to hit your local hospital.
As I will show you next with simple math, it’s going to be a tsunami, which is why we need to start resting in place today and stop all air travel and why you need to share this post with everyone you know.
The second key thing from the chart is the height of the orange bars after the lockdown date. See the number of new ACTUAL cases (orange bars) that absolutely explode even after the lockdown date? This is the bomb that goes off for our hospitals until we actually get through the peak, provided we are locked down enough. All the new cases fill up the hospital beds and exceed the number of beds and respirators and supplies of masks and clinical staff. It looks like an Orange Mountain or an Orange Tsunami because that’s what it is: it’s a Tsunami of COVID cases coming for your town that will bury your hospital, health-care providers and community.
WUHAN LOCKED DOWN QUICKLY AND COMPLETELY IN ONE DAY. THE USA HAS NOT.
Remember a week ago in the US how it was 250 people we could hang with and now it’s 10? As a country we have incrementally made changes? This was the wrong strategy. Italy and France made the same mistake. Unfortunately so did the USA.
Remember how Italy waited and then shut down everything? And then France and Spain did the exact same thing? I have a friend in Spain and it’s barricades in the streets and checkpoints. I am not making this up.
This is what we must do in order to stop the transmission of the virus: we need to immediately move to rest in place (just stay home) and stop all air travel, for 20 days. It’s the only strategy that will stop the virus (and it will stop it because the virus can’t travel by itself). This is what France, Italy and Spain came to the same conclusion and have now imposed countrywide lockdowns, like Wuhan did early on. The Chinese learned from previous viral outbreaks (MERS et al) but also had sufficient testing so they can see how fast COVID spread, and the Chinese knew what to do: Full lockdown, immediately. France, Italy and Spain made the same error we are making, and didn’t learn until it was too late. Full lockdown to stop all material levels of transmission of COVID is the only way to prevent a catastrophe. The longer countries wait, and the impact financially and in terms of loss of life is exponentially greater.
Here’s the math that supports resting in place: 12 days is probably the best and shortest time to the the peak of ACTUAL COVID cases, because China implemented extreme martial law which is probably the most efficient and fastest way to stop any outbreak (other than containment which we will talk about when this is all over.
The key point is that we are not China, and we do not need to institute martial law and set up checkpoints, but it means that our lockdown is less secure, so it would be foolish to expect the outbreak to peak in only 12 days because of this fact.
Here’s the math which further explains why we need to move to rest in place and stop all air travel. From the chart above, cases in Wuhan went from ~700 cases a day on the day after complete and immediate martial law lockdown (as I understand it was) to ~3,800 cases a day 12 days later. Cases per day increased by an average of about 16.6% every day up until the peak (tip top of the Orange Mountain). I estimated the data from the Wuhan chart above to make this simple illustration:
Here’s the key math: the total of the yellow column is the bomb that goes off in the hospitals, which are already overwhelmed. This is the cumulative total of new cases that fill up and then bury the hospitals with COVID patients. Every day, COVID positive patients keep coming, until we get past that peak, the top of the Orange Tsunami. That number, the total of the yellow column is estimated to be 40,113 from the Wuhan chart (you can add them up if you want). Important point: This yellow column is only showing the new patients per day up to day 18 past the complete and immediate Chinese martial law shutdown. The patients keep coming and coming and coming every day until the spread of the virus is stopped. It’s just not shown in the chart. Because of math.
If you read anything about the pandemic, read this:
This math is the bomb that absolutely crushes the hospitals, because once a patient gets admitted to the hospital, their treatment takes a few weeks, if they recover. And recovery depends on if they have enough doctors and nurses to care for them. And if they have enough beds. And enough ventilators, and enough personal protective equipment for the medical staff to provide a standard of care that doesn’t infect the nurses and doctors and clinical staff or other patients.
Consider this: the hospital beds will fill up and medical staff get overwhelmed despite working double shifts which increases their stress levels and decreases their immune system, putting them at greater risk. The hospitals in Seattle, New York and elsewhere are already critically low on PPE (personal protective equipment). The viral loads on the doctors and nurses and other clinical staff are elevated due to exposure, putting them at risk for infection. In Wuhan, many Chinese medical staff had superior PPE when compared to the United States and had to be treated. Which means fewer doctors and nurses to care for the sick so more patients die. If you want to support your local medical teams and their families, the best decision at this point is to stay home.
HOW TO GET A HANDLE ON WHAT’S GOING TO HAPPEN WHERE YOU LIVE:
It’s difficult to predict what is going to happen in your home town without enough COVID tests and without knowing how well the lockdown is working. This is why Dr. Fauci keeps repeating himself:
“I’ll say it over and over again,” Dr. Fauci said. “When you’re dealing with an emerging infectious diseases outbreak, you are always behind where you think you are if you think that today reflects where you really are.”
He says it over and over again because people die. Millions of people die and we don’t see it coming because of exponential math.
So here’s a question you should consider: do you believe our current social distancing in the USA will be anywhere close to as effective and complete as the Chinese martial law and lockdown that happened (it was put in place in one day)? You see what’s happening with your friends and family who are not doing it because they have to work, or are concerned about finances or already booked their flight or don’t see the problem or think it’s the flu. This is an existential problem for you and for me and everyone in your family and my family.
Because we are not in full, Wuhan-like lockdown, and because the virus is so contagious, the peak will not come 12 days from now for the USA, like it did for Wuhan. It feels like we have locked down because a lot of has changed in a short amount of time, but it’s not enough to stop the transmission of the virus.
This is the same mistake the France, and Italy and Spain made. This is why today the Italian death toll overtook China’s because Italy waited and did not do what China did [source]. The peak will continue to grow and continue to grow in the United States, and for more days than 12 but nobody knows for sure because sadly, we don’t have enough COVID tests.
Remember Dr. Fauci: “When you’re dealing with an emerging infectious diseases outbreak, you are always behind where you think you are if you think that today reflects where you really are.”
It’s because of exponential math and the way our brains work that it’s very difficult to see the coming wave of infections, in the same way we can’t see how far it might be to take 30 exponential steps.
WHY REST IN PLACE AND FULL LOCKDOWN IS THE RIGHT DECISION MATHEMATICALLY: From the Wuhan Data in Chat 1 (the one with the Orange Tsunami Wave) we can see that the counts of daily cases after lockdown increased about 2.5 times after complete lock down by Day 12. The virus transmission stopped growing exponentially immediately upon lockdown,because transmission of the virus is impossible when everybody stays home. But new cases continued to grow linearly at about 16.6% every day until the peak, which remember the peak is the top of the Big Orange Tsunami Wave.
A reasonable assumption that cases for the USA will continue to grow for 20 days after we really get to full lockdown. It will not be 12 days in the USA, and it will much, much worse if we do not move to full rest in place and stop air travel. We cannot prove this or model it or show you the math because we don’t have the data or the time but mostly because in America we don’t have enough COVID tests so we can’t see what is happening without the count of CONFIRMED cases. Many sick patients can’t get tested and infect others. We are flying blind without the tests.
This is important for everyone to comprehend: without available testing the virus is using exponential math against us as it continues to spread exponentially, but we are unable to see or measure the growth because of the lack of testing.
CRITICAL MATH EXERCISE WHICH ILLUSTRATES WHAT MATH REVEALS WILL HAPPEN IN YOUR COMMUNITY:
Once we eliminate a far greater number of human to human interactions, the virus cannot easily spread and will ultimate be extinguished over time, or a vaccine will be available. Presuming 20 days to the peak of cases, this is how we can calculate an estimate for the total COVID Hospitalizations in your town.
I am going to warn you this exercise may be difficult for some because the numbers of infections grow very large, from a seeming very small number, but we all must understand the math because this is how exponents work. This is the reason 20 exponential, 3-foot steps leads to a 600 mile walk. The numbers go from very small to impossibly large with exponents.
STEP 1: CALCULATE THAT ACTION CASES LIKELY TO EXIST, SINCE THERE ISN’T ENOUGH TESTING:
Take your current CONFIRMED cases in your town and multiply by a factor of 10 to get the ACTUAL forecast COVID cases. Remember from the last post, that because we don’t have enough tests, and the virus has been spreading exponentially every day and will continue to spread until we prevent the virus from spreading through human contact, there are many more cases than those that are CONFIRMED so we must account for that.
50x is what Harvard thought last week, and we have some indications to suggest that there are more unconfirmed cases than previously thought and that unconfirmed cases are adding to hospital caseloads more than expected. Some people estimate there are 100x more ACTUAL cases than CONFIRMED cases. But we can’t know because in America we do not have enough tests. You have to decide what number to use. And we want to be conservative because people die. Lots of people will die.
We will use my home town of Bend, Oregon as an illustration:
6 CONFIRMED cases as of 3/19/20 x 10 = 60 estimated ACTUAL Cases Present in Bend on 3/19/20. Because there are always more ACTUAL cases than CONFIRMED cases because many people have the virus and don’t show symptoms, and we do not have enough COVID tests.
Step 2: Calculate the Number of ACTUAL Cases Requiring Hospitalization. In Bend, Oregon:
15% of 60 actual cases = 9 Cases Requiring Hospitalization on 3/19/20. Some of these may not be hospitalized yet, because patients take 2 –14 days to show symptoms, and then a few days more to get really sick. Note everything “seems fine” in Bend because our brains cannot process the exponential growth of infection that is still happening, despite partial “lockdown” due to the lack of available testing.
Step 3: Finally, we use the Wuhan, Post Lockdown Growth Rate to See What Happens After We Fully Lockdown Our City
Next, calculate the number of daily cases that will continue until the estimated 20 day peak, despite the lockdown. This is the pent up, undiscovered infections (because we can’t test) that we don’t discover until after the lockdown, once people show symptoms and get really sick.
If after we go to full “rest in place” with no air travel and truly do a “lockdown” and if it does take 20 days for Bend, Oregon to reach the peak of cases, we can conclude that the rate of continued cases will be similar to what Wuhan experienced until they peaked, which will be this:
Chart 3: Forecast infections even after truly locking down for Bend, Oregon, (where I live). Note: I did not model beds freeing up due to fatalities or recovery because of immateriality
Once we go to full rest in place with no air travel and eliminate social contact between our citizens, after 20 days we should reach the peak. Here is the tough part that we will get through because we are the United States of America but which will be the most difficult part: Bend will have an additional 1,116 total cases until the peak and then more after that because the cases of sick COVID patients will continue to come for many days after the peak.
Important point: this chart above illustrates the number of cases just to the peak, which is the point when cases start to diminish. The cases will keep coming after the peak, until all cases are either recovered or deceased.
Bend only has 226 hospital beds at St Charles Medical Center, 65% of which, at least, are already full (I think they are maxed out already on beds but I haven’t had an opportunity to confirm. If anyone in Bend can DM me to confirm as a resident of Bend I would very much like to have this information). There are thousands of COVID patients in the Big Orange Tsunami that are going to bury St. Charles hospital where I live. Many people will die and there will be great suffering.
Key Point: Everything seems locked down but it is not enough to avoid the Big Orange Tsunami of people infected with COVID. Not in Bend, Oregon, and we only have 6 cases. And not where you live either. You can do the math where you live. Start with the number of CONFIRMED cases and work through Steps 1, 2, and 3.
Today, people are still flying on airplanes and traveling through airports. People are still vacationing, recreating in large groups, and not avoiding all but the essential social interactions. Many people are still going to work, and I understand that this is a difficult hurdle. The reason why this is important because we must flatten the curve which also minimized the duration of the overall economic impact for everyone.
But despite our best intentions in the last week, COVID19 is is still transmitting at an exponential rate.
This is the point that Dr. Fauci keeps making over, and over again: we are always behind where we think we are.
Because of the delay in truly locking down, Italy is in a countrywide catastrophe. It’s the math which is working against us all. I wish I could say we are going to come out better than Italy but the math is the same in Italian as it is in English. Math is math. And once they realized it they locked down completely, but they now have to go through a much bigger Tsunami of COVID patients.
Lots and lots of people die because it’s an exponential bomb that is too big for the capacity of our healthcare systems, in any town, in any State. The wave of COVID patients is a Tsunami: there will be no more beds and no more masks and no more PAPR hoods and not enough space and the new cases will keep coming every day even past the lockdown date.
After interviewing 5 nurses in Seattle yesterday, I need to paint this picture that they shared with me. I spoke with them personally and will share a more detailed account ASAP: After a few days of admitting the Tsunami of COVID patients, the hospitals can no longer treat everyone so they are forced to make impossibly difficult decisions. The first mitigation protocol shared by nurses to whom I spoke (off the record, all five were not supposed to be talking to me) is as the COVID volume spikes, they are forced to only provide palliative care to those 65 and older. This is because they don’t have enough people, beds, time, or other medical resources so they have to make hard choices based on who is most likely to recover. This is battlefield medical response protocol.
As I stated in last week’s post, this will affect all of us. Everyone will know people who die. So when your grandma or your elderly friend arrives at the hospital the staff will place them in a place where they can die humanely but alone, because once they are admitted to the hospital their friends and family cannot visit for fear of spreading the virus so they die without saying goodbye to their family, alone, in a makeshift unit because there is no more space but we have to take the patients to a place where they can die in a way that is as humane as possible. This is the protocol in Seattle for when the Tsunami of COVID patients arrives.
Overwhelmed hospitals mean none of us will receive care to the standards we are accustomed. The hospitals are doing all they can to prepare. I have spoken with the nurses. When the hospitals are overwhelmed, and your brother has a heart attack there is no one to care for him because his chance of survival is less than 10% and the hospitals are overwhelmed. When your Dad with diabetes needs acute care there is no one to care for him because all the beds are full so he is taken to a triage tent but there are no masks and the doctors are busy and there are too many patients and so your Dad will not be treated.
WHAT WE DO NEXT REALLY, REALLY MATTERS AND WE HAVE TO START TODAY
I’m writing to the citizens and mayors of the towns and cities and locations where COVID19 seems like maybe it’s not going to be a big deal because you are still a few days or a week or 9 days or 12 days or even longer behind Seattle and New York and California and Italy and you may think you are already practicing enough Social Distancing. I’m sure the numbers still seem small in your area. In Bend we only have 6 CONFIRMED cases but because we can’t see the ACTUAL cases (because we don’t have COVID tests) and because the virus had been in Bend and in your town for weeks and has been spreading exponentially, the Big Orange Tsunami of COVID cases is already going to hit us, we just can’t see it yet because of the math and because we don’t have testing. Wuhan and Japan and Singapore had testing.
California was smart to enact the rest in place mandate a few days ago. Now every other geography in America needs to the same. And we need to shut the airports. And everyone must stay home for work. But only for 20 days until we can reassess.
Though your city may have zero or few confirmed cases (like we have in Bend, OR) as of this writing. I implore you to do the math exercise above, and read my first post which has been read 3.5M times in only 3 days.
This is not a time to panic, but we cannot wait. We do not need the government to mandate it, because the math will tell us what to do, and math is clear and math is predictable, 100% of the time:
For the next 20 days, below are the 7 things we all must do to flatten the curve, shorten the duration, reduce the loss of life and minimize the financial hardship for all of us. There is no other way, and no other option. Anything less threatens to destroy us and our nation, because the virus is using exponential math against us and we are unable to see it now because of the lack of COVID tests.
7 Things That All Americans Must Do, Starting Today:
1. You must begin to shelter in place for the next 20 days.
2. You must avoid all unnecessary contact with other people, for the next 20 days. You can still go to the grocery store, or get gas or get medications. Just be smart. It’s well documented what you must do. Stay 6 feet apart. Wash your hands. You know the drill.
3. This one is tough: You must tell your boss that you cannot work for 20 days. Show them this post and ask to carefully consider this information. This will actually decrease financial loss because of the shorter duration. If we wait it leads to exponentially more financial hardship for everyone in America.
4. You must cancel or change your flight, even if you are away from home and even if the airline charges you for the flight. Tell the airlines and hotel to read this post. We will work out the details after 20 days.
5. Once we agree that this is required, you must do your best to convince others and fellow citizens that we must all do these 7 steps. Many may struggle, as we all have struggled to make these huge changes and accept what is really happening. We are all scared and the math is difficult for all of us to comprehend. In addition, due to the uncertainty around money, and finances and hardship and fear they may struggle to come to terms with this truth. I have done my very best, to explain our predicament in the simplest ways I am able, given that we don’t have time to spare.
6. You may contract the virus. You may get sick. But you must not go to the hospital unless you get very sick in order to allow hospital providers to treat those in need of critical care.
7. If you are an influencer or know an influencer, or other people with large followings, please contact me or assist the influencer in reading this post. The best way to contact me is through Facebook DM. People with millions of followers must help spread the message. Because of exponential math the virus continues to spread so every hour matters. Everyone must read this.
8. Call or email or send this post to your mayor or government official. Time is of the essence. The fastest way to implement the required measures is for government to help us both communicate, and enforce the behaviors. This a key responsibility of government, to help us through times like these when we struggle with monumental issues like the COVID pandemic.
Finally: Wuhan stopped the virus in 12 days and is returning to normal, because you cannot easily transmit the virus without person to person contact. There are no more cases in Wuhan. It took them 12 days to get to the peak, and a lot of discomfort after the peak. Many died, but we now know there is only way to defeat the virus.
I know it feels uncertain, and is scary. But I challenge you this: it is just 20 days. At the end of 20 days we all have more information and the next steps will be clearer. We may need more time after 20 days. But sheltering in place is required in order to get through this with the least amount of suffering and loss of life.
We will rebuild, like we always have, and be stronger and more united as a nation because of it. And we must come together, and help one another, because getting through this requires that we do.
Please share this post, and when you share it, tell everyone why they should take the time to read such a long post.
This is not panic, but the time to act is now. We all must go “all-in” to defeat the virus or the impact will be greater and far more catastrophic. I’ve explained it all using math to the best of my abilities.
Our great nation will get through this, but it’s up to each of us, as Americans of every color, from every ethnicity, from every social stature, from Alaska to Hawaii, from Florida to Washington, to rally together in unity and truth, to do what is right for the sake of fellow citizens and the future of this great nation. It is just 20 days.
God bless all of us, and God bless America.
Be smart. Stay vigilant. Help others.
To all the healthcare workers: thank you for your service, and for sharing your stories with me. Thank you for your bravery, and your service to all of us. Our great nation will rise up to support you. You are the true heroes. God bless you.
Follow me on Facebook if you want to receive future updates, I will have more information to share and will share via followers on Facebook and Medium.
NOTE: Anyone, including the media, is free to use this post, any related content, in all or in part, for any purpose, in any format, with no attribution required. Please direct message me on FB if you have other ideas for how to raise awareness.
Finally, I can no longer keep up with friend requests on Facebook given how much my posts have been shared. To receive updates or follow me, please use the “Follow” button on Facebook. My Facebook page is here, or follow me here on Medium, but Facebook is probably best as I may provide other updates that are not a blog post.
email@example.com [I am likely to be very slow to respond to email]. Include in any message the size of your audience and a URL for your organization and what date and time you propose during which we may amplify this message. I will make myself available on any days including the weekend if required, provided the audience size is appropriate. I am on Pacific Standard Time.
Influencers with very large followers:
When you share, please explain the importance of why you are sharing when you share this post. Your followers need to know why they must read this. If you wish to speak with me first, DM me on Facebook. Tell me who you are, and how many followers you have. Time is working against us so we must prioritize based on who is able to amplify the message the most. I am one guy.
URGENT: We all would benefit from solving these three challenges:
1.) Translating this into all languages. If someone could help with this please share it with me via a Google doc at jwarner@recruitingdash. Don’t forget to label each language so I can label the links once reposted. I only speak English. Time is of the essence, please help.
2.) If someone has skills in making a simple explainer video of these concepts, that would be helpful to better reach people given this is such a long-form explanation.
3.) One challenge is that this post is too long, and I don’t know what to cut and still explain the concepts sufficiently.
More math is below from people smarter than me:
I laid out the above in simple math so everyone can understand in plain language. If you have more sophisticated models send them to me at firstname.lastname@example.org and I will consider posting them here. Caveat: we don’t need more models, because the math is the same and math is predictable 100% of the time and I’ve reviewed this people smarter than me to confirm I’m not off. If you still don’t believe this post, go read Tomas Pueyo’s. He lays it out in plain language here.
One reason this post is difficult to believe is because the pain and the suffering and numbers will be so great and we have never seen anything like this before in our lifetimes. This is not hype. It’s math.
That said, below are more sophisticated models taken from the data sources as indicated. This is important to understand: there is an inherent problem with sophisticated graphs: the average person doesn’t understand complicated graphs. Because they cannot translate a fancy graph into the reality of what is going to happen in their town. When you combine fancy graphs with exponential math, everyone misses the key points. That’s why I wrote this post, because everyone in America needs to understand. We don’t need more graphics, we need more understanding.
Which is why I wrote this post and laid it all out and created the simple math exercises.
This first one below (Modeled US Population CorVID19 Infection Growth), shows the infection rate spread across Americans if we don’t do the 20 day action steps above and keep things as is. We had to assume a lower rate of virus spread, since we know some people are doing social distancing, but many are not. You see them. You know this it true. So we estimated a lower rate of growth.
Here’s how to interpret the graph below: The red numbers are the count of CONFIRMED cases of COVID up through today.
The blue Tsunami Wave is the future growth of COVID infections, over the coming weeks, adjusted for daily growth rate since we have done some social distancing already starting a few days ago. So the rate of infection will grow at slower rate next from March 23 through the 31st and even slower the following week. The rate of infection slows down but we don’t know how much because we do not have COVID testing to confirm if our current social distancing strategy is working.
The big problem that is illustrated in the graph below: If we don’t start today 0.1% or 350,000 Americans will be infected by the second week of April (where the arrow is). And more after that. And we know from the Orange Tsunami Math Exercise that it will be unbearable for your community to bear.
I can’t sugar coat the table below for you: This is the modeled count of deaths of Americans, broken out by age group since we know the mortality rate varies by age. Note that the count of dead Americans is in thousands: So 500 = 500,000 and 1,000 equals 1 million. So 1,382 equals 1 million, three hundred eighty two thousand deaths.The bottom line: if we take action as described at the end of the post, millions more Americans will die from COVID-19. This is not hype. It’s math.
Photo credits: Jason S. Warner
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