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spartansaver

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The epicentre of the Coronovirus in the US is Kirkland, Washington (pop 90,000) located on the outskirts of Seattle (3.5 million). Today Washington State Public Health provided an update. Bottom line, the situation does not look good to contain this outbreak. It is clear from listening to the update (link posted below) the health care system there is already overwhelmed. They have 39 confirmed cases and 10 deaths (King and Snohomish counties). Bad, but not that bad... right? Keep reading...

 

Even though they have a health emergency there is still limited testing going on in Washington State. They acknowledged  there is ‘huge demand’ right now for testing. But there is limited capacity and they are ‘working hard’ to increase capacity. Up until yesterday, the criteria from the CDC for who could be tested was quite restrictive. Yesterday the CDC relaxed their testing requirements. People who have mild symptoms are being told they do not need to be tested.

 

At Life Care, the longterm care facility (with 108 patients) where the outbreak first occurred last week the situation is grim. 5 patients have died from the virus and more are in serious condition. Most of the staff left when they started showing symptoms and are now in self quarantine at their own homes. So the long term care facility has been running on a skeleton staff. Quality of care for patients is poor and the facility’s ‘ability to function has gotten more difficult over time’. Sounds like things fell off the rails today. People who had no symptoms were not removed from the facility (but were separated at the facility from those who were showing symptoms) but family members fear they have now become infected. They are not able to test the residents. Those residents who are able to get into a hospital can be tested; those in the facility who cannot get to a hospital are not being tested and are being told that testing is not necessary anyway as they will still receive the same level of care for the condition they are in (whether they have the virus or not). Tomorrow (Thursday) they expect a Federal disaster medical team to arrive and provide much needed support. Family members are freaking out. There has been no communication from Washington State Public Health with family members who have loved ones at the facility; they are too busy.

- CNN news article on Life Care: https://www.cnn.com/2020/03/04/health/washington-state-nursing-facility-coronavirus-family/index.html

 

Family members who have been to the Life Care facility over the past month and likely exposed to the virus are not being contacted by health authorities (they are too busy). In the press briefing Washington State Public Health ‘asked’ these people to handle the issue on their own.

 

The recommended actions that are being given to the larger community from Washington State Public Health are determined in consultation with the CDC based off the number of reported cases in the community. Because the reported number of cases continue to be low they are recommending only basic actions at this time (wash your hands, stay at home if you are sick, stay away from large groups if you are high risk, work from home if you can etc). But we know the number of reported cases are vastly understated (due to lack of testing). So the recommended actions are also likely behind the curve.

 

Bottom line, the virus is winning the fight right now. This is going to get worse. But we aren’t going to hear how bad it is until they actually start to test in volume.

 

I am starting to think BC and neighbouring US states may have to issue travel advisories for Washington State. At least until they get the situation under some kind of control. Because right now it looks to me like the virus has gotten a 4-6 week head start. I wonder if this is what happened in Northern Italy and South Korea (delay in identifying outbreak and then slow response by overwhelmed health care providers).

 

King County Public Health, state health officials give update on coronavirus response - March 4 - 45 minutes

 

- testing update: at 24 minutes

- care home: at 28 minutes

- what to do: at 46 minutes

The comments section at the end of the video provide some clarity on how local residents are feeling

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Viking,

 

That reads like a terrible nightmare in full daylight. Imagine getting run over by a bus that you need a microscope to see. And the US healthcare authorities have had all the strategies executed on first in China, next all the European etc. strategies to study, copy & make adjustments to before execution - now for several weeks -, and now this.

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John, i live three hours from Kirkland. I was there with my son for his hockey tournament in November. Wonderful time; great people. Yes, it is a tragedy in the making. I cannot understand why they are not taking more aggressive steps. My guess is the health care professionals know they are screwed already. Seattle is too big to quarantine (3.5 million people). So this is going to get much worse and they will simply ‘do their best’.

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Viking,

 

Right now the overall situation reminds me of the plot in Deep Impact, just before the POTUS declares for the World Society, that the first attempt - by secretive preparations among several countries - to blow out the comet from space has failed, by declaring on television : "We have failed.".

 

- - - o 0 o - - -

 

Well, perhaps an exaggeration for my part. And then not : In short, all attempts so far to contain the virus have failed, as far as I know, no matter the strategy executed.

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Princess Cruise Ship held off the coast of CA...

 

NY area guy who caught it spread it to multiple families, attended religious services/events while likely infected (but "untested"):

https://www.washingtonpost.com/local/social-issues/new-york-coronavirus-westchester/2020/03/04/a9e0c5e0-5e48-11ea-b014-4fafa866bb81_story.html

 

It begins, America. Washington state may seem like the "epicenter" now, but due to compounding, severe under testing due to bungling by Federal Gov't, and several week delay for onset of symptoms, this has likely spread throughout the major population areas...and continues to spread as more and more undetected infections are generated on a daily basis.

 

Do u think Pence/Trump understand this? What about the career Republicans who are in charge of what should be scientifically based agencies? What we are witnessing is what happens when we elect scientifically illiterate people into power who strip out the budgets for these things. It is fine most of the time, but when shit hits the fan, you know the value of preventative measures that could have been. Guess we can all wait for the pvt sector "invisible hand" to save us.

 

Black swans are easy to underestimate early on. China was mocked for dismissing early cases, but once they understood the seriousness, literally locked down tens of millions of people...

 

Guess few understand the precautionary principle with systemic, multiplicative, and nonlinear processes such as this one.

 

As was once said "an ounce of prevention is worth a pound of cure" -BF.

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“ Here is the President of the United States telling the country it's okay to go to work with Coronavirus.

 

I'm not kidding”

 

 

“To get a sense of how badly the US government is handling the coronavirus pandemic, consider that of this week they had only done 500 tests in a population of 330million.

 

Australia has tested 10,000 people with a population of 25million“

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A small status update from Norway. I have no strong opinions right now on how good/bad this is handled. Life goes on as normal with a bit more hand-washing for most people, and it actually seems like the "fear mongering" in the papers are less now than a week ago. It seems pretty certain that the Norwegian tourism-industry is facing a horrible year though.

 

72 confirmed cases (20 in my city, population 250k ish) , 64 of those got the virus traveling abroad. 56 of those 64 in northern Italy (main reason probably being winter holiday last couple of weeks). Earlier today they said 1400 people in Norway (population 5 million)  was tested in total so far, probably a bit more now. As I understand it they only test people that both show some symptoms _and_ either have been in one of the areas abroad with outbreaks, or have been in contact with people that have. "They" are the institute of public health (https://www.fhi.no/en/). It seems one reason for not testing more widely is the fear (probably fact) of running out of testing-equipment.

 

As mentioned elsewhere in this thread, one of the main goals are to spread the infections out in time, to try to not overwhelm hospitals (and everything else). That said, colleagues who have spouses that work in health-care say that they have to work double shifts because their colleagues are in home isolation (perhaps only precautionary, until tested and found to not be infected).

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Ray Dalio

 

https://westfaironline.com/121925/ray-dalio-covid-19-will-create-emotional-but-not-economic-impacts/

 

While Im not a huge Dalio fanboy, what he says, seems on the money. Obviously fertile grounds for long/short strategies. Be careful about what you're buying. Dont be irrational. Seem like how we should always invest....

 

To compare this to Spanish flu 100 y ago where world was vastly less interconnected and it took weeks to travel to diff continent is laughable. If you try to model a black swan’s effects by studying the past, you will likely get hurt. But that’s human nature I guess: trying to predict the future by looking at the past. What’s that investing adage about studying past performance ?

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Earlier today they said 1400 people in Norway (population 5 million)  was tested in total so far, probably a bit more now. As I understand it they only test people that both show some symptoms _and_ either have been in one of the areas abroad with outbreaks, or have been in contact with people that have. "They" are the institute of public health (https://www.fhi.no/en/). It seems one reason for not testing more widely is the fear (probably fact) of running out of testing-equipment.

 

This Google Translated article probably does a better job than I explaining it: https://translate.google.com/translate?hl=&sl=no&tl=en&u=https%3A%2F%2Fwww.aftenposten.no%2Fnorge%2Fi%2FjdAaGA%2Ffryktet-at-1400-nordmenn-kunne-vaere-korona-smittet-men-de-fleste-var-bare-forkjoelet

 

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You’re right, 102 years of medicine and healthcare advances may help fight this relative to 1918

 

I work in healthcare. The only advances that we have come up with in that time that are effective against this are 1) hand washing, 2) contact isolation, 3) mechanical ventilation (but by this point it is already way too late). Also, we severely lack # of ICU beds and resources which will become apparent soon. It is already apparent we lack resources if you look at how testing for this has rolled out.

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You’re right, 102 years of medicine and healthcare advances may help fight this relative to 1918

 

There's that, and there's also the other side of the media fear mongering; people actually have information available necessary to take precautions against this. Much harder to get information out to the masses(especially on a global basis) back in 1918.

 

People will bitch about the "information" being released, mainly because its a convenient cover to express political frustrations, but the bottom line is that the public is aware of this and has been for weeks now, which if nothing else, allows folks to be on alert.

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I don’t work in healthcare but I  read Wikipedia

 

The bar for 1918 is pretty high right? Infecting 25% Killing 1-4% of the population. And yet the global economy and markets pressed on, right? Don’t get me wrong, I have some disaster hedges, but I’m also fully infested and corona will certainly not stop that.

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People in the old days (pre smallpox eradication, pre measles vaccine), etc had a much greater tolerance for death even among kids/family members because it was far more common before vaccines/basic medical interventions came about. The world was very different than it is now and this was right after many had also perished in WWI. When the 1918 flu came around, the freakout and resulting economic impact was much smaller than it will be now...

 

We are glued to screens monitoring information and very sensitive about deaths with people we know bc we have faced far less hardship than those generations 100y ago (look at infant/child mortality in 1900 UK). Economic growth already in very low single digits. Basic setup for panic and strong economic fallout.

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You’re right, 102 years of medicine and healthcare advances may help fight this relative to 1918

 

I work in healthcare. The only advances that we have come up with in that time that are effective against this are 1) hand washing, 2) contact isolation, 3) mechanical ventilation (but by this point it is already way too late). Also, we severely lack # of ICU beds and resources which will become apparent soon. It is already apparent we lack resources if you look at how testing for this has rolled out.

 

Lack of testing (thus giving visibility) and means of spread prevention are two different things in my opinion. They work together on some level for sure. But for something as infectious as this, if you miss a single person who is infected anywhere it is already too late. In fact the incubation period alone (14 days) is enough to come to the conclusion that stopping spread is pretty much impossible.

 

Even if the US and other countries started preparing for COVID-19 the minute the heard about it, the time frame for vaccine development would still likely be 1 year. If test kits were developed in masses on the first day it still would be too late because individuals are walking around for potentially 14 days with no symptoms. Eventually would most likely show "mild" symptoms that they probably wouldn't seek testing for to begin with.

 

People are putting way too much emphasis on testing (as if testing is going to stop it). My wife (a healthcare professional) agrees. The best thing is to take spread prevention precautions such as limiting contact with others, washing you hands, drinking lots of water, and staying away from high risk individuals who already have acute or chronic illnesses.

 

Anyone who is at high risk of dying from COVID-19 is going to be treated the say exact way they are treated for the flu. If you have a 80 year old grandmother who spent her life smoking and she developed a severe cough what would you do? You would take them to the doctor and they would be treated with standard protocol. But you would do this both before and after COVID-19 existed.

 

https://www.medicalnewstoday.com/articles/256521#covid-19

 

Shutting down schools, daycare and any type of senior care facilities is probably the best course of action. 

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Last year was a good year. S&P up 30%. Bull mkt 11 years on. Absolutely no reason to be greedy at this pt...I’ve gone to significant chunks of cash as of late and took some profits on multibagger TSLA as well.

 

Only the paranoid survive.

 

I am paranoid of a permanent impairment in corporate earnings power or value in the real assets I own. For this reason I own puts.

 

I am paranoid of reinvestment risk and not ever being able to buy the great companies and assets that I own at these prices again, given what is an unprecedented rate environment. For this reason I'm fully invested.

 

my first paranoia cost me 100-200 bps / year.

my second costs me full beta to the market's swings up to about a 20-30% drawdown, which is more than handle-able.

 

I am paranoid too. i have become a bit of a perma-bull, but I think we all need to keep the upside tail in mind.

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You’re right, 102 years of medicine and healthcare advances may help fight this relative to 1918

 

I work in healthcare. The only advances that we have come up with in that time that are effective against this are 1) hand washing, 2) contact isolation, 3) mechanical ventilation (but by this point it is already way too late). Also, we severely lack # of ICU beds and resources which will become apparent soon. It is already apparent we lack resources if you look at how testing for this has rolled out.

 

Lack of testing (thus giving visibility) and means of spread prevention are two different things in my opinion. They work together on some level for sure. But for something as infectious as this, if you miss a single person who is infected anywhere it is already too late. In fact the incubation period alone (14 days) is enough to come to the conclusion that stopping spread is pretty much impossible.

 

Even if the US and other countries started preparing for COVID-19 the minute the heard about it, the time frame for vaccine development would still likely be 1 year. If test kits were developed in masses on the first day it still would be too late because individuals are walking around for potentially 14 days with no symptoms. Eventually would most likely show "mild" symptoms that they probably wouldn't seek testing for to begin with.

 

 

This is wrong though. Basic epidemiology and how R nought works. Each person you contain prevents about 2-3 other infections.

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To add an anecdote, a friend's mother was recently in northern Italy and returned home to the Netherlands. She then experienced flu-like symptoms, and was told to self-quarantine and that a test kit would be delivered to her.

 

Within three/four days, she had the test kit performed and results back (negative - thankfully).

 

 

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I don’t work in healthcare but I  read Wikipedia

 

The bar for 1918 is pretty high right? Infecting 25% Killing 1-4% of the population. And yet the global economy and markets pressed on, right? Don’t get me wrong, I have some disaster hedges, but I’m also fully infested and corona will certainly not stop that.

 

People stating that we were fine in 1918 are missing that the world and Financial markets are very different now ( much more connected stronger feedback loops ) and back then WW1 was actually a much larger problem ( and the reason why  information about the flu was censored ).

 

I am sure we as a species survive this, we survived 9/11 which imo is the closest comparable, but it wasn’t pretty.

 

I also think that we will see more political changes based on how the people in power handle this ,or how it is perceived.

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