As COVID-19 pandemic rages on, governments at various levels start to issue orders/guidelines from initial international travel bans from hot spots around the world, to domestically social distancing, shutdown of restaurants, sports, entertainment venues, and then shelter-in-place of various degree of restrictions. These actions are the controls to mitigate the covid-19 risks.
When we can not eliminate the risks, the best way to reduce risks is to impose controls. How can we design/install control to have the most effective risk mitigation?
A widely used engineering risk analysis method - 5 x 5 risk matrix - is used to perform the evaluations of various controls imposed or proposed.
The risk mitigation of covid-19 is much more complicated than an engineering risk mitigation because of several factors: 1) the risk is not uniformly distributed across states; 2) the somewhat subjective risk assessment is more complicated now - politics motivated extreme proposals, only looking at worst case scenarios, ... can and did induce panic...Fortunately China's efforts to combat and contain covid-19 can be our baseline; 3) controls implemented to combat conronavirus may induce or amplify other risks, e.g. a) shortage of supplies, b) other preventable, curable diseases are pushed to second tier, and the consequence could be that more people die from these diseases than from covid-19.
1) Travel bans, social distancing and selected shelter-in-place are all good measures. I am pleased to see that Texas governor Abbott refrained from declare shelter-in-place for the whole state despite the calls from some mayors and county judges of severely affected cities/counties. It is noted that he did encourage county and city governments to make that decision for their locality, I happened to watch the live interview of governor Abbott on local CBS news. He gave a fact and data based assertive reasoning of his decisions. He was also aware of the fluid nature of the situation, but he made plan for next steps based on data, model projection, not on fear and panic.
We don't need across nation or across Texas shelter-in-place; but we do need much stronger restrictions at the epicenter of the crisis - currently CT- NY-NJ along Interstate 95, we should lock-down NYC, or quarantine CT-NY-NJ, and other hotspots!!
When this idea was floated - There was howling from NY - claiming it could not be done, there was jabbing from pundits in media - saying it had to be done nationwide to be effective.
China gave a us a good example in lock-down only the epicenter - Wuhan, China, and they have contained the epidemic.
The compromise announced this morning is the CDC travel advisory which asks residents in CT-NY-NJ not travel in next 14 days. Because of no lock-down or quarantine of CT-NY-NJ, several state governors, including Texas', announced requirements that people from CT-NY-NJ have to self quarantine for 14 days upon arrival.
Note: the population of these three states (32.0 million) is 1/10 of total US population (327 millions), they have 53.5% of the confirmed cases and 47.2% of covid-19 death of the US totals.
2) News media is a very important aspect of the war on covid-19: Education of US residents about covid-19, such as symptoms, preventive measures, and make governments' orders well known to citizens.
Unfortunately both national and local news media, especially TV news, have done a poor job - they sensationalize individual cases, they report only the bad statistics, and buried encouraging statistics, see some examples in my earlier post on the subject. This is not only my opinion, per Gallup poll, 60% Americans disapprove news media's report of covid-19.
We need to put the coronavirus infection rate, death rate in perspective, e.g. compared to influenza infection rate and death rate, which I listed some examples in my random thoughts about coronavirus, as well as overall mortality of the population. Here are mortality rates of the whole world, China, the last epicenter of covid-19, and US, the current epicenter:
World wide: 150,000 people died everyday in 2019
China: 27850 people died everyday in 2019 (mortality rate 7.261/1000, 10.2 million for the year).
United States: 7200 people died everyday in 2019 (mortality 8.782/1000, or 2.63 million for the year)
On balance, there are babies born everyday, in fact more life come to this world than leaving, thus the growth of the global population. Death and birth form the circle of life.
3a) The extreme focus on conronavirus will contain the spread of the virus, will also reduce number of people dying from this virus. But at what price? what about other infectious diseases such as influenza which killed ~ 10 times more people so far this season than coronavirus has killed as of March 29th? we have an acquaintance who had severe flu and could not get appointment with her physician. What about people with other diseases? There were reports from China that people who had stroke could not get the emergency care they needed. There were reports here in US that cancer patients could not continue chemotherapy they underwent. I wonder how many people died due to lack of regular medical care from this all-hands on deck to save every coronavirus patient.
The policy makers and the citizens in general, need to have a holistic view of the crisis. We need to have a balanced focuses between covid-19 death and other preventable death.
3b) Earlier in March, there were widespread panic shoppings, many supermarkets had empty shelves - which was induced by sensationalized reports at national and local TV stations about isolated panic shopping. In Texas, the governor went on TV to calm Texans that there was no shortage of supplies, which was true, and continue to be true to this day.
On the other hand, we may have serious issue in supplies if the pandemic lasts for long time because we have outsourced our manufacturing oversea. Relying on other countries for our basic needs is a threat to national security, especially in crisis like covid-19 pandemic.
4) Additional comments
Urbanization makes the pandemic inevitable and globalization makes the pandemic spread fast from country to country, from continent to continent.
I believe in help oneself first before helping others, so to me, American First is a good policy from start. This covid-19 pandemic just validates the policy.
Based my opinions outlined here, I thought that the federal government has done a great job, which is also the opinion of 60% of the Americans per Gallop
In summary, the macroscopic risk mitigation of covid-19 should be holistic, single minded single purpose across the board action typically does more harm than good. However US should learn from China, have rigorous and strict regional/local lock-down or quarantine over covid-19 epicenter and hotspots. If China can limit coronavirus growth in a single region, US should be able to do it as well.
* the impact of covid-19 on economics is only touched up. The 2T stimulus package passed last week had enormous ramifications, but is not discussed here.
On balance, there are babies born everyday, in fact more life come to this world than leaving, thus the growth of the global population. Death and birth form the circle of life.
3a) The extreme focus on conronavirus will contain the spread of the virus, will also reduce number of people dying from this virus. But at what price? what about other infectious diseases such as influenza which killed ~ 10 times more people so far this season than coronavirus has killed as of March 29th? we have an acquaintance who had severe flu and could not get appointment with her physician. What about people with other diseases? There were reports from China that people who had stroke could not get the emergency care they needed. There were reports here in US that cancer patients could not continue chemotherapy they underwent. I wonder how many people died due to lack of regular medical care from this all-hands on deck to save every coronavirus patient.
The policy makers and the citizens in general, need to have a holistic view of the crisis. We need to have a balanced focuses between covid-19 death and other preventable death.
3b) Earlier in March, there were widespread panic shoppings, many supermarkets had empty shelves - which was induced by sensationalized reports at national and local TV stations about isolated panic shopping. In Texas, the governor went on TV to calm Texans that there was no shortage of supplies, which was true, and continue to be true to this day.
On the other hand, we may have serious issue in supplies if the pandemic lasts for long time because we have outsourced our manufacturing oversea. Relying on other countries for our basic needs is a threat to national security, especially in crisis like covid-19 pandemic.
4) Additional comments
Urbanization makes the pandemic inevitable and globalization makes the pandemic spread fast from country to country, from continent to continent.
I believe in help oneself first before helping others, so to me, American First is a good policy from start. This covid-19 pandemic just validates the policy.
Based my opinions outlined here, I thought that the federal government has done a great job, which is also the opinion of 60% of the Americans per Gallop
In summary, the macroscopic risk mitigation of covid-19 should be holistic, single minded single purpose across the board action typically does more harm than good. However US should learn from China, have rigorous and strict regional/local lock-down or quarantine over covid-19 epicenter and hotspots. If China can limit coronavirus growth in a single region, US should be able to do it as well.
* the impact of covid-19 on economics is only touched up. The 2T stimulus package passed last week had enormous ramifications, but is not discussed here.
