There is a very slight glimmer of something, that the US rates appear to be slowing. The timing is right for this to be a reflection of the stay home efforts. This doesn’t fix anything. It only spreads out the damage, lessening the impact on hospitals (still catastrophic) while increasing dramatically the duration of the economic destruction.
Sam
This appears to be the case in several places. Italy appears to have reached a peak in its new infections and new deaths. They are bouncing around a bit, but not increasing day over day. Can you explain where you think it might go from here? The health care system in Lombardia is deeply stressed, but not collapsed. I don't think other areas of Italy are far over capacity. It seems like the hospitals should be able to now mostly keep up, and perhaps start to get some breathing room if the rates slow a bit more.
Obviously that leaves a long slog to go, but is catastrophe guaranteed? Can you lay out a time line that you expect to see?
dnem,
I wish I had a clue. Exponentials tend to run away rapidly if you don't aggressively control them. That is equally true in nuclear reactors, chemical reactions leading to deflagrations and explosions, and biologic growth. The details are different for each of these classes, but the principles are the same.
Riding on top of an exponential and trying to control it is delicate and dangerous. You have to have intense negative feedbacks built into the system that work at speeds faster than the exponential driver. Humans aren't nearly fast enough. In nuclear reactors this is accomplished in several ways. Yet every now and then the control conditions are exceeded or people intervene to do stupid stupid things, and in nearly the blink of an eye things go all pear shaped at the very best and catastrophically destructive at the worst.
For chemical reactions it is even dicier though with smaller consequences. Riding the edge of a thermal kinetic reaction is scary - terrifying actually. When they run away the result immediately is a BLEVE (that is a terrifying thing you never ever ever want to experience), detonations (well, you likely won't survive that), or if you are really lucky - deflagrations. You might survive that, maybe, with massive experience and a huge dose of luck. Following the initial event, there may be subsidiary events. Flee! And there are often toxic releases that are vastly more catastrophic than the initial blast.
For biologics, well - you are now living through one of those. They are perhaps the scariest of all and have the largest most catastrophic consequences. They are also the slowest to develop. They too may have secondary and tertiary effects and follow on waves of new infections with similar or different properties that evade most of whatever we learned in the first wave.
Riding on an exponential to try to control it goes as you are seeing it now play out with COVID. If you are really really good, brutal, and fast, as China was, you might just control it - if you are very very good and very very lucky. Staying in control is like riding a bucking bull bare hand on the deck of a small ship at sea in the midst of 150 foot crashing waves from a hurricane while a team of snipers is shooting at you. Good luck with that. Catastrophe is all but assured.
And that is where we are now. The catastrophes are playing out in over 100 countries. The experts are behind the curve and applying tools honed for mild seasonal epidemics and ill suited to rapidly spreading pandemics. This thing is moving far faster than anything the vast majority of them were ever trained for. This is a run away. By that I mean it is running away on its own & your best answer is to run away from it as fast as you possibly can, slamming doors behind you as you go.
When people understand things like this, they act accordingly. I was once involved in an actual activation of a criticality alarm at a US Government site (a detected nuclear run away). It turned out to be a false alarm triggered by a technician working on the alarm system - live. ALL of us ran faster than we have ever run in our lives to flee the area. I saw a coworker quite literally jump over a 12 foot fence on the dead run without ever touching it. Stress can cause you do do amazing things.
For this, we cannot run away. There is no "away" to run to. We have to stand and fight. That fight in this case means sheltering in place until the danger passes. But, this will take long enough to pass that some of us will have to brave it out. These are the heroes. These are the emergency workers of all types and kinds from the obvious from line - the doctors, nurses, EMTs, and their support staff - people like the janitors who are heroes in this battle - to clearly visible people like grocery clerks and staff - to the nearly invisible - the postal workers and delivery people, the long haul truckers, the farm laborers that keep the crops coming in, the restauranteurs and others who keep people paid and working in ways no one planned for, and the emergency operations people who work long hours behind the scene working the logistics to make things happen.
Then there are the people who think they are important and who demand praise - and their front men and women. These are not generally heroes, with exceptions like Governors Cuomo and Inslee. Mostly they are buffoons, cowards, conmen, thieves, and idiots like Trump, Pence and three
score dozen (now less) of other Governors in the US. Other nations have their equivalents. (corrected)
As to where this goes and what the time line is?.... well that very much depends on the actions each country, and region choose to take, how well they implement those, and how clearly they think the problem through.
It doesn't matter whether anyone thinks they have the right answer. It will be crucial to watch the data, seek the data, and act on that. By that I absolutely do NOT mean the usual scientific methods. Those are mostly wonderful for proving things, though even there they have terrible failings in dozens of ways. What I do mean is using real time data to make real time decisions and to take real time actions. That involves a good deal of estimation and guess work. It will be at least slightly wrong all of the time. Most of the time it needs to be close. And those "working the problem" must constantly be seeing new insights, new information, new analyses to gauge where they have gone wrong, where they and we are vulnerable - to act - boldly and quickly - all the while knowing that you are going to make mistakes. Some of those will be terrible. And you have to keep moving. You cannot stop or even pause for long.
If all of that goes well, you get the outcome China had. Societally that has huge negative repercussions that will take decades to work through. And it too can go all pear shaped in a whole lot of ways. A political revolt to those limitations during the response can lead to utter collapse and catastrophe. Overly suppressing such feelings can result in equally dire outcomes. The Chinese deserve huge credit for threading the needle in this crisis. Will that ultimately work out well? Who the hell knows? That depends on the leaders involved and on the mass of the populace. If the leaders can avoid the tendency toward authoritarianism - perhaps. If the public can be patient and do their part - perhaps.
The West lacks many of the tools the Chinese had. Can we lead people by example to get them to adhere tightly enough to what is needed to succeed? I sincerely doubt that. One need only look to Donald Trump's followers to see that in spite of direct evidence they believe insane things and act on those beliefs. You can see some of that here.
Desires and core beliefs have to change to succeed. I do not see that happening.
As a consequence, I suspect that most of the world will either let the virus mostly run free with an enormous death toll and financial and economic consequences, OR they will try to ride herd for a time, then ultimately give up (a la Donald Trump deciding to let up before Easter). Depending on how long that takes or how quickly, that too will have even more devastating effects.
Ultimately what is likely to bring it to an end is either of two things.
1) The virus burns itself out having infected 90% of the population. That leaves behind the huge death tolls that are now so obvious.
2) Vaccines are successfully developed and deployed. I do not see that happening in less than a year.
Some nations and places will no doubt try other strategies. And we will ge two see how effective those are and what consequences they bring with them.
One such that seems likely is having everyone over a certain age (55-65) ordered to shelter and stay sheltered for at least six months, likely longer. And then allowing the rest of the nation to intentionally get the disease to try to burn it out of the population through herd immunity. They then also support the older population by bringing things to them while they are isolated.
Would that work? Who the hell knows? But I can envisage some nation trying it.
In the mean time, we can work like hell to try to soften the blow and limit the damage.
Sam