[ExI] Questions about R0 or maybe we'll be OK

Rafal Smigrodzki rafal.smigrodzki at gmail.com
Sun Mar 15 03:28:19 UTC 2020

Greyenlightenment discussed the possibility that the R0 estimated for Wuhan
virus based on cruise ship cases and nursing home cases may be too high.
There are certain situations where the initial infected person remains in
relatively close contact with others and this increases R0 but in most
other situations R0 is actually much lower. For example, a cruise ship has
central AC system that may spread infection among a captive group over many
days. A nursing home has highly vulnerable elderly in close contact with
health aides who may spread fecal material among multiple targets and we
know the virus is spread also through feces. Countries with a lot of
elderly, such as Italy, may have a more susceptible population. Countries
with poor sanitation, like China, may have higher R0.

If the above is true and the Wuhan virus R0 is under most circumstances
lower than currently estimated, it would explain why some countries (e.g.
Taiwan) have been successful in containing the spread. Mild social
distancing and the usual control measures (tracking and isolation of
infected individuals) would be unlikely to work well if Covid-19 was as
infectious as measles (R0 12 to 18) but it will work with R0 just a bit
over 1.

The US does have some advantages over many other countries. We are more
likely to drive rather than using public transportation. Our cities are
less crowded than Chinese cities. Our population is younger than Italy's.
The US is cleaner than most countries of the world. Establishing herd
immunity in the US might be easier than elsewhere.

I had a very pessimistic estimate of our chances of avoiding infection that
I shared with Ben. Right now I don't have enough information to modify this
estimate but who knows, maybe we'll be OK, in the sense of the pandemic
being only a few times worse than the flu, rather than hundreds of times
worse. Time will tell.

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