COVID-19 Update: Expectations－The Surge Increases

Welcome back. So this is going to be a pivotal week. Over the weekend, we saw about 2,000 new cases over the United States. So the reason I say this is going to be a pivotal week is we want to see a big uptake in the number of cases in the United States. We've been expecting this. We've been talking about this for the last four to six weeks, about how if the doubling is every three to five days, that eventually we'll see a huge uptake. And it appears that over this weekend it hit the United States. So I just want everybody to expect that in the news today and tomorrow, in the next couple days to hear about this and realize that this is not something we did not expect. So we'll talk about that briefly right now. Something else tomorrow. I'm going to also answer some questions about anxiety. Some people have been asking questions about how do we deal with anxiety throughout this. And then we'll talk about that briefly in relation to COVID 19 and things you can do to help keep yourself together at home. So a little bit of a brief perspective just with this pivotal week. The COVID 19, it just keeps getting closer. Back in January, it was this beginning of January, it was this unknown virus in this place called Wuhan that no one even probably knew what it was at that point in time. Then it got closer to Iran, but no one really paid attention to that. Even Italy, it was kind of. Huh, Italy. It wasn't until about mid March that we were like, whoa, this is actually getting to be a big deal. It's being closer and closer. It got to New York City. Now we're seeing epicenters in New Orleans and Detroit. And pretty much by now everybody has heard of someone locally getting it. And it's going to continue to get closer until friends and family members have gotten it. The reality is that 80% of us will get this at some point in time in the next year or two, might be sooner, might be later. Of that, 80% of people will get a head cold and get better. So we actually probably won't know who those 80% are until we actually have some kind of testing. 15% of people that get this, 15, 20% of people will get hospitalized and about 5% will need intensive care in the hospital. So those numbers haven't really changed in the last couple of weeks. It's just getting closer to home. It's actually now palpable in our local communities, especially here in Virginia and central Virginia. And I'm sure wherever you are as well, that you're Starting to feel this. So the point is, this was expected. We've been knowing it's coming. Be prepared, be aware. We have put together a COVID 19 survival guide that will hopefully be launched this week. A resource for you all to kind of just continue that whole preparedness, Being aware, being ready for things. So a couple other updates to keep things in mind. Here in Virginia, our quarantine is actually till June 10th. Hoping that it'll be cut off a little earlier, but that's how far out we're looking at this. The national back to work date is April 30th. So at a bare minimum, if the national back to work date is optimistic, that's gonna be another two, two to three weeks of the lockdown. Hopefully we'll get through things a little sooner. But that's what it's looking like right now. And in Virginia, we're looking at June 10th, which my hope is that will be cut off as well. There would be bans on mass. My thinking is that they'll probably be bans on mass gatherings for some time. Even when this initial phase is over, there's still going to be. People still aren't going to be going to basketball games, there's still going to be festivals, things that typically characterize a spring and a summertime. Wherever you are from the United States, those will probably be limited for some time, maybe the entire summer. We just don't know about that. Again, until we get testing, until we can find out who's got this, who's got immunity. We're just kind of playing by ear, to be honest with you. Now, I was listening to a pod. I was listening to a podcast over the weekend by El Arian of Allianz. Those of you who are in the financial sector will find it. Well, that name will ring a bell. He's a very well known fund manager and something he was saying rung true with me. What we're doing right now. He was just talking about his family and how with his daughters being really, really scared about everything, he just every day looks at the numbers and talks to them and says this is what's going on. Just that knowing that there is some order to the chaos, that we can actually grasp these numbers, that there's actually some plan, even though it's very up in the air, there's still, we still have a knowledge of what's going on was very calming to them and I've been getting a lot of feedback as well with what we've been doing here. That's been calming. It's been helpful. And so that's kind of how it's kind of helping me to understand that these updates, even though sometimes it's repetitive, but just hearing that there is some. There are people who kind of know what's going on, even though we say there's more that we don't know than what we do know. And there are actually things we can do to kind of keep our head in the game, so to speak. Life will go back to normal, but it's going to be a new normal. It's going to be different from the normal than we've had in the past. And we don't quite know what that's going to look like. We don't quite know what the criteria for entering back into society will be. People have talked about getting these certificates that you're immune to testing. We don't know what they even looks like. We haven't even started. Everybody hasn't even been tested yet. So even knowing what that criteria for entry back into social society, it's just not known. How do we determine when people go back to work? Depends on the kind of work. I've been working this whole time, actually today's day eight for me. I was at work this past weekend. That's the reason why I'm wearing scrubs in the morning because I'm actually literally getting ready to go to work right now. Some people might not be back to work in two to three months. Many people will lose their jobs. There's so many things that are just up in the air right now we just don't know about. There's going to be some way we need to verify who's had disease and who is clean. That's going to be via some kind of testing. People also need their own kind of personal protection equipment, face masks, which now they've been the norm in South Korea and China and Taiwan in the Western societies. We've been a little hesitant of that. Now as of this past week, the CDC is saying, hey, face coverings, good idea. Again, they weren't saying that six weeks ago. We're going to need some kind of personal protection equipment when we go back out initially, whether that's face masks and gloves, not quite sure. But there's going to be some changes to our daily activities and our daily way of life. So let's think about. Let's talk about a few countries really briefly. Taiwan. I want to talk about Taiwan because Taiwan is a very interesting case, a very interesting country. They've had 373 cases in the Entire country. Think about that. Taiwan's a, it's a small size country with a large population. Right beside China, they've tested 37,000 people. That means there's 99 tests per case. Okay, to put that in perspective, in America we have five tests per case. In Virginia we have nine tests per case. In Germany, nine tests per case. That means that for every nine tests done in Virginia and Germany, one person tests positive. In Taiwan, it's been 99 tests per positive case. They jumped on this quickly. They tested people when they were positive, they isolated them and They've only had 373 cases as of today in the entire country because they were on the ball. In the United States, we've tested a total of 1.7 million people. Sounds impressive until you realize that for that 336,000 cases in our country right now, there's been only five tests per case. Germany. Germany is an interesting situation because initially we weren't quite sure why the fatality rate was so low in Germany. Germany now has 100,000 cases. They've tested over 900,000 people at about nine tests per case. It appears that actually the initial cases in Germany were actually young individuals skiing in the surrounding countries, Switzerland, Austria, and they brought COVID 19 back to Germany. So the first cases were actually young people among young people. Now it's actually upticking in Germany and they actually have a, I think a 1 point about a 2% case fatality rate. So their fatality rate has actually popped up into the range of Rs in the United States now. So again, we're still learning about how this is processed in different countries differently in Italy versus China versus Taiwan versus South Korea versus Germany and the United States. So it's really interesting to see how different countries have responded and how this has progressed or not progressed. China, now the second wave is happening in China. They actually cut down, eased some of their own guidelines, and now we're seeing an uptake in numbers in China. But we just don't really know how to talk about the numbers in China anymore because now pretty much everybody accepts the fact that the data from China is flawed, it's inaccurate, and a lot of stuff not being told. Back in January, initially the World Health Organization was told by China that there was no human to human transmission, this disease. The WHO told the rest of the world that. And so what happened was we didn't really expect this to spread. Then they stopped testing for a while and then there's no cases. There's a while, there's no new cases in China. So now there's some new cases. So I think the point of all that is that information coming from totalitarian governments just can't be trusted and relied on. And I don't think that's new information but, but that just has helped me to tone down. I still look at their data, I still look at the published information that's being published several times a week coming out of there. But I just have to take it with a grain of salt and take it in perspective. Other places like Italy, so Italy appears to be, numbers appear to be peaking now. The number of new cases is actually in decline. So we have to think about the process of a country of someone getting infected. First, there's an exposure. Second, you see people get symptoms about seven days later. Most of those people never interact with the healthcare system. Some people get diagnosed in that period of time if they're sick enough, others don't. Within 19 to 21 days you'll see a peak in deaths related to those initial exposures. 21 days, 19 and 21 days before, on day 10 ish is when people start getting really sick, the cytokine storm occurs about them. So the point is, is that it takes about three weeks to see an uptick in deaths, about 14 days to see an uptick in cases before exposure. So right now we're seeing a leveling off in Italy based on stuff they've been doing for the last two, four weeks. Once a quarantine is instituted, it takes about three weeks to see a change in the death curve. And that's where we're at in Italy now. Our prairies are with them. They've had a rough haul of this. It's been pretty amazing how they respond, how their country has responded. Other countries around them have responded. And so our hope is that we are actually seeing a leveling off. They still have some time to go, but we'll see how they deal with things. Definitely different than what's going on in the United States. The United States, our current mortality is 2.8%. One thing I like people to think about, the United States population wise is equivalent to the eu, the European Union. So when people compare the United States to England or Germany or Italy, it's not an apples to apples comparison. You need to say the United States compared to the eu. That's really the way you need to compare it because literally that's, it's almost like the country of Texas versus the country of California versus the country of Florida. And even within these we have metropolitan mega Cities like New York, you know, like Chicagoland, that really need to be thought of as separate entities within this big, you know, United States of America. And that's the way it's actually playing out in the United States with New Orleans versus Detroit, et cetera. So what's happening right now is the projections from European data have given us the numbers of the mortality rate initially, and we're seeing our numbers come down. Some of the modeling that's saying we have probably 20 fold more people with this disease is showing us maybe having mortality as low as 0.67%. To put that in perspective, the typical flu season has a mortality of 0.1%. So we've seen this mortality come down from 6.7 to 5.4 to 2.8. Virginia's mortality is about 1.8 to 1.9% right now. So we're seeing all these numbers coming down. That's good news. As we learn more about this, as we get more testing, as more people get sick and get well, we're seeing the mortality is not as bad as originally expected. Still not good. You know, a 0.67% mortality is still putting 250 to 400,000 people in our country dying from this, which aligns with Dr. Fauci's estimates from the CDC. So none of this information is out of left field. It's all expected. It's just reassuring that, you know, this is not going to be as bad as originally projected. And that's one of the things about projections and modeling. We talked about that last week about modeling projections. Projections are projections. They change on a daily and weekly basis. The model is as only good as the data you put in. If you put junk data in, you could junk that out. The more information we get, the more quality data we put in, the better the modeling is getting. But still, it's still modeling and evolution. We're still learning. So. But I think the point for me is that these mortality numbers are continuing to come down. California did not get overrun. It actually appears to be controlled in the hospitals. New York City, still a bad situation, but it looks to be capping off there a little bit as well. New Orleans is peaking. It looks like letting Mardi Gras go on without any kind of control was a bad idea in New Orleans. And so we're having a huge up ticking numbers there. Detroit as well, it's having uptick. Those are the new epicenters in the United States. My state of Virginia, as of this morning, we have 2,600 cases. There's been 23,000 tests, about nine tests per case. Our mortality is 1.9%. So ours is lower than the national average. Again, these numbers keep on evolving and getting better. The rest of the world, South Africa, it's just beginning in South Africa and a lot of these poor countries, South America, it's going to be hard to control it in these countries where quarantining is not going to work very well. If someone literally gets the food for the day and the money to buy the food for the day, they can't quarantine for a month. There's concerns about the breakdown society in places, particularly South Africa. So we'll have to see how those countries play out. Our thoughts and prayers are with them. We'll be watching it closely and we'll have to see how we can help as well with that. So what's next? What's next? Well, a lot of these things are cause for anxiety and I'll be talking about that a little bit tomorrow. We need to increase testing. We need to isolate confirmed positives and people related to these exposures. Everybody needs to get their own personal protection equipment. That's going to be a norm at least for the near and coming future. We need some blood testing. We need to find out who these 80% of people are. They're going to get infected and well, so they can go back out into society. How do we reintroduce ourselves to society and work? How do we go back to school? These are all questions we don't quite know yet. At least in Virginia we know there's not going to be school this spring. But other localities still don't quite know what that looks like for them. Currently working on drug development, vaccine development. The vaccines will probably take 12 to 18 months to develop, maybe up to 18 months to get these vaccines and 320 million arms. So again, a lot of unknowns. We're still working through this information. Hopefully this was helpful. Tomorrow we'll be talking about anxiety a little bit and that's it. That was today's update. Hope you all have a great day. Stay informed, stay aware. But we are, we are learning more and it appears that things are starting to turn a little bit. Again, just keep on finding good quality source of information you can trust and rely in getting good information is going to help you deal with anxiety because there's so much spin out there, there's so much misinformation that's just creating lots of anxiety. And hopefully this will be one of a resource for you that you can use to help kind of keep your feet moored in this time of uncertainty. Take care and be safe.