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This is the full transcription of podcast 'Hidden Forces'.
Coronavirus An Analysis Using Complex Dynamic Systems Theory Yaneer Bar-Yam #Podcast #Transcription #ReadAlong #KnowledgeUnlocked
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Today's episode of Hidden Forces is made possible by listeners like you. For more information about this week's episode or for easy access to related programming, visit our website at hiddenforces.io and subscribe to our free email list. If you listen to the show on your Apple Podcast app, remember you can give us a review. Each review helps more people find the show and join our amazing community. And with that, please enjoy this week's episode. What's up everybody? This is another special episode. I keep calling this episode special because I've gotten so used to putting out weekly content with a lot of prep and time to think about the subject to prepare for the guest. And I've decided that that's really not feasible anymore. Just given what's going on, we're living in the most radical period that I've experienced since 9-11. It feels surreal in much the same way that 9-11 did. It also feels hopeful, I think, in a way because there's a lot of camaraderie. Maybe hopeful is the wrong (1/41)
word. You get this sense of camaraderie that you had after 9-11. Whenever I speak with anyone, and I'm not talking about friends, I mean in a professional way, there's a level of compassion and empathy and concern for the other person that I remember was prevalent after 9-11. This is a lot what this feels like, but it's a difficult thing to try and cover because I like to always feel like I'm providing reliable information. It's difficult for me to vet what's out there because there is so much information. So I've decided to just go with it. My guest for this episode is Professor Yannir Barhyam. I came across Professor Barhyam's work on YouTube. He was actually introduced to me through a friend who had been following his lectures or had been to one of his lectures because he's very close with Naseem Taleb. They actually do lectures together and have been releasing videos on YouTube that you can actually watch dealing with COVID-19. Professor Barhyam has also created a website. He's (2/41)
also the president in case I didn't mention this. He's the president of the New England Complex Systems Institute. So that was a cool thing. We've long time listeners know my affiliation, informal affiliation with the Santa Fe Institute. I was invited to stay there for a period of time in the beginning of Hidden Forces in the first six months or so. I've had on a number of people from SFI, Brian Arthur, Sam Bowles, Geoffrey West, people like that. And complexity science has played a major role in the progression of Hidden Forces. And it's something that I've incorporated into my own models and ways of thinking. So that made me feel comfortable. He also has a website called endcoronavirus.org where he puts out a lot of information about coronavirus, what it is, how businesses should deal with it, guidelines for self-isolation, recommendations for policymakers and stuff like that. You can sign up to his newsletter or to get updates from him and his team. So you should definitely go check (3/41)
that out. I want to find a way to talk about this subject from a human standpoint because it's like I'm sitting here and I'm recording this and I'm like, okay, how do I do this professionally? While at the same time, not dehumanizing what's happening because this is unnerving. It's especially unnerving if you have been following it for months like I have. I think a lot of people have who are on Twitter and many of you will already know who heard my episode with Kyle Bass that I think came out in November. We talked about this. Kyle talked about it. He talked about it in a different context. Talked about it in terms of bioweapons from China. But bioweapons aside, this is a virus that came from China which is now disrupting our lives and our economies. I have friends that have already gotten laid off. I was just speaking with a radiologist friend of mine today who has seen 12 scans of COVID-19 patients in the last 24 hours. If I remember correctly, 11 of those 12 were people between the (4/41)
ages of 30 and 45. I am not a radiologist, but based on what he said, the scans look pretty bad. The idea, he told me that this is just old people is just not true. I also know from another physician friend of mine who sent a patient of his to get tested for COVID-19 at a Northwell clinic in New York City. Northwell is the largest healthcare provider in New York State. They told her that she should expect the results back in eight days. It's really hard to know where we stand with the numbers, with the number of infected, with the number of deaths and how to reconcile those numbers to get some type of mortality rate that actually reflects reality. Case mortality is one thing. The mortality rate among confirmed cases is one thing, but what is the overall mortality rate? Those numbers are still coming in. Someone like Professor Yannir would say that it doesn't matter. It's really bad and we should be doing something about it. I'm not disputing that, but I'm just trying to get a grip on (5/41)
the facts to try and help all of you navigate them. That's my objective now. I've decided to get into this. I've reorganized my schedule. I've canceled a lot of guests that I had booked. I still have an episode tomorrow with Ben Hubbard, the Middle East correspondent for the New York Times, to discuss the Saudi price war and do a deep dive into the kingdom and the rise of Muhammad bin Salman. I think that's relevant, especially for those of you out there who are interested in what's going on in the oil market. The markets have been decimated. It has been a bloodbath. It's actually more acute than 2008. At least that's how I remember it. I mean, what were we down yesterday? 12% I'm recording this on Wednesday, March 18th. I think yesterday we were down 12% or was it the day before? I can't remember. I mean, it's wild and the price of oil has collapsed in part because of Saudi Arabia's commitment to flooding the market, but obviously it's in the face of a giant demand shock and bond (6/41)
yields have been up and down. I mean, I think they were all the way down below 0.4%. And last I checked, they were something like 1.3, 1.2. I mean, don't quote me. I don't spend a lot of time looking at the markets. And that's the other thing. It's kind of... Part of me wants to be on top of everything that's happening, but if I'm on top of everything that's happening, I can't really prepare for any type of conversation. So anyway, I've said enough. This is going to be a work in progress guys trying to figure this out. Right now, I'm committed to the weekly release schedule and the idea is to release extra episodes like this one when I can. I may change that and just start releasing stuff as soon as it gets recorded, but we're all going to kind of figure this out together. So my conversation with Professor Yannir lasts for about 30 or 35 minutes or so. I just recorded it, haven't listened to it yet, and just recording this intro now. So I hope that it's informative. I hope that it (7/41)
provides some type of value for you. And as we move forward, I hope to be able to do more of this, not necessarily or exclusively dealing with the actual virus or the biology of this situation. Dealing with the entire scope of what people are experiencing emotionally, what people are experiencing with work. You know, I think there are really interesting opportunities to do episodes about companies that are thriving in this environment. So we'll see. But I hope all of you stay safe. I hope all of you stay calm and we will get through this one way or the other and it's going to be okay in the end. So please enjoy and always feel free to reach me at DK at hiddenforces.io if you have any thoughts you want to share. I get many emails these days. I can't respond to anywhere near enough of them, but I read all of them. I love hearing from you. And those of you who are interested in supporting the program, you can go to patreon.com slash hiddenforces and you can subscribe to one of our three (8/41)
content tiers or even just support the show with a lower donation if you want. And also please subscribe to our mailing list. I haven't made much use of it in recent years, but I'm going to be doing that in the near future. I can promise you that. So please enjoy everyone and you'll hear from me again soon. Professor Yannir Bariam, welcome to Hidden Forces. Thank you for having me. Well, thank you for coming on the program. So maybe you can give our listeners who may not know you or be familiar with your work. Give us your background, how you got involved in studying COVID-19 and what you want listeners to understand about this virus. So I'm a physicist and I started about 30 years ago working on understanding complex systems. So systems that have many interacting components and the fundamental tool for dealing with this requires kind of mathematics that goes beyond traditional calculus and statistics and is not widely used. And that enables us to think about sudden sharp transitions (9/41)
like boiling water or things like that really require a different kind of mathematics. And that's important for thinking about various real world systems because dependencies actually matter and statistics and correlations are not adequate. So about 15 years ago, one of the topics I started working on over the last number of years was the issue of pandemics. And it started from a very simple model of the effect of long range transportation on pathogen dynamics. And the result of our analysis was that there was a transition like boiling of water that happens as you add more and more transportation. What happens is you go from a situation where you have local extinctions because the pathogen spreads locally to global extinctions as the pathogen is able to spread globally. And that transition is a sharp transition, which means that you're going along adding more flights around the world and you are getting close to that transition and all of a sudden instead of having small local events (10/41)
happening, you have massive global events. And that was a big concern to me. So we started raising the alarm and unfortunately people didn't pay much attention. In 2014, there was the Ebola outbreak in West Africa, which was eventually 10 times as large as a previous Ebola outbreaks. But actually other people were predicting that it was going to be much, much larger. They thought it would go to burnout with 10 million people dead. But I was thinking how one could stop outbreaks. And the idea which comes from complex system science is that you can go to a larger scale. So instead of thinking about individuals as transmitting the disease, you can think about communities as transmitting the disease and you can treat communities as infected. And the trick is then you go into the communities and you detect people that are in the early stages of symptoms and you stop them from transmitting, you isolate them and that's actually what was done. So in West Africa, people created teams in (11/41)
neighborhoods of neighborhood people and they went door to door and they used forehead thermometers to find out when symptoms were present and those people were isolated and that stopped the outbreak. So it went from an exponentially growing, every week, doubling epidemic to dropping like a rock, again, exponentially declining and it disappeared within a few months. So I've since worked on Ebola outbreaks in the Congo, working with the World Health Organization. And again, the strategy of doing community empowerment, really, having the communities be responsible for outbreak response was successful there as well. Or beta important contribution, surely wasn't the only thing, but it was really key to the success. So that brought us to the present. I mean, the Ebola outbreak just stopped. It was going on for a year and a half before eventually this approach was used aggressively and it was stopped. So how does this idea of transportation dynamics relate to network connectivity and how can (12/41)
listeners think about that? So the main thing is that disease transmits through these contacts between people. So people touch each other. They breathe the same air. They touch surfaces that other people touch. Those are all relevant to the coronavirus transmission. Each disease has its own network because of the way it transmits. But that network connects people and the disease transmits through it. If you imagine one person is infected, they infect a few others and then it spreads out across the network and jumps to different places through long range contacts, people traveling. And then the question is, how do you know to evaluate its propagation? And the answer is people characterizing using the multiplier. They characterize it by number, R0, which is the number of people that are infected by a particular person who's infected in that. If it's a mild disease, you can say, hey, we don't care, but if it's a severe disease, you want to stop it. And coronavirus are severe diseases and (13/41)
the social cost is unacceptable. And because it's unacceptable, the stopping of it requires radically pruning the network. And radically pruning the network has two parts. One is the local part because people are strongly connected to each other locally. And one is the long range part that got us in trouble because we connected communities around the world and now we're vulnerable to the outbreak. So if you cut the long range links aggressively, then you can work on killing the outbreak locally by isolating people. This is what was done in China and in South Korea in order to stop it by locking down communities, which basically means having people stay at home so that they can infect each other. But once you do that, you can really smash the outbreak because people don't transmit. So you know you have a solution. You just have to aggressively do it and China did it. They cut transportation around the country and they locked down the area of Wuhan, the Hubei province, in order to (14/41)
prevent any local transmission. And there's an incubation period of a couple of weeks. So after a couple of weeks, basically, they had the outbreak under control and then it's really beyond that. It's just a question of transmission to family members and a little bit of leakage because at the beginning they allowed people to go and get groceries every few days. Later on they stopped that and they went door to door to find all the cases. So they really focused on stopping all possible transmissions. And again, the door to door process, just like we had in West Africa, was an essential part of it and the outbreak stopped. And it was gone within four to five weeks. And basically two of those weeks in most of the country were just waiting until you were really sure that you had no cases. So I definitely want to ask you about a symptomatic transmission and what was done in China and some other countries as well, as well as many other questions. Just to clarify one more point there, when you (15/41)
talk about transportation, is this simply a question of volume and availability of travel and transportation? So more flights, more trains, more cars, is that how we're measuring this? And how does the interconnectivity of the world today measure to where it was, let's say, a hundred years ago with the Spanish flu? So several things. First of all, yes, it's kind of the amount of travel. It's the amount of global travel as opposed to local travel. But the more travel you have, the more connected you are, the more vulnerable to large events. The Spanish flu, even though it was a global event, it spreads comparatively slowly. Here we have the coronavirus over weeks, basically spreading globally. And that affects which diseases are able to travel worldwide. So there is this disease dependence that does matter. But the point is that as you increase the transportation, this transition shifts in terms of the qualities of the disease. If there is a disease that has an incubation period of a (16/41)
year and people are not aware that they have it and they walk around and they transmit it and eventually it gets around the world, then we're all dead. But there are not that many diseases like that. It's very hard for the diseases to sustain themselves. So the point is that within the cataclysm of disease we have, we are now in the domain of risk. And that's key. How unusual is that feature of this novel coronavirus that it is contagious, that it can be transmitted from person to person during this window of possibly up to 14 days without symptoms? Ebola does not transmit before the symptoms start. And the coronavirus is actually not even clear that it does. The parameters of the disease transmission early in the infection are not so clear. And part of the challenge of saying, hey, it transmits before symptoms or doesn't is that symptoms are very mild often in cases. So people can be walking around with a little bit of a sniffle or something or sore throat, whatever it is, a little (17/41)
bit of shortness of breath. And sore throat is not one of the symptoms actually. So I shouldn't have said that. But you know... Is that right? Because that's been reported. The primary symptoms of the coronavirus are fever, cough, and shortness of breath. So sore throat is not actually one of them. And I don't know that that means that it's never a symptoms, but it's not surely one of the primary symptoms. Now the point is that the way the disease works is that there's mild symptoms that can extend for a fairly long time. So you have kind of up to two weeks where you start showing symptoms and then you can have two to three weeks of mild symptoms. And then all of a sudden you have severe symptoms and require ventilation and an ICU. So there are these different stages and the boundary between the no symptoms and the mild symptoms is surely not very sharp. So it's hard to tell whether people are just not noticing or purposefully ignoring or whether there's actual transmission before (18/41)
symptoms start. And that's kind of hard to tell. But regardless, even if there are, you know, whichever it is, it creates some stress on different kinds of approaches. But each of the approaches has some utility. And lockdowns don't care, right? Because if you lock everyone down, regardless of whether they transmit before symptoms or not, they can't transmit to people that they're not near. So that's the advantage of the lockdown. The lockdown is kind of the action of last resort that really guarantees you that you will be able to stop an outbreak. And that's why we need it because we're in that kind of state. The transmission rate is high and people bandy around all kinds of numbers. But it's around three, three to four. Some people say we're at any range for two to five, but the lower numbers are based upon the early part of the transmission in China. And the early part of the transmission in China is based upon just a really few cases that are not sampling the distribution of what's (19/41)
going on. So that's the R not number. That's the R not number, right? That means the number of people that one person can infect when they come in contact with them. That's right. We're going about daily life. The problem is that there is no typical person, right? Someone goes to an event with hundreds of people like in South Korea and all of a sudden you have hundreds of people that have been infected by one person. That's a super spreader event. And hundreds of people being infected compared to a typical number of people that are infected, which is probably in the range of one to two to three, is just a totally different ball game. So that brings us back to this point about exponential growth versus linear growth and... Well, exponential growth can happen without super spreader events. The exponential growth is just this multiplier that, you know, and the easiest way to think about it is not with R not, but just with a multiplier from day to day to day. How many more new cases do you (20/41)
have in the next day than in the previous day? And the number there, people can estimate it variously, but it's at least over 1.3, which means there... And in the US, it's been going up by 32%, 1.32. So every day, you have 32% more new cases. And that has to sink in. It's much faster than Ebola. And the reason for that is because... So this is another question I have for you again, because there's been so many different things thrown out there. How does this get transmitted? Is it through the air? Is it from people touching their face and having touched something that someone else with the virus had touched? How are people getting this virus? Well, let me focus on one thing at a time. Okay, let's talk about the exponential growth. The point is that if you have 1.32, you have seven times as many cases a week from now as today. And you know, it's actually maybe a little bit higher. So let's say it's 10, just for easy numbers. And if you go to 10, it's 10-fold, right? I mean, even 7 is (21/41)
huge, right? So if we have 100 cases today in a week, we have 700 cases. In two weeks, we have 4,900 cases. So 5,000 cases. And that's so fast. People think that it's a small number today. But the point is that all those people have already been infected that are going to show up as infected in a few days. And so if you react today to what's happening today, it's not going to do anything because the reality is much more serious. It's a tip of the iceberg kind of situation. And it's a dynamic tip of the iceberg. So basically every day, the iceberg has gotten bigger in a way that you're seeing more of the iceberg, but then the iceberg has already extended further. So we have this ongoing dynamic where it's getting worse and worse and worse, very fast. So from what I understand, we were at about 10,000 cases or so outside of China around two weeks ago. Well, let's look at China first. China did a lockdown when they had 800 cases. 800 cases. And because when they locked down, there were (22/41)
already so many people that were infected. And there's also the course of the disease, right? So people are becoming infected over time. They're infected with their family members. Maybe there are a few other people that are infected in hospital systems and someone might go into the supermarket even though they were locked down. The number of cases they had eventually altogether was 80,000 cases. Right. These are reported cases to be clear, especially the initial ones, which were probably drastically under measured. Right. But the 80,000 cases that they eventually had led to such hospital overcrowding with 10% of people end up on ventilators. So you had about 8,000 people on ventilators and you had an additional 8,000 people that had to be hospitalized. So 20,000 total were hospitalized. And then they built hospitals. They had 14 temporary hospitals, 14 for different stages, you know, mild, moderate, severe and on ventilators. And they sent 42,000 healthcare workers from all parts of (23/41)
China. And they were overwhelmed, overwhelmed. And yesterday, after, you know, now they're down to one case that wasn't, you know, an imported traveler. And they sent all of those people home. And you have to understand that many of the cases that are in hospitals take a long time to resolve, weeks to resolve. So even though they don't have any new cases, there are still thousands of people that are in hospitals being treated now. But today or yesterday, we already had about 2,400 cases in New York state. Well, I know from speaking with physicians at ER rooms here in New York and New York Presbyterian and other hospitals, they've started to see those numbers begin to move up in a very noticeable way in the ER. And a lot of, I was actually just speaking with a radiologist about an hour ago who has seen, I think, in the last day, an additional 12 scans of people coming in with coronavirus. And one of the interesting things that he had to say was that all of these were between the age of (24/41)
30 and 45, with the exception of one patient who was 63. And all of them had significant signs of pneumonia in the lungs. Yeah. So it isn't even something that's just for old people. No. People think that this is just old people. But over 50, you have a much higher chance of dying. And young people get it too and die too. It's not going to let people, people don't have a free pass. It's a very severe disease. People are just not getting it. So imagine that we have 2,400 cases in New York state. The population of New York state is one in 75 of China. We're China has 1.4 billion people. How many people are in New York state? I think it's 20 million the number. Yeah, that sounds about right. 20 million people. So we have 2,400 cases in New York state for a population of 20 million. 2,400 cases means that we're going to go to 240,000 cases. So that was one of the things I wanted to ask you. There are a couple of things that come up. Again, to your point about these are complex systems. (25/41)
China is a very dense country. It's a densely populated country. New York state is also very densely populated. And New York city is particularly densely populated. Both China and the United States did a poor job in the beginning of really monitoring this. I don't know who was worse. I would imagine China was worse. No. China did a poor job until they had 800 cases. And the US had all of this time. We saw what happened in China. We saw what happened in South Korea. We had a month, at least, more like two months to prepare for this. And we did nothing. We waited until we had local transmission before we did testing for this. We don't have the capacity to even test enough in order to see where the cases are. Worse than that, we waited until after we had 800 cases. I mean, even if we had 800 cases in the whole country, I mean, this country only has 350 million people compared to China. It's one quarter of China. Why would you wait until you're going to have 80,000 cases? And now we're (26/41)
going to have over 200,000 cases in New York state. And we have over 6,000 cases in the US. Now, today, it's going to be over 7,000, because we still haven't done anything. Well, to your point, I spoke with a physician yesterday whose patient went to the New York state's largest healthcare provider, Northwell, and was told that she wouldn't get her test results for eight days. Now, maybe this is also a good sign in the sense that they're getting backed up because people are actually doing testing. No, no, no, it's crazy. You don't understand. This is insane. The situation, and I mean, you can look for discussions of this online. The fact that we can't do testing is crazy. South Korea set it up so that they could do a lot of testing, and they used it to identify who was sick and isolated them. We don't have that possibility in this country. We're so far behind in terms of testing. So I want to ask you about both South Korea and Italy, maybe compare those two countries. Before I do, I (27/41)
was going to mention that from the numbers I've seen, and again, it's hard to get. I've relied mainly on Johns Hopkins and the World Health Organization. We were at roughly 10,000 cases outside China about two weeks ago. We're over 100,000 today. What do you think that we should see in the next two weeks? Because based on your numbers, it would sound like over a million. Why are you worried about that? Well, no, I'm not worried. So the reason I'm asking about this is because I think that one of the things that is very challenging for people is to understand how the growth happens. I think a lot of people look around. Right, so I think for people, it's hard to get that around their head. And so maybe giving people a sense of where the official numbers would be in two weeks from now, just based on the current growth trajectory. Well, the problem is that we don't yet know how people are going to act. If today, we lock down everybody in the country, and I really mean it. I'm not joking. So (28/41)
what does that mean, a lockdown? If we lock down everyone in the country, then we will have in this country over half a million cases, over half a million cases. And the hospital system will be over flooded. It will be indeed like Italy and much worse. We will have half a million cases if we lock everyone down now. And what lockdown looks like is everyone stays at home. They're not in contact with anybody else. The only thing that we're going to be able to do is do essential services, getting people food and medicines and basic necessities. So people can't even go out to get their own food in this type of scenario. It has to be delivered. Well, the way it was done in China early on is that people were allowed once every three days to go to the supermarket to pick up groceries. Later on, they didn't even allow that because they enabled delivery to take place. And the best thing is, again, to take every precaution. So the point is that we have to go to extreme. We have to go to the not (29/41)
normal. We have to figure out how to stop the outbreak by action because we're in no position to identify who's sick and who's not. The people around who have been identified as being sick, it's only about one in a hundred, maybe one in 30 of the people who are actually sick because we're not testing. I mean, there are these people, of course, that won't test positive because they're early in the infectious period. They're just been infected. So they don't have symptoms. They won't test positive yet. So that's a factor of about 10, let's say. And then there's another factor of about three or 10 because we're not doing enough testing. So somewhere between 30 and 100 more cases than what we see. And that's what's going to happen. I think that's one of the most unnerving things about this virus. The number of people that are asymptomatic that haven't developed symptoms yet, but will develop them who are infected. I think that's one of the most unnerving things. The basic thing is that we (30/41)
have this wrecking ball that's headed towards us. And as long as people are saying, hey, it's not that bad. And maybe if we wash hands, it'll be all right. It's like putting a tissue in front of you in order to stop the wrecking ball. And Italy did that. Italy showed us by example. And honestly, the fact that we waited for Italy to show it to us after China did what they did is pretty crazy. But Italy was in a situation in Italy. Italy, what they did is at first they started to shut down the north. But then they kind of said, well, hey, you know, maybe if we don't test, we won't notice that the cases are there and everything will be OK. And they waited until the hospitals got overloaded before they did anything. So now every day there are 3,000 new cases and they're out of hospital beds. So all of those hospital beds are taken. And remember that it takes a few weeks for people to heal, to cure, even if they do cure. Some of them, many of them will die. So what do you do when you run (31/41)
out of hospital beds and you have 3,000 new cases? Now, not all of those cases are severe, but say 20% of them are, 600. So you have 600 people showing up to hospital and you have zero new hospital beds. And that's going to happen today. It's going to happen tomorrow. It's going to happen the next day. It's going to happen the next day. So I mean, this is not a fantasy. This is not a joke. People are dying because there aren't any ventilators in Italy. So let's talk about that also because in terms of information, on your website I pulled some information. I've also heard you talk about this. You've said, and your organization has put out that about 20% of coronavirus cases. This is not a number that we invented. The number is, I mean, you can look in articles, some people say it's as much as 30%. This is just a medical piece of information. Well, okay. I guess my point is that, again, there's all this different information out there and I'm just trying to get a picture. No, no, this (32/41)
is not ambiguous. I mean, you have to understand why does anybody think that the fact that the Chinese locked down Wuhan and had to build 14 hospitals is somehow something that is not going to happen here. The fact that Italy is having all of these hospitals overloaded and the doctors are reporting, hey, you guys don't know what's going to hit you. It's going to hit you. This is not a make-believe situation. So I guess two questions. One, what is the best resource for people who want to become informed on what we're dealing with with respect to this virus? And two, what does your organization suggest? Well, how do you propose that governments, because again, going back to this point about complexity and systems thinking, this is not something that individuals can resolve on their own. Yes, individuals can take individual measures, but this has to be a collective response. So how do you think that people should respond and government should respond? And where can people find the best (33/41)
information on this? So first of all, so we have been trying to put out solid information two and a half weeks ago, when people clearly didn't get it in the West, in Europe, in the US about what was coming. I send out a call for volunteers and we now have about 3,000 volunteers. And the face of the organization that was created is on a website called EndCoronavirus. That's ENDcoronavirus.org. And there's a possibility of volunteering there for those who want to join. But the main thing is it has information and you can go and look at it. I mean, there are many other sources of good information, but obviously there's a lot of confusion because there are many sources of bad information as well. But people are beginning to get it. And in terms of action, yes, government should act great, but we don't have to wait for them. Everyone can protect themselves. They can protect their families. They can help their friends to protect themselves. And in a few days, when the hospitals become (34/41)
overloaded, the government is going to act. It should have acted two weeks ago or maybe a month ago, but they didn't. But it doesn't mean that you have to wait for them in order to act. And if you protect yourself for a few days and the government acts, then you'll be safe. You'll reduce the transmission so fewer people will get sick, including perhaps you. And when they do act, when the hospitals become overloaded, you'll be able to sit back and say, I did it first. And then everyone else will have a higher probability of being sick. But eventually it'll be taken care of. I do believe that once the hospital become overloaded, people will act. That's what happened in Italy. And I do think that that's what will happen here. And what does an overloaded hospital look like? Again, I really described it. There's only so many ventilators. I mean, we just don't have the capacity to deal with a huge number of patients that need their lungs, you know, the pump of air in order to survive. It's a (35/41)
terrible horrendous situation because the death rate is going to go from about 4% to about 10%. And the doctors, and this is what they're doing in Italy, they're doing military triage. Yeah. Well, I think for listeners who are curious, the New York Times Daily did an excellent interview with the physician from Bergamo, Italy, a hospital there with approximately a thousand patient beds. And they converted the surgery wards into areas for coronavirus patients. And they now have 50% of their hospital beds allocated towards coronavirus. They've had to send 650 nurses home who are sick, either with corona or something else, or just exhaustion. They're treating their own physicians as well at the hospital. And they have exactly, I just had to make choices about who to save and who not to save. And it's become very clear that that is where we're headed. And I guess the question is, at what point will governments, local, federal, state, how will they coordinate? And at what point will they put (36/41)
in these types of lockdown procedures that you're describing? And you think it's simply an inevitability in your point of view. And the answer is, the more we act, whether it's to save ourselves or to tell other people that action is needed, the more likely it is that people will act. So that's what we're doing. So in closing, Professor, what advice would you like to give listeners who are either individuals or people who are in positions to actually do something at the state, local, or federal level? And also businesses. Every business has the ability to safeguard their employees, their customers by taking action. We have put out guides on the website, the endcoronavirus.org website, trying to explain to people how to create safety for themselves, their families, improve the safety of other people around them, as well as guides for government, for business, and so on. And the main thing to understand, and this goes back to your question about transmission that we didn't quite talk (37/41)
about, is that the disease transmits basically in two ways. The first is by breathing in or by sharing air with people who have the disease. You have to be over six feet away from others in order not to catch the disease. And even then, you don't want to do that for a long time. And the other thing is that that breathing out or sneezing or whatever happens, that even just breathing out of the virus from your lungs, it falls onto every surface around. So if you touch a surface where other people have either touched or breathed on, the virus there will go onto your hands. And so it's a good idea to wash it, but one way or another, you touch it and you're likely to get sick from it. So you have to be careful about surfaces that are public or shared surfaces. So don't go or don't touch, use gloves and don't touch the gloves to yourself. But bottom line, don't touch things that are in public spaces, surfaces in public spaces or in shared spaces. And don't be near anybody that has any (38/41)
possibility of being infected. So what you want to do is you want to self isolate as if you're in a quarantine. You self isolate you and whoever you choose to be with during this period of time. And everyone who is together has to agree that they will follow the rules about, you know, not being in touch with anybody else except for the people who are in the group. Physical touch. You can always do FaceTime and phone calls and text people, but the physical contact is where you can't go. Professor, I appreciate you taking the time to speak with me today. And again, you want to give our listeners your website so they can check it out if they're interested and maybe subscribe to your mailing list. Sure. It's end-en-d-coronavirus.org. And there is a sign up. We have a few thousand people on a technical channel called Slack channel where people can collaborate and work together on all kinds of projects. And they're working on both on trying to influence decisions. But they're also working on (39/41)
ways to mitigate, you know, to help with the shortages that are going to happen in hospitals and all kinds of other things. So we're doing what we can. And it would be great if you join us. And aside from that, soon we'll have other ways people can collaborate that are in addition to the Slack channel. So look forward to people helping and making this work. All right. Well, thank you very much for being on the program. Take care. Today's episode of Hidden Forces was recorded at Creative Media Design Studio in New York City. For more information about this week's episode or if you want easy access to related programming, visit our website at hiddenforces.io and subscribe to our free email list. If you want access to overtime segments, episode transcripts and show rundowns full of links and detailed information related to each and every episode, check out our premium subscription available through the Hidden Forces website or through our Patreon page at patreon.com. Today's episode was (40/41)
produced by me and edited by Stylianos Nicolaou. For more episodes, you can check out our website at hiddenforces.io. Join the conversation at Facebook, Twitter and Instagram at Hidden Forces Pod or send me an email at dk at hiddenforces.io. As always, thanks for listening. We'll see you next week. (41/41)