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Liz Specht Mar 6
Replying to @LizSpecht
HCWs are already getting infected even w/ access to full PPE. In the face of PPE limitations this severe, it’s only a matter of time. HCWs will start dropping from the workforce for weeks at a time, leading to a shortage of HCWs that then further compounds both issues above. 20/n
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Liz Specht Mar 6
Replying to @LizSpecht
We could go on and on about thousands of factors – # of ventilators, or even simple things like saline drip bags. You see where this is going. 21/n
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Liz Specht Mar 6
Replying to @LizSpecht
Importantly, I cannot stress this enough: even if I’m wrong – even VERY wrong – about core assumptions like % of severe cases or current case #, it only changes the timeline by days or weeks. This is how exponential growth in an immunologically naïve population works. 22/n
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Liz Specht Mar 6
Replying to @LizSpecht
Undeserved panic does no one any good. But neither does ill-informed complacency. It’s wrong to assuage the public by saying “only 2% will die.” People aren’t adequately grasping the national and global systemic burden wrought by this swift-moving of a disease. 23/n
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Liz Specht Mar 6
Replying to @LizSpecht
I’m an engineer. This is what my mind does all day: I run back-of-the-envelope calculations to try to estimate order-of-magnitude impacts. I’ve been on high alarm about this disease since ~Jan 19 after reading clinical indicators in the first papers emerging from Wuhan. 24/n
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Liz Specht Mar 6
Replying to @LizSpecht
Nothing in the last 6 weeks has dampened my alarm in the slightest. To the contrary, we’re seeing abject refusal of many countries to adequately respond or prepare. Of course some of these estimates will be wrong, even substantially wrong. 25/n
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Liz Specht Mar 6
Replying to @LizSpecht
But I have no reason to think they’ll be orders-of-magnitude wrong. Even if your personal risk of death is very, very low, don’t mock decisions like canceling events or closing workplaces as undue “panic”. 26/n
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Liz Specht Mar 6
Replying to @LizSpecht
These measures are the bare minimum we should be doing to try to shift the peak – to slow the rise in cases so that healthcare systems are less overwhelmed. Each day that we can delay an extra case is a big win for the HC system. 27/n
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Liz Specht Mar 6
Replying to @LizSpecht
And yes, you really should prepare to buckle down for a bit. All services and supply chains will be impacted. Why risk the stress of being ill-prepared? 28/n
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Liz Specht Mar 6
Replying to @LizSpecht
Worst case, I’m massively wrong and you now have a huge bag of rice and black beans to burn through over the next few months and enough Robitussin to trip out. 29/n
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Liz Specht
One more thought: you’ve probably seen multiple respected epidemiologists have estimated that 20-70% of world will be infected within the next year. If you use 6-day doubling rate I mentioned above, we land at ~2-6 billion infected by sometime in July of this year. 30/n
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Liz Specht Mar 6
Replying to @LizSpecht
Obviously I think the doubling time will start to slow once a sizeable fraction of the population has been infected, simply because of herd immunity and a smaller susceptible population. 31/n
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Liz Specht Mar 6
Replying to @LizSpecht
But take the scenarios above (full beds, no PPE, etc, at just 1% of the US population infected) and stretch them out over just a couple extra months. 32/n
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Liz Specht Mar 6
Replying to @LizSpecht
That timeline roughly fits with consensus end-game numbers from these highly esteemed epidemiologists. Again, we’re talking about discrepancies of mere days or weeks one direction or another, but not disagreements in the overall magnitude of the challenge. 33/n
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Liz Specht Mar 6
Replying to @LizSpecht
This is not some hypothetical, fear-mongering, worst-case scenario. This is reality, as far as anyone can tell with the current available data. 34/n
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Liz Specht Mar 6
Replying to @LizSpecht
That’s all for now. Standard disclaimers apply: I’m a PhD biologist but *not* an epidemiologist. Thoughts my own. Yadda yadda. Stay safe out there. /end
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Liz Specht Mar 6
Replying to @trvrb
Addendum: to anyone who found this useful or interesting, highly recommend you follow who actually does modeling and forecasting for a living. This thread is a great place to start:
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Liz Specht Mar 7
Replying to @threadreaderapp
A lot of folks have been requesting a compilation of this thread that they can share with friends and family who don't use Twitter. You can find that here, courtesy of :
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Liz Specht Mar 10
Replying to @statnews
I'm honored that invited me to publish my thread as a slightly more nuanced opinion piece (including new details such as the striking differences in hospital beds per capita btwn US and S Korea). "Simple math offers alarming answers" on :
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Liz Specht Mar 13
Replying to @WIRED
While and infectious diseases have been a passion of mine for ~15 years, 4 years ago I made the leap into bc I feel this is actually the most impactful area for addressing global health. My latest op-ed in explains why.
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Alan Oursland Mar 6
Replying to @LizSpecht
Now run the numbers for 3.4 day doubling.
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Klerkin Mar 6
Replying to @alanou @LizSpecht
Dude, 2^10 is 1024. Just think 10 doublings =1000 times. So 34 days, assuming 3.4 days doubling time, is approximately 1000 times as many. So ~68 days for a million-fold increase. Expect early May for effective saturation w/3.4 days doubling, ~140 days w/7 days doubling time.
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