Activism for COVID-19 Local Preparedness

by ebr1 min read1st Mar 202011 comments


COVID-19 pandemic

Would activism to ensure local hospitals and health departments are adequately preparing for COVID-19 be high-leverage?

COVID-19 may infect 40-70 percent of the world's population, per Harvard epidemiology professor Mark Lipsitch. The virus kills roughly one in every one hundred people infected. (See this post by someone who works in biosecurity and this Atlantic article.)

Hospitals and local health departments will need to prepare for the virus. In the United States, that response falls to the local level. Local health systems have substantial work to prepare:

The third lesson is to prepare health systems for what is to come. That entails painstaking logistical planning. Hospitals need supplies of gowns, masks, gloves, oxygen and drugs. They should already be conserving them. They will run short of equipment, including ventilators. They need a scheme for how to set aside wards and floors for covid-19 patients, for how to cope if staff fall ill, and for how to choose between patients if they are overwhelmed. By now, this work should have been done.

There will probably be a variation in preparedness since there isn't a central authority to ensure sufficient readiness (at least in the United States). Given the virus' mortality and potential reach, increasing local preparedness could be a high leverage opportunity.

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COVID-19 may infect 40-70 percent of the world's population.

What is your source for this? This seems way too high given that even in Hubei (population: 58.5 million), only about 1.1 in 1,000 people (total: 67,103) had confirmed cases.

This page collects expert opinions on the spread of COVID-19, and has one quote giving 40-70% and one quote giving 60% (and no other concrete predictions). Marc Lipsitch gave his reasoning for the 40-70% prediction here.

Note that he said "Should have said 40-70% of adults in a situation without effective controls." Based on my observations (reading a large amount of COVID-19 discussions and news stories), I think China, Taiwan, and Singapore have effective controls, South Korea is borderline, and Japan, US, and most of Europe are not likely to have effective controls. (And of course less developed countries almost certainly will not have effective controls.)

ETA: For example:

“We cannot do what China has done here, as that would start a panic, runs on supermarkets and banks, and any contingency measure has a negative effect on businesses and the real economy,” said a senior German government official involved in the crisis management.

Thanks, important info.

The second link is incorrect; should be:

Thanks for reporting the incorrect link. I left off the "https://" (I copied it from my Chrome address bar, which leaves off the protocol if you click on the address bar instead of pressing "alt-d"; very annoying), and it still worked on but not on

Very helpful; thanks!

I've also heard that 40-70% figure (e.g. from German public health officials like the director of Germany's equivalent of the CDC). But I'm confused for the reason you stated. So I'd also appreciate an answer.

Some hypotheses (other than the 40-70% being just wrong) I can think of, though my guess is none of them is right:

(a) The 40-70% are a very long-term figure like risk of life-time infection assuming that the virus becomes permanently endemic.

(b) There being many more undetected than confirmed cases.

(c) The slowdown in new cases in Hubei only being temporary, i.e. expecting it to accelerate again and reaching 40-70% there.

(d) Thinking that the virus will spread more widely outside of Hubei, e.g. because one expects less drastic prevention/mitigation measures. [ETA: This comment seems to point to (d).]

My guess is that this is referencing Harvard School of Public Health's Marc Lipsitch who was quoted projecting this in this article (I think, I'm now paywalled so can't confirm) somewhat out of context and subsequently defended the range in this podcast.

Dr. Lipsitch is well respected in public health and epidemiology communities, FWIW

Thanks! Here's the quote:

Harvard epidemiologist Marc Lipsitch estimates that 40 to 70 percent of the human population could potentially be infected by the virus if it becomes pandemic. Not all of those people would get sick, he noted.

It looks like other users have clarified that figure, but I was referring to a quote by Mark Lipsitch in the Atlantic article I linked to. Thank you for pointing that out.

I'm personally less optimistic about advocacy especially in targeted scientific and medical domains, because I think there's a strong worry that the professionals should do their jobs (especially since they're likely to be overtaxed very soon) and advocates can easily be more harmful than helpful.

I'd feel more optimistic about this if EAs in biosecurity or public health strongly encourage this (though I understand if this isn't politically feasible for them to do so).

I don't know nearly enough about what local hospitals are currently doing, so I have no idea whether it is inadequate and if it is what I could do about it. (Why would they listen to me, a random stranger?) That said, I could be convinced that there is something I could usefully do -- e.g. if someone who works in a hospital comments saying that my local hospital might be unprepared and might listen.