Is anyone else putting together a DNR or Advance Care Directive?

I'm 69 years old. I have asthma, hypertension and heart failure. After reading a couple of doctors' descriptions of late stage Covid-19, I finally decided to set down my wishes for my partner and doctors. My directive specifies sedation instead of intubation, and includes an "Allow Natural Death" clause. I will also be adding a request for medical assistance in dying if I end up in that state, if that is possible. If not, sedation will have to suffice.

I've lived my life, and I'm quite satisfied with it. I don't want to suffer at the end, and I want to make sure I don't use medical supplies and attention that are needed more urgently by others.

Who else is making such preparations?

US cases have been increasing by 33%/day for the last 3 weeks.

That means the case count is doubling every 2.5 days. The behavior is remarkably consistent since at least March 2, when there were only 105 cases. If that exponential behavior remains in place for just another two weeks, there will be on the order of 2.5 million cases in the USA.

The global All Case Fatality Ratio (including cases that are still active) has gone up to 4.4%, and the Case Fatality Ratio for resolved cases (those who have recovered or died) has risen to 13.9% from 5.6% two weeks ago.

That last number scares the living shit out of me. Unless something really major happens to change the epidemiology of this thing, the USA is looking at an unavoidable human catastrophe that will make the argument over stimulus packages look like playground name-calling.

Keeping up with the numbers

Data comes from https://www.worldometers.info/coronavirus/ as of 4:00 pm March 18 and 11:30 pm March 21

Global data:

March 18: Cases are increasing by over 17,000 per day. Deaths are increasing by almost 1,000 per day.
March 23: Cases are increasing by over 32,000 per day. Deaths are increasing by almost 1,700 per day.

March 18:The "All Case" CFR (Total Cases/Deaths) is 4.1%. The "Closed Case" CFR ((Recoveries+Deaths)/Deaths) is 9.6%
March 23:The "All Case" CFR (Total Cases/Deaths) is 4.25%. The "Closed Case" CFR ((Recoveries+Deaths)/Deaths) is 11.9%

What I call the "All Case" CFR is what Wikipedia calls the preliminary CFR. The Closed Case CFR approximates what Wikipedia calls the "final CFR". The article contains this caution:

Tonight I'm feeling like

Mother Nature has sent us all to our rooms to think about what we've done.

My latest COVID-19 numbers and estimates

Data comes from https://www.worldometers.info/coronavirus/ as of 4:00 pm March 18, 2020.

Global data:

Cases are increasing by over 17,000 per day.
Deaths are increasing by almost 1,000 per day.

The "All Case" CFR, using the data for all cases and deaths is 4.1% It has been climbing continuously for the last month up from 2.8%.

The "Closed Case" CFR using the data for recoveries and deaths is 9.6%, and has been climbing steadily for a week and a half, up from 5.6%.

Projections based on quadratic fits to the month of global data since 19 February, and extended out to April 15 indicates 600,000 cases for a second-order fit (R^2=0.976), and 1.4 million for a tighter third order fit (R^2=0.998).

US Data:

American cases are rising by 1500 per day, but there really isn't enough data yet to be confident of the trends.
Based on data from 1 March, projections indicate between 70,000 and 225,000 cases by April 13.

Every fruit tree benefits from pruning

One month global COVID-19 case load projection with and without Chinese data

The data for this post is taken from https://www.worldometers.info/coronavirus/ retrieved March 16 at 4:00 pm EST.



This graph doesn't address deaths, just the identified cases from Feb 19 to March 16, with projections out to April 16. The projections are all third-order quadratic fits, and the tightness of the fits is given by the R-squared value for each curve. The dividing line between actual and projected cases is the thick line at today's date.

I had previously been plotting both second- and third-order fits, but the current data is diverging further from the second-order fit, resulting in a steadily dropping accuracy. As a result I don't think the second-order fit is useful any more, at least for this dataset. The third-order fits are remarkably tight.

It's clear from the shape of their green line that China has a handle on their spread. To segregate that effect, I plotted the Chinese data separately, and graphed the world data both with and without the Chinese data included. It's evident that the global spread is now being driven by non-Chinese cases. At the moment the major contributors are Italy, Iran, Spain, S. Korea, Germany, France and the USA.

In one month, if social distancing is not effective, the world could have close to one and a half million cases, with almost all of them (1.4 million) outside China.

As of today, the "Total Case" CFR is 4.2%, and the "Closed Case" CFR is 8.3%, based on the reported data for active cases, recovered cases and deaths from the source listed above. It's still early days, of course, but the fatality ratios based on reported data are still climbing.

We're walking (or running?) deeper into the woods

Well, I'm in the grip of dread tonight.

I feel like I just saw the Japanese tsunami 200 meters offshore.

My partner and I are 77 and 69 respectively. She has immune problems, I have asthma and a bum heart. So, we're in isolation. We have enough food and TP for at least a couple of weeks, maybe a couple more if we stretch. We've put strict entry rules in place - mostly for me if I have to go out. I doubt we'll be letting anyone in.

Some of you may know that I've been a long-time doomer. I've been preparing myself psychologically for the end of global industrial civilization for 15 years now. But it still surprised me. I thought it would be climate change that would toll the bell, but I know that major depopulation events are always diseases.

I've been running the numbers and reading epidemiologist reports online tonight, and I'm freaked right the fuck out. This thing is far bigger, way more severe and moving much faster than most people realize, or even could realize. Even than I, with all my practice, could realize. I wouldn't be surprised if, when all is said and done, much will have been said, but we'll all be done.

For example, many of us thought it didn't affect younger people so much. I just saw the demographics of positive cases in China, and 30% of them were 20 to 29 years old. Maybe not symptomatic, but definitely contagious.

My curve plots project over a million cases globally by mid-April, but those are based on diagnosed cases. The word from Harvard and Yale is that for every diagnosed case there are 10 to 50 unknown cases, walking around breathing and touching doorknobs.

To quote Kurtz from Joseph Conrad's "Heart of Darkness", "The horror! The horror!"

Sorry to be a Debbie Downer. I'll make sure to call my aged father in his locked-down retirement home regularly to make up for it.

I just realized that this feels like watching the Japanese tsunami come ashore

Right now the thin, innocuous white like on the horizon is about 200 metres offshore, and we're running for high ground. When it hits, it will sweep all before it.