Here are some thoughts about why I worry about the US:
I have been following the outbreak pretty much non-stop since Jan 20, from well before it was called COVID-19
I have been following the outbreak pretty much non-stop since Jan 20, from well before it was called COVID-19
Six weeks ago, when it started in China, there was a debate about whether this was a smaller or bigger thing than SARS 2003. Anybody looking at the trajectory of cases in China could quickly project that this was much bigger:
Then China took dramatic measures. They essentially shut down the entire economy (except critical industries) from Jan 24 and 20-30 days onwards, and allowed gradual normalization from then:
Why would China shut down huge parts of its economy (like a war-zone), if they were dealing with 'just a new flue'?
Since then:
China has had remarkable success controlling the outbreak, in Hubei, and the rest of the country.
But we have seen significant international outbreaks in Japan, Singapore, Italy, Korea, and Iran. And the list of countries is now up to 75.
China has had remarkable success controlling the outbreak, in Hubei, and the rest of the country.
But we have seen significant international outbreaks in Japan, Singapore, Italy, Korea, and Iran. And the list of countries is now up to 75.
Meanwhile, what was done in the US:
On Jan 31, a 'travel ban' relative to China was put in place.
But since then, we had more than a month of almost no preventive action, and very limited US testing.
On Jan 31, a 'travel ban' relative to China was put in place.
But since then, we had more than a month of almost no preventive action, and very limited US testing.
There has been no restrictions on travel from other hotspots than China (except further restrictions on travel from Iran on Feb 29).
Travellers could come from Italy or Korea without any screening in the airport (such screening is now coming into effect, announced by Pence yesterday), but with a > month lag relative to when the China travel ban was put into effect.
(and I did not even mention all the other countries where they have few reported cases, but do almost no testing, so they could have a massive outbreak we do not know about: Eqypt, India, Indonesia are candidates here; still no restrictions there)
Meanwhile, there has been almost no testing for COVID-19 in the US. As of Feb 29, only 472 tests were done, mostly because the CDC essentially put in place a 'test ban', so that you could only test if you had a connection to China (up to very recently).
We are now seeing fatalities, that have not even been diagnosed at death. This is quite extraordinary and shows how an extreme lack of testing is causing real damage:
How can the US have one of the highest 'statistical' fatality rate in the world? (6/60 =10%!) Because nearly no testing is done for patients with mild symptoms! 
China has gone into a war-like response, and shut the economy down for a month to contain COVID-19. Everybody works from home in Singapore and Hong Kong, to avoid spread. Korea tests >10K per day now, to detect the spread everywhere.
mohw.go.kr/react/al/sal03…
mohw.go.kr/react/al/sal03…
How can we expect to contain the outbreak in the US, with almost no restriction on inbound travel and very limited testing (although the 'test ban' has now finally been lifted).
There is talk about a lot of test kits being on their way to the states. But the CDC has stopped releasing data on how many tests they do (somebody tell me if there are any stats on that after Feb 29). Nobody seem to actually know how what test capacity will be in coming days.
This was a long thread. With only a few of the arguments for why to worry. The outbreak is global, and still out of control in many places. And in the US, almost no proactive action has been taken to stop it. I cannot say I expect good news in coming days and weeks.
