My journey to understanding Covid-19

In the last 72 hours, I have read a lot about what is needed to flatten the curve. It’s a lot, more than most people understand. We need to take many measures that in normal circumstances would be considered extreme. I stand by that panic is bad, and that it is real – hoarding masks and medical supplies are real and serious problems. Above all, we need to maintain societal order and cohesion. But we are in deep trouble here in Stockholm.

After sharing an infographic three days ago, I got some pushback that I didn’t really understand at first. Two friends thought that I was promoting complacency, while I felt I was promoting attentive but measured proactive behavior. One of them ended up unfriending me over it - even though we basically agreed on the major points. A very strong reaction and a strong signal should not be wasted. This led me down the path of spending eight hours last night getting even more familiar with the data, setting up my pipeline of data so that I could better understand what was happening. I looked at a lot of numbers, graphs, and plots. But what really hit home for me was a series of tweets from the ground, from a hospital in Northern Italy.

This is what I am worried about happening in Stockholm. Doctors having to choose which life to save, letting some people die unattended because they are old or far gone. We can prevent this from happening by flattening the curve and keeping the load on our hospitals from breaking the system.

Countries that are prepared, like South Korea or Hong Kong, manage to keep fatality at 0.5%. When systems get overwhelmed, it is rather 5%. We can prevent 9 out of 10 deaths by being prepared!

This estimate, and much more, came from a very insightful Medium post.

After reading up for the last 24 hours, I came out with a changed understanding of the situation. I think there is no denying it - Covid-19 is going to hit us very badly in the next week or so. Stockholm is likely to be very badly hit by Covid-19. Worse than most cities, by my predictions. In a 2 million people city, we already have around 250 confirmed cases, of the total 500 in Sweden. Out of those 500, only 35 were confirmed a week ago. Community transmission has been confirmed, and today we had our first death.

It is not looking good. It has been a well-known fact for a couple of years that our hospitals in Stockholm are already at full capacity and the regional government passed a budget earlier this year that cut funding further, no joke.

Everything we can do to #flattenthecurve is paramount. And I can now better understand the pushback from those friends 72 hours ago, since they probably felt a lot of frustration towards what they felt was complacency. We should indeed cut back on contact, work from home when we can, practice social distancing, cancel public events and take plenty of other measures in the next couple of weeks.

However, there is also a tone of “blame the incompetent government” and “this useless society that will crumble at the smallest crisis” in the Swedish discourse. This is directly counterproductive. Sowing distrust in public institutions is the last thing we need when we might be about to face a crisis where it is paramount that people get accurate information. You may think they are incompetent, you may think they are wrong, but when your only response to that is to ignore what they say and trust what you read on social media, you are begging for chaos. We need to have faith, not because of authority, but in all of us as a society. We need to improve our cohesion and tune in to a common cause. That’s how we beat this.

I am also truly worried about how the distrust in society and everyone-for-themselves sort of bunker mentality will play out. I think that keeping calm but careful keeps us compassionate, and there are plenty of examples of how a crisis plays out when we lose compassion. The people I was arguing with didn’t rate that risk as high as I do, and that is fair enough. I won’t be smug about it though – the pushback of these two people made me spend another 8 hours looking at the data and reassessing the situation. Having a number of people in a society going very far is pushing the overtone window towards caution, and that is probably a good thing.

So what am I doing this week?

  • Last week I started plans to order 25 liters of ethanol and a liter of glycerol to make large amounts of hand sanitizer to hand out to people around me if stocks keep running out.

  • Started contingency plans for Noden, Blivande, and cancellation of all events I am involved in.

  • Washing my hands whenever I arrive somewhere.

  • Working a lot more from home.

  • Avoiding public transport when I can.

  • Going out less, a lot less.

  • Reading up, spreading the word. Especially making sure that friends and family in risk groups are well informed about the risks and developments.

And because I find it soothing to really understand the data, I have set up my own real-time updated dashboard with calculations that I find relevant to keep track of. If you have any use for it yourself, go ahead. Among other things, I am keeping track of how Sweden is developing in comparison to Italy (disaster), Germany (systems still standing) and South Korea (reversed trend).


Lots of good advice about that is here (as the domain might indicate):

And this study, which to me indicates that an obligation to wear masks in public would be a good thing to try to flatten the curve. It tested also home-made masks and found them effective to a degree that promises an anti-epidemic effect when applied as a population-wide measure. (That avoids resupply issues, as the industry-made masks can be reserved for medical staff.)

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I have also heard of studies that point to:

  • That masks tend to make people touch their faces more
  • That while the enzymes and oils on the skin help agains viruses that make it onto your face, breaking them down. This does not happen if a virus attaches to the mask.

Any thoughts?

My opinion: try not getting caught up in the details too much. Somebody else will argue that masks tend to make people touch their faces less as a part of it is now covered. And then somebody else that transmission via the hand-face self-inoculation route is so far thought to be a lesser concern for this virus, and so on.

Particle masks are made to decrease particle count in the inhaled air, and they properly work for that purpose since decades. Viruses come attache to particles. Not everyone inhaling a single virus gets infected – the viruses have to come in sufficient numbers. So reducing the virus count that somebody is exposed to should always be a good thing to break chains of infection. I really can’t see a compelling reason to the opposite (apart from supply difficulties).

For sure under ordinary circumstances, more studies would be needed to know about the effectiveness of masks worn by the general population. It is quite telling that humanity does not yet know these simple facts, and so we got to make an educated guess …

Overall, I’d not be surprised if we’ll find out eventually that all it takes to stop an epidemic of respiratory disease is contact tracing plus wearing masks at all times. Everyone would just have a pack of 100 FFP3 masks stored at home.


Why don’t you use the ECDC data? Advantage: you get all EU countries covered. Your friends in BE would thank you :slight_smile:

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Because, no programmatic access. Johns Hopkins GitHub repo has a CSV that can live update to the google spreadsheet.

Unless there is a CSV there somewhere with a preserved URL between updates?

OK, but it does not matter, I see that you actually have a lot of extra countries in this sheet.

Just found this Lancet article that basically backs this argument: “Mass masking in the COVID-19 epidemic: people need guidance”. They also argue that masks provide outward protection against an infected mask wearer (true – and for that reason, don’t use FFP2 / FFP3 masks with valve). And they have one more persuading argument why obligatory masking is good:

If everyone puts on a mask in public places, it would help to remove stigmatisation that has hitherto discouraged masking of symptomatic patients in many places.


Just added Belgium with my extra calculations to the sheet!


I agree that blanket condemnation of government is not helpful. But then you don’t have the Trump administration over there. You spend a lifetime growing your own wealth at the expense of others, you get elected on a platform of fear and loathing, you methodically rip out the wiring that allows government to quickly help people, and then come out with a bunch of remedies that don’t directly help anyone. Is it any wonder there is little confidence you are going to do anything actually helpful?

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On the plus side, this pandemic is probably the Black Swan event preventing a second term of Trump …


one possible silver lining.

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many roads lead to Rome ?

What I don’t get is why people are hoarding toilet paper of all things?