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Markdown lint english resource files #326

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11 changes: 11 additions & 0 deletions _scripts/mdlint-rules.yml
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# For more information about the markdown rules and how to configure them, see:
# https://github.com/DavidAnson/markdownlint/blob/master/doc/Rules.md

comment: Markdown conformance rules for FTC project.
line_length: false
first-line-h1: false # Our md files may not have top level headings, they are fragments.
blanks-around-headers:
lines_above: 0 # Allow for things like {:.do} and such.
no-inline-html:
allowed_elements:
- div
61 changes: 44 additions & 17 deletions _sections/COVID-19/en/05-this-is-not-normal-flu.md
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## This is not a normal flu
**Not even in the best case**
## This is not a normal flu **Not even in the best case**

The World Health Organization estimate of 3.5% mortality rate is an average across age groups.
According to Centers for Disease Control and Prevention director Dr. Robert Redfield, [up to 25% of cases are asymptomatic, and they are infectious.
Covid-19 is likely three times more infectious than flu](https://www.npr.org/sections/health-shots/2020/03/31/824155179/cdc-director-on-models-for-the-months-to-come-this-virus-is-going-to-be-with-us).
Data from Iceland [suggests as many as 50% of cases may be asymptomatic](https://www.cnn.com/2020/04/01/europe/iceland-testing-coronavirus-intl/index.html).
There is very strong consensus that those aged 60+ and those with underlying conditions are the most severely impacted.
The World Health Organization estimate of 3.5% mortality rate is an average across age groups.
According to Centers for Disease Control and Prevention director Dr. Robert Redfield, [up to 25% of
cases are asymptomatic, and they are infectious. Covid-19 is likely three times more infectious
than
flu](https://www.npr.org/sections/health-shots/2020/03/31/824155179/cdc-director-on-models-for-the-months-to-come-this-virus-is-going-to-be-with-us).
Data from Iceland [suggests as many as 50% of cases may be
asymptomatic](https://www.cnn.com/2020/04/01/europe/iceland-testing-coronavirus-intl/index.html).
There is very strong consensus that those aged 60+ and those with underlying conditions are the most
severely impacted.
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@jaysonvirissimo jaysonvirissimo Apr 9, 2020

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What do we think of semantic, rather than merely length-based line breaks? For example, "severely impacted" would still be on line 10, because it is part of the same unit of thought (sentence, in this case). I personally find this style leads to easier to understand GitHub diffs.

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I'd be in favor of that but I think it's also much easier to enforce at the time of writing rather than when we try to make the markdown files compliant.


![Chart showing COVID-19's mortality rate tops at 14.8% on adults over 80 years old, and is less than 1% on people under 50](/images/mortality-rate-by-age.svg)
![Chart showing COVID-19's mortality rate tops at 14.8% on adults over 80 years old, and is less
than 1% on people under 50](/images/mortality-rate-by-age.svg)

Earlier in the pandemic, there was hope that the 3.5 percent figure was grossly overestimated.
However as evidence continues to emerge, there is [dwindling support for that hope](https://www.statnews.com/2020/02/25/new-data-from-china-buttress-fears-about-high-coronavirus-fatality-rate-who-expert-says/).
The numbers out of South Korea are so far the most optimistic in the world ([0.7% cases were fatal](https://twitter.com/marcelsalathe/status/1236914078632812544)); however, a) the South Korean population is younger on average and b) South Korea (in contrast to the USA) have been doing everything right from the earliest stages of the outbreak: they have done massive roll out of testing coupled with radical transparency, public support and [brilliant drive-through testing!](https://twitter.com/cnni/status/1234524871226482688)
If this strain of coronavirus is like other viruses, aggressive measures that reduce transmission may also lower the average ‘dose’ of viral particles that cause any given case; this might reduce the average severity of disease and decrease overall death rates. Time will tell.
However as evidence continues to emerge, there is [dwindling support for that
hope](https://www.statnews.com/2020/02/25/new-data-from-china-buttress-fears-about-high-coronavirus-fatality-rate-who-expert-says/).
The numbers out of South Korea are so far the most optimistic in the world ([0.7% cases were
fatal](https://twitter.com/marcelsalathe/status/1236914078632812544)); however, a) the South Korean
population is younger on average and b) South Korea (in contrast to the USA) have been doing
everything right from the earliest stages of the outbreak: they have done massive roll out of
testing coupled with radical transparency, public support and [brilliant drive-through
testing!](https://twitter.com/cnni/status/1234524871226482688) If this strain of coronavirus is like
other viruses, aggressive measures that reduce transmission may also lower the average ‘dose’ of
viral particles that cause any given case; this might reduce the average severity of disease and
decrease overall death rates. Time will tell.

Moreover, even IF the true Covid-19 mortality rate is as low as 1% ([as it is so far with the Diamond Princess](https://wwwnc.cdc.gov/eid/article/26/6/20-0452_article)), that would already be [ten times higher than the mortality rate of a typical seasonal flu](https://www.bloomberg.com/opinion/articles/2020-03-05/how-bad-is-the-coronavirus-let-s-compare-with-sars-ebola-flu).
Moreover, even IF the true Covid-19 mortality rate is as low as 1% ([as it is so far with the
Diamond Princess](https://wwwnc.cdc.gov/eid/article/26/6/20-0452_article)), that would already be
[ten times higher than the mortality rate of a typical seasonal
flu](https://www.bloomberg.com/opinion/articles/2020-03-05/how-bad-is-the-coronavirus-let-s-compare-with-sars-ebola-flu).

![Bar chart showing COVID-19 mortality rate estimated between 0.5% and 4.0%, versus Seasonal Flu at 0.1%](/images/mortality-rate.svg)
![Bar chart showing COVID-19 mortality rate estimated between 0.5% and 4.0%, versus Seasonal Flu at
0.1%](/images/mortality-rate.svg)

> The 61,099 flu-related deaths in the U.S. during the severe flu season of 2017-2018 amounted to 0.14% of the estimated 44.8 million cases of influenza-like illness.
There were also an estimated 808,129 flu-related hospitalizations, for a rate of 1.8%.
Assume a Covid-19 outbreak of similar size in the U.S., multiply the death and hospitalization estimates by five or 10, and you get some really scary numbers: 300,000 to 600,000 deaths, and [4 million to 8 million hospitalizations in a country that has 924,107 staffed hospital beds](https://www.bloomberg.com/opinion/articles/2020-03-05/how-bad-is-the-coronavirus-let-s-compare-with-sars-ebola-flu) \[for all illnesses combined\].
> The 61,099 flu-related deaths in the U.S. during the severe flu season of 2017-2018 amounted to
> 0.14% of the estimated 44.8 million cases of influenza-like illness.
There were also an estimated 808,129 flu-related hospitalizations, for a rate of 1.8%. Assume a
Covid-19 outbreak of similar size in the U.S., multiply the death and hospitalization estimates by
five or 10, and you get some really scary numbers: 300,000 to 600,000 deaths, and [4 million to 8
million hospitalizations in a country that has 924,107 staffed hospital
beds](https://www.bloomberg.com/opinion/articles/2020-03-05/how-bad-is-the-coronavirus-let-s-compare-with-sars-ebola-flu)
\[for all illnesses combined\].

For most people, infection results in a mild but still transmissible illness; **that is how it spreads.** Those that get severe illness are hit really hard. Mortality is not the full picture: Italy reports that [10% of cases need not just hospitalization but also ICU care](https://twitter.com/marcelsalathe/status/1235662457261023232) -- and they need that care over a period of [3-6 weeks](https://www.washingtonpost.com/health/2020/03/07/how-doctors-treat-sickest-coronavirus-patients/). This is unsustainable.
For most people, infection results in a mild but still transmissible illness; **that is how it
spreads.** Those that get severe illness are hit really hard. Mortality is not the full picture:
Italy reports that [10% of cases need not just hospitalization but also ICU
care](https://twitter.com/marcelsalathe/status/1235662457261023232) -- and they need that care over
a period of [3-6
weeks](https://www.washingtonpost.com/health/2020/03/07/how-doctors-treat-sickest-coronavirus-patients/).
This is unsustainable.
16 changes: 10 additions & 6 deletions _sections/COVID-19/en/06-keep-the-main-thing-the-main-thing.md
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## Keep the main thing the main thing

[**\#FlattenTheCurve**](https://twitter.com/hashtag/FlattenTheCurve?src=hashtag_click)

A lot of ink has been spilled on speculation about the "true" rate; however we are still in the early phase of the pandemic and it could
take years to precisely determine the rate. BUT we know that it is somewhere **between .5% and 4 percent mortality; this range is more than
adequate evidence to warrant decisive, immediate, large-scale preventive action**. Far and away, the most important thing to do is [flatten the
curve of the epidemic](https://www.economist.com/briefing/2020/02/29/covid-19-is-now-in-50-countries-and-things-will-get-worse)
so that our health systems can cope and to give time for the scientists to research vaccines and treatments.
A lot of ink has been spilled on speculation about the "true" rate; however we are still in the
early phase of the pandemic and it could take years to precisely determine the rate. BUT we know
that it is somewhere **between .5% and 4 percent mortality; this range is more than adequate
evidence to warrant decisive, immediate, large-scale preventive action**. Far and away, the most
important thing to do is [flatten the curve of the
epidemic](https://www.economist.com/briefing/2020/02/29/covid-19-is-now-in-50-countries-and-things-will-get-worse)
so that our health systems can cope and to give time for the scientists to research vaccines and
treatments.

![](/images/health-system-capacity.svg)
![Health care system capacity](/images/health-system-capacity.svg)
52 changes: 35 additions & 17 deletions _sections/COVID-19/en/09-relative-to-other-countries.md
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## Relative to other countries, US labor and healthcare policies are a perfect storm for pandemics

- Zero universal guaranteed [paid sick leave](https://www.worldpolicycenter.org/policies/for-how-long-are-workers-guaranteed-paid-sick-leave)
- Even among those \*with\* paid sick leave, the covered time frame is often on the order of days, not the weeks adequate to account for
prolonged illness.
- Zero guaranteed paid family leave to care for sick members
- Zero guaranteed financial or operational support for people who should self-quarantine. [People are therefore ignoring quarantine
because they need to eat.](https://twitter.com/abcnews/status/1236462655012917249)
- Many people are uninsured. Given where things are right now (cryptic transmission and no available vaccine), the insurance companies have
a moral obligation but have no financial incentive to improve testing and ensure access to care.
- In the USA insurance is tied to their employment, so when they get sick they are also vulnerable to bankruptcy. In a pandemic year this is devastating for an economy.
- Zero universal guaranteed [paid sick leave](https://www.worldpolicycenter.org/policies/for-how-long-are-workers-guaranteed-paid-sick-leave)
- Even among those \*with\* paid sick leave, the covered time frame is often on the order of days,
not the weeks adequate to account for prolonged illness.
- Zero guaranteed paid family leave to care for sick members
- Zero guaranteed financial or operational support for people who should self-quarantine.
[People are therefore ignoring quarantine because they need to eat.](https://twitter.com/abcnews/status/1236462655012917249)
- Many people are uninsured. Given where things are right now (cryptic transmission and no
available vaccine), the insurance companies have a moral obligation but have no financial incentive
to improve testing and ensure access to care.
- In the USA insurance is tied to their employment, so when they get sick they are also vulnerable
to bankruptcy. In a pandemic year this is devastating for an economy.

The fact that these safety nets have not previously existed in the US complicates the behaviors required to #flattenthecurve compared to most other countries affected so far. However, legislation passed Friday by the US House of Representatives aims to address some of these critical issues. Namely, the bill will provide enhanced unemployment benefits, free virus testing, and additional funds for food assistance and Medicaid. The bill is reported in the [New York Times](https://www.nytimes.com/2020/03/13/us/politics/trump-coronavirus-relief-congress.html), [CNN](https://www.cnn.com/2020/03/13/politics/coronavirus-relief-congress/index.html) and by other news organizations. Read the text of the bill [here](https://www.cnn.com/2020/03/13/politics/read-bill-text-families-first-coronavirus-response-act/index.html).
The fact that these safety nets have not previously existed in the US complicates the behaviors
required to #flattenthecurve compared to most other countries affected so far. However, legislation
passed Friday by the US House of Representatives aims to address some of these critical issues.
Namely, the bill will provide enhanced unemployment benefits, free virus testing, and additional
funds for food assistance and Medicaid. The bill is reported in the
[New York Times](https://www.nytimes.com/2020/03/13/us/politics/trump-coronavirus-relief-congress.html),
[CNN](https://www.cnn.com/2020/03/13/politics/coronavirus-relief-congress/index.html) and by other
news organizations. Read the text of the bill
[here](https://www.cnn.com/2020/03/13/politics/read-bill-text-families-first-coronavirus-response-act/index.html).

## Global tracking and communication

Doctors worldwide are getting pummeled on the frontlines of this crisis,
the lack of protective equipment is causing them to get infected, and themselves unable to get the care they need. For a personal lens on
this, have a look [here](https://twitter.com/stuff_so/status/1236467114933813248), but this is by no means unique; the accounts are flooding in.
Doctors worldwide are getting pummeled on the frontlines of this crisis, the lack of protective
equipment is causing them to get infected, and themselves unable to get the care they need. For a
personal lens on this, have a look [here](https://twitter.com/stuff_so/status/1236467114933813248),
but this is by no means unique; the accounts are flooding in.

Globally speaking, [authoritarianism can limit pandemic control](https://www.theatlantic.com/technology/archive/2020/02/coronavirus-and-blindness-authoritarianism/606922/) since it can limit the expertise and transparency required for good decisionmaking, to make the best use of resources, and to communicate status to the regional and global citizens.
Examples of this have been seen in China (earliest in the epidemic), and in Iran, Turkey and Russia, which until recently had reported the statistically unrealistic scenario of no cases.
Country-specific US Embassy pages are now reporting cases, for example, the [Russian Embassy](https://ru.usembassy.gov/covid-19-information/).
A number of effective data visualizations and world-wide case tracking are now available, for example at the [Johns Hopkins Coronavirus Resource Center](https://coronavirus.jhu.edu/map.html) and the [New York Times Coronavirus Case Maps](https://www.nytimes.com/interactive/2020/world/coronavirus-maps.html).
Globally speaking,
[authoritarianism can limit pandemic control](https://www.theatlantic.com/technology/archive/2020/02/coronavirus-and-blindness-authoritarianism/606922/)
since it can limit the expertise and transparency required for good decisionmaking, to make the best
use of resources, and to communicate status to the regional and global citizens. Examples of this
have been seen in China (earliest in the epidemic), and in Iran, Turkey and Russia, which until
recently had reported the statistically unrealistic scenario of no cases. Country-specific US
Embassy pages are now reporting cases, for example, the
[Russian Embassy](https://ru.usembassy.gov/covid-19-information/). A number of effective data
visualizations and world-wide case tracking are now available, for example at the
[Johns Hopkins Coronavirus Resource Center](https://coronavirus.jhu.edu/map.html) and the
[New York Times Coronavirus Case Maps](https://www.nytimes.com/interactive/2020/world/coronavirus-maps.html).
19 changes: 9 additions & 10 deletions _sections/act_and_prepare/en/02-do/03-lower-your-overall-risk.md
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are in the acceleration phase. The duration and severity of each phase can vary depending on the characteristics of
the virus and the public health response.*


The United States is a big country, with 50 states, each handling this in a different way. Therefore, community spread
is going to be occurring at different rates in different places. The best thing to do, if not required by your employer, is to stay home until this curve has sufficiently flattened.

- Do not dine out.
- Do not go to the movies - listen to the radio, watch TV, listen to podcasts, do puzzles, play board games, create an in-home disco.
- Do not go to church - use home rituals or streaming services.
- Do not go to work unless you must, and when you return have a routine for coming back so as not to bring the virus into your home.
- Do not go shopping for non-essentials.
- If you get restaurant food delivered, use a service that you can prepay and have the delivery person leave the food on the doorstep. Order well before you want to eat so you can isolate the food for a few hours, then heat it up if needed.
- When you go grocery shopping, wear gloves and isolate your purchases (and your gloves!) in a safe spot for a few hours before unpacking.
- Get outside! But keep walking. Say hi to people, get some social interaction, but get it in passing. Keep physical
distance from others. Don't stop and form groups. Make sure and wave to all the pets being walked.
- Do not dine out.
- Do not go to the movies - listen to the radio, watch TV, listen to podcasts, do puzzles, play board games, create an in-home disco.
- Do not go to church - use home rituals or streaming services.
- Do not go to work unless you must, and when you return have a routine for coming back so as not to bring the virus into your home.
- Do not go shopping for non-essentials.
- If you get restaurant food delivered, use a service that you can prepay and have the delivery person leave the food on the doorstep. Order well before you want to eat so you can isolate the food for a few hours, then heat it up if needed.
- When you go grocery shopping, wear gloves and isolate your purchases (and your gloves!) in a safe spot for a few hours before unpacking.
- Get outside! But keep walking. Say hi to people, get some social interaction, but get it in passing. Keep physical
distance from others. Don't stop and form groups. Make sure and wave to all the pets being walked.
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{:.do.no_toc}
### Cancel all non-essential face-to-face medical appointments

Hospitals are hot spots for transmission; get your vaccinations at a pharmacy rather than at the doctor. Find ways to do your physical therapy at home if possible.
Hospitals are hot spots for transmission; get your vaccinations at a pharmacy rather than at the
doctor. Find ways to do your physical therapy at home if possible.

Telemedicine professionals, this is your time to save the day, for everyone's benefit but especially those in rural areas who are hard hit and without easy access to medical care. https://doxy.me and https://vsee.com/clinic/ provide free HIPAA compliant video platforms for telehealth.
Telemedicine professionals, this is your time to save the day, for everyone's benefit but
especially those in rural areas who are hard hit and without easy access to medical care.
<https://doxy.me> and <https://vsee.com/clinic/> provide free HIPAA compliant video platforms
for telehealth.

JHU is developing resources here for hospital staff and administrators; more info [here](https://www.cbsnews.com/news/coronavirus-containment-dr-jon-lapook-60-minutes-2020-03-08/).
JHU is developing resources here for hospital staff and administrators; more info
[here](https://www.cbsnews.com/news/coronavirus-containment-dr-jon-lapook-60-minutes-2020-03-08/).
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