Social distancing is the only way to stop the coronavirus(theatlantic.com)
theatlantic.com
Social distancing is the only way to stop the coronavirus
https://www.theatlantic.com/ideas/archive/2020/03/coronavirus-cancel-everything/607675/
77 comments
Note that this is effectively now two septuagenarian candidates. Sanders is at the point where he will not automatically be nominated at a brokered convention if Biden is unable to run.
I'd say I'm in the camp of cancelling everything right now, instead of waiting till the last minute. Seems doing so now would also have less of a social impact.
That said, what I've yet to hear about is what the end game looks like?
Do you cancel everything for a month or two, and then go back to normal? Wouldn't the virus just take hold again? So do we go on a routine monthly quarantine every quarter?
Do we cancel everything until we find a vaccine?
Do we quarantine the "at risk" and actually have everyone else interact even more so that all the healthy people get it quickly and recover to develop immunity?
If anyone knows, I'd be curious, what kind of end game are we looking at here?
That said, what I've yet to hear about is what the end game looks like?
Do you cancel everything for a month or two, and then go back to normal? Wouldn't the virus just take hold again? So do we go on a routine monthly quarantine every quarter?
Do we cancel everything until we find a vaccine?
Do we quarantine the "at risk" and actually have everyone else interact even more so that all the healthy people get it quickly and recover to develop immunity?
If anyone knows, I'd be curious, what kind of end game are we looking at here?
Time is critical. Vaccine research, time for hospital infrastructure to scale and establish procedure, research on novel mitigation methods (is there a particular wavelength of UV that is effective? Can we scale that to millions of handheld devices?), time for orgs working with vulnerable populations to change operations, time to train up additional staff, more spare capacity of areas less impacted to help out situations like Iran instead of worrying so much about their own, will summer give us a tailwind? etc etc. Essentially everyone who is already specialized in this area is getting slammed right now and alleviating their problems will be measured in lives saved.
If they make the test cheap enough, convenient enough, and in sufficient quantity, we can bring everything back online in a low risk manner long before we have a vaccine.
The test has enough false positive rate to make it annoying to use in general population. It's being improved.
The test is already cheap enough. At least, in Europe.
Explained in https://www.flattenthecurve.com/
We cancel large meetings now to reduce the peak and delay it, so the health care system isn't totally overloaded. Eventually, a vaccine.
The total number of people getting sick is not reduced by that.
The drastic measures take in China seem to be working.[1] China had 507 million people in full or partial lockdown at peak. "In the Hubei city of Huanggang, people caught in public without a mask or wandering outside without authorization have to pay a 1,000 yuan ($140) fine, and a fee of 40 yuan a day for two weeks of “forced study” classes, which are conducted in a sports stadium with students seated far apart, Huanggang residents said in interviews." Tracking of travel from phone info. Tracking devices on people's doors. Followup by cops and local Communist Party committees to keep people in line.
New infections in China are dropping rapidly.[2] Restrictions are being slowly lifted and life is returning to normal. Yesterday, the only new infections found outside Wuhan came from people entering China.
There's a good chance China will be mostly back to normal in a month, but with lots of testing to keep infections from getting going again.
[1] http://archive.is/qWmFw [2] https://www.reuters.com/article/us-health-coronavirus-china-...
The drastic measures take in China seem to be working.[1] China had 507 million people in full or partial lockdown at peak. "In the Hubei city of Huanggang, people caught in public without a mask or wandering outside without authorization have to pay a 1,000 yuan ($140) fine, and a fee of 40 yuan a day for two weeks of “forced study” classes, which are conducted in a sports stadium with students seated far apart, Huanggang residents said in interviews." Tracking of travel from phone info. Tracking devices on people's doors. Followup by cops and local Communist Party committees to keep people in line.
New infections in China are dropping rapidly.[2] Restrictions are being slowly lifted and life is returning to normal. Yesterday, the only new infections found outside Wuhan came from people entering China.
There's a good chance China will be mostly back to normal in a month, but with lots of testing to keep infections from getting going again.
[1] http://archive.is/qWmFw [2] https://www.reuters.com/article/us-health-coronavirus-china-...
"The total number of people getting sick is not reduced by that."
Correct, or at least possibly so. But by flattening the curve you can greatly increase then number of people that survive. Entering respiratory distress because of serious case of corona virus in a overburdened hospital is likely to be fatal. Much less so if there's a bed in the pneumonia ward for you.
Also early treatments are showing promise, in particular zinc + the malaria drug.
Correct, or at least possibly so. But by flattening the curve you can greatly increase then number of people that survive. Entering respiratory distress because of serious case of corona virus in a overburdened hospital is likely to be fatal. Much less so if there's a bed in the pneumonia ward for you.
Also early treatments are showing promise, in particular zinc + the malaria drug.
Agree the aim must be to flatten the curve. As for treatments showing promise, please provide source.
From what I've heard from health officials, it'll be at least 6 months before trials can begin on any vaccine, and 12-24 months before it might be available. Is the plan to ask everyone to stay home for the next two years?
As that page says, "Relative to Other Countries, US Labor and Healthcare Policies are a Perfect Storm for Pandemics". Small businesses in Seattle are already closing shop for good, in anticipation of the next month. I'm an hourly worker who depends on people going out, and I have zero upcoming work.
Social Distancing is an excellent short-term plan. It's not an end game.
As that page says, "Relative to Other Countries, US Labor and Healthcare Policies are a Perfect Storm for Pandemics". Small businesses in Seattle are already closing shop for good, in anticipation of the next month. I'm an hourly worker who depends on people going out, and I have zero upcoming work.
Social Distancing is an excellent short-term plan. It's not an end game.
The end game is to develop a vaccine. In the meantime, stop the spreading by quarantine, social distancing, washing hands etc.,
I don't believe that we will be using the current extreme form of "social distancing" for as long as it takes to develop a vaccine. Vaccine could easily be a year and a half out.
I think we will return to a more moderate social distancing, where appropriate, after tests have been deployed and we have a better sense of the actual rates of infection in different regions.
I think we will return to a more moderate social distancing, where appropriate, after tests have been deployed and we have a better sense of the actual rates of infection in different regions.
The current "social distancing" can't continue indefinitely without massive changes. It's not sustainable. Beyond a few weeks, it'll put a lot of people out of work, and the system can't support long-term wide-spread unemployment.
Yes. Testing is ramping up at the moment. I think we'll have a much better idea of actual infection rates and distribution before a few weeks.
Stretch out the initial infection spike until we've rebuilt the iron lung supply is one of the big things.
Well, ventilators anyway. Iron lungs are for a different kind of respiratory issue that isn't occurring with COVID-19.
A simple nasal cannula with oxygen ought to work for most cases. Assuming you need physical help though:
Iron lungs are superior. They avoid throat injury caused by tubes, they allow semi-normal talking and eating (time it right), and they generally make people more comfortable.
We got rid of iron lungs for cost reasons. They are physically huge and heavy. They slow down all patient care that doesn't involve the head.
There is a new device that is even better than an iron lung, but it is extremely uncommon. It operates the same way, but it is in the form of a body-conforming shell (like a turtle) and it has a push-pull action. It even has a button to request coughing, which turns out to be important.
I feel that we ought to somehow pressure hospitals to upgrade. It isn't right that people have to suffer with tubes jammed down their throats when far superior alternatives are available.
Iron lungs are superior. They avoid throat injury caused by tubes, they allow semi-normal talking and eating (time it right), and they generally make people more comfortable.
We got rid of iron lungs for cost reasons. They are physically huge and heavy. They slow down all patient care that doesn't involve the head.
There is a new device that is even better than an iron lung, but it is extremely uncommon. It operates the same way, but it is in the form of a body-conforming shell (like a turtle) and it has a push-pull action. It even has a button to request coughing, which turns out to be important.
I feel that we ought to somehow pressure hospitals to upgrade. It isn't right that people have to suffer with tubes jammed down their throats when far superior alternatives are available.
> They slow down all patient care that doesn't involve the head.
That's an understatement. The entire body is in a pressure vessel and is inaccessible. You can't even easily give medication or draw blood. I wouldn't say iron lungs are "superior"; they're no longer used for good reasons that don't just boil down to cost/bulkiness reasons. Also, modern ventilators aren't that cheap anyway.
That's an understatement. The entire body is in a pressure vessel and is inaccessible. You can't even easily give medication or draw blood. I wouldn't say iron lungs are "superior"; they're no longer used for good reasons that don't just boil down to cost/bulkiness reasons. Also, modern ventilators aren't that cheap anyway.
You easily give medication or draw blood via the head. Air locks and captive gloves (like a glove box) are also workable.
If you were to be the patient, I think you would say iron lungs are "superior". The alternative is tubes jammed down your throat, which is horrible torture. I had a relative who literally chose death over the tubes. He would fight to rip them out, despite knowing that he needed them. Finally the hospital gave in, and now he's dead.
If you were to be the patient, I think you would say iron lungs are "superior". The alternative is tubes jammed down your throat, which is horrible torture. I had a relative who literally chose death over the tubes. He would fight to rip them out, despite knowing that he needed them. Finally the hospital gave in, and now he's dead.
Curtain ventilators and tents are quite commonly used still, they're much less bulky.
However they're a maintenance pain, esp. disinfection.
However they're a maintenance pain, esp. disinfection.
Sure. They're not iron lungs though. No one in the medical profession is seriously calling for the return of iron lungs.
Yeah, you're right. Point being there's less than a thousand sufficient beds according to the last thing I've read and 4ish percent of patients may need one.
Which was just a wham line for me.
Which was just a wham line for me.
That is the only valid reason I can see for all the canceling. Given that a vaccine is 1-2 years out, it is likely to spread through the population regardless. All that canceling does really is slow it down so the healthcare infrastructure has time to adjust.
I also wonder if giving people time to discover and sort out their health problems would save many people. I know more than one person that hasn't gotten a doctors checkup in years.
Neither have I. There'd be no point.
"One large-scale review, published in 2012, found that annual physical exams do nothing to improve a person’s disease and mortality risks" [1], while costing us billions of dollars, and taking doctors' time away from patients who actually need it.
[1]: https://time.com/5095920/annual-physical-exam/
If people have health issues that need treating, then absolutely go see a doctor when you can. If it's simply been a year and they're not in a high-risk population and have no reason to believe anything has changed, then don't bother.
"One large-scale review, published in 2012, found that annual physical exams do nothing to improve a person’s disease and mortality risks" [1], while costing us billions of dollars, and taking doctors' time away from patients who actually need it.
[1]: https://time.com/5095920/annual-physical-exam/
If people have health issues that need treating, then absolutely go see a doctor when you can. If it's simply been a year and they're not in a high-risk population and have no reason to believe anything has changed, then don't bother.
Friend I went in for an annual checkup despite being in apparent perfect health. Blood test results led to some other tests which led to the discovery of precancerous growths early enough to stop things. I’m in my mid 40s with a young family. Be careful with advice like this.
4 week long world wide vacation. only no travelling and you dont get paid for it.
It's not really complicated.
You cancel things until the virus is gone.
Not by a time limit.
You cancel things until the virus is gone.
Not by a time limit.
[deleted]
The purpose of quarantine is not to save lives, the purpose is to expand the power of the state. This virus is a totalitarian dream come true. Agents of the state telling you who you can meet, where you can go, when you can leave the house. Expect the state to draw this one out as long as possible.
There are only two ways to stop the virus: vaccination, and everyone having been in contact with the virus and having built immunity.
Everything else is only trying to slow the spreading. It is not useless though.
And keep in mind that without a vaccine, there is a fair chance for the virus to come back another winter (assuming it stops spreading in the summer).
Everything else is only trying to slow the spreading. It is not useless though.
And keep in mind that without a vaccine, there is a fair chance for the virus to come back another winter (assuming it stops spreading in the summer).
I really don’t believe that washing your hands is the way to stay safe. I don’t touch my eyes, nose, or mouth with dirty hands. I’m not a kid that puts things in my mouth.
But yet, I have always gotten sick during the winters at work, in an office setting. Always.
The only winter where I didn’t get sick, was when I stayed home all winter, and avoided most public contact. And miraculously, I didn’t get sick that season.
So the flu virus or whatever I caught, was likely, always via airborne transmissions. Either I was in the same room as someone that sneezed or coughed, and the virus diffused through the air inside, or it got transmitted through the ventilation system.
Keeping your hands from your eyes, nose, and mouth, is important, but so is the usage of a face mask. If anything, it should at least try to stop or slow down some airborne viruses. And face masks will work better, when everyone is using it, so their germs stay localized to themselves.
But yet, I have always gotten sick during the winters at work, in an office setting. Always.
The only winter where I didn’t get sick, was when I stayed home all winter, and avoided most public contact. And miraculously, I didn’t get sick that season.
So the flu virus or whatever I caught, was likely, always via airborne transmissions. Either I was in the same room as someone that sneezed or coughed, and the virus diffused through the air inside, or it got transmitted through the ventilation system.
Keeping your hands from your eyes, nose, and mouth, is important, but so is the usage of a face mask. If anything, it should at least try to stop or slow down some airborne viruses. And face masks will work better, when everyone is using it, so their germs stay localized to themselves.
Certainly washing hands is not the end of everything, but it cuts about 20% of the total number of transmissions, for flu at least. So it is significant, when you have a pandemic with a virus for which nobody has immunity.
The second point is that the less you have fat on your hand skin, the shorter lived is the virus when it lands on it. That is the rational behind "wash your hands often" messages.
The second point is that the less you have fat on your hand skin, the shorter lived is the virus when it lands on it. That is the rational behind "wash your hands often" messages.
I live in Boston, I'm in my 30's, and I've decided I won't cancel anything. If I get the virus, so what? I firmly believe it's unwarranted panic. I'll enjoy the empty metropolis and remember this event for the rest of my life, like I remember 9/11, the financial crash, and how my parents remember the JFK assassination and the Blizzard of '78. Strange times
EDIT - Let me clarify. If I get the virus, I will quarantine (of course), but I'm not going to prematurely ruin my life in fear of this event, which is in itself not a death sentence - only 0.2% of those under 40 die at worst case https://www.worldometers.info/coronavirus/coronavirus-age-se...
Everyone needs to RELAX
EDIT - Let me clarify. If I get the virus, I will quarantine (of course), but I'm not going to prematurely ruin my life in fear of this event, which is in itself not a death sentence - only 0.2% of those under 40 die at worst case https://www.worldometers.info/coronavirus/coronavirus-age-se...
Everyone needs to RELAX
If you get the virus, you will likely survive, and I hope you do. The point of the cancelling is to slow the spread, to reduce the risk that your parents will get it, or that if they do, the health care system will have enough capacity to care for them. You hope for an empty city? Be patient, Boston might get another big blizzard in your lifetime.
Everything seems normal to me, it's the hyper-connected Twitter / HN / social media that's losing its mind. Everything is mostly the same and I'll keep the economy humming.
> Everything seems normal to me,...
Sounds a lot like "this is fine" when considering the less optimistic death and injury rates are surpassing the flu by multiples of ten.
Sounds a lot like "this is fine" when considering the less optimistic death and injury rates are surpassing the flu by multiples of ten.
Everything is normal now, that's the power of exponentials, things go from normal to crazy very quickly and the more people like you the quicker it gets there.
Everything in China was normal 2 months ago, everything in Italy was normal 2 weeks ago.
Everything in China was normal 2 months ago, everything in Italy was normal 2 weeks ago.
Revisit this in a week or two
> If I get the virus, so what?
You end up passing it along to someone who’s not as fortunate as you, that’s what.
“Cancel everything” isn’t about saving you. It’s about saving all the people around you.
You end up passing it along to someone who’s not as fortunate as you, that’s what.
“Cancel everything” isn’t about saving you. It’s about saving all the people around you.
seibelj(2)
>I'm not going to prematurely ruin my life
>Everyone needs to RELAX
You need to understand how hypocritical this sentiment comes off as. Some people are panicking - however, most people and sources (that I am exposed to) are advocating for responses within the range of reason (and there is room for a range of opinions within the range of reason). If you want to spread reason, support the fight against price gouging and against people who buy far too much bulk supplies. But please don't tell random threads full of people to just generally "relax" in all capital, italic letters, while at the same time throwing out wild hyperbole like "I'm not going to ruin my life". It's a very mixed message.
>Everyone needs to RELAX
You need to understand how hypocritical this sentiment comes off as. Some people are panicking - however, most people and sources (that I am exposed to) are advocating for responses within the range of reason (and there is room for a range of opinions within the range of reason). If you want to spread reason, support the fight against price gouging and against people who buy far too much bulk supplies. But please don't tell random threads full of people to just generally "relax" in all capital, italic letters, while at the same time throwing out wild hyperbole like "I'm not going to ruin my life". It's a very mixed message.
I can go about my day like normal, or I can live in 24/7 fear of getting a virus that has 1/500 chance of killing me (at worst)? Has everyone gone insane? I still believe it's a bad flu, and if I get it I'll follow guidelines, but I'm not going to panic. Just giving a different perspective to the hyperventilating internet culture.
You're incredibly selfishly increasing the risk to everyone else around you, but I get it. I was in the same camp just a few days ago.
One can imagine certain futures where it's actually a good thing for low-risk populations quickly develop an immunity, styming the spread later on.
The low risk populations are actively spreading it and are passing it on to high risk populations bin that case. We'd rather have the disease spread slowly and move some of those infections from now to later so our health system doesn't get overwhelmed, and we'd rather delay as long as possible to get a vaccine developed
Well, lock yourself inside for the next 12 months then.
Hygiene, social distancing, targeted quarantine, etc. There is a spectrum. It's not binary: normies vs hermit prepped.
Having had a compromised immune system I don't wish it on anyone. But hey maybe if more people were casual about these things then they too can learn the hard way.
Having had a compromised immune system I don't wish it on anyone. But hey maybe if more people were casual about these things then they too can learn the hard way.
We might have to if Italy and China are any indication.
Nope - I wash my hands. You want me to self-quarantine already? I'm not going to be afraid of 0.00001% of my state being infected.
Ah, yes, washing your hands. The completely infallible way to prevent the spread of a disease.
I don't want you to be afraid - I want you to minimize the risk that you get coronavirus and become another infection vector, endangering the at-risk populations around you.
I want you to do that because it is the socially responsible thing to do, and it will decrease the chance of someone who is far more at risk of serious complications from the disease catching it.
I don't want you to be afraid - I want you to minimize the risk that you get coronavirus and become another infection vector, endangering the at-risk populations around you.
I want you to do that because it is the socially responsible thing to do, and it will decrease the chance of someone who is far more at risk of serious complications from the disease catching it.
Every disease has its super spreaders, this poster is just a good example of why we should cancel everything and be careful, since there is at least one person out there with no understanding of risk and disease epidemiology. There are likely to be more, and the less chances we give them to put us and vulnerable populations in harm's way, the better. If we knew everyone would react appropriately we wouldn't need drastic action, but this is a perfect example of why we need to act fast.
I took the subway today, and it was about 1/4 full for the time. But everyone there wasn't pulling their hair out in abject terror. Last night my wife and I ate dinner at a Thai restaurant, and it was pretty full. I'm just going with the huge portion of society that doesn't choose to be afraid.
That's good that you're patronizing Asian businesses, a lot of them have been hit hard by people avoiding them due to virus fears.
You do realize that every confirmed case (and fatality) is a lagging indicator, right? Further delayed by the fact that testing is still basically nonexistent.
...and lo' you're going to be one of those dudes who wanders around pregnant women while incubating the measles.
I can't say anything good about this decision of yours.
I can't say anything good about this decision of yours.
The individual risk is low, but the systemic risk is high. Please try to understand that. Health services could be overwhelmed if more than 5% of the population gets infected in a short period of time (at a 5% hospitalization rate).
[deleted]
You will quarantine yourself but will have probably started spreading the virus before you knew you had it.
So everyone on earth should quarantine? That's not the recommendation. You quarantine if you have it, not out of fear.
There are a two options: first is to do social distancing properly and the virus will naturally die out, the other is to "go on as normal" and eventually most people will be infected.
The current low infection rates are because people are changing their behaviour, not because the virus isn't a serious problem. This effort is slightly thwarted by selfish randos who ignore the risks.
The current low infection rates are because people are changing their behaviour, not because the virus isn't a serious problem. This effort is slightly thwarted by selfish randos who ignore the risks.
> There are a two options: first is to do social distancing properly and the virus will naturally die out, the other is to "go on as normal" and eventually most people will be infected.
Will social distancing really work over the long term though? We can't live in caves forever, eventually we have to come out.
Will social distancing really work over the long term though? We can't live in caves forever, eventually we have to come out.
Do you get vaccines? After all, vaccines can have adverse outcomes. The overall mortality rate for mumps is .01%, so why bother inconveniencing yourself if the impact is going to be so negligible?
A German report that came out today indicated that there is significant pre-symptomatic viral shedding. So you could be not showing any symptoms yet unknowingly pass the disease on to the people around you that you care about. This is, of course, not an issue if there are not people around you that you care about...
A German report that came out today indicated that there is significant pre-symptomatic viral shedding. So you could be not showing any symptoms yet unknowingly pass the disease on to the people around you that you care about. This is, of course, not an issue if there are not people around you that you care about...
Odds are pretty high we are headed for the next William Henry Harrison situation.
https://en.wikipedia.org/wiki/William_Henry_Harrison