State projections for Covid-19(covidactnow.org)
covidactnow.org
State projections for Covid-19
http://covidactnow.org
270 comments
Garcetti, the Mayor of Los Angeles, covered this in his address last night.
We are buying time to get more tests, more hospital beds set up, more ventilators, more medicine. The Navy is talking about turning Aircraft Carriers into hospitals. China is getting things under control and switching factories to produce medical supplies. It takes time to build these logistics chains, and we are buying that time by slowing our economy down and implementing social distancing.
I agree that this information is not well-circulated right now.
EDIT: another commenter posted this great link which I will also share: https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-th...
We are buying time to get more tests, more hospital beds set up, more ventilators, more medicine. The Navy is talking about turning Aircraft Carriers into hospitals. China is getting things under control and switching factories to produce medical supplies. It takes time to build these logistics chains, and we are buying that time by slowing our economy down and implementing social distancing.
I agree that this information is not well-circulated right now.
EDIT: another commenter posted this great link which I will also share: https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-th...
Thank you for this resource. Incredibly well researched and presented.
Those are linear increases for an exponential disease. The time-buying has to be for something new that battles the exponential: rushing a vaccine, finding an anti-viral, or figuring out how we can actually practice containment. (Testing availability is part of that, but we'd also need a tracking system.)
Replenishing the supply of masks, handing them out, and making them mandatory to wear in public places would go a long way to reducing the rate of spread, simply by changing people's behavior. I went out Tuesday for some errands (wearing a respirator of course), and it seemed to be business as usual for most people - very little distancing or concern about crowding.
A respiration device is complete overkill unless you are medically examining the person or in a confined space with people and highly vulnerable.
Catching a Corina virus with less than 15 minutes personal contact is very unlikely and it's extraordinary unlikely to be able to acquire a virion and get it to a host cell just walking past an infected perso on the street.
It's not even clear how infectious the surface to face vector is.
Italians and Spaniards running around kissing each other and rubbing cheeks as is their ancient custom likely has more to do with the issues there than anything
Catching a Corina virus with less than 15 minutes personal contact is very unlikely and it's extraordinary unlikely to be able to acquire a virion and get it to a host cell just walking past an infected perso on the street.
It's not even clear how infectious the surface to face vector is.
Italians and Spaniards running around kissing each other and rubbing cheeks as is their ancient custom likely has more to do with the issues there than anything
Absolutely on board with both increasing availability and then making them mandatory. Along with gloves.
Masks are very hard to come by... that might be why it looks like business as usual? I'd love to get some myself, tips appreciated.
Masks are very hard to come by... that might be why it looks like business as usual? I'd love to get some myself, tips appreciated.
My years in cleanrooms and a postdoc in a shared appointment in biochemistry have taught me to see gloves as contamination distributors.
It's literally not okay to be wearing gloves in a chemistry/biochemistry building when you push an elevator button.
It's literally not okay to be wearing gloves in a chemistry/biochemistry building when you push an elevator button.
Yes, of course you remove and trash gloves to avoid contamination. I did biochemistry for years. We wore gloves to protect proteins in samples from our proteases, and to protect ourselves from radionuclides. When I labeled stuff with mCi levels of I-125, I worked in a fume hood, behind lead bricks, wearing a lead apron, and three layers of PVC gloves.
But I always tossed the gloves before leaving the work area. And usually I'd put on fresh gloves before removing the lead apron.
That wouldn't be workable day to day. You'd probably go through 50-100 gloves per day, doing it right.
But I always tossed the gloves before leaving the work area. And usually I'd put on fresh gloves before removing the lead apron.
That wouldn't be workable day to day. You'd probably go through 50-100 gloves per day, doing it right.
I worked in biotech manufacturing with biohazards. 50-100 gloves/person/10hr day is about right.
Presumably that doesn't mean people forgo gloves in the lab though, right? The point is you get them dirty, and then you take them off.
You don't just "take them off". You carefully pull them off, inside out. And then dispose of them, as hazardous waste.
I wore a p95 (similar in performance to the n95) today while shopping. I'm in the Midwest, and the number of looks made me think I had two heads.
My daughter is also sewing cloth mask using a pattern from https://www.craftpassion.com/face-mask-sewing-pattern/
I know these aren't as good, but they probably improve my chances of avoiding SARS-CoV-2 by at least 10% when I have to go outside. I plan on using them once, then leaving them in a bucket in the garage. Once I've used them all up, I'll wash them and by that time (and hopefully the detergent + bleach action), the virus will be dead.
My daughter is also sewing cloth mask using a pattern from https://www.craftpassion.com/face-mask-sewing-pattern/
I know these aren't as good, but they probably improve my chances of avoiding SARS-CoV-2 by at least 10% when I have to go outside. I plan on using them once, then leaving them in a bucket in the garage. Once I've used them all up, I'll wash them and by that time (and hopefully the detergent + bleach action), the virus will be dead.
> I know these aren't as good, but they probably improve my chances of avoiding SARS-CoV-2 by at least 10%
It's no better than avoiding personal contact generally.
It's no better than avoiding personal contact generally.
Not everyone can avoid personal contact. Eventually you'll need to interact to some degree with others when getting groceries etc.
https://smartairfilters.com/en/blog/best-materials-make-diy-...
https://smartairfilters.com/en/blog/best-materials-make-diy-...
> Eventually you'll need to interact to some degree with others when getting groceries etc.
The main risk when getting groceries, unless people are coughing or sneezing in your face, is transfers from your hands, which a surgical or n95/r95/p95 mask does roughly zero to help with. (Now, getting everyone else to wear such a mask would reduce the odds of them contaminating something that would get on your hands, but that's not a benefit of you wearing mask.)
The main risk when getting groceries, unless people are coughing or sneezing in your face, is transfers from your hands, which a surgical or n95/r95/p95 mask does roughly zero to help with. (Now, getting everyone else to wear such a mask would reduce the odds of them contaminating something that would get on your hands, but that's not a benefit of you wearing mask.)
I disagree with gloves. Gloves may serve as a psychological signal, and they can be put on and taken off, but I haven't heard of hands being an infection route.
Several states fairly recently passed laws requiring food preparers to wear gloves. Then they backtracked when they realized that they actually decreased safety.
Several states fairly recently passed laws requiring food preparers to wear gloves. Then they backtracked when they realized that they actually decreased safety.
Hands are absolutely an infection route, by acting as a transport vehicle to your nose and eyes. Gloves don't change that fact though, unless it reminds you to not touch your face. (It does to me: I work with gloves and epoxy resin a lot, and I've developed a pretty strong reflex to not touch myself with gloved hands even though I do it all the time with bare hands.)
It was on NBC news two nights ago that the virus does not infect you through eyes or blood. It can only infect and replicate in the lungs. So only nose and mouth if that report was correct.
I have no idea whether this particular virus can survive contact with tears and make the journey, but your eyes drain into your nose.
[deleted]
A mask does far more, comparatively, used by high-exposure or critical-service workers: medical staff and responders, retail workers. Those highly exposed and hard to replace.
For the average person, a mask likely is an individual benefit. But in a world with insufficient masks and asymmetric risks, social benefit, literally the health of the public, benefits most by limited and targeted use.
Distinguishing between personal and communal risk is critical here. That message has been poorly conveyed, even by ordinarily excellent communicators -- Zynep Tufekci comes to mind.
For the average person, a mask likely is an individual benefit. But in a world with insufficient masks and asymmetric risks, social benefit, literally the health of the public, benefits most by limited and targeted use.
Distinguishing between personal and communal risk is critical here. That message has been poorly conveyed, even by ordinarily excellent communicators -- Zynep Tufekci comes to mind.
Yes, but fundamentally that's still just bargaining with the problem. If spread is supercritical, the hospitals fill up regardless of how protected healthcare workers are.
My comment was in the context of "what can time fix", which would mean supplying healthcare workers and everybody else with masks before letting up. Retail workers wearing masks would go a long way to creating some peer pressure to act differently.
My comment was in the context of "what can time fix", which would mean supplying healthcare workers and everybody else with masks before letting up. Retail workers wearing masks would go a long way to creating some peer pressure to act differently.
Please write to your political and opinion leaders to advocate this. If you need supporting evidence please consider my letter https://news.ycombinator.com/item?id=22641943
Are you saying the masks are helpful to prevent contraction of the virus, or to stop the spreading of it from those who are contagious, but don't know about it yet?
There is a very succinct explanation by Michael Osterholm [1][2] where he says that the virus is spread both by droplets & aerosols, and that sharing the same air with another person is the primary vector (that isn't intended to sound as alarmist as it probably does).
From what I understand the best prevention is to reduce face-to-face contact with other people where possible, but an N95 mask would definitely help prevent contraction in public spaces.
Of course, these measures seem extreme since ~80% of people will barely notice they are infected / have mild symptoms, but it's all about peak-load reduction.
[1]: https://www.youtube.com/watch?v=V1xBiBVH7U4 [2]: https://www.youtube.com/watch?v=E3URhJx0NSw&t=7s
From what I understand the best prevention is to reduce face-to-face contact with other people where possible, but an N95 mask would definitely help prevent contraction in public spaces.
Of course, these measures seem extreme since ~80% of people will barely notice they are infected / have mild symptoms, but it's all about peak-load reduction.
[1]: https://www.youtube.com/watch?v=V1xBiBVH7U4 [2]: https://www.youtube.com/watch?v=E3URhJx0NSw&t=7s
They do both. But I was saying that at the very least masks would also remind people to actually keep distance from one another.
Wearing a mask to prevent contracting it is like wearing medieval platemail to protect yourself against an M16.
It gives you very limited protection. There's no replacement for just avoiding people, 15 feet away from everyone.
They're mainly good for people who are infected to not transmit pathogens.
When doctors operate on infectious people, they wear hazmat suits. Full face mask, air filter and body condom. You can get a virus through your ears, eyes, mouth, nose, or microabrasions on your skin.
You can wear a mask, but I fear that people will start thinking it's anywhere near full protection. False sense of security is probably not worth even encouraging in a situation this dire.
It gives you very limited protection. There's no replacement for just avoiding people, 15 feet away from everyone.
They're mainly good for people who are infected to not transmit pathogens.
When doctors operate on infectious people, they wear hazmat suits. Full face mask, air filter and body condom. You can get a virus through your ears, eyes, mouth, nose, or microabrasions on your skin.
You can wear a mask, but I fear that people will start thinking it's anywhere near full protection. False sense of security is probably not worth even encouraging in a situation this dire.
Masks definitely helpful to stop spreading it from those who are contagious. If they help prevent contracting it depends a lot on how disciplined you are at using them. If fiddling with a mask, you're more likely to contaminate it and yourself.
They’re helpful for both, but even if they were only helpful for one, it’d still be worth doing.
[deleted]
Those things are happening too. Here's a summary of sixteen companies' efforts according to https://www.statnews.com/2020/03/19/an-updated-guide-to-the-...
- Gilead Sciences; remdesivir for treatment; currently in phase 3 clinical trials
- Ascletis Pharma; danoprevir/ritonavir for treatment; currently in phase 1 clinical trials
- Moderna Therapeutics; mRNA vaccine; currently in phase 1 clinical trials
- CanSino Biologics; attenuated vaccine; currently in phase 1 clinical trials
- Arcturus Therapeutics; hybrid RNA vaccine; currently preclinical
- BioNTech; mRNA vaccine; currently preclinical
- CureVac; mRNA vaccine; currently preclinical
- Eli Lilly; isolated antibody treatment; currently preclinical
- GlaxoSmithKline; vaccine adjuvants; currently preclinical
- Inovio Pharmaceuticals; DNA-based vaccine; currently preclinical
- Johnson & Johnson; attenuated vaccine; currently preclinical
- Pfizer; assistance with both vaccines and treatments
- Regeneron Pharmaceuticals; engineered antibody treatment; currently preclinical
- Sanofi; hybrid DNA-based attentuated virus vaccine; currently preclinical
- Takeda; isolated antibody treatment; currently preclinical
- Vir Biotechnology; isolated antibody treatment; currently preclinical
Most of these are in very early stages, but I'm optimistic that that speed of development of both treatments and vaccines will exceed the consensus expectations.
- Gilead Sciences; remdesivir for treatment; currently in phase 3 clinical trials
- Ascletis Pharma; danoprevir/ritonavir for treatment; currently in phase 1 clinical trials
- Moderna Therapeutics; mRNA vaccine; currently in phase 1 clinical trials
- CanSino Biologics; attenuated vaccine; currently in phase 1 clinical trials
- Arcturus Therapeutics; hybrid RNA vaccine; currently preclinical
- BioNTech; mRNA vaccine; currently preclinical
- CureVac; mRNA vaccine; currently preclinical
- Eli Lilly; isolated antibody treatment; currently preclinical
- GlaxoSmithKline; vaccine adjuvants; currently preclinical
- Inovio Pharmaceuticals; DNA-based vaccine; currently preclinical
- Johnson & Johnson; attenuated vaccine; currently preclinical
- Pfizer; assistance with both vaccines and treatments
- Regeneron Pharmaceuticals; engineered antibody treatment; currently preclinical
- Sanofi; hybrid DNA-based attentuated virus vaccine; currently preclinical
- Takeda; isolated antibody treatment; currently preclinical
- Vir Biotechnology; isolated antibody treatment; currently preclinical
Most of these are in very early stages, but I'm optimistic that that speed of development of both treatments and vaccines will exceed the consensus expectations.
Could you explain your reasoning or evidence for saying “ I'm optimistic that that speed of development of both treatments and vaccines will exceed the consensus expectations.” or is it just a feeling?
Just a feeling. I used to work in medical device testing, so I'm familiar with the layers of regulation that weigh down the pipeline. Even in normal times there's debate about whether it's too onerous. But now a lot of that shit's going to be cut out. For example, Moderna is skipping the animal safety trials, and starting with phase 1 human testing straight away. They say animal testing will proceed in parallel if a special new breed of mouse is ready in time.
This, along with recent advancements in bioengineering will, I believe, lead to surprisingly rapid progress.
(The best current mouse models for human coronavirus are not very good; the mice are generally resistant to the virus, so it's difficult to determine whether a vaccine or treatment is working.)
This, along with recent advancements in bioengineering will, I believe, lead to surprisingly rapid progress.
(The best current mouse models for human coronavirus are not very good; the mice are generally resistant to the virus, so it's difficult to determine whether a vaccine or treatment is working.)
Curious about this new breed of mice you mentioned - what's special about it.
We learned from the SARS epidemic that there are no naturally occurring animals that match humans in terms of receptiveness to the virus, direct symptoms, and immune-enhanced damage. Here are a couple of articles that explain better than I can:
https://www.statnews.com/2020/03/05/coronavirus-labs-scrambl...
https://www.statnews.com/2020/03/11/researchers-rush-to-star...
https://www.statnews.com/2020/03/05/coronavirus-labs-scrambl...
https://www.statnews.com/2020/03/11/researchers-rush-to-star...
The time buying is to stop the exponential.
It does not stop the exponential spread - that ship has sailed. At this point, it just slows it down by reducing the multiplier - "flatten the curve".
Worse yet is that if we let the measures off, we just get the same curve later. A bit lower at peak, but still exceeding healthcare capacity several times (say, 6x rather than 8x, if we do a 5-month lockdown).
But this still saves lives - just not anywhere as many as we could have saved if we contained it. It also gives us a chance to build more hospitals, manufacture more ventilators etc - although it still won't catch up with demand.
The best endgame is that we either get a vaccine, or enough tests to test everybody, and then do targeted quarantine from there.
Worse yet is that if we let the measures off, we just get the same curve later. A bit lower at peak, but still exceeding healthcare capacity several times (say, 6x rather than 8x, if we do a 5-month lockdown).
But this still saves lives - just not anywhere as many as we could have saved if we contained it. It also gives us a chance to build more hospitals, manufacture more ventilators etc - although it still won't catch up with demand.
The best endgame is that we either get a vaccine, or enough tests to test everybody, and then do targeted quarantine from there.
There are two sides to an exponential. If R0 is >1, it just keeps going up. However, if R0 is <1, it just keeps going down. The point of the lockdown is to get it <1 so it keeps going down for a while, until the case counts are low enough that we can adopt a different strategy.
Including cycling lockdown on and off without me very reaching a caseload that causes collapse of the healthcare system until we get a vaccine, etc., to change the basic equation. But first we've got to get R<1.
The "Best endgame" you describe is exactly the goal. We lockdown now so that we can buy time to get tests and tracing systems setup. Then we can start to open up everything again and control hotspots with aggressive testing and individual quarantine (as opposed to the blanket quarantine we are doing now). With good testing/tracing coverage, we can stop the virus from spreading exponentially for more than a few hops.
Also locking down everything DOES stop the exponential spread. That's the whole point. If you don't see other people, you aren't spreading the disease, reducing the rate of new infections. If each infected person infects less than 1 other person on average, we'll have stopped the spread. China and SK have already succeeded in this.
Also locking down everything DOES stop the exponential spread. That's the whole point. If you don't see other people, you aren't spreading the disease, reducing the rate of new infections. If each infected person infects less than 1 other person on average, we'll have stopped the spread. China and SK have already succeeded in this.
My point was that a 1-month or even 3-month lockdown doesn't stop exponential growth permanently, it just pauses it. A permanent lockdown would stop it, but it's obviously not sustainable.
And I wasn't trying to dispute your claim that the "best endgame" is the goal, merely clarify it - and also point out that even then, we will still see our healthcare overwhelmed, and a lot of people will still die because they will be rationed out of the system. People who wouldn't have died if we locked things down when containment was still realistic - so I consider them all preventable deaths that we have failed to prevent as a society.
To be absolutely clear: a lockdown is still our best bet, and the lives it'll save are worth it.
And I wasn't trying to dispute your claim that the "best endgame" is the goal, merely clarify it - and also point out that even then, we will still see our healthcare overwhelmed, and a lot of people will still die because they will be rationed out of the system. People who wouldn't have died if we locked things down when containment was still realistic - so I consider them all preventable deaths that we have failed to prevent as a society.
To be absolutely clear: a lockdown is still our best bet, and the lives it'll save are worth it.
* If each infected person infects less than 1 other person on average, we'll have stopped the spread.*
This isn't exactly correct. It means that, eventually, the spread would die out even if there were an infinite number of potential hosts. But it's still spreading. If that number is exactly 1, ~everyone will still end up getting infected. If it's just a bit below 1, it will behave as a decaying exponential but will still take a long time to die out.
This isn't exactly correct. It means that, eventually, the spread would die out even if there were an infinite number of potential hosts. But it's still spreading. If that number is exactly 1, ~everyone will still end up getting infected. If it's just a bit below 1, it will behave as a decaying exponential but will still take a long time to die out.
Slowing down infection rate whether exponential or not is good because it lets more time for medical system to prepare and because it spreads cases over long period of time.
Certainly: locking down the populace and the economy, without any plans to take advantage of the resulting respite, is unacceptable.
Giving up and attempting to resume normal activity is also unacceptable, full stop.
The best/latest explanation I've seen is https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-th.... Please read it (everyone, not just parent) if you haven't already.
Then if you're frustrated that your political leaders aren't moving to make best use of your sacrifice... let them know!
Giving up and attempting to resume normal activity is also unacceptable, full stop.
The best/latest explanation I've seen is https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-th.... Please read it (everyone, not just parent) if you haven't already.
Then if you're frustrated that your political leaders aren't moving to make best use of your sacrifice... let them know!
That article has been written by a growth hacker not an epidemiologist, and it does not start with that disclaimer. Please consider not spreading it.
Thanks for the link. Most involved read I've seen on strategy, but unfortunately for me I'm in the UK, so now I'm significantly more concerned than I was previously.
I will see what my MP has to say about it. Couldn't find a UK petition about it.
I will see what my MP has to say about it. Couldn't find a UK petition about it.
That's a great article, thanks for posting that.
The damage of not minimising the spread starts with an overwhelmed medical system, and ends with too many people ill at the same time to keep the lights on and the stores stocked with essentials.
The details of managing the economics are more than a footnote, but if the worst possible peak isn't avoided everything else becomes irrelevant, because there's no surviving economy to speak of - except maybe one of local barter.
The economics are not externalities. The virus is.
The economics are a social and political choice. They don't actually require money or other symbols, although they'll probably be mediated through for reasons of comfort and familiarity.
They require enough basic provision of food and services to keep people alive, and enough provision of shelter to keep people from rioting, especially once winter comes.
The worst possible economic outcome - after a Killer Peak - is a critical mass of angry and hopeless people with nothing to lose.
Realistically, avoiding that will probably mean helicopter money and aggressive price controls to prevent gouging and profiteering. The usual rules about inflation won't apply because the alternative will be a cratering depression and mass deflation which will do far more harm to the economy than hand-outs will.
It may also mean something worse, like some form of civil conscription to get essential work done. I really hope that doesn't happen, not just because it's better to call for volunteers first, but because it's so easy to abuse politically.
But it's also true this has the potential to become the equivalent of a war time situation, and in extremis the rules may need to change to keep food+lights happening.
Shit choices. But it's a shit situation, and IMO there's no chance of business as usual returning for quite some time.
The details of managing the economics are more than a footnote, but if the worst possible peak isn't avoided everything else becomes irrelevant, because there's no surviving economy to speak of - except maybe one of local barter.
The economics are not externalities. The virus is.
The economics are a social and political choice. They don't actually require money or other symbols, although they'll probably be mediated through for reasons of comfort and familiarity.
They require enough basic provision of food and services to keep people alive, and enough provision of shelter to keep people from rioting, especially once winter comes.
The worst possible economic outcome - after a Killer Peak - is a critical mass of angry and hopeless people with nothing to lose.
Realistically, avoiding that will probably mean helicopter money and aggressive price controls to prevent gouging and profiteering. The usual rules about inflation won't apply because the alternative will be a cratering depression and mass deflation which will do far more harm to the economy than hand-outs will.
It may also mean something worse, like some form of civil conscription to get essential work done. I really hope that doesn't happen, not just because it's better to call for volunteers first, but because it's so easy to abuse politically.
But it's also true this has the potential to become the equivalent of a war time situation, and in extremis the rules may need to change to keep food+lights happening.
Shit choices. But it's a shit situation, and IMO there's no chance of business as usual returning for quite some time.
[deleted]
Thank you for this. You make the essential point that others are missing: flattening the curve isn't to buy time; it's to prevent massive loss of life and societal collapse. Buying time to improve prevention and treatment is of secondary concern.
Excellently put.
The argument that we should find a balance between saving lives and maintaining a strong economy is reasonable, but seems to have a catch-22 to me. If our economy is truly "strong" it seems it should survive a few months of "social distancing", right?
Perhaps the argument would be better stated: We need to balance saving lives and maintaining the thin veneer that is our economy.
That isn't quite as inspiring, but perhaps that is reality? Even if our economy is a "veneer" we still need it. I find it less compelling though. I'm far more willing to trade lives for a "strong economy" than I am to trade lives for "the illusion of a strong economy".
"Grandma and Grandpa died at home without medical support, but at least our economy is 'strong', so strong it could probably survive weeks of social distancing!"
If our "prize" for sacrificing hundreds of thousands of elderly to an exceptionally uncomfortable death is an economy we all know can't handle even a minor pandemic and is incapable of doing what China and other countries have done, that will be a sad trade.
Perhaps the argument would be better stated: We need to balance saving lives and maintaining the thin veneer that is our economy.
That isn't quite as inspiring, but perhaps that is reality? Even if our economy is a "veneer" we still need it. I find it less compelling though. I'm far more willing to trade lives for a "strong economy" than I am to trade lives for "the illusion of a strong economy".
"Grandma and Grandpa died at home without medical support, but at least our economy is 'strong', so strong it could probably survive weeks of social distancing!"
If our "prize" for sacrificing hundreds of thousands of elderly to an exceptionally uncomfortable death is an economy we all know can't handle even a minor pandemic and is incapable of doing what China and other countries have done, that will be a sad trade.
"Strong" is usually defined in terms of output. And I think we tend to forget that economy is literally people going around their day-to-day things - we tend to forget about that because our abstract models of it are, well, abstract. But if you, say, tell half of your population to not work, that's half of your economy. Not only that, but it's the half that actually produces physical goods. Take a strong man, and paralyze them waist down - are they still strong? Does it mean they weren't strong before?
The more interesting question is how much of our economy is literally waste. I suspect we'll find out.
The more interesting question is how much of our economy is literally waste. I suspect we'll find out.
I think rather than strong what we’d expect is resilient. It’s why people are joking about businesses eating less avocado toast. The advice given to a lot of people in financial hardship is often well meaning but unhelpful. Why didn’t you have three months cost of living saved? Why do you buy frivolous things? Etc. then when it’s business expected to take a few months off suddenly these ideals are no longer important. Why do profitable companies have no ‘rainy day fund’? How is an economy ‘strong’ if it is not resilient to disruption?
What we’re learning globally to a greater or lesser extent is that our economies are not resilient. That capitalism of various kinds has failed us. And that when it comes down to it we need one another to give a shit about each other.
What we’re learning globally to a greater or lesser extent is that our economies are not resilient. That capitalism of various kinds has failed us. And that when it comes down to it we need one another to give a shit about each other.
On the contrary, we're learning that our economies are incredibly resilient. Nobody's concerned that we'll stop being able to deliver food, water, toilet paper, Netflix - the businesses which provide those basic necessities (and imagine telling someone even 30 years ago that on-demand home video is a basic necessity!) are almost entirely unaffected. This is a success story of capitalism by any reasonable metric - I would not have predicted that Amazon could keep making deliveries and Costco could continually restock their shelves in the middle of a global pandemic.
Unfortunately, even the best economic system can't disguise the fact that fewer people working means fewer products and services are available.
Unfortunately, even the best economic system can't disguise the fact that fewer people working means fewer products and services are available.
You should probably wait for another couple of months before declaring it a "success story". The lockdown has barely begun, and we haven't even see the first large wave of people fresh out of jobs getting their major bills in the mail.
There’s a big ‘yet’ there. Also that things didn’t immediately collapse isn’t the economy showing resilience. It cannot be a binary thing like that. We’re seeing the first waves of mass unemployment, of enormous businesses like Boeing collapsing, of small businesses being grossly unprepared for any kind of disruption and of individuals likewise being ill prepared. The economy we leave this emergency with will be a shadow of the one we went in with. A gross structural failure.
There are going to be trillions of dollars spent attempting to bail out the economies of the world.
There are going to be trillions of dollars spent attempting to bail out the economies of the world.
Before the internet (and still, but less so), you could measure the GDP impact of building a bridge because it would allow people to drive back and forth faster and all that moving around leads to more commerce. You’re right, the economy literally is people moving around doing stuff.
Do you expect these segments of the economy to survive 2mo+ of their business collapsing to near zero?
Airlines, Bars, Restaurants, Hotels, Cruises, Conferences, Taxies, Hair Salons, Chiropractors, dozens more...
That's 10s of millions of jobs. Livelihoods ruined.
Maybe your job is safe. Mine too. But you have to put yourself in the shoes of someone who is being financially ruined, and whose life expectancy will likely be greatly diminished as a result.
There are major tradeoffs here.
Airlines, Bars, Restaurants, Hotels, Cruises, Conferences, Taxies, Hair Salons, Chiropractors, dozens more...
That's 10s of millions of jobs. Livelihoods ruined.
Maybe your job is safe. Mine too. But you have to put yourself in the shoes of someone who is being financially ruined, and whose life expectancy will likely be greatly diminished as a result.
There are major tradeoffs here.
Airlines are essential, and will be bailed out despite their past financial misbehavior.
Bars and restaurants will re-open, those are always in high demand, and easy to start.
Hotels have facilities and real estate that are valuable, and should bounce back once people feel comfortable traveling again.
Cruises can die in a fire. They've always been hotbeds of disease, and are now pretty much tainted.
Conferences might switch permanently to a virtual methodology as Apple is doing with WWDC. This could increase the reach of the conference since it's insanely expensive, as well as hard to get tickets.
Taxis (including Uber/Lyft), hair salons, all easy to restart, and demand will bounce back. Chiropractors are frauds, so I don't care if they fail.
Bars and restaurants will re-open, those are always in high demand, and easy to start.
Hotels have facilities and real estate that are valuable, and should bounce back once people feel comfortable traveling again.
Cruises can die in a fire. They've always been hotbeds of disease, and are now pretty much tainted.
Conferences might switch permanently to a virtual methodology as Apple is doing with WWDC. This could increase the reach of the conference since it's insanely expensive, as well as hard to get tickets.
Taxis (including Uber/Lyft), hair salons, all easy to restart, and demand will bounce back. Chiropractors are frauds, so I don't care if they fail.
> Conferences might switch permanently to a virtual methodology
A conference means people travelling, hotel rooms, meals in restaurants, good dresses, presents for the family... It may be better for society to make them on-line (it would be better for the environment, for example), but the economic impact would be huge.
A conference means people travelling, hotel rooms, meals in restaurants, good dresses, presents for the family... It may be better for society to make them on-line (it would be better for the environment, for example), but the economic impact would be huge.
Agreed. Chiropractors are not helpful; better to go to an actual hospital and get a real expert for back problems.
Very sympathetic. Points taken
People not having jobs means they could end up homeless and vulnerable. Hard to practice social distancing in a homeless shelter and get access to adequate nutrition, especially if they become overpopulated, and there could be a huge amount of deaths as a result as well. Is the government going to suddenly pay everyone's rent that loses a job? $1000 checks won't pay rent in many part of the country.
You're right that human lives are on both sides of the balance.
It's interesting that paying people's rent for them is on the table, but denying rent to the literal rent-seekers isn't. As though ensuring those who collect rent get their rent is more important than keeping people in homes.
It's interesting that paying people's rent for them is on the table, but denying rent to the literal rent-seekers isn't. As though ensuring those who collect rent get their rent is more important than keeping people in homes.
> It's interesting that paying people's rent for them is on the table, but denying rent to the literal rent-seekers isn't. As though ensuring those who collect rent get their rent is more important than keeping people in homes.
do you imagine every tenant's landlord is a literal scrooge mcduck?
my elderly neighbors rent their basement out. should they just be told they don't get paid for a few months?
my retired parents own REITs, and pay their bills with those dividends. if the real estate companies don't get paid, there's no dividends, and then my parents are buying cat food.
pensions and retirement funds across the country rely on rents coming in.
this "just suspend rents" line would be less insane if you'd acknowledge there are trade-offs to it.
do you imagine every tenant's landlord is a literal scrooge mcduck?
my elderly neighbors rent their basement out. should they just be told they don't get paid for a few months?
my retired parents own REITs, and pay their bills with those dividends. if the real estate companies don't get paid, there's no dividends, and then my parents are buying cat food.
pensions and retirement funds across the country rely on rents coming in.
this "just suspend rents" line would be less insane if you'd acknowledge there are trade-offs to it.
> People not having jobs means they could end up homeless and vulnerable.
Eviction/foreclosure bans have in many places been adopted along with shelter-in-place orders.
> Hard to practice social distancing in a homeless shelter and get access to adequate nutrition, especially if they become overpopulated
Why California’s emergency approach includes the power to seize hotels to rapidly expand shelter capacity (and why SF is in negotiations to buy hotel space for an extended time for that purpose.)
Eviction/foreclosure bans have in many places been adopted along with shelter-in-place orders.
> Hard to practice social distancing in a homeless shelter and get access to adequate nutrition, especially if they become overpopulated
Why California’s emergency approach includes the power to seize hotels to rapidly expand shelter capacity (and why SF is in negotiations to buy hotel space for an extended time for that purpose.)
> Eviction/foreclosure bans have in many places been adopted along with shelter-in-place orders.
They are simply pausing evictions. So, you lose your job due to the pandemic and as soon as it has improved then you still get kicked out. I don't think that is much relief, especially if there is another wave.
Here is the order:
https://www.michigan.gov/whitmer/0,9309,7-387-90499_90705-52...
> Why California’s emergency approach includes the power to seize hotels to rapidly expand shelter capacity (and why SF is in negotiations to buy hotel space for an extended time for that purpose.)
All I've seen is for quarantine sites, not for shelters.
They are simply pausing evictions. So, you lose your job due to the pandemic and as soon as it has improved then you still get kicked out. I don't think that is much relief, especially if there is another wave.
Here is the order:
https://www.michigan.gov/whitmer/0,9309,7-387-90499_90705-52...
> Why California’s emergency approach includes the power to seize hotels to rapidly expand shelter capacity (and why SF is in negotiations to buy hotel space for an extended time for that purpose.)
All I've seen is for quarantine sites, not for shelters.
Seattle / Wa state has already been buying hotels around here too. And we started building temporary hospitals on soccer fields.
They can ban eviction, however.
Temporarily banning evictions until things improve (possibly temporarily) is only going to help people stay in their homes in the short term, and they will still be required to pay rent for those periods.
Socialized housing for everyone?
Maybe. It seems likely that the optimal economic and societal systems are going to be different during these unusual and temporary circumstances. Thus, to not make temporary changes would be sub-optimal.
It's interesting contrast to read Krugman's piece in the nytimes just yesterday.
He ignores the "economy", he says that layoffs are necessary, which is to basically suggest that the economy will adapt.
And everywhere you have internet commenters "But what about the economy?" and citing serious consequences of recession/depression in order to criticize isolation/quarantine/lockdown.
He ignores the "economy", he says that layoffs are necessary, which is to basically suggest that the economy will adapt.
And everywhere you have internet commenters "But what about the economy?" and citing serious consequences of recession/depression in order to criticize isolation/quarantine/lockdown.
My understanding is that it is necessary to slow the progression to “flatten the curve” below hospital capacity, and that extra time for building increased hospital capacity is a nice side effect but not the primary goal. Basically, when more people get sick than the hospitals can take in, the mortality rate skyrockets, which is why Italy has more reported deaths than China right now.
Edit: Here’s the old paper from 2007 the CDC is using to inform some of the policy around “flattening the curve” below hospital capacity. https://stacks.cdc.gov/view/cdc/11425
Edit: Here’s the old paper from 2007 the CDC is using to inform some of the policy around “flattening the curve” below hospital capacity. https://stacks.cdc.gov/view/cdc/11425
But after the three month delay, you’ll have the same exponential growth, if life goes back to usual. It’s even present in these plots, at the right hand side (see California). It’s unfortunate the plots aren’t extended more to show longer term trends.
If the flat curve is extended for long enough, you get enough immunity to not have exponential growth when you lift restrictions.
Universal mask wearing combined with unlimited testing is the quickest way to get the economy restarted. We need to ramp up both. And of course more ppe for medical workers. We don't need a ton of ventilators. Without skilled medics ventilators by themselves are not useful.
It is terrifying how fast reasonable people have jumped on board with China-level lockdown policies that will decimate life-as-we-know-it after they end.
I've been reading every whitepaper and journal publication I can find on this disease.
The picture that I'm seeing is that this disease is both more infectious (higher R0) and less deadly than previously thought.
In light of those facts I am fairly convinced the lockdowns and resulting economic impacts will be worse than just isolating the most vulnerable and letting the rest of the population go about their business.
https://www.medrxiv.org/content/10.1101/2020.02.12.20022434v... (Suggests the R0 is much higher and IFR much lower than reported)
https://www.epicentro.iss.it/coronavirus/bollettino/Report-C... (shows that the people dying are very old and very sick already. Also given the fact that part of the population is so impacted strongly suggests the disease is much more widespread)
Also, all of the celebrities, politicians and athletes that are testing positive are proof, in my opinion, of how wide this has gone.
I've been reading every whitepaper and journal publication I can find on this disease.
The picture that I'm seeing is that this disease is both more infectious (higher R0) and less deadly than previously thought.
In light of those facts I am fairly convinced the lockdowns and resulting economic impacts will be worse than just isolating the most vulnerable and letting the rest of the population go about their business.
https://www.medrxiv.org/content/10.1101/2020.02.12.20022434v... (Suggests the R0 is much higher and IFR much lower than reported)
https://www.epicentro.iss.it/coronavirus/bollettino/Report-C... (shows that the people dying are very old and very sick already. Also given the fact that part of the population is so impacted strongly suggests the disease is much more widespread)
Also, all of the celebrities, politicians and athletes that are testing positive are proof, in my opinion, of how wide this has gone.
The fatality rate so far only applies as long as the health care system isn't overwhelmed though. Plenty of non-elderly are affected severely enough to need ICU care, and they will start showing up as fatalities once there aren't any free spots any more. Washington State is almost at this point and is preparing triaging procedures.
I'm astonished how many people think that they know better how to respond than the professional epidemiologists. If anything the response actually enacted is tempered from what they recommend by the politicians.
I'm astonished how many people think that they know better how to respond than the professional epidemiologists. If anything the response actually enacted is tempered from what they recommend by the politicians.
Being one of those reasonable people who has not fallen for the complete lockdown argument, I feel that the ball is rolling and no argument can reduce the measures right now.
In Denmark there are 42 people requiring ICU care and 13 deaths. Just two years ago more than 1.600 died due to the common flu, but that hardly got any coverage nor any of the counter-measures being employed right now.
If I should find some positive in this over-response, that would be the benefit for the environment due to less pollution. If we could reduce emissions to the current level, the climate would be so much better for it.
If I should find some positive in this over-response, that would be the benefit for the environment due to less pollution. If we could reduce emissions to the current level, the climate would be so much better for it.
I mostly agree with your underlying assumptions but I'm still advocating for a different course of action.
The problem with this disease is that while many people don't die, they require intensive care. As we can see in Italy currently this will overwhelm hospitals at some point (and Italy has already put drastic measures into place). At that point it becomes a huge problem for society: a lot of people are dying and the health system doesn't work anymore. People die because of appendicitis etc.
The problem with this disease is that while many people don't die, they require intensive care. As we can see in Italy currently this will overwhelm hospitals at some point (and Italy has already put drastic measures into place). At that point it becomes a huge problem for society: a lot of people are dying and the health system doesn't work anymore. People die because of appendicitis etc.
Did you read the Imperial College paper that starts the whole thing? That paper acknowledges multiple different strategy (with full lockdown being one of them) and details what the long term strategy could be.
I'm with you.
We will all catch this unless we stay locked up until the vaccine comes.
So, expect everyone to catch it.
We will all catch this unless we stay locked up until the vaccine comes.
So, expect everyone to catch it.
Whether we catch it is not the issue, the vast majority of us will. It's whether when you do and have complications, you can go to the hospital or die waiting for an ambulance that never comes because the system is overwhelmed.
The thing about exponential growth is that it is slow growing (relatively) in the beginning. This means if we cycled between lockdown and business as usual we can keep things contained quite easily. Not sure what would be most efficient, but something like 1 week lockdown every 2 or 3 weeks would keep the spread minimal until a long-term solution is found.
Obviously travel etc. gum up this plan but instead of containment or mitigation we can move to a "time gapped reset" policy that predicts a continuous growth/halt cycle for the virus instead of pointlessly trying to eradicate it completely.
Obviously travel etc. gum up this plan but instead of containment or mitigation we can move to a "time gapped reset" policy that predicts a continuous growth/halt cycle for the virus instead of pointlessly trying to eradicate it completely.
> I want to know when people estimate that the societal damages of the illness start to be outweighed by the damages of our response.
Loss of life to the inner vs loss of life caused by economic consequences, I've seen that argument before and it's not entirely unappealing. But wherever I saw it there was the unspoken assumption that the economy would just continue completely unaffected by an uncontrolled epidemic. But much of the economic damage will be there no matter which path you take. There are likely same areas where a short, hard wave would even be worse, economically, than a controlled lockdown. The delta is even harder to estimate than the cost of slowdown strategies, but an argument that only looks at the economic cost of one option is flawed.
Personally, given the choice, I'd take option C, "show me a rerun of 2019". Unfortunately this isn't in the cards that we are dealt.
Loss of life to the inner vs loss of life caused by economic consequences, I've seen that argument before and it's not entirely unappealing. But wherever I saw it there was the unspoken assumption that the economy would just continue completely unaffected by an uncontrolled epidemic. But much of the economic damage will be there no matter which path you take. There are likely same areas where a short, hard wave would even be worse, economically, than a controlled lockdown. The delta is even harder to estimate than the cost of slowdown strategies, but an argument that only looks at the economic cost of one option is flawed.
Personally, given the choice, I'd take option C, "show me a rerun of 2019". Unfortunately this isn't in the cards that we are dealt.
> Shutting down the economy has externalities; those externatlities can be life or death as well. If the strategy of those implementing the "shelter in place" is one of just waiting it out: then I'm going to be off the wagon fairly quickly.
I think the problem with this very common attitude is the demand for immediate answers, or else. It's an ultimatum.
We don't expect programmers and engineers to come up with complete, ready-to-commit solutions to a complex problem immediately. Thinking like a consumer doesn't help. An alternative is to demand transparency and to be engaged in the process of decision making. But that requires an attitude/intellectual realignment.
I think the problem with this very common attitude is the demand for immediate answers, or else. It's an ultimatum.
We don't expect programmers and engineers to come up with complete, ready-to-commit solutions to a complex problem immediately. Thinking like a consumer doesn't help. An alternative is to demand transparency and to be engaged in the process of decision making. But that requires an attitude/intellectual realignment.
I don't think a complete solution is expected. An incomplete but scaffolded solution would be very well received. A clear statement that we expect infections to level off by date X and we can relax restrictions after condition Y would be very nice - especially since people could start making Y happen as fast as possible.
What's concerning about the current messaging is that it's not clear whether it's incorporated the underlying limits to how long people will tolerate a lockdown. An ultimatum is the right framing; decisionmakers need to know, and we need to know they know, that "then we'll lock down for 6 months" is not part of the solution space.
What's concerning about the current messaging is that it's not clear whether it's incorporated the underlying limits to how long people will tolerate a lockdown. An ultimatum is the right framing; decisionmakers need to know, and we need to know they know, that "then we'll lock down for 6 months" is not part of the solution space.
Ultimatums are bad faith and basically anti-liberal so I don't care for that sort of rhetoric, and I think more people should try that as a baseline.
When the ultimatums themselves do not account for the well-being of the elderly and vulnerable, we should not be giving that rhetoric credit. There's an ideological and intellectual distinction to be made between people's behaviors; those who want to discuss the "COVID tradeoff problem", and those who simplistically repeat talking points "but the economy will cause deaths too" (in reactance to the other narrative, the prediction of collapse of healthcare systems).
Sure, I’m happy to discuss taboo tradeoffs with people who are willing. Even a 3 month lockdown is clearly not worth the lives it would save. If you could rescue some Kansas man you don’t know from cancer, by cutting off friends and family and career for 3 months, you wouldn’t do it. And there’s orders of magnitude less than 1 life per person at stake here.
Most people aren’t willing to explicitly discuss how many lives it’s worth to be allowed to hug your mother, so for general consumption it must be framed in absolutes. There’s a number of weeks past which the cost is unacceptable and I’m joining the mob at City Hall, and that number is not in the double digits.
Most people aren’t willing to explicitly discuss how many lives it’s worth to be allowed to hug your mother, so for general consumption it must be framed in absolutes. There’s a number of weeks past which the cost is unacceptable and I’m joining the mob at City Hall, and that number is not in the double digits.
The thing about exponential growth is that it is slow growing (relatively) in the beginning. This means if we cycled between lockdown and business as usual we can keep things contained quite easily. Not sure what would be most efficient, but something like 1 week lockdown every 2 or 3 weeks would keep the spread minimal until a long-term solution is found. Obviously travel etc. gum up this plan but instead of containment or mitigation we can move to "time gap" reset policy that predicts continous growth/halt of the virus instead of pointlessly trying to eradicate it.
The Imperial report suggested this exact thing, but by their estimations, we'd still need to have lockdown in effect about 2/3 of the total time to prevent healthcare systems from getting overwhelmed in US and UK.
> Assuming that understanding is sufficiently correct, what I'm not hearing enough of is what is being done with the time we're buying.
This was along the lines of my first thoughts as well. Theoretically, we want to maximize the usage of our medical resources (personnel, reusable supplies such as bed space, non-reusable supplies such as medication that become available at a variable rate), to keep just enough below the capacity to handle the needs and allow for some spikes (if we can even get it that low).
To my eyes, that calls for the ability to reassess and shift directives for the public (that is, maybe ease up on shelter-in-place next week, but put it back the week after), track and optimize resource flow, and coordination between locales. As a national level emergency, it makes sense there would be national level coordination on how to deal with it. Instead it appears we have governors and mayors making their own calls on what to do based on what advice they are personally getting, and the health care system is just struggling to figure out what to do.
What we don't have is any leadership putting forth an actual plan, or any real indication that they are even attempting to do so, or that if they are that they're putting any real teeth behind making sure officials are on board.
This was along the lines of my first thoughts as well. Theoretically, we want to maximize the usage of our medical resources (personnel, reusable supplies such as bed space, non-reusable supplies such as medication that become available at a variable rate), to keep just enough below the capacity to handle the needs and allow for some spikes (if we can even get it that low).
To my eyes, that calls for the ability to reassess and shift directives for the public (that is, maybe ease up on shelter-in-place next week, but put it back the week after), track and optimize resource flow, and coordination between locales. As a national level emergency, it makes sense there would be national level coordination on how to deal with it. Instead it appears we have governors and mayors making their own calls on what to do based on what advice they are personally getting, and the health care system is just struggling to figure out what to do.
What we don't have is any leadership putting forth an actual plan, or any real indication that they are even attempting to do so, or that if they are that they're putting any real teeth behind making sure officials are on board.
I wonder the same thing. A lockdown cannot be done in perpetuity and I think even 90 days would be too long. So the best bet is a lockdown while we ramp up the healthcare system to deal with the outbreak as best as possible. At some point we will have to go back to some semblance of normal life as the economy and people’s personal finances can’t continue to lockdown. Unfortunately we don’t seem to ramping up the healthcare system enough during this lockdown period.
And no the vaccine is still too far in the future so the idea that the lockdown is biding time until the vaccine is ready is ridiculous.
And no the vaccine is still too far in the future so the idea that the lockdown is biding time until the vaccine is ready is ridiculous.
Well said. Nobody seems to know what is being done with the time we're 'buying'. I get the feeling everyone just thinks if we sit at home for a month (or two? or three!?!), it will just magically go away. This site even admits "A second spike in disease may occur after social distancing is stopped". It's very possible that sitting at home will just delay the acceleration phase, and it will rear it's ugly head after we come out of out caves.
Why have we all (I'm speaking for people in the USA) immediately bought into the idea that shutting down out lives and the economy is the only way to combat this thing? South Korea didn't shut everything down in an authoritarian fashion, and they already have this thing beat. I know, not a fair comparison, USA is way bigger, less experienced in handling disease outbreaks, different governments, etc, etc. But aren't there smarter ways we can handle this than just blanket isolation & lock downs?
From the CDC:
"Pandemics begin with an investigation phase, followed by recognition, initiation, and acceleration phases. The peak of illnesses occurs at the end of the acceleration phase, which is followed by a deceleration phase, during which there is a decrease in illnesses. Different countries can be in different phases of the pandemic at any point in time and different parts of the same country can also be in different phases of a pandemic."
So we know from South Korea's example it is possible to hit acceleration phase, execute a smart plan of attack, and have it carry you into deceleration, without blanket lock downs. Lock downs can still be an effective tool, and should be used in areas seeing steep acceleration to take pressure off the medical system.
Our plan doesn't have to be exactly the same, but we can learn from theirs. Seems like nobody is even trying to think out of the box. We just accepted that we have to turn our country into an authoritarian state and that's the only way to beat this.
Focusing on making testing widely and easily accessible is key for sure. If people could easily get a test, it would eliminate a lot of the fear/ uncertainly that is gripping everyone. Healthy people who are at low risk to get severe reactions could go about there lives normally, while still practicing 'social distancing' in public, not locked away in their homes in fear
Why have we all (I'm speaking for people in the USA) immediately bought into the idea that shutting down out lives and the economy is the only way to combat this thing? South Korea didn't shut everything down in an authoritarian fashion, and they already have this thing beat. I know, not a fair comparison, USA is way bigger, less experienced in handling disease outbreaks, different governments, etc, etc. But aren't there smarter ways we can handle this than just blanket isolation & lock downs?
From the CDC:
"Pandemics begin with an investigation phase, followed by recognition, initiation, and acceleration phases. The peak of illnesses occurs at the end of the acceleration phase, which is followed by a deceleration phase, during which there is a decrease in illnesses. Different countries can be in different phases of the pandemic at any point in time and different parts of the same country can also be in different phases of a pandemic."
So we know from South Korea's example it is possible to hit acceleration phase, execute a smart plan of attack, and have it carry you into deceleration, without blanket lock downs. Lock downs can still be an effective tool, and should be used in areas seeing steep acceleration to take pressure off the medical system.
Our plan doesn't have to be exactly the same, but we can learn from theirs. Seems like nobody is even trying to think out of the box. We just accepted that we have to turn our country into an authoritarian state and that's the only way to beat this.
Focusing on making testing widely and easily accessible is key for sure. If people could easily get a test, it would eliminate a lot of the fear/ uncertainly that is gripping everyone. Healthy people who are at low risk to get severe reactions could go about there lives normally, while still practicing 'social distancing' in public, not locked away in their homes in fear
>I know, not a fair comparison, USA is way bigger, less experienced in handling disease outbreaks, different governments, etc, etc. But aren't there smarter ways we can handle this than just blanket isolation & lock downs?
Not if you don't have as advanced infrastructure, quick government, and decisive politicians like Korea, and 1/4th of the country is in third world conditions regarding access to healthcare, or even shelter, etc.
Not if you don't have as advanced infrastructure, quick government, and decisive politicians like Korea, and 1/4th of the country is in third world conditions regarding access to healthcare, or even shelter, etc.
> Health people who are at low risk to get severe reactions could go about there lives normally, while still practicing 'social distancing' in public, not locked away in their homes in fear
You don't need tests for that, just common sense. If you have low risk, by all means keep working while keeping high sanitary precautions. It's unrealistic to expect all people to stay at home, hence those of us who are likely to get a mild COVID-19 case should make sure the people at risk or already sick have services while they stay at home.
If you're healthy, take precautions and still get COVID-19, after recovering you become another line of defense with your new immunity.
That being said, tests are very important, but don't wait for free and widely available tests to decide if you can keep working, your circumstances decide that.
You don't need tests for that, just common sense. If you have low risk, by all means keep working while keeping high sanitary precautions. It's unrealistic to expect all people to stay at home, hence those of us who are likely to get a mild COVID-19 case should make sure the people at risk or already sick have services while they stay at home.
If you're healthy, take precautions and still get COVID-19, after recovering you become another line of defense with your new immunity.
That being said, tests are very important, but don't wait for free and widely available tests to decide if you can keep working, your circumstances decide that.
> Nobody seems to know what is being done with the time we're 'buying'.
You're allowing people to get infected, but reducing the rate at which they get infected, thus allowing your healthcare system to cope with the demand while the rest of society slowly builds immunity.
You're allowing people to get infected, but reducing the rate at which they get infected, thus allowing your healthcare system to cope with the demand while the rest of society slowly builds immunity.
Yeah, I just wish we were doing it it a more precise way. Ramp up the more aggressive measures only in the areas seeing acceleration.
My girlfriend’s brother in-law owns a large, successful restaurant in the city next door. They city has only 1 confirmed case, and that guy got it from traveling to Italy. Still the governor threw a blanket ban on restaurant dining rooms, and they are forced to lay off most of their workforce.
I doubt his business will fail, but he told me he already knew of two other restaurants in the city that already went out of business because of such low traffic even before the lockdown. Seems like we should implement these bans in a more targeted way.
My girlfriend’s brother in-law owns a large, successful restaurant in the city next door. They city has only 1 confirmed case, and that guy got it from traveling to Italy. Still the governor threw a blanket ban on restaurant dining rooms, and they are forced to lay off most of their workforce.
I doubt his business will fail, but he told me he already knew of two other restaurants in the city that already went out of business because of such low traffic even before the lockdown. Seems like we should implement these bans in a more targeted way.
Your aprocach in this is the problem. Your girlfriend's bother in law's customers and staff, on the way to that establishment, and within, could easily be spreading the virus. Untested, without symptoms, simply going about their usual lives. This is why we're seeing tested cases in the US (now that there's tests) rise so suddenly. There is no 'only 1 person has it in a town). That was my town yesterday, with only one case, and then bam, more people got tested.
https://youtu.be/jUnVxjaWIBM
Sorry you are inconvenienced.
Sorry you are inconvenienced.
Basically we need a timeout to recover from and reassess a month of negligent inaction. The time to institute a "smart plan of attack" relying on easy testing/public temperature checks/physical distancing was three weeks ago, when we still had headroom to weather the results.
Notice that the CA style shelter in place has an uptick at the end. Once you let people out it starts right where it left off. My assumption is that this thing is not going to be eradicated and is highly contagious, so the only way it will stop is once there are enough people vaccinated or previously infected so the exponential decays. Under those assumptions, slowing it serves two purposes. One is to prevent deaths due to overwhelmed treatment facilities. The other is to prevent it from just hitting everyone. Maybe only 20-60 percent of the population needs immunity to stop it, but if it runs rampant we could overshoot that. I'm sure there are other reasons to slow it, and other models, other assumptions, etc...
The time can be used to do a lot of things:
* Rapidly expand healthcare capacity
* Develop a vaccine
* Build out a testing infrastructure that allows for targeted containment, rapid response, and chain-of-infection tracing without needing a full lockdown
* Rapidly expand healthcare capacity
* Develop a vaccine
* Build out a testing infrastructure that allows for targeted containment, rapid response, and chain-of-infection tracing without needing a full lockdown
If you do nothing, and an antiviral comes along in a month (which can stop severe disease), then you have effectively killed a lot of people unnecessarily. An affective antiviral is looking more and more likely, and unlike other approaches, can be scaled rapidly.
Apart from developing drugs, vaccines, and expanding hospitals, the time could allow us to produce enough tests to detect infected people before they are contagious. Perhaps even earlier, we could test all the contacts of people who were detected after they were already contagious.
With enough testing and sufficient frequency of testing, isolating just the people who test positive (and perhaps their contacts) should be enough to stop exponential growth, which means we could mostly return to normal life.
With enough testing and sufficient frequency of testing, isolating just the people who test positive (and perhaps their contacts) should be enough to stop exponential growth, which means we could mostly return to normal life.
Agreed. Politicians just shutting things down without a plan for what we do in this time is unacceptable. A vaccine won’t be safely available for a year. Shutting down that long will destroy everything.
I liken it to the immune system. Shutting things down can work for a short period but if the system goes into a full panic it begins attacking good cells and shutting down organs and the host dies a slow, painful death.
We need to be using this bought time to building medical equipment, beds and places to put them, manufacturing existing therapies to help, training people to use specific equipment, creating a system for the most vulnerable to quarantine but get food, medicine, safely as they wait for acceptable safety to them.
We can’t lock down for months and months. People will eventually be fed up, see their risk is low, and throw the dice. The economy can’t grind to halt for a long time.
We need to prepare to minimize death and we need to do it now. Lockdown is not much of a strategy or something that will work beyond a few weeks before people ignore it massively.
I liken it to the immune system. Shutting things down can work for a short period but if the system goes into a full panic it begins attacking good cells and shutting down organs and the host dies a slow, painful death.
We need to be using this bought time to building medical equipment, beds and places to put them, manufacturing existing therapies to help, training people to use specific equipment, creating a system for the most vulnerable to quarantine but get food, medicine, safely as they wait for acceptable safety to them.
We can’t lock down for months and months. People will eventually be fed up, see their risk is low, and throw the dice. The economy can’t grind to halt for a long time.
We need to prepare to minimize death and we need to do it now. Lockdown is not much of a strategy or something that will work beyond a few weeks before people ignore it massively.
https://youtu.be/jUnVxjaWIBM
Would this work for ya?
Would this work for ya?
We are trading economic output in exchange for lowering the transmission rate of the disease. By lowering the transmission rate, we are lowering the peak use of medical resources, lowering the loss of life. Your second paragraph acknowledges this, and I think pretty much everyone is on the same page here at this point.
But the question in your third paragraph "what is being done with the time we're buying" could be restated as "what are we getting for our loss in economic output _in terms of economic output_?' That's not what we are doing, we are giving up economic output, not getting it. Of course any schemes/inventions/techniques that increase the coefficient of return of this trade off would be welcome, but doesn't change the fundamental direction of the tradeoff.
And that's not to say we are doing nothing at all with that time. Maybe we have "more time to develop a vaccine", or "time to make ventillators."? But those _are_ economic outputs. Those actions trade back lives (via increased transmission rates) for production of utilities that we believe will save lives in an equation that nets a positive. And it's not to say that people won't do some productive things during this (like the memes of inventing calculus in isolation or whatever), but for sure society is reducing it's overall economic output.
So from this point on the questions (and threats of defection) you raise kinda presuppose that trading economic production for saving lives is not worth it (at whatever ratio you're expecting). Potentially this is because you expect higher economic costs/lower life savings than the generally accepted projections, or because you value life less, or you believe the economic loss will lead to greater loss of life long term. I think the burden then is on you to either produce better projections, or promote candidates into government/leadership positions that share your moral outlook, or formulate and promulgate a model that shows the dramatic effects you expect due to the economic loss.
To put it another way, a simplified answer to 'what are we doing with the time' could be 'approximately nothing', and our society at large seems to be on board with that trade. If you're not, change my/our mind.
But the question in your third paragraph "what is being done with the time we're buying" could be restated as "what are we getting for our loss in economic output _in terms of economic output_?' That's not what we are doing, we are giving up economic output, not getting it. Of course any schemes/inventions/techniques that increase the coefficient of return of this trade off would be welcome, but doesn't change the fundamental direction of the tradeoff.
And that's not to say we are doing nothing at all with that time. Maybe we have "more time to develop a vaccine", or "time to make ventillators."? But those _are_ economic outputs. Those actions trade back lives (via increased transmission rates) for production of utilities that we believe will save lives in an equation that nets a positive. And it's not to say that people won't do some productive things during this (like the memes of inventing calculus in isolation or whatever), but for sure society is reducing it's overall economic output.
So from this point on the questions (and threats of defection) you raise kinda presuppose that trading economic production for saving lives is not worth it (at whatever ratio you're expecting). Potentially this is because you expect higher economic costs/lower life savings than the generally accepted projections, or because you value life less, or you believe the economic loss will lead to greater loss of life long term. I think the burden then is on you to either produce better projections, or promote candidates into government/leadership positions that share your moral outlook, or formulate and promulgate a model that shows the dramatic effects you expect due to the economic loss.
To put it another way, a simplified answer to 'what are we doing with the time' could be 'approximately nothing', and our society at large seems to be on board with that trade. If you're not, change my/our mind.
>I also understand that we are -not- trying to contain the disease, just "serialize" its progression (so to speak) through the population.
That's not true. Even with massively ramped up hospital capacity, we'd still have to spread it out over years to support the whole population getting sick. And realistically, if you can keep the disease progression spread out over a long period of time, it means you've stopped the exponential growth (i.e. R0 <= 1), and it isn't that much harder to actually contain it.
What we want to do is to contain it using blanket measures until we can get our act together with large scale testing, contact tracing, and basic sanitation measures (e.g. general mask wearing, hand-washing, and social distancing by the public without needing to lock everything down). This was where China got to after an early lockdown, and it's where South Korea has always been (without the need for a massive lockdown in the first place). Then in a year hopefully the disease can be stopped altogether with mass vaccination.
That's not true. Even with massively ramped up hospital capacity, we'd still have to spread it out over years to support the whole population getting sick. And realistically, if you can keep the disease progression spread out over a long period of time, it means you've stopped the exponential growth (i.e. R0 <= 1), and it isn't that much harder to actually contain it.
What we want to do is to contain it using blanket measures until we can get our act together with large scale testing, contact tracing, and basic sanitation measures (e.g. general mask wearing, hand-washing, and social distancing by the public without needing to lock everything down). This was where China got to after an early lockdown, and it's where South Korea has always been (without the need for a massive lockdown in the first place). Then in a year hopefully the disease can be stopped altogether with mass vaccination.
> Even with massively ramped up hospital capacity, we'd still have to spread it out over years to support the whole population getting sick
Keeping in mind that something like 80% of people will only experience mild symptoms, does this assertion still hold?
Keeping in mind that something like 80% of people will only experience mild symptoms, does this assertion still hold?
Buying time:
a) Saves millions of lives.
b) Allows researchers to develop, produce and distribute a safe vaccine.
a) Saves millions of lives.
b) Allows researchers to develop, produce and distribute a safe vaccine.
There's even more, though. It gives us an opportunity to replenish masks, hand sanitizers, tests, and other supplies we have an immediate need for. Once this plateaus and stockpiles replenish, we can take some small steps to normalcy.
Medium term, we can more properly organize and distribute medical resources, assemble temporary hospitals, learn more about current anti-virals to better manage it, etc. Allowing even more steps towards normalcy.
The vaccine is immensely important, but there are major steps before then that we don't have to be completely locked down waiting for.
Medium term, we can more properly organize and distribute medical resources, assemble temporary hospitals, learn more about current anti-virals to better manage it, etc. Allowing even more steps towards normalcy.
The vaccine is immensely important, but there are major steps before then that we don't have to be completely locked down waiting for.
[deleted]
Here is what I wrote to my governor and local newspaper. Feel free to adapt and forward if anyone agrees:
Universal Mask Wearing Is the Quickest Way to Restart the California Economy
We urgently need universal mask wearing to slow down the spread of COVID-19 and restore our economy.
This is CDC's advice on how healthcare providers can protect themselves if they suspect that a patient has COVID-19:
" Assess and triage these patients with acute respiratory symptoms and risk factors for COVID-19 to minimize chances of exposure, including placing a facemask on the patient and placing them in an examination room with the door closed." (What Healthcare Personnel Should Know about Caring for Patients with Confirmed or Possible COVID-19 Infection https://www.cdc.gov/coronavirus/2019-ncov/hcp/caring-for-pat...)
If a facemask on a patient can protect the doctor in close proximity, it surely can also protect the general public. Yet the message from our nation's leadership is that mask wearing is ineffective for the general public (Why Telling People They Don’t Need Masks Backfired https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-...). Yes, it is not 100% effective in protecting an individual from others, but it is absolutely effective in protecting the general public from a potential patient. This is the herd immunity we can quickly achieve without waiting for a vaccine:
"An 80% compliance rate essentially eliminated the influenza outbreak. " (Modeling the Effectiveness of Respiratory Protective Devices in Reducing Influenza Outbreak https://www.ncbi.nlm.nih.gov/pubmed/30229968)
California is in a unique place to lead the nation and restore its own economy. We have a large Asian population that are receptive to mask wearing but are wary of being singled out. We have technology companies that can come up with solutions for mask making. We have idled workers that can be quickly retrained to jumpstart mask manufacturing. China was able to ramp up production 12 times in February alone. We can do it too.
What we need to do is to legally require people to wear masks in public and in the workplace to protect each other. We don't need to wear N95 respirators that are hard to use and that should rightly be reserved for medical workers; we can wear masks that are much more breathable to protect others from our own droplets. By making it a legal requirement, companies like Tesla will be motivated to either quickly secure masks from suppliers or, better yet, start making and supplying masks for their own employees and for the public. Asian countries have shown that universal mask wearing can prevent large outbreaks and slow down the spread of the disease without shutting down their economy. Let's learn from their experience. Governor Newsom should immediately work on this with the state legislature in order to lead us to a speedy recovery.
Universal Mask Wearing Is the Quickest Way to Restart the California Economy
We urgently need universal mask wearing to slow down the spread of COVID-19 and restore our economy.
This is CDC's advice on how healthcare providers can protect themselves if they suspect that a patient has COVID-19:
" Assess and triage these patients with acute respiratory symptoms and risk factors for COVID-19 to minimize chances of exposure, including placing a facemask on the patient and placing them in an examination room with the door closed." (What Healthcare Personnel Should Know about Caring for Patients with Confirmed or Possible COVID-19 Infection https://www.cdc.gov/coronavirus/2019-ncov/hcp/caring-for-pat...)
If a facemask on a patient can protect the doctor in close proximity, it surely can also protect the general public. Yet the message from our nation's leadership is that mask wearing is ineffective for the general public (Why Telling People They Don’t Need Masks Backfired https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-...). Yes, it is not 100% effective in protecting an individual from others, but it is absolutely effective in protecting the general public from a potential patient. This is the herd immunity we can quickly achieve without waiting for a vaccine:
"An 80% compliance rate essentially eliminated the influenza outbreak. " (Modeling the Effectiveness of Respiratory Protective Devices in Reducing Influenza Outbreak https://www.ncbi.nlm.nih.gov/pubmed/30229968)
California is in a unique place to lead the nation and restore its own economy. We have a large Asian population that are receptive to mask wearing but are wary of being singled out. We have technology companies that can come up with solutions for mask making. We have idled workers that can be quickly retrained to jumpstart mask manufacturing. China was able to ramp up production 12 times in February alone. We can do it too.
What we need to do is to legally require people to wear masks in public and in the workplace to protect each other. We don't need to wear N95 respirators that are hard to use and that should rightly be reserved for medical workers; we can wear masks that are much more breathable to protect others from our own droplets. By making it a legal requirement, companies like Tesla will be motivated to either quickly secure masks from suppliers or, better yet, start making and supplying masks for their own employees and for the public. Asian countries have shown that universal mask wearing can prevent large outbreaks and slow down the spread of the disease without shutting down their economy. Let's learn from their experience. Governor Newsom should immediately work on this with the state legislature in order to lead us to a speedy recovery.
I always took "Telling People They Don’t Need Masks" as there is about to be an immense shortage so known infected and medical staff should be prioritized. If everyone tried to start wearing masks a month ago we wouldn't have /any/ left and we'd probably see a lot more desperate acts around getting them. Not to mention the average person not wearing it properly and not getting proper protection.
Right now there's a huge shortage and we still have a very small number of cases--it's all people stockpiling and using them where it's not as critical.
Like you say, after we can replenish the supply I'm sure it will be more commonplace.
Right now there's a huge shortage and we still have a very small number of cases--it's all people stockpiling and using them where it's not as critical.
Like you say, after we can replenish the supply I'm sure it will be more commonplace.
China had a similar shortage (actually more severe due to their population size) but they got on with the program and furiously ramped up their production. We need to do the same here. Remember the whole world will be looking to buy masks and we have no reason to believe that we will be in the front of the line.
Current mask situation reminds me of a doctor that promoted hand washing: https://en.wikipedia.org/wiki/Ignaz_Semmelweis
Yes this is a low tech war. There are simple ways to win it but people are curiouly unaware of what others are doing or have done.
Simple DIY masks may be an effecive stop-gap measure until professional masks become available again in sufficient numbers [0]. Fully agree that official & media messaging with respect to masks is quite misleading, of course they work.
[0] https://medium.com/@matthiassamwald/promoting-simple-do-it-y...
[0] https://medium.com/@matthiassamwald/promoting-simple-do-it-y...
The UK chief scientist, Patrick Vallance, has stated that they suspect a winter resurgence is possible, thus I also question the value of waiting and flattening curves. World governments should clarify this matter by saying that a bad winter resurgence, months after nations are fatigued with lockdown, is definitely not going to happen.
But right now no government dares suggest any vision past a few months.
But right now no government dares suggest any vision past a few months.
>The UK chief scientist, Patrick Vallance, has stated that they suspect a winter resurgence is possible, thus I also question the value of waiting and flattening curves.
By winter we'd have more equipment, masks, drugs tested, doctors taking a break, etc. The big spread also stops in warmer climate.
>World governments should clarify this matter by saying that a bad winter resurgence, months after nations are fatigued with lockdown, is definitely not going to happen.
Of course it's possible and very likely to happen. The answer is not no lockdown, it's a second lockdown then as the need arises.
By winter we'd have more equipment, masks, drugs tested, doctors taking a break, etc. The big spread also stops in warmer climate.
>World governments should clarify this matter by saying that a bad winter resurgence, months after nations are fatigued with lockdown, is definitely not going to happen.
Of course it's possible and very likely to happen. The answer is not no lockdown, it's a second lockdown then as the need arises.
[deleted]
[deleted]
This site openly admits the obvious flaws in their model:
- R0s for interventions are guesses, in some cases informed by data. There is no historical precedent for what is going on right now to draw from.
- The default R0 used in this model is an average. The model does not adjust for the population density, culturally-determined interaction frequency and closeness, humidity, temperature, etc in calculating R0.
- This is not a node-based analysis, and thus assumes everyone spreads the disease at the same rate. In practice, there are some folks who are “super-spreaders,” and others who are almost isolated. Interventions should be targeted primarily at those most likely to spread the disease.
Are there any epidemiologists using less naive statistical models who are producing easily readable results like this? The "average R0" logistic function model seems better suited for examining historical epidemics than estimating risk to inform decision-making for ongoing epidemics.
- R0s for interventions are guesses, in some cases informed by data. There is no historical precedent for what is going on right now to draw from.
- The default R0 used in this model is an average. The model does not adjust for the population density, culturally-determined interaction frequency and closeness, humidity, temperature, etc in calculating R0.
- This is not a node-based analysis, and thus assumes everyone spreads the disease at the same rate. In practice, there are some folks who are “super-spreaders,” and others who are almost isolated. Interventions should be targeted primarily at those most likely to spread the disease.
Are there any epidemiologists using less naive statistical models who are producing easily readable results like this? The "average R0" logistic function model seems better suited for examining historical epidemics than estimating risk to inform decision-making for ongoing epidemics.
That's generally what you should do with a scientific model: state your assumptions and methodology clearly.
And most if not all scientific and engineering models spread properties across a group of objects and use averages. R_0 is an average. And it's the average behavior that matters here
In a well tested population, you might be able to focus interventions on infected people and their contacts. In the US population, the people most likely to spread the disease are those who interact most with other people. That means getting those people to reduce their interaction rate.
It's a semi-empirical model, as are many if not most models used to make decisions.
And most if not all scientific and engineering models spread properties across a group of objects and use averages. R_0 is an average. And it's the average behavior that matters here
In a well tested population, you might be able to focus interventions on infected people and their contacts. In the US population, the people most likely to spread the disease are those who interact most with other people. That means getting those people to reduce their interaction rate.
It's a semi-empirical model, as are many if not most models used to make decisions.
I agree. The graphs are very pretty but would look very different if the R0 was even slightly modified. The mortality rates probably varies widely by state demographics as well.
That said, the implication that strict isolation should be maintained is almost certainly correct.
That said, the implication that strict isolation should be maintained is almost certainly correct.
Hey guys - owner of the model in question here. Thanks for your feedback, and yes, the model isn't perfect. Idea is just to give some forward-looking picture for policy-makers to use to make decision.
Interestingly, the model is not nearly as sensitive to R-values as you would think, until they get under 1.5 (half the current observed number in most places).
See here: https://www.researchgate.net/figure/Doubling-time-Average-do...
Interestingly, the model is not nearly as sensitive to R-values as you would think, until they get under 1.5 (half the current observed number in most places).
See here: https://www.researchgate.net/figure/Doubling-time-Average-do...
Really appreciate you putting this together.
I still feel there is compelling evidence that lung damage from things such as exposure to local pollution is a big driver in serious cases.
I say this as someone that thinks they had it a month ago. I was on steroids for a week, then a respirator, then steroids for another week. Worst asthma attack of my adult life. I live in Seattle... (And yes, i had fevers)
I did not get tested, but having a hard time shaking that I had it. And if I did, so has my family. With my kids all having fevers, but no shortness of breath.
Edit: I hasten to add that I am socializing this as a call for what am I missing? I am not encouraging inaction.
I say this as someone that thinks they had it a month ago. I was on steroids for a week, then a respirator, then steroids for another week. Worst asthma attack of my adult life. I live in Seattle... (And yes, i had fevers)
I did not get tested, but having a hard time shaking that I had it. And if I did, so has my family. With my kids all having fevers, but no shortness of breath.
Edit: I hasten to add that I am socializing this as a call for what am I missing? I am not encouraging inaction.
So, if a lot of people have already had it, which I see a lot of people thinking they did, we need to find out if you can get reinfected.
Yeah this point has been bugging me for a while now. What’s the reinfection rate / immunity rate? I know there are some reinfections but does that mean everyone can be reinfected or is it just a fraction that don’t gain immunity?
lots of “reinfections” were debunked as false positives. search on r/COVID19 for details.
And it should be emphasized that 100% of reported reinfections were just news reports saying "hey this person tested positive after testing negative" - there was never tremendously strong evidence for it.
There is also the question of why is it so severe in places? And could it get that severe elsewhere?
Studies of SARS showed that regions with high pollution were significantly more at risk for death from it. If that is the case for this, the severity expected in many parts of the world will be considerably lower than projected.
Again, stay home. I am not encouraging breaking self distancing. The panic message is worrying me because everyone seems to only be looking for reasons to panic.
Studies of SARS showed that regions with high pollution were significantly more at risk for death from it. If that is the case for this, the severity expected in many parts of the world will be considerably lower than projected.
Again, stay home. I am not encouraging breaking self distancing. The panic message is worrying me because everyone seems to only be looking for reasons to panic.
I catch a cold once or twice each year. This year was different as we have a son in daycare, so we've been sick about once a month. In January we all went through a very weird flu. Bowel issues, followed by very dry and sore throat with a mild dry cough that lasted for just under two days, followed by what felt like a normal flu for another day and then came the respiratory issues, for me. I never before in my life had considered going to the ER for a flu, but that one felt different. I had trouble taking deep breaths. The discomfort lasted for several days and I felt slightly exhausted, but still roughly 80% normal. After a couple of days of that I asked my wife if I should consult. We chose not to and I took a few days off and everything went back to normal. All in all, I must have been "sick" for about 8-9 days. (EDIT: I am male, under 30.)
The symptoms as a whole didn't quite feel like a flu, we all thought they were weird, but hey who am I to know, right?
Well a few weeks later we remembered that two days prior to feeling ill, we had ordered some Chinese takeout. The delivery man (not a Chinese national) looked like he was going to collapse. He had trouble getting up the stairs, had a bad cough, looked like he had a fever - god knows why he was working. After taking the food and paying, I wondered if he'd make it back down the stairs but forgot about it for a few weeks.
We probably won't know if we had this bug or not, but it's definitely possible. Maybe I just happened to develop a respiratory distress caused by a bad flu right when the epidemic in China was not controlled, and not any other year prior. Who knows!
The symptoms as a whole didn't quite feel like a flu, we all thought they were weird, but hey who am I to know, right?
Well a few weeks later we remembered that two days prior to feeling ill, we had ordered some Chinese takeout. The delivery man (not a Chinese national) looked like he was going to collapse. He had trouble getting up the stairs, had a bad cough, looked like he had a fever - god knows why he was working. After taking the food and paying, I wondered if he'd make it back down the stairs but forgot about it for a few weeks.
We probably won't know if we had this bug or not, but it's definitely possible. Maybe I just happened to develop a respiratory distress caused by a bad flu right when the epidemic in China was not controlled, and not any other year prior. Who knows!
I don't get it, because these measures can't last forever. Let's pretend USA completely extreme isolates...step foot outside and you get arrested. Fine, the virus disappears in a month or two. Then what? Unless every single person on the globe does the same thing, you have to effectively keep your borders closed forever. This isn't a solvable problem at the state or national level, it's a completely global thing. We can attempt to slow it, but it's just gonna rear its ugly head again when we let our guard down.
These actions are for the ~5-10% of people who get this bug and who require intensive care in order to survive. The death rate is pretty low even for those who end up with severe symptoms if the full weight of modern medical technology and care can be applied to their recovery.
Right now, as I type this, many hospitals in the United States have had all of their excess intensive care capacity used up by Covid-19 cases. Not all, but many.
Once large groups of hospitals reach capacity, then there will be no choice but to black tag people who could otherwise be saved and leave them to die in the hallways.
Click this graph, then click Logarithmic at the top: https://mackuba.eu/corona/#united_states
You're right to note that this is a global problem. Given that, the vast majority of human to human contact is NOT cross border.
This bug is probably going to end up infecting most of the people in the United States. The main thing we can do at this point is to keep hospitals from being too overwhelmed, to keep the number of black tagged people, dying in the hallways, to a minimum.
Right now, as I type this, many hospitals in the United States have had all of their excess intensive care capacity used up by Covid-19 cases. Not all, but many.
Once large groups of hospitals reach capacity, then there will be no choice but to black tag people who could otherwise be saved and leave them to die in the hallways.
Click this graph, then click Logarithmic at the top: https://mackuba.eu/corona/#united_states
You're right to note that this is a global problem. Given that, the vast majority of human to human contact is NOT cross border.
This bug is probably going to end up infecting most of the people in the United States. The main thing we can do at this point is to keep hospitals from being too overwhelmed, to keep the number of black tagged people, dying in the hallways, to a minimum.
> This bug is probably going to end up infecting most of the people in the United States.
Exactly. As you say, we need to flatten the curve to keep hospitals from becoming overwhelmed, and we need to use the time to develop treatments to save the vulnerable when isolation eventually fails.
Exactly. As you say, we need to flatten the curve to keep hospitals from becoming overwhelmed, and we need to use the time to develop treatments to save the vulnerable when isolation eventually fails.
> Right now, as I type this, many hospitals in the United States have had all of their excess intensive care capacity used up by Covid-19 cases. Not all, but many.
Do you happen to have a source for this? I haven't heard much about hospital problems yet.
Do you happen to have a source for this? I haven't heard much about hospital problems yet.
Anecdotal: my wife and I are friends with two ER nurses, one in Maryland and one in St. Louis, and my reports mirror what they're telling us.
The measure's are to get a hold on the explosive number of cases. Once we get a grip on it, then you keep it contained with aggressive testing + targeted isolation.
[deleted]
You don't need to keep your borders closed forever. You can allow outbound flights without restrictions and make everyone on inbound flights go to a centralized quarantine facility for 2 or 3 weeks + test them.
What about cargo? Better yet illegal cargo we can't seem to get a grasp on. Or illegal border crossings? It only takes a single thing/person to kick off a chain reaction that gets us back to here.
Cargo isn't believed to be a significant transmission vector and has almost universally been excluded from border closures. If a country wants to be very cautious they can mandate that cargo sits in a warehouse for a few days, although that was almost always going to happen anyway.
Hey - owner of the model in question here. The idea here is to buy time; time to roll out testing (so only those that test positive need to isolate), prepare beds and ventilators, and develop therapeutics (vaccines are likely quite a bit farther off).
The frustrating challenge to this is how long symptoms take to appear. Isolation will stop the spread from the individual but only after the virus has been spread around quite a bit already. So, sure, much of what you said about localized preparedness will need to happen but we won’t be able to do the kinds of things we did with diseases like Ebola to limit its spread.
One study shows around 18% of those that test positive show no symptoms [1].
Perhaps this reduces the infection rate.
[1] https://www.forbes.com/sites/brucelee/2020/03/18/what-percen...
Perhaps this reduces the infection rate.
[1] https://www.forbes.com/sites/brucelee/2020/03/18/what-percen...
The goal is to delay and fit into the number of bed and the logistic stuff in hospital.
If a person get good care in hospital the rate of survival would be totally different.
For those country which had sudden high fatality rate was because their resources and supplies were exhausted - there were no bed, no consumable, even no protection for the nurses.
If a person get good care in hospital the rate of survival would be totally different.
For those country which had sudden high fatality rate was because their resources and supplies were exhausted - there were no bed, no consumable, even no protection for the nurses.
The non-forever outcome is a vaccine. Covid-19 becomes endemic, always around, restrained by a vaccinated herd. It becomes like measles, small outbreaks here and there when sufficiently many unvaccinated come in contact.
The projections are ignoring a very important datapoint - there is significant evidence that COVID-19 does not have a positive R0 in warm climates. This means that in many areas, there is no need to flatten the curve - it will flatten naturally in the next month or two. On the contrary, by aggressively shutting down the spread now, we are leaving ourselves more vulnerable to winter outbreak which will be hard to stop.
Now the really terrible part is that the economic effect of the mass closure is going to grow exponentially. So layoffs start small and grow more massive week by week. And unlike COVID-19, that economic effect will not subside with the warming weather...
Here is some evidence:
Compare the slow growth in cases per day (green line) in CA and FL (warm) vs NY and WA (cold):
https://covid-19.direct/state/CA
https://covid-19.direct/state/FL
https://covid-19.direct/state/NY
https://covid-19.direct/state/WA
See for example how in Malaysia there was an outbreak due to a very large Muslim gathering with foreign travelers, that seems to diminish every day (indicated an R factor < 1) - https://www.worldometers.info/coronavirus/country/malaysia/ The same is true for Qatar.
Same examples all over the world for warm countries: https://www.worldometers.info/coronavirus/
Now the really terrible part is that the economic effect of the mass closure is going to grow exponentially. So layoffs start small and grow more massive week by week. And unlike COVID-19, that economic effect will not subside with the warming weather...
Here is some evidence:
Compare the slow growth in cases per day (green line) in CA and FL (warm) vs NY and WA (cold):
https://covid-19.direct/state/CA
https://covid-19.direct/state/FL
https://covid-19.direct/state/NY
https://covid-19.direct/state/WA
See for example how in Malaysia there was an outbreak due to a very large Muslim gathering with foreign travelers, that seems to diminish every day (indicated an R factor < 1) - https://www.worldometers.info/coronavirus/country/malaysia/ The same is true for Qatar.
Same examples all over the world for warm countries: https://www.worldometers.info/coronavirus/
Maybe I don't understand. The number of confirmed cases is going up exponentially in all of the warm locations you mention. This is in spite of a lack of testing. How is that evidence of R < 1?
Is there any evidence beyond the layperson analysis you are submitting here in this comment?
My critique of this analysis is that there is no way you are controlling for all of the factors: different starting dates for community spread, uneven testing / reporting of cases, random luck due to super-spreading events, differences in behaviors between regions, and so on.
My critique of this analysis is that there is no way you are controlling for all of the factors: different starting dates for community spread, uneven testing / reporting of cases, random luck due to super-spreading events, differences in behaviors between regions, and so on.
How can you reliably use confirmed cases to suggest a trend given the disparity between states in test availability, population density, and timeline of introduction?
We are looking just at the trend. And the testing methodology that different states take is just a multiplicative constant of the confirmed cases. And exponentially growing function will make it negligible.
We are looking just at the trend. And the testing methodology that different states take is just a multiplicative constant of the confirmed test. And exponentially growing function will make it negligible.
Consider that the evidence you are presenting does not show the actual influence of temperature on the virus itself. I would argue (anecdotally) that warmer climates mean people are less confined in general, therefore adding some element of "natural" social distancing.
Annoyingly, I would think it could proxy details that are reverse correlated. Colder means more gloves and fiddling with more clothes that cover the face, as an example.
Which is to say, I accept it is complicated. If it correlates with something, that is just another question. Not likely an answer in itself.
Which is to say, I accept it is complicated. If it correlates with something, that is just another question. Not likely an answer in itself.
Brazil is not seeing any slowdown due to high temperatures. Looking at your cities on very different climates, temperature seems to not be a factor at all.
City density, by its turn, is huge.
City density, by its turn, is huge.
Sheltering in place would be less necessary if everyone would stay at least 2 meters apart, wear masks, wear gloves, not talk unnecessarily or cough/sneeze at anyone, and wash up with soap when they get home. Some people seem unable to stay away and feel compelled to get in your face and talk.
https://covidactnow.org/state/CA
This is missing a HUGE point. At the very end of the California "shelter-in-place" plan, the numbers will go up. What it doesn't show is that this will merely delay the epidemic to 3 months in the future. The chart useless with only a 3 month time horizon.
This is missing a HUGE point. At the very end of the California "shelter-in-place" plan, the numbers will go up. What it doesn't show is that this will merely delay the epidemic to 3 months in the future. The chart useless with only a 3 month time horizon.
Keep reading. This footnote is attached to the California-style scenario:
> * A second spike in disease may occur after social distancing is stopped. Interventions are important because they buy time to create surge capacity in hospitals and develop therapeutic drugs that may have potential to lower hospitalization and fatality rates from COVID-19. See full scenario definitions here.
> * A second spike in disease may occur after social distancing is stopped. Interventions are important because they buy time to create surge capacity in hospitals and develop therapeutic drugs that may have potential to lower hospitalization and fatality rates from COVID-19. See full scenario definitions here.
Thanks. I did see that, but it should more than a (literal) asterisk at the bottom of the page.
There’s a balance here between insight and precision. As you make information more precise, you often make it less understandable.
If you put the information in the footnote into the table, it makes the table harder to read.
As it is, the footnote is right below the table (not at the bottom of the page) and the information about the second spike is BOLD. That stands out to me.
If you put the information in the footnote into the table, it makes the table harder to read.
As it is, the footnote is right below the table (not at the bottom of the page) and the information about the second spike is BOLD. That stands out to me.
If done correctly, it doesn't have to be like that. See Korea, etc
Korea could test their way out of it, because they started early enough to contain it. US is past that point now - the scale of testing that we need to catch all the heretofore undetected cases is much bigger. And we need to find those cases to switch from blanket measures to targeted ones.
In the end, that's likely what we'll have to do anyway. But it'll take longer than 3 months.
In the end, that's likely what we'll have to do anyway. But it'll take longer than 3 months.
I guess the operative detail is whether shelter-in-place will get us to a "23%" total infection rate vs 70%.
I wonder if that's accurate. I also wonder if this is recurring in the fall, and every year, and whether physical distancing will be mandatory every year?
I wonder if that's accurate. I also wonder if this is recurring in the fall, and every year, and whether physical distancing will be mandatory every year?
How many recurrent seasons would it take for countries/society to adapt and cope (whether that's hugely more full-time remote workers, or blanket acceptability of it part-time/during such occasions, or something else) I wonder?
If you expect it to spread at the rate this thing spreads, after a couple of years nearly everyone will have been exposed to it and thus have developed an immunity (or died). From then on it mostly becomes a childhood disease, like measles. The goal thus becomes to spread out the exposures enough so that people who need medical help to survive their exposure can reliably get it.
Of course the above assumes that immunity really does develop after one exposure, and that the virus doesn't mutate into some sufficiently different form to reset the immunity counter to zero again. The evidence seems to indicate positive things on the immunity front, but it's still preliminary. And as for mutation, who can say?
Of course the above assumes that immunity really does develop after one exposure, and that the virus doesn't mutate into some sufficiently different form to reset the immunity counter to zero again. The evidence seems to indicate positive things on the immunity front, but it's still preliminary. And as for mutation, who can say?
Just one I think. People are already coping, and it's barely started. If people knew a 3 month shelter-in-place was a yearly rule, we could plan for it.
People with either cushy office jobs or enough savings to be long-term unemployed are coping. The millions of service industry employees either aren’t, or soon won’t be.
I would assume there would be changes to how unemployment works if this was a regular thing.
The problem is that those changes are highly politicized, because they hit a bunch of culture war buttons about "socialism".
And it's been a while since American legislators have considered the possibility of torches and pitchforks, so they still prioritize their electability (especially in the primaries, where ideological purism is more important) over social necessity.
And it's been a while since American legislators have considered the possibility of torches and pitchforks, so they still prioritize their electability (especially in the primaries, where ideological purism is more important) over social necessity.
Hey - admin of covidactnow here. I don't think anyone has any idea if this will recur, mutate, etc.
The key is to buy time, now. To add hospital capacity, develop therapeutics and vaccines, and learn more about the disease...
The key is to buy time, now. To add hospital capacity, develop therapeutics and vaccines, and learn more about the disease...
Stupid question: why do all the curves go down way before reaching a large percentage of the population? For example, California's curve peaks at ~900,000, only 2% of its population (and only a bit more if you consider cumulative hospitalizations). I guess 2% is not enough for herd immunity to kick in so what is it?
Edit: Oops, brain fart. Those numbers don't include all cases, just hospitalized ones.
Edit: Oops, brain fart. Those numbers don't include all cases, just hospitalized ones.
Those are hospitalizations, not infections.
The graphs are the number of cases requiring hospital care.
Site is broken for me. The url https://covidactnow.org/data/wa.7.json is returning an HTML document with the text "You need to enable JavaScript to run this app." and there's a JSON.parse error in the console.
Washington wasn't working for me, either. Just a blank page. And I do have javascript enabled. Other states work fine, like Illinois.
thanks for this, looking now
So, this projects 3-months out. But what about after that? The graph for my state (MN) showed 3 months of sheltering in place would keep infections down, but then start to rise immediately afterwards. Then the graph ends. I think super-extended voluntary isolation is going to be a tough sell.
Hey guys - owner of the model in question here.
Yes, that's exactly right, but 3 months (or even 1 month) may be enough time to prevent unnecessary deaths by preparing hospitals, getting more ventilators, rolling out testing, and hopefully finding a therapeutic drug (vaccines are probably farther off).
Nobody can predict the future, though.
Yes, that's exactly right, but 3 months (or even 1 month) may be enough time to prevent unnecessary deaths by preparing hospitals, getting more ventilators, rolling out testing, and hopefully finding a therapeutic drug (vaccines are probably farther off).
Nobody can predict the future, though.
3 months is definitely not enough to grow the hospital and ICU capacity 7x, which is what's necessary to prevent deaths due to lack of healthcare availability. It'll improve some, and that will save some lives, but not most of them.
Pervasive testing looks like the best short-term hope right now - it's easier to drastically ramp up test manufacturing, and you don't need a full-fledged hospital for mass testing.
Pervasive testing looks like the best short-term hope right now - it's easier to drastically ramp up test manufacturing, and you don't need a full-fledged hospital for mass testing.
I sure hope so. Thanks for your effort educating people.
Naive question: in the states I looked at, the "California-style shelter-in-place" line consistently goes up again toward the right side of the graph (end of June to July), whereas none of the other approaches have that second lift. Why is that?
Because herd immunity isn't acquired with effective quarantine, so after quarantine ends people become infected again. This doesn't happen with the two weaker options since herd immunity is effective, and I guess they assume complete elimination of the virus with a totalitarian lockdown.
Because the first wave is enough to develop herd immunity and reduce the R-rate of the virus
But the second lift suggests the model is showing the R-rate going up after a drop, which is what I'm asking about. The other curves -- which presumably also involve herd immunity to some degree -- are pretty much bell curves.
The second lift would suggest that isn't true.
This was just used to trigger a shelter in place in Dallas. Thanks to whoever built this!
https://www.dallasnews.com/news/public-health/2020/03/22/hos...
https://www.dallasnews.com/news/public-health/2020/03/22/hos...
This seems to be treating number of positives test results and number of hospitalizations as the same thing? That seems...wrong...
This is what worries me:
> Our models show that it would take at least 2 months of Wuhan-style Lockdown to achieve full containment. However, it is unclear at this time how you could manage newly introduced infections.
When will Wuhan accept travelers from Spain or Italy ? Or are we going to live with border controls & quarantines forever?
> Our models show that it would take at least 2 months of Wuhan-style Lockdown to achieve full containment. However, it is unclear at this time how you could manage newly introduced infections.
When will Wuhan accept travelers from Spain or Italy ? Or are we going to live with border controls & quarantines forever?
It appears this assumes a doubling rate of 3-4 days? That's pretty pessimistic compared to what the science-heads are saying, right? I've heard 5-6 days, 6.2 from another source.
EDIT: I'm talking about the doubling rate of the actual cases, not the confirmed cases.
EDIT: I'm talking about the doubling rate of the actual cases, not the confirmed cases.
The US has averaged over 30% daily increases in infections for the last 20 days. 1.3 x 1.3 x 1.3 = 2.2x growth every 3 days making that 4 day doubling optimistic. https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_t...
New infections are modeled to noticeably slow down once ~1/5 of the total population is infected, but at that point things have already fallen apart.
New infections are modeled to noticeably slow down once ~1/5 of the total population is infected, but at that point things have already fallen apart.
The US has also been ramping up testing, assuming number of infections is a linear function of known cases is a mistake.
We are not doing 16,000 / 42 = 380x more tests per day on March 20th vs March 1st. It’s not even obvious if we are overlooking a larger fraction of infections today than back then.
Also of note that 30% daily increase I spoke of underestimates the difference between March 1 and March 20th.
Also of note that 30% daily increase I spoke of underestimates the difference between March 1 and March 20th.
It's doubling even faster right now, but that may be more related to increased testing than anything.
Unfortunately, the US is further along the curve than all these sites are showing due to the fact that we didn't have any testing in the beginning (and still don't have enough).
Unfortunately, the US is further along the curve than all these sites are showing due to the fact that we didn't have any testing in the beginning (and still don't have enough).
New York City doubled in one day - yesterday simply by having the capacity to do more tests.
Right, which isn't relevant to projecting future new infections.
In my opinion this page isn't terribly informative unless you happen to live in Texas or California.
Basically every state has measures in place already. None of that is reflected here, and there is no way to tell where it fits relative to the scenarios shown.
Basically every state has measures in place already. None of that is reflected here, and there is no way to tell where it fits relative to the scenarios shown.
Where is this data coming from?
I have not seen any numbers to indicate Utah was at 96 hospitalizations as of yesterday. Are other state's number correct? Was California at 952 hospitalizations as of yesterday?
Is this just using number of cases as hospitalizations?
I have not seen any numbers to indicate Utah was at 96 hospitalizations as of yesterday. Are other state's number correct? Was California at 952 hospitalizations as of yesterday?
Is this just using number of cases as hospitalizations?
So according to these models, we should be Wuhan-ing our states?
Well I still have a fundamental question, what happens when China, or anyplace else, un-Wuhan's?
They seem to be opening stores, starting flights to SFO, but surely China is not clear of the virus. So, are we expecting a pick up in infections now. And, if not, please explain why not.. I'm really curious..
They seem to be opening stores, starting flights to SFO, but surely China is not clear of the virus. So, are we expecting a pick up in infections now. And, if not, please explain why not.. I'm really curious..
Here's an expert discussing that: https://www.youtube.com/watch?v=EpQmMkPj-mE&t=3m8s
I get the impression that it's BS to say "look at South Korea and China, they're beating the outbreak and will soon be able to relax because they have lots of testing and transmission tracing". I haven't heard a single expert suggest that a "second wave" is avoidable at this point. It might have been avoidable if the whole world had reacted quickly and decisively in the early stages, but that ship has sailed.
The CDC also suggested that China was reporting falsified data in January (not surprising). Why should we trust their numbers now?
I get the impression that it's BS to say "look at South Korea and China, they're beating the outbreak and will soon be able to relax because they have lots of testing and transmission tracing". I haven't heard a single expert suggest that a "second wave" is avoidable at this point. It might have been avoidable if the whole world had reacted quickly and decisively in the early stages, but that ship has sailed.
The CDC also suggested that China was reporting falsified data in January (not surprising). Why should we trust their numbers now?
They're starting to open up now. It works fine as long as you have broad testing & can identify everyone who has been exposed to it.
Exponential curves are easy to stop as long as you catch them early.
Exponential curves are easy to stop as long as you catch them early.
You don't need these models to tell you that. It's self evident that if you keep people from contacting each other you can stop things.
It's just not so clear it's possible to do such a lockdown in non-Authoritarian, free, countries.
It's just not so clear it's possible to do such a lockdown in non-Authoritarian, free, countries.
It is possible and in fact it has happened already in a lot of European states.
Enacting a lockdown is possible, but having the populace respect it - or enforce it otherwise - is another matter.
Besides, the worst lockdowns have only just begun recently. There are a lot of people who will go ahead with, say, a 2-week lockdown, but will balk at 3 months. The true test for the ability to maintain things that way is still ahead for Western countries.
Besides, the worst lockdowns have only just begun recently. There are a lot of people who will go ahead with, say, a 2-week lockdown, but will balk at 3 months. The true test for the ability to maintain things that way is still ahead for Western countries.
It's happening in a lot of United States!
This would be a lot more helpful if there were a line with actual daily hospitalizations as well.
Is there an accumulative data chart for the entire nation?COVID-19 has no state boundaries!
[deleted]
Having read some of the comments here, I want to say that I think I fall in the "cynical" portion of the population. Then again, my family is Russian, and we all typically think we're all gonna be screwed somehow.
The most optimistic outcome, for me, is that remote work becomes a bigger possibility when companies realize they're wasting tons of money on too much office space.
People already know that we can live with less. _Businesses_, however, do not realize this. I hope businesses ( especially big ones ) realize this.
Shortcomings in our economy and health care ( not just America, but world-wide ) will be realized and fixed.
However, I do not think any of the above will become true. Humans have short memories. I think once the crisis is over, business as usual will resume and we will have made no progress. Other than another vaccine.
The most optimistic outcome, for me, is that remote work becomes a bigger possibility when companies realize they're wasting tons of money on too much office space.
People already know that we can live with less. _Businesses_, however, do not realize this. I hope businesses ( especially big ones ) realize this.
Shortcomings in our economy and health care ( not just America, but world-wide ) will be realized and fixed.
However, I do not think any of the above will become true. Humans have short memories. I think once the crisis is over, business as usual will resume and we will have made no progress. Other than another vaccine.
would like to be able to look at a whole country projection, if possible
Not sure how much effort you want to put into it, but the raw data is in JSON files on the site under the following pattern:
https://covidactnow.org/data/{{state_abbreviation}}.{{scenario_number}}.json (where scenarios go from 0 - 7)
https://covidactnow.org/data/{{state_abbreviation}}.{{scenario_number}}.json (where scenarios go from 0 - 7)
very cool, thank you
I see a lot of rumbling in this thread about how we need to ask ourselves if the costs of a shutdown is worth it, or what happens after a shutdown?
My question is this: what would you propose we do? If we don’t lock everything down, we’ll overwhelm the hospitals and the death rate will skyrocket. And then the deaths will be less skewed towards the elderly, because virtually all causes of mortality will shoot up when we no longer have a functioning medical system to treat anyone for anything except this.
Are you really proposing we just let hundreds of millions of people all over the world die over the next 6-12 months? So we’ll all just go back to work and to restaurants and on vacation while 5% of the population is gasping their last breaths in a hospital somewhere? We’ll just say goodbye to a huge chunk of our parents and grandparents and aunts and uncles and coworkers? Because the economic cost is just too high?
It’s easy to complain about this course of action. It sucks. But unless you can lay out a plausible alternative, this still seems like the best one to me.
My question is this: what would you propose we do? If we don’t lock everything down, we’ll overwhelm the hospitals and the death rate will skyrocket. And then the deaths will be less skewed towards the elderly, because virtually all causes of mortality will shoot up when we no longer have a functioning medical system to treat anyone for anything except this.
Are you really proposing we just let hundreds of millions of people all over the world die over the next 6-12 months? So we’ll all just go back to work and to restaurants and on vacation while 5% of the population is gasping their last breaths in a hospital somewhere? We’ll just say goodbye to a huge chunk of our parents and grandparents and aunts and uncles and coworkers? Because the economic cost is just too high?
It’s easy to complain about this course of action. It sucks. But unless you can lay out a plausible alternative, this still seems like the best one to me.
Nobody is proposing we just let people die. At least, nobody credibly that I have seen.
There are some questions on if there was really going to be a curve to flatten. Such that, if we flatten it now, was it the social distancing we did, or was it going to flatten anyway?
These are not reasons to abandon caution. They do seem valid questions, though. Especially considering the costs of the actions we have taken.
There are some questions on if there was really going to be a curve to flatten. Such that, if we flatten it now, was it the social distancing we did, or was it going to flatten anyway?
These are not reasons to abandon caution. They do seem valid questions, though. Especially considering the costs of the actions we have taken.
> Nobody is proposing we just let people die.
Agreed, but a lot of people are arguing for the thing that will almost certainly lead to a lot more deaths.
Right now, as I type this, many hospitals in the United States have had all of their excess capacity filled with Covid-19 cases. Not most, but many.
Now, please click this link, then click Logarithmic on the top.
https://mackuba.eu/corona/#united_states
Once large groups of hospitals reach saturation, people who could otherwise be saved will be black tagged and left to die.
Two women my wife is Facebook friends with, after two weeks of a mild fever, malaise and a moderate, unproductive cough, started having a hard time breathing. They went in and were both positive for Covid-19. They were placed on ventilators, and were soon in critical condition. One of them died this morning, the other is clinging on to life.
Neither of these people are old; neither of them have any substantial medical history or other comorbidities.
This bug is dangerous for all of us; it's extremely dangerous for some of us.
It's true that few people are soberly thinking about the mid and long term economic cost of this pandemic. In my opinion, there's a good chance we're facing something on the order of the great depression.
Be that as it may, lives must come first.
Agreed, but a lot of people are arguing for the thing that will almost certainly lead to a lot more deaths.
Right now, as I type this, many hospitals in the United States have had all of their excess capacity filled with Covid-19 cases. Not most, but many.
Now, please click this link, then click Logarithmic on the top.
https://mackuba.eu/corona/#united_states
Once large groups of hospitals reach saturation, people who could otherwise be saved will be black tagged and left to die.
Two women my wife is Facebook friends with, after two weeks of a mild fever, malaise and a moderate, unproductive cough, started having a hard time breathing. They went in and were both positive for Covid-19. They were placed on ventilators, and were soon in critical condition. One of them died this morning, the other is clinging on to life.
Neither of these people are old; neither of them have any substantial medical history or other comorbidities.
This bug is dangerous for all of us; it's extremely dangerous for some of us.
It's true that few people are soberly thinking about the mid and long term economic cost of this pandemic. In my opinion, there's a good chance we're facing something on the order of the great depression.
Be that as it may, lives must come first.
> Right now, as I type this, many hospitals in the United States have had all of their excess capacity filled with Covid-19 cases.
Today Santa Clara county has 65 people hospitalized:
https://commons.wikimedia.org/wiki/Data:COVID-19_Cases_in_Sa...
In comparison, Stanford hospital has 600 beds:
https://facts.stanford.edu/about/hospital/
Today Santa Clara county has 65 people hospitalized:
https://commons.wikimedia.org/wiki/Data:COVID-19_Cases_in_Sa...
In comparison, Stanford hospital has 600 beds:
https://facts.stanford.edu/about/hospital/
Total beds is an incomplete picture. Stanford hospital appears to run at 88% capacity [1] and Seattle's Harborview operates at 95% capacity [2].
1 - https://stanfordhealthcare.org/content/dam/SHC/about-us/bond... (page 5)
2 - https://www.seattletimes.com/seattle-news/health/short-staff...
1 - https://stanfordhealthcare.org/content/dam/SHC/about-us/bond... (page 5)
2 - https://www.seattletimes.com/seattle-news/health/short-staff...
A lot of the beds are used for routine scheduled stuff that can be postponed. While the ER/ICU/telemetry capacity is much smaller (can’t find online source but it’s about 150 beds in Stanford), these are usually reserved for postop and ER flow (car accidents, etc.). Plus there are expansion possibilities. Overall, there about 500-1000 beds for critical care in Santa Clara that can be made available (I also suspect there are not that many car accidents, broken legs, etc right now). Overall, we are at about 10x in available capacity right now.
Edit: source is my wife who used to be ER nurse and then ER nurse manager in several Bay Area hospitals.
Edit: source is my wife who used to be ER nurse and then ER nurse manager in several Bay Area hospitals.
Actually this link from another reply here shows 3.8k total beds in Santa Clara which confirms my estimate for critical care beds that can be made available (about 25% from total):
https://covid-19.direct/county/CA/Santa%20Clara
https://covid-19.direct/county/CA/Santa%20Clara
Ok, maybe not yet. But once you start the lockdown, exponential growth continues for a couple of weeks (at least). If it grows at the same rate as in Europe, at the end of those two weeks Santa Clara county will need to hospitalize more than 15000 people.
I strongly suspect that the epidemic spread will be very different between large and small cities, suburbs, and country side. Plus Santa Clara county has very different demographic than Italy.
BTW, with the amount of people going back and forth between Bay Area and China, I have hard time believing that we had no cases in Jan/Feb. I personally know two people (and I met with both within a few days after their return) who came back from Wuhan in Dec and early Jan. A lot of people were sick in late Dec and early Jan with very similar symptoms.
BTW, with the amount of people going back and forth between Bay Area and China, I have hard time believing that we had no cases in Jan/Feb. I personally know two people (and I met with both within a few days after their return) who came back from Wuhan in Dec and early Jan. A lot of people were sick in late Dec and early Jan with very similar symptoms.
Santa Clara County started the lockdown a few days ago. Maybe that's where a lot of the dispute in this thread is coming from; for those of us living in the Bay Area, maximum emergency measures are a given, so the most urgent priorities left are manufacturing medical equipment and finding a way to lift those measures.
A month ago, I had a hard time breathing. A week in, I went to an emergency care facility. They put me on steroids. A week later, I went to my doctor still unable to breath well. They put me on a respirator and another week of steroids. (Plus antibiotics, since I had had a fever in that time.)
So, to that end, I suspect I had this. It also went through my entire family of six. Nobody else even got sick enough that we would have help them home, except the had a fever that lasted a night.
So, in not arguing this isn't serious. If you have trouble breathing, get help. Immediately.
I'm growing less confident in all of the simulations I'm seeing of it's out of control growth, though.
Why? Because from all reporting, I almost certainly had it. And if I had it, my kids school was almost certainly saturated with it. Such that I think of there was going to be exponential growth in cases, that skip sailed over a month ago.
So, to that end, I suspect I had this. It also went through my entire family of six. Nobody else even got sick enough that we would have help them home, except the had a fever that lasted a night.
So, in not arguing this isn't serious. If you have trouble breathing, get help. Immediately.
I'm growing less confident in all of the simulations I'm seeing of it's out of control growth, though.
Why? Because from all reporting, I almost certainly had it. And if I had it, my kids school was almost certainly saturated with it. Such that I think of there was going to be exponential growth in cases, that skip sailed over a month ago.
If it’s already widespread, then why are 90% of tests coming back negative?
More likely: you didn’t have it.
More likely: you didn’t have it.
Also, the tests deployed right now return negative for recovered people...
So a huge portion of the population had it, including you and your family a mere 3-4 weeks ago, but now only 10% of those tested actively have it, many of the other 90% are fully recovered in the last few weeks? But hospitals are mysteriously only now seeing an influx of cases?
Me and my family would not be a huge percentage. My kids school? Gets bigger.
I also just was told the Z-Pak I was put on is similar to what treats this. So, really not sure what to think. But my entire office was put sick for the month leading to this. My neighbor is the one that told me about the medicine, since she just finished a round.
So, maybe? Our hospitals are not seeing influxes if severe cases. They are getting swamped from panic and lack of supplies, from what I'm seeing. Not severe cases of people about to die.
I also just was told the Z-Pak I was put on is similar to what treats this. So, really not sure what to think. But my entire office was put sick for the month leading to this. My neighbor is the one that told me about the medicine, since she just finished a round.
So, maybe? Our hospitals are not seeing influxes if severe cases. They are getting swamped from panic and lack of supplies, from what I'm seeing. Not severe cases of people about to die.
the PCR test (throat swap) only test for active infections; we need antibody tests to determine if someone had the decision in the past
Can you cite some references on "there was really going to be a curve"? I haven't seen any models that expect it to die out on its own without infecting a significant proportion of the population first - all of them assume exponential spread, just different rates of it (which is exactly what social distancing lowers).
Your question is part of my complaint. There have to be models that this didn't spread exponentially in the severe cases. Where are they, and what were their odds?
> There have to be models that this didn't spread exponentially in the severe cases
Why ? Model have to fit what we observe. And we always observe exponential.
Why ? Model have to fit what we observe. And we always observe exponential.
But we haven't observed much, yet. This is akin to the xkcd about how married you will be for days after your wedding. We are way too early to know what the later curve looks like.
The more accurate curve is a Logistic Curve. You have to factor in that eventually people become immune or die, and there's a total population ceiling. Obviously, the number of confirmed cases cannot exceed this limit!
There are other fudge-factors as well. There is evidence that the very early stages are not exponential, but possibly quadratic or some other curve, but this doesn't matter very much in the grand scope of things.
If you want to be really pedantic, you have to do Monte Carlo simulations using census and geospatial data for each area, factoring in things like school days, work hours, mass transit usage, and tourism.
However, it turns out that after all that effort you end up pretty much with a logistic curve, the first half of which is barely distinguishable from an exponential curve.
All previous pandemics and plagues have followed curves like this.
There is no magic math formula that will dispel this plague. Sorry.
There are other fudge-factors as well. There is evidence that the very early stages are not exponential, but possibly quadratic or some other curve, but this doesn't matter very much in the grand scope of things.
If you want to be really pedantic, you have to do Monte Carlo simulations using census and geospatial data for each area, factoring in things like school days, work hours, mass transit usage, and tourism.
However, it turns out that after all that effort you end up pretty much with a logistic curve, the first half of which is barely distinguishable from an exponential curve.
All previous pandemics and plagues have followed curves like this.
There is no magic math formula that will dispel this plague. Sorry.
My main point of contention, is someone has to explain the delta between Italy, China, and Japan.
My favored hypothesis on exposure to local pollution does a decent job of explaining. That said, so far every curve people are looking at assumes all nation's curve should be the same. But they aren't. Not even the cruise ships we have locked up have followed Italy or China style patterns.
My favored hypothesis on exposure to local pollution does a decent job of explaining. That said, so far every curve people are looking at assumes all nation's curve should be the same. But they aren't. Not even the cruise ships we have locked up have followed Italy or China style patterns.
To provide an entirely unscientific observation about Japan:
I've been there on month-long holidays for the last three years straight, and the thing that struck me as the most alien was their borderline obsessive hygiene and cleanliness.
I'm sure you all know that Japanese people take their shoes off when they enter a house, right? Well, the Chinese recently discovered that coronaviruses can live on pavement for days in cool weather, and people track the viruses into their apartments on the soles of their shoes. The kids and pets roll around on the carpet, and presto... everyone in the household gets The Plague.
Shops in Japan package everything. If you buy a single strawberry mochi for about $1, it'll come in a tiny little plastic container, which they will put in a little paper takeaway bag, which then they will hand to you in a small plastic shopping bag. They sell individual bananas in plastic shrinkwrap. I shit you not.
All this while the cashier wears gloves and a facemask as standard, way before the coronavirus was a thing.
The bus and taxi drivers all wear white gloves. They have doilies on the seats, and I bet they wash them daily, given how pristine and white they looked.
At shinto temples, the first thing you're meant to do before entering is a ritual washing of your hands with fresh springwater. Then, of course, you take your shoes off.
It goes on and on.
Meanwhile, I regularly see people in shopping centres here coughing their lungs up. On to each other, the food, or just generally into the air to spice things up a bit. We're playing Pandemic Legacy on hard mode.
The cultures are entirely different, and Japan basically didn't even have to change anything to prepare for the coronavirus. They just kept doing what they're doing already...
I've been there on month-long holidays for the last three years straight, and the thing that struck me as the most alien was their borderline obsessive hygiene and cleanliness.
I'm sure you all know that Japanese people take their shoes off when they enter a house, right? Well, the Chinese recently discovered that coronaviruses can live on pavement for days in cool weather, and people track the viruses into their apartments on the soles of their shoes. The kids and pets roll around on the carpet, and presto... everyone in the household gets The Plague.
Shops in Japan package everything. If you buy a single strawberry mochi for about $1, it'll come in a tiny little plastic container, which they will put in a little paper takeaway bag, which then they will hand to you in a small plastic shopping bag. They sell individual bananas in plastic shrinkwrap. I shit you not.
All this while the cashier wears gloves and a facemask as standard, way before the coronavirus was a thing.
The bus and taxi drivers all wear white gloves. They have doilies on the seats, and I bet they wash them daily, given how pristine and white they looked.
At shinto temples, the first thing you're meant to do before entering is a ritual washing of your hands with fresh springwater. Then, of course, you take your shoes off.
It goes on and on.
Meanwhile, I regularly see people in shopping centres here coughing their lungs up. On to each other, the food, or just generally into the air to spice things up a bit. We're playing Pandemic Legacy on hard mode.
The cultures are entirely different, and Japan basically didn't even have to change anything to prepare for the coronavirus. They just kept doing what they're doing already...
What makes you think those questions haven’t been asked by the public health experts working on this?
And you didn’t answer my question. What is your plan?
And you didn’t answer my question. What is your plan?
I think they haven't been asked because I haven't seen them asked. I'm asking on a sibling top post.
I am seeing tons of extra reasons to panic every day. Not much on why to stay calm. That worries me.
For my plan? I'm taking the safe route for now. Though, I'm 99% that I had it a month ago. Week of steroids, then a respirator, then another week of steroids. Not tested, as I wasn't in the then current risk profile. Would be today, if even close to those symptoms.
Now, if I'm at all close to right, my entire family of six didn't even bat an eye at this. Why? Have we drastically misstated the risk pool?
Again, my plan is to take the safe path. Is an easy plan for me, as I can do so. Large parts of our nation can't.
I am seeing tons of extra reasons to panic every day. Not much on why to stay calm. That worries me.
For my plan? I'm taking the safe route for now. Though, I'm 99% that I had it a month ago. Week of steroids, then a respirator, then another week of steroids. Not tested, as I wasn't in the then current risk profile. Would be today, if even close to those symptoms.
Now, if I'm at all close to right, my entire family of six didn't even bat an eye at this. Why? Have we drastically misstated the risk pool?
Again, my plan is to take the safe path. Is an easy plan for me, as I can do so. Large parts of our nation can't.
If the hospital were full, as they are expected to be due to the steep curve of infected, there is a real chance you could have died. Are you saying that is fine? Should we not try to flatten the curve as much as reasonably possible?
Apart from that, it's not like there is no economic help. In Germany, for instance, there is a rather easy process for the employed as well as businesses to get state funding. So it is not like most businesses will go under or people lose their houses.
Apart from that, it's not like there is no economic help. In Germany, for instance, there is a rather easy process for the employed as well as businesses to get state funding. So it is not like most businesses will go under or people lose their houses.
If my evidence is that I had it, any attempt to flatten the curve should have happened in January. Effects happening now are just as likely from when we weren't doing anything.
The obvious answer is to test aggressively and quarantine the infected and direct contacts. Then the rest can be out and about.
Coronavirus has an incubation period of avg 5 days, and it gets contagious on the 2nd day. So, no, that will not work unless we have billions of tests and we test every citizen 3 times a week. Given that we don't have tests, and we cannot test every citizen with force; this is not gonna work.
Because everyone keeps parroting what you're saying. We are effectively now in a fear bubble. So now everyone's mindset is "stop the world lets hunker down and cower in a corner for the impending doom. Nothing positive or new data can change my mind."
In a couple weeks/months they'll start testing people to find out if they did have the virus. The tests right now only show if you currently have it. Once the real numbers come out I am confident it will be a massive over estimate for the CFR.
The fear bubble is causing people to underlook the data in places like SK, SG, Japan, Germany and overlook the data in Italy, China, Iran. It could be quite possible that a mixture of smoking, age, over reporting causes, and bad healthcare (gasp not in Italy where socialized medicine is world beating) is being overlooked.
So what we get now is stopping of society and the economy, millions of people will go through displacement and a host of negative things. People's savings will be depleted, not to mention teacher's/public servants/ pension and 401ks will take a MASSIVE hit. Oh and add to that more trillions of USD to the debt.
In a couple weeks/months they'll start testing people to find out if they did have the virus. The tests right now only show if you currently have it. Once the real numbers come out I am confident it will be a massive over estimate for the CFR.
The fear bubble is causing people to underlook the data in places like SK, SG, Japan, Germany and overlook the data in Italy, China, Iran. It could be quite possible that a mixture of smoking, age, over reporting causes, and bad healthcare (gasp not in Italy where socialized medicine is world beating) is being overlooked.
So what we get now is stopping of society and the economy, millions of people will go through displacement and a host of negative things. People's savings will be depleted, not to mention teacher's/public servants/ pension and 401ks will take a MASSIVE hit. Oh and add to that more trillions of USD to the debt.
The alternative to over reaction is under reaction. I'd rather take extreme precautions and deal with the economic fallout then under react and deal with the situation that italy is currently in.
I think in this situation fear is good, it ensures urgency and assists with decisive action making, coupled with humility to change course when your wrong. Apathy is much scarier than fear in these situations.
I think in this situation fear is good, it ensures urgency and assists with decisive action making, coupled with humility to change course when your wrong. Apathy is much scarier than fear in these situations.
It’s hard to take you seriously when you just dodge the question.
Also, the idea the economy will just keep rolling along somehow if we don’t do anything to slow the virus is wrong. When people are dying in the streets due to lack of health care capacity you’ll see what a real panic looks like. The economy is going to hard stop, probably including the food supply chain.
Also, the idea the economy will just keep rolling along somehow if we don’t do anything to slow the virus is wrong. When people are dying in the streets due to lack of health care capacity you’ll see what a real panic looks like. The economy is going to hard stop, probably including the food supply chain.
The most comprehensive analysis of the disease puts the average age of death from COVID at about ~80 years. Almost all of victims had a pre-existing condition. Fully choking the economy now means that we are much more likely to choke the supply chains and the healthcare system since we are stopping even healthy, younger people who are usually the main contributors to economic output. Without that output, it will only get harder to help those most vulnerable to the disease.
So the argument that stopping the economy now to help it later, eventually, even if we don't know how long we will need to keep it shut doesn't make any sense imo. We are jeopardizing our future ability to fight against the disease, big time
So the argument that stopping the economy now to help it later, eventually, even if we don't know how long we will need to keep it shut doesn't make any sense imo. We are jeopardizing our future ability to fight against the disease, big time
Sorry, forgot to add a source for the numbers. There it is:
https://www.bloomberg.com/news/articles/2020-03-18/99-of-tho...
https://www.bloomberg.com/news/articles/2020-03-18/99-of-tho...
You’re dancing around my question: what would you do right now with what you have available right now?
Just let 5% of your population die and tell the rest to get back to work, restaurants, vacation?
Just let 5% of your population die and tell the rest to get back to work, restaurants, vacation?
That's a ridiculous false choice fallacy. First of all, the 5% doesn't make sense and is demonstrably false. You are cherry picking the data that fits you and assuming everyone infected got tested. Also, if you go by your logic, why do you think killing 5% of the population better than killing even more people by completely wrecking the supply chains that allow us to treat enough people?
Also, you've literally ignored all of my argument that addressed what would be better and why it would be better. You also shifted back to a rhetorical question to avoid talking about whatever you said about dead people in the streets. It's absurd to move the goalposts like this.
But even if you are clearly being dishonest here, I'll say it again. The best option would be to not lock down the vast majority of the population because it will only mean less resources to help the sick and fight against the disease itself. It will also only lead to a breaking point where people will simply not be able to afford to stay on lockdown no matter how bad it gets. That will make the whole thing much more deadly because people will simply not follow any measure if they are hungry or completely broke.
Also, you've literally ignored all of my argument that addressed what would be better and why it would be better. You also shifted back to a rhetorical question to avoid talking about whatever you said about dead people in the streets. It's absurd to move the goalposts like this.
But even if you are clearly being dishonest here, I'll say it again. The best option would be to not lock down the vast majority of the population because it will only mean less resources to help the sick and fight against the disease itself. It will also only lead to a breaking point where people will simply not be able to afford to stay on lockdown no matter how bad it gets. That will make the whole thing much more deadly because people will simply not follow any measure if they are hungry or completely broke.
You’re suggesting letting the virus spread, uncontrolled. That means a million dead in the US, assuming everyone had access to good care. Of course, not everyone has access to good care on the best of days in the US. Once the healthcare system is overloaded few will get good care and the mortality rate from Coronavirus and everything else, for everyone will be much higher. And, as people die in the streets, the economy will shut down anyway.
So your plan is to essentially let this spread unchecked to save the economy. Unfortunately, that’s not how this will play out. That’s how you collapse a medical system and see mortality rates above 5%, and almost certainly wreck the economy anyway. There’s a reason literally no country has done that. Thank science you’re not in charge of anything.
There isn’t some magical good option or plan here. It’s a choice between terrible, terrible options, and you’re sticking your head in the sand and ignoring that.
There isn’t some magical good option or plan here. It’s a choice between terrible, terrible options, and you’re sticking your head in the sand and ignoring that.
You didn’t answer my question. What is your plan?
It sounds like your plan to deal with an exponential outbreak is to wait a few weeks until you have better testing to see if this is really something to worry about, or if those disaster countries that came before you were just a fluke.
Do you not see the problem here? No one is suggesting we don’t test. But the disease is rapidly spreading while we dither about, and if you’re wrong about the CFR, it’ll be way, way too late by the time we know that.
It sounds like your plan to deal with an exponential outbreak is to wait a few weeks until you have better testing to see if this is really something to worry about, or if those disaster countries that came before you were just a fluke.
Do you not see the problem here? No one is suggesting we don’t test. But the disease is rapidly spreading while we dither about, and if you’re wrong about the CFR, it’ll be way, way too late by the time we know that.
The only country that has correctly dealt with the virus is SK, because the had the test infra ready to test enough people to actually do science.
The others countries have all had debate on optimistic vs precautious solutions, buying time vs saving the economy, but the reality is that none are able to correctly assess the spread of the virus. They can’t do correct science.
The others countries have all had debate on optimistic vs precautious solutions, buying time vs saving the economy, but the reality is that none are able to correctly assess the spread of the virus. They can’t do correct science.
HK/Singapore/Japan numbers also don't seem too bad either[0]. Seems their responses have been pretty good? SK's numbers are higher (last I checked), but I know they had the issue with those religous gatherings hampering their containment efforts.
[0] https://www.worldometers.info/coronavirus/#countries
[0] https://www.worldometers.info/coronavirus/#countries
I’ll tell you what we do. We don’t shut down the country and destroy millions of lives and future generations. We definitely don’t do it if there’s already overwhelming evidence this impacts the 70+ year old crowd.
We can talk dream scenarios if this actually impacted the youth. Because in that case then there’s actual risk to future societies.
Have you seen an actuarial table for a 70 year old? Go ahead and tell me those numbers and how they compare to the sub 1% CFR seen in Germany, SG, South Korea and Japan.
We can talk dream scenarios if this actually impacted the youth. Because in that case then there’s actual risk to future societies.
Have you seen an actuarial table for a 70 year old? Go ahead and tell me those numbers and how they compare to the sub 1% CFR seen in Germany, SG, South Korea and Japan.
Still waiting for you to share your plan. We all are well aware of what you think we shouldn’t do. So what should we do?
My thinking stems from the conclusion that at this point there is no containing this virus, because this whole thing started with a single infection and transmission is asymptomatic so unless we test all humans & quarantine till we get vaccine this going to spread.
If you accept that premise, then the only solution is to manage hospital capacity. So I propose that we use hospital overload as a high watermark for quarantining the local communities. so basically you initiate quarantine when hospitals are say at 50% of their capacity (because they will peak after quarantine begin). Wait & once they fall below say 10% release the quarantine. Repeat the process until you get herd immunity or vaccine.
If you accept that premise, then the only solution is to manage hospital capacity. So I propose that we use hospital overload as a high watermark for quarantining the local communities. so basically you initiate quarantine when hospitals are say at 50% of their capacity (because they will peak after quarantine begin). Wait & once they fall below say 10% release the quarantine. Repeat the process until you get herd immunity or vaccine.
Your numbers are totally unrealistic. Assuming the growth rate is similar as in Europe (and afaik there is no reason to think it is any different), if you start the quarantine with hospitals at 50%, they will be at 100% capacity in 3 days, and the cases that require hospitalization will keep doubling every 3 days for at least 2-3 weeks. A quarantine won't magically reduce it to 10%.
thats a valid criticism, but I didn't mean the thresholds as prescriptive. they would depend upon a few things but actual values can be calculated based on infection rate & also be learnt from past cycles after you have gone through it once. the idea is that quarantine will slow down R0 enough to give hospitals a breather & work through the cases. also it will buy enough time to manufacture more ventilators.
Lastly once we go through a couple of these on-off cycles it will help establish that the virus is a know quantity to the larger economy so we can plan around this. which is way better than current 'OMG we are headed for depression' style panic.
Lastly once we go through a couple of these on-off cycles it will help establish that the virus is a know quantity to the larger economy so we can plan around this. which is way better than current 'OMG we are headed for depression' style panic.
I get that right now we're buying time. My current understanding is that we're trying to slow the spread of the disease because the existing health care system was going to quickly collapse under the weight; whether or not that should have been the case or not is a discussion for another day. I also understand that we are -not- trying to contain the disease, just "serialize" its progression (so to speak) through the population.
Assuming that understanding is sufficiently correct, what I'm not hearing enough of is what is being done with the time we're buying. Many in the Hacker News audience likes to talk about "externalities" and how the wise appreciates those externalities in their actions. Shutting down the economy has externalities; those externatlities can be life or death as well. If the strategy of those implementing the "shelter in place" is one of just waiting it out: then I'm going to be off the wagon fairly quickly. I want to start hearing strategies that start to address the issues of how we minimize impacts of this problem. I want to know what we're buying for the pain that we're being sold on. I want to know when people estimate that the societal damages of the illness start to be outweighed by the damages of our response.
I see the admin of the site suggesting we're buying time for these things. I want to start hearing this from the officials making policy.