Insane that this is happening without federal coordination.
The text of the order itself is not available. I hope it is not as poorly thought out as the article suggests. What about home maintenance providers - plumbers and electricians? Surely they must be allowed to perform essential services. Delivery personnel - can I still order things from Amazon? What if I need medical supplies or equipment that is not available from a local provider, who will deliver it?
TFA explicitly mentions some things you're talking about:
>Everyone is to work from home, or stop working, unless they provide an essential service, which includes health care workers; police, fire and other emergency responders; and utility providers such as electricians, plumbers, and sanitation workers.
The only thing that covers is electricians and plumbers, and that in the context of utility providers; it's not clear whether it also covers them if they don't work for a utility company.
[Edited for clarity.]
Edit2, from the FAQ that was just posted: "plumbers, electricians, exterminators, and other service providers who provide services that are necessary to maintaining the safety and sanitation" are exempt from the order.
I know an electrician who was doing a job in a hospital last week.
Even if an electrician doesn't work for a utility company, isn't it pretty vital that medical facilities are able to call him/her in if needed?
I'm also thinking it's not wise to forbid services to homes. Yes, this risks homeowners and workers spreading coronavirus. But there are bigger risks from people going extended periods without electricity / running water.
> Insane that this is happening without federal coordination
Not surprising, because the feds are providing zero leadership right now. Just today, Trump told the governors on a conference call that they should "get their own ventilators". We should not expect competent and engaged leadership from this administration any time soon.
That's quite the fake news you got there. Trump said governors should feel free to provision their own if they have a faster pipeline, rather than waiting for the fed's orders to arrive and then have to apply, etc.
But to claim the federal government has not bought equipment it plans to distribute is a lie .
To clarify, this is what the president stated about 30 minutes ago during the ongoing press conference, when asked about his previous statement. Before that we only had the unqualified phrase.
More reasonable stuff is coming out of Trump now. This is encouraging.
Amusingly, this morning, there was zero Trump content on the Fox News home page. All epidemic info was from more reliable sources. The story behind that must be interesting.
“Respirators, ventilators, all of the equipment — try getting it yourselves,” Mr. Trump told the governors during the conference call, a recording of which was shared with The New York Times. “We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.”
Imagine if you had to go to your VP or CEO to get approval to buy a new laptop. How long would you have to wait? How much of their time would be sucked up with organizationally-irrelevant bs?
The US military has the principle of solving things at the lowest level possible. Not only does it prevent extra time and hops but it means the people closest to the problem are the ones solving it.
minor nitpick, "being the primary sovereign entities" is de jure. De facto, the primary sovereign entity has become the federal government.
That said I completely agree that it's a wonderful thing that these things are happening at the local (not even state) level. That's the most sensible thing, really.
Other things, like disease spread tracking, should probably happen at the federal level. But absent a missing amendment that I don't know about legally (A pity, the framers didn't know about disease theory) there's no clear mandate for that, which contributes to the ambiguity of what the feds should or shouldn't do about this, which becomes a matter of judgement, and there are certainly pros and cons to both stances.
Sure, but the states still have the power to do way more than uncle sam without much oversight. They should exercise it at times like these. Moreover, as I stated, this is only at crisis levels in some parts of the country. Local action could have prevented a bigger outbreak overall. Some states are taking much more preemptive action and will be better off because of it, like Ohio.
Three weeks is very long to lock down 6.7 million people. I assume that enforcement will be assisted by someone like the National Guard. Wonder if there will be a large fleeing out of the area (since people are not forbidden from leaving).
It’s not accurate to say this will not be enforced for residents.
From article:
> The order calls for the sheriff or chief of police to “ensure compliance.”
> All non-essential gatherings of any size are now banned, along with non-essential travel “on foot, bicycle, scooter, automobile or public transit.” People may travel for shopping for necessary supplies, accessing health care, and providing aid to family and friends who need assistance, and for non-residents, returning to their home outside the Bay Area.
Once the hospitals a past capacity and people are dying in tents, it will make a lot more sense. This should have been done earlier but it wasn’t, and likely could not be in a free country.
Dying is a charitable word...you'll be left to essentially drown fully aware. Have you read the stories from Italian docs? Old and/or those with diabetes and heart issues are left alone, not by choice. Triage.
First it's true and I'm not telling it to a 4 year old. And second:
He bitterly scorned people "on social networks who pride themselves on not being afraid and ignoring the rules, complaining because their normal lifestyle habits are 'temporarily' in crisis - all the while an epidemiological disaster is taking place".
Edit: From the FAQ that was just posted, "Businesses that ship or deliver groceries, food, goods or services directly to residences" are an essential service and can continue operating.
> People in the six counties will still be able to go shopping for items such as food and household supplies, and seek medical care. They will be able to go outside for walks or exercise as long as they keep six feet away from anyone they don’t already live with.
Grocery stores and pharmacies will remain open, and restaurants may stay open to provide takeout food only. Also staying open: veterinary services, gas stations and auto repair shops, hardware and other home supply stores, banks and laundry services.
Daycare centers may stay open, but children must be kept in groups no larger than 12, and they must stay with the same group of children every day.
They also explicitly talked about going out to walk the dog, go for a hike, etc, as long as you keep your distance. (presumably, not from the person you live with and will get infected by anyway)
I'm not particularly interested in getting in a bike crash and taxing the ER even further, but i'll be avoiding cabin fever for sure.
> The relationship between high-mortality events and future fertility patterns is well-established in the academic literature. Previous academic literature has shown that high-mortality events as diverse as famines, earthquakes, heatwaves, and disease all have very predictable effects on reducing births nine months later.
If you are a couple living together, it may increase your chances to make more babies. Especially if you are not allowed to get out to buy some protective gear (;
A large number of my Polish friends are part of the “Baby a Boom of Solidarity”: the anomalously high birth rate that followed imposition of Martial Law with mandatory curfews.
Babies aside, there maybe more divorces or breakups because couples will spend most of their time together. Fighting for chores, kids responsibilities or increasing financial pressures during this outbreak.
Just a heads up, This kind of things are already happening in China. You may want to think hard and get prepared for your family.
This is pretty much a copy-paste what we did here in Czech Republic ~2 days ago, with less stringent stuff gradually comming before that.
As such rules are IMHO quite sensible and effective, it is a good thing others are applying them as well. I guess that could be another reason to act quick on stuff like this - so that others can see this is possible and apply it themselves.
Because of robust social housing policies, yes. Homeless people exist but are much more rare. A large number of homeless people is the mark of a weak, dysfunctional society.
I guess they're not technically homeless, but there's rat tribes and ant tribes in china. I wouldn't want to be living in those conditions if covid came to beijing.
I'm genuinely curious as to the legality of any kind of lockdown order (presumably that's the next step). I don't doubt that people really need to stay home, away from others in order to stop the spread. But can the governor or a mayor actually order you to stay home under penalty of law?
We've heard that in Italy there are fines and jail time ... but does that even pass constitutional muster here in terms of freedom of movement?
There's a lot of interesting questions here. Constitutionally speaking (at the Federal level), there is an express right given to the Executive branch: "The Privilege of the Writ of Habeas Corpus shall not be suspended, unless when in Cases of Rebellion or Invasion the public Safety may require it." This situation would certainly fall under the latter condition.
On the other hand, habeas corpus itself isn't so directly tied to freedom of movement, since it's a procedure that applies after you get detained. Also, the outcome of the procedure could be that a judge upholds the legality of your detention!
If police stop people on the street and tell them to turn around and go home, habeas corpus might not be a particularly relevant remedy.
The short answer is yes. Police powers[1] are not absolute, but extend pretty far. The more extreme applications have been few-and-far between, so they're not tested much.
I guess that would catch the casual scofflaw who hadn't thought things through, but it's not like it's terribly difficult to just lookup a couple stores in the vicinity of where you actually want to go. combine that with the fact that you're apparently allowed to visit friends/family who "need assistance" as well as walk around for exercise, a halfway clever individual could have an excuse to go pretty much wherever they want. of course, there aren't many places other than the grocery store that are actually open.
also, how does the conversation begin in the first place? do they pull you over under suspicion that you're not on your way to a grocery store, gas station, or friend/relative's house?
I have to think that the government/police have very little interest in harsh and perfect enforcement. As long as most people mostly follow the order -- and likely most will, because they're not all engineers who like looking for loopholes in everything ;) -- it will help. Better is better, but pretty good is better than nothing.
The order also allows going for walks as long as you're not with someone you aren't housed with, so the misdemeanor part is likely to be about gathering, not travelling.
Great article, thanks for sharing. I needed someone to calm my minds thoughts concerning this. These powers to limit organizing in groups seems extremely dangerous and my conspiratorial mind is running circles with this current situation, I needed a little bit for the other part of mind to chew on calm down the train.
Legal issues haven't stopped mandatory curfews in the event of other emergencies. I've been under them in the past after really bad hurricanes. As long as it doesn't specifically target a subset of people and is applied only in relation to an emergency it appears to be legal. We're currently in an official national state of emergency so it seems like it's possible
A state of emergency does weird things to executive power. Last time habeus corpus was suspended, Lincoln did it during the Civil War via executive order in April and it wasn't struck down by a Court until June. Everyone preceded to ignore the ruling anyway, until Congress could pass the bill that made the suspension legal two years later (due to partisan bickering, surprise!). By then, Lincoln had arrested a Congressman and a significant fraction of Maryland's state legislature.
The legitimacy of the courts really took some big hits in the last few decades. Will the judicial branch even have the power to stop the other branches before this is all over? Only time will tell.
I intend to break any sort of mandatory lockdown/curfew, without putting myself or anyone else at risk (e.x. going for a walk in a non-crowded outdoor area). I'm not comfortable with the government telling me when and where I can be on such a broad and open-ended basis.
To be clear, I'm not being reckless like people still going on vacations or eating at crowded Red Robins or whatever (https://brobible.com/culture/article/miss-nevada-katie-willi...). I've already been social distancing for a week and am now in full self-imposed lockdown (excluding mentioned outdoor walks and picking up essential supplies)
I think that going out for a run or bike ride BY YOURSELF and keeping away from anyone else doesn't seem unreasonable and I don't think is reckless. Going to the bar or a friends house for a get-together DOES seem unreasonable.
I just hope that whatever lockdown happens if it happens is sensible and reasonable as much as it can be.
>I intend to break any sort of mandatory lockdown/curfew, without putting myself or anyone else at risk (e.x. going for a walk in a non-crowded outdoor area)
In the 19th and early 20th centuries the US suffered epidemics of cholera, typhus, yellow fever, bubonic plague, and probably others. Forced quarantines and lock downs were imposed, litigated, and found acceptable, at least when imposed by states or cities.
Generally, the fall under the state's police powers and the 10th Amendment. They have to be targeted at serving a legitimate state interest (stopping the spread of disease certainly qualifies), not be arbitrary, not have some equally effective alternative that doesn't burden civil rights, etc.
"Freedom of movement" in the constitutional sense refers to the ability to enter and leave the individual States as a citizen of the United States.
As for the shelter-in-place order, see:
California Health and Safety Code
Sec. 120130
(d) The health officer may require strict or modified isolation, or quarantine, for any case of contagious, infectious, or communicable disease, when this action is necessary for the protection of the public health.
California Health and Safety Code
Sec. 120295
Any person who violates Section 120130 or any section in Chapter 3 (commencing with Section 120175, but excluding Section 120195), is guilty of a misdemeanor, punishable by a fine of not less than fifty dollars ($50) nor more than one thousand dollars ($1,000), or by imprisonment for a term of not more than 90 days, or by both. He or she is guilty of a separate offense for each day that the violation continued.
I would say in most major cities on the west coast it doesn't get much attention at all. Theft as a crime is generally something the police will never get involved in - this is why you should always have insurance for valuables.
When I had my car stolen in Seattle - it was still given parking tickets after being reported stolen a few days prior. I had to visit the city council in person to get them written off. On top of that, the only reason it was only found was because the thieves made a bunch of noise when getting out of the car and abandoning it. So, a lady reported the car to the police for it being a nuisance. Cranky people - sometimes good for something...
More seriously, `Violation of or failure to comply with this Order is a misdemeanor punishable by fine, imprisonment, or both. (California Health and Safety Code § 120295, et seq.)`
Per the SF mayor's press conference, I think it means giving people walking around outside a talking-to, up to and including a misdemeanor (though they stressed that they don't want to just start handing out tickets, and would prefer to start with "education").
They're obviously not being hardasses about it, as doing so is precluded by the "essential activities" loophole; if you're on your way to something frivolous, you can just tell a cop you're going to the grocery store or pharmacy. But it prevents people from doing things that are obviously non-essential, like hanging out with each other in the park (or going to destinations like gyms that are now effectively required to be closed).
Most shops are staying open until they’re force closed. Seeing a lot of curbside pickup. Brands across the board are canceling patient appreciation days but are allowing the shops to run the deals on their own.
At this point, it should all be considered medical. Cannabis is an effective way to accelerate the perceived passage of time when you're stuck alone at home for months.
Reminds me of the game Super Hexagon. It’s a great game but a terrible time killer because you need all of your concentration to survive for… one minute. Most of the time you’re dead in less than 10 seconds. It’s terrible when you’re killing time at the bus stop.
Anecdotally, traffic on the main street by my home looks normal, judging by what I can see out my window in SF. Had a motorcade go by just now but apart from that.
> Under the order, residents will still be allowed to take a walk, exercise or take a pet out to use the bathroom as long as people remain at least six-feet away from others who are not a member of their own household.
In Italy, they've actually banned bike riding as a training activity since you're not supposed to go far from home, and out of an abundance of caution: if you hurt yourself you might be tying up desperately needed medical services, and also going near the hospitals full of COVID-19 patients.
Seems like it'd be a good idea to limit really big, difficult workouts in order to not tire yourself out too much, and probably stay close to home as well.
That's not true: driving results in between 3 and 12 times fewer deaths per passenger-mile than cycling, depending on your methodology. [0]. Even if you take it to be only 3x and compare per passenger-hour rather than per passenger-mile, which nobody ever does, you would find they are roughly equally dangerous.
If you subtract all the cyclists who are hit by cars from those statistics, then cycling is orders of magnitude safer. It's only dangerous when there are cars on the road.
Like I wrote in the other comment, you can ride your bike to work/the grocery store in Italy, just not go for training rides.
If you want to really start factoring stuff in to how healthy or not it is, you should factor in the sedentary lifestyle that too much driving leads to, as well.
> Even if you take it to be only 3x and compare per passenger-hour rather than per passenger-mile, which nobody ever does
But driver-hours (definitely not passenger-hours) are the correct metric if you're considering biking as a substitute for driving. People take longer trips in cars than they do on bikes because they can. If the mode of transportation shifts, trips to the store won't get longer to adjust -- the stores will become more dense to accommodate the reality that people need closer stores.
For commuting, passenger-mile is important. And that's a vital part of why cities want to increase the share of cycling, to solve traffic during rush hour.
No, it's not, that's what I'm saying here. The length of a commute is determined by the cost it imposes on the commuter. That cost is measured in time and money, but not in distance. Nobody cares about distance. Commutes are the length they are because that's what people can tolerate. If you slowed everybody down, they wouldn't spend more time commuting; they'd commute for the same time over less distance.
"Even" Beijing didn't ban bike riding? Who's more likely to ban bike riding: the place where bikes are a vital form of everyday transportation, or the place where they're a weird recreational activity?
Yes, but you don't have to go outside to exercise.
Plenty of exercise can be done indoors, and without any equipment either.
You could do bodyweight exercise like push-ups, L-sits, burpees, and many others without any equipment.
For a small investment you could get a couple of barbells or a pull-up bar to extend even further the number of exercises you can do indoors and in a very small space.
Jeff Cavaliere just released an excellent home training program that doesn't require any specialized equipment. He does an amazing job at explaining why you should do each exercise and provides variations for different levels of ability. The video description contains details of the program, sets & reps. Highly recommended: https://www.youtube.com/watch?v=vc1E5CfRfos&t=1s
Going outside could also be detrimental to your health. Humans are not so weak they can’t stay inside for a few weeks. Please do us all a favor and take this seriously. I promise you won’t die from staying inside for 3 weeks.
I’m glad your comment is being downvoted. Panicking, moralizing commentary like yours does absolutely no good to anybody and just stokes people’s fear.
The main focus of my comment was this: If you catch yourself rationalizing, it's a sign that something is suspect in your thinking process. Deciding to ignore those misgivings is foolish, especially in important matters.
Deciding which particular activities are too risky in this situation is left as an exercise to the reader.
> Panicking, moralizing commentary like yours does absolutely no good to anybody and just stokes people’s fear.
My comment was not panicking. However, if advocating that adults think clearly and avoid rationalization counts as "moralizing", then guilty as charged.
People not taking this seriously and staying inside is what causes this to spread. Putting yourself in risky situations does no good to anyone either and just creates a better environment for a virus to propagate.
I’m sure they’re experts in this area and definitely an authority on the matter. SF has a massive homeless problem, how “happy” do you think that virus is in the city atm?
They would most likely be fine. People who know more about medical stuff than random HN posters say it is perfectly fine to walk or run outside. So do it. It is good for your mental and physical health.
Daycare will be closed--we know why.
Curfew will be imposed.
People need to prepare for 2 months of lock-down (two weeks didn't work anywhere)
Virtually everything will stop, no one will risk their life (food, pharma and essentials obviously will go on)
Where is this second order against walking, hiking, and running in the Bay Area? Where do I find this curfew and what it is? Same for this "2 months prep".
(A bit off topic) The current situation is a good argument for owning a car.
I don't own a car -- I take the subway to work (about 25 minutes each way). But it seems dumb to use the subway at this time, which means I have to work from home. If I had a car, I'd feel safe commuting.
In cases like this, however, it seems a car is the solution to the wrong problem: you should not be commuting at all.
A car is also the "solution" to an individual problem -- "how do I get safely from A to B?" -- but this is a societal problem: "how do we as a society overcome this disease while causing as little damage as possible?". Solutions must be oriented towards the community, not the individual. Everyone using their cars, if they even have them, is not the solution.
It is disappointing how unaware many urbanites are of the realities of life in rural areas. After the travel restrictions are lifted we would do well to get out of our bubbles and see firsthand how others live. That could help reduce the current political and cultural divides.
What's really disappointing is the degree to which we subsidize the incredible climate costs of non-urban people. When the carbon taxes are finally required, rural Americans will learn just how much they've been externalizing.
Our food will be more expensive and it should be but all those other parts of rural living are just this horrendous climate abuse.
EDIT: Oops, I mean the costs should be baked in. Obviously governments should provide food aid.
So let me get this straight: You want food to be more expensive when we already have families that struggle to put food on the table (see recent worries about closing schools affecting access to the food they provide)?
Urban populations have their own fair share of climate related problems.
Sounds to me like you just want people to starve in order to solve your precious climate ‘crisis’.
Some people stocking up on supplies, to the detriment of their neighbors, is also a "solution"... to those people. Not to their neighbors. A "solution" must scale, otherwise it's selfish. Even worse, if a lot of people think "cars are the answer!" they are compounding the problem.
Fighting coronavirus requires a societal response, one that works for most people and where people don't take individual actions that seemingly benefit them (and only them).
Cars are fine for essential transportation as defined in this order. They aren't making the immediate situation any worse. Overall vehicle traffic is way down and will be even lower tomorrow.
They are fine only because not everyone uses them during an emergency. If everyone felt validated to start driving their cars, it would probably not be fine.
What if you need to see your family, or help out a friend? Or vice versa? Or go pick up medication? This comment strikes me as pretty insensitive.
I live in SF and don't own a car. It's never been more tempting for me to get one. I live alone, far from family, and now seemingly can't see my friends or significant other. It's already getting incredibly lonely. A car would enable me to at least go straight to my gf's place without being in contact with anyone, or to the pharmacy for meds without taking public transit.
Well, I didn't mean to. In fact, I'm advocating for the community at large. An individualistic "solution" ("if only I had a car, I would be able to [...]") is not the best solution for the problem at large. Everyone fending for themselves, driving their cars, is obviously not the answer, and in fact it might make things worse.
That you, and many others, are feeling pretty lonely and isolated is part of the reality of this outbreak. It's obviously going to be very hard for a lot of people. Many people's livelihoods are at stake here, regardless of the seriousness of COVID-19. Unfortunately this is going to have some big consequences regardless of individually owned cars.
update: it seems the city of SF has an advisory, and is mandating (among other things) against taking "unnecessary" trips in public transportation, car or motorbike: https://sf.gov/stay-home-except-essential-needs
Some excerpts:
"You cannot have dinner parties. You cannot invite friends over to your home to hang out.
[..]
You cannot take unnecessary trips on public transport or in your car or motorbike."
"Can I leave home to visit friends or family members if there is no urgent need?
No. For your safety as well as their safety, we need to help each other fight the spread of COVID-19 by staying at home."
How do we think health workers and sanitation workers and police/fire and other vital workers should get to work? Not everyone has 24-hour public transportation available.
I think it goes without saying that emergency services are an exception. There's no need to take my argument to the absurd. I'm assuming the OP meant he was a regular worker (not an emergency or law enforcement worker). In any case, don't emergency services provide transportation for their employees?
> Not everyone has 24-hour public transportation available.
I don't think public transportation is the safest choice at this moment either. In fact, everyone should avoid it if at all possible (in some cases and parts of the world, it's not possible at the moment).
Emergency services don't provide transportation to their workers. Most of them drive their own cars to work just like everyone else. Some law enforcement agencies do allow officers to drive squad cars home when they have extras available.
Some do, some don't. But you took issue with the less important part of my answer, I assume because you agree with the rest: that what is fine for emergency workers is not necessarily fine for ordinary citizens.
I make a point of riding transit daily in my city (Toronto) because I think it's better for the community, planet, and myself.
Since last week I have been driving 100% & not using transit. Now is not the time for reusable mugs & public transit. Right now we optimize for distancing & isolation, not resource conservation.
To be clear, I wasn't arguing from a "green" point of view. I'm arguing driving a car as an individual solution to the outbreak is not a particularly useful solution to the community at large; this must be a community effort.
Mine wasn't an argument about pollution or the environment, but about individualist vs collective solutions.
But when I don’t get sick,
I also don’t spread it to you or your child or your grandpa. We all benefit. Everyone should increase distancing however they can, and driving and biking rather than taking transit is a part of that solution. Those who have no choice but public transit also benefit from me driving because now it’s less crowded and transmission is less likely. Everyone benefits.
It is unlikely that this virus will kill more people than die in car crashes in a single year. Let's keep some perspective.
edit: Commenter below asked for citations, which is reasonable. :-)
This comment applies to the USA only.
There were 37,991 deaths classified under one of the WISQRS "Motor Vehicle Traffic Death" codes last year.[0]
Another 1000-3000 are reasonably counted also, for example, the 203 deaths coded as "Pedestrian injured in nontraffic accident involving other and unspecified motor vehicles." (this includes some cases of people injuring themselves with cars on private property, etc).
I think we can safely say 40,000, without even including any part of the long-term health effects of cars; this is just deaths from crashes.
We've had 71 deaths from COVID-19 so far[1]. We don't know how many total infections or transmissions have occurred; estimates vary unbelievably wildly because of so little test coverage. [2]
It's possible that our death rate is high, more likely that, at least so far, it is much, much lower than has been published in the media (the 8% of people over 65 figure, for example, uses only confirmed cases, which almost certainly represent only a tiny fraction of cases).
Based on these numbers and sources, I think it's a reasonable assertion that the number of otherwise unexpected deaths to result from COVID-19 is unlikely to be higher than the number killed by cars.
You are probably baking in assumptions like "people who need critical hospital care but do not have COVID-19 can still receive it", which are deeply under question right now given the number of expected hospitalizations from the virus.
One of my dads friends just went through the first set of rounds of Chemo for lymphoma. They are having trouble figuring out when he can do his second set.
Deaths so far is an astonishingly bad metric to use for this, it's analogous to 63 grains of rice on the 6th day of the classic chessboard story.
If we don't do drastic measures, many experts are citing numbers in the high hundreds of thousands to over a million (example [1], which is well worth reading). But if we do act, the experience of China, South Korea, and Singapore teach us that we can do better.
It is not the case that "many experts are citing numbers in the high hundreds of thousands to a million people". From the blog post you've cited (and which I agree is thoughtful, and which I had already read when another friend sent it my way a couple hours ago): "There are no experts. There are only good people trying their best to sift through the raft of information coming in extremely fast."
But the numbers you've cited do not represent a mainstream view in the papers currently being reviewed and published as far as I can tell.
...and for that matter, take some time to consider generally the resources on CIDRAP; they are one of the few academic centers that seem to be actually focused on science instead of hype. http://www.cidrap.umn.edu/
Thanks for the article link and the reference to CIDRAP. I'm trying to take in a lot of information, especially views dissenting from the mainstream. These are useful resources.
> It is not the case that "many experts are citing numbers in the high hundreds of thousands to a million people".
You are objectively wrong on this. The UCSF panel on 3/10 presented an estimate with a range of 1.5 million on the high side. Dr. Osterholm said on the Joe Rogan podcast,
"We conservatively estimate that this could require 48 million hospitalizations, and over 480,000 deaths over the next 3-7 months." The Imperial report warns of up to 2.2 million in the US, and even with mitigations in place a large number of fatalities. Not one of the epidemiologists I follow on Twitter has called this estimate into question, and many have praised the report.
Nobody has the real answers, and we all have to do our best interpreting the evidence that's out there, but making shit up is not helpful.
edit: OK, wow, I realize that I did indeed misinterpret Osterholm's statement on the podcast - at first listen, I thought he was discussing worldwide numbers. You are correct; his warning, based on the American Hospital Assocation, is 480k deaths in the United States.
As best I can tell, he is citing the "leaked webinar" for hospital prep from the American Hospital Association. I can't find this document or other interpretations of it.
But yeah, I was dead wrong about what he said.
---
Ahh, gotcha.
I think there's some confusion about what we're talking about.
I thought you were talking about a number of deaths in the USA (ie, compared to my pointing to the approximately 40k traffic deaths).
480k deaths, the CIDRAP estimate cited by Osterholm (which, by the way, I can't find a PDF for - do you happen to have a link), is unlikely to include more than 40k US deaths; I don't think there has ever been a pandemic where the US accounted for 9% of the worldwide deaths, has there?
For example, the 2009 H1N1 outbreak saw 284,000 deaths worldwide, with 12,000 in the USA. [0]
> The Imperial report warns of up to 2.2 million in the US, and even with mitigations in place a large number of fatalities.
We might need help interpreting the 2.2 million number - it is described as the calculation of an "unmitigated pandemic", and appears to take the worst death rate for each age group observed worldwide and combining it with the "cumulative ICU cases trigger" (the report loses me here), and then simply applying it to the USA population.
In other words, I don't think it's meant as a prediction, but a ceiling to define the parameters of the report.
It seems unadvisable to look at exponential curves with a linear mindset…
Consider a different way of estimating:
There are >300m people in the US.
It's easily conceivable that >50% of them could catch the virus.
CFR is likely to end up >.5% (Korea, with excellent medical care and very widespread screening, so probably one of the smaller numerators / largest denominators around, still currently has rates higher than that).
That would already give a rather high number of fatalities. And if the health care system gets overloaded, CFR is going to be quite a bit higher than assumed above.
[Disclaimer: Not medically trained or otherwise qualified]
> It is unlikely that this virus will kill more people than die in car crashes in a single year. Let's keep some perspective.
I wouldn't be so sure. Italy may hit that amount this week. Italy has 3,333 deaths from car accidents per year. They currently have 2,158 deaths from covid-19, adding 368 just today.
You seem to be really bad at math. Hint: This is going to be MUCH larger than you seem to think even with extraordinary containment which is being put in place far to late.
Yep. I’m nearly the only employee at my job and I’m trying to decide if it makes sense to work from home. The biggest issue is that I would need to go to the gas station every few days if I keep going to work. I’m probably going to pack up the 3D printers and some other stuff and just work from home to avoid unnecessary exposure. My roommate has respiratory issues.
Most 3d printers shouldn't produce dust or off gassing. If printing with ABS it can be smelly and an enclosure is recommended (but more for the ABS than for you). In general it's a good to always work in well ventilated areas.
That couldn't possibly help people in the next half year. An interesting change to the public transportation system is a tree one plants for the decade or two later.
Often, small tweaks are overlooked or outright dismissed out of hand because people think it's not enough and insist it won't make a difference.
But the 80/20 rule tends to apply. If you do whatever small and easy things are immediately possible, you get 80 percent of the way there and it frees up resources and extends the runway so that last hard 20 percent can be resolved or at least better tolerated.
For your idea to work, there still has to be an interesting change to how public infrastructure works, and not merely in the change-your-lifestyle way. Having to walk a little bit is already part of the bus/subway/train bargain unless you're pretty lucky.
But once you're on the bus there's only so much social distancing you can do. What are you going to do then? Thus, the car is the ultimate vehicle if you don't want even want a driver.
Renting a car is the lowest hanging fruit right now for dealing with this problem. If you have a low hanging fruit suggestion then put it out there, but it's not trying to socially distance yourself on a bus, right?
I've lived without a car for for more than a decade. People who drive have mental maps attached to driving everywhere. They frequently can't see the small shortcuts and the like that already exist.
When I gave up my car, I was in an apartment complex within a twenty minute walk of four shopping centers. There were two other apartment complexes lined up next to mine.
No one walked. They literally got in their car to drive their trash to the dumpster or pick up their mail or go to the pool.
Me and my sons began walking. And when you walked, you didn't have to go all the way down the hill to the street. You could cut through the grass and one of the shopping centers didn't even require you to cross a street.
If you aren't familiar with various options, you don't have the mental maps to do things quickly and easily. You impose mental maps from an unrelated process and draw inaccurate conclusions because your brain superimposes the car path you would need to take when you aren't going to go walk down to the street and walk in the street, etc.
I gave up my car and the internet told me it was not a walkable neighborhood because there was no theater or something. My favorite grocery store was on the corner.y bank branch was across from it. I was near my job and other shopping.
It wasn't perfect, but it met a lot of my needs. I'm not a big movie goer. I did not care that there was no theater.
And I can talk until I'm blue in the face and people who don't walk as a form of transit will shout me down and tell me I'm a whack job.
But if you want to beat this thing, you may find that you have other options to do things you need to do if you will just look for them.
Sir down and list an essential task.
Food.
Work.
Banking.
Write out the sticking points. Why is this a problem currently.
Search Google maps for all nearby options. Zoom in. Think about what's actually conveniently close.
I'm not saying no one should drive. I'm just saying it's not better for driving to become the new monolith everyone should pursue because of the pandemic.
Shopping when it's less crowded is effective. It's a practice I'm pursuing. It reduces exposure and it has nothing to do with how I go there. It's just a function of timing.
> It's actually not. It's a good argument for actually diversifying our transit options so people have real choice.
> If it is easier to do a mix of walking, public transit, etc, then there's no single point of failure.
I have "real choice". Subway, buses, uber, walking, biking. That's normally how I get around.
But I, someone who relies on public transportation, have noticed that there are, in fact, situations where owning a car is advantageous. Like an epidemic.
Forget my commute. I can't visit my sister, who lives 15 miles away, without uber/metro/bus. Those options would put me in the wake of hundreds or thousands of other people. If I had a car, I could just drive and it would be significantly safer.
I'm not saying "everyone should buy a car". I'm noting that, hey, there actually are situations where being able to safely move around by yourself is helpful. That's not so shocking!
You know, I know there's a pandemic on and we're all snappish, me included. But real choice includes "choice to own a car, if you so wish, and drive it where you want."
That's my entire point. You should have a choice.
It shouldn't ever be an argument of "all public transit, all the time" versus "cult of the car." But Americans turn it into an either/or argument all the time.
This has nothing to do with any of the things I've posted in this thread. I do have a choice. I could buy a car. Many people own cars. My point was that a pandemic (or similar event) is a good argument for owning a car.
I'm a little bewildered at how you've chosen to communicate but, uh, have a nice day.
Public transport is a hub for diseases no matter how well it's designed. You really need a personal transportation vehicle that isolates you from others.
I'm not sure if you missed the news today but large parts of the world have politely asked it's citizens to avoid all non essential travel. In a week or two they are going to stop with the polite part.
You don't need a personal vehicle, you need to figure out how to stay home.
Yea, my habits are very tuned to living in a dense city[1], and all those habits are suddenly very maladaptive...dense urban living is, in general, has a lot of dependencies on the "thrive" part of the thrive/survive spectrum, and as such is not great in times of chaos.
[1] Not stocking up on things since I constantly pass stores that contain necessities, locating myself where I can access a dozen parks (and a million activities) instead of having lots of personal living or yard space, not owning a car since I can easily (and cheaply) rent or take the subway...etc
From the FAQ that was just posted: "Businesses that ship or deliver groceries, food, goods or services directly to residences" are an essential service and can continue operating.
I'd be curious to hear what the rationale for taking this exact measure is, versus something more or less severe. Yes, it's to stop the spread of the virus, but what information is going into this decision? Is this simply an effort to copy the effective strategies employed by China and Korea to slow down the virus, or based off a simulation/modelling effort?
Or even a basic cost/benefit analysis. "We expect this will save X lives, at a cost of $Y to the economy." Shouldn't someone be doing that analysis? There are lots of things that would save lives if we did them (e.g. ban cars), but we don't because the cost is too high.
That's a measure of what we should spend to save lives, such as by installing safety equipment. Those expenditures increase the size of the economy.
The amount by which we should shrink the economy to save lives might be quite a different number. I haven't seen a good analysis of that case.
In general, shrinking the economy costs lives elsewhere such as by malnutrition or lack of money to spend on safety equipment. So the number ought to be lower.
It's not anything like the parable of the broken windows, because installing safety equipment makes people's lives better, while breaking windows does not.
What if 90% [n.b.: this is not a real statistic but I do believe 97% of deaths are in people older than 60] of the deaths were of people older than 70 with pre-existing conditions?
Could the economic gains from fewer retirees consuming lots of medical care and social security funds outweigh the losses in senior experience and volunteerism? Maybe. But not to them.
I'm sure anyone who's done a thorough job putting a number to it (probably insurance companies) is probably also smart enough to know that there is little potential upside and much potential downside to sharing that analysis with current society.
I agree that this analysis should be the basis of the decision, and I'm sure it's not simple tradeoff between lives and economic cost. For instance, no preparation, no response, and huge body count 4 weeks later when a huge fraction of the workforce is sick will damage the economy as well.
That metric is hard to calculate because the transmission rate is still not very well understood for Covid-19, i.e. In order to calculate the cost of staying open, you need to accurately estimate the number of infected, number of deaths, and impact on current healthcare capacity.
What is known is that it is incredibly contagious, so they're taking precautions for a worse-case scenario with these shut downs.
"That metric is hard to calculate because the transmission rate is still not very well understood for Covid-19"
I've heard multiple times from the virologists at This Week in Virology that we're not going to know the real numbers until it's all over.
In addition to that, they are going to be highly variable depending on the demographics, pre-existing conditions, and the level of medical care you are able to get.
So it's going to be very difficult to calculate these sorts of metrics even when the actual infection/death rates are known.
> In addition to that, they are going to be highly variable depending on the demographics, pre-existing conditions, and the level of medical care you are able to get.
Which is a big concern to the US, since there is no universal care. That said, I'm in Canada and the healthcare options in rural areas is often hit or miss -- sometimes just a clinic, sometimes just nothin.
This is a misstatement. Nobody is trying to stop the spread, they're trying to slow it within a bubble. The surrounding counties, cities, and states aren't under quarantine. The bay area is simply hitting the pause button, with a slight rewind, for three weeks. Once those three weeks pass, the pause button is released.
One thing is for sure, unless there's some compensation or forgiveness of late payments/credit score hits from the state, this is going to really harm the lives of those already struggling to afford the bay area.
> Once those three weeks pass, the pause button is released.
I haven't been assuming that. I think this step is needed, but nobody has really defined precisely what success looks like. In 3 weeks I assume they re-assess and could very well leave restrictions in place.
>In 3 weeks I assume they re-assess and could very well leave restrictions in place
I had assumed that as well. No reason things will look better by then, and the preventative measures taken in that time probably won't sufficient enough to otherwise resume normal life either.
Also, the cynic in me says that the government class wants to get people used to the idea of a shelter in place piecemeal, because it might not go over as well if they said 1 month straight out of the gate.
It can be used to effectively stop it. Flattening the curve doesn't work if we need to put people in quarantine for a year, no one will accept that. But if we wait long enough until there's at least some treatment, we can loosen restrictions then. I guess that's the plan of most governments now. Because without a treatment, the current strategy will backfire when rules have to be relaxed again in a month or two.
Basic biology class. Viruses spread between using, stay away from each other to minimize spreading. You don’t need modeling, you just need common sense.
Does anyone know if this is legally binding, or just a recommendation? I'm moving from one of the affected counties to another of them very soon. I've already paid a deposit on movers and signed a lease, and I need to move out of my old apartment or I'll be paying rent in two high-rent areas at the same time. I can't afford to pay over $7000/mo while I wait to see when this will be lifted. If my movers refuse to disobey the health order then I don't know what I'm going to do. I just don't have the money...
Unless the job is in a pharmacy, grocery store or hospital, your start date may have just moved right by at least a month
Or at least you won't be going into the office.
Suspension of rent and mortgage payments is very possible. Current landlord won’t have any replacement renter or ability to evict you. Unlike 9/11 or 2008, this could be viewed as one giant economic freeze for everyone.
I'm not worried about me personally getting pulled over, I'm worried about moving companies not operating. I need a moving truck in order to vacate my old apartment or I'm stuck still paying rent.
Yeah this is a real concern. I have heard that home staging companies (for home sales) are not operating, and appraisers may follow suit. Movers are a sort of adjacent industry and may shut down operations. Try giving them a call. They probably don't know for sure either but may give you some peace of mind and/or direction.
Why don’t you call and ask them. Better yet you should talk to both landlords and attempt to push this date back some. What are you going to do if you or the movers get injured? This seems unacceptably risky to me and if the new landlord wouldn’t accept a delay then I would walk away from the lease personally. Take it to court if needed.
I'm in the same boat (as is the person who is moving out of the place I'm going to move into).
I was planning to do the move myself, with a rental truck. I'm not confident that rental trucks will be available. I'm not sure I'd want to be in one anyway -- even before the pandemic the sanitary condition of rental trucks was dubious at best.
I'm hoping that moving will be considered essential travel, although tonight is just before the start of the new policy. If a lot of people ignore the "shelter in place" during the next week, the enforcement will probably get stricter.
I don't have an answer for you but it's a real problem. Paying double rent (or rent plus a mortgage) involves a huge amount of money in the Bay Area.
I'm probably going to try to contact the county government tomorrow and get an answer but I'm sure I'll be the millionth person on hold on the phone.
(Also, guess who needs a smog check to register his car and might not be able to get one?)
Some of my local moving companies have shut down, but others have decided they are essential businesses. So far, the order is not being enforced and it is essentially voluntary for individuals to leave their homes. I would suggest moving as soon as possible in case the government decides to really lock things down.
I think in practice this will be a warning or civil infraction unless you make a bad impression on the cop since that is basically how every other crime where the officer had the discretion to choose between civil/criminal goes.
Are any well-informed researchers recommending this level of lockdown? At least some experts, including CIDRAP, are opposed to closing schools, let alone locking people down. Is anyone seriously considering and commenting on the damage this policy will do to vulnerable populations?
This seemingly solid paper[0], published in the Journal of Medical Virology, shows Vitamin D to be an important intervention. And obviously fresh air and sun are generally important for health and well-being.
These steps seem uninformed, authoritarian, and wrong-headed.
And with all due respect, what relevance does Vitamin D have to do with the price of tea in China? I hope you're not suggesting this thing will magically go away if we just get our vitamin supplementation right.
Do you have a citation on CIDRAP opposing school closures? I couldn't easily find it.
> these steps are informed, authoritarian, and right-headed
I have to say, I think this is a very insensitive thing to say. Being in a position of privilege to likely avoid the consequences of authoritarian tendencies is wonderful, but most people don't enjoy such a position.
Authoritarian tactics are per se wrong.
> And with all due respect, what relevance does Vitamin D have to do with the price of tea in China? I hope you're not suggesting this thing will magically go away if we just get our vitamin supplementation right.
I didn't suggest that, no. But it is one of the interventions that makes sense. And generally, obviously, fresh air and exercise are important for overall health and wellness. Tangentially related: warmth and humidity is likely, according to some researchers, to drastically reduce replication and transmission. [0] [1] So getting out in the sun (with reasonable social distancing) can't hurt, and it might help.
(Even more tangentially: some researchers believe that very high heats, such as with sauna therapy, can even further reduce replication, based on this 2004 paper [2])
> Do you have a citation on CIDRAP opposing school closures? I couldn't easily find it.
Michael Osterholm himself has spoken extensively on his apprehension about shelter-in-place as a policy to combat coronaviruses, including COVID-19, including during his recent (very informative) interview with Joe Rogan, during which he specifically discussed school closings as well. [3]
By the way, his contention is also that neither environment heat nor sauna therapy are supported by the data as likely mitigations. So different smart people are saying different things, as we might expect in such a situation.
Thanks for the citation from CIDRAP. I haven't watched the Joe Rogan podcast, but I did read an interview [1] where Dr. Osterholm gave reasoning, basically saying that the science is not in yet on the role that children have in the transmission of the virus. That's fair, though I think that is starting to fill in. For example, in the Imperial study [2] (one of the most important documents of the day), their modeling shows a fairly substantial improvement in deaths from closing most universities and schools compared with not doing so (I'm looking at PC_CI_HQ_SDOL70 vs CI_HQ_SDOL70 on the chart on page 9 in particular). I think we'll have an increasingly solid scientific basis for this decision soon.
The discussion on authoritarianism is one too deep for this comment thread, but I would like to leave you with a question, now hypothetical, but might be less so soon. This virus is a bit of an uncontrolled experiment on the ability of different countries and regional governments to handle crisis. What if the evidence provided by this experiment suggests that authoritarian systems are better able to suppress the virus because they can actually get people to avoid harmful behavior, where in freer systems it's just not possible to get the rate of selfish behavior down to the point of being effective?
The FAQ explicitly states that it is permissible to go outside and get all the fresh air, sun, and vitamin D that you like, provided that you stay away from other people.
No they think this is to little to late, we should have done this massively a week or more ago. Your comment reeks of uninformed, cherry picked to fit your world view, drivel.
Who is "they"? I linked a page full of papers, curated and updated daily, from peer-reviewed journals, by experts in infectious diseases. Can you do the same?
This is ridiculous and completely overblown. WFH home is plenty along with simply avoiding crowded spaces. They better not do something stupid like close the airports I need to visit family beginning in April.
The equivalent of a flight from Austria/Vienna to Germany.Berlin is a flight from Georgia/Atlanta to Massachusetts/Boston.
Vienna to Berlin is 425miles, same language, same currency.
You can't fly from Vienna to Berlin right now.
You can't take a train from Vienna to Berlin right now.
You can't drive from Vienna to Berlin right now.
You can't walk from Vienna to Berlin right now.
Germany has closed its borders.
Atlanta to Boston is 1025 miles, same language, same currency.
Color me skeptical with the absolute necessity of this.
More and more I’m beginning to feel like these measures are being done to destroy small businesses while the local governments know they can simply beg for money from federal after the smoke clears.
The timing and severity of these measures seems all too convenient in light of the huge money grab federal bill moving through the senate at this point.
Please return to this post in a few weeks and question what led you to be so wrong.
It's sort of like when South Carolina became the last state to get rid of a law requiring all cocktails to be poured out of mini liquor bottles. There was much pearl-grasping about "what if the bars rip off their customers," and "what if bars pour too much alcohol and road DUI deaths shoot way up?"
When, instead of coming with implausible or unlikely theories, you could just look at what is happening in other places and act accordingly.
It's fairly easy to reason about the factors that go into the spread of the disease. We have diligent data from Japan, Korea, Spain, and Italy. All show infection curves with very similar shapes along the same timelines. What's more, we can see how quarantining measures have benefited Japan and Korea. Not to mention that the spread of infectious diseases, especially the flu, has been studying quite heavily with modern scientific methods for over a century.
It is far more likely that these measures are being taken because they have been proven effective to prevent harm to citizens, than as a conspiracy to destroy small businesses.
This disease is both very infectious and relatively very deadly. We know that the death rate can double or triple if emergency health care is not available. We also know that without dramatic quarantining measures, the number of people requiring emergency care will overwhelm our health care capacity.
I am a San Francisco resident, and I am grateful that my local government is taking action. I agree with Mayor Breed's assessment that the federal government's response is terrible.
They also are testing anyone who wants a test for free. And if someone tests positive, they are using cell phone location records to contact everyone you may have been near while you were infected to come in and get a free test.
Digging into it, they also had an incredible testing network, which is claimed to be a key differentiator. In the US, the government is actively telling people not to get tested on their own judgements.
I too would prefer much better visibility over a shelter in place order. Unfortunately, we have next to no visibility. So lacking that, I would prefer dramatic measures.
Japan has had extremely limited response, only restricting travel from China and South Korea, with no legal means of internal quarantine. The fact that their numbers are similar to countries with strict measures indicates that strict measures have not been more effective than lax measures.
Measures are being taken, and the Japanese government believes that the rate of infection is still very much growing [1]. Schools have been shut down in Japan. And while the government is not actively enforcing quarantining, that may be due to bureaucratic roadblocks. [2]
When would these kind of measures ever not seem "all to convenient"? When absolutely nothing else is happening in the federal legislature or executive branch?
If we shelter in place and the disease is not eradicated, won't it just come back?
It seems like we need to either eradicate it 100% or develop herd immunity by exposing as many people as possible.
There is clearly value in limiting the rate of infection, but that means the shelter in place is just a rate limit, and we are in for something much longer than just a few weeks.
Everyone just needs to shelter in place long enough for testing capacity to improve. Early detection is key, but without that, we have to slow the spread.
Friends partners family in China were under lockdown for two months as the Chinese got a handle on getting testing up and running. I think the big reason for lock down is to break the transmission chains from a large diffuse network into a bunch of small poorly connected islands. If you do that the disease starts to burn itself out. Uninfected islands stay that way. Infected ones quickly develop heard immunity.
Makes sense. I'm afraid we're about to be at the point where a large portion of the US will need to shelter in place. I can't imagine us being able to do something like that for 2 months though.
We’ve been fortunate in the US to not have to shelter in place for an extended period of time in our history. We’ll get through this, just like everything else.
It’ll take time, too many will die, but instead of remembering that most folks will likely complain about being stuck at home.
Weddings/concerts/flights are all cancelled and the only way to get things back on track is to shelter in place long enough for us to get testing up and running and to isolate the virus.
Half measures in this situation just won’t cut it and the longer we take to accept that, the more will die.
Caveat: I’m a fortunate person who has the ability to work remotely. I realize that many don’t have enough savings to make it through a week, much less two months. I hope our safety net is there to support them as well as the business owners who will all be severely impacted.
How does testing help anything? Other than just providing good reporting. It doesn't address the issue, nor solve the actual underlying problem.
I mean, if I'm feeling sick wouldn't I just proceed as if I had it? How doesn't actually knowing change anything? My course of action should be identical.
Testing helps. If you do have the virus, it lets you know you do and then you won't leave your home. If there's no testing, you might see that you have no symptoms and mistakenly believe you don't have the virus, go out and infect more people. It's about asymptomatic carriers.
That's why everyone needs to stay home until we have enough testing to accurately determine who can safely go out.
Having the ability to test quickly means you can save hospital isolation wards from unnecessary overcrowding, because you can now know whether a person who comes in with respiratory symptoms actually has Covid-19 rather than having to treat everyone as though they might. "It means you can move from a presumptive stance to a more informed stance"[1]
If doctors know you're sick with COVID-19 and your disease is severe enough, they might offer you one of the experimental treatments for it, or you might be offered to participate in one of the hundreds of ongoing research studies.
Testing will also help determine where scarce medical resources need to be allocated, which people need to be isolated, and around which people medical personnel need to wear protective equipment.
Finally, testing will let epidemiologists track the progress of the disease and have better estimates about how severe it's going to be, and possibly predict in which communities it'll get better or worse. This will help public health officials decide where and when to declare or end quarantines/lockdowns.
There are some promising drugs that attenuate the virus, and the earlier the intervention, the better. If we can test, and if these drugs do in fact work, we can administer them in an orderly way.
Comprehensive testing and surveillance lets you concentrate resources on the contagious and minimize undesired effects on the well, permitting the economy to function at a higher level.
Evidence is developing that as much as 75% of transmission events is from non-symptomatic individuals.
Testing alone won't help us unless we can really test everyone. Germany already has broad testing and some areas are discussing to close down testing facilities as there's no benefit from testing at the moment. Positively tested people are as much quarantined as everyone and the personnel used for testing would better treat other patients.
Testing only really makes sense if we either can test everyone to ensure we can eradicate the virus by isolation, or if we have medication to define who should receive treatment.
People will still get sick with shelter-in-place, since they need to go to grocery stores and such. This means part of the population has immunity next time.
We also may have better treatment options in the not-so-distant future, making everybody better prepared for a future spread.
In fact it seems you could flatten the curve too much? Suppose this shelter in place is very successful we hold cases steady for the next 3 weeks. Then what? If we pull the band-aid off we're basically back where we started. The idea with flattening the curve is to have a controlled, lower flow of infections that slowly translates to herd immunity right?
Won't this just delay the outbreak for three weeks?
It seems we're just trying to delay the inevitable.
And before you respond about how we're trying to slow exposure so medical services are available -- that would imply we're going to need to quarantines for a few weeks every few weeks for, what, a year? More? There's no way this action is sustainable.
This analysis suggests that actually flattening the curve would require us to slow this virus down over the course of a decade:
flattenthecurve.com has a good general audience to smart person presentation on why this is needed. For a more expert audience, the recent report from Imperial College [1] provides detailed analysis.
[edit, as apparently you edited your comment after I posted my response] The essay you linked praises the complete lockdown in Wuhan as being effective. That said, it's written by an AI researcher, as opposed to a public health expert.
But given that it only applies to a limited geographical region with free movement in and out not restricted it is unclear it will have the desired effect. This policy needs to be at the state or national level to be effective.
It would be better to have a coordinated response on this. But as a wise leader once said, “You go to war with the army you have, not the army you might want or wish to have at a later time.”
It's not about a specifically bounded result, it's about being either a flatter curve or a taller one. The more people act in the interest of flattening the curve is the benefit.
It's a model, and a lot can change. In that time frame, it's actually quite reasonable to expect we'll develop effective vaccines and treatments. We might be able to roll out comprehensive and fine-grained testing (as has been done to some extent in countries like South Korea and Singapore).
The alternative is to just let it burn through the population, hoping it takes out mostly economically unproductive people (the sick and elderly), and letting business as usual go on. Some might find this an acceptable policy, but I do not.
The people who will start flooding the hospitals in the next few days are infected now. This action assumes these emergent cases are about to hit and will be followed by a leveling off of demand and increase of resources (e.g. temp hospital space).
> that would imply we're going to need to quarantines for a few weeks every few weeks for, what, a year? More? There's no way this action is sustainable.
That's exactly what it implies (or a continuous lockdown for months). It may seem like a crazy proposition today after a century of life being relatively tame, but WWII lasted six years.
This is what we're facing. We're in survival mode through the end of the year. It is crazy, but we'll get through it.
No, it’s been proven in both China and SK state level action can halt the virus. Once the exponentially growing death count is halted, we need to be in a hovering pattern while we search for a potential prophylactic- there are a few clinical trials underway that may bear fruit by summer.
Do you think gun shops will close? I read in the news a lot of people were lining up for guns recently in California. With that 10 days wait law, a lot of these people would not get their purchase before the stay in shelter takes effect. I also know the 2nd amendment is a big deal in the USA.
A surprising number of people commenting that this is an overreaction. I suggest reading this[1] and this[2] before you're so hasty to dismiss this. This is absolutely the right move (and if anything should have been done sooner).
Also luckily the comment ranking here seems to mean your peers disagree with you.
One perspective is that people are tired of getting the short end of the stick. Yet again the young incur an outsized proportion of the cost while the old reap an outsized proportion of the benefit.
It's true, but it has zero relevance to the fact that people are naturally resistant to being told to make huge sacrifices almost solely for the benefit of another group of people. Particularly at a time when one of the major (pre-coronavirus) world storylines is around the first group of people suffering from the climate decisions made by the older group.
Every generation inherits a world full of the problems created or only half-solved by the generation before it. It's not unique to our generation and it won't be unique to the next one, unless the young people are the first generation of perfect people capable of living their lives without creating a single new problem for the next generation.
The older generation also solved a lot of problems, and gave us great gifts, as did every generation before them, and as we will for the ones that follow us.
It's not productive to try to pit the young against the old, and the GP is right to point out that you too will be old one day, if you're lucky, so it's certainly unwise to reform the system so that it discriminates against the very group you should hope to join someday (and sooner than you would imagine, sooner than anyone wishes), especially considering the alternative.
I think my point is more that the pandemic + this sort of government response inherently pits the young vs old. The government has enacted a sweeping lockdown (unprecedented loss of freedom AFAIK^) that overwhelming hurts people of working age for the benefits of high-risk older people. But where is the help for those that now can't pay their rent or buy enough food? That situation inherently breeds resentment at a time where resentment is already a mainstream topic.
^This matters because it shows that the government is capable of taking dramatic action
> The government has enacted a sweeping lockdown (unprecedented loss of freedom AFAIK^) that overwhelming hurts people of working age for the benefits of high-risk older people.
Be sure to tell grandma how much you care, junior.
> But where is the help for those that now can't pay their rent or buy enough food?
Folks in California are eligible for up to $1800/month in unemployment benefits.
> That situation inherently breeds resentment at a time where resentment is already a mainstream topic.
> people are naturally resistant to being told to make huge sacrifices almost solely for the benefit of another group of people
This has gotta be the most nihilistic thing I've ever read. And I spend time on Reddit.
The ascendance of humanity is due to a) our brains, and b) our aggregating into communities and working for collective benefit. Our entire existence disproves your hyper-libertarian/utilitarian notion.
Then again, clearly some people hold this perverse idea... which explains the random edge lords on Twitter bragging about violating social distancing protocols.
It's not nihilistic at all. It's just human nature proven time and time again over history. Us vs them is a core concept of human society. That's why it's so heartwarming when we see stories of people making major sacrifices for people that aren't part of their family/community.
If you're always agreeable and self-sacrificing, you'll be taken advantage of by malicious actors. And it's not always easy to figure out whether the other person is actively trying to take advantage of you or not.
There's likely to be massive job loss either way. At least this way there's a chance to keep our health care system from being overwhelmed as well.
Either way, we may be looking at an economic depression the likes of which hasn't been seen for a hundred years.
Unfortunately, the current government is very unlikely to offer a New Deal to get us out of it, and it remains to be seen what the voters who survive this pandemic will do about it.
I'm doubtful about your first statement. People are resilient - I find it hard to imagine a maybe 2x increase in annual US deaths causing such widespread and complete shutdown of economic activity.
The estimates that I've seen have ranged from 330k to 10 million deaths in the US.. and that's just directly from COVID-19 alone.
An overwhelmed health care system and lack of medicines and medical supplies is likely to cause even more deaths.
That's not to mention other possible deaths due to the ensuing chaos and social and economic disruption brought about by the above deaths, global political instability, and reduced supply and demand from the rest of the world as it battles this pandemic.
400k people die from smoking related illnesses every year. Can we ban tobacco? How about sugar to prevent obesity related illnesses? I think these measure are reasonable, I think allowing other such stupid things is unreasonable.
How many people will die from climate change? It really feels like unless it is an uncontrolled threat to baby boomers we will not take action on it.
> 400k people die from smoking related illnesses every year. Can we ban tobacco?
400K people die from smoking related illnesses, as a result of consuming something they knew would do that to them. What we outlawed was second-hand smoke, where we prevented innumerable deaths of people who didn't get to choose whether they smoked: at bars, at restaurants, at casinos, on airplanes. That is a fair place to draw the line. If you want to kill yourself smoking, you know the risks, and so long as you're not impacting anyone else, have at it.
> How about sugar to prevent obesity related illnesses?
As in this case a debate should be had: personal liberty vs. companies who know they're selling a harmful product. The right place to draw the line could easily be to outlaw advertising of sugar-added products to children.
> I think these measure are reasonable, I think allowing other such stupid things is unreasonable.
Not going out to the detriment of others is far closer to second-hand smoking than to first-hand smoking so I'd wager an entire couple of decades of case law and precedent exists.
> How many people will die from climate change? It really feels like unless it is an uncontrolled threat to baby boomers we will not take action on it.
Boomers represent 22% of the US population as of 2018, and obviously, falling. If I remember my math right, democracy gives the youth a pretty big edge so they can't really pin this one on the boomers anymore.
It's a CFR of 0% in Korea under 29, and we're still missing a large portion of the population that's already either had it, or has it and is asymptomatic, or has it and is writing their symptoms off as a mild flu. Potentially divide all the numbers by 6 if the other article posted today is accurate.
In places where health care systems are overwhelmed, medical personnel are having to choose to who let in to the ICU, and they've been choosing to let in those most likely to survive, which tend to be young people.
In such a situation, old people are going to effectively be left to die, and it'll be younger people who are more likely to survive (which they are anyway, simply by virtue of being young).
The only old people that are likely to benefit are those who manage to live long enough in isolation to not get infected before a vaccine or effective treatment becomes widely available... which could take a long time.
you’re thinking of just covid-19 cases. but they compete with all other cases for medical care.
if you come in messed up from a car accident and you need 5 doctors to survive, or those 5 doctors can keep 5 covid patients alive each, you’re going to be left to bleed out. regardless of how young you are.
(i’m not claiming those relative numbers are realistic.)
EMTALA in the US appears to dominate among a myriad other sister regulations in this medicolegal and medical ethics problem space. The decision should be left to the staff on the ground with the details of the situation at the moment.
An unaddressed gap is medical staff on the pandemic front lines without adequate PPE are still shackled by these rules made for a system that is not overwhelmed by a pandemic. These need to be waived for the duration of the emergency.
No, but a person in an ICU bed will need a lot of other services which might be subject to triage. (Remember that "beds" is a shorthand here - it's not a shortage of physical beds that's an issue, it's easy and quick to build beds.)
I suppose it makes sense to have an explicit discussion of this trolley-style problem. Given an choice between $9.6 trillion damage to the economy and the deaths of a million mostly elderly people, which would you choose? An economist following the most recent US figure cited on the "Value of life" Wikipedia page [1] would say this is break even. A particularly selfish young person would say it's a good deal. I personally would not take it, but that might just be my own personal biases.
As with such trolley problems, real life is rarely so clear-cut. If done intelligently, massive loss of life can be prevented, and the economy can find smart ways to adapt.
Agreed. And the frustration is that we are seeing tons of government action to prevent loss of life, but the effort to protect against the economic damage is basically non-existant. Couple a lockdown with something like a moratorium on rent collection and a widespread effort to help feed everyone and it would feel much less one-sided.
> A surprising number of people commenting that this is an overreaction. I suggest reading this[1] and this[2] before you're so hasty to dismiss this. This is absolutely the right move (and if anything should have been done sooner).
> Also luckily the comment ranking here seems to mean your peers disagree with you.
I've noticed these discussions all revolve around problems related to the virus. However, these quarantine measures are also economic in their nature and I'm not seeing even the standard university economics professor trotted out in front of the press to support why this is all going to be okay.
If you are concerned about old people, consider that their investments go belly-up, their pensions funds dry up, their house goes negative equity, and they cannot physically work. How bad is for them after this happens? Because this is what is going to happen with the economy shut down.
> Old people are generally in bonds at this point in their life. Bonds have been on a tear lately. Their investments are doing OK.
This is assuming no CPI increases from all the money creation, especially if they send the money directly to consumers, likely reducing the Cantillon effects.
And "lately" isn't after weeks or months of substantially reduced economic activity.
That's a retro thinking back to the era of the bond vigilantes. That's gone. There's so much stuatory purchases of t-bills that will outweigh any inflationary pressure from QE4. The demand for t-bills was almost insatiable _before_ this mess. Now, it's even more.
T-bills will do just fine despite any outward appearances of inflation. BTW, would rather load up on real estate than "precious" metals. Gold is a relic from a bygone era.
> That's a retro thinking back to the era of the bond vigilantes. That's gone. There's so much stuatory purchases of t-bills that will outweigh any inflationary pressure from QE4. The demand for t-bills was almost insatiable _before_ this mess. Now, it's even more.
> T-bills will do just fine despite any outward appearances of inflation. BTW, would rather load up on real estate than "precious" metals. Gold is a relic from a bygone era.
It is further back to the inflationary period of the 70s, which is the last period that there was a mass flight from dollars due to the rate of CPI increase.
Investopedia[1] states the problem related to T-Bills rather well:
> Treasuries also have to compete with inflation, which measures the pace of rising prices in the economy. Even if T-Bills are the most liquid and safest debt security in the market, fewer investors tend to buy them in times when the inflation rate is higher than the T-bill return. For example, if an investor bought a T-Bill with a 2% yield while inflation was at 3%, the investor would have a net loss on the investment when measured in real terms. As a result, T-bill prices tend to fall during inflationary periods as investors sell them and opt for higher-yielding investments.
So when the CPI is going up and dollars are being used to bid up the price of physical assets, who is buying T-Bills?
You're comparing stagflation double digit interest rates from the 1970s to today? We'll be in a declining or low rate environment for the rest of our lifetime. We'll never see double digit interest rates again.
> You're comparing stagflation double digit interest rates from the 1970s to today? We'll be in a declining or low rate environment for the rest of our lifetime. We'll never see double digit interest rates again.
> Gold is useless.
I am making the comparison on the worst-case assumption that $1000 is sent to every American every month (extended lock-down of the economy will still require people to have some measure of income or they will riot in the streets), so that's $330 billion pumped into consumer goods sectors every month. Your position is that this will not cause CPI rate of increase to go up?
I just reread my post and I can't find the word "gold" anywhere in the post and I am assuming that your claim is to be amended to state "Gold is useless [as an asset]" since it is one of the most useful minerals known to mankind. Where do you get this from?
"Physical assets" can be anything physical: a building; a lot's worth of used cars; a warehouse full of Play-Doh, etc. When people don't want dollars or financial assets, they will replace them with whatever seems like a better deal.
Consumer price inflation is mostly a monetary phenomenon. The increased money supply is only one side of the equation. We must also subtract the deflationary effects of debt defaults. Banks create new money by issuing loans, and when debtors default the banks are forced to write down the value of those loans. Thus money which formerly existed in the financial system vanishes.
So for the next year or so as defaults accelerate I expect that deflation will be a larger concern than inflation, and central banks will try to counter that by large, frequent injections of new money.
> Consumer price inflation is mostly a monetary phenomenon. The increased money supply is only one side of the equation. We must also subtract the deflationary effects of debt defaults. Banks create new money by issuing loans, and when debtors default the banks are forced to write down the value of those loans. Thus money which formerly existed in the financial system vanishes.
> So for the next year or so as defaults accelerate I expect that deflation will be a larger concern than inflation, and central banks will try to counter that by large, frequent injections of new money.
The flow of new money creation is not evenly distributed throughout an economy, and this is called the Cantillon Effect (which can also be applied to deflation).
The new money creation has been going strong for some time now, but hasn't been flowing into sectors measured by the CPI. This has kept CPI increases relatively low in comparison to the increases.
However, send $1000 per month to every American and nearly all of that will go into sectors measured by the CPI, which will then go up.
Not the type of bonds that give returns. Anything that's yielding more than 0% real (higher than 2.5% nominal), like high yield bonds (4-5%) are way down, even high yield muni bonds are down 20% or more from their peaks.
How bad is it for all these "old people" if they are dead?
It would be really nice to hear compassion instead of worry about money. How about we keep people alive, then deal with the economy? Something tells me the country that can burn $2T in less than a week will be just fine until this passes. Talking about the long term health of the economy in terms that push people out into unsafe situations, when we have a virus that kills people in 3 weeks, borders on evil.
There is one way to solve the virus problem: social isolation. There are infinite ways to solve made up economic problems we foist on ourselves.
Small tidbit but the Federal Reserve, which I assume is what you refer to with the statement around $2T, is a private central
Bank. It is not public and it is not affiliated with the US Government or what we would typically consider a “government bailout.”
---
EDIT: as expanded on below my main intent behind the Federal Reserve <> Government affiliation remark is that the Feds decisioning and repro market fund pumping is not government affiliated.
Not affiliated with the federal government? You do know about the Federal Reserve Act of 1913 don't you? Member banks are required to buy stock in their district Federal Reserve Bank and keep a certain amount of money on "reserve" at the Fed as set by the Governors. The Fed Board of Governors is appointed by the president and confirmed by the senate.
My larger intent behind the affiliation remark was "The Fed pumps $1.5T into overnight repro markets" is not a Government action and it is not government money - and theoretically all decisioning Fed decisioning is to be 100% apolitical. These outrageous figures that individuals are conflating with "Wall Street Bailouts" are not government affiliated and are not government funds.
You can see my reply to the above commenter. I do agree the Fed is affiliated - my intent here was that the Feds action in the repro markets, however, is not.
>How bad is it for all these "old people" if they are dead?
It would be really nice to hear compassion instead of worry about money.
Economic factors should absolutely be taken into account. Money pays for life saving medication and treatments. Tax money from the economy pays for social medicine.
For example, 280,000 EXTRA people died from cancer between 2008-2010 in the OCED. When you consider heart disease, other indications, and the rest of the world, you are talking millions of lives.
Far more people could easily die from the economic fallout in the US than the virus.
10 a. For the purposes of this Order, individuals may leave their residence only to perform any of the following "Essential Activites."
...
iii. To engage in outdoor activity, provided the individuals comply with Social Distancing Requirements as defined in this Section, such as, by way of example and without limitation, walking, hiking, or running
This is a massive overreaction. We are past the point of containment, yet we are enacting policies based on containment.
The virus is here to stay in the US for the next year. It doesn't make any sense to limit social interaction (for young people) for just 2 weeks. If there is no vaccine and the rate of expose gets down, after the "lockdown" is lifted, transmission will simply pick up again.
The media and WHO are complicit in spreading hysteria like claiming the mortality rate is 3.4% (https://www.usatoday.com/story/news/politics/2020/03/05/coro...) based on completely faulty numbers. These numbers are obviously flawed because they do not account for people who have not had major symptoms and thus have not been diagnosed.
The actual way to stop the spread is to tell elderly folks and people with underlying health conditions to stay at home. Not to keep young people out of their gyms (All bay area gyms are now shutdown). The hospitalization rate for under 45 year olds is very low. By allowing under 45 year olds to get sick and develop immunity, we can actually stop the spread.
There is no endgame for social distancing everyone other than waiting for a vaccine (won't happen soon) or hoping the summer stops the transmission rate (not guaranteed). It is selfish to expect the majority of the population to stay away from work and gyms when the risk is extremely low for them. Note that young and old will continue to cross paths in close proximity at grocery stores, the post office and other "essential" locations. It is just wishful thinking that a two week break will lead to a long term fix.
There is a lot that remains unknown about the COVID-19 disease. Is it biphasic? Does it leave lung scarring or other chronic ailments? I think you are being very presumptuous as to the type of virus SARS-CoV-2 and disease COVID-19 are. Could you imagine how naive you would sound giving this advice during other unknown viral pandemics? For example the 80s HIV and AIDS crisis. Obviously COVID-19 is nowhere as fatal, but to assume there are zero long term repercussions is a little early as of now. Perhaps slowing down and waiting for more answers as research ramps up is not the worst short term trade off.
The opposite extreme would be to let everybody get infected, see >15% of the 65+ population die, which I am sure some economic model might favor.
I do hope, but doubt, that this crisis will start changing how our society manages crisis and is pro-active about it, rather than being reactive. I this point I don't care which banner a politician represents. I will only care for the one with a plan for direct accountability at the highest level. Otherwise they're all d-bag.
Theoretically there are two factors that make this virus dangerous:
1. Experience elsewhere in the world suggests the transmission rate is high under normal social conditions. Say 2:1 or 3:1. If those numbers are accurate, the infection will spread exponentially. Are they accurate? Dunno.
2. Experience elsewhere in the world suggests a high rate of infections require long stays in ICU, with some of those cases dying. What rate and how long and how many? Dunno.
But there is some combination of transmission rate and hospital load where the healthcare system gets absolutely gummed up. If that happens, they must deal with the scenario where large numbers of patients who normally would have been treated get triaged to to end of life instead. I assume that would mean all major cities start digging mass graves, because what else do you do with 1000s of unplanned dead bodies all at once?
The purpose of the lockdowns is to lower transmission rate below 1:1, where it will essentially fizzle out on its own as long as we remain locked down. Again I've read that experience elsewhere in the world suggests this can be effective. Again, I'm not aware of any especially convincing evidence of this.
Given this model, the optimistic outcome is a short lockdown will buy enough time to come up with less harmful interventions. For example, better testing would allow healthy people to return to normal life while keeping transmission rate below 1:1. Or improved treatment would reduce the load on the healthcare system. Or a vaccine. Or maybe the estimated parameters are too high, but we can't know until more testing is done.
Less optimistic outcome is lurching along in uncertainty while the economy implodes, followed by the unpopular mass grave scenario.
The wording of the Santa Clara order (only one I read) is interesting. If one splits time between two locations (both private residences) one residing in one of the impacted counties and one not, is transit between both allowed for?
I'm going with the assumption that surrounding counties outside the six mentioned in the article will take up a similar measure.
According to below (and I don't know enough about the Bay Area geography to know if this covers your use-case), you cannot without leaving the area "for good" (until the order is lifted):
> Am I allowed to leave the areas covered by this Order to travel to/from a vacation home outside the Bay Area?
> No, except to the extent that you leave the Bay Area and do not travel back or are leaving for a permitted purpose. That kind of travel runs the risk of spreading the virus around the state or elsewhere, and that puts others at risk. Stay put and don’t risk exposing yourself or others.
548 comments
[ 4.3 ms ] story [ 314 ms ] threadThe text of the order itself is not available. I hope it is not as poorly thought out as the article suggests. What about home maintenance providers - plumbers and electricians? Surely they must be allowed to perform essential services. Delivery personnel - can I still order things from Amazon? What if I need medical supplies or equipment that is not available from a local provider, who will deliver it?
>Everyone is to work from home, or stop working, unless they provide an essential service, which includes health care workers; police, fire and other emergency responders; and utility providers such as electricians, plumbers, and sanitation workers.
[Edited for clarity.]
Edit2, from the FAQ that was just posted: "plumbers, electricians, exterminators, and other service providers who provide services that are necessary to maintaining the safety and sanitation" are exempt from the order.
Even if an electrician doesn't work for a utility company, isn't it pretty vital that medical facilities are able to call him/her in if needed?
I'm also thinking it's not wise to forbid services to homes. Yes, this risks homeowners and workers spreading coronavirus. But there are bigger risks from people going extended periods without electricity / running water.
Not surprising, because the feds are providing zero leadership right now. Just today, Trump told the governors on a conference call that they should "get their own ventilators". We should not expect competent and engaged leadership from this administration any time soon.
But to claim the federal government has not bought equipment it plans to distribute is a lie .
Amusingly, this morning, there was zero Trump content on the Fox News home page. All epidemic info was from more reliable sources. The story behind that must be interesting.
https://www.nytimes.com/2020/03/16/us/politics/trump-coronav...
The US military has the principle of solving things at the lowest level possible. Not only does it prevent extra time and hops but it means the people closest to the problem are the ones solving it.
Apparently a TV station broke the embargo early, the announcement wasn't to happen until 1pm local time (in 10 minutes, as I write this).
Edit: now available here: https://sf.gov/stay-home-except-essential-needs
Um... it's good. States have more powers than the federal government, being the primary sovereign entities in the united states of america.
Also, most of the united states (and most states of the united states) are not affected the way the west coast and new england are.
That said I completely agree that it's a wonderful thing that these things are happening at the local (not even state) level. That's the most sensible thing, really.
Other things, like disease spread tracking, should probably happen at the federal level. But absent a missing amendment that I don't know about legally (A pity, the framers didn't know about disease theory) there's no clear mandate for that, which contributes to the ambiguity of what the feds should or shouldn't do about this, which becomes a matter of judgement, and there are certainly pros and cons to both stances.
From article:
> The order calls for the sheriff or chief of police to “ensure compliance.”
> All non-essential gatherings of any size are now banned, along with non-essential travel “on foot, bicycle, scooter, automobile or public transit.” People may travel for shopping for necessary supplies, accessing health care, and providing aid to family and friends who need assistance, and for non-residents, returning to their home outside the Bay Area.
Still doesn’t speak to it not being enforced.
https://www.independent.co.uk/news/health/coronavirus-italy-...
https://news.sky.com/story/coronavirus-italian-doctor-says-f...
He bitterly scorned people "on social networks who pride themselves on not being afraid and ignoring the rules, complaining because their normal lifestyle habits are 'temporarily' in crisis - all the while an epidemiological disaster is taking place".
Edit: From the FAQ that was just posted, "Businesses that ship or deliver groceries, food, goods or services directly to residences" are an essential service and can continue operating.
> People in the six counties will still be able to go shopping for items such as food and household supplies, and seek medical care. They will be able to go outside for walks or exercise as long as they keep six feet away from anyone they don’t already live with.
Grocery stores and pharmacies will remain open, and restaurants may stay open to provide takeout food only. Also staying open: veterinary services, gas stations and auto repair shops, hardware and other home supply stores, banks and laundry services.
Daycare centers may stay open, but children must be kept in groups no larger than 12, and they must stay with the same group of children every day.
I'm not particularly interested in getting in a bike crash and taxing the ER even further, but i'll be avoiding cabin fever for sure.
I wonder how this crisis and lockdown will affect dating and future birth rates.
https://www.nytimes.com/2019/07/16/opinion/letters/central-p...
But that was only a one day event.
https://ifstudies.org/blog/will-the-coronavirus-spike-births
Just a heads up, This kind of things are already happening in China. You may want to think hard and get prepared for your family.
As such rules are IMHO quite sensible and effective, it is a good thing others are applying them as well. I guess that could be another reason to act quick on stuff like this - so that others can see this is possible and apply it themselves.
Don't think China or Singapore have that issue...
With many more homes, far fewer will be homeless.
I realize this is on a much different timescale than the epidemic, even if something impossible would be allowed.
Don't be a dick, the homeless are going to be affected by this in a major way, probably many more deaths than the general population.
I'm rolling my eyes at our deeply dysfunctional housing situation, that will now kill even more people. Not the homeless themselves.
What does this mean?
We've heard that in Italy there are fines and jail time ... but does that even pass constitutional muster here in terms of freedom of movement?
If police stop people on the street and tell them to turn around and go home, habeas corpus might not be a particularly relevant remedy.
[1] This is not about cops. https://en.wikipedia.org/wiki/Police_power_(United_States_co...
also, how does the conversation begin in the first place? do they pull you over under suspicion that you're not on your way to a grocery store, gas station, or friend/relative's house?
The order also allows going for walks as long as you're not with someone you aren't housed with, so the misdemeanor part is likely to be about gathering, not travelling.
https://medium.com/center-for-an-informed-public-at-uw/law-i...
The legitimacy of the courts really took some big hits in the last few decades. Will the judicial branch even have the power to stop the other branches before this is all over? Only time will tell.
I intend to break any sort of mandatory lockdown/curfew, without putting myself or anyone else at risk (e.x. going for a walk in a non-crowded outdoor area). I'm not comfortable with the government telling me when and where I can be on such a broad and open-ended basis.
To be clear, I'm not being reckless like people still going on vacations or eating at crowded Red Robins or whatever (https://brobible.com/culture/article/miss-nevada-katie-willi...). I've already been social distancing for a week and am now in full self-imposed lockdown (excluding mentioned outdoor walks and picking up essential supplies)
I just hope that whatever lockdown happens if it happens is sensible and reasonable as much as it can be.
Going for a walk in a non-crowded area is permitted under the order. See https://sf.gov/stay-home-except-essential-needs :
>It is OK to go outside for walks if you are not in a group.
https://www.cdc.gov/quarantine/aboutlawsregulationsquarantin...
And that's back when things like Polio was raving populations, and could cripple you for life even if you made it through.
Point is, we've had to deal with this before... just not much recently.
Generally, the fall under the state's police powers and the 10th Amendment. They have to be targeted at serving a legitimate state interest (stopping the spread of disease certainly qualifies), not be arbitrary, not have some equally effective alternative that doesn't burden civil rights, etc.
As for the shelter-in-place order, see:
California Health and Safety Code Sec. 120130
(d) The health officer may require strict or modified isolation, or quarantine, for any case of contagious, infectious, or communicable disease, when this action is necessary for the protection of the public health.
California Health and Safety Code Sec. 120295
Any person who violates Section 120130 or any section in Chapter 3 (commencing with Section 120175, but excluding Section 120195), is guilty of a misdemeanor, punishable by a fine of not less than fifty dollars ($50) nor more than one thousand dollars ($1,000), or by imprisonment for a term of not more than 90 days, or by both. He or she is guilty of a separate offense for each day that the violation continued.
When I had my car stolen in Seattle - it was still given parking tickets after being reported stolen a few days prior. I had to visit the city council in person to get them written off. On top of that, the only reason it was only found was because the thieves made a bunch of noise when getting out of the car and abandoning it. So, a lady reported the car to the police for it being a nuisance. Cranky people - sometimes good for something...
More seriously, `Violation of or failure to comply with this Order is a misdemeanor punishable by fine, imprisonment, or both. (California Health and Safety Code § 120295, et seq.)`
They're obviously not being hardasses about it, as doing so is precluded by the "essential activities" loophole; if you're on your way to something frivolous, you can just tell a cop you're going to the grocery store or pharmacy. But it prevents people from doing things that are obviously non-essential, like hanging out with each other in the park (or going to destinations like gyms that are now effectively required to be closed).
Accelerate? Maybe medical marijuana is different, but my non-medical experience was of time seeming to stretch out forever, not to speed by.
> Under the order, residents will still be allowed to take a walk, exercise or take a pet out to use the bathroom as long as people remain at least six-feet away from others who are not a member of their own household.
Seems like it'd be a good idea to limit really big, difficult workouts in order to not tire yourself out too much, and probably stay close to home as well.
[0] https://bicycleuniverse.com/bicycle-safety-almanac/
If you want to really start factoring stuff in to how healthy or not it is, you should factor in the sedentary lifestyle that too much driving leads to, as well.
But driver-hours (definitely not passenger-hours) are the correct metric if you're considering biking as a substitute for driving. People take longer trips in cars than they do on bikes because they can. If the mode of transportation shifts, trips to the store won't get longer to adjust -- the stores will become more dense to accommodate the reality that people need closer stores.
No, it's not, that's what I'm saying here. The length of a commute is determined by the cost it imposes on the commuter. That cost is measured in time and money, but not in distance. Nobody cares about distance. Commutes are the length they are because that's what people can tolerate. If you slowed everybody down, they wouldn't spend more time commuting; they'd commute for the same time over less distance.
Everyone should exercise, sleep, and eat right to prepare for the coming battle inside our bodies :)
Plenty of exercise can be done indoors, and without any equipment either.
You could do bodyweight exercise like push-ups, L-sits, burpees, and many others without any equipment.
For a small investment you could get a couple of barbells or a pull-up bar to extend even further the number of exercises you can do indoors and in a very small space.
If we're facing a serious medical crisis, please don't rationalize any potentially risky behavior. Use your best dispassionate judgement instead.
Deciding which particular activities are too risky in this situation is left as an exercise to the reader.
> Panicking, moralizing commentary like yours does absolutely no good to anybody and just stokes people’s fear.
My comment was not panicking. However, if advocating that adults think clearly and avoid rationalization counts as "moralizing", then guilty as charged.
Daycare will be closed--we know why. Curfew will be imposed. People need to prepare for 2 months of lock-down (two weeks didn't work anywhere) Virtually everything will stop, no one will risk their life (food, pharma and essentials obviously will go on)
There are similar orders for each county.
Edit: It actually says that going out for safe exercise is allowed.
I don't own a car -- I take the subway to work (about 25 minutes each way). But it seems dumb to use the subway at this time, which means I have to work from home. If I had a car, I'd feel safe commuting.
A car is also the "solution" to an individual problem -- "how do I get safely from A to B?" -- but this is a societal problem: "how do we as a society overcome this disease while causing as little damage as possible?". Solutions must be oriented towards the community, not the individual. Everyone using their cars, if they even have them, is not the solution.
I don't see this as a poor solution to my particular needs, but I do look forward to it being electric and charged from solar panels on my roof.
It's not that unusual in desert communities like mine.
Our food will be more expensive and it should be but all those other parts of rural living are just this horrendous climate abuse.
EDIT: Oops, I mean the costs should be baked in. Obviously governments should provide food aid.
Urban populations have their own fair share of climate related problems.
Sounds to me like you just want people to starve in order to solve your precious climate ‘crisis’.
Some people stocking up on supplies, to the detriment of their neighbors, is also a "solution"... to those people. Not to their neighbors. A "solution" must scale, otherwise it's selfish. Even worse, if a lot of people think "cars are the answer!" they are compounding the problem.
Fighting coronavirus requires a societal response, one that works for most people and where people don't take individual actions that seemingly benefit them (and only them).
I live in SF and don't own a car. It's never been more tempting for me to get one. I live alone, far from family, and now seemingly can't see my friends or significant other. It's already getting incredibly lonely. A car would enable me to at least go straight to my gf's place without being in contact with anyone, or to the pharmacy for meds without taking public transit.
Well, I didn't mean to. In fact, I'm advocating for the community at large. An individualistic "solution" ("if only I had a car, I would be able to [...]") is not the best solution for the problem at large. Everyone fending for themselves, driving their cars, is obviously not the answer, and in fact it might make things worse.
That you, and many others, are feeling pretty lonely and isolated is part of the reality of this outbreak. It's obviously going to be very hard for a lot of people. Many people's livelihoods are at stake here, regardless of the seriousness of COVID-19. Unfortunately this is going to have some big consequences regardless of individually owned cars.
update: it seems the city of SF has an advisory, and is mandating (among other things) against taking "unnecessary" trips in public transportation, car or motorbike: https://sf.gov/stay-home-except-essential-needs
Some excerpts:
"You cannot have dinner parties. You cannot invite friends over to your home to hang out.
[..]
You cannot take unnecessary trips on public transport or in your car or motorbike."
"Can I leave home to visit friends or family members if there is no urgent need?
No. For your safety as well as their safety, we need to help each other fight the spread of COVID-19 by staying at home."
This thinking led to all sorts of atrocities in the past 100 years, from fascism to communism -- and the murders to starvation that accompanied them.
Public transit, walk, bike, or... rent a car.
Without a car it's incredibly difficult to fulfill even a trip to the pharmacy with only a compromised public transportation system.
> Not everyone has 24-hour public transportation available.
I don't think public transportation is the safest choice at this moment either. In fact, everyone should avoid it if at all possible (in some cases and parts of the world, it's not possible at the moment).
Since last week I have been driving 100% & not using transit. Now is not the time for reusable mugs & public transit. Right now we optimize for distancing & isolation, not resource conservation.
Mine wasn't an argument about pollution or the environment, but about individualist vs collective solutions.
edit: Commenter below asked for citations, which is reasonable. :-)
This comment applies to the USA only.
There were 37,991 deaths classified under one of the WISQRS "Motor Vehicle Traffic Death" codes last year.[0]
Another 1000-3000 are reasonably counted also, for example, the 203 deaths coded as "Pedestrian injured in nontraffic accident involving other and unspecified motor vehicles." (this includes some cases of people injuring themselves with cars on private property, etc).
I think we can safely say 40,000, without even including any part of the long-term health effects of cars; this is just deaths from crashes.
We've had 71 deaths from COVID-19 so far[1]. We don't know how many total infections or transmissions have occurred; estimates vary unbelievably wildly because of so little test coverage. [2]
It's possible that our death rate is high, more likely that, at least so far, it is much, much lower than has been published in the media (the 8% of people over 65 figure, for example, uses only confirmed cases, which almost certainly represent only a tiny fraction of cases).
Based on these numbers and sources, I think it's a reasonable assertion that the number of otherwise unexpected deaths to result from COVID-19 is unlikely to be higher than the number killed by cars.
0: https://webappa.cdc.gov
1: https://www.worldometers.info/coronavirus/
2: http://perkinslab.weebly.com/uploads/2/5/6/2/25629832/perkin...
That reallllllllllly depends on how we respond as a society in the coming weeks...
If we don't do drastic measures, many experts are citing numbers in the high hundreds of thousands to over a million (example [1], which is well worth reading). But if we do act, the experience of China, South Korea, and Singapore teach us that we can do better.
[1] https://tincture.io/dispatch-4-from-the-front-lines-79c74fa6...
(I want to link https://www.linkedin.com/pulse/notes-from-ucsf-expert-panel-... which actually does give numbers, but that might no longer be available)
That means (2 ^ N) - 1 cumulative grains of rice on the N first squares.
So 63 total grains of rice on the first 6 squares is correct.
But the numbers you've cited do not represent a mainstream view in the papers currently being reviewed and published as far as I can tell.
Give this a read, "2019-novel coronavirus (2019-nCoV): estimating the case fatality rate—a word of caution": https://smw.ch/article/doi/smw.2020.20203
...and for that matter, take some time to consider generally the resources on CIDRAP; they are one of the few academic centers that seem to be actually focused on science instead of hype. http://www.cidrap.umn.edu/
> It is not the case that "many experts are citing numbers in the high hundreds of thousands to a million people".
You are objectively wrong on this. The UCSF panel on 3/10 presented an estimate with a range of 1.5 million on the high side. Dr. Osterholm said on the Joe Rogan podcast, "We conservatively estimate that this could require 48 million hospitalizations, and over 480,000 deaths over the next 3-7 months." The Imperial report warns of up to 2.2 million in the US, and even with mitigations in place a large number of fatalities. Not one of the epidemiologists I follow on Twitter has called this estimate into question, and many have praised the report.
Nobody has the real answers, and we all have to do our best interpreting the evidence that's out there, but making shit up is not helpful.
ETA: I found a working link to the 3/10 UCSF panel: https://tincture.io/an-expert-covid-19-panel-from-ucsf-664a3...
As best I can tell, he is citing the "leaked webinar" for hospital prep from the American Hospital Association. I can't find this document or other interpretations of it.
But yeah, I was dead wrong about what he said. ---
Ahh, gotcha.
I think there's some confusion about what we're talking about.
I thought you were talking about a number of deaths in the USA (ie, compared to my pointing to the approximately 40k traffic deaths).
480k deaths, the CIDRAP estimate cited by Osterholm (which, by the way, I can't find a PDF for - do you happen to have a link), is unlikely to include more than 40k US deaths; I don't think there has ever been a pandemic where the US accounted for 9% of the worldwide deaths, has there?
For example, the 2009 H1N1 outbreak saw 284,000 deaths worldwide, with 12,000 in the USA. [0]
> The Imperial report warns of up to 2.2 million in the US, and even with mitigations in place a large number of fatalities.
We might need help interpreting the 2.2 million number - it is described as the calculation of an "unmitigated pandemic", and appears to take the worst death rate for each age group observed worldwide and combining it with the "cumulative ICU cases trigger" (the report loses me here), and then simply applying it to the USA population.
In other words, I don't think it's meant as a prediction, but a ceiling to define the parameters of the report.
But again, I'd appreciate some help interpreting.
0: http://www.cidrap.umn.edu/news-perspective/2012/06/cdc-estim...
It seems unadvisable to look at exponential curves with a linear mindset…
Consider a different way of estimating:
There are >300m people in the US.
It's easily conceivable that >50% of them could catch the virus.
CFR is likely to end up >.5% (Korea, with excellent medical care and very widespread screening, so probably one of the smaller numerators / largest denominators around, still currently has rates higher than that).
That would already give a rather high number of fatalities. And if the health care system gets overloaded, CFR is going to be quite a bit higher than assumed above.
[Disclaimer: Not medically trained or otherwise qualified]
I wouldn't be so sure. Italy may hit that amount this week. Italy has 3,333 deaths from car accidents per year. They currently have 2,158 deaths from covid-19, adding 368 just today.
It's actually not. It's a good argument for actually diversifying our transit options so people have real choice.
A lot of people aren't really pro transit options. They are really for public transit and/or against cars.
If it is easier to do a mix of walking, public transit, etc, then there's no single point of failure.
If the transit system isn't overloaded, you can sometimes find yourself on the bus by yourself for a bit.
If you have flexibility to work from home or go in when you feel like it, that's another way to not be trapped in a crowded bus or whatever.
We need to break some lockstep patterns, not trade one monolith for another, which tends to be the argument.
But the 80/20 rule tends to apply. If you do whatever small and easy things are immediately possible, you get 80 percent of the way there and it frees up resources and extends the runway so that last hard 20 percent can be resolved or at least better tolerated.
But once you're on the bus there's only so much social distancing you can do. What are you going to do then? Thus, the car is the ultimate vehicle if you don't want even want a driver.
Renting a car is the lowest hanging fruit right now for dealing with this problem. If you have a low hanging fruit suggestion then put it out there, but it's not trying to socially distance yourself on a bus, right?
When I gave up my car, I was in an apartment complex within a twenty minute walk of four shopping centers. There were two other apartment complexes lined up next to mine.
No one walked. They literally got in their car to drive their trash to the dumpster or pick up their mail or go to the pool.
Me and my sons began walking. And when you walked, you didn't have to go all the way down the hill to the street. You could cut through the grass and one of the shopping centers didn't even require you to cross a street.
If you aren't familiar with various options, you don't have the mental maps to do things quickly and easily. You impose mental maps from an unrelated process and draw inaccurate conclusions because your brain superimposes the car path you would need to take when you aren't going to go walk down to the street and walk in the street, etc.
I gave up my car and the internet told me it was not a walkable neighborhood because there was no theater or something. My favorite grocery store was on the corner.y bank branch was across from it. I was near my job and other shopping.
It wasn't perfect, but it met a lot of my needs. I'm not a big movie goer. I did not care that there was no theater.
And I can talk until I'm blue in the face and people who don't walk as a form of transit will shout me down and tell me I'm a whack job.
But if you want to beat this thing, you may find that you have other options to do things you need to do if you will just look for them.
Sir down and list an essential task.
Food.
Work.
Banking.
Write out the sticking points. Why is this a problem currently.
Brainstorm alternatives: ATM, online banking, PayPal, prepaid debit card, e-gift cards, etc.
Search Google maps for all nearby options. Zoom in. Think about what's actually conveniently close.
I'm not saying no one should drive. I'm just saying it's not better for driving to become the new monolith everyone should pursue because of the pandemic.
Shopping when it's less crowded is effective. It's a practice I'm pursuing. It reduces exposure and it has nothing to do with how I go there. It's just a function of timing.
> If it is easier to do a mix of walking, public transit, etc, then there's no single point of failure.
I have "real choice". Subway, buses, uber, walking, biking. That's normally how I get around.
But I, someone who relies on public transportation, have noticed that there are, in fact, situations where owning a car is advantageous. Like an epidemic.
Forget my commute. I can't visit my sister, who lives 15 miles away, without uber/metro/bus. Those options would put me in the wake of hundreds or thousands of other people. If I had a car, I could just drive and it would be significantly safer.
I'm not saying "everyone should buy a car". I'm noting that, hey, there actually are situations where being able to safely move around by yourself is helpful. That's not so shocking!
That's my entire point. You should have a choice.
It shouldn't ever be an argument of "all public transit, all the time" versus "cult of the car." But Americans turn it into an either/or argument all the time.
Take care. Safely move around as you choose.
Wash your hands.
Stop touching your face.
I'm a little bewildered at how you've chosen to communicate but, uh, have a nice day.
You don't need a personal vehicle, you need to figure out how to stay home.
[1] Not stocking up on things since I constantly pass stores that contain necessities, locating myself where I can access a dozen parks (and a million activities) instead of having lots of personal living or yard space, not owning a car since I can easily (and cheaply) rent or take the subway...etc
The amount by which we should shrink the economy to save lives might be quite a different number. I haven't seen a good analysis of that case.
In general, shrinking the economy costs lives elsewhere such as by malnutrition or lack of money to spend on safety equipment. So the number ought to be lower.
If that isn't broken windows, I'm not sure why.
If so, I don't see the connection.
https://en.wikipedia.org/wiki/Parable_of_the_broken_window
No relation to the other. Sorry - my mistake in assuming sufficient familiarity with both to disambiguate from context.
https://www.youtube.com/watch?v=SnzzWGcdMqY
What is known is that it is incredibly contagious, so they're taking precautions for a worse-case scenario with these shut downs.
I've heard multiple times from the virologists at This Week in Virology that we're not going to know the real numbers until it's all over.
In addition to that, they are going to be highly variable depending on the demographics, pre-existing conditions, and the level of medical care you are able to get.
So it's going to be very difficult to calculate these sorts of metrics even when the actual infection/death rates are known.
Which is a big concern to the US, since there is no universal care. That said, I'm in Canada and the healthcare options in rural areas is often hit or miss -- sometimes just a clinic, sometimes just nothin.
https://news.ycombinator.com/item?id=22596594
This is a misstatement. Nobody is trying to stop the spread, they're trying to slow it within a bubble. The surrounding counties, cities, and states aren't under quarantine. The bay area is simply hitting the pause button, with a slight rewind, for three weeks. Once those three weeks pass, the pause button is released.
One thing is for sure, unless there's some compensation or forgiveness of late payments/credit score hits from the state, this is going to really harm the lives of those already struggling to afford the bay area.
I haven't been assuming that. I think this step is needed, but nobody has really defined precisely what success looks like. In 3 weeks I assume they re-assess and could very well leave restrictions in place.
I had assumed that as well. No reason things will look better by then, and the preventative measures taken in that time probably won't sufficient enough to otherwise resume normal life either.
Also, the cynic in me says that the government class wants to get people used to the idea of a shelter in place piecemeal, because it might not go over as well if they said 1 month straight out of the gate.
I was planning to do the move myself, with a rental truck. I'm not confident that rental trucks will be available. I'm not sure I'd want to be in one anyway -- even before the pandemic the sanitary condition of rental trucks was dubious at best.
I'm hoping that moving will be considered essential travel, although tonight is just before the start of the new policy. If a lot of people ignore the "shelter in place" during the next week, the enforcement will probably get stricter.
I don't have an answer for you but it's a real problem. Paying double rent (or rent plus a mortgage) involves a huge amount of money in the Bay Area.
I'm probably going to try to contact the county government tomorrow and get an answer but I'm sure I'll be the millionth person on hold on the phone.
(Also, guess who needs a smog check to register his car and might not be able to get one?)
You should be okay on the smog check, because auto repair shops are considered essential in the order.
This seemingly solid paper[0], published in the Journal of Medical Virology, shows Vitamin D to be an important intervention. And obviously fresh air and sun are generally important for health and well-being.
These steps seem uninformed, authoritarian, and wrong-headed.
0: https://onlinelibrary.wiley.com/doi/full/10.1002/jmv.25707
And with all due respect, what relevance does Vitamin D have to do with the price of tea in China? I hope you're not suggesting this thing will magically go away if we just get our vitamin supplementation right.
Do you have a citation on CIDRAP opposing school closures? I couldn't easily find it.
I have to say, I think this is a very insensitive thing to say. Being in a position of privilege to likely avoid the consequences of authoritarian tendencies is wonderful, but most people don't enjoy such a position.
Authoritarian tactics are per se wrong.
> And with all due respect, what relevance does Vitamin D have to do with the price of tea in China? I hope you're not suggesting this thing will magically go away if we just get our vitamin supplementation right.
I didn't suggest that, no. But it is one of the interventions that makes sense. And generally, obviously, fresh air and exercise are important for overall health and wellness. Tangentially related: warmth and humidity is likely, according to some researchers, to drastically reduce replication and transmission. [0] [1] So getting out in the sun (with reasonable social distancing) can't hurt, and it might help.
(Even more tangentially: some researchers believe that very high heats, such as with sauna therapy, can even further reduce replication, based on this 2004 paper [2])
0: https://nusmedicine.nus.edu.sg/medias/news-info/2230-hot-and...
1: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3551767
2: https://www.ncbi.nlm.nih.gov/m/pubmed/14722281/
> Do you have a citation on CIDRAP opposing school closures? I couldn't easily find it.
Michael Osterholm himself has spoken extensively on his apprehension about shelter-in-place as a policy to combat coronaviruses, including COVID-19, including during his recent (very informative) interview with Joe Rogan, during which he specifically discussed school closings as well. [3]
By the way, his contention is also that neither environment heat nor sauna therapy are supported by the data as likely mitigations. So different smart people are saying different things, as we might expect in such a situation.
3: https://www.youtube.com/embed/E3URhJx0NSw?autoplay=1&auto_pl...
The discussion on authoritarianism is one too deep for this comment thread, but I would like to leave you with a question, now hypothetical, but might be less so soon. This virus is a bit of an uncontrolled experiment on the ability of different countries and regional governments to handle crisis. What if the evidence provided by this experiment suggests that authoritarian systems are better able to suppress the virus because they can actually get people to avoid harmful behavior, where in freer systems it's just not possible to get the rate of selfish behavior down to the point of being effective?
[1]: https://www.postbulletin.com/life/health/this-is-not-going-t...
[2]: https://www.imperial.ac.uk/mrc-global-infectious-disease-ana...
Why do you think this stupid? Why would the same not be necessary in a country of 300m people?
You're not visiting anyone outside of your state in April. Start being calm about it now.
As far as I can tell, this is untrue. Many countries have placed restrictions on international travel, but few have closed airports completely.
Details available here: https://www.nytimes.com/article/coronavirus-travel-restricti...
Vienna to Berlin is 425miles, same language, same currency.
You can't fly from Vienna to Berlin right now. You can't take a train from Vienna to Berlin right now. You can't drive from Vienna to Berlin right now. You can't walk from Vienna to Berlin right now.
Germany has closed its borders.
Atlanta to Boston is 1025 miles, same language, same currency.
https://www.sccgov.org/sites/phd/DiseaseInformation/novel-co...
More and more I’m beginning to feel like these measures are being done to destroy small businesses while the local governments know they can simply beg for money from federal after the smoke clears.
The timing and severity of these measures seems all too convenient in light of the huge money grab federal bill moving through the senate at this point.
It's sort of like when South Carolina became the last state to get rid of a law requiring all cocktails to be poured out of mini liquor bottles. There was much pearl-grasping about "what if the bars rip off their customers," and "what if bars pour too much alcohol and road DUI deaths shoot way up?"
When, instead of coming with implausible or unlikely theories, you could just look at what is happening in other places and act accordingly.
It is far more likely that these measures are being taken because they have been proven effective to prevent harm to citizens, than as a conspiracy to destroy small businesses.
This disease is both very infectious and relatively very deadly. We know that the death rate can double or triple if emergency health care is not available. We also know that without dramatic quarantining measures, the number of people requiring emergency care will overwhelm our health care capacity.
I am a San Francisco resident, and I am grateful that my local government is taking action. I agree with Mayor Breed's assessment that the federal government's response is terrible.
They also have had the best results of any country to date.
Digging into it, they also had an incredible testing network, which is claimed to be a key differentiator. In the US, the government is actively telling people not to get tested on their own judgements.
I too would prefer much better visibility over a shelter in place order. Unfortunately, we have next to no visibility. So lacking that, I would prefer dramatic measures.
Measures are being taken, and the Japanese government believes that the rate of infection is still very much growing [1]. Schools have been shut down in Japan. And while the government is not actively enforcing quarantining, that may be due to bureaucratic roadblocks. [2]
[1] https://english.kyodonews.net/news/2020/03/8aafa8e3636c-loca...
[2] https://www.japantimes.co.jp/news/2020/03/11/national/politi...
It seems like we need to either eradicate it 100% or develop herd immunity by exposing as many people as possible.
There is clearly value in limiting the rate of infection, but that means the shelter in place is just a rate limit, and we are in for something much longer than just a few weeks.
It’ll take time, too many will die, but instead of remembering that most folks will likely complain about being stuck at home.
Weddings/concerts/flights are all cancelled and the only way to get things back on track is to shelter in place long enough for us to get testing up and running and to isolate the virus.
Half measures in this situation just won’t cut it and the longer we take to accept that, the more will die.
Caveat: I’m a fortunate person who has the ability to work remotely. I realize that many don’t have enough savings to make it through a week, much less two months. I hope our safety net is there to support them as well as the business owners who will all be severely impacted.
I mean, if I'm feeling sick wouldn't I just proceed as if I had it? How doesn't actually knowing change anything? My course of action should be identical.
That's why everyone needs to stay home until we have enough testing to accurately determine who can safely go out.
Having the ability to test quickly means you can save hospital isolation wards from unnecessary overcrowding, because you can now know whether a person who comes in with respiratory symptoms actually has Covid-19 rather than having to treat everyone as though they might. "It means you can move from a presumptive stance to a more informed stance"[1]
If doctors know you're sick with COVID-19 and your disease is severe enough, they might offer you one of the experimental treatments for it, or you might be offered to participate in one of the hundreds of ongoing research studies.
Testing will also help determine where scarce medical resources need to be allocated, which people need to be isolated, and around which people medical personnel need to wear protective equipment.
Finally, testing will let epidemiologists track the progress of the disease and have better estimates about how severe it's going to be, and possibly predict in which communities it'll get better or worse. This will help public health officials decide where and when to declare or end quarantines/lockdowns.
[1] - https://www.wired.com/story/fda-approves-the-first-commercia...
A good intro: https://www.youtube.com/watch?v=vE4_LsftNKM
Evidence is developing that as much as 75% of transmission events is from non-symptomatic individuals.
Testing only really makes sense if we either can test everyone to ensure we can eradicate the virus by isolation, or if we have medication to define who should receive treatment.
We also may have better treatment options in the not-so-distant future, making everybody better prepared for a future spread.
https://www.worldometers.info/coronavirus/country/china/
Currently we're Knight Capital and our algos are blowing money. We could worry about the delay or we could turn everything off.
It seems we're just trying to delay the inevitable.
And before you respond about how we're trying to slow exposure so medical services are available -- that would imply we're going to need to quarantines for a few weeks every few weeks for, what, a year? More? There's no way this action is sustainable.
This analysis suggests that actually flattening the curve would require us to slow this virus down over the course of a decade:
https://medium.com/@joschabach/flattening-the-curve-is-a-dea...
[1]: https://www.imperial.ac.uk/mrc-global-infectious-disease-ana...
[edit, as apparently you edited your comment after I posted my response] The essay you linked praises the complete lockdown in Wuhan as being effective. That said, it's written by an AI researcher, as opposed to a public health expert.
The alternative is to just let it burn through the population, hoping it takes out mostly economically unproductive people (the sick and elderly), and letting business as usual go on. Some might find this an acceptable policy, but I do not.
That's exactly what it implies (or a continuous lockdown for months). It may seem like a crazy proposition today after a century of life being relatively tame, but WWII lasted six years.
This is what we're facing. We're in survival mode through the end of the year. It is crazy, but we'll get through it.
You mean forever? Hopefully.
Also luckily the comment ranking here seems to mean your peers disagree with you.
[1]: https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
[2]: https://www.flattenthecurve.com/
It's true, but it has zero relevance to the fact that people are naturally resistant to being told to make huge sacrifices almost solely for the benefit of another group of people. Particularly at a time when one of the major (pre-coronavirus) world storylines is around the first group of people suffering from the climate decisions made by the older group.
The older generation also solved a lot of problems, and gave us great gifts, as did every generation before them, and as we will for the ones that follow us.
It's not productive to try to pit the young against the old, and the GP is right to point out that you too will be old one day, if you're lucky, so it's certainly unwise to reform the system so that it discriminates against the very group you should hope to join someday (and sooner than you would imagine, sooner than anyone wishes), especially considering the alternative.
^This matters because it shows that the government is capable of taking dramatic action
Be sure to tell grandma how much you care, junior.
> But where is the help for those that now can't pay their rent or buy enough food?
Folks in California are eligible for up to $1800/month in unemployment benefits.
> That situation inherently breeds resentment at a time where resentment is already a mainstream topic.
Response to a disaster should breed solidarity.
This has gotta be the most nihilistic thing I've ever read. And I spend time on Reddit.
The ascendance of humanity is due to a) our brains, and b) our aggregating into communities and working for collective benefit. Our entire existence disproves your hyper-libertarian/utilitarian notion.
Then again, clearly some people hold this perverse idea... which explains the random edge lords on Twitter bragging about violating social distancing protocols.
Either way, we may be looking at an economic depression the likes of which hasn't been seen for a hundred years.
Unfortunately, the current government is very unlikely to offer a New Deal to get us out of it, and it remains to be seen what the voters who survive this pandemic will do about it.
An overwhelmed health care system and lack of medicines and medical supplies is likely to cause even more deaths.
That's not to mention other possible deaths due to the ensuing chaos and social and economic disruption brought about by the above deaths, global political instability, and reduced supply and demand from the rest of the world as it battles this pandemic.
How many people will die from climate change? It really feels like unless it is an uncontrolled threat to baby boomers we will not take action on it.
400K people die from smoking related illnesses, as a result of consuming something they knew would do that to them. What we outlawed was second-hand smoke, where we prevented innumerable deaths of people who didn't get to choose whether they smoked: at bars, at restaurants, at casinos, on airplanes. That is a fair place to draw the line. If you want to kill yourself smoking, you know the risks, and so long as you're not impacting anyone else, have at it.
> How about sugar to prevent obesity related illnesses?
As in this case a debate should be had: personal liberty vs. companies who know they're selling a harmful product. The right place to draw the line could easily be to outlaw advertising of sugar-added products to children.
> I think these measure are reasonable, I think allowing other such stupid things is unreasonable.
Not going out to the detriment of others is far closer to second-hand smoking than to first-hand smoking so I'd wager an entire couple of decades of case law and precedent exists.
> How many people will die from climate change? It really feels like unless it is an uncontrolled threat to baby boomers we will not take action on it.
Boomers represent 22% of the US population as of 2018, and obviously, falling. If I remember my math right, democracy gives the youth a pretty big edge so they can't really pin this one on the boomers anymore.
You aren't thinking of second-order effects.
In such a situation, old people are going to effectively be left to die, and it'll be younger people who are more likely to survive (which they are anyway, simply by virtue of being young).
The only old people that are likely to benefit are those who manage to live long enough in isolation to not get infected before a vaccine or effective treatment becomes widely available... which could take a long time.
if you come in messed up from a car accident and you need 5 doctors to survive, or those 5 doctors can keep 5 covid patients alive each, you’re going to be left to bleed out. regardless of how young you are.
(i’m not claiming those relative numbers are realistic.)
An unaddressed gap is medical staff on the pandemic front lines without adequate PPE are still shackled by these rules made for a system that is not overwhelmed by a pandemic. These need to be waived for the duration of the emergency.
As with such trolley problems, real life is rarely so clear-cut. If done intelligently, massive loss of life can be prevented, and the economy can find smart ways to adapt.
[1]: https://en.wikipedia.org/wiki/Value_of_life
> Also luckily the comment ranking here seems to mean your peers disagree with you.
> [1]: https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop....
> [2]: https://www.flattenthecurve.com/
I've noticed these discussions all revolve around problems related to the virus. However, these quarantine measures are also economic in their nature and I'm not seeing even the standard university economics professor trotted out in front of the press to support why this is all going to be okay.
If you are concerned about old people, consider that their investments go belly-up, their pensions funds dry up, their house goes negative equity, and they cannot physically work. How bad is for them after this happens? Because this is what is going to happen with the economy shut down.
This is assuming no CPI increases from all the money creation, especially if they send the money directly to consumers, likely reducing the Cantillon effects.
And "lately" isn't after weeks or months of substantially reduced economic activity.
They'll be even higher if/when that happens. They're not in bonds for the interest. They're in bonds for safety and price appreciation.
> They'll be even higher if/when that happens. They're not in bonds for the interest. They're in bonds for safety and price appreciation.
Assuming someone is interested in buying those bonds, since during inflation physical assets (e.g., precious metals) tend to be what buyers prefer.
T-bills will do just fine despite any outward appearances of inflation. BTW, would rather load up on real estate than "precious" metals. Gold is a relic from a bygone era.
> T-bills will do just fine despite any outward appearances of inflation. BTW, would rather load up on real estate than "precious" metals. Gold is a relic from a bygone era.
It is further back to the inflationary period of the 70s, which is the last period that there was a mass flight from dollars due to the rate of CPI increase.
Investopedia[1] states the problem related to T-Bills rather well:
> Treasuries also have to compete with inflation, which measures the pace of rising prices in the economy. Even if T-Bills are the most liquid and safest debt security in the market, fewer investors tend to buy them in times when the inflation rate is higher than the T-bill return. For example, if an investor bought a T-Bill with a 2% yield while inflation was at 3%, the investor would have a net loss on the investment when measured in real terms. As a result, T-bill prices tend to fall during inflationary periods as investors sell them and opt for higher-yielding investments.
So when the CPI is going up and dollars are being used to bid up the price of physical assets, who is buying T-Bills?
[1] https://www.investopedia.com/terms/t/treasurybill.asp
Gold is useless.
> Gold is useless.
I am making the comparison on the worst-case assumption that $1000 is sent to every American every month (extended lock-down of the economy will still require people to have some measure of income or they will riot in the streets), so that's $330 billion pumped into consumer goods sectors every month. Your position is that this will not cause CPI rate of increase to go up?
I just reread my post and I can't find the word "gold" anywhere in the post and I am assuming that your claim is to be amended to state "Gold is useless [as an asset]" since it is one of the most useful minerals known to mankind. Where do you get this from?
"Physical assets" can be anything physical: a building; a lot's worth of used cars; a warehouse full of Play-Doh, etc. When people don't want dollars or financial assets, they will replace them with whatever seems like a better deal.
So for the next year or so as defaults accelerate I expect that deflation will be a larger concern than inflation, and central banks will try to counter that by large, frequent injections of new money.
> So for the next year or so as defaults accelerate I expect that deflation will be a larger concern than inflation, and central banks will try to counter that by large, frequent injections of new money.
The flow of new money creation is not evenly distributed throughout an economy, and this is called the Cantillon Effect (which can also be applied to deflation).
The new money creation has been going strong for some time now, but hasn't been flowing into sectors measured by the CPI. This has kept CPI increases relatively low in comparison to the increases.
However, send $1000 per month to every American and nearly all of that will go into sectors measured by the CPI, which will then go up.
It would be really nice to hear compassion instead of worry about money. How about we keep people alive, then deal with the economy? Something tells me the country that can burn $2T in less than a week will be just fine until this passes. Talking about the long term health of the economy in terms that push people out into unsafe situations, when we have a virus that kills people in 3 weeks, borders on evil.
There is one way to solve the virus problem: social isolation. There are infinite ways to solve made up economic problems we foist on ourselves.
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EDIT: as expanded on below my main intent behind the Federal Reserve <> Government affiliation remark is that the Feds decisioning and repro market fund pumping is not government affiliated.
Economic factors should absolutely be taken into account. Money pays for life saving medication and treatments. Tax money from the economy pays for social medicine.
For example, 280,000 EXTRA people died from cancer between 2008-2010 in the OCED. When you consider heart disease, other indications, and the rest of the world, you are talking millions of lives.
Far more people could easily die from the economic fallout in the US than the virus.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
I was reading the Contra Costa County order when their site went down.
https://webcache.googleusercontent.com/search?q=cache:ilhKHP...
When the panic hugs end, the Contra Costa order will be available in one of these two locations:
https://www.contracostahealth.org/coronavirus/pdf/HO-COVID19...
https://cchealth.org/coronavirus/pdf/HO-COVID19-SIP-0316-202...
10 a. For the purposes of this Order, individuals may leave their residence only to perform any of the following "Essential Activites."
...
iii. To engage in outdoor activity, provided the individuals comply with Social Distancing Requirements as defined in this Section, such as, by way of example and without limitation, walking, hiking, or running
The virus is here to stay in the US for the next year. It doesn't make any sense to limit social interaction (for young people) for just 2 weeks. If there is no vaccine and the rate of expose gets down, after the "lockdown" is lifted, transmission will simply pick up again.
The media and WHO are complicit in spreading hysteria like claiming the mortality rate is 3.4% (https://www.usatoday.com/story/news/politics/2020/03/05/coro...) based on completely faulty numbers. These numbers are obviously flawed because they do not account for people who have not had major symptoms and thus have not been diagnosed.
The actual way to stop the spread is to tell elderly folks and people with underlying health conditions to stay at home. Not to keep young people out of their gyms (All bay area gyms are now shutdown). The hospitalization rate for under 45 year olds is very low. By allowing under 45 year olds to get sick and develop immunity, we can actually stop the spread.
There is no endgame for social distancing everyone other than waiting for a vaccine (won't happen soon) or hoping the summer stops the transmission rate (not guaranteed). It is selfish to expect the majority of the population to stay away from work and gyms when the risk is extremely low for them. Note that young and old will continue to cross paths in close proximity at grocery stores, the post office and other "essential" locations. It is just wishful thinking that a two week break will lead to a long term fix.
The only thing that I believe is objectively contentious in my post is whether allowing young people to get exposed would help things.
The opposite extreme would be to let everybody get infected, see >15% of the 65+ population die, which I am sure some economic model might favor.
I do hope, but doubt, that this crisis will start changing how our society manages crisis and is pro-active about it, rather than being reactive. I this point I don't care which banner a politician represents. I will only care for the one with a plan for direct accountability at the highest level. Otherwise they're all d-bag.
Theoretically there are two factors that make this virus dangerous:
1. Experience elsewhere in the world suggests the transmission rate is high under normal social conditions. Say 2:1 or 3:1. If those numbers are accurate, the infection will spread exponentially. Are they accurate? Dunno.
2. Experience elsewhere in the world suggests a high rate of infections require long stays in ICU, with some of those cases dying. What rate and how long and how many? Dunno.
But there is some combination of transmission rate and hospital load where the healthcare system gets absolutely gummed up. If that happens, they must deal with the scenario where large numbers of patients who normally would have been treated get triaged to to end of life instead. I assume that would mean all major cities start digging mass graves, because what else do you do with 1000s of unplanned dead bodies all at once?
The purpose of the lockdowns is to lower transmission rate below 1:1, where it will essentially fizzle out on its own as long as we remain locked down. Again I've read that experience elsewhere in the world suggests this can be effective. Again, I'm not aware of any especially convincing evidence of this.
Given this model, the optimistic outcome is a short lockdown will buy enough time to come up with less harmful interventions. For example, better testing would allow healthy people to return to normal life while keeping transmission rate below 1:1. Or improved treatment would reduce the load on the healthcare system. Or a vaccine. Or maybe the estimated parameters are too high, but we can't know until more testing is done.
Less optimistic outcome is lurching along in uncertainty while the economy implodes, followed by the unpopular mass grave scenario.
Especially since the order says Violation of or failure to comply with this Order is a misdemeanor punishable by fine, imprisonment, or both.
I'm going with the assumption that surrounding counties outside the six mentioned in the article will take up a similar measure.
> Am I allowed to leave the areas covered by this Order to travel to/from a vacation home outside the Bay Area?
> No, except to the extent that you leave the Bay Area and do not travel back or are leaving for a permitted purpose. That kind of travel runs the risk of spreading the virus around the state or elsewhere, and that puts others at risk. Stay put and don’t risk exposing yourself or others.
https://sf.gov/stay-home-except-essential-needs#main-content
(sorry, there's no anchor for the FAQ elements, you'll have to search for the text).