One of the things the press seems to have had trouble grasping is that there are no good options, and quite possibly never were. (Short of stopping the virus from spreading out of Wuhan in the first place, which might barely have been possible if the world acted fast enough - but that was never going to happen.)
The US never really closed their border with China. Americans returning from China were let back in with minimal checks, and some were probably presymptomatic. Not only would it have had to be earlier, it would have had to strand American citizens abroad until they could be tested, which was never on the cards.
The author considers letting the epidemic run its course on the demographics most at risk, to be the most unrealistic outcome. He writes:
> I care about my privacy, but not nearly so much as I care about my mother.
Most people care about their own mother. But if lockdowns, unemployment and poverty continue, I can definitely imagine people saying, "I don’t care about your mother, so why should I stay unemployed and confined to my home just to keep her safe? I’m sure my mother will be fine." Of course, believing that one’s own parents will escape the epidemic might be mere wishful thinking, but this is the way that human beings rationalize things in times of crisis.
In the UK they're now making noises about letting the 20-30 year olds who live alone go back to work first.
I imagine this is really code for "if we infect all these low-risk people first, we get a large proportion of our workforce immunised, for a fairly low hospitalisation proportion".
I don't know enough about the models, but I also guess having a large chunk of your low-risk population already immune reduces R0 for later waves too.
I can also see it back-firing when these same people think it's alright to nip round Mum's to say hi and give her a quick hug, it's only 5 minutes after all.
I've also heard that a large fast food chain estimates it will take up to 8 weeks before they can get supply chains up and running again. As an example the sheer quantities of lettuce they need aren't being planted because there's no demand for them, and you can't just magic them out of thin air when someone says 'you can open your stores again'.
> I imagine this is really code for "if we infect all these low-risk people first, we get a large proportion of our workforce immunised".
I think it’s really code for “let’s repeat the mistakes we made early on when we adopted ‘herd immunity’ rather than isolation as an I itial strategy and spread this as rapidly as we can and create another critical peak”, because those people aren't completely isolated from the rest of the population, and spreading it more rapidly in that segment of the population will also spread it more rapidly in the rest of the population.
But I guess it's good to know the the incompetence of the present British government is resilient enough to survive the temporary incapacitation of the PM as a fairly direct result of the incompetence on the very same issue. I'm not even sure the US federal administration would be that committed to it's own (otherwise more complete) incompetence on the issue.
I'm not sure what you're talking about, but the herd immunity thing was a throw-away statement tacked on to the end of an initial briefing, it was never the plan.
Also, we shut-down pretty quick when it became clear how much worse Italy was faring than the stats China had claimed.
There seems to be some pretty ridiculous things being said in foreign papers at the moment about Britain's response as it's an easy way to deflect criticism of themselves.
The only people who have the right to throw shit are the Germans, Soth Koreans, Taiwanese as they're the only ones who seem to have got ahead of this thing.
The British is on a similar trajectory (if not lower) then America/Italy/Spain/etc., if you put aside the frankly unprofessional and crazy IMHE projection (which is already failing to match real-life three days later).
> The British is on a similar trajectory (if not lower) then America/Italy/Spain/etc.,
Yes, it's among the worst hit as all those you name are, and like the US that's mostly a result of national government incompetence and not other circumstances that put it in that group (Italy seems from what I understand to be other circumstances, Spain I'm less clear on.)
Current plan for Norway is to start gradually opening up after Easter:
* Opening up kindergartens, physiotherapy, hair salons and allowing cottage holidays from 20th April
* Opening schools for 4 youngest classes, After School and some higher education in final years from 27th April
So you go after lowest-hanging fruits gradually, but it's a learning phase and could need rollback if people don't follow restrictions enough to contain contagion. This advice is a mix of political and expert analysis, after observing decline of new cases and deaths, after timely though not early, lockdown.
Norway is a small and nimble country, so could more easily be leading the response in the West. Though a new normal will have to include pandemic response in nearly all aspects of social life. The clustering and stochastic nature of the spread may become somewhat managable, with enough tracking, testing and preparations.
Does anyone know why I've seen various reports that they think opening schools will have a low impact on the virus spread? Kids still get infected, so will spread the disease (and I would assume more than most people being careful) as well as then spread it to their households.
Is it because children rarely commute outside a community, so it wouldn't spread between communities, just within communities already infected?
Contagion very rarely trace back to kindergarten and schools, kids have much higher chance of mild infections and it is possible low amounts of virus exposure are safer. Not enough evidence so leaders need to lead and experts collect data and analysis, what measures may not contribute enough to justify.
To some degree it could be true, as we see that Covid 19 hasn’t been a racially blind phenomena [1]. In the US, not all communities are in the same boat, even during an international crisis.
Texas still allows religious groups to meet in size of 50, declaring it an essential service, while abortion clinics have been closed. We aren't in the same boat.
A simple alternative would have be to quarantine the at risk people (60+ and pre-existing conditions) and let the rest of the world create the wealth necessary to help keep the at risk groups alive, focusing our healthcare attention on the at risk groups.
Oh my god, the system described by the CAP plan covered in this article cannot be allowed to come into being. Instant dystopian nightmare state. This kind of tool can't be un-made.
Unfortunately, the PEPP-PT approach will not protect privacy in many European countries. This is because an individual is linked to a phone number. Since you cannot purchase a SIM card in many countries without showing ID (and a copy of your ID is made and sent to the state authorities), the state is easily able to match phone numbers with people’s real identities. Consequently, the authorities will easily be able to track the user’s movements, or at least track what other people that person interacted with over a period of time, which is essentially the same thing.
If you read the PEPP-PT documentation closely, the “privacy protections” are mainly keeping you anonymous to other ordinary people. But people should reasonably want to remain anonymous from the state as well.
I agree that PEPP-PT is not too clear on their commitment to protecting privacy. I disagree that anything about the DP-3T system divulges SUM numbers. Go read the 3 pager and see.
The linked article describes a tracking system that would be mandatory for every single American in order to e.g. board public transportation. (Such a system has already been rolled out in China where people get an automatic red–yellow–green health code and have to show it in public places.) While one can reasonably assume that the NSA is already capable of tracking a huge amount of phone location data from Google or Apple devices, people are still free to not have such a phone and they are still able to move around in public.
I started studying the US news reports of Covid-19 related to ventilators weeks ago when I realized there were no interviews with survivors, and ignored the speculation around partial testing results and R0 calculations because of the lack of hard data, and exponential rate of infection making analysis moot.
Essentially, ICU admission for ventilators, and subsequent deaths, are the most complete and factual data we have.
The solid information we have is that 66% - 90% of ventilator patients die, as reported for both China and the US. Interviews with doctors all report that ventilators are supposed to be used for up to a week, not 3 weeks.
Although the occasional patient makes it off a ventilator, from a public healthcare policy standpoint, ventilators just don't work well enough, so there's no reason to "flatten the curve" now (April 10, 2020) aside from accumulating PPE (masks, gowns, gloves for hospital staff.) (A cure will likely take 18 months to invent and approve, so that's not something to put on a roadmap.)
The plan should be this:
1. have our healthcare policy experts (CDC, etc.) study today's reported data on patient mortality and PPE supplies for a couple days
2. inform seriously ill, high-risk corona hospital patients about the risks of ventilators (ie. you're probably going to die on one anyway, and horribly)
3. have dedicated quarantine and palliative buildings for moderately ill confirmed corona patients with O2 available (like the Javits Center in NY, as an example for discussion, or an anchored cruise ship moored off each major city). Recovered people can work there safely it appears.
4. have dedicated hospitals for corona ICU patients if they choose to try a ventilator (China has dedicated hospitals)
5. lift the US lockdown and treat corona like any other seasonal flu, mainly because it is, and also to avoid destruction of our economy and related uncertainty
6. the exception is passenger airline flights, which should be grounded until further notice. develop a plan to make airliners safer to fly (hepa filters, etc.) Cities shouldn't be under lockdown, but airlines are almost certainly a major disease vector and need to be treated as such.
(FYI: Wuhan has an international airport only 2 hours flying time to Shanghai Pudong International, which is a major hub. So that's likely how it spread world-wide.)
The impediments for the US to implement this plan are:
1. as a society, the US has lost the ability to formulate and execute policy at the highest level, whether healthcare, hurricane response or infrastructure. At this time, we need experts (like the CDC) to lead.
2. Trump should not be involved in any way, since he doesn't care about facts.
(The reasons California Governor Newsom broke contact this week with the federal government are essentially the above.)
I'll add my collection of supporting links later today. They are all consistent with each other, so the facts I outlined above are not in dispute.
Although the information from China was publicized late, it appears overall to be accurate and helpful. They used their previous experience with corona and bird flu infections to move fairly assertively on Covid-19 - a far better response than the US or Europe.
Please leave a comment if you want an area of my outline above to be fleshed out more.
If somebody could look into how Sweden and Germany have fared with less social distancing, that would be helpful. Please leave a comment about that.
The big problem with this plan is that it would require giving up and letting a large number of Americans die, which is a political and social nonstarter given current expectations around life, death and healthcare. (Well, at least amongst the secular parts of America. Some of the more religious communities seem to still hold the view that it's futile and arrogant to think this is something we can fight, much to the anger and bemusement of secular society.)
For herd immunity, the number discussed is 80% of the population getting Covid-19. Since there are cases world-wide, I don't see containment at this point working.
To even consider containment succeeding, we would need a way to test 300 million people a couple times a week. Since we can't do even 1 million tests a day, the math doesn't add up.
"Giving up" is a strange way to look at it. We have various flus annually. There will be a time limit to lockdown of several weeks, not 18 months.
So it's important to look at the data and make an informed public healthcare policy decision.
This plan is stupid. In U.S. under lockdowns, already 18k people died in just a few weeks, and every day 1k more die, and that number is still growing. The worst estimate for 2018 flu was 56k (e.g. less than a month left under current lockdown regime to surpass it), best is 12k which is long surpassed.
People die every year from flu in the tens of thousands, or car accidents, or myriad other causes.
Rather than an emotional response, we need healthcare policy experts to look at the data as of today.
What has changed in the past month is that we know ventilators don't work 66% - 90% of the time, so they should be taken out of the "flattening the curve" equation.
Please see my post with several links to learn more.
Where do you see emotional response? I just gave you numbers. You can look at the curve, see where it is going, and imagine what would happen, if there was no lockdown.
Source Links for my post earlier today starting with the text "I started studying the US news reports of Covid-19 related to ventilators weeks ago"
Please read through these and let me know of any comments or questions. They strongly imply ventilators don't work on corona patients across multiple reporting countries, so a different policy direction should be investigated for treatment of confirmed cases and lockdown duration. If you agree with what I wrote, please upvote my posts so that people can more eaily find my research.
It appears that ICU doctors, politicians and the public are all working on different narratives, which is counter-productive.
Thank you.
Wuhan shrimp seller identified as coronavirus ''patient zero''
What's the alternative? Let the virus rage, totally overwhelm the medical system and kill a whole bunch of people? Stay on lockdown for years until a vaccine's ready?
We could have locked down the vulnerable (60+ and those with pre-existing conditions), and anyone with a temperature, focused our healthcare efforts on them and let everyone else go about their business with more caution (masks + hand washing).
We would have built societal (cows are a herd, humans are a society) immunity by this point and could slowly return to normal for the at-risk crowd.
As it stands, we haven't built up any social immunity and will have to wait over a year for a vaccine which, by definition, we will not know the long term effects of.
Cynically, since the morbidity is mostly in the elderly parts of the population vs. the younger ( a la 1918 ), I can see the Lt. Gov of Texas's attitude of " let the olds make their sacrifice" be the driving principle...
Not simply just old people [1]. Texas has also categorized religious gatherings of 50 as an essential service, whereas abortion clinics have been closed.
Texas is taking a very different approach from California.
> Any feasible plan starts with massive testing, completely subsidized by the government. And yet just yesterday the president claimed we don’t need mass testing.
This is something I've been saying from day 1: short of universal vaccination, the only way to get back to some form of normalcy is widespread testing of the population. Any government with some sense of reality would spend billions in testing, to avoid losing trillions in the economy. Unfortunately it doesn't seem that the US government has any notion of how (or desire) to do this.
Cheer! Because with 28%, you are close enough to herd immunity that you can push R0 below 1 with social distancing.
In fact, herd immunity does not require 70% of the population to be immune. It just requires 70% of all potentially transmitting contacts being eliminated. And if those 28% who contracted the virus first are also the ones that have more contacts than average citizen (which should be the case, because that is why they probably got it before the other 72%), we might already be fine. Let's these 28% have 72% of all human contact (because human is -like almost everything - not distributed equally), then we would already be there and have reached herd immunity. There would still be sporadic local outbreaks, but nothing dramatic any more.
A lot of trade goes over those borders, and it only takes a few cases on the wrong side. Sure if on 1 Jan the RoW had shut borders with china things might have gone ok.
You can never get 100%, but it seems you can get enough to prevent it from flaring into community transmission. Keep in mind if I'm wrong, this lock down never ends - that's the only way you can keep other hot spots in the world from reinfecting your country after you get it under control.
No because you cannot close borders off to American citizens. Even travel bans aren't terribly effective because you can pass through other countries or be infected in other countries.
We'd just need something like Ellis Island to quarantine returning travelers who are American citizens, simple as that.
But realistically unless they imposed a blanket 2 week quarantine, they would just be letting the asymptomatic carriers through anyway. Nobody was prepared that early to go to such extreme measures.
I wonder whether taking the temperature is enough when combined with social distancing? For that, it would be interesting to know what percentage of people that are infectuous have an elevated temperature. 50% might already be enough, because that means we could cut the infection rate in half just by quarantining everyone with a slight fever.
Even if you only find half of all infected, it would already help a lot. The infection rate is cut in half if half the infected are immediately quarantined.
The goal has never been to bring the transmission rate down to zero. If we could quickly test everyone at the onset of symptoms, then trace and test anyone likely to have been exposed to the virus by that symptomatic individual, we could bring the transmission rate down considerably. It's been done in other countries. Add in some other precautions, like automatic temperate checks, and the transmission rate can be lowered even further. Low enough? Dunno, but lockdowns can't last forever and our healthcare capacity is getting better by the day.
How much money would it take to make testing everyone a realistic possibility? How much money are we losing by just shutting everything down? Which one costs more?
You are NOT injecting some vaccine shit into my body without my consent! And you will only get it when the China controlled WHO is disbanded and the virus true origin is determined. I bet my left but that it's from China's biological weapons lab four blocks from the market...
Not to mention few outside a small group of think tanks appear to be thinking about this. Perhaps if we had a President realistically planning for what to do next it’d be a bit easier. Regardless it’s not the President who figures these situations out, but the leaders at the CDC, FDA, and NIH. If they put out realistic plans and the press focuses on something more than the President, then we have a chance to plan for the next steps. For example it wasn’t the President who prevented the FDA from authorizing emergency testing back in January and February; it was all the FDA leadership.
In my state (Ohio) at least, protest are starting to form on the legality and length of shutting down businesses. It's still only a handful of people but seems to be growing every day. There is a very slim chance the government can enact shut downs for long and still maintain authority
Where in Ohio is this? I'm not doubting, just like to read local news on it as I'm in Ohio too.
I applaud DeWine for acting quickly, but I'm concerned that maybe for rural and small city locations the shut down was too much. I wonder if we are creating a cry wolf effect for non-metro areas. All the mass effects in my area are purely from the response. Of course, one may say, what if we hadn't a shut down; but, I think that argument is going to be harder to make to the small businesses in a small city or rural area next time around.
When I see that small businesses get shut down, but Walmart gets to keep selling everything because they have a grocery section, I get a little disgruntled too. New Mexico just shut down standalone liquor stores... but Walmart will be allowed continue selling liquor. If I owned a store, I'd be pretty upset that the governor appears to be enriching the very biggest "everything" stores while driving me out of business.
Honestly, how long are people going to be able to not pay rent for. I've already seen several businesses in my town permanently shut down at the beginning of April. This is people's livelihoods. People's source of food and shelter. Once people start losing that, authority means nothing any more.
Yeah, turns out my fellow Americans are a lot more bark than bite about certain "inalienable rights" once when they got frightened and had some skin in the game.
Given how happy people are to report their fellow citizens for the infraction of peacefully assembling, I suspect they'll put up with a lot more are long as you tell them it'll keep the virus away.
States shouldn't need federal guidance and should prefer not to receive it. Without federal oversight, states and municipalities can tailor policy to their own area
I don't disagree, absent a well stocked National Stockpile, the Great States should build their own emergency reserve for Natural Disaster and Pandemic. Each state building its own stockpiles of some things that don't hit all areas equally could be wasteful. Keep close relationships with manufacturing firms who are prepared to be ready on short notice.
This is as much a failure of planlessness as it is policy.
The same is true for nations. Any argument for forcing the states to be subordinate to the federal government is also an argument for forcing the federal government, and all other national governments, to be subordinate to a single supra-national entity.
Except that it's easier to temporarily close national borders or institute things like temperature checks or quaranting arrivals than it is state borders in the US, as far as I can tell.
For how much I understand the need to lower the curve and reduce the R0 of the infection, I start to see also another argument.
We are basically pausing the life of younger people, indefinitely, to protect the elders.
Again, since the quarantine started in my area I exist twice to buy groceries and that's all. So I understand the need and the importance of it.
But should I really throw away on year of my life? Shouldn't we quarantine only the elders? Would your opinion change if you were living by yourself with your significant other locked up somewhere too far away to meet in two months?
And yes I am aware that also younger people died from the virus but the chance are so much smaller that I don't believe is fair to compare it.
The opportunity cost is so much different and nobody is addressing the issue.
How do you lock down elders? Do you expect cops to look at people's IDs and check if they're 65+? This is ridiculous, the only practical way is to close places where people are inclined to gather such as bars/restaurants etc.
Do you not consider it a "punishment" to lose your family members an avoidable way? How about avoidably dying when you have a car accident because the ICU is overloaded?
Do you think people over 60 (or wherever the fatality rate spikes) existed in a self-isolated bubble staying home alone before now? Have you talked to any of them recently? The ones I know are having a rough time of it, at least as much as the younger people I know.
If locking down "just the elders" was a workable solution, what do you think it would really look like?
Yes! I think many people don't realize that COVID by itself is not the problem so much as the additional burden it places on the healthcare system, which could be used to help people with other problems. We are already seeing cases of people with cancers having surgeries delayed because hospitals are trying to conserve PPE.
I was unlucky enough to fracture my ankle right before California instituted shelter-in-place and to fracture it in a way that needed corrective surgery. I was lucky that CA managed to avoid the worst of it, so that my surgery was able to proceed on schedule. Otherwise I was looking at potential long term complications in addition to being off my feet for 5-6 months instead of the 2 months they expect now.
This issue was addressed by the original UK policy that they about-faced on. Why? Because although it does not tend to kill young people, it does tend to put them in the hospital, and we cannot handle that many people in the hospital at once.
And what I am saying is that the lockdown punish different class of people very differently. And the most punished are the least affected by the virus itself.
That may be true, but if it is it would lead to "slightly less lockdown for some people," not "no lockdown for some people." But to your broader point, that nobody in government is considering the finer aspects of modeling and optimization: yes, I know, I don't expect anything more from them, and I think they're a bunch of nincompoops who only know how to write legal documents and strike deals. However if I saw any push for more technical and effectiveness-oriented adjustments to the procedure I would jump on board.
>We are basically pausing the life of younger people, indefinitely, to protect the elders.
No, we're pausing the life of everyone to protect everyone. If you overload the hospital systems then everyone dies. If you pause and keep things barely managable then mostly only old people die.
I believe we both agree that locking down 20/30 years old people who still have to study, to meet people, to make experience, to find lovers and to find themselves is very different that lock down 70/80 years old people right?
Then there is no doubts that the virus hit hardest the elders.
Again, what I am saying is that younger people are hit by the lockdown much more than the elders while being the less concerned about the virus itself.
I'm 22 y.o. I simply do not understand this logic. Not being able to "find lovers" doesn't seem comparable to others dying. Yes, you will not be able to go to a bar and pick up girls/boys until things get better. These are not normal times, young people cannot act as if nothing is happening.
The argument here is about what should happen when things do get better. Many people are arguing that you shouldn't be allowed to go to a bar even then, because if you're allowed to have fun things might get worse again.
> Again, what I am saying is that younger people are hit by the lockdown much more than the elders while being the less concerned about the virus itself.
The problem with saying this is that it's incorrect. Many elders suffer during lockdown in the exact same ways and in some cases to the exact same extent that younger people do, including in the ways you imagine: socially, sexually, economically.
Additionally, there are many young people (many of them here on HN) who do just fine during lockdown because WFH and online interaction actually promote their senses of well being. [0]
The insistence with which you have been asserting that young people are being "punished" reveals adherence to an agenda more than an evenhanded analysis of the facts.
The insistence with which you have been asserting that young people are being "punished" reveals adherence to an agenda more than an evenhanded analysis of the facts.
I don't think that's fair to the OP. They seem to me to just be describing what they see and feel.
In a cold, utilitarian sense, the ripple effects from messing up a young life are many times more significant. If schooling, work, romance, and childbearing of young people are all disrupted, you can expect to see that in the economy for decades to come (just look at the name "baby boomers" for the opposite case). But, again in the cold utilitarian sense, if the life of someone with 10-20 years left is disrupted, that disruption doesn't last as long.
* What age defines "young person"? What's "old"? What are the mortality rates of these groups? How many hours of "home-time" should each serve daily?
* Any concern for the COVID-resilient groups running around spreading the germs to more susceptible? How do we measure what level of social life one is allowed to have while putting other groups at risk?
* Enforcement. How do we advertise and enforce these new rules? Will certain people feel discriminated against? Should police card/arrest people if they look just a little too gray/old/wrinkly?
I think just "talking" about this will be opinions vs opinions. We should start with numbers and then try to see what makes sense.
On wednesday I was shown the obduction pictures of a ~30yo regular guy from my city, who had holes in his lung, by a friend who‘s working in ICU.
This friend basically said that if you are young and need to be ventilated you enter ICU with a better lung than older people.
So when you leave ICU you have enough lung left to not die. You would have died with an overwhelmed ICU, though, and you‘ll likely need a long time to get back the health you had before. If ever.
80 year olds not ready to die will quarantine themselves, no lockdown needed for them.
Some young people are benefiting with fewer car accidents. Some old people are having to wait longer for transplants as there are fewer organ donors dying of accidents.
Also fewer middle aged people are having myocardial infarcts.
My children are not so upset that they don’t have to go to school.
I wonder if countries benefitting from tourism will finally get rid of visas and passports to encourage international travel again. Probably not, but one can dream.
Maybe if the us ends up bailing out the entire world, there won’t be a reason to protect the borders with passports as we will have a United States of earth. Fed swap lines are already available to around a dozen countries.
I've seen a coronavirus study that estimates 90% of the economic benefit of the lockdown accrues to those over 50. (Standard quality-adjusted-life-year rates.)
I've also seen pre-coronavirus studies noting the stark disparity in wealth between baby boomers and millennials at the same point in life. Fun times indeed!
I can afford this myself, but sparks will be flying.
People have been making this argument since before the lock down. But on the contrary to your prediction, the argument has seemed sillier and sillier the more we see the effects of the virus. Things are really freakin bad, and that's with a lockdown. I suspect that all but a very small minority will be able to see the sense in spending serious effort on mitigation for the foreseeable future.
Even if people somehow manage to forget the horror and deaths of the past couple of weeks, a loosened lockdown and the inevitable spread of disease that will follow would quickly remind them.
The argument against a few weeks of lockdown has seemed sillier and sillier. The situation's very bad, and it's worth spending serious effort to mitigate for the foreseeable future.
A ban on all social activity for years is far beyond "serious effort to mitigate". Millions of lives isn't worth a global dystopia.
Years of lockdown really would be draconian and I think we could start to compare it to the value of human lives. I think we need much more focus on how and when the isolation ends.
Which means doubling your chance of death in a year. Can you think of any activity you would willingly engage in that doubles your risk of death in a year? Most people won't even stand outside unprotected in a lightning storm - and this is much worse.
A quick Google suggests that if your risk is representative, a 0.2% additional risk of death equates to going skydiving around 3-400 times in a year.
Or, based on overall fatalities from motorcycles per mile, it would equate to about 8,000 miles per year.
Or, based on light aircraft fatalities per hour, it would be around 200 flight hours in a year.
Of course, you could argue that the casualties from both activities are skewed upwards by people who do stupid things early and don't live long enough to engage in the activity a lot.
Anyway, I'm not particularly agreeing or disagreeing. The risks above are considered reasonable by a lot of people and unreasonable by others.
And people will die from suicide due to economic destitution. The ones pretending are those that think public policy should be discussed in morally squeaky clean terms. Crisis policy is a dirty conversation about who sinks and who swims.
We are talking about trading people for people, and we’re saying in some trades the numbers work out better.
No one is addressing the issue right now because we aren't even in a situation to exploit the alternate arrangement. Suppose at this very moment we switch over to the quarantine the old people strategy, and go to largely unrestricted life for other age groups. Even in the 20-50 year old range, the hospitalization rate looks like 20%. Say we're actually missing 50% of cases cause they're so mild, so it's really 10%.
330 million Americans, says 70% aren't at highest risk, all become infected, at 10% hospitalization -> 23 million hospitalizations required. Spread over 18 months, that's still an additional 1.25 million hospitalizations every month. That's 0.3% of Americans in hospital for COVID, constantly (assuming average 1 month time in hospital required - yes I made that up).
For context, roughly 0.7% of Americans are incarcerated at any given time.
Still a logistical nightmare. You can tweak those numbers however you wish, but they generally all giving mind boggling logistical nightmares.
It’s going to take a while to unpack your comment.
Until then, while you mention Ro, you might not know that some recent reports show it approaching 6 in some areas, not 2.x as thought by some over a month ago. With an Ro of 2.5 and a mean infection duration of 5 days, each person can cause infection of up to 244 cases in a month.
Also, since testing is not widely and reliably available in most countries, there is no way to loosen stay-at-home as a practical matter. Pervasive testing, quick contact tracing, isolation and quarantine are the only way forward.
And I’m not sure you are factoring in that Covid-19 positive people can be contagious before they show ANY symptoms.
So if you’re not concerned about older people or people with comorbidities generally, you might look around at the people you know and care about.
The other part of this is the impact on health care providers and first responders. They are getting infected and dying. The have more pressing issues than those you mention.
I find thinking about my community and taking certain matters of personal responsibility seriously helps me dwell less on myself.
Personally I am myself in the stricter form of quarantine I can do.
However, the argument I brought forward will start to raise stronger and stronger. And if we don't discuss about it, and if we don't do it fast, it will be problematic for everybody.
I personally don't even mind that much the lockdown, but I am not the only youngest around...
But it's not the rest of your life. It's just until we come up with a treatment or a vaccine, most likely a year or two. Yes, that's an annoyingly long time, but still better than being dead.
Certainly nobody is making the following fictional argument: "I'm not going to die anyway, and it's better for you to be dead than for me to be socially isolated."
Sweden uses much lighter restrictions with industry still running, most shops still open, and schools for younger children open. One of the keys in this lighter strategy was to protect the elderly, with bans on visits to homes for the elderly and so on. Unfortunately that wasn’t enough, the spread has hit many such facilities with a high number of deaths as a result.
It’s hard to isolate the elderly if they are so old that they need care by the young.
Isolating the not-quite-so-old that can self-isolate is easy.
Test the young caregivers for antibodies. Only permit those with antibodies and no viral load to get anywhere near the elderly. Pay extra if necessary, it would be much better than breaking society.
The problem is that the problem of finding staff is difficult in normal circumstances, and almost impossible right now when lots of people are sick. Add to that the fact that unlike healthcare professionals these caregivers have much less hygiene trained and currently littlr PPE available, and you have the recipe for trouble.
Antibody tests are also almost useless on an individual level: If they have 4% false positive rate and 10% have antibodies then there are 36000 false positives (4% of 900k) when a million people are tested! Antibody tests are good at a group level to measure the progress of the epidemic, but unless the incidence is high or better test methods are found, they are near useless for what you are describing, sadly.
You misunderstand the current exercise. The only thing these stay at home policies are designed to do is keep the healthcare system from collapsing by slowing the spread of the virus. That's it since we are way past the point of having any hope of containing it.
Sure, the immediate beneficiaries are those at highest risk from the virus. But younger people who fall on the extreme end of the symptoms would also be dying at relatively higher rates too. Have no fear, once the powers that be are confident that society won't collapse, the stay at home orders will start lifting and life will go on... including allowing people young and old to die at 'acceptable' rates from the virus.
I agree with what you're saying, but it's not a misunderstanding - the original article really is saying that the stay at home policies are designed to contain the virus and won't end until a containment plan is in place.
To protect the elders, yes, but also the young, the frail, the immunocompromised, the asthmatics, the poor, the homeless; human life in general. Also, we are attempting to ensure people going to the hospital for anything else are still actually able to receive care, as healthcare labor is limited and resources are strained. Screw the market.
I'm extremely skeptical of any analysis that discusses political non-viability at this point. If you asked any commentator 2 months ago whether it was politically viable to issue general stay at home orders, or to give every American a bunch of free money, or to pass a multi-trillion dollar stimulus bill, they would have told you no.
Giving every American a token cash handout is something Republicans have done before, it's hardly unbelievable if you actually have historical context. And by far most of that bill is corporate handouts. And the oversight has been fired. Everything about this aligns exactly with what you'd expect politically. It's a debacle.
Furthermore, while there has been a lot of shutdown, it's not equal across the board. Tons of places are taking half measures or no measures still, and the reasoning is entirely politically biased (business more important than people, etc.) It's clearly a case of more right leaning areas taking less cautious measures in favor of money.
In fact, I'd argue that everything that has happened, especially all the horribly obvious "mistakes" (read: intentional, corruption riddle, failures in the case of the federal administration) aligns with political viability as expected and confirms in retrospect the claims about viability.
I have seen a few click-bait headlines stating that the "oversight was fired" but it is not exactly true. There is some politics going on about who is chair of the PRAC but the other ~20 members of the committee have not changed.
The procession of a dictator is more nuanced and complex than people realize. A totally typical tactic is to repeatedly fire anyone who will take up the role in a fashion that does not directly benefit said dictator. That anyone was fired from this duty without a clear explanation and justification is cause for alarm. It doesn't matter if there are 20 or 2000 more ready to step into that position. Dictator will keep firing until he sees a loyal drone in the slot.
Replace the word "dictator" with "leader" in your statement, and your sophistry becomes obvious. You are just describing common traits of executive leadership, conflating them with a shallow and dumbed down version of "dictator" to try to make it fit.
>that does not directly contribute towards said leader's goals and the goals of his electorate
Well yeah, in most of these cases you are talking about unelected bureaucrats caught trying to undermine and subvert the elected President's agenda and constitutional authority.
Are you trying to say a President should not have people helping him, and that he should permit employees who have been secretly and actively working against his agenda and undermining his authority? Seriously?
>repeatedly fire
How do you "repeatedly fire" someone?
>That anyone was fired from this duty without a clear explanation and justification is cause for alarm
Good thing nothing like that has happened, no matter what the fired individuals or their "resistance supporters" might like everybody to think. Falling for this line depends purely on ignorance and buying into the opposition's propaganda without question.
What part of Commander and Chief of the United States do you not understand? Was Obama a "dictator" when he blanket fired all of Bush's political appointees without explanation? Or was it, rather, the routine action of an incoming President attempting to set up his incoming agenda for success?
>until he sees a loyal drone in the slot
As opposed to a disloyal drone? Come on... This is just sad at this point.
>The procession of a dictator is more nuanced and complex than people realize.
Not really, though it really is fun to see Progressives leak their inner motivations through projection.
You're not wrong, but the first part is largely what I'm talking about. When people say something is "light-years beyond the kind of political leadership and public-private coordination we’ve seen thus far", I don't think they're doing a principled analysis of what political leadership or coordination has been able to accomplish in the past.
> It's clearly a case of more right leaning areas taking less cautious measures in favor of money.
While I see where you’re coming from with this statement, I’m not sure I agree. From where I stand - a town of 13k people surrounded by a large rural area - it makes sense that we’re taking less aggressive action because the virus is not yet endemic here. Given the growth of confirmed cases in my area (northern Arkansas), it seems those steps are working adequately to keep it from becoming endemic as well.
I propose that areas with lower population density are taking less aggressive action, and those areas are also predominately right-leaning.
Literally everyone in this scenario thinks this way at first because they can't comprehend exponential growth. Nobody can, there are actual studies that show nobody can understand it so it's not a slight.
The only way you can convince me based on evidence elsewhere that your scenario is going to be any better than anywhere else is if your leadership in your area is doing aggressive testing, contact tracing and targeted isolation protocols akin to South Korea.
I'm not sure why it's a question of "going to be". The scenario in most states is better than New York, and has been for a while, even though many of them confirmed their first case earlier.
Consider the R0 value that you're trying to reduce by social distancing.
New York City starts with a high value. People encounter each other in apartment hallways, packed subways, crowded streets, and huge stadiums.
Rural places don't have any of that. People don't pass by any non-family when going from home to car. Non-family don't share that car. The streets are nearly empty of people, with just the occasional person out walking a dog.
There might not be exponential growth. If R0 is below 1, there is exponential decay.
I’ve been watching this situation for months at this point, so I can assure you I’m personally taking it seriously.
It’s not that my area is taking no measures at all - only that we’re being much less aggressive about it than other areas. All of the restaurants are closed for dine-in, as many as possible are working from home, and we’re social distancing.
The governor of Arkansas is convinced that is enough. So far - at least for the area where I live - that does indeed seem to be the case. There have been a total of five confirmed positives in my county, and one of them is already listed as recovered. The data are not above teh noise floor, so it’s hard to be completely sure, but it really looks like we’re succeeding in keeping it from getting a foothold here.
Trump flip-flops within one briefing, let alone over a few days.
He'll be saying America's got the bestest, most wonderful, mass-testing that he helped invent and he'd always said mass testing was the way to go within a week or two and everything else is fake news.
The political food fight is hogging bandwidth to the point that it's difficult to discuss how to restart the economy... or even how to get protective equipment to medical professionals.
We're all tempted to feed that, but please resist. Thank you.
Daring Fireball's argument is that "Trump is saying X". So of course it's relevant, you can't trust a single thing that man says because he changes his mind within hours if not minutes.
It's a pretty objective truth if you watch any press conference he does.
I don't know enough about them to say for sure, but I haven't heard of any sort of virus being transmitted by mosquitoes. Malaria is caused by a parasite, not a virus.
My understanding is that no, they can’t, because the virus does not reproduce in mosquitos.
Similarly to HIV, it is theoretically possible for a mosquito to feed off someone with the virus then within minutes feed off someone else, be killed, and the infected blood contain enough remaining particles to cause an infection... but to my knowledge this has never been shown to happen in practice.
I’m more concerned about stray cats. It has been shown that felines can both host 2019-nCoV and get COVID-19.
As somebody who has been tracking and interested in this story since late January, the one thing I can without qualifications is that whatever seems true now will change in a few weeks' time.
In general the outlook has gotten better as the data got better and we were able to compare notes, although there have been some setbacks, too.
I don't think we'll ever, ever get back to "normal" as this is the pandemic we've been reading about and planning for over the last century. Nobody [alive today] has ever lived through something like this and it is bound to have lasting consequences.
But I would be cautious about reading long-term plans. I know everybody wants to know how the story ends, but people who have engaged in long-range planning over the last couple of months have consistently had to re-plan. I would expect that trend to continue. We don't know exactly what small changes might have large consequences. For instance, monitoring temperatures at points of entry and exist for all businesses could have a major effect, or forms of "frontier testing"
No doubt this is a period for the history books. We'll probably have to live through it to finally figure out how it's all going to end.
what do you mean "nobody has ever lived through this?" We've had huge pandemics in the past: the plague, Spanish Flu, measles, polio, smallpox.
I agree we should be cautious about reading long-term plans.
I meant nobody alive today. I guess now we could argue about smallpox, measles, and the like, but I am working from the general definition of the last pandemic being the Spanish Flu.
I have added the two missing words to my original post for clarification. Thank you.
Thank you, this context is important. Swine flu killed between 150,000 to 575,000 globally in 2009, and almost nobody even remembers it. HIV is a recent pandemic that many living people have lived through, from discovery to treatment.
And of course the flu, which is different than SARSCoV2, kills between 250,000 and 500,000 each and every year. If you're 30 years old, between 7 and 15 million people have died from flu in your lifetime.
'I don't think we'll ever, ever get back to "normal"'
People keep saying this, but it's a meaningless sentiment. The "normal" of today was never going to be the "normal" of two years from now, with or without this pandemic. It's not like the world was going to be frozen in time until this coronavirus came along.
Before 9/11 we didn't have to take off our shoes to fly. Now we usually do. Im sure there will be plenty of similar changes due to the pandemic, and most of them will be similarly easy to adapt to, just as we adapt to so many other changes year after year.
But this threat that we may never "get back to normal" rings hollow to me.
This article seems like a lot of fear mongering, almost doomsaying. I think we will get back to normal, and we will basically return to what we were doing before with little change.
Lots of business are converting to delivery. I think this is good. The warehouse style of store, prevalent since the 1960s is an outdated model.
Schools are moving more courses online. Another major upgrade.
The restaurant experience hasn't been rewarding for a long time. People should learn to cook at home. Experiment with fancier cuts of organic meat.
Movie theaters have been terrible for decades. Sticky floors, too many commercials, overpriced food. Now many film festivals are moving online.
Fast fashion was just a way of getting people to buy poorly made clothes from sweat shops.
So much of the crap people bought recently was just excessive junk; causing an environmental disaster.
We should just pay people to stay home and learn new skills. Why not pay people to taking online biology courses though the pandemic? There should be a startup that pays people to stay home and take biology courses. Exams can be online and for real verification done over video conference with an examiner. The startup then can get a % of your salary when you start working. Or, be paid through advertising from medical companies.
But isn't there something to be said about the kind of human experiences each of the "outdated" industries you mentioned provide? Namely schools, stores, going to movie theaters with friends, etc. People like seeing and being around other people. Some really, really don't, but most do. Moving the majority of activities indoors forever will have a negative impact on the psyche of the most people.
I agree that what most people buy is junk and that there is waste in the spaces you mentioned. But I'm not sure how "natural" is will feel for people to do all that isolated in their homes with a small amount of people indefinitely...
What I see happening. People are indoors and pursing something that they are really interested in. Maybe knitting, trumpet playing, etc. They are connected with new people online who share the same interests as them. In a few months people will be connecting in person with these people. Modernity will do what modernity always does...connect people who have distinct, unique, interests together. As a society I think that we've outgrown the idea of just going to a movie theater and hanging out with friends. I think that the older model society will re-emerge...fraternities, social clubs, members only places, hackerspaces. Let's say you get passionate about a hobby right now, lets say playing an instrument. You'll want to find a safe space to meet. Maybe a few people will pitch in some cash and just rent a space to turn into a private hangout club. With the coming recession space will become cheaper.
You really think everybody is enjoying being isolated inside, alone, with no human contact, no mass gatherings like concerts or games?
> As a society I think that we've outgrown the idea of just going to a movie theater and hanging out with friends.
This is an antisocial and unhealthy perspective. We've yet to see the mental health ramifications from this extended period of isolation. We're not built to sit inside by ourselves all day. Even as great as online connections can be, they are no replacement for the real presence of a human being. Saying we've "outgrown" it is preposterous.
In some societies people don't have much a say of what they do, who they hang out with, what jobs they do. In a small rural society everybody was/is expected to conform. Modernity lets us hangout with people that we share interests with. This crisis will push that even further. We'll hang out more with people that share our interests, and less just hanging out randomly.
I think the last point is rooted in some modern ideas about what it costs to develop and deliver an education.
Our education system cost (At least in the States) is absurdly overpriced and most of that money is not going to the professors.
You don't need to pay people to take biology courses. You need to pay people UBI so that they could choose to take biology courses. Then you only need a (relatively) modest amount of money to design the course, pay the graders, and deliver the content.
While working as an adjunct I got paid maybe $5k in total? For developing and delivering a new online Bioinformatics course for two semesters. What's sad is I actually got paid a bit more than other adjuncts.
While the pay could be increased to make it better it still doesn't require turning students into a revenue stream for % of their salary over X years.
> You don't need to pay people to take biology courses. You need to pay people UBI so that they could choose to take biology courses. Then you only need a (relatively) modest amount of money to design the course, pay the graders, and deliver the content.
I agree with your sentiment, forcing people into Biology is entirely the wrong approach--I was and I detested my HS level classes, and even most of my lower division classes in University as it was mainly just rote learning--but because I met a Community of students and professionals online when I was still in HS I got to learn what research they were focusing on and it intrigued me enough to go to the BS level, all while attending upper division University lectures in various subjects during my Junior/Senior years of HS.
While I'm a proponent of UBI, I still think a concerted effort is needed to make the Life Sciences appealing to the masses; I personally subscribe to the Biohacker and Community Science approach, and having (wet) lab extensions built into local community libraries would go so much further.
I've been out of the Industry for 8 years now, but I'd gladly volunteer and teach Plant Science and some Molecular biology labs for free if we had UBI and I could offset some living expenses. I know of 3 or so recent biology grads who wish they could do the same.
I think we're on the same page. Now I don't have the wet lab background (I come from comp sci and did a bioinformatics m.s.). But yea, if I had just a little money to be able to dedicate a consistent amount of time to developing courses I'd do it.
I've tried my hand at doing it completely free a few times, but when it doesn't pay the bills the effort quickly gets put on the backburner.
If you and/or those recent grads start putting something together feel free to reach out and I'd love to contribute. My github username is the same as my HN username and you can get everything else from there.
Life Sciences would be appealing to the masses if it paid better, more like Computer Science does. It would pay better if there were a need for more people to do Life Sciences.
If you think moving school online is a "major upgrade", you're sadly mistaken outside of a few niches. K-5th grade is really difficult to do. It requires a full time parent at home (which is not tenable for many families), and it's hard to have the curriculum be virtualized. This age range requires a lot of literally hands on teaching.
Even older grades have trouble with virtual learning. Plus an important part of school is learning socialization skills. That's pretty hard to do online. Plus teachers will need more than a few weeks to adjust; curriculum development isn't trivial, and teachers would need to be retrained to use the new pedagogy.
As the father of two, and someone who cut his teeth in online learning, it sounds great to say move "more courses online", but the reality is quite different.
>"The CAP and Harvard plans both foresee a digital pandemic surveillance state in which virtually every American downloads an app to their phone that geotracks their movements, so if they come into contact with anyone who later is found to have Covid-19, they can be alerted and a period of social quarantine can begin."
If this refers to the bluetooth supported apps I've seen developed by several institutions, does this not sound like a horrible idea? Let's say two people walk past each other on the street or stand close in a shop, as far as we know the risk of transmission is non-existent or extremely low. Are you just going to build a connected graph and then ping everyone if one person gets sick? You'd be pinging half the population of a dense city after one day.
Before putting these surveillance measures into place I'd like to know if they're not causing more harm and paranaoia then they help.
I don't mean to rip on you, it's important to notice problems, but that seems very solvable. Just require some minimum duration of proximity before you alert.
It's not that easy. Social networks, particular urban dense ones have the characteristics of small world networks (https://en.wikipedia.org/wiki/Small-world_network). The distance between every person in a city is maybe 5-6 individuals. You can imagine how many hundred people you stand next to, how many people they stand next to, and so on.
So if say, the chance of being infected in an interaction is say 5%, then the chance at a distance of two is 0.25%, the chance for someone at a distance of 3 is merely 0.01%, etc..
Do you really think it's a rational use of resources or your attention that if you're one of the countless 'distance 3' people to alert you? Unless you had some mysterious ability to determine with extremely high fidelity that infection has occured from metadata alone, which doesn't exist, it's a tool for mass panic.
Bluetooth will give you a match for up to 10 meters. The official safe distance is 6 feet. You can't even tell from a bluetooth match if people were close enough at all.
> Let's say two people walk past each other on the street or stand close in a shop, as far as we know the risk of transmission is non-existent or extremely low.
We don't. The primary transmission path is droplets through people in close contact (less than two meters, inhaling aerosols etc..). There is no current evidence that people simply walking past each other can somehow infect others at a meaningful rate, and surface tranmission is negligible as well.
See most recent results from the German researchers in Heinsberg.
Walking past each other and people standing close to each other both imply close contact at less than two meters. Coughing can send the virus around seven meters. You do the math.
Are CAP and Harvard so far in their bubble to realize that not every American has an updated smartphone that can even install new applications, let alone a cell phone at all? This also relies on people having the responsibility to keep their phone charged on their person with the app running at all times.
Maybe I'm just fed up with how the news has been handling this situation, but I find usage of words like "scary" in a title to be incredibly worthless. If I can't even get to the end of the title without being told how to feel, it speaks volumes about the intentions of the post.
This is just one of the numerous examples of lazy and bad intentioned attempts to use anxiety to convince readers to click the article. The entire journalism industry should be ashamed of how the absolutely miserable way in which they've handled this event.
You need to take a hard look at yourself if your industry revolves around damaging people's mental health in order to draw page views.
What level of normalcy? Free domestic movement, business open, schools open? That will probably work with some restrictions if social distancing works. Countries are trying different levels of restrictions so it will soon be obvious what works and what doesn’t.
International travel, sports events and other large gatherings I’m not optimistic will be back to normal in 2020 unless something big changes.
Bad shit happens to a minority of people every day, permanently disrupting their lives and forcing them to abandon long-term plans. The majority remain oblivious and see an enduring status quo.
Suddenly a Black Swan craps on everyone at once, and a great many people are whining 'why is this happening to me' and 'when will someone fix this so I can go back to my routine'.
Guess what? Your routine is probably fucked. Throw it out, get used to the new normal, and accept that no one knows how to fix this (yet?), just like every other time we get hit by a context-changing problem.
Of course some people get too attached to their context, and those who come later and find their remains might label such events as 'out-of-context problems'...
In practice this seems to be a subset of the first choice. Everyone who has a proposal to control the rate of infection also says we need to lockdown indefinitely until their proposal is fully implemented.
Here's the thing though, that binary choice is predicated on what we know right now, tomorrow we may know more, and we will definitely know more in a few weeks, in a month or two we may know enough that we have better choices to make. Our ability to treat this virus is very limited right now, but that may not be true in a month, so just throwing up your hands and saying let everyone die now when we don't have good treatment options is basically just signing peoples death warrant for no good reason.
This, precisely. Maybe we find better treatment (especially treatment that reduces the incidence of patients needing hospitalization or ventilators). Maybe we get testing technology widespread enough that we don't have to treat everyone like they're positive unless proven otherwise. Maybe we get antibody tests that allow us to figure out who isn't immunologically naive to the virus. Maybe we learn more about how it spreads. Maybe we learn more about why some people are asymptomatic.
Basically there are countless ways in which quality of life can be improved over time as we continue to maximize efforts to contain spread.
Yeah sure. a month, a year, a decade. How much of my life are you willing to steal?
The fatality rate for octogenarians is 15%. Octogenarians also have a 10% chance of dying every year anyway. At 18 months of lockdown 15% of them are dead anyway and you took a single digit percentage of my life away
Your chance of getting a severe case of you are infected is 5-10% or something similar. That’s a case that you want to have a hospital bed for, maybe an ICU bed.
If all beds are taken then many of those severe cases will kill people. Say mortality is 3% instead of 0.5% once hospital capacity runs out. Assume 60% need to get it before we have herd immunity. I don’t think 3% mortality without healthcare is pessimistic. Unfortunately we’ll soon find out if the disease hits Syria and similar places.
Not only that, thousands would also die from strokes and heart attacks and other things that they wouldn’t die from if hospitals weren’t full.
Hospital staff will simply quit when their job becomes a constant struggle to keep the hallways clear of corpses instead of saving people.
It’s not “0.5% dies why are we doing this?”, it’s “we do this so only 0.5% die”.
Between a 0.5% chance of dying and a 3% chance of dying I’d happily observe some measure of distancing for 12 months to get 0.5%.
What your comment is missing is that the mortality of ventilators is 66% - 90%. So they're not a good solution for most patients. ICU doctors have been recommending using non-intrusive methods like cannulas as long as possible before intubating. However, that causes aerosolization of corona, so quarantine buildings are needed.
It doesn’t really matter if mortality in ICU’s is high so long as it’s much higher without ICU treatment. For young patients the mortality is very low exactly because they are likely to survive ICU care, while a 70 year old is unlikely to survive and an 80 year old is unlikely to be given ICU care to begin with.
If ICU mortality is extremely high (e.g over 2/3) then doctors probably need to be more selective. The judgement should be not only that patients should walk out, but also survive for a period after treatment, say a year. It’s also not only about ICU treatment, regular hospital beds and doctors are also not unlimited.
I think in many places doctors are feeling pressured to use invasive ventilation for patients that have a low chance of surviving a year after care. Patients who get invasive ventilation should be carefully selected even if there is no shortage. If mortality is very high, this is a signal that doctors are giving ICU care to too many patients that aren’t helped by it.
Early numbers from Sweden report 80% survival from ICU. Not all of those were on invasive ventilation, and there may be a bias where survivors are discharged sooner while those who eventually die are still there. But numbers are definitely encouraging says doctors.
The whole plan is number 2. We are waiting until this burns out through the population, most people get better, and move on with their lives.
The purpose of social distancing is to slow the burn so our hospitals aren't overwhelmed, and won't have to triage coronavirus patients vs. people with any other sort of emergency coming to the hospital.
This practice will save thousands of lives of people with a bad case of coronavirus, but also the people who get into car crashes, or have problems with giving birth, or heart attacks, or any other reason that requires immediate emergency care.
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[ 3.2 ms ] story [ 245 ms ] thread> I care about my privacy, but not nearly so much as I care about my mother.
Most people care about their own mother. But if lockdowns, unemployment and poverty continue, I can definitely imagine people saying, "I don’t care about your mother, so why should I stay unemployed and confined to my home just to keep her safe? I’m sure my mother will be fine." Of course, believing that one’s own parents will escape the epidemic might be mere wishful thinking, but this is the way that human beings rationalize things in times of crisis.
I imagine this is really code for "if we infect all these low-risk people first, we get a large proportion of our workforce immunised, for a fairly low hospitalisation proportion".
I don't know enough about the models, but I also guess having a large chunk of your low-risk population already immune reduces R0 for later waves too.
I can also see it back-firing when these same people think it's alright to nip round Mum's to say hi and give her a quick hug, it's only 5 minutes after all.
I've also heard that a large fast food chain estimates it will take up to 8 weeks before they can get supply chains up and running again. As an example the sheer quantities of lettuce they need aren't being planted because there's no demand for them, and you can't just magic them out of thin air when someone says 'you can open your stores again'.
I think it’s really code for “let’s repeat the mistakes we made early on when we adopted ‘herd immunity’ rather than isolation as an I itial strategy and spread this as rapidly as we can and create another critical peak”, because those people aren't completely isolated from the rest of the population, and spreading it more rapidly in that segment of the population will also spread it more rapidly in the rest of the population.
But I guess it's good to know the the incompetence of the present British government is resilient enough to survive the temporary incapacitation of the PM as a fairly direct result of the incompetence on the very same issue. I'm not even sure the US federal administration would be that committed to it's own (otherwise more complete) incompetence on the issue.
Also, we shut-down pretty quick when it became clear how much worse Italy was faring than the stats China had claimed.
There seems to be some pretty ridiculous things being said in foreign papers at the moment about Britain's response as it's an easy way to deflect criticism of themselves.
The only people who have the right to throw shit are the Germans, Soth Koreans, Taiwanese as they're the only ones who seem to have got ahead of this thing.
The British is on a similar trajectory (if not lower) then America/Italy/Spain/etc., if you put aside the frankly unprofessional and crazy IMHE projection (which is already failing to match real-life three days later).
This is incorrect. Herd immunity very much was the plan, driven by the fucking idiots in the nudge unit.
Here's David Halpern talking about cocooning and herd immunity: https://twitter.com/BBCMarkEaston/status/1237694665824047111
Here's a thread demolishing David Halpern's work. https://twitter.com/sophie_e_hill/status/1242512602112155650
Yes, it's among the worst hit as all those you name are, and like the US that's mostly a result of national government incompetence and not other circumstances that put it in that group (Italy seems from what I understand to be other circumstances, Spain I'm less clear on.)
* Opening up kindergartens, physiotherapy, hair salons and allowing cottage holidays from 20th April
* Opening schools for 4 youngest classes, After School and some higher education in final years from 27th April
So you go after lowest-hanging fruits gradually, but it's a learning phase and could need rollback if people don't follow restrictions enough to contain contagion. This advice is a mix of political and expert analysis, after observing decline of new cases and deaths, after timely though not early, lockdown.
Norway is a small and nimble country, so could more easily be leading the response in the West. Though a new normal will have to include pandemic response in nearly all aspects of social life. The clustering and stochastic nature of the spread may become somewhat managable, with enough tracking, testing and preparations.
Is it because children rarely commute outside a community, so it wouldn't spread between communities, just within communities already infected?
If we want more unity then this has to change.
[1]: https://www.theverge.com/2020/4/8/21213974/african-americans...
Texas still allows religious groups to meet in size of 50, declaring it an essential service, while abortion clinics have been closed. We aren't in the same boat.
Emergency powers to fund world wars are still in place — eight decades later.
It never goes away.
This is what we'll hopefully be using in Switzerland.
If you read the PEPP-PT documentation closely, the “privacy protections” are mainly keeping you anonymous to other ordinary people. But people should reasonably want to remain anonymous from the state as well.
[1] https://www.linkedin.com/pulse/proposal-way-reduce-coronavir...
Essentially, ICU admission for ventilators, and subsequent deaths, are the most complete and factual data we have.
The solid information we have is that 66% - 90% of ventilator patients die, as reported for both China and the US. Interviews with doctors all report that ventilators are supposed to be used for up to a week, not 3 weeks.
Although the occasional patient makes it off a ventilator, from a public healthcare policy standpoint, ventilators just don't work well enough, so there's no reason to "flatten the curve" now (April 10, 2020) aside from accumulating PPE (masks, gowns, gloves for hospital staff.) (A cure will likely take 18 months to invent and approve, so that's not something to put on a roadmap.)
The plan should be this:
1. have our healthcare policy experts (CDC, etc.) study today's reported data on patient mortality and PPE supplies for a couple days
2. inform seriously ill, high-risk corona hospital patients about the risks of ventilators (ie. you're probably going to die on one anyway, and horribly)
3. have dedicated quarantine and palliative buildings for moderately ill confirmed corona patients with O2 available (like the Javits Center in NY, as an example for discussion, or an anchored cruise ship moored off each major city). Recovered people can work there safely it appears.
4. have dedicated hospitals for corona ICU patients if they choose to try a ventilator (China has dedicated hospitals)
5. lift the US lockdown and treat corona like any other seasonal flu, mainly because it is, and also to avoid destruction of our economy and related uncertainty
6. the exception is passenger airline flights, which should be grounded until further notice. develop a plan to make airliners safer to fly (hepa filters, etc.) Cities shouldn't be under lockdown, but airlines are almost certainly a major disease vector and need to be treated as such.
(FYI: Wuhan has an international airport only 2 hours flying time to Shanghai Pudong International, which is a major hub. So that's likely how it spread world-wide.)
The impediments for the US to implement this plan are:
1. as a society, the US has lost the ability to formulate and execute policy at the highest level, whether healthcare, hurricane response or infrastructure. At this time, we need experts (like the CDC) to lead.
2. Trump should not be involved in any way, since he doesn't care about facts.
(The reasons California Governor Newsom broke contact this week with the federal government are essentially the above.)
I'll add my collection of supporting links later today. They are all consistent with each other, so the facts I outlined above are not in dispute.
Although the information from China was publicized late, it appears overall to be accurate and helpful. They used their previous experience with corona and bird flu infections to move fairly assertively on Covid-19 - a far better response than the US or Europe.
Please leave a comment if you want an area of my outline above to be fleshed out more.
If somebody could look into how Sweden and Germany have fared with less social distancing, that would be helpful. Please leave a comment about that.
AMA.
To even consider containment succeeding, we would need a way to test 300 million people a couple times a week. Since we can't do even 1 million tests a day, the math doesn't add up.
"Giving up" is a strange way to look at it. We have various flus annually. There will be a time limit to lockdown of several weeks, not 18 months.
So it's important to look at the data and make an informed public healthcare policy decision.
Rather than an emotional response, we need healthcare policy experts to look at the data as of today.
What has changed in the past month is that we know ventilators don't work 66% - 90% of the time, so they should be taken out of the "flattening the curve" equation.
Please see my post with several links to learn more.
Q: "What's the most important part of a message?"
A: "The name of the messenger."
I'd really appreciate the feedback to decide what my next step is after my initial 2-3 weeks of research and thought.
Please read through these and let me know of any comments or questions. They strongly imply ventilators don't work on corona patients across multiple reporting countries, so a different policy direction should be investigated for treatment of confirmed cases and lockdown duration. If you agree with what I wrote, please upvote my posts so that people can more eaily find my research.
It appears that ICU doctors, politicians and the public are all working on different narratives, which is counter-productive.
Thank you.
Wuhan shrimp seller identified as coronavirus ''patient zero''
https://medicaldialogues.in/medicine/news/wuhan-shrimp-selle...
Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
For some survivors, coronavirus complications can last a ‘lifetime’
https://www.france24.com/en/20200402-for-some-survivors-coro...
Ventilators Are No Panacea For Critically Ill COVID-19 Patients
https://www.npr.org/sections/health-shots/2020/04/02/8261052...
Doctor: Splitting a single ventilator only works for some (his research was for temporary use for up to 12 hours, not days or weeks)
https://www.cnn.com/videos/health/2020/04/06/splitting-venti...
A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients
https://www.healthleadersmedia.com/clinical-care/medical-wor...
COVID-19 twice as contagious as previously thought – CDC study
https://thinkpol.ca/2020/04/08/covid-19-twice-contagious-pre...
Santa Clara County Coronavirus (COVID-19) Data Dashboard
https://www.sccgov.org/sites/phd/DiseaseInformation/novel-co...
Covid-19 Timeline (please ignore the clickbait publisher URL, this has very useful info)
https://www.nationalreview.com/the-morning-jolt/chinas-devas...
If you're an aide to Governor Newsom, or know one, please leave your contact information below and I'll contact you.
Louis CK's "OF COURSE... but maybe" skit:
https://www.youtube.com/watch?v=XLGzFQg_1xc
We could have locked down the vulnerable (60+ and those with pre-existing conditions), and anyone with a temperature, focused our healthcare efforts on them and let everyone else go about their business with more caution (masks + hand washing).
We would have built societal (cows are a herd, humans are a society) immunity by this point and could slowly return to normal for the at-risk crowd.
As it stands, we haven't built up any social immunity and will have to wait over a year for a vaccine which, by definition, we will not know the long term effects of.
Texas is taking a very different approach from California.
This is something I've been saying from day 1: short of universal vaccination, the only way to get back to some form of normalcy is widespread testing of the population. Any government with some sense of reality would spend billions in testing, to avoid losing trillions in the economy. Unfortunately it doesn't seem that the US government has any notion of how (or desire) to do this.
So you mandatory test everyone and determine that 28% of the population has been exposed to the virus. Now what?
In fact, herd immunity does not require 70% of the population to be immune. It just requires 70% of all potentially transmitting contacts being eliminated. And if those 28% who contracted the virus first are also the ones that have more contacts than average citizen (which should be the case, because that is why they probably got it before the other 72%), we might already be fine. Let's these 28% have 72% of all human contact (because human is -like almost everything - not distributed equally), then we would already be there and have reached herd immunity. There would still be sporadic local outbreaks, but nothing dramatic any more.
Definitely border restrictions plus testing seems to be effective in keeping it out, see Taiwan.
Once you get enough local transmission going then it didn't matter anymore. Every western country reacted too slowly in this regard.
But realistically unless they imposed a blanket 2 week quarantine, they would just be letting the asymptomatic carriers through anyway. Nobody was prepared that early to go to such extreme measures.
This testing provides a false negative which allows vectors to mix with healthy people -- a false sense of security. You might as well not do it.
When you have symptoms? Too late.
330 million people testing weekly? Not possible.
There is no realistic way to mass test everyone in a meaningful way.
We can tests a classroom weekly with one test. If it's positive, come back in three weeks, if not hear the parents cheer.
We can let companies be responsible for having people tested, if they want people in the office.
Once scaled up, we can have restaurants, bars even festivals be full of people, that the owner/organizers tested.
The goal has never been to bring the transmission rate down to zero. If we could quickly test everyone at the onset of symptoms, then trace and test anyone likely to have been exposed to the virus by that symptomatic individual, we could bring the transmission rate down considerably. It's been done in other countries. Add in some other precautions, like automatic temperate checks, and the transmission rate can be lowered even further. Low enough? Dunno, but lockdowns can't last forever and our healthcare capacity is getting better by the day.
I applaud DeWine for acting quickly, but I'm concerned that maybe for rural and small city locations the shut down was too much. I wonder if we are creating a cry wolf effect for non-metro areas. All the mass effects in my area are purely from the response. Of course, one may say, what if we hadn't a shut down; but, I think that argument is going to be harder to make to the small businesses in a small city or rural area next time around.
Rural places don't have great health care structure in a lot of places.
Hope this helps.
Given how happy people are to report their fellow citizens for the infraction of peacefully assembling, I suspect they'll put up with a lot more are long as you tell them it'll keep the virus away.
Maybe they will form their own federation to circumvent the current federations ineffectiveness. https://www.bloomberg.com/news/articles/2020-04-09/governors...
That's at least one emergent non-California nation state coming to be. Maybe we could call it the Great States. Toronto can come too. https://en.wikipedia.org/wiki/Great_Lakes_Megalopolis
Culturally; North Central, The North, Midland, St Louis Cooridor, Inland North, W. Pa.; make a nice package. https://www.wbez.org/stories/_/9054d7a4-f876-4c53-8ce1-08ada...
This is as much a failure of planlessness as it is policy.
We are basically pausing the life of younger people, indefinitely, to protect the elders.
Again, since the quarantine started in my area I exist twice to buy groceries and that's all. So I understand the need and the importance of it.
But should I really throw away on year of my life? Shouldn't we quarantine only the elders? Would your opinion change if you were living by yourself with your significant other locked up somewhere too far away to meet in two months?
And yes I am aware that also younger people died from the virus but the chance are so much smaller that I don't believe is fair to compare it.
The opportunity cost is so much different and nobody is addressing the issue.
Again, what I am saying is that the lockdown punish purple differently, the most punished are the least affected by the virus itself
It’s a shit situation for young adults, but sometimes life isn’t fair.
Moreover, lock down all the elders and the ICU won't be so busy...
True, but that doesn't mean a whole lot of young people wouldn't needlessly die.
You seem really committed to turning this into a generational thing.
Do you think people over 60 (or wherever the fatality rate spikes) existed in a self-isolated bubble staying home alone before now? Have you talked to any of them recently? The ones I know are having a rough time of it, at least as much as the younger people I know.
If locking down "just the elders" was a workable solution, what do you think it would really look like?
I was unlucky enough to fracture my ankle right before California instituted shelter-in-place and to fracture it in a way that needed corrective surgery. I was lucky that CA managed to avoid the worst of it, so that my surgery was able to proceed on schedule. Otherwise I was looking at potential long term complications in addition to being off my feet for 5-6 months instead of the 2 months they expect now.
And what I am saying is that the lockdown punish different class of people very differently. And the most punished are the least affected by the virus itself.
And yes, less lockdown for someone is already something...
Well no. It does sometimes, but it tends to not.
No, we're pausing the life of everyone to protect everyone. If you overload the hospital systems then everyone dies. If you pause and keep things barely managable then mostly only old people die.
Then there is no doubts that the virus hit hardest the elders.
Again, what I am saying is that younger people are hit by the lockdown much more than the elders while being the less concerned about the virus itself.
And we should talk also about this.
The problem with saying this is that it's incorrect. Many elders suffer during lockdown in the exact same ways and in some cases to the exact same extent that younger people do, including in the ways you imagine: socially, sexually, economically.
Additionally, there are many young people (many of them here on HN) who do just fine during lockdown because WFH and online interaction actually promote their senses of well being. [0]
The insistence with which you have been asserting that young people are being "punished" reveals adherence to an agenda more than an evenhanded analysis of the facts.
[0] https://news.ycombinator.com/item?id=22821256
I don't think that's fair to the OP. They seem to me to just be describing what they see and feel.
In a cold, utilitarian sense, the ripple effects from messing up a young life are many times more significant. If schooling, work, romance, and childbearing of young people are all disrupted, you can expect to see that in the economy for decades to come (just look at the name "baby boomers" for the opposite case). But, again in the cold utilitarian sense, if the life of someone with 10-20 years left is disrupted, that disruption doesn't last as long.
* Any concern for the COVID-resilient groups running around spreading the germs to more susceptible? How do we measure what level of social life one is allowed to have while putting other groups at risk?
* Enforcement. How do we advertise and enforce these new rules? Will certain people feel discriminated against? Should police card/arrest people if they look just a little too gray/old/wrinkly?
I think just "talking" about this will be opinions vs opinions. We should start with numbers and then try to see what makes sense.
This friend basically said that if you are young and need to be ventilated you enter ICU with a better lung than older people.
So when you leave ICU you have enough lung left to not die. You would have died with an overwhelmed ICU, though, and you‘ll likely need a long time to get back the health you had before. If ever.
Some young people are benefiting with fewer car accidents. Some old people are having to wait longer for transplants as there are fewer organ donors dying of accidents.
Also fewer middle aged people are having myocardial infarcts.
My children are not so upset that they don’t have to go to school.
I wonder if countries benefitting from tourism will finally get rid of visas and passports to encourage international travel again. Probably not, but one can dream.
Maybe if the us ends up bailing out the entire world, there won’t be a reason to protect the borders with passports as we will have a United States of earth. Fed swap lines are already available to around a dozen countries.
I've also seen pre-coronavirus studies noting the stark disparity in wealth between baby boomers and millennials at the same point in life. Fun times indeed!
I can afford this myself, but sparks will be flying.
Even if people somehow manage to forget the horror and deaths of the past couple of weeks, a loosened lockdown and the inevitable spread of disease that will follow would quickly remind them.
Let not-so-at-risk people go around will also helps in not moving completely blond in this episode.
I know people that are sure to have caught it, didn't get tested, it pass away, and now are still locked down for the foreseeable future.
In Italy it was asked to several people to donate blood, all of them though to have never got the virus, turns out 60% of them already got it.
We need something more than just staying at home.
A ban on all social activity for years is far beyond "serious effort to mitigate". Millions of lives isn't worth a global dystopia.
Do not pretend this can't hurt young people, badly.
https://nypost.com/2020/03/31/12-year-old-belgian-girl-becom...
The article also contains accounts of two more youngsters dead, at 14 and 16.
This thing can kill anyone.
0.2% chance of death for 30 year olds is roughly the same as a 30 year old's chance of dying in any given year.
Or, based on overall fatalities from motorcycles per mile, it would equate to about 8,000 miles per year.
Or, based on light aircraft fatalities per hour, it would be around 200 flight hours in a year.
Of course, you could argue that the casualties from both activities are skewed upwards by people who do stupid things early and don't live long enough to engage in the activity a lot.
Anyway, I'm not particularly agreeing or disagreeing. The risks above are considered reasonable by a lot of people and unreasonable by others.
We are talking about trading people for people, and we’re saying in some trades the numbers work out better.
330 million Americans, says 70% aren't at highest risk, all become infected, at 10% hospitalization -> 23 million hospitalizations required. Spread over 18 months, that's still an additional 1.25 million hospitalizations every month. That's 0.3% of Americans in hospital for COVID, constantly (assuming average 1 month time in hospital required - yes I made that up).
For context, roughly 0.7% of Americans are incarcerated at any given time.
Still a logistical nightmare. You can tweak those numbers however you wish, but they generally all giving mind boggling logistical nightmares.
Until then, while you mention Ro, you might not know that some recent reports show it approaching 6 in some areas, not 2.x as thought by some over a month ago. With an Ro of 2.5 and a mean infection duration of 5 days, each person can cause infection of up to 244 cases in a month.
Also, since testing is not widely and reliably available in most countries, there is no way to loosen stay-at-home as a practical matter. Pervasive testing, quick contact tracing, isolation and quarantine are the only way forward.
And I’m not sure you are factoring in that Covid-19 positive people can be contagious before they show ANY symptoms.
So if you’re not concerned about older people or people with comorbidities generally, you might look around at the people you know and care about.
The other part of this is the impact on health care providers and first responders. They are getting infected and dying. The have more pressing issues than those you mention.
I find thinking about my community and taking certain matters of personal responsibility seriously helps me dwell less on myself.
Good luck...
Personally I am myself in the stricter form of quarantine I can do.
However, the argument I brought forward will start to raise stronger and stronger. And if we don't discuss about it, and if we don't do it fast, it will be problematic for everybody.
I personally don't even mind that much the lockdown, but I am not the only youngest around...
You don't have to throw it away. There are plenty of productive ways to spend your time.
Yes, social isolation is burdensome. But it's damn sight better than being dead.
Nobody is saying that.
It’s hard to isolate the elderly if they are so old that they need care by the young.
Isolating the not-quite-so-old that can self-isolate is easy.
Antibody tests are also almost useless on an individual level: If they have 4% false positive rate and 10% have antibodies then there are 36000 false positives (4% of 900k) when a million people are tested! Antibody tests are good at a group level to measure the progress of the epidemic, but unless the incidence is high or better test methods are found, they are near useless for what you are describing, sadly.
If not, can you explain again what you are saying?
Sure, the immediate beneficiaries are those at highest risk from the virus. But younger people who fall on the extreme end of the symptoms would also be dying at relatively higher rates too. Have no fear, once the powers that be are confident that society won't collapse, the stay at home orders will start lifting and life will go on... including allowing people young and old to die at 'acceptable' rates from the virus.
Furthermore, while there has been a lot of shutdown, it's not equal across the board. Tons of places are taking half measures or no measures still, and the reasoning is entirely politically biased (business more important than people, etc.) It's clearly a case of more right leaning areas taking less cautious measures in favor of money.
In fact, I'd argue that everything that has happened, especially all the horribly obvious "mistakes" (read: intentional, corruption riddle, failures in the case of the federal administration) aligns with political viability as expected and confirms in retrospect the claims about viability.
>that does not directly contribute towards said leader's goals and the goals of his electorate
Well yeah, in most of these cases you are talking about unelected bureaucrats caught trying to undermine and subvert the elected President's agenda and constitutional authority.
Are you trying to say a President should not have people helping him, and that he should permit employees who have been secretly and actively working against his agenda and undermining his authority? Seriously?
>repeatedly fire
How do you "repeatedly fire" someone?
>That anyone was fired from this duty without a clear explanation and justification is cause for alarm
Good thing nothing like that has happened, no matter what the fired individuals or their "resistance supporters" might like everybody to think. Falling for this line depends purely on ignorance and buying into the opposition's propaganda without question.
What part of Commander and Chief of the United States do you not understand? Was Obama a "dictator" when he blanket fired all of Bush's political appointees without explanation? Or was it, rather, the routine action of an incoming President attempting to set up his incoming agenda for success?
>until he sees a loyal drone in the slot
As opposed to a disloyal drone? Come on... This is just sad at this point.
>The procession of a dictator is more nuanced and complex than people realize.
Not really, though it really is fun to see Progressives leak their inner motivations through projection.
While I see where you’re coming from with this statement, I’m not sure I agree. From where I stand - a town of 13k people surrounded by a large rural area - it makes sense that we’re taking less aggressive action because the virus is not yet endemic here. Given the growth of confirmed cases in my area (northern Arkansas), it seems those steps are working adequately to keep it from becoming endemic as well.
I propose that areas with lower population density are taking less aggressive action, and those areas are also predominately right-leaning.
The only way you can convince me based on evidence elsewhere that your scenario is going to be any better than anywhere else is if your leadership in your area is doing aggressive testing, contact tracing and targeted isolation protocols akin to South Korea.
New York City starts with a high value. People encounter each other in apartment hallways, packed subways, crowded streets, and huge stadiums.
Rural places don't have any of that. People don't pass by any non-family when going from home to car. Non-family don't share that car. The streets are nearly empty of people, with just the occasional person out walking a dog.
There might not be exponential growth. If R0 is below 1, there is exponential decay.
It’s not that my area is taking no measures at all - only that we’re being much less aggressive about it than other areas. All of the restaurants are closed for dine-in, as many as possible are working from home, and we’re social distancing.
The governor of Arkansas is convinced that is enough. So far - at least for the area where I live - that does indeed seem to be the case. There have been a total of five confirmed positives in my county, and one of them is already listed as recovered. The data are not above teh noise floor, so it’s hard to be completely sure, but it really looks like we’re succeeding in keeping it from getting a foothold here.
He'll be saying America's got the bestest, most wonderful, mass-testing that he helped invent and he'd always said mass testing was the way to go within a week or two and everything else is fake news.
We're all tempted to feed that, but please resist. Thank you.
It's a pretty objective truth if you watch any press conference he does.
Can mosquitoes transmit this virus like they do malaria?
Similarly to HIV, it is theoretically possible for a mosquito to feed off someone with the virus then within minutes feed off someone else, be killed, and the infected blood contain enough remaining particles to cause an infection... but to my knowledge this has never been shown to happen in practice.
I’m more concerned about stray cats. It has been shown that felines can both host 2019-nCoV and get COVID-19.
In general the outlook has gotten better as the data got better and we were able to compare notes, although there have been some setbacks, too.
I don't think we'll ever, ever get back to "normal" as this is the pandemic we've been reading about and planning for over the last century. Nobody [alive today] has ever lived through something like this and it is bound to have lasting consequences.
But I would be cautious about reading long-term plans. I know everybody wants to know how the story ends, but people who have engaged in long-range planning over the last couple of months have consistently had to re-plan. I would expect that trend to continue. We don't know exactly what small changes might have large consequences. For instance, monitoring temperatures at points of entry and exist for all businesses could have a major effect, or forms of "frontier testing"
No doubt this is a period for the history books. We'll probably have to live through it to finally figure out how it's all going to end.
I have added the two missing words to my original post for clarification. Thank you.
And of course the flu, which is different than SARSCoV2, kills between 250,000 and 500,000 each and every year. If you're 30 years old, between 7 and 15 million people have died from flu in your lifetime.
It's hard to argue that this isn't _VASTLY_ worse than the flu in both scope and intensity.
People keep saying this, but it's a meaningless sentiment. The "normal" of today was never going to be the "normal" of two years from now, with or without this pandemic. It's not like the world was going to be frozen in time until this coronavirus came along.
Before 9/11 we didn't have to take off our shoes to fly. Now we usually do. Im sure there will be plenty of similar changes due to the pandemic, and most of them will be similarly easy to adapt to, just as we adapt to so many other changes year after year.
But this threat that we may never "get back to normal" rings hollow to me.
Schools are moving more courses online. Another major upgrade.
The restaurant experience hasn't been rewarding for a long time. People should learn to cook at home. Experiment with fancier cuts of organic meat.
Movie theaters have been terrible for decades. Sticky floors, too many commercials, overpriced food. Now many film festivals are moving online.
Fast fashion was just a way of getting people to buy poorly made clothes from sweat shops.
So much of the crap people bought recently was just excessive junk; causing an environmental disaster.
We should just pay people to stay home and learn new skills. Why not pay people to taking online biology courses though the pandemic? There should be a startup that pays people to stay home and take biology courses. Exams can be online and for real verification done over video conference with an examiner. The startup then can get a % of your salary when you start working. Or, be paid through advertising from medical companies.
I agree that what most people buy is junk and that there is waste in the spaces you mentioned. But I'm not sure how "natural" is will feel for people to do all that isolated in their homes with a small amount of people indefinitely...
> As a society I think that we've outgrown the idea of just going to a movie theater and hanging out with friends.
This is an antisocial and unhealthy perspective. We've yet to see the mental health ramifications from this extended period of isolation. We're not built to sit inside by ourselves all day. Even as great as online connections can be, they are no replacement for the real presence of a human being. Saying we've "outgrown" it is preposterous.
So does industrialization as a whole, but I'm not for rolling that back either. Ride the ennui all the way to posthuman psyches. c:
Our education system cost (At least in the States) is absurdly overpriced and most of that money is not going to the professors.
You don't need to pay people to take biology courses. You need to pay people UBI so that they could choose to take biology courses. Then you only need a (relatively) modest amount of money to design the course, pay the graders, and deliver the content.
While working as an adjunct I got paid maybe $5k in total? For developing and delivering a new online Bioinformatics course for two semesters. What's sad is I actually got paid a bit more than other adjuncts.
While the pay could be increased to make it better it still doesn't require turning students into a revenue stream for % of their salary over X years.
I agree with your sentiment, forcing people into Biology is entirely the wrong approach--I was and I detested my HS level classes, and even most of my lower division classes in University as it was mainly just rote learning--but because I met a Community of students and professionals online when I was still in HS I got to learn what research they were focusing on and it intrigued me enough to go to the BS level, all while attending upper division University lectures in various subjects during my Junior/Senior years of HS.
While I'm a proponent of UBI, I still think a concerted effort is needed to make the Life Sciences appealing to the masses; I personally subscribe to the Biohacker and Community Science approach, and having (wet) lab extensions built into local community libraries would go so much further.
I've been out of the Industry for 8 years now, but I'd gladly volunteer and teach Plant Science and some Molecular biology labs for free if we had UBI and I could offset some living expenses. I know of 3 or so recent biology grads who wish they could do the same.
I've tried my hand at doing it completely free a few times, but when it doesn't pay the bills the effort quickly gets put on the backburner.
If you and/or those recent grads start putting something together feel free to reach out and I'd love to contribute. My github username is the same as my HN username and you can get everything else from there.
Even older grades have trouble with virtual learning. Plus an important part of school is learning socialization skills. That's pretty hard to do online. Plus teachers will need more than a few weeks to adjust; curriculum development isn't trivial, and teachers would need to be retrained to use the new pedagogy.
As the father of two, and someone who cut his teeth in online learning, it sounds great to say move "more courses online", but the reality is quite different.
If this refers to the bluetooth supported apps I've seen developed by several institutions, does this not sound like a horrible idea? Let's say two people walk past each other on the street or stand close in a shop, as far as we know the risk of transmission is non-existent or extremely low. Are you just going to build a connected graph and then ping everyone if one person gets sick? You'd be pinging half the population of a dense city after one day.
Before putting these surveillance measures into place I'd like to know if they're not causing more harm and paranaoia then they help.
So if say, the chance of being infected in an interaction is say 5%, then the chance at a distance of two is 0.25%, the chance for someone at a distance of 3 is merely 0.01%, etc..
Do you really think it's a rational use of resources or your attention that if you're one of the countless 'distance 3' people to alert you? Unless you had some mysterious ability to determine with extremely high fidelity that infection has occured from metadata alone, which doesn't exist, it's a tool for mass panic.
Bluetooth will give you a match for up to 10 meters. The official safe distance is 6 feet. You can't even tell from a bluetooth match if people were close enough at all.
WTF? What we know is exactly the opposite.
See most recent results from the German researchers in Heinsberg.
This is just one of the numerous examples of lazy and bad intentioned attempts to use anxiety to convince readers to click the article. The entire journalism industry should be ashamed of how the absolutely miserable way in which they've handled this event.
You need to take a hard look at yourself if your industry revolves around damaging people's mental health in order to draw page views.
International travel, sports events and other large gatherings I’m not optimistic will be back to normal in 2020 unless something big changes.
Suddenly a Black Swan craps on everyone at once, and a great many people are whining 'why is this happening to me' and 'when will someone fix this so I can go back to my routine'.
Guess what? Your routine is probably fucked. Throw it out, get used to the new normal, and accept that no one knows how to fix this (yet?), just like every other time we get hit by a context-changing problem.
Of course some people get too attached to their context, and those who come later and find their remains might label such events as 'out-of-context problems'...
1) indefinite lockdown 2) everyone gets the virus
Between a 0.5% chance of dying, and life imprisonment, I'd take my chances.
Basically there are countless ways in which quality of life can be improved over time as we continue to maximize efforts to contain spread.
The fatality rate for octogenarians is 15%. Octogenarians also have a 10% chance of dying every year anyway. At 18 months of lockdown 15% of them are dead anyway and you took a single digit percentage of my life away
If all beds are taken then many of those severe cases will kill people. Say mortality is 3% instead of 0.5% once hospital capacity runs out. Assume 60% need to get it before we have herd immunity. I don’t think 3% mortality without healthcare is pessimistic. Unfortunately we’ll soon find out if the disease hits Syria and similar places.
Not only that, thousands would also die from strokes and heart attacks and other things that they wouldn’t die from if hospitals weren’t full.
Hospital staff will simply quit when their job becomes a constant struggle to keep the hallways clear of corpses instead of saving people.
It’s not “0.5% dies why are we doing this?”, it’s “we do this so only 0.5% die”.
Between a 0.5% chance of dying and a 3% chance of dying I’d happily observe some measure of distancing for 12 months to get 0.5%.
My restrictions at this point (Sweden) shows that with luck, perhaps restrictions don’t have to mean house arrest.
Complete lockdowns aren’t sustainable. I think countries will converge on a “new normal” which is far from lockdowns, while not “normal”.
https://www.sccgov.org/sites/phd/DiseaseInformation/novel-co...
What your comment is missing is that the mortality of ventilators is 66% - 90%. So they're not a good solution for most patients. ICU doctors have been recommending using non-intrusive methods like cannulas as long as possible before intubating. However, that causes aerosolization of corona, so quarantine buildings are needed.
Please see my links for more detailed info.
If ICU mortality is extremely high (e.g over 2/3) then doctors probably need to be more selective. The judgement should be not only that patients should walk out, but also survive for a period after treatment, say a year. It’s also not only about ICU treatment, regular hospital beds and doctors are also not unlimited.
I think in many places doctors are feeling pressured to use invasive ventilation for patients that have a low chance of surviving a year after care. Patients who get invasive ventilation should be carefully selected even if there is no shortage. If mortality is very high, this is a signal that doctors are giving ICU care to too many patients that aren’t helped by it.
The purpose of social distancing is to slow the burn so our hospitals aren't overwhelmed, and won't have to triage coronavirus patients vs. people with any other sort of emergency coming to the hospital.
This practice will save thousands of lives of people with a bad case of coronavirus, but also the people who get into car crashes, or have problems with giving birth, or heart attacks, or any other reason that requires immediate emergency care.