> Germany is a democracy, so it ultimately comes down to the quality of the leadership decisions made by the populace.
This is not entirely true. Democracy is a broad term and different democracies work very differently.
In Germany for example political parties are quite powerful, politicians have to be elected by party members, there are no primaries like in the US. Being a politician in parliament or becoming chancellor in Germany requires a political career that takes quite some time.
This excludes people in ways that are both good and bad. On the good side someone like Trump would have no chance at all because he lacks the political track record and relationships. On the bad side politicians in Germany are not a very diverse group. There is a strong bias towards older people, people who've been in politics for their entire life and people in professions that allow for spending time as a politician in parliament for a couple of years and continuing in their regular job afterwards. In practice this means teachers and lawyers, at least in Germany.
German politicians seem to be younger than the ones in the US. It’s really sad to see that the best the US parties could come up with is people older than 70.
I agree about the point with teachers and lawyers being predominant. Although it seems that worldwide politics is mainly run by lawyers which is a bad thing in my view.
Night and day when compared with the grandstanding and gaslighting that we're seeing from Trump.
It's what burnt me about the Marc Andreessen article that generated a lot of discussion on HN yesterday and opened with this premise:
Many of us would like to pin the cause on one political party or another, on one government or another. But the harsh reality is that it all failed — no Western country, or state, or city was prepared — and despite hard work and often extraordinary sacrifice by many people within these institutions. So the problem runs deeper than your favorite political opponent or your home nation.
The assumption that a Clinton, Kasich, or Obama administration would not have managed this more competently is stupefying. We can just look at how H1N1 was handled by Obama in 2009:
And here we have clear evidence of a Western country whose response to the present crisis has not been failure (ignoring all together South Korea, where the response appears to have been even more successful).
How are we going to make radical systemic changes in society when we pretend like the people in charge make no difference?
Angela Merkel has a Ph.D. in quantum physics, and an academic background is probably exactly what's needed in a situation like this (versus the more business oriented skills of e.g. Trump).
trump is terrible at business, very likely to have grossly underperformed against putting his inheritance and loans into an index fund. he’s good at grabbing attention and being a reality tv actor/celebrity however.
> he’s good at grabbing attention and being a reality tv actor/celebrity however.
He's good at marketing. Sadly he didn't put these skills to good use in the current crisis so far. Virology isn't his strongest suit. He performed a worse show than usual since it is not just about boasting about himself and branding other people with hilarious nicknames.
not really. he’s good at self-promotion, which you might argue is an overlapping skillset with promotion, a component of marketing dealing with sales, advertising, and the like.
but he’s most certainly not good at any other aspect of marketing (product, price, distribution, etc.), which is why he’s terrible at business and why he’s been losing credibility to state leaders.
Merkel is not as narcissistic as other politicians. You have to have a big ego to become the leader of a country but among her peers she seems to be one of the most grounded. In such a crisis you definitely want somebody like her to be leading.
> The generosity and solidarity [...] have been missing in Germany’s response to poorer European nations in the south, which were hit hardest by the virus.
Germany gave away many hundreds of respirators, took in hundreds of patients from all neighboring countries (including Italy). Italy was offered money under the ESM which they didn't want. All while high ranking officials from Italy called Germans Nazis multiple times. All that although the Italian population has a higher median wealth, lower taxes, higher rate of home ownership and lower retirement age.
American here. This is the first I’m hearing anything but good things about how Germany has handled this crisis. And I consider myself to be fairy tuned in. Don’t sweat the trolls, you’ll never make them happy.
I regret that I have but one upvote to give. This whole experience has further disillusioned me to the news media and the idea they contribute value in any way whatsoever. At this point, I trust Twitter more.
American here, I can only dream of the United States having a response as good as Germany's. Your country is an example of a how a democracy should react in a situation like this and demonstrates that we don't need a totalitarian regime to handle a large scale crisis. I'm not saying it is perfect (what is?), but just that it is one of the free countries setting a strong standard.
To add to your point, Germany actually has a federalized system similar to what the United States has. A key difference in this specific scenario was that the United States didn't fully trust the federalized system for healthcare and disease prevention like the Germans did. Our CDC ended up owning the development, manufacturing, and distribution of test and therefore were able to tell doctors in all 50 states who could be tested and who couldn't. I think that this is a grossly inferior model and we should have instead allowed the states to have more money and therefore more control over creation of the tests.
I think that the big issue that was exposed was not lack of centralization but too much of it with the wrong organizations. A nation of 330 odd million is much harder to govern especially in a centralized manner.
an additional question I have is what do you think has been so awful about the United States response? From a pure numbers perspective I feel like the US isn't really doing badly from a per capita basis.
Nobody has run out of ventilators yet. Infection rates are below the 95% confidence interval of the original models. Just curious as to your perspective. Do you think that these numbers are due to bad models and luck or due to the fact that the population has largely adhered to social distancing?
I don't want to get into partisan politics, but the US central authorities weren't serious about the problem until relatively late in the process, and our testing ramp up was also very slow. The move to block travel from China was well timed, but it can arguably be seen as more influenced by geopolitics than health concerns.
The US now is catching up fairly well as the country started playing on its strengths, such as the extremely strong industrial base, financial power and, for better or worse, international leverage.
Regarding the more centralized system, it has advantages and disadvantages. The advantage of Germany's central coordination is that it made generally good decisions from the get go, so the country was able to move quicker. The US had a confused central response and the states were able to implement local fixes that prevented the entire system from falling apart.
So I think the US model has the advantage of offering a second layer of defense from poor central planning, which perhaps wouldn't be as easy in Germany (I'm speculating here, I don't know much about Germany democratic guards against bad central decisions).
The US had the issue of complete failure of a federal monopoly. CDC and FDA failed at the most critical time and prohibited private enterprise and states from rushing in.
Measured by what? We achieved better results than every single pre-peak best case estimated outcome. If you know of a predicted outcome that we havent come in under, please link to it.
Measured by a month of delayed testing at the outset of a virulent pandemic?
> Forced to suspend the launch of a nationwide detection program for the coronavirus for a month, the C.D.C. lost credibility as the nation’s leading public health agency and the country lost ground in ways that continue to haunt grieving families, the sick and the worried well from one state to the next.
In science, when errors are made, we are supposed to acknowledge and correct them, which is what the CDC did.
Why base your opinion on a second order result rather than first hand outcomes? If we had not tested at all, and still had this _drastically better than predicted_ result, might you still be unhappy about it?
And the NYT... They are not just a news orginization. Still run by the BBC's Mark Thompson I see.
You misunderstood the parent poster. Germany's healthcare system is very decentralised; Germany had 16 states which have large legal, financial, etc independence in a number of fields such as healthcare it education.
A key difference though is that most of German healthcare is public; there are very few private clinics and those play no major role in the pandemic response.
Insurance is mandatory but cheap (and independent of employment). Healthcare is accessible no matter your budget and maybe in the pandemic nearly as important, everyone has the right to sick leave. You get s doctor's certificate and can stay home for a week or two or three, if needed. You also won't be fired for it as labour protections are strong.
I always joke about the love-hate relationship between Italy and Germany (Italy and Germany in the broader sense, not only the actual countries) saying that this feeling has been here since the times of general Stilicho [https://en.wikipedia.org/wiki/Stilicho].
Slightly off-topic, but you want to write "General" with a capital G in this case because you're referring to a concrete general. I had trouble parsing your sentence because I took "general" to be an adjective.
I feel you. I think the media (especially US media) has latched onto the doomsday side of this pandemic, and it's easy to sell panic porn. Please ignore the trolls.
As a Berliner, I've had the chance to see the German response from the frontlines. I've never seen such socially responsible citizens. Every once in a while my friends and family from US/UK/Asia etc call and ask me what's the secret of Germany's success. The response from German govt. was perfect in such situation, you can't help others without securing your position.
Meh... it’s a bit of both. Nazi comparisons are just annoying now, and people outside Germany tend not to realize how much of a faux pas they are, triggering reflexes of both “I’m sorry” and “Go fuck yourself”.
OTOH the help was a bit lackluster, especially at the beginning. I’m not sure about the “hundreds” of patients —- it’s probably closer to 100 than it is to 1,000 especially when only considering Italian patients. In any case it’s fairly symbolic considering the scale of this in Italy.
The cause of all this was probably bad timing more than any unwillingness to help. As Italy was most in need, cases in Germany were also growing explosively. There was probably just too much going on, and too much uncertainty to easily part with resources that might be needed rather soon.
The sky was falling according to everyone. People and politics were scrambling and panicking. And we still gave away all these resources. Italy's north in particular isn't a third world country. We still helped with all this, and it's considered lackluster? Can you imagine a reversed situation - when Germany would ever beg for help for anything? I don't understand why these expectations exist so naturally.
I am surprised at this statement of Italians having a higher median wealth, I guess that must all be the older generations since the last decade at least is all about how poorly the younger generations are doing - do you have a source for this assertion?
The conditions of the ESM is more or less the entire point. They were offered the money they need - with some guards attached. But they wanted more, and not just borrowed but entirely given by the EU (=Germany). With no oversight. And they got that by calling Germany Nazis. That's despicable.
> not just borrowed but entirely given by the EU (=Germany).
You can't have a workable monetary union without a fiscal union. Germany wouldn't have such a big surplus if its exports weren't massively boosted by the southern states depressing the exchange rate of the Euro. Unions require unity, and if Germany feels like its pulling more than its own weight, it can exit. But you see exactly the opposite, Germany (at least nominally) states that its goal is to preserve the union, and this betrays the fact that the union brings massive advantages for the German economy. It is not out of a sense of benevolence and european solidarity, but of pure self-interest.
Well, if Germany and the North want the union to survive, they will have to treat it like a real partnership and respect and recognize the contribution of their other partners.
The current "solution" of bailing out Italy and Spain with even more debt on the condition of further future austerity will only lead to further instability, unemployment, discontent and financial ruin when the debts come due.
It is not a question of "solidarity" with the South. It is a question of whether the North recognizes the contribution of its partners to the union, and whether they can act in mutual self-interest to save it.
If that does not change, the Eurozone is a doomed project.
In a monetary union, the regions running a surplus enjoy a massive boost due the exchange rates being depressed by the regions running a deficit, while the industries of the deficit regions struggle to catch up, hampered by the lack of natural corrective forces of a floating exchange rate. If a monetary union has to work, the deficit regions have to be fiscally supported by the surpluses generated elsewhere, or they just spiral further and further into debt, unemployment and industrial collapse.
That is not how this works. The value of the Euro is depressed compared to what it would be if the deficit running regions were not part of the common currency.
Yes, it is true, but the difference is that the US is also a fiscal union, which is not the case with the EU, making it fundamentally unworkable in its current state.
I assume you mean ventilators since it would be fairly insulting otherwise, especially when considering Germany's knee-jerk reactions to the initial outbreak in Italy.
The ESM has historically some bad reputation in my country, mainly in relation to Greece (I'm aware the ESM did not exist at the time, but most of the comparisons are drawn to that in our media). The government did not want it, or so they said, but in the end signed the agreement anyway (although I don't know if they'll ask for the money or not).
Ask the Greeks why Italy didn't want the ESM money (hint: it comes with forced privatisations and foreign imposed austerity).
> All while high ranking officials from Italy called Germans Nazis multiple times
There has never been a serious discussion in Germany about its failed post-WW2 denazification programme, history got in the way. Just yesterday I was on the wikipedia page of the first commander of the Gestapo, a certain Rudolf Diels, only to learn that immediately after WW2 he led quite a peaceful life, perfectly integrated in the German state institutions:
> After 1950 he served in the post-war government of Lower Saxony[3] and then in the Ministry of the Interior, until his retirement in 1953.
Like, what the hell?
Even on the economy side you've still got BASF and Bayer happily doing business of hundreds of billions each year, while suffering almost no economic repercussions as a result of their role in WW2.
One of the few Germans from the public sphere that I know of and who really wanted to confront this problem head on was Heinrich Böll.
> There has never been a serious discussion in Germany about its failed post-WW2 denazification programme, history got in the way.
I am quite skeptical as to „never“. The example you give is an infuriating one and there are too many of those. But that there has been no discussion about de-nazification is simply not true.
In academia the topic definitely has been dealt with. See for example this article by the Centre for political education [0] which I consider an example of making this available to the public.
Also these efforts didn’t happen in a vacuum, Europe and Germany was in ruins, the allies wanted to wrap them up as well. Ironically the Sowjets were more drastic than the Western allies with their efforts, and we’ve ended up with a second totalitarian regime in Eastern Germany. They’ve even re-used the concentration camps.
Anyhow. I remember talking about this in school and critically discussing the History of Germany in the last century. We must not forget, we must not repeat.
I would love to know how Germany has been able to discover a sufficiently accurate antibody assay before many excellent groups in other countries. Finding some antibodies is one thing; making it mean something is another. Does the presence of a particular antibody imply that someone is now no longer infectious to others? Are they themselves now immune to reinfection?
These questions are unanswered AFAIK so I am curious as to what the Germans are actually learning.
Eh not really, these aren’t measurements these are for the most part binary tests the current assays seem to trigger on AB’s for multiple coronavirus strains and even worse other common viruses.
Without knowing the specificity and sensitivity of this specific test you can’t say any “inaccurate guesses” based on it is an upgrade.
Say the test has really poor sensitivity but 100% specificity then sure it might not identify a lot of past infections but it won’t produce false positives so which ever figures come out you can extrapolate of them fairly easily.
If it has terrible specificity then it’s a whole other problem unless you have additional tests that have high specificity that you can use to exclude false positives.
But if you want to know "what percentage of my population have had coronavirus in each town and age group", then these tests, combined with research to find out the sensitivity and selectivity, will answer that question.
Most of the big decisions governments have to make depend on only aggregate statistics after all...
My vague understanding is, that the tests can also test positive for antibodies from other similar viruses. They have a significant false-positive rate that you should not rely on a positive („you are immune“) result but overall they will provide a big picture approximation how many citizens might have already resistance. They are not good enough for a rumored „immune certification“.
Currently we have no idea how many people have had covid. We have a good idea how many have died, but no country has managed to do the kind of testing that would give a good indication of how many people have been infected. Do 2% of people getting it die, or 0.2%, or 0.02%? Testing 1 million people at random across the country will give good results of not only how deadly it is, but also how likely it is to spread in different areas of the country.
We have a pretty good idea it isn't 0.02% because there's an upper bound on the infection rate (around 75%) and the number of bodies is known and in all cases exceeds 0.3% of the maximum possible infections.
How did you come up with 0.3% number of bodies / maximum possible infections, aka total population? I'm trying to wrap my head around this whole mess...
Take Lombardy, hardest hit region in Europe. 1130 deaths / million, or about 0.1% death rate. All German states are under 100 deaths per million, which is less than 0.01% death rate. Sanity check: Bayern, 1.2k deaths/13M people ~ 0.01%.
Of course, this is a lower bound estimate assuming all people in a given region have got through the disease. Which is definitely not true. To figure out how bad is going to get we need the total number of infected people. Hopefully the random testing strategy will shed some light on that number. But at least we start [much] lower than 0.3%.
To my knowledge, the tests that are carried out in Munich use a so-called ELISA device. My vague understanding is that this tests reacts with a specific protein of SARS-Cov2 and has no known cross-reaction with other harmless corona viruses. Disadvantage of the test is probably that it is quite complex and not much capacity is available. Here in Munich, however, about 3000 households are now randomly selected and tested in order to estimate the real number of infected persons. This is the press release of the munich university. DeepL.com works great to translate german texts to english: https://www.lmu-klinikum.de/aktuelles/pressemitteilungen/mun...
I can't comment on the test itself, but there is a wider point here: don't test individuals, test populations.
Most countries are only testing people who arrive at hospital with serious conditions (and billionaires and nba players!?). That's pointless because the treatment is the same whether they have COVID-19 or some other respiratory infection.
If we tested populations and did so regularly, you would know whether lockdown was working, whether you could afford to partly lift it and how and when to reinstate it.
Right now, we are all sitting at home with no idea if this is working or not. In a few weeks, we will start roping thing with no idea whether that is a good idea or not. We'll just guess.
But it hasn't ramped up yet and they loosen the lockdown already by monday. The got R down to .7 at best and that only on average, not in the hotspots.
I bet in 2 weeks (I hope it's not even more delay) they will notice that (partially) opening schools and shops was a mistake and will have to row back. I just hope they will be as lucky as with the initial curve-flattening.
Germany has flattened the curve, but that still means they are roughly on it's summit. There are still more infected than ever and every misstep might be costly.
I believe it’s very much expected to see some resurgence and to adjust measures accordingly. Over time, it might become easier to measure which interventions are most effective and to focus on those.
Schools are certainly a risky gamble, but their closing is also among the most expensive measures. Many people are staying at home because they have no options for their children, including many doctors and nurses.
You might be right. I wished they'd publish what exactly they aim for and what the plan for different outcomes of this experiment is.
For now they seem to aim at R = 1, which means waiting for the vaccine with whatever is possible to keep it at 1. (Probably not much more than barbers and very few school classes.)
love how people casually say "oops" and "we'll adjust"
those "oops" are painful suffering deaths that could have been avoided
everything has been reduced to numbers we mindlessly argue when we are talking about deaths that could have been avoided
even people who recover, this does long term lung and maybe heart damage
all could have been avoided with a true two week lockdown to let the virus die off, but nope, trade two weeks for months more of "resurgence and adjust measures"
It's astonishing how virulently your very sensible post is getting downvoted. By bots? Or actual HN real people? Either possibility is very very bad for humanity.
> even people who recover, this does long term lung and maybe heart damage
The problematic ACE2 receptor sites are also in the brain, intestines and liver and have seen damage. The brain one is the most alarming one from a survival perspective. We survive, but with irreparable permanent brain damage. We're no longer ourselves, we have a different personality, and we are incapable of doing our previous jobs. Is death preferable?
everything has been reduced to numbers we mindlessly argue when we are talking about deaths that could have been avoided
What is mindless is refusing to consider any action that might conceivably increase the number of deaths without considering tradeoffs. Or should we shut down the country during every flu season and universally limit cars to 20mph?
this isn't a cold, it does -damage-
Lockdowns also do damage; not just economic and psychological but also medical. We've stopped "elective" procedures like cancer screenings, which is guaranteed to result in worse outcomes for some patients. I agree that as of right now it's best to maintain the lockdown, but in order to make that determination we really do have to use numbers.
Until a vaccine is found, 60-70% of the population will need to get infected for "herd immunity". While at the same time making sure infection doesn't grow exponentially, and overwhelms the health system.
Loosening the lockdown, and being prepared to row back, will achieve that if done carefully, while at the same time getting the economy slowly back to normal.
And that probably are a lot more people are already infected without symptoms will help with that.
Trying to somehow contain the infection won't work, because it will just get carried in from the outside again, eventually.
Sorry, I have no knowledge on virology topics. But this “herd immunity” thing is a complete nonsense. Politicians may repeat it as long as they want, but it still makes no sense. 50 million people must be infected, 1,5 million will die. It will take many years. While immunity very probably(????) disappear after months. Asian countries had many different viruses in the past, all of the contained. Why is it so difficult to follow their path?
Asian countries have not contained all viral outbreaks in the past. In both 1957 and 1968, Asian-origin flu epidemics killed millions. It's possible that containment could have been achieved if every country had swiftly followed Korea's example in early February, but there's no precedent for containing a human-to-human transmissible disease with millions of cases across the world without a vaccine.
How do you start? Write invitation letters with date and time to first batch to be infected? Nonsense it is because it’s barely doable. The people will simply leave country unless one puts military on the borders.
Well, unless you have a vaccine, the virus does all of the work for you. Also, you can't really leave a country now anyway, and even if you could, the virus would be at the destination.
The herd immunity is not really something that you do but more of an unavoidable side effect. I'm not sure that we have much of a choice now that we are well beyond the point of containment.
I think the analogy says more about the person using it than the actual topic. If it was appropriate to compare people with... well... cows? Why not slaughter the lot and start over? Or take the stupid analogy to the next level and talk crop engineering? There! The solution has been staring us in the face all along.... or wait...
Oh but I do! Group immunity or collective immunity will do just fine. I really don't care how popular this zoology terminology is. For me taxonomy works like: A pack of wolves, a flock of birds and a herd of cattle.
Beware when they start calling you [say] a consumer.
Herd immunity is a real phenomenon -- it's the strategic goal behind widespread vaccination, and the reason that vaccination controls disease even if less than 100% of the population takes the vaccine or gets immunity from it.
That said, I think you're right to be skeptical of the "let everyone get it and we'll have natural herd immunity" idea.
You don't know how many people are currently immune. Or how immunity even works for this virus. No one does. Zika was rendered mostly harmless by herd immunity before experts even knew what happened.
I don't see what is gained by making armchair proclamations as if you know something the rest of us don't. You don't even seem to know what you don't know.
Worldwide at this moment total (cumulative) deaths over total (cumulative) cases is nearly 7%, with considerably over half the total cumulative cases still active. Granted that we know that there are many undiagnosed cases, but we don't have a clear picture how many. There's no basis right now for your assertion.
The basis is studies of closed communities. Here in Germany there was a study of a whole village (testing everyone), that found a death rate of 0.37%. Other interesting data sets may be Diamond Princess cruise ship, Theodore Roosevelt carrier, or Health Care Workers.
So saying there is "no basis" is a bit rich. There may still be uncertainty.
Edit: this (just googled) article cites Diamong Princess to lead to an estimate of 0.5% death rate https://www.sciencenews.org/article/coronavirus-outbreak-dia... (the percentage of deaths on the DP was higher, but the passengers were also comparatively old on average).
There are a lot of people on HN (and the internet at large) who view any statement adjusting-downward death rates as "COVID denialism", and will reflexively downvote attempts to correct in that direction.
In the most charitable reading, you could view them akin to the CDC and masks, trying to keep the public slightly misinformed for the greater good (preserve mask supplies for hospitals). In the least charitable reading, there are a lot of depressed and angry people on the internet, who want to believe that this disease is truly civilization-ending, and attack any opposing narrative.
Either way, I would not take it personally, or as a judgement on your actual quoted facts.
Another interpretation is that a lot of people on the internet (HN, reddit) have actually seen net improvements to their life from the lockdown.
For the introverted tech worker that prefers to work from home, the quarantine hasn't really negatively impacted their routine that much, and it might have actually lifted any peer pressure to go out and socialize with friends/co-workers/family.
For someone in that situation, there's not much of a benefit to advocate for reopening, and the deadlier the virus seems, the longer the lockdown will continue.
I really hope you're wrong, because that would be implying that HNers are selfish assholes who don't care a dime about the rest of their community.
While I personally am comfortable working from home and my company is doing well, I'm sad that I couldn't visit my parents and my grandmother for Easter. And it particularly frustrates me that my grandmother has to sit at home and practice social distancing, where she cannot do anything much besides sitting in her chair and watching TV all day. (She doesn't have or want a smart device, and her chronic back pain keeps her from engaging in most other home activities.) And that's before I consider the people around me whose lifelihoods have been impacted or obliterated by the shutdown, or the essential workers who often have to work without adequate PPE.
I don't mean to imply that it's the majority of people here. People are complex and HNers aren't a monolithic group. But I do think the general pro-lockdown sentiment wouldn't be nearly as strong if the majority of posters were in the service or retail industry.
That's not to say people here are selfish, only that it's easier to advocate for safety when you yourself are in a position of relative stability.
Again, the current worldwide figure is 7%, with two thirds of the known cases still pending.
Even if absolutely 0 of the pending cases turn into deaths, and the true percentage of cases that are undetected is the full 50% that has been mentioned recently, that still puts us well above 3%.
Arithmetic: 7 in 100 right now. Add 0 to deaths, resolve all open cases and discover double the known case count: 7 in 200, 3.5%
---
For the surveys you mentioned. The Roosevelt still has active cases. The Princess likewise did at the time that article was written. You're citing that 0.5% figure incorrectly: that's a projection from the Diamond Princess onto China. I found a different source for the German survey -- that link isn't working for some reason. The same applies there.
Most importantly, these surveys are not representative of the global population. See above.
The recent results that have shown 50% asymptomatic cases are not conclusive yet, because it's too soon to say that all of those people will never have symptoms.
I would be ecstatic if I was wrong; I would love it if the upper estimate for asymptomatic cases was correct, and we had far fewer deaths than anyone's expecting. But it's just not in the numbers right now.
"Again, the current worldwide figure is 7%, with two thirds of the known cases still pending."
No. You can not simply calculate the death rate by dividing known deaths by known cases. Those numbers depend on who got tested and on how deaths are being counted, which also varies greatly from country to country. For starters, people who have severe symptoms are more likely to show up at hospitals and get tested. That introduces a huge bias already.
"You're citing that 0.5% figure incorrectly"
No I didn't, read what I wrote. And ALL numbers are projections. Even your calculation is a projection. Your calculation is an extraordinarily simplistic projection. Scientists hopefully make better projections, because they account for more influencing factors.
"The recent results that have shown 50% asymptomatic cases are not conclusive yet, because it's too soon to say that all of those people will never have symptoms"
What makes you so sure? It seems possible to make an estimate of when somebody got infected, especially in those studies of closed communities. After two weeks or so (scientists would determine a more prices number), it would be reasonable to assume they won't develop symptoms.
Death rates change based on how well the healthcare system can keep up. The Diamond Princess was best case in that sense, so the floor of the death rate is about 0.5% if your somewhere with great medical care and f cases. As for the German study:
> About 1,000 people participated in the study by way of questionnaires, throat swabs, and blood tests to detect the presence of COVID-19 antibodies. These interim results are based on data from about 500 people.
So only a sample size of 500 plus not accounting for other local factors there, like being a small village.
"Death rates change based on how well the healthcare system can keep up."
Not really, actually. At least I haven't seen a number of "people who died because they couldn't receive care" - do you have one? It seems possible that once health care systems are overwhelmed, more people die. But how often, if ever in this pandemic, has that point been reached? I don't think that often - there is no good treatment anyway.
"only a sample size of 500"
It's science. 500 can be a lot, or few. It was a sound and thorough study by acknowledged scientists.
> At least I haven't seen a number of "people who died because they couldn't receive care" - do you have one?
No, that's impossible to provide between people dying at home because hospitals are full and the general chaos of those situations. And then there's the big difference between quality of care in various countries, death rates of just about everything will be much higher in Mozambique than they will be in Sweden, it's nonsensical to think that quality of medical care will not have an effect.
> It seems possible that once health care systems are overwhelmed, more people die. But how often, if ever in this pandemic, has that point been reached?
Many times in many countries, look at the national totals somewhere like here (https://covid19info.live/), the trend is nearly always that more cases at once translate to much higher death rates. Partly due to not knowing the true number of infections, but mostly due to the availability of medical care.
"No, that's impossible to provide between people dying at home because hospitals are full and the general chaos of those situations."
That's another claim you make, that you should be able to support. Have people been denied hospital care and therefore died at home?
"the trend is nearly always that more cases at once translate to much higher death rates"
Could have any number of explanations, like maybe infected old people homes.
"it's nonsensical to think that quality of medical care will not have an effect."
Again - are there cases of people dying because they couldn't receive care in the US, and how many?
"but mostly due to the availability of medical care."
Again, can you give any examples of people dying because they couldn't receive care? Especially in the US. And show that it is a significant number of people?
Herd immunity is not just a buzzword. We have two options to reduce the harm of infectious diseases: eradicate them or build herd immunity. The first option has become impossible with this virus that's now truly global and likely much more spread than is known. Therefore herd immunity is the ONLY option.
The question then is how to get as many people as possible immune - you'll either need a vaccine or many need to get the infection and survive. A vaccine is not on the horizon for another 6-12 months, so the best course of action is to build the number of survivors.
What brings death? Mainly the sudden onslaught on the health system. If there is no bed, respirator, blood supply, ... Left then you're much more likely to have patients die than if you have a hospital at regular capacity. There are some that WILL for but by slowly building immunity (i.e. allowing some parts of the population to get exposed) you avoid the high death toll of an unmanaged outbreak.
So if total eradication is impossible, slow infection rates are better than none. Why? Because if you don't build the immunity you will again have violent outbreaks killing many. And you simply can't lock everyone at home for another 6 months.
Most of the people who go on respirators die. If the health system is going to be our weapon here until the vaccine is developed, we need to find ways to manage the disease before it gets to the point where we intubate people. Remdesivir might be that drug, but we're unlikely to have the kind of supply needed for what you propose until after the first vaccines potentially may be available.
There is no reason you can't keep a disease at a very low level (to the point any given person is unlikely to get the disease over their lifetime) via testing, contact tracing and quarantine. Iceland and South Korea both prove you can in fact.
Iceland is tiny and it is a little early to proclaim SK an unqualified success. If the only way to keep the disease at a very low level is to have a new normal of strong quarantine indefinitely, then you are asking for something unrealistic. Even more so in western democracies where people are accustomed to a great deal of personal freedom.
Eradication is not impossible but takes will and choices.
If the virus had certain death rates and longer periods where it remained dormant. We would have to make choices to eradicate that. We're in a different situation where we have different choices and outcomes.
Immunity does not disappear. The virus could mutate, but not likely and surely would become less deadly. Herd immunity is a fact. It is natural. And we’ll probably reach it sooner than you think. I hope like everybody for a vaccine but I personally don’t think we’ll make it on time enough.
We can roughly estimate how long that will take if we stay at R=1. That's maybe 100k new infections monthly in germany. Meaning it takes ~40 years to reach 60%. (83000k*0.6/100k/12)
Maybe it's less if you can get more aggressive with more immunity, but even if I'm wrong by a factor of 10 it's still years and the vaccine is the more realistic bet.
We can roughly estimate precisely nothing until we know how many people have been infected, how many are immune and how long immunity lasts. We currently know none of those things.
I took the best case scenario: all tested become immune for ever. If you want add a 3x factor for unreported cases and you're still at 10 years waiting time.
Estimates make sense, especially if they proof your point even if you are off by a factor of 10.
One way to shorten the time is to constantly increase hospital capacity, so that in each month lets you infect more people. Especially if plasma donations turn out to work to reduce severe cases.
Another way is to separate young people from old people more effectively. Then you might be able to permit 1m young people to be infected each month with the same hospital budget we have today
That's assuming that the only two outcomes of a SARS-2 infection are "dead" and "completely recovered". There are case reports of young and otherwise healthy adults who survived SARS-2, but where a CT shows the lung tissue mostly obliterated. Sure, they survive, but running a marathon or going on that diving vacation might be a sudden death sentence for them.
I hope we can get actual studies soon because the anecdata is scary to me. I hope these stories only make news because they are rare not just because it happens to be a celebrity:
60% to 70% refers to an R0 of about 3. But the R0 is more likely to be around 6. That means you need 5/6th of a population to be immune - that's about 80% to 90%.
UPDATE:
"Results show that the doubling time early in the epidemic in Wuhan was 2.3–3.3 days. Assuming a serial interval of 6–9 days, we calculated a median R0 value of 5.7"
"Results show that the doubling time early in the epidemic in Wuhan was 2.3–3.3 days. Assuming a serial interval of 6–9 days, we calculated a median R0 value of 5.7"
There have been several studies that have come up with different numbers. I guess we can calculate some interesting stuff based on the range, but it's a really big range (I've seen somewhere in the range of 1.5 to 7 in various articles/studies).
There is not going to be a vaccine and there is not going to be herd immunity. You can't count on either of those outcomes any more than you can count on there being a vaccine and herd immunity for the common cold.
However you can make it mandatory for anyone with cold/flu symptoms to self-isolate rather than do the manly thing of bring it into an office and work through it. You can also make it so that people have to go into quarantine after international travel. You can also do some testing.
Rabies has been kept outside of the UK for decades by the quarantine approach. Pets can go one way from the UK to the rest of the world quite freely but on the way back they have to be quarantined. With rabies free Ireland an exception can be made.
With this approach we can avoid the indefinite lockdown required until the holy vaccine is found.
I think a vaccine is quite likely to be developed within the next couple years, the virus isn't as complex or difficult as influenza or hiv to target and we have some well defined targets to go after, as well as numerous vaccines already in clinical trials.
Unfortunately herd immunity does not work.
Germany has ~83m pple x 70% = 58m need to be infected for herd immunity
The ages 65+ you want to protect and don't infect ~17m
That reduces the people which naturally get herd immunity to (83m- 17m) x 70% = 46m
How do you want to infect the remaining 12m pple? By force?
If you go by likelyhood of death by age, basically everyone below the age of 45 has to be infected to protect the elderly.
An important issue raised by Karl Lauterbach (health-focussed politician) is that we may have averted a full crisis (for now), but every loosening of the measures will lead to a higher spread of the virus and that directly means more deaths. We should think hard whether we should only focus on free ICU beds.
By what metric will it turn out to be a mistake? I think there are better alternative to the course taken, but a universal, indefinite lockdown is neither appropriate nor feasible. What would you prefer - and again by what standard and which metrics?
If they have to row back completely and be worse off than before it would be a clear mistake. Anything in between is debatable and includes the difficult mix of economy vs. health vs. mental health etc.
It's unrealistic to use RT-PCR testing on the entire U.S. population to derive what is essentially a binary result.
RT-PCR tests are too time consuming, too sensitive, and too reliant on specialized laboratory equipment for that. Right now however, they are all we have to achieve results accurate enough for some form of certification.
Immunoassays are simpler, faster, localized, and less expensive, but may also yield positive results for other coronaviruses such as 229E, NL63, OC43, HKU1, SARS-CoV, and MERS-CoV.
Germany may be isolating potential COVID-19 positives by using immunoassays, then using RT-PCR to be certain. I don't know. But it doesn't mean those "negatives" will always remain so.
Please correct me if I'm wrong, but rt-PCR can only detect active SARS-Cov-2 shedding - meaning active disease, whereas immuno-assays check for the existence of antibodies.
A SARS-Cov-2 naive person will be negative to both; early on, rt-PCR will be positive[0] and immunoassay will be negative; then (if and when the immune system manages to synthesize the right antibodies) they will both be positive; then the virus is eradicated so rt-PCR will go negative, but the immunoassay will stay positive (for a while; unknown yet if for life)
The recent seroprevalence study performed in Santa Clara County [0] [1] used an immunoassay manufactured by Premier BioTech, Minneapolis, MN.
Their page entitled "PCR And Serology Based Testing Explained" does a very good job explaining what we both understand [2].
I stand by my opinion that it is unrealistic to use RT-PCR testing on the entire U.S. population. It is too sensitive and too time-consuming given the time constraints we are under. This Wash Post article (printed by MSN) describes why the CDC had to recall its initial testing kits. [3]
The simple reality is that unless you have a large proportion of your population immune (either due to infection or vaccine) you will NOT be able to reverse the lockdown successfully without seeing a surge in infections and deaths shortly after. So you can test as much as you want, but this whole pandemic started from ONE person in China so as long as there is 1 or 5 or more likely 100s or 1000s of cases in any country then as soon as restrictions are loosened the infection rate will exponentially go up again.
You can play the game of opening/closing schools/shops every couple weeks for about 2 years until everyone either got eventually infected or we might see a vaccine hitting the public. Even if a vaccine might be available at the end of 2020, it won't be available to the public across the globe for yet another year if not longer. That is just simple maths on manufacturing and distribution, anyone who thinks differently is completely dillusional.
So my question remains, what is the end goal with all of the testing? Calling testing as a way out of the lockdown is either a dumb assertion, because more testing won't stop the spread (contact tracing and isolation will only slow the exponential outbreak by days or couple weeks), or it is a lie to give the public false hope.
There is only two ways out:
- Now, by lifting all lockdown restrictions, target, shield and isolate the most vulnerable in our society (old & fragile, people with diabetes, cancer, HIV, etc.), ramp up hospital capacity and let the virus rage through the remaining population, hoping that everyone else will mostly experience mild or no symptoms and only very few people who need hospitalisation and who will die given that the most vulnerable remain in isolation...
or
- stay in lockdown for 24 months at a minimum until there's the capacity to manufacture and supply a vaccine to roughly 60% of the population with a pointless ping pong exercise of easing and tightening the restrictions
I'm honestly not sure which one is better, but there is literally NO OTHER OPTION.
Most of Europe is currently going down the second option and Sweden is mostly leading on the first option. I predict that if in ~ 6 months time countries will see that there's little difference in the death rate between countries with tright restrictinos and those with lax restrictions (because tight restrictions only delay the deaths, but don't prevent) then everyone will change to a more Swedish model probably.
I don't think option 1 as you wrote is is any good. There appear to be strong signs that even with very mild symptoms patients can have significant lung damage, and also damage to other organs.
It is not clear yet how far that will heal. Only time will tell, but from the extend, I've seen discussions that the people affected might be patients for the rest of their lives.
> There appear to be strong signs that even with very mild symptoms patients can have significant lung damage, and also damage to other organs.
This is completely contradictory. You should stop reading fake news or social media reports, because this is where some utter stupid statements like this come from. COVID-19 is a novel coronavirus, but it's not a novel virus. It is a coronavirus, which means that that we know that it is a respiratory virus like other viruses. It doesn't attack organs like so many dumb people claim. It attacks your respiratory tract, which also includes your lungs. That itself is harmless in most people as their immune system will quickly produce anti bodies and then erradicate the virus from your body. In some cases the virus multiplies faster than the immune response, which means the lungs get heavily inflamed and your body starts to get less oxygen than needed. This is the reason why organs fail, because of a lack of oxygen. If one person was infected with mild symptoms and then has been cleared of the virus (~ 7 days later, and I was one of these people myself) then the virus is gone from your body and there's no way to magically all of a sudden get any long term damages to anything if you don't have them to begin with. It's not like your organs start out of nowhere to just stop working. Also before you even get to that point you are so severly ill that you need a ventialtor to breath, so it's not like you can get a damage to an organ out of nowhere without noticing it.
> I've seen discussions that the people affected might be patients for the rest of their lives.
If they fully recovered then this is not possible. If they were extremley severely ill and lack of oxygen damanged some organs then yes maybe but that is not the case for 99% of people.
> This is completely contradictory. You should stop reading fake news or social media reports, because this is where some utter stupid statements like this come from.
It depends what exactly 'mild' means I guess.
I might not have worded it well (not my first language etc). Just to be sure I went to the most reliable sources available (not just standard news - it's in German though, they cite a lot of papers if anyone is interested, but most are for SARS-CoV-1, 45-48 specifically talk about long-term damages) and I still stand by my statement, though the phrasing I chose make it appear more drastic than I meant it.
If everyone gets it and a few percent of the population get lasting damage (which from a quick paper survey does not seem totally unrealistic), is that acceptable?
You really need to educate yourself a bit on basics, so that you don't believe every stupid news report. Remember, since the lockdown news papers have nothing else to report on except coronavirus. They must find something new newsworthy every day and therefore a lot of utter shit gets printed.
1. The news article which you originally posted is a summary of the message which the doctor gave in a scubadiving magazine. In that magazine the message is less sensationalist.
2. Not every COVID-19 infection ends up affecting your lungs. COVID-19 in particular starts in your throat (which is why many report a sore throat to begin with). Once it is in your throat the virus multiplies and will eventually penetrate your lungs. However, if you are fit and healthy then normally your body will react quickly and start fighting the virus. In my case I had really high fever for 2 days and on day 3 and after I was getting significantly better. My immune system was able to fight the virus before it even got to my lungs. I had a sore throat, high fever, didn't taste my food, had a cough, fatigue, but I didn't have shortness of breath. If the virus never enters your lungs it can't damage them.
3. Even if the virus enters your lungs it doesn't mean anything yet. It really depends how strong your immune system is in reacting to the virus. If it takes 7-10 days like with old or weakend people then your lungs might get severly infected before your body starts to fight it off, however when you're healthy then you might fight it off before you get a bad lung infection.
4. A lung infection is not unique to COVID-19. It doesn't matter what causes your lung infection, once you have it the symptoms and possible outcomes are the same. Doesn't matter if bronchitis, a flu, a bad cold or COVID-19 caused you to get a lung infection or pneumonia. Anyways, with some medical support even those people will get over it in most cases. However, it is VERY COMMON to have many weeks after a lung infection still some leftover symptoms. Some patients have a cough for two months after a bad cold or flu. It is common that there will still be traces visible in a lung scan many weeks after, but almost all these cases eventually clear up. An inflamation means that tissue has gone sore. Your body fights off the virus, but your tissue takes longer to recover from the soreness. That is normal and it's not unique to COVID-19. EXACTLY the same would happen after a flu or cold.
Hope these facts make it a lot clearer, because the amount of false information spread via social media and some low key fake news websites is astonishing and really harmful.
> there's no way to magically all of a sudden get any long term damages to anything if you don't have them to begin with
Based on what exactly can you claim that?
It's surely not how every non-latent virus works. Every non-latent virus actually destroys whatever cells it enters. (1) (2) If your immune system stop its spread in your body, it still doesn't mean that exactly that virus hasn't permanently destroyed some of your tissues before the immune system had the time to stop the actions of the virus.
> This is completely contradictory. You should stop reading fake news or social media reports
The report he linked was Italian state media (quoting Austrian doctors). Not exactly well known for "fake news". The report is anecdotal, for sure, but still no reason to call a respected European news outfit "fake news" or "social media".
Yes it was printed in some low key European online news, but the original article was a scubadiving magazine where this Austrian scubadiving doctor was just giving some commentary. Even Austria's newspaper "derstandard.at" saw criticism over printing an overly sensationalist summary of that scubadiving commentary by the doctor and everything the doctor has said is completely normal to see in pneumonia patients as well, because sore tissue (which is what an inflamation in your lungs is) takes longer to heal than getting rid of the virus itself, but just like any wound it heals.
If there was ANY significance to this and this wasn't just an out of context over sensationalist news article to get people scared then it would be all over the big news.
It is really really scary how many supposedly intelligent people on HN are falling for so much shit. No wonder the world is what it is when the majority of people are so incapable of critical thinking and making their own educated opinion rather than repeating every shit they are being fed by someone who wants you to believe something different every day.
See, regarding the issue at hand, you are most probably right. It is anecdotal as I already said, and especially, simply far too early to judge "permanent" damage. Even with Sars 1, while there are minor lasting damages reported to the lungs in some cases, those seem to heal over time.
The only thing I object to is the aggressiveness with which you bash a concerned person for reading an article on a well respected news site. Telling people they "should stop reading fake news or social media reports" was entirely inappropriate.
I’m no expert, but this is close to my assessment of the situation.
One hope is that you open up a bit, and keep R0 low enough so that over 18 months it doesn’t kill many people. Just have to keep R0 as close to 1 as you can. After some practice treating it as a control system, you could get quite good at it. This is where testing would fit it - feedback into your controller (which would be public policy).
More generally it seems to me that historically herd immunity has always been the way out. By that argument, only something truly novel will help - only example I can think of is exploiting smartphones somehow to do contact tracing. That doesn’t mean it will work, just that it’s the only thing I can think of that hasn’t been tried before in this situation.
If our assessment is correct, then China’s situation seems to be miraculous... either it’s a matter of time before we’re proven correct, or contact tracing + authoritarian state is enough. And then the question is, can that work in democratic countries?
Option 2 is totally unrealistic, to be honest. I commend you if you find a way to keep people locked up for 24 months, without economic, social and mental health repercussions. I'm going insane for "just" close to 50 days.
I vote for option 3: drug development and usage. The first wave of results (many, I expect, won't be stellar, but that's what often happens) on repurposed drugs will arrive in a couple months. Afterwards, there will be the new agents in study (more targeted to SARS-CoV-2 or the adverse clinical effects).
Biocentury lists more than 200 molecules among vaccines and therapeutics in study at this point. If we have to bet short term, instead of locking down, it's the drugs we need to place our bet on.
This is my biggest concern. These current stay-at-home orders (like California's) are very unsustainable and can only last so long. Unemployment is already well into double digits and government spending will outpace tax revenue way too quickly. Then what?
We know the virus will not be suppressed as SARS or MERS were; this coronavirus is basically everywhere and spreading. I can't see how mitigation isn't the only option after a month or two. From the very beginning the whole point of social distancing has been to flatten the curve so hospitals can operate effectively.
On the other hand, having tests so widely available that groups (probably VIP groups to begin with, pending greater availability) can all get tested before banding together to do business would be beneficial. For example, I wonder if the motion picture industry will do this for film shoots, where basically a skeleton crew all gets together for a camp and have no contact beyond each other for the during of work.
According to a diagram [1] of the Robert Koch Institute the effective reproduction number was already down to 1 two days before the measurements of March 23. It also didn't go down further in this diagram.
I looked into that a bit. Basically everyone was already self-quarantining.
I looked at mobility on sundays (because that isolates it to the private lockdown as ordered on the 23rd and excludes school, shops and work quite a bit):
Stop testing individuals and start testing populations. That's the only way to know what is happening. That is the only way to start controlling the epidemic instead of just guessing.
161 comments
[ 2.6 ms ] story [ 186 ms ] threadGermany is a democracy, so it ultimately comes down to the quality of the leadership decisions made by the populace.
This is not entirely true. Democracy is a broad term and different democracies work very differently.
In Germany for example political parties are quite powerful, politicians have to be elected by party members, there are no primaries like in the US. Being a politician in parliament or becoming chancellor in Germany requires a political career that takes quite some time.
This excludes people in ways that are both good and bad. On the good side someone like Trump would have no chance at all because he lacks the political track record and relationships. On the bad side politicians in Germany are not a very diverse group. There is a strong bias towards older people, people who've been in politics for their entire life and people in professions that allow for spending time as a politician in parliament for a couple of years and continuing in their regular job afterwards. In practice this means teachers and lawyers, at least in Germany.
I agree about the point with teachers and lawyers being predominant. Although it seems that worldwide politics is mainly run by lawyers which is a bad thing in my view.
My experience on new information summed up by the vid in my profile. I still find it astonishing.
https://twitter.com/BenjAlvarez1/status/1250563198081740800
Night and day when compared with the grandstanding and gaslighting that we're seeing from Trump.
It's what burnt me about the Marc Andreessen article that generated a lot of discussion on HN yesterday and opened with this premise:
Many of us would like to pin the cause on one political party or another, on one government or another. But the harsh reality is that it all failed — no Western country, or state, or city was prepared — and despite hard work and often extraordinary sacrifice by many people within these institutions. So the problem runs deeper than your favorite political opponent or your home nation.
The assumption that a Clinton, Kasich, or Obama administration would not have managed this more competently is stupefying. We can just look at how H1N1 was handled by Obama in 2009:
https://www.snopes.com/fact-check/obama-wait-swine-flu-n1h1/
And here we have clear evidence of a Western country whose response to the present crisis has not been failure (ignoring all together South Korea, where the response appears to have been even more successful).
How are we going to make radical systemic changes in society when we pretend like the people in charge make no difference?
He's good at marketing. Sadly he didn't put these skills to good use in the current crisis so far. Virology isn't his strongest suit. He performed a worse show than usual since it is not just about boasting about himself and branding other people with hilarious nicknames.
but he’s most certainly not good at any other aspect of marketing (product, price, distribution, etc.), which is why he’s terrible at business and why he’s been losing credibility to state leaders.
False, it's a diplom in chemistry.
[0] https://en.wikipedia.org/wiki/Angela_Merkel#Education_and_sc... [1] https://en.wikipedia.org/wiki/Dr._rer._nat.
Germany gave away many hundreds of respirators, took in hundreds of patients from all neighboring countries (including Italy). Italy was offered money under the ESM which they didn't want. All while high ranking officials from Italy called Germans Nazis multiple times. All that although the Italian population has a higher median wealth, lower taxes, higher rate of home ownership and lower retirement age.
And we're still the bad guys.
I think that the big issue that was exposed was not lack of centralization but too much of it with the wrong organizations. A nation of 330 odd million is much harder to govern especially in a centralized manner.
an additional question I have is what do you think has been so awful about the United States response? From a pure numbers perspective I feel like the US isn't really doing badly from a per capita basis.
Nobody has run out of ventilators yet. Infection rates are below the 95% confidence interval of the original models. Just curious as to your perspective. Do you think that these numbers are due to bad models and luck or due to the fact that the population has largely adhered to social distancing?
The US now is catching up fairly well as the country started playing on its strengths, such as the extremely strong industrial base, financial power and, for better or worse, international leverage.
Regarding the more centralized system, it has advantages and disadvantages. The advantage of Germany's central coordination is that it made generally good decisions from the get go, so the country was able to move quicker. The US had a confused central response and the states were able to implement local fixes that prevented the entire system from falling apart.
So I think the US model has the advantage of offering a second layer of defense from poor central planning, which perhaps wouldn't be as easy in Germany (I'm speculating here, I don't know much about Germany democratic guards against bad central decisions).
> Forced to suspend the launch of a nationwide detection program for the coronavirus for a month, the C.D.C. lost credibility as the nation’s leading public health agency and the country lost ground in ways that continue to haunt grieving families, the sick and the worried well from one state to the next.
https://www.nytimes.com/2020/04/18/health/cdc-coronavirus-la...
Why base your opinion on a second order result rather than first hand outcomes? If we had not tested at all, and still had this _drastically better than predicted_ result, might you still be unhappy about it?
And the NYT... They are not just a news orginization. Still run by the BBC's Mark Thompson I see.
https://imgur.com/VUdcIou
https://pbs.twimg.com/media/CIMxvS-WEAER49I.png
https://pbs.twimg.com/media/CINJUoqUwAEkSip.jpg
This was a problem in Germany as well. End of January, the German minister of health still said that Corona is not as bad as the yearly Influenza.
> until relatively late in the process, and our testing ramp up was also very slow.
Ramping up testing was also very slow in the beginning and highly chaotic.
A key difference though is that most of German healthcare is public; there are very few private clinics and those play no major role in the pandemic response.
Insurance is mandatory but cheap (and independent of employment). Healthcare is accessible no matter your budget and maybe in the pandemic nearly as important, everyone has the right to sick leave. You get s doctor's certificate and can stay home for a week or two or three, if needed. You also won't be fired for it as labour protections are strong.
I always joke about the love-hate relationship between Italy and Germany (Italy and Germany in the broader sense, not only the actual countries) saying that this feeling has been here since the times of general Stilicho [https://en.wikipedia.org/wiki/Stilicho].
Slightly off-topic, but you want to write "General" with a capital G in this case because you're referring to a concrete general. I had trouble parsing your sentence because I took "general" to be an adjective.
As a Berliner, I've had the chance to see the German response from the frontlines. I've never seen such socially responsible citizens. Every once in a while my friends and family from US/UK/Asia etc call and ask me what's the secret of Germany's success. The response from German govt. was perfect in such situation, you can't help others without securing your position.
OTOH the help was a bit lackluster, especially at the beginning. I’m not sure about the “hundreds” of patients —- it’s probably closer to 100 than it is to 1,000 especially when only considering Italian patients. In any case it’s fairly symbolic considering the scale of this in Italy.
The cause of all this was probably bad timing more than any unwillingness to help. As Italy was most in need, cases in Germany were also growing explosively. There was probably just too much going on, and too much uncertainty to easily part with resources that might be needed rather soon.
Also in the case of the ESM I guess you are accurate that they were offered money that they didn't want, but you didn't note why they didn't want it, which I guess is probably important https://www.reuters.com/article/us-health-coronavirus-italy-...
Yet, if you take the 2017 budget [1] for example, nearly half of the net contributions (excluding the UK) were paid by Germany.
[1] https://www.bbc.com/news/uk-politics-48256318
You can't have a workable monetary union without a fiscal union. Germany wouldn't have such a big surplus if its exports weren't massively boosted by the southern states depressing the exchange rate of the Euro. Unions require unity, and if Germany feels like its pulling more than its own weight, it can exit. But you see exactly the opposite, Germany (at least nominally) states that its goal is to preserve the union, and this betrays the fact that the union brings massive advantages for the German economy. It is not out of a sense of benevolence and european solidarity, but of pure self-interest.
Well, if Germany and the North want the union to survive, they will have to treat it like a real partnership and respect and recognize the contribution of their other partners.
The current "solution" of bailing out Italy and Spain with even more debt on the condition of further future austerity will only lead to further instability, unemployment, discontent and financial ruin when the debts come due.
It is not a question of "solidarity" with the South. It is a question of whether the North recognizes the contribution of its partners to the union, and whether they can act in mutual self-interest to save it.
In a monetary union, the regions running a surplus enjoy a massive boost due the exchange rates being depressed by the regions running a deficit, while the industries of the deficit regions struggle to catch up, hampered by the lack of natural corrective forces of a floating exchange rate. If a monetary union has to work, the deficit regions have to be fiscally supported by the surpluses generated elsewhere, or they just spiral further and further into debt, unemployment and industrial collapse.
$1 now buys you a mere €0.92
https://blogs.imf.org/2018/02/21/the-euro-area-needs-a-fisca...
I assume you mean ventilators since it would be fairly insulting otherwise, especially when considering Germany's knee-jerk reactions to the initial outbreak in Italy.
The ESM has historically some bad reputation in my country, mainly in relation to Greece (I'm aware the ESM did not exist at the time, but most of the comparisons are drawn to that in our media). The government did not want it, or so they said, but in the end signed the agreement anyway (although I don't know if they'll ask for the money or not).
> All while high ranking officials from Italy called Germans Nazis multiple times
There has never been a serious discussion in Germany about its failed post-WW2 denazification programme, history got in the way. Just yesterday I was on the wikipedia page of the first commander of the Gestapo, a certain Rudolf Diels, only to learn that immediately after WW2 he led quite a peaceful life, perfectly integrated in the German state institutions:
> After 1950 he served in the post-war government of Lower Saxony[3] and then in the Ministry of the Interior, until his retirement in 1953.
Like, what the hell?
Even on the economy side you've still got BASF and Bayer happily doing business of hundreds of billions each year, while suffering almost no economic repercussions as a result of their role in WW2.
One of the few Germans from the public sphere that I know of and who really wanted to confront this problem head on was Heinrich Böll.
[1] https://en.wikipedia.org/wiki/Rudolf_Diels
[2] https://en.wikipedia.org/wiki/Heinrich_B%C3%B6ll
I am quite skeptical as to „never“. The example you give is an infuriating one and there are too many of those. But that there has been no discussion about de-nazification is simply not true. In academia the topic definitely has been dealt with. See for example this article by the Centre for political education [0] which I consider an example of making this available to the public.
Also these efforts didn’t happen in a vacuum, Europe and Germany was in ruins, the allies wanted to wrap them up as well. Ironically the Sowjets were more drastic than the Western allies with their efforts, and we’ve ended up with a second totalitarian regime in Eastern Germany. They’ve even re-used the concentration camps.
Anyhow. I remember talking about this in school and critically discussing the History of Germany in the last century. We must not forget, we must not repeat.
[0]: https://m.bpb.de/geschichte/nationalsozialismus/dossier-nati...
These questions are unanswered AFAIK so I am curious as to what the Germans are actually learning.
Also, when you currently have no knowledge, even potentially inaccurate guesses are a big upgrade...
Without knowing the specificity and sensitivity of this specific test you can’t say any “inaccurate guesses” based on it is an upgrade.
Say the test has really poor sensitivity but 100% specificity then sure it might not identify a lot of past infections but it won’t produce false positives so which ever figures come out you can extrapolate of them fairly easily.
If it has terrible specificity then it’s a whole other problem unless you have additional tests that have high specificity that you can use to exclude false positives.
Most of the big decisions governments have to make depend on only aggregate statistics after all...
The current AB tests were found to be insufficient.
Take Lombardy, hardest hit region in Europe. 1130 deaths / million, or about 0.1% death rate. All German states are under 100 deaths per million, which is less than 0.01% death rate. Sanity check: Bayern, 1.2k deaths/13M people ~ 0.01%.
Of course, this is a lower bound estimate assuming all people in a given region have got through the disease. Which is definitely not true. To figure out how bad is going to get we need the total number of infected people. Hopefully the random testing strategy will shed some light on that number. But at least we start [much] lower than 0.3%.
https://covid19.quersive.com/chart?c=M&e=IT-Lombardy&e=DE-BW...
And how about being tested negative, and a few weeks later being tested positive? I suppose that would improve the accuracy.
Most countries are only testing people who arrive at hospital with serious conditions (and billionaires and nba players!?). That's pointless because the treatment is the same whether they have COVID-19 or some other respiratory infection.
If we tested populations and did so regularly, you would know whether lockdown was working, whether you could afford to partly lift it and how and when to reinstate it.
Right now, we are all sitting at home with no idea if this is working or not. In a few weeks, we will start roping thing with no idea whether that is a good idea or not. We'll just guess.
I bet in 2 weeks (I hope it's not even more delay) they will notice that (partially) opening schools and shops was a mistake and will have to row back. I just hope they will be as lucky as with the initial curve-flattening.
Germany has flattened the curve, but that still means they are roughly on it's summit. There are still more infected than ever and every misstep might be costly.
Here are the different regions, just recovered/dead are not included in the graph I think: https://preview.redd.it/x7g0xnlblds41.png?width=894&format=p...
Generally it peaked at 70k infected and is back at 50k https://studylib.net/coronavirus#country-de
Schools are certainly a risky gamble, but their closing is also among the most expensive measures. Many people are staying at home because they have no options for their children, including many doctors and nurses.
For now they seem to aim at R = 1, which means waiting for the vaccine with whatever is possible to keep it at 1. (Probably not much more than barbers and very few school classes.)
those "oops" are painful suffering deaths that could have been avoided
everything has been reduced to numbers we mindlessly argue when we are talking about deaths that could have been avoided
even people who recover, this does long term lung and maybe heart damage
all could have been avoided with a true two week lockdown to let the virus die off, but nope, trade two weeks for months more of "resurgence and adjust measures"
https://www.independent.co.uk/news/world/americas/coronaviru...
this is also why I get upset at "just let everyone get infected for herd immunity" arguments - this isn't a cold, it does -damage-
> even people who recover, this does long term lung and maybe heart damage
The problematic ACE2 receptor sites are also in the brain, intestines and liver and have seen damage. The brain one is the most alarming one from a survival perspective. We survive, but with irreparable permanent brain damage. We're no longer ourselves, we have a different personality, and we are incapable of doing our previous jobs. Is death preferable?
What is mindless is refusing to consider any action that might conceivably increase the number of deaths without considering tradeoffs. Or should we shut down the country during every flu season and universally limit cars to 20mph?
this isn't a cold, it does -damage-
Lockdowns also do damage; not just economic and psychological but also medical. We've stopped "elective" procedures like cancer screenings, which is guaranteed to result in worse outcomes for some patients. I agree that as of right now it's best to maintain the lockdown, but in order to make that determination we really do have to use numbers.
Loosening the lockdown, and being prepared to row back, will achieve that if done carefully, while at the same time getting the economy slowly back to normal.
And that probably are a lot more people are already infected without symptoms will help with that.
Trying to somehow contain the infection won't work, because it will just get carried in from the outside again, eventually.
The herd immunity is not really something that you do but more of an unavoidable side effect. I'm not sure that we have much of a choice now that we are well beyond the point of containment.
Beware when they start calling you [say] a consumer.
That said, I think you're right to be skeptical of the "let everyone get it and we'll have natural herd immunity" idea.
I don't see what is gained by making armchair proclamations as if you know something the rest of us don't. You don't even seem to know what you don't know.
https://www.worldometers.info/coronavirus/
So saying there is "no basis" is a bit rich. There may still be uncertainty.
Edit: this (just googled) article cites Diamong Princess to lead to an estimate of 0.5% death rate https://www.sciencenews.org/article/coronavirus-outbreak-dia... (the percentage of deaths on the DP was higher, but the passengers were also comparatively old on average).
Edit 2: lol for the downvote. What the fuck?
Edit 3: about the study in Germany https://www.theblaze.com/news/german-study-shows-coronavirus... (don't know "The Blaze", but if you care, you can google for better sources - google for "Streeck").
Edit 4: Theodore Roosevelt carrier https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_on_U...
In the most charitable reading, you could view them akin to the CDC and masks, trying to keep the public slightly misinformed for the greater good (preserve mask supplies for hospitals). In the least charitable reading, there are a lot of depressed and angry people on the internet, who want to believe that this disease is truly civilization-ending, and attack any opposing narrative.
Either way, I would not take it personally, or as a judgement on your actual quoted facts.
For the introverted tech worker that prefers to work from home, the quarantine hasn't really negatively impacted their routine that much, and it might have actually lifted any peer pressure to go out and socialize with friends/co-workers/family.
For someone in that situation, there's not much of a benefit to advocate for reopening, and the deadlier the virus seems, the longer the lockdown will continue.
While I personally am comfortable working from home and my company is doing well, I'm sad that I couldn't visit my parents and my grandmother for Easter. And it particularly frustrates me that my grandmother has to sit at home and practice social distancing, where she cannot do anything much besides sitting in her chair and watching TV all day. (She doesn't have or want a smart device, and her chronic back pain keeps her from engaging in most other home activities.) And that's before I consider the people around me whose lifelihoods have been impacted or obliterated by the shutdown, or the essential workers who often have to work without adequate PPE.
That's not to say people here are selfish, only that it's easier to advocate for safety when you yourself are in a position of relative stability.
Even if absolutely 0 of the pending cases turn into deaths, and the true percentage of cases that are undetected is the full 50% that has been mentioned recently, that still puts us well above 3%.
Arithmetic: 7 in 100 right now. Add 0 to deaths, resolve all open cases and discover double the known case count: 7 in 200, 3.5%
---
For the surveys you mentioned. The Roosevelt still has active cases. The Princess likewise did at the time that article was written. You're citing that 0.5% figure incorrectly: that's a projection from the Diamond Princess onto China. I found a different source for the German survey -- that link isn't working for some reason. The same applies there.
Most importantly, these surveys are not representative of the global population. See above.
The recent results that have shown 50% asymptomatic cases are not conclusive yet, because it's too soon to say that all of those people will never have symptoms.
I would be ecstatic if I was wrong; I would love it if the upper estimate for asymptomatic cases was correct, and we had far fewer deaths than anyone's expecting. But it's just not in the numbers right now.
No. You can not simply calculate the death rate by dividing known deaths by known cases. Those numbers depend on who got tested and on how deaths are being counted, which also varies greatly from country to country. For starters, people who have severe symptoms are more likely to show up at hospitals and get tested. That introduces a huge bias already.
"You're citing that 0.5% figure incorrectly"
No I didn't, read what I wrote. And ALL numbers are projections. Even your calculation is a projection. Your calculation is an extraordinarily simplistic projection. Scientists hopefully make better projections, because they account for more influencing factors.
"The recent results that have shown 50% asymptomatic cases are not conclusive yet, because it's too soon to say that all of those people will never have symptoms"
What makes you so sure? It seems possible to make an estimate of when somebody got infected, especially in those studies of closed communities. After two weeks or so (scientists would determine a more prices number), it would be reasonable to assume they won't develop symptoms.
> About 1,000 people participated in the study by way of questionnaires, throat swabs, and blood tests to detect the presence of COVID-19 antibodies. These interim results are based on data from about 500 people.
So only a sample size of 500 plus not accounting for other local factors there, like being a small village.
Not really, actually. At least I haven't seen a number of "people who died because they couldn't receive care" - do you have one? It seems possible that once health care systems are overwhelmed, more people die. But how often, if ever in this pandemic, has that point been reached? I don't think that often - there is no good treatment anyway.
"only a sample size of 500"
It's science. 500 can be a lot, or few. It was a sound and thorough study by acknowledged scientists.
No, that's impossible to provide between people dying at home because hospitals are full and the general chaos of those situations. And then there's the big difference between quality of care in various countries, death rates of just about everything will be much higher in Mozambique than they will be in Sweden, it's nonsensical to think that quality of medical care will not have an effect.
> It seems possible that once health care systems are overwhelmed, more people die. But how often, if ever in this pandemic, has that point been reached?
Many times in many countries, look at the national totals somewhere like here (https://covid19info.live/), the trend is nearly always that more cases at once translate to much higher death rates. Partly due to not knowing the true number of infections, but mostly due to the availability of medical care.
That's another claim you make, that you should be able to support. Have people been denied hospital care and therefore died at home?
"the trend is nearly always that more cases at once translate to much higher death rates"
Could have any number of explanations, like maybe infected old people homes.
"it's nonsensical to think that quality of medical care will not have an effect."
Again - are there cases of people dying because they couldn't receive care in the US, and how many?
"but mostly due to the availability of medical care."
Again, can you give any examples of people dying because they couldn't receive care? Especially in the US. And show that it is a significant number of people?
The question then is how to get as many people as possible immune - you'll either need a vaccine or many need to get the infection and survive. A vaccine is not on the horizon for another 6-12 months, so the best course of action is to build the number of survivors.
What brings death? Mainly the sudden onslaught on the health system. If there is no bed, respirator, blood supply, ... Left then you're much more likely to have patients die than if you have a hospital at regular capacity. There are some that WILL for but by slowly building immunity (i.e. allowing some parts of the population to get exposed) you avoid the high death toll of an unmanaged outbreak.
So if total eradication is impossible, slow infection rates are better than none. Why? Because if you don't build the immunity you will again have violent outbreaks killing many. And you simply can't lock everyone at home for another 6 months.
Most of the people who go on respirators die. If the health system is going to be our weapon here until the vaccine is developed, we need to find ways to manage the disease before it gets to the point where we intubate people. Remdesivir might be that drug, but we're unlikely to have the kind of supply needed for what you propose until after the first vaccines potentially may be available.
If the virus had certain death rates and longer periods where it remained dormant. We would have to make choices to eradicate that. We're in a different situation where we have different choices and outcomes.
Maybe it's less if you can get more aggressive with more immunity, but even if I'm wrong by a factor of 10 it's still years and the vaccine is the more realistic bet.
Estimates make sense, especially if they proof your point even if you are off by a factor of 10.
Another way is to separate young people from old people more effectively. Then you might be able to permit 1m young people to be infected each month with the same hospital budget we have today
https://www.nbcnewyork.com/entertainment/entertainment-news/...
UPDATE:
"Results show that the doubling time early in the epidemic in Wuhan was 2.3–3.3 days. Assuming a serial interval of 6–9 days, we calculated a median R0 value of 5.7"
https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article
A herd immunity strategy involving fast immunization by continuing business as usual would then involve an R0 > 5.
https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article
A herd immunity strategy involving fast immunization by continuing business as usual would then involve an R0 > 5.
However you can make it mandatory for anyone with cold/flu symptoms to self-isolate rather than do the manly thing of bring it into an office and work through it. You can also make it so that people have to go into quarantine after international travel. You can also do some testing.
Rabies has been kept outside of the UK for decades by the quarantine approach. Pets can go one way from the UK to the rest of the world quite freely but on the way back they have to be quarantined. With rabies free Ireland an exception can be made.
With this approach we can avoid the indefinite lockdown required until the holy vaccine is found.
How do you want to infect the remaining 12m pple? By force? If you go by likelyhood of death by age, basically everyone below the age of 45 has to be infected to protect the elderly.
RT-PCR tests are too time consuming, too sensitive, and too reliant on specialized laboratory equipment for that. Right now however, they are all we have to achieve results accurate enough for some form of certification.
Immunoassays are simpler, faster, localized, and less expensive, but may also yield positive results for other coronaviruses such as 229E, NL63, OC43, HKU1, SARS-CoV, and MERS-CoV.
Germany may be isolating potential COVID-19 positives by using immunoassays, then using RT-PCR to be certain. I don't know. But it doesn't mean those "negatives" will always remain so.
A SARS-Cov-2 naive person will be negative to both; early on, rt-PCR will be positive[0] and immunoassay will be negative; then (if and when the immune system manages to synthesize the right antibodies) they will both be positive; then the virus is eradicated so rt-PCR will go negative, but the immunoassay will stay positive (for a while; unknown yet if for life)
[0] Assuming perfect accuracy and specificity.
The recent seroprevalence study performed in Santa Clara County [0] [1] used an immunoassay manufactured by Premier BioTech, Minneapolis, MN.
Their page entitled "PCR And Serology Based Testing Explained" does a very good job explaining what we both understand [2].
I stand by my opinion that it is unrealistic to use RT-PCR testing on the entire U.S. population. It is too sensitive and too time-consuming given the time constraints we are under. This Wash Post article (printed by MSN) describes why the CDC had to recall its initial testing kits. [3]
[0] https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v... [1] https://news.ycombinator.com/item?id=22899272 [2] https://premierbiotech.com/innovation/pcr-and-serology-based... [3] https://www.msn.com/en-us/news/us/contamination-at-cdc-lab-d...
The simple reality is that unless you have a large proportion of your population immune (either due to infection or vaccine) you will NOT be able to reverse the lockdown successfully without seeing a surge in infections and deaths shortly after. So you can test as much as you want, but this whole pandemic started from ONE person in China so as long as there is 1 or 5 or more likely 100s or 1000s of cases in any country then as soon as restrictions are loosened the infection rate will exponentially go up again.
You can play the game of opening/closing schools/shops every couple weeks for about 2 years until everyone either got eventually infected or we might see a vaccine hitting the public. Even if a vaccine might be available at the end of 2020, it won't be available to the public across the globe for yet another year if not longer. That is just simple maths on manufacturing and distribution, anyone who thinks differently is completely dillusional.
So my question remains, what is the end goal with all of the testing? Calling testing as a way out of the lockdown is either a dumb assertion, because more testing won't stop the spread (contact tracing and isolation will only slow the exponential outbreak by days or couple weeks), or it is a lie to give the public false hope.
There is only two ways out:
- Now, by lifting all lockdown restrictions, target, shield and isolate the most vulnerable in our society (old & fragile, people with diabetes, cancer, HIV, etc.), ramp up hospital capacity and let the virus rage through the remaining population, hoping that everyone else will mostly experience mild or no symptoms and only very few people who need hospitalisation and who will die given that the most vulnerable remain in isolation...
or
- stay in lockdown for 24 months at a minimum until there's the capacity to manufacture and supply a vaccine to roughly 60% of the population with a pointless ping pong exercise of easing and tightening the restrictions
I'm honestly not sure which one is better, but there is literally NO OTHER OPTION.
Most of Europe is currently going down the second option and Sweden is mostly leading on the first option. I predict that if in ~ 6 months time countries will see that there's little difference in the death rate between countries with tright restrictinos and those with lax restrictions (because tight restrictions only delay the deaths, but don't prevent) then everyone will change to a more Swedish model probably.
Only time will tell the truth.
It is not clear yet how far that will heal. Only time will tell, but from the extend, I've seen discussions that the people affected might be patients for the rest of their lives.
(eg. https://www.rainews.it/tgr/tagesschau/articoli/2020/04/tag-C... in German)
This is completely contradictory. You should stop reading fake news or social media reports, because this is where some utter stupid statements like this come from. COVID-19 is a novel coronavirus, but it's not a novel virus. It is a coronavirus, which means that that we know that it is a respiratory virus like other viruses. It doesn't attack organs like so many dumb people claim. It attacks your respiratory tract, which also includes your lungs. That itself is harmless in most people as their immune system will quickly produce anti bodies and then erradicate the virus from your body. In some cases the virus multiplies faster than the immune response, which means the lungs get heavily inflamed and your body starts to get less oxygen than needed. This is the reason why organs fail, because of a lack of oxygen. If one person was infected with mild symptoms and then has been cleared of the virus (~ 7 days later, and I was one of these people myself) then the virus is gone from your body and there's no way to magically all of a sudden get any long term damages to anything if you don't have them to begin with. It's not like your organs start out of nowhere to just stop working. Also before you even get to that point you are so severly ill that you need a ventialtor to breath, so it's not like you can get a damage to an organ out of nowhere without noticing it.
> I've seen discussions that the people affected might be patients for the rest of their lives.
If they fully recovered then this is not possible. If they were extremley severely ill and lack of oxygen damanged some organs then yes maybe but that is not the case for 99% of people.
It depends what exactly 'mild' means I guess. I might not have worded it well (not my first language etc). Just to be sure I went to the most reliable sources available (not just standard news - it's in German though, they cite a lot of papers if anyone is interested, but most are for SARS-CoV-1, 45-48 specifically talk about long-term damages) and I still stand by my statement, though the phrasing I chose make it appear more drastic than I meant it.
If everyone gets it and a few percent of the population get lasting damage (which from a quick paper survey does not seem totally unrealistic), is that acceptable?
(https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...)
(eg https://onlinelibrary.wiley.com/doi/full/10.1111/j.1440-1843...)
1. The news article which you originally posted is a summary of the message which the doctor gave in a scubadiving magazine. In that magazine the message is less sensationalist.
2. Not every COVID-19 infection ends up affecting your lungs. COVID-19 in particular starts in your throat (which is why many report a sore throat to begin with). Once it is in your throat the virus multiplies and will eventually penetrate your lungs. However, if you are fit and healthy then normally your body will react quickly and start fighting the virus. In my case I had really high fever for 2 days and on day 3 and after I was getting significantly better. My immune system was able to fight the virus before it even got to my lungs. I had a sore throat, high fever, didn't taste my food, had a cough, fatigue, but I didn't have shortness of breath. If the virus never enters your lungs it can't damage them.
3. Even if the virus enters your lungs it doesn't mean anything yet. It really depends how strong your immune system is in reacting to the virus. If it takes 7-10 days like with old or weakend people then your lungs might get severly infected before your body starts to fight it off, however when you're healthy then you might fight it off before you get a bad lung infection.
4. A lung infection is not unique to COVID-19. It doesn't matter what causes your lung infection, once you have it the symptoms and possible outcomes are the same. Doesn't matter if bronchitis, a flu, a bad cold or COVID-19 caused you to get a lung infection or pneumonia. Anyways, with some medical support even those people will get over it in most cases. However, it is VERY COMMON to have many weeks after a lung infection still some leftover symptoms. Some patients have a cough for two months after a bad cold or flu. It is common that there will still be traces visible in a lung scan many weeks after, but almost all these cases eventually clear up. An inflamation means that tissue has gone sore. Your body fights off the virus, but your tissue takes longer to recover from the soreness. That is normal and it's not unique to COVID-19. EXACTLY the same would happen after a flu or cold.
Hope these facts make it a lot clearer, because the amount of false information spread via social media and some low key fake news websites is astonishing and really harmful.
Based on what exactly can you claim that?
It's surely not how every non-latent virus works. Every non-latent virus actually destroys whatever cells it enters. (1) (2) If your immune system stop its spread in your body, it still doesn't mean that exactly that virus hasn't permanently destroyed some of your tissues before the immune system had the time to stop the actions of the virus.
1) https://science.howstuffworks.com/life/cellular-microscopic/...
2) https://en.wikipedia.org/wiki/Cytopathic_effect
There are also many observations of SARS-CoV-2 destructiveness of various tissues, not only lungs:
https://www.sciencemag.org/news/2020/04/how-does-coronavirus...
The same article was also on HN: https://news.ycombinator.com/item?id=22915660
The report he linked was Italian state media (quoting Austrian doctors). Not exactly well known for "fake news". The report is anecdotal, for sure, but still no reason to call a respected European news outfit "fake news" or "social media".
If there was ANY significance to this and this wasn't just an out of context over sensationalist news article to get people scared then it would be all over the big news.
It is really really scary how many supposedly intelligent people on HN are falling for so much shit. No wonder the world is what it is when the majority of people are so incapable of critical thinking and making their own educated opinion rather than repeating every shit they are being fed by someone who wants you to believe something different every day.
The only thing I object to is the aggressiveness with which you bash a concerned person for reading an article on a well respected news site. Telling people they "should stop reading fake news or social media reports" was entirely inappropriate.
One hope is that you open up a bit, and keep R0 low enough so that over 18 months it doesn’t kill many people. Just have to keep R0 as close to 1 as you can. After some practice treating it as a control system, you could get quite good at it. This is where testing would fit it - feedback into your controller (which would be public policy).
More generally it seems to me that historically herd immunity has always been the way out. By that argument, only something truly novel will help - only example I can think of is exploiting smartphones somehow to do contact tracing. That doesn’t mean it will work, just that it’s the only thing I can think of that hasn’t been tried before in this situation.
If our assessment is correct, then China’s situation seems to be miraculous... either it’s a matter of time before we’re proven correct, or contact tracing + authoritarian state is enough. And then the question is, can that work in democratic countries?
I vote for option 3: drug development and usage. The first wave of results (many, I expect, won't be stellar, but that's what often happens) on repurposed drugs will arrive in a couple months. Afterwards, there will be the new agents in study (more targeted to SARS-CoV-2 or the adverse clinical effects).
Biocentury lists more than 200 molecules among vaccines and therapeutics in study at this point. If we have to bet short term, instead of locking down, it's the drugs we need to place our bet on.
We know the virus will not be suppressed as SARS or MERS were; this coronavirus is basically everywhere and spreading. I can't see how mitigation isn't the only option after a month or two. From the very beginning the whole point of social distancing has been to flatten the curve so hospitals can operate effectively.
On the other hand, having tests so widely available that groups (probably VIP groups to begin with, pending greater availability) can all get tested before banding together to do business would be beneficial. For example, I wonder if the motion picture industry will do this for film shoots, where basically a skeleton crew all gets together for a camp and have no contact beyond each other for the during of work.
I live in the wrong country. Can I come live with you Germany?
[1] https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2020/17... https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2020/Au... --> Page 14, "Abb. 4"
I looked at mobility on sundays (because that isolates it to the private lockdown as ordered on the 23rd and excludes school, shops and work quite a bit):
So the bulk of it happened in advance, because people where already isolating themselves during the initial "panic".Data from here http://rocs.hu-berlin.de/covid-19-mobility/mobility-monitor/ (I wonder why there is no Sunday dip for the 5th of April though)