I'm in continued amazement that people act like we've beaten this things, when infection rates are shown leveling off. All that shows is that NOT opening, and staying quarantined are effective.
And I'm in continued amazement that people don't seem to understand that "beating it" was never the goal. It was to flatten the curve, not eliminate it. Empty hospitals likely mean we went too far.
Staying quarantined until a vaccine is available is likely not a sustainable plan.
> And I'm in continued amazement that people don't seem to understand that "beating it" was never the goal
I've argued with many people who firmly believe it is worth burning the economy to the ground in order to "save lives". Eventually, the argument distills down to: "Do you care more about corporate profits and bankers and billionaires OR peoples' lives?"
It doesn't even boil down to that. Plenty (essentially all) of credible economists attribute much of the economic harm to the disease epidemic, and not just to the government response.
People have to feel like eating at a restaurant is safe for being open to matter.
> That being said, the government response and the media has certainly ratcheted up the fear.
This is not brought up enough. There's a family of immigrants in my neighborhood from Sierra Leone, and the mom is so terrified of covid-19 that she won't let her kids go out and play, or even go to the local elementary school for free meals (they are on government assistance). We've delivered them food because of this fear. I've tried to explain that kids are at low risk and that it's probably worse to keep them locked inside for months vs. letting them play out side, but alas, the fear is too strong...
Depends which government and which media. People who were going to spring break in Florida in March apparently weren't scared enough, and messages from the government and Fox News that this would be over by Easter didn't help that.
"VISCUSI: If you multiply the 1 million lives saved [Trump], and if the lives are worth $10 million each [OHSA], the result is $10 trillion. … Ten trillion dollars is half of the U.S. GDP, which means that in order to justify completely opening businesses back up, the economy would need to lose half of its value."
Er no, as TFA mentions, when the USG they tried that American protested with signs saying "Granny for sale". Sufficiently that the USG dropped the 'pensioner discount'.
You'd have to argue why its suddenly OK now.
You can also argue to discount children - where I live, we make them by the dozen. It is less applicable to COVID-19 through.
But VSL the correct framework because its based on the premium the average American at large puts on jobs to compensate for the risk of injury or death.
What could be more democratic?
But $10T is such a large envelope that even if you added the granny discount, you would still come out at an enormous fraction of USA and hence world GDP.
The 'economy' is not some abstract entity. It is us, the people, going about our business every day. A hard lockdown is destroying all of the economy. No accounting tricks can mask that. We should not play accounting tricks to begin with. If we want to stoop at the article's level, note that the numbers are flawed, as they don't account for age distribution of the risk.
What makes that question even harder is when you take into account the huge body of people back in January which were right at the margin of famine.
When supply chains stop how will the lowest of the lowest on the ladder cope?
"About 265 million people around the world are forecast to be facing acute food insecurity by the end of this year, a doubling of the 130 million estimated to suffer severe food shortages last year." [0]
Excess death because overrun hospitals should never happen, but the global perspective is horrifying and will never give any easy answers.
No, the argument doesn't distill down to "corporate profits and bankers".
It goes down to - do you want to save lives of wealthy - usually old middle class people in 1st world countries who can "afford to quarantine" or do you want to save more lives of people who are going to starve, become homeless or die due to massive economic disruption this extended quarantine is going to bring upon.
It's only middle class pencil pushers who can quarantine at will semi-indefinitely and work from home who think extended general quarantine is even a viable option in the first place.
There is, and was, a lot of confusion about what the goals were, although they all aligned in immediate massive action.
'Crushing' the curve and getting back to contact tracing levels is one. 'Flattening' and avoiding Lombardy is another.
I was hoping we would have used the time to have massive testing programs by now in the US, to follow Korea's example, but that hasn't happened at all.
The US has more testing capacity than South Korea relative to total population (so we've ramped up significantly), the problem is that our numbers of infected are too high to use that capacity for suppression.
Exactly! I am amazed at how many people have said, "Well we'll have a vaccine in 18 months." This is absolutely irresponsible of the big-pharma industry to push. Safe vaccines take years or decades to develop, and some of the techniques they're clinically trialing now have never created vaccines that made it through the approval process before. Could one of these magically work? Maybe, but it's still highly unlikely everything in these trials will go perfectly.
Places like NZ are looking at total eradication, but the rest of the world will most like just have this spread through our populations before any effective treatment of vaccine is produced. Countries like NZ .. might not ever be able to open their boards again.
If the antibodies don't last long, yes we could see reoccurances for the rest of our lives. It's in our environment. It took 20 years of very big vaccination efforts to eradicate smallpox. Sure we have better technology now, but to think we can eliminate this in less than a year is hubris.
I wrote this post last week, about how we might just be in denial that our life expectancy might now be lower, and how we might need to just come to terms with that:
The plan is to almost beat it, get the new infections down to almost zero by strict lockdowns. Then commence contact tracing and quarantine for each new infection and all first, second and maybe third order contacts while general restrictions are eased. This continues until a vaccine or cure is found. If you want to know more, google Hammer and Dance.
Flattening the curve just below hospital capacity is shown to be dangerous because you cannot control the infection rate with sufficient precision, causing slipups and second, third, fourth waves necessitating repeated longer lockdowns. All in all this damages the economy more because of the panic it periodically creates, repeated longer lockdowns (albeit maybe not as strict) and the uncertainty. There is always another lockdown looming just a few bad numbers ahead. Flattening the curve is sooo March 2020 ;)
Respectfully, that's the plan that you may have wanted, but it's not the plan that most governments have actually implemented. "Almost zero" is not generally considered feasible.
Your perspective, i. e. "flatten the curve", is outdated. It's entirely obvious now that R can be pushed below 1.0. The data from Germany, for example, implies their (medium) level of lockdown came out to about 0.5. China, with harsher measures, did even better.
Germany is now trying to feel its way to a best possible compromise of somewhat lesser/better targeted restrictions that still keep R<1.0 and, thus, the virus on track for elimination.
5 days of lockdown won't be enough to keep for all people infected during the first 2 days to show symptoms - this means they may make it back to the society after the 5 days and spread the virus further.
That would grant that the virus is spread to all the family unit, all for a benefit of 8 working days a month. A benefit that probably wouldn't be enough to sustain their families (or pay the additional healthcare bills) in any case.
3 work/4 off (13 working days per month) may work too. It better to test idea on simulator. 40-60% of salary is much better than 0 in city on lockdown.
I’m slowly coming to the conclusion that government “lockdowns” and “reopenings” are lagging instructions for what many people had already been doing. By the time shelter in place orders were signed by governors many of us (who were fortunate enough to be able) had already been socially distancing. I remember seeing a thread on HN of MTA data that showed ridership dropping off significantly in the first and second week of March. At that point De Blasio was still encouraging NYC to go about business as usual.
Likewise, by the time governments officially started easing restrictions many people had grown weary of long-term social distancing and the weather started getting nicer so people started venturing out more than they had been.
People are already infectious much earlier (2..3 days I think?).
Also people already started to take the restrictions less seriously quite a bit earlier than the official relaxations.
And the lockdown was never very strict in Germany in the first place. Some types of businesses had to close, but people could go outside "for no particular reasons", just keep a distance to people not in your own household and if possible don't travel across Germany.
And finally, AFAIK the RKI "infection rate computation" is based at least partly on predictive models.
PS: The actual lockdown rules differed slightly across the German federal states. I think at least Bavaria had stricter rules then what I described, which makes sense because they've been hit harder.
> Also people already started to take the restrictions less seriously quite a bit earlier than the official relaxations.
The regulations where eased on some issues, but stricter requirements were introduced in other place, e.g. masks were made mandatory in public transport, super markets in most (all?) states etc.
I don't know, I rarely use public transport, I take my bike everywhere. The few trains and buses I've seen in passing weren't having many passengers, so they were spread out.
You have to wear a simple mask now on public transport and when shopping. This is in addition to keeping distance, but I don't know if it's actually enforced on trains (in shops, yes). Typically there are warning signs with the rules at the door (wear a mask, keep at least 1.5m distance).
In my city public transportation has taken a big hit because with the rules in place trains and buses can only carry 30% of the usual passenger load even with full system capacity.
The first minor easing was weeks ago. People started to ignore other rules that were expected to get dropped, and police stopped enforcing them (at least outside of the more conservative and more severely affected South).
By now there’s a lot of empty beds and there’s more than sufficient capacity in testing. It totally makes sense to reopen a bit and try to find sustainable mode of quarantine.
I’d like to see a focused approach on protecting nursing homes and the elderly. This is no way for the world to live. Please don’t try to normalize this.
A lot more people than you realize are willing to sacrifice them to get the economy (and normal life) running again. They just don't talk about openly in stark terms, for obvious reasons.
Everybody is willing to do so, the difference is only when.
Some may think we should "sacrifice" them immediately, because living without a mocha latte grande whatever just isn't okay, but if we'd face mass starvation, I'm pretty sure that everybody would agree that we can't keep going. Of course, that's unlikely, but let's not pretend that there's some (sane) group of people out there, that actually say "under no circumstances may any life be put in danger, ever".
It is simply incredible that you've reduced the argument for lifting lockdowns to "getting a mocha latte grande whatever." I have never seen an argument made in such bad faith before.
The US has just suffered its largest job losses in history. The people who lost these jobs skew heavily toward lower income brackets and little or no savings. The losses are still growing.
How can you say something like this with a straight face?
> It is simply incredible that you've reduced the argument for lifting lockdowns to "getting a mocha latte grande whatever." I have never seen an argument made in such bad faith before.
It's meant to be the worst possible reason to end the lock down, with "otherwise everybody dies" being the best possible reason. Everybody falls somewhere between these extremes. I just wanted to make clear that there is no sane position that responds to the worst possible circumstances by saying "lives must not be lost because of Covid-19, but I'm fine with them being lost because of our reaction to Covid-19".
My personal opinion is somewhat close to yours, I believe. I'm aware that a massively shrinking economy has severe real world consequences.
It's a focussed effort to contain/eradicate the virus. At current levels, it's already possible to extensively investigate every single case and trace & isolate contacts. That should allow for continued reduction with far lower restrictions on daily life compared to the blanket measures of the last few weeks.
And while specifically protecting nursing homes and the elderly is obviously being attempted, that's just far harder than one might think: nursing homes have a lot of employees, almost all of which are rather young. While some contacts can be minimised by, for example, switching to external catering, the need for care, cleaning, and medical treatments are rather inflexible.
People in nursing homes and the elderly are not the only ones who can die or suffer from lifelong consequences, so yes, we have to adapt to new normality for at least a year, in which everyone is part of the effort. If it means, that certain businesses or jobs won’t survive — so be it, others will get stronger out of it and new competitors will appear, but this is going to work. It has to. Germany and German people are in good position here, because government is spending generously and welfare system is good. Wir schaffen das.
German Government is also collecting taxes insatiably. I am happy I can finally see some benefits of it: support of small businesses and freelancers impacted by COVID crisis and that our hospitals are well equipped. Unfortunately, it is not the case with our infrastructure, Kitas, and school.
Contact tracing and testing continues to be abysmal. Friends had 15 minute contact to a person which was identified as positive 1 day later. Took 5 days for them to receive their test result taken on the day after notification.
In Germany? You have probably the biggest, best coronavirus testing program out there right now. Your program is the one that our press in the UK always points at in order to convince us that our government has failed us on testing. (Not all of their comparisons are actually true, but that's another topic.)
I guess the real facts will only be known in the years after the crisis. Currently everyone is very much in propaganda&blame mode. I wouldn't trust any such comparison. For example two weeks ago the RKI "accidentially" reported a 30% rise in testing. Later they admitted no rise and a clerical error... Truth is, Germany currently has around 50% of its testing capacity unused because the bureaucracy still behaves as if tests were precious or just doesn't get around to issuing testing papers fast enough. And they still don't work in the weekends...
While not perfect, it's the notification that needs to be fast.
After that, you're expected to isolate for two weeks no matter what, because any test wouldn't necessarily detect an infection if it's still in the earliest stages.
No, on the contrary. Germany has about 4 times as many ICU units as France, Italy or the UK. That's why we had so low fatality numbers, because hospitals never even got significantly above 50% capacity.
This map [1] shows intensive care beds utilization is at 60% of capacity on average in Germany currently. In my local hospital they are starting to do elective treatments again, but are required to hold free 20% of regular beds, 25% of intensive care beds and have to be able to free up further 20% of beds within 72 hours if necessary. They are doing a PCR test for every patient admitted to the hospital (since April 6) and starting from Monday will test every admitted patient three times every week.
More fake news from the fascist elites.
Wake up and go outside. Stop reading this shit. Enjoy life and be careful, you'll be ok. Most people already had it and didn't even know.
Ok, that's fair. I interpreted "we" from moduspol as "we as a society" but I agree that the German numbers are more relevant here.
(Incidentally, using traffic death numbers as a baseline for a rate of fatalities we should accept is bad anyway because those numbers are also higher than we should tolerate, IMO.)
Worry about invisible death from a cube neighbor sneezing is not going to generate the sanity needed to be productive
If you all are so uninterested in having to cope with the reality of this, the 2nd amendment puts relief within arms reach for yourself alone
You want to consider it the perspective of ratio alone? Ok.
You’re just 1 in 7 billion+ right? Why should I care about your existence... is effectively the narrative you’re peddling by clustering humans into an abstract math object?
Ok well I don’t care if you are one of those people in the math object you think matters
Annotate the math as if you’re inside the object. Then grow some nuts and live it
Typical American, throw everyone else at the fight
Edit: Oh no my fake internet points! An online community that is a minority of the populace doesn’t like what I put before them! But even as a collective their value to humanity as a whole is statistically unimportant so who cares?
We don't, though! Automobiles are heavily regulated by a staggeringly large bureaucracy that works at all levels from driver training to equipment design to collision analysis science to traffic pattern analysis to infrastructure maintenance.
And now we're doing the same kind of thing (in, obviously, very different ways) to fight the covid pandemic. And it's working too, though better in some areas than others. Germany in TFA is worried that maybe their R0 might have slipped above 1.0 and started growing again. Outside NYC, the US epidemic is still large and still growing.
We accept it by allowing cars to be driven. That we separately take other steps to lessen the number does not negate the fact that we still accept it.
And it's the same thing with COVID-19. We can't quarantine everyone indefinitely, this is unlikely to end without us reaching herd immunity, and the quarantine itself causes non-negligible suffering. We have to approach this rationally.
We don't quarantine everyone, not remotely. Best estimates are that about 20% of the US economy is halted right now. Hyperbole doesn't help.
Why is trying to minimize a US death toll on the order of hundreds of thousands[1] at the cost of a 20% GDP hit not a "rational" choice? It may not be your personal choice, but it seems to be to most people. And it's absolutely a well-understood tradeoff by everyone involved. No one went into this blind to the costs.
[1] Maybe only ("only") mid-tens-of-thousands if you use the kind of life-years-saved metric that seems to be en vogue among the "open up" set.
The problem with "pro-quarantine" arguments is that they miss that:
a) they are not going to "save hundreds of thousands of deaths", because quarantine doesn't stop the virus it only slows it down, in other-words quarantine will spread out those deaths in time, but many of those deaths are still going to happen (in due time)
b) 20% GDP hit will inevitably directly and indirectly kill, make homeless and starve a lot of people
c) in 2nd and 3rd world contries the distruption of the global economy to this degree will kill a metric ton of people
d) it's impossible to keep quarantine for extended periods of time, because then it's going to be way more than 20% GDP hit.
The only question is which approach is going to kill more people and do more damage in the long run.
To me it seems obvious that extended general quarantine is going to do an order of magnitude more damage (than doing the sane thing - like isolating at risk groups).
> a) they are not going to "save hundreds of thousands of deaths"
They literally (literally literally!) already have. What do you think would have happened in late March if the lockdowns hadn't bent the curves? Why do you think the high exponent mode (doubling every 3-6 days) stopped, if you don't think the lockdowns did it?
The problem with the "anti-quarantine" arguments is that they confuse the death rates of the status quo (locked-down semi-containment) with those that obtain from an unrestricted economy. That's not how it works.
> The only question is which approach is going to kill more people and do more damage in the long run.
Find a serious person with numbers that support your case. I think you'll be surprised.
Yes. To highlight the response to a) - flattening the curve means that the peak is lower, but also that the area is smaller. The herd immunity level is always reached and overshot, but with a flatter curve the overshoot is smaller, and it can also be reached with vaccination. Thus, saving lives, even without full containment.
Delaying deaths (slowing the spread) doesn't mean that "deaths" are prevented - they are still going to happen just spread across significantly larger timeframe, however, the extreme measures taken to slow down the spread have already and will kill, starve and impoverish way more people and do way more damage overall.
If quarantine made the virus go away (which it doesn't) - or it bought enough time to make vaccines or effective treatments, then it would make sense, but it doesn't.
All it does it make it seem like you are saving lives, while in effect the deaths are just spread across a longer timeframe and now you're killing, starving and impoverishing people from the severe and dire economic consequences.
If I recall correctly, from the people that get put on ventilators only half of them live.
Secondly, why is nobody ever talking about the amount of deaths, starvation, homelessness and impoverishment that will result from economic damage of general quarantine. This always gets completely ignored and negated as if it doesn't exist.
You can't say that quarantine saves lives unless you quantify how many people are killed and are going to be killed by it.
My argument is that this by far will kill, starve and impoverish way more people than whatever number of people will get saved by having access to a ventilator.
> Delaying deaths (slowing the spread) doesn't mean that "deaths" are prevented
For... the TFA is literally about Germany, a nation that had its outbreak R0 drop below one (i.e. their outbreak was shrinking), far, far, far underneath the herd immunity threshold. It's simply not true that Germany didn't prevent any deaths, that analysis is straight wrong. The same holds for most of east asia.
The only reason, quite frankly, that this doesn't seem to be happening in the US is because there is a segment of the population being led to believe that lockdowns are impossible, or that they don't work, or that they're an imposition on fundamental freedoms. So we're doing it badly. But it can absolutely be done well, as nations like Germany show.
I frankly don't get where the misunderstanding is.
If you take 1000 deaths and spread them across a 6months or a year instead of 2weeks, no lives have been "saved".
Similarly the act of spreading it out via general extended quarantine, does massive economic damage that will result in deaths, starvation, homelessness and impoverishment that arguably will completely eclipse whatever lives are actually saved by the quarantine (due to say availability of ventilators and medical care not being overrun).
Maybe that damage isn't as large in some developed countries like Germany who can maybe afford it, but it is in many other countries.
> I frankly don't get where the misunderstanding is. If you take 1000 deaths and spread them across a 6months or a year instead of 2weeks, no lives have been "saved".
That is not the effect of a lockdown. There is your misunderstanding. The proof is in the linked article (or data for Hong Kong, Korea, Taiwan, Hawaii, all of whom also contained the virus before reaching herd immunity).
I suppose you are referring to having R0 below zero.
Now then the question becomes what kind of measures are necessary to keep it there and if those measures are feasible long-term.
If those measures are not feasible long term (this seems to be the case), that means they R0 can be held below zero only briefly.
In other words, the spread of the virus is only slowed down (or even reversed briefly, with R0 < 0) and delayed, and in essence the most deaths are simply delayed and not saved.
While the deaths from the quarantine measures itself doesn't seem to ever get accounted for.
And that is the problem - those quarantine measure/economic damage deaths doesn't ever seem to be put into equation as if they don't exist or are negligible.
Which makes me question if quarantine does net-benefit or does more harm in log term when all the externalities and knock on effects are actually accounted for.
> the US epidemic is still large and still growing
Rt is below 1 in all states except Minnesota and Nebraska [1]. So the US epidemic is still large, but already shrinking. With that said, when lockdowns are eased, Rt can increase again.
That model isn't consistent with data on the ground though. Many more states are showing clear and obvious growth over the past 7-10 days (which is about the best fidelity that measurement can achieve anyway). Check out the link below for my personal list of "worry states". A few might have ticked down in the past 2-3 days, but the overall trend of all of these states is upward and there's no reliable evidence of a genuine halt in growth.
Edit: in fact I went back and spot-checked Iowa. That link you posted says that Rt dropped below 1.0 20 days ago. In fact the real world new case rate is almost three times higher than it was 20 days ago! I'll just say it: that site you linked is garbage.
That explanation made sense for the hyper-growth mode (2-3 day doubling) in, say, NYC's early explosion, because there was giant pool of infected being discovered with new tests. It doesn't explain states like Iowa which are doubling only ("only", sigh) every 6-10 days. In that realm you'd expect positives to track linearly with test growth, and they don't.
I'm sorry. Those graphs you linked are pretty, but they're just dead wrong.
Doubling of cumulative cases in 6-10 days, after adjusting for increased testing, is not that far off from Rt=0.94. Even Rt=1.1 still falls within the uncertainty interval.
No. You're going to need to cite me some analysis with real numbers if you genuinely want to convince me that a 3x growth over 20 days is consistent with an Rt less than one.
I'm serious: that site is bad. It's a bad model. You have to stop reading and linking it. The only way to make it "right" is to assume (as you are) wild divergence between measured case incidence and "actual" unmeasured infection statistics, which isn't borne out in any papers I'm aware of from any outbreaks anywhere.
Basically: I'm telling you that measured data makes this model very wrong. And your response is to tell me that this is because measured data is itself extremely (like 3x!) wrong. That's bad science.
I'm not trying to convince you. I'm just saying that the data you quoted does not contradict the model I linked to. New cases in Iowa are essentially flat for a while now, which is consistent with Rt close to 1. https://coronavirus.jhu.edu/testing/individual-states/iowa
I personally find it astonishing that we are accepting >100 deaths per day.
Who is we? In the UK, for example, the baseline expected death rate is around 2000 per day. Sure, adding another 500 to that is a big deal, but it is maybe not as big a deal as everyone seems to think it is.
(German here. 100 deaths per day is more than any all terror deaths over the last couple of years)
The death toll due to covid is already is visible on all averaged yearly death per day/week charts and we have not even gotten to 1% of population having gotten the disease. That is a big deal.
> The death toll due to covid is already is visible on all averaged yearly death per day/week charts and we have not even gotten to 1% of population having gotten the disease. That is a big deal.
Only when one year is taken into account. How about decade averages? I bet tobacco is #1 on the list and covid does not even make top 10
> I personally find it astonishing that we are accepting >100 deaths per day.
Close to a million people die in Germany in any given year, we're always accepting >100 deaths per day. The question in 12 months will be whether the death rate significantly increased or whether it primarily moved the cause of death, so more people died from Covid-19 and less died of atypical pneumonia, old age, cancer, heart disease or the flu.
It is not possible. The number of active cases peaked 2 weeks ago and is dropping ever since. What do you suggest? Keep everything closed for a minimum of 18 months? What do we do if we never find a vaccine? It is absolutely the right move to open up carefully once your healthcare system has enough capacity.
Well, we could have at least waited until masks are widely available and we have a contact tracing system that is able to trace all contacts of contacts of those infected each day. At 1000 infected per day in Germany, this would be 100.000 to 400.000 contacts traced by day.
And of course, we should have kept up the social distancing.
Masks are widely available! There isn't a single person without mask in the supermarkets. Not one. Social distancing is widely observed. I don't know where you get your information from but my experience is very different.
What region are you referencing with your anecdote? Where I live, mask usage isn't even close to 50% unless the store requires it, and that's including bandit scarves, masks not covering noses, homemade masks of dubious quality, ad infinitum. Social distancing is not well observed at the grocery store when I have to shop.
That number has to be put in perspective. There's barely any excess mortality in Germany since COVID hit (meaning it's within normal variation). That's success any way you look at it.
But note this includes estimates from February, with a lot more unknowns, and fails to take into account improved treatments (Remdisivir, Plasma, ventilator use improvements, etc).
Moving forward, given treatment improvements, I think a consensus IFR range would likely be 0.1% to 0.7%.
It's not. The goal with more successful efforts like the one in Germany isn't just "flattening the curve", it's containment. Once the infection rate is low enough you have enough testing capacity to test everyone who gets sick, and all their contacts, and thus you can find and quarantine new outbreaks before they start spreading generally.
But this only works with a very low infection rate. Once your testing capacity (which is still, basically everywhere, much smaller than hospitals' ability to treat the same outbreak) is overwhelmed, you lose control and end up back where everyone else is.
That's were contact tracing and testing are key. If when a person is identified as having COVID you can identify who they have had contact with and test them you can reduce or ideally totally prevent onward infections. Effectively breaking the chain.
> The question is if treatment capacity is overwhelmed.
It eventually will be if R0 is greater 1.0. The government's position is that it needs to stay below one. The official metric to that effect is the number of new infections per 100,000 people. If it crosses above 50 for any administrative district, lockdown measures ought to be tightened. As of today, there are four above that threshold.
You have misunderstood what R0 and R_effective mean. R0 certainly can, and often does, go below 1. The only difference between R0 and R_effective is that R0 assumes everyone in the population is suaceptible to the virus.
I’m amazed how this idea seems to endure, even in the face of dozens of countries showing reductions of 90%+ (Italy, Spain, Germany, Austria, Australia, Switzerland, Iceland, Norway, South Korea, France, etc) or even complete elimination (China, NZ).
Just because the US and UK can’t get their act together doesn’t mean it’s impossible.
It's not over until those countries' policies are back to how they were prior to the outbreak (borders open, travel allowed, no lockdowns). Until then, it's just hoping for the best for when they do.
Unfortunately this requires either indefinite lockdowns or indefinite suspension of international travel. What’s the point of eliminating 90% of infections if that remaining 10% is going to develop into a new outbreak?
China is still finding new cases so it isn’t eliminated. New Zealand can keep the virus out because it’s an island (but they better be prepared to live without tourism).
This is just one of many questions. Right now even with the best treatment, 1% of people die.
Your statement implies that if we could guarantee hospitals would never get overwhelmed we would happily let this wash over the whole population and kill 1% of us. That should be avoided (and would also hurt the economy just like the lockdown is, it’s not an either/or choice).
This isn't going to end until we reach herd immunity. Herd immunity doesn't imply all of us get infected. And the fatalities of this are not among a random 1%, it's primarily known groups that can be quarantined or protected separately.
Just to be precise: 14 days is not the median. The median is far lower (4-6 days), and I think we need studies on how early during the asymptomatic period one can actually spread the virus, because last I heard (but I lack reliable evidence), it was 2 or 3 days before symptoms showed up.
>Or it could be like the flu, and mutate / continue indefinitely.
I gather that is unlikely, coronaviruses don't mutate like the flu.
In fact, according to experts, it is most likely that this coronavirus will decrease in severity over time and become endemic like the other several coronaviruses that are responsible for 15% of common colds. Or, alternatively, occasionally returning like a bad flu year. https://www.statnews.com/2020/02/04/two-scenarios-if-new-cor...
I remember reading in other places this may have happened before, something about a really bad flu year in the 1870's that may have been another coronavirus introducing itself to humanity.
Healthy 30 year olds are ending up in the ICU. Many of them will have organ damage that will take years or may never heal. We can eradicate like New Zealand did. We choose not to. Is bugchasing really such a common kink?
Healthy 30 year olds die from traffic accidents. Do you yearn for life in which all risk is avoided at all costs, and do you think it’s proper to force that on everyone else?
0.5% of 30 year olds is not going to the hospital for Covid-19 by a long shot.
In the Netherlands there are approximately 1.100.000 people between 30 and 34 years old (inclusive). Of those people 150 entered the hospital. That’s 0.01%. Most of these people are not dying (in fact only 3 of them did, which is 0.0003%) and while there isn’t a number of people with the chronic problems it definitely isn’t all of them.
By the way slightly more than 0.1% of the population dies every year due to smoking. I have yet to see the massive safety efforts.
In the Netherlands the estimates are actually about 10% so if you really stretch it you end up with 0.1% hospitalized, which still is not near your 0.5%
As far as I've read, the number of healthy 30 year olds who went to the ICU and had organ damage is vanishingly small. Is there somewhere this is happening in any statistically significant way? There's a lot of ways a healthy 30 year can die yet only one particular way is getting any attention.
Respectfully, I do not agree. New Zealand went on lockdown March 23 when they jumped overnight from 66 to 102 confirmed cases. They have 1144 as of yesterday.
There are now 1.3 million cases in the U.S., almost that many in Western Europe. There are not even enough tests to know the real number. Antibody tests are indicating that a couple tens of millions of people may have already been exposed.
I know of no precedent for using quarantines to eradicating a disease that is already so widespread. There is no evidence that such a thing is possible. It would have been at some point in the past, when there were some hundreds of known cases, but not any more.
What to do from this moment forward? Did you mean to imply that you thought we could stay locked down until this is eradicated?
I wonder if there are models that can give us covid predictions based on continuing the existing lockdowns versus easing of lockdowns, with a vaccine in 12 months versus a vaccine in 4 years, and estimated economic and social costs of lockdowns. I don't think it's responsible to make these big decisions without objectively weighing all the data, and the data is fuzzy, refined over time. (Although I am pleased at how much data is publicly available.)
>we would happily let this wash over the whole population and kill 1% of us
Thats exactly what will happen. Based on sampling its much much less like .1% to .5% but there not much of an option. It would be like saying no one should smoke or drive cause people will die.
> The reproduction rate has risen to 1.1 - that means that ten people will pass the virus on to 11 more people. To keep the pandemic in check this level should be below one.
So Germany is going for total eradication of this virus? What makes them think that’s possible.
We (the Czech Republic) and many neighboring countries did just that - the borders have been closed for everyone since middle of March, with police and army making sure this emergency meassure is observed. Only goods trains and trucks are let through and even they are often checked for compliance (driver has no fewer, etc.). Even cross border workers had to either stop commuting or arrange temporary accomodation on the other side of the border.
So it is definitelly possible to "emullate an island" even in the middle of Europe, and it seems to have worked for the countriws that did it - daily case numbers are staying low, death toll is really low, so some of these restrictions are slowly being rolled back, with cross border bis and train lines resumming from 15th of May.
If the rest of the world doesn't have full eradication and we see this thing spread through our environment, NZ could be in the interesting position of not being able to open their borders to people for a very long time.
Other countries and territories are also heading towards eradication. There is talk of an alliance between these places forming with free travel inside the alliance but locked down to people from outside.
Sure. Getting R below 1.0 will, over time, lead to eradication. Infection rates have/had already fallen by about 85% from the peak in about 30 days, or one month. Plug it in:
6000 (peak daily infections) * (1 - 0.85)^Months, and you’d get to <1 daily infections within five months.
And, of course, having already reduced cases by 85% makes tracing the remaining cases far easier. That, plus improvements in understanding the dynamics of the virus and all the countermeasures, now allows for a “budget” so-to-speak, to be spent on some loosening of restrictions and adding whatever is necessary to keep re-introductions at bay.
Couldn't be because of the incubation period, no? I think that trying to determine how well a state is doing so shortly after re-opening is fraught due to limits on testing etc. If death counts are dropping at the 6 week mark, I think you could claim "success."
It is not the eased lockdown that is causing the rise, but the changed behaviors of people. Many states were never really locked down (yes, shops and schools were closed through the country. But companies could continue to work in offices and factories).
People are now meeting face to face much more. This is causing the increase.
This headline is a bit misleading. The R factor calculation in Germany by the RKI is rather volatile. They explicitly stated in their report that this needs to be monitored carefully, but that it is too early to make strong conclusions from this data yet.
There were also 2-3 larger clusters discovered this week. Looking at the nationwide numbers might be not as useful in this case. I'm not saying there is no case for concern here, but right now these are very few data points on a noisy curve, and a similar spike that turned out to be nothing happened a few weeks ago. We really have to wait a few days to actually get some reliable numbers.
In addition to this, the timing of these announcements in the last two weeks were suspiciously close to lockdown relaxation dates. I would not be surprised if the RKI is using these numbers as a tool to influence behaviour, even though they know that there is a rather large error bar on the R factor. A case in point is that before the lockdown restrictions were lifted the R factor was around 0.9, but the RKI said the uncertainties are so high that we cannot be certain it is even below 1 - and suggested delaying the opening. Also, internally leaked government documents a few weeks ago showed that there is an explicit strategy of the government, to generate fear in the population in order to make people comply.
Also, their numbers, cases as well as R factor, show a strong weekly periodicity. Leading to hilarious press conferences on wednesdays where the spread panic because the cases from the weekend have finally been passed through bureaucracy... Only to announce improving case numbers on fridays. Their R calculation uses a 4day sliding window, so the increase is just the usual wednesday I guess.
> Also, internally leaked government documents a few weeks ago showed that there is an explicit strategy of the government, to generate fear in the population in order to make people comply.
A quick scan seems to indicate a document meant to summarize the situation and possible outcomes including options for actions.
They explicitly propose to be as transparent as possible and to openly discuss the worst case scenario.
Without reading it in depth, this sounds like a sensible thing to write down to prepare the relevant authorities for what's coming.
Relevant quote:
> Wir müssen wegkommen von einer Kommunikation, die auf die Fallsterblichkeitsrate zentriert ist. Bei einer prozentual unerheblich klingenden Fallsterblichkeitsrate, die vor allem die Älteren betrifft, denken sich viele dann unbewusst und uneingestanden: «Naja, so werden wir die Alten los, die unsere Wirtschaft nach unten ziehen, wir sind sowieso schon zu viele auf der Erde, und mit ein bisschen Glück erbe ich so schon ein bisschen früher»
Google Translate> We have to get away from communication centered on the case mortality rate. With a case mortality rate that sounds insignificant in percentage terms, and which affects the elderly in particular, many then think subconsciously and admittedly: «Well, this is how we get rid of the elderly who are pulling our economy down, we are already too many on earth anyway, and with a bit of luck I inherit a little earlier »
And I would say this is quite spot on, for what we actually see on Twitter and elsewhere...
I think a smart approach will be to deploy these “emergency brakes” as TFA mentions, but preferably far before it seems necessary, because of the cryptic transmission and long incubation period.
And a lot of comments here talk about restrictions deployed simply to avoid an overwhelm of the healthcare system. While that’s important, the longer we can prevent the disease running through the population, the lower we can make the case severity and fatality rate due to advancements in treatment.
A lot of commentary on COVID-19 recently presumed that we can’t control outcomes, only the rate of spread. That may be true at a point in time, but the longer we hold out, the better the outcomes will be on the tail end with advancements in treatment research.
And my work wants me back on site in an open office...
I calced a bit and saw about a 1% chance of getting infected within a month at the office. Maybe acceptable for a month, not for a year (>10% risk than).
Yeah, that's my concern as well. We have the worst of both worlds in my office; cubicles that don't restrict anything, and we're walled in with glass walls (a NOC) that limits airflow. The cubicle pathways prevent us from following social distancing, and there's over 30 of us in the NOC. Good times. Hope I can continue to WFH forever.
Viruses have little ability to influence their spread; they depend entirely on human behaviours. It is physically possible to all-but eliminate the coronavirus worldwide in ~3 weeks if everyone magically knew when they were spreading the virus.
Reproductive numbers are important, but I'm not sure governments have really stepped up to the plate to explain how the virus spreads and what people need to do to stop spreading the thing. "Social Distance", "wash your hands" and sometimes "wear a mask" really lacks lacks explanatory power.
Given the vast costs the world has put up with so far to slow the coronavirus down, there is actually room in the conversation to have teams of people travel around and conduct some sort of training session on how not to spread this thing and have people actually act out simulations. There need to be finer grained tools than mass lockdowns and alternatives to tracking everyone with apps.
I've seen a lot of basic confusion on HN about whether masks even help. This is pretty clear evidence of uncertainty in the broad community about how to deal with respiratory viruses. I don't believe that is due to a lack of research; engineers have had the practical tools to research droplets in airflows work for more than a century now.
Even the fact that "SARS with a risk of asymptotic spread" didn't have world leaders slamming borders closed in Jan/Feb hints at a possible general misunderstanding of how virus spread works. There were other considerations at the time, but in retrospect more general education on the subject would have been well worth the time invested.
Absolutely correct. We need better understanding of how the virus spreads, but this is not an engineering problem but an epidemiology question. Record every infection contact and determine highest risk activities so these can be reduced.
Either or. I suspect the aeronautical engineers would be better people to ask than epidemiologists if it turns out the virus is mainly transported through the air. Turbulence and control thereof would be the most important factors.
But these are exactly the sorts of things that shouldn't still be open for discussion after 4 months and global lockdowns. Even among the general public.
This is just one data point so far, but with the party atmosphere that I see going on here at day and night, and school openings coming soon, I am pretty convinced personally that this will escalate quickly.
I've rarely been more unhappy about the state of our politics. There was a lot of public discussion about easing the lockdown and regions randomly made their own decisions, affecting people's behavior even where no decision had been made yet and forcing Merkels hand in the end, who was much more in favor of playing it safe.
We were on course to get the level of containment and traceability that several Asian countries have achieved, if we had only waited a little longer, maybe just a few weeks.
To me it seems we might be letting the economy run itself into the ground. I hope I am wrong.
We don't know how many cases are out there. There is just not enough testing.
We can only count deaths, but even that is tricky since people that were given 30 days to live are being counted as COVID-19 victims if they were infected.
The only way to know what the impact of the virus is/has been, is to compare with deaths from the previous years.
168 comments
[ 3.3 ms ] story [ 183 ms ] threadStaying quarantined until a vaccine is available is likely not a sustainable plan.
I've argued with many people who firmly believe it is worth burning the economy to the ground in order to "save lives". Eventually, the argument distills down to: "Do you care more about corporate profits and bankers and billionaires OR peoples' lives?"
People have to feel like eating at a restaurant is safe for being open to matter.
This is not brought up enough. There's a family of immigrants in my neighborhood from Sierra Leone, and the mom is so terrified of covid-19 that she won't let her kids go out and play, or even go to the local elementary school for free meals (they are on government assistance). We've delivered them food because of this fear. I've tried to explain that kids are at low risk and that it's probably worse to keep them locked inside for months vs. letting them play out side, but alas, the fear is too strong...
"VISCUSI: If you multiply the 1 million lives saved [Trump], and if the lives are worth $10 million each [OHSA], the result is $10 trillion. … Ten trillion dollars is half of the U.S. GDP, which means that in order to justify completely opening businesses back up, the economy would need to lose half of its value."
[1] https://www.npr.org/transcripts/835571843
You'd have to argue why its suddenly OK now.
You can also argue to discount children - where I live, we make them by the dozen. It is less applicable to COVID-19 through.
But VSL the correct framework because its based on the premium the average American at large puts on jobs to compensate for the risk of injury or death.
What could be more democratic?
But $10T is such a large envelope that even if you added the granny discount, you would still come out at an enormous fraction of USA and hence world GDP.
https://twitter.com/AndyBiotech/status/1241741127205572609/p...
But feel free to add the 38% USG pensioner discount (or 100% if you care).
You'll still come out at a very, very large number.
When supply chains stop how will the lowest of the lowest on the ladder cope?
"About 265 million people around the world are forecast to be facing acute food insecurity by the end of this year, a doubling of the 130 million estimated to suffer severe food shortages last year." [0]
Excess death because overrun hospitals should never happen, but the global perspective is horrifying and will never give any easy answers.
[0]: https://www.theguardian.com/world/2020/apr/21/global-hunger-...
It goes down to - do you want to save lives of wealthy - usually old middle class people in 1st world countries who can "afford to quarantine" or do you want to save more lives of people who are going to starve, become homeless or die due to massive economic disruption this extended quarantine is going to bring upon.
It's only middle class pencil pushers who can quarantine at will semi-indefinitely and work from home who think extended general quarantine is even a viable option in the first place.
'Crushing' the curve and getting back to contact tracing levels is one. 'Flattening' and avoiding Lombardy is another.
I was hoping we would have used the time to have massive testing programs by now in the US, to follow Korea's example, but that hasn't happened at all.
Paul Romer's plan is my favorite but the country has seen little progress since he proposed it https://www.newyorker.com/news/q-and-a/paul-romer-on-how-to-...
Places like NZ are looking at total eradication, but the rest of the world will most like just have this spread through our populations before any effective treatment of vaccine is produced. Countries like NZ .. might not ever be able to open their boards again.
If the antibodies don't last long, yes we could see reoccurances for the rest of our lives. It's in our environment. It took 20 years of very big vaccination efforts to eradicate smallpox. Sure we have better technology now, but to think we can eliminate this in less than a year is hubris.
I wrote this post last week, about how we might just be in denial that our life expectancy might now be lower, and how we might need to just come to terms with that:
https://battlepenguin.com/politics/this-is-not-a-time-of-hon...
Flattening the curve just below hospital capacity is shown to be dangerous because you cannot control the infection rate with sufficient precision, causing slipups and second, third, fourth waves necessitating repeated longer lockdowns. All in all this damages the economy more because of the panic it periodically creates, repeated longer lockdowns (albeit maybe not as strict) and the uncertainty. There is always another lockdown looming just a few bad numbers ahead. Flattening the curve is sooo March 2020 ;)
Germany is now trying to feel its way to a best possible compromise of somewhat lesser/better targeted restrictions that still keep R<1.0 and, thus, the virus on track for elimination.
The vast majority of the early countries in Europe and Asia has seen drastic successes. See, for example, https://www.nytimes.com/interactive/2020/world/coronavirus-m... (scroll up slightly or search for "decreasing").
Among the richer countries, it's just the UK, US, and Sweden that are "levelling off".
Does anybody know an opensource epidemic simulator to test the idea?
Likewise, by the time governments officially started easing restrictions many people had grown weary of long-term social distancing and the weather started getting nicer so people started venturing out more than they had been.
Also people already started to take the restrictions less seriously quite a bit earlier than the official relaxations. And the lockdown was never very strict in Germany in the first place. Some types of businesses had to close, but people could go outside "for no particular reasons", just keep a distance to people not in your own household and if possible don't travel across Germany.
And finally, AFAIK the RKI "infection rate computation" is based at least partly on predictive models.
PS: The actual lockdown rules differed slightly across the German federal states. I think at least Bavaria had stricter rules then what I described, which makes sense because they've been hit harder.
The regulations where eased on some issues, but stricter requirements were introduced in other place, e.g. masks were made mandatory in public transport, super markets in most (all?) states etc.
Now I look like a fake news idiot :D
Some may think we should "sacrifice" them immediately, because living without a mocha latte grande whatever just isn't okay, but if we'd face mass starvation, I'm pretty sure that everybody would agree that we can't keep going. Of course, that's unlikely, but let's not pretend that there's some (sane) group of people out there, that actually say "under no circumstances may any life be put in danger, ever".
The US has just suffered its largest job losses in history. The people who lost these jobs skew heavily toward lower income brackets and little or no savings. The losses are still growing.
How can you say something like this with a straight face?
It's meant to be the worst possible reason to end the lock down, with "otherwise everybody dies" being the best possible reason. Everybody falls somewhere between these extremes. I just wanted to make clear that there is no sane position that responds to the worst possible circumstances by saying "lives must not be lost because of Covid-19, but I'm fine with them being lost because of our reaction to Covid-19".
My personal opinion is somewhat close to yours, I believe. I'm aware that a massively shrinking economy has severe real world consequences.
And while specifically protecting nursing homes and the elderly is obviously being attempted, that's just far harder than one might think: nursing homes have a lot of employees, almost all of which are rather young. While some contacts can be minimised by, for example, switching to external catering, the need for care, cleaning, and medical treatments are rather inflexible.
After that, you're expected to isolate for two weeks no matter what, because any test wouldn't necessarily detect an infection if it's still in the earliest stages.
[1] https://interaktiv.morgenpost.de/corona-deutschland-intensiv...
The question is if treatment capacity is overwhelmed.
Otherwise we should have tried to keep it in an acceptable very low level. I personally find it astonishing that we are accepting >100 deaths per day.
https://en.m.wikipedia.org/wiki/Motor_vehicle_fatality_rate_...
(Incidentally, using traffic death numbers as a baseline for a rate of fatalities we should accept is bad anyway because those numbers are also higher than we should tolerate, IMO.)
https://www.asirt.org/safe-travel/road-safety-facts/
38,000 a year ~= 104 / day
(based on 120,000 preventable deaths in 2016: https://www.oecd.org/germany/health-at-a-glance-germany-EN.p... )
Worry about invisible death from a cube neighbor sneezing is not going to generate the sanity needed to be productive
If you all are so uninterested in having to cope with the reality of this, the 2nd amendment puts relief within arms reach for yourself alone
You want to consider it the perspective of ratio alone? Ok.
You’re just 1 in 7 billion+ right? Why should I care about your existence... is effectively the narrative you’re peddling by clustering humans into an abstract math object?
Ok well I don’t care if you are one of those people in the math object you think matters
Annotate the math as if you’re inside the object. Then grow some nuts and live it
Typical American, throw everyone else at the fight
Edit: Oh no my fake internet points! An online community that is a minority of the populace doesn’t like what I put before them! But even as a collective their value to humanity as a whole is statistically unimportant so who cares?
We spend enormous amounts of money because we "don't accept" the high fatality rates seen in automobiles. And it works. Check out the charts here for very clear proof: https://en.wikipedia.org/wiki/Motor_vehicle_fatality_rate_in...
And now we're doing the same kind of thing (in, obviously, very different ways) to fight the covid pandemic. And it's working too, though better in some areas than others. Germany in TFA is worried that maybe their R0 might have slipped above 1.0 and started growing again. Outside NYC, the US epidemic is still large and still growing.
And it's the same thing with COVID-19. We can't quarantine everyone indefinitely, this is unlikely to end without us reaching herd immunity, and the quarantine itself causes non-negligible suffering. We have to approach this rationally.
Why is trying to minimize a US death toll on the order of hundreds of thousands[1] at the cost of a 20% GDP hit not a "rational" choice? It may not be your personal choice, but it seems to be to most people. And it's absolutely a well-understood tradeoff by everyone involved. No one went into this blind to the costs.
[1] Maybe only ("only") mid-tens-of-thousands if you use the kind of life-years-saved metric that seems to be en vogue among the "open up" set.
a) they are not going to "save hundreds of thousands of deaths", because quarantine doesn't stop the virus it only slows it down, in other-words quarantine will spread out those deaths in time, but many of those deaths are still going to happen (in due time)
b) 20% GDP hit will inevitably directly and indirectly kill, make homeless and starve a lot of people
c) in 2nd and 3rd world contries the distruption of the global economy to this degree will kill a metric ton of people
d) it's impossible to keep quarantine for extended periods of time, because then it's going to be way more than 20% GDP hit.
The only question is which approach is going to kill more people and do more damage in the long run.
To me it seems obvious that extended general quarantine is going to do an order of magnitude more damage (than doing the sane thing - like isolating at risk groups).
They literally (literally literally!) already have. What do you think would have happened in late March if the lockdowns hadn't bent the curves? Why do you think the high exponent mode (doubling every 3-6 days) stopped, if you don't think the lockdowns did it?
The problem with the "anti-quarantine" arguments is that they confuse the death rates of the status quo (locked-down semi-containment) with those that obtain from an unrestricted economy. That's not how it works.
> The only question is which approach is going to kill more people and do more damage in the long run.
Find a serious person with numbers that support your case. I think you'll be surprised.
If quarantine made the virus go away (which it doesn't) - or it bought enough time to make vaccines or effective treatments, then it would make sense, but it doesn't.
All it does it make it seem like you are saving lives, while in effect the deaths are just spread across a longer timeframe and now you're killing, starving and impoverishing people from the severe and dire economic consequences.
Secondly, why is nobody ever talking about the amount of deaths, starvation, homelessness and impoverishment that will result from economic damage of general quarantine. This always gets completely ignored and negated as if it doesn't exist.
You can't say that quarantine saves lives unless you quantify how many people are killed and are going to be killed by it.
My argument is that this by far will kill, starve and impoverish way more people than whatever number of people will get saved by having access to a ventilator.
For... the TFA is literally about Germany, a nation that had its outbreak R0 drop below one (i.e. their outbreak was shrinking), far, far, far underneath the herd immunity threshold. It's simply not true that Germany didn't prevent any deaths, that analysis is straight wrong. The same holds for most of east asia.
The only reason, quite frankly, that this doesn't seem to be happening in the US is because there is a segment of the population being led to believe that lockdowns are impossible, or that they don't work, or that they're an imposition on fundamental freedoms. So we're doing it badly. But it can absolutely be done well, as nations like Germany show.
If you take 1000 deaths and spread them across a 6months or a year instead of 2weeks, no lives have been "saved".
Similarly the act of spreading it out via general extended quarantine, does massive economic damage that will result in deaths, starvation, homelessness and impoverishment that arguably will completely eclipse whatever lives are actually saved by the quarantine (due to say availability of ventilators and medical care not being overrun).
Maybe that damage isn't as large in some developed countries like Germany who can maybe afford it, but it is in many other countries.
That is not the effect of a lockdown. There is your misunderstanding. The proof is in the linked article (or data for Hong Kong, Korea, Taiwan, Hawaii, all of whom also contained the virus before reaching herd immunity).
If those measures are not feasible long term (this seems to be the case), that means they R0 can be held below zero only briefly. In other words, the spread of the virus is only slowed down (or even reversed briefly, with R0 < 0) and delayed, and in essence the most deaths are simply delayed and not saved.
While the deaths from the quarantine measures itself doesn't seem to ever get accounted for.
And that is the problem - those quarantine measure/economic damage deaths doesn't ever seem to be put into equation as if they don't exist or are negligible.
Which makes me question if quarantine does net-benefit or does more harm in log term when all the externalities and knock on effects are actually accounted for.
Or am I missing something?
Rt is below 1 in all states except Minnesota and Nebraska [1]. So the US epidemic is still large, but already shrinking. With that said, when lockdowns are eased, Rt can increase again.
[1] https://rt.live
https://91-divoc.com/pages/covid-visualization/?chart=states...
Edit: in fact I went back and spot-checked Iowa. That link you posted says that Rt dropped below 1.0 20 days ago. In fact the real world new case rate is almost three times higher than it was 20 days ago! I'll just say it: that site you linked is garbage.
I'm sorry. Those graphs you linked are pretty, but they're just dead wrong.
I'm serious: that site is bad. It's a bad model. You have to stop reading and linking it. The only way to make it "right" is to assume (as you are) wild divergence between measured case incidence and "actual" unmeasured infection statistics, which isn't borne out in any papers I'm aware of from any outbreaks anywhere.
Basically: I'm telling you that measured data makes this model very wrong. And your response is to tell me that this is because measured data is itself extremely (like 3x!) wrong. That's bad science.
Who is we? In the UK, for example, the baseline expected death rate is around 2000 per day. Sure, adding another 500 to that is a big deal, but it is maybe not as big a deal as everyone seems to think it is.
The death toll due to covid is already is visible on all averaged yearly death per day/week charts and we have not even gotten to 1% of population having gotten the disease. That is a big deal.
Only when one year is taken into account. How about decade averages? I bet tobacco is #1 on the list and covid does not even make top 10
Close to a million people die in Germany in any given year, we're always accepting >100 deaths per day. The question in 12 months will be whether the death rate significantly increased or whether it primarily moved the cause of death, so more people died from Covid-19 and less died of atypical pneumonia, old age, cancer, heart disease or the flu.
And of course, we should have kept up the social distancing.
But note this includes estimates from February, with a lot more unknowns, and fails to take into account improved treatments (Remdisivir, Plasma, ventilator use improvements, etc).
Moving forward, given treatment improvements, I think a consensus IFR range would likely be 0.1% to 0.7%.
But this only works with a very low infection rate. Once your testing capacity (which is still, basically everywhere, much smaller than hospitals' ability to treat the same outbreak) is overwhelmed, you lose control and end up back where everyone else is.
People are watching this closely.
It eventually will be if R0 is greater 1.0. The government's position is that it needs to stay below one. The official metric to that effect is the number of new infections per 100,000 people. If it crosses above 50 for any administrative district, lockdown measures ought to be tightened. As of today, there are four above that threshold.
Just because the US and UK can’t get their act together doesn’t mean it’s impossible.
China is still finding new cases so it isn’t eliminated. New Zealand can keep the virus out because it’s an island (but they better be prepared to live without tourism).
It’s all just not very sustainable.
Your statement implies that if we could guarantee hospitals would never get overwhelmed we would happily let this wash over the whole population and kill 1% of us. That should be avoided (and would also hurt the economy just like the lockdown is, it’s not an either/or choice).
But yes, it could end before herd immunity. Or it could be like the flu, and mutate / continue indefinitely.
I gather that is unlikely, coronaviruses don't mutate like the flu.
In fact, according to experts, it is most likely that this coronavirus will decrease in severity over time and become endemic like the other several coronaviruses that are responsible for 15% of common colds. Or, alternatively, occasionally returning like a bad flu year. https://www.statnews.com/2020/02/04/two-scenarios-if-new-cor...
I remember reading in other places this may have happened before, something about a really bad flu year in the 1870's that may have been another coronavirus introducing itself to humanity.
In the Netherlands there are approximately 1.100.000 people between 30 and 34 years old (inclusive). Of those people 150 entered the hospital. That’s 0.01%. Most of these people are not dying (in fact only 3 of them did, which is 0.0003%) and while there isn’t a number of people with the chronic problems it definitely isn’t all of them.
By the way slightly more than 0.1% of the population dies every year due to smoking. I have yet to see the massive safety efforts.
Respectfully, I do not agree. New Zealand went on lockdown March 23 when they jumped overnight from 66 to 102 confirmed cases. They have 1144 as of yesterday.
There are now 1.3 million cases in the U.S., almost that many in Western Europe. There are not even enough tests to know the real number. Antibody tests are indicating that a couple tens of millions of people may have already been exposed.
I know of no precedent for using quarantines to eradicating a disease that is already so widespread. There is no evidence that such a thing is possible. It would have been at some point in the past, when there were some hundreds of known cases, but not any more.
What to do from this moment forward? Did you mean to imply that you thought we could stay locked down until this is eradicated?
I wonder if there are models that can give us covid predictions based on continuing the existing lockdowns versus easing of lockdowns, with a vaccine in 12 months versus a vaccine in 4 years, and estimated economic and social costs of lockdowns. I don't think it's responsible to make these big decisions without objectively weighing all the data, and the data is fuzzy, refined over time. (Although I am pleased at how much data is publicly available.)
Thats exactly what will happen. Based on sampling its much much less like .1% to .5% but there not much of an option. It would be like saying no one should smoke or drive cause people will die.
So Germany is going for total eradication of this virus? What makes them think that’s possible.
They also have a lower population and density.
Is the same thing realistic for an industrialized country in the middle of Europe?
So it is definitelly possible to "emullate an island" even in the middle of Europe, and it seems to have worked for the countriws that did it - daily case numbers are staying low, death toll is really low, so some of these restrictions are slowly being rolled back, with cross border bis and train lines resumming from 15th of May.
You're quoting the journalist, not any German authority.
6000 (peak daily infections) * (1 - 0.85)^Months, and you’d get to <1 daily infections within five months.
And, of course, having already reduced cases by 85% makes tracing the remaining cases far easier. That, plus improvements in understanding the dynamics of the virus and all the countermeasures, now allows for a “budget” so-to-speak, to be spent on some loosening of restrictions and adding whatever is necessary to keep re-introductions at bay.
People are now meeting face to face much more. This is causing the increase.
There were also 2-3 larger clusters discovered this week. Looking at the nationwide numbers might be not as useful in this case. I'm not saying there is no case for concern here, but right now these are very few data points on a noisy curve, and a similar spike that turned out to be nothing happened a few weeks ago. We really have to wait a few days to actually get some reliable numbers.
> Also, internally leaked government documents a few weeks ago showed that there is an explicit strategy of the government, to generate fear in the population in order to make people comply.
A quick scan seems to indicate a document meant to summarize the situation and possible outcomes including options for actions.
They explicitly propose to be as transparent as possible and to openly discuss the worst case scenario.
Without reading it in depth, this sounds like a sensible thing to write down to prepare the relevant authorities for what's coming.
Relevant quote:
> Wir müssen wegkommen von einer Kommunikation, die auf die Fallsterblichkeitsrate zentriert ist. Bei einer prozentual unerheblich klingenden Fallsterblichkeitsrate, die vor allem die Älteren betrifft, denken sich viele dann unbewusst und uneingestanden: «Naja, so werden wir die Alten los, die unsere Wirtschaft nach unten ziehen, wir sind sowieso schon zu viele auf der Erde, und mit ein bisschen Glück erbe ich so schon ein bisschen früher»
Google Translate> We have to get away from communication centered on the case mortality rate. With a case mortality rate that sounds insignificant in percentage terms, and which affects the elderly in particular, many then think subconsciously and admittedly: «Well, this is how we get rid of the elderly who are pulling our economy down, we are already too many on earth anyway, and with a bit of luck I inherit a little earlier »
And I would say this is quite spot on, for what we actually see on Twitter and elsewhere...
And a lot of comments here talk about restrictions deployed simply to avoid an overwhelm of the healthcare system. While that’s important, the longer we can prevent the disease running through the population, the lower we can make the case severity and fatality rate due to advancements in treatment.
A lot of commentary on COVID-19 recently presumed that we can’t control outcomes, only the rate of spread. That may be true at a point in time, but the longer we hold out, the better the outcomes will be on the tail end with advancements in treatment research.
I calced a bit and saw about a 1% chance of getting infected within a month at the office. Maybe acceptable for a month, not for a year (>10% risk than).
Reproductive numbers are important, but I'm not sure governments have really stepped up to the plate to explain how the virus spreads and what people need to do to stop spreading the thing. "Social Distance", "wash your hands" and sometimes "wear a mask" really lacks lacks explanatory power.
Given the vast costs the world has put up with so far to slow the coronavirus down, there is actually room in the conversation to have teams of people travel around and conduct some sort of training session on how not to spread this thing and have people actually act out simulations. There need to be finer grained tools than mass lockdowns and alternatives to tracking everyone with apps.
I've seen a lot of basic confusion on HN about whether masks even help. This is pretty clear evidence of uncertainty in the broad community about how to deal with respiratory viruses. I don't believe that is due to a lack of research; engineers have had the practical tools to research droplets in airflows work for more than a century now.
Even the fact that "SARS with a risk of asymptotic spread" didn't have world leaders slamming borders closed in Jan/Feb hints at a possible general misunderstanding of how virus spread works. There were other considerations at the time, but in retrospect more general education on the subject would have been well worth the time invested.
But these are exactly the sorts of things that shouldn't still be open for discussion after 4 months and global lockdowns. Even among the general public.
I've rarely been more unhappy about the state of our politics. There was a lot of public discussion about easing the lockdown and regions randomly made their own decisions, affecting people's behavior even where no decision had been made yet and forcing Merkels hand in the end, who was much more in favor of playing it safe.
We were on course to get the level of containment and traceability that several Asian countries have achieved, if we had only waited a little longer, maybe just a few weeks.
To me it seems we might be letting the economy run itself into the ground. I hope I am wrong.
We can only count deaths, but even that is tricky since people that were given 30 days to live are being counted as COVID-19 victims if they were infected.
The only way to know what the impact of the virus is/has been, is to compare with deaths from the previous years.