It'll be interesting to see how this goes in terms of compliance. You miss mother's day, ok, fine, call her and send her something. You miss memorial day, eh, I guess it's for a good cause. You can't have your annual 4th of July BBQ now your kinda annoyed. You can't do anything all summer and you can't send the kids away to summer camp either, well now you're pissed off. The fewer the local number of cases the harder it is to justify obeying the order in people's minds (especially if they see pics on FB and Instagram of their friends/relatives in other states out and about) and the more people are gonna just disregard the order.
And the measures don’t make much sense either. In Sonoma County parks are closed but stores are full. If there ever has been a safe place then it would be hiking in a park in my view. Also remind people to keep distance on beaches but don’t just close them.
Yeah. Nate Silver has tweeted a few times about disliking beach shutdowns -- a lot of evidence says outdoor transmission is pretty negligible, and you gotta weigh that against the "cost" to public opinion. People wanna go to the beach pretty bad right now.
At some point, people are gonna wanna stop paying the cost, and will simply stop complying with lockdown -- so you gotta ask, where do you trade a little extra risk in return for greater compliance to the rest of the rules?
I took a drive up the coast from Monterey northbound and every beach access was lined with cars. If there was a parking space meant for cars it was closed with yellow caution tape and cones, but if there was a space to park on the side of the road near beach access it was full.
It seems they've discovered their authority extends to closing parking lots and not much further, and they don't want to arrest people and get their orders struck down in court.
So much of the reaction to this is emotional/political.
I had a friend tell me he yelled at someone entering a closed park. I said its probably safer in a giant closed park than in my own backyard. He said: well, if I'm not allowed to go to the bar then he can't go to the park.
As I was telling a friend of mine, it feels like a collective case of "misery loves company". Any indication on my social media that someone is stepping out their front door to be proactive about their mental health is met with an unfortunate amount of derision and shaming.
And the political aspect to this can be just as depressing. It seems a nuanced conversation on the benefits of reopening is impossible with my friends on the left side of the political spectrum (which is most of them, and includes myself). I have incredibly smart friends on the left, and I'd love to hear a point of view from them that I didn't feel was being driven from an "us vs them" mindset.
It's really unfortunate that advocating for reopening has been cast as the position of the looney right in the national discourse. When to reopen could be the most important question we face in decades, and a reasoned, dispassionate discussion of the pros and cons sure would be wonderful.
Nobody is sure how it transmits. But if it's airborne, moving air and sunlight are certainly going to make gathering at a beach much safer than gathering inside an office building.
Handwashing stations and ULPA filters in HVAC systems set to renew the air x times more often I think will end up being the long term solution, along with a persistent disease which is just a part of life. The masks seem to just be a joke made up by people wanting to do something.
The problem with opening up the beaches.. are the congregation of large groups of people at choke points such as crosswalk intersections and such places.
Indeed. I think compliance will be really interesting to see, especially in comparison to states that allow small relaxations in the coming weeks. At some point, if they don't feel like progress is happening, people will get fed up with the current situation and begin to socialize without precautions. Meanwhile, if you allow people to do a little socializing, they may end up being more compliant overall.
There is no way that people will keep complying for such a long time. I am all for mask wearing and work from home as much as possible but a lockdown for such a long time is crazy. What’s the goal? Flattening the curve or no deaths at all? We will probably see in a few months where things are going but from the stats I have seen so far the connection between lockdowns and lower death rates is not that strong. By now I would have thought that all hell would break loose in Florida but it doesn’t seem to be happening.
Arguably, most of the party-goers were out-of-state, but it also would've been relatively easy for authorities to link a spike in deaths to those events. So far we have not seen the spike take place.
> Arguably, most of the party-goers were out-of-state, but it also would've been relatively easy for authorities to link a spike in deaths to those events. So far we have not seen the spike take place.
How would we know? They are spread across the nation.
People on spring break are mostly young and the people they interact with while on spring break are mostly young. You would probably need to look at contacts two or three degrees away from them to notice the spike. Has there been an in depth analysis of the extended network of those people?
On 3/14 we had about 3k COVID-19 cases in the US. By the end of April, we had about 200k. Our contact tracing efforts at the time (and now) likely aren't sufficient to tie specific cases back to Florida's spring break, but it's unlikely to have helped.
We had 3k reported cases, not 3k cases. That's a large difference. I wouldn't be surprised if the actual number of cases from 3/14 was hundreds of thousands.
There were 58 deaths reported by 3/14. If you assume that mortality is 1% (probably on the high side, but good enough for estimates), that translates to ~6k cases.
However, since we know that deaths lag cases by 1-3 weeks (let's assume 2 weeks for the analysis), we should be looking at deaths two weeks from 3/14, which would be 3/28.
By 3/28, there were ~3k deaths from COVID-19, meaning that the true estimate of the number of cases from 3/14 is likely around 270,000 cases (estimate range is 130K - 800K).
This also means that there were about 8.5 million cases in the US on May 1st (I happen to think mortality is closer to 0.5%, so that would be ~17 million cases instead), and that we've most likely crossed the 10 (or 20) million case mark by now.
> it also would've been relatively easy for authorities to link a spike in deaths to those events. So far we have not seen the spike take place
What makes you say it "would've been relatively easy" given contact tracing is not widespread in the US and certainly wasn't during the weeks of US Spring Break (ca. mid-Mar)?
In any case, you are mistaken that "we have not seen the spike take place". [0] See, especially, the map "generated by Tectonix GEO and X-Mode Social" about 1/3 of the way down the page.
> What makes you say it "would've been relatively easy" given contact tracing is not widespread in the US
Plane tickets were bought, credit card spending took place, cell phone towers were pinged, hotel reservations had names linked to them, relatives, friends or colleagues aware of the whereabouts and can be interviewed post-mortem?
We had a big spike in Quebec after spring break as people returned from Florida and France. The province is still the worst in Canada. BC took note and advised people not to travel for spring break (our break here is later). BC is doing very well by comparison.
GA "opened up" salons on 4/24 and restaurants on 4/27. I say that with quotes since many places remain closed for dine-in service. Nonetheless, it's been 2 weeks and we've only seen a slight decrease in case rates: https://www.nytimes.com/interactive/2020/us/georgia-coronavi...
At least for Illinois, models predicted that a May 1 reopening would lead to a very large second peak in June with high probability. See e.g. https://www.chicagobusiness.com/greg-hinz-politics/look-insi.... It's more than 2-week lag time due to the time required for R_0 to increase (due to people's habits), a number of generations required to noticed, and the general lag time of the issues.
I think that is intentionally being manipulated. They are pushing for asymptomatic people to be tested in droves. The % is accurate but the biases in sampling don't make it an apples-to-apples comparison anymore.
The lockdown and resulting economic damage is much less an effort of state enforcement than it is individuals being (correctly) terrified to engage in commerce unless absolutely necessary.
"The lockdown and resulting economic damage is much less an effort of state enforcement than it is individuals being (correctly) terrified to engage in commerce unless absolutely necessary."
What makes you so sure that average people should be CORRECTLY terrified of this virus?
If I'm in a high-risk category, I get it. But what about others? Are the rates of severe infection remotely high in people who aren't elderly, immuno-compromised, or with underlying conditions?
Keep in mind, the advice on this SHOULD be different depending on where you are. NYC? Sure, be incredibly vigilant. Nebraska? Probably not a big deal.
Looking at all the trackers I have bookmarked I'm not seeing much of an indication of this. Yes, confirmed cases seem to be up in the last week, but that seems to track with increased testing (a good thing). The rate of positives is showing a decline over the same time period.
More indicative of an outbreak would be increased hospitalizations or deaths. Hospital bed usage has been at the same level since mid April, and deaths have been at a steady 1 to 3 per day since the end of April.
are the two I count on the most. I don't really trust any of the confirmed case counts to matter much since testing isn't consistent. In most parts of the state you can't get tested unless you're exhibiting symptoms.
One of the local hospitals reported that they're currently at 50% ICU capacity just with COVID-19 patients.
Nebraska's not a hot spot. Another poster put data and references down supporting this.
The reason you have a few hot spots WITHIN Nebraska is due to 4 different meat processing plants in 4 different counties. The worst hit county, Dakota County, is home to a massive Tyson facility.
And explain to me why this doesn't make Nebraska a hotspot?
Do those workers magically teleport elsewhere after work? Do they not go to the grocery? Do some of them go to church? Do they not wind up in the local hospital?
I think it's a simple fact that these are localized infections. The reason meat processing facilities have been hot spots has to do with close quarters combined with cold temperatures. When the employees leave those buildings they're not interacting with the general public in refrigerated facilities.
The point I'm making is that if this was a dispersed infection that was spreading through normal community interactions it would be much worse and harder to contain than if it's at a few facilities..
It's almost like depending on where you are and what the data says you should have a different action to optimize the outcome... And that's the point. This one size fits all everybody act like we live in Wuhan isn't working well.
>What makes you so sure that average people should be CORRECTLY terrified of this virus?
50% of Asymptomatic and 80% of Symptomatic cases on the Diamond Princess had ground glass opacity on CT scans. Usually indicates irreversible lung damage. Care to gamble on decreased lung capacity for the rest of your life?
There's been a huge increase in activity in Atlanta since the reopening. Not pre-lockdown levels of course, but lots of people outside the past 2 weekends, on the beltline, etc.
This is what I see in my network; people continue to self isolate. The effect would be lower case/death peak at the expense of economic “back to normal” that seems to be priced into the stock market.
This perfectly illustrates the "opening up" paradox. If you, as a Government, aggressively open but the public still sees risk, not much will change. People won't go outside much because they perceive risk. We'll have to wait much longer to actually know whether opening aggressively is a mistake or not. From my perspective the risk of opening too early and starting a second wave much later in the year, is worth taking very seriously.
I'd say anyone drawing conclusions from a a few weeks data has a 50% chance of getting burned at this point.
That's interesting because I live in a country where it's the opposite, e.g still only essential services after 2 months, limited goods sold, ban on cigarette and alcohol sales, curfews for shopping.
Point is I think the opposite of what you're saying might happen here, i.e. regulations loosen and there's going to be a disproportionate number of exposures as a place not so tightly regulated
I could have been more clear. My point is that aggressively reopening might still be dangerous, but it'll take a while for the public to convince themselves it's safe enough to start going out, even though it isn't. I'd imagine this would be driven by both consumers not wanting to get sick _and_ businesses trying to avoid liability for employees and customers.
I've heard that Georgia also just changed how they report cases - instead of date of diagnosis, it's date of onset - so the numbers themselves now have additional lag and we won't know a given day's real numbers until a week or two later as they're backfilled.
I've been watching closely, one convenient thing about this is we only have to wait about 3 more weeks to have the definitive answer on GA, FL, and maybe even TX. It's not like we have to wait decades to see it play out.
Go here and scroll down to Cases by US States/Territories per Day and highlight GA, FL, and TX then play with the metrics. All three seem pretty stable so far.
http://91-divoc.com/pages/covid-visualization/
> How long ago did Florida open everything back up? If I remember correctly it was just May 4th?
Parent is referring to weeks and weeks of predictions that Florida would be utterly decimated because of large Spring Break parties, taking a long time to shut down in the first place, beaches not closing down for a long time, etc.
Florida, like apparently everywhere else in the US, has been perpetually “two weeks away” for the past six weeks from becoming New York City.
The eight days is in reference to Florida easing some lockdown restrictions. Most of the US has been under some sort of lockdown since mid to late March.
100% not that. It's more of a suggestion to stay at home. Restaurants and bars are closed to dine-in. Movie theaters and other fun things are closed.
We 100% do not have military threatening arrest for going out. At this point, many (rural) police districts and politicians are even saying they won't enforce the stay-home orders anymore.
Growth is slowing down. ICUs are still not completely full but getting there. Certain areas in the Andes do not have any cases which is great, but the infection rates in certain cities (like Iquitos) are high, mainly because of markets.
But the spreading continues, and I can see it taking multiple generations to make a clear trend. It's not like in 2 weeks there are 10x more people, the R0 is not that high. You have to have enough to be noticeable compared to the previous visible amount.
The goal is to stabilize the infection rate and boost healthcare capacity so that some semblance of normality can be resumed without overwhelming the healthcare system.
> a lockdown for such a long time is crazy.
And people will rebel, and the infection rate will spike yet again, and people will die, and the lockdowns will be imposed with force.
Better to listen and understand than to disobey and risk worse. What's the expression? Regulations are written with blood?
A nitpick, but I fear that we're not boosting the healthcare capacity... whether due to healthcare still being profit-seeking here, or due to the Fed Govt being completely inept.
In which case it's easy to feel like it's all for nothing.
I personally still support it but I can see why people are frustrated, and I think as this goes on you can't just extend it without some really clear and transparent communication.
> The goal is to stabilize the infection rate and boost healthcare capacity so that some semblance of normality can be resumed without overwhelming the healthcare system.
Everytime someone posts something along these lines I am reminded how difficult it is to get a sense of exponential growth & how the gap between needing them, not needing them, being overwhelmed, having this blow over is a smaller than it intuitively feels.
>people will rebel, and the infection rate will spike yet again
that is unknown. If anything, the flu experience shows that the hot dry air minimizes transmission by minimizing the lifetime of the exhaled aerosol mini droplets which carry the virus.
The rate will most probably spike again in the Fall, lockdown or no lockdown, because of the colder moist air then, and I think it is very misleading to promise people the lockdown avoidance later in exchange for a larger lockdown now.
Governments at all levels seem to be doing only lockdown, which basically means doing nothing by the governments themselves and just putting the burden squarely on the people shoulders and waiting hoping that the issue resolves on its own. Where are the true government actions to fight pandemic - i mean at least bare minimum - masks, testing, contact tracing? Why Whole Foods, not the government, should give away free masks? I guess, no money for masks in the $6T dollars that have just been printed and have propelled the stock market back into the bubble.
right, that's why no one in Australia or Israel or other hot countries got it, like India. But that was a sarcastic comment. It is spreading in hot places. It's a lot more reducing exposure that limits it than hot weather, based on reality, not magical thinking.
So far all I've seen on this topic are mostly models.
I'd love some experimental data for once (with regards to SARS-CoV-2, a lot is modeling, and a lot less is bench work) to know if this is true or not (there are a few studies but most of them aren't that great, at least the ones I've read).
The minute this disease hit the US, 0.3% of the population was immediately living on borrowed time. The goal of the lockdowns was to keep that 0.3% from rising to 3% because of overwhelmed medical services. For most of the country it's worked, but there's nothing you can do to save the 0.3%, and inciting the country to riot is only going to add to the toll.
If people mill about and it doesn't stop till we reach herd immunity, imagine at 50% of pop, 0.3 or 0.5% die, that's a big number 330mil * .05 * 0.005 = 825k deaths. IHME estimates assume we won't just keep standing around until half of us get it. The fools walking around are competing with that vision.
Ok, did not realize national hadn't leveled out, so I take back 'most'. I feel like my state's (CO) re-opening response is appropriate but we've been relatively 'flat' for a couple weeks. Apparently we're also one of the few states that can afford a Tableau license, we've had a decent site https://covid19.colorado.gov/data/case-data since March.
There's multiple promising therapeutic treatments going through high quality studies and vaccines aren't impossible.
Why so defeatist?
Also, there's mounting evidence that social distancing is being done socially (by people making their own choices) as much or more than by governments.
It's not defeatist- vaccines and treatments take time, implementing contact tracing takes time. But pushing for unrealistic outcomes is just going to lead to distrust and lack of preparation for the next event when they inevitably fail.
How are you so sure people will stop complying? Is the risk of opening everything up just to shut it down again really worth it?
I think people are smarter and more accepting of the status quo than those who are making the most noise. As for those who are overburdened by the lockdown (i.e. lost jobs), its on the governments to provide the safety net until we have everything under control.
I dunno. People in West LA already seem to be complying poorly.
There are a lot of entitled people around here, and a lot of folks doing plague cosplay (wearing a mask around their neck like a talisman, gathering but moving to "safe" distance when other people draw close, etc.)
“its on the governments to provide the safety net until we have everything under control.“
There are limits to this and the burden is distributed very unevenly. If you have a spa, your business is taking a big hit , but the landlord is not required to stop asking for rent. We would have to switch the whole economy to a non profit model, otherwise the lucky ones make out like bandits and others are being driven out of business.
This "some businesses are saved" effect that's happening now is the most unfair thing, in my opinion.
If the government wanted to provide support to keep everyone roughly where they were before the pandemic, that's great. But picking and choosing is really unfair.
And it seems to be hurting small business owners and the middle class the most. Unemployment payments max out at what, $4000 per month? Meanwhile a middle class professional in the Bay Area might pay that much just for rent, before considering food or other expenses.
Freezing rents and interest throughout the entire economy would substantially reduce the amount of government assistance needed. It's also not the same as a non-profit economy.
> How are you so sure people will stop complying? Is the risk of opening everything up just to shut it down again really worth it?
I live in California and I can tell you that people are already extremely over this shit. Go out and about and hardly anyone is wearing masks, hardly anyone is social distancing. Some people are trying ... but you are only as strong as your weakest link. It's tough to keep up stringent personal standards when everyone around you has said fuck it and given up.
So I completely 110% agree with the parent commenter that people have already been demonstrating they don't want to comply. I mean, it's human nature. No one wants to be told what to do.
The hospital boat off the shore is completely empty (it treated a total of 77 patients). Most of our hospitals are significantly below capacity.
We've all been sitting around twiddling our thumbs waiting for the apocalypse and nothing is happening. Just crickets. Unavailable unemployment funds, closed businesses, lost jobs.
The one thing everyone is learning from this is that the government will not help you. It doesn't matter how liberal or conservative your state is, or whether you believe most in federal or state governments ... everyone is doing a shitty job in one way or another.
So if the government is not going to do fuck-all for me, why should I do fuck-all for the government?
I guess it depends on where you are (California is a big state!), but at least here in SF people are still taking this very seriously. Almost everyone on the street is wearing a mask.
> The hospital boat off the shore is completely empty. Most of our hospitals are significantly below capacity.
I think a lot of people don't realize this. My wife's friend is a nurse shift supervisor at our local hospital. The hospital is practically empty because there are no elective surgeries. They've been laying off nurses over the past month. She had her hours reduced. She's expecting to be laid off soon too.
If the whole point of this is to buy time for hospitals, doing so to the point where they have to start laying off staff members is a pretty dumb way to do it.
Government has to subsidise them to be ready in the event there is a surge in cases. If people are being laid off there was no point to cancelling elective surgeries.
There was also very poor visibility on the likely case growth, because testing was so limited. It's only the last couple of weeks where there are enough tests to be testing people with likely exposure instead of just people that were gravely sick (so now healthcare workers and first responders and other essential workers can be tested without requiring that they be symptomatic).
And so many elective surgeries are out-patient meaning there was no reason to pre-emptively suspend. If the capacity overwhelm that never happened had actually happened, we could have suspend surgeries then. And frankly it should be on a case-by-case basis. Some surgeries are more important than an extra hospital bed-day.
I have a large labral tear in my shoulder, an impaction fracture on my humerus, there’s a bone bruise with bone marrow leaking out, my glenohumeral ligament is stripped from the glenoid rim, I have a new area of full-thickness articular cartilage loss...
...And because CA suspended ALL elective surgeries statewide for a month, my surgeon has a month backlog before he can get to me. Until then I cannot perform any of the activities that keep me healthy and sane. Also my arm is at risk of dislocating in my sleep until I get surgery
Suspending elective surgeries was the dumbest possible decision we could have made yet our leaders won’t ever admit that they fucked up and completely botched their covid response.
I hear what you're saying, but my understanding is that PPE shortages were behind the decision to suspend other medical activities.
Failure to maintain an adequate stockpile of PPE is probably what made the lockdowns necessary, more than anything else. If everyone in the US could have been given masks and instructed to keep their distance from other people, that would probably have been enough to allow us to lock down only the most vulnerable. At least we could have begun with that approach, and moved on to heavier measures only if/when they proved necessary.
> I live in California and I can tell you that people are already extremely over this shit. Go out and about and hardly anyone is wearing masks, hardly anyone is social distancing.
It's a big state. Compliance varies a lot by area, and by local culture. Just because there are some people who don't take social distancing precautions doesn't mean that those who have the civic sense to take those precautions should abandon their efforts.
I'm just painting a picture of the vibe I am experiencing as a native Californian who has been out a lot in LA and OC. I still wear a mask when I am out and do my best to abide by social distancing rules. We have lots of hand sanitizer in our vehicles, about a hundred medical-grade masks, and a lot of bandanas and other stuff in case we need it.
No, people are pretty over it in the Bay Area too. I don't know a single person who's staying within the letter of the stay-at-home orders any longer. (Admittedly, everyone I know has been pretty diligent about masks and handwashing since March.)
If you know of any polls about compliance with stay-at-home orders, I'm all ears. I get the impression that pollsters are deliberately avoiding asking about it.
If you look at our counties by population, LA and OC are doing pretty stellar relatively speaking. Add up all the counties in "SoCal" and you're looking at roughly 20 million people. The Bay area is what... ~4 million for SF/Alameda/Santa Clara? Not trying to start a pissing contest here but the fact that we're going to have more cases and deaths is just a numbers game.
Yeah, but most of the charts and graphs further down are per 100k, and the doubling rate for SoCal has tended to be much worse whenever I've checked the page. (I only bring it up because I've wondered on more than one occasion what might account for the difference.)
Fortunately, it seems to be leveling off somewhat, except for Santa Barbara. I really, really hope we can keep it that way.
In Santa Barbara, the stats are bad because they have been counting infections at a federal prison in Lompoc, where there are something like 70% infection rate and 2 deaths already.
> Add up all the counties in "SoCal" and you're looking at roughly 20 million people. The Bay area is what... ~4 million for SF/Alameda/Santa Clara?
> the fact that we're going to have more cases and deaths is just a numbers game.
The rates are higher in LA/OC too, not just the absolute numbers.
The LA metro area population (which includes OC) has 13 million people. There are 36k confirmed infections. So the confirmed infection rate is .28%. There are 1600 deaths so far, so the death rate is .01%.
The Bay Area population is 7.75 million, the # of infections stands at 10k, which is confirmed infection rate of .13%, and deaths are 360, which is a death rate of .005%.
It's absolutely not a contest, but the rates are what they are. If you choose to expand either areas' stats out to include their neighboring counties, the differences in the rates don't change much, but will eventually converge with CA wide rates, since this disease is most prevalent in urban areas.
Both the Bay Area and LA/OC appear to have lower infection rates than many other urban parts of the country and world, but the Bay Area is currently seeing both a lower infection and death rate than Southern California. Only time will tell if that holds.
It might look like people are over it, because all you see outside are: the people outside. For every dummy out there horsing around during a global pandemic, there are 100, maybe 1000 following the rules and staying inside. When you sprint out there to grab some groceries, you see people out and about and assume "people are over it." But all you are really seeing is the few people doing essential business and the few "I just wanna break the rules" people.
I also noticed that traffic hasn't really changed in my neighborhood and people all seem to be ignoring stay-at-home, but have gradually come to the conclusion that that doesn't have anything to do with the actual stay-at-home compliance rate.
Unsure why you are getting downvoted, I am seeing the same thing in the bay area, but this is hospitals being ghost towns, etc. I do see alot of people wearing masks but doing it wrong, people wearing them in their car by themselves, or out all alone and wearing them. My own Doctor has told me covid-19 cases have fallen off a cliff and the tents in hospital parking lots are being torn down unused.
If I'm out doing two errands - e.g. I went to Home Depot for a light bulb and air filters and then to a grocery store - I will keep my mask on in the car. Unless I've brought a change of gloves - I will not touch my facemask until I've returned home - discarded my gloves and then removed my mask.
So - you may have seen someone like me (who doesn't want to touch his face or mask) driving with a mask.
I can't speak for the original commenter, but I guess I just don't see it as a big problem. I have hand sanitizer in my car, but I dunno, a mask isn't so uncomfortable that I feel like I have to fiddle with it a bunch depending on whether people are nearby that second.
Aside from being "over it", I think it's also that people are (correctly) perceiving their individual risk to be very low and acting accordingly.
It's a bit of a birthday paradox problem in that if you have large groups of people not social distancing in an area with pretty low prevalence like CA, the risk to any one person of contracting the virus could be extremely low, while the risk that some of those people will contract is extremely high.
Americans are, for better or worse, really not used to thinking in collectivist terms.
Herd immunity will require between 60-80% of the population to be infected. At the bottom end of that scale it's 198M people. The IFR is roughly between .1% and 1%. The range for these deaths will be 198K to 1.98M. Fatalities. Hospitalization is roughly 5%, so between 1M and 10M hospitalizations with unknown long term effects.
Think of it this way; if 2/3rds need to become infected before this crap is over, don't you want to be in the 1/3 that doesn't risk death/hospitalization?
Ever hear of the term speakeasy? The high school kids are going to be kicked out of their basement bars by their parents who will want it for themselves.
>> its on the governments to provide the safety net
That's not really working out now. Plenty of people in WA state as well as NY state are waiting on unemployment claims dating back to March. Fed is backstopping large corp. losses while the every day person gets nothing. WA state is rolling out a "science and data" dashboard that looks like an MS Word clipart project from an 8 year old kid.
Our governments are mostly inept at anything resembling complexity. Something ten times more complicated and difficult like this shows how slow they are to action.
This was foreseeable. The WA state subduction zone report shows that in a simulated catastrophe due to liquifaction / earthquake in the Pacific Northwest, mean time for government intervention for aid-related activities was on the order of 3-4 weeks.
We talk about how large corporations privatize gains and socialize losses; government agencies are quick to act on authoritarian measures like lockdowns but slow to act on remedies to keep them going in an equitable fashion. The only surprising thing ongoing in the nation right now is the degree of ineptitude of our government agencies. Not even I thought they were this bad at getting aid to people.
>its on the governments to provide the safety net until we have everything under control.
Let's be clear-- there is no true safety net for middle-income professionals. We can draw down savings and cross our fingers that this resume gap doesn't kill a professional career. And that's just the financial and career consequences. There definitely are other consequences of unemployment too.
I feel fortunate not to live in L.A. county but the public health response my state is not a lot less draconian. I just am astounded. I would love to wrap everyone and everything in bubble wrap as much as the next person to protect everyone from a very dangerous world but this is too much.
Everyone's situation is different. Unemployment isn't 100% and the class of 2021 won't have this gap. Think employers are rational enough to iron that out? Nah, you have more faith than me.
There hasn't been a "previous downturn" with this concentrated (size × time) an unemployment spike. It's weird to claim we know now how employers will react to it yet when they see "unemployed, May 2020" on a resume.
The Department of Labor didn't collect unemployment numbers until the 1940s, but it's my understanding that the recent spike in filings is unique in size since they did.
Where is the government going to get this money? Most social programs are funded by income taxes, if no one is working there are no income taxes to take from people to pay the people not working
Unless you just want infinite money printing. The Federal Unemployment increase ends in July, and it highly unlikely this will be extended, so the county of LA has no ability to print more money, or really extend their debt
CA only has $17.5 billion in reserve as of February. This will most definitively don't last until July.
And the government has made it clear they won't bail out states.
Once the money drys up CA can't afford to keep counties locked down indefinitely.
It is literally impossible for a sovereign entity like California to go bankrupt. If the state government becomes insolvent then they'll just stop paying some debts and issue IOUs (like with the 2009 budget crisis).
While it has never happened, States unlike the federal government can become insolvent, Issuing IOU's (aka debt) only works if the businesses are willing to accept and loan the state the money. and IOU for services is no differant functionally than a loan, and if your business does not believe the state is good for it then you will stop providing services
Further I am sure employee will stick around for a long time when their paychecks are replaced with "IOU's"
So sure technically there is no bankrupcy court for the entire state, the fact remains that a State can absolutely enter in to a condition that is more or less the same thing as bankrupcy. The feds can just print more money, and most likely CA would beg the feds to do just that to bail them out should that happen
Local municipalities and counties can absolutely go bankrupt. Which is more likely in this situation
"I think people are smarter and more accepting of the status quo than those who are making the most noise. As for those who are overburdened by the lockdown (i.e. lost jobs), its on the governments to provide the safety net until we have everything under control."
This is the problem with a website for desk jockeys commenting on orders that don't impact their livelihoods.
For any individual, there is a cost/benefit analysis for the lock downs.
The cost is a hell of a lot lower for you and me than it is for restaurant, construction, factory, etc workers who have lost their livelihoods. Let's not forget about the small business owners and independent contractors.
These folks are incurring a much higher cost, and as far as the government assisting them, how smooth do you think that is going?
Have you personally gone and applied for unemployment benefits, or an SBA loan to keep your business afloat?
The government safety net isn't ideal, or pleasant, to deal with. Mayor Garcetti hasn't done well with reforming the LA government, nor dozens of predecessors. The state government of California isn't fun to deal with either.
You probably don't have kids either, if you fit the typical demographic on HN.
A complete failure of empathy on the part of members of the professional/managerial class, who bear little costs of the lockdown towards those who pay the most.
This stay at home order doesn't seem to be informed by updated models and data on this illness. The disease is highly contagious, and deadly at an unacceptably high rate to certain high-risk categories of the population. Those people should change their behavior.
The "wait 2 weeks" thing is what I keep hearing people who are stuck in the "only lockdowns will work" mindset say about every place that has lifted or not implemented lockdowns. It's almost as if they are hoping for it.
Let's be clear: If Georgia and Texas are fine a week from now, that will be good news for the whole country. Even if this good news proves your previously held opinion wrong, it will still be good news. I sense that people on here are hoping for bad news instead, because then they would be right.
Your statement about people being "smarter". Let's be real here, what you mean by "smart" is people who share your beliefs about the best solution to this virus. As if anyone knows with certainty what the best path is. Nobody does. We are all trying our best with the latest data. Except for politicians, who are hell bent on proving that their initial, poorly informed decisions are indeed the way to go by doubling down on them.
Honestly, they should just open up, pass some mask rules and other targeted measures, and then stay open come what may. A broad, untargeted shutdown was always both the bluntest and most expensive approach to this problem. Perhaps its sole merit is that it was really, really good at getting peoples' attention.
Unfortunately, LA is governed by people who do not understand what "the economy" actually means, and view it as a thing to disdain. They will not bear the costs of lost jobs, lost medical screenings, lost K-12 education, and lost social services (both now and pursuant to the city budget shortfalls).
> its on the governments to provide the safety net until we have everything under control.
There is no plan for "under control." We are still looking at a scenario where 50-70% of the population gets the virus. There is a possibility of a vaccine, yes — but no one credible suggests we ought to be planning for it in the next year.
Plan for a 2-year shutdown order, or plan to reopen soon. A three month shutdown, in the middle of that range, doesn't make any sense at all.
I happen to entirely agree with you, but the counterargument is that a treatment (not vaccine) becomes available earlier which makes the incidence of actual lasting damage from wuflu so low as to not warrant any more shutdown.
WA reopened outdoor spaces for the first time this week (to be fair, that also coincided with hot weather). The situation at the trailheads was insane. There were cars lined up along the road half a mile from the parking lot in places (someone posted a video on FB suggesting people don't go). We went climbing and the giant pullout by a climbing/hiking area that isn't even an official trailhead and has no facilities had at least twice as many cars as I've ever seen there, maybe more. Most were hikers and there definitely was no social distancing happening (the climbing areas were busy but there were few enough people to technically be 6ft apart, as is usually the case in this area).
Oh, and 2 out of my ~10 teammates at a major tech company took Friday off, one for a "long weekend" roadtrip, one for unspecified reasons... I also doubt that's a coincidence.
I can't wait to see what happens when restaurants reopen. I'm definitely heading to a bar asap.
They have established objective metrics to use in determining when to loosen restrictions, and there are also procedures in place for partial reopening of restaurants, recreation areas, etc. Your questions are answered in the article.
In this case though, I think it’s okay to have the measure be the target. If people can self-regulate their behavior to fit a certain rate of infection, what’s wrong with that?
(Not to mention the infection rate is a really lagging indicator)
I feel like this just needs a better branding. For one thing, across California the stay at home orders have barely been enforced anyway. People are hanging out in parks, even meeting up with friends in parks all the time. So it's been an open secret this whole time that it's more voluntary than an "order". Now with curbside pickup, and restaurants partially opening, it seems like taking another step towards more targeted interventions and away from the broadest stay at home orders.
This all seems in line with what anyone would have expected. Anyone who thought that on June 1 when the stay-at-home orders officially end everyone would just jump back into normal life and it would magically be safe clearly hasn't been paying attention.
The difference between California and states like Georgia that have "opened up" actually seems to be quite minimal. Some people are taking more risks (which is not really being stopped in either place), the majority are still being very cautious. That's bad news for people hoping that the small businesses that have been financially hurt would spring back immediately, but hopefully good news for where we are in containment of the virus. And, knock on wood, at least for now it seems to be enough to keep the disease spread from ramping back up.
I still think it would have been nice to just go all the way with the lockdown from day 1 back in March, actually enforce the rules and keep more people inside, and squashed the curve faster so that by now we'd be a lot more open than we are. But instead we chose the route of making most people only moderately miserable instead for a long time, instead of even slightly more miserable but for a shorter time.
It's real world political game theory. The unspoken side benefit (whether intentional or not) here is to limit the government liability in case of health related lawsuits in the future related to opening too soon, which is great as a state taxpayer.
Hesitate to bring it up since its so contentious but this is actually probably a huge side benefit of the Alameda County go slow approach. For the interim county health advisor, there's no benefit for going out on a limb and providing the rubber stamp to allow a plant to open as they'd ultimately individually be scape-goated if things went wrong. All politicians above would be free to claim - "I wasn't consulted on such details". Now since the plant is open without full approvals, all legal liability is on the private company for any health issues that arise. In fact the state hasn't really officially said the plant could open and so is free from liability and now that the president has chimed in, the interim county health advisor is completely free from liability.
It's a great get out of jail free card, release from liability stance as the individual or company is against government orders.
> The unspoken side benefit (whether intentional or not) here is to limit the government liability
If the government wants to limit its liability it should stop telling people what to do and let them decide for themselves.
> For the interim county health advisor, there's no benefit for going out on a limb and providing the rubber stamp to allow a plant to open as they'd ultimately individually be scape-goated if things went wrong.
So the only alternative is for the government, after imposing the costs of the lockdown on everybody, to simply refuse to accept the costs of reopening?
There's still some liability on the state in leaving it interpretable. They will also be called out for lack of leadership if they don't provide guidance.
The best political safe alternative for all players involved is to do what's happening now; the government provides a hard line on guidance and then is lax on enforcement and lets the plant re-open and begin production. If it goes well (and hopefully it goes well), it goes well.
If it doesn't go well, then people who were advocating taking the risk and with the most to gain if had it gone well, are ultimately responsible for the downside liability. Which seems fair?
> They will also be called out for lack of leadership if they don't provide guidance.
Called out by whom? I won't. I don't expect the government to provide me guidance. I'm an adult human being and I don't need a parent.
> The best political safe alternative
I have no interest in a "political safe alternative". Politicians worrying more about their political safety than the good of the people is what got us into this mess. Without a culture of "political safe alternative" the FDA would not have had the power to keep state and local health authorities from coming up with their own testing protocols when it was clear the FDA and the CDC weren't up to the job. And without a culture of too many people waiting for "guidance" from the government, people would not have waited to take obvious common sense precautions against a possible pandemic until the government and the media told them to, way too late.
> Which seems fair?
I have no problem with people who decide for themselves what to do with their own lives having to live with the consequences.
What I have a problem with is someone else claiming the power to decide for me what I am allowed to do, and the only consequences to them if they screw up being "political".
The scenario as a taxpayer that's concerning is as follows:
1.) Individual (or Company) A does some potentially unsafe activity and the Government says hastily - "Great, sure; continue!" or doesn't provide any guidance (edited).
2.) Individual (or Company) B is affected negatively - so negatively in fact that they decide to sue not only Individual (or Company) A but the Government as well since the Government said everything was on the up and up either through explicit approval or inaction (i.e. Individual B thinks the Government should have acted) - (edited).
The Government then loses the lawsuit and uses taxpayer money to pay the settlement. Then Taxpayer A, B and C proceed to also sue the government due to gross mismanagement of tax payer dollars and the government loses that as well. And now the rest of us Taxpayers D thru Z have to pay for all these settlements.
> Individual (or Company) A does some potentially unsafe activity and the Government says hastily - "Great, sure; continue!"
Who gave the government the power to make that decision unilaterally?
> Individual (or Company) B is affected negatively - so negatively in fact that they decide to sue not only Individual (or Company) A but the Government as well since the Government said everything was on the up and up.
So if the government were out of the picture, B would simply be suing A. There would be nobody else to sue. And the taxpayers would not have to pay anything.
So what value, exactly, is the government adding here?
> everyone’s choices impact everyone else in serious, often fatal, ways
No, some people's choices impact some other people in serious, often fatal ways.
My wife and I started taking precautions more than two months ago. We have drastically cut down the number of shopping trips we make--one of us used to go to the grocery store, drugstore, or whatever every other day or so, now it's about once every 10 days, and we make sure to stock up so we don't have to go more often. We wear mask and gloves whenever we do go to the store or any other public place where we can't reliably social distance. When we walk our dogs, we stay well away from anyone else.
How have our choices impacted anyone else negatively?
> You have voluntarily restricted your own freedoms
No, I've exercised my own freedom to choose what's best for me.
> I’m not sure what we’re arguing about.
First, you made an obviously wrong factual claim, so I called you on it. It is not true that "everyone’s choices impact everyone else in serious, often fatal, ways".
Second, this wrong factual claim is not harmless, because, as you yourself note, it is being used as justification for the government to exercise draconian powers to restrict everyone's freedom. The government cannot be trusted to exercise such powers responsibly. No government can, because governments are run by humans, and no humans can be trusted with that much power over other humans. That was supposed to be the key lesson that got the United States of America started as an independent country, but we seem to have forgotten it.
I have found getting accurate data to be very difficult.
I saw one chart which allegedly mapped the effect of the lockdown over four weeks with various various indexes:
COVID - significant drop. Death from other medical items - even more significant drop. Death from traffic accidents - even moreso.
Number of deaths from suicide - significant jump. From drug overdose - even more significant jump. Number of mental breakdowns and newly diagnosed illnesses - jump. Number of deaths from people not getting care they needed - jump.
I cannot find that chart anymore, and when I tried to verify the items, I could not.
Anyone who knows the chart I am referring to, or generally reliably sources for these things (and not just COVID deaths), please reply!
But if the deaths from suicide, drug overdose, delayed medical care, ulcers and other stress related sicknesses, and abuse are enough, they will offset those numbers.
If the drop into poverty as people lose jobs create slums, gangs, and muggings, there will be a lot more deaths, and those will also offset the numbers.
So, even quality of life aside, I am not sure we come out ahead even on saving lives.
I would like data though, since anyone can speculate. Can someone point to real data?
>But if the deaths from suicide, drug overdose, delayed medical care, ulcers and other stress related sicknesses, and abuse are enough, they will offset those numbers
Not if they get counted as a COVID death. You better believe that drug overdose death is getting a test if there's federal reimbursement in play.
It's a common speculation, but employment (and recreation, regular life, going outdoors) actually kills a lot of people.
Every % rise of unemployment in Europe during the financial crisis resulted in a 3.5% drop in all cause mortality, and that includes a ~35% increase in suicides. We can probably extrapolate that for a scenario where business as usual also kills a good amount more people due to a pandemic.
Clearly the US, being the US, could be different due to cultural differences in how the poor and underemployed are treated.
I recognize that you're making a joke here, but that's categorically not true. Mental-health related deaths have gone up, and will continue to go up. A lot.
We could always lock everyone up in individual units, with no means to suicide because we would control all the tools they get access to for their own safety, and they can get two meals a day delivered to their door. The delivery person puts the ration down, rings a bell and steps away. The person inside a unit picks up their ration. And we can arrange for people to volunteer to help with making those rations and deliveries -- they would want to get out of their unit for an hour a day, so they can be productive during that hour.
Ok, i'm only being mildly sarcastic. Flashbacks from stories told by a grandfather and father. Honestly, if someone told me last year I would be typing this in a discussion on HN on this topic I would have told them they were insane. And here we are, people on HN actually discussing "stay at home" as if it was a not a big deal.
These are the people who work for Google and Facebook and Instagram and Twitter? It horrifies me. It should terrify the population.
The connection between influx of new COVID cases, deaths, and safe-from-home is pretty clear from looking at the daily new cases, which flattened exactly two weeks after lockdown began. Look here at the general US statistics: https://covid19info.live/us/
It is. People are still getting sick. They are dying in greater numbers. They are getting Vitamin D which actually helps with fighting. But they are mildly discomforted.
I don't know the goal, but I see plenty indirect benefits in lockdowns around the world, and hope they'll happen more often, like for a heatwave or a pollution peak, to give nature a needed break
The goal is drastically cut down both deaths and hospitalizations. There are various estimates for how to get to herd immunity, 50% of population has to have it, up to 75%. The current estimates for how many people die ranges from 0.3% (3/1000) to 0.5%. A lot more end up in the hospital, perhaps 5-10x more than those who die, I don't have as good a number for this. [1] has good info.
330 million * 50% * 0.005 = 825k die. 5-10x in the hospital is 4 million to 8 million. Those are big impacts.
Some people want to argue the next thing "those are mostly old people or sick people", so too bad for them?
> Some people want to argue the next thing "those are mostly old people or sick people", so too bad for them?
The argument re: old/sick people is a combination of "these people have fewer years left to live anyways, making deaths less impactful" and "this is a smaller subset of the population that can be isolated while the rest are set free".
It's probably not the best use of time to cite data referencing 300 million people spread across almost 4 million square miles. Each state, and really each county, is its own unique circumstance/set of data.
Since there are no wide scale antibody testing in most of the US due to lack of coordination/faulty health system perhaps we can look at closed systems to ascertain the true death rate. Looking at Lompac prison it appears that 70% of the inmates have tested positive for covid-19 [1]. If the remainder of the inmates are tested, a somewhat accurate death rate can be found. I feel like the only people that should quarantine should be pre-existing medical conditions and the very old, but want to see hard data to back this up, interesting info from the linked article, "The vast majority of positive individuals report minor or no symptoms" I don't know how soon from positive test to infection these cases are as well as the age distribution at the prison but this should be looked at regardless.
It's not only a question about how many have to get it to reach herd immunity but also how long this will take. 3 months in lockdown won't cut it and there is no vaccine available in 3 months.
> Some people want to argue the next thing "those are mostly old people or sick people", so too bad for them?
No, they are most vulnerable and should therefor treated differently than other groups that are not. They also don't tend to work. Considering that ~20%-50% of covid deaths are nursing home residents, protecting them should be priority, not shutting it all down in hope it will dry up over the next 3 months, it won't.
Hasn't it already been demonstrated that it is impossible to test at these numbers? Furthermore, due to relaxed mnufacturing requirements, something like 50% of the tests are completely unreliable/inaccurate?
It's impossible to test at these numbers today, but there is no technical reason that it can't be achieved in the future.
And the quality issues can be solved as well, it just makes point one even worse -- it'll be that much harder to maintain the testing rate and the quality.
It's only impossible in the us because we have a failure at the federal level. South Korea, Taiwan, Israel have better testing than the US. Even China can test to it's hearts content. Not us, because we aren't even trying collectively. In Washington State there was an article in the Seattle Times about the national guard having 30 people manually putting test kits together. Why aren't they making them in a factory? Because we aren't organized enough, we don't have supplies, etc.
Exactly. So it’s an unattainable pipe-dream metric. This is more reason to stop spouting these numbers to people as the “official target for reopening”
South Korea has been testing less people than the US no matter how you slice it - per-capita or total, all-time or current testing rate - either way the US is doing more Covid-19 tests. (And as far as I can tell, Taiwan has tested far less people than South Korea in turn.) The US media has just managed to convince people that the opposite is true. It's not even close either - 14 per thousand in South Korea versus 30 per thousand in the US apparently[1], and current testing rate has even more of a gap. If there's some criteria for the testing rate that the US or any part of it isn't meeting, it's a safe bet that South Korea or most other countries aren't either - even all other countries for some of the more extreme ones being pushed by the media.
A number of people on here have made this claim, and every time I try and point out that it's the complete and exact opposite of the truth it gets downvoted. It seems to be something everyone on HN firmly believes. Maybe I should give up? Trying to get coronavirus testing-related comparisons to bear any resemblance to actual numbers feels more and more like eternally tilting at windmills.
(Admittedly, the media has done a good job on this one. There was even a really bizarre, cynical part in the last Trump press conference where he claimed that all US states are now testing more than South Korea and a reporter accused him of making "this a global competition", as though it was him and not the press that had been pushing this comparison - and all the media discussion became about his row with that journalist, ensuring that no-one heard about the underlying facts and updated their false belief that the US was behind South Korea in testing due to the federal government fucking up. Masterfully done. Practically Trumpian.)
Now, Israel is genuinely doing more testing than the US, but you'd kind of hope for that from a much smaller country with a big globally-relevant pharmaceutical industry.
I would like to get an official explanation for two things:
1) What is the goal(s) of the "stay-at-home" order?
2) How well it is achieved compared to other counties/countries with different policies?
>> 1. To flatten the infection curve, in order to keep healthcare systems from becoming overwhelmed like those in northern Italy.
Very few regions have had anything close to overwhelmed hospitals. More regions have had to lay off hospital staff than have been overwhelmed. Some like UW medicine now face a $500 million budget shortfall due to the ban on elective procedures.
Social distancing measures may have an effect on r_t as low as 0.1 per analysis by Nate Silver. Others show a negative or no correlation between government lockdowns and reduction of r_t.
It is fair to question if these lockdowns - as instituted - have done anything.
The entire hospital staff doesn't just sit around waiting for a pandemic. Most elective procedures have been postponed during this. Large portions of the healthcare system are idle _because_ everyone is at home. The parts of the hospital that can handle the symptoms of the virus are what we're trying to reduce the burden on.
> More regions have had to lay off hospital staff than have been overwhelmed.
That's a bit of a red herring. Hospitals aren't laying off ER and ICU staff. They're furloughing in areas like dermatology, plastic surgery, and the like - parts of the hospital that see largely elective procedures.
I'd be happy to wager there are substantially more dermatology visits in your average hospital than there are kidney transplants.
There's a range of severity in "elective" procedures, certainly. There are a lot of procedures folks will willingly postpone right now, and it's not surprising that hospitals are furloughing staff that service them.
It is disingenuous to suggest that furloughs in these elective areas demonstrate an excess of capacity in the ER/ICU.
Certainly, but you'll likely find it has a higher proportion of elective procedures that can be held off than, say, the NICU.
Which will mean that department's staff - docs, nurses, receptionists, billers, cleaners, etc. - will be more likely to be on the furlough lists than the ER or ICU.
Focusing on hospital stays misses an enormous aspect of what hospitals do; routine visits, outpatient procedures, etc. There are plenty of reasons one might visit a hospital for something elective that doesn't show up as a "hospital stay" from that link.
My kids get eye exams at the hospital. My son's allergist is there. These visits can wait, and they make up a lot of a hospital's business; the staff in those areas have little to do at the moment.
Kidney transplants are considered essential surgery, not elective procedures according to the DHHS. [1] I would be incredibly surprised if any other transplant surgery was considered elective since time is usually of the essence in transplants.
[1] “We are grateful to the Administration for clarifying that transplantations are an essential surgery which can be performed safely if a hospital feels they have the staff and resources available during the COVID-19 crisis,” said Joseph Vassalotti, MD, Chief Medical Officer, National Kidney Foundation.
https://www.kidney.org/news/national-kidney-foundation-urges...
As someone with a pregnant wife, I'd also like to mention that birthing classes, breastfeeding classes, etc. are also not available at the moment.
My wife has had to "visit" an OB/GYN over Zoom.
I don't know how effective or not midwives and such are (I really should get on that...) but women are having to go without them or choose to go without having fathers by their sides. Some places have stopped any visitors from being present.
There are potentially long term health impacts from the above changes, I'd imagine.
Not all of what a hospital deals with is immediately life threatening, though putting it off can certainly make it so.
Hospitals are rightly trying to figure out what rules make sense. It's not surprising there's some uncertainty, and adjustments will be made as we learn more.
> Labor and delivery patients are permitted one visitor throughout the labor, delivery, and postpartum period, which can include a partner, family member, doula, or other support person. The visitor cannot be rotated.
It seems like there is no option to have both a doula and the father present.
I honestly have no idea if we would even use a doula--I've done approximately zero research into them at this point--but it's a pretty hard choice to make at the moment.
you are a literal npc. the hospitals are empty. the curve is at zero. you need to have people get sick to keep the curve going. stop parroting what people are telling you.
> 1. To flatten the infection curve, in order to keep healthcare systems from becoming overwhelmed like those in northern Italy.
I could buy this line of reasoning if there was any indication that hospitals outside of NYC were at any point “whelmed”, nevermind “overwhelmed.” All across the country you’ve got doctors and nurses getting their hours cut, furloughed, and laid off. And the ones who actually are in the hospitals have enough time to coordinate elaborate dance videos on TikTok.
Do you think anyone in their wildest dreams back in March imagined that hospitals all over the country would look like ghost towns? I’m pretty sure we were expecting hospitals to at the very least be experiencing high loads in the midst of these lockdowns.
You know, it IS possible for both “lockdowns work” and “the models and experts were a bit off base” to be correct.
It's not surprising the models weren't perfect in the first go-around. It's good they were flawed in this direction, and I'm glad hospitals aren't collapsing as a result.
I hope we don't overcorrect, open up too soon and too much, and get to see what the other side of getting it wrong looks like.
Not every doctor exists to respond to an acute respiratory viral infection.
Also, I don't think you can accurately determine the workload of a nurse based on a 30 second tiktok video. You know, I saw some truckers sleeping for a few hours at a truck stop on the highway. Why aren't they driving to deliver their packages? Clearly they have plenty of time.
An overloaded _system_ does not necessarily result in overloaded _workers_. In fact, it should minimize the number of overloaded workers as much as possible to avoid preventable mistakes. Taking some time to film a fun video with your coworkers should be viewed as workers taking necessary time to unwind, not as workers taking unnecessary time to goof off.
Ok sure, and I bet a lot of the _people_ want to help.
But another limiting factor is the facilities with which they work. When I say "not every doctor" I don't just refer to the warm body that went to medical school, I'm talking about the doctor and the facilities they use to perform their duties. A podiatrist's office can't just turn into a COVID ICU overnight, however willing or able that podiatrist may be to lend a helping hand.
1 is insufficiently clear. Is the endgame 1) getting new infections down to such a small number that they can be individually detected and isolated, 2) keeping hospital utilization from overrunning capacity while allowing the population to reach herd immunity, or 3) staying in lockdown until we have a vaccine or cure?
Until this question is answered clearly and officials show that whatever goal they set is achievable in a reasonable timeframe, I think it’s unreasonable to expect people to continue to comply.
I agree that 1 seems impossible. I think 3 is impossible without complete economic and social collapse. 2 would involve loosening restrictions and allowing spread that doesn’t quite max out capacity. It looks like 2 is functionally what the states are going to pursue, while no one admits it out loud, and the people who thought we were doing #1 express horror.
Edited: meant to say states are doing 2 (comment initially said they are doing 3)
The longer you do #2, the less you need #3, if the goal of #2 is to keep hospitals being utilized at the highest sustainable capacity with whatever safety margins are required.
As more people become immune, the spread naturally gets slower, reducing the likelihood of hospitals being overwhelmed in the first place and thus reducing the desire to maintain stricter control. The individual risk of any given social interaction is reduced.
Conversely, the more infected, the more dead, meaning the number of life-years that would be saved via a stricter lockdown until a vaccine or effective treatment gets developed gets smaller and smaller.
I believe the shortest time it has taken to develop a new vaccine is the 5 years it took to develop one for Ebola, so I don't think one will be available in any meaningful way for this pandemic, though I'd love to be wrong.
Most of the companies and universities working on vaccines have experience on earlier coronaviruses: for example Moderna and the Jenner Institute / Vaccitech worked previously with MERS vaccines. So they're not starting from scratch.
Other companies like Sinovac have also been doing challenge testing already (I believe Oxford too, but AFAICS they haven't published anything yet) in animals, so far with good results. EDIT: Sinovac findings were a preprint, but now it's been published in Science, so I guess it has more weight.
Also to speed up trials, Oxford is doing a hybrid Phase II / Phase III trial, hoping to get emergency use authorization in September if vaccine responses are positive.
Lastly, most companies and consortia are ramping up manufacturing at-risk (because there's no guarantee vaccines will work) to make sure the demand is met earlier.
So it is likely that if a vaccine works, it will be around earlier than before. Whether everyone will be able to have it, is a different matter entirely.
That link you provided doesn't look like its taking into account the population size of those countries. The US has ~330 million people.
For example, Russia looks like its #2 on the page but Russia has less than half the population of the US. If you look at per capita Russia would be above the US according to your graph.
I didn't scroll down all the way so I didn't see the normalized chart. Thanks for that.
I think that the number of cases which is the default isn't all that important. In fact the higher number who are infected could make herd immunity happen sooner. The number of deaths is far more important. When you look at that on your chart the US is behind many Western European countries and it definitely doesn't look as bad. Its not great but it could be worse.
Do you have a chart that is looking at population density? I think that would also be a useful comparison when comparing different areas. Its not fair to compare NYC with Nebraska for example. I am not really sure how the European countries compare and am interested in a comparison if you know of one.
This is the best response. We know the answer to #1 from the feds earlier on, but we need to make sure states and cities are on the same page.
There is no way to prevent all death. We won't and can't get to zero deaths in the short term - testing, tracing and vaccines are all far out from useful yet.
Given that we don't have a government like Denmark, that can support all workers staying at home with job security, we have the tough choice of "rot at home and lose our jobs and businesses" or "take some risk, try to be smart, and keep hospitals from getting slammed".
Protect the old and the immuno-compromised, and give them the support they need. Mandate mask use in crowded areas until we hit certain non-pandemic levels of new infection. Continue heightened production of PPE, sanitizer, etc. and work to allow small-medium in-person gatherings to be feasible again.
If we do have large events, or open nightclubs, I could see requiring contact tracing apps. Like, give us your name/number so if you get infected, we know about it and can track it; if we(the club) cause an outbreak, we can notify people.
But we can't sit at home much longer, financially or psychologically.
> What is the goal(s) of the "stay-at-home" order?
This is my biggest complaint. The press briefings and the media have been worthless for trying to figure this out. I want to now the exact plan and I realize it will need to adapt over time but that should be explained by the plan. All the White House wants to talk about is the economy. I just want to know, are we going to wait for everyone to get vaccinated or tested for antibodies? How is the progress on those things? I don't care if some idiot who's not a doctor thinks some malaria drugs might help because he stands to benefit from that.
Or is our goal to fully go to 0 new cases and just hope it doesn't pop up again. That seems unlikely since I don't know how that's possible without a complete lockdown for at least two weeks. Also, is there any possibility that this just goes away on its own?
Saying we're opening things up just because of the economy seems completely moronic to me. I want to know what the actual plan is. Everything seems just arbitrary right now.
> I don't care if some idiot who's not a doctor thinks some malaria drugs might help because he stands to benefit from that.
Not everyone is this shady. There's a real trial (University of Minnesota) trying to determine if HCQ works or not as post-exposure prophylaxis. Sadly, it only needs 150ish more people but it's struggling to get them (at least according to its PI).
Many of my childhood friends (living in LA) have already been incredibly angry at measures before this came out, and many other protests have already been seen.
It seems strange to me to not try to do a partial reopening of businesses that can guarantee social distancing guidelines -- and yet they're reopening recreational activities, including the beach. This feels back-asswards, and I really hope it works out well, but I think they need to think this through really carefully.
Did you read the article? Because your concerns are addressed. The beaches are planned to reopen soon, and there are procedures in place for partial reopening of some businesses.
Admittedly, I had skimmed parts of the article, though it seems like you didn't read my message either. I mentioned in my original message that the beaches were being reopened soon... so unsure why you're drawing attention to it again.
I had missed that they are planning to reopen some businesses:
> Under the plan, some in-restaurant dining, car washes and shopping malls could also be allowed to reopen in coming weeks if public health officials in a county are able to demonstrate that the spread of the virus has stabilized and that they have adequate testing and hospital capacity.
Specifically: "dining, car washes and shopping malls could"
These are _not_ the type of businesses I was referring to. I meant more along the lines of factories, and other "not quite essential, but maybe essential" such as dental offices.
What is wrong about the video? It's just criticizing Bill Gates paternalistic and misguided command of public health from the Gates Foundation.
Edit: I am not endorsing the channel, but this video seemed reasonable and didn't describe any conspiracy that wasn't well known (Microsoft anti trust).
we'd clearly be waay better off with no organizations trying to figure out what's happening. The seattle flu study is a terrible thing (which started testing covid-19).
The us federal govt has abrogated much of its responsibility, our only hope at this stage is local/state govts and ngos. These paranoid people things that bill gates is coming for their precious bodily fluids is sad but predictable.
I don't think this has sunk in yet for most people. We can be thankful that the disease is barely any more deadly than an average flu.
Here in Korea, some clubs were reopened and abrutly reclosed because of a spike in coronavirus cases linked to club. This totally confuses the objective. "Flattening the curve" is one thing, and "keeping everything closed until there is zero transmission ever again" is something else. It seems to me that the disease will be with us possibly forever. Whether we reopen today or 6 months from now. If LA County et al have this firm requirement of zero transmission to qualify for reopening:
(1) This is not "flattening the curve"
(2) This threshold may possibly never be reached
> is barely any more deadly than an average flu.
This is heavily debated and the most optimistic of those estimates it at 10x worse -- current reported numbers are closer to 15-20x worse. NYs current mortality rate for this year compared to the flu is 21x:
https://www.medpagetoday.com/infectiousdisease/covid19/86176
There is a study for every truth. There are plenty of other data showing it is hardly dangerous. Also, so many deaths are being counted as covid when the patient already had a severe condition - Dr Birx and many other public health officials have made this clear, too. The numbers are way inflated.
"there are plenty of other data" -- would you be able to educate with some sources? I've been digging in deep and trying to keep an impartial opinion, but have not seen solid evidence that this is true -- or, as you say "there is a study for every truth", I've seen no study to indicate "it is hardly dangerous" (which also feels subjective in those words)
> Also, so many deaths are being counted as covid when the patient already had a severe condition
Yes... as many scientists talk about, COVID-19 has a much more severe effect in people with underlying conditions. Here is where Dr. Fauci, or the CDC as a whole talks specifically about underlying issues:
https://www.cdc.gov/.../hcp/underlying-conditions.html
"the numbers are way inflated" is using generalized language for something that might be true, but even if you take a _very_ conservative view and consider 50% of the reports are false (and I've seen nowhere claiming it's anywhere near that high), the 50% of remaining deaths and complications are significantly high enough that it's far worse than the flu, and far worse if lockdown wasn't in play where some basic math indicates it would be 10x worse:
https://www.youtube.com/watch?v=Kas0tIxDvrg
It's barely more deadly than the average flu when viewed across the entire population, but to the part of the population in a nursing home, it's basically like ebola. There have been multiple nursing homes just in my state that are seeing death rates between 20 and 40 percent, which is just bonkers.
Over here on the East coast of the US we're looking at Cali and saying "they did it right." "People" are blaming NY on the fact that a lot of people arrive their from foreign ports (air and other)- completely oblivious to the fact that if you are coming from China SF and LA are also destinations-and maybe preferable for flights.
It's really a case that because they contained it so well it looks like they didn't need to. Kudos.
I firmly believe it's coming.. There's no way people are going to keep going along with it into summer, especially if the number of cases isn't growing or feels distant.
I can see this easily. Unemployment is insurance—it’s not designed for more than a small number of people actually using it at once. Once that money is gone, and the federal unemployment backup fund is gone, and the food bank has to turn people away, a good number of them will steal in order to eat.
I'm concerned about people wearing masks being targeted.
We've already seen some of that early on, but it was before masks were broadly recommended, and was tied into anti-Asian racism. This time, I'm worried that masks are rapidly becoming the visible, prominent symbol of social distancing etc; there's already active pushback against them, and attempts to enforce them, to the point of extreme violence. At some point, merely wearing them around people who do not do so, becomes an unwelcome reminder to those people, even if you're really only wearing it for safety reasons.
This is a reasonable and necessary response because testing still hasn't ramped up yet. The lockdown's purpose is not only to flatten the curve but to get to a point where trace and test is a viable strategy. It is unfortunate that the US is still only at around half the absolute minimum of daily tests (300k vs 500k) so we still have a long way to go before reopening is actually viable. If authorities wanted to open earlier, they should have increased the testing capacity. Unfortunately, that was not done. It doesn't even matter why at this point and that is a debate for another time and place. The fact of the matter is, we don't have enough testing to reopen in the US. I'm glad at least one county sees that.
Testing has indeed "ramped up" in Los Angeles. Last time I checked there were 39 locations in Los Angeles where you could get a free test, no symptoms necessary. That count does not include going to your doctor or to a private lab. Would love to see the models behind 300k-500k test count and what that achieves. The goal is unclear in Los Angeles.
The problem is that I remember, in the long dark mists of a month ago, when the US was only at around half of the absolute minimum of 130k. I think this is a moving target and that whatever amount of tests we have will always be considered unsatisfactory.
Amazing how science changes as we learn more. Not that that was ever a realistic number or proposed by anyone credible. 500k is almost unrealistic. One million a day is probably more along the lines of what we need.
See, this time it only took 6 hours for the goalpost to change. I'm sure in a month, when we start getting comfortably above 500k, people will show up to tell me that it was obvious we'd need 2 million.
I'm familiar with the concept, and indeed it motivates my stance here. A rule that we won't open up until we're certain we have enough testing reduces to a rule that we'll never open, because that certainty is unachievable.
Actually how are the county level officials got into office? City and state officials are elected. What's the process to install a county officials in CA?
This is absolutely insane, if LA wants to see a return to the bad old days(think Rodney King/Watts riots/extreme levels of crime) keep up this nonsense. This will absolutely destroy the middle/lower class along with a huge chunk of the economy. This was not put up for a vote, and is being forced down people's throats. There is no timeline for large scale antibody testing, live testing is completely broken, expect to see a huge migration out of California.
Very little is. That's why we elect executives at various levels of government. If you want direct democracy, you'll need somewhere like Switzerland, and even there, there's some concept of executive power in emergencies.
While white people do think that having to stay inside is the same/worse as decades of oppression by the police, thankfully we don't have to worry about them actually putting their money where their mouth is and doing anything about it.
This is getting dumb and to mixed in with politics; it's
a bad but not catastrophic illness and we have to have a bit of adjustment to further mitigate but these generic-stay-at-home orders are just dumb
> This is getting dumb and to mixed in with politics
In what world could a government shelter orders ever not be involved with politics? I see this comment day-in and day-out on HN and I just can't even begin to conceptualize a world wherein there's some sterile, politics-free zone.
There are plenty of places in the world where it isn't so politicised. America does tend to get its knickers in a twist over things the rest of the world barely takes any notice of.
You're witnessing a real-time process of adaptation. What you need to understand is even if officials and leaders agree that generic lockdowns are "dumb", it takes days or weeks to enact those changes at the macro level. You also need to add on the 14 day incubation period of the virus. If you make sweeping adjustments to lockdown or distancing rules, you will not know the true effects for 10-14 days. This makes progress seem very slow whereas the reality of it is that progress is actually moving quite fast in the macro (global) sense.
I think we are all going to get to the same fatality rate but at different speeds. The lockdown is only going to delay the inevitable unless we get a treatment or vaccine.
This is totally fair, however the reason everyone in the US were told to stay home was to flatten the curve to not overwhelm hospitals, and to buy time. That has been done. Hospitals are no where near capacity and new case counts are falling week over week. We have a lot of testing now, a lot of ventilators, a lot more PPE. We are better prepared now. Now the new thing seems to be for stay at home orders to exist so that we have no cases at all. That's not realistic. Politicians need to wake up to the reality that this can't go on. Even if our best case scenario is to avoid all the death we can...it's just not feasible. Not economically, morally, etc. The only real choice is a mixed policy that just have strict guidelines for businesses serving customers. It's the only way.
This is expected. Their curve will peak much earlier, but there is no reason to expect the area under the curve(deaths) for LA will be much different than Sweden.
Available evidence (which is scant) seems to indicate that Sweden is enjoying no better economic circumstances but much worse health outcomes compared to its neighbors.
Which is difficult to gauge, since Sweden's economy depends on exporting to other countries that are in a full lockdown. So it's possible that if all countries took Sweden's approach, things would be a lot better.
Compliance is already way down; as someone who has to drive across LA a few times a week (from one isolated situation to another) it has gone from "Night of the Comet" ghost town to "not quite the normal traffic jams but sure a lot of cars out there".
Someone else said he fears riots; I think that's unlikely. Much like when a substitute teacher is there, it will just be more and more people slowly pushing the rules until it's like there are no rules.
I hate to deliver triumphant "told you so" messages, but I hope that all the people who say "nobody wants to lock down forever" are starting to understand they've been misled.
I was 100% behind the initial lockdowns. We had next to no testing and we were seeing disturbing surges. We needed to lockdown to get a handle on what was going on.
But now we know what's going on and we don't seem to have a goal to deal with it. Some are going after 0 deaths. Some are going after don't overwhelm hospitals. And some don't destroy the economy.
I think we are at a point that every government restriction needs to have a very clear goal attached to it.
This is a big deal, especially given the apparent polarization on this issue. I would love to
(1) See the statistics being used by the government, with clear goals when stay-at-home orders can be lifted.
(2) How does the govt. plan to enforce this? People in LA weren't following it very well as it is.
I think its just general frustration with California's handling of the lockdown and testing of covid-19, as well as the opaque release of information regarding where cases are located at and lack of wide-scale antibody testing. I'm fine as I can wfh for long time, I feel for others who do not have the opportunity to and cannot come up with rent and food for their families as the Govt. is providing little to no assistance during this time.
The previous threads about covid have a large number of comments basically saying you can choose between saving lives or the economy. Anybody who suggested we should open up was accused of being greedy and wanted people to die to avoid being inconvenienced.
People are getting a more complete view of the potential outcomes and options.
If the most likely outcome is that 50-70% of the population gets infected anyway, then the goal shouldn't be to save lives. It should just be to keep a buffer of beds available in hospitals and to close only enough to keep that buffer. This is what NY is doing with their 30% hospital capacity buffer metric. The bay area has had plenty of hospital capacity and people can see that as a failure with the 50-70% assumption.
Of course, that all could be wrong, and we could save millions by continuing to be mostly closed. I'm not sure. But the change in tone could be people moving towards the first option.
> The previous threads about covid have a large number of comments basically saying you can choose between saving lives or the economy. Anybody who suggested we should open up was accused of being greedy and wanted people to die to avoid being inconvenienced.
You said "what do you expect, positive comments?". I was explaining that in previous posts there were quite a few positive quotes about requiring everybody to stay home. Anybody who suggested we shouldn't stay at home was vilified.
Data shows that most of the virus propagation happens inside and that, health wise, all that stay at home eating and watching TV will definitely have a cost on health, both body and mental, and still, a lot of people want the lockdown to continue.
Another of those instances where I don't understand my contemporaries I guess...
That seems like a mischaracterization of the order. LA is doing a gradual reopening of beaches starting tomorrow. The Taylor Swift concert in July with 100k attendees may not happen, but it's not like you're trapped at home
Which seems more likely: People getting cabin fever after being cooped up inside for weeks in the spring, or notorious Russian trolls pretending to be the former?
There are three basic positions people are taking:
1. "It's just a bad flu": We never should have shut down in the first place. Vulnerable people can self-quarantine, everybody else should mostly carry on as normal.
2. "Lives are precious": We have to do everything we can to protect people, and that means shutting down until we have a vaccine or have few enough cases so we can effectively test-and-trace. Any economic damage is irrelevant compared to people's lives.
3. "Flatten the curve": Prevent hospitals from being overwhelmed and causing people to die who otherwise could have been saved. But acknowledge that most people are going to get it sooner or later, and the economic and psychological harm of lockdowns are very high, so we should consider the costs and benefits of specific restrictions and reopen in a controlled manner. (As you can probably tell, this is my position).
A month ago, almost everyone in the third group supported the lockdowns, because it looked like there was a real possibility that hospital capacity could be exceeded. But that didn't happen even with effectively uncontrolled spread in the densest city in the US, and is very unlikely to happen in the future because people aren't going to be rushing out to raves even if all restrictions were lifted. So we're starting to see conflicts between the second and third groups, and that's only going to increase.
Thank you for articulating this so well. This is indeed how I'm beginning to see the divides shape up, and I tend to include myself in the 3rd group as well.
> Dr. Anthony Fauci, the nation’s top infectious disease expert, warned Congress that states that push too quickly to ease orders could undo progress that would trigger an outbreak.
Its not about strictly avoiding triggering an outbreak, its about the hospitals having capacity to deal with the inevitable outbreaks, plural!
We aren't going to tolerate Mayors, Governors and Public Health agencies picking business types one by one forever. This was always about slowing exposure, not preventing it. In Norcal we have been very tolerant and cooperative, but I'm watching Socal as a precursor.
Somebody else linked Goodhart's law in this thread, and I think that's pretty applicable. Using these measures as strict criteria rather than looking at the bigger picture that they paint seems like a huge mistake. All of LA can't open if just a single 95 year old person dies of COVID in the past two weeks?
You're complaining about a metric--"No death in the past 14 days"--that doesn't exist and merely posed rhetorically.
The principle metric in California, as almost anywhere else, is access to widespread testing. Testing resources are only a fraction of what they need to be in order for the state to be able to even theoretically contain outbreaks under ideal circumstances. The Federal government should have been all over this months ago, but it refuses to accept responsibility even though it's the only entity in the nation that can make it happen anytime soon.
Secondly, daily reported cases are continuing to rise in California. So to suggest the criteria is no new deaths is ridiculous. Rather, it appears they were originally hoping to wait for a cessation in the increase in daily deaths, but that appears to not be in the cards given how shelter-in-place compliance will never be as good as it was a few weeks ago.
The dilemma here is either playing with people's livelihoods vs playing with their lives. These are two different things, as anyone who's lived in a war zone or famine would attest. I'm pretty sure I know which one most people would choose if they were faced with the stark choice, but they're rarely faced with that choice, or if they are they deny it and move on. That's basic human behavior and I don't expect that change, but it's important to understand the distinction when criticizing a public leader making population-wide choices.
FWIW, nearly 1/3 of Americans are 55+. It's amazing how quickly we turn to infighting. How ironic, yet entirely unsurprising, that most of the people we're so quickly willing to sacrifice are the ones who literally went to war--WWII, Korea, and Vietnam--for the United States.
I stand corrected. Leaving my comment unedited so I suffer the embarrassment in perpetuity.
FWIW, the 14 day criteria is for moving from stage II to stage III (or quasi stage-III--it's a stage II "variance"). Stage III reopens places like gyms and movie theaters. But in stage II most places can open, including factories, so long as they maintain social distancing. Stage II appears to be where China, etc, are still at.
That's a good point on the criteria being for Stage III, in which case it seems more reasonable. I do still hope that when the decision comes to move to that stage, that they look at the full picture rather than relying just on the metric.
I understand why you might assume that it's a merely rhetorical metric, but it is not so. The state government's official guidance is that restaurants and malls should not reopen until there have been no deaths in the past 14 days.
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[ 2.7 ms ] story [ 214 ms ] threadAt some point, people are gonna wanna stop paying the cost, and will simply stop complying with lockdown -- so you gotta ask, where do you trade a little extra risk in return for greater compliance to the rest of the rules?
It seems they've discovered their authority extends to closing parking lots and not much further, and they don't want to arrest people and get their orders struck down in court.
I had a friend tell me he yelled at someone entering a closed park. I said its probably safer in a giant closed park than in my own backyard. He said: well, if I'm not allowed to go to the bar then he can't go to the park.
As I was telling a friend of mine, it feels like a collective case of "misery loves company". Any indication on my social media that someone is stepping out their front door to be proactive about their mental health is met with an unfortunate amount of derision and shaming.
And the political aspect to this can be just as depressing. It seems a nuanced conversation on the benefits of reopening is impossible with my friends on the left side of the political spectrum (which is most of them, and includes myself). I have incredibly smart friends on the left, and I'd love to hear a point of view from them that I didn't feel was being driven from an "us vs them" mindset.
It's really unfortunate that advocating for reopening has been cast as the position of the looney right in the national discourse. When to reopen could be the most important question we face in decades, and a reasoned, dispassionate discussion of the pros and cons sure would be wonderful.
Handwashing stations and ULPA filters in HVAC systems set to renew the air x times more often I think will end up being the long term solution, along with a persistent disease which is just a part of life. The masks seem to just be a joke made up by people wanting to do something.
heres an update on Florida.. https://www.orlandosentinel.com/coronavirus/os-ne-coronaviru...
How do you socially distance at a beach bathroom? Does everyone hit up the same fast-food bathrooms nearby - concentrating the risk?
How long ago did Florida open everything back up? If I remember correctly it was just May 4th?
That's only 8 days. This thing lags by two weeks. Put a note on your calendar to check again in 7 days.
Arguably, most of the party-goers were out-of-state, but it also would've been relatively easy for authorities to link a spike in deaths to those events. So far we have not seen the spike take place.
How would we know? They are spread across the nation.
https://www.forbes.com/sites/rachelsandler/2020/05/13/elon-m...
Keep in mind that the young person might be a medical worker, or in the family of a medical worker.
There were 58 deaths reported by 3/14. If you assume that mortality is 1% (probably on the high side, but good enough for estimates), that translates to ~6k cases.
However, since we know that deaths lag cases by 1-3 weeks (let's assume 2 weeks for the analysis), we should be looking at deaths two weeks from 3/14, which would be 3/28.
By 3/28, there were ~3k deaths from COVID-19, meaning that the true estimate of the number of cases from 3/14 is likely around 270,000 cases (estimate range is 130K - 800K).
This also means that there were about 8.5 million cases in the US on May 1st (I happen to think mortality is closer to 0.5%, so that would be ~17 million cases instead), and that we've most likely crossed the 10 (or 20) million case mark by now.
What makes you say it "would've been relatively easy" given contact tracing is not widespread in the US and certainly wasn't during the weeks of US Spring Break (ca. mid-Mar)?
In any case, you are mistaken that "we have not seen the spike take place". [0] See, especially, the map "generated by Tectonix GEO and X-Mode Social" about 1/3 of the way down the page.
[0] https://www.nytimes.com/2020/04/11/us/florida-spring-break-c...
Plane tickets were bought, credit card spending took place, cell phone towers were pinged, hotel reservations had names linked to them, relatives, friends or colleagues aware of the whereabouts and can be interviewed post-mortem?
For what it's worth, they're able to pinpoint specific parties or night club performances https://www.pasadenastarnews.com/2020/05/09/pasadena-identif... https://ktla.com/news/local-news/former-rancho-palos-verdes-...
Meanwhile, our testing rates have shot up to the ~7500/day range and our positive test rate has gone from ~25% down to 13.2% today: https://docs.google.com/spreadsheets/d/1wrGsD3T_JIvKwsudQwVH...
https://compote.slate.com/images/6e5b79c5-c6db-47ab-95cd-7c9...
The lockdown and resulting economic damage is much less an effort of state enforcement than it is individuals being (correctly) terrified to engage in commerce unless absolutely necessary.
What makes you so sure that average people should be CORRECTLY terrified of this virus?
If I'm in a high-risk category, I get it. But what about others? Are the rates of severe infection remotely high in people who aren't elderly, immuno-compromised, or with underlying conditions?
Keep in mind, the advice on this SHOULD be different depending on where you are. NYC? Sure, be incredibly vigilant. Nebraska? Probably not a big deal.
Looking at all the trackers I have bookmarked I'm not seeing much of an indication of this. Yes, confirmed cases seem to be up in the last week, but that seems to track with increased testing (a good thing). The rate of positives is showing a decline over the same time period.
More indicative of an outbreak would be increased hospitalizations or deaths. Hospital bed usage has been at the same level since mid April, and deaths have been at a steady 1 to 3 per day since the end of April.
Sources:
https://coronavirus.1point3acres.com/en/test?state=NE
https://covid19.healthdata.org/united-states-of-america/nebr...
https://infection2020.com/#
and
https://www.nytimes.com/interactive/2020/us/nebraska-coronav...
are the two I count on the most. I don't really trust any of the confirmed case counts to matter much since testing isn't consistent. In most parts of the state you can't get tested unless you're exhibiting symptoms.
One of the local hospitals reported that they're currently at 50% ICU capacity just with COVID-19 patients.
The reason you have a few hot spots WITHIN Nebraska is due to 4 different meat processing plants in 4 different counties. The worst hit county, Dakota County, is home to a massive Tyson facility.
Do those workers magically teleport elsewhere after work? Do they not go to the grocery? Do some of them go to church? Do they not wind up in the local hospital?
You don't just ignore inconvenient data.
The point I'm making is that if this was a dispersed infection that was spreading through normal community interactions it would be much worse and harder to contain than if it's at a few facilities..
It's almost like depending on where you are and what the data says you should have a different action to optimize the outcome... And that's the point. This one size fits all everybody act like we live in Wuhan isn't working well.
50% of Asymptomatic and 80% of Symptomatic cases on the Diamond Princess had ground glass opacity on CT scans. Usually indicates irreversible lung damage. Care to gamble on decreased lung capacity for the rest of your life?
https://pubs.rsna.org/doi/10.1148/ryct.2020200110
I'd say anyone drawing conclusions from a a few weeks data has a 50% chance of getting burned at this point.
Point is I think the opposite of what you're saying might happen here, i.e. regulations loosen and there's going to be a disproportionate number of exposures as a place not so tightly regulated
Go here and scroll down to Cases by US States/Territories per Day and highlight GA, FL, and TX then play with the metrics. All three seem pretty stable so far. http://91-divoc.com/pages/covid-visualization/
Parent is referring to weeks and weeks of predictions that Florida would be utterly decimated because of large Spring Break parties, taking a long time to shut down in the first place, beaches not closing down for a long time, etc.
Florida, like apparently everywhere else in the US, has been perpetually “two weeks away” for the past six weeks from becoming New York City.
Almost the exact time most states started stay-at-home orders.
Hello from Peru! Where I have been in lockdown for 58 days straight and counting...
We 100% do not have military threatening arrest for going out. At this point, many (rural) police districts and politicians are even saying they won't enforce the stay-home orders anymore.
So. Yeah. Not quite the same.
Summary: under control, but still not great.
Perú: there are 992 for the entire country (195 are still free).
Two weeks is the period within > 99% cases exhibit symptoms. The median incubation is between 4 and 6 days.
> a lockdown for such a long time is crazy.
And people will rebel, and the infection rate will spike yet again, and people will die, and the lockdowns will be imposed with force.
Better to listen and understand than to disobey and risk worse. What's the expression? Regulations are written with blood?
"Comply or be killed" will be an interesting order, I look forward to seeing that one go out.
Civil tickets. Revocation of business licenses. Fines. Arrests. Tear gas.
https://www.seattletimes.com/seattle-news/port-of-seattle-pl...
In which case it's easy to feel like it's all for nothing.
I personally still support it but I can see why people are frustrated, and I think as this goes on you can't just extend it without some really clear and transparent communication.
meanwhile... https://news.ycombinator.com/item?id=23115056
that is unknown. If anything, the flu experience shows that the hot dry air minimizes transmission by minimizing the lifetime of the exhaled aerosol mini droplets which carry the virus.
The rate will most probably spike again in the Fall, lockdown or no lockdown, because of the colder moist air then, and I think it is very misleading to promise people the lockdown avoidance later in exchange for a larger lockdown now.
Governments at all levels seem to be doing only lockdown, which basically means doing nothing by the governments themselves and just putting the burden squarely on the people shoulders and waiting hoping that the issue resolves on its own. Where are the true government actions to fight pandemic - i mean at least bare minimum - masks, testing, contact tracing? Why Whole Foods, not the government, should give away free masks? I guess, no money for masks in the $6T dollars that have just been printed and have propelled the stock market back into the bubble.
Very true. There should be no shortages of tests, masks or other protective equipment. Instead the stock market is going up.
I'd love some experimental data for once (with regards to SARS-CoV-2, a lot is modeling, and a lot less is bench work) to know if this is true or not (there are a few studies but most of them aren't that great, at least the ones I've read).
Do you have something that reinforces this? JHU dashboard data extrapolation (https://coronavirus.jhu.edu/us-map) and revised models (https://www.livescience.com/trump-administration-models-pred...) starkly disagree.
If people mill about and it doesn't stop till we reach herd immunity, imagine at 50% of pop, 0.3 or 0.5% die, that's a big number 330mil * .05 * 0.005 = 825k deaths. IHME estimates assume we won't just keep standing around until half of us get it. The fools walking around are competing with that vision.
Why so defeatist?
Also, there's mounting evidence that social distancing is being done socially (by people making their own choices) as much or more than by governments.
I think people are smarter and more accepting of the status quo than those who are making the most noise. As for those who are overburdened by the lockdown (i.e. lost jobs), its on the governments to provide the safety net until we have everything under control.
There are a lot of entitled people around here, and a lot of folks doing plague cosplay (wearing a mask around their neck like a talisman, gathering but moving to "safe" distance when other people draw close, etc.)
There are limits to this and the burden is distributed very unevenly. If you have a spa, your business is taking a big hit , but the landlord is not required to stop asking for rent. We would have to switch the whole economy to a non profit model, otherwise the lucky ones make out like bandits and others are being driven out of business.
If the government wanted to provide support to keep everyone roughly where they were before the pandemic, that's great. But picking and choosing is really unfair.
And it seems to be hurting small business owners and the middle class the most. Unemployment payments max out at what, $4000 per month? Meanwhile a middle class professional in the Bay Area might pay that much just for rent, before considering food or other expenses.
I live in California and I can tell you that people are already extremely over this shit. Go out and about and hardly anyone is wearing masks, hardly anyone is social distancing. Some people are trying ... but you are only as strong as your weakest link. It's tough to keep up stringent personal standards when everyone around you has said fuck it and given up.
So I completely 110% agree with the parent commenter that people have already been demonstrating they don't want to comply. I mean, it's human nature. No one wants to be told what to do.
The hospital boat off the shore is completely empty (it treated a total of 77 patients). Most of our hospitals are significantly below capacity. We've all been sitting around twiddling our thumbs waiting for the apocalypse and nothing is happening. Just crickets. Unavailable unemployment funds, closed businesses, lost jobs.
The one thing everyone is learning from this is that the government will not help you. It doesn't matter how liberal or conservative your state is, or whether you believe most in federal or state governments ... everyone is doing a shitty job in one way or another.
So if the government is not going to do fuck-all for me, why should I do fuck-all for the government?
I think a lot of people don't realize this. My wife's friend is a nurse shift supervisor at our local hospital. The hospital is practically empty because there are no elective surgeries. They've been laying off nurses over the past month. She had her hours reduced. She's expecting to be laid off soon too.
If the whole point of this is to buy time for hospitals, doing so to the point where they have to start laying off staff members is a pretty dumb way to do it.
There was also very poor visibility on the likely case growth, because testing was so limited. It's only the last couple of weeks where there are enough tests to be testing people with likely exposure instead of just people that were gravely sick (so now healthcare workers and first responders and other essential workers can be tested without requiring that they be symptomatic).
I have a large labral tear in my shoulder, an impaction fracture on my humerus, there’s a bone bruise with bone marrow leaking out, my glenohumeral ligament is stripped from the glenoid rim, I have a new area of full-thickness articular cartilage loss...
...And because CA suspended ALL elective surgeries statewide for a month, my surgeon has a month backlog before he can get to me. Until then I cannot perform any of the activities that keep me healthy and sane. Also my arm is at risk of dislocating in my sleep until I get surgery
Suspending elective surgeries was the dumbest possible decision we could have made yet our leaders won’t ever admit that they fucked up and completely botched their covid response.
Failure to maintain an adequate stockpile of PPE is probably what made the lockdowns necessary, more than anything else. If everyone in the US could have been given masks and instructed to keep their distance from other people, that would probably have been enough to allow us to lock down only the most vulnerable. At least we could have begun with that approach, and moved on to heavier measures only if/when they proved necessary.
Y was more than they had to they panicked
When X was found to be a massive over estimation they still doubled down and said "well in 2 week we will be over run"
2 weeks came, and it was "well in 2 weeks we will be over run"
2 weeks later and "well in 2 weeks...."
It's a big state. Compliance varies a lot by area, and by local culture. Just because there are some people who don't take social distancing precautions doesn't mean that those who have the civic sense to take those precautions should abandon their efforts.
Fortunately, it seems to be leveling off somewhat, except for Santa Barbara. I really, really hope we can keep it that way.
The rates are higher in LA/OC too, not just the absolute numbers.
The LA metro area population (which includes OC) has 13 million people. There are 36k confirmed infections. So the confirmed infection rate is .28%. There are 1600 deaths so far, so the death rate is .01%.
The Bay Area population is 7.75 million, the # of infections stands at 10k, which is confirmed infection rate of .13%, and deaths are 360, which is a death rate of .005%.
It's absolutely not a contest, but the rates are what they are. If you choose to expand either areas' stats out to include their neighboring counties, the differences in the rates don't change much, but will eventually converge with CA wide rates, since this disease is most prevalent in urban areas.
Both the Bay Area and LA/OC appear to have lower infection rates than many other urban parts of the country and world, but the Bay Area is currently seeing both a lower infection and death rate than Southern California. Only time will tell if that holds.
Stats from:
https://en.wikipedia.org/wiki/Los_Angeles_metropolitan_area
https://en.wikipedia.org/wiki/San_Francisco_Bay_Area
https://coronavirus.jhu.edu/map.html
I also noticed that traffic hasn't really changed in my neighborhood and people all seem to be ignoring stay-at-home, but have gradually come to the conclusion that that doesn't have anything to do with the actual stay-at-home compliance rate.
So - you may have seen someone like me (who doesn't want to touch his face or mask) driving with a mask.
It's a bit of a birthday paradox problem in that if you have large groups of people not social distancing in an area with pretty low prevalence like CA, the risk to any one person of contracting the virus could be extremely low, while the risk that some of those people will contract is extremely high.
Americans are, for better or worse, really not used to thinking in collectivist terms.
Think of it this way; if 2/3rds need to become infected before this crap is over, don't you want to be in the 1/3 that doesn't risk death/hospitalization?
That's not really working out now. Plenty of people in WA state as well as NY state are waiting on unemployment claims dating back to March. Fed is backstopping large corp. losses while the every day person gets nothing. WA state is rolling out a "science and data" dashboard that looks like an MS Word clipart project from an 8 year old kid.
Our governments are mostly inept at anything resembling complexity. Something ten times more complicated and difficult like this shows how slow they are to action.
This was foreseeable. The WA state subduction zone report shows that in a simulated catastrophe due to liquifaction / earthquake in the Pacific Northwest, mean time for government intervention for aid-related activities was on the order of 3-4 weeks.
We talk about how large corporations privatize gains and socialize losses; government agencies are quick to act on authoritarian measures like lockdowns but slow to act on remedies to keep them going in an equitable fashion. The only surprising thing ongoing in the nation right now is the degree of ineptitude of our government agencies. Not even I thought they were this bad at getting aid to people.
Let's be clear-- there is no true safety net for middle-income professionals. We can draw down savings and cross our fingers that this resume gap doesn't kill a professional career. And that's just the financial and career consequences. There definitely are other consequences of unemployment too.
I feel fortunate not to live in L.A. county but the public health response my state is not a lot less draconian. I just am astounded. I would love to wrap everyone and everything in bubble wrap as much as the next person to protect everyone from a very dangerous world but this is too much.
Unless you just want infinite money printing. The Federal Unemployment increase ends in July, and it highly unlikely this will be extended, so the county of LA has no ability to print more money, or really extend their debt
LA and CA has a real chance of going bankrupt,
Further I am sure employee will stick around for a long time when their paychecks are replaced with "IOU's"
So sure technically there is no bankrupcy court for the entire state, the fact remains that a State can absolutely enter in to a condition that is more or less the same thing as bankrupcy. The feds can just print more money, and most likely CA would beg the feds to do just that to bail them out should that happen
Local municipalities and counties can absolutely go bankrupt. Which is more likely in this situation
This is the problem with a website for desk jockeys commenting on orders that don't impact their livelihoods.
For any individual, there is a cost/benefit analysis for the lock downs.
The cost is a hell of a lot lower for you and me than it is for restaurant, construction, factory, etc workers who have lost their livelihoods. Let's not forget about the small business owners and independent contractors.
These folks are incurring a much higher cost, and as far as the government assisting them, how smooth do you think that is going?
Have you personally gone and applied for unemployment benefits, or an SBA loan to keep your business afloat?
The government safety net isn't ideal, or pleasant, to deal with. Mayor Garcetti hasn't done well with reforming the LA government, nor dozens of predecessors. The state government of California isn't fun to deal with either.
You probably don't have kids either, if you fit the typical demographic on HN.
A complete failure of empathy on the part of members of the professional/managerial class, who bear little costs of the lockdown towards those who pay the most.
This stay at home order doesn't seem to be informed by updated models and data on this illness. The disease is highly contagious, and deadly at an unacceptably high rate to certain high-risk categories of the population. Those people should change their behavior.
The "wait 2 weeks" thing is what I keep hearing people who are stuck in the "only lockdowns will work" mindset say about every place that has lifted or not implemented lockdowns. It's almost as if they are hoping for it.
Let's be clear: If Georgia and Texas are fine a week from now, that will be good news for the whole country. Even if this good news proves your previously held opinion wrong, it will still be good news. I sense that people on here are hoping for bad news instead, because then they would be right.
Your statement about people being "smarter". Let's be real here, what you mean by "smart" is people who share your beliefs about the best solution to this virus. As if anyone knows with certainty what the best path is. Nobody does. We are all trying our best with the latest data. Except for politicians, who are hell bent on proving that their initial, poorly informed decisions are indeed the way to go by doubling down on them.
Unfortunately, LA is governed by people who do not understand what "the economy" actually means, and view it as a thing to disdain. They will not bear the costs of lost jobs, lost medical screenings, lost K-12 education, and lost social services (both now and pursuant to the city budget shortfalls).
> its on the governments to provide the safety net until we have everything under control.
There is no plan for "under control." We are still looking at a scenario where 50-70% of the population gets the virus. There is a possibility of a vaccine, yes — but no one credible suggests we ought to be planning for it in the next year.
Plan for a 2-year shutdown order, or plan to reopen soon. A three month shutdown, in the middle of that range, doesn't make any sense at all.
I can't wait to see what happens when restaurants reopen. I'm definitely heading to a bar asap.
[1] https://en.wikipedia.org/wiki/Goodhart%27s_law
(Not to mention the infection rate is a really lagging indicator)
This all seems in line with what anyone would have expected. Anyone who thought that on June 1 when the stay-at-home orders officially end everyone would just jump back into normal life and it would magically be safe clearly hasn't been paying attention.
The difference between California and states like Georgia that have "opened up" actually seems to be quite minimal. Some people are taking more risks (which is not really being stopped in either place), the majority are still being very cautious. That's bad news for people hoping that the small businesses that have been financially hurt would spring back immediately, but hopefully good news for where we are in containment of the virus. And, knock on wood, at least for now it seems to be enough to keep the disease spread from ramping back up.
I still think it would have been nice to just go all the way with the lockdown from day 1 back in March, actually enforce the rules and keep more people inside, and squashed the curve faster so that by now we'd be a lot more open than we are. But instead we chose the route of making most people only moderately miserable instead for a long time, instead of even slightly more miserable but for a shorter time.
Hesitate to bring it up since its so contentious but this is actually probably a huge side benefit of the Alameda County go slow approach. For the interim county health advisor, there's no benefit for going out on a limb and providing the rubber stamp to allow a plant to open as they'd ultimately individually be scape-goated if things went wrong. All politicians above would be free to claim - "I wasn't consulted on such details". Now since the plant is open without full approvals, all legal liability is on the private company for any health issues that arise. In fact the state hasn't really officially said the plant could open and so is free from liability and now that the president has chimed in, the interim county health advisor is completely free from liability.
It's a great get out of jail free card, release from liability stance as the individual or company is against government orders.
If the government wants to limit its liability it should stop telling people what to do and let them decide for themselves.
> For the interim county health advisor, there's no benefit for going out on a limb and providing the rubber stamp to allow a plant to open as they'd ultimately individually be scape-goated if things went wrong.
So the only alternative is for the government, after imposing the costs of the lockdown on everybody, to simply refuse to accept the costs of reopening?
The best political safe alternative for all players involved is to do what's happening now; the government provides a hard line on guidance and then is lax on enforcement and lets the plant re-open and begin production. If it goes well (and hopefully it goes well), it goes well.
If it doesn't go well, then people who were advocating taking the risk and with the most to gain if had it gone well, are ultimately responsible for the downside liability. Which seems fair?
Called out by whom? I won't. I don't expect the government to provide me guidance. I'm an adult human being and I don't need a parent.
> The best political safe alternative
I have no interest in a "political safe alternative". Politicians worrying more about their political safety than the good of the people is what got us into this mess. Without a culture of "political safe alternative" the FDA would not have had the power to keep state and local health authorities from coming up with their own testing protocols when it was clear the FDA and the CDC weren't up to the job. And without a culture of too many people waiting for "guidance" from the government, people would not have waited to take obvious common sense precautions against a possible pandemic until the government and the media told them to, way too late.
> Which seems fair?
I have no problem with people who decide for themselves what to do with their own lives having to live with the consequences.
What I have a problem with is someone else claiming the power to decide for me what I am allowed to do, and the only consequences to them if they screw up being "political".
1.) Individual (or Company) A does some potentially unsafe activity and the Government says hastily - "Great, sure; continue!" or doesn't provide any guidance (edited).
2.) Individual (or Company) B is affected negatively - so negatively in fact that they decide to sue not only Individual (or Company) A but the Government as well since the Government said everything was on the up and up either through explicit approval or inaction (i.e. Individual B thinks the Government should have acted) - (edited).
The Government then loses the lawsuit and uses taxpayer money to pay the settlement. Then Taxpayer A, B and C proceed to also sue the government due to gross mismanagement of tax payer dollars and the government loses that as well. And now the rest of us Taxpayers D thru Z have to pay for all these settlements.
Who gave the government the power to make that decision unilaterally?
> Individual (or Company) B is affected negatively - so negatively in fact that they decide to sue not only Individual (or Company) A but the Government as well since the Government said everything was on the up and up.
So if the government were out of the picture, B would simply be suing A. There would be nobody else to sue. And the taxpayers would not have to pay anything.
So what value, exactly, is the government adding here?
So I should have my freedom restricted because other people can't handle theirs responsibly?
No, some people's choices impact some other people in serious, often fatal ways.
My wife and I started taking precautions more than two months ago. We have drastically cut down the number of shopping trips we make--one of us used to go to the grocery store, drugstore, or whatever every other day or so, now it's about once every 10 days, and we make sure to stock up so we don't have to go more often. We wear mask and gloves whenever we do go to the store or any other public place where we can't reliably social distance. When we walk our dogs, we stay well away from anyone else.
How have our choices impacted anyone else negatively?
No, I've exercised my own freedom to choose what's best for me.
> I’m not sure what we’re arguing about.
First, you made an obviously wrong factual claim, so I called you on it. It is not true that "everyone’s choices impact everyone else in serious, often fatal, ways".
Second, this wrong factual claim is not harmless, because, as you yourself note, it is being used as justification for the government to exercise draconian powers to restrict everyone's freedom. The government cannot be trusted to exercise such powers responsibly. No government can, because governments are run by humans, and no humans can be trusted with that much power over other humans. That was supposed to be the key lesson that got the United States of America started as an independent country, but we seem to have forgotten it.
I saw one chart which allegedly mapped the effect of the lockdown over four weeks with various various indexes:
COVID - significant drop. Death from other medical items - even more significant drop. Death from traffic accidents - even moreso.
Number of deaths from suicide - significant jump. From drug overdose - even more significant jump. Number of mental breakdowns and newly diagnosed illnesses - jump. Number of deaths from people not getting care they needed - jump.
I cannot find that chart anymore, and when I tried to verify the items, I could not.
Anyone who knows the chart I am referring to, or generally reliably sources for these things (and not just COVID deaths), please reply!
If the drop into poverty as people lose jobs create slums, gangs, and muggings, there will be a lot more deaths, and those will also offset the numbers.
So, even quality of life aside, I am not sure we come out ahead even on saving lives.
I would like data though, since anyone can speculate. Can someone point to real data?
Not if they get counted as a COVID death. You better believe that drug overdose death is getting a test if there's federal reimbursement in play.
Every % rise of unemployment in Europe during the financial crisis resulted in a 3.5% drop in all cause mortality, and that includes a ~35% increase in suicides. We can probably extrapolate that for a scenario where business as usual also kills a good amount more people due to a pandemic.
Clearly the US, being the US, could be different due to cultural differences in how the poor and underemployed are treated.
https://www.sciencedirect.com/science/article/pii/S009174351...
I recognize that you're making a joke here, but that's categorically not true. Mental-health related deaths have gone up, and will continue to go up. A lot.
Ok, i'm only being mildly sarcastic. Flashbacks from stories told by a grandfather and father. Honestly, if someone told me last year I would be typing this in a discussion on HN on this topic I would have told them they were insane. And here we are, people on HN actually discussing "stay at home" as if it was a not a big deal.
These are the people who work for Google and Facebook and Instagram and Twitter? It horrifies me. It should terrify the population.
330 million * 50% * 0.005 = 825k die. 5-10x in the hospital is 4 million to 8 million. Those are big impacts.
Some people want to argue the next thing "those are mostly old people or sick people", so too bad for them?
1. IHME, https://covid19.healthdata.org/united-states-of-america
The argument re: old/sick people is a combination of "these people have fewer years left to live anyways, making deaths less impactful" and "this is a smaller subset of the population that can be isolated while the rest are set free".
[1] https://beta.trimread.com/articles/14804
> Some people want to argue the next thing "those are mostly old people or sick people", so too bad for them?
No, they are most vulnerable and should therefor treated differently than other groups that are not. They also don't tend to work. Considering that ~20%-50% of covid deaths are nursing home residents, protecting them should be priority, not shutting it all down in hope it will dry up over the next 3 months, it won't.
A 14 day decline in new cases while maintaining a testing rate 200/100,000.
And the quality issues can be solved as well, it just makes point one even worse -- it'll be that much harder to maintain the testing rate and the quality.
But they are achievable goals.
A number of people on here have made this claim, and every time I try and point out that it's the complete and exact opposite of the truth it gets downvoted. It seems to be something everyone on HN firmly believes. Maybe I should give up? Trying to get coronavirus testing-related comparisons to bear any resemblance to actual numbers feels more and more like eternally tilting at windmills.
(Admittedly, the media has done a good job on this one. There was even a really bizarre, cynical part in the last Trump press conference where he claimed that all US states are now testing more than South Korea and a reporter accused him of making "this a global competition", as though it was him and not the press that had been pushing this comparison - and all the media discussion became about his row with that journalist, ensuring that no-one heard about the underlying facts and updated their false belief that the US was behind South Korea in testing due to the federal government fucking up. Masterfully done. Practically Trumpian.)
Now, Israel is genuinely doing more testing than the US, but you'd kind of hope for that from a much smaller country with a big globally-relevant pharmaceutical industry.
[1] https://www.worldometers.info/coronavirus/
2. Thus far, it's worked to keep hospitals functioning. We're doing worse than most other countries (https://91-divoc.com/pages/covid-visualization/).
Very few regions have had anything close to overwhelmed hospitals. More regions have had to lay off hospital staff than have been overwhelmed. Some like UW medicine now face a $500 million budget shortfall due to the ban on elective procedures.
Social distancing measures may have an effect on r_t as low as 0.1 per analysis by Nate Silver. Others show a negative or no correlation between government lockdowns and reduction of r_t.
It is fair to question if these lockdowns - as instituted - have done anything.
I feel like that's a symptom of a much larger problem...
That's a bit of a red herring. Hospitals aren't laying off ER and ICU staff. They're furloughing in areas like dermatology, plastic surgery, and the like - parts of the hospital that see largely elective procedures.
Stop. This is incredibly misleading.
Elective just means that you can choose the time to do the surgery. It doesn't mean they are optional for health.
Elective surgeries include inguinal hernia surgery, cataract surgery, mastectomy for breast cancer, kidney transplant, and hip surgery.
Most surgeries are elective.
Don't minimize this as a bunch of delayed facelifts.
There's a range of severity in "elective" procedures, certainly. There are a lot of procedures folks will willingly postpone right now, and it's not surprising that hospitals are furloughing staff that service them.
It is disingenuous to suggest that furloughs in these elective areas demonstrate an excess of capacity in the ER/ICU.
Which will mean that department's staff - docs, nurses, receptionists, billers, cleaners, etc. - will be more likely to be on the furlough lists than the ER or ICU.
https://www.hcup-us.ahrq.gov/reports/statbriefs/sb186-Operat...
Knee replacements, hip replacements, even Coronary artery bypass graft can be considered "elective" if there is not an urgent need.
My kids get eye exams at the hospital. My son's allergist is there. These visits can wait, and they make up a lot of a hospital's business; the staff in those areas have little to do at the moment.
[1] “We are grateful to the Administration for clarifying that transplantations are an essential surgery which can be performed safely if a hospital feels they have the staff and resources available during the COVID-19 crisis,” said Joseph Vassalotti, MD, Chief Medical Officer, National Kidney Foundation. https://www.kidney.org/news/national-kidney-foundation-urges...
My wife has had to "visit" an OB/GYN over Zoom.
I don't know how effective or not midwives and such are (I really should get on that...) but women are having to go without them or choose to go without having fathers by their sides. Some places have stopped any visitors from being present.
There are potentially long term health impacts from the above changes, I'd imagine.
Not all of what a hospital deals with is immediately life threatening, though putting it off can certainly make it so.
Hospitals are rightly trying to figure out what rules make sense. It's not surprising there's some uncertainty, and adjustments will be made as we learn more.
Yes, that's right -- sorry for the mix up.
> If so, New York indicated doulas wouldn't be counted as visitors, but essential healthcare staff
Thanks for sharing, but that's seemingly not the policy in the actual hospitals that I can see.
From NYU Langone's visitor policy (https://nyulangone.org/patient-family-support/visiting-hours):
> Labor and delivery patients are permitted one visitor throughout the labor, delivery, and postpartum period, which can include a partner, family member, doula, or other support person. The visitor cannot be rotated.
It seems like there is no option to have both a doula and the father present.
I honestly have no idea if we would even use a doula--I've done approximately zero research into them at this point--but it's a pretty hard choice to make at the moment.
I could buy this line of reasoning if there was any indication that hospitals outside of NYC were at any point “whelmed”, nevermind “overwhelmed.” All across the country you’ve got doctors and nurses getting their hours cut, furloughed, and laid off. And the ones who actually are in the hospitals have enough time to coordinate elaborate dance videos on TikTok.
You know, it IS possible for both “lockdowns work” and “the models and experts were a bit off base” to be correct.
I hope we don't overcorrect, open up too soon and too much, and get to see what the other side of getting it wrong looks like.
Also, I don't think you can accurately determine the workload of a nurse based on a 30 second tiktok video. You know, I saw some truckers sleeping for a few hours at a truck stop on the highway. Why aren't they driving to deliver their packages? Clearly they have plenty of time.
An overloaded _system_ does not necessarily result in overloaded _workers_. In fact, it should minimize the number of overloaded workers as much as possible to avoid preventable mistakes. Taking some time to film a fun video with your coworkers should be viewed as workers taking necessary time to unwind, not as workers taking unnecessary time to goof off.
When you disallow elective procedures and everyone else stays away from hospitals for fear of catching the disease, they kinda do.
But another limiting factor is the facilities with which they work. When I say "not every doctor" I don't just refer to the warm body that went to medical school, I'm talking about the doctor and the facilities they use to perform their duties. A podiatrist's office can't just turn into a COVID ICU overnight, however willing or able that podiatrist may be to lend a helping hand.
Until this question is answered clearly and officials show that whatever goal they set is achievable in a reasonable timeframe, I think it’s unreasonable to expect people to continue to comply.
The actions you take for #2 and #3 are similar, and which one you wind up implementing depends largely on how long the vaccine takes to develop.
Edited: meant to say states are doing 2 (comment initially said they are doing 3)
As more people become immune, the spread naturally gets slower, reducing the likelihood of hospitals being overwhelmed in the first place and thus reducing the desire to maintain stricter control. The individual risk of any given social interaction is reduced.
Conversely, the more infected, the more dead, meaning the number of life-years that would be saved via a stricter lockdown until a vaccine or effective treatment gets developed gets smaller and smaller.
I believe the shortest time it has taken to develop a new vaccine is the 5 years it took to develop one for Ebola, so I don't think one will be available in any meaningful way for this pandemic, though I'd love to be wrong.
Other companies like Sinovac have also been doing challenge testing already (I believe Oxford too, but AFAICS they haven't published anything yet) in animals, so far with good results. EDIT: Sinovac findings were a preprint, but now it's been published in Science, so I guess it has more weight.
Also to speed up trials, Oxford is doing a hybrid Phase II / Phase III trial, hoping to get emergency use authorization in September if vaccine responses are positive.
Lastly, most companies and consortia are ramping up manufacturing at-risk (because there's no guarantee vaccines will work) to make sure the demand is met earlier.
So it is likely that if a vaccine works, it will be around earlier than before. Whether everyone will be able to have it, is a different matter entirely.
For example, Russia looks like its #2 on the page but Russia has less than half the population of the US. If you look at per capita Russia would be above the US according to your graph.
(There's also one further down, "normalized by country population", in which we still don't look great.)
I think that the number of cases which is the default isn't all that important. In fact the higher number who are infected could make herd immunity happen sooner. The number of deaths is far more important. When you look at that on your chart the US is behind many Western European countries and it definitely doesn't look as bad. Its not great but it could be worse.
Do you have a chart that is looking at population density? I think that would also be a useful comparison when comparing different areas. Its not fair to compare NYC with Nebraska for example. I am not really sure how the European countries compare and am interested in a comparison if you know of one.
There is no way to prevent all death. We won't and can't get to zero deaths in the short term - testing, tracing and vaccines are all far out from useful yet.
Given that we don't have a government like Denmark, that can support all workers staying at home with job security, we have the tough choice of "rot at home and lose our jobs and businesses" or "take some risk, try to be smart, and keep hospitals from getting slammed".
Protect the old and the immuno-compromised, and give them the support they need. Mandate mask use in crowded areas until we hit certain non-pandemic levels of new infection. Continue heightened production of PPE, sanitizer, etc. and work to allow small-medium in-person gatherings to be feasible again.
If we do have large events, or open nightclubs, I could see requiring contact tracing apps. Like, give us your name/number so if you get infected, we know about it and can track it; if we(the club) cause an outbreak, we can notify people.
But we can't sit at home much longer, financially or psychologically.
This is my biggest complaint. The press briefings and the media have been worthless for trying to figure this out. I want to now the exact plan and I realize it will need to adapt over time but that should be explained by the plan. All the White House wants to talk about is the economy. I just want to know, are we going to wait for everyone to get vaccinated or tested for antibodies? How is the progress on those things? I don't care if some idiot who's not a doctor thinks some malaria drugs might help because he stands to benefit from that.
Or is our goal to fully go to 0 new cases and just hope it doesn't pop up again. That seems unlikely since I don't know how that's possible without a complete lockdown for at least two weeks. Also, is there any possibility that this just goes away on its own?
Saying we're opening things up just because of the economy seems completely moronic to me. I want to know what the actual plan is. Everything seems just arbitrary right now.
Not everyone is this shady. There's a real trial (University of Minnesota) trying to determine if HCQ works or not as post-exposure prophylaxis. Sadly, it only needs 150ish more people but it's struggling to get them (at least according to its PI).
Many of my childhood friends (living in LA) have already been incredibly angry at measures before this came out, and many other protests have already been seen.
It seems strange to me to not try to do a partial reopening of businesses that can guarantee social distancing guidelines -- and yet they're reopening recreational activities, including the beach. This feels back-asswards, and I really hope it works out well, but I think they need to think this through really carefully.
I had missed that they are planning to reopen some businesses: > Under the plan, some in-restaurant dining, car washes and shopping malls could also be allowed to reopen in coming weeks if public health officials in a county are able to demonstrate that the spread of the virus has stabilized and that they have adequate testing and hospital capacity.
Specifically: "dining, car washes and shopping malls could"
These are _not_ the type of businesses I was referring to. I meant more along the lines of factories, and other "not quite essential, but maybe essential" such as dental offices.
Edit: I am not endorsing the channel, but this video seemed reasonable and didn't describe any conspiracy that wasn't well known (Microsoft anti trust).
The us federal govt has abrogated much of its responsibility, our only hope at this stage is local/state govts and ngos. These paranoid people things that bill gates is coming for their precious bodily fluids is sad but predictable.
Here in Korea, some clubs were reopened and abrutly reclosed because of a spike in coronavirus cases linked to club. This totally confuses the objective. "Flattening the curve" is one thing, and "keeping everything closed until there is zero transmission ever again" is something else. It seems to me that the disease will be with us possibly forever. Whether we reopen today or 6 months from now. If LA County et al have this firm requirement of zero transmission to qualify for reopening:
(1) This is not "flattening the curve" (2) This threshold may possibly never be reached
In addition, a lot of people aren't talking about the fact that this seemingly has left a lot of people with significantly longer lung problems: https://www.hopkinsmedicine.org/health/conditions-and-diseas...
> Also, so many deaths are being counted as covid when the patient already had a severe condition
Yes... as many scientists talk about, COVID-19 has a much more severe effect in people with underlying conditions. Here is where Dr. Fauci, or the CDC as a whole talks specifically about underlying issues: https://www.cdc.gov/.../hcp/underlying-conditions.html
"the numbers are way inflated" is using generalized language for something that might be true, but even if you take a _very_ conservative view and consider 50% of the reports are false (and I've seen nowhere claiming it's anywhere near that high), the 50% of remaining deaths and complications are significantly high enough that it's far worse than the flu, and far worse if lockdown wasn't in play where some basic math indicates it would be 10x worse: https://www.youtube.com/watch?v=Kas0tIxDvrg
It's really a case that because they contained it so well it looks like they didn't need to. Kudos.
We've already seen some of that early on, but it was before masks were broadly recommended, and was tied into anti-Asian racism. This time, I'm worried that masks are rapidly becoming the visible, prominent symbol of social distancing etc; there's already active pushback against them, and attempts to enforce them, to the point of extreme violence. At some point, merely wearing them around people who do not do so, becomes an unwelcome reminder to those people, even if you're really only wearing it for safety reasons.
Very little is. That's why we elect executives at various levels of government. If you want direct democracy, you'll need somewhere like Switzerland, and even there, there's some concept of executive power in emergencies.
https://www.weforum.org/agenda/2020/05/switzerland-relaxing-...
Isn't that the entire purpose of a representative government?
In what world could a government shelter orders ever not be involved with politics? I see this comment day-in and day-out on HN and I just can't even begin to conceptualize a world wherein there's some sterile, politics-free zone.
Is "politically polarized" what "politics" means to you?
How is this different from what the article proposes?
Someone else said he fears riots; I think that's unlikely. Much like when a substitute teacher is there, it will just be more and more people slowly pushing the rules until it's like there are no rules.
But now we know what's going on and we don't seem to have a goal to deal with it. Some are going after 0 deaths. Some are going after don't overwhelm hospitals. And some don't destroy the economy.
I think we are at a point that every government restriction needs to have a very clear goal attached to it.
If the most likely outcome is that 50-70% of the population gets infected anyway, then the goal shouldn't be to save lives. It should just be to keep a buffer of beds available in hospitals and to close only enough to keep that buffer. This is what NY is doing with their 30% hospital capacity buffer metric. The bay area has had plenty of hospital capacity and people can see that as a failure with the 50-70% assumption.
Of course, that all could be wrong, and we could save millions by continuing to be mostly closed. I'm not sure. But the change in tone could be people moving towards the first option.
What it has to do with my comment?
Data shows that most of the virus propagation happens inside and that, health wise, all that stay at home eating and watching TV will definitely have a cost on health, both body and mental, and still, a lot of people want the lockdown to continue.
Another of those instances where I don't understand my contemporaries I guess...
1. "It's just a bad flu": We never should have shut down in the first place. Vulnerable people can self-quarantine, everybody else should mostly carry on as normal.
2. "Lives are precious": We have to do everything we can to protect people, and that means shutting down until we have a vaccine or have few enough cases so we can effectively test-and-trace. Any economic damage is irrelevant compared to people's lives.
3. "Flatten the curve": Prevent hospitals from being overwhelmed and causing people to die who otherwise could have been saved. But acknowledge that most people are going to get it sooner or later, and the economic and psychological harm of lockdowns are very high, so we should consider the costs and benefits of specific restrictions and reopen in a controlled manner. (As you can probably tell, this is my position).
A month ago, almost everyone in the third group supported the lockdowns, because it looked like there was a real possibility that hospital capacity could be exceeded. But that didn't happen even with effectively uncontrolled spread in the densest city in the US, and is very unlikely to happen in the future because people aren't going to be rushing out to raves even if all restrictions were lifted. So we're starting to see conflicts between the second and third groups, and that's only going to increase.
Do you think it's a good way to debate to judge people with different opinion than yours to be bots or russians?
https://news.ycombinator.com/newsguidelines.html
Note the one about not posting insinuations of astroturfing. There's a long body of explanation of why we have this rule: https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme... if anyone's interested.
Its not about strictly avoiding triggering an outbreak, its about the hospitals having capacity to deal with the inevitable outbreaks, plural!
We aren't going to tolerate Mayors, Governors and Public Health agencies picking business types one by one forever. This was always about slowing exposure, not preventing it. In Norcal we have been very tolerant and cooperative, but I'm watching Socal as a precursor.
European countries have opened up with less than that, and it hasn't been a disaster so far.
This is also just dumb: Face coverings will be required when not in the water, and sunbathing won’t be allowed.
The principle metric in California, as almost anywhere else, is access to widespread testing. Testing resources are only a fraction of what they need to be in order for the state to be able to even theoretically contain outbreaks under ideal circumstances. The Federal government should have been all over this months ago, but it refuses to accept responsibility even though it's the only entity in the nation that can make it happen anytime soon.
Secondly, daily reported cases are continuing to rise in California. So to suggest the criteria is no new deaths is ridiculous. Rather, it appears they were originally hoping to wait for a cessation in the increase in daily deaths, but that appears to not be in the cards given how shelter-in-place compliance will never be as good as it was a few weeks ago.
The dilemma here is either playing with people's livelihoods vs playing with their lives. These are two different things, as anyone who's lived in a war zone or famine would attest. I'm pretty sure I know which one most people would choose if they were faced with the stark choice, but they're rarely faced with that choice, or if they are they deny it and move on. That's basic human behavior and I don't expect that change, but it's important to understand the distinction when criticizing a public leader making population-wide choices.
FWIW, nearly 1/3 of Americans are 55+. It's amazing how quickly we turn to infighting. How ironic, yet entirely unsurprising, that most of the people we're so quickly willing to sacrifice are the ones who literally went to war--WWII, Korea, and Vietnam--for the United States.
FWIW, the 14 day criteria is for moving from stage II to stage III (or quasi stage-III--it's a stage II "variance"). Stage III reopens places like gyms and movie theaters. But in stage II most places can open, including factories, so long as they maintain social distancing. Stage II appears to be where China, etc, are still at.
...except it is a criteria explicitly specified by California?
https://www.gov.ca.gov/wp-content/uploads/2020/05/5.7.20-Pre...
I don't see how the wording in that document can be interpreted as "not existing" / "posed rhetorically".