HN Explorer

Ask HN: Seriously, how do we stop Covid?

11 points by dchuk ↗ HN
The last few weeks have been very disheartening as the disease is spreading more and more rapidly, to the point where any hopes of "getting back to normal" are feeling quite far out of reach.

How the hell do we actually/pragmatically solve this thing? Is a widely accessible vaccine the only option? How long will that take?

23 comments

[ 2.4 ms ] story [ 60.6 ms ] thread
decafninja
Until a vaccine comes into play, I feel the logical thing to do is look at countries that have managed to curb the spread. Taiwan, South Korea, New Zealand, Vietnam, amongst others. IIRC there was a report saying Taiwan has not had a single homegrown case in 200 days.

Granted, every country is different in terms of size, politics, culture, etc.

I don't think you can replicate what Taiwan or South Korea are doing in the USA for example because of. both size and cultural issues. However there are still elements you can take - i.e. wearing masks. Unfortunately even that has become a political/cultural issue.

ganoushoreilly
100% cultural difference are at play. Almost all of the asian countries have a strong sense of doing things for communal reasons over self issues. This is sort of against the freedom model of western liberal ideals. Most of the actions recommended for minimizing transmission have and continue to be standard behaviors people collectively adhere to in those countries.

At least in the US, the fact that both sides have extreme political views on a myriad of things, Covid has ended up becoming an issues vs people stopping and saying ok, how do we meet in the middle, treat each other as humans, and positively convince people to work for the better good. Yelling at someone and calling them a myriad of names because they don't want a mask, isn't going to win them over. Ironically it's the same root problem we have in politics. Both sides also have to accept that they don't have the answer, they have an answer with the truth lying somewhere in the middle.

These days though, i'm losing faith in the ability of people to be calm and collective in discourse. I guarantee just the discussions here will be downvoted when the opinions don't match 100%.

That's the real problem we're going to have to solve.

giantg2
The extreme views you mention are partly due to the difference in philosophical development. Eastern philosophies tend to believe the truth lies between opposing views. In western philosophies, it is generally believed that one side is right and one side is wrong. We even see this in the adversarial basis of our judicial system (a fair fight between two parties will produce the truth). Our primary and voting system is partly to blame here. Extreme candidates in primaries get more support because their voters are more driven. Since primaries take place at different times, the first states might have 6 candidates and the last states to vote might have only one or two.

I think your last two paragraphs allude to a belief I have - democracy is only as "good" (rational, reasonable, logical, etc) as the citizens are. I wish schools taught philosophy of argument classes (logic).

giantg2
"a political/cultural issue"

I agree. We see this with pretty much any disease. Even look at Zika virus - the US is concerned about it becoming endemic and focuses resources to combat it when it does pop up, yet we don't do anything preventive like restrict travel nor institute mandatory travel quarantines. This used to be a standard practice for international travel to areas with known diseases. We probably need to bring this back. Basically the option is kill tourism in those areas or deal with extension treatment and containment programs - either one would be very costly. So for now, we do like always - we ignore it.

ganoushoreilly
We don't stop it. It's not going away and we have to treat it as such. We can't put that genie back in the bottle so to speak. Because of the western liberal ideals of freedoms Europe and the rest of the west will never be able to enforce a proper true 100% lockdown on the scale of Wuhan.

What we have to do is continue to mitigate risks and evolve medical treatments. We are making great strides in this regard. Many companies are working over time and we have proven treatment methods that help minimize and reduce negative outcomes. Now we need to scale these treatments. What we need most is Time and that's arguably the one thing none of us have excess off.

Wearing masks in public are fine, washing hands diligently are fine. These are good things. Long term though secondary effects of the disease are proving to be just as damaging to the world. Lockdowns aren't the fix and are arguably not likely to be legal.

Both the left and the right have to stop poo pooing advances and yelling at each other with blame. Yes, people aren't wearing masks as they should, thing is that was and will always be the case. We account for that by majority working with the system. There will always be a minority that fights against it and accounting for that is more important.

The #1 thing I think that will help with managing covid, is Civility. The more we respect each other, the easier it is to find common ground and social agreement on best steps to take.

We will get through this as we do everything else. We have to stop over dramatizing things for the sake of political points. No one disputes the harm of this virus, or the deaths it's caused. One death is too much, but we also have to recognize that we have people dying in large amounts because of a lot of issues.

Notably, the second thing that will improve our success in beating this long term, is emphasis on healthy life styles. The fact that I hear almost 0 about health and minimizing comorbidity issues is astounding. Yes, I realize people can't all of a sudden not have co-morbidities, but we can instill these behaviors now with evidence that may help prevent issues the next time something like this transpires.

TLDR: Being more civil with each other and addressing personal health issues will be the biggest impact to collectively reducing risk and improving survivability.

ambivalents
Replace a few words here and there and this almost sounds like how we deal with climate change, too.
bjourne
> Notably, the second thing that will improve our success in beating this long term, is emphasis on healthy life styles. The fact that I hear almost 0 about health and minimizing comorbidity issues is astounding. Yes, I realize people can't all of a sudden not have co-morbidities, but we can instill these behaviors now with evidence that may help prevent issues the next time something like this transpires.

This is befuddling given that many that have died from Covid-19 have had co-morbidness and have suffered from life style diseases.

One positive side effect of the pandemic is that a lot of people have stopped smoking. Because early on, a lot of people believed that smoking made you more susceptible to the virus. Apparently, that wasn't true but it is a damn shame that it wasn't more drummed up in media. Imagine the positive health effects a disinformation campaign could have had! Some pictures in The New York Times of lifelong smokers' lungs, next to pictures of Covid-19 patients lungs, and some suggestive text. Wouldn't have to be any outright lies, just enough to enable people to make the association. It could have saved millions of lives.

gt565k
How do we stop COVID? Be educating people to be healthy and conscious of their surroundings.

Physical exercise and proper nutrition prevent most diseases, but no one talks about it. Why? Cause big pharma would rather you be sick and pop pills for the rest of your life.

Make sure you take multi vitamins, eat healthy, are not vitamin d deficient, load up on vitamin C in the winter, exercise, meditate, breathe clean air and 90% of diseases wont touch you.

Keep proper distance, practice good hygiene, eat a balanced healthy diet, exercise.

Hey look! Those alone prevent obesity, heart disease, high blood pressure, high cholesterol. WTF? But what about the pills?

folli
That sounds like some New Age BS. Sure, a healthy lifestyle will be preventive for a lot of diseases. But especially for infectious diseases, I would be very cautious with such statements.
giantg2
A better way to put it is that it reduces the comorbidities, which generally improves chances of prevention or asymptomatic infection depending on the disease, better treatment outcomes, and increased survival, especially in the case of covid but also in many other infections (there are exceptions). So it's not so much about prevention itself but about improving the overall patient outcome.

If you also include things like washing your hands and using PPE, then lifestyle can have a tremendous impact on prevention. Take condoms and HIV for example. The efficacy of this theory of lifestyle and infectious disease prevention will vary from example to example, but should not be categorically discounted as BS.

gt565k
You are more likely to die from the flu or covid if your immune system is compromised and you have other diseases that have weakened it. Fighting a myriad of other problems such as having to deal with nutrient and vitamin deficiencies weaken your immune system.

A healthy diet, exercise, fresh air, and less stress eliminate the need for 99% of pharmaceutical products.

New Age BS... god forbid you tell people to eat healthy and exercise, they rather just sit at home and rot into their couch poppin big pharma pills and vaping til their bodies give up, hoping for a transplant.

ambivalents
Sucks you're being down voted, half the battle is in prevention of the damn thing.
giantg2
Mostly agree, except you shouldn't need multivitamins if you are eating a healthy diet.
Foober223
We still haven't stamped out the older corona viruses (ie common cold). Those corona's have cycled through the population for so many centuries, everyone still alive has some resistance.

The same will happen with this new corona. A vaccine could make your first exposure to the virus much safer. Social distancing is meant to flatten hospital capacity curves and buy time for vulnerable people to get a vaccine before their first exposure.

Does any government have a goal of permanently ending corona virus? I'm not aware of any. It is with us for the next 5000+ years.

kleer001
Go underground. Become Morlocks.
runawaybottle
Vaccine pretty much. It ruined every business that was operating at the edges, restaurants that were playing it loose financially couldn’t withstand it. It’s all pretty fucked up, and honestly we just have to take the L and wait for this vaccine.

Nothing to fix anymore.

giardini
dchuk asks >"How the hell do we actually/pragmatically solve this thing? <

By prescribing zinc plus low dose hydroxychloroquine and azithromycin EARLY in serious cases:

https://news.ycombinator.com/item?id=24930365

Article Date: 26 October 2020

Article title: "COVID-19 outpatients – early risk-stratified treatment with zinc plus low dose hydroxychloroquine and azithromycin: a retrospective case series study"

FTFA:

>"As of June 2020, diagnosis and treatment of COVID-19 have been almost exclusively studied from an inpatient perspective, including intensive care with mechanical ventilation. Only one study has described characteristics and key health outcomes of COVID-19 diagnosed patients in an outpatient setting [3]. This is surprising as primary care physicians often see COVID-19 patients first. They could play a critical role in early diagnosis, treatment, and management of disease progression and virus spread. This assumption is supported by the established principle in medicine that speed of eradication is linked to the outcome of life-threatening infections [4].

The early clinical phase of COVID-19 has not been the focus of much research so far, even though timing of antiviral treatment seems to be critical [5]. The optimal window for therapeutic intervention would seem to be before the infection spreads from upper to lower respiratory tract and before severe inflammatory reaction ensues [6]. Therefore, diagnosis and treatment of COVID-19 outpatients as early as possible, even based on clinical diagnosis only, may have been an underestimated first step to slow down or even stop the pandemic more effectively. Based on clinical application principles of antiviral therapies, as demonstrated in the case of influenza A [7], antiviral treatments should be used early in the course of infection."<

We're not as helpless as you believe.

Also see

"States Bow to Pressure to Reverse Course on HCQ" (Sep. 9 2020) at

https://yated.com/states-bow-to-pressure-to-reverse-course-o...

and

"Is HCQ banned in your state? (probably not)"(Aug 18 2020) at

http://www.freerepublic.com/focus/f-news/3875427/posts

rawgabbit
Yes a vaccine is the only realistic option. Masks, no more handshakes, and social distancing can help. But you can get COVID simply by breathing in the aerosol left behind by an infected person.

https://www.health.harvard.edu/diseases-and-conditions/preve... “A person infected with coronavirus — even one with no symptoms — may emit aerosols when they talk or breathe. Aerosols are infectious viral particles that can float or drift around in the air for up to three hours. Another person can breathe in these aerosols and become infected with the coronavirus.”

twright
TL;DR with a good chunk of time and maybe packing (nay, rebalancing?) the courts.

In the US, even if a vaccine comes it will take several years to roll out such that we cannot immediately go back to “normal”. Given its current performance, I do not believe the current administration and its party to be capable of effectively distributing a vaccine. I also suspect a modest portion of the population supporting this party will not consent to such a vaccine under any circumstances.

(Warning: political speculation partly driven by election anxiety) “Wait,” you say, “there could be an administration change soon, what if that happens?” Unless the Senate is secured–such that a bill could be passed through reconciliation–the aforementioned party will return to the same diehard obstructionist form as we saw the during the Obama administration (even if many agree with the contents of the bill McConnel would never allow a vote). It will be up to the executive branch to issue executive orders in order to distribute the vaccine. This is not guaranteed to be effective either. Whatever the order is it will immediately be challenged in court only to be struck down as “grossly unconstitutional” thanks in part to the three most junior justices of the Supreme Court, wherein (I suspect) their opinions on executive power apply only to presidents of the party that appointed them.

I would expect similar legal challenges and outcomes even if the senate majority is Democrat. See the Affordable Care Act, wherein the existential legal challenge _National Federation of Independent Business v. Sebelius_ decided that it is constitutional (by the skin of its teeth 5-4 Roberts in the plurality.) Which, by the way, I would not count on it being constitutional after opinions are issued from the upcoming Supreme Court term so the count of uninsured will skyrocket sometime next year, great time (/s) to deliver a vaccine through a for-profit healthcare system. Elections matter.

salamimonger
As much as you want to act like vaccine skepticism is a right-wing thing, I don't think it's that clean and cut. If you asked them, most people are probably fine with vaccines. There's a small portion of very vocal people on both sides who you could describe as "antivaxxers" or people skeptical of vaccination. Now, the thing is, I imagine if you asked most people if they would be up for government-mandated, no-questioning forced vaccinations, I'm sure that's how you'll get bipartisan support AGAINST vaccinations and even further light the fire of antivaxxers in this country. Be careful with what you wish for.
enchiridion
Two ideas I heard here back in April that I don't see anymore.

1. Massive testing. Test the whole country every week. At least cover those who are out around people a lot.

2. Run an artificial selection campaign to find the least lethal stains and spread those as an ad hoc vaccine.

aaccount
I don't think there is any chance to stop it now. Its too wide spread. Even though countries like NZ have done a very good job at lock down, they can't keep those counties permanently closed.

The best option is just to carry on so we don't have bigger problems due to collapsing economies. Although that might be a bit late for some countries.