Two months seems like the minimum. The really hard problem is that even if you reduce spread to near zero, it’s almost guaranteed that cases will continue to spread among the essential workers who are still active during the lockdown. As long as that’s the case, the end of the lockdown will result in the cycle starting over.
It seems to me that what we’re really doing with the lockdown is buying the time to “mobilize,” in the military sense, our healthcare system. If we had the testing capacity to test everyone and contain only the sick, this would be less serious. If we had 10x as many ventilators, and 100x as much protective equipment, this would be less dangerous. If we had an effective treatment (like a Tamiflu for Covid), then this would be less dangerous. Etc.
It seems to me unlikely that we will be locked down less than 2-3 months. But after that, I doubt the public will be willing to endure another global lockdown of this magnitude. Thus I think everything we’re doing now is really about delaying the inevitable long enough for us to get a coherent response in place.
To the extent that anyone is a “winner” in a pandemic, it certainly appears to be Taiwan and South Korea, who responded fast enough to the first wave to keep it from requiring an authoritarian response (or, at least thus far).
I'm skeptical that the public can endure a single 2-3 month lockdown to begin with. But a lot can change in 2 months, so it is far from certain the lockdown will last that long.
For example
- a treatment might be found which reduces the fatality rate, making it a less dangerous disease
- widespread testing might show that a significant portion of the population already had it and were asymptomatic, thus we have herd immunity sooner than expected in places like New York and Spain/Italy
- antibody testing might become mainstream, so if there was a certificate for people who have already gotten it, that subset of the population can return to a normal life.
- the public support for the lockdown evaporates if it goes on for too long and unemployment skyrockets, so the government might move to a more moderate measure - e.g.: only lock down the people at risk, and let everyone else return to a normal life.
- rapid and cheap tests because widespread, so perhaps you can just get tested before boarding a plane, or entering a shopping mall, etc.
(widespread testing might show that a significant portion of the population already had it and were asymptomatic, thus we have herd immunity sooner than expected in places like New York and Spain/Italy)
I think this is a dangerous myth as till now infected people are infecting a lot of the people they come in contact with. Had the virus already passed through a lot of people already the spike in number of ICU cases would not be happening now nor keep increasing at the same rate
Sure, many positive developments may happen, but we should prepare for the likely possibility of not one of those things happening.
What if we don't find a cure and a vaccine takes 3 years?
Cheap, fast testing is almost there but I don't see how that actually helps... What do we do with people who didn't yet get the virus? Should they stay at home? Since they're a majority, it's not very different from the current situation. Or should they go out and "chance it"? Are you willing to do that in the absence of a cure?
Yes, I'm willing to do that in the absence of a cure. I wouldn't like, go to a packed stadium, but I'll happily invite friends over or eat at a restaurant once it's permitted again.
Simply put, yes - staying at home all day isn't living, it's just existing. And giving up 3 of the best years of my life isn't a price i'm willing to pay, even if there is no cure or vaccine.
If you aren't willing to "pay the price" now, then you will pay the price in other ways later. Your actions are not isolated and affect others, and not doing your part to prevent this from getting worse is an extremely selfish action. Obviously it's one thing if you have to go to work, or go out to get food, but if you willingly go out just because you want to experience the "best years of your life" and potentially put yourself and others at risk, you should reflect on that and realise how selfish and potentially dangerous that is.
If you have a difficult time putting this in perspective, just swap COVID-19 and social distancing for HIV and condoms.
I don't follow the analogy. Social distancing restrictions are much more severe than condoms; unless you live with a SO, you're not allowed to even touch anyone right now.
I don't buy this. You can have two populations one that social isolates and one that doesn't. You get pick which one you want to be in. Those two populations can't mix.
Having this level of foresight and the guts to risk millions of unemployed workers for a "maybe scenario" is rare. If you were running the country, or were the governor of a coastal state like NY/CA, at what precise date would you have started ramping up ventilator&mask production?
Would you have instituted a statewide lockdown when there were 1-2 cases in California?
Would you be willing to trade certain unemployment and economic unproductivity for 2+ months, in exchange for the possibility that you might end up like Italy instead of Taiwan/South Korea? The last datapoint we had was SARS-Cov-1, which ended up not becoming a huge pandemic. Of course, the disease characteristics for SARS-Cov-2 are different, but without the benefit of hindsight, was the decision really that clear?
Incompetent US administration aside, the financial markets - which can be thought of as an expensive forecasting computer - certainly did not price in what would happen, so I'm not sure we can expect policymakers to arrive at far-superior decision making.
Considering that China is not completely out of the woods yet either, and the US/Italy lags about 1 month behind them in pandemic progression, how would you advise the US act now, with the knowledge of what China is doing?
That type of “wait and see” approach to leadership and government is exactly what this virus exploits.
The U.S. should have started ramping up supply production in the early days, not because they had some guarantee that this particular virus would wreak havoc in America, but because two things should have been readily apparent:
1) The stockpile of essential supplies was apparently abysmally low, both at a state and federal level
2) That if this specific respiratory virus didn’t end up arriving on U.S. shores, it was just a matter of time before one did.
Aggressive production should have begun long ago, with the assumption that supplies may be needed for this outbreak, and if not, it ought have been treated as a wake up call and at least the country would be more prepared for a future outbreak that could happen at any time.
Not only production, but aggressive public messaging about reasonable social distancing, hand washing, etc. should have begun much earlier.
The inaction was, in my view, bizarre and indefensible, and few elected officials exhibited the true qualities of leadership that are needed to foresee the risk and act swiftly to hedge against the risks that were readily apparent early on.
I'm not talking about locking down early, I'm talking about starting a crash program to produce masks and tests, organizing a national system to redirect resources like masks and ventilators, etc. If we had the testing capacity we have now a month ago, we would be in a much better position.
We didn't know how much it was spreading in the US because we weren't testing cases that didn't have a nexus to China/SK. So we had no idea what the spread was like and there was no data to go on to inform decisions to lock down. Seattle only got there early because some local flu researchers disobeyed their own IRB rules and tested cases for the virus without approval.
California seems to have gotten the lockdown about as early as was practical and has done much better than NYC, so they're actually doing well, all things considered.
I'm talking about starting a crash program to produce masks and tests, organizing a national system to redirect resources like masks and ventilators, etc.
Pretend for a second that you're Andrew Cuomo on January 1, 2020. What information would you have to justify this crash program?
Pretend that you're Andrew Cuomo on April 4, 2020. You're aware of what stage China is in. What would you do differently?
We should have started preparing the day we knew a c19 patient was in the US. I think that was late January. Definitely should have had a lockdown by late February at the latest but earlier would have been better and feasible. When the who and cdc said it was almost a pandemic, we should already have been prepared knowing that "almost a pandemic" to those organizations means the shit has hit the fucking fan and it's no longer preventable. Of course, this would have required leadership from the top and that's non-existent.
SARS wasn't able to spread nearly as quickly as the novel coronavirus, possibly because of the incubation period and prevalence of asymptotic carriers in this coronavirus.
That wasn't true of SARS which made people very sick so it was able to be contained (it's possibly that the novel coronavirus is just far more contagious but I don't know that for sure).
By mid to late January we all knew this. It was happening in China in full view of the world. The question was whether it could be contained, we didn't know that at the moment. But without extreme intervention it was just simple math that this would happen, and it did.
If we had 10x as many ventilators, and 100x as much protective equipment, this would be less dangerous.
Only up to some point, then you run out of specialized personnel who know how to properly treat each patient (including controlling said ventilators). (Re-)training personnel probably takes months to years.
The value of specialized personnel isn't as large as I think you're expecting. Most hospital care boils down to "put them in bed and deliver medication and food at the appropriate times", and patients who need more are likely to die no matter what care they get. It's tragic that some people will die who could have been saved with intensive specialized intervention - but once everyone can be intubated, there's probably no "overload threshold" where lots of people die when they would have otherwise left in good health.
It's not just intubation but varying other protocols for treating sepsis, ARDS, etc depending on the exact set of symptoms. Even the ventilator itself is far from "hook it up and leave it" - there has to be a careful and up-to-date balance between getting enough oxygen into the bloodstream and not damaging the lungs more than absolutely necessary.
The people on a nasal cannula of oxygen probably only need limited skilled intervention and supervision, but once they're intubated it's pretty intensive.
In two if the three studies a third of the people who survived were able to come off ventilation. It’s not a panacea as the article says, but I suspect without ventilators the death rate would be more like 100%, and I’ll take my chances with 1/3 versus 0 any day.
We get it, we are going to have to shut down the main street economy for months, and potentially on and off for years.
OK, we aren't rioting yet.
So, elites, what's the plan to keep people from starving and being thrown out in the streets? A one time $1000 check at some point in the future isn't a plan.
People who swarm criticize anyone saying "this is crazy" need to start presenting feasible economic plans, or they are gonna see fully operational crazy in a month or so.
From economical perspective, I don' think United States can stay 'shut down' as it is now.
10 million+ jobless claims MINIMUM in past two weeks.. (since those not eligible are not counted)
Gotta figure out a way to get healthy people to work.
Or I mean, they could stay closed for 2-4 months but that would be quite a wild time.
What’s interesting is the wage gap. Many (most) of the shut off jobs are the lower paying ones. Waiters and factory workers. Obviously some weird exceptions (pro athletes).
Many of our nations higher paying jobs are either essential (doctors, nurses), or remote friendly (developers , to some extent lawyers and real estate agents).
Even if 25% of our economy is not working, we can make near 90% of our GDP.
Which isn’t ideal but it makes the lockdown perhaps less dire than it appears for the economy.
It may be true for few weeks or so, but if this continues the fallout will be widespread. Lower wage jobs is the bedrock of the whole economy. How much lawyering can you do if you have to take care of your own food prep, childcare, or - simply put - your clients start disappearing one by one because they cannot pay? How much longer you can continue to pay to the banking staff if mortgages and business loans default like house of cards? How much longer can you pay to programmers at Facebook when advertisers like restaurants, spas, hotels are not paying for advertising?...
Advertising is an incredibly recession resistant industry.
Especially for FB and Goog, as they use second-price auctions, so anyone who measures their results will see performance improvement, make more money and thus (theoretically) invest more in advertising until it is no longer profitable.
They'll lose some revenue, but it won't be anything ridiculously large; and even if it is, some of the previously priced out advertisers (less profitable mobile games, for instance) will return.
Advertising is a hell of a business, especially online.
Google stock has fallen significantly since its highs. So has FB. MSFT has been doing well because of cloud and Teams.
Airlines are heavy advertisers and their industry is crushed. We’ll see the next quarterly results. I bet at-least 30% revenue quarterly loss compared to last year.
The economy is very intertwined. Especially when people start defaulting on mortgages en-masse. The 2 trillion stimulation hasn’t yet started sending out cheques to those who need it. Banks haven’t figured out how to loan to businesses that need it.
The worst death count / day of virus is still to come.
People can may be weather one or two months, after that. Shit will really hit the fan.
Stock prices are mostly bullshit. US equities (particularly growth stocks) have been massively over-valued for years, because of low interest rates and QE.
Nontheless,they have a good business model and will most likely be fine (even if they show no revenue growth, they make a lot of money).
If you're suggesting 30% revenue loss relative to last year, that's probably flat to -10% revenue for each of them, which in the midst of a global pandemic is pretty good.
Like, things are going to be really bad for a whole lot of people, on that we agree.
However, i continue to believe that Goog and FB's businesses will weather the storm a lot better than most other technology companies.
For the short to medium term, a high % of their wage is replaced with unemployment benefits. This was also extended a bit by federal money, right? So it’s not like 25% of the population drops to 0 income.
Edit - your math is also counting babies and kids. Not many babies or kids lost jobs in the past month.
Population of working age (15-64)[0]: ~206M
206M * 25% = 51.5M
That's still a whole lot of people left with their hands out that you seem to be dismissing quite easily. To me, this is the danger of statistics. The numbers loose all meaning. These are fellow human beings. This isn't war where the generals accept a certain percentage of losses of volunteering soldiers. These are normal people that through no fault of their own now have not job and source of income.
The babies and kids are relying on working adults to feed them. They may not count in the jobless statistic, but they certainly are affected by the unemployment situation.
The $600 boost was calculated because it takes the average recipient to full pay, so, yeah it's a high percentage. For high wage workers it's a smaller percentage, both because before the boost there is a benefit cap in most state formulas and because the $600 boost represents a smaller additional percentage, but most workers aren't high-wage workers.
It's not just low wage workers, it's an incredible amount of small business owners as well. We've been shut down for about three weeks and a significant percentage of restaurants in my area are not even providing take-out anymore.
> remote friendly (developers
The layoffs in software engineer world are still yet to come and we've already seen quite a few. Sure, not nearly as many layoffs as low-wage workers, but you've seen the layoff threads here on HN, right?
This is only the start of the downturn if the US stays shut down.
I think there's a plausible case to be made that there exists a 75% slice of our jobs that could produce 90% of our GDP. I'm a lot less confident that we can construct such a slice, and almost completely sure that government planners trying to reify the term "essential business" won't construct it.
I'm sure that fact will be comforting to the millions of people getting evicted and going hungry on the streets which will happen the day evictions are allowed again, which in many places is today. $1200 isn't going to go far for most people, certainly not more than a month. Unemployment might help for those that can collect it. But let's not mistake gdp for a well functioning economy. If half of the nation ends up homeless and on the streets, it'll be irrelevant if we're making 99% of the gdp. This applies to normal times too. Pretending like this figure is a reflection of how well the economy is doing is absurd. In current times, it's even more absurd to pretend that just because we're making 90% of our gdp that things are going well or are less dire than they appear. What nonsense.
This was this kicker for me. Based on 2018/2019 taxes, I do not qualify for the stimulus check. However, I was laid off in Oct of '19, and have been earning 3/4 of my previous salary. The jobs I was getting were strictly short term freelance gigs based on corporate events. Since they have all been canceled until ???, I'm making even less. Yet my government says tough cookies based on previous experience not current situations. Luckily, my landlord is very sympathetic. Hopefully my ISP and utilities will be as understanding.
Something to note: The stimulus checks are an advance on a 2020 tax credit, so you'll get it (much delayed) next year in your scenario, as long as you don't make above the threshold by the end of this year.
> That could change if the Treasury Department decides to alter its guidance.
> That could include some kind of declaration form where you could provide evidence that your 2020 income has dropped, such as an unemployment insurance claim.
Do you really think that people are going to be spending any money with bodies in the streets instead? Even in the best-case scenarios, the world economy is in a deep freezer for the next couple of months.
I don't agree with the conclusion here. We can draw the conclusion from this that it takes two months for lockdown to work. But that doesn't mean we can start loosening lockdown restrictions after two months. There's a causal relationship between lockdown and slowing the spread: if you remove the lockdown, the spread will rise again.
Some speculation: a big part of why lockdown takes that long to work is that it seems to take that long for people to start taking things seriously enough for lockdown to work. A few weeks ago in NYC there were still people coughing on each other in public and laughing about it, and my observation of a lot of people's behavior over time is that for some people, they need someone proximal to them to die of it before they will start complying.
I don't say this judgmentally. Personally, I probably didn't take things seriously for about a week after I probably should have, and looking back at why, it wasn't because I didn't care, it was a fear reaction--one very human reaction to something scary is to downplay it or pretend it isn't happening.
There have been studies of this from previous pandemics. Together with studies from the Great Recession / financial collapse the gist is there's definitely going to be an increase in mental health problems of all those sorts -- substance use, suicide, etc.
The interesting thing is that in previous situations deaths attributable to these things was offset by a decrease in deaths due to automobile accidents, workplace stress-related incidents, etc. That doesn't make it ok at all, and it's possible this time around is worse socioeconomically so things aren't offset. But it might not show up in overall trends if you just looked at general disability or death.
On one hands tons of countries locked down after China (relative to the number of serious cases or deaths - I understand there is a debate about Chinese numbers, but I don't find it relevant here, because Italy or France also did not test a lot and also under-reported deaths -- basically counting only cases that were tested and died in an hospital -- in the end given the dynamic of the epidemics and other uncertainties it does not change a lot rough date predictions even if there would be 3 times more deaths)
So it even could take a few more weeks to get to the same low point again. Plus China had an extremely aggressive strategy, accumulating the measures, and even Italy did not use all of them. And France does less than Italy (non essential production has not been stopped by the government in France).
On the other hand I doubt we are going to eradicate the disease (at least not in the immediate future and not only with worldwide lockdowns), so we might want to use another lifting strategy than what they did in China (if we manage to develop means to control the spread at a very low rate)
2 months is still a reasonable approximation, given all the unknowns. But I will not even be surprised if it ends up being 3, and 4 is not out of the question.
Does anyone believe the numbers that China has given?
I asked as I see everyone use them to compare against but then I see articles popping up talking about reporters who reported difference numbers just vanish over night.
Different government track the numbers differently. While I do believe Chinese government uses the best way to make it looks good on them, but I don't think the 'actual number' will be drastically different. Because if they do, then it's releasing false signal to citizen, which could cause a second wave of infection.
There is a very aggressive surveillance method in place, which I doubt is acceptable by other countries:
https://www.nytimes.com/2020/03/01/business/china-coronaviru...
I personally don't believe them for a variety of reasons: I don't know that any country's numbers are entirely accurate, the substantial reports of active suppression of reporting about it (leaked communication, disappeared providers etc), and features of the reported data are suspicious.
On the other hand, there's probably an opportunity if not now than soon to start modeling the plausibility of Chinese reports. That is, a lot of them use China as a sort of baseline, but at some point things are going to get flipped on their head and the aggregate of other country's trends are going to start affording the ability to ask questions like "given what we know about the distribution of trajectories in other places, how plausible is it that data from country X is valid?"
There's complications due to heterogeneity in population networks, healthcare, response, etc. but I think quickly we're going to start seeing things being sorted out empirically. You can only hide things for so long.
Doctors are deciding what the cause of death was, not the government. The only way to find out how many people died due to this epidemics is to compare the average death rate before and during epidemics. It will also include people withot ncov-19 that died due to health care system being overloaded.
The exact numbers? Of course not. Especially early on, they were suppressing information in addition to just not having complete information themselves. The cat's out of the bag at this point though, with WHO observers and foreign reporters on the ground. Even if there's some fudging and incompleteness, the overall trajectory of the infection curve is likely about right.
Does anyone believe the numbers being reported by anyone? There is no way possible to accurately provide numbers. There's not enough tests. Not everyone is holding their hand up and saying I have a fever, but I'm not going to the doctor for a test that may or may not be available.
since the criticisms of the Chinese numbers tend to be wild derivations from urns or anonymously sourced US propaganda, yes I am inclined to believe the numbers.
If you are seeing these articles "pop up" then you read fake news btw
Given the number of times the Chinese government has been shown to lie and actively try to hide dissenting people/information when it tells a story they don't want told... I think it's fair to start from a point of distrust. Sure, it doesn't mean they're lying about the numbers here, but they started out this whole thing by lying about it, by throwing someone (a doctor?) that did speak out in jail.
My apologies, I was mis-remembering. Dr. Li Wenliang was arrested, questioned, and officially reprimanded for warning about the Corona virus outbreak. Looking now, I don't see that he was actually thrown in jail.
That being said, it does still speak to the point of the Chinese government and their attempts to control the narrative. At least for me, that makes me start from a point of distrust over anything they say.
I would suggest that you look at the region-level data for China, and just see if it looks anything like the European data.
For my money, I don't trust the US intelligence community but I still think that the Chinese numbers are somewhat implausible.
The charts show an identical dropoff in almost every region at the same time. We can see, from the European experience, that there's a lag between lockdown and case saturation. This does not appear in the Chinese data, which makes me somewhat sceptical.
Note that I'm not an epidemiologist, so it's possible that there's something else driving those numbers that I'm missing.
The author missed inter-family infection growth during a lockdown. If you have a family of 5 people and person 1 is infected, person 2 gets infected by 1 after one week, a week later person 2 infects 3, a week later person 3 infects 4, a week later person 4 infects 5. And only then does the infection cascade stop.
This is also happening in hospitals, in nursing homes, in homeless shelters...all are also "families" for this purpose. If your "lockdown" was truly no contact between any two humans, the cascade would stop quicker. But that's not the case.
Comparing the US to China is wrong, because the US isn't doing MOST of what China did to allow the lockdown to be lifted.
"The rate of growth at a given day is the number of new cases on this day, as a percentage of the number of cases from the previous day. The rate of growth is constant for an exponential evolution, and is 0 when there is no more growth. (Mathematically, it is the derivative of the function divided by the function itself.)"
I don't think that's the curve they're talking about flattening.
I don't believe any country can eradicate the virus within its borders once it has spread sufficiently, at least without some form of herd immunity. I think China knows this and is already finding ways to blame foreigners. I think China could completely shut down its borders and still be at significant, if not inevitable, risk.
Note that I think other countries will also play the blame game. I don't plan to buy into the finger pointing as it doesn't really solve anything.
As others have pointed out, this only gets thing to a steady state while everyone is still locked down. All the countries that have loosened their lockdown restrictions had to tighten them back up after they had new "flare-ups".
We're in this for many, many months. Somehow a lot of people have forgotten that "flattening the curve" greatly lengthens the time period of the curve.
Also, the thesis behind flattening the curve is still that the same number of people eventually get it, and it's only once you get broad population immunity that the spread stops.
We will be fighting this with social distancing until there is a vaccine.
"We will be fighting this with social distancing until there is a vaccine."
Well, not really. We can also fight it by producing more needed medical supplies, developing better treatments and expanding hospital capacity. We aren't just trying to influence the curve, but also the line we are trying to keep the curve under. And some nations have had luck flattening the curve using testing and tracing (but the US does not seem to be interested in this approach for some reason). It's also worth considering that the level of social distancing is not fixed. There is a wide range of options between universal quarantine and business as usual.
Okay, so if I promise you you'd have a hospital bed and a ventilator for your last week on Earth, you'd go let some infected people cough in your face?
If your answer is no, you're still worried about the consequences of infection including death and permanent disability, then the public is still going to want to avoid infections even if ICU beds were completely unlimited.
The US was too little and too late with testing for contact tracing to work. It might become possible again if the number of cases gets low enough, though.
That's not how I understand it. "Flattening the curve" refers to reducing the peak. In the models I've seen, at the end of the epidemic, the %of population who have been infected is roughly the same with and without intervention. The point is that there were fewer infected at the same time.
Reducing the load on the medical system is the immediate goal, but the total number of people infected will also be smaller.
Take the extreme example of Taiwan. If reports are accurate and they maintain their current situation, the literally flat curve there will lead to a few thousand people getting infected out of 23 million.
Or compare this outbreak to the first SARS, where asymptomatic spreading was much less of an issue. Very few people globally got SARS, exactly because interventions to stop the spread were effective.
> Very few people globally got SARS, exactly because interventions to stop the spread were effective.
But SARS was also much less contagious than this virus, especially during the asymptomatic phase. SARS also was much more lethal, meaning people that got it had less of a chance of transmitting it, because they were dead.
This virus is kind of the worst of all world's, in that it's very dangerous but only for a relatively small portion of the population, and that it can be spread by asymptomatic people much more easily. This means that it's very easy for any "embers" burning anywhere to eventually flare up into huge blazes wherever there are large number of people that still don't have immunity.
That's called "containment," not "flattening the curve." It's great that some countries have been able to contain the virus, and I hope it lasts. I wish I could believe we had sufficient leadership and discipline to achieve that in the USA.
I'm confused -- or rather, think the author may be -- about what's being measured and inferred. A rate of growth of 0 still means the number of new cases is increasing. The rate of growth needs to be negative before the rate of new cases can peak, slow, and (hopefully someday) stop. Acceleration vs velocity vs position. Right?
> The rate of growth at a given day is the number of new cases on this day, as a percentage of the number of cases from the previous day.
I haven't read the whole thing, but here he's defining "rate of growth" as the number of new cases. If there are 0 new cases each day, then eventually the number of total cases goes to zero.
Right, my point is that a single lockdown is not enough. You have to have good monitoring and intermittent lockdowns in different areas based on that monitoring
Which would further imply that circumstances must change to get that manageable rate as long as group immunity is not proven and a vaccine is still lacking. The circumstances pre-lockdown allowed the virus to easily travel beyond China. Both measures and mindset in many Western countries are still incredibly lax. The symptoms mimicking those of cold, flu, etc. also don't help. People value their current freedom, privacy and hyper-mobility way too much for a manageable rate to come to fruition without locking down.
Otherwise you'll just end up with a new trend of locking down things for 2 months, then opening up, only for a new patient 0 to lock down everything 2 months later.
I don't think "we" have any desire so clearly defined and articulated as that. This virus so so extremely contagious and deadly that there isn't a manageable rate that is going to get us to a high fraction of immunity within the next two or three years. And the measures apparently required to keep it from growing explosively are pretty extreme. I think that China actually does intend to eradicate the virus domestically, and, tbh, short of a vaccine I'm not sure there's any other politically acceptable exit from this situation. Fwiw I don't think allowing millions of deaths is politically tenable, and I don't think that "lock down the only the vulnerable" is going to work.
(I wish I could believe that contact tracing and partial lockdown were sufficient but even Singapore, which by all reports was doing these things, is now SIP with 1/4 as many cases per capita as the US. I think our best case if we can't eradicate is going to look a bit like SK, where schools are shut down and life is very different from what we would typically expect. But that is a best case scenario assuming competent and diligent institutions, which I'm not sure we have.)
So we all lockdown and the rate goes down. It stop staying locked down won't the rate go back up? The only way the rate stays down is if we stop staying locked down is
(a) most people already caught it and are immune
(b) we develop a vaccine
(c) we develop a cure that is easily mass produced and easily distributed.
Until one of those happens we're in lockdown. No? And that means 12 to 24 months.
What were holding out for is testing capacity. Once tests are readily available, we can isolate people who catch it and all they people they've been in contact with, and the virus can be held down in quarantine while the rest of society goes on.
This strategy has worked in China and South Korea, where life is now slowly resuming, but most other countries haven't caught up with their testing numbers yet.
The reason we're all quarantined now is that there's presently no rapid reliable way to tell who needs to be quarantined and who doesn't.
Really? Because I have heard of no plan at the federal or state level to implement a wide-scale test and trace program to contain the virus. This seems like a very good idea, but not one being implemented in the US.
The US is far beyond containment at this point. As are many other countries right now, as well. Only when the cases go down again due to successful measures is containment an option again, as you need enough resources to trace contacts and test every potential infection.
"Only when the cases go down again due to successful measures is containment"
We have already taken measures to contain the virus. So why aren't we preparing these needed resources for testing and tracing while the lockdowns are in effect? Two months will pass and we will be no better prepared than we are today because no government in the US is working towards this. The containment will be for nothing, just a temporary measure that will have to be repeated over and over because we aren't even trying to implement a better solution.
For most countries, the month before lock down was one where people acted as they always had. The months after lock downs are relaxed will not have people acting the same way, and there is a lot of middle ground between lock down and buffets at international conferences.
Enormous deployment of serological tests and rapid RNA tests can also change the way we approach day to day activities.
It's a bit more nuanced than that. For example people proven to have been already infected can reduce distancing. Some distancing measures vs baseline can be left in place permanently (e.g mask wearing).
It could be theoretically possible to reduce distancing between immune persons. However this creates
1) a social and economic pressure to also get infected and ignore the risks
2) a control problem: Suddenly, many people are outside and socialize. How should the police differ between the two kinds?
3) even after the symptoms have gone away, the virus is still contained, e.g., in the stool. So you would need vast and repeated testing to check who is not infectious and immune.
8 million people might be a small number compared to the deaths caused by a 24 month lockdown. There would be virtually no economy to support healthcare, and ‘deaths of despair’ would skyrocket to a point that makes the virus look like child’s play.
And frankly, it might be a rare example of a social policy where "revolutionaries enact a coup to overturn it" needs to be explicitly considered and risk weighted.
As long as there are a few cases in the community-- and there always will be-- the end of each lockdown potentially will trigger a surge of cases, and thus a new lockdown.
I think what is really going on here is world leaders assume China is most knowledgeable about this virus, because goodness knows its labs probably have been studying it for 15 years, they don't have confidence that China is forthcoming about what it knows, and in a few nations globally the effect borders on catastrophic so it's not something to be ignored. So, governments have copied the moreknowledgeableactor, which happens to be an autocratic communist government, in hopes that it's approach is the best informed and effective scientifically .
Thus, the answer to 'when do the lockdowns end' really is: when we feel more knowledgeable about the virus than the nations that resorted to placing their populations under house arrest, and therefore feel confident enough to stop following China's example.
If real information about China were to leak out, my guess is it would happen through the vector of internet/social media. Chances are, some other source would need to copy + repost it before being taken down. This is what I looked for.
- lots more people have died that communicated (there's an estimate of ~22m due to missing cell phone contracts)
- riots are happening between regions where lockdown occurred, and regions next to them)
- lockdown isn't practically over in areas where resurgence of infection is happening (pending other containment approaches)
edit: I've eaten dinner with some friends from China in the past month before lockdown started, and am in frequent contact with people traveling throughout SEA. I was trying to provide and summarize a potential semi-primary source. Added some more specific #'s, info, and removed inflammatory words. Sorry - I wasn't trying to be fear-mongery. However, I am trying to accurately reflect a harsher reality
I do think it's quite reasonable to assume some areas of China are getting back to normal.
I also think it's quite unreasonable to assume info _isn't_ being censored and controlled, especially post journalist-eviction.
Do people on HN really have no friends/connections in China? People post comments like this as if it's some mysterious information black hole where we can never know what's really happening.
I communicate pretty often with people living in China and with family and living in China. Things, even close to Wuhan, are returning to normal. People are going out, eating out, socializing more.
From all of the everyday people reporting there is no obvious or visible things not being reported. By and large people in China are primarily worried about America right now.
It wouldn't shock me if there was some important information not being reported, but this conspiratorial "If real information where to leak out" is nonsense since you can very easy interact and talk with actual people living in China.
There is also the willingness of Chinese companies and individuals to ship PPE gear to the US. If the government there were really still in crisis mode, you would expect it to clamp down hard on that sort of thing.
It seems to me that what we’re really doing with the lockdown is buying the time to “mobilize,” in the military sense, our healthcare system. If we had the testing capacity to test everyone and contain only the sick, this would be less serious. If we had 10x as many ventilators, and 100x as much protective equipment, this would be less dangerous. If we had an effective treatment (like a Tamiflu for Covid), then this would be less dangerous. Etc.
It seems to me unlikely that we will be locked down less than 2-3 months. But after that, I doubt the public will be willing to endure another global lockdown of this magnitude. Thus I think everything we’re doing now is really about delaying the inevitable long enough for us to get a coherent response in place.
To the extent that anyone is a “winner” in a pandemic, it certainly appears to be Taiwan and South Korea, who responded fast enough to the first wave to keep it from requiring an authoritarian response (or, at least thus far).