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Lt. Gov. Josh Green hopes to reopen Hawaii’s tourism industry by July (hawaiinewsnow.com)
33 points by bookofjoe on May 28, 2020 | hide | past | favorite | 54 comments



In the U.S., friends who have taken the test report wait times of up to 7 days for results, during which time the person being tested could catch COVID even if the result is negative. There is also a problem with false negatives (~3%, https://www.unionleader.com/news/health/coronavirus/state-of...).

But I have also read some other countries like Taiwan and Korea have better testing regimens in place, which high accuracy and fast results. Could Hawaii implement such a system for incoming travellers?


Emirates has been using a test that has a 10 minute turnaround to test passengers on some flights...

https://www.npr.org/sections/coronavirus-live-updates/2020/0...


The rapid tests tend to be less accurate, and are particularly dependent on the operators following proper sample collection procedures.


antibody tests are security theater, unless they only allow immune patients to fly.


The rapid tests are checking for viral RNA fragments in the upper respiratory tract. They aren't drawing blood and checking for antibodies.


If it's true Hawaii better get use to having no tourism to their state. No one can just go get tested. You have to show multiple signs of covid before they will allow you to test, and at that point you surely won't be traveling. This is an unsustainable approach for a state which heavily relies on tourism to sustain itself.


What about exposure and infection from the time the samples were taken till the arrival into Hawaii?


I suppose there's only so much one can do.


So then much like the TSA, this is security theater


Not at all. The name of the game is keeping the transmission rate low. Catching some infected passengers (even if not all) serves that purpose directly and effectively. Nothing remotely "theater" about it.


Are you sure it's effective?


If by "effective" we mean "reduces the transmission rate of the virus" then yes, temperature checks, wearing masks, washing hands, testing for the virus, physical distancing... these are all effective ways to reduce the spread of the virus.


Will Hawaii require me to take a training course to make sure I know how to wear a mask and wash my hands? It will lower transmission rates.


By that logic, you can justify literally anything: if it might have some theoretical impact on “transmission rate”, you do it because doing something makes people feel like they’re doing something.


That's ridiculous reasoning.

We know that infected people can spread COVID19 without any deliberate action on their part through the simple, reflexive action of exhaling. This part is not in doubt. The virus has an R0 greater than 2 in uncontrolled circumstances, meaning that each infected person will likely infect at least 2 others. This is the lower bound; other analyses have placed the uncontrolled R0 for COVID19 as high as 6.

Thus, identifying and quarantining as many of those who are infected as possible will reduce the transmission rate because there will be fewer opportunities for those infected people to (unwittingly) infect others. This part is not in doubt. It's basic physics and basic medicine.


You’re focusing on the “virus scary and contagious” part, and skipping the part where you show that the proposed method is effective at stopping it.

As many others have noted now, if I can bring a test result taken days ago, I can easily have acquired the virus in the meantime. On the plane, for example. As you note, respiratory viruses are usually contagious, and there’s an incubation period where you probably won’t test positive or show symptoms.


I will stress again, the name of the game is keeping the transmission rate LOW, not bringing it down to zero. Do you think 6 feet prevents all droplet transmission? No, of course not, but it helps reduce the transmission rate. Do masks prevent all infection? Absolutely not, but it helps to reduce the transmission ate.

If we can devise low impact ways to reduce the transmission rate (masks, chokepoint testing, remote temperate checks) then we can do away with the more onerous methods (closing down the entire global economy for example).


I will stress again that if your only bar is ”seems like it might reduce transmission rate”, then you can justify literally anything.

We have to do something (to reduce transmission)! This is something! Let’s do it!


You may recall that we shut down the entire global economy because of this virus. So yeah, it's true, we can justify a whole hell of a lot in service of keeping the transmission rate low.

And there's nothing theoretical about this. Regularly stopping infected individuals form boarding planes will reduce the transmission rate, not in theory, but in fact.


Yep, we’ve done all manner of unproven, dubiously effective measures at incredible cost, because “we have to do something!”

That is not itself a justification for doing more of them.


Do you think TSA is security theater?

Because the name of the game is keeping the terrorism rate low. Catching some potentially-dangerous passengers (even if not all) serves that purpose directly and effectively. Nothing remotely "theater" about it.


My personal opinion -- and opinions may differ -- is that yes, the TSA is security theater.

To my knowledge, the TSA has never caught a terrorist.

Moreover, the Department of Homeland Security conducted a test where they attempted to smuggle weapons or mock explosives onto airplanes. 67 out of 70 times, they succeeded.

https://abcnews.go.com/US/exclusive-undercover-dhs-tests-fin...

In the meantime, passengers have to wait in long lines and endure random indignities.


The point of the TSA is to be the first hurdle in a multi-tiered approach to preventing terrorist acts on airplanes. It was never meant to be the only mechanism, nor even the primary mechanism.

It was simply intended to raise the difficulty of getting weapons onto a plane enough that terrorists would choose other, easier options. It's irrelevant that DHS can get weapons onto a plane--there's no risk to their agents when they get caught since they can just flash a badge and move on with their lives. If a terrorist gets caught with actual weapons, the consequence is failure and imprisonment for the rest of their life. The risk may be small, but it's significant enough, and it's just the first hurdle. (There are additional hurdles, like locked cockpits, randomly-assigned US marshals on most high-value flights, and 100s of fellow passengers that a would-be terrorist must also contend with.)

And it worked. Terrorists in the West shifted their goals away from attempting to bomb/hijack planes and trains to simply renting trucks and trying to drive them into crowds. This is why bollards began surrounding so many areas that draw large crowds, like sports arenas and pedestrian thoroughfares. (In the U.S. bollards have been required for federal buildings and mass-crowd facilities like Sports Arenas since the Oklahoma City bombing. After a mass-fatality driving accident at Santa Monica's Third Street Promenade, California began requiring them at outdoor malls as well and this has become standard practice in the U.S.)


The actual thing to do would be a mandatory 14-ish-day quarantine on arrival at that point.


That's what they're doing right now, but they'll need to relax it for any hope of tourism.


Which doesn't really work well for tourism.


Would testing be performed upon arrival, or would people be able to somehow bring proof of their negative test results? If the latter, then how would you verify the validity? What happens if you don't have proof, or if you test positive?


This pretty clearly falls under the Off-Topic section in the guidelines.


Then hit the flag button or don't upvote.


People with antibodies in their system should be allowed in everywhere without quarantine.

The world really needs to stop self harming itself in order to protect a few boomers with power.

It's very clear that the vast majority of people under 50 are not at risk of dying from covid19 in developed countries with adequate healthcare.


A lot of anecdotal stories I see from young people who have gotten it talk about it being the worst illness in their life and feeling close to needing hospital care. I think I'll pass. There is more than live/die in the end, such as maintaining quality of life.

Regarding anti body tests, there was literally just a notice from the CDC saying the current tests can't really be trusted for policy decisions. https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/anti...


Anecodotes are not data.

The numbers are absolutely clear: if you’re under the age of 50, you are overwhelmingly likely to have nothing more than a minor illness. Over 30% of infections are estimated to be asymptomatic. In New York, over 90% of hospitalizations (in addition to being heavily skewed to the elderly) involved one or more comorbidities. Nearly 90% had two or more.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...

https://www.google.com/amp/s/www.the-scientist.com/news-opin...


This really shouldn't be downvoted. It's factually accurate that the vast majority of people who get this who are young and healthy do not experience even noteworthy symptoms. Stories of it being the worst illness people have ever experienced are likely to be cherrypicked, especially because most people who had the unremarkable symptoms won't even know it.

Acknowledging that most cases are minor and not that bad doesn't mean you have to run down the entire path of doubting the virus' threat.


> People with antibodies in their system should be allowed in everywhere without quarantine.

Creates pretty bad incentives if implemented (people will seek out the virus). Also relies on accuracy of individualized antibody tests.


If you're young and healthy, it may make complete sense to get the virus is a controlled manner with low viral load. I'd likely sign up to do this. Immunity is not proven, but its highly probable at least for a while. It would be nice to not constantly question whether or not I'm asymptomatically infectious and a threat to those around me.

infection passports are problematic because these incentives crop up for people who are actually at notable risk but either need the economic livelihood or just don't believe the facts around the virus


Does it though? Chicken pox parties are still common. With literally millions of people in risk of dying and the apparent years until we’ll get to a vaccine, is it really that crazy to just spend two months intentionally infecting all low risk people to build up herd immunity?

I know it’s unconventional but this is not a normal situation. If it was done in an orderly and controlled fashion, possibly even incorporating vaccine testing, this had the greatest odds of actually fixing the problem as a whole.


It's not a cake walk illness for many that get it. The things I read seem to assume that you're completely fine if you aren't on death's door. But many of the first hand accounts from people that got it (and didn't go to the hospital) is the you absolutely do not want it.

I'm going to err on the side of not getting it if given a choice.


Sure, and I think everyone's on the same page that you should be free to do that. The question is how the rest of us can best get back to a (mostly) normal life.


Just to be really clear, you're free to do what you want. And I don't care what you do.

What I don't feel is correct is to institute policy based on things that the CDC says are not effective enough to determine policy. Or to support intentional infection based on not understanding the illness well enough. The reason I don't support that is not because I care about what the people forcing infection do to themselves, but what they do to the people that need to support them (hospitals, going out when ill and infecting others who didn't sign up for that, etc).


That makes sense to me. I certainly agree that we shouldn't institute ineffective policy that won't accomplish our goals, and I share the CDC's skepticism of immunity passports.


I’d rather get it intentionally and have a rough month than kill my parents. It’s not about the healthy ones like us.


I'm not convinced that it would actually help that? What % of the population needs it to gain herd immunity? Will older people chip in to contribute or only younger people? What risk is there to younger people in general? We already know there are long lasting effects possible and deaths are still possible.


The percentage needed for herd immunity is waaaaay less than the low risk population. And using intentional exposure combined with vaccine testing will bring us to a successful vaccine much faster.

This isn’t about perfection. Millions of people will die. We need an answer now. Not in years.


Chickenpox has a vaccine and long term consequences... nobody should be doing chicken pox parties


I know. I probably should have said “were” as they are much less common now due to the vaccine. The point was that they were safer than not getting it later in life before we had a vaccine. My mistake in wording that.


Chicken pox partiers don't harm others who vaccinate or are covered by herd immunity.


What doctors are finding out about the damage done to younger people who survive a serious brush with COVID is not reassuring.

And the problems they experience will have an impact economically going forward.


This is a false narrative about serious issues with young people designed with the good intention to convince younger people to take precautions and not infect those at higher risk. It’s not actually a real problem outside of extreme outliers.


Well yeah, besides the people it happens to, it doesn't happen at all.


> younger people who survive a serious brush with COVID

only a small percentage get seriously ill, less than 5% across all age groups, with much less in the younger groups

> And the problems they experience will have an impact economically going forward.

The US economy at large is/has been destroyed, with up to half of the layoffs likely being permanent job losses.

Europe has avoided mass layoffs, but the US is throwing tens of millions of its citizens under a bus. Lockdown has to end in weeks, not months.


To the extent Europe has avoided American-style mass layoffs, it's been through direct and indirect government funding of continued employment. Businesses and employees are being kept warm — they're in the cache.

In the US, this is anathema to the ruling party, so even trillion-dollar nominal relief legislation is structured to channel money with little oversight primarily to corporations, and erect preferential barriers to relief reaching states, local governments, and citizens' pockets.

There is more concern in the US ruling party over the "moral hazard" of a fast-food worker in a big city on the edge of poverty receiving unemployment that exceeds their $8 per hour salary, than there is over shell companies thrown together in a week receiving $55M no-bid contracts to resell PPE seized by the federal government from the states [1].

[1] See Blue Flame Medical, Oren-Pines, Panthera, et al.


Europe has way better social safety net and labor rules.

The way to have done this was to have a swift, effective response to the virus. We missed that. Now we are suffering the consequences.

Other places did better and are not having to make as stark a choice.


While it’s tempting, from a safety perspective, to implement something like this I think a system of “haves” and “have nots” based entirely on medical records is a recipe for disaster in the long-term. I would rather wear a mask and socially distance so that everyone is equal and equally inconvenienced.


>The world really needs to stop self harming itself in order to protect a few boomers with power.

While I would not phrase it so harshly, I understand the point. But looking further down the road: I worry that if we encounter a virus that truly does threaten the entire population, that we'll end up in a permanent, North Korea-like state. The precedent has been set for this by the Covid-19 experience.




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