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Comment by ipnon | Hacker News Reader

Let alone the United States, a country in which people delay healthcare until the latest possible moment to avoid the costs. This strategy is advantageous to the individual but disadvantageous to the group. The individual may survive without treatment, but without quarantine they proceed to infect those around them. Those around them may be in similar financial conditions.

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The United States has already been handling the few cases it has pretty aggressively, and following up with anyone who might have come into contact with each person. This feels like you're just jumping on the opportunity to say "US healthcare is bad, guys", which doesn't really make sense when comparing our handling of an outbreak (in which the CDC will mobilize and largely bypass the issues in our healthcare system to mitigate disaster) to India and Africa not having anywhere near the infrastructure to handle this.

People are still dying of swine flu in India, a decade later. There's really no comparison, no matter how much you may dislike the US healthcare situation

Infected people in the US so far were wealthy (traveling back from China) and so didn't have the cost concerns mentioned above.

Logic would dictate that that would continue to be true, since the cost of flying from China is unlikely to get drastically cheaper. So I'm not sure what you're getting at.

You don't have to be wealthy to have traveled on a cruise ship. The US is also pretty well organized, and generally very transparent about this sort of thing. While China is...not. The US, on a relative basis is also a much cleaner and sanitary country than China.

Replace "wealthy" with "not poor" and the grandparent's point stands.

Or even just interpret "wealthy" in a global context instead of local.

Its also worth noting that Japan's response has been roundly criticized both from within and without. They've kept these citizens in a cruise ship sized pitri dish and the effects are now playing out. On the other hand, they have been more hands off when it comes to monitoring and quarantining people traveling to and from China via air. Most other countries, including the US, seem to be reacting with stronger measures, which may make a big difference.

There's a discussion on this Twitter thread about why it could become a problem: https://twitter.com/SuperMugatu/status/1229229188273627136

The CDC has just had its budget cut by 16%, is still forbidden from using the terms "evidence-based" and "science-based", and has dragged its feet long enough that containment is very unlikely at this point.

Trump proposed cutting the CDC's budget by 16%, but given that Congress sets the budgets this is not meaningful at this time.

I'm curious what you mean by the CDC having "dragged its feet". I know a dozen people at the CDC, they've all - ALL - been aggressively sidelining their previous projects to focus on COVID-19 for some time. They certainly don't feel internally the way you do.

I'm curious as to what exactly "some time" means for the 12 people that you know. Is it greater than 4 weeks?

12 people may not be a lot, but his anecdote of 12 people seems stronger than what you've offered up so far. What actual evidence is there that the CDC has dragged their feet on this?

January 24th is quite late to the game relative to what we've known publicly for quite some time.

https://www.cdc.gov/media/releases/2020/archives.html

https://www.cdc.gov/media/releases/2019/archives.html

Testing delays and scheduling issues for testing before the CDC distributed kits were also critical missteps.

I have texted the seven people of those 12 who I'm on "texting terms" with. Three of them began shifting some of their time in mid-November, two in mid-December, one in January, one no response. Four of the seven have traveled to US ports beginning in January to begin testing and monitoring efforts.

The CDC has finally issued a level 1 travel advisory for Hong Kong as of February 21st.

That's what I call "dragging feet."

Anothet example of CDC dragging its feet during the same time period.

https://www.reddit.com/r/nyc/comments/fayko1/my_covid19_stor...

This is my experience as well. I'm on three different conference calls per week with CDC folks, and I'm only peripherally involved.

Us health care hasn’t had to deal with something like the Spanish flu since the creation of the modern health insurance system. It’ll be interesting to see how well it handles millions of people who need extremely expensive ICU care all at the same time.

I expect we’ll see one or more insurance companies collapse or need a government bail out.

The information release so fare makes this look more like a bad flu with a 2.5% mortality rate, nothing like the Spanish Flu's 10%~20%. The Spanish Flu was also especially bad because it effected young adults disproportionately[1]. This caused massive problems because that was the age group of most care givers.

1. as appose to 0.1~0.2 for regular flu 2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734171/

> People are still dying of swine flu in India, a decade later.

In the 2017-2018 flu season over 70,000 people died in the US, and the main strain was H3N2 - a type of Swine Flu.

The A(H1N1pdm09) strain is still circulating in the US and still causes death there too. https://www.cdc.gov/flu/weekly/index.htm

https://www.cdc.gov/flu/pandemic-resources/burden-of-h1n1.ht...

> CDC estimates that from 2009 through 2018, influenza A H1N1pdm09 has caused at least: 100.5 million illnesses, 936,000 hospitalizations, and 75,000 deaths.

my understanding is that the CDC can and will resort to extreme measures to contain any dangerous disease, but what I don't understand is who is paying for treatment of individuals that are affected by those measures. (disclaimer: European here)

I'm sure the government would likely kick in to quarantine people.

The problem are all the people who will wait until they're really sick before checking in, or won't go to a doctor at all, and they've already spread it by that point.

People will still most likely be stuck with the price of their care unless we get to the point that the CDC and the government at large are opening quarantine and treatment facilities of their own to deal with a true outbreak. Short of that most people will just wind up in the normal hospital and healthcare system which means they'd be paying for their own care.

It'd be a sad but ultimately useful twist if a big outbreak hitting the US pushed us to finally adopt a reasonable centralized healthcare system. I could see it happening but I could also just see a block of money being set aside to pay for peoples' care too.

It's highly likely that in such a mass event the US would have a debt forgiveness program or work with healthcare providers to subsidize costs. At that point it would become a national security emergency which would open up federal spending flood gates.

"Americans can always be counted on to do the right thing…after they have exhausted all other possibilities."

-- Meme

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