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Comment by jtdev | Hacker News Reader

“ Philadelphia had scheduled a big Liberty Loan parade for September 28. Doctors urged Krusen to cancel it, fearful that hundreds of thousands jamming the route, crushing against each other for a better view, would spread disease. They convinced reporters to write stories about the danger. But editors refused to run them, and refused to print letters from doctors. The largest parade in Philadelphia’s history proceeded on schedule.”

I see that Switzerland has imposed a ban on gathering of 1000 or more in response to COVID19 - maybe other countries should consider doing the same?

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To add a little context: I’m currently scheduled to attend a ~50000 attendee international conference in the U.S. My employer has sponsored - and I’m not in a position to refuse to attend (yet). The host org is standing firm on pushing forward as scheduled, but has released a bunch of PR B.S. communications about hand sanitizer, face masks, etc. being provided and quarantine of symptomatic individuals at the event (not sure how they’re going to swing that). I’m not in the age demographic for high mortality from COVID19, but I’m concerned that I might pick it up and bring it back to my home community - where there are people in the high mortality demo. It seems that a neutral third party (CDC???) should step in and say “we’re recommending that this event be canceled”. Which would make it much easier on all to simply not attend if the event does in fact go forward.

Out of curiosity, what conference is that big? NAB?

HIMSS (Health Information and Management Systems Society), the irony is just...

I suggest dropping some of your concerns around social media to see if it picks up steam. If it gets the attention of enough people, they'll have to take it more seriously. The way you've described it irks me a little bit.

being blocked by HIMSS on twitter for asking and having a conversation should really ring alarm bells. hope some high follower accounts pick this up and RT it for more visibility.

I’ve been seeing quite a lot of major conferences being cancelled and/or large companies deciding not to attend. In many cases they’ve waited as long as possible before officially cancelling to see if things improve. I would think you have the right to express your concerns and decide not to attend - if enough people do the same, the event may be postponed or cancelled.

They (HIMSS PR) blocked me for asking about the preparedness plan (which is completely inadequate) on Twitter... maybe I should have asked via email, but it seemed like a conversation that the community would have interest in. They seem to be in complete “protect sunk costs at all measures” mode.

HIMSS is a healthcare conference? That’s rather ironic.

Health IT. Less about fixing broken humans and more about selling technology. But, your point stands.

Panic is unwarranted.

On the cruise ship, which is known for being full of old people, there were 3 deaths out of ~750 known cases. Almost everyone dying so far has had another medical issue or been very old. Reports now say that many people testing positive have no symptoms at all and aren't getting sick. There have been zero deaths of children so far, which is unlike the flu. The youngest death was in his mid 30s.

Everyone should chill. Visit with your parents or compromised friends on FaceTime for a few weeks. Wash your hands. Don't go to work sick. If you're pregnant take extra precautions. Otherwise live your normal life.

Quick fact check: first of all, 3 deaths out of 750 isn't relevant without knowing the timeline of transmission, as most deaths occur 3-4 weeks post infection.

Second, there have deaths of people in there 20's a casual google search of 'youngest death coronavirus' yields that information as the first result.

And if you believe every young death (or every death) in Hubei province is being publicized, you haven't been paying attention.

I do agree that it's important not to panic, but we absolutely should be taking social distancing measures to reduce the r0.

So... if we’re not in the high mortality demographic we should just engage in activities that could be a catalyst for pandemic and significant loss of life? Not sure I follow your thinking.

> Almost everyone dying so far has had another medical issue or been very old

I agree with not fomenting panic. However, "had another medical issue" means diabetes, which alone covers 11% of the US population, and has so far been associated with a mortality rate of about 8%. This likely includes at least one family member in more or less every US family.

It's entirely reasonable to view that as a compelling reason to avoid things like major conferences with significant inter- and trans-national mass transit.

Would be interesting to know how the level of your treatment to diabetes affects your chances to die. I'm type 1, A1c under 6% and I do constant exercise. Is it worse with bad control, I haven't found an answer yet.

My understanding is that high blood sugar impedes the immune system. So, the better your blood sugar is controlled, the better off you will be.

That's what I understood also. I've spent tremendous amount of time understanding my diabetes, and your comment here validated my assumption in the case of CoV.

It's still quite scary to see how diabetics have a very high risk with the virus. Luckily the treatment I get with my closed loop gives me an easy access to excellent control.

This is dead wrong. Please check your facts. 6 deaths. Many in bad shape. Most still sick. Honestly, people should be scared. Leadership is doing everything they can to prevent that.

I don’t think being scared should ever be a recommendation. Concerned, proactive, and calm are the way to go.

>3 deaths out of ~750 known cases

Actually it's 6 out of 705. [0][1] May seem like a small difference, but a 0.8% chance of dying is 8x more than the flu.

Never mind the fact that the data out of China, Italy, Japan and Iran is all trending around the 2-3% CFR calculated and published in multiple peer reviewed journals. [2][3]

(However, South Korea might be reason for hope.)

>or been very old

It bothers me immensely when people mention it's "just old people". I'm not sure why I should "chill" about my parents having an 8% chance of dying if they contract this. [3]

[0] https://bnonews.com/index.php/2020/02/the-latest-coronavirus...

[1] https://www.worldometers.info/coronavirus/

[2] https://jamanetwork.com/journals/jama/fullarticle/2762130

[3] http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9...

>Actually it's 6 out of 705. [0][1] May seem like a small difference, but a 0.8% chance of dying is 8x more than the flu.

There's a good chance being confined to a cabin in a cruise ship and acquiring COVID-19 is more detrimental to someone than if they had a community acquired infection going about their normal life.

Being restricted like that implies they're getting significantly less exercise than they would normally, and the stress combined with lack of sun can do a number on someone's sleep cycle. That in turn can influence cognition, especially in the elderly, and I imagine increases the chances of being dehydrated/etc...

It's like being in a hospital, which tends to do a number on most people, but without supportive around the clock care.

While it may not kill many quickly, you might be underestimating the long term effects of permanent lung damage. [0]

[0]https://www.nationalgeographic.com/science/2020/02/here-is-w...

Cruise ship analysis is naive.

People from the cruise ship are still in the process of dieing. 2 more deaths occured today.

The number of recovered cases from the cruise ship is low, so naive inference on death rate so far is misleading.

Quarantine? A non-governmental person/entity doesn't have legal power to detain anyone in the U.S., including for the purpose of quarantining them. See https://www.cdc.gov/quarantine/aboutlawsregulationsquarantin...

The only way you could legally be physically detained in quarantine at a conference would be by a sworn offer (e.g. a police officer) acting on a government order.

HIMSS is using the word "isolated" [1]. HHS defines "isolation" and "quarantine" as the following [2]:

"Isolation is used to separate ill persons who have a communicable disease from those who are healthy. Isolation restricts the movement of ill persons to help stop the spread of certain diseases. For example, hospitals use isolation for patients with infectious tuberculosis.

Quarantine is used to separate and restrict the movement of well persons who may have been exposed to a communicable disease to see if they become ill. These people may have been exposed to a disease and do not know it, or they may have the disease but do not show symptoms. Quarantine can also help limit the spread of communicable disease."

Seems like the only real distinction is in terms of whether on not you're currently ill, but fundamentally they both restrict movement.

From HIMSS [1]: "Screening procedures established by the CDC will be conducted on site throughout the conference; HIMSS and the Orange County Convention Center will consult health teams at Orlando Health when necessary.

Should screening reveal an elevated risk for an attendee, the person will be isolated immediately to prevent exposure to conference participants."

[1] https://www.himssconference.org/updates/himss-update-coronav...

[2] https://www.hhs.gov/answers/public-health-and-safety/what-is...

My point is simply that without a directive from the government, it would be illegal for the conference organizers to physically detain you, even if it's to isolate or quarantine you. Even if they did have a directive, it would probably still have to be a sworn officer doing the detaining (there may be case law on this to the contrary). Hospitals obviously have such a directive, but I'm not sure that even a hospital security guard who isn't a sworn officer would have the power to detain you under the hospital's directive. In any event, it's not at all clear to me that HIMSS has a directive from a government agency, let alone that the detaining would be done by sworn officers and not some hired help with "guard cards".

Same conference, similar position. "45,000 healthcare professionals from 90 countries" Absolutely crazy. Might there be a public outcry if the citizens of Orlando were made aware of it?

You could call in sick?

For the USA at least, wouldn't imposing a ban rather than a recommendation be a violation of the Constitutional right to freedom of assembly?

Not a lawyer, I think it would depend on the exact laws and rulings around martial law. Curfews are a thing, but I don’t know if they’re constitutional.

Sure, a recommendation seems good too... anything rather than just burying our heads in the sand.

Aren’t some authorizations still needed to organize larger events? I think that’s the ban, no more concerts, sold out football matches, etc.

SCOTUS has repeatedly recognized quarantine as an exception.

If the CDC merely urged that all large gatherings be cancelled, that would probably result in the cancellation of 95% of them, with no constitutional implications.

Can they at this point? It seems like their authority has been emasculated.

I don't understand what you mean by this.

"Emasculated" is a bizarre word to use, but I assume it's in reference to Trump putting Pence, rather than anyone at the CDC or HHS, in charge of official messaging around COVID-19.

Ah, I've been on a politics fast for a few days, so I missed that.

Without devolving into an inevitable political shouting match, what would the purpose of that move be?

Signaling that it's being taken seriously at the "highest levels" to support confidence?

I wonder if it could also be an insurance strategy: if things go south, Pence takes all the blame and is booted from the 2020 ticket?

Pence exists to lock down the evangelical vote, there's no way he'll become a fall man.

Although, that's traditional thinking, and this president is anything but traditional. So maybe you're right.

VP Pence has been given veto authority over all messaging, and the CDC’s funding in this area was gutted early in the administration.

The CDC's funding was not gutted in that area, that's a false propaganda point being shoveled by several prominent Democrats. Trump attempted to push cuts through and failed, fortunately.

> AP FACT CHECK: Democrats distort coronavirus readiness

> Democratic presidential contenders are describing the federal infectious-disease bureaucracy as rudderless and ill-prepared for the coronavirus threat because of budget cuts and ham-handed leadership by President Donald Trump. That’s a distorted picture. For starters, Trump hasn’t succeeded in cutting the budget.

> He’s proposed cuts but Congress ignored him and increased financing instead. The National Institutes of Health and the Centers for Disease Control and Prevention aren’t suffering from budget cuts that never took effect.

https://apnews.com/d36d6c4de29f4d04beda3db00cb46104

You’re correct that funding wasn’t impacted. I was wrong about that.

However he did indeed cut the people tasked to deal with pandemics.

https://foreignpolicy.com/2020/01/31/coronavirus-china-trump...

> But other White House efforts included reducing $15 billion in national health spending and cutting the global disease-fighting operational budgets of the CDC, NSC, DHS, and HHS. And the government’s $30 million Complex Crises Fund was eliminated.

> In May 2018, Trump ordered the NSC’s entire global health security unit shut down, calling for reassignment of Rear Adm. Timothy Ziemer and dissolution of his team inside the agency. The month before, then-White House National Security Advisor John Bolton pressured Ziemer’s DHS counterpart, Tom Bossert, to resign along with his team. Neither the NSC nor DHS epidemic teams have been replaced. The global health section of the CDC was so drastically cut in 2018 that much of its staff was laid off and the number of countries it was working in was reduced from 49 to merely 10.

I'm pretty sure the CDC can "say" what they want.

You'd hope so, but then we have this: https://www.nytimes.com/2020/02/27/us/politics/us-coronaviru...

tl;dr- "directing them to coordinate all statements and public appearances with the office of Vice President Mike Pence"

The CDC budget has not been cut.

https://thehill.com/homenews/media/485025-ap-fact-checkers-f...

The truth is more complex.

https://foreignpolicy.com/2020/01/31/coronavirus-china-trump...

It’s really unfortunate that the word “right” is used here because no “right” is absolute.

Freedom of speech doesn’t mean you can falsely yell “active shooter” in a crowded theater.

Freedom to bear arms doesn’t mean you’re allowed to own nuclear weapon or a surface to air missile battery.

Freedom of assembly doesn’t mean you can go where you want, when you want.

Other needs and limits can preempt these “rights” so they’re not really right at all.

Restrictions on that right are subject to "strict scrutiny", which is the highest standard of judicial review.

To satisfy it, the government has to show that it has a compelling state interest and that their solution is narrowly tailored to serve that interest.

Curfews for public safety after natural disasters like fires and floods, or to prevent spread of disease, or in times of extreme civil unrest like riots have been found to meet the strict scrutiny standard.

Since a ban on large gatherings is less of an imposition on your freedom of assembly than a curfew, I'd expect that it would be allowed.

Legal eagle did a video on Youtube that came out yesterday that seemed to suggest that the government has leeway in cases of pandemics (sort of like in wartime) that it wouldn't have otherwise. It might technically be unconstitutional under some readings of it, but SCOTUS might rule that it's warranted.

Basically: "the Constitution is not a suicide pact" https://en.wikipedia.org/wiki/The_Constitution_is_not_a_suic...

There's an awful lot of case law to date that allows for public health departments to violate constitutional rights to address a public health emergency. The legal right to quarantine is pretty much predicated on "for the good of society, your constitutional rights are out the window."

I hope I don't sound critical of this. I'm not. I'm in favor of empowering public health departments, with accountability and oversight and judicial review, to do what is needed to prevent massive tragedy. I'm just putting it bluntly: our case law on this topic is reasonably well-settled, and one-sided, as pertains to epidemics. (Now, as pertains to vaccinating...)

It can be regulated if it impinges upon my rights.

I believe the current legal interpretation of freedom of assembly in the US is that it only applies if your assembly is ‘to petition the Government for a redress of grievances’.

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