Tell HN: My MD says that Europe is not preparing for containment but pandemic

Containment was already impossible when news first broke in the west in late January. At that point the virus had already escaped not just Wuhan, but China. With airborne spread, r0 of 3-5, asymptomatic carriers, and ~2 weeks between infection and when it becomes severe enough to warrant medical treatment, it's virtually impossible to trace all infections. All it takes is one getting through screening and you have a massive epidemic - that seems to be what happened in Italy. Epidemiologists have estimated that it's been circulating in the Seattle area since at least mid-January - that was about 10 days before any news of it hit Western media.

For some reason people tend not to react well when told "You will get it. Guaranteed. There's nothing you can do about it. If you're young and healthy you have about a 1 in 500 chance of dying from it; if you're old and sick it could be as much as 1 in 4." It may not be that your doctor thinks it's OK when old people die, just that it's inevitable, and it's not worth worrying about inevitable things.

I agree. Another point is that the doctor probably know about the dead rate of the flu, that is lower but not much lower https://en.wikipedia.org/wiki/Influenza#Prognosis

(There is a vaccine for the flu, it will not help against corvid-19, but this may be a bad year to get a bad flu while the hospital is full of covid-19 patients.)

I think it is very stretching to say that <1% is not much lower than 8-14% (depending on the age bracket).

It's 8-14% of the cases that are confirmed by a special analysis in the lab, so it's a 8-14% of the cases that are bad enough to justify the cost of the analysis. In general population for the same age slots, it is probably (hopefully) much lower.

I think if people really think that all human life should be valued then every country would have implemented measures similar to China.

I thought first that it is incompetence but apparently it is possibly just matter of values.

China doesn't value human life - if they did they would never let air pollution in Wuhan get to the point where a good day is like the Bay Area when all of California is on fire, or have opened their arms to Phillip Morris such that > 50% of Chinese men are smokers.

China values political survival, and they know that if dead bodies are piling up on the streets, the days of the regime are numbered. That's why you see all these harsh quarantines now. Eventually they'll drop the quarantines, the coronavirus will re-infect China (because that's what viruses do), and about 20M people will die, quietly.

I do not agree or disagree but I have thought that what strategy the Chinese have in mind.

They took very hard measures to contain the virus inside China but they did not close the borders to not let it spread out of the China.

Do they plan to close the borders now to keep the virus out of China as this would be politically more acceptable for them?

Because if there is pandemic then also they should be expected to have it again, or they will use some measures to keep it happening?

I'm not sure I agree. China has successfully contained the virus despite being the source of the virus. Containment takes an extra-ordinary effort but it's feasible.

I think the question is: Do you want to contain this and potentially stop the economy or do you want to let the elderly die. The west definitively pick the latter.

You can't really stop a virus. But on the bright side, in France only 11 persons have died of 949 infections. In Germany no one has died despite 800 infections. That indicates that with access to proper medical services the death rate is actually quite low.

Find stats here: https://www.nytimes.com/interactive/2020/world/coronavirus-m...

The death rate for European countries is about 0.7% at the moment.

If European countries could keep the number of infections low I imagine the death rate would stay low, the issue is going to be when hospitals are saturated.

Those hospitalisations cause pressure on healthcare systems, which means that people without covid-19 but with other life threatening respiratory problems are at increased risk of death.

Is there any indication that the health care system will fail in any European country excluding Italy?

At the current point no, if we hit anything like 1% or above infected in a single country then yes we'll probably see that.

Current containment efforts are made to let medical care systems handle the outbreak in a controlled way.

SARS-CoV-2 will be with us forever, maybe not everyone will get infected because of some immunity factor we haven't learned yet. But we are not going to be all isolated forever. Human contact is essential for our survival too.

I am upset that the human life is not valued

I'm not sure how you get "human life is not valued" from this. Even here in the US there is a lot of talk about how containment simply isn't going to be successful, and that we might as well accept that this is going to be a widespread pandemic. If containment is going to fail no matter what we do, then pretending otherwise isn't going to help.

OTOH, accepting a pandemic, and the possible presence of a new seasonal affliction doesn't mean people don't value human life. There are still people working on (a) vaccine(s) for this, and treatments for it (or researching if existing treatments for similar viruses may help with this). If a vaccine is successfully developed, then we don't necessarily have to accept large numbers of deaths from Covid19 over the long-term. Yes, some people are going to die, but that seems like a tautology anyway to me.

It looks to have worked in China and it is still possible in many places. It was also possible in my opinion in Italy but it needed hard measures that nobody has been willing to take.

It appears paradoxically that China has taken very difficult and expensive measures to save some expendable old people.

WHO is also still thinking that containment is possible and is urging countries to take action.

Update: Milano area is in lockdown https://www.open.online/2020/03/07/coronavirus-ultime-notizi...

> I'm not sure how you get "human life is not valued" from this.

See for example this retired nurse who says that a pandemic would be a useful way to kill off many old people who tend to cause patient-flow ("bed blocking") in the system.

https://www.independent.co.uk/news/health/coronavirus-news-u...

I'm not saying there are NO examples of people who don't value human life. I was just referring to the context of the story the OP told in the original post. That, to me, didn't seem to contain much support for the "human life isn't valued" sentiment.

Beyond that... all sorts of people have different moral/ethical systems. I suppose people who believe in some brands of utilitarianism can adopt the position you cite here, and feel that it's justified.

I think that there are more layers in this story. There is medical community and there are politicians.

I expected that medical community would strongly advise in such situation about the policy that would save the most lives.

It is possible to politicians will find courage to take measures that will save lives. It is now up to them to find this courage.