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Comment by steve_adams_86 | Hacker News Reader

You don't think precautions in North America are sufficient? I'm not totally clear on how much we're mirroring Italy right now. I'm hoping we're doing better to isolate and prevent, and we're less dense in population, but... I'm still worried.

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We don't have nearly enough isolated ICU beds or ventilators on hand if we take what happened in China and Italy as a warning.

The sad thing to me is that there is at least one American company that still makes ventilators here in the states, but they reported that they haven't been asked to ramp up production.

They even make a simplified and hardened version of a ventilator specifically aimed at meeting surge demand during a pandemic, so the engineering effort has already been done.

http://www.alliedhpi.com/mcv.htm

Why haven’t management of this company not gone into mass ramp up on their own? If anyone can see the need it would have to be them.

NPR did an interview with the owner of one of the last companies to make surgical masks in the US. He said that during the last panic they ramped up production and just as the new machines started coming online demand evaporated. It very nearly destroyed his company. Ramping up production is not an instantaneous thing and doing it without a clear customer for the increased product is an incredible business risk.

If I'd hazard a guess, it might be because someone still has to operate the ventilator, and hospitals are expecting a drop in healthcare workers (since you don't want a sick person treating patients).

A couple things being done to help reduce pressure on medical personel here in Czech Republic:

- elective surgeries being canceled, hospitals cleared as much as possible

- medical students were ordered to stay in their residence area and are taking disaster medicine courses

- teaching students are volunteering to take care of children of medical personel (as all schools are closed, someone needs to take care of childrens & students are free to do so)

Once you're infected, would it matter if a sick healthcare worker treated you?

(Presumably uninfected patients with unrelated issues wouldn't want a sick healthcare worker, but that's not everyone.)

The US is about 11 days behind Italy, with approximately the same growth rate (keeping in mind this is only counting confirmed cases).

Compare the "Total Coronavirus Cases" charts: https://www.worldometers.info/coronavirus/country/italy/ https://www.worldometers.info/coronavirus/country/us/

But the question is whether the social distancing being implemented across the US will reduce the rate of growth. There’s been drastic action taken this past week.

I mean it's very state by state right now and in disarray. In NYC they've tried to ban public events and large gatherings; no public schools are being shut down and it's pretty much whatever each entity decides. It's a hard choice to make in a city like this, but I feel we are on the "not doing enough" side of things. I think for the US they are definitely trying to weigh the economic cost so that's just competing with the heath cost. I guess time will tell.

Boston just canceled public school until the week of April 27.

Based on what’s about to happen, the schools won’t be able to reopen, because it’ll be too dangerous.

Different major cities are likely to experience different outcomes, by chance and by actions taken. Maybe we’ll hear of overwhelmed hospitals in some areas of the country. But I’m hopeful that the US has enacted social distancing measures at an earlier stage of the spread than did Italy.

I am not seeing much social distancing. People are talking about it, but I don't think people are really doing it. I see pictures of other countries where people are visibly standing 3-6 feet apart, everywhere. Here people are standing in groups in the supermarket telling jokes as they're stocking up, as if they're involved in a light-hearted roleplay of a pandemic.

The precautions that would be needed to prevent hospital overloads would be things like nearly shutting down cities. We are seeing some time-buying measures enacted by local governments (event cancellations for example) along with some from the Federal government (border closing). However these measures buy us at most a few days of replication time. Factors like average age and population density slow it down, but that only delays the wall-hitting.

Other countries (mine included) are in almost complete shutdown, with only super markets and pharmacies open. Any other place where people congregate (schools, night clubs, cinemas, cafeterias, restaurants) are closed. This is with fewer than 200 cases country-wide, and it's still probably not going to be enough.

I think there's more the US should be doing.

A big part of the problem here in the US has been a complete lack of national leadership from Washington, which has left all the various states to come up with policies on what should and shouldn’t be closed on their own. The results are (predictably) all over the place.

All sporting events in the US have been suspended (read: effectively cancelled) or outright cancelled, multiple states are enacting bans on congregations larger than 100/200/etc. people, many colleges and public schools are going on 2-3 week breaks, tech employers are starting to roll out mandatory work from home policies, etc. This is about as extreme as its ever been in recent memory.

> I think there’s more the US should be doing.

If you want more to be done, then politicians need to be honest about what we’re dealing with. Everyone, and I’m not talking about just Trump here, has been giving a lot of wishy-washy “well it’s not really bad, but it kinda is, but not really, we just want to prevent the spread of disease is all” answers but the actions we’re seeing seem to imply that this is some super-virus that’s gonna wipe out 20% of the population. And maybe that’s the case, but if you want people to treat it that way, we need to hear that.

All I’ve been hearing from foreign and domestic leaders is “this is basically a really nasty flu.” Well guess what, the flu is background noise to everyone. Yeah it kills people but it’s just not perceived as some massive ongoing threat. Meanwhile you’ve got entire countries locking themselves down like it’s 28 Days Later over this particular virus. But again, nothing but “eh nothing to worry about, just like, quarantine yourself for the next couple weeks” talk from our leaders, how is anyone supposed to take this seriously if no one will admit that this virus is “something different this time”?

I have had a couple of physician friends describe it as “just a really nasty flu” as well. However, I couldn’t square it with the seriousness with which I was seeing th authorities address it. That’s when I realized, that the comparison is misleading. For example, you could describe a lion as “just a really nasty cat”, but that wouldn’t be doing it justice.

If the 2% fatality rate is accurate, compared to the flu’s 0.1%. That is 20x worse. The other scary part is that we don’t yet know if this virus is going to be seasonal like the flu.

The dissonance comes from three aspects:

1) people selfishly reason from their point of view: "there is a 2% chance I'll die". But it is more than 10% for those aged 70+.

2) people don't think systemic and forget second-order effect s. If the health system can't handle everyone being sick at the same time, it's not 2% but much more. Moreover, anyone requiring intensive care will be subject to triage, not just Corona cases.

3) people forget the health impact after healing (diminished lung functions due to fibrosis, etc)

if you look at graphs of net new cases per day, US is about 2 weeks behind Italy. The current measures are insufficient to prevent it getting as bad.

That's if those stats are even relatively accurate. The testing kits are lacking to say the least and the qualifications to use them seem very unrealistic in preventing it from spreading.

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