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Comment by Engineering-MD | Hacker News Reader

The problem is the alternative is even less feasible. Containment is very unlikely to work, and slowing the epidemic too much leads to it happening in winter.

The only thing which they should have done is delayed a decision on this. They are a few weeks behind other countries, and could have observed effectiveness of social distancing in arresting spread. If it worked, it could be copied (ina modified form) and if it failed, it would be much easier to sell to the public. Currently it’s a brave (but likely correct) position it would seem.

But then again, what do I know. While I’m a doctor, I’m No specialist so my opinion is of limited value, and experts seem to disagree with each other. This is what makes this so difficult, no one seems to know what is the best option this current data.

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The problem is the alternative is even less feasible. Containment is very unlikely to work, and slowing the epidemic too much leads to it happening in winter.

Containment has worked in Wuhan. Containment is being attempted after-the-fact in Italy. Containment is possible, it's just a matter of how extreme gets. But even the most containment does not look the hundreds of thousands or millions dead that letting everyone be infected looks like.

It's possible to contain it with extreme measures, of course. But what happens when you release the lock down and it's still burning through the rest of the world, especially Africa and India? Do you ban every foreign visitor for the next year?

Seems like a small price to pay.

from a high risk country, yes. from a low risk country, test every single arrival.

But the tests have a high false negative rate. Let them through and it can all re occur.

Current ones, yes. New ones are in development and keep appearing weekly.

That’s the bit I don’t get - what’s the end game with the lock down? Are you hoping that everyone actually gets it slowly over the course of being isolated (ish). Otherwise have you not just postponed the issue until you set everyone free again?

For now, but what's going to happen as they go back to work, school and resume travel? Unless they stay locked down until we have a vaccine, which is a year+ away at least. And second waves can be worse than the first.

I don't think anyone knows for sure what strategy is going to work best in the meantime, considering experts disagree and the world is conducting a massive A/B test...

no, test everyone, quarantine every positive case and their contacts. need time to build testing infrastructure. SK shows this is viable.

Why? When you have aggressive testing everywhere, eliminating the virus seems quite possible. Moreover, when you move slowly to reopen and test aggressively, you can detect any reappearance and squash it.

A variety of the world's diseases are controlled by testing and surveillance, not by cures - TB, for example.

What does aggressive testing everywhere mean though? People spread it whilst asymptomatic. They don't know they need testing. There aren't enough test kits to literally test everyone over and over, and people wouldn't put up with it anyway.

Most viruses aren't as infectious as this one is, comparison to TB or even previous SARS viruses doesn't work for that reason. You can track people down by them expressing symptoms, then test them, then isolate them and it works. That hasn't worked so far with this.

> Containment is very unlikely to work

Except in Hong Kong, Singapore, Taiwan, or (more arguably) Japan. And South Korea, while they had a rougher early outbreak, seems to have gotten a lid on the disease now.

That's not really correct. Containment certainly can work. Whether it will or not is still an open question. Right now no western country has been able to match that. Italy, Spain, France and Germany are probably out of time to try. But the UK is still relatively early on its curve.

So, for that matter, might the UK "infect the herd" trick. The science isn't unsound, though it's not nearly certain. So the risk management is just crazy and I can't understand it either. But... it really might work.

> Except in Hong Kong, Singapore, Taiwan, or (more arguably) Japan. And South Korea, while they had a rougher early outbreak, seems to have gotten a lid on the disease now.

And how long can they keep strict containment in force, and what happens when it lifted? You're speaking as if China or SK are now magically immune from a second wave as soon as they relax their restrictions.

they're building testing capacity to test everybody arriving in the country.

Surely that’s not a viable long term solution?

it's the most viable until a vaccine comes, so why not?

Good for them, lets see how long that takes and how effectively that works at a pre-epidemic scale, and over the long term.

> he science isn't unsound

In this case the science is flat out unsound: There are several coronaviruses known to infect humans. None are known to result in lasting immunity, and some are known to not result in lasting immunity. This is one of the challenges in making a vaccine.

Given the observed hospitalization rates, many millions in the UK will require hospitalization due to corona. At the moment, their hospitals could support merely thousands. We know from other cities that the mortality rate (particularly among younger people) is dramatically higher when adequate medical care is not available.

Under the UK's argument, the worst outcome of aggressive mitigation is that you are actually successful at it and achieve containment which just shifts the infection later in time at a high economic cost. Given the existing known infection rates in the UK that seems unlikely at that point, but even if it were to happen it would provide time to ready treatment facilities and allow for the discovery of more effective and/or scalable treatment techniques.

Fortunately, the UK has been backing off from its initial position and has now been recontextualizing their position as 'mitigate as much as possible'-- which is what pretty much all of the west is doing.

We don’t know much about this virus still.

Time is vital.

>While I’m a doctor, I’m No specialist so my opinion is of limited value, and experts seem to disagree with each other.

Given the state of modern politics, this is a time for people to very carefully consider their opinions, because the unpopularity of Trump and Boris is going to potentially sway decisions irrationally. This includes professionals and key decision makers.

This is not a value judgement regarding any world leaders. It's just a call to be very aware of bias and spitefulness can cloud judgement even in the most rational among us.

Boris just won a massive election landslide victory.

if his plan for this clusterf* succeeds, he won't win the next one because his voters won't be there.

I think the comment was alluding to the unpopularity of these figures within the "intelligentsia". This group has been making politicised statements masquerading as authoritative announcements quite often. This group love these interjections and the people that follow them do to. But they have sowed distrust.

The person is making a fair point, but cocking it up a bit.

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