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Comment by asdfman123 | Hacker News Reader

If we were halfway rational, we would have started this in January. Failing that, start now.

Have you ever been in an executive leadership position that required you to make tough decisions? As someone who recently has entered this realm, let me tell you: most of the decisions in front of you are essentially choices between a whole bunch of options that all have one thing in common: they totally suck. You learn quickly that you are going to make harmful decisions because sometimes a good option isn’t in the hand life has dealt you. It’s the nature of the gig. A true executive leader makes a decision quickly and moves on. When they recognize they have made a bad decision (often with more data now available), they change their mind. Most bad leaders are incapable of doing this last bit. They dig in and hold their ground. The good ones just switch. They won’t even admit it because of ego (Steve Jobs is a great example outside politics of someone with this behavior).

If the US had gone into lockdown in January, the ACLU might have sued the government in court (or another civil liberties org). The UAW would have fought GM on shutting down the plants (let alone the shareholders!). College students would be protesting encroachment on civil liberties. Businesses would have been screaming. The stock market would have gone into a tailspin. People in a free society would have flouted the orders out of civil disobedience. For all this stuff to actually work in a free country, a significant percentage of the population has to believe the threat and cooperate. I’m a highly educated person with a degree in molecular biology. I know all about viral illness and epidemics. Even I did not come around on the severity of this until last week (Despite reading all the articles!). It just pattern matched against all the other pandemics that were a big deal in Asia and elsewhere, but didn’t really impact daily life in the US.

Fair enough. But you move towards the target by having leadership that says "This is serious. We need to start doing this now. I am not going to invoke war-like power to force us all to do this (yet), but we've got to understand the seriousness of the risk and start social distancing now while there's still time".

Instead, we got 2 months of "it's nothing".

One of the roles of leadership is to persuade a significant percentage of the population that threats are real and cooperate. The current US leadership utterly failed at this.

There was no need for national 'lock down' in January, what was needed was preparation.

Specifically with respect to testing, and the operations behind testing - this should have been sorted out.

There was no reason to 'lockdown' in January. The ACLU would not have sued, it would be irrelevant anyhow. College students would not be protesting en masse, and if they did, it wouldn't matter.

Once America has contained the virus, the rest of the world will need medical staff, beds, ventilators. There are 7 billion people out there, the surpluses will get used.

China was building hospitals over a 'few days' - this should have been a 'shocking moment' for everyone to start thinking about how to 'build hospitals in 2 days' or at least commandeer office towers or whatever as facilities. Knock out doors, widen entries, rip out the carpets, get backup generators, put in tbeds etc. carpenters can do a lot quickly.

There was a lot CEOs could have been doing 8 weeks ago.

There was in fact a game plan in place:

Qualls N, Levitt A, Kanade N, et al. Community Mitigation Guidelines to Prevent Pandemic Influenza — United States, 2017. MMWR Recomm Rep 2017;66(No. RR-1):1–34. DOI: http://dx.doi.org/10.15585/mmwr.rr6601a1

https://www.cdc.gov/mmwr/volumes/66/rr/rr6601a1.htm

Referenced in the US CDC's Feb 25 press telebriefing:

https://www.cdc.gov/media/releases/2020/t0225-cdc-telebriefi...

Or you might want to hear from the expert who literally wrote the book on pandemic response, a quarter-centry ago:

"'Every American Should Be Outraged' Says Pandemic Expert About Government Response"

https://www.wbur.org/hereandnow/2020/03/18/us-government-res...

To be fair, if we had started back then there is almost zero chance that we'd need to pull in additional factories like this.

Although arguably there might not be much need now either. The companies that make these have said that production can be increased.

In fairness, this is a discussion of hypotheticals at this point. We're likely to need the ventilators. Other nations are likely to need the ventilators. We have to get as many companies as is reasonable making them to meet the need.

Detroit certainly has the engineering and manufacturing expertise to retool in a hurry. It's the sort of thing they do a lot of, so that sounds like a reasonable place to look for additional capacity.

As for the rest of the discussion? I mean, yeah, I suppose if Lincoln had not been shot, we might have never needed Martin Luther King. But, Lincoln was killed. So we did get MLK. Which is fine, no real reason to harp on how dumb it was to kill Lincoln.

Should've, would've, could've is less than useful when you're still at "need to". Save the shoulda woulda coulda for the post-mortem.

I just saw on Twitter that hospital in NY is already "double respirating" people, meaning two people share one respirator, so it seems the time to act was well before yesterday.

I don't see how people can read that and not say "Holy crap, let's not let people suffocate to death on their own phlegm" if it just means spending a few billion dollars.

Obviously the time to act was yesterday. But we've got a chance to act today, so let's get the details of these devices shipped to Detroit in a hurry and get the retooling process started.

We should also be asking China what their capacity is? I do know they've been supplying Italy with extra ventilators, but we should see if they are able to make even more. I mean, we just need to find ways to get the requisite medical equipment into the field on a global scale. That's PPE's, that's masks, that's ventilators, that's the diagnostics, etc. Between China and the US, there is no reason that shouldn't be able to be done.

We can only start from where we are is what I'm saying. Yes, we're unprepared. Yes, we should have been prepared. Now that all that's been conceded, let's hurry up and get prepared.

In retrospect sure, but as late as mid-January the WHO was saying there was no evidence of human-to-human transmission [1].

[1] https://twitter.com/WHO/status/1217043229427761152?ref_src=t...

This is pure hindsight. This didn't warrant that kind of response in January, not by a longshot. In January it looked exactly like the other comparatively minor respiratory viruses that pop up every few years. We can't shut down industry and retool factories just in case.

Not sure if you recall, but in January China put large portions of the country under lockdown in a quarantine effort of unprecedented scale. At that point, the writing was on the wall that this was not something that "looked exactly like the other comparatively minor respiratory viruses that pop up every few years".

I was literally pounding my desk asking myself why is Trump taking this as a joke. I mean ok if you don't trust China, fine... But South Korea, Japan, Italy, Taiwan, Singapore. Are our allies in on the joke too?

The writing was on the wall flashing in bright neon signs.

The timeline is interesting. The lockdown started on Jan 23. At this point they had a few thousand cases and 50 or so deaths, less than many countries have now.

The announcement of transmission without symptoms came out on Jan 26. Around this time China also extended restrictions over the whole country.

Many countries including the US started announcing travel restrictions on travelers from China in the next few days, to take effect around Feb 1. The WHO and China called it an overreaction.

> This didn't warrant that kind of response in January

Could China's mobilization of resources have been a hint to us that this would have made sense? Even early on there were stories breaking of people taking double doses of some meds to lower their temperature to get through fever screening. Shortly after that we found out there was a very long incubation period. Shortly after that there was talk of mild/asymptomatic spread.

All the while no one shut down air travel and boarders while China locked down it's country.

It's not the time to play the blame game but saying this is entirely hindsight doesn't make sense to me. Many people were talking about stocking and isolating in Jan/Feb. Back then they are just met with misinformed masses "the flu kills..."

By late January the Chinese government had already ordered the lockdown in Wuhan. There were plenty of signs that this wasn't an unremarkable minor respiratory virus.

the correct response should look like an overreaction in hindsight. But it's tough to explain the cost of the overreaction if said overreaction prevented all of these problems.

I make the analogy with an engineer receiving accolades for fixing bugs and outages with heroic effort. But the engineer that creates trouble free code, that never has any problems, but takes a long time to create code that's bug free seems to be over-cautious or over-engineering a solution. They get reprimanded for taking too long or using too much resources during development. But they never receive the praise for the non-events like no outages or no errors/issues.

Yes, it probably will look like an overreaction, but that doesn't provide carte-blanche to overreact every time there's a new virus.

As GP mentioned, this happens every few years. Most of the time, it fizzles out. We can't transition all production to hospital equipment every few years, even if it is the right call twice a century.

I have often reprimanded (and have in turn been reprimanded) for overengineering a solution to a problem which just needed a quick fix, because it's not often appropriate to dedicate a lot of resources to ensuring that there are no possible errors. If it is, I'll ask for that specifically.

So, how many lives will justify spending more money?

Should we spend $1 billion to save 500,000 people? Less? What's your cutoff for (most probable number of lives saved)*(money per life)?

Why do you assume that lives will be saved by redistributing resources like the ancestor proposed?

Once in fifty years it will save lives, certainly. What about the shortage of other manufactured goods the other twenty times a century that you reassign factories to diseases that turn out to be nothing?

I think it's a bad idea because it will hurt people, not because I want to save money.

EDIT: Removed a political aside.

Most of the time it's a new flu for which we can make a vaccine quickly and isn't a huge threat. This one we knew was novel, a spreader and a killer.

SARS, swine flu, bird flu, ebola - just in the past couple of decades these all caused considerable concern of pandemic. We're talking about what we knew of COVID19 in January here, which was basically nothing.

Hindsight justification for which ones were a real problem isn't useful.

We keep a MASSIVE oversupply surplus for the military at all times.

If that's OK, why not do that for health related issues too?

You'd need to ask someone who thinks it's a good idea to keep a massive oversupply for the military. (Note that I'm not American, so I have no skin in that game.)

I don't, though, disagree with keeping a large stockpile of goods.* I just disagree with constantly kneejerk reassigning production to it.

* I still don't know that it can work, but only because I think people too quickly forget that it's important. If people could be convinced otherwise in the long term, I think it's a great idea.

> We keep a MASSIVE oversupply surplus for the military at all times. If that's OK, why not do that for health related issues too?

When your military isn't strong enough, you get fire, rape, pillage, death, starvation and epidemics, and people really really don't like that.

Or miscellaneous actors stepping on your oil supply lines and shipping traffic.

Most people would accept that epidemics (let alone pandemics) are bad enough on their own. Many people would say bad enough to avoid a Just In Time approach to public health.

Maybe most people would. But I've heard first hand accounts of how devastating it is to lose a war, and I'll go with that.

May I recommend "Savage Continent":

https://www.amazon.com/Savage-Continent-Europe-Aftermath-Wor...

It was so terrible I abandoned reading it.