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Comment by testfoobar | Hacker News Reader

The virus is terrible. But our solution could turn into an economic catastrophe. It simply isn't possible to shut down the economy and then pay people, businesses to sit idle for an undetermined amount of time.

The solution is aggressive, continuous testing so that people can feel safe going back out.

1. Make hundreds and millions of the rapid tests available. 2. Deploy them to every business, every institution. 3. Test everybody coming into work every morning. 4. Isolate and quarantine the positive ones. 5. Elderly and immunocompromised self-quarantine.

Lets find the actual contours of this infection within the population. And then squeeze it down.

- Want to get into a theme park? You need a negative test result on your phone from this morning.

- You got tested at one of the thousands of mobile test stations. You received a code with your test.

- 15 minutes later, you get a test result on your phone - also sent to a national database in real time.

- The theme park worker scans your phone and validates the result.

This is not a fool-proof system. But it or something like it will instantly reduce anxiety of people trying to work.

If you knew that everyone at your coffee house, at your gym, in your lecture hall, etc. tested negative in the morning. You'd feel safer and we'd all be able to move forward.

View on HN

China's Red Cross supposedly advised Italy yesterday that 'total economic shutdown'[1] is the only way to contain the COVID-19 situation in the country now.

It all comes to what part of the curve the country is now, the choice being total lockdown incl. economic shutdown vs aggressive testing.

Considering US lapsed on aggressive measures in the beginning and that proper test kits are just being flown in from Italy[2]; total economic shutdown seems to be the only option left.

P.S. There are still high-risk countries which hasn't gone into lockdown neither doing aggressive testing as of now, claiming the number of cases are low although the day-to-day delta is increasing exponentially.

[1]Italy correspondent of Aljazeera gave this information multiple times on live, couldn't find static link to it as of writing.

[2]https://www.msn.com/en-us/news/us/air-force-flew-500000-coro...

> total economic shutdown seems to be the only option left

That's quite the overreaction.

Italy found that among fatalities the median age is over 80 (older than the average lifespan of an Italian man).

99% of fatalities were among people with a prior illness. About 50% of the deaths were people suffering from at least three other illnesses.

https://www.bloomberg.com/news/articles/2020-03-18/99-of-tho...

To put it another way: most of the folks dying from COVID-19 were already dying. This disease is the straw that broke the camel's back.

Should we just give up on them? No! But instead of quarantining everyone, and sending us back to the stone age, we should work to quarantine these folks while the rest of us return to normalcy and build up our antibodies and herd immunity.

> 99% of fatalities were among people with a prior illness. About 50% of the deaths were people suffering from at least three other illnesses.

So far... wait until you get the number of critical cases above the number of ICU beds and you'll see 18 year olds dying from this

You won't, because we triage patients.

Triage isn’t a cure

No, but it's something every software developer understands is necessary in every system every day.

Ventilators are first come first serve. Once someone is on a ventilator it’s not like you can unhook them for a younger patient.

And there are always ventilators becoming available and patients getting triaged for their order in line (if there is a line).

Not any more:

"With demand outpacing supply of beds and respirators, medical workers are told to prioritize younger patients."

"The principle of "first come, first served" has been abandoned, said Mario Riccio, an anesthesiologist who works at a hospital in Cremona."

- https://www.politico.eu/article/coronavirus-italy-doctors-to...

Based on what? According to the Bloomberg article -

”As of March 17, 17 people under 50 had died from the disease. All of Italy’s victims under 40 have been males with serious existing medical conditions.”

They reached maxed capacity of beds or ventilators right? We read stories of doctors having to make life & death decisions. Where are the dead 18 year olds?

Spreading info like that on a hunch, or an exaggeration, is counterproductive if not damaging.

> They reached maxed capacity of beds or ventilators right?

They just started to reach max capacity, and not in every region, every hospital at the same time...

Fair enough, I should have said, ”In some areas”. A little snippet from the CDC I have posted a bunch that I found useful -

”Pandemics begin with an investigation phase, followed by recognition, initiation, and acceleration phases. The peak of illnesses occurs at the end of the acceleration phase, which is followed by a deceleration phase, during which there is a decrease in illnesses. Different countries can be in different phases of the pandemic at any point in time and different parts of the same country can also be in different phases of a pandemic.”

So, we know not all the hospitals are experiencing the same levels at the same time. A big reason I wish we were more precisely targeting shutdowns and quarantines.

It doesn’t make sense to throw these blanket executive orders over entire states. As we can see from the slides, the economic consequence are dire. Why not target the cities entering acceleration only?

In the meantime, start building drive thru testing. Distribute thermometers. Practice social distancing & aggressive sanitation, but not destroy out national security in the process.

But this part,

”All of Italy’s victims under 40 have been males with serious existing medical conditions”

Sure it’s early, but even in Italy, in one of the worst places in the world for the virus right now, that information should be very illuminating to us I think.

> Why not target the cities entering acceleration only?

Because the long incubation period and the lack of sufficient testing makes it impossible to know which cities are infected early on.

And, to put more bluntly, because we have two models to look at and choose from: the Chinese one, with harsh containment measures that were very effective (if you believe their numbers) and the Italian one, with moderate containment measures and a lack of sense of urgency from the populace, which resulted in a downward spiral with more deaths than China despite having only ~58% the number of cases.

> I should have said, ”In some areas”.

And no, you shouldn't have said that, you should just wait another week.

Here is a fresh preprint from University of Padova showing that weak quarantines have no significant effect:

Quantifying undetected COVID-19 cases and effects of containment measures in Italy

https://www.researchgate.net/publication/339915690_Quantifyi...

Current situation in Geneva, Switzerland - 2 critical male patients, one 27, one 29, no prior comorbidities at all. Not sure they will make it. Wife is a doctor and just checked this in their information system.

The idea that relatively young (most of folks here) will be just fine is not true. With overwhelmed healthcare, most criticals will simply die. Once doctors will get sick (and they will), it will make everything, I mean literally any disease and injury much more dangerous. Sure, most will survive, hopefully without any permanent lungs/kidneys/testes damage (was this confirmed or just a rumor?).

Maybe as humanity we've grown weak and can't tolerate medieval mortality rates anymore, but this is who we are right now. There is no easy solution to this. There is unavoidable harsh economic impact coming. Nobody has clue which option will be at the end better than others.

Accept it, and try to find ways to help fellow human beings instead. We are in this all together, rich and poor, left and right alike.

>Current situation in Geneva, Switzerland - 2 critical male patients, one 27, one 29, no prior comorbidities at all. Not sure they will make it. Wife is a doctor and just checked this in their information system.

I don't know about the law in Switzerland but unless you are lying that is something she could be fired for in many countries.

For checking overall status without going into details? All doctors within given hospital have this kind of access here. 'Many countries' sounds rather like very few for this case, aren't you thinking US specifically?

It is as tough in Sweden, doctors and nurses have of course access to patient files but every access is logged and if someone is caught accessing files about a patient they are not working with they will be reprimanded or fired.

The last thing hospitals want to do right now is to fire doctors.

I mean sure, but I was just saying that countries outside US takes unauthorized access to personal medical data incredibly serious.

Two examples doesn't change the stats. There were 0.8% of deaths in Italy that did not have any prior comorbidities. Picking two of those examples does not increase the 0.8%.

I don't think any one is under some kind of delusion that some young people will die. The only question is what percentage and what changing those numbers will cost. Picking specific examples of bad outcomes and pretending the risk is as high as older people isn't doing anyone any favors.

I wish I could upvote this about 50 more times.

It's not just old people though. Infants. Immunocompromised individuals. People with asthma. People undergoing chemotherapy.

The narrative that this disease only affects the economically unproductive is dangerous at best, and inhumane at worst.

Honestly, what do you think is going to happen to these people if the economy totally shuts down? it's going to be easy to have a chronic & serious health condition? The same?

My feeling is that I'd rather be chronically sick in a good economy than in a depression. What happens when medicine becomes unavailable due to supply chains being cut off?

The ultimate purpose of the shutdown is to not overwhelm healthcare providers, so people who need treatment actually receive it rather than die waiting in an overcrowded ER. So yes, they would fare better in a shutdown with lessened spread of the virus and fewer people putting strain on healthcare.

Why didn't you respond to the actual point? What do you think is going to happen to people with chronic health conditions in a depression, or when supply chains stop functioning? What happens when (random example) e.g. anti-HIV medicine shipments can't be made and we start to get new mutations in those diseases?

Do you just assume we'll treat chronic health issues as a priority in a depression? I'd like to think we do as well, but the point is that things may well just stop working.

People with chronic health conditions outside of the coronavirus aren't going to get much care in a crammed ER run on triage and therefore serving acute cases rather than chronic if we don't attempt to limit the spread. The staff shortage is worse than any supply shortage. In a healthy economy free of pandemic, CA is short on doctors and nurses.

> what do you think is going to happen to these people if the economy totally shuts down?

I expect the economic impacts to be rough either way. We don’t have a choice for “no economic impact” anymore. Either we do it in a coordinated and somewhat controlled manner now while we still have a handle on cases vs illness, or the impacts hit, roll, and peak along with the cases of illness while well/well-ish people try to improvise individual responses which probably have similar econ impacts but may not be as effective.

Or did we think that thousands on thousands falling ill at once wasn’t going to hurt economically?

How can you say the economic impacts will be of similar magnitude when looking at the age distribution in severe cases & death here? How do hospitals being overwhelmed have the same magnitude of effect as a literal shutdown of a country? Or, indeed, the shutdown of multiple?

To me it seems likely the difference between a recession (guaranteed) and a real, extremely serious depression which will be fully capable of exacting its own toll on lives.

First, while I fully expect that the worst effects will hit the advertised danger demographics the hardest, at wide enough infection coverage there are going to be poster children for folks who didn't fit that profile[0]. Not just a few.

Second, I expect that the illness impacts will hit even broader, both in sheer numbers and crossing demographic expectations, resulting in people directly absent from work and consumption for weeks at a time.

Those are the first order effects. The second order effects on psychology among a large number of folks having loved ones dying and acquaintances suffering are going to produce some behavior changes. Some of them would be similar to those we're seeing with lockdown, but as I said, improvised rather than coordinated, probably combining some degree of the same impacts but with less of the benefits.

The recession might be milder if we trade a higher death toll. Might.

But the financial markets sure didn't think we were going to escape one even before US civil measures started ratcheting up.

[0] https://medium.com/@juliael84791135/this-isnt-a-normal-flu-i...

"these people" are dying in mass and overwhelming the medical system and even the crematoriums. And they deserve to have quality of life and die with dignity and proper care.

I'd rather a strong, comprehensive public health response than trying to economic recovery ourselves out of this problem. IMHO, the economy is a distraction to numb us from the tsunami of ICU patients and deaths to come.

The economy is not sacred, and is cyclical, and needs a good purge and rebalancing every 8 years or so. Recessions reallocate capital to be used more efficiently. After 2008 they were politicized as something to be avoided at all costs.

The part of the economy that is responsible for electricity, clean running water, food and emergency services absolutely is sacred. The rest of it can maybe be put on hold for a few months; but it will be very painful for many, many people.

What isn't sacred are the people who own all that. They are as disposable as are any other parts of the economic machine. Replacing them is probably a good idea.

So what’s your proposed solution? Let’s get back to work, let the fire burn and who dies, dies?

It’s a solution ( it wouldn’t work the way you think, but it’s an option), but at least admit it clearly and live with it.

I'm sure that accusing someone with righteous indignation here feels edifying, but it indicates to me that people are perfectly okay with trading on lives - future ones. At least admit it clearly and live with it.

I think the interesting question (that we don't know yet) is how much of these actions are political because they want to show themselves strong and the public demand some kind of action. And how many of these actions are needed to flatten the curve, prepare the healthcare system and to work on cures/vaccines? For example shutting down schools have a huge effect on society but does it have a similar huge effect on the spread of disease?

How long can you just shut down industries, keep kids out of school and will it make a significant dent in the total mortality? It could be that a couple of weeks of social distancing will be enough but can it be months and what are the comparable effects.

I know it is more dangerous than the normal flu and I will not downplay that but take Italy (that yes, would be worse of without shutdowns) you have 4k deaths so far; mostly old people while a couple of seasons ago they had 24k deaths attributed to a bad flu season.

The social distancing and shutting down society needs to work reasonably fast otherwise I wonder if it is worth it, at least in countries where you already have widespread disease.

Let's assume for a moment that governments did nothing.

Obviously, the illness itself was always going to cause an economic blow by killing and sickening people.

And then there would be damage from behavioral changes. People were pulling kids out of schools, canceling events, and avoiding travel without being ordered to do so.

It doesn't seem like the "good economy" you suggest was ever an option.

Honestly, what do you think is going to happen to these people if the economy totally shuts down? it's going to be easy to have a chronic & serious health condition?

https://www.statista.com/statistics/505995/adults-with-hyper...

The state with the lowest incidence of hypertension still has roughly 1 in 4 adults with hypertension. West Virginia is at the top with more than 1 in 2 adults. What do you think happens to them when they develop COVID-19? Hypertension is at the top of the list of co-morbidities that worsen outcomes. Medication to treat hypertension is often extremely inexpensive even without insurance ($10-$20/mo at the low end) and thus hypertension is often easy and inexpensive to manage.

How many folks working at pharma companies do you think have hypertension? What happens to the supply chain when people are incapacitated?

Even if a minority of the population will need hospitalization (hell, even if the minority is small enough to avoid overwhelming hospitals)... how many do you think will work through a SARS-CoV-2 infection?

The gravity with which I treat this pandemic is in large part based on government action. China quarantined nearly 100 million people. Iran is building mass graves. The uber-pro-business trump crony that serves as the secretary of the treasure took one look at the GOP plan and essentially said "double it, and make it cash with no means testing."

The folks arguing for immediately disruptive action aren't ignoring the economic consequences, they've decided that the economic consequences of doing nothing will be worse.

WHO director specifically mentioned in his briefing yesterday that 'Young people are not invincible and that data from many countries show number of cases below age <50 getting admitted to hospitals make up a significant proportion of patients'.[1]

It's not just fatalities, hospitalisation i.e. exhausting healthcare facilities is the primary concern with COVID-19.

There is no guarantee that young people wouldn't make up high mortality list in a poor country with high younger population, rich countries should get their acts together to stop that from happening in vulnerable countries.

[1]https://youtu.be/6BOKgSCPD4E?t=32

Not to mention complications. Little is known yet, but there are indications that some surviving patients get permanent lung damage. Especially when intensive care is not available. Imagine having 30 million 40-year-olds who will be short of breath for the rest of their lives.

There is no need to imagine, we have the forecasts from the Imperial College report:

https://www.imperial.ac.uk/media/imperial-college/medicine/s...

There are 40 million 40-somethings in the USA, you're proposing that 100% of them will have lung damage.

Let's imagine that 80% of the population is infected, that 80% of cases are symptomatic, and that 80% of the 4.90% of hospitalised cases (this 4.90 is direct from the report) get damaged lungs. This is one million 40-somethings, not the entire population.

1 million sounds like a lot, but its only 2.5% of the population at that age range, and assume worst-case.

You know what causes reduced lung functionality in adults? Asthma, driven by air pollution from vehicles and coal power plants. 7.7% of adults have Asthma. Where is the war-scale drive to eliminate fossil-fueled vehicles and power generation?

So true, I can't understand why climate change hasn't been given the same considerations in the past :(

> Where is the war-scale drive to eliminate fossil-fueled vehicles and power generation?

Might as well just shut the economy down to eliminate that.

> You know what causes reduced lung functionality in adults?

Vaping. I see most of the young adults doing this. Its probably why they're having the higher hospitalization rates with coronavirus. They already have lung damage.

Yes, thank you. So many people are confused about this just being about the # of people dying from covid. The entire health system gets knocked down and all the other preventable diseases that killed us before are no longer prevented.

We haven’t built herd immunity to the flu despite millennia of trying.

This thing has evolved three strains with only a couple hundred thousand cases. A couple billion turns it into a shit show.

Stop spreading this. Median hospitalization age is 65. 40% of patients on icu are under 50. With the rates of hospitalization in 30-39 year olds no country would have enough icu beds even for them

Gonna need to see some actual data. Median hospitalization age of 65 and then 40% of patients in the ICU being under 50 already doesn't even make any sense.

Maybe a moot question/point, but do we take into account patients in ICU that are unrelated to COVID? E.g. traffic accidents, workplace accidents, heart attacks, etc. I am not trying to spoil the discussion, and I do understand that medical services try to save all lives irrespective of age. So someone who's 80 and is down with COVID and someone who is 25 and fell from his Kawasaki doing 200km/h will each occupy a unit in ICU. That would skew the data.

(my bad, it's not easy to go through the slides on a phone)

Edit: by "skew" I imply mix the two categories COVID Vs "all other causes" and will give false average if we are trying to focus only on the COVID cases.

Sure it does. 40% under 50 years old means 60% are 50+ years old. The median is by definition the 50th percentile; aka, at least 50 years old and likely somewhat older, since more than half of all cases are in people who are 50+ years old. Median age being 65 aligns pretty well with that, given that 65 is somewhat above 50.

This looks correct. Here's the data https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm... Scroll down for TABLE. Hospitalization, intensive care unit (ICU) admission, and case–fatality percentages for reported COVID–19 cases, by age group —United States, February 12–March 16, 2020

Parent was referring to fatality rates and you instead presented hospitalization rates, why do you want them to stop spreading fatality rate information?

When hospitals are full, the fatality rate will approach the current hospitalization rate.

You will get tarred and feathered for your comment but you are correct.

Here is why you'll get tarred and feathered, because right now the media is covering the health costs of the virus extensively, but it's not covering the economic costs, which are already unfolding now in the form of businesses dropping vendors and announcing layoffs because their anticipated revenue until further notice is zero.

I've seen so many bros on my feeds who puffed out their chests a month or two ago and said, this virus is not a big deal. Then there were cases in their state and the media was reporting the deluge of new cases in the US and they said oh I was wrong, we need to be on total lockdown, and they're hiding in their apartments.

What will happen next is the jobless claims will come in, which we can clearly predict based on current business activity, and they will break records. I saw one estimate of around 1.5 million jobless claims this week, which is a record. I guess the bros will start squawking about the economic damage in 2-3 weeks once the media has covered this widely and people they know are out of work.

Small businesses (and some large ones too) typically don't have large cash reserves like Google. They also don't know whether this will last for one month or six. So they are in the process today of shutting down and telling everyone to go home without pay, they have to do this until they know what the long-term outlook is.

Nothing changes, most people are sheep, they parrot whatever's in their feed, they are poor at prognostication and self-examination, their attention is occupied by whatever narrative is being shouted most loudly. Nothing you can do.

I noticed yesterday for the first time that there is starting to be some discussion about the damage caused by the lockdowns. Before that I was amazed that no one was interested in even discussing it. So there seems to be a trend of people waking up to it. Thanks for your brave comment. Bros are slow ;)

Take a pause for 2-4 weeks and reevaluate. Everyone has a 6 month buffer right..? :)

Quarantine doesn't send anyone to the stone age. The economic shock will be devastating. But there is no long-term, sustained growth without occasional pruning.

Also...

You make the error of assuming that (A) high blood pressure, diabetes, and heart disease mean that a person is "already dying," and (B) people who survive don't become debilitatingly sick.

Some of this economic damage is also the result of toppling imbalances that have been artificially propped up since before 2008.

The virus is just a convenient excuse; a crisis would have hit at the first sign of trouble.

> The virus is just a convenient excuse; a crisis would have hit at the first sign of trouble.

Sure, the market was seeming to be overheated and due for a correction.

Without the virus, maybe it's 2008.

With the virus, it's starting to feel like 1929 again.

Huge numbers of people are unemployed right now that wouldn't be in a normal recession.

Wait till the unemployment numbers come out.

> Italy found that among fatalities the median age is over 80 (older than the average lifespan of an Italian man).

> 99% of fatalities were among people with a prior illness. About 50% of the deaths were people suffering from at least three other illnesses.

This is true, but what about the overcrowded hospitals this causes? People who weren't gonna die will now die. And what do we do about the doctors and nurses who are pleading with everyone to act?

Perhaps something along the lines of strict contact tracing could have been done, but now it seems like it's out of hand.

Death rate is still pretty high for young people, too 0.5 - 1%. I wouldn’t take that risk.

> Italy found that among fatalities the median age is over 80 (older than the average lifespan of an Italian man).

Selection bias. They're so overwhelmed they're using age as a primary factor to triage patients. Clearly, if you put your medical resources towards saving the younger patients, the younger people are going to have a better survival rate. Lack of a ventilator, when you have a severe lung disease, is a massive risk factor at any age.

> 99% of fatalities were among people with a prior illness. About 50% of the deaths were people suffering from at least three other illnesses.

Again, if you look at the oldest people, you're probably going to find more diseases there. This could easily be just another consequence of age-based triage.

I dislike this hyperbole. I still have electricity, running water, heating. Where is this stone age? Where is my cave?

Can we make millions of the tests rapidly available? I am still reading about test shortages on both coasts, even under the restricted testing regime we have been in so far.

Maybe the no-contact thermometers could be a scalable approach. Go to the bank? Forehead scan to get in. Go to the grocery store? Same. At least until--and maybe even after--we can scale the RNA testing.

Get IDT or (other nucleotide synthesis company) to start mass producing the detection primers, and ship them to their whole active customer catalog, they all have thermal cyclers. Then figure out the other reagents needed to locally produce tests that trade off false positive rate for the lowest false negative rate you can get. How to get swabs to the closest lab with a thermal cycler, no idea, but we have phones with gps. Rate limiting step here is probably the step from swab to sample ready for amplification. I kind of wonder if it makes sense to tell people to start swabbing now and keep the swabs in the freezer until testing comes online so that we can start filling in the missing data.

I really feel like you guys are ignoring a lot of the difficulties in ramping up production to nation scale for this hypothetical test. A "rapid" test no less. These things are not as easy as everyone is making them out to be. Making one? Simple. Scaling that up to 8 figures worth? Not so simple. A lot of us are being a little too Jedi hand-wave-y about this issue.

And think about it, I'm only talking about getting up to 10 mil or so here. We'd need a lot more than that to implement the plans being proposed on this thread. Logistics really does demand that medical personnel, and emergency responders be tested regularly to ensure their continued fitness for purpose under such schemes. Consider, there are right around 12,000 law enforcement officers alone in Washington state. Not counting doctors, nurses, EMT's and firemen. (And lest we forget the most important emergency worker of all right now, the Walmart stock boys.)

Add all that up. Multiply it by 50 states, some much larger than Washington. Under the plans you guys are proposing, we'd need multiple tests as the crisis goes on for each of these workers to make sure they aren't out infecting citizens when they interact with them. (Or when they put food on shelves that a customer picks up 4 hours later.)

Please, try to be reasonable. Maybe the current approach is not tenable, but the ideas being proposed on this thread are problematic as well.

Aren't there multiple existing labs all over the country who do this regularly? Are these tests made in small batches or something? Do you need to grow viral cultures? What exactly is the limit here and why can't a typical lab just double production in a few weeks by doubling it's hardware?

You don't have to culture anything (if we did we might as well just give up). We use PCR to amplify a known section of the viral genome. With the oligo production capacity in this country alone we could synthesize enough primers test everyone in the country 10 times in a couple of days. That is not the limiting reagent. The limit is either sample prep or sample collection. Actually running the amplification shouldn't be a bottleneck, there are hundreds of thousands of thermal cyclers across the country. In my more cynical moments I might say the bottleneck is that some companies might want to make money from all the tests ....

Yes I am also cynical about the situation. There is something not insurmountable standing in the way.

I'm trying to learn a bit more about how testing works. Aside from the logistics (getting the samples to the lab, etc), what are the necessary steps for sample prep? Heating to inactivate the virus? Splitting the sample into RNA/DNA/proteins?

Also, where do you draw the numbers of primer production capacity from? IIUC, the only other things that an amplification needs are enzymes (just DNA polymerase for PCR) and "food" (nucleotides), but that I assume is not a bottleneck?

How difficult is it to safely dispose of amplified samples? Can you basically just dump them in the toilet?

Well, figuring all that out sure seems a lot more fun than sitting and waiting. I take dying trying to do something useful over just dying.

Like in war profits will probably be huge but if there is enough pressure government cna seize stuff too.

> Maybe the no-contact thermometers could be a scalable approach. Go to the bank? Forehead scan to get in. Go to the grocery store? Same.

This is the reality in China. Literally every single public place have a remote thermometer they scan on your forehead. supermarket? scanned. subway? scanned. restaurant? scanned. If you have a fever you'll go into quarantine in no time.

People can take ibuprofen prior to going shopping.

People can do a lot of things. It's not a big deal that measures won't be perfectly effective - in the presence of any suppression measures, once the case count stabilizes, there's a lot of room between "literally impossible to spread the virus" and exponential growth.

That's nice, but one such person can shut down the entire production line in some factory, or the hospital department. (happened already in my country) Such people have disproportionate effect on the economy.

Asymptomatic transmission is the key here. It's why "stay home if you're sick" or denying entry to detectably sick people isn't enough.

Considering that people generally go to work even when they're sick in the US, and that people are scared to go to the doctor because of the hidden cost, I don't think your solution is valid.

On the other hand, we cannot pause the economy for too long. The damages are already done but what is going to happen if we wait too much?

I cannot imagine the level of stress the people working at the government must be under now... Whatever solution they come up with could be the collapse of the US as we know of now.

>>Whatever solution they come up with could be the collapse of the US as we know of now.

Pretty sure that ship already sailed.

> It simply isn't possible to shut down the economy and then pay people, businesses to sit idle for an undetermined amount of time.

Why not? This is a matter of survival. If the economic system breaks because of one pandemic that will last less than a year maybe that economic system needs to die and be replaced by something more solid and useful for most.

“If the economic system breaks...”

No, this is people breaking. Peoples lives and livelihoods break due to this kind of economic and social strain.

And the quarantine effects everyone severely, not just 14% of people.

> If the economic system breaks because of one pandemic that will last less than a year maybe that economic system needs to die and be replaced by something more solid and useful for most.

Out of curiosity, why do you think it's likely that something more solid and useful to most is likely to come out of an economic collapse? Economic collapses have happened before - are there any instances of a solid and useful system coming out of them (maybe the new deal after the great depression? That one is arguable though).

French Revolution? Arguably the Russian Revolution if you accept the USSR as a step up from feudalism.

> French Revolution?

Didn't even last a decade until they got themselves an emperor.

> Arguably the Russian Revolution if you accept the USSR as a step up from feudalism.

Considering that the USSR killed orders of magnitude more of its own people than feudalism under the Czars ever did, I'm going to vote "no" on this one.

It also brought an unprecedented amount of economic development to what was an incredibly backwards country.

Not that it's a model to imitate. Although some folks in this thread sound rather ready to sacrifice millions of people, for the sake of keeping the economy limping along...

> Although some folks in this thread sound rather ready to sacrifice millions of people, for the sake of keeping the economy limping along...

That’s because they believe they are young and would fight off the virus with no problem. Change one of those variables and they will change their tune.

I can understand that it is prudent to take a worst case scenario here but it depends on how widespread this thing already is without us knowing it.

So Sweden has right now 1,639 confirmed cases with 16 deaths so far. There are some young people treated in critical care but so far it has been older people who has passed away, often with other diseases as well. Sweden currently only tests older people, people with severe symptoms, healthcare workers and similar personal and those who can work from home these days and travel is discouraged.

One expert estimated that we have around 100k infected in total right now and discussed that some things like shutting down schools for younger kids will have a large effect on society but not do that much on the spread of the virus. Instead you should focus on protecting vulnerable groups, stay home if you feel any symptoms of cold etc.

100k out of 10 million population would fit roughly with Iceland who did random sampling and found 1% of their population affected.

Of course he acknowledged that there is no way to know and taking extreme measures are better than taking too small but emotional/political reactions vs practical is really a discussion to be had.

Immediate aftermath of October Revolution was widespread death and famine. It was so bad that the communists introduced market capitalism again, called New Economic Policy.

The immediate aftermath of the October Revolution was actually five years of a civil war that killed ten million people, which was then capped off by a severe drought.

Perhaps it's rare due to man's tendency toward corruption.

Are there reasons you see why a more robust cannot be developed? I suspect HN could easily come up with a substantial list of improvements. Limiting stock buybacks seems like a good place to start.

Imagine if we had a system where you don't have to pay for any basic necessities, from shelter to food to healthcare to education.

We all work in the system, some would make more than others but even those who work the least or not at all would not be left behind. So if you make more you can enjoy more "stuff" and gadgets and if you make less you are still stress free about life.

Would we have $1000 phones or shopping shelves filled with hundred of fake choices? Most likely not but at least we won't have people rationing insulin or people living in the street of the richest city in the richest country.

We live in a world with so much production and people spend their time worrying about surviving and getting ahead instead of relaxing and making the world a better place.

this assumes the existence of magical economic systems with infinite reserves in other planets. The economy is people, its a dynamic system, it doesn't actually have reserves

It's not about abstract "economic system".

Let me put it in simple word: you'll loose your job. Your friends and family will loose their jobs.

As a result, when your savings run out, you'll loose your appartement. And so will your friends and family.

You won't be able to afford food without government assistance.

And even if shutdown lasts only 30 days, it'll wreck the economy for a long time. Once a restaurant defaults and closes, it won't just re-open. Those jobs will be lost for a long time.

Now, maybe you're one of the lucky ones with enough savings to ride this out and this won't affect you. But it'll affect millions of others.

You cannot imagine an economic system where the default state of a human being is to become destitute?

People are going to be destitute if nobody is producing goods and services. Money is worthless if there's nothing to buy.

I think one thing that this pandemic is teaching us is that most people's jobs do jack shit to maintain the basic needs of society, and the ones with important jobs are often paid the least.

> the ones with important jobs are often paid the least.

that's the wrong way to think about it, and also a misunderstanding of economics.

If a teacher is paid the way a CEO is paid, there won't be enough money for very many teachers. You'd find it hard to afford a teacher for your kids, let alone free education.

A doctor, back in the middle ages, is only affordable to the nobility. These days, doctors are still quite highly paid (too high imho), and that is one reason why medical services are expensive.

Imagine if you associate the "importance" of a resource with its price. Water would cost more than diamonds and gold! Water is needed for sustaining life - you die without it. Therefore, in theory, it's so important that you end up paying infinity amount of money to have it, under your system!

The fact that we have water so cheap (literally 0.000001 cent per cup), is a good outcome. Everybody can afford water.

You literally cannot imagine an alternative to capitalism.

No need to imagine it. There are plenty of history books documenting life under those alternatives.

No thanks.

CEO of what? Bullshit inc?

> If a teacher is paid the way a CEO is paid

You are thinking about it wrongly. We should pay the CEO the same as the teacher. Managing a bunch of adults can't possibly be harder than teaching children. Education is an actual investment. Bullshit inc not so much.

The beauty of capitalism is "we" don't decide CEO pay. The owners of the company do, and it's paid out of the owners' pocket.

Anyone is free to start a corporation, name a CEO, and pay him whatever they want to (from their money). They can even name themselves CEO!

> The owners of the company do, and it's paid out of the owners' pocket.

This is not true for publicly traded companies - where the board (consisting mostly executives at other companies) determines compensation on behalf of the owners

The board members operate only at the pleasure of the shareholders, so the shareholders ultimately determine CEO pay and are the ones who are paying it. Shareholders can (and often do) sell their stock the moment they don't like what the board and CEO are doing.

I'm sorry, I should have explained what seems so obvious to me. Let me try put it more sensible...

We have a finite amount of labor and a finite amount of resources available to us.

The thing our governments lack since the days of lords and god kings is direction. This is necessary since a group of people poorly working together isn't smarter than the smartest person in that group.

We all do stupid shit at times, if a lot of people decide to support the same stupid thing it is entirely possible to dedicate all time and resources to throwing virgins in the volcano, smoking opium or borrow money in stead of printing it. Who knows, someone might create the ultimate video game, we could retool our entire civilization to play the game non stop.

A [proverbial] god king would have other priorities, there might be a war coming with the neighboring country, there might be regular floods, there might be an insect plague, there might be a disease or the food might be running out.

We have distributed wealth recklessly (to put it blunt) and ended up with millions of little emperors who pay their little generals whatever they like. They are constantly at war with the next little empire.

The plague or the flood simply become economic developments that one can leverage for ones advantage. What is left of our government is a vending machine that one can use as a weapon to do whatever each little empire is willing to pay for.

I should mention we've made a ton of technological progress with this role playing game. It might just be that we've created the ultimate game already and that everyone is playing it. If so I'd have to argue we have one shitty dungeon master. The adventures planned out for most of us are not very interesting. Most of us are simply chasing the carrot on the stick. The heroes are not gaining as much experience points as they could, they are not learning as many new skills and abilities as they could. We can do better and we know it.

Say you are in charge for sake of argument. The orc's are getting ready to attack from the east, the goblins from the west but all your population cares about is opium. Would you dedicate resources to making swords and training or would you give the CEO of Opium inc in his competitive struggle with Meth corp the 10 000 men he wants for a promotional parade? The people might be enraged. If we make swords who will care for the poppy fields??

> Anyone is free to start a corporation

Indeed, I could create a product triggering superior production of endorphins. I could win a large market share and then present myself as if a philanthropist on a mission to help humanity with its struggles. I could prove it by moving funds into a non profit organization that might not do anything by design or struggle hard not accomplishing anything.

It's almost funny, the real needs retooled into a vehicle for public relations. If you play enough candy crush we will be sure to defeat the orc's.

Thanks for your time.

> We have a finite amount of labor and a finite amount of resources available to us.

There is an infinite amount of labor available - because of improvements in efficiency. The manpower required to make a shirt has declined by something like 99% in the last 200 years. For growing food has dropped a similar amount. And on and on.

Resources are infinite because they can always be re-used and re-purposed for other things. For example, despite everyone eating chicken and ham, there is no looming shortage of chickens or pigs, because people figured out how to raise them efficiently.

All of those are the result of the horrible 'economic system' we find ourselves in. People lose their apartments when they lose their jobs because we have few safety nets. And for small businesses we're demonstrating how little it takes for something to completely destroy them.

If humanity can't react appropriately to pandemics like this, then how can we expect to survive in the eventuality that something even worse comes along? And any economic system that gets crushed by this proves that it simply wasn't prepared and needs to be replaced, lest it cause even more damage to individuals.

Why do we need jobs to survive? That alone is an insane system. We desperately need to separate work activity and survivability.

Even without this pandemic, we live in a World where there is enough shelter, food and drugs for everyone but we still have homeless people, people starving or at the least malnourished and people dying in a rich country because they have to ration fucking insulin.

This economic system is not working at all. People die every die directly because of this system[0]. This pandemic just brings it to light.

[0]: https://en.wikipedia.org/wiki/Structural_violence

Yep, this situation is a socialist wet dream

Of course socialism is a failed economic model but hey maybe this time it will work /s

How is it a failed system? I'd say people cannot afford insulin is proof enough that Capitalism is a failed system.

Just go ask Argentina[0], collapsing months after IMF was praising the "good" work Argentina was doing and how a good Capitalist country it has become[1].

This pandemic just made most people feel what the lives of billions is like all year long under Capitalism. And your dismissive comment is just shameful and disgusting.

[0]: https://en.wikipedia.org/wiki/1998%E2%80%932002_Argentine_gr...

[1]: https://www.imf.org/external/pubs/ft/fandd/2000/03/pou.htm

>>How is it a failed system?

ohh I dont know, the millions upon millions that have died in starvation due to socialism over the many decades that it has been tried

but those where not "real socialism" right....

Pointing to one good that some people can not afford (the reason is largely due to government control not capitalism BTW) does not in any way "prove capitalism failed"

it is true that sometimes with capitalism you will get breadlines, but with socialism sometimes you get bread

It's really something witnessing /r/the_donald spill over here.

It is really something to have people confuse libertarianism with Donald Trump

We don't need restaurants. If you cook your own food the empployees can find a useful job. Until they do we can sustain them just like we could sustain them while doing useless work.

The 'economic system' is based on fundamentally one thing: people doing stuff. If people can't do stuff, literally, like go out of their houses, then no new economic model can work. It's like, the one requirement for everything.

Ok, you can pay them money, but what are they going to BUY with that money? If people aren't working to produce things, there isn't going to be anything to buy with the money we pay people. That is how you get runaway inflation.

They don't need lots of money to buy lots of stuff. They need to keep themselves fed and keep the electricity on while they're out of work. Food and electricity are two things that will still be produced throughout any "shutdown".

> It simply isn't possible to shut down the economy and then pay people, businesses to sit idle for an undetermined amount of time.

The Swiss Federal Council is setting aside billions of CHF (I think the total is currently at 32 billion) for exactly this: some relief for small and medium sized businesses. They've recently announced a process to have 80% of your salary insured up to a certain high cap, between 150k and 200k CHF.

There might be vastly different political and scale differences between the USA and Switzerland that make this infeasible for the USA. But Switzerland is showing that in principle it can be done. Making your blanket statement for the whole world, false.

France is having same stategy. “Chomage partiel”

42 billions total now, the 32 billions just announced is on top of the 10 billions already put aside last week.

And yes with these measures essentially any income is now assured: Salaries, salaries of SMB owners (normally excluded from unemployement benefits for obvious reasons), hourly workers, limited contracts, internships/apprenticeships, self-employed (i.e. without being employed by an LLC or something else like that) business like artists. Also daily stop-gap money if you have to stay home for more than a few days to figure out how to take care of your homeschooled kids.

Plus like 20 billions in credit guarantees for small businesses to avoid a cash flow squeeze.

All measures use existing infrastructure for paymenet (commandeering the banks for the cash flow squeeze credits) to guarantee the money has arrived by end of the month, latest. And that it will continue to flow, like regular pay check.

> The solution is aggressive, continuous testing so that people can feel safe going back out.

I disagree, and strongly.

This would be a knee-jerk, hyberbolic, and woefully ineffective over-response.

Typical for the times.

The only thing this might achieve is creating an even greater climate of fear and loathing.

There will be false positives. And false negatives.

There are with every medical test.

Back-of-the-envelope calculation: Assuming we "test everybody", and assuming both a 5% rate for both false positives and false negatives -- which is better than we currently do with influenza testing![1] -- we would needlessly quarantine 12.5 million people, and fail to quarantine an equal number of infected carriers.

Not to mention, the data about COVID-19 is all over the map. We still know very, very little about this disease. Understanding it well enough to calculate the appropriate response will take time.

Testing is part of the solution, yes. But the economic and social impact of "test everybody, every day" would be catastrophic.

Until then, in the short term, there are things we can, and should, be doing, as individuals:

(1) Limit your physical contact with others.

(1a) Especially at-risk individuals. The elderly, young children, etc.

(2) Support your local businesses through delivery, online ordering, and gift certificates.

(3) DON'T HOARD SUPPLIES! You do not need a decade's worth of toilet paper. Three months' worth is fine.

(4) Related to the above, maybe use this as an opportunity to live a bit more sustainably.

I'm down to four sheets per wipe -- certainly fascinating, relevant, and not at all disgusting to all of our readers -- which means that a single CostCo-sized pack of TP might keep my household going for well over six months.

On that note, I'm learning to garden. Let's see if I can manage to actually grow a fucking potato this year, all I got last year was a big leafy plant with zero tubers.

A discussion on government policy in response to this is a big ball of... things that require four sheets of Kirkland Signature, so I'm so not going there.

[1] https://www.cdc.gov/flu/professionals/diagnosis/rapidlab.htm

> we would needlessly quarantine 12.5 million people

As opposed to needlessly quarantining 300 million people?

There is a gross difference between "quarantine" and "limit your physical contact, especially with the young and old, while we sort this out".

Your logic is off. In the absence of data there is more fear because you have no idea who might possibly be sick. Once you start testing you can bring epidemiological tools online and alert people to possible exposures. If you don't do that the only sure thing is to quarantine everyone because you have no data, that will tank the economy for sure.

> Your logic is off. In the absence of data there is more fear because you have no idea who might possibly be sick.

There is a massive gap between "test everybody!" and "test nobody!"

We have a finite capacity to test. Tests have accuracy limitations. We can work within both of those limits to mitigate risk as much as possible.

Drastic times require effective measures.

> ...we would needlessly quarantine 12.5 million people, and fail to quarantine an equal number of infected carriers.

Well, the failure the quarantine would be the false negative rate times the infection prevalence. A significantly smaller number than the false quarantine rate, until the whole gadonkun no longer matters.

Very true. Mine was a quick back-of-the-envelope calculation based on a highly charitable scenario.

The alternative is total economic destruction.

Interesting that almost all of your examples of "contours of infection" are places that people don't need to go to, and the last one can be replaced by teleconferencing. That makes it sound easy: if you don't want to be tested, or it's too much hassle, just don't go there!

I assume in your system that everyone would need to be tested before going to work every day, because that's the most common in-person gathering for most people. The USA has run fewer than 50,000 tests in the months since this began. Your plan would require 100,000,000 tests in the USA every day.

No need to make the test stations "mobile". You could put 1,000 in every city, and they'd never have time to be moved. Every sidewalk downtown would be lines of people waiting for a test -- which itself would be a bigger gathering for me than just going to work.

Well worth noting:

If everyone is tested, the disease can be controlled:

https://www.theguardian.com/world/2020/mar/18/scientists-say...

Not to mention it isn't really solving the virus situation in most implementations. For example, everybody is packed into the local supermarkets at the same time in my area. Not only is there higher density due to closed restaurants, but also due to reduced hours (somebody thought curfews were a good idea).

In their panic, people want "something" to be done. In a couple years, we will be talking about how 90% of policies enacted during this crisis were a net negative, and 50% of them directly made the problem worse. Not to mention the ethical concerns of legal overreach.

* Disclaimer: It's a serious situation and I do not endorse a hands-off approach. That doesn't mean we can't have a civil debate about the complexities of trying to mitigate it, though.

Thank you, I thought I was the only that see these government measures as not only being destructive to the economy but actively make the situation worse

They are shutting down many businesses, and more or less forcing people in to situation where the virus will spread further.

the Panic in society currently right now will do more to spread this virus than anything.

But hey lets destroy our economy as well, that will do wonders to stop the panic

> For example, everybody is packed into the local supermarkets at the same time in my area.

Well in my country (Poland) with all the noise and confusion some rational procedures get implemented. Supermarkets limit strictly the number of customers inside. Cashiers get physical protection from customers. Contactless payment limits have been doubled. Etc.

So we are getting time for implementing changes and the life can start returning to 'new normal'.

> 90% of policies enacted during this crisis were a net negative

Compared to what? An exponential explosion, like what we saw in Italy, prior to the measures, but ten times worse, because you don't even do anything to check it?

Leave it to HN to come up with an oversimplifying app-on-your-phone-solution to any of the world's problems.

By the time you're done developing the app, deploying "thousands of mobile test stations", figuring out a way to get test results in 15 minutes (!!!) and implementing security checkpoints at each establishment from gyms to workplaces, we'll all be infected.

> Want to get into a theme park?

Nobody cares about theme parks right now. We care about getting infected at the supermarket, or bringing infected bags home. You're missing the forest for the trees.

Unfortunately the tests can’t be replicated and distributed at anywhere near the rate that the virus can be.

It is a good idea, however it is too late to execute it well at this moment. As a society we should put incentives differently, so that things like adtech and cheap imports from China get less incentives, but health and solving social problems get more than today and can attract and retain more talent.

It would likely take longer to develop and roll out a system like that than for social distancing to run its course

> It simply isn't possible to shut down the economy and then pay people, businesses to sit idle for an undetermined amount of time.

Is that actually true though? What resource are we low on? Do we not have enough nonperishable goods or public funds to pay for utilities and basic infrastructure?

We might have enough food etc stockpiled, but the servicing of debt (upon which everything is built) drives a certain modest urgency through the whole system.

The need to service crushing debt is a large part of what everybody is hoping will fall away. A primary economic concern right now is people losing their homes for failing to make rent, whether they rent from a landlord or "own". Businesses will go bankrupt for much the same reason - high burn rates that were mainly just going to the banks.

Debt has metastasized and spawned many industries, so its retraction is unlikely to be a peaceful event. But it is a cancer that will kill our society some time. The only question is if now is that time, or if some patching will get the system through this and we can go back to pumping the stock market as a false idol of productivity.

Yes! That's what my comment was hinting at.

We have:

* work to be done

* people willing and able to do the work

* resources with which to do the work

So what exactly is stopping us from putting those three together?

I think it is implied that the debt is serviced via quantitative easing.

As a point of theory, in a highly deflationary scenario the correct response may be for the government to (controllably) print paper. Given the right distribution mechanism debt could be serviced on the freshly printed paper. The effectiveness of such a strategy is dependent on how efficient the mechanism to distribute paper to end debt holders as well as how well monitored the money supply is.

The worst case on such a scenario is that an economy sits on rationing for a period of time, followed by a strong and possibly inflationary demand spike, but businesses and people's balance sheets could be partially paused.

>. It simply isn't possible to shut down the economy and then pay people, businesses to sit idle for an undetermined amount of time.

We need to develop that capability. Imagine the next pandemic was worse, spread more asymptomatically and/or required a longer isolation time to get over without spreading combined with higher fatality rate, or fatalities in a younger demographic.

This could also help us learn how to deal with more tangentially related things like grid disruptions (hopefully we don't eliminate cash in response though as that might hurt in that scenario).

I agree with the spirit, but theme parks specifically should probably stay cancelled until the virus is completely and universally suppressed. Temperature checks in smaller public accommodations, absolutely.

> It simply isn't possible to shut down the economy and then pay people, businesses to sit idle for an undetermined amount of time.

Thinking abstractly, why not? If the businesses are open, the money is there to pay everyone. If you send everyone in the economy home, where has that money that would have been used for salary gone?

Someone is holding it rather than distributing it, that's the only reason. So, take a look at who is hoarding money like a dragon sleeping on a pile of gold, tax it, and pay everyone else enough for a roof and food.

Huh? An idle business can only distribute cash for so long before it runs out.

But again, follow the money. Where is that exact dollar that would have gone to that business had there not been any coronavirus?

The economy is a circular river system. If it stops one day, there is going to be areas of drought in places, as well as huge reservoirs protected by dams. Money does not disappear, it only moves. You lose money on stocks, someone else on the other side of the world made money with their short position.

Perhaps that dollar is held up in some whale's cash account after they closed their positions. You would tax that whale for that cash, and redistribute it to the working class to afford food and shelter.

In any recession, the big stall is capital being too skiddish to pay for labor, resulting in lowered consumer spending, justifying less demand for labor, and creating a worsened financial crisis due to even lower consumer spending levels. If you are able to keep the working class afloat, you can conceivably keep consumer spending afloat, and therefore keep the economy afloat, even if capital is fearful.

If the business is providing no services or products, then it cannot afford to pay its employees. This is because the economy is built around mutually beneficial exchange, which only happens when people can work.

Example: I go to a clothing store and give them an amount of money that I value less than the clothes they give me in exchange. We are both better off because we have made that mutually-beneficial exchange. If the exchange doesn't happen because the store is closed, then there is no revenue (let alone profit) to divvy up.

The only way to simulate that transaction in a way that gives money to employees is to literally take it from customers who receive nothing in return.

What I'm saying is there is still money even if it's not currently circulating. In your example, you go to the store and it's closed, the money remains in your pocket; it still exists.

My solution would be to tax you redistribute that money from your pocket to the people who need food and shelter, the same people who stimulate consumer spending, because you are unable to currently do that yourself due to shelter in place orders and/or perceptions of the state of the economy.

You are not acknowledging the core economic problem which is that the productive capacity of the economy is going to be destroyed if this doesn’t end soon.

What you are describing is essentially how to ration the dwindling supplies of goods during the epidemic.

Enacting arbitrary taxes where the government simply appropriates funds from entities that have it and gives it to those who don’t is unfair, dangerous, and will undermine trust in the rule of law. It will be ripe for abuse and predatory behavior. It is also a system that loses the critical information market mechanisms provide, instead replacing with “command” based allocation which is a dangerous precedent.

The way to achieve what you propose that is not at odds with civil society is for the government to “print” new money, and distribute it through moderately means based criteria.

The US has unlimited capacity to increase its money base as a sovereign entity. Normally this is done through the Fed buying bonds from the treasury. The treasury has the authority to create money directly if they choose.

This has the effect of devaluing the currency as a whole. By distributing the new currency ti citizens that need it, it is effectively a transfer of wealth that is distributed throughout the economy in a decentralized and proportional way.

It is only necessary to target those who need help, opposed to harder problem created when the need to target who can “afford” to sacrifice their savings is added.

This doesn’t address the problem of productivity lost, but it allows what productive output there is to be more fairly rationed.

It also less subject to being the legal and political nightmare your suggestion entails.

> The economy is a circular river system.

The economy is the collective action of people producing the goods and services that you and I consume - food, haircuts, medicine, video games. Money is a claim on some portion of that stuff that has been or will be produced. Redistributing money is not going to suddenly make us productive again when most people are only leaving their house once a week to stock up on groceries.

Where is all the stuff that we use in our day to day lives going to come from while the economy is 'paused'? Who is going to make the food, distribute the food, sell the food, drive the trucks, etc?

There are two sides of our society; production and consumption. If we aren't producing, how are we continuing to consume?

Well, there's inventory of various essential goods in a variety of places, and all the essential services you note, as well as power, plumbing, etc.

Instead of going to a restaurant, I make a sandwich, instead of buying a new shirt, etc. GDP has indeed dropped, and some people have no cash flow (fixable), but I'm not seeing physical (excluding the abstraction of the banking system) reasons why this can't be sustained for months if necessary.

You can easily find the person who is holding rather than distributing the money. In fact, you looked at them in the mirror this morning.

I am voluntarily (10% family-preservation, 90% community service) staying in my house. I’m now “hoarding” (to use your hyperbolic term) all the money that would normally go to fuel, eating out, and entertainment.

The restaurant, movie theater, and gas station owner would, circumstances permitting, surely prefer to be able to serve me and I likewise.

Why don’t I just mail checks to people that I’d normally buy from? Because I don’t know what my own economic future looks like. Will I have a job in 6 months? What will my retirement savings look like then? Plus, I can’t just send the money where it would have gone and also send it to the people who are now selling me more at-home food or new goods/services that I need to be productive at home.

I’m fortunate to work as a W-2 office worker/spreadsheet miner, at least for now. If I were a bar, movie theater, or auto repair shop owner or worker, I’d be in a lot worse shape.

This is not a Bezos, Gates, Musk driven problem. This is driven by the inability of the consumer to consume normally.

You could buy gift cards for future service at these bars and restaurants. The business gets cash now and you get a discount.

If they remain open. That might be about a coin-flip on average at this point.

As a moral issue, we are choosing to continue to pay our every-other-week house cleaner to not clean our house. Everyone else is getting paid iff they provide current goods/services. We have our own financial survival to look out for until more is clear about the economic outlook.

I mean this is what unemployment and governments are for. To insure losses in the extreme. We should have policies and procedures where a 2-4 week or month lockdown doesn’t destroy you financially. That gives the economy and people time to adjust.

I don't know what to say.. Do you want your local food and bars to remain in business? If so you have to prepay. If you buy a gift card you are basically insuring them against default. I am sure they will factor in some loyalty reward. Restaurants and bars close and change ownership all of the time.

No, that will not work. This virus is so infectious, one person can infect a whole bus by just coughing a few times, or the whole elevator by just breathing in an elevator. By the time he tests positive, he had infected dozens of people.

That's what happened in South Korea, as far as I understand. They missed just one guy out of 31, and he started a massive infection.

Yes, massive testing is indeed better than what we do now, but if you let people to just walk around, it will do absolutely nothing.

the test kits would be positive when it's too late to stop this highly contagious virus. PCR tests are needed, which means, every day submitting a spit sample in some collection space, and get the result at night. It's not impossible, with a lot of automation and scaling of PCR machines and huge mobilization. It could become a routine for a long time if automated.

Are you writing a “Black Mirror” episode?

Yeah, sorry buddy, I'm not going to get tested like that.

I don't think this solution is sustainable either. It takes one bad apple to restart the exponential growth rate. Look at south Korea and patient 31.

I suspect after 1 or 2 months people will say enough is enough and force their reps to call off the quarantine. We can't do this for 18 months.

And then 3 weeks later, they'll say enough is enough, and beg for it back.

There are not enough tests and it will take months and months to make them.

Also HIPPA laws prevent what you propose.

What do you base the months and months estimate on?

Worth discussing, but it would take months to deploy the level of testing required. You’d need to test a significant fraction of the entire US population every day. Say 30%, which is probably too low. So we need 100 million tests per day? That’s many months away, as is the miraculous (and privacy issue laden) database you’re talking about. By then, this will all be over and millions dead if we just let it run unchecked. We’re buying time to be able to actually implement something like that. It can’t happen in a matter of days or weeks.

Test everyone at onset of cold symptoms or a fever. Taking hypochondria into account it should come out to once a month. So 10 million tests per day.

People can be contagious before symptoms. And that’s also a very different strategy than testing everyone before they go into work each day. You’ll miss the vast majority of people if you just test people with symptoms.

South Korea isn’t testing everyone, every day. Neither is China.

So there’s a middle ground here somewhere.

Neither country took the middle ground compared to where the US was when we finally started reacting.

South Korea has been aggressively testing, contact chasing, and quarantining from day 1. Look at their number of tests per capita compared to ours.

China did indeed shut down the entire economy for months for provinces containing 900M people iirc. In barely hit provinces they have teams of thousands of people doing aggressive testing, contact tracing, and quarantine.

South Korea has tested 0.5% of their population by some accounts.

I mean, yes, that's great, but it's not as widespread as people are implying.

The number of new cases in South Korea has started to increase again, and they keep getting new clusters unlinked to any known cases: https://uk.reuters.com/article/uk-health-coronavirus-southko... I suspect that they're going to have to give up on the tracing and testing approach in the next few weeks.

Daily New Cases isn’t actually trending upward at this point;

https://www.worldometers.info/coronavirus/country/south-kore...

The article you linked is based on a single day’s new case count.

Stopping every transmission isn’t necessary. We just need some way to drive R < 1.

China’s approach (lots of temperature taking, testing everyone with a fever) might not eradicate the disease here, but it could keep it manageable until a vaccine is deployed.

Yes, you are the voice of reason! R of .9 is just fine. Pushing R to 0 is unnecessarily costly.

Focusing on positive or negative is the wrong focus, we need to test for immunity. Those who are immune can contract the virus again in a year, but will do so without symptoms, according to older studies for similar viruses.

And most importantly, those with immunity can go on to lead a normal life and participate in the economy.

https://twitter.com/NAChristakis/status/1240689935557865472

Yep, I am not totally sure what you do about it (stuff like testing people at work is going to be tricky legally) but I came to this conclusion the other day too.

The issue really isn't the virus but the fact that people who end up spreading it, don't know they have it. Shutting down the economy is a backwards way of solving this...it is assuming that everyone has it.

I am not sure how exactly we get to that point and you are kind of hoping that people who have it isolate...but testing really should be priority. My govt is ramping up but the numbers they are talking about are still ludicrously small...total tested is 0.1% of population, and they are saying it is a resource issue (whilst they are spending literally hundreds of billions on stuff that is being caused by their testing strategy).

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