When Will Coronavirus Social Distancing Be Over? | Hacker News Reader

When Will Coronavirus Social Distancing Be Over?

theatlantic.com

41 pointselorant76 comments

Long before things are completely back to normal, we'll have a "new normal" that allows businesses to reopen under strict anti-virus protocols.

We can't do it in North America yet because we don't have enough masks, gloves and other PPE.

Example from China: https://www.youtube.com/watch?v=ddx_z1Qtn9w&feature=youtu.be

This. There are many possible scenarios how to end the shutdown, not one is back to normal on Monday.

> not one is back to normal on Monday

No one in the US seriously believe this right? You're all behind schedule and the worst have yet to come. As far I understand, there are many places in the US where a lockdown/quarantine hasn't even taken place yet, so count on a couple of months before things get back to normal.

Unfortunately, the belief that everything will be back to normal by Easter is coming from the President.

Heh, I guess you get what you vote for

The words "contact" and "tracing" didn't even appear once in the article. Are people outside of Asia not even considering test'n'trace as a possibility? Privacy concerns aside, it seems like an effective way to save lives without forcing everyone to stay home indefinitely.

Is that the term for tracing and alerting people who were near people who positively test for covid-19? If so, it does seem to be done local to me, but probably not with the same rigorousness.

Contact tracing was happening at the start, and it'll presumably happen again once caseloads become manageable. As you'd expect with such a quickly moving story, coronavirus predictions have a huge splintering problem; most people writing about it don't have all the facts.

Contact tracing is great for diseases like SARS and MERS, but it just doesn't seem to work adequately for this coronavirus Even Singapore is being forced to enact stricter and stricter lockdown measures. Also, you're not even going to get it to work as well as it did in Singapore unless the virus is coming from a known, external set of sources that allow you to narrow down the pool of potential cases.

(Public Health England in the UK had a fairly competent, though not totalitarian-level, contact tracing program. They stopped a while back because it became evident that despite their best efforts, the disease was becoming so widespread that it was reaching the limit of their contact tracing resources and most of the infections were probably unknown community spread that couldn't be found via contact tracing anyway. Other countries are likely similar.)

Contact tracing is, as far as I've read, the very first strategy initiated by most Western governments and health organisations. In the early stages of reported cases.

As it stands, my country is still in relatively early stages compared to many others, and contact tracing became unviable as a first defence well over a week ago. Over 60% of our cases are community transmission.

We're still doing contact tracing, it's probably worthwhile, but it's not going to be a major factor in mitigation.

What about contact tracing apps? Tracing won't work unless you know who was nearby each infected person. It's difficult to find that info unless a big portion of people are using a tracker app. Is that sort of thing happening where you are?

It's happening here in Israel. The government is promoting an app which claims it stores the location history on-device and fetches known-disease-vector data from the server to compare it locally. (For good or bad it doesn't use the device's existing location history if it's already stored...)

They just announced it's had 1M installs (in a country of 8.7M) in the last week.

It's been announced here (Ireland), though the official government contact-tracing app is as yet unreleased. It's believed to be a based on Singapore's BTLE one.

It's largely irrelevant though. As much as it may help a little, this just isn't manageable through contact tracing. While Singapore are being lauded for their CT approach, they've still largely been successful in their efforts due to social distancing (and a culture of widespread adherance), along with things like widespread testing, and effective govt. communication of data.

If I understand it right, in a “perfect universe” if every person was able to stay home for 14 days and also perfectly avoided infecting anyone then the virus would effectively have died off. The 14 day’s might not be the exact time required but it illustrates a concept. We of course can’t uphold that perfect universe. So we’re stuck using that technique to slow it’s roll enough that it won’t overwhelm and kill like 3% of 7 billion people in addition to the usual attrition rate.

It would be longer than that. At 14 days, some people would just start exhibiting symptoms. However those can be mild enough to disregard. I believe recovery would still take another week. Then multiply that by the number of people with whom you cohabitate. And that assumes you didn’t go food shopping or collect your mail.

It seems like the basis for a numerical model to understand the phenomena.

It’s interesting to think about how many other viruses would perish if there were no new hosts for them to live in. Maybe we should start doing this every year as a sort of cleansing of viruses? 3 weeks in February - quarantine weeks. Every year.

It's not going to work. This should be done worldwide and you need some interaction for people to be able to live.

It’s doable with a year of planning and social initiative. But we’d also need a sea change in our laws to make it not a yearly recession.

I wonder if you could do it as a kind of near universal social and economic time-out? Let's say it starts on a Sunday night and is to last for two weeks.

What happens is that everything starting Monday is pushed back two weeks. Stock markets close. Non-essential workers stay home. Non-essentially businesses close.

During the two weeks, government pays for everyone's utilities, food, rent, and so on, both for people and companies.

The idea is to as much as possible pause the normal economy for a couple of weeks, and then resume it hopefully pretty much right where it left off, with the government seeing to everyone's needs during the economic pause.

Do this once a year as a readiness exercise, probably trying to time it around when that year's flu season is getting serious so that it may also help reduce the intensity of flu season.

Over the years, the government should over fund this to build up a cushion, so that whenever the next pandemic comes around they have enough to do longer than a two week pause if necessary.

I am not a microbiologist, but I'm not confident that this "three week annual quarantine" even works in an ideal world, much less the imperfect world that we actually live in.

Is it a guarantee that 100.0000000000% of the population will eliminate the virus with their own immune system in three weeks? If one or two people with poor immune systems carry around the virus for one day past the quarantine then we we would very quickly have gotten back to where we started.

It's also implausible to quarantine everyone for the same three week period. Are we just supposed to let anyone with a major health crisis die at home if it happens mid-quarantine? What would we do about the millions of people who require round the clock care in nursing facilities, etc.?

Additionally, I'm willing to bet that if we dedicated 5.8% of worldwide GDP (21 days out of 365) to fighting viruses, the results would be much more successful and less invasive.

It's definitely something we should put a marker on to come back to. Three weeks is a lot, and the full extent of measures here just isn't feasible outside of a pandemic. But if we come back in a year and realize there's been a significant impact on overall disease burden, maybe we should mandate a 2 week block of national holiday for all nonessential businesses.

> 3 weeks in February - quarantine weeks. Every year.

But it's summer in the southern hemisphere that time of year...

I live in Spain. We've been in full quarantine at home for about two weeks today. The cases are still raising, and so are the deaths.

I think the two week mark is the bare minimum, ideally you would have two weeks for symptoms to surface, then additional time until you're healthy and then two weeks more. So one month and a bit more.

Which, seems to be the way we're going, as the quarantine here is seemingly continuing.

I'm visiting Spain, staying on La Palma in the Canary Islands, and today was Day 16 of quarantine for me. I had to leave the house to return my rental car. It was so nice to get out of the house just for a little while! Here's a pic I took on the way back to the airport.

https://photos.app.goo.gl/k1kKJxjuHcdTJe4F6

I feel you, I had pneumonia two weeks before the lockdown, so been one month at home now, as I've been self-isolating. Good thing you managed to get out for a while, be careful of the police who fines people on sight and stay away from others.

The office that rented me the car closed, and I was not able to get in touch with them. I called the US Embassy and they were able to help me arrange for the car's return. They're main tip was to make sure I had a copy of the rental agreement with me.

Today is the first day in which confirmed cases have grown less than the previous day (6 vs 8 thousands) if we can trust the official numbers.

Seven or eight days after first symptoms infected people either get much worse or not, then some die in the few next days.

So we could see the same death rate of 800, or even a little worse, for the next week or two, that would double the current 6,500 toll. Then it would slow down, but I believe it's too optimist to set the limit in two more weeks to end the quarantine. With more masks and tests maybe we could start working selectively.

14 days probably not but with perfect isolation per household for 1-2 months it is possible. so assuming we can keep all services running unattended for that period of time (electricity, water, internet) and that each household somehow stocks up the bare minimum essentials for that period and finally somehow enforce the curfew without potentially exposing the police to the virus its doable.

BUT.. not going to happen, this can't even happen perfectly in China where the government can get away with a lot more than any western nation.

My wife is already talking about moving out of the city to get a bit of space and it's only been two weeks indoors for us. Anecdotal, of course, I think the desire to be away from others is going to persist a while.

Interesting. I wonder how prevalent and deep such reflections will be upon people after this.

It’s possibly the best thing we could have done for the people who claim to be ok with the standard of pollution and climate change baked into an oil based civilization. Like pulling your hand out of a warm bath of water it’s been soaking in for a few seconds and plunging it back in the same water feels much warmer.

Density of human development also has benefits, though. The US lifestyle is especially bad at some of this. People think that their car-centric suburban or exurban life is away from chaos and closer to nature, but actually, they are driving their cars everywhere, increasing costs of getting goods to them, destroying the planet in the process.

My friends and I in London are already salivating at the prospect of going to the pub, night clubs and music festivals. Each to their own.

I think the unstated assumption is that there won't be any more pubs, night clubs, and music festivals, as we knew it.

What are you smoking? In any case, do not try to bring it through customs.

The crux of the article: "The answer is simple, if not exactly satisfying: when enough of the population—possibly 60 or 80 percent of people—is resistant to COVID-19"

But then in the next paragraph nonchalantly says "though we don’t yet know if recovering from the disease confers any immunity at all"

I'm not sure sure how articles like these get published.

It's all about the clicks. Nobody proof-reads anything anymore.

I mean, that makes perfect sense. Itll stop when people are resistant. Are people becoming resistant? We dont know. Its presenting the state of things, and that includes uncertainty

It's a very misleading sense of uncertainty. There's every reason to believe people gain long-lasting immunity, and no way to concretely prove it right now. No public health authority is seriously considering the possibility that survivors aren't immune.

In general, in science, if you're uncertain, you're considering everything, even that survivors might not be immune. There is every reason to assume anything can be possible right now, as we don't have enough data. Once we have data, you can start to reason and consider things, but we're not there yet.

I just don't think that's true. Every infectious disease expert I've seen has been very confident that survivors gain long-lasting immunity, based on their knowledge of how other coronaviruses and diseases in general work. We don't have a ton of specific data about this specific virus, but it's not accurate to say we know nothing at all.

Even if it were true, there are decisions about strategy and response that must be made now and can't wait for data to come in, and those decisions are being made under the presumption that survivors become immune.

> it's not accurate to say we know nothing at all

No one is saying this. We do know things about viruses in general, but again, don't have enough data about this particular one to say anything for sure.

You don't need to have an answer before you ask a question.

When people break not when policy dictates. People get complacent once numbers go down and there seems like containment which looks to be happening in Korean and Hong Kong.

Young adults living in cramped share houses in a city aren't going to stay in for the summer or go celibate for the months decision makers are thinking. At least in dense urban areas, there's too much quality of life disparities for long term behavior change like this to be feasible.

IMO Social distancing is to buy a few precious months max for logistics and medical system to prepare. Pretty soon economic stress exceeds fear of the disease. The financial aid package in most of the countries that can afford it leaves a lot of people behind.

If it lasts too long then it'll be over when people grow tired of it. People will weigh the risk/rewards and decide for themselves. If the authorities are not able to control the initial trickle then the dam will burst and people will decide what to do themselves. There's a very thin line of control of this whole issue.

From CNN FAQ [1]

"How long will we have to keep social distancing? Probably for several months. But you might have to do it “over and over again,” since the outbreak could come in waves.

Research by the Imperial College in Great Britain “would suggest you have to institute these kinds of measures for five months, very vigorously,” said Dr. Celine Gounder, an infectious disease specialist at Bellevue Hospital Center.

“And then you may be able to relax for a period. And then you would re-institute as the cases go up again. But we’re basically looking at doing this over and over and over again, even after a five-month period of strict social distancing, in order to curb cases until we have a vaccine.”

Health officials say we’re at least a year away from the first publicly available coronavirus vaccine. In the meantime, they say everyone should avoid large crowds and stay at least 6 feet away from others."

I hope we can relax the lockdown and still get satisfying results (following some Pareto's principle). For instance, avoiding indoor events maybe a good measure. But avoiding people to go exercise outside isn't really needed? Also, hopefully we'll get masks and tests in a near future and that we'll make it easier to contain the virus too.

[1] https://edition.cnn.com/interactive/2020/health/coronavirus-...

I think they're taking the Imperial model with more credulity than is warranted here. Social distancing for 5 months was the suppression scenario the paper considered, but I don't think anyone believes the current set of severe restrictions could be sustained for that long. 5 months of a ban on large events, maybe.

I think a worst case scenario is one in which:

- The virus becomes seasonal, like the flu

- Like the flu, every year there are new strains (so surviving it doesn’t grant immunity)

- And we’re unable to develop a vaccine for it

Someone please correct me if I’m wrong but this scenario implies that the situation we’re in now becomes the new normal. Every year, we’ll lose an additional percentage of our elderly and those with pre-existing conditions. Medical systems will either be ground down by repeated surges, economies will be ground down by enforced social distancing, or both.

What else would be in the cards?

This is what happened with Spanish flu, but people lived with it, and each year it got less deadly, and it still persists to this day as Influenza A [1].

Personally I assume if it's more than a 6-month ordeal people would accept the losses rather than fundamentally changing the economy as we know it.

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2749954/

The Spanish Flu is estimated to have killed around 50 million people worldwide (google) in 1918 when the world population was 1.9 billion. Just linearly that would be around 200 million today.

> Like the flu, every year there are new strains (so surviving it doesn’t grant immunity)

Even if it mutates, the immune systems of people who recovered from it this year will still be able to fight it much better next year, because they've learned how to fight that kind of virus. This is why even though the flu mutates every year, it isn't particularly lethal: our bodies have learned how to fight that kind of virus.

If however one were to take the flu to e.g. an uncontacted tribe who'd never encountered influenza before, it'd completely devastate them, much as how viruses from European settlers were estimated to have killed a double-digit percentage of the native American peoples.

We don’t develop immunity to other coronaviruses such as the common cold, so I don’t think we can assume we will for this one.

We do develop immunity to other coronaviruses such as the ones causing common cold - thing is, there are so many different viruses (some of them are coronaviruses, some not - there's a huge variety) causing similar symptoms, so we don't even attempt to diagnose which of the many common-cold-group viruses you have because we don't care; but you do develop immunity against that particular single virus.

We do. Actually they find antibodies for the orignal SARS ten years after.

Other corona viruses are different. We only get chicken pox once in our lives, but we can be infected with other herpes viruses after chicken pox(infection or vaccine).

There are some virii, such as dengue fever, where getting one strain, makes getting the next strain much worse. This is because the change to the immune system to fight off the first strain creates a new pathway for the second strain to use to infect.

Sounds like an improvement actually. Less people leeching off the system, either through welfare, or by being rich enough to just sit and live off savings. A young person with money would be more likely to start a company rather than just retire. Their productivity would help everyone.

People that do survive would be healthier to begin with. There would be more room, and less pollution.

More research put into medicine would help everybody live healthier lives. The economy would be less ecologically harmful allowing nature to flourish. In San Francisco, wild foxes are already starting to wander through the city. Imagine what it would be like after 20 years of this.

Overall, a much better place.

> Sounds like an improvement actually. Less people leeching off the system, either through welfare, or by being rich enough to just sit and live off savings.

Any opinion that starts with the equivalent of "I'm OK with the deaths of those people because I don't think that they have full value" (referring to someone as a leech on the system is basically just saying that they are worth less as a part of society than the non-leeches) is not one that I hope to see much endorsed.

I never said they didn't have full value. I'm just looking at what would happen to society in this sort of scenario. It may be harsh to say it, but there is a potential brightside whether you choose to acknowledge it or not.

It is not influenza it is coronavirus. This means it mutates way slower, so vaccinces will work.

Worthless article. Basically says 1-month to years. Well thanks Sherlock.

The article is giving you the answer to the question. The real world has this thing called uncertainty. There are a lot of different ways things could go, amd if the article said itll be uber in 4 months exactly, that would be total bull. If the only thing people consider "worthy" reporting is reporting that oversimplifies hard questions and pretends there no uncertainty to give simple, pleasing and wrong answers, and the reporting people consider "worthless" are articles that grapple with the complexity of a situation ultimately leading to unsatisfying answers but with a sense of why its unsatisfying, well, that would make sense with what news reporting looks like today.

I didn't need an article to tell me "dunno lol". I knew I didn't know already.

> I didn't need an article to tell me "dunno lol". I knew I didn't know already.

But I think a lot of people don't know that they don't know. There are lots of problems where the scientific consensus is in, but the will isn't there to implement it—whether due to denial of the science or to fear of the costs. This is a situation where the scientific consensus isn't in; no-one knows for sure—and that's not a state in which the modern person is used to living, or realising they're living.

> But I think a lot of people don't know they don't know

I think that's generally true, but probably not in this particular case. In any case, the answer of "We don't know" is only three words long and could have been put in the headline, but then it wouldn't have been exploitative clickbait...

If you don't know then title the article "Why we don't know when Corona will end," so I can save my time. This article deliberately link-baits by purporting to answer a question and then giving a non-answer.

No one really needs to be near other people. I think just keep it going. A lot of industries really aren’t essential to life. Maybe we should question why we need them. Theme parks, sports, gyms.

Physiologically, no, we don't. Psychologically? I think there will be issues. For your sports example, there is definitely a primal need being fulfilled, otherwise athletic competitions would not have existed in ancient times. It's true that many industries aren't essential to life. That doesn't mean they're not essential to wellbeing.

> Physiologically, no, we don't.

The grandparent mentions gyms as one of these non-essential institutions, and they or their equivalent are something we need even physiologically. The impacts on health of not being able to get out and move regularly, much less to have serious exercise, are going to worsen the already serious problem of obesity.

To be fair, you don't need a gym to get out and move regularly or have serious exercise. Lot of people just got in the park every day, and plenty of exercises exist that use only body weight for strength training. You're not going to become Arnie in his prime, but you'll be fit.

I agree that there are things one can do (and I do get out in the park as often as convenient, but social distancing there is hard), but are there things one will do? I'm in reasonably good shape from indoor climbing, but that only works because I like doing it so much that I don't notice I'm exercising. So far, the inertia of having to set up a body-weight routine (rather than continue with my existing climbing-gym routine) has kept me constantly attending to other things first, so barely active. And that's someone with a habit of physical activity who really dislikes having to skip the routines—so what about those people without such a habit?

Seriously? Your argument is that we should get rid of things that aren’t essential to life? And you include gyms in that list? I wonder how you view human well-being, leisure activities, hobbies, and activities that may have secondary benefits (e.g. Formula 1’s impact on the automotive industry).

> No one really needs to be near other people.

This isn't true now or at any point when "humans" were an identifiable concept. We're not solitary animals. If you made everyone live alone, we might well go extinct.

People do vary in how much contact they need with other people. Some people will quickly become mentally ill if they're not getting enough social contact. I'm quite far over at the other end of the spectrum... but after living in China with no social group for several months, a friendly cashier greeting me in English with "Welcome to Lotus" was enough to get a very positive reaction from me.

If that's going to be the prevailing attitude once this pandemic is brought under control, it would seem I picked a doubly bad time to quit programming and become a restaurateur.

Won't the population die out then?

Some would argue that having fun and feeling fulfilled are essential to life, and for some that would put those three things firmly on the list. And interacting with other people is (in my opinion) basically the point of being alive, and it’s much easier to do if you’re near them.

Really if we only needed things that were essential to life, each of us could be living in a broom cupboard doing nothing and drinking Soylent for sustenance, but what kind of life would that be?

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