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Bill Gates calls for nationwide shutdown

thehill.com

160 pointsevo_9381 comments

I definitely feel the US is constantly behind the curve in this. After trying to downplay it for a while the administration had to accept reality but instead of taking strong measures they still do things only very reluctantly. Then on the other hand they close parks while at the same people are crowding in stores without masks or gloves.

stores in the UK are limiting the number of people allowed in at any one time, and people queuing outside have the sense to to leave gaps to allow for some social distancing in the queue

It is the same here in many states, though I don't think a occupation limit has been imposed federally

I think many people will misunderstand the U.S. effort, since it's something like looking at the whole EU (but with less population density).

They look at the central government and they're like "this is not enough!", when often the things they're asking for are deployed to some reasonable degree in every state.

neither has one been imposed in the UK, it's just using common sense and also protecting their staff

And yet the UK is testing at a rate 1/2 that of the US per capita (with a max capacity of only 12,750 per day) [1]. Two weeks ago they were barely testing at all.

This is in fact going on across all of Europe, very few nations are doing anything right including on the testing front. That includes supposedly good outcome nations such as Sweden, which has made a terrible mistake of not properly quarantining, and even bragging about this fact [2]; meanwhile their case numbers are surging by the day, tripling in roughly 10-12 days.

It's just that people ignorantly like to target the US with abuse because it feels good, while pretending everything is going swimmingly elsewhere (it's not). They count on Americans not following the news of the disaster that's still unfolding across Europe.

There are a handful of nations doing kinda-sorta well in Europe and that's it.

[1] https://www.reuters.com/article/us-health-coronavirus-britai...

[2] https://www.bloomberg.com/opinion/articles/2020-03-27/corona...

> “I’m deeply concerned,” virology professor Fredrik Elgh told state broadcaster SVT. Epidemiologist Joacim Rocklov told the FT it was “a huge experiment” that could go “crazily” wrong. Mathematician Marcus Carlsson, less politely, said it amounted to “Russian roulette.”

Regarding the rate of testing, since the whole country is in lock down the rate of testing isn't actually that helpful. It's more about damage limitation. The UK, and most countries, are no longer in a containment phase that ship has sailed. Now it's more a case of reducing burden on the NHS. So the rate of testing only has a limited use at this point. I gives a guestimate about the total infection rate, and it is probably essential for hospitals to ensure containment of patients, but in terms of testing the general public, not that helpful.

The US might get more use out of it at the moment in the remotely located populations such as towns that currently have limited infection rates Then testing is extremely helpful postponing infection. By doing so, it bides time for stock of medical supplies to increase after the significant burden that infected cities will have in the coming months.

Micro Center here in the states has you give them your phone number and they text you when you can come in. The one by me doesn’t even let people queue up and wait there - you have to go somewhere else while waiting.

that's a great idea even if it just means people can sit in their vehicles outside the store.

And the store owner gets the phone numbers of their customers and ca at least roughly map it to a set of sales from that time frame. If they survive this allows nice marketing in future.

But yeah, pragmatic solution.

Microcenter is already terrible about sucking up all consumer information they can. When I check out with a credit card it shows an address from three apartments before in another state .. not updating it.

This seems to be a global feeling. People in most countries seem to think that theirs is constantly behind the curve, that they aren't locking down fast enough and their testing is so grossly inadequate compared to the rest of the world that their government is practically trying to kill them.

This is just not true. Norway quaranteed people coming from infected areas, and brought up understandable restrictions by a unified front across ministries, sparrowheaded by the Prime Minister. Curve of infected and deaths seem almost linear, and the Gov is considering opening up low-hanging restrictions after Easter.

The clue was right responses at right time, correct nation-wide communication, coordination and leadership. With earlier response, maybe this could've been stopped at borders. But effectiveness is doubtful, since most countries have dismantled pandemic and crisis capabilities.

The contrast between Norway and Sweden is particularly stark.

I'm in Canada. We were a bit late to the punch, but I think by and large my government layers (municipal, regional, provincial, and federal) have taken the right actions at the right times given the information available. And they're clearly working in conjunction with experts, so there's that.

I definitely have policy beefs with both my premier and PM. I didn't vote for either of them and probably won't the next time either, but I can still be pleased at the degree to which they've stepped up. The contrast with US federal government is especially stark.

Canada missed the boat by not being serious about checking travellers returning to Canada. If the fake followup questionaire that was routinely not asked was asked and had detailed questions, if an assessment of people returning was done, if airports were shutdown earlier, if returning people didn't have to wait for hours in line in close contact with thousands of others returning.. The airports are the weak links.

Now they go on tv and yell at people for not doing enough. When two weeks before they downplayed, mocked those who would dare wear masks. The majority of the initial outbreak was spent telling people they were racist for not shopping in Chinatown.

I'm in pretty much exactly the same boat as you. Not a fan of the PM or Premier of my province, but am not unhappy with how things are being handled.

While I have a lot of issues with the messaging (in that it could be blunter and clearer [1]), it appears to be an issue in all Western countries, so I guess I give them a pass for that.

I also have some issues with the CERB (I would have personally preferred a simple universal benefit over something you need explainers for [2][3])

[1] https://www.reddit.com/r/coolguides/comments/fmlg1y/communic...

[2] https://www.reddit.com/r/toronto/comments/fpz6g6/update_2_ce...

[3] https://drive.google.com/file/d/1lOJn7XS6ETIkbLRodYk681M_2dx...

No. Where I'm from, only specific kinds of stores (groceries, pharmacies, gas stations and similar) remain open, there's a police curfew from 8pm to 5am (with ~250 euro fine), bars, cafes, hairdressers etc are completely shut down, restaurants can only do delivery, covering your face is obligatory when in public, public transport is completely shut down.

Admittedly, it is a small country (~4 million people) but we've been doing this since we had ~50 cases. If anything, people were arguing that we took drastic measures a bit too soon, but we're able to pin point individual clusters thanks to a quick response.

On a side note, one company anniversary party is responsible for about 17.5% of confirmed cases so far, so please stay the fuck home.

The leader of the free world is still coming to terms with the economic damage on the horizon, not to mention there will be nothing left of his personal brand once / if he does the right thing.

As with climate change, the solution has been broadsided by petty politics.

"The Leader of the Free World" is such an unnecessary term. It started out as propaganda and hasn't gotten more true since about any POTUS.

I would interpret the GP as I treat any reference of such a title and Trump: As satiric. Some predecessors might have tried to fill such a title and living up to it. For Trump it is a non-goal.

It's not just Trump. If you're interpreting their comment as satirical solely because of the reference to Trump, you're missing the point of my own. No one in charge of the United States has ever deserved that title, nor tried to live up to it. It was never anything but well-aimed propaganda. That it's lived past the Cold War (and, do note, was coined in reference to someone far more damaging to freedom than Trump) is ridiculous.

One of the characteristics of an exponential spread is that you will be either behind or ahead. If it seems like nobody is at "just right", it's because "just right" is an exponentially small target.

I would suggest cutting people some slack in both directions.

(It wasn't that long ago when our government was being criticized as moving too fast and xenophobically shutting the borders before it was justified. Moving back and forth between "too far ahead" and "too far behind" is also a thing that will continue to happen.)

Quite agree, and your comment reminds me of this: https://en.wikipedia.org/wiki/Bang%E2%80%93bang_control

In this situation most would agree it's better to be ahead; the criticism is justified.

Would they? First of all, the criticism I mentioned was when the governent was "ahead"; experience indicates people were not "agreeing it was good to be ahead". "Ahead" in this case may be shutting down the economy far more than is justified. While it may be fun to talk about "the rich" and stuff, remember that "the economy" is what feeds all of us, clothes us, houses us, and keeps us in electricity and clean water. It is even now not necessarily clear that we aren't "ahead", once you put aside the partisan political sniping, and doing ourselves much greater damage than is actually justified. Thousands of deaths are bad, but a 30% employment rate (and presumably growing) is going to be bad too. I am not implicitly claiming one is worse than the other... I'm saying right here, right now, we don't actually know.

The "correct" response is an exponentially small target. Right now in the fog of war we don't even know what it would be. It would fit the evidence that the coronavirus fatality rate really is sub-.5%, if you count all the asymptomatic cases that may exist, and that we're badly overreacting. It would fit the evidence that coronavirus is still, if anything, downplayed, that there is no reserve of asymptomatic cases, and that even if it doesn't kill you there will be a generation of people crippled by it just like there was by polio. The nastier end of the rumors I'm hearing are really nasty [1]. It will only be visible in hindsight.

[1]: Can the virus kill the part of the brain responsible for determining whether or not you have enough oxygen in your blood, and then also kill your lungs, so that you think you're recovered and doing well and everything's fine even as your blood oxygen level sinks until you just keel over dead? Is that what the videos of people literally keeling over dead in the streets of China were? Dunno. Won't know for a while yet. But if it can do stuff like that, it could be a scar on us for the rest of our lives. Or that could be something else entirely, up to and including some intelligence agency's way of fearmongering. Heck if I know. Maybe it is ultimately just a bad cold that tends to cause pneumonia and everything else is just the Internet doing its echo-y thing. Zoonoses (diseases that jump the species barrier) have a history of that sort of thing.

> It is even now not necessarily clear that we aren't "ahead", once you put aside the partisan political sniping, and doing ourselves much greater damage than is actually justified

I haven't been out in over a week, but have we actually gotten to the point where everybody now wears a mask in public?

The shutdowns were partly necessitated by an utter failure to produce and distribute PPE (whether by market or by fiat), which made it impossible for most people to just take reasonable precautions and then continue about (most of) their daily lives. Until the supply catches up until everybody who wants a mask has one, and front line grocery store workers have them provided by their employers, I would say we're most definitely still "behind".

>I haven't been out in over a week, but have we actually gotten to the point where everybody now wears a mask in public?

Certainly not in the bay area. I just got back from shopping (first time I've been out in about a week and a half). I couldn't find a mask in stock online, so I cut up and old shirt and some coffee filters and sewed my own. No one looked at me funny, but I was a bit surprised to find that maybe 1/3 of the people in the store had any kind of mask on. Most people seemed to be making very little effort to keep their distance either. Lots of good the little markers for the checkout lines are going to do when people are still walking past each other barely a foot apart in the aisles.

1 week early and you end up with 1% of deaths as other countries and complaints that "too much was done", then when people rebel against the lockdown after a few weeks, deaths shoot up again.

1 week late and you end up with 100 times the deaths as other countries

The xenophobia remarks were probably more in relation to classifying it as a "Chinese problem" and the targeting of specific nationalities, instead of fully closing the borders, as if this was going keep us in our bubble of protection, when the spread had probably already occurred, and was by then coming in through all ports of entry, not just Chinese people from China.

'The xenophobia remarks were probably more in relation to classifying it as a "Chinese problem"'

At the time, it was a "Chinese problem". It's hard to "close your borders to China" without being accused of "xenophobia" in the modern era. What's your/their concrete counterproposal for the time? Leave them open? That certainly appears to have been the implicit counterproposal being made by the accusers; what else could they possibly mean? In hindsight, how has that fared?

Or perhaps close the borders with Brazil and other countries, just to avoid singling out China, even though at the time, the disease was only in China?

The accusation of xenophobia can only float in an environment where the accusers aren't actually responsible for making concrete policy proposals. Once you have to manifest the accusation in concrete proposals, then you're playing the "are you going to be ahead or behind?" game just like everybody else, and will lose in one direction or the other, just like everybody else.

(One of the privileges of being the minority party is the ability to take shots at the majority party without having to actually propose anything concrete that would allow counteranalysis. This seems to be a non-trivial component of how the parties tend to oscillate back & forth. I phrase it as the "minority party" precisely because it isn't an accusation I'm slinging at a specific party. I've seen the cycle several times now on both sides.)

> At the time, it was a "Chinese problem". It's hard to "close your borders to China" without being accused of "xenophobia" in the modern era. What's your/their concrete counterproposal for the time? Leave them open? That certainly appears to have been the implicit counterproposal being made by the accusers; what else could they possibly mean? In hindsight, how has that fared?

Most of the criticism I've seen covers two factors:

1. It only made perhaps a little dent, as it'd spread far past China already. Trump is dramatically exaggerating its effectiveness in an attempt to distract from how feckless the overall response was.

2. It was implemented in a rather silly fashion. Instead of actually banning travel from China, we permitted US citizens to come back with minimal screening to spread it here.

https://www.factcheck.org/2020/03/the-facts-on-trumps-travel...

The US did actually slow the spread significantly. Look at when the first case appeared in each country. The time until the virus started spreading in US was weeks after other countries first cases.

South Korea and the US had their first case on the same day.

Compare their numbers now.

The US is actually one of the least flattened curves. Orange line: https://upload.wikimedia.org/wikipedia/commons/3/33/Epidemic...

Look at the inflection point, South Korea's inflection was much sooner. Obviously population differences exist as well.

How can you make that statement given the piss poor testing going on? The numbers are not trustworthy.

Where are the drivethru testing centers, where anyone who wants a test can get one? Those were promised weeks ago.

Tests are still being heavily rationed.

Our first case was in January. The US acted too slowly and worse, they acted incompetently. The borders were not actually closed so we knowingly brought back infected people without testing and without quarantining them. That's not closing the borders, that's just incredibly negligent. Criminally negligent. You'd think the government would at least have some common sense and test/quarantine/track people coming back from China. Nope. And as of two to three weeks ago, it's still doing no checks of people returning here from Europe.

A lot of the inaction was actually on behalf of the markets. Fear of upsetting Wall Street played a bigger part in not closing off access to China than meanies complaining about xenophobia. Also probably presidential denial of it being an actual issue.

I dunno, California and Washington seem to be doing a better job than most, and they were the first hit in the US. First community transmission case was in CA, first death was in WA. And yet, it's places like NY, NJ, LA, and MI on the other side of the country who are having an issue with hospitals being overrun. The Bay Area took the lead on shelter in place orders and they don't have the situation NYC has. What if they took it as seriously as CA and WA?. US and South Korea reported their first cases on the same day with very different outcomes. What if the US responded like South Korea instead of the way it did?

"Some people are ahead and some people are behind" doesn't exactly contradict what I said.

You seem to be suggesting that the right response is unknowable ahead of time. But the people who listened to epidemiologists early had better outcomes, so it seems like we did know what to do -- we just didn't want to or were in denial. I just don't see how given that any slack is warranted in the aftermath of this.

There's a wide range of measures that lead to effectively no infection. You have no way of knowing that the "correct" measures were taken, only that measures at least as expensive as necessary were taken. They could well be far more expensive than necessary.

That's the future-history perspective, too, where we assume that we can already count them as having successfully contained the disease; in the here-and-now perspective, there's plenty of time for it to develop that they in fact didn't do enough either and will explode in disease in the next two weeks or something. Or months. Or, in the worst scenario, years. (See Spanish Flu history, as you've probably seen cited; what we know of as the "Spanish Flu" was not the original outbreak, but a later one.)

Fact check: Almost all health experts and political leaders agreed with (or did not publicly oppose) implementing travel restrictions[1], and the xenophobic remarks were being taken out of context, and are likely aimed at Trump's attempt to re-name COVID-19 as the "China Virus"[2]

[1]https://www.factcheck.org/2020/03/the-facts-on-trumps-travel... [2]https://www.statesman.com/news/20200330/fact-check-did-biden...

source on the government being criticized as xenophobic for moving too fast? I follow politics pretty closely and did not see any such criticism. Was it from a major figure or publication?

I checked into it myself - perhaps OP was referring to this Trump claim, which is supported only by a single tweet? https://www.google.com/amp/s/www.statesman.com/news/20200330...

At the same time, it's my understanding that New York is having such a large problem because many Italians flew in from Italy to that region. But I don't recall anyone calling that out at the time.

I heard New York is having such a large problem is because they waited and shut down their state two weeks after New York and California shut down their states. If you remember correctly, Seattle started with the largest number of cases, but since they did a great job at containing it, the COVID-19 case growth has been linear but not exponential allowing many other big cities to surpass it.

Well given the polarized climate/full of mistrust, top down "strong measures" will run into all kinds of issues.

Local leadership, preparation, measurement and imagination at the state and county level is what is going to decide how things play out.

National leadership in all countries has been a gigantic kabuki performance for the media and political fan clubs.

It's common in times of crisis to dwell on "what could we have done to prevent this?" or "what could we do better"?

There are many positive actions also taking place. Not to mention brave front-liners who are helping managing this to the best of their abilities.

No one could have predicted the magnitude of this.

The best time to plant a tree was 30 years ago. The next best time is now.

> No one could have predicted the magnitude of this.

Public health experts all over the world have predicted the magnitude of this sort of thing for decades, and this particular virus for months.

We have plenty of historical examples of pandemics to reference.

Hell, Bill Gates himself gave a TED talk in 2015 about exactly this: https://www.geekwire.com/2020/bill-gates-warned-us-covid-19-...

> “If anything kills over 10 million people in the next few decades, it’s likely to be a highly infectious virus rather than a war,” Gates said during the Ted Talk. “Not missiles, but microbes.”

> Public health experts all over the world have predicted the magnitude of this sort of thing for decades

That reminds me of all of the finance experts that have been predicting a major asset bubble pop for the last 7 years.

It is not true that “no one could have predicted this” since myself and other have been discussing exactly this since mid January.

Lots of people predicted this and the tools we needed to prevent it were in place just a few years ago: not to mention we had over a month of warning by just observing the situation in China. We should definitely dwell on why we were so unprepared for this.

> No one could have predicted the magnitude of this.

People did predict the magnitude of this, and it was ignored, repeatedly, which is why it got out of control in the first place.

> No one could have predicted the magnitude of this.

Anyone who was paying attention to what was going on at ground-level in China in January could see this coming. It's the lack of testing at that time up through February that caused us (speaking as someone from the U.S.) to follow Italy's trajectory (or worse) rather than South Korea's.

And no one is disparaging those at the front lines who are doing their best to mitigate this very very bad situation.

https://en.wikipedia.org/wiki/Crimson_Contagion

https://int.nyt.com/data/documenthelper/6824-2019-10-key-fin...

> In the exercise scenario, forcasting gives a 90% change that the pandemic will be of very high severity, with 110 million forecasted illnesses, 7.7 million forecasted hospitalizations, and 586,000 deaths in the U.S. alone.

> During the exercise, a significant topic of concern centered around the inadequaces of existing executive branch and statutory authorities to provide HHS with the requisite mechanisms to serve successfully as the lead federal agency in response to an influenza pandemic.

They are and the only saving grace I can think of is that they just didn't want to shut down the entire economy based on China's/WHO's data alone. Our economy is a tad more important than many other countries and unfortunately that has to mean we're among the last to turn the lights off.

At least Trump and Kudlow shouldn’t have said that this is well contained and no problem. That was based on zero facts and just made up. I don’t envy political leaders in this situation having to choose between very bad options but at least don’t make stuff up. It’s ok to say that you don’t know. They also seem to be more concerned about blaming others instead of taking charge.

A Paul Graham tweet on the reason for that https://twitter.com/paulg/status/1244995102818304000

As the saying goes, you can depend on Americans to do the right thing when they have exhausted every other possibility. (Not by Churchill [1].) Plus, it's not a given that it is the right thing to do, especially if there's no plan for what comes after; and there reportedly are early signs of social unrest on this side of the pond [2]. A shutdown can't last until there's a vaccine. At best it buys you time.

[1]: https://quoteinvestigator.com/2012/11/11/exhaust-alternative...

[2]: https://www.theguardian.com/world/2020/apr/01/singing-stops-...

> At best it buys you time.

That's the very point. It takes some (or a lot of) burden off the health infra. Lockdown is being done in many countries so that not everybody will need hospitalisation at the same time.

Sure, but for how long will it remain sustainable? The lockdown hasn't lasted a month in Italy and they're already seeing early signs of food theft that could potentially degenerate into food riots. I'm struggling to imagine how any country will make it sustainable for more than a month or two. Yet on paper, a prerequisite for stopping the lockdown seems to be that you've been testing on a fairly large scale, which only Korea seems to have pulled off.

The situation in France, for instance, is unenviable at the moment and absolutely not sustainable: albeit to a lesser degree as in the US, there's not enough PPE for essential staff, not enough masks for everyone else, and most crucially not enough tests to go about. Yet there's a full lockdown with fines and all, and insofar as I'm aware there isn't enough financial help for employers or employees or the self-employed or anyone else. It's only a matter of time before everyone realizes that they're going into this like it's 1914, expecting it'll all be over by the autumn.

It won't.

It won't, because of asymptomatic cases and because the virus is spreading in developing countries. Rich countries won't want to shell out the trillions that might be needed so the latter can cope with the situation. (And that will translate into yet another migration crisis to boot. Etc. Etc.)

For better or worse, the current lockdown measures in a growing number of countries are only postponing the inevitable mass outbreak by a few weeks. That is, unless countries get their act together and find a huge pot of money to tap into -- and in periods with a collapsing economy, the only sane pot of money to tap into is wealth. I'm not holding my breath.

Till the time widespread testing is ensured (and hospitals have some breather). Then test and isolate the clusters and keep relatively relaxed other "relatively unaffected" areas and not impose full blown lockdown.

There is an unfortunate balance that needs to be struck between economic collapse and death.

...and it would seem logical that the most efficient balance is county-dependent, dependent upon how many are locally infected.

A nationwide hammer seems like it would do lots of economic damage in places that have very few cases.

I live in a country going through the second week of Shutdown. This is simply stupid and irresponsible. Unlike China which had a limited regional shutdown and where the government controlled lots of everyday life; most of the other countries are running with the private sector.

A 3-4 months shutdown is going to bankrupt pretty much everyone. Those who were running thin but also those who were saving a bit. Unless you have a 1 year expenses upfront and probably own your house in your name, you are going bankrupt and will be relying on the government for help.

Next we are going to see massive disruption for pretty much everything and every consumer good. This is a good opportunity for government intervention and for government (or Big Co) to own pretty much everything.

The virus might kill 100k in the US (or millions) let's just assume that cost and prepare for a future outbreak.

Virus is going to kill 1m in the US no matter what, even if every single person had a dedicated ICU [1]. People who can't emotionally accept that shouldn't partake in the discussion, because that's table-stakes.

[1]. https://spiral.imperial.ac.uk/bitstream/10044/1/77482/5/Impe...

> Neil M Ferguson

You do realize this guy, the first guy listed in the paper, originally said the UK would loose 400,000 and the US 2 million no matter what. Now he's saying 20k for the US, but he's still trying to tell us his original estimate wasn't wrong, it was just assuming people did nothing, which is not what his original estimate said at all!

None of his estimates have matched the numbers so far, not even in Italy. Ferguson and his other researchers are spreading bad and dangerous information.

> Now he's saying 20k for the US

Whatever numbers can be believed, the US is already over 4000 deaths at 900+/day.

What the hell are you talking about? The US is still at ~400 deaths per day and we're just under 4000 total currently.

This shows a jump of 800 deaths yesterday (as of 4:00 PM EST): https://covidtracking.com/us-daily/

The other poster is probably basing their numbers off this tally, which is more up to date and shows 912 deaths yesterday:

https://www.worldometers.info/coronavirus/country/us/

I didn't realize that. Thanks.

Author's character aside, the math still seems right to me.

But I'm receptive to any published journal articles that explain how 350m people with a 1%~ fatality rate leads to less than 1m deaths.

I'm not sure why you're calling the author's character into question here...

> which is not what his original estimate said at all!

That 'original estimate' is from the paper that 'alexandercrohde linked, and that's pretty much exactly what his original estimate said.

> In the (unlikely) absence of any control measures or spontaneous changes in individual behaviour, we would expect a peak in mortality (daily deaths) to occur after approximately 3 months(Figure 1A). In such scenarios, given an estimated R0 of 2.4, we predict 81% ofthe GB and US populations would be infected over the course of the epidemic. Epidemic timings are approximate given the limitations of surveillance data in both countries: The epidemic is predicted to be broader in the US than in GB and to peak slightly later. This is due to the larger geographic scale of the US, resulting in more distinct localised epidemics across states (Figure 1B)than seen across GB. The higher peak in mortality in GB is due to the smaller size of the country and its older population compared with the US. In total, in an unmitigated epidemic, we would predict approximately 510,000 deaths in GB and 2.2 million in the US, not accounting for the potential negative effects of health systems being overwhelmed on mortality.

"In the (unlikely) absence of any control measures or spontaneous changes in individual behaviour" means "assuming people do nothing."

Can you please provide a link to more info about the 20k number?

EDIT: thanks to 'alexandercrohde, the 20k number is in fact for the UK, not the US, meaning that it is from this same paper too (see rest of thread)

He said that for the UK apparently, here https://reason.com/2020/03/27/no-british-epidemiologist-neil...

Lol, thanks. So the 'new,' 'revised,' number is literally from that same paper too (see table 4). Little things like which country the estimate is for...

'djsumdog, it's pretty clear who is spreading misinformation here, and it isn't Ferguson. I don't know where you get your information, but Ferguson has not shown any inconsistency. The report gave numbers for the unmitigated scenario and the scenario with mitigations. I don't see how he could be accused of walking back his original prediction when they were all presented at once in a single table.

You are the one spreading bad and dangerous information. The original paper had the estimates of 2million deaths in the US and clearly stated it was without mitigation. The paper then goes through multiple supression and mitigation strategies with different outcomes.

This is such an outrageous thing to say. Do yourself a favour and go read the paper:

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

Researchers go and model data, making every caveat imaginable along the way, and then predict outcomes based on possible actions taken, and your response is to label them as spreading "bad" and "dangerous" information. You're literally condemning them for doing the science at all. You're inadvertently screaming at models...

What number of deaths would it take to convince you to agree to a 3-4 month shutdown?

What qualifications do you have to assume this virus might kill 100k and not 10 million? Are you ok with 10 million?

Assuming you have friends who have elderly parents, are you ok with visiting them to tell them they are likely to die but it's for a good cause - 'the economy'.

Well, one way to do the math is say, a 6 month shutdown is losing half-a-year for * 300m people. So it costs 150million years of dating, going to the park, the beach, etc.

So if the average lifespan is 75 years, a 6 month shutdown could be viewed as costing 2million lifespans of being outside.

Now this is rough, because being dead versus quarantined isn't the same. On the other hand, the people dying are predominantly at end-of-life, so the figure might really want to multiply by 10 to get a better estimate (because most of the dying people will have had < 10 years left anyways).

And that's entirely aside from the economic consequences.

A far better plan would have been to quarantine the at risk population. Hard as that sounds, the current system is probably going to be much worse. Somewhere between a quarter and a half of working class adults aren't working right now, and that is going to make the depression look like childs play, because when those people stop paying their morgage, car payment, its going to ripple up the economy. You might be protected in IT at big CO this month but in 12 months when there is a 50% decline in revenue due to the lagging effects your going to get laid off too, which is going to just keep getting worse.

> What number of deaths would it take to convince you to agree to a 3-4 month shutdown?

None. You are either ready for a massive shutdown or you are not. I actually was convinced of the shutdown until just a couple days ago. Things start to break. Your car insurance might expire. Your heater might go down but there is no one to repair it. Cabin fever (even though I'm an introvert and probably handling it better than most people out there). Some people are stuck in one place and need to move to another place.

As time goes by, I can see more and more people changing to the opinion that this was a bad idea. They are not ready and the shutdown risk completely devastating their life or worse.

> What qualifications do you have to assume this virus might kill 100k and not 10 million? Are you ok with 10 million?

We know it's deadly but not that deadly. The numbers from Korea, Italy and the Diamond princess are not good but they are not world-ending either. They are painful but that's it.

> Assuming you have friends who have elderly parents, are you ok with visiting them to tell them they are likely to die but it's for a good cause - 'the economy'.

I have elderly parents. The guideline is that they stay at home. They have a garden, a couple dogs and enough food. But at some point I expect that they'll probably be okay with the risk and seeing me rather than spending 2 year confined with no human contact.

> Cabin fever (even though I'm an introvert and probably handling it better than most people out there).

This part has been interesting - I live alone, and have worked from home for a while, but it's still starting to get to me. I can't imagine people that live by themselves and are used to going to the office every day / are more extroverted.

They are going bonkers. I live in a small compound with gardens. I have a strict policy for not interacting with neighbors or not getting into their affairs (for lengthy reasons). A couple days ago I was about to call the police for what's possibly a bad fight/domestic violence for the neighbors next door. The neighbor above me had decided she wants to become a singer and now (as I am typing) is loudly signing. The one above that (second floor) is dropping kitchen object every other day and comes to collect/apologize for that.

This is fine.

Same for me, doing okay, but kinda getting to me. On the other hand, my partner is an extrovert and has cried multiple times saying "Imagine how you would feel if you were forced to go to a crowded party every day after work. I feel stressed and overwhelmed".

My wife and I argue [playfully, but still] about who gets to make a grocery run.

I'm the introverted one, so under normal circumstances I take any chance I get to stay at home. But I do get a certain kind of energy just from being around people in public, which is why I like grocery shopping.

> Your car insurance might expire.

Do it online, or over the phone. (I just did!) New York is waiving things like annual car inspections and registration renewals, as well.

> Your heater might go down but there is no one to repair it.

Most of the shutdown implementations permit emergency repairs and grocery/medicine shopping.

> Do it online, or over the phone. (I just did!) New York is waiving things like annual car inspections and registration renewals, as well.

I live in a third-world. That's not an option. Insurance is waived for 2 weeks. But they just extended the confinement for 2 weeks more. How much are they going to keep waiving?

> Most of the shutdown implementations permit emergency repairs and grocery/medicine shopping.

These get disrupted because of the regulations/bureaucracies. Repairers now have to get a permit to go outside and drive. A simple grocery trip now takes 1.5-2 hours and lots of items are no longer available. This will get worse as the chain is pretty much disrupted at multiple levels.

> How much are they going to keep waiving?

This seems like a silly question. If they're already waiving, it's likely they'll continue to do so as long as the travel restrictions are in place. The first waiver seems like a pretty clear "we're not idiots" signal.

Not that you need car insurance if you're stuck at home...

> This will get worse as the chain is pretty much disrupted at multiple levels.

It's likely it'll get better as the initial supply shock eases and supply chains recover. It's not like we're all suddenly eating twice as much food - we just bought more than usual all at once.

insurance law nitpick: there are countries where not having an insurance active will cost you dearly just for that fact alone even if the car happily sits in a walled-off garage.

There's no number? So even if 90% of people were going to die you would be against a shutdown? Wat

If the virus killed 90%, we might actually do something about it. Like having everyone in a hazmat suit and do massive testing. Everybody will be going on about their life better than. Remember that some viruses (like Smallpox) kill at 30% and the world didn't have a shutdown but actually many wars through.

But because this is an opportunity for power grab by the government they'll much better prefer to have everyone confined rather than implement sanitary procedure and do massive testing.

Smallpox became endemic (https://en.wikipedia.org/wiki/Endemic_(epidemiology)) long before fast international travel. If a disease like it emerged today (high R0 factor, high mortality) we would absolutely need a shutdown.

> Like having everyone in a hazmat suit and do massive testing.

That'd require a shutdown in order to produce enough PPE and tests. Just like we're currently experiencing.

> If a disease like it emerged today (high R0 factor, high mortality) we would absolutely need a shutdown.

This is what worries me. This disease isn't as bad as it could be, but will reset expectations. Go in too hard and next time, with a similar disease but with a higher utilisation and it's a mess.

a smallpox analog now would break this world. covid-19 is a minor inconvenience in comparison. you've given me shivers just by making me think about it.

We know it's deadly but not that deadly. The numbers from Korea, Italy and the Diamond princess are not good but they are not world-ending either. They are painful but that's it.

I am unclear on what you mean by "not that deadly". So let's discuss exactly how deadly we are talking about.

However https://www.thelancet.com/journals/laninf/article/PIIS1473-3... is a research paper published 2 days ago. Their median estimate for the infection fatality rate is 0.66%. Which, applied to the US population, suggests on the order of 2 million deaths. (More if everyone gets it, probably a bit less since only most of us would be likely to get it.)

If half the world population gets it, make that about 20 million. Or about a third of the total deaths in WW 2.

These kinds of evidence based numbers are rather worse than I would describe as, "...painful but that's it." But maybe your standards are different than mine.

> Their median estimate for the infection fatality rate is 0.66%. Which, applied to the US population, suggests on the order of 2 million deaths

3 million a year die in the U.S. each year anyway. How many of those 3 million will die of covid this year rather than cancer, or heart failure? Does that really matter?

Yes, it really matters.

How much does it matter? How much are you willing to spend to kill someone from cancer in July than kill someone from pneumonia in May?

The idea that every one of the millions dead from COVID-19 would've died anyways in the same year is... unsupported, to say the least.

The idea that many of them would have died anyways within a year or three is rather better supported, though. As is the idea that we need to run a cost-benefit analysis here.

See https://news.ycombinator.com/item?id=22751269 for a cost benefit analysis.

Long story short, it is worth it.

As with iso1631 there, I disagree. The lockdown will only save significant numbers of lives if it lasts until we have a way to reduce population death rates (either via better treatment, prophylactics, or vaccines) OR if we can exterminate it entirely and prevent COVID-19 from becoming endemic to the US again. I think the latter is unlikely, and the former requires 6+months of lockdown.

If we do three months of lockdown and then people give up and head out as normal again, we've burned a few trillion dollars, and a hundred million years of US citizen lives, for nothing. The deaths still come, just shifted back three months. That's the worst case, and it's what we might be heading for.

It should be entirely possible to ramp up masks and ventilators in a couple months. China is already making immense amounts.

Universal mask wearing would go a long way, especially with a much lower baseline of active infections.

There are far too many unknown, and indeed unknowable variables, for a cost-benefit analysis, even if it were politically acceptable.

There are broadly three options the US has

1) Total lockdown

2) Sporadic geographic lockdowns of various intenstiy

3) Do nothing

Factors we don't know include how behavior would change even without top down pressures (i.e. doing nothing will still damage economic output), and how long lockdowns can last before protests, riots, and full on civil war, how effective a lockdown would be, what pressure there will be on healthcare providers in each scenario (including say healthcare workers refusing to treat patients)

While our higher brains knows that as a society we are unwilling to spend $1 billion to extend someone's life by 2 days, when it comes to this sort of magnitude there are other considerations than financial benefits, indeed the entire situation brings questions of what is the value of money anyway. When we say we're willing to spend $150k to extend a life by a year, what does that actually mean?

Over $20.000.

I got that figure from http://content.time.com/time/health/article/0,8599,1808049,0... which suggests that a year of life should be worth about $130,000. So that is a bit over $10k per month.

Furthermore your hypothetical is slanted to minimizing the problem. Sure, these people are often old and sick. The median age of those killed is around 80. But they were Generally not on death’s door. From https://www.ssa.gov/oact/STATS/table4c6.html your average 80 year old has over 3 years to live. So we should be willing to spend at least $400k. Per life at the median. We are starting to talk about real money now.

But even so it is still low. Because the arithmetic average of this grizzly calculation is pulled up a lot by the younger people who die.

OK, I see you retort, so you’re coming to an order of a magnitude of a trillion dollars for the USA. But aren’t we doing more trillions in stimulus? Does that make sense?

The answer is yes. When we “spend” trillions in stimulus, we get most of it back. (In 2008 we actually made a profit.)

So even if you want to argue straight dollars and cents like an actuary does, we still come out ahead. Preserving human lives, even old people who do not have long to live, is valuable.

Lets say average life expectency of victims if they didn't have COVID is say 15 years.

Lets say 2 million would die without a lockdown.

That's 30 million years of life without a lockdown.

In the U.S. a year of life is under $150k, so that's an upper "value" of lockdown of $4.5T

U.S. GDP is 21T, so a 25% drop in GDP caused by a lockdown would not be value for money.

That is a good comparison point, and one I hadn't thought of.

Currently Goldman Sachs is estimating that next quarter will see production drop by 24%. If production drops for a single quarter by that much then rebounds, this is still worthwhile on that estimate. If it drops for a whole year by that much, you are right that the implicit value we are giving these lives is more than we are willing to pay to save lives in other circumstances.

This is an objective way to look about it. One important element missing is how much we'd have to pay in economic loss if we ended the lockdown today....

Just think about it. Will life simply return to normal with everybody going to beaches, stores, parks etc if they know the risks giving the new awareness of the disease? What I'm saying is that there is a high chance of a recession from the fear alone (not saying "irrational fear", simply "fear") as people will stay home and take fewer risks as they normally would, with the associated economic damage. Many will simply refuse to go back to an office.

So when calculating the savings from ending the lockdown, you have to take in consideration our losses from people's voluntary self-quarantine until the pandemic is effectively over if ending the lockdown prematurely.

There's also the subjective view - we aren't robots, people aren't objective automatons, many of us play the lottery for example, despite on average ending up behind, because we value the idea that we could get rich more than the value of the money we'd save not playing it.

There's then the relative weighting -- who suffers from that 25% fall in GDP? We may be willing to accept a 0.1% chance that someone in our close family will die in a car this year for $50k of personal gain, but we won't accept a 50% chance for "the economy" gaining $100m, of which $99m will go to "the 1%".

A crashing GDP affects "the 1%" more in financial terms than the majority. On the other hand with no cash to pay

There's then the value of a life. To me, my life and my family's life is far more important than yours. That's human nature. In the trolley problem where the choice is between killing their child and diverting it to kill 2 anonymous KKK members, almost everyone will divert it. Will a typical 25 year old with no family, a minimum wage job, and no health insurance, be willing to lose their home and live on the streets for the next 10 years in the unlikely save an 80 year old billionaire who doesn't care about them?

Good points. There are too many variables, and unknown changes to said variables for us to predict an optimal long term policy for handling this.

Thinking of it as objectively as I can, I can't see a scenario where the country keeps functioning well with the massive, rapid number of deaths associated with Covid-19. I know people die by the thousands in car accidents and other things. But at least in the short term, the widespread panic from a novel disease in ~2x/day geometric growth with 0.5-1.0% death rate (at best) would far exceed in severity anything we've ever seen.

Imagine Italy with no lockdown, would that be conducive to a healthy, or just mildly impacted economy? I don't see it. We had time to act, we didn't, now every option is bad, and now we're feeling the pain of the "less bad" option.

> The numbers from Korea, Italy and the Diamond princess are not good but they are not world-ending either.

You lumped Korea and Italy together which is strange. Then apparently (seeing your comment chain) you tried to transpose it onto US and rest of the world.

Korea was ready (experience with previous outbreaks). They started early. They tested like there's no tomorrow and are still doing that. Test - isolate, test - isolate, test - isolate. Everybody wearing masks - negative, positive, or untested. Everybody [1]

And their health infra is impeccable. They are people with a great civic sense (I have lived there for months).

1. https://www.youtube.com/watch?v=gAk7aX5hksU

Perhaps we should be asking ourselves if our current system is flawed if have to choose to kill millions of people to keep the economy afloat. Certainly poor people will be greatly affected by the shutdown but to me that shows clear need for systematic change. Perhaps universal basic income isn't so wild an idea after all.

The problem with your question is that the options are shut down or lots of people dying. Realistically, it looks like we're going to have a shut down and then lots of people dying. The shut downs won't stop the virus. They will only delay it and they won't delay it long enough for a vaccine or treatment unless we get really really lucky.

This has been explained over and over again. The goal of reducing the spread of the virus is to allow our medical system to cope with the massive load.

A too-large rush of cases will overload our system and result in medical providers succumbing to the virus as well, resulting in it shutting down.

That would result in millions more suffering and possibly dying.

Even in ideal conditions we don't have much impact on the lethality of the virus. If we are in a scenario where everyone gets infected lots of people are going to die. Medical care can change that by some percent but not enough to change it from "lots of people" dying. For example, something like 2/3s of patients that go on ventilators will die. Of the 1/3 that do survive a significant chunk, if not the majority, will have significant complications. They will live for another few months to a year with a poor quality of life before dying.

That might make you think a ventilator surge might save 10-20% of people who otherwise would have died. But that's not true because we can choose who gets the ventilators. The actual difference in death rate will be small because we will stop ventilating the cases that still have a 95%+ chance of dying even with ventilating. Ultimately, the impact of the ventilator surge is going to be a bunch of 80+ year old patients with significant comorbidities getting pointless interventions. It's going to save few lives and will only marginally impact the mortality rate.

Not only will the shutdown only delay deaths, the shutdown itself will cause deaths. With 3 million people ALREADY losing their jobs after less than a few weeks of shutdowns, we could see 10 to 20 million losing their jobs if this lasts several more months. Suicides alone from the shutdown would exceed the loss expected from the virus. Then as into that the number of people kicked of healthcare from losing their jobs or that just don't have enough money to afford that expensive health treatment. Now beyond jobs effect look at what will happen to the crime rate and murder rate when poverty strikes, and as others have said if you no longer afford car or home insurance, now people on the brink lose more than everything from fires or accidents. Im not about to calculate the exact number of ancillary deaths from a shutdown, and maybe it is very difficult to quantify which is why no one is doing it but as the president said the cure can't be worse than the disease.

Suicides alone from the shutdown would exceed the loss expected from the virus.

It is unlikely but possible that suicides from the shutdown will exceed deaths from the disease. But it is absolutely not true that they will exceed projected deaths from letting the disease run its course unchecked.

Here is a parallel. We are afraid of buildings catching fire, so we build sprinkler systems into them. But the result is that in actual fires, the water damage from the sprinkler system exceeds the damage from the fire. That's because there is a fairly small fire and a big wet area from the sprinklers.

Is this an argument for not having the sprinkler system? Of course not! Because the damage from the sprinkler system is far less than what the damage from an unchecked fire would have been.

Suicides may very well exceed the loss. The current virus estimates are for 240,000 deaths/year. Suicides from 20 million layoffs could easily exceed that. The comparison to sprinklers is a false equivalency. It would be more like, if one house catches fire, should you turn on the sprinkler system for the entire city?

Do you have a source for that estimate and the assumptions it is based on.

By my estimate, the deaths in the USA alone, with no lockdowns, is around 2 million this year. Other attempts that I’ve seen to estimate it come out with similar figures.

Shutdown won't delay long enough for a vaccine, but it has already delayed long enough for improved treatment capacity and possibly improved treatments.

Every day of delay increases the chances of treatments being more available and better understood.

I agree that every life must be saved, but every month is a battle, and there will be a war.

China locked down and won a battle, but you will likely see another outbreak in a few weeks, and if they lockdown again, there will be another outbreak when they open up again. The daily cases chart will look like a dribbling ball.

Notice that US officials are focusing flattening the curve, instead of a strict quarantine to prevent all infections. It's not only because they're worried about the economy or the logistics. It's because a strict quarantine only works if everyone is doing it - I mean EVERYONE in the world. If we do a Nationwide lockdown, we will need to do another one when an asymptomatic visitor/citizen enters/returns to the US.

I see two outcomes: 1) Eventually, most everyone will either be infected or immunized for this pandemic to stop. 2) We do a global lockdown for 5 weeks.

The virus will kill 2 million in the US if nothing is done and only 100k with shutdowns.[1] But note that we may need 400 days of shutdowns over a 2 year period. [2]

Economies with good human capital recover after disaster, like the Japan and Germany did after WWII.

[1]: See Page 7 and 13 https://www.imperial.ac.uk/media/imperial-college/medicine/s...

[2]: Second paragraph of page 15

> Economies with good human capital recover after disaster, like the Japan and Germany did after WWII.

It’s worth noting that the United States invested in repairing the economies of both nations after WWII

OK, 2 million dead. Most victims are fairly old -- lets say average life expectency of victims without COVID is say 15 years.

That's 30 million years of life without a lockdown. In the U.S. a year of life is under $150k, so that's an upper "value" of lockdown of $4.5T

U.S. GDP is 21T, so a 25% drop in GDP caused by a lockdown would not be value for money.

"How can you equate money with life saved"? Ask that when nobody is uninsured.

you don't have parents or grandparents? or did you just write them off for a max of $900k loss incurred? maybe less if you count inheritance...

"OK 2 million dead". Wow, who says something like this? Unreal.

>> In the U.S. a year of life is under $150k

Um, no that's not even close. It's $10M[1] based on VSL. Try your math again.

[1] https://en.wikipedia.org/wiki/Value_of_life

How do you count the impact of economic disruption on people? Even on the lower end, you should count fractional loss of life for people forced into survival mode, the stress, etc. You also have to count knock-on effects on people who become homeless, have a bad childhood affecting their entire life, etc.

If you are so inclined, how do you count the dip in births during the bad economy? That is 80+ years of life expectancy each, whereas the GP is over-estimating the life expectancy loss from COVID, I think the average age of the dead in Italy, after overwhelming healthcare, is over 80.

Then, on the higher end, economic collapse of the Soviet Union reduced life expectancies so much that that probably destroyed more life years than hypothetical COVID epidemic ever could, all by itself; before you count the above.

The year of life estimate of $10M is also preposterous. If I gave you a choice of living to 85 with average wage lifetime earnings, or 84 with the same +$10M, which would you take?

Yes, even a two month shutdown will bankrupt many people in the developing countries, where many have moved to cities to make a living.

Are you volunteering to die a painful death?

That's a harsh over-response to this particular comment, but I've read your follow-up comments below, and you seem to be dismissing the human cost far too easily.

You're bored and frustrated as someone experiencing a lockdown, and there is definitely a case to be made for balancing out economic harm with human deaths, but you're not making that case. You don't seem to be adequately weighing the difference between 200,000 and 2,000,000 people dead at all.

Far from stupid or irresponsible, a total lockdown would likely literally save millions of lives. The impact of several million lives on the economy is a big one.

> Are you volunteering to die a painful death?

We don't shut down the road network despite the number of deaths that causes.

How many lives would a lockdown really save? And how many years of life will it save? If it kills people now that would die of Flu next winter that is different than if it kills someone in their 20s. Nobody really knows the answer. How many road deaths will be saved due to lockdown? How many extra deaths from heart failure due to people not exercising? How many fewer deaths from people not eating junk food?

How much is the economic cost of that lockdown? Again nobody really knows - without a lockdown people are still likely going to be more subdued in their economic activity from a social point of view.

One thing that is sure is that healthcare systems will collapse without a lockdown. How many lives do hospitals save each year?

The comparison to road deaths is flawed logic. We are not all forced to travel against our will - we travel because it adds massive economic benefits to our GDP.

What benefit does the Covid-19 epidemic confer that you can compare it to road travel?

We go out and don't shut down because it adds massive economic benefits to our GDP.

We accept the deaths that travel and activity cause

> What benefit does the Covid-19 epidemic confer that you can compare it to road travel?

Well, going out and working has rather large economic benefits.

Going out and working is not the only way to catch Covid-19. You are refuting a straw man here.

And driving isn't the only way to die in an auto accident. What's your point?

Look, driving kills people, and we accept it because it brings huge benefits. Going to work as normal in the current environment would ALSO bring huge benefits, and kill people. We don't know how many, but we think it's a few million in the US. This is probably not worth it, but if it were a few thousand people instead it WOULD be worth it.

That's the comparison here.

Actually you're peddling bad logic, comparing apples and oranges.

Road deaths involve humans undertaking an action (driving) for a particular benefit (transport) that involves risk (accidents).

You cannot compare driving to the 'covid-19 epidemic', because driving is an action, and the covid 19 epidemic is not. You can't compare the epidemic to driving. You must compare action to action.

A more apt comparison is that humans go out of their home (the action) to work and be productive (the benefit) while understanding they may catch disease when with other humans (the risk).

You are not forced to leave your house against your will -- that is slavery, and is illegal. Anyone can stay home. Leaving your home has the benefit of both enriching you and your neighbor, and collectively, the country. Thus it is a very apt comparison.

The fact of the matter is we don't close roads because we judge them too important to merit doing so, and we decide to accept the risk (deaths). We have decided now against leaving homes because some states judge it too dangerous to do so and is unwilling to accept the risk (deaths), but that is not constant, and will likely change quite fast. I would not be surprised if many of those who called for a lockdown, start calling for it to end quite soon. Most people are only principled up until it starts actually affecting them.

contrary to what thatcher says, there is such a thing as a society. if you catch the disease, you risk not only your death or permanent disability, but also that of your family and neighbors, and in case of asymptomatic transmission, you have no idea you are a risk.

roads are a bad analogy because you don't spread crashes if you crash yourself or get crashed into. car crashes do not follow an exponential curve and aren't contagious. you always know you've been in a crash (except if you die). somebody's always at fault if there's a crash. pretty much none of these are true in case of a plague. we close roads and quarantine people because diseases are contagious and kill people or leave them disabled more or less randomly.

You are giving an argument as to why coronavirus is more threatening to society at large than crashes. That is not relevant to the discussion at hand, which is about whether or not allowing road travel means being complicit in deaths.

Your argument is that, yes, road travel means we choose more deaths (thus implicitly validating the argument you're trying to critique), but that because the deaths don't spread exponentially, this is okay. That is a fine viewpoint, but it relies on the premise you're trying to disprove (that we are in fact okay choosing more death in order to facilitate unnecessary human interaction).

And frankly, Thatcher has nothing to do with this, so you should probably stop bringing her up.

I would understand if you were trying to do a cost benefit analysis between saving lives versus saving the economy but it sounds like you're trying to frame this to focus on semantic differences between closing roads vs closing the economy temporarily. Baq's point is that mortality rates from the covid 19 grow at exponential rate compared to car fatalities which are flat YOY. If you let covid 19 continue to spread, about everyone will be infected, of which 1% will die - young and old - because we will have overwhelmed our healthcare system. This is why the road analogy is flawed.

I was with you on comparing action to action even though I could quibble with your trifurcation of action/benefit/risk because all frameworks are instantly valid and fictitious ;)

Lets go with it. Now is going out of your home and being productive the only way to catch Covid-19? What about going for a walk, a meal, shopping, hanging out in the park, a theater, concert......I think you are setting up a strawman here.

> What about going for a walk, a meal, shopping, hanging out in the park, a theater, concert

All these things have been deemed non-essentials in large parts of the world, and the government is enforcing it. Clearly if preservation of life is goal #1, the government can certainly shut down most life to pursue that goal. In reality, the government -- and by extension the people -- make the decision to value life in quality of life terms -- in other words, money. Thus, while I don't think people who say we should open the economy up right now are correct, I don't fundamentally disagree with their premise that human life is valued monetarily by governments all the time when deciding what policies to enact. And that is okay.

Oh stop. China contained the virus with local measures. China has less land area than the United States, which is a very large country. The United States needs sustained regional lockdowns, and other measures in other areas. It does not merit a national response.

To put it in perspective, closing down the nation due to big outbreaks in particular regions is like closing down Darwin Australia due to the initial outbreak in Wuhan.

> China has less land area than the United States, which is a very large country.

Isn't China bigger than the States by land area?

America is slightly bigger. According to Google, USA is 3.797 million sq miles, and and china is 3.705 million square miles.

It's an old infamous error, where they measure water surface for the US but not China in order to appear higher in rankings.

China is larger though by all accounts.

https://www.worldometers.info/geography/largest-countries-in...

I mean, not by much though. They're about equivalent in size.

Is there any way to verify this? How do we know they are telling the truth? Also why is Russia so quiet about their population infection numbers?

These are all good questions. Unfortunately, America is the first big country infected that is friendly to America.

Just assuming the cost does little to prepare us for the next one. Think of this as a dry run for testing all the strategies for tech and social norms that will help us with the next one.

China acted relatively speedily. Even then we don't know the extent of the public health damage caused in China. Countries like SK, HK, TW, SG acted relatively quickly and for that are now able to still carry out business with relatively low community spread.

The countries that responded with inaction must now pay the price, or will pay the price.

I don't think it would be a 3-4 month shutdown anyway. I expect a gradual loosening of rules starting in a month or earlier, as new cases drop, and as we understand more about the virus, as well ad the efficacy of various lockdown measures.

Mr. Gates is already rich and insulated from a likely downturn. It's important to balance the welfare of Americans with their financial welfare, and we can't just borrow our way out of the economic fallout that a months-long shutdown would produce.

Edit: ITT people saying I want to sacrifice 2 million for the economy. I didn't say remove all preventative measures, I said we need to balance. I'd guess this looks something like a production possibilities frontier graph: we'll be sacrificing a lot of economy to get a little more health past a certain point, and vice-versa. It's the job of lawmen to strike that balance.

I think you will be surprised that you can borrow your way out of it. what do you think is going to happen, humans are going to survive coronavirus only to be killed because the economy is no longer functioning? the market is there for the benefit of humans not the other way round.

Okay, fair points. Here are some of the issues I see with that. You have two options, borrow or print, right? If you borrow, you pay it back. If you print, you don't, but your citizens absorb a serious financial blow. So let's say we don't want to ruin the savings of Americans, so we borrow. Who lends? As of Dec. 2019, 74% of our debt was held by the public [0]. Odds are on that Americans fleeing to financial security would buy the better part of new debt issued, too.

So, you've kicked the can for 10 years; now it's time to pay back. Where do we get the money now? If you cancel it, you're destroying the retirements of millions of Americans, not just hurting some abstract entity of "the Market". Remember that a large number of people feel the effects of a market downturn, even if through a retirement account or pension plan.

So, to avoid retirees eating dog food, you now have to pay back. How do you propose to do this, given we already have a truly colossal $23.6 trillion in debt?

[0]: https://www.thebalance.com/who-owns-the-u-s-national-debt-33...

look you were able to find $2.4trillion for the Iraq and Afghanistan wars and your economy didn't collapse. that is 10% of your total national debt. this is not going to cost that much (and even if it does it's money better spent than on those wars).

now you are asking how do you pay it back? well you could start by taxing some of the ~600 billionaires that live there. the top eight richest billionaires own as much combined wealth as "half the human race".

so it's not like there isn't a pot of money there, and taking some of it certainly is not going to cause those people hardship. now you look at some of the major corporations and they're very low tax compared to revenue and profit and you have another pot of money that you can access again without causing too much hardship on the company.

the money is out there it's just very unfairly distributed.

I completely agree. It's incredible to me how many people in this and similar threads argue that we should just give up on isolation and allow many more millions to die. This pandemic is the perfect argument for UBI and universal healthcare and yet many are still unwilling to even entertain such ideas. Human life is worth saving and we have the means.

People do indeed die as a result of economic collapse.

yes and if that was the reason people were dying now then I would say fix the economy, but that's not what is happening. the economy can be fixed when we have ensured that the people who make that economy happen are safe.

if you were at war with a foreign country, and they were killing and injuring your population, you would fight back, the economy should be shattered, but you fight the war and when you win you rebuild. that's what this is, a war. it's just the enemy is not quite the same as it has been in the past.

We are exactly going to borrow our way out. We always do.

So how many lives are you willing to sacrifice for the economy? 0.7% of the US? That's two million people. That's a pretty optimistic number too. Maybe the 4% world-wide case fatality rate is closer to the true fatality rate. Remember that in Italy the case fatality rate is around 10%.

Choices have to be made. You can't save all lives and then have no economy to return to. It's a horrible choice, but it's the job of government to balance that. And yes, before you or anyone else says "what about your grandmother, your mother, father, etc", I get that. I also don't want to lose my job, my home, access to food, either.

The medical field is pushing their agenda. I don't mean that in a bad way. It's the Hippocratic oath...save all lives. If they save 100% of the population, they've done their job. They're not economists though. What people forget is that it's the job of our governmental leaders to balance on one hand the health and safety of the populace while on the other hand ensuring that there is a country left for them when they are healthy.

It’s a false choice. Without a shutdown, do you think everyone will just start going back to restaurants? Will all businesses bring everyone back, filling up the elevators?

The purpose of shutdown is to drive absolute case numbers low enough for a new regime of contact tracing and testing to take over as the primary, far more granular means of fighting its spread.

You're taking it to the extreme and ignoring the whole point I made. As has been said by the president, you can't have the cure worse than the disease. I want to see people argue that point. I get the whole flattening of the curve.

Choices are already being made. We're not all confined to our homes with the military distributing rations, even though that would probably be the most effective way of stopping the disease.

But it's a pandemic, not a war. No infrastructure will be lost in the next few months. The economy should be reasonably fine, once we can safely go out again.

> and we can't just borrow our way out of the economic fallout

Why not? The dollar is getting even stronger as the world rushes to our currency out of fear that their currency will have even more problems.

The problem is that we didn't pay down our debt in the supposedly "booming economy" of the last 3 years. Cutting taxes during a boom was a supremely stupid thing to do.

There are a few reasons for this, but the obvious one is that all the factory, worker, machinery, etc time that has been forcibly idled is gone, destroyed, everything it would've produced does not exist and no clever financial tricks can fix this. There's of course a bunch of more indirect effectis involving mass unemployment, the collapse of many businesses, the failure of demand for things, etc which are also going to be devastating. The US is likely to come out of this better than many countries - it looks like the deaths from this economic destruction are going to be co ncentrated in developing countries - but that's not much reassurance.

You could also say the booming economy was fueled by tax cuts. Personally I think the majority was from deregulation however the tax cuts did play a role

I mean, he's probably also capable of living in indefinite isolation at Xanadu 2, protected with his family from the virus. I'm content to take his counsel at face value on this one.

The real issue is that the US doesn't have a safety net for either scenario— whether dying of poverty or plague, you and your indiegogo page are pretty much on your own. Perhaps other countries have found it easier to stomach national shutdowns because they understood that it would be hard, but the people would ultimately be taken care of.

He’s also old and if 2mn Americans die he could easily be one of them

I'm ok with a little financial uncertainty if it prevents people from dying.

Not sure what you mean by insulated. Bill wants to live in a country that hasn't completely gone down the drain just like you or I; he can't buy what isn't made.

A lot of people are pushing this tradeoff narrative and it's a completely false one. It's not like mass death has no economic consequences. If people are scared of a pandemic they're not going to just go back to their normal economic life, regardless of any cheerleading from government officials.

The way to get the economy back on track is to stop the virus as quickly as possible. The way to do that is to lock down hard for about six weeks, then open up but have lots of testing and contact tracing.

At least 895 people died of Covid-19 yesterday in the United States; I say 'at least' because poor test coverage guarantees the number is much higher.

895 annualized to a year is about 330,000, which puts it above all other causes of death in the US except cancer and heart disease, higher than:

   Accidents (unintentional injuries): 169,936
   Chronic lower respiratory diseases: 160,201
   Stroke (cerebrovascular diseases): 146,383
   Alzheimer’s disease: 121,404
   Diabetes: 83,564
   Influenza and Pneumonia: 55,672
   Nephritis, nephrotic syndrome and nephrosis: 50,633
   Intentional self-harm (suicide): 47,173

More alarmingly, the growth:

https://mackuba.eu/corona/#united_states.log

Can Covid-19 keep spreading and eventually kill 1/3 of a million people? Easily: one percent of the US population is 3.2 million.

I know you're not putting forward an all or nothing proposition. I also know that the economic impact of this pandemic will be enormous, more enormous than almost anyway can currently predict, whatever our 'lockdown level'.

I agree. To be honest - How long can we go on consuming for before we start to run out of food and other basic nessecities? What happens when food shortages start? 5 missed meals from a revolution, and that revolution will kill more people than the CoronaVirus ever would.

The ads on this page are ridiculous. Here’s a link to the actual op-ed: https://www.washingtonpost.com/opinions/bill-gates-heres-how...

https://www.washingtonpost.com/opinions/bill-gates-heres-how... would be the better link, no?

Paywall, no?

A paywall that's painless to circumvent.

> The Washington Post is providing this story for free so that all readers have access to this important information about the coronavirus. For more free stories, sign up for our daily Coronavirus Updates newsletter.

"Having places shut down and places not shut down is like having a peeing section in the pool."

-- Fun comment on Reddit from user deafmute88

I also saw that comment and laughed. However, I really don’t think it is a good comparison at all. It’s more just funny to think about.

How about a smoking section on an airplane or in a restaurant?

Man I miss those.

It fails to capture the exponential nature of the possible disease spread, and while disgusting, pee in the pool isn't actually dangerous, but it does get the idea across that you can't confine things where you don't have walls to confine them, which is the main point. As metaphors go, it's not terrible, since we're short on metaphors that do capture the exponential nature.

This Gates dude has a 66,000 sq/ft house. Easy for him to say that everyone should just stay at home with no access to public parks and beaches. And he has a private waterfront.

For the rest of us, there's no no scientific study that says staying 24hrs/day in our little hovels is more healthful than occasionally walking and enjoying public amenities while maintaining appropriate physical separation from others.

No one is saying you shouldn't take the occasional walk while maintaining physical separation, in fact, that's what's being encouraged here. The reality is that the physical separation part needs to be enforced across the country in order to make a dent.

The article referenced a closure of beaches. New York recently closed "parks." This is counterproductive. People need spaces in order to be socially distant. If you close all the spaces, they will not be distant.

This is not counterproductive. People have been mobbing the parks. The parks need to be closed. I live in Brooklyn and the groups I've been seeing until VERY recently are disturbing. When you close the parks, there's no where for groups of people to hang out. Need to go on a walk? Sure go on a walk and stay away from people. Not everyone needs to be on the street at the same time either. The reality is that in a densely populated city, parks or not, you can't find the distance unless you go out early morning or late at night and stay off the beaten path.

> No one is saying you shouldn't take the occasional walk while maintaining physical separation, in fact, that's what's being encouraged here.

It depends where. There are countries on lockdown where you are not allowed to go more than 100 m from your home even for exercise. If you live on a street consisting of blocks, then that means there are so many people at a time who would want to do their exercise, that you couldn't really maintain physical separation. Consequently, the authorities expect everyone to stay at home and e.g. buy an exercise bike. Also note that China’s approach in Wuhan was that no one may leave their housing block.

During walks, I believe the recommended 6-10 feet of separation is not enough. An infected person's perspiration / saliva / phlegm lie on the path, and, within 3 days, any subsequent passerby traversing that path could potentially pick up the virus along the bottom of their shoes. And, upon entering their homes, they will have brought the virus, this creating a whole new branch of infections.

Sorry, I'm not really aware about the situation of COVID-19 in the US, is it that serious so that there are shutdown opinions? What is the current status in the US?

Big clusters or unprecedented outbreaks can be controlled with mass/rapid testing and selective quarantine - is the US's situation that bad to all-stop the economy?

Mass/rapid testing is not a thing here due to gross incompetence at a federal level. Some regions are outliers and have been able to ramp up on their own.

.... and just yesterday HN had an NPR article explaining that Germany is doing so much better because they have local regions that can make autonomous decisions, unencumbered by a one-size fits all mandate.

There are lots of opinions on how to fight coronavirus. It's hard to tell which ones are right.

// Yesterday's contradictory words of wisdom https://www.npr.org/2020/03/25/820595489/why-germanys-corona...

US seems to be going through different stages of denial. First it was that only Chinese will spread the disease. Then it was dismissed as mere flu. Now they seem to have acknowledged the severity of the situation.

It is disheartening to read in this thread some comment taking the human life so lightly. Is not that the US going to support those going through unemployment with cheques and other benefits? Is it not more important for the people to be healthy so that the economy can be restarted once all this is over? It is depressing to read the comments from citizens of the wealthiest country in the world.

It's not necessarily that people are taking human life lightly, just that priorities may not be the same for everyone.

In the UK we've already had cancer patients who have died because their treatment was cancelled to free-up hospitals for COVID patients. Nine murders have been attributed to people not being able to cope with lockdown in their own homes. Why are the lives of ( primarily ) old people with comorbidities considered of higher priority than them?

Pragmatically one could argue that economically and socially it would be fairer to just let people who contract COVID die. But politics intervenes and forbids that.

> Pragmatically one could argue that economically and socially it would be fairer to just let people who contract COVID die. But politics intervenes and forbids that.

Really? And what if two thirds of the world contracted it and ~3% of those died. I ask you to provide your own proof, models or what not, that letting this virus run rampant won't have equally or even more disastrous affects economically and socially.

This is ignorant. The country is the size of a continent. Each subregion should be managed based on current and developing conditions, density of population, weather conditions, etc. Some states have zero deaths, presently and only a few dozen cases. Even China didn't shut down the whole country. Masks and fever checks along with testing should be enough to slow the spread without triggering Great Depression 2.

China didn't shut down the entire country does not give us any information on spread of the disease in China. if you are buying the Chinese figures for infections and deaths then I have a bridge to sell you.

I'm so sick and tired of this conspiracy theory going all around reddit. Do we have any reason to disbelieve China's numbers are orders of magnitudes wrong? China's numbers are wrong in the same way Italy and USA's numbers are wrong, because data collection is flawed. It is also very plausible to claim China has incentive to hide new infections in their country. Even US has incentive to have this to minimize the panic. But claiming a country with 1.3 billion people, who recently accepted WHO to audit their pandemic management has a massive epidemic when they're reporting almost no new patients is "US didn't go to the moon" level conspiracy theory. Please put your tin foil hat away.

Studies have suggested that something like 80% of Covid-19 infections in China were not reported. In addition, recently there was credible reporting concerning the numbers of cremation urns released post-lockdown. I don't think it's reasonable to talk "tin foil hat". I do think it's reasonable to continue to seek factual answers to important questions.

yes we do have reason to disbelieve [0]

[0] https://www.businessinsider.com/wuhan-residents-say-chinese-...

> Do we have any reason to disbelieve China's numbers are orders of magnitudes wrong?

Crematoriums in Wuhan seem to be doing more than the usual number of cremations:

https://www.vice.com/en_in/article/88435z/wuhans-crematorium...

Crematoriums tend to operate at capacity, just 5-10% increases in death rate would easily overwhelm them.

Seems unlikely. An extra 5-10% would be an extra hour of operation a day.

No, it's not. Other sources of data show a massive drop in population in China correlating to the disease. There is a massive amount of evidence that China grossly under-reported case counts and deaths. I know people love to shill for China, but remember they jailed the doctor who first identified the new disease (who is now dead) and ejected all American reporters from the country after they started reporting about the massive amount of deaths being recorded as "unknown pneumonia" and not attributed to COVID-19 in Wuhan.

so how about this

https://www.bloomberg.com/news/articles/2020-04-01/china-con...

I don't wear a tin foil hat and I'm not a conspiracy theorist.

I don't disagree with you, but do you believe the figures for infections and deaths in the US? Or any country, for that matter? If so, why or why not?

no other country has reason to under report. this came from China, they downplayed the severity from the start and disappeared doctors who were reporting it. no one else is doing that. the figures may be counted differently between nations due to those with underlying conditions, but I don't distrust them like I do Chinese figures.

> Masks and fever checks along with testing should be enough to slow the spread without triggering Great Depression 2.

So right now we're at 0/3? We CAN shut the country down today, but we can't get enough masks, fever checking, and testing for everyone, and I don't know when we will be able to.

It's extraordinarily ignorant, which is unfortunate in the case of it being Bill Gates.

Instead, Texas and low-infection states should be helping to keep states like New York afloat through this, economically by helping the nation and in terms of manufacturing capabilities. Texas has 41 deaths and isn't seeing a surge due to its different climate.

Now you’re being ignorant. Texas rates are so low because we are not testing. I live in Austin and we are only performing 20-30 tests a day. Of course the available data doesn’t reflect the real numbers.

I would honestly ignore the case rates for the reason you stated. What if you had 500,000 tests tomorrow and discovered 30,000 people who didn't even know they had it? What does that really tell you?

Fatality rates are what people should focus on. Is Texas's fatality rates doubling every three days, or is it staying steady, or going down?

Europe is already having trouble with fruit production. Fruit is rotting because seasonal pickers can't work. If we loose food sources, a lot more people are going to die than from COVID-19.

The Texas curve is ramping up like every other state.

https://www.politico.com/interactives/2020/coronavirus-testi...

There are no low infection states- just states that are a week or two behind the states that got hit first.

It's crazy: All we've been hearing from politicians for months is how the virus's spread is affected by political borders. "It only spreads in China!" "It only spreads in China, Iran and Italy!" "It only spreads in China and Europe!" "It's only a problem in Washington State!" "I mean Washington and California!" "Oh, New Yorkers need to worry about it too, but nobody else!"

Turns out viruses don't care about lines on a map. Who knew?

Am I missing something? The NYT lists each state having at least 100 cases.

https://www.nytimes.com/interactive/2020/us/coronavirus-us-c...

Cases are a really bad measure. We don't do randomly sampling in each state and we don't have any antibody tests (to see people who might be exposed, but have no longer have viral load). I found the best measures to be fatalities and the exponential scale graph by Aatish Bhatia (which uses case data, but with a lot of caveats).

https://covid19data.ml/

Fatalities may not be a great measurement, either.

https://www.buzzfeednews.com/article/nidhiprakash/coronaviru...

> And two of the hardest-hit areas in the nation — New York City and Los Angeles County — released guidance earlier this week encouraging doctors not to test patients unless they think the test will significantly change their course of treatment. That means that potentially more people in both places could be admitted to hospitals with severe respiratory symptoms and recover — or die — and not be registered as a coronavirus case.

Maybe you're right, however in Italy when they announced the shutting down of regions in the north, people fled to the south and immigrants started flying home, which helped spread the virus in all of Italy and throughout Europe.

It is now generally believed that a better strategy would have been for all of Italy to be shut down at once [1]

Also Bill Gates might be wrong on this one, but I wouldn't call his opinions in this field ignorant. Given his track record and the work that his foundation is doing, I'm pretty sure he has expert counseling and his advice on the matter is anything but.

[1] https://hbr.org/2020/03/lessons-from-italys-response-to-coro...

Shutting down Italy wouldn't have prevented migrants, tourists and people on business trips from going back home.

Shutting down whole US would be more similar to shutting down whole EU because of Italy.

Even today "shut down" in EU differs a lot from country to country.

That EU's measures differ from country to country is regrettable.

It means that countries like Germany, which are doing extensive testing (500,000 tests per week), have hospitals in good shape and overall a good administration, will get out of this crisis before other countries and will keep their borders closed for longer than necessary, this delaying everyone's economic recovery.

These days solidarity, cooperation and coordination are of the utmost importance.

Note that I am an EU citizen and I hope we'll all be alright.

germany is doing extensive testing?

last i heard we couldn't get a test without either paying for it yourself or proving that you've had direct contact with a confirmed corona patient... did they change that?

I don't live in Germany, but they started doing 160,000 per week and now they've ramped up to 500,000 tests per week.

That's extensive testing. Not sure about your situation, but from official numbers at least, they are doing more tests than everyone else in Europe.

i just checked, it really looks like they changed it...you can now get tested if a doctor deems it necessary, which he is allowed to if you're showing corvid-19 relevant symptoms.

good to know, and thanks for pointing it out!

As a citizen of EU member, I don't agree at all. It's good that each member can fine-tune details to their specific situation.

Italy/Spain/France are fucked and they do need super strict measures.

Meanwhile in my country we have relatively few cases. Most of them are imported and good chunk of local cases are medicine personnel. Right now we're far from full lock-down as seen in most unfortunate places. Many businesses that don't have customers on premises are operating more or less as usual. Sports outside are still allowed.

Right now amount of daily cases is not growing. Significant part of them are people coming home from more affected countries. Medical system is far from overrun. Given that the country is relatively sparse and social norms are rather distant, we're looking forward to having fewer and fewer new cases.

If all goes well, some restrictions will be lightened up in mid-April. E.g. outdoors cafes may be allowed to open up given that distance between visitors will be enforced. Next, non-essential shops may be allowed to open up for visitors with masks etc. It will probably take a long time to allow mass events though. But that's relatively small part of economy.

Why should we stay in lockdown if all is good locally, but Italy, Spain or Sweden still have ongoing crisis? We'll obviously keep our borders closed till our neighbours clean up their acts.

Solidarity is having life going on as much as safely possible and making stuff for affected allies. Not staying in lockdown side-by-side.

Because everyone else is only 20 days or so behind Italy.

As WHO experts say from their experience with Ebola and others, it's better to act early.

I see a lot of disbelief on this site too, it appears that exponential growth can fool even us.

Only 2 weeks ago I noticed people here saying that Trump must be doing something right in the US because the country hasn't gone to hell. I replied with "give it another week or two". And now the situation in New York is dire and everyone else is following, with the US poised to be the next epicenter.

What country are you from btw? Are you sure the population is properly tested? Given the lack of tests or expertise on the market I kind of doubt it.

This virus is dangerous because 75% or more of the infected population is close to asymptomatic, yet highly contagious. You might be having a lot more cases among you than you realize.

> Because everyone else is only 20 days or so behind Italy.

No. Over here we have flat growth. Amount of new cases is not growing at all. In fact last 5 days day-to-day amount was lower than record day. Meanwhile amount of tests done is growing.

> As WHO experts say from their experience with Ebola and others, it's better to act early.

Yes. And we did act early. Our situation 3 weeks ago weren't as bad as Italy or Spain, thus we didn't as harsh measures. It looks like it worked.

> I see a lot of disbelief on this site too, it appears that exponential growth can fool even us.

It's not exponential everywhere.

> What country are you from btw?

Lithuania

Best statistics we got bellow. Top-right is cases (overall vs daily), bottom-right is testing (overall vs daily).

https://vu-lt.maps.arcgis.com/apps/opsdashboard/index.html#/...

> Are you sure the population is properly tested? Given the lack of tests or expertise on the market I kind of doubt it.

What is "properly tested"? Testing everybody? No. Testing suspects? Yes. We're also testing everybody coming from abroad (EU or not) for over a week. Before that, it was self-isolation + testing on symptoms since late february. Big chunk of new cases comes from that.

> This virus is dangerous because 75% or more of the infected population is close to asymptomatic, yet highly contagious. You might be having a lot more cases among you than you realize.

We definitely have much more asymptomatic cases. But amount of new symptomatic cases is not growing. Either it's only spreading asymptomatic (which is unlikely), or spreading is slowing down.

We're now in our 3rd week of quarantine (social distancing + restaurants and non-essential shops closed). Had it not worked, we should already see a spike of symptomatic cases.

I hope you'll be OK, however I'm not holding my breath.

I'm from Romania and we were at 500 cases and a doubling time of roughly 6 days only a week ago or so. Our cases were also imported, via emigrants returning home. Confirmed cases have exploded since then due to a couple of community hotspots and we're well on track to join the west.

So good luck to you, I hope we'll all come out of this well.

No worries, I do take this 100% seriously. I cut down my contacts to minimum, not visiting any places were people get together (groceries bought online etc), basics like washing hands etc. Unfortunately it's hard to get a mask yet, so I've to resort to scarf when coming into contact with people. And most people seem to take it seriously too.

So far we had few nasty spreads in hospitals (mostly doctors coming from skiing trips) and parties. But all cases so far seem to be +/- contained. Fingers crossed we don't get a superspreader sometime soon. Emigrants' comeback routes are virtually closed. Pretty much only traffic from outside is truckers. Easter weekend and the week after it will be make-it-or-break-it. I could see life slowly opening up if masks are widely available by that time.

Stay safe. It's not end of the world. Stay calm, wear mask, wash hands and we'll be fine.

China shut down travel inside the country, which is something no one wants to do in the US.

There's literally one state with 0 deaths, and it's the same state that had to inform our president that there aren't enough tests available for them to contain the virus. To which he responded with confusion because he was convinced that there are more than enough tests and have been for weeks (that response should tell you how much trouble we're in). It is not a matter of if, but when they will see their first death.

https://usafacts.org/visualizations/coronavirus-covid-19-spr...

I'm not sure what your source of information is on this virus, but you've got an extremely naive outlook if you think anything other than a total shutdown is going to contain it at this point. And quite frankly contain isn't even the right term because we can't contain it anymore, all we can do is try to limit the death count.

Deaths on the scale of 0-10 per state are not noteworthy. Flattening the curve is about keeping the case count within hospital capacity.

We are well beyond "contain it"; it has been everywhere in US for weeks now. But low density regions with sufficient hospital capacity don't need to use the same tactics as high density urban settings where hospital beds are at a premium.

> low density regions with sufficient hospital capacity

These regions were already struggling with hospital capacity before the virus hit.

https://www.nbcnews.com/news/us-news/rural-hospital-closings...

> More than 100 rural hospitals have closed in the United States since 2010 and another 430 are at risk of closing, which a new study says could have life-or-death implications for rural communities.

> University of Washington researchers examined 92 rural hospital closings in California from 1995 to 2011. They found that while the closings of urban hospitals had no impact on their surrounding communities, rural closings caused their populations — which have limited access to health care and other services — to see mortality rates rise 5.9 percent.

There is a limited amount of time we can be on a lockdown. For example, in Massachusetts where all non essential business are shut down, pretty much all routine medical care has stopped. The major safety net hospital in Boston is laying off 10% of the workforce because they are not seeing routine patients). So the time in lockdown needs to be spent wisely, otherwise we will create more health problems than we solve. 8-9 million people a year die from cardiovascular disease in the US. If that rises by just 5%, we will have made things a lot worse

Agreed. Another example: I have a dental abscess I can't get treated because all dentists have shut down at least into May. In my case it can probably wait, but some people's dental issues will lead to acute complications here and now, and also bad dental health can lead to heart problems in the long term, thus again worrying in terms of cardiovascular disease.

I'm not sure why shutdown prevents routine patients though? At least, in my country anyone needing to go see a doctor is exempt from the lockdown.

Doctors and dentists routinely catch colds and flus from their patients. In most countries they are not working behind a perspex face shield (and as you know, there is now a shortage of such safety equipment). Consequently, they could easily catch coronavirus during this lockdown and spread it, or even perish from it.

This is ignorant.

What makes you think that you are better informed on infectious diseases than the guy whose charity has been engaged with the issue for about 20 years now?

It is buried in https://www.usatoday.com/story/news/nation/2020/03/27/scient... but among the other useful tidbits is this. In California today, about 50% of new COVID-19 cases are from out of state travel. 30% are from people known to be at high risk (medical workers and family members of people who have it). And 20% from community spread. Which means that California's biggest problem now is that other states aren't taking sufficient action to reduce the spread of COVID-19.

Another common misconception is that stringent measures aren't needed in lower density areas. Take one look at Dougherty County, GA — whose outbreak was also spurred from an out-of-town traveler to a funeral:

https://www.nytimes.com/2020/03/30/us/coronavirus-funeral-al...

> With a population of only 90,000, Dougherty County [Georgia] has registered 24 deaths, far more than any other county in the state, with six more possible coronavirus deaths under investigation... The region’s hospitals are overloaded with sick and dying patients, having registered nearly 600 positive cases. Last week, Gov. Brian Kemp dispatched the National Guard to help stage additional intensive care beds and relieve exhausted doctors and nurses.

Which makes me wonder - do states have the authority to shut down travel from other states? Airports are mostly a federal thing, aren't they?

IANAL, but my reading of the situation is that state governors can declare martial law. Once they do so, they have pretty broad powers that extend beyond what would usually be considered constitutional. Until that happens, I think the right to freedom of movement makes it impossible to effectively shut down interstate travel.

His comments are ignorant and frankly careless. Gates will have zero problems with a nationwide shutdown: he's the second-richest man in the world. He doesn't seem to realize that tens of millions of people will lose their jobs, businesses will collapse, crime will rise, and all sort of other unpredictable bad things will happen if the country shuts down. This isn't fixable with a paltry $1200 check that comes in a month.

Conveniently, none of this will affect Gates.

"Conveniently" this virus will not affect Gates either, he can just shut himself in and ignore the world in one of his mansions for a few years.

We need to put UBI in place immediately and shut down the economy as we know it, so that our parents, grandparents, and friends don't die at horrifying rates. I know you really need to get your Whopper, but there are more important things than "the economy."

Just where do you think the trillions needed for Universal Basic Income will cone from if there is no functioning economy with tax-payers?

This kind of response just further proves that our "economy" only serves to enrich wealthy VCs. We can provide enough food, and housing, and other necessities that people in the country need. Where will the money come from? Where did the money for this $2T bailout come from? It can come from the same place -- just instead of funneling it to rich corporations, we should give it the American people so they can eat.

You want to argue that Bill Gates has never made a bad judgment call in his life? Are you kidding me? I know the guy called a future pandemic. I watched his TED talk. Doesn't change the fact that he's wrong on this call. I am saying with caveats: 1) leave the country open 2) require masks in public 3) temp checks for fevers 4) expand and continue drive thru testing

It's not hard to grasp that rural areas are going to have a slower rate of transmission as a matter of course because social distancing is built into those communities. For one, there's less public transportation. Two, all major gatherings have already been cancelled. Three, people are already voluntarily limiting social contact.

This disease is going to fester for another year or so. It's not practical any more to try to contain the outbreak. The idea at this point is to limit the number of cases at any given time to prevent overburdening the local community's medical resources. My mother is a nurse. They've cancelled all elective surgery in preparation for a tsunami of patients in central Florida. As a result their hospital has less than 50% utilization right now. It's slower than it normally is for their hospital! All these other health problems are getting the back burner for COVID-19. How long can you carry that on for? The disease may peak in NYC in 2 weeks but peak in Montana in 2 months. New Mexico may peak in October. You've got to have a rolling adaptable policy for each region. You cannot do blanket policies.

You want to argue that Bill Gates has never made a bad judgment call in his life? Are you kidding me? I know the guy called a future pandemic. I watched his TED talk.

Where did that come from? My comment is that he is not ignorant. You just agreed that he is not ignorant. In which case you shouldn't be calling his comments ignorant.

Full stop.

Doesn't change the fact that he's wrong on this call. I am saying with caveats: 1) leave the country open 2) require masks in public 3) test for fevers 4) expand and continue drive thru testing

You are convinced that he is wrong and you are right. And expect me to agree simply because you assert it.

However, as is widely reported, we do not have sufficient masks, and we do not have sufficient testing. Perhaps you shouldn't be telling everyone what should be done when you are unaware of these basic and widely reported facts.

What you are saying makes sense, but I am not convinced.

In rural communities, people are spread out but have ways to get around. They often work in close proximity to each other, and whether you work in a field or paper mill, you're more likely to be working in an essential service that stays open.

Furthermore there is often a false sense of security. Major gatherings may have been officially cancelled, but the rural people that I have known are more likely to ignore such rules than city folk.

(Note, I've lived in rural areas before. I have lots of family in rural areas.)

Thinking of this disease as something that "peaks" on its own is highly misleading. It will not peak on its own without killing millions. The peaks that people are trying to project are the result of effort to reduce transmission. Nor should a peak make you too comfortable. You can ease up some, but too much and the epidemic returns.

If you put out less effort, it is longer to the peak and a more severe peak. If different areas have different policies, then you reintroduce epidemics to areas that thought they were past it. Therefore the kind of rolling policy that you are recommending is a recipe for multiple waves sweeping back and forth between regions. And for worse peaks.

Bill Gates knows this very well. It is central to his thinking. But that seems to be one of the key points about epidemics that you have not yet grasped.

Bill Gates is laser focused on the disease and pandemics, but the complex trade-offs between containing this disease and treating other health problems and the economic ramifications and the domino effects are beyond any one person's total comprehension. That's why we debate and discuss things in an open forum and we don't make Bill Gates overlord of humanity.

Again, no one is making Bill Gates overlord. But he has actual data and experience backing up his side of the debate. What exactly do you have? Where are these sources that offer insight into the economic ramifications of keeping an economy open during war or during a global pandemic?

The fact that debate is necessary does not make all debate useful.

The prerequisite for debate to become useful is that all participants involved have to try to provide information and reasoning, and then try to incorporate new information and counter-arguments into their thinking.

Bill Gates does this. I try to do it. I look forward to your taking advantage of the opportunities in front of you to do it as well.

Where did he argue that Bill Gates has never made a bad judgment call? You still have zero evidence for your take on this, no matter how practical it may seem. You are going on your intuition and common sense on how to solve this crisis for an entire country?

Your mothers' hospital should be running tests with that other 50% of unused utility right now. Conduct trials on patients found to be positive, etc. That's literally the second point Gates made.

> It's not practical any more to try to contain the outbreak. The idea at this point is to limit the number of cases at any given time to prevent overburdening the local community's medical resources.

Lockdown is the most effective way of limiting the number of cases.

The only thing your intuition and experts agree on is the knock that the world economy is going to take. I challenge you to provide models that show that your "practical" handling of this situation won't have the same disastrous effects on the economy when instead of 3% of a smaller number of the population die, 10% of a much larger portion of the population die. These numbers are in line with countries that implemented lockdown early or have very strong government influence versus countries that implemented lockdown too late.

Ok, let's say we lockdown for 2-3 months. What do you think will happen again after we open back up?

A lot will have to happen _during_ lockdown, you can't just sit idly by. Basically it will buy time.

Of course the virus will still spread once lockdown is lifted, but for countries like the US (not even to mention Italy and Spain) who started behind the curve any time you can buy to bolster your response should be taken.

To that end, I agree with you there.

3blue1brown's latest video on YouTube demonstrates that we can also buy time by using a combination of mitigation techniques short of a full lockdown. It's a video of a computer simulation created by a mathematician fwiw, but it shows some of our options, and that brute force may not be required.

Sometimes I want to advocate for a full global lockdown, but I think about the random emergency appendectomy, and other weird edge cases that would be complicated by a lockdown of any magnitude.

Masks and fever checks only do so much. First off, you need to have masks for people to be able to wear masks. That is something we don't have right now in the US. Secondly, fever checks only go so far. There are tons of people that are asymptomatic for two weeks before having a fever. Going off of China's numbers is ignorant in itself. Why don't you take a look at https://www.nytimes.com/series/people-who-have-died-of-the-c... so you get a better sense of people in just New York city dying from this?

50% of corona virus carriers are asymptomatic, so fever checks are going to have a huge false negative rate.

Home-made masks or even wrapping a scarf around mouth/nose helps a ton.

> Some states have zero deaths,

Do all the states use the same methods to count covid-19 deaths? What is that method?

In the UK we have two different numbers.

The Public Health England number is anyone who dies in an NHS hospital who has been tested (and had a positive result) for covid-19.

The Office for National Statistics number is anyone who dies where covid-19 is mentioned on the death certificate.

> fever checks along with testing

People are infectious before fever develops, and they stay infectious after their fever ends. Some people have covid-19 but don't get fever -- they might get one of the other symptoms like anosmia or upset stomach.

You're missing data. The data you're missing (which you should now research) is how China blockaded cities and regions, with guarded checkpoints. Since we Americans love Freedom so much, many many more of us will die.

"We can start now by building the facilities where these vaccines will be made," Gates wrote. "Because many of the top candidates are made using unique equipment, we’ll have to build facilities for each of them, knowing that some won’t get used."

"Private companies can’t take that kind of risk, but the federal government can. It’s a great sign that the administration made deals this week with at least two companies to prepare for vaccine manufacturing. I hope more deals will follow," he added.

Arguably, this is precisely the kind of risk that venture capital and startups take every day. Yes, government needs to co-ordinate funding for this and execute where it can. Anything that helps them is great.

However, if someone wants to put $10 million (total of large seed rounds or a small A) into building these facilities as well, open it up, as there is a huge amount of cash sitting on the sidelines right now, and if a small team can get these built, it's worth examining the potential.

Nations need to have a soul but companies need not. Health is wealth and sometimes, life is more valuable than dollars.

Easy for Bill Gates, he won't be standing in the food lines in 12 months when the result of this shutdown starts to really hit home.

We are going to look back on this as a huge mistake. Its one thing if 50% of the population dies and your trying to save them. Its another thing when its somewhere around 2%, which is roughly the yearly death toll, which means about 2x the number of people who were going to die this year are going to die.

Wouldn't it be the original death toll + 2%? Ie, double the death total for the year? That sounds like a BFD to me.

Not to mention the rest of the deaths that will happen due to the medical system being overloaded after free-transmission period took place.

Unless they’re going to scale up grocery delivery or contactless pickups, I’m not sure it’s going to matter.

I had to pick up a prescription yesterday and everyone was mad rushing and hanging out at the store because nothing else is open. Never seen the parking lot that full and this was in the middle of the day, well into a lockdown.

shut down or lockdown generally means you can't leave unless you have a good reason such as getting food or medicine it doesn't mean nobody can leave the house ever without the express permission of the government

I understand full well what it means, but if you have no limits on how these stores operate and everyone congregating at them, you’re undercutting a lot of your response. See also how businesses are skirting the limits and lobbying behind the scenes about essential vs non-essential work.

I've been surprised by the number of businesses that are classified as "essential". I have a friend that works for a place that is essential, so she still went to the office a few times a week despite being fully able to work remotely.

at first anything like this has to be done with the cooperation of everybody involved, there are not enough police to enforce something like this. in general most people will operate sensibly, but of course you might get some companies that are still going to try and make that money and will risk their employees and customers for it. some people are selfish assholes

The bill to implement it would have to be called the "START" Bill.

Ideally if we closed off the borders early to non-citizens + temporary residents, we’d be in an entirely different situation.

The administration did things half-assed. At the first notice of the virus, Trump was in denial. The first case was on Jan 20th. After 40 days they were still downplaying it saying it will go to zero.

The borders and airports were where it would spread. Ideally every incoming passenger would have been tested. Every single one.

The other way would be to lock down hotspots. Like China locked out Wuhan from rest of country. However in US many things are just hard to achieve since we are a democracy.

US most likely will have more deaths than other countries, mostly because we have third highest population. China and India seem somewhat competent. I guess time will tell.

Is Bill willing to pay for it? I really don't want to see anything from the mega billionaires right now other than zeros on the checks they are giving to charity, government, and people.

https://en.wikipedia.org/wiki/Bill_%26_Melinda_Gates_Foundat...

> As of 2018, Bill and Melinda Gates had donated around $36 billion to the foundation.

Yes, he is.

"As of 2018..donated around $36 billion to the foundation.."

You mean Bill's foundation? How about as of April 1st, 2020 how much as Bill and Melinda given in billions separate from their foundation? Is there something more...current you can find?

You've moved the goalposts so far we're playing a different sport. I know March 2020 seemed like a decade, but 2018 is a pretty recent number, and $36B is a pretty big number even if it's two years old.

No, someone pulled up something from 2018. You may not have noticed but things are considerably different between 2018 and right now. We’re in a totally different world. Did you find something a little more current?

Forgive me for second commenting, but I missed one salient point: the genesis of this discussion is that Bill Gates would like the entire economy to shut down. My argument is that gates should instead be looking to inject significantly more cash separate from his foundation, directly into our economy, before he starts demanding the economy shut down.

Did you find anything more current, yet?

It's been 9 days. Did you find something more current?

Why should they give something seperate?

Their charity is among the most effective. Should Bill be willing to let people die whom their foundation could have saved just to please those who think it's self-serving?

B&M Gates recognized most charities aren't particularly effective, and that there were few places they could convert their cash to QALY's. They created a foundation which effectively does that and now pour their money into it.

I don't exactly understand what they should have done instead. Settle for a worse charity that would save fewer lives?

I did a quick Google search to try to find what the Gates foundation is doing, but I’m with OP. We are in uncharted waters here, it would be helpful to have a full understanding of what they are doing right now.

Rich-bashing is so unproductive. You do realize he runs a huge charitable foundation and has pledged half his money to it, right? Why are you mad at “the billionaires”? Why can’t they have a voice and a platform? Because they’re rich and out of touch? What evidence do you have of that?

I’m not mad at the billionaires, I’m disappointed. If I could direct your attention away from the hyperbole and to what I actually said: Bill and Melinda may give tons of money to their foundation, and he may have pledge to give away all of his money to his foundation, but I would like to see where he is giving money personally to other places. I don’t hate Bill Gates really any billionaire, but I’m deeply suspicious when everything is basically circular going into their foundation and their causes.

Interesting fact

27% of the Senate are over 70, 66% over 60. This disease almost exclusively affects people over 60.

It affects people with particular underlying medical conditions more than those who are older. It's just that those who are older tend to have more underlying medical conditions, but any young person with particular underlying medical conditions is at greater risk than a 99 year old with no underlying medical conditions. I saw yesterday a healthy 99 year old survived it.

Bill Gates for president!

downvoters: relax! it's April's fools day

More like you need to turn it off and on again.

I'm not impressed by Gate's OpEd. Nothing about making the social changes necessary to keep functioning the way places like Korea have been able to. No mention of Facemasks. All he says is that we should shut everything down for months, test more, and make a vaccine. If you look at his suggestions from a month ago[1] they seemed to be mainly to help poor countries and fast track vaccines. Just a month ago he was completely blind to how much of a problem this would be for wealthy countries, and how weak their response to it was.

[1] https://www.gatesnotes.com/Health/How-to-respond-to-COVID-19

a shutdown will help with initial prevention of transmission, once that has been achieved you can end the shutdown but you will still need people to wear masks to prevent a secondary flare up. in places such as Korea, wearing a mask is common anyway so changing that behaviour is not necessary. you try getting America to adopt facemasks overnight and it will likely fail, it will take weeks before you see any fall in infections relying solely on the adoption of face masks.

Evidence suggest that masks will slow the spread right now, and every day we wait on this is another day we're not doing everything we can to stop the spread.

I don't disagree I'm saying that getting people to wear masks is going to be hard. a shutdown removes the reason for leaving the house. if there was no shutdown people would still go out, some in masks and many without, this would mean transmission would continue and so would pressure on health care services. you would flatten the curve but A) at a higher point and B) extend the length of the plateau, instead of seeing the descent

Sure, but the argument isn't that we should just tell people to wear masks and return everything else to normal. The argument is that we should be pushing for a more robust response, including mask wearing, that would lower the spread now and hopefully allow us to reopen things earlier than otherwise (not impossible if you look at countries that have successfully handled it). The lockdown buys us time, but we don't seem to be using that time effectively.

again preaching to the choir. I agree.

That's funny, I just read the article you linked from a month. It mostly says that it'll take a ton of investment and immediate action because COVID-19 will become a pandemic. That all seems correct in hindsight.

And why do you think Bill Gates should be talking about facemasks?

> It mostly says that it'll take a ton of investment and immediate action because COVID-19 will become a pandemic. That all seems correct in hindsight.

None of what Gates' recommended in his article from a month ago would have made an impact on things now. He didn't criticize the way governments in the West were handling the outbreaks in their countries, or suggest that we start locking things down. More investment in vaccines is great, but that's something that wont have an impact anytime soon. Gates' newest piece says that the U.S. missed the opportunity to get ahead of the virus, but he didn't suggest a different course when things were actually unfolding.

As for masks, there's a lot of evidence that they might be vital to the effort to slow the spread of this[1], and our inability to act on this is yet another example of our poor response.

[1] https://docs.google.com/document/d/1HLrm0pqBN_5bdyysOeoOBX4p...

> "Private companies can’t take that kind of risk, but the federal government can. It’s a great sign that the administration made deals this week with at least two companies to prepare for vaccine manufacturing. I hope more deals will follow," he added.

I assume this is Gates trying to bait Trump and his handlers into making this all a 'Greatest deal in the world!' ego massage for the one person both legally capable yet emotionally incapable of acting.

Bill Gates should stick to writing software that works, instead of preaching destruction of the economy /s

I'm tired of the "shutdown everything" acting like the underpants gnomes. Gates argues for a 10 week or more shutdown and then says we are ~18 months from a vaccine. If we are 18 months from the definitive solution shutting down for 10 weeks doesn't solve much.

Sure, it might knock the infection load back down to what it was in late January. But then 2-3 months later we will be right back where we are now. What's the plan then? Another 10+ week shut down?

Covid-19 is with us for the foreseeable future and we have to figure out how to live a normal life with it. The effort should be focused on getting us to that place. Ubiquitous masks, temperature checks at public places like work, stores, etc. and a culture shift to stay home when you're sick.

> I'm tired of the "shutdown everything" acting like the underpants gnomes. Gates argues for a 10 week or more shutdown and then says we are ~18 months from a vaccine. If we are 18 months from the definitive solution shutting down for 10 weeks doesn't solve much.

We're a few weeks away from mass-testing in the USA.

By shutting down for a few weeks, we will at least give time for test-kit manufacturers to mass produce test kits and get our health-policy experts ahead of the curve on this.

For now, the US has the steepest exponential rise in the world and some of the fewest test-kits per capita. It seems like our citizens are not taking the lockdown seriously, and the disease continues to spread far faster than it really should be.

----------

This isn't about "winning against the disease" anymore. Its about stalling for time so that our nurses have enough N95 masks to be safe while treating people again.

We're out of supplies. The nationwide stockpile of masks is depleted. Hospitals are running out of equipment. Stalling for a few weeks will help significantly.

>We're a few weeks away from mass-testing in the USA.

Mass-testing isn't a panacea and is only one piece of the puzzle. We can be implementing the other pieces while our testing capability continues to ramp up.

>This isn't about "winning against the disease" anymore. Its about stalling for time so that our nurses have enough N95 masks to be safe while treating people again.

Barring some manufacturing miracle we won't have enough disposable N95 masks for a long time. There are plenty of reusable N95 or better masks stockpiled around the country to provide one to every health care worker. We just haven't made a national decision to do that.

>We're out of supplies. The nationwide stockpile of masks is depleted. Hospitals are running out of equipment. Stalling for a few weeks will help significantly.

It's wishful thinking that a few weeks are going to change anything. We will have pretty much the same tools that we do now to fight the disease. The change that is needed is to make use of what we have.

> It's wishful thinking that a few weeks are going to change anything

When we have mass testing in a few weeks, things will be better. This isn't about "panacea", its about buying time so that our statistics can become more effective.

We all know that our testing regime is buckling under the current load. No one trusts the numbers, aside from being a clear and gross underestimation of the overall COVID19 problem.

At a minimum, in a few weeks when mass testing is available, we'll have better COVID19 numbers to make decisions off of.

---------

We're clearly in a situation where there is more infected people than test kits! Doctors / hospitals are rationing the very few test kits they got and only testing people who they think already are infected AND are at high risk. Under these circumstances, our statistics and decision making framework is almost entirely guesswork.

Yes, a few weeks will buy us important time. Important time where we can actually gather proper data (through proper testing).

The most immediate goal for policy makers is to slow down the disease to the point where our statistics / data-gathering can catch up to reality. That way we stop relying upon guesswork.

Your last paragraph is correct. I think that's what Gates is advocating for as well. But it's hard to implement when hospitals are overwhelmed. He's proposing one serious shutdown to calm things down before we gradually go back to normal life.

Hospitals in the country aren't overwhelmed. The majority of them are seeing lower than normal patient counts as they've canceled elective procedures and people are avoiding the hospital because of Covid. Only a handful of hotspots like NYC, NO, and Seattle are being significantly impacted.

>He's proposing one serious shutdown to calm things down before we gradually go back to normal life.

The point is we can't go back to "normal life". Going back to normal life gets us back to where we are now 2-3 months after the lock down ends. We have to get to a new normal that will stop the spread.

That's what I meant about gradually moving to normal life. As for hospitals, many are not overwhelmed yet! Based on projections we're not yet at peak hospital resource use at any state. I live in MA where hospitals are still OK. But projections say we will be at peak in 2 weeks and unless the state does something about it (which they do) we will have a serious shortage of beds and equipment. So a serious shutdown for let's say another ~3 weeks should help us passing the peak without major problems.

Eventually everyone either (1) gets it and has none or mild symptoms, or (2) gets it and requires hospitalization if available and then either recovers or dies, until (3) there is a working vaccine available in quantity for those not yet infected. Dealing with (2) is the biggest issue and that requires masks, gloves and ventilators and universally available free testing. (3) will happen eventually but not right now. Social distancing helps with (2) until we have enough capacity to help them, which is the major problem. But you still have to have food to eat and a place to stay and that requires some measure of assistance, logistics and production and distribution still functioning. Once you can deal with (2) if everyone was careful (which isn't happening) you could function until (3) with some limitations.

> temperature checks at public places like work,

People infected with covid-19 may not ever get a temperature. We've focussed heavily on that because it seems obvious, but it's possible that plenty of people spreading covid-19 have anosmia but no other symptoms.

Some people will get temperature, but they can spread covid-19 before their temperature starts and after it's finished.

We don't need one method to stop all transmissions. Some will be stopped with a temperature check, some by masks, some by symptomatic people staying home, some by washing hands, etc. The goal is for all of those "somes" to add up to infected people, on average, transmitting it to fewer than 1 other person. That will lead to it eventually dying out.

> Gates argues for a 10 week or more shutdown and then says we are ~18 months from a vaccine. If we are 18 months from the definitive solution shutting down for 10 weeks doesn't solve much.

It actually does. Theresa a trade-off between shutdown costs and other costs, and the other costs get worse the longer a continuous shutdown is, so the recommendation of pretty much every source I've seen, that treats this as “we need to get to effective vaccine/treatment before full return to normalcy” favors a 2-3 month general shutdown to flatten the curve followed by an extended period where local decisions about the degree of shutdown needed are made based on local capacity and caseload trends, which likely means on-again, off-again shutdown to a certain extent. The strategy is about preventing healthcare system overload while mitigating the adverse effects of extended total shutdown, until you've got vaccine or treatment deployed.

I doubt Mr Gates has been to most of the country or is really capable of understanding he people who live there

Very true. This idea is an extreme measure and there are costs that are outside the virus, costs that could cost more lives:

https://battlepenguin.com/philosophy/covid-19-is-two-disease...

Right. And a lot of the middle of the country 'flyover states', are incredibly rural and already enact social distancing. They are currently not as affected. People think the United States is one homogenous entity, and that if New York City is endangered, the entire country is. Nothing can be further from the truth.

New York City is 1400 miles from Oklahoma City. To put that in perspective, if a simultaneous lockdown of the entire United States is warranted based on an outbreak in New York City, then a lockdown of Mo i Rana Norway is warranted due to the spread in Lombardy. Or, being 3800 miles away, locking down Nome, AK because of New York, is like locking down Darwin Australia in December due to the outbreak in Wuhan.

In other words, the distances make these suggestions absolutely ridiculous.

In reality, the virus takes time to spread over land, and the US has a lot of empty land. Lockdowns will need to happen in the interior to flatten the curve, but only after the virus starts to manifest there. The goal with lockdown is to not overwhelm the healthcare system while simultaneously insuring enough people get it to ensure herd immunity.

Interior states should encourage people to prepare and suggest those especially at risk to limit interactions. For the most part they are. As they become more affected, they should institute a lockdown at the latest possible moment they can to avoid an overwhelmed healthcare system. In the meantime, they should take advantage of their working economy to prepare.

The rest of the country benefits from the continued industry of the middle states while they are in lockdown. When it comes time for us to open back up, and them to start lockdown, we should return the favor, by maintaining some semblance of our economy

He has a point. People in shutdown states/cities try to "escape" to other places that don't have a shutdown yet. States with very few cases might feel safe but it's shown already that acting early is best.

Is Bill Gates an elected official? Is he a medical doctor?

Sorry, I understand that he means well, but we need more democratic engagement and less opinions from billionaire industrialists.

He played a big part in polio eradication efforts. I’d say he has some credibility to speak on this

Did he do more in that effort than play the role of the big wallet?

When you spend that kind of money on an effort, you don't just write a check and forget about it. He's been known to be very hands on in his global healthcare efforts.

It's not like he's been to medical school, or has he? So far all I've seen, including your comment, boils down to "Trust him, he's rich."

It's not "he's rich". It's that he has been actively engaged with all the research programs that he's funded. Global health philanthropy has been his primary job for over a decade. When you're working with experts in the field for that long, you do learn a thing or two.

Seriously, you're picking the wrong argument here.

Now, if Gates had started talking about rainforest conservation efforts in South America (random topic), he'd have little authority. But on this specific topic, he does.

Loads of people have been engaged with the programs Bill Gates has funded, including a great many doctors. Bill Gates doesn't have some unique level of experience dealing with organizations addressing these matters, and a great many people dealing with these organizations seem to have more expertise in the matter than Bill Gates.

> Global health philanthropy has been his primary job for over a decade

Key word there being philanthropy, e.g. he's rich. Instead of listening to the guy with the wallet, we'd be better off listening to the people who actually put Bill Gates' money to use with their actual expertise in matters other than being rich.

He is the second-richest person in the world and has virtually nothing to lose from a nationwide shutdown or the unpredictable cascading effects that will come from it. The other 327 million people have a lot to lose.

His part was paying experts who know how to deal with infectious diseases to eradicate polio. Don't get me wrong, he's an awesome person, and we should all be thankful to him for helping. But I agree with GP that we need more democratic engagement and less opinions from billionaires.

It just so happens that we think Bill Gates is a good person and listening to him due to his billions ends up being good. This is clearly not always the case, so taking someone's opinion just because they're immensely rich is a slippery slope.

EDIT: As a disclaimer, I agree with him on this, we need a national shut down.

He's presumably still paying experts who know how to deal with infectious diseases, and listening to them.

This is an almost offensive statement to anyone familiar with the life and philosophies of Jonas Salk, who came up with the polio vaccine. He actively worked to avoid enriching himself, and avoid becoming a billionaire industrialist, by refusing to patent the cure.

He has the credibility of keeping himself informed and of acting on that information using his own money.

I agreed with you at first but that argument could also be used to justify malicious behavior- e.g. I'm a fossil fuel executive who knows that fossil fuels are dying so I'm going to delay that as much as possible by using my money to lobby for pro-oil candidates.

Regardless, I think the OP of this thread is not giving Bill as much credit as he deserves- running and funding an international global health effort is not a simple task and I wouldn't be shocked if he was better at handling public health issues than writing code now.

he's spent years fighting with polio. i'd say he's way more qualified to say that than you're qualified to say he isn't.

Because the officials have done such a great job so far?

Bill Gates has literally been warning us about this for years.

Which makes his views very bias. Italy's numbers finally seem to be turning down. South Korea, Japan and Germany haven't seen the same growth. ICUs in America are filling up, but so far I haven't heard reports of them being over capacity.

The thing is, people are going to die no matter what. There is no vaccine. You could catch this thing tomorrow or in August, but if you're one of the unlucky ones with the overactive immune response, you could get immediate care, be looked after in an ICU and still die.

I understand they don't want everyone to catch this at once, but if most places are able to keep up now, is shutting down the country preemptively really a good idea?

He totally saw this coming from a mile away and actively tried to warn the world about it. Years ago.

https://www.youtube.com/watch?v=6Af6b_wyiwI

He runs the largest private foundation in the world. A part of their work is combating infectious diseases. Disregarding his informed opinion because of his wealth is petty.

1) Bill Gates doesn't have any governmental power - he's stating his opinion and hoping it will be heeded. 2) Bill Gates probably knows better than most medical doctors: https://en.wikipedia.org/wiki/Bill_%26_Melinda_Gates_Foundat...

If you're asking if he has domain expertise in fighting rapidly spreading diseases, then yes, he has domain expertise in fighting rapidly spreading diseases.

Last Friday a very senior elected US official in charge of agencies like the CDC, FDA & HHS said COVID was just the “flu”? A month or two ago this same official described it as a “hoax.”

Other more junior officials spent weeks saying masks were ineffective. Suddenly those same officials are now calling for certain workers to be protected with masks, and are mulling recommending all Americans wear masks.

At this point why should we trust expert or official opinion over any other crank?

He has access to top medical experts. I saw a talk from him once where he described access to experts to explain things to him as one of the biggest perks of his position.

I'm also a bit skeptical that Americans elected officials making decisions is much related to "democratic engagement"...

Gates gave a prescient TED talk in 2015 [1] in which he describes the risk of a global pandemic and the general lack of preparedness. The Gates foundation has also been working for years to help eradicate diseases like polio and malaria [2][3]. Given his expertise in this area, it would seem worthwhile to listen to what he has to say rather than dismissing him as just a "billionaire industrialist."

[1]: https://www.youtube.com/watch?v=6Af6b_wyiwI

[2]: https://fortune.com/2018/04/18/bill-gates-foundation-malaria...

[3]: https://www.businessinsider.com/bill-gates-letter-eradicate-...

Given that Bill Gates has spent years now working on polio eradication, who do you think might understand this better?

The President, Republican politicians, anchors on Fox News, or Bill Gates?

Who is getting the most public mindshare right now?

Nobody should be comfortable with the honest answers, and when this is all done, perhaps it's time for America to "talk that over" at the ballot box and by turning off cable news.

No, but he's a chairman of a well-endowed foundation (BMGF) that probably had more experience managing responses to contagious virus epidemics than most elected officials.

https://www.reuters.com/article/us-health-zika-gates/bill-ga...

he's using his status to evangelize. of course bill Gates is smart enough to know that he doesn't know everything. I would not be surprised at all if he's simply parroting one of those experts.

let me put it another way. if he had the experts come out and say things instead of himself, i doubt it would be on the front page here.

this is why people have celebrities endorse their causes

As many conspiracy theorists have lamented, he's an unelected world leader. Which is true - his philanthropic investments drive a lot of progress in the world of energy and public health.

He is a gifted human in his ability to consume knowledge from books and people. If you listen to his interviews with professionals (in the medical and energy fields) it sounds like he himself is a professional in the field himself because he has a deep base of knowledge in fields that he pursues.

In many scenarios, the hive mind of democracy is not the best solution. He's right, and not the only person saying that a complete shutdown will stop COVID-19 dead. Its just that the economic and civil effects of a total shutdown are untenable for republics and otherwise representative governments to mandate.

I disagree here. I don’t think a total shut down of the economy is necessary, and I would like to see the nations billionaires stepping up with more cold hard cash. I appreciate what Bill and Melinda have done through their foundation, but I’m a little suspicious. I guess I just like to see more from him then shut down the economy and everybody stay home in our mansions… I mean homes.

A $19 trillion dollar economy is largely shut down to protect - mostly but not entirely - those 65 and older. That's fine, but let's be direct about it. We're sacrificing our doctors, nurses, jobs, national security and much more for our aged and elderly. I'm not saying this is wrong. I'm not saying we should do differently. I really just want to see is clearly stated in this thread.

How many times will this have to be repeated: not doing anything will cause more people to die because of overcrowded hospitals, health workers would be even more stressed and people under 65 would die of unrelated health issues due to lack of beds and available health worker. People will be sick, sick people can't work (dead people too), the economy would tank either way.

This isn't on on/off switch: "let the old die and keep 100% of the economy" VS "try to save the old and destroy the economy"

>the economy would tank either way.

If we look at the Spanish flu, the economy recovered pretty well after that, although the war also ended which may have had something to do with it. Look at it this way: even if 20% of people are really sick and can't work, that's still 80% of people working, which is way more than the near 0% of people working if there's a complete lockdown. And even in the worse case of 2% of the population dying (and all being working age; in practice we'd expect most to be retirees), that would on average reduce GDP by 2%, which is way less than it's predicted to fall if there's a 2+ month long complete shutdown.

What about if people panic and stop shopping / going to bars, restaurants etc? Well clearly there's still a non-insignificant proportion of people interested in patronising those businesses even with the virus around, otherwise lockdown measures wouldn't be necessary because everyone would be staying at home anyway.

20% are sick and can't work. Then a good chunk of other 80% are not needed because a good chunk of customers are gone. Then quite a bit of people are scared of getting virus, ain't in the mood because of their relatives dying and/or economic situation and don't consume. Demand goes even lower. More people loose their jobs and demand goes even lower. And the spiral continues.

Bars and restaurants are great for spreading the virus. Once people learn it the hard way, remaining people won't go there that much.

In my country patronising of bars and restaurants fell down the cliff in a couple days mid-march. Closing them down due to quarantine was just a formality in many cases. Sure, some people would still go. But they wouldn't have enough traffic to cover fixed costs.

This is an unprecedented measure. I can understand the need to do everything possible, but there are other costs. Shutting down rural areas could shut down food supplies, which we're already seeing with seasonal fruit pickers in Europe.

COVID-19 becomes critical in people because their immune system overacts and ends up hurting living cells. If they recover, it's just some dead bloodcells and they can be replaced. When our society starts overrating with out social immune system, people die. I wrote about this hidden cost last week:

https://battlepenguin.com/philosophy/covid-19-is-two-disease...

This is dangerously false (we don't yet know what the long-term effects of COVID-19 will be).

How do I flag this for moderator removal?

Did you read the article? It's my blog post. I wrote it. Instead of just saying it's dangerously false, explain why. Let's have a discussion instead if you jumping the flag button.

There are already cases in Europe where fruit is rotting because no one is available to pick it. If the country shuts down like Gates suggest, there are lots of secondary effects that can injure people. It's just like COVID-19, in someone's immune system, overreacting and killing more cells when it doesn't need to. That should not be acceptable in our society.

There's no evidence to suggest that people who recover from COVID-19 have "only dead blood cells" that can "just be replaced".

There is a bunch of evidence that it can cause scarring in peoples' lungs, and it's unclear what other long-term effects there will be.

That wasn't what I was implying at all!! In your immune system, it can kill off bad cells and that's acceptable. But when it comes to human beings, we can't let some people die to save the rest. That's unacceptable. That's the analogy I was trying to draw.

Human beings are not cogs in a machines. We are not cells who some master brain can dictate things to. We are complex, self-aware beings. You turn off a machine and you can turn it back on again later. Your body kills off a ton of infected cells and that's fine because they grow back and those cells aren't special.

Your turn off large parts of this complex machine we've constructed to support 6~7 billion human beings on this planet, and a lot of people are going to die. Even if you can keep people from dying, there is going to be a lot of civil unrest, protests, because there are limits of what we can take as human beings.

The point of the post is that there are two diseases. The first is the virus that's killing of tens of thousands of people. Then the second disease will hit; the economic impact of all we are doing to stop the disease, which could leave millions without necessities.

> Shutting down rural areas could shut down food supplies, which we're already seeing with seasonal fruit pickers in Europe.

Do you really thing the government didn't think about that question ... It's not like two weeks down the line all the experts will be like "damn, we forgot about the food".

The only affected crops are hand picked fruits, which aren't a necessity. All grains, potatoes, most veggies are picked by machines, there won't be any food shortage, unless you only feed on raspberries.

> Do you really thing the government didn't think about that question

Yes.

Please excuse my ignorance.

If immune system overreaction is what's killing people, why aren't we giving them immunosuppressants in carefully balanced doses?

Bill Gates' meddling is a big part of what got us into this mess. He's practically bought out the WHO, here's some good reading on that: https://www.politico.eu/article/bill-gates-who-most-powerful...

So we have a weak WHO that people are manipulating for their personal goals, altruistic or not. Then there's this outbreak in China, and the WHO just completely screwed up every opportunity to contain the thing. They went right along with the Chinese government and announced no evidence of human to human transmission (their travel advisory said if you go to Wuhan you should wash your hands).

Now in my opinion the WHO should be tearing into the Chinese government for an apparent coverup and allowing the virus to spread internationally. Instead Tedros, WHO head and Bill Gates connection, is praising China.

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