Americans are underestimating how long disruptions will last, health experts say | Hacker News Reader

Americans are underestimating how long disruptions will last, health experts say

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Many Americans are underestimating how disruptive a mass uncontrolled pandemic is going to be to their lives. If hospitals are completely overflowing and most people who get serious symptoms die for lack of available treatment capacity, and everyone knows friends and family members who've already died form it, do you think life isn't going to be massively disrupted anyway? People will hunker down and go nowhere out of a sheer sense of self-preservation, without the government needing to tell them to.

The pandemic itself is what's causing all the disruption and economic hardship. The social distancing measures are NOT the cause -- in the absence of them we'd be doing even worse off in the long run.

I already have friends and family members who have died of various causes. We haven't destroyed civilization over it.

How many of those friends and family members died of causes that could be prevented through temporary social distancing? And how many years was that spread over, vs the single month we'd be looking at here with an uncontrolled coronavirus pandemic?

You're underestimating how bad things can get.

Everyone I know who has died could have been at least temporarily saved by extreme, civilization-destroying efforts.

“Temporary social distancing” is much less benign than you make it sound. More like “intentionally creating an economic depression of unknown severity”.

Life went on mostly as normal after the Spanish flu, by the way, which is the closest thing we can compare this to.

Are you not aware that, during the Spanish flu, entire cities were shut down for months, exactly like what's happening now? And that without these actions the effects of it would have been much worse? You bringing this up is exactly proving the opposite of the point you're trying to make.

Enforced social distancing is nothing NEW. It's as old as pandemics themselves.

Medical science barely existed at that time.

They weren't idiots. They understood that the flu spread from person to person, and that shutting gatherings of people would curtail the spread.

This happened. It's part of history. You can't argue against it. There are thousands of contemporaneous newspaper articles about all the measures that were taken to curtail the spread of the Spanish influenza.

My point being that we have significantly better data to inform us on exactly how to reduce the transmission rate, we have constantly-improving testing methods, we have the ability to research medicines than can help, we have the ability to research a vaccine. Not only is the not the Spanish flu, it is happening in a profoundly different context. The comparison is superficial.

Define normal in this context. The effects of the 1918 flu pandemic really were region dependent, because some regions were more strict than others (in terms of social distancing, curfews, etc.) and those regions that were more relaxed were affected more heavily (the classic American example is Philadelphia vs St. Louis). We see some evidence of this happening now in places taking stricter measures globally, although the data is too early to say anything conclusive.

> intentionally creating an economic depression of unknown severity

Okay, assuming it's a strict trade-off between 1) no social distancing, economic disruption happening at some point in time in the future, and significantly higher death rates; or, 2) social distancing, economic disruption now, and lower death rates, which is better? This is the reality of the situation -- there will be economic disruption no matter what, and so if we don't attempt to quantity the disruption, the two differences here are social distancing and number of deaths.

Social distancing will save at most 1million lives (mostly 60-is 70 year olds, who had 10 years left anyways) in America.

6 months of quarantine in the US would cost 2 millions lifetimes of going outside. Full lifetimes, that is, not 10-year-lifetimes.

This is aside from all the economic damage. The cure is worse than the disease.

It's not remotely equivalent to compare a year spent dead to a year spent indoors. You need to put a large multiplier on that.

Hospitals are not overflowing. We have 6,100 hospitals,989,000 hospital beds available. And my best friend is a Registered Nurse (California) and says they are not even close to capacity. She also stated what is presented on the news is 100% a lie.

Okay. I also have a friend. He is 35yo and has COVID and his blood oxygen saturation is at 80%. The UCLA hospitals refuse to admit him. They’re already over capacity.

No hospital in the US is currently turning away patients who have acute hypoxemia. If your friend's blood oxygen is actually 80% then he is at immediate risk of death. Call an ambulance right now.

That is because CA went "stay at home" first and was able to avert the disaster that is NYC. Open everything and we are fucked.

In 2018 CA hospitals actually were over capacity for the flu. They aren't now as much as the covid obsessed want them to be.

That is likely true but if this runs it’s course naturally we will see an enormous peak and then just as rapid a drop as we reach herd immunity in a couple months

The true choice here is between a lot of deaths and a couple months of staying at home and fewer deaths but years of staying at home.

> That is likely true but if this runs it’s course naturally we will see an enormous peak and then just as rapid a drop

And millions of preventable deaths, just in the US alone. You're underestimating the psychological and economic impacts that would have.

In reality we wouldn't experience such a sharp peak because people aren't stupid; many will start self-quarantining anyway as the pandemic rips through the nation. The economic disruption isn't a choice we're making; it's going to happen one way or the other with this pandemic. Don't think people are going to continue merrily going out in society when it's a guaranteed ticket to a terrible disease.

I would like to hear an estimate of how badly this would effect demand. If a million people who spend a thousand dollars a month die then isnt that 12 billion shaved off spending over that next year? Im sure its more complicated due to ecnomic rent relations and other things I don't even know about but isnt this by itself a disaster?

The actuarial value of the typical human life is roughly in the neighborhood of 5-10 million dollars. It wouldn't just be spending shaved off in one year, it'd be every year after that too, and then there'd be all the knock-on effects of more government required assistance for dependents that can no longer be supported properly, lots of foreclosures, a reduction in childbirth and size of the next generation ...

And by the way, your math is off by a factor of one thousand.

From a purely economic standpoint, most of those deaths are not significantly reducing GDP.

As others have said, with a virus more contagious than influenza, the only real choice is for lots of people to get it. I'm all for a partial quarantine of the old and at-risk that lasts for a year, but it just isn't possible to shut down the whole world for that long. People don't understand how interconnected the global supply chain is. If this goes on, it will start with some simple things like your favorite deodorant brand and snacks disappearing from store shelves. Hopefully, people notice and pull back restrictions before it gets worse.

OK, so my wife and I are both over 70, and she's immunocompromised. Even so, personal issues aside, I agree that a global shut-down for a year or more would be hugely, even unimaginably, disruptive. And I also agree that health impacts for those not at high risk would be relatively minor.

However, once Covid-19 was circulating freely in the general population, isolation for old and otherwise at-risk populations would arguably be less effective. So we'd need more effective isolation for them.

I don't know what that might look like. Upon reflection, I don't believe that relocation-based isolation would be acceptable, and it probably also wouldn't be safe.

I've been trying to imagine how my wife and I might avoid infection for a year or more. We're lucky, I suppose, because we live in a well-organized community. And there are teams of younger people who do most of the shopping.

But for most people, there's no structure for anything like that. Except for those who belong to churches, I guess. And maybe it could develop via social media.

The question we have to ask, is as an at-risk person, do you have a higher chance of contracting the disease over the course of its activity if you are quarantined for two months but most people aren't, or if everyone is quarantined for a year?

I.e. if during quarantine you need to interact with people once per week to get groceries, etc., and there is only a partial quarantine, many people will be carriers, so each time you go out you have a 5% chance of contracting the virus. Your chance of contracting it during this time is 1 - 0.95^9 ~= 37%.

In the full quarantine, fewer people are carriers at a given time, but the virus will be in circulation longer. So let's say there is a 1% chance of getting it every time you go out. Your chance of contracting it during this time is 1 - 0.99^52 ~= 40%.

This is a simplified model that doesn't account for the way the percentage changes over time, but it makes a valid point.

So the odds of each at-risk person contracting the disease may not be much higher (or possibly even lower) in a partial quarantine, even though more people overall are getting it and over a smaller time period (pressuring hospitals). The advantage being that the world continues to function during this time.

If it behaves like other coronaviruses, there's a pretty good chance that it'll be circulating indefinitely. So at long as at-risk people haven't been infected, they'll need to isolate indefinitely.

As I see it, quarantines can only flatten the infection curve, so that healthcare resources don't get maxed out. And realistically, I doubt that any quarantine could be enforced long enough, and so remain effective long enough, to prevent eventual infection. The only hope is that, when they do get infected, adequate medical care will be available.

There's no such thing as a "full quarantine" for everyone. It's totally impossible.

"it will start with some simple things like your favorite deodorant brand and snacks disappearing from store shelves"

Something tells me that those will come back on the store shelves, no more and no less but for their market potential (in a restored size market, of course) ...or people will just pick another candidate for their favorite product. I prefer to enjoy the ride to that postcoronavirus world and be glad to live these interesting times in general.

What impact? First, the worst case estimate with soft distancing from the Imperial College paper everyone is quoting is 1M in the US. Even if it isn't an overestimate (their models have tons of assumptions and past pandemic estimates for death rates/etc were usually overblown), 3M people die in the US every year iirc, and given the demographics there'd be a large overlap. It's significant, but not worth messing up the lives of 100s of millions in the USA alone for years, and knock-on effects potentially for decades.

> The true choice here is between a lot of deaths and a couple months of staying at home and fewer deaths but years of staying at home.

Where did the years part come from?

However long it takes to make a vaccine and distribute it widely

Saying Americans is possibly too broad because from the looks of it, there really are some attempts to walk a different route. The same is with some nations.

Let’s see, for example, if the Texas more relaxed approach performs better than California. The nuances between approaches may blossom into a wider difference. It’s not obvious that Americans are all sailing in the same boat.

> The social distancing measures are NOT the cause -- in the absence of them we'd be doing even worse off in the long run.

I don't share your high level of certainty about that.

I don't believe an uncontrolled pandemic would have caused the amount of business closures and layoffs and mass unemployment the lockdowns have already caused. It would certainly be bad for business, and there would be some layoffs, and we would almost definitely have a recession, but many businesses that are now closed would have remained open, motivated purely by self-preservation.

Even now we see people out and about, even though the government tells them to stay home, and I don't believe that would change very much if the disease was uncontrolled. The rich can afford to stay at home, but the poor need to go to work. Self-preservation includes the desire to earn an income.

Hopefully we don't find out later on that the total amount of human suffering caused by the lockdowns outweighs the suffering caused by the disease. I think it probably won't, but we need to consider the possibility.

You aren't accounting for the massive economic costs of all these extra unnecessary deaths.

As I wrote, I believe there would be a recession either way. The question is whether the recession caused by the lockdowns will be worse than one caused by an uncontrolled pandemic.

Why do you think those unnecessary deaths would cause more economic damage than a government-mandated shutdown of almost all work that cannot be done from home?

A recession where people live is better than the exact same recession where people die. (Yes, I know, people do in fact die from purely economic reasons in a recession. That's still different from people dying being the cause of the recession, because in the second case, there's more dying. The people die from the disease, which causes the recession, and then people die from the economic consequences of the recession.)

But even in strictly economic terms: Here's a person who's 30. If they die, we lose 35 or 40 years of their work. If they have to stay home for two months, we lose two months of their work. (Yes, far more people have to stay home than would die if we all just went about our lives. But even assuming a 1% death ratio, N people x 2 months is less than N/100 x 40 years. There's also the health care costs of all the ones who are hospitalized. It's better economically to do it this way.)

People also aren't factoring in that, while the death rate may be low for young healthy people, the hospitalization rate is still quite high, and recovery time is long. And the death rate even for young people goes up substantially if the hospitals are so overwhelmed that they can't even provide oxygen and nurses for young healthy people.

Do you have solid data sources for this?

maybe you could go verify this information yourself and post back if you find something worthwhile refuting the original claim

It is a new narrative that isn't really compatible with anything else I've heard. Which is basically that asymptomatic carriers are the norm, you are contagious even without symptoms, and this kills people in the risk pool.

So, someone making a claim that it is dangerous for non risk pool people feels like something that should be easy to back up.

That's actually been the standard story for most of the time. Dangerous mostly to at-risk individuals, but requiring ventilators for a succinct percentage of people who aren't at risk.

That's the main reason that Britain changed their tactic, and the main reason most countries are worried, especially about ventilators.

That narrative isn't final- there's a lot of unknowns. As you say, we are now thinking there are more asymptomatic people than we thought, which would be huge.

Yeah, sounds like I am just further in how I read the asymptomatic narrative. My understanding is it is now the narrative that most people that get this week barely register a cold. See the story of Greta.

Such that most people are asked to distance, since they are no risk for themselves, but extreme risk for the people in the risk pool.

Is that not the fully accepted narrative now?

I don't think that is actually the case, I hope you had quite a few you first-hand accounts of people who had it and it was not 'barely a cold'. more like 4 days in bed, still very lethargic for the next 2 or 3 days. it depends on the viral load that is received. small load = milder symptoms.

I think this is why it is so dangerous for healthcare workers, they get prolonged exposure and them by the time they become ill they have a lot of virus. if you picked it up off someone on public transport, for example, then your exposure would have been maybe 10 or 15 minutes, so you get a milder case.

Is this established? Last I heard asymptomatic was the norm. And they had no explanation for why.

Note that I am definitely not costuming this is a no risk virus. If you are in the risk pool, this is clearly deadly. They don't know what that risk pool is, though. All evidence is that kids are nigh immune to it. Older people are likely in the risk pool. But age is looking like a proxy here.

> asymptomatic carriers are the norm

Asymptomatic people while they are infecting others doesn't mean these people will remain asymptomatic all the time. Just that at the moment they are spreading the virus they aren't having any symptoms. They can and it seems a lot of them do develop the symptoms only days later (especially once the children aren't considered).

That just means that it's hard to contain the carriers early enough to limit the growth of infection based on the symptoms. Until the antibody tests show otherwise, we can't even assume that "most will be fine" in the sense that it's not true that 20% of all infected (again, maybe excluding children) would really need the hospital.

One of the reasons 20% of all "confirmed cases" need the hospital is that the doctors can't know who of those 20% will get even worse to need the machine to be kept alive.

And no country could ever have enough doctors and machines to treat such a big part of population at once.

My question is if you are making up 20%. Especially if you consider children and younger family, it is a reasonable hypothesis that entire Italian families are getting this, not just the older members. At that point, it seems also reasonable that it could have hit many many more than they are reporting.

My hypothesis is that whatever that number is, it is not constant across regions. Something is marking it higher where it is higher. Across age ranges, even; unless Japan starts a massive upswing soon.

> My question is if you are making up 20%.

No. There are countries which do test all that could possibly be infected (e.g. if they were in contact with the person who was tested positive). Even then, those that are positive are the small percentages from all tested, but it‘s still that 20% from positives need the hospital.

I haven't been able to find hospitalization numbers. And this seems flat incompatible with the idea that asymptomatic is the norm. Which, I grant is the new narrative, not the old.

I have found reliable death numbers. Well, posted death numbers. Quite easy to find that. I haven't even seen any posted recovery time numbers. Just recovered. Do, not sure what to make of that.

I assume you could proxy "serious/critical" with "needs hospitalization". But, that number seems to be all over the place. From 4% to 10%. Still below 20%. So, where are you getting 20%?

> From 4% to 10%. Still below 20%. So, where are you getting 20%?

From the graphs of all countries that publish their data. Those that publish give you statistic of the number of tested, number of tested positive, those needed hospitalisation and the dead. The death happens with delay of up to two weeks, hospitalsation one. The doubling time of positive tested is 3 days typically. Calculate.

What is the label that says hospitalization? All I have seen are "serious". And that has not been 20%. Am I just finding junk sources?

Yes, in the countries that officially label cases as such, the "serious" ones are those needing hospitalization. Others are being told to remain at home and stay isolated. Also note that even some of those who remain at home get worse later, and some die before they can be hospitalized. The major point that you have to be aware of is that the hospitalizations and deaths come later and that the doubling time is short. Also, the doubling time of 3 days means that the country which has 1/2 of the coronavirus allocated bed capacity on 1st of April won't have enough beds starting with 4th.

Also, please try to analyze as much countries (I know about European ones) as possible. Go for the official sources, or the pages in the Wikipedia on local languages, you'll find much more reliable data, and for some countries even official "in hospital" "in intensive care" and "deaths" numbers.

> Also note that even some of those who remain at home get worse later

The most recent example Boris Johnson is in hospital since only a day:

https://www.theguardian.com/politics/live/2020/apr/06/uk-cor...

News about him being tested positive: 27 March 2020:

https://www.bbc.com/news/uk-52060791

at that moment: "the total number of UK deaths 759, with 14,543 confirmed cases."

Now: "47,806 confirmed, 4,934 dead."

That they understand that it's going to grow more: "The National Health Service freed up 30,000 beds by discharging patients who were well enough and delaying non-emergency treatment,[342] and acquired use of 20,000 beds in private sector facilities." (wikipedia)

But they still also hope that the current measures will slow down the growth.

The Nederlands publishes hospitalizations:

https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_t...

All cases, hospitalized, deaths: 10,866 3,483 771

They test less than some countries though, but you can see the factor of hospitalizations against the deaths, and note that deaths reflect many days older (and smaller) "cases" count and hospitalizations are somewhere in between.

Haven't been back where I can post.

The time lag is a valid way of deriving this number. In places that do a lot of testing, the number does look lower than 20%. Especially considering most only test those that go to the hospital.

https://www.worldometers.info/coronavirus/coronavirus-age-se...

people from all age ranges are dying, it is higher rate the older you are but 0.2% is still a lot of young people(10-39years old)

This is one where the nature of this virus not sending most young people to the hospital throws off that stat, heavily.

So, if they are right and most cases don't go to the hospital, then this is high. If they are wrong, and most cases do go to the hospital, then they have basically no idea how it spreads so quickly. At least, their stories are going to need massive revisions.

And again, I'm not claiming anyone wants this. Nor that I know all. Age just feels suspiciously like a proxy for whatever is upping someone's risk.

There is also the massive economic costs of everyone who gets sick. With uncontrolled pandemic, something like 5-10% of people would be out sick, 20% of those in the hospital. Plus, all the people who are caring for the sick or quarantined.

Essential businesses which are in person would be more vulnerable. There is a significant risk that health care, manufacturing, transportation, or grocery stores would need to shut down because too many workers are out sick and the rest are afraid to come to work.

> With uncontrolled pandemic, something like 5-10% of people would be out sick, 20% of those in the hospital.

It doesn't look that that estimate is nearly right. It is true that there are always people reported as "tested positive having no symptoms at the moment" but that is different from "tested positive and never developed the symptoms" due to the point where we are in the exponential curve. In short, the numbers could be significantly worse in an uncontrolled pandemic.

Now if it's only e.g. every second person that can be infected and completely remained asymptotic all the time, in an uncontrolled outbreak you'd have a moment where e.g. 10% of all population is so sick to need the hospital. And no system could sustain that. The reason for the huge hospital need is not "to give them a nice bed" but that they could be exactly those who will eventually need the machine to be kept alive.

Hate to break it to you, but hospitals are going to be overrun either way. 70-year-olds outnumber ICU beds 1,000 to one in many counties, some counties have no ICUs, some counties have no hospitals! [1]

Because hospitals will be overwhelmed by a factor of 10 or so, social-distancing to slow things down by 50% is not going to change that.

The numbers paint a pretty clear picture, for those who bother to look at them.

1. https://khn.org/news/as-coronavirus-spreads-widely-millions-...

> but hospitals are going to be overrun either way

Only if COVID patients are prioritised.

What's the point of assigning an ICU bed to a 79yo with two potential comorbidities who will be dead within the week regardless of how much treatment is given? Compared to a 30yo who has been in a car crash and has a chance of survival.

The societal cost of covid19 vs social distancing depends on the time scale. Three to six months? Covid19 is almost certainly worse. Nine to twelve months? Fifteen months? Two years? Strict social distancing will be much much worse at those time scales. People will starve and segments of the logistical network necessary to sustain the medical industry will be in danger of collapsing. Not to mention the enormous strain on governments and services caring for tens if not hundreds of millions of people.

Lucky for us, South Korea has shown that this thing is beatable, even without a vaccine. Exhaustive testing, contact tracing, and enhanced hygiene measure are a great follow up for social distancing (though I have no idea what's going to happen in southeast Asia or Africa). But larger countries will require more supplies and time to manage the virus. The question I haven't heard the answer to yet is how long can the shutdown last before it effects our ability to treat covid19 and provide for basic necessities? I'd rather not we not figure that one out the hard way. We need to be looking for active solutions and this article provides some good ideas.

Disruption from Spanish Flu was short-lived, and yes the damage caused is from the lockdown, not the pandemic. In the worst-affected areas (except maybe on small city level), the deaths are still a blip. If there was no media circus around it, everybody would still be mostly unaware; any kind of reaction would just be starting now with some areas having issues in hospitals, and even then judging by how people ignored the lockdown in Seattle when it was partial, it wouldn't be as bad as now. Then, by CA govt's own admission in the worst case they'd be near herd immunity (iirc they listed 56% infected) in 8 weeks. That includes the times where the deaths are still a blip compared to flu, and hospitals are not overwhelmed. So let's say 5 weeks of panic. And then that's it.

I've been telling my wife and friends I expect this to last well over a year. I've been told I "sound like an idiot" and that my negativity isn't helping. We'll see.

Well the Chinese have been able to successfully contain the disease after a 60day lockdown so it shouldn't take more than that. Unless of course there's an agenda we're not aware of.

> Well the Chinese have been able to successfully contain the disease in 60days so it shouldn't take more than that.

Though they did seem to delay action, when they took it they went hard. Some of the US is past the point that China threw the brakes on, and the rest of the country continues to accelerate. We can't expect the timeline to align in any way.

did they contain the disease or the information?

The disease, obviously. When the disease was running rampant through Hubei, there were innumerable reports of it on social media.

The WHO has had a large team of disease experts, public health experts and others in China since late January, and they say China has been totally transparent.

The unfortunate truth is that authoritarian regimes are better suited to dealing with a pandemic, particularly competent, technocratic regimes like China's.

They were well suited AFTER the two months of trying to bury it. Once the cat got out of the bag, when keeping it in the bag was the whole point.

Not really a fair accounting at all. Everyone points to local efforts to control information about the disease, but that lasted a couple days, not two months.

Genetic analysis indicates a single index patient sometime around mid-November. In late December, there was a large cluster of pneumonia cases with multiple patients at the same hospital in Wuhan, which were mostly linked to the Huanan Seafood Market.

And this is exactly what you would expect. One case in mid-November, 2-3 cases a week later, 4-9 cases by early December, 16-81 cases by mid December, and maybe a couple hundred cases by late December. And among these cases, only a minority are going present to a hospital for treatment. Most will get sick, but simply stay home.

On December 31st, the Wuhan Municipal Health Commission became aware of the Huanan Seafood Market cluster and issued a notice to local hospitals. That same day, Li Wenliang made a statement to friends about the unknown pneumonia cases, which was shared by friends to social media. Local authorities arrested Li Wenliang and made him sign a statement acknowledging a misdemeanor, and ordered him not to talk about the illness publicly.

Later that same day, Chinese officials notified the World Health Organization of an outbreak of pneumonia of unknown cause.

On January 1st, local authorities closed the seafood market.

On January 7th, Chinese researchers identified SARS-CoV-2 as the causative agent in the outbreak.

On January 12th, Chinese researchers shared the viral genome with the world health community.

On January 22nd, with about 500 confirmed cases, China locked down Wuhan, and all of Hubei Province the next day.

There were clearly some local efforts at suppressing information about the virus, but at a time that very little was known about it, and apparently all at the local level.

Somehow this is seen by some in the West as state-sanctioned efforts at suppression, but the President of the United States saying it's just the flu, nothing to worry about, there are very few cases, most of them are getting better, it's totally under control - that's not suppressing information, just efforts to project calm.

The reality is that China's response to this novel virus represents a new gold standard for emergent disease response. In terms of both speed and efficacy, it was the best response the world has ever seen.

I agree this started in Nov., but dont have a source. Do you have a link?

As I've written before, "a powerful flu like corona" was circulating in SE Asia already by Dec. 10. So the Dec. 31 WHO notification was pretty slow.

I'm lukewarm on congratulating China since they were the epicenter for SARS-1 in 2002/2003, and various bird flus since. I wonder how many hospital staff Wuhan lost in Dec. 2019? Must have been dozens - did that make the press?

Here's a genetic analysis that was widely shared last month, which points to an index patient in late November around Wuhan: https://bedford.io/blog/ncov-cryptic-transmission/

Here's an article from Feb 11th in the SCMP which notes 500 health care workers in Wuhan were infected with the virus:

https://www.scmp.com/news/china/society/article/3050077/leas...

The question is how long will it remain contained?

The chinese are also using mass surveillance to keep the problem under control. You need to show a qr code on your phone that proves you are allowed out at many checkpoints.

There's some question of how successful they have actually been.

There is nothing close to a lockdown currently in place anywhere in the US or Canada. Not to say that that's what's needed, just pointing out that China's policy was more extreme.

Mild cases in America are being told to quarantine at home where they'll infect their families.

Americans are not wearing masks universally.

There are no bans on movements between hotspots like New York and the rest of the country.

And Americans expect to successfully contain the disease in weeks.

Western leaders aren't even trying to contain the disease, and they readily admit that. It's all about flattening the curve, and a flat curve stays flat a long time.

This is a lie. China now has another outbreak, and several country's intelligence agencies have suggested that their original numbers were completely made up.

Would you mind providing proof ?

Anonymous non specific leaks from the most reputable, apolitical of sources, that has no vested interest in this - the White House.

Here is a good overview: https://www.taiwannews.com.tw/en/news/3871783

Proof:

1. China's numbers simply do not match models that take all their measures into account.

2. China only tested syptomatic people, and did not classify pneumonia sufferers as COVID: https://www.reuters.com/article/us-health-coronavirus-china-...

3. Wuhan crematoriums are seeing way more deaths than reported: https://www.vice.com/en_us/article/88435z/wuhans-crematorium... http://www.asianews.it/news-en/Wuhan,-endless-queues-for-ash...

China's new outbreak: https://www.aljazeera.com/news/2020/04/china-fears-wave-covi...

You might want to compare the strictness of the Chinese lockdown to what western countries are doing.

The goal of the lockdown must be getting the case numbers low enough that contact tracing works again. To do that you need to get the replication number well below 1 and hold it there for two months or so. The measures we're currently taking are totally insufficient for that. R is still closer to 3 than to 0.5.

My take is that if my government managed to successfully lie about the number of deaths (assigning COVID-19 as the reason only in cases where the patient had no chronic illnesses) then China is more than capable of doing the same and has a major incentive to do so.

China's can more effectively control people's movements than the US, which helps with containment.

But at the same time, as in the US, reported infection rates are probably much lower than the actual rates, since both countries' administrations have an interest in minimizing the reported rates, or when that fails, minimizing the timeline for normalization of life.

Public health authorities are the only people who have no incentive to exaggerate or suppress information.

US has some incentive to undercount, but US has lots of semi independent state/local governments and non government epidemiologists.

In China, province/local government leaders would be jailed for speaking against the party line.

I agree that the saving grace in the US is that we have independent state and local officials. Kudos especially to Ohio's governor for bucking the party line and declaring a lockdown in a timely way.

Local officials have credibility right now from being the actual local boots on the ground. Their voices have cornered the administration into admitting, however begrudgingly, the scale of the problem.

Given the administration's incentives, it's good that the institution aggregating the numbers right now is John's Hopkins, and not the administration's VP-led task force.

With mass surveillance and literally welding some people into their homes. The US isn't even near that level of containment. I'm scared for your guys.

I'd also be scared if you were welding people into homes too. For a different reason.

There really isn't a great solution here other than masks for all, and people behaving responsibly. Which isn't going to happen. :(

The Chinese lockdown is much more severe than anything being enforced in the US. They track everyone's movements with their phones, large areas of the cities where cases have been reported are sealed off with checkpoints at the exit points. Your temperature is checked almost everywhere you go, the temperature of anyone working in food production is checked every 30mins, to board the subway you must scan the QR code in the specific carriage. It's very hard to explain just how drastically different the measures China are taking compared to the rest of the world but here is a good video that gives some insight: https://youtu.be/YfsdJGj3-jM

Can you imagine this happening in the US? What happens if this is what it takes to avoid the 60-80% infections required before herd immunity kicks in?

Let’s say this is true.

So what? The rest of the world is still a hot zone. As soon as one infected person slips through your net—tomorrow or six months in the future—you have an outbreak again.

Depends what you mean by "this" - do you really believe we won't be allowed to leave our homes for anything non-essential for over a year?

I don't think it can be comoletely ruled out. However I do believe that's a maximun as the vaccine will be well tested and released in under a year.

Where are you seeing that? Every projection of which I'm aware has been in the range of 12-18 months. It's reasonable to hope for faster, but not to plan on that basis.

You can safely rule out a one year lockdown because people will not tolerate it. They will violate the lockdown and the virus will spread.

> the vaccine will be well tested and released in under a year.

This is a bizarre misunderstanding of the vaccine development process.

I'm just a layman, but my understanding of vaccine development is that the timeline has little to do with how long it takes to actually research, make or distribute the thing (although that's certainly part of it).

The reason you need to wait so long is to prove its efficacy. By definition, you make a vaccine to give to everyone who is healthy and does not have the virus. So the absolute worst possible outcome would be to inject 95% of the population with a vaccine and discover in 6 months that it causes some horrible side effect.

Well the other option is that everyone already catches it by then, and we move in without the immediate need for a vaccine, depending on length of natural immunity. Which I think is becoming the more likely outcome, given the increase in non symptomatic carriers.

The catch will be if we attribute a drop off in hospital admits as successful containment or as the result of natural immunization/ herd immunity.

I'm just curious. Where do you live that you are not allowed to leave your home? I know different places are implementing social distancing differently.

UK - we're only permitted to go out if it's essential[0], such as buying food or collecting medicine. You're also permitted to travel to work, only if you have a job you can't do from home, and you work at one of the designated "essential" businesses/organisations. You're also allowed out for excercise.

The police here have in some cases been acting with ludicrous heavy-handedness, such as posting drone footage of 1-2 people walking over an empty moor, claiming they shouldn't because it's "NOT ESSENTIAL!". The actual laws actually seem quite reasonable, and leave room for common sense - hopefully the police will stop this nonsense, or their behaviour may cause people to lose respect and start flaunting the rules.

I believe it's the same situation across most/all of Europe now.

[0] https://www.gov.uk/coronavirus

The actual law is a little bit more permissive. https://www.legislation.gov.uk/uksi/2020/350/contents/made

This difference between the law and the government guidance seems to be causing a few teething troubles as police adjust to it.

Hah, I actually just updated my comment to make that kind of thing clearer, and see someone has already pointed it out ;)

I'm with you. Even if the 'shelter in place" restrictions get lifted, the economic fallout will last a while.

I'm highly skeptical of the "economy will just unpause" theory.

The current nearly total shutdown of retail businesses cannot and will not last for a year. If it needs to last for a year in order to contain the virus, it still can't and won't, and people will die from the virus.

I think it should last between 18 to 24 months too, but the confinement measures will be lifted much sooner. Once the epidemic curve is going down and its well under control, people will be allowed to go back to work with face masks, slowly industry by industry before the end of the year. This should only take a couple of months.

There's no reason to expect "Once the epidemic curve is going down and its well under control"

before there's a vaccine deployed or everyone has been infected and paid the personal cost of their viral lottery ticket.

Best bet might be a modifier herd immunity plan, of infecting healthy people with a miniscule viral load and hoping the immune system can handle it better than a heavy load from getting sneezed on or spending all day at a hospital.

That's just modified variolation with a flu virus. We don't use that method anymore for many good reasons. Controlling a viral infection is nearly impossible, let alone literally billions of people, all at once.

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

Back in January, my friends were trying to convince me to do a spring break type vacation in Miami in March. I said, I dunno if we should book just yet, this Coronavirus in China is certainly going to become a global pandemic. They thought I was a tinfoil hat lunatic.

Then, in early March, right when SF starts it's social distance / lockdown, and SXSW and stuff like that starts getting canceled -- the Spring break thing we wanted to do in Miami is canceled, too. No surprise.

Immediately after, my friends try to convince me that we should do this thing in Chicago in early May. Flights and hotels are stupid cheap right now, they say. We should take advantage.

I'm like, guys, there is enough data from China, SK, Japan, Singapore, Hong Kong, Italy, and Iran to know that this is going to be at its worst by early May.

They think I'm insane. This will be over in a week or two at best, they say.

Now there's yet another event in October. They're trying to convince me to do that now! I'm like, GUYS! Hopefully the world is somewhat back to normal by then, but who knows? Why don't we just wait a bit. The deals will be around for a while.

It really seems like Fusion energy. Instead of always being 40 years away, everyone seems to think Coronavirus is always 2 weeks from just going away in its own.

You can still go if you are not taking orthogonal risks. We just cancelled our rock climbing vacation because we intended to do some stuff that's hard for us and I don't want to end up in a hospital for unrelated reason and take up the capacity. Otherwise (e.g. if we were going for a beach vacation), viewing lockdown as hugely net negative I'd totally go.

As far as I'm concerned, violating lockdown right now is basically civil disobedience - I normally run about once every 2-4 weeks, but if they close the park next to my house I'll make sure to go do it as often as my legs allow.

It is just as likely that health experts are overestimating how long Americans can stop the economy. This happened so fast that most people really could not even wrap their head around the changes. I would love for us to keep working from home, reduce travel, and get this thing under control, but at least up until now, I have a salary, and am not being adversely impacted.

The number of Americans being adversely impacted is in excess of 10 million today, likely closer to 20 million, and pretty soon almost everyone is going to share some level of pain.

This is going to be a very tumultuous 2 years.

I am reminded of the factoid about how airlines will often announce a extended delay by first announcing a shorter delay and then continuing to push it back several times. That is supposedly done to increase moral. Apparently several smaller disappointments are easier for people to process, accept, and forgive rather than one large disappointment. I wonder if this is the government's approach, because no one looking at the facts of the situation could have believed resuming things by Easter or anytime in the next few weeks was likely.

It doesn't help that many of our leaders have tried to sweep the potential impacts of this under the rug.

We're constantly lied to. It's not the fault of the people in America. It's the fault of those in charge.

It's the fault of the American people for voting these morons into office.

It’s not like the system is giving them much choice.

The system has choices, it's that people are herd animals and will outcast and ridicule anyone who doesn't fall into "a side".

Go one level deeper: it's an inevitable outcome of combining democracy and normally distributed human ability

This, so much. The root of all of these issues is a drastic overestimation of the average persons cognitive ability. To use IQ as a proxy, the mean (100) is shockingly incompetent and to paraphrase a famous comedian, half of us are below that average.

There was a time when merit tended to bubble up into positions of authority but that has been increasingly untrue for decades, for a host of reasons that all point to a rotting western culture.

> There was a time when merit tended to bubble up into positions of authority but that has been increasingly untrue for decades, for a host of reasons that all point to a rotting western culture.

When, exactly?

Before diversity and inclusion drives skewed hiring toward genitals and skin color as opposed to merit.

Before we started throwing billions of dollars at our worst performers, and lowering standards across all school districts, in a failed attempt to bring our lowest up, at the measurable cost of bringing our top performers down.

What proportion of the population do you think actually contributes to the progression of society? Scientists, engineers, competent politicians, doctors, policymakers...maybe the top 10% are capable of being and carrying out the orders of visionaries? In the West we've gradually reallocated our resources towards the needy, and now we reap the reward of decades of neglect for our top performers as we graduate 18 year old "adults" who are barely equipped to even live alone. Not to mention how pitifully we are outcompeted on the world stage - have you been to a college career fair lately? It says something about our society that the majority of students, at top tier schools, are foreigners.

This is what happens when "nationalism" and "individualism" are turned into dirty words by decades of propaganda. Either this war on corona turns things around and brings us out desperately needed Pattons and Churchills, or this truly is the beginning of the end of the American Empire.

I'm sorry but the people who most complain about diversity and inclusion being the downfall of our civilization have not exactly been shown to be the brightest minds in this whole thing.

I don't see top performers being actually concerned by this at all. On the contrary, top performers seem to be fairly concerned about how traditionally exclusionary measures have impeded a lot of talent from being developed.

>I'm sorry but the people who most complain about diversity and inclusion being the downfall of our civilization have not exactly been shown to be the brightest minds in this whole thing.

That's because one side is taboo and culturally suppressed. This thread may get me banned from HN, for example.

But by definition the push for diversity, which started in academia, bled into government, and has most recently been taking over the corporate world, selects for characteristics (race and gender) which are not correlated with merit.

Ignoring the fact that the entire idea rests on an unsupportable basis (a conflation of equality of opportunity with equality of representation/outcome), it's a theoretical mechanism by which we can explain the decline of performance across every corporate, political, and academic sector. We spend more per capital on school children than any other country in the world, by the way, so it isn't a question of funding. And the issues seem to exist in all states, regardless of government party, so it isn't likely a strictly political issue.

Clearly there is some deep cultural problem at hand and the people making policy have been leaning left for years in all sectors. Including media outside of Fox news. It fits.

Being white isn't correlated with merit despite what you think.

You are the one thinking in racist terms not the OP.

That's not my point at all. And it is a myopic conclusion to draw from my comments. Unfortunately in our society we have been conditioned to expect a singular outcome from any such discussion and immediately avoid it on grounds of offensiveness.

The point is that here you literally have a mechanism which is explicitly prioritizing traits which have nothing to do with merit. Regardless of whether our other metrics are appropriate, it is by definition clear that with this system you will inevitably dilute competence -

Incidentally this is a source of political bias in academia; you get your way if you can convince a generation or two that that having people with different skin colors working together is somehow going to improve the quality of science that you practice.

No, it is absolutely the point, unless you believe that the skill for CEOs was fairly distributed in its proportion of old, white men, or if you feel that whites and Asians objectively make for better engineers, or if you think that blacks make for better jazz musicians.

Drop this ridiculous rationalization of racism and sexism.

>or if you think that blacks make for better jazz musicians.

But it isn't racist to suggest that they may be better sports players, right?

Look, none of what I'm saying justifies discrimination against individuals, because we are still dealing with probabilistic distributions. What it does suggest is that inequality of outcome can be explained without resorting to racism and sexism. Further it suggests that our goals of gender and racial parity in industry cannot occur without some penalty to merit, which may be worse for society.

> Further it suggests that our goals of gender and racial parity in industry cannot occur without some penalty to merit, which may be worse for society.

Sure, now go out and prove that that's actually what happened and that the penalty is worse than the benefit of elevating of people who used to have no status to even play the game.

No, it's because you're creating conspirative BS that is so far out of reality it's not even worth considering.

In 15 years of being in the workforce I have never seen any diversity initiative having so much as a modest effect on people taking classes or employment.

You are probably going to get banned because this a racist tirade from an ignoranimus who clearly has no real life experience in neither academia nor industry. It's stupid, delirious, and forgettable.

>In 15 years of being in the workforce I have never seen any diversity initiative having so much as a modest effect on people taking classes or employment

Well, start here [1].

>this a racist tirade from an ignoranimus who clearly has no real life experience in neither academia nor industry. It's stupid, delirious, and forgettable.

You are throwing a lot of vitriol my way but not discussing any of my points. Though it should not be relevant, I am not white. And I am the son of immigrants. There is no need to make this personal.

The entire position between diversity and inclusion is inconsistent. The claim is that diverse teams outperform homogeneous teams - this implies that diverse people's perform differently. If they perform differently, why should we expect them to be equally represented in merit based roles?

1.https://www.theatlantic.com/education/archive/2017/08/why-me...

> It's the fault of the American people for voting these morons into office.

Eh, not so much. Americans are forced to express their complex ideas and preferences through a system that consists of a handful of essentially binary choices. And most voters probably don't even strongly approve of any of the choices they're given.

Speaking as an American, I'm aware. But the morons wrt this particular crisis...are universally from one of those two choices. You can certainly find fault with the other choice, but they don't nearly have the "ignore facts, ignore what anyone other than I tell you, ignore even the evidence of your own eyes" message.

I totally hear you, but elections aren't just about selecting leaders with competence and honesty. They're also about expressing preferences on moral issues, too. A lot of voters are willing to set aside the former and vote on the latter, because in their minds, they aren't given the choice to do both. I also think that lack of choice has a really corrosive effect on voters who find themselves in that situation.

Then this will be an interesting moral lesson for them. If they choose to actually learn it.

> Then this will be an interesting moral lesson for them. If they choose to actually learn it.

For them, and us. Our agency contributes to this problem as well as theirs.

And us? What is this lesson teaching us that we didn't already know?

Yes, we have to deal with the consequences of their idiocy. I fail to see how our agency, given we aren't voting for these clowns, is contributing to the problem.

Bluntly, your "us or them", your (or at least your candidate's) "they're a basket of deplorables"... yeah, you're contributing to the problem.

What this should be teaching you is to not write off people that you don't agree with. They're still human beings. They're still Americans. You think they're wrong, and that's fine, but regarding them with contempt does not make it easier to persuade them to agree with you.

You may say that the contempt originated with them. You may be right. But be better than them, not just like them.

You don't have to strongly approve of a candidate to vote for them to be president. And if you don't, then you can't be too surprised with the racist, bigoted, incompetent holder of the office.

We can demurr about the complexities of the Republican primaries in 2016 but the depressing take here is simply that people preferred racist and bigoted over competent.

If it's the fault of anyone, it's the fault of decades of clever sociopaths realizing that humans will swallow simple lies more easily than complex truths, and exploiting the trait to gain power.

That's a complex truth, and I don't like it either.

No, the morons will just blame the president.

I don't think that is entirely fair. They are operating on what they know at the time, maybe underestimating themselves. Situation is constantly evolving.

Some of them knew enough to dump stocks while downplaying it.

Right. Diane Feinstein and the others should be jailed.

Then they speak with that level of confidence. "This is what we believe, but it's not confirmed", "There's a high level of variability and unknowns here".

Instead Trump and cohorts are speaking in horribly over-optimistic platitudes that are based on his _hopes_, not his knowledge - and he doesn't have the oratory nuance to make one sound different to the other.

South Korea and the US had the first reported case of corona on the same day. Both countries took polar opposite approaches. What’s most optimistic timeline for US to get handle on the covid to lift shelter in place rules? At least two months?

The US response hasn't been a monolith. Seattle and Bay Area for example have had fairly successful responses so far.

Yes, but unfortunately, while we don't allow flights from Paris to Seattle, we still allow flights from Miami to Seattle.

Good responses from particular states are undermined by bad responses from others.

Without a nationwide plan, we won't be able to control the virus. Localized responses is good at controlling hot spots. We need to put out all hot spots at once which requires a federal plan and more testing to control the virus.

This is a dangerous attitude. Yes, leaders should be held accountable, and also people need to take responsibility for themselves and their communities by working together and rejecting poor leaders.

Placing all of the blame on others is how you end up with poor leaders in the first place as you follow people who share that same trait.

> It's the fault of those in charge.

While that can never be discounted, we also need to factor in disinformation from both China and WHO as late as mid-January [1]

[1] https://twitter.com/who/status/1217043229427761152?lang=en

Tweet starts with:

> Preliminary (...)

Wouldn't call that disinformation.

I would. By that time, it should have been very apparent that human-to-human transmission was a certainty.

There's some blame to go around, but I put most of it on the CCP. Their early coverup and subsequent actions have contributed the most to making this situation as bad as it is. They arrested doctors[0] and continue to lie about their case totals[1].

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

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

I guess on an emotional level it makes sense for people to believe that if we do a good job of social distancing, we will be rewarded by finishing it sooner. That's usually how hard things work. But according to my understanding, there is no such thing as a local end to the coronavirus. Even if some locality (city, region, country) implements such effective measures that the virus stops spreading there, they will still be vulnerable to outbreaks so long as they have enough unexposed, non-immune people to sustain person-to-person spread. Unless you hermetically seal your borders a la Plague Inc., the way for a community to go back to normal life is for a critical percentage of people to be exposed so we get herd immunity under the conditions of normal life.

In short: It's flattening the curve, not shrinking the area under the curve. The better we do it, the longer it will take.

P.S. Since this is inevitably political: in my personal experience the misconception that "the better we do it the sooner we can stop" is being spread by liberal/lefty people who are in favor of strict social distancing for as long as it takes. I think they're trying to rally enthusiasm for compliance, but the fact that this optimistic spin coincides with the political rhetoric from certain conservative ideologues should give them pause. Some politicians are anticipating and subtly fomenting a loss of patience with social distancing, and anything that raises unrealistic expectations plays right into their hands.

> In short: It's flattening the curve, not shrinking the area under the curve. The better we do it, the longer it will take.

That's too narrow of a view -- it assumes that we can't raise hospital capacity, that supplies shortages are permanent, that treatments won't be developed, that vaccines are vapourware. The point of flattening the curve is to give enough time for those things to be developed such that we can get hospitalization/death rates down and manage a higher rate of infections.

I agree that effective medicines and/or vaccines would shrink the area aka total percentage of the population that eventually become infected. Although both remain unknowns, let's assume one or two years.

Neither adequate supplies nor hospital capacity would shrink the area. But they would increase the maximum tolerable infection rate. That is, the infection rate that wouldn't overwhelm resources, and increase the death rate.

Given all that, it seems pretty clear that disruptions will last at least a year or two. Perhaps we could move everyone at risk into isolation camps, and let everyone else get infected and recover, hopefully with some lasting immunity. And then perhaps use antiserum from them to help protect the isolated at-risk populations.

However, said isolated at-risk populations would likely be at huge risk of mass die-offs, unless there was substantial compartmentalization. Maybe tent cities?

I don't agree with this. Right now we're locking down to get R0 well under 1.0. With its super strict lockdown, Wuhan got it down to supposedly 0.3. That means number of cases goes down by 70% or so roughly every five days. The goal is to get the case count down to in the range of dozens. The better job we do of stopping transmission, the quicker we get out of this phase.

Once the case count is sufficiently low, we just need R0 to be less than 1. 0.9 is sufficient. That means that each case infects 0.9 people on average. To do that, we're going to need everyone to wear masks, stop having big gatherings, aggressive rapid testing, and electronic and human contact tracing.

The low case count we're going for with the lockdown does two things. First, it stops mass death and hospital overload. Second, with fewer cases, you can actually allocate the manpower to trace all of them thoroughly.

> Once the case count is sufficiently low, we just need R0 to be less than 1. 0.9 is sufficient

Consider that it takes days-to-weeks for patient-zero to show symptoms, another couple weeks for symptoms to appear in spreadees, and still more days for the government to responds with strict enforcement. This kind of feedback loop will make this kind of control impossible.

The effective phase of infection only starts when the first symptoms occur. The virus is not airborne, it relies on liquid droplets to be inhaled by the next victim, thus even infected, as long as the individual does not exhibit sings of sneezing or coughing, the posed risk of infecting others is quite low.

This feels directly contradictory to every story out right now. Are you sure you have the right?

That feedback loop is why need to have widespread testing and contact tracing. First patient may take time to show symptoms but then you test everyone they had contact with and catch positives before they show symptoms or are asymptomatic. Also important is quarantining anyone with symptoms until tests prove they are negative.

South Korea and Taiwan show that this kind of control is possible.

Police state here we come?

It is pretty amazing to watch how quick we are at giving the benevolent government a dystopian level of control.

> Once the case count is sufficiently low, we just need R0 to be less than 1. 0.9 is sufficient. That means that each case infects 0.9 people on average. To do that, we're going to need everyone to wear masks, stop having big gatherings, aggressive rapid testing, and electronic and human contact tracing.

Right -- which is why that isn't a sufficient condition for restoring normal life, where people can go to weddings, concerts, festivals, church services, sporting events, and other large gatherings. To get back to that, we need the virus to be gone, or we need herd immunity. The only way we are going to get there fast is if we fail badly and let tons of people die unnecessarily. The goal is to do it slowly so we can take care of sick people properly.

Avoiding "weddings, concerts, festivals, church services, sporting events, and other large gatherings" is a minor inconvenience, not a crisis situation. It would even make sense to avoid those as a matter of course during cold/flu season.

That's a massive change to almost every human culture on earth. I don't think you'll find many people willing to write it off as a minor inconvenience.

Smaller gatherings are fine, especially if e.g. limited to folks from your local neighborhood or small town. "Almost every human culture on earth" still functions basically on that scale anyway.

Agreed that we're better off overdoing it, but we can't just stay indoors forever.

I don't agree that we can get herd immunity without mass death. First, the fatality rate is still high even with medical care. Second, it would take years to process everyone that needs to get it through proper medical care.

Finally, to do the flatten the curve strategy, you need to get R0 at exactly 1.0. Too high and it blows up again. But if you get it a little too low, and you keep it there for a while, the virus just dies out. If we're capable of keeping R0 at exactly 1.0 for five years, we're certainly capable of keeping it at 0.95 for two years until we have a vaccine.

But the better we do, the sooner the crisis will be over. Sure, there will be a drawn-out painful phase of figuring out how to reboot the economy while maintaining social distancing, but it will be much less painful for most people if they don't personally know someone who died.

(I said "for most people" because apparently some commenters here think it's fine for people to die as long as they are old.)

In South Korea, people have already shifted to complaining that the government didn't prepare well for online school curricula, because that's what people are worried about now. Their children's education.

> is being spread by liberal/lefty

This part of your message does not help. To divide and radicalize people it will just make society weaker and individuals more irrational. For the virus there is no party lines nor nationalism. For the virus we are all together on this.

Social distancing, washing your hands and face masks are effective. And, I hope that next time we will be better prepared for this kind of emergencies. Humanity learns from each challenge.

I would include myself in that "liberal/lefty" group. I saw that several of the comments made prior to mine were blaming calculated conservative manipulation, and I wanted to point out that the misconceptions are also arising naturally on "our side" out of desire to promote compliance and optimism.

I didn't expect this issue to become political until I observed it happening. The political aspects of the issue have to be addressed, including the assumption that made-up facts can be benign if they're spoken by the right people with the right intentions.

> I didn't expect this issue to become political until I observed it happening.

There seem to be people (on both sides) who care more about "winning" against the political "enemy" than they do about literally keeping people from dying. That frightens me, maybe more than the virus does.

I agree. I have a hard time with the news these days, and I was hoping that a bright side of the coronavirus would be that there would at least be some non-political news that I could follow and chit-chat with people about. Sadly, no.

I wonder how many people will die from the economic impact of a prolonged shutdown. I wonder how many lonely older folks will wish they were dead now that they can no longer receive the few visitors they had.

I'd be willing to bet it's more than the actual numbers affected by a virus and an overburdened hospital system.

Older folks? I have a mid 30's coworker who used to get most of social activity from the office and tech events and meetups (which is bad for a whole other set of reasons) but even from our fairly active work and friend group chats and you can tell he's really feeling the loneliness and depression.

He started drinking more during the week and has mentioned several times that he is very sad and can't wait for this to be all over. I know that there are thousands of people in the exact same scenario.

I come to observe suffering in people on the other end of the spectrum - the social butterflies that are like caged wild animals nowadays. Calling acquintances left and right was ok for the first two weeks or so, but as the quality of the discussed subjects dwindled and with it the frequency of social virtual interactions, there's a clear sign that the self-isolation feels more harsh for extroverted people.

Our company instituted a smart policy that only management need come to the office because they tend to be extroverts unlike the ordinary developers

You shouldn't be downvoted. The economy is not some abstract separate thing that can stopped and started at will. A prolonged economic depression will kill people just as surely as the virus. They will die deaths of despair from suicide, substance abuse, and chronic disease over months and years but in the end they'll be dead all the same.

Governments can mitigate the problem to a limited extent through temporary measures like giving people money and halting evictions, but that will only help at the margins.

Older folks seem to be having the most polarized reactions, to be sure. My mother is terrified and letting her next-door neighbor do her shopping for her so her contact is limited to a single person. There's certainly no consensus among older people that they want to take their chances for the sake of the economy.

"It's flattening the curve, not shrinking the area under the curve"

That's not necessarily true. Numberphile recently did a piece on "The Coronavirus Curve." It describes "the so-called SIR Model being used to predict the spread of cornavirus."

At https://youtu.be/k6nLfCbAzgo?t=920 (15:20 into the video), they point out that in the model, if the infection rate is reduced hugely, not only does the peak get smaller, but so does the total number of infections.

Thanks for the link, that was a fascinating watch, but I don't think they're modeling a return to normal life there. They assume a transmission rate that is decreased by social distancing measures, and they leave the transmission rate constant over time. I think that means they are modeling what happens if we continue the same social distancing practices indefinitely, rather than a return to normal life.

Another way of looking at it is that they are modeling herd immunity under social distancing, which is achieved at a lower infection rate than herd immunity under normal social behavior.

I believe it's the latter - a fast spread will overshoot past the minimum herd immunity, while a slower spread won't, thus resulting in fewer overall deaths and ICU visits.

In other words, shrinking the area under the curve while flattening the curve.

Of course, that's a highly simplified model, might not be true, etc., etc. But it gives me, a leftist, some support for my belief that some "social distancing for as long as it takes" is a more reasonable viewpoint than no social distancing.

(I replaced "strict" with "some" because I prefer the Swedish model - see https://news.ycombinator.com/item?id=22768170 . I just haven't a clue for how things will turn out.)

That model doesn't account for other countries not following the same (presumably strict) procedures. We aren't islands, and even if there is a short term suppression in your current country, it seems unlikely you're going to quarantine every incoming flight (and its crew!) for 2 weeks per flight. I suspect any model that doesn't result in the majority of the population getting it eventually is probably wrong.

Sure, but my point wasn't that the SIR Model is correct (elsewhere I wrote 'that's a highly simplified model, might not be true, etc., etc'), it was to show that dkarl's model - flattening the curve doesn't change the overall number of infected people - isn't necessarily correct.

I'll give you that it isn't necessarily correct, but I don't know if it's sufficiently incorrect either :-)

The biggest problem isn't political, it is that we're limited in how many people can be infected at any given time by our health care system. The capacity of our health care system must be taller than the height of the curve to limit the number of deaths.

I expect/aspire/hope to get to about 80% normal by October or so.

At this point I hope to but do not expect to be able to make my normal Christmastime holiday travel, and that's about my horizon.

What do you think 80% normal will look like? I'm currently planning a small (30-50 people) event in October and I'm trying to figure out if I need to postpone/reschedule.

It's probably not a good idea to hold such events before a vaccine or an effective treatment are available. Neither is likely in the next 12 months.

I'd just assume it needs to be rescheduled into 2021. Should group gatherings resume before the end of the year, which seems unlikely, it seems a safe bet that turnout would be rather low just due to people not wanting to risk it. On top of that, we're most likely going to be neck-deep in a pretty painful recession (at least) by then.

I was actually wondering about Christmas yesterday. I moved across the country a decade ago and go home for two weeks at Christmas each year. Assuming there is no vaccine by then (which seems to be the most likely case), I was wondering what was worse: 2 4+ hour flights and the airport time or taking the 3 days and 2 hotel stays to drive (or even sleeping in my car at a rest stop if that is even allowed). And that's all assuming there aren't travel restrictions in place in 8 months.

By that point almost everyone will have been exposed anyway no matter what quarantine measures we take. At this point we're just trying to slow the spread, but essential activities have to continue (food, transportation, utilities, healthcare, infrastructure, military, emergency services, etc) and so everyone involved in those is going to act as transmission vectors. Once the vast majority of people have been exposed, any further widespread quarantine measures will become moot.

The airline industry is going to be crippled though, and might still be operating at limited capacity in October.

Part of this is due to many institutions, companies, governments, etc, just closing 'for the next month or so'. Then after a few weeks, they extend it another month, and so on.

It seems like many expect the pandemic to just magically disappear when you do a very low-effort quarantine and sit back and relax for a bit.

Remember, this entire pandemic started from one person being infected. As long as there exists one person with this virus, it can start back up and easily scale to millions of cases all over again. Victory is not easy, and some of the main reasons we are doing quarantine are to learn a lot more about treatments, cures, how to cope with these changes to our supply chain, and many other things; that is, to buy us time. The levels of quarantine most countries are doing obviously slow the spread down, but are not sufficient enough to completely stop it. This is a long-term event and will be with us for a long time.

I think the real question here is whether or not the disruption will continue?

If things continue as they are for months, there’s simply going to be a change in mindset and we’re going to realize that there is a new “normal”. Full protective gear for a normal workday could easily become the norm.

Maybe they underestimate how long “this” will continue, because they expect “this” will drastically change normal life.

Wow, just imagining how much more waste we would generate if all of human population needed PPE every time we left our homes as the new normal.

Ironically, that could also be a huge boost to some real recycling programs, and not just with protective gear.

Once people are focused on recycling something they use every single day and there are easy mechanisms to do that, recycling other things becomes less of an issue.

The article doesn't say we are all going to be shut in for he next 12-18 months, it just says life is going to be different for a while. Once the number of cases is dropped down to a manageable level again, which for many states in the US is projected to be somewhere from the end of April to the end of June, we can open things up a bit provided we have a strategy for extensive testing, following exposures and isolating people that test positive. Yes that will still be significantly different than our previous lives, but for many people it will be much closer to how things were before. The key is we need to continue to ramp up testing and we need a system in place for authorities to randomly test healthy people so that they can monitor the extent of the outbreak before it turns into hundreds or thousands of deaths a day again. So the average person will be able to go to work, socialize and more or less return to life as normal but they may have to submit to a nasal swab once in a while on the way into the grocery store or something like that. It doesn't seem like a terrible trade-off.

Serious question: how long does it take for humans to permanently adjust their sense of normalcy? There is a concept of `creeping normality`[0] that gets at this, but there isn't a lot of discussion about how to speed it up and make it permanent.

We know from South Korea that public mask-wearing is probably the most effective form of dropping the R0 quickly. If somehow 100% of Americans could get access to face shields (via 3d printing, for example), then the engineering and logistic problem is solved.

But the bigger problem is the social one. How do you socialize the acceptable use of masks or face shields in everyday public life? If enough people feel enough distress, I could see every person wearing masks, forever. If that happened, the talking points about this dragging on or immediately rebounding start to change.

Given enough technical choices in lifestyle design, there has to be some optimal solution that minimizes droplet emission while maximizing freedom of movement.

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

I think health experts are over estimating how long Americans are willing to have their lives disrupted.

I think whether or not they are willing is not a major concern in these governors’ minds. They have all activated the national guard for a reason...

The state cannot hold back the majority with the army

So far, there's strong public support up here in Canada for the measures. According to polls, the great majority believe breaking the public health orders should be a crime, at least in serious cases. There may be period of time where the government still has a strong, popular mandate to enforce distancing, but there is increasing non-compliance and resistance.

Just the folks who start to snap mentally over the next weeks and months will be a serious and growing problem, even if everyone who stays mostly-rational wants to continue to maintain distancing.

I’m sure for now people are willing to go along (also who would tell a pollster they want people to die, but that’s a separate point). If this goes on for months expect public opinion to change.

That's kind of my point. The public opinion may change, but until it mounts to a point that government policy changes, they'll probably keep enforcing the distancing measures with increasing heavy-handedness.

It may also become increasingly polarized with strong "I don't want to die!" and "I just want to talk to someone!" factions becoming increasingly set in their beliefs.

Civil unrest could occur at that point.

So, unfortunately, I think as soon as actual force is necessary we lose - but while increasing heavy-handedness involves fines and parking a patrol car outside someone's house to make them adhere to self-isolation I think we'll be alright.

I feel like that's a strong differentiator of Canada and the United States - America seems like it's always holding its breath and waiting for the next revolution which will change everything, while we here in Canada just want things to get back to normal.

I agree - up here folks are being quite cooperative, someone even recently painted a mural of Bonnie Henry & Dr. Tam[1]. That all said, some parts of America are quite different from Canada with some churches openly protesting the orders[2] (and putting the most vulnerable at risk).

My big concern down there in America is, if folks get crazy and LEOs need to step in and enforce quarantine it will make that quarantine ineffective and LEOs will become the new disease vector. Additionally if any significant portion of the population decides to violate the order than the LEOs, National Guard and even standing army won't be sufficient to enforce the peace - because the peace can't be enforced, peaceable society can only be accomplished through voluntary social contracts.

1. https://www.citynews1130.com/2020/03/31/fans-paint-murals-dr...

2. https://www.theadvocate.com/baton_rouge/news/coronavirus/art...

Noth Korea begs to differ.

willing to bet that the vast majority of NK agree with the Dear Leader if polled. Why is a different story

What majority? If the majority of people are stupid enough to rise against the tyranny of social distancing, they deserve what they get. At least, I hope that doesn't happen.

Distancing for what, months, years? Lose businesses, homes, future because there's a risk that 1% might die?

Lives will be disrupted either way, lifting restrictions too early will result in more deaths, which is the ultimate disruption of life.

You'd be surprised how many people are already willing to let the death rate increase. The perception is that this virus mainly wipes out sick people and boomers. If there's one thing millennials hate, it's boomers.

Except most of the people willing to take the risk ARE the boomers and elderly. The millenials are the ones sheltering in place and posting about it on Twitter.

I think in both cases it’s a minority but a noticeable or vocal minority who engage in this sparring. Also the spring breakers are not the boomer age group.

I really doubt anyone has the data to make such a claim.

He has data, it's on Twitter...

20% hospitalization rate is what everyone should focus on. CFR is 3% but hospitalization of young adults is extremely high. When young people have to get treatment and they can't - they'll suffer and have serious consequences if not death.

Edit: Listen to the person replying to me. It is not 20%, but 3.3%. I am off by an order of magnitude.

None of those numbers are accurate. Latest research: https://www.thelancet.com/journals/laninf/article/PIIS1473-3...

.66% CFR, with 3.3% hospitalized (and fewer ICU) under age of 40. Even in the >80 age range, hospitalization is < 20%.

If you're going to make a point, make the point with accurate numbers -- those are off by an order of magnitude.

3.3% is still insanely high. If 50% of US population is under the age of 40, that's 5 million people in hospitals.

This changes nothing.

> This changes nothing.

It literally changes everything, as you're spreading false information. Instead of 20%, it's 3.3% - that doesn't change anything? It's the difference of tens of millions of lives just in the United States!

Yes, 3.3% is still high, but it's not even in the same ballpark as 20%. And not everyone will be hospitalized at once, which is the entire point of flattening the curve.

The point is that 20% or 3.3%, the amount of hospitalizations would far exceed the capacity. We shouldn’t get there in the first place. So the proposed idea of opening things up is a non starter.

I’ve already edited my comment to concede on 20%. Why get so combative in responding? I’m not trying to spread false information and willing to concede when new factual information is reported. Jeez.

> Why get so combative in responding?

Because you were arguing tens of millions of deaths "changes nothing."

The data I've seen so far shows that it's mostly young people with complications. If you're one of those people with such complications, you can self select out and remain quarantined while the rest of the country tries to return to work.

That's not to say that a few young people with no health issues might be harmed. There will be some, but from what I've see thus far, all other potential causes of death in the next year from things like cars accidents are more likely than dying of COVID19 in the next year for those young people with no co-morbidities.

Just saying young people in general have a CFR of 3% isn't helpful.

The crazy think is I still see plenty of young people smoking and vaping. WTF? Now might be a good time to take care of your lungs.

There are zero hospitals in America that over capacity right now including NYC.

How much of that is due to hospitals clearing out and refitting themselves to support what they knew was coming? Do you expect that trend to continue?

The operative words are "right now", with the current evolution of the virus and the population not taking the measures seriously, how long do you think that is going to last?

25,000 cases to 250,000 cases in two weeks.

Give it another two weeks. Thank god people with foresight and basic math skills are the ones planning for increased hospital capacity.

More and more tests means more and more cases. More cases with less deaths means the mortality percentage is lower. The number of cases does not matter at all.

BTW God should be capitalized it's a proper noun.

I'm in NYC and I have no idea what you're talking about. Many of our hospitals are well beyond capacity, the most well reported on example being Elmhurst Hospital. Go look it up.

The NYTimes article seems to disagree with you [1]

> Across the city, hospitals are overrun. Patients have died in hallways before they could even be hooked up to one of the few available ventilators in New York. Doctors and nurses, who have had to use the same protective gear again and again, are getting sick. So many people are dying that the city is running low on body bags.

[1] https://www.nytimes.com/2020/04/02/nyregion/ny-coronavirus-u...

You do understand that the outbreak has exponential growth which has not peaked anywhere? Even NYC cases will likely double this week before their peak. If anywhere in fact is "over capacity" now then they'll be in much deeper shit than they are now, which is already pretty deep.

I'm not sure what you mean by "over capacity", either. If you're talking beds, ICU slots, and ventilators, maybe not yet. If you're talking lack of staffing, lack of PPE availability, general workload, then I think many are straining or over capacity now.

I am talking about the former which is true. I concede there is a strain on staff. There seems to be a belief out there that hospitals are already full which is not true.

It's also impossible to know if we if we have peaked or not. It's just like trying to time the stock market. The only thing that really matters is the death rate. The rate of cases doesn't matter and is likely under counted. We are testing more and more people which increases the case rate. If we tested everyone including those with no cases and found a lot more people than expected have the virus the death percentage would go down.

I am also skeptical of how the start of the spread in the US was determined. It's possible it was much earlier and early cases were confused with Flu and we are in fact near the peak of the death rate.

Do you have a source for that? I think we are doing all this, so some people can live 3 years longer.

A few more months like this and people will start dying from other causes (crime, hunger...).

Like guns the virus is much more of a problem in urban places than rural places. Americans not in cities aren’t going to take much more of this shutdown imo.

Shouldn't this be asterisked with a "So far"? The black plague devastated rural communities along with urban.

The Black Plague was spread by rodents. Coronavirus currently required a human carrier. I do agree about the "So Far" bit though, if precautions aren't taken, eventually someone will catch it and it'll spread.

It's already happened in a few places.

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

Those will also be the locations with less preparedness. How many small towns even have ICUs?

This is misguided. The capacity of the healthcare system in rural areas will be even easier to overwhelm.

Of course it's misguided. Which country handled this crisis worse than US? Misguided is an understatement.

If I use the words that I think are appropriate for the obstinate middlebrow skepticism of HN in the face of an uncontrolled pandemic, I get flagged :^)

Maybe Brazil?

> "We're all going to die one day"[0]

> “I’m sorry, some people will die, they will die, that’s life,” Bolsonaro said in a television interview on Friday night. “You can’t stop a car factory because of traffic deaths.”[1]

> Bolsonaro has compared the new coronavirus to a "little flu," condemned the reaction to it as "hysteria," and said Brazilians' immune systems are so strong they can swim in raw sewage and "don't catch a thing."[2]

> He has called the virus a “measly cold.” “Some will die” from it, he said, because “such is life.” [3]

> ..more than 20 members of Bolsonaro’s U.S. delegation have tested positive for the coronavirus. Bolsonaro ignored his own health ministry’s advice to self-isolate for a couple of weeks and to discourage large gatherings. He made a defiant show of shaking hands and taking selfies at a rally that attracted hundreds of his supporters. [4]

[0] https://www.marketwatch.com/story/brazils-bolsonaro-downplay...

[1] https://www.nytimes.com/reuters/2020/03/27/world/americas/27...

[2] https://www.afp.com/en/news/15/bolsonaro-takes-down-virus-sh...

[3] https://www.nytimes.com/2020/04/01/world/americas/brazil-bol...

[4] https://www.theatlantic.com/politics/archive/2020/03/bolsona...

Our death rate per capita is substantially lower than China and Italy for example.

Y'all need to understand what an exponential function looks like.

Y’all need to not compare absolute case numbers on an exponential curve between countries with vastly different populations.

I find it odd that people are comparing "worst" by number of cases and not accounting population. The US has 320mn people while Italy has 60.5, Spain has 46.8, and Germany has 83.8. These are the countries with the most cases and by population the US is doing the best out of all of them and Spain the worst. If we look at deaths, Germany is only slightly better than the US but Spain and Italy are each much higher.

The US sure has a lot of problems, but that doesn't mean everything we do is the worst.

The US spread is a few weeks behind the other countries. People are projecting based on incubation time and mitigation response what will happen. The US growth rate is on track to make everyone else look peachy keen.

I doubt there is any definitively proven date of the start of the spread. It very well could have started sooner than claims.

Every one except SK Israel and perhaps Germany.

New York has 1,600 ICU beds; there are a bunch of counties in rural America that have zero. The CFR in these counties if the virus gets out of hand will be appalling.

I think, actually, this statement is misguided, for a couple reasons. Its very likely that people are underestimating the average city's "hospital beds per capita" metric; frankly, a ton of people live in the average city (duh). Are there enough beds in many of America's tier-2 (say, Austin) and tier-3 (say, Cleveland) cities to cover all of the population?

By comparison, outside of cities, the spread will be far, far slower than within. Yes, healthcare is worse, but there's an order of magnitude fewer cases. People travel less. They go to the store once every two weeks, not every 4 days, even when there isn't a quarantine. They don't visit the new hipster restaurant down the street. They don't live twenty feet away from their neighbors.

NYC has 25% of all of the United State's cases, despite having ~2% of the US's population. This is the same story that is playing out in every state. Let's take Indiana as an example, being that they're having a relatively moderate outbreak with mostly rural areas surrounding a top 15 US city by population: Indianapolis has 41% of the state's cases, despite representing ~12% of the state's population.

This shouldn't be a surprise; diseases spread faster in cities. But, what you're asserting is that, eventually, rural areas will see the same spread that cities are. This feels misguided. That isn't to say that some, or even most, rural hospitals wont be "running hot" for a really long time, and that the virus wont spread and these areas, but its simply unlikely that the situation will ever be as bad as in major cities.

My position is based on the unpredictability of exponential phenomena and the fact that the healthcare system in rural areas has been in the process of being hollowed out for quite some time. The incubation period of COVID-19 (estimated median 6 days last I checked?), coupled with the fact that most people who carry it are asymptomatic means that it's only a matter of time before it hits rural areas whose capacity is like, what? 0.5 ICU beds per county? If you need a ventilator out there you're gonna fucking die.

The majority of COVID-19 patients who need a ventilator are going to die regardless of whether they actually get a ventilator or not. Hopefully that will change as more effective treatments are developed, but that's the current reality. By all means let's do whatever it takes to deploy more ventilators, but they're not a panacea.

I've been curious on this. Do you have numbers for people that have been put on them?

Confirmed cases depend on testing. What’s the testing capacity in Indianapolis vs rural areas?

There’s also a time lag. I think it hit New York first because of all the travel connections.

But why would rural areas be immune? People do still meet each other. They do go to church.

Tellingly, flu death rates tend to be higher in rural areas:

https://www.washingtonpost.com/nation/2020/03/19/rural-areas...

Yep everyone in rural places blindly goes to church no matter every Sunday (eye roll).

Legal action has had to been taken already to prevent gatherings at churches.

https://www.foxnews.com/us/louisiana-pastor-who-defied-coron...

Many US states do not currently have restrictions on churches. I was replying to the point that people in rural areas are spread out. My point was that some activities, like church, bring people together into an enclosed space.

Alright well when urban Americans start talking about breaking up the country over this I don't want to hear any kvetching from the rural areas.

I have a feeling rural folk will be a-ok with that.

Until the subsidy checks run out.

My money is on the group that controls the food supply.

The people that own the food supply live far away from where it is produced.

Agree, I am saying rural America controls the food supply and is armed.

Anyone looking at this as just a New York or LA or Miami problem will learn soon enough. The cities were hit first for obvious reasons but it viruses don't self-isolate to population centers.

I hope that's true because the country needs food. I don't think rural communities without any protections will be any better off though. Rural communities still gather in stores, bars, restaurants so I don't see why the spread would be any less impactful.

Because they interact less and interact less with world travellers, have less world class workers imported from around the globe. They are spread out more, take public transit less. Doesn't mean it won't spread but in a rural setting you see thousands of people less per day on average.

Honestly, my life in the suburbs hasn't been much different since this all started. It's basically been business as usual, except for things like stores not having as much food variety, fast food places being drive through only, and big box stores being less crowded. I think people in the cities will be most effected because of the large number of small shops and independent restaurants that had to close, but out in the suburbs the impact hasn't been any worse than when we get a big snow fall.

I've been thinking about this and how talking about the US as a homogenous entity is a mistake. The R0 of a big city is going to be higher than in a smaller city, suburb or the country side. For example, even before the shutdowns I could go to the grocery and count on one hand the number of people I might be within 6' of. Now it's even less. In a place like NYC, that seems impossible.

I and all the people I know are taking all the precautions, but density has to play into how fast something can spread.

And yet there have been very dense, urbanized countries that have gotten a handle on it well (such as Singapore and Hong Kong). We could do it here, but we don't have enough testing or enough masks. The density of the country is not the main driving factor behind which countries are getting hardest hit and which are not.

On the other hand, many rural communities are vastly less capable of providing the care for even a small fraction of the big cities. Many rural counties in Colorado and Idaho have the highest rate of death and are most overwhelmed in their states because they have far less capacity.

Less likely to get it vs less likely to get medical treatment.

Logically it make sense to want more rural. If you test positive go to the nearest big city for treatment.

Assuming their hospital isn't already overwhelmed.

Americans are not taking this shutdown at the moment, anyway. I live in Boston, other than that people who can work from home, work from home and restaurants/bars are close, absolutely nothing seems to have changed.

My roommate works in a random thrift shop, they're classified as "essential business" so he still shows up to work every day to read book.

I don't know why a thrift shop would be classified as "essential". Here in Minnesota they are not.

Blue collar Americans in the cities are within a couple of weeks to telling everyone to shove it. These are people who had less than a $1000 dollars extra in their bank accounts. They have been out of a job for one paycheck already.

Credit card companies are slashing credit lines. Postal service is failing to deliver mail in some locations. Unemployment numbers/systems work as well as Healthcare.gov did upon launch.

We are one to two weeks away from massive civil unrest when thousands of people have no money to pay for food.

If you don't want this unrest, start giving people food. The solution is obvious, and is only unpalatable to idealogues.

There's no centralized system to do this. Everything relies on thousands of little trading businesses. Those businesses are now closed. It will take at best a couple of months to get a different system in place.

If that system gets rolled out, the US as the country is over because it is an admission that the US is not capable of maintaining it's existing economic system.

All the groceries are currently open. All the farms are currently working, minus migrant labourers, because we would rather have crops rot in the field, than let them into the country. All the truckers are currently hauling.

The only part of the distribution system that isn't working very well because of the shutdown is the part that distributes dollars.

Any service disruptions right now are not due to the shutdown - they are due to the actual effects of the virus. Look at the MTA. Half of its employees are sick, and the other half have called in sick. Train service has been reduced, and passengers are now packed like sardines in a can on the trains that are still running. Look at the supply chain disruptions - they aren't caused by people being stopped from coming in to work - they are because people can't, or are afraid to come into work.

As well they should be, given the state of healthcare in this country. Who is going to pay for their care if they are one of the 20% that need hospitalization after catching it?

> All the groceries are currently open.

That's a talking point.

Chinatown grocery stores are mostly closed in both Manhattan and Queens. Patels is closed everywhere.

Edit: Downvotes don't protect from reality

https://www.patelbros.com/coronavirus

Enough grocery stores are still open, and grocery delivery services are doing roaring business. We're not remotely (yet?) at risk of people starving from inability to obtain food.

Non-gigantic grocery stores are going to start closing because contrary to the official positions logistics is broken. Smaller grocery stores have very small margins and operate on COD basis. A friend of mine owns one. His distributors raised prices between 10-50% across the board and removed all the incentives. He does not have enough money to stock up at the new price points so he is slowing the buys, cleaning out inventory and is going to close unless the social distancing goes away by the end of the month. Anecdotally, other small supermarket operators are thinking about doing the same.

Effective grocery store prices are 2x - all of the sales have been removed. Eggs in Queens went from $1.69/dozen to $7.99 a dozen.

$1200 tax credit for 2020 ( this is what it actually is ) is nothing for people who live and support high cost areas which are the people who allow for the white collar jobs to exist.

Are those logistics broken because the government shut the logistics operators down, or because people running them have fallen ill, or are afraid of falling ill?

Every state with shutdown orders considers logistics essential services. Nobody but the virus is preventing the people working in them from going to work.

I'll repeat it: Nobody working in food production and distribution is forbidden from going to work.

If prices are rising, it has nothing to do with the shutdown, and everything to do with the fact that there's a global pandemic... Which will be made worse if lift the shutdown orders.

Are you planning on ordering these people back to work at gunpoint, to lower the price of eggs? Or are you going to instead, consider extending a short-term loan, so that the grocer can absorb the price hike? The number of hens laying eggs hasn't changed over the past four weeks.

You keep repeating talking points from TV.

> I'll repeat it: Nobody working in food production and distribution is forbidden from going to work.

That is not the message that is being repeated on TV and on the news. The message is "stay home. if you are close to people you are going to be infected and die. stay home". The message is not "Stay home unless you work in list in blah blah blah. Also, unless you have comorbidity such as diabetes, heart disease, compromised lunges you are going to be fine". If you keep repeating that people are going to die, people are going to believe you even though the number of people who are going to die that do not have comorbidity factors have a very low risk. That's how you destroy logistic.

Right now Amazon, objectively a logistics company, has an equivalent of the ground hold on all non-essentials. I cannot get a frying pan delivered until April 24th.

> I'll repeat it: Nobody working in food production and distribution is forbidden from going to work.

We are at 10% of seasonal flu death numbers heading head first into a wall.

> Right now Amazon, objectively a logistics company, has an equivalent of the ground hold on all non-essentials. I cannot get a frying pan delivered until April 24th.

Amazon is having a hold because demand for everything is up, because people are trying to avoid going outside to shop... And because their employees are concerned about their personal safety. No government agency has stepped in to shut down an Amazon warehouse. If you lift the shutdowns, you will actually increase their concerns about personal safety.

> If you keep repeating that people are going to die, people are going to believe you even though the number of people who are going to die that do not have comorbidity factors have a very low risk.

Those people have relatives who are at risk, or may not be interested in rolling the dice on ending up in the hospital. This virus has a much higher hospitalization rate than the flu. Are you ready to pay for all their medical bills? Has socialized medicine finally found its moment to arrive on the shores of the United States? Or, alternatively, are you personally ready to take a job lifting boxes in a warehouse for $15/hour with no medical benefits? One that you commute to in a subway car that's packed shoulder-to-shoulder with sick people?

The MTA is unable to operate the NYC subway, because they have so many sick employees. Do you think a Krelminesque order to stop broadcasting bad news on the telly is going to defy reality, and get the subway running at full capacity, again?

> We are at 10% of seasonal flu death numbers heading head first into a wall.

Italy has, over the span of 4 weeks, hit 300% of their regular seasonal flu deaths, and 50% of the hospitalizations, despite a lockdown but this apparently does not stop people on the internet from drawing false equivalences to the flu.

Do you have a better plan for dealing with a virus that sends more people to the hospital in 4 weeks, than the flu does in half a year? How many hospitalizations and deaths do you think they would have hit if cases continued to double every three days?

> Amazon is having a hold because demand for everything is up, because people are trying to avoid going outside to shop... And because their employees are concerned about their personal safety.

You cannot have it both ways - either employees are concerned for their safety and logistics therefore is affected or they are not and logistics is not affected.

> The MTA is unable to operate the NYC subway, because they have so many sick employees. Do you think a Krelminesque order to stop broadcasting bad news on the telly is going to defy reality, and get the subway running at full capacity, again?

MTA decided to cut the service on NYC subway because it projected a drop of demand. It is an organization has been been mismanaged for decades. I find it very difficult to believe that it would suddenly be making marginally optimal decisions in "the stay at home" environment.

> Italy has, over the span of 4 weeks, hit 300% of their regular seasonal flu deaths, and 50% of the hospitalizations, despite a lockdown but this apparently does not stop people on the internet from drawing false equivalences to the flu.

The vast majority of hospitalizations and deaths come from comorbidity.

> Do you have a better plan for dealing with a virus that sends more people to the hospital in 4 weeks, than the flu does in half a year? How many hospitalizations and deaths do you think they would have hit if cases continued to double every three days?

Order a stay at home for at risk population and population with comorbidity. Lift it from anyone else. Eat 10-15% hit to the economy rather than a total devastation. The mass poverty creating economic hit is going to destroy the medical system much faster than COVID-19.

> You keep repeating talking points from TV.

This is a very weird line of argumentation. Do you think there is some media-wide conspiracy in favor of containment? To what end?

These "talking points" are also what the epidemiologists and politicians are saying. Just because you are in the minority that doesn't agree with it doesn't make you right and everyone else wrong.

Yes, the issue is becoming dollars. There are programs in place that seek to do this. Specifically "food stamps" -> the latest bill funds these a lot more.

But due to years of people handwringing over abuse, and "economists" encouraging thrift, the process to get food stamps isn't speedy, it's state-by-state, and now it's overwhelmed.

Due to the general anthemia among the GOP for welfare type programs, different states are going to see different levels of urgency with boosting the food stamp programs. It's much the same as how some GOP led states refused the medicaid expansion that was part of the ACA.

Hopefully this will reveal new information to voters of those states as they slowly starve and as they realize that certain other states are doing better - what's the difference? Competent governance. You can't buy it, but you can vote for it.

Of course there is. It's called the National Guard. It's called the US Army, Airforce, and Navy. It's called FEMA. I'm sure there are plenty of other centralized systems with tons of funding ready to do this on a moment's notice. What we don't have is leadership, with an idiot leading this country who said the pandemic is a "hoax."

The optics of the National Guard (read: men with guns) delivering food for months in the entire United States would trigger a nearly immediate break down of economic ties both internally in the US and between the US and the rest of the world

What do you think FEMA does after a hurricane?

Difference is the orders of magnitude

Where does the food come from if nobody is picking it, transporting it, processing it or selling it?

Food production and distribution has not ceased, nor is there any reason it will. Getting that food to people who cannot afford it is a different issue.

It is somewhat amazing to me that politicians don't seem to understand this. The solution is so simple: give people money directly, give money directly to businesses with the promise that they will not fire anyone, and do it yesterday.

Perhaps I'm simply misreading the situation and am in a bad mood, but it seems that whenever we see a government program rolled out, politicians seem more interested in preventing fraud, misuse, and politically sensitive spending than they are in seeing the program actually succeed / solve it's stated problem. This results in layers of complexity, regulations, and bullshit that impede the program from functioning efficiently. I would rather a cash transfer program have a 25% fraudulent claim rate and a 90% legitimate claim success rate than a 2% fraudulent claim rate and a 50% legitimate claim success rate. Politicians seem to want the latter. Further, there were arguments during the negotiations about the 2 trillion dollar bail out about abortions and oil subsidies ffs. These guys need to get their heads out of their asses and join us in the real world.

They actually are doing both of those points. Everyone's heard of the $1200 checks to individuals, but they also created the Paycheck Protection Program[1] which advertises itself as a small business loan program but "will forgive loans if all employees are kept on the payroll for eight weeks and the money is used for payroll, rent, mortgage interest, or utilities." In other words, if you run a small business, Uncle Sam will cover your payroll for 2 months if you don't fire anyone.

It's the "do it yesterday" part that they're having trouble with. Major banks are saying that the government isn't forthcoming with the details they need to actually implement the lending program, so they've had to delay its launch.

[1] https://www.sba.gov/funding-programs/loans/coronavirus-relie...

[2] https://www.forbes.com/sites/brianthompson1/2020/04/03/no-sm...

There has never been a single program administered by the SBA that was not comically broken.

There are two possibilities:

1. This program is going to continue the great tradition of government epic failures of providing help to small businesses

2. This time around it works and small businesses get an immediate ( in a commercial sense of the word ) help in record time.

One won't need to be a genius to figure out the implication of 2. Personally, I think it would be 1.

> The solution is so simple: give people money directly, give money directly to businesses with the promise that they will not fire anyone, and do it yesterday.

The CARES act did do this, and it did it yesterday.

Passed != Implemented

> It is somewhat amazing to me that politicians don't seem to understand this.

Since we are now awaiting implementation, politicians are no longer in the picture. They understood what needed to be done, and did their jobs. It is now up to the bureaucrats.

This isn't an accurate picture of the US Federal government.

Now that congress has passed the law, it's up to the EXECUTIVE BRANCH of the government to make it happen. There's a politician at the head of that - POTUS.

People wanted an outsider in the White House, someone who would "shake things up", and this is the consequence. This is what it means.

The POTUS can and should be making this implement faster.

> Now that congress has passed the law, it's up to the EXECUTIVE BRANCH of the government to make it happen. There's a politician at the head of that - POTUS.

This is implemented through the agencies of the Executive branch, the operations for which are almost entirely run by bureaucrats. When Trump entered office, he didn't just fire all of the bureaucrats at the Department of Labor, he just replaced its head.

The folks that work on the day-to-day operations of processing unemployment insurance claims, or maintaining/improving the systems remain largely unchanged. Their employment is a function of the budget and funding, which is determined by Congress, and then assented by the POTUS.

In the case of CARES, the Senate unanimously passed it, and POTUS quickly signed it into law. He is not going to micro-manage its implementation. It's now up to the bureaucrats.

This is flat-out not true. People in rural areas still congregate with other people enough to cause bad epidemiological outbreaks. Past pandemics have not only hit the city and spared the countryside.

I grew up rural bet you didn’t.

I suspect rural folks are more likely to go to church, but I could be wrong.

Stereotype much?

That's true up until someone brings it to their church, a funeral, school graduation and the entire community gets it and it's like a small bomb going off. Truck drivers still go through small towns, packages still come in and out, they get food.

That's armchair quarterbacking from people with more than enough money for shelter and food.

Exactly.

I see most of the advocates for "shelter in place until we're safe!" are white collar people with space at home and direct deposit.. not hourly workers who just lost their livelihoods with kids at home and the only internet is on their phone.

White collar carnage will start by the end of this month.

Not all US states are doing it the same way so it’ll be interesting to see how things go.

That's false. Death is the natural and inevitable outcome of life. The people who would die of COVID are nearly exclusively people who would die relatively soon anyway. For an average 85 years old person, the risk of dying due to COVID if no mitigation is attempted is 6.3% [1], less than the risk of dying of other causes during the next year (9.6%) [2].

A 20 years old is more likely to be struck by lightning than to be killed by COVID.

The life expectancy saved by the lockdown is just so small. I find it extremely hard to believe that the lockdown will cause less loss of life than the new virus would have.

[1] https://www.thelancet.com/action/showPdf?pii=S1473-3099%2820...

[2] https://www.ssa.gov/oact/STATS/table4c6.html#fn1

My assumption was that at least part of the reason for isolation measures is to prevent what happened with the Spanish Flu, where unfettered transmission created the conditions for a mutation that turned the U curve for mortality into a W curve.

Is Covid-19 more likely to suddenly mutate and become more lethal to young adults than, say, some strain of influenza doing that (again)?

The opposite. It mutates more slowly than the flu.

I think it's mostly to avoid the bad press of having to do triage at hospitals, long-term consequences be damned.

You're getting downvoted, but while it may not be pretty to think about, these other factors are important to consider. Even the expected years of life lost (which are factors found in medical literature). Unfortunately COVID-19 does affect younger people to a degree (40-50's) who could live healthy productive lives for decades, so it's not going to be pretty numbers.

Still "Flattening the curve" seems to be the only thing epidemiologists are focusing on, but ignoring the death toll from unemployment, domestic abuse, depression/suicide, and others. Not to mention how many people will die from exposure to being evicted due to being unable to pay rent or hunger from buying groceries. Or the long term effects of depressions or social anxiety from being locked down, etc. These are real factors.

The CDC's lack of modeling of these factors is disconcerting, if not bordering on _incompetence_. I've been searching for models (preferably using STAN or similar to calculate adjusted statistical likelihoods) to estimate holistic effect of lockdowns on overall death rates adjusted for those factors. So far I haven't found anything, or very limited research.

It sucks, but as a society, we have to be able to critically analyze the situation, including the tough factors of triage at a societal level.

Are people expected to suffer the disruption of having a substantial number of people taking two weeks off to recover from this disease with a non-trivial chance of needing medical intervention?

Are you going to be willing to postpone all medical interventions for the next three months because there's just not going to be available hospital capacity for your broken tooth?

It's substantially more than two weeks for people who get a worse case of it, by the way. I had a mild case and was off for two weeks. If you get a more severe case, and especially if you need hospitalization, you're looking at at least a month of recovery. This virus attacks your lungs, which take a lot longer to recover from than your typical cold or even flu. The best comparison as to how long you're out of commission for is pneumonia.

> The people who would die of COVID are nearly exclusively people who would die relatively soon anyway.

Why are we building emergency mortuaries?

I think the parent was implying people are more willing to risk coronavirus death than to be stuck at home for as long as they're expected to.

This may be true for now when most peoples' lives are as yet still unaffected by it, but it's very much not going to be true after a month of uncontrolled pandemic when everyone will know many people who've died from it.

I agree, though it'll be a little late at that point.

You're overestimating the impact. The worst case scenario is more like 1 out of every 100-200 Americans dying. Concentrated mostly in the elderly. The majority won't have anyone close to them die and few will have "many".

No, the worst case scenario is much worse than that. Hospitals won't have room to take care of most people with the virus or other illnesses for that matter, and many will die as a result of just that. The hospitalization rate is quite a bit more than 1%, and that becomes the death rate when no hospital can take care of you. These have all been repeated in the media many, many times by now. I'm in fascination of how people are receiving the memo so slowly in 2020.

Not to mention 1/100 is enough for a lot of people to result in at least one person they know dying.

>No, the worst case scenario is much worse than that

It's really not. People just don't seem to grasp that the rates for positive cases are drastically different than the rates for people infected. We aren't doing nearly enough testing to catch even all the symptomatic cases let alone the asymptomatic and mild ones.

The infection fatality rate is almost certainly under 1% and not everyone will get infected even in the worst case.

>Not to mention 1/100 is enough for a lot of people to result in at least one person they know dying.

Only if we use a very broad definition of what "know" means.

You appear to be taking about the mortality rate when medical care is available. What is the rate after the hospitals are full?

Look at parts of Italy--there are areas that have already had 1% of the population die. Note that most of these are not being reported as Covid-19 deaths (presumably because of the overload, they never got tested), we simply see it in excess mortality.

>Look at parts of Italy--there are areas that have already had 1% of the population die

Which parts are that?

Nembro, Italy. Pop. 11000, 152 deaths. 1.38% of the population died. In March.

I believe there are more examples, but that is one of them.

A small town doesn't really count as a "part" of a country.

It's also probably just a statistical outlier. Even if the overall IFR is 0.5% you will see some areas with rates higher or lower than that from chance or their demographics.

It's still early on in the pandemic. The vast majority of the people who will die from it still haven't yet. It's way too early to be putting ceilings on the overall death rate.

Isn't that the part of Italy where hospital collapse actually happened? And in the same article they conjecture they are now at ~herd immunity. And the demographics are skewed towards the elderly so again they themselves estimated the death rate being consistent with 1%, age-adjusted. And they counted ALL the surplus dead. This is an upper bound of the absolute worst case, as far as I can tell.

Nobody there is going to die in April from covid?

They are past the peak (again based on the info from the original article), so it doesn't seem likely the numbers will change a lot; not to the level of 6%/3%/other numbers being suggested in other sources.

First, the uncontrolled number is more like 4% because the healthcare system crashes. 1% is what you get when the healthcare system still works.

And most people have family members that are in the high risk group.

It's amazing how many people are willing to sacrifice millions of people on the altar of the economy--when it wouldn't even work very well because people are going to be minimizing risk anyway.

A useful question I've found is "So which of your friends and family are you prepared to sacrifice so we can all get back to normal?" Statistically speaking, with a rapid uncontrolled pandemic, everyone is gonna know at least several people who end up dying.

That’s unfair unless you also answer which of your friends you’re willing to sacrifice to unemployment, poverty, homelessness, depression, etc. so we can go on lockdown for longer.

I hate this framing that makes it seem like it’s a choice between caring about people and caring about money. When the economy crashes it causes real misery for real people.

The economic consequences of the shutdown will not be remotely as harmful as the deaths from not shutting down.

How do you know?

None of my friends are family are being sacrificed to any of those things. Most are able to work from home or are classified as essential workers and are still working for that reason (e.g. I know some nurses and police officers), and the ones who were in the service sector are furloughed and are getting unemployment. None of this holds a candle to them dying.

What do you think is the overall right length of time for the lockdown? Do you think we should already be getting back to work now?

So basically you think there won’t be too much contagion and people who have jobs or are getting unemployment benefits now will still be in that state after a few months? And that the unemployment system can handle an almost overnight order of magnitude increase in demand? And that essential services like farms, shipping and grocery stores will survive long term despite the major supply chain disruption? That seems crazy optimistic to me but I guess I can’t convince you.

Please read up on the Great Depression. Economic downturns can be pretty bad. If they could have solved it by just giving everyone unemployment, they would have.

Edit:

> What do you think is the overall right length of time for the lockdown?

I don’t know dude, I’m not an economist. I just think the economic effects should be properly taken into account and weighed against the health effects. Yes, there is some amount of economic damage that it’s worth some number of people dying to avoid. That seems obvious to me, but people act like you’re a Nazi if you point it out.

But the ones who will go against lockdowns will be the one who have no savings and that means mostly young people who virus affects with less severity than older ones.

It seems old ones are also the people who have most real estate in America?!

So if virus is passed on to old people and they die. Then natural consequence will be that, their property will be passed onto their kids who will most likely sell it immediately and cash out why? Because kids of most wealthy suburban families usually live in huge Metropolitan cities so they are unlikely to hold onto property in suburb.

And does it mean soon lots of cheap properties will be available for sale in suburb?

For those without saving lockdown means that everything is paused. Right now in many places landlords cannot charge late fees, services can't be cut off. Additionally there's lots of sympathy for those in need. While isolation persists we'll see more programs like NYC provided 3 meals a day.

Once isolation ends then the bill collectors will start coming and the free meals will be come rare but people will remain severally unemployeed.

The people with no savings are the ones that are going to most want this to last since there's no going back to the way things were right now. Many of the jobs lost will not be immediately replaced when the isolation stops.

Nothing is paused. You will still have to pay for everything, maybe latter, but eventually you will get kicked out.

I will probably go to prison, child support is still enforced. There is ZERO sympathy.

What do you think about the real estate?

Do you expect more properties to come on market for younger folks? Will it become cheaper to buy new property?

That's what I'm thinking. People all over the world knowingly make unhealthy decisions because it makes our lives more enjoyable in the short term, at the expense of usually shortening your lifespan. I don't see people putting up with forced isolation for very long, especially when the vast majority of people won't die from it.

Exactly. We all make these tradeoffs all the time and sacrifice lives for convenience and financial reasons. For example, close to 40K die in the us in traffic accidents every year. That number could be reduced to almost nothing with a 5 mph speed limit. of course, we've decided to take that calculated risk - the benefits of driving at speeds up to 65 or 70 outweigh the low number of annual deaths.

The problem is the risks are orders of magnitude more than the "tradeoffs we make all the time", and clearly not enough people understand this. 40K/300M is 0.013%. It's nothing compared to coronavirus hospitalization or even death rates.

That's an annual number while Coronavirus is one and done. A better comparison would be lifetime risk of dying in a car accident.

Okay, feel free to slice and dice it however you want and share the results.

The lifetime risk of dying in a car accident is about 1% in the US, according to https://www.iii.org/fact-statistic/facts-statistics-mortalit... .

And you're equating a lifetime chance with a < 1 year chance because... why? Is having a 1% chance of dying in the next hour the same to you as having a 1% chance of dying in the next 100 years? Is having a 99% chance of dying in the next hour the same to you as having a 99% chance of dying in the next 100 years?

I'd assume when you apply that comparison to society at large it becomes close to the same thing.

Let's get the virus on the phone and explain that we don't wanna. I'm sure it will be understanding.

Which is why we won't ever fix climate change.

I agree with you in that the climate crisis and pandemics are major emergencies that require species-level thinking in order to mitigate effectively. That said, your comment could use some context.

Yeah, you're right. Mostly I was trying to spur conversation and perhaps I wasn't giving enough context to do so.

What we're all doing globally right now is only a small step in the right direction for tackling climate change. We could stay on this path right now, and continue to work to restrict ourselves and reimagine what an economy could look like and end up with some really impactful change. But we don't seem to be interested in doing any of that; instead we're more interested in how to get back to commuting to work, buying more stuff, getting supply chains back in order, manufacturing cars, extracting cobalt from the earth and on and on.

I think we'll have to find ways to loosen things, though. Maybe everyone, or almost everyone, just wears a mask in public and we use the defense production act to keep the supply up. Maybe sick leave becomes mandatory and businesses restructure to stay open while keeping people physically apart.

Maybe we phase in and out restrictions and get rid of the ones that have the most harm and least impact. Maybe that drug Trump was pushing really does enough to keep people from dying from this. I dunno, but we probably can't just hide for two years and let half of the country be out of work.

Hopefully we do a lot more vaccine work, too. Ideally we'd wipe out some other scary threats like Ebola while we're at it.

Approximately 200,000 people will die. All of us will know someone that got sick. Most of us will know someone that died. I think Americans will get over it.

That is the number that will die if the lockdowns continue.

If they don't, a hell of a lot more will.

I don't know where these numbers come from. But given a the current 1.1% case-fatality-rate in America (even before hospitals are overwhelmed) and that more than half of the population is estimated to get it, I don't see how it'd be less than 1% * .5 * 350million = 1.75 million people, with or without lockdown.

I suspect politicians are trying to "ease into" the honest numbers, because I guess "a million" sounds like a lot to people.

It's hard to say anything with certainty, but I personally can't find any math that explains how social distancing can reduce that by more than 10%, short of a cure or vaccine being developed within 60 days.

Plasma would be the best hope of this.

I have seen a few seriously sourced articles discussing the possibility of various forms of airborne transmission during certain stages of certain strains. If stuff like this is the reality then the truth is that social distancing can't be as effective as we'd like, even on top of whatever inherent flaws it has, but it's probably still the best/only advice that can actually be given, taking our woeful preparedness into account. Masks probably should have been the recommendation from day 1 but clearly economic priorities and lack of skilled preparation and leadership overruled longer term judgment.

It seems to me some are expecting business as usual to resume quickly because under normal circumstances, where the heads of each department hadn't been chosen for their desire to shut it down ASAP, that is probably more what would happen, but the reality of today's government is vastly different. I completely agree they're trying to slow roll the actual truth here.

Your CFR is with respect to diagnosed cases. Many cases are mild and have no symptoms. The real CFR is likely an order of magnitude lower.

That's one theory, but the evidence is mixed. For example, I believe in cruise ships, where everybody was tested the CFR was ~ 3%. However maybe the age distribution was older.

There are a lot of factors, some cause underestimating of cfr (he died of pneumonia, didn't have a test to spare, cause of death pneumonia).

Lockdown requires an eventual vaccine to really save lives, and at minimum universal testing to be effective, to prevent a second wave. Otherwise, once lockdown ends, we go exponential again.

2,813,503 people died in 2017

https://www.cdc.gov/nchs/fastats/deaths.htm

State your point clearly please.

Pretty sure being dead isn't something you just "get over".

Try applying some reading comprehension and reading the response again within the context of the overall discussion.

It doesn't matter how long the period of isolation lasts, we're emerging from it to face a economic crisis that will far exceed the great depression. That crisis hasn't even started to materialize yet.

There's no normal to return to, and the immediate future after this will be bleaker than the time we're all in isolation. While isolation continues people won't be kicked out of their apartments, communities will help those in need with food, and nobody will have to worry about those bills that are pilling up. The second everything starts again, all of those debts will be unpaused, all of that community support will dry up, and people will be back to fending for themselves rather than in this together.

There will someday be a normal again but it won't resemble the normal we had in February in US any more than the world returned to "normal" after 9-11, of WWII for that matter.

The second isolation ends then reality will really set in.

edit: Can someone explain the downvotes? Is there anyone that thinks the claim that the economic consequences of this will be horrific is downvote worthy?

"Our baseline forecast does not see GDP reverting to its pre-virus levels until late 2021 in the US and Europe." [0]

[0] https://www.fitchratings.com/research/sovereigns/deep-global...

I mean this is hard to say. I'm in grad school and I don't really feel that disrupted. Instead of hiding in my office all day I just stay home. Meetings and classes are all over Zoom, which means my advisor actually has more time to talk (WOW!). And I do CS, so all my work is on a computer anyways, where I'm usually remoting into another machine to run my experiments. I can still get takeout. I have more time to cook. The only real disruption is that I'm not going to the climbing gym. On the other hand, my cat is super excited that I'm around more often. And as a millennial, I'm already used to living in existential dread.

I'm just trying to say that it is hard to measure what this disruption means for a lot of people. If I was in a big city, like NYC, I'm sure this would be completely different. I don't think this is an easy topic and in such "Americans" is far too broad of a term to have much meaning.

What do others think the right timeline to plan for is, and is there anything different people should be doing if it's going to be another 6 months or longer? Personally, I'm assuming this will last until at least September. Better to be pleasantly surprised if it's earlier.

It's unlikely most Americans will tolerate a 5-6 month lockdown. Eventually quarantine violations will hit a tipping point and the transmission rate will jump, likely overwhelming our healthcare system.

> It's unlikely most Americans will tolerate a 5-6 month lockdown.

It's not really a matter of tolerating, they'll literally start starving to death at a certain point. A couple months is enough time for credit cards to be cancelled for lack of payments or all limits to be hit, enough time for these various stimulus plans to run out, etc. Enough time for all but the most well capitalized businesses to just fail.

A massive percentage of the country just can't survive that long. There's more ways to die than just COVID.

In the UK I'm expecting restrictions and lockdowns till around October ish.

> Is there anything different people should be doing if it's going to be another 6 months or longer?

With the sort of open-ended timeline we’re talking about, it’s important to take as broad a look as you can at the things you’ve had to cut out, what need they were filling for you, and what substitute activities can cover those needs.

Most people instinctively understand this for things like food, shelter, and income, but the needs higher up Maslow’s hierarchy also need to be considered. That’s things like stress reduction, emotional support, physical activity, intellectual stimulation, comraderie, creativity, escapism, etc.

I'm planning on stay at home lasting (here in the U.S.) until sometime between early June and late-July. I think once it is lifted (probably in stages) we'll have all sorts of restrictions on larger gatherings throughout at least the end of the year. That's not to say that it will be over by then, just that the rate of cases will be manageable and hospitals will have the resources they need to handle them.

As for what to do to plan for it, I'm mainly just keeping a good supply of easy to prepare food on hand with a long shelf life. Other than that, I'm not sure what can be done that doesn't start to venture into tinfoil hat territory.

The timeline to plan for is vaccine + 6 months; best estimate for a vaccine is Spring 2021.

If I see the inside of a movie theater in Summer 2021 I will be pleasantly surprised.

Buy two of whatever you get 1 of every time you go to the grocery store, which should be no more than once per week.

We've only got a few months in the tank economically and flattening the curve alone will keep us on lock-down for years.

They aren't talking too much about it but the plan is almost certainly to buy time to transition to a new strategy. The keys to this IMO will be squashing new cases, those 15 minute tests(billions of them), a health enforcement agency of some sort to conduct tracing and targeted quarantines, and increasing the capacity of the health system.

The pieces could be in place July-ish.. Unfortunately it's going to take an impressive display of administrative competency at the federal level.

>The pieces could be in place July-ish.. Unfortunately it's going to take an impressive display of administrative competency at the federal level.

I hope when all is said and done, people take their state governments more seriously. The federal government is just not equipped to handle this kind of issue. I've been impressed with California's level of response.

I think there's a shard of truth in the assertion that: if you ask an epidemiologist how long people should remain locked in their homes, they'd tell you "forever". If you ask a capitalist how long, they'd say "lets re-open today". Neither of these answers are realistic solutions to this problem.

Dr Fauci says "the virus sets the timeline; not us". This is, unfortunately, false. Western governments do not have the teeth necessary to enable this to be true, and it is not "naturally" true. Humans, at the end of the day, will do whatever they want. Americans are a weird, maybe beautiful, breed; there's a surprising number of us who would rather just get sick and possibly die than sacrifice the freedoms and amenities of normal life.

At some point, maybe a month or three from now, people will get restless. They'll re-open businesses, remove WFH policies, try to get back to normal. There will be another surge in cases. At that point, what does the government do? Remind people "hey, we never lifted the stay at home 'suggestion', please stop"? Do they put more teeth behind it? Or, maybe then we'll have better therapeutics + small herd immunity, and we should just let the disease run its course without as many economically disruptive mitigations?

Point being, this isn't a situation where predictions about the future are useful. Its constantly evolving.

The economic restrictions can be lifted in a just couple of months since the curve is under control, but people will have to go to work wearing face masks while the pandemic runs its course through 2021.

I think, and hope, that this is the best case solution, and its what we pursue. As long as people take the core of the "social distancing" measures to heart, and practice them every day, we can control the spread without Stay-at-Home. Wash hands. Sanitize high-touch surfaces every few minutes. Wear a mask, maybe even gloves. If you feel sick, stay home.

If we are diligent, we can "have our cake and eat it too". But we have to be diligent.

> If you ask a capitalist how long, they'd say "lets re-open today".

The economists are flat-out NOT saying this, because they understand that the long-term negative economic impact of an unchecked pandemic will be worse than one which is at least partially controlled.

> I think there's a shard of truth in the assertion that: if you ask an epidemiologist how long people should remain locked in their homes, they'd tell you "forever". If you ask a capitalist how long, they'd say "lets re-open today". Neither of these answers are realistic solutions to this problem.

> Dr Fauci says "the virus sets the timeline; not us". This is, unfortunately, false. Western governments do not have the teeth necessary to enable this to be true, and it is not "naturally" true. Humans, at the end of the day, will do whatever they want. Americans are a weird, maybe beautiful, breed; there's a surprising number of us who would rather just get sick and possibly die than sacrifice the freedoms and amenities of normal life.

> At some point, maybe a month or three from now, people will get restless. They'll re-open businesses, remove WFH policies, try to get back to normal. There will be another surge in cases. At that point, what does the government do? Remind people "hey, we never lifted the stay at home 'suggestion', please stop"? Do they put more teeth behind it? Or, maybe then we'll have better therapeutics + small herd immunity, and we should just let the disease run its course without as many economically disruptive mitigations?

> Point being, this isn't a situation where predictions about the future are useful. Its constantly evolving.

The philosophical capitalists would state that actors should be free to choose their desired level of risk.

You statement suggests a stereotyped version of a capitalist who might order everyone to go out and work.

The problem is that public health officials are completely misusing terminology and sending contradictory messages, and it is 100% not the fault of Americans misunderstanding it (this is from the same article!):

> Public health experts have said the near-term goal is to flatten the epidemic curve of new cases

> “We let things get out of hand,” said Mina, who is also associate medical director of clinical microbiology at Boston’s Brigham and Women’s Hospital. “So now the place that we’re left in is we have to absolutely beat this down with a hammer and get to near zero cases.

Getting near zero cases is not flattening the curve -- that's suppression! Flattening the curve is an assumption that everyone will eventually get the disease, and trying to not overload the health system. THAT is what Americans have gotten onboard for, and what a 2-4 week lockdown would set us up to do (give us time to expand hospital capacity, etc)

But if on the other hand, past the propaganda, the public health plan is ACTUALLY to eliminate the disease entirely, that's a completely different plan, and it will take months or years. It's not the fault of Americans for not understanding the implications, when they are being actively lied to about what the plan IS.

Yeah. The more I learn, the more confident I am that nobody has a real plan, and it's just a fiesta of acronyms and agencies who are only pseudo-educated (e.g. couldn't recite essential statistics about mortality rate once one a ventilator off the top of their head) on the topic.

It's hard to say though, how much of it is raw political ignorance versus hiding bad news.

> Yeah. The more I learn, the more confident I am that nobody has a real plan, and it's just a fiesta of acronyms and agencies who are only pseudo-educated

I disagree. No one at the top has a real plan (probably including the political appointees at the agencies), but I'm pretty sure those agencies could put together a better one with leadership that would let them do it.

https://www.nytimes.com/2020/04/02/opinion/jared-kushner-cor...

> (e.g. couldn't recite essential statistics about mortality rate once one a ventilator off the top of their head)

Couldn't, or didn't want to?

Once there is a cheap and high reliability antibody test widely available, there are going to become two classes.

Those who move freely about and do what they want, and those that live in fear of the others because they can still get infected and don't know who is who.

Imagine a dystopian near future where you have to carry a government approved ID showing your immunities to get into establishments or to even move about the country.

Nope. We will just w8 for any vaccine and hopefully this would be over.

This is the world I'm already living in. I got coronavirus in mid-March and have since recovered from it. Now I'm walking about with impunity. I still try to maintain social distancing to keep others at ease, but I'm not worried when people violate it.

If only there were restaurants for me to go to ...

(And yes, I'm eagerly awaiting the blood antibody test because I want to know for sure; my symptoms were pretty textbook coronavirus, but not serious to warrant hospitalization, and hence no test was available for me.)

mid-March? Be aware that while some studies say you still virus-shed for two weeks after, some say as long as five weeks it can still be detected.

Just because your fever broke doesn't mean the virus is gone, just means your body is fighting it and "winning".

I strictly self-quarantined for the recommended 14 days, plus 3 days following the end of symptoms.

I doubt many people are going to be down for the ~7 weeks of strict quarantine you're suggesting.

welcome to china.

> carry a government approved ID showing your immunities

Bill Gates is funding an effort to tattoo it into your skin [1].

At best, Mr. Gates is dangerously naive, assuming that because he has good intentions, governments will never abuse his idea for evil purposes.

Governments' track record on this subject is not great.

(The last time a government tried to tattoo a unique identifier into a large number of people, it was the Nazis. They wanted to keep track of Jews and other undesirables, so they could more efficiently be run through the systematic processes of captivity, enslavement and mass murder.)

[1] https://old.reddit.com/r/Coronavirus/comments/fksnbf/im_bill...

Whenever I read these health experts, I get the impression they feel the economy is just some superfluous activity to keep the masses engaged.

> I get the impression they feel the economy is just some superfluous activity to keep the masses engaged.

I understand your frustration, but, remember how news talk about computers and how much simplification is needed to get the overall public to understand the concepts.

Do not judge experts from the two liners that you read in the news. Stimulus packages, social distancing, new ways of producing needed equipment... everything is part of solving the problem.

> I understand your frustration, but, remember how news talk about computers and how much simplification is needed to get the overall public to understand the concepts.

> Do not judge experts from the two liners that you read in the news. Stimulus packages, social distancing, new ways of producing needed equipment... everything is part of solving the problem.

The article I'm commenting on, which I also read prior to commenting, is not what you are describing.

From the article:

> Those resources do not current exist, said Konyndyk, who also noted that hospital capacity across the country needs to be expanded and protective equipment for health workers restocked. There are currently global shortages.

> “If we want to be able to — as I think we need to — turn our economy back on in a safe way, we need to be able to do that sort of thing at scale,” Konyndyk said. “And we do not have anywhere close to the public health infrastructure that’s needed to pull that off.”

His statement suggests that he thinks the economy operates as a switch that is simply turned off and on at a whim, while also saying there do not exist enough resources to perform the needed tasks. Where does he presume these resources to come from? Printed money?

Also from the article:

If they truly have nothing but the best intentions for keeping society healthy, they would understand that economics are more complex and more powerful than anyone can command or comprehend. If they keep the economy shut down all the way until there are "zero cases", there will be a lack of basic health care as resources rapidly dwindle.

I also think they are terrible at grasping stats. I have yet to see published average random sampling of the population. Undergrad stats for nearly every major teaches you don't have to sample very many people to estimate a population. And there doesn't seem to be any attempt to analyze overall mortality rates, which should at least on a monthly basis be up over past years.

Sweden is the country to watch as they are the policy outlier.

It appears that their infection, hospitalization, and death rates are not higher than other countries which implemented lockdowns.

It also appears that their economic activity has declined by a similar amount as did that of countries which implemented lockdowns.

So if staying at home is made voluntary, the economy won't reflate all of a sudden, and illness and mortality probably won't increase. Because even if staying at home is voluntary, many people will still stay at home, including potential patrons of reopened businesses.

We'll see how things progress in the months ahead, but our course seems set regardless of policy.

Due to the nature of how we believe this virus spreads, it's likely too soon to read much into what's going on in Sweden. A month from now will probably give a much clearer picture of the differences in the two approaches.

You just can't compare Sweden to a country like the US. Sweden is largely homogenous with regard to race, religion, and culture. Their poverty rate is 1%. The US on the other hand is extremely diverse, has 30x+ the population, and has a 10% poverty rate.

I don't understand why Sweden is being held up as a paragon. Their death rate is currently 9th worst worldwide and over 2x that of the United States':

https://www.statista.com/statistics/1105914/coronavirus-deat...

Edit: Both are good replies. Thank you.

Death rate is high in Sweden because the number of confirmed cases is wildly underreported.

Comparing the death rate between countries is pointless at this stage, given the inconsistencies in reporting and the fairly long period between symptoms onset and death.

Sweden stopped testing people who don't get hospitalized about 3 weeks ago. Before that their death rate was extremely low, on par with Germany.

> However, that strategy has now changed. Authorities have shifted their focus away from testing all possible cases, and instead on protecting the most vulnerable groups. People with severe respiratory symptoms or who belong to a risk group will still be tested.

https://www.thelocal.se/20200320/fact-check-has-sweden-stopp...

We can and should reframe the economic disruption as an opportunity to build a new and more humane economy, even before the virus is brought under control.

We should be able to flatten the curve and tackle our economic issues at the same time: the resources required are orthogonal while the benefits are synergistic.

Folks in the developing countries don't have any safety net(no $1200 IRS check; no unemployment tax; etc). Most of them are day laborers or small scale business people selling food on the street side. If this will continue, many in the developed world, esp in cities, will struggle for food.

Something wrong with this website statnews.com--

At least for me using Safari browser. I was auto-redirected something like 40+ times to upgrade my Norton Anti-virus, to install Flash, and one or two other fracking things.

Looks like HN killed this post. It's no longer showing on the homepage

The number of people who die, on average, per day in the US (as of 2015) was roughly 7,500. We're less than 5 doubling periods from those being our daily numbers - i.e., for the death rate in the US to be doubled. At 3-5 days per doubling, that's less than a month away. Every day after that, until we either burn through 80% of the population or invent and distribute a vaccine, is going to be something we are unprepared for in our history as a nation. Approximately 8 doubling periods from then, or about two months away, and if we haven't gotten this under control, more people will die in one day than will die all year in a normal year. At least then, we will pretty much have hit the upper end of the curve, and at that point may well gain herd immunity. I give it about 4 more weeks until we consider hell to have officially broken loose. I expect human behavior to be less predictable at that point - or perhaps all too predictable...

I'd like to see an economist stand on the podium next to the president and Dr. Fauci and talk about the other side of the trade-off the government has decided to make.

Even if the current US shutdowns are effective, no more than 5 or 10 percent of the population will have gained immunity. We'll be nowhere near what's required for herd immunity.

The shutdowns will at best give us a "do over", a second chance. The only way to end the shutdowns and not have cases explode again will be to replace them with a smarter strategy: wide-scale testing, fast contact tracing, antibody tests, mask-wearing, temperature checks, social distancing. The federal and state governments need to be planning this now. The virus has an R0 over 3 and getting it below 1 will not be easy.

This all disappears if we find a vaccine or therapy, but hoping for that is not a plan.

The 2008 crisis brought us extra half million cancer deaths, according to a study in Lancet. That's only cancer! It doesn't include poverty, other disease, less funds for charities, suicides and other forms of misery.

It seems we are setting ourselves up for countless millions deaths globally if we continue with the lockdown.

The key to this is better testing and positive interventions. Right now we are just flattening the curve, but there are a couple things that could help speed up a return to normal life long before a vaccine:

1) Widespread, accurate testing: For example, if we could test everyone in a few minutes before they enter a workplace or home that could go a long way to enabling many activities to restart.

2) Improvements to treatment: If some relatively safe malaria drug or other intervention can reduce the severity of the disease such that treatment requires days instead of weeks and/or doesn't require ventilators/ICU this would be a huge boon. Less people would die, most importantly, but also the healthcare system would be able to handle many more cases, further reducing the need for extreme social disruption like we are doing now.

I'm personally optimistic that at least some material progress will be made on both fronts in the near future. A planet full of very smart people is working on this.

Can you blame them? This is the US, we have no safety net for non-corporate persons. If people don't convince themselves the disruption will end sooner than later then they may as well start looting because we're going to die starving and cold in the streets.

Locales that had the pandemic under control are seeing new flare-ups.

So either we lock down till a drug treatment is authorized (there are promising candidates), a vaccine is found or we accept that it’s unstoppable short of the above and we go about knowing the risks but while minimizing the known risks.

My guess we will be out of quarantine by memorial day.

>Though vaccine development is proceeding at a historic pace, in a best-case scenario a product won’t be available for the general public for at least 18 months, and likely longer.

Without a vaccine, the limiting factor are ICU beds. If 1% of sick people need an ICU bed, then the number of infections has to be limited to 100 times the number of ICU beds.

Now, if people need 30 days to heal, and you have 100,000 ICU beds, that means you can treat 1,200,000 people per year and let 120,000,000 people be infected. There are 300 million people in the USA, so it takes roughly 2 years to reach something like herd immunity.

If done properly (i.e. everyone except law enforcement, medical, utility and delivery workers stays home, with military/police enforcement, then everyone who did not stay home is tested multiple times) eradication is possible in a month.

Unfortunately we found out that almost the whole world, with some possible exceptions, has leadership that is either incompetent or has other incentives, so we will probably have to wait for a vaccine for a full return to normal life.

> Unfortunately we found out that almost the whole world, with some possible exceptions, has leadership that is either incompetent or has other incentives, so we will probably have to wait for a vaccine for a full return to normal life.

'Normal life' includes hundreds of thousands people dying of infectious disease each year that nobody notices. I give it about 4 more weeks before we return to the normal way of acting and about 4 months until this is no longer a major news story so we can all forget about those who have died.

Not saying it's right, just my observations on how people behave.

> 'Normal life' includes hundreds of thousands people dying of infectious disease each year that nobody notices.

I really think that people notices when a loved one dies, whatever the cause.

What makes you think that normal people just shrugs off the death of a loved one?

I am old enough to remember how many people used to die in traffic accidents and how much money, effort, and regulations where put in place to lower that numbers.

I am happily impressed by how much people, from doctors to retail clerks, are doing their part and how governments have moved the economy to support that in need.

Your divisive message is out of place and does not help.

> I really think that people notices when a loved one dies, whatever the cause.

Oh I agree, but hundreds of thousands die from infectious disease every year, and while their family mourns (and ought to of course), life goes on.

> Your divisive message is out of place and does not help.

I simply said what I thought would happen, not what I think is right.

> I am happily impressed by how much people, from doctors to retail clerks, are doing their part and how governments have moved the economy to support that in need.

All governments worldwide have actually and intentionally neglected to help people suffering from depression, mental health, and suicidal thoughts, which are almost certainly also going to lead to more deaths quite soon. I give it a few weeks before suicide numbers come out and indicate these lockdowns as a direct cause. Again, I'm indifferent to whether or not these sanctions are warranted, but I'm just pointing out what I think will happen.

Americans will prevail due to their uncanny ability to adapt to adverse/diverse conditions

What makes Americans in particular so much more special than other humans? This kind of American exceptionalism is ridiculous and should have been put to bed decades ago.

The effectiveness of the propaganda has been astounding - of course they are underestimating it, they were convinced that masks didn’t work to avoid wasting them, just as they were convinced that a 15 day window would flatten the curve.

Who is 'they'?

And, no one thought masks didn't work; the guidance was "don't buy the masks that work because health professionals need them, and you can achieve the desired effect by keeping distance".

Now there is some thought that maybe, MAYBE the virus can stay airborne longer than thought (no proof of that; we have yet to see any infectious agent actually do that, even in a lab), and that maybe, MAYBE a non-medical mask can help a bit if that's the case, so sure, why the hell not, wear a mask, but not a medical grade one, please, we need those for our doctors and nurses.

I would assume that "they" is referring to Americans, given that they are the subject of the article.

There were actually several high profile experts around the world (WHO, US Surgeon General, most European authorities, even children's programmes) that said without any qualification:

"Don't wear a mask, there is no need to wear mask if you are not sick, in fact it may even be harmful and may create a false sense of safety.".

This was a harmful and factually false message that caused and will cause unnecessarily deaths and those who propagated it should be held accountable.

see e.g. https://twitter.com/Surgeon_General/status/12447444277357813...

Even that statement you know was qualified, since I'm assuming you aren't implying it was to practicing medical personnel.

"There is no need" - there still isn't. There are zero instances, even in a lab, where we've seen the virus aerosolize. If you keep your distance, all indications are you should be fine.

The only thing that has changed (and remember, this is advice based on facts, and so as new facts are uncovered, the advice can change too; that's called "science", and is different than "propaganda", which is what I was directly responding to) is that we have seen some cases we can't explain...and so the guidance has become "just in case, sure, why not...just please not the medical ones because we need those for people who have to get within 6 feet of sick people".

I disagree that for the general public there is no need to wear masks. If you go to a supermarket and someone sneezes/coughs at you, even a scarf around the nose gives _some_ protection. Less than perfect, but more than nothing. A proper mask would give more protection. The fact that there are not enough masks is a different issue, but it doesn't mean they are not needed.

I don't need any evidence or data for this and I don't need to have a theory of aerosoles to understand this, as it is common sense, and there is zero downside to do it, so it is a no-brainer.

But if I still needed data, I could look at which countries have the most widespread mask-wearing among the general public: Japan, SK, Taiwan, China, HK, Singapore. Basically, all the countries that managed to contain the epidemic with reasonable success. When the top Chinese epidemics/virology expert was asked in an interview what Europe and US are doing wrong, he said if he had to mention one thing, it would be lack of masks.

Exactly. I don’t consider it unequivocally evil, but it’s still propaganda.

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