Covid-19 and the basics of democratic governance | Hacker News Reader

Covid-19 and the basics of democratic governance

nuffieldbioethics.org

21 pointsrich_sasha14 comments

A very nice summary of the communication and policy failings of the UK government re Covid-19.

Apart from repeating the necessary mantra of “stay at home”, there is very little transparency as to the scientific, social or economic backbone to the government’s decision making.

This essay outlines it nicely and why it is important. Probably applicable to some other countries too.

Definitely applicable to the US as well

The best summary of how "science" and an epidemiologic modeling is not governance and the tradeoffs of most governmental actions are seemingly not even recognized let alone balanced.

The main grief I have is that the gvt doesn't seem to have a plan, or if it has, does zero communication on it. Are we still trying to build herd immunity? Are we trying to freeze everything until a vaccine is available? If so how long is it acceptable to freeze everything? I don't think this is specific to the UK but I have the feeling that outside of South Korea and Sweden, so far the policy responses have been pure short term improvisation.

Denmark has a long term plan, which requires a sharp lockdown at first to make sure hospitals weren’t overrun, and to buy time to get our own production of protection gear and testing kits going.

We’re currently entering stage two of the plan which involves mass testing, quarantine for positives and a gradual opening of society while social gatherings of 10+ remain “illegal”. This stage will last until there is a vaccine.

I think most European countries aside from the UK has had pretty decent plans and responses because Italy showed everyone it was necessary. At the same time those plans are incredibly adoptive and agile because new information is made available all the time.

It’s hard to say though, I have access to the crisis group in the municipality where I work, and things coming from the top has been extremely coordinated throughout the whole thing, but at the same time, no one really knows what goes on inside the command bunker as we’re all just receiving instructions and sending data back.

Here on the west coast the nominal strategy is the traditional one: testing and contact tracing to get R<1.

In order to do that, you need enough testing capacity for anyone with similar symptoms (which we finally have), though most of those are other conditions. You also need to do contact tracing on positives, and test all of those folks. That's 10-20x the number of true positives, so you can do the math on how many tests you need.

Large events can seed massive hotspots, so I imagine some limitations on gatherings and mask requirements will stay in place until either testing is fully ubiquitous (test everyone), or a vaccine is developed.

But ubiquitous testing doesn’t prevent people from getting sick, and presumably we do not plan to have all these constraints ad vitam. So implicitly it means they are either banking on a vaccine in the short term or this virus going away by itself. These are strong assumptions, we are told by scientists in the UK that a safe and efficient vaccine may or may not be found. [1]

[1] https://www.thetimes.co.uk/article/dont-bank-on-a-coronaviru...

Ubiquitous testing would be sufficient to stop the epidemic.

I don't think that is realistic to expect unless testing would be as simple as blowing into a sensor.

why not apply this to every disease then? We could then stop every transmissible disease once and for all.

you know what the real solution is? What mother nature already gives you, your immune system. The key is finding out how to help the body avoid severe reactions. That is the path of success, finding out how to keep people's own bodies over-reacting, then everyone could deal with it just fine.

Such a thing is feasible for most infectious diseases with sufficient resources. You'd be surprised by how little funding virology research gets.

You mean ubiquitous testing forever? It only took one guy in China to infect tens of millions of people. This virus is bound to come back again and again. I am not sure this is a long term solution.

And it is possible that this virus goes away by itself (ie it won’t be reimported). Apparently some viruses do. But if it is the assumption it should be stated.

at what point would you think that no contact tracing is necessary? Should you track people that are not at risk at all, just because some people are? What percent of those people should be at risk for this to make sense?

these are the type of issues that the original post talks about, real numbers that allow you o see what exactly is being traded off for what

how mild should a disease (in general) be for this to not be necessary?

would you advocate contact tracing for the flu? Should we contact trace HIV?

If you get R<1, eventually the disease will die out (see SARS-1). Coronavirus get deletions, etc. A vaccine will likely be developed (we got lucky, at first glance, that SARS antigens are fairly stable). All these things take time.

You don't "track" people with contact tracing, you ask positive cases who they came in contact with and ask those people to get tested.

We could probably "eliminate" influenza with ubiquitous testing (at least for 99.99% of the human race). There just isn't an obvious entity to fund such an effort. There should be, but there isn't.

Contact tracing is done for HIV.

That is my frustration too. The government, for good reason, massively encroaches on our liberties and even our right to personal safety - exercise, mental health, family ties, access to non-emergency health care. This warrants a good explanation and clear expectations of future plans, not just “duh, science”.

Not questioning the need for severe restrictions as such, but the form in which they arrive.

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