Seattle’s leaders let scientists take the lead, New York’s did not
newyorker.com
newyorker.com
Frankly, I've been on both sides of the aisle when it comes to projects that allowed for great design and projects that resulted in doing an endless marathon for 3 weeks straight to put out a fire because of poor design; I can tell you without a doubt that doing great design doesn't take anywhere near as much of a toll on your body and mind as doing an endless marathon; I've severely damaged interpersonal relationships (that I can't undamage) through these marathons.
While this can be great for team execution, by definition it insulates managers from the nitty-gritty of design/development, which is where most of the preventative measures happen. However if you try to remedy this and bring the manager into the fold, you invite micromanaging and harm execution, as well as preventing the manager from doing more managerial things.
It's when things go wrong and heroes emerge that people get raises and promotions, if simply because the manager can point to those highly visible efforts as rationale for why this person gets more. Also in large orgs a manager might not know all their direct reports personally so those incidents make the person stick out, like how a professor knows the kids who sit at the front of the class the best.
I suppose the ideal would be a technically experienced manager who understands how to promote good design practices and lets his team do so, but on sheer educated faith with no metrics. Given that metrics are the lifeblood of large-org management careers, the incentive structure isn't there to produce such people en-masse.
Steve Jobs and Elon Musk are famous/notorius micromanagers (though they have some problems with the ,,respect'' part). At the same time as they understand the problems with the product development deeper, they are able to plan more iterations ahead.
One example is the autopilot hardware. About 10-12 years ago I was working at Google, sitting in a self driving car in Mountain View when it was a secret project. I was already at that time amazed that the car could do some offroading tricks that I wasn't capable of, and I was quite certain that within 5 years it would be self driving without safety driver.
Now it's 2020, and it seems to me that in no more than 10 years Tesla will win the autonomous race, as Elon understood that the computer needs lots of deep learning instructions (more than what NVIDIA could provide) and HD maps and lidars are not just unnecesary, but they are the wrong direction, as the visual sensing problem needs to be solved for safe self driving.
In Google there are so many product managers at this point, that they themselves are actively hindering the product development itself, as they don't want to get into the details of the real problems.
Covid-19 makes clear that we should be showering the people who stopped SARS, the many Ebola outbreaks, and more with gratitude.
So the devil is in the statistical details... Which is greater? The average effort required to prepare for all the possible problems, or the average damage caused by the subset of those issues that will actually develop into problems.
The hoaxers are a clear and present threat to the essential workers. The number of MBTA staff infected with COVID-19 has more than doubled in the past week; they can't avoid people, and they're being infected by those who won't.
You would be surprised to find out how many of essential workers rely on public transport to get to their jobs.
He didn't say "they need to work" (although they might). He said "we need them to work".
No matter how greedy the ruling class might be, we still need medical people to staff hospitals, police to police, firemen, etc. These people are not serfs or cowards because they're going to their jobs.
We're just slowing it to a manageable rate with fairly extreme measures like lock-downs (which will likely be loosening soon anyways), and I don't see small pockets of uncooperative people making a sizable difference in the general outcome, not at this stage.
A minor but salient point: in common usage, a hoaxer would be a person perpetrating a hoax, not a person who believes (incorrectly) that someone else is perpetrating a hoax. The people who you are referring to hear are better labelled "denialists" than "hoaxers".
The real lesson I got from the article is that politicians are the worst face of a pandemic response: it risks that half of the populace will do the opposite of the advice given.
Once the issue is politicized, that snowballs -- propaganda has infected modern discourse to a disturbing degree, and it's hard to see well-organized denialism being amplified by far-right media as anything but a cold-hearted hoax.
That simply begs the question. Whether you label it "hoax" or "misinformation" doesn't matter. What matters is whether or not something someone says corresponds to actual truth. The beauty of science is that you don't have to take anyone's word for anything, you can actually go and do the experiment for yourself. So by all means, if you think Donald Trump is on to something and the press and the scientists are all conspiring against him to make him look bad for political reasons, then do the experiment: go inject yourself with bleach. I won't stand in your way. But I will give you long odds that it won't end well for you.
We just had the NFL draft this week. Plenty of these players will have their bodies seriously harmed in the next few years, while others will get multiple concussions and potentially set themselves up for CTE or other brain damage. Not once did anyone raise any alarms about, maybe these young people shouldn't go into this line of work...
You know we can just literally choose to not have this problem, instead of buying into other people's narratives.
>Not once did anyone raise any alarms about, maybe these young people shouldn't go into this line of work
Actually plenty of people do. It's just not a very thrilling subject to the U.S. populace.
how can people facing financial ruin right now choose not to have it?
The feasibility of succeeding at that is a different thing than your question.
Especially considering that we've already passed the largest economic bailout/safety net measures in world history in a matter of 3 weeks, and it looks like more is on the way. It would seem that "society" is doing its best over here given the realities of the situation, theoretical Kumbaya ideals aside.
For a gun analogy, I go with it's like if someone said "We could choose to make it much more difficult to own a handgun" and then someone fired back with a rejoinder about that not helping the people getting shot right now. The rejoinder doesn't address the statement.
Try saying this after a few months of lockdown, when a severely damaged economy leads to food shortages, and printing money does nothing to help.
What a ridiculous statement.
If one poorly-chosen element is labelled as a "non-essential business", it can cause all the other metaphorical Jenga blocks to collapse.
No, you can't. Goods and services are scarce, legislating them to every person in a country does not lead to everyone getting them.
Maybe you're just going for rhetorical force but you are factually wrong. Plenty of people have "raised alarms" about e.g. concussions caused by playing football.
https://www.espn.com/nfl/story/_/id/22226487/nfl-concussions...
https://en.wikipedia.org/wiki/Concussions_in_American_footba...
And there have been consequences.
I feel for the people who have lost their jobs, I have family who have lost their jobs and are trying right now to figure out how to pay their May rent and bills and buy food. It's scary. My mom has lived in the same place so long that her rent is about 1/3 of what her neighbors pay. If she misses some payments I doubt they'll try to evict her, at least not for a few months anyway, but they will likely try to break her lease and charge her 3x her rent. She can't afford that and would be forced to move, probably to a different state. That alone could kill her from stress even before factoring in the additional exposure to possible infection. What I'm saying is, even though I'm a healthy computer nerd, this is still very personal for me.
FWIW I think the simplest thing would be for the government to just give people money. But what do I know?
'thomasmcgalvin' stated that all non-essential workers are either taking COVID-19 seriously, or are hoaxers. He dismisses what is probably the majority of people -- normal working people who understand there is a risk, but who still want to work in order to avoid a personal economic disaster.
In the places I've worked, it would be impossible to observe social distancing. Open office plans mean you're usually within six feet of someone else.
Couple of point (all my opinions):
1. Without the "hoaxers" and deniers we would be able to trust the people to "observ[e][...] sanitization & social distancing measures". To some extend the strict measures are necessary due to those groups.
2. Concussions are not contagious, so the NFL players are making decisions about their own health only. With Covid-19 you take responsibility for _other_ people.
3. The fact that one can be financially ruined this way points to deeper problems in society that should be fixed. Rather than forcing sick people back to work and putting the ethical dilemma of working vs. the safety of others on them, we should support those in need.
>> Bills seeking to ban tackle football for kids under 12 or 14 have been proposed — and failed — in five states to date
https://www.usatoday.com/story/sports/2019/03/04/football-ba...
>> none of those proposed bans have come close to being passed into law
https://www.boston.com/sports/parenting/2019/03/03/massachus...
At the same time you cannot _possibly_ be serious about equating the NFL drafts with the Corona virus safety measures in terms of their impact on other people and harm that can be caused!
That's like saying "Well, I might have engaged in risky behavior, but I won't practice safe sex now because these people I met last week didn't wear their seatbelts."
The fact that the harm is this severe is a separate failure. Job losses hitting such a huge portion of the population don’t have to happen. Other countries have found ways to manage this with far less suffering.
> I'd prefer to work, observing sanitization & social distancing measures, than to have my entire financial life ruined.
It’s not just your health/life you are risking. The contacts you can’t avoid making (home, shops, medical appointments etc) are all directly impacted too.
I can imagine more groups. For example people might need to get out of the city/house for psychological reasons. Taking a small chance to get/spread the virus might be better than hurting oneself/others.
So aside from the shit show of the Trump administration, I’m not seeing even the areas that are being praised as being the “best” in America really take this seriously.
At this point, it looks like we’re way off the trajectory of squashing the outbreak. The curve has plateaued, but we aren’t on track to get the numbers low enough to safely open businesses again and go back to containment and contact tracing. We’re failing at the “hammer” stage of the hammer and the dance, and it seems to me like the probable outcome at this point is a whack a mole of continuous, half hearted hammering for the next year or more where we won’t be able to lift this lockdown much at all.
Lots of people have at least some intention to take it seriously, but not the steely heart for the hardcore isolation that’s required.
I look at it this way, and it sounds harsh but it's big-time decision-making life:
1. You could compel people to listen to something to ensure their safety by force, and then have a riot.
OR
2. You could urge sensible people do something for their own safety while letting the idiots commit suicide and clean-up the gene pool in the process.
I say take option #2 all-day, everyday because it's easier, cheaper, and better for others who do listen to have one less fewer, stupid liability in the world who would otherwise put others in danger.
Of course, "idiot" is pretty relative, and not everyone going out is an idiot, but that would undermine your eugenics argument
- Infection hospitalization rate -- similar.
- Probability of getting a vaccine in a moderately quick timeframe -- I'd call this one 50/50. Hard to bet on.
- How long it takes case counts to decay to a point where a contact tracing regime works -- This really depends. It looks like to me that in the US jurisdictions with the best controls, Rt =~ 0.6. This will take a -long- time to decay to the 1 case per million threshold where contact tracing, etc works; 6 months or more. Some models put the decay much quicker, at like a month from now, but I cannot understand why.
- Efficacy of a herd immunity strategy / serology information from various jurisdictions -- looking hopeful, but imperfect information. Sweden is getting there...
- Critical care utilization. In the SF Bay Area, we're below seasonal norms and COVID-19 cases in ICU have been (very slowly) decaying for the past 3 weeks.
- Seasonal effects. We don't really know, but it looks like there is probably a small seasonal swing to Rt. Seasonal effects justify more dramatic action either direction (containment or relaxation). Containment efforts will be made more effective during summer, but it's also an ideal time to experiment with loosening controls while seasonal factors are on our side.
Always follow the first link on a Wikipedia page (excluding parentheticals with etymology and pronunciation), rinse and repeat: you eventually end up at philosophy.
The thing is, it's really dark. I have a pretty dark streak in my sense of humor, but were are a lot of moments when I thought to myself, "Did these guys forget that this show bills itself as a comedy?"
SPOILER ALERT
I think the most horrible scene was when some of the passengers get the idea that they aren't really trapped in space, that it's all a simulation and they're really on Earth after all. And so they decide they want to leave. Through the airlock...
And Captain Laurie and the engineer who won't shut up about being underappreciated by the morons around her (Why would you care about their opinions? They're morons) are in between them and the airlock.
Now maybe this means I'm a bad person, but my first gut reaction was, "Hey, let them go outside. It's evolution in action. A problem that solves itself, yeah?"
But then my real self kicks in and points out that, unless I try my very hardest to prevent these fucking morons from sucking vacuum, letting them spacewalk sans spacesuit is tantamount to murder. And I'm not a murderer.
Even though they are useless fucking morons who seemingly only exist to cause problems, standing by and letting them kill themselves is wrong. You'll hate yourself if you do.
That's the downside of self-awareness and intelligence. If you are the only person on the spaceship who knows the score guess where the buck stops?
I read the season as an allegory for where we are now politically. The captain is a figurehead, the passengers are readily manipulated, the far-off owners don’t care, yet everyone aboard is hurtling through space in a very complex machine that they don’t really understand.
Hugh Laurie is doing a great job in the show. Another draw is the creator, Armando Iannucci, who did Veep.
Attending an anti-lockdown protest without taking proper social distancing measures is more akin to driving drunk on the freeway than it is to shooting heroin into one's veins. The latter can in many circumstances be understood to have negligible impact on the rights of others, the former cannot.
The question of "at what point do social distancing measures overstep the legitimate exercise of government power" is a nuanced one. It requires weighing individuals rights against one another in a situation where cause and effect are at best thinly statistical, emergent from collective behavior, and regionally variable (NYC != rural Kentucky).
No government is going to get their response to COVID-19 100% right, but I'm pretty sure focusing exclusively on individual self-harm would be an abysmal heuristic.
I think that is the case with lots of calls to re-open now. There are so many businesses that could return safely now if people followed safety protocol, but realistically not only will there be unintentional safety errors but loosening of some government restrictions will lead to the loosening of people's personal safetly restrictions they have been doing since the start.
On Feb 26th, every single level of the Seattle "scientific" community laughed at Ms. Reid, the Superintendent of the Northshore School District when she closed Bothell High School over a potent positive case of a staff member that travelled overseas. She wanted to make sure her students were safe and the building was disinfected.
The "scientific" King County Deptartment of Health went as far as to specifcally send out a document stating that closure was unwarranted - they did not just sit there and let her do her job - they went out of their way to ensure the public was informed they thought she was nuts.
You do not get to do that and then claim to be the greatest organization of all time 2 days later.
One of the earliest public things I'm aware of this posting from a scientist in Seattle on Feb 29th, by researcher Trevor Bedford, part of the Seattle Flu Study about covid-19 tracing genetically. They were testing flu samples for covid-19 (the govt refused permission for them to do that but eventually they just did it, because it was so important). https://twitter.com/trvrb/status/1233970271318503426
3rd paragraph is the grovelling the school district needed to do to deal with the interference of the King County Health Department.
There is also the "red dawn" emails which clearly show that King County was not doing a single thing in the face of knowing it was a problem - Dr. Duchin (King County Health) on March 1st - not 4 days after this public rebuke of the school idstrict.
"We are having a very serious challenge related to hospital exposures and impact on the healthcare system. Would be great to have a call to discuss. Will be meeting with your team here this morning and then maybe we can chat after that"
So it goes from laughing to all hell breaking loose to doing nothing for almost 2 more weeks? That's the Health Department leading the way?
* Washington schools closed very late. My friends' schools in Indianapolis had already been closed a week.
* Barely any of the volunteer WFH was taken, at least among my group at Microsoft. Maybe 10% participation.
* Volunteer child removal from school was spotty, maybe 25%, not enough to make a huge difference.
While I like most of how our governor has managed it, and I like science, I have a hard time saying that it's more than marginally responsible for the NYC - SEA disparity. In fact as the article alludes, many of the decisions were driven by factors beyond the need to minimize covid deaths, like providing school lunches for families who couldn't afford them. So coming to the conclusion that these decisions are responsible for the disparity is disingenuous.
All the other points in the article, including luck, carry a lot more weight. NYC is the city that never sleeps. SEA is the city where if one person is Sleepless then they make a bestselling movie about it....
The other things really that might make a difference, that few have mentioned is that
* The first hit of the virus was ripping through a life care center. That put people naturally on edge.
* Knicks and Nets both had long homestands during the beginning of the outbreak, whereas let's just say the Sonics have been on a rather long road trip.
I think if the experts of evaluating these policies are saying that putting them in place without delay saved lives, it's probably unwise for all us armchair epidemiologists to sit around coming up with other things we think might explain it.
How many does Seattle receive?
The current state of both cities has nothing to do with what they did or didn't.
Same thing with Europe. The most affected countries are the most visited ones. Which also makes me question about the effectiveness of lockdowns.
That other 99% really don't seem to know for sure lockdowns are effective; the only arguments I've ever seen them present are "my model says they're effective" or "it would be strange in principle if they weren't". (Some laypeople draw dishonest comparisons to control measures for the Spanish Flu, but epidemiologists know that these measures didn't include orders to stay at home or close all businesses.)
Sweden did start much more slowly that switzerland but they clearly are vastly underperforming in saving their citizens.
You took Switzerland as an example, but if you would have taken Belgium, Sweden would do actually very well. Still, Belgium took quite strict lockdown measures and in a pretty early stage.
What really seems to have had a significant result on keeping the death rate down, is testing: countries like Germany and Switzerland are testing often and early and have done so already in an early stage of the outbreak. This way they were able to treat patients early and to protect vulnerable patients against others in their surrounding that were infected.
The US would probably be at over a million deaths by now if life had continued normally without lockdowns.
I also think we have many different ideas about what's best. (Again, all people I assume are smart.)
This is just a hard scenario. There is no obvious 'best' answer. There may not even be a 'right' answer.
I disagree.
Specifically, Deblasio took forever to close the schools. I don’t live in NYC, and I remember when before they closed the schools wondering why they hadn’t done it yet.
So some actions matter more than most.
https://www.theguardian.com/world/2020/apr/21/boy-with-covid...
The Paediatric Intensive Care society put out an alert (weirdly using Twitter to do so): https://twitter.com/PICSociety/status/1254508725227982848
https://www.hsj.co.uk/acute-care/exclusive-national-alert-as...
What's your source on that though?
The Northeast US is, at least in parts, some of the worst in the world that is known about and, other than being pretty dense, it really doesn't map to especially poor government response by reasonable definitions. Perfect hindsight doesn't count.
My family is in New England. Massachusetts has 10x more deaths per capita than New Hampshire even though, if anything, Massachusetts has been a bit ahead in terms of closures and interventions.
No one who's been to NYC can miss the fact that it's one of the filthiest places in America, from the perspective of disease possibilities. Many parts simply pile their trash on the curb and there are rats are everywhere. People pack into subway cars like sardines, and there's no way to avoid droplet transmission. During my time there, I saw several people vomit in public and just walk off.
There are plenty of great things about the city, but lacking a real culture of cleanliness (e.g., Tokyo), density breeds disease.
COVID-19 is spread principally by breathing, which is unaffected by cleanliness.
And if you think people are packed into subway cars in New York... have you been to Tokyo?
I'm not saying New York is a paragon of cleanliness, but you will have to show some scientific evidence that curbside trash pickup or the occasional subway rat has anything to do with the prevalence of modern-day diseases. Because they simply do not as common knowledge suggests.
Modern diseases like colds and flus are spread through close contact in schools, office buildings and subways the exact same as they are every other major city on the planet.
I haven't been to Tokyo, but I have sat and watched groups of rats feast on curbside trash in Upper Manhattan. Many times. (And the roaches--ugh.)
Masks?
> I'm not saying New York is a paragon of cleanliness, but you will have to show some scientific evidence that curbside trash pickup or the occasional subway rat has anything to do with the prevalence of modern-day diseases. Because they simply do not as common knowledge suggests.
Initial reading: https://en.wikipedia.org/wiki/Rats_in_New_York_City#Disease,...
Diseases carried by NYC rats: https://www.ncbi.nlm.nih.gov/pubmed/25316698
Hong Kong and literal SARS: https://pubmed.ncbi.nlm.nih.gov/12932393/
"Urban Norway and black rats (Rattus norvegicus and Rattus rattus) are the source of a number of pathogens responsible for significant human morbidity and mortality in cities around the world.": https://doi.org/10.1089/vbz.2012.1195
Yes, we all know rats can carry disease, and that this has been a historical problem (e.g. the Black Death).
But it's not like coming into physical contact with a rat, or even their droppings or anything, is a common occurrence in NYC.
In 10 years living in New York City, I've seen a rat maybe 50 times total? Every single one was on the subway tracks (i.e. inaccessible), except exactly once I saw one at the end of the deserted platform, but far away from people.
Now I'm sure there are rats elsewhere, I'm just a single data point.
But nevertheless, to put it simply, getting diseases from rats is not a known public health problem in New York City. You cannot extrapolate a risk here simply from the presence of rats.
If you're up for a more disturbing experience, go sit on those benches at the south end of Riverside Park--the ones next to the ivy or whatever. Listen for the squeaking. Guess what? Those are rats. Lots and lots of rats, like in Jurassic Park or something.
Your argument would basically be saying at that point "China has much more cases even though they have stricter restrictions, which means restrictions don't work!"
Saying that New York's approach wasn't science based is absurd. The most notable screwup was the delay in school closures due to the dependence that many have on getting breakfast and lunch at school. IMO, at the time I don't think awareness that asymptomatic "super spreaders" may exist was known. (Assuming that is true, much of the data known to CDC is now classified so it's difficult to really know!)
--
'More subway' doesn't really capture it. NYC has ~70x the daily ridership on metro rapid transit.
https://en.wikipedia.org/wiki/List_of_United_States_rapid_tr...
Overall population density is much higher as well:
https://en.wikipedia.org/wiki/List_of_United_States_cities_b...
NYC also has the lowest car ownership in the nation, so you're basically left with walking or uber/taxi/public transportation just to get to the store/doctor/etc.
https://www.governing.com/gov-data/car-ownership-numbers-of-...
Also ~25% more airline traffic hauling bugs in from everywhere.
https://en.wikipedia.org/wiki/List_of_busiest_city_airport_s...
Combined with a long transmissable dwell time before symptoms, wouldn't surprise me if 90%+ of the people in NYC were materially exposed.
Looks like you have a possibly important point:
If so, then they would be well on the way to herd immunity and, thus, essentially at the end new cases and the end of the epidemic.
So, for your point, at
https://www.breitbart.com/politics/2020/04/23/andrew-cuomo-1...
is in part:
"Andrew Cuomo: 13.9% of New Yorkers Tested Positive for Coronavirus Antibodies; 21% in NYC"
The 21% is huge.
So, it looks like the virus spread much faster than symptoms indicated and now ballpark 1/4th NYC has been "exposed" to the virus and is either infected without symptoms or recovered without ever having significant or any symptoms. Amazing. So, if want to accept the usual situation for viruses, then the 1/4 of the population soon can't get or transmit the virus.
Ah, but wait; there's more: As at
https://www.msn.com/en-us/news/us/in-four-us-state-prisons-n...
is, call it an exploitation of a captive audience,
> When the first cases of the new coronavirus surfaced in Ohio’s prisons, the director in charge felt like she was fighting a ghost.
> “We weren’t always able to pinpoint where all the cases were coming from,” said Annette Chambers-Smith, director of the Ohio Department of Rehabilitation and Correction. As the virus spread, they began mass testing.
> They started with the Marion Correctional Institution, which houses 2,500 prisoners in north central Ohio, many of them older with pre-existing health conditions. After testing 2,300 inmates for the coronavirus, they were shocked. Of the 2,028 who tested positive, close to 95% had no symptoms.
> “It was very surprising,” said Chambers-Smith, who oversees the state’s 28 correctional facilities.
and the article has more such data.
Then if want to accept an estimate that 50% of the population immune means herd immunity, NYC is ballpark half way to herd immunity which would be close to the end of the epidemic. E.g., even people in NYC so far never exposed to the virus would not get infected even from infected new arrivals before they were recovered or dead.
So, a guess is that the virus SARS-COV-2 is very strange in two respects: (1) It is astoundingly communicative, that is, spreads very easily and (2) has some huge fraction of people with the virus but without symptoms.
A guess at an explanation: In NYC, the virus was often getting spread just via the air, e.g., via building central HVAC systems?
The good news, if want to believe all such evidence and related common assumptions, is that we can get to a fraction of the population with immunity large enough to have herd immunity and, thus, essentially be well on the way to the end of the epidemic, all surprisingly quickly.
Only, there's no evidence that folks who recover from COVID are immune. Herd immunity might never come, so lockdowns remain beneficial in reducing hospital crowding.
https://www.npr.org/sections/coronavirus-live-updates/2020/0...
Yup. But the usual assumption, experience, history, situation, whatever of viruses is that recovery means immunity at least for some significant time, say, a year or so.
Also, I stated
> So, if want to accept the usual situation for viruses,
I didn't explicitly repeat this qualification just before your quote but went for fewer words.
>> So, if want to accept the usual situation for viruses...
You're saying that we should assume "normal situation" in the face of evidence that your assumptions do not hold. Anything you say based on this faulty assumption is hardly worth consideration.
Folks don't develop immunity to this virus. They can get re-infected immediately after recovering. Herd immunity is a phenomenon observed elsewhere, but not here.
This is an extraordinary claim without evidence.
There's a few case reports of "reinfection", but they are rare. In all cases A) symptoms were mild, and B) researchers were unable to culture SARS-CoV-2 from them. Many viral illnesses have people shed virus again a few times after "recovering", and this seems no different.
A bigger concern is, humans seem to lose antibodies to coronaviruses with time-- this is how we get the common cold again and again. But infections after the first time seem to be less severe, thanks to longer-lived immunity from memory t-cells, etc. And at least for SARS-COV-1, immunity lasted quite a bit longer than typical for other human coronaviruses, with decent antibody titers at 3 years (no followup past then).
Not really! As you say, this virus is new. Soooooo, we are short on info. So, we should entertain several possibilities.
I didn't say "should" and, to entertain more than one possibility, only said "If"! Biggie difference.
Yup, we don't know. If we do a lot of very well designed and executed statistical trials, controlled, double blind, randomized, simple random sample, stratified sample, etc., then maybe in five years we will know enough to be sure on all the major points, across seasons, ages, other medical conditions, reinfection, spreading via HVAC systems, therapeutics with dosages, side effects, and contraindications, vaccines with number of shots, contraindications, etc. Ah, just wait five years!!!!
Well, nope, to paraphrase, we go to war with the info we have and not the info we want.
So, for the info we have, from the history of viruses, once recovered, then likely immune for a long time; for now we have to take that seriously and maybe are in effect forced to act as if we believe it.
Yup, there are reports of "reinfection" from maybe China or South Korea -- I didn't pay much attention to those reports due to concerns about, call it, data quality. But, net, yup, maybe in some cases, maybe even in all cases, recovery does not mean immunity.
At high cost, we will be finding out with some relatively good data, and in less than five years! Did I mention high cost?
Here in the SF Bay Area, I'm seeing a 40% decay weekly in hospital admissions. If you assume infections outnumber hospital admissions by 20x, it's going to be months before we reach the low case counts (1 per million) needed for contact tracing and suppression efforts amid semi-normal activities. And that's assuming we keep the 40% decay rate, and don't encounter subpopulations with higher Rt's that keep the virus circulating much longer or even growing.
Lockdowns are definitively, absolutely effective in curbing spread. It is backed by solid evidence of reduction is spread in places where lockdown was implemented, AND we have logical scientific reasoning to explain why. The only debatable aspect is whether they are the best solution, given all the trade-offs. And that is a difficult choice. But given no other solutions, if you can afford a lockdown, it is the right first step while you figure out other options.
Countries have been able to avoid a lockdown if they have sufficient quarantine facilities, contact tracing and hospital capacity. But in the absence of these, lockdown is the most effective way to navigate this.
Real number is less than that and could be way less than that.
Lockdowns create their own form of havoc, but I think they were the right decision at the time until we had more information.
Now we need to figure a low risk way forward
Not overwhelming hospitals.
The why, as Washington State Governor Jay Inslee said, "The penalties are you might be killing your grandfather if you don't do it."
It's innocent others; our grandparents, those with known compromised health conditions, and those, even young and likely uninsured, with unknown health conditions, that are being saved.
Putting this another way, I don't care if someone is a smoker in isolation. That's their choice. I care when it spreads and affects others, including myself. The balance of freedom must be considered when conflicts exist, with a bias towards preventing tragedy of the commons.
- There is a deadly virus out there that is spreading very quickly.
- People who are not showing symptoms are spreading it.
- Community transmission has started
Given these data points, if one leader decided to lockdown sooner and another decided to wait it out, I think it is fair to say that the leader who picked lockdown made the right decision. Yes, if you add an additional data point that 50% of population is already infected, sure, you could argue that maybe it is doing more harm than good. But there is no evidence for this, and this almost certainly was not true when the lockdown decision was made in Washington and California.
_If_ is the key part of this sentence. We simply do not know, which is why - as you point out - testing is key!
If we were strict on lock-down and on testing, we can be very effective with this:
After a few (say 6 or 8) weeks if lock-down we can know with high likelihood who is and who is not sick. Now test all the sick people (and their friends), and start testing the general public for anti-bodies. Then start tracing any new infections.
That requires folks following the lock-down and health measures and the mass availability of virus and anti-body tests.
https://www.bloomberg.com/opinion/articles/2020-04-24/corona... "in the most severely affected regions only about 10% to 15% of the population had been infected"
So, um, no, we are nowhere near the 50 percent, at least according to any data we might have. And, depending which expert do you heed and what is the definition of "herd immunity" they're after, we need 70%, 90% or 95% before this is over.
50% would lower a 2.0 R0 to 1.0. 66% would lower a 2.5 R0 to 1.0. And this ignores that we may have permanently changed behaviors (e.g. handshakes) that facilitate spread, so we may not even need this fraction to curb tramission.
New York City is presently somewhere past 23%, so that's a big chunk of the way to a 1.0 Rt without controls.
The long term effect is arguable since we don't know if we can prevent the majority of people from getting infected.
That's why the phrase "slow the spread" makes sense. Even if we can't prevent people from getting infected eventually, we can slow the spread enough that hospitals can handle incoming patients. If everyone gets infected at the same time, there won't be enough ventilators to treat everyone.
Some Italian scientists did an RNA analysis on samples from infected people from Italy, and confirmed they descended from the first German case.
Basically, if this hypothesis is true then German quarantine and/or exposure tracking failed. Had they played it safe and properly quarantined the entire staff of the office building , Europe's coronavirus pandemic might have gone entirely differently.
According to virologist Dr. Drosten, this idea has been mostly disproven. Some scientists believed it initially but after more debate, the consensus has emerged that both Italy and Germany got their virus directly from Wuhan or Shanghai.
Source (in German language): https://www.ndr.de/nachrichten/info/coronaskript174.pdf page 79
It might well be that containment failed, and that a single person caused hundreds or thousands of the deaths in Italy, much like patient 31 in South Korea.
On the other hand, without those extra deaths, authorities would simply have waited a bit longer with a lockdown, people would have acted as usual for longer, and the end result might just have been very similar with a delay of a few weeks.
If you read the article you'll see that doesn't matter. By the time Seattle took action the disease was already widespread in the population at large.
Other factors, like size, density, and use of public transport, are discussed in the article.
> The most affected countries are the most visited ones. Which also makes me question about the effectiveness of lockdowns.
The countries we have the best data on are developed countries. Again, read the discussion on the different tactics and approaches -- lockdown is only one of the issues.
A tiny number compared to NYC or Seattle. Yet, the state hasn't issued stay-at-home orders, and now they have a major outbreak.
So far, they've had 10 deaths. The total projected number of deaths through August 3rd is 93.
New York is projected to suffer 23,232 deaths for the same time period.
https://covid19.healthdata.org/united-states-of-america/sout...
Looking at 2019 passenger statistics for the big 3:
JFK[1] = 62.6 MM
LGA[2] = 31.1 MM
EWR[3] = 46.3 MM
Total = 140.0 MM
> How many does Seattle receive?Equivalent 2019 metric for SEA[4] puts it at 51.8 MM.
So as a ballpark measure, greater NYC process 3x more than SEA.
The CDC[5] reports ~13k cases in WA, whereas NY alone is at ~267k cases; add another ~102k for nearby NJ.
Extending the benefit of the doubt, that's ~20x positive incident for 3x flight activity. Even if we pretend that WA is under-reporting by a factor of 2, and half of NY cases are false positive, the argument still falls flat on its face...keep in mind, NJ isn't even being accounted for in this thought experiment.
[1] https://www.panynj.gov/content/dam/airports/statistics/stati...
[2] https://www.panynj.gov/content/dam/airports/statistics/stati...
[3] https://www.panynj.gov/content/dam/airports/statistics/stati...
If you read the article, they largely discuss NYC's inability to arrive a decision promptly, which allowed things to spread. Also, resistance to the idea of social distancing looks like it made things much worse.
It's like everyone who is commenting here didn't even read the article and is just spouting opinions.
More visitors may kick off more chains of infection (so higher numbers) but that's just linear growth. Stopping exponential spread is what prevented something far worse than what we have seen.
At some point, people would have got the idea about reducing contacts for themselves, but say that didn't happen in New York until 2 or 3 or 4 times as many people were infected. Not a ridiculous scenario, and who knows what the economic situation would be.
If by upstate NYC you mean Westchester County, that's still largely affected by the spread of the virus in NYC given how interlinked the two communities are.
Going by https://www.nytimes.com/interactive/2020/us/new-york-coronav..., NYC is the most affected per capita, with Westchester placing #3
Can the state government close airports and prevent flights from Europe landing in NYC?
NYC has the economy of some small countries and they do have the backing of the Fed, no matter what excuses Cuomo gives.
Trump has been such a complete failure, and demonstrated such complete ignorance, that any kind of competency shines in contrast.
We're at the point in American politics where "believing science" and "accurately quoting statistics" is a heroic stand, and people are jumping on the Cuomo train because he's a comparative light in the darkness.
I hope this means that people are motivated to vote in November and take their government back, and I hope that the US is prepared to vote in a safe and secure manner. Unfortunately, McConnell and the GOP are blocking any such efforts.
[1] https://twitter.com/BilldeBlasio/status/1234648718714036229
One is that, basically, he's doing the right thing now, whatever early missteps. That matters.
Another is contrast - being competent is, sadly, not a given with our current leadership.
A final one is just that US culture specifically and humans generally flock to leaders in times of crisis. He's being a leader, there you go.
Rudy "noun, verb, 9-11" got the same treatment until he started making noises about violating the term-limit rules, as much as folks hated him.
This article picks on DeBlasio / Cuomo and indirectly DeBlasio’s health commissioner heavily for encouraging continued going out to restaurants and events and riding the subway in late Feb and into mid-March. But remember in late Feb the President was still saying it was going to just magically go away. Bay Area politicians including the speaker of the house Pelosi were encouraging lots of people to come to Chinatown parades. Florida even left their beaches open all the way through mid March for spring breakers to come. While those events have almost certainly led to additional cases and deaths, other areas of the country seem to have largely gotten away with a less proactive and later response than Seattle.
I think we are probably going to see that the real challenge on NY is that we just don’t have another city in the US with New York’s density, air travel volume, and high utilization of public transit. Comparing NY to Seattle just because they are both in the US is probably not as relevant. Given what we know now about the propensity of high volume super spreader events to drive the bulk of the R0, NY can probably only really fairly be compared to London and Paris in the Western world, at least.
This assessment is really premature.
That seems like a rather murky assertion...
https://www.snopes.com/fact-check/pelosi-tweet-chinatown-tou...
(/s)
https://komonews.com/news/coronavirus/seattle-flu-study-alle...
The government did not act as fast on the West Coast either.
There is an inconsistency and inequality in how these restrictions were selected. The arbitrary nature makes me think it is simply was what was politically expedient, rather some principled design. As for an example of political expediency, right now the city’s socialist council is trying to pass an “Amazon tax” under the auspices of the mayor’s emergency proclamation, which due to a technicality would make it immune to subsequent referendum even after the emergency expires (https://sccinsight.com/2020/04/08/the-amazon-tax-bill-is-des...).
If Seattle or Washington were truly responsible, they should’ve shut port traffic (at airports) early and aggressively. Even if that wouldn’t have stopped the coronavirus from arriving ultimately, it would have at least delayed it and provided more time to prepare. I think they should also have taken steps to make their shelter orders more nuanced, rather than the blunt weapon one size fits all approach.
I also do a lot of hiking and on nice days the popular (and most accessible) trails are utterly packed with people. There would be no way you would be able to consistently stay 6ft apart.
On the trails - I think we could easily force them to operate at half density by closing half the lot at popular trailheads. People would spread out to other locations as a result.
Even so, you don’t have to be 6 feet apart all the time. The WHO’s guidance is only 3 feet, for one. But you also get a benefit from just MOSTLY reducing contact, and even on crowded trails people aren’t on top of each other except at the destination. With mask requirements the risk is likely low.
Greenlake cannot be cordoned off though, so it has to be just closed.
What's your plan to settle what should be open and what should not be?
Parks, golfing, fishing are all open in CA. Private construction should have been permitted this entire time since it is trivial to do it responsibly - but everything from new home construction on an open air site to remodels done by one person are not permitted. Numerous European countries have already taken their first incremental steps to reopening things but we don’t even have a date for those first steps in WA. And yet jogging and cycling are fine even though many studies show they’re more dangerous than most other outdoor activities.
As for parks - the city prevented people from gathering in open areas and likely caused them to gather in closed areas or in smaller parks. The big parks have tons of room and can easily be used responsibly, and the city and state need to strike that nuanced balance, instead of just using the most risk averse approach possible.
I find it odd that the Liberals are the ones who are falling for health theater after spending a decade talking about the idiocy of security theater.
Sweden is past their peaks like many other areas, all while retaining their liberties and economic vigor, and domestically their approach has been very popular (see https://www.dailymail.co.uk/news/article-8257353/Swedens-vir...). There’s a value to retaining some degree of normalcy and individual liberties, and it is not reasonable to claim that saving lives is automatically more valuable. As far as trade offs go, I think they’re doing a fine job, although I realize that’s a personal assessment. But leaving Sweden aside, others like Denmark are also taking a nuanced and thoughtful approach, rather than simply banning everything - see https://www.bbc.com/news/world-europe-52226763.
So I am not easily impressed, but this freaked me out for a second. Just to be clear - one man had died on that day, not dozens of people. Sheesh.
I suppose there's some valuable comma somewhere in that sentence, or absence thereof, that should have kept me on the even keel? Or did they just did that on purpose?
I would have written it off as just another error, but I am having hard time accepting that The New Yorker would let that slip through by accident.
Still a little awkward but not bending the language to the breaking point. Pretty sad considering New Yorker's editorial prowess.
The frequently-visited man died.
The day after he'd had all the visitors, he died.
I think that's just it. I'd add the word "family" in there, to make the connection stronger:
The man, who had had all the family visitors, died.
If the federal government rolled in with a heavy hand, we’re all stuck with whatever they think is best. The governors should be the ones that decide for their state, and the federal government should support that in whatever way possible.
The same is said for countries. When the dust settles we can examine the data and see what really worked and what made things worse. This is how we become stronger.
Obviously that's one person's view, but if it's true that means somewhere between 5,550 and 8,800 people have died needlessly. Innovation is good, but not at any cost.
I think he would have because DeBlasio implemented quite a few restrictions earlier. On the 13th, he cancelled large gatherings and limited smaller venues to 50% capacity.
https://www1.nyc.gov/office-of-the-mayor/news/138-20/mayor-d...
On the 15th, he issued an order closing bars and restaurants,
https://www1.nyc.gov/office-of-the-mayor/news/152-20/stateme...
and closed schools.
https://www1.nyc.gov/office-of-the-mayor/news/151-20/new-yor...
Even San Francisco didn't issue a lockdown order until the 16th, and Washington state was even later than NY. I don't remember anyone considering a lockdown on the 10th.
A vaccine showing up before we have to relax controls is not a given. If we have to rely on population immunity, a certain number of people need to get sick for us to attain it. Of course, we want the least vulnerable people to do that, and for it to happen at a rate that doesn't cause healthcare overload and excess mortality (which NYC came perilously close to).
The opposite is probably a given. In the US, opening won't be initially full throttle but I think it's probably a given that significant re-opening will happen over the next 30-45 days.
I'm really not. It makes sense that different states should try different things, and I imagine that if all politicians listened to the scientists there would have been different answers proposed for different states.
If you do it too late then more people will die than could have, if you do it too early you will end up overreacting and sending economy into a tailspin every other year without a good reason. You will also lose trust of the people, killing your chances at effective containment in the future.
Also, sorry about the downvotes you're getting. I think you're raising a good point and in a good manner.
Yeah, like saving people's lives instead of entertaining some muppet's idea of what it means to be scientific.
Hint: If you're not listening to trained, professional scientists while attempting to sound scientific and curious, you're probably just performing an intellectual jerk off.
What happened instead is the result of decades of underfunding in the educational system colliding with years of trust in media being undermined (most obviously with the current Presidency, but mis-information was a thing before his campaign), trust in politicians generally being eroded for decades (gridlocked Congress, Iraq WMD lie) and decades of underfunding of social security nets - of course it is a hard decision to close schools when literally tens of thousands of kids rely on them for basic needs such as food and clothes washing!
The crisis is entirely on the last decades of inaction and underfunding. And not only in the USA (where it is the worst) but also in other parts of the world. I hope that the world at least learns from all the needless death...