Comment by jariel | Hacker News Reader

Comment by jariel | Hacker News Reader

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So what are the alternatives exactly?

Because we have the whole world on lockdown waiting for someone to tell us.

Unfortunately, without a vaccine or cure - there are only 2 approaches that work:

1) Eradication - like Taiwan. They have a tiny number of cases in full quarantine. Nobody comes on or off the island without being checked. So they are in total isolation.

But we can't do this.

2) Contact tracing - like Korea. They keep the virus under wraps by aggressively isolating cases, using social policy centered around contact tracing. Of course, they have masks, widespread testing, but a very asserted focus on contact management. FYI we have to get it down to low-levels before this policy can be implemented.

But it works.

Regular 'social distancing' does not do enough. Right now - we are coming out of our 'lockdowns' but the virus will likely just bounce back - why would it not? Other than the fact weather does play a role and it's getting warmer, there's no reason for the COVID growth to come back to where it was.

So either you stay away from other people - or - at least you consent to inform them if somehow you were near them, which requires contact tracing obviously with the addition of good operational capabilities there, it's not 'just an app'.

The longer the country is shut down the more lives we’ll lose to poverty related deaths. Total covid deaths are still below last seasons Flu death total and that’s Counting all the probable covid deaths that are included in this years count. That was with the population operating under pre covid lifestyle. We can get back now and take caution.

Shelter those above 65 and anyone with an underlying condition. (Of course anyone should stay home if they feel the need)

Everyone else back to life with social distancing and preventative measures in place (masks, no concerts etc)

Build immunity and slowly bring the rest of society back.

Sources: Go research. Look at the data we are way over doing it. Anything I post will be taken with a grain of salt anyway.

I did. We're two days away from matching the top end estimates for 2019 flu deaths[1]

And that's with an estimated ~1/30th of the infections.

Based off the most liberal estimates of deaths directly related to the financial crisis, we're many multiples higher (est: 10,000+)[2] and a couple of day from being par with both direct, and indirect deaths related to stress and financial strife (assuming all the cancer patience died, which they did not) [3].

We're moving towards what you're suggesting, now that most countries have a serious testing infrastructure in place. Randomized testing, plus regular testing of the medial professionals tied with social distancing is what our near future hold. Most things open up to a limited extent, and we'll move from there. [1] https://www.hopkinsmedicine.org/health/conditions-and-diseas... [2] https://www.bbc.com/news/health-27796628 [3] https://www.hsph.harvard.edu/news/press-releases/economic-do...

Actually, not exactly. The antibody tests, everywhere from NYC to California to Germany to Italy, is showing that unreported infections may be 80x as high as reported infections.

In fact, entire homeless shelters have been tested with about a third being infected, and zero showing symptoms.

What this means is that COVID19 is significantly less dangerous than we originally thought.

1 in 5 NYCers have antibodies; and this was sampled a week ago. Given how fast COVID spreads, it could be 1 in 4 now. This means that if we flatten the curve enough, we could possibly see ~3x the deaths (to reach a 80% infected rate) and reach herd immunity.

Now, no one likes thinking about this, but is another 32K deaths worth fully re-opening NYC and getting rid of social distancing? I think it is arguable to say yes, just as it is arguable to say no.

We absolutely cannot be in lockdown till a vaccine is found, we cannot stay at home for 18 months or we will witness decades of economic devastation for 7.5 billion people on the planet (given how connected the world is); not to mention all the mental health harm; as well as physical health harm (deferral of non-essential but still highly important surgeries like hip replacements; less preventative check ups from people going to doctors; etc).

There are trade-offs to be made: we have cars despite the fact that they kill. We allow cigarettes despite the fact that they kill. We allow alcohol despite the fact that they kill.

For anyone who this message resonates to, please join us on /r/LockdownSkepticism. We're about using logic and data discuss what the best course of action is for society as a whole.

> Now, no one likes thinking about this, but is another 32K deaths worth fully re-opening NYC and getting rid of social distancing? I think it is arguable to say yes, just as it is arguable to say no.

Would you hold the same position if you knew you would be one of those deaths? Or if you knew your mother or father or child would be?

Are you personally willing to die to reopen NYC?

Many people have and will die because NYC is closed. As the potential and projected harm of COVID diminishes dramatically, the harms of shutdown and isolation only continue to compound.

A lot of cancer patients have missed chemo. A lot of brain surgeries rescheduled. A lot of stokes and heart attacks went untreated. And so on...

Here’s an excellent summary from a Stanford doctor;

https://nypost.com/2020/04/26/science-says-its-time-to-start...

Even though it should have been obvious from the beginning, now that it has become increasingly obvious that only those at the highest risk should self isolate, the vast majority of people should get back to work, life, and their regular medical treatments.

No, I don't want to die. But we can't take the perspective of aiming for 0 deaths. If so, we'd never ever ever leave our homes.

We won't have cars. We won't have alcohol. We won't have sex (STDs). We won't even have exercise, because exercise sometimes kills.

In 2015, 57 million died in the world. We need to put that into perspective.

There have been tests for antibodies, yes, in NYC. Where is the information for Germany? Italy? California? Two week follow-ups on those test?

Hypothetically speaking, these folk have antibodies, that doesn't mean they're in the clear.

Keep in mind there there are thousands, if not millions of strains of this virus. It is not a static entity, its RNA base means that it can mutate itself to non-existence, or to a more lethal form as it replicates(RNA lacks error correction[1]). That means that even if they have antibodies to a weaker form of the virus, they can still be re-infected by a deadly strain, and be hospitalized, taking up resources for people who are injured, or sick through a normal day.

You have tailing commentary as if I'm disagreeing with your sentiments about lockdown (as of present). I was all for the initial lockdown as the infections needed to be managed (as they were initially miss-managed). Many places are getting a handle on it, and should be able to start opening up over the next couple of months (with social distancing, and random + targeted testing).

[1] https://www.ncbi.nlm.nih.gov/pubmed/9343347 As a note, this is why pandemic need to be stamped out immediately. The more people that get infected, the higher chance it has to replicate highly contagious varieties, which can then replicate to more deadly versions along the pathway(if I understand it correctly).

The same might apply to the flu and other viruses, a lot of cases might be undetected.

This won't work.

First - I would add - none of my detractors or 'downvoters' have provided any workable solution.

Even with 'widespread immunity' that was going undetected - for example, 20% of New Yorkers possibly infected, it still means about a 0.8% overall death rate.

Right now we 12K deaths in NYC (it will be 15K if no more infections due to death-lag in reporting) for the 1.8M already supposedly infected. This is about a 0.8% overall death rate.

It means about another 60K dead in NYC alone (the commenter below puts the number here as well)

This is beyond'acceptable risk'.

60K of NYC is a huge number, and it's equivalent to a few million Americans.

I do not think we're just going to give up on shelter-in-place and then hide our elderly and accept millions of Americans dying.

Again - the solution is already there Contact Tracing.

If you want to talk about 'facts' and 'data' consider Koreas numbers [1]

They are spectacular. 250 dead in a country of 24M people and they have COVID under control. Their economy is not locked-down.

They have scientifically demonstrated a workable solution, it involves community participation via contact tracing.

It's irresponsible for us to avoid proven solutions.

[1] https://www.worldometers.info/coronavirus/country/south-kore...

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