It’s Not Too Late to Go on Offense Against the Coronavirus
newyorker.com
newyorker.com
Note that this can take a while. What the article suggests - getting back to the containment phase - is the stated goal of some countries. However, to get there quick you need very drastic measures. With the measures we adopted, it will take a bit of time - I read one estimate that the reproduction number in Switzerland has been around 0.59 since the lockdown was enacted, so you'd expect cases to drop by a factor of this per generation - it still takes weeks/months to go from 1000+ cases to below 100 (where they estimate they have enough resources for contact tracing).
I keep waiting for the uptick in cases since they announced their plan for reopening though. I'm unconvinced we'll be through it so smoothly.
The Swedes have taken this line as well, saying they 'trust' their citizens.
I think it's not very rational, and also borderline chauvinist for people to say this.
First - what evidence does anyone have that Swiss/Swedes or anyone for that matter are consistently behaving in one way or another that is more 'responsible' or 'sensible' than others?
I don't see any evidence.
A nationalist self-image of responsibility doesn't count as Science, and neither does a few images of fools on a Florida beach as it's all rather anecdotal.
The other issue is that policy is material, not just 'responsibility' - for example - we know from Wuhan that restaurants and other places are a vector for transmission. So it doesn't matter if certain groups are 'behaving responsibly' so much - if they are going to restaurants, hotels, tanning salons etc. - even that otherwise 'responsible behaviour' inside the scope of 'following the rules' that is actually causing transmission.
Given all of the variables we have to look at, the last place I think we can infer variation is with regards to who is 'being reasonable' by some arbitrary definition.
That said - it would be really good to look at different nations varying policies and see how it works.
It could be that <5 people is 'enough' to keep the R1 below 1, though there are obviously other factors. Maybe the Swiss have found the 'sweet spot'?
In Canada, the problem was stopped, but there's already a continued second wave in long-term care homes, it's possible those are structured differently in Canada than other countries.
"A nationalist self-image of responsibility doesn't count as Science"
I mean, take a look: https://aatishb.com/covidtrends/?location=Canada&location=De...
I'm not sure why people are having such a hard time accepting that what Sweden is doing is in fact working, in the face of a pretty clear graph. Just because it appears counter-intuitive or possibly not in line with their preexisting ideas of what should be done?
There's still 5 US states without any form of lockdown (the Dakotas, Nebraska, Iowa and Arkansas), too, so you could say they're "following the Swedish model." Wyoming, Utah and Oklahoma are only under regional partial lockdowns, too. Of course they only account for about 5% of the population but it remains notable.
Or, for a more direct comparison: https://i.insider.com/5e9d6a5015ea4b315c0b4d0a?width=1100&fo... (from https://www.businessinsider.com/how-sweden-and-norway-handle...) - Sweden's population is 2x that of Norway so keep that in mind when comparing, but the difference is really apparent.
To the extent their new case burden remains flat and their medical system capable of treating cases as they arise (which they seem to be) then they are meeting their objectives.
Their goal was never "pretend its not happening and hope it goes away" -- and it certainly was never to have fewer cases than neighboring countries -- so it seems a strange way to compare them. Their goal isn't zero new cases, either. With that said, a flat case count is certainly positive and totally compatible with their goals, which makes it IMO a fair axis of comparison.
If other countries do succeed in containing the virus, that means travel in and out of Sweden will have to be restricted in that time frame, and death rates will have been higher (and not just a deferral effect).
Since some countries apparently have been succeeding in containing the virus, I don't think that is a good bet to make.
Some islands. Those, naturally, have well-defined borders due to their being surrounded by water. I'm not sure any non-island nation has had any luck.
1) The evidence doesn't look that great for Sweden.
2) But my issue is not with their specific policy - I'm saying the Swedish rhetoric of 'we trust our citizens' doesn't make sense because 'trust' isn't really the issue, it's actual policy.
So as for 1) you show a graph of 'cases' but testing rates, and the size of the countries are different, so it's hard to compare.
If you look at the growth of daily cases, Sweden doesn't look like it's peaking, also, they are doing less testing - covid is likely more widespread than indicated.
Sweden has 2x the rate of death of Canada.
But it's not 'terribly bad' - and they are not 'exploding' so is helpful information for countries that may want to 'relax' to Swedens level.
Here is Sweden daily cases [1] it wavers because they publish on different days of the week, but it's still trending up.
Here is the US [2] - slightly trending down.
Switzerland is clearly locking it down [3]
2) But 'trust' is not a policy.
Swedish public health officials have reiterated several times as that 'citizens will behave responsibly' - but I don't think this really is the issue at all.
If Swedes are allowed to eat at restaurants, and Canadians are not allowed - well that's just a matter of policy - not a matter of 'responsible behavior'.
'Trust' and 'responsible behavior' really are a matter of how well those countries actually adhere to the policies laid down - and there is no evidence that Swedes or the Swiss are more faithfully carrying out the orders of their public health officials, than folks in other countries.
I don't think we should accept without evidence that certain groups are behaving in a specific way without evidence.
[1] https://www.worldometers.info/coronavirus/country/sweden/ [2] https://www.worldometers.info/coronavirus/country/us/ [3] https://www.worldometers.info/coronavirus/country/switzerlan...
One clear such example is the vaccination of children, which has been repeatedly cited as one data point on how to set policy.
There are medical professionals dedicating their careers to policy issues. It is very far from a "nationalist self-image". If you have doubts about the quality of data used for setting policy, there are plenty of ways to express this in a qualified manner.
Once the lockdowns kicked in the doubling rate dropped dramatically and new case numbers went from a peak of around 500 a day to 10-20 day for a population 1/10 the US.
From /r/coronavirusdownunder linking the stats with the lock-down measures gives a good idea of the timeframe involved.
date cases growth doubling
2020-03-21 1071 1.22 3.1
2020-03-22 1352 1.26 3.3 <== 10 days ago, Tom Hanks
2020-03-23 1716 1.27 3.5
2020-03-24 2146 1.25 3.8
2020-03-25 2431 1.13 4.0 <== 10 days ago, overseas self-isolate 14 days
2020-03-26 2805 1.15 4.5 <== 10 days ago, Vic declare State of Emergency
2020-03-27 3179 1.13 5.3
2020-03-28 3639 1.14 6.4
2020-03-29 3985 1.1 7.0 <== 10 days ago, TAS self-isolation 14 days
2020-03-30 4250 1.07 8.0 <== 10 days ago, closing borders to all
2020-03-31 4560 1.07 9.3 <== 10 days ago, rule of 4 square metres
2020-04-01 4864 1.07 11.5
2020-04-02 5136 1.06 13.6 <== 10 days ago, no social gathering
2020-04-03 5358 1.04 15.6 <== 10 days ago, WA,SA closing border
2020-04-04 5552 1.04 18.7
2020-04-05 5687 1.02 22.9
2020-04-06 5795 1.02 28.1
2020-04-07 5908 1.02 33.1
2020-04-08 6013 1.02 38.8 <== 10 days ago, mandatory hotel quarantine
2020-04-09 6103 1.01 46.5
2020-04-10 6203 1.02 52.2
2020-04-11 6292 1.01 60.7
2020-04-12 6313 1.003 69.6
2020-04-13 6359 1.007 83.5 <== 10 days ago, QLD closing border
2020-04-14 6400 1.006 96.5
2020-04-15 6447 1.007 114.2
2020-04-16 6468 1.003 106.9
2020-04-17 6523 1.009 121.1
2020-04-18 6565 1.006 129.2
2020-04-19 6606 1.006 157.3
2020-04-20 6619 1.002 165.0 <== 10 days ago, Good Friday
2020-04-21 6645 1.004 210.6
2020-04-22 6649 1.001 247.4
2020-04-23 6661 1.002 307.7
2020-04-24 6675 1.002 301.3
2020-04-25 6695 1.003 350.7
2020-04-26 6711 1.002 298.7
At the moment they easily have the resources to track down every case quickly, and with a million people signed up to the app that should get easier.
Actually, Taiwan has done better. They've had no local cases for 14 days.
https://taipeitimes.com/News/front/archives/2020/04/27/20037...
They did it by ignoring the WHO's advice and locking down early and then aggressively containing all cases, preventing a general outbreak.
They've been pursuing this since December 31st, when they issued a warning to the WHO about what was going on and locked down. The WHO ignored them.
https://www.taipeitimes.com/News/front/archives/2020/04/12/2...
They've taken 4 months to get to no new cases. From a much better starting point. With a much smaller population.
I'm very skeptical about what this guy is advocating.
Blame the constitution. In the US system of government health is largely a state matter. Setting aside trump, the federal agencies just aren't setup to lead. They can issue statements and guidelines but lack any actual authority on the ground. State governors have the power, but even then they cannot boss corporations around (hospitals/insurance companies). They cannot even divert masks from one hospital to another, let alone demand that a patient be moved.
Now in other countries, the ones with government-provided healthcare, the national government has real authority. They can directly order policy changes. They can close individual hospitals and/or move patients. They can control the flow of equipment because they are the ones paying for that equipment. Canada just deployed soldiers into some care homes. It took less than 24 hours without any new legislation needed. A US state governor might be able to use the local national guard, but deploying the army within the US? Into a privately-run care home? That is a power trump doesn't have.
In so far as the federal government sets health policy, it does so through the carrot and stick of federal funding through equalization and other programs. I am reasonably certain that this is also an approach the US federal government has used in areas of devolved authority (particularly education).
And looking at the specific situation you're talking about, it appears the Ontario government requested military assistance, and it was granted, not the other way around.
The US federal government may not have explicit authority, but the idea that it is absolutely helpless to coordinate efforts among the states (aka interstate commerce) seems kind of blatantly absurd. Never mind that they seem to, in fact, have done quite a lot of diverting masks from where they were going to elsewhere already. Just you know, not in a helpful way.
Domestic use of US soldiers, even with a state request, is not a simple matter. Trump wanted to deploy troops along boarder --> no go. Federal troops cannot be used to implement domestic policy. New York probably couldn't get troops if it asked.
Canadian troops, if asked by any level of government, can deploy domestically and do so regularly. That's the advantage of a single sovereign authority (the crown). Everyone is literally on the same team.
The US fed exercises its health power indirectly, through spending. It can demand that certain hospitals, those that receive federal funds, act in certain ways. But it cannot dictate treatment regimes. (This fed-state split on health has been heavily influenced/reinforced by the abortion debate.)
one where blind fear and panic can’t easily trigger a cascade into surveillance fascism for a pandemic trending to be ~3x worse than the flu?
Non-biased random sampling anti-body studies reliably point to an IFR of around 0.5%
3x is just wishful thinking at this point
"The Constitution is not a suicide pact."
https://en.wikipedia.org/wiki/The_Constitution_is_not_a_suic...
Yes, this is a global pandemic. But at the same time, I prefer a response that is fine-tuned to local circumstances and I’m glad the WHO does not have envy authority over the decision taking in my city. Corona does not strike every region equally and at the same time. Furthermore, diversity of regulation is very important for learning what works and what does not. For example, if the Swedish approach turns out to be successful, we can copy that in case of a second wave. There is a common misconception that a coordinated approach is necessary to make sure everyone does the optimal things. That’s wrong. Regions are free to copy each other if they see what works elsewhere. If there are local differences, there is often a good reason for it and you wouldn’t want a central authority to enforce a “one-size-fits-all” response.
We could have learned a lot from them, but WHO chose to ignore their advice for political reasons.
Also, I generally think local decision-taking is faster than centralized decision-taking. So if speed is important, you should try to decentralize power and allow local governments to act on their own.
Why pick national? Almost any aspect of the response can be implemented on any level of governance except maybe individual.
It isn't at all obvious that centralising on the federal level is sensible. Realistically; the optimal organisational unit for the response might be the catchments around each hospital and so somewhere around the local level.
If the US states were literally independent countries, then they'd be able to do more. They're not, so the federal government should be doing a lot more then it is.
Your taxes pay for federal government. An entirely different set of taxes pay for state government. _Why_ are you not demanding better service?
And note the US Federal government creaking under a historically high level of debt, it has already given people far more than any taxpayer is contributing to the tune of something like @3k per if https://usdebtclock.org/ is accurate.
Of course, there are many advantages from this model. The comparison between these models of governments reminds me of 'the Prince' from Machiavelli. In that book, he compared France with the Ottoman Empire. French king has relatively weak power since the nobles own their fiefs. While the Ottoman Empire there are only province officers, and the sultan can easily move or fire those officers. The comparison seems to echo what the US and China's modern political systems and possibly the pros and cons remain the same.
PS: There's a documentary from the BBC named 'the Chinese Mayor' that might help people have an initial understanding of the Chinese political system from a mayor's perspective. Chinese officers transfer from provinces to provinces in a very frequent manner, in order to avoid the local governments have too much power. This feature remains the same in China for two thousand years.
Here is what happens when someone tries to reveal to real situation:
https://www.youtube.com/watch?v=1U1VYck6KOo
The person filming is currently missing.
With that being said, I didn't mention any number, but the situation turned to be optimal for quite a while - it's too obvious to anyone who lives here.
It's quite a thing to see once the government realized the downplaying was a fault, how fast and effective they could implement their quarantine policy into every corner in the society. It's both incredible and terrifying to see the executive orders implemented by every community, village, malls, and every individual.
The original point I wanted to make is, there were a lof people believed the history was ended by American style democracy, it wasn't. There is still quite a room for optimization.
Good hand hygene and wearing masks and keeping distances in most places go a long way towards preventing infections. Events like the Oktoberfest and other gatherings of thousands in direct contact might be cancelled for undetermined time, but the rest of the life can continue.
All the nations he mentions are creditor nations that have savings to undertake huge public works projects in order to surveil those who might be infected. That’s why we can’t do similar programs in the US, we’re heavily indebted and collectively broke. Same story with the PIGS, if the EU dissolves these areas will succumb to hyperinflation too, and also why they can not implement similar programs.
* that anything China claims is true, so far they've been lying constantly, we know this.
* that we will be able to accurately contact trace. This is problematic because its easy to tell who I have had contact with. But it's much harder to tell who has used the same door knobs or shopping trollies that I have. It's also an exponentially larger number. You can quarantine the 50 people I've touched or spoken to in the last week, you can't quarantine the 2000 who went to the supermarket the same day as me. Not without just quarantining everyone anyway, so why bother contact tracing?
* that I can be isolated if I am not sick. Imagine if your housemate got the disease, with proof via testing. Now what? You can't leave the house for 2 weeks? Good luck surviving off whatever is already in your cupboards, it's hard enough to keep people from doing things they shouldn't under social isolation, but mass house arrest is unenforceable, at least in the west.
Also,the author perpetuates a myth that's risen about social isolation. Let's clarify: The plan is NOT to keep everyone locked away until the case count actually reaches zero, that will never happen. The plan is to work out how many infected people we can cope with at a time.
If you have 25k ventilators, and 5% of patients need ventilation then you know you can have 500k people get the disease simultaneously. That way, the mortality stays at the minimum rate because everyone who needs treatment can get it. Any higher and you have to ration ventilators and the death rate spirals.
So we will aim to have a certain number of people get it at a time. If we drop below this number, we will relax social distancing somewhat, maybe reopen schools or permit some use of restaurants in order to INCREASE transmission. But then reverse that when the infected load rises.
This is the real reason testing is important. It's irrelevant whether you have the disease, it's very important to know how many people have it (especially how many people have it now and will need treatment in 1,4,7,14 etc days). Tests should be used for population monitoring not individuals. This was a key error from day one that is still happening today. Whatever your condition, YOU do not need to be tested.
Eventually we will develop a herd immunity which will gradually allow more and more openness without increasing transmission rates. Until one day so many people have had it that no measures are needed to keep the rate low enough to deal with. That's when we return to normal.
There are nuances to how we do this. High risk groups should remain more isolated for longer as they are more likely to die or need ventilation. We need population testing, something governments are stubbornly refusing to do. We don't know transmission rates under various levels of lockdown. All this needs to be managed semi-locally, so London might be opening up while Cornwall remains closed.
This approach is clearly laid out and was at the beginning of the current measures both academically and generally.
This is about control, not eradication, because eradication is not possible. Any attempt at eradication will fail when we're unable to find literally every case world wide, we relax quarantine and then suddenly it rockets back in.
As soon as the author started talking about eradication, he left the scientific concensus. As soon as he claimed we could return to normal life if we got contact tracing working, he made a claim with no evidence to back it up. Contact tracing is a nice to have, but not important. The important things are healthcare capacity (aka ventilators) and population monitoring.
Something i have read is that there is a split between epidemiologists and public health experts. Epidemiologists accept that we can't eradicate, and so have to manage the outbreak. Public health experts still think in terms of eradication.
My understanding is that this is an inertia thing. Public health experts have spent decades focused on eradicating diseases, so that's the only way they can think. Meanwhile, epidemiologists only study diseases that have escaped containment, so that's the only way they can think!
It's somewhat ironic that this expert's own expertise is what stops him from listening to the real experts...
What lies are you specifically talking about?
A lot of people have the impression that China is some sort of black hole: no information gets out, so who knows what's going on inside?
There is a huge amount of information coming out of China. People I talk to there tell me about what their everyday lives are like. There are millions of Chinese people communicating with the outside world every day. What's certain is that the situation is completely different from how it was in late January through February. The epidemic really does appear to be under control there.
> Contact tracing is a nice to have, but not important. The important things are healthcare capacity (aka ventilators) and population monitoring.
What you're proposing is a control strategy, in which the epidemic is held at a level that doesn't overwhelm hospitals, but in which a large number of people continue to be infected each day. It's a steady state with R ~ 1 and a manageable case load. In the US, this is the current situation, and it means a steady pace of ~2000 deaths/day.
In that strategy, the second you reduce social distancing measures, the epidemic will flare up again, because you're balancing on a knife's edge.
The strategy that China pursued was suppression (R << 1), followed by containment of the epidemic at a much lower level. In the first phase, extreme social distancing and quarantine measures reduced the number of new infections to a small number (tens/day). In the second phase, social distancing measures have been relaxed, and widespread testing and contact tracing are being used to try to catch nearly every new case in the country. That's only feasible if the number of cases is small.
This two-phase strategy is the only one I can see that does not lead to ~0.5% of the population being sacrificed.
If you don't believe me, that's fine, just go Google it. US intelligence have publicly stated this. Just in the last few days the UK has stopped listing Chinese numbers at all because they as so badly wrong.
I don't doubt that there are a lot of personal anecdotes coming from China, but as far as I know the only numbers are the official ones and they are pap.
If you can offer factual evidence that that is not true, I'd be very pleased to be wrong since apparently Chinese coronavirus is 100 times less deadly than average...
So that brings us to contact tracing.
I'm happy to agree that contact tracing would mean we could keep R values lower with less disruption to people's lives. You could let people without contact go out more etc IF AND ONLY IF you can accurately do contact tracing.
But we've never done that before in the West. I belive it has been semi managed in Africa with Ebola. But Ebola is easier to test for. And its much faster to show symptoms. And patients tend to self isolate because they're so sick they can't get out of bed.
Coronavirus is airborne and seems to survive for long periods on surfaces. So you get many many more contacts even if you get fewer infections per contact.
The article doesn't attempt any maths despite these factors being key to knowing whether contact tracing works for a given disease. Do you know of any such model? Do we know what parameters we need to input for coronavirus (what defines a contact, how many contacts require quarantines etc)? I think these values are total unknowns for coronavirus, it's taken us this long to get to a semi reliable R0 value, we still don't know how R changed with quarantine methods and levels. So will we discover any of this in time to use it with COVID-19? Or will we just do the less accurate but just as effective measures we need to do and get through this in another 2-3 months?
Fyi, 0.6% (plus or minute 0.2percetage points) overall population fatality is what we are aiming for already based on having 100% treatment availability as far as I know. So apparently contact tracing offers exactly the same outcome? I have to ask again, what's the point? Isn't this at best a nice to have and at worse a wild goose chase?
> That's what basically every Western country had said.
I've heard the US and UK governments say this, coincidentally at exactly the moment when they were coming under political pressure because of their insufficient early responses to coronavirus.
> US intelligence have publicly stated this.
They're not a reliable source of information.
> apparently Chinese coronavirus is 100 times less deadly than average...
Where are you getting that from? Case fatality rates in China were similar to what was later found in Western countries.
> we still don't know how R changed with quarantine methods
There's actually very interesting research coming out of China about how different measures affected the reproductive rate of the virus. The Journal of the American Medical Association just published a study on exactly this question.[1]
It strikes me as careless to write off this important information so easily. I think the reasons for doing so are primarily political: a lot of people have a hard time accepting that the Chinese government did something effectively, or that it succeeded in suppressing the epidemic where Western governments have so far mostly failed.
May I ask, what do you believe the Chinese death toll has been in total so far? The official number is 4642 I think. So if other countries are as efficient as China, this whole pandemic will kill only around 23,000 world wide. Let's up the Chinese are being accurate and we get these excellent numbers!
Just for the record, I am actually very happy to concede that the Chinese government has been effective (after the first few weeks of the outbreak at least). I think China has a very effective government and I envy them that. But effective does not mean reliable. Aside from the above and needing to close their wet markets and treat their minories better, I don't have major objections to China...
Your reasoning doesn't make any sense. The number of deaths is dependent on the number of people that get sick. China's lower number of deaths simply reflects the stricter containment measures it took to control the spread of the epidemic.
The mortality rate among those who get infected is probably similar in China and Western countries. I could imagine that the mortality rate might vary by a factor of a few, based on how many ventilators are available, how overwhelmed hospitals are, and other similar factors. But the percentage of the total population that gets infected can vary by orders of magnitude, based on how aggressively you contain the epidemic.
As of yesterday, based on the number of confirmed cases (a lower limit, but it gives you a sense of the differences):
* 0.02% of the population of South Korea has contracted the virus.
* 0.3% of the population of the United States has contracted the virus.
Expecting the same percentage of the population to die in South Korea and the United States would be silly, based on the very different rates of infection. The same goes for China.
> I am actually very happy to concede that the Chinese government has been effective (after the first few weeks of the outbreak at least).
Then why is it so surprising to you that the extreme public health interventions they took (cordons sanitaires, quarantine centers, strict lock-downs of many cities, regular symptom checks for large swaths of the population, etc.) suppressed the reproductive rate of the virus and drove the number of new infections down drastically?
There's even documents describing this blame China strategy as a way to deflect Trump's failures: https://www.washingtonpost.com/politics/2020/04/25/senate-go...
Despite not having any concrete evidence, you don't trust China's numbers and that they have coronavirus contained. Have you considered that you might be thinking this way because of a coordinated propaganda campaign?
Objectively looking at the situation on the ground in China right now, life is going back to normal and there hasn't been massive outbreaks of covid19 and rushes to the hospital. You can't hide exponential growth if the virus was not contained.
Is that your position?
I should be clear: I don't trust Trump or the West particularly. But mass faking numbers like this is common in China and very rare in the west. The west cheats in other ways...
How do you figure that? The lesson from China is that the way to keep the death toll low is to enact extreme public health interventions to stop transmission of the virus and suppress the epidemic. The lesson isn't, "Everything will be fine if we do nothing."
The reason fewer people have died in China is because fewer people have gotten sick in the first place. The way that happened was through lock-downs that were far stricter than anything implemented in the West (and a whole host of other measures, like regularly checking everyone's temperature and quarantining anyone with a fever).
Until people will actually comment on that, everything else is just he said she said.
> Does anyone here actually believe the current Chinese numbers? 4600 dead?
I think that they are as reliable as the figures coming out of the United States. That is, they are probably in the right ballpark. As in the United States, there are probably certain categories of uncounted deaths (e.g., thousands of uncounted nursing home deaths in the US), but they probably do not change the overall numbers enough to qualitatively change any conclusions you'd draw.
Now that I've explicitly answered your question, please show some sign that you acknowledge that the logic leading from "only 4600 people have died in China" to "only 23k people will die worldwide" makes no sense whatsoever.
But that's ok, you have a different explanation for why China has apparently done amazingly well. So let's look at the numbers and quantify just how good China are, since that is why their numbers are better right?
China has 4633 deaths as of last night. They're down to 723 active cases, so for them the epidemic is basically over.
The USA has had 56009 deaths. And they're only at the start of the issue. So even ignoring the fact that China had almost 5 times as many people and less funding for healthcare and knew nothing about the disease and has had it for longer and all that, they managed to deal with it with 93% fewer deaths.
That's incredible isn't it?
But maybe the USA are just really shit at this? Trump isn't exactly a great leader right?
The UK a tiny country with a population 25 times smaller than China has 152,000 cases. Almost twice what China and the UK also has only just started to get it under control. 20732 people dead already. 5 times more than China roughly. God China are really incredibly incredibly good aren't they? A disease that's killed 20k people in the UK only killed 5k in China despite every other factor except the excellence of their leaders being against them.
We should consider the Germans to maybe? famously efficient, public health oriented, stay home order obeying Germans. They even have some of the best number for testing and treatment. No they're also way behind China with more cases and more deaths despite getting infected later and seeing what happened in Italy.
So we are forced back to the same question of opinion, but this time it's not just "is China lying or <intentional but apparently too subtle bs about only having 23k fatalities work wide>". Now you have proposed another possibility:
Either China is lying, or all the governments in the western world are so incompetent they're making this at least 10 times worse, killing 10s or 100s of thousands of their own citizens".
Can I assume your sticking to option 2?
"This is a disease that will be circling the globe for a long time. The virus could very well become seasonal, like the flu—and, like the flu, it might mutate regularly, making it a moving target for vaccine researchers. Without a durable system in place, we may find ourselves trapped in a cycle of lockdown and stimulus, waiting and hoping, with no end in sight."
That's not to defend people who actually have the virus breaking quarantine. Limited quarantines have always been compatible with freedom, that's just dumb selfishness. But if the proposal is that the 30k new infectees a day* and all their close contacts should be forced out of their homes into quarantine camps, yeah, that's not going to work here.
* I know the real number is likely much higher than this.
And you can see in Italy how the (hoped) path for the fewest deaths as opposed to (rather than along with) freedom led to a horrible result. The current PM has basically trampled on every constitutional right with authority that he should not have, and the effects of the policy (besides locking up people for at least 75 days) aren't that great. And let's not talk about the social / economical aspect.
The authoritarian aspect of these moves was clearly shown when he threatened closing things again if infections rise (as if it's the fault of the people he's supposed to protect).
1-2% of people will be unable to live in the unquarantined society due to dying, and a significant number more may never fully recover. It's more "live free AND die".
I think you may be misunderstanding my perspective. When someone proposes remote quarantine of all contacts of 30k/day infected cases, or shelter-at-home for the next year, I react as if they said "forcibly infect everyone below 65". If you sit down and do the math, sure, these policies will significantly decrease the death rate below the baseline of an uncontrolled pandemic. But they have the critical flaw that they're weird authoritarian control fantasies, which fail to respect the general public as anything other than bodies which must be optimized for their own good.
By the way the hoarding of paper products is a worldwide thing. It was problem even in Japan far before the US.
Unless, you know, it's as contagious as corona. Then it only takes one person to infect an office or grocery store or hospital (as happened with SARS-1 in S. Korea.)
I wish people would start using facts, instead of hope.
If each new case, on average results in less than one new case, and all cases eventually resolve (recovery or death), then it's a mathematical truth that the number of active cases must go down over time. The decrease isn't necessarily monotonic, but over a long enough time frame it's inevitable. The bursty nature of super-spreading will produce variance, but as long as these super-spreaders are accounted for in the observed r0, the variance itself doesn't change the long-term outcome.
Now, the estimated/measured r0 is just a sample/estimate of the (unknowable) "true" r0, and r0 isn't constant, but those are separate issues.