London may have gone into a Covid-accelerated decline
economist.com
economist.com
> But covid-19 and the extreme social-distancing measures used to combat it pose a new and more profound danger to the capital
I feel that during lockdown a fair few people have turned mildly insane - they seem to honestly believe that we're going to stand very far apart from other humans for the rest of time.
It's just not the case. I'll be in the pub by the end of the year.
I returned a bike yesterday in North Beach (SF) and people were crowded together. Maybe half of the people were wearing masks. There was a 4 piece street band walking around playing brass instruments like it was a carnival.
That's an aspect of the universal 6-foot rule that everyone seems to forget. It originally appeared as advice for business (restaurants). You don't want to sit too close to someone else in still air. But if we are spitting, singing, shouting, coughing, panting, playing in a Jazz band, or are simply downwind of someone, that 6-foot distance is probably not enough. Airlines have basically said as much about their cabins. If the air is being circulated artificially in a closed environment, specific measured distances are probably irrelevant.
I do appreciate that public health authorities have to make clear and simple recommendations to avoid confusing people. But let's not pretend there is anything scientific about it.
it doesn't mean you won't get it outside that radius or that you will get it inside that radius, just that the opportunity to catch it is increased or decreased based on distance.
Such data is much harder to collect after an infection has become endemic, but early contact tracing can provide great data.
You can easily smell cigar smoke at 10 meters but you are ver unlikely to get infected at the same distance, current estimates put it to 4 meters in hospital settings.
Also,the amount of virus you receive matters, and distance decreases it.
The smoke analogy is not perfect, as it's composition is less moist, but it is closer to the truth than the '6 foot' model that was itself already a compromise between the now accepted as disproved macro fluid projectile model and economic concerns.
"The particles in tobacco smoke are liquid aerosol droplets (~ 20% water), ..."
So, sharing a room with someone sick probably gives you a high chance of encountering the virus, but outdoors one hopes the concentrations would be so low that our bodies can fight it off.
And if you're wearing a mask and can still smell cigarette smoke, then surely it means that mask would let the virus particles through as well.
https://www.latimes.com/world-nation/story/2020-03-29/corona...
https://www.mercurynews.com/2020/05/13/how-coronavirus-sprea...
Isn't "requiring hospitalization" pretty much the definition of "severe symptoms"? As far as I can tell, when doctors talk about "mild symptoms", that can include anything from a mild cough to weeks of heavy fever, muscle pains, ... .
But more importantly: even if you're complete asymptomatic, you're still very likely to infect other people and contribute to the spread of the virus and the disease. That's bad for other people's health, causes extra deaths, is bad for the economy, and generally makes everything worse for everybody including yourself.
True, if you are scared then by all mean isolate yourself, do not meet other people.
>causes extra deaths
Assume, in the worse case everyone infected, the estimated death rate is only 1%, that's not going to make difference to most people life or the economy.
And most other causes are not simultaneously sending several multiples of that number to the hospital, or spreading like wildfire in same hospital.
If you are discharged from a hospital and require rehabilitation you will probably be placed in some form of nursing facility with other patients who may or may not have been infected.
The last part is the hidden disaster of the COVID-19 crisis.
Clearly a lot of people are not willing to take the risk of contracting the virus.
This seems a very difficult point for most people.
Early on, we had an exponential rise in cases and it appeared we would overwhelm hospitals. Therefore quarantine orders were issued (rather delayed imo) to offset the growth and allow hospitals to not have more cases than beds/equipment.
We had a lot less data initially and had to be proactive. The initial call was correct, and slowly easing it with monitoring is correct now.
it is totally disingenous to suggest that anyone actually proposing the "lockdown" claimed that it was about eradicating it or waiting for it to pass (both of which are widely understood to be absurd goals at this time).
And no the lockdown isn't about "lot of people are not willing to take the risk of contracting the virus", it is about keeping the pace of the tiny fraction of infections that go bad to under the capacity of the NHS / ICUs. At least that was the stated goal. It seems now that we have switched to a goal of zero infection (and not sure that it makes sense, given that I hear the WHO now refering to this virus as an "endemic disease").
There is no practical way to "isolate the sick and the elderly" when there are no supplies of PPE or testing kits for care workers. The whole point is that the sick and elderly need care, and when there's a pandemic that care requires extra measures to prevent the spread of infection.
In reality the government did the exact opposite - knowingly sending elderly people with Covid infections back to care homes, and then saying "Oh that's nothing to do with us - every move was signed off by a clinician."
And that in turn makes even less sense when you realise that tens of millions were spent on Covid-ready Nightingale Hospitals, which were opened to great fanfare - and then literally left empty, while old people were being sent to nursing homes to infect others.
Evil, or "simply" stupid and incompetent? It doesn't even matter any more A lot of people are dead for no good reason, and far more are going to die in the UK before this is over.
This is just completely wrong. It's a useful exercise to work out how many people would need to die before herd immunity could be achieved. Use mortality numbers based on what we've learned about the virus and estimates of what percentage of the population would need to be infected to achieve herd immunity based on the behavior of any number of other viruses.
And that's assuming infection confers immunity with this virus, which we don't know yet.
As for the death rate, the rate to the non vulnerable population is immaterial. With appropriate isolation we could absolutely achieve herd immunity with minimal losses. Instead we have sent covid infected patients back in nursing homes in both the US and the UK with catastrophic results.
The numbers don't look very immaterial to me. [1] Granted there's a weird amount of variance between regions and there's a lot that isn't certain.
> If you are still questioning whether infection confers immunity, then what other strategy than herd immunity do you suggest? If we don’t develop immunity naturally, there won’t be a vaccine either. Permanent lockdown?
(Let's hope some reasonable amount of immunity is conferred! It seems likely, but I think it's useful to consider the worst case.)
I'd be happy with people doing what they ought to be doing anyway: exercising some caution and doing the obvious things to limit the spreading of the bug. I'm in a constant state of amazement at how bad we are at all of this.
In the crazy worst case where there isn't much immunity conferred by the infection, we could hopefully rely on Darwin to eventually provide us with a less dangerous version of the virus.
[1] https://en.wikipedia.org/wiki/Mortality_due_to_COVID-19#Mort...
Unfortunately once you scare everyone into locking down you can't reverse course on a dime.
https://www.sfgate.com/news/editorspicks/article/Los-Angeles...
https://english.elpais.com/society/2020-05-14/antibody-study...
Most studies in Europe show this: 0,5 - 1.
Though I'd be cautious about being too confident in antibody study results, for now. A lot can depend on test accuracy (especially where covid is rare anyway).
This was their criticized quote:
> Globally, about 3.4% of reported COVID-19 cases have died
It was true.
One they are being scared into thinking that if they get infected they will die a horrible death and so will everyone around them. This is obviously an exaggeration because for people under 40 the vast majority will not even notice the infection. And please if you reply grasping at the straw of ‘some people are ill for long’ specify how many people and if they are seriously ill or just tired for a long time.
Second they are not in a position to set policy. The people who make the rules are even more scared and make the rules much tighter than is useful.
We know that sars-cov-2 is highly contagious - R0 values up above 2 without any action. This means that with no action, the entire population will be infected rapidly. Out of the entire population a certain percentage will have no symptoms. Another group will have mild symptoms. Another group will have severe symptoms. Another group will require hospitalization. Members of the last two groups will die.
The point of current public policy (at least from the POV of the people smart enough to understand and propose it) has been to decrease R0 so that it takes much longer for the entire population to become infected (which will almost certainly happen anyway unless an effective vaccine appears quickly). Why would we want to do that? Because if the entire population is rapidly infected, the numbers requiring hospitalization would vastly exceed the resources of our medical system. That means that:
1. Some of those who might have survived COVID-19 had they received effective hospital care will die. 2. People with other treatements requiring hospital care will find it difficult or impossible to receive it, leading to more deaths from non-COVID-19 causes.
None of this has anything to do with "if they get infected they will die a horrible death and so will everyone around them" - that's nothing but a silly strawman painted by people who, for some reason, want to downplay the risk of allowing a virus with R0 > 2 to plough through a population.
Everywhere you see governments building up these huge emergency hospitals and then tearing them down again without them being used.
If your story were true they’d keep the hospitals and loosen restrictions to maximize use, saving the economy while keeping a safe margin.
> allowing a virus with R0 > 2 to plough through a population
Sounds so scary but
> the entire population to become infected (which will almost certainly happen anyway)
Is the same thing, but put in a not scary manner.
These people making the rules are not as smart as you think they are. When the rules were made there was a lot of uncertainty and a lot of pressure to take action. Logically some of the rules work and some don’t. Truly smart people would just say ‘oh well we will remove the rules that don’t work’. Instead what you see is clinging to ineffective rules, defending them with poor excuses as doing otherwise means admitting you were wrong.
In the US, look at mr. Cuomo and his indefensible failure of sending infected old people to nursing homes. It’s clearly the worst thing to do and look at his reaction now that the results are in! He just says he didn’t know even though his signature is on the page ordering it. How smart is that.
Handwaving nonsense. You said that, not people advocating for serious and sensible public policy re: COVID-19.
> "Sounds so scary ..."
Have you actually listened to the people who had COVID-19 and recovered from more than mild symptoms? If there was an army or a terrorist group about to invade the US and kill 100k people, mostly at random, I suspect you'd consider that fairly "scary", as would most other people.
> "Is the same thing..."
As noted by another sibling comment, no it's not the same thing at all.
> "... there was a lot of uncertainty ..."
There is still a lot of uncertainty. We don't really know what works and what doesn't work. What you characterize as "clinging to ineffective rules" I would characterize as "trying to be cautious in the face of massive uncertainty".
I would never defend all of Cuomo's actions as NY Governor. He made a number of extremely serious errors, even though his demeanour in his later press briefings was exemplary.
> allowing a virus with R0 > 2 to plough through a population
puts a very concrete time estimate on it. We know that the SARS-CoV-2 replicates every 4 days on average, so this scenario has a doubling of cases every 4 days. Starting from a single infected person, the US would become completely infected in roughly 120 days, i.e. they would roughly be done by this point or early next month, with all the consequences that entails. In contrast,
> the entire population to become infected (which will almost certainly happen anyway)
does not imply any specific timeline. It could happen in 30 days, it could happen in 30 weeks, it could happen in 30 years.
And it is not like under 60s are all that safe. In the US 25% of deaths are under 65.
More or less infeasible than throwing millions of people out of work and forbidding everyone from seeing their friends and families?
And it is not like under 60s are all that safe. In the US 25% of deaths are under 65.
85% of the US population is under 65. So 15% of the population has 75% of the deaths, meaning a randomly selected person over 65 is 17 times more likely to have died than a random person under 65.
For politicians it was just easier to lock us all in because such measures are more accepted by the public if everyone has to give up and not just a few. On the other hand, the lockdown for all created so much noise that we didn't focus enough on those at risk and easing their lockdown in some way. Even Sweden got it wrong by banning visits to elderly homes only by late March.
Besides the lockdown for elderly (and a growing list of others at risk) I wish they'd broken up elderly and care homes where-ever possible. If just half the residents moved to a younger relative for a year (and pay the relative for their work, obviously) the homes might not be those death traps they are.
Here in Austria the government worked a lot with Angst. It went so far that the younger were more afraid of the virus than the elderly. I had to spend days to persuade a 35-yr-old that she doesn't have to be afraid and from her initial "I don't want this virus" position she moved to "I already had it" six weeks after...
Young people in their 20's and 30's are dying too, just at a lower percentage.
Many young people who survive COVID-19 end up with permanent lung damage and other on-going issues.
A New York Times staffer who's 33-years old ran 3 miles and walked 10 more the day before she came down with COVID-19 on April 17.
And now this: "I am one of the lucky ones. I never needed a ventilator. I survived. But 27 days later, I still have lingering pneumonia. I use two inhalers, twice a day. I can’t walk more than a few blocks without stopping."—https://www.nytimes.com/2020/05/14/opinion/coronavirus-young...
Far lower. It may be still undesirable, but if we want to talk about risk, there is no absence of risk for anyone, yet the risk changes a lot depending on age and comorbidities. This matters if one wants to take the risk or not, given that it will never be zero.
> Many young people who survive COVID-19 end up with permanent lung damage and other on-going issues.
Some of these issues apply to any type of pneumonia. It takes a year or so to fully recover if you had a bad one. And to evaluate "permanent" damage, we need more time. It would be better to say "we don't know yet if the damage is permanent or not".
TBH, I have yet to hear a decent argument against this, given the following thoughts:
1. Development of a vaccine will take a minimum of 12 months, more like 18.
2. It is not feasible, either for democracy or our economy, to stay locked in/sheltered at home for this long.
3. Thus, the main concern should be to "flatten the curve": keep the infection rate low enough so that, even though people still get infected, hospital systems don't get overwhelmed. I think it's important to note that the only places yet that have had overwhelmed (or close to it) hospital systems had extreme density (Wuhan, NYC), often coupled with lots of mixing of young and old (Northern Italy).
4. A corollary to number 3 is that as long as hospital systems aren't overwhelmed, or close to it, that you shouldn't lock down further. The belief is that the majority of society becoming infected within 12/18 months is inevitable, so extreme lockdowns will do little beyond push deaths out a bit.
5. Do everything you can to protect the highly vulnerable (old, immuno-compromised) as they appear to be at exponential greater risk.
I mean, as the US starts to open up, it is quite clear the virus has not been contained, so for better or for worse the above is the approach we are taking as well.
We are deeply embarrassed about Sweden.
Supposedly, Singapore and South Korea were proof that this could work anyway, but it seems to have failed in both places - Singapore had to give up and lock down after cases exploded, whilst South Korea also had a whole bunch of spread that completely escaped contact tracing and nowhere near enough testing to pick it back up again, but somehow managed to reverse it through stricter social distancing measures well short of a full lockdown for reasons no-one has explained. I'd be very interested to see what serology studies have to say about South Korea's actual infection rate.
It is hard to imagine SK's infection rate is anything other than very small, given their extremely low death rate (264 for a pop of ~50MM) - to insinuate otherwise is, well, questionable.
Sadly a different dimension has crept into what should be a reasoned public health emergency response. I'm not sure from where, or why, or indeed who - but we should be vigilant, the cost is terrible.
Herd immunity only happens when a critical mass of the population - >70% at a minimum - is given immunity by a vaccine.
This creates a population with a low enough R to guarantee that outbreaks die out, even if some people aren't vaccinated.
Even then it still doesn't guarantee personal immunity, because people in small clusters can still become infected. But instead of a national health emergency which threatens to overwhelm primary care, you get small localised individual/cluster outbreaks which are very much easier to handle.
I think you've got a selection bias there. Those illnesses are household names because they are/were so prevalent. But what of the illnesses that never became prevalent enough to become household names because populations developed immunity fast enough to suppress the spread?
2017 flu had 60k deaths, despite likely undercounting.
As Nietzsche once put it: “insanity is rare in individuals, but common in the herd”
you could be severely sick with some other disease then get COVID19 in addition, what killed you?
I think 10 years from now we will look back at this time as the time where everything was counted as COVID19
https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm
These data are subject to being modified after the fact.
I don't mean to say that Covid is not a problem -- of course it is. But the response is not correct given the magnitude and nature of the problem.
To me it seems like massive government investment in protecting at risk populations is the answer.
A non-trivial proportion of those become seriously ill for months. It's possible they're going be left with permanent health problems.
I know of one music app developer in his forties with no health issues who spent more than a month on a ventilator. He recovered - barely - but it's going to be a while before he's back to working full-time.
Nonsense about flu statistics is just ignorable whataboutery. Covid is a very nasty illness, and until a vaccine is developed it has potential to do huge direct damage.
Without lockdowns it would have spread like wildfire and a lot of people would have been off work at the same time. Some food supply chains in the US are already struggling.
Imagine what would have happened with only ten times more casualties.
You had me up to that one. It does mean you're likely to require hospitalization if you have severe Covid symptoms. You may not require a weeks long stay in the ICU and you may not require a ventilator. If you have severe symptoms, you're at a very elevated risk of death. This is why so many young people have been hospitalized by it as a percentage of all cases ending up in the ICU, even though they're still far more likely to live through the severe symptoms.
If you're in those categories by all means, update your will and self-isolate. But otherwise you'll do fine. Even the healthy elderly, and there are plenty of them, do fine.
Such a case is very unusual and I would question severely the use of "young and healthy" to describe such a person. Sorry if that seems harsh but naming is meaningful here.
So while there are relatively few Covid-19 patients and even fewer Covid-19 deaths, there are indeed a minuscule percentage of such cases. It's not worth worrying about for the average person.
Indeed that is the point: Covid-19 odds are so low that there is no reason for a normal intelligent person to be unduly concerned about catching Covid-19. Take precautions and go about your business. Truth is you're more likely to get killed in a car accident than by Covid-19.
The real problem may be characterised by the fact that half of the population has an IQ below 100. However as a society we've given up on eugenics, so that is a path not chosen!
In the US during 2018 there were ~36,000 auto fatalities. For the first half of 2020 Covid-19 is nearing 100,000 deaths with all the precautions. And there may be a surprising number of people with health complications of one kind or another (over 30% of US population is obese) that could be exacerbated by this virus.
> The real problem may be characterised by the fact that half of the population has an IQ below 100. However as a society we've given up on eugenics, so that is a path not chosen!
We are stronger when we work together. Suggesting that the government regulate procreation to increase society's IQ is ... not going to help toward that end.
> The question Fenner asked was: What happens when such a virulent virus spreads through a very susceptible host species on a continental scale? He focused on two possibilities. First, the highly lethal virus might evolve to become less lethal. Second, the highly susceptible rabbits might evolve resistance. Thanks to Fenner, we now know both happened.
> The work showed that the almost invariably lethal progenitor virus strain was replaced within a few years by strains with case fatality rates of 70 percent to 95 percent. Some field isolates killed fewer than half the lab rabbits. Over the next few decades, things settled down, and strains at both ends of the lethality spectrum become increasingly difficult to find. Fenner showed why. The highly lethal progenitor virus killed rabbits so fast that its infectious period was shorter than that of the less lethal viral mutants. That meant that the less lethal strains were able to infect more new victims and spread throughout the population.
Edit: as an example, my county (Santa Clara) is using under 10% of hospital beds for Covid. This is typical, check your county dashboard if they have one and you are likely to see a similar number. Source: https://www.sccgov.org/sites/covid19/Pages/dashboard.aspx#ho...
One reason Sweden's approach may work out in the end is they have the highest proportion of single person households of any country on Earth.
Was it? NYC has reported more deaths than Lombardy (with less population) and NY/NJ as many deaths as Italy with half the population.
So far all the places that have had hospital systems overwhelmed (or on the verge) have had extremely high density, lots of intergenerational mixing, or both.
It may work out for them because it's a lowly populated country but I wouldn't try that model anywhere with an higher density.
[1] https://www.theguardian.com/world/2020/may/21/just-7-per-cen...
[2] https://www.businessinsider.com/sweden-coronavirus-per-capit...
Sweden has a very low population density on average, but they also have some densely packed metro areas. Just the Stockholm and Gothenburg metro areas make up over a third of the total population.
- Japan is populated extremely densely[2].
- Japan is number 2 by the population's median age (for comparison, Italy is 5th)[3].
- Japan had 808(!) COVID-19 fatalities[4].
- Despite the lockdown, in New York "most new coronavirus hospitalizations are people who had been staying home"[5].
- New York had 29112(!) deaths[6].
One just has to ask, do lockdowns even have that big of an impact on the spread of the virus? Or did it just ran its natural course in each country -- in lockdown or not -- and differences in the numbers of deaths are just down to dumb chance?
"... there’s little correlation between the severity of a nation’s restrictions and whether it managed to curb excess fatalities..."[7]
[1] https://www.bloomberg.com/news/articles/2020-05-22/did-japan...
[2] https://en.wikipedia.org/wiki/List_of_countries_and_dependen...
[3] https://en.wikipedia.org/wiki/List_of_countries_by_median_ag...
[4] https://www.worldometers.info/coronavirus/country/japan/
[5] https://www.cnbc.com/2020/05/06/ny-gov-cuomo-says-its-shocki...
[6] https://www.worldometers.info/coronavirus/usa/new-york/
[7] https://www.bloomberg.com/graphics/2020-opinion-coronavirus-...
Who would choose to die now without a "lockdown" when the other option is die later with a lockdown, including the added bonus of there being more work done to understand the virus and how to treat it, which might mean not dying at all.
0.1% of the rest of my life is less than three weeks, it's not a bad gamble to avoid an 18-month lockdown if that were the choice.
Umm, lots of people? If we prohibited all vehicle traffic we would prevent 1.3 million deaths worldwide, yet lots of people appear willing to drive.
Look, I don't mean to minimize the deaths, and the lockdowns were a very rational response given what was known initially. At the same time, humans make risky choices all the time, and it's not unreasonable to ask if the cost of the lockdowns is worth the lowered risk, especially in lower-density locales.
Sure, seems a bit extreme though. I suggest we remove all the safety features on cars, it costs the car companies loads in R&D to comply with all those regulations. You take a risk when you drive, and to be honest people should just be better drivers and there will be less accidents.
Far less accidents in lower-density locales as well.
There is a lot of pent up health care need building up. Some of it lethal.
The impact of the lockdown is going to be 10-100x that of coronavirus itself. No healthcare system is prepared for it.
But you blew it with those crazy numbers..
https://www.theguardian.com/us-news/2020/may/23/missouri-hai...
It’s already happening
Addendum: and we have financial tools to deal with the economic stress. We don’t have much in the way of treatment for the virus yet.
The fact that we’re not throwing money at the unemployed is a crime.
I'm not sure what's the basis of your idea.
This is direct, primary source data, not a media report.
That you say it's not the case while linking to only your own county.. feels bad.
https://www.foxnews.com/science/mayo-clinic-furlough-or-cut-...
All the field hospitals in the UK and US have been now closed.
Eventually-eventually, but if it turns out immunity lasts a year and 10% of the population has had it next February, you'll never get herd immunity until people say "fuck it."
Compare with Ebola. They don't have Ebola in Europe. But if it pops up somewhere, we will contain it as soon as possible.
It doesn't mean that they need to live in isolation for the rest of time.
Millions of people with Corona are asymptomatic or have mild flu-like symptoms and are therefore easy carriers.
OTOH once you have Ebola symptoms (and that's when you are infectious), you have only a coin's flip chance of surviving it. You can be pretty sure no random guy on the street is giving you Ebola. You can't say the same for Corona.
It has been widely reported since the very beginning of the pandemic that the likely time to develop and deploy a vaccine is on the order of 18 months. Yes, it might be more, it might also be less (quite a few are already in testing!). But the idea that this is permanent has never been a feature of any expert advice nor mainstream reporting.
The idea that the people who support lockdowns (which is, let's be clear, almost everyone) want to be shut down forever is, itself, a fever swamp hallucination.
Stay home until it's beaten, and then open up slowly so we don't lose control again. Much of the world outside the US and the UK, in fact, is already opening up.
The problem with London are the aristocratic measures of social distancing. The danger of being caughed at at low distance is exponential. The recommendation is 1-2 meter. The UK did 2m, likely because the ones who came with that idea never use public transport, and want to be safe from the plebs. Face masks don't help at all against direct caughing. only against droplets.
2m distancing doesn't work in public places at all. 1 - 1.5m do work, if in the subway, bus, restaurant, pub somehow. I don't know who else did 2m. And the death mortality is directly proportional to the severity of the measures. Maybe not causal, but those are the numbers. 2m don't help at all. When you are being caughed at, it goes far over 5m, even up to 20m. So social distancing in public places does not help much. indirect caughing via droplets is not that dangerous, transmission via surfaces at very low percentages. there's no known case so far. but hard to prove.
https://science.sciencemag.org/content/early/2020/05/19/scie...
Lifting prohibition wasn't going to make alcoholism disappear.
Lifting the war on drugs won't make overdoses disappear.
There are many things we could do in society to make negative externalities that cause hundreds of thousands or millions of deaths disappear. Yet we don't do those.
If anything it only gives the anti-vaxxers more ammunition and brings down the overall credibility of vaccination as a concept, and heaven knows we don't want to deal with that right now.
I tend to agree that there is some potential for fuckups, but 12-18 months seem reasonable to have most (if not all) of the vaccines as reliable.
For example, the Oxford University team said it may be ready by next fall[0] some weeks ago, and they seem on track for now (i.e. human trials already started and being expanded). Moderna also started human trials and had preliminary positive results.
Other entities said they aim for this winter.
Considering early 2020 as the start of the research I would say that fits the 12-18 months figure.
[0] https://www.bloomberg.com/news/articles/2020-04-11/coronavir...
I just don’t think that people are going to quarantine any longer. Almost no matter how bad it gets, I think people care about social interaction above almost all else even their own safety.
Now that said: I’m in a bar that is only outdoors, it’s sunny, there is a breeze, and the closest person is 15 feet away. Everybody is wearing a mask who isn’t eating, everything is getting washed and sanitized.
People will find a way to keep doing this, and it isn’t going to be VR or zoom calls. It’s going to be real in person experiences where you can see other people’s faces.
> Almost no matter how bad it gets, I think people care about social interaction above almost all else even their own safety.
Ultimately, my struggle is that I don't understand this. I don't value social interaction this way, and most of my close family and friends don't either (though it's far closer to 50/50 than I am comfortable with).
Ultimately people are irrational. People want to be masters of their own destiny. Is it illegal to go outside? Am I going to get in trouble? So long as people can act without consequence, they will.
With a deadly virus that spreads so silently, I really fear for humanity here. The fools will be the end of us all.
The only hope of real consequence is contract tracing and frankly, I don't think the majority of people want contract tracing to even work, especially Americans, who value their liberties to such extremes. People would rather kill anonymously without consequence.
This all makes me so sad.
Your "close friends", unless you met them all on IRC or whatever, literally _exist_ because you met them. Your family exist because you spent time close to each other.
I don't think you really understand what this whole brave new "social distancing" world means. It means never forming social bonds. It means young people never finding a partner, having children. It means children growing up thinking that their friends are virons.
We can do it in lockdown, for a while, that's what we're doing, and sensible people have no issue with that.
If you think we are going to do it for years, you're being daft. It's like imposing a chronic disease on 100% of the population.
Sure, some people will go right back to indoor dining, bars, nightclubs, whatever is allowed to open back up. But, a lot of people aren't going to go back to pre-Covid behaviors just because things are open. Many will seek to resume social interaction, but in safer ways, and your example of the pub is a good one. Time for more beer gardens!
Just thinking about myself, I probably won't dine inside a restaurant for a long while. But outdoor dining set up in a reasonably safe way? That's possible.
For better or worse, we're moving into reopening, so there should be a big focus on harm reduction: https://www.theatlantic.com/ideas/archive/2020/05/quarantine...
> What does harm reduction look like for the coronavirus? First, policy makers and health experts can help the public differentiate between lower-risk and higher-risk activities; these authorities can also offer support for the lower-risk ones when sustained abstinence isn’t an option. Scientists still have a lot to learn about this new virus, but early epidemiological studies suggest that not all activities or settings confer an equal risk for coronavirus transmission. Enclosed and crowded settings, especially with prolonged and close contact, have the highest risk of transmission, while casual interaction in outdoor settings seems to be much lower risk. A sustainable anti-coronavirus strategy would still advise against house parties. But it could also involve redesigning outdoor and indoor spaces to reduce crowding, increase ventilation, and promote physical distancing, thereby allowing people to live their lives while mitigating—but not eliminating—risk.
I mean, you might be, but it may not be the pub as you know it. The current Irish plan calls for reopening of pubs in phase 5 (last phase) in late August (I don't think the UK has a concrete plan on this, but it'll likely be similar enough). But it will be pubs with social distancing.
EDIT: Looks like UK pubs may be allowed reopen in July, but with social distancing and table service. So, not very pub-like, then.
People will go out, get smashed, snog, dance, hug, etc. If you force them out onto the street they'll do that. Maybe we'll even have a resurgence of good old pub violence.
Most pubs can't even support this nonsense - a business with 10% of its' normal capacity is a dead business, there's no point in even opening the doors.
I'll accept that the Government _might_ attempt a re-closure after the above happens, but I find that unlikely.
This is denial masquerading as cynical realism. Covid-19 cases in the UK continue to increase at 1% or 2% a day. This is much better than the double digit growth of March and early April, but it is still bad.
At 2% a day cases double every 5 weeks. Would anyone apply this reasoning to any other disease? Can you imagine anyone saying "We have AIDS under control, cases are only doubling once every 5 weeks."
You might say that on the best days, the increase has only been 1%. That's fantastic. As soon as people start going back to the pubs, the rate of spread will again accelerate to something more than 1% a day.
Classic psychological denial is clearly operating in force. A textbook case might be the man with pain in his chest and numbness in his left arm but instead of thinking it's a heart attack he keeps thinking "It's nothing, just stress." Denial is in force when things are so grim that people do not feel comfortable facing how grim they are. Some people don't see reality until they are forced to. Some people only have a lucid moment when they are in the ambulance on the way to the hospital. Some people never have a lucid moment, they simply die.
In reality, the struggle against Covid-19 will take at least another year and might take two or more years. Things are going to be very bad for a long time. But no doubt, some people won't see that clearly till they've personally known some people who've died.
The biggest worldwide increase for this illness was 2 days ago:
The people will stop caring, they've already stopped caring.
They're not the ones who are going to die. The realization is dawning that it's only the old that die.
Much like the starving kids in Africa, it's rapidly becoming a "Well, it's tragic, but I can't see it" problem.
Note I don't know how I personally feel about this, I think this is just the reality of what's about to happen in Western democracies.
I think the old will ultimately be chucked under a bus. We'll get lots of tragic stories about care homes and a whole load of hand wringing, but no-one will actually care all that much to bring in another lock-down.
Or, as you say, the other option is that we all throw 5-10 years of our lives away in a massive global recession for some old people who've already had the best years of their lives to live a couple of years more.
I think we've got to start hoping beyond hope for a magic cure, or that basic social distancing kinda keeps r below 1, so we don't have to look ourselves in the mirror in 5 years time and have to face the reality of what we just did.
I think that what's happened is the opposite - the young have been thrown under the bus (even disregarding social activity we have things like school closures, university admissions, exams cancelled), and that economic activity is being hindered unnecessarily, which is having enormous knock-on effects already which will persist for a generation.
I think that the appropriate response is for the vulnerable (old, immunocompromised, or really just anyone with low risk tolerance) to isolate and be given the resources to do so.
Care homes, for example, should be dealt with via paying the staff much higher salaries and having them stay on-site, effectively 'sealing off' the care home and creating an isolated unit.
If you're poor and have to go to work, you should be given enough money such that it's your free choice and you can stay at home if you want.
My vulnerable friends and family are forced into doing this, lockdown or no lockdown, they're disinfecting packages, haven't been outside for months, and probably will be forced into a "new way of life" for the foreseeable future.
This is the sort of thing that we should be using the severe lockdown time for - determining an appropriate way of protecting the individuals which we know to have very high fatality/complication rates - the people for whom we're bothering to do this at all.
What I strongly disagree with is the idea that the lives of the healthy should be deleted in some asinine attempt to drag out the (in my view, inevitable) death toll over a multi-year period.
That's not feasible. Those people have families, too.
They can't even realistically do this with the NBA and associated support staff, and that's a hell of a lot fewer people than vulnerable/old people and their support staff.
I, too, wish it were that easy, but it's simply not.
Why not? I don't think the parent meant staff should stay on-site forever.
There can be shifts. Staff on shift get tested or even stay isolated for two weeks, then enter the unit, spend a month on-site and leave for home.
Does this sound like a dream job? Not really, I guess.
Does it sound that different from sailors, long-haul drivers, deployed military personnel and many other professionals who stay away from their families for prolonged period of times?
It has to happen, because people cannot stay inside forever, with all the will in the world.
This is definitional unless you're planning to create a police state and forcibly prevent the young from interacting with each other for years at a time.
Protecting the vulnerable is the only practical solution.
So we have four weeks of quarantine for every month worked. That means we would need double the staff, and also we would have to pay them way more to even find someone willing/able [1] to accept this shift arrangement. This means that a huge part of the inhabitants will be priced out of the nursing home market and forced to stay at home with inadequate care.
[1] Re "able to accept this", for instance, single mothers would not be able to work under these conditions at all.
So now you're in a place where you're intelligent enough, and aware enough, that you follow the rules or you play Russian Roulette with people's lives.
Rage all you want about what could be and reality, the two rarely meet.
The current situation is some sort of distributed trade of mental health for physical health; the brains of the youth for the bodies of the old. It's not a stable state and will break at some point.
Regarding "russian roulette":
Everyone I know who feels at significant risk is doing the whole "don't leave the house" thing.
Care homes are almost certainly fucked regardless.
I tend to think the major impact is going to be amongst 50+ year olds who are in good health and decide that they can't be arsed with staying inside. We basically don't have a way to deal with this issue collectively.
The young are the old, in due time. I'm guessing that the majority of young people today would prefer to grow old in a society that will care for them, that has demonstrated that it will care for them, rather than one that is prepared to "throw them under the bus" to "protect the young".
All of us are young at some point and many of us will grow old. We must be treated fairly in both states. The sensible way to do that in the current situation is to establish some sort of protocol for interaction with each other that will allow economic life to go on, because obviously everyone wants that, but without exposing the vulnerable to the virus. And that doesn't mean locking them up until it's gone, because that is still throwing them under the bus. After all, there is a substantial minority of people with chronic diseases etc that are still young, and have many productive years of life ahead of them. But for the rest, also, there is what I say above: if we throw the old under the bus now, we'll throw the young under the bus also, when it's their turn to be old.
And this protocol must necessarily be a strict form of social distancing and some measure to reduce transmission, like wearing masks. We know that works. Until there is a better solution, that's the best solution.
So there's no point in saying "this can't be done, you'll find me at the pub". It has to be done. And it has to be done for the good of everyone, young and old, vulnerable and strong. There's no point in thinking that "I'm young, this doesn't affect me" and carrying on as before because "it only kills the old and sick". One day, you yourself will be old and sick. And whatever kills the old and sick at that point will get you, unless the young and strong around you take care of you, like we are asked to take care of the old and sick right now.
And if young people don't care for the old and sick right now, they're digging their own graves.
That's exactly how this is different. Most people in the UK or US don't have a starving African kid in their direct family. They do have people at high risk for COVID-19 in their direct family.
> Or, as you say, the other option is that we all throw 5-10 years of our lives away in a massive global recession for some old people who've already had the best years of their lives to live a couple of years more.
I must live in a weird bubble because none of my friends are willing to sacrifice their parents'/friends'/coworkers' lives for economic indicators. Besides, that is a false dichotomy: adapting to new circumstances is not "throwing 5-10 years of our lives away".
This really resonates with me. yet I've seen highly educated good friends go from "shit we need to do something about this" to "I don't care if people die, I want my summer vacation" within two months now. It's really depressing to see.
It seems that for many people, changing anything about their previous lifestyle is already pain enough that they stop considering the impact on others. And this was a person who prides themselves in adapting and who constantly rants about how people resist change...
So yeah, there are definitely restrictions, but "a complete pause on life itself" would be a wild overstatement. If it's different where you are, it's either because the government failed to take effective steps early on and thus contributed to the spread of the virus, or if your society's culture facilitates the spread better than ours in Germany.
EDIT: For completeness' sake, I am worried that many businesses (restaurants, cinemas, etc.) will not be sustainable if they have to operate under social distancing guidelines indefinitely, since their price calculations are based on a certain occupancy rate. But I'm not an expert in this regard, so I'm honestly not sure how this will play out. Maybe rents will drop when landlords realize that this calculation looks similar for every prospective tenant.
I don't think going back to normal is practical, nor desirable. Ref work-from-home, air travel, etc. But for many people, apparently the bar for acceptable is "everything is exactly as before or it's too much change."
Who are you talking about? You and your circle of friends? Large majorities of the public continue to support lockdown measures, in both the USA and the UK.
You should consider that those who are not in denial are looking at the situation with a risk assessment very different than your own, and such people as those currently constitute the majority.
Yes, most people are on board with a lockdown of a few months. Flattening the curve is a sane aim.
If you persist with this idea of deleting social interaction for multiple years, people are going to rightly conclude that you're insane and just want to force your antisocial vision on them.
That's what's causing the antsiness - there's no exit plan, it's all "oh, well, you might be able to have a normal life.. or perhaps post-2020 we deleted society".
If you can't understand that, you're probably in a special situation (either very introverted, or living with family so you already have some social contact).
If you're living alone, then you still have no idea when it will legally be permitted for you to embrace, play games with, spend the night with, kiss, hold hands with - experience humanity with - literally anyone else.
If you're single, all of that _plus_ you now need to fight through a 2 metre social bubble in order to perform basic human functions like, for example, attracting a mate in order to perform sexual intercourse.
All of the above is very silly to me. I honestly think the whole "let's wait for the science" approach misses the point. At an absolute minimum we need a hard deadline of something like "look, in N weeks/months you can go and be a husband again".
People _will_ take a risk of death in order to do the above. If you think this is all about young individuals believing that they're invincible you've completely missed the point - the issue is that a life without those things is _not life_ - 1 year of being a hermit for many may as well just be a deletion of 1 year of the prime of their life, i.e. a >1% mortality rate imposed upon them anyway.
The longer term view on this is people actually starting to worry that perhaps that's just it - their parents had a good life when you used to be able to go out, party, meet a girl, and so on and so forth - and now, oops, that's illegal, sorry, we're doing social distancing for the next 10 years. It's utter madness.
If the Government refuses to address this, and they very much are refusing to do so, then the inevitable consequence will be that people just begin to wholesale ignore the guidelines.
If I had children on the other side of the country I'm not watching them grow from age 5 to age 6 over a video link regardless of what the R number is. There's no political process to address these concerns, other than just doing it anyway, so people will do it anyway.
Also, that's the risk of dying. Serious illness that can do long-term damage is another issue. I'm not sure how common that is supposed to be.
Yes, that's the point that people in this thread is making.
It doesn't matter how serious covid-19 is, nor what the R rate is: young people perceive themselves to be at low risk, and they don't care about the risk to other people, so they're going to go out as much as they used to.
You only need to look at crowded parks and beaches or queue outside fast food places to see this.
Cummings' shenanigans haven't helped (which is I suspect the point of them).
I don't know but maybe the flu [1]? I don't think focusing just on the infection rate is useful.
> Classic psychological denial is clearly operating in force.
I think the denial is in thinking that we can beat the virus by extending the lock down for years (you say "might take two or more years"). It is likely that all we are doing is slowing down the spread, and that it will eventually infect most of the population, stopping only when we reach herd immunity. I say this is likely because this is where we are headed unless we come up with a vaccine or treatment at an unprecedented speed -- not something I would bet on.
If this is indeed where we are headed, it may be better to open up as much as possible short of overwhelming the healthcare system. Note that in many places, the healthcare systems are significantly below capacity (e.g. [2]).
[1] https://www.who.int/docs/default-source/coronaviruse/situati...
[2] https://www.sccgov.org/sites/covid19/Pages/dashboard.aspx
There were enough people outside to make it impossible to have everyone at 2m distance, but for a second I considered breaking social distancing for drinking a beer in a warm sunny day.
So everyone is going back and forth in that narrow band, some jogging, others walking their dog, others pretending, etc.
The whole thing makes absolutely no sense.
I think many politicians don't know how humans actually behave and write policy based on the assumption we're robots or slaves. Or maybe they did not realize that reducing the size of the public space we're allowed to use implies a higher density of people in the remaining space we're allowed to use.
Does this mean that you think the risk of serious morbidity or mortality is overestimated, or because you think at some point the reduction in social interaction is worse than the pandemic itself?
Personally I’m mostly indifferent to whether or not the current restrictions are an overreaction, though I’m in the fortunate position of not being particularly severely affected by them. I would rather an overreaction than an underreaction.
It already seems to be happening - there's a massive ideological split between the group that wants to minimise risk at all cost, and the group that is willing to die to live a normal life.
You maybe, but how many others will? 10-20% less people in pubs, fewer tourists visiting west end shows, banks and other companies using work from home, could have a huge knock on effect on other businesses, property and taxes.
I'm willing to bet you in the next ~12-24 months virtually everyone. This isn't the first pandemic in human history. It's frankly ridiculous how people seem to have no awareness of how strongly we tend to overestimate events simply because we're living through them.
This will obviously be more pronounced in countries with a greater historic discrepancy between tourism expenditure and receipts.
e.g. Spain will no doubt be more effected than NZ, whereas the UK could actually benefit:
https://data.worldbank.org/indicator/ST.INT.XPND.CD?end=2018...
https://data.worldbank.org/indicator/ST.INT.RCPT.CD?end=2018...
I can't help but wonder if we're gonna have another century repeat: After the Spanish Flu came the Roaring Twenties.
Some London pubs have already figured out that they can legally sell take away beers in plastic cups. So while you can't sit down inside the pub, everyone stands around in the street outside the pub drinking their "take away" beer.
"The war will be over by Christmas."
At this point we've gone way beyond any semblance of 'flattening the curve' and gotten stuck because there was no plan to unwind the lockdown.
As long as 1) the virus is still around, 2) we do not have a vaccine, 3) we have not reached a certain level of herd immunity, policy making should be based on the day to day data that we have, and about the immediate term.
Perhaps the evolution of the situation means that it will be safe to be back in the pub celebrating with your buddies for Christmas. But then again, perhaps not. We don't know.
Claiming broad things like "I will be back in the pub by the end of the year" is not about sensible decision making, it's pure emotion and is not what we need right now.
(Watch the people thinking "You're not taking our need to socialize seriously!" burn this comment to the ground...)
A lot more people have lost jobs. Restaurants continue to go bankrupt. Retail and airlines continue to let people go.
To sell the other side as petulant children is bordering on slanderous.
But I have a friend already going through depression who is going through hell with this stupid lock down. It affects people differently.
You may be in a pub by the end of the year, but you won't be in a pub at the end of the year, because at that point we'll locked down in the midst of a second wave of coronavirus, with some pent up seasonal flu thrown in for good measure.
I figure we have N waves, with herd immunity building during the process, and an eventual vaccine which may or may not need to be applied across the whole population by that point.
And how many people have to die to reach it?
What I've been reading so far, the genetic analysis of its mutations[1] has not suggested that it will.
That isn't to say that it won't evolve into something more like the common cold, just that the features that make it SARS appear to me to be locked into specific genetic elements of the current virus (and MERS and SARS-Covid-1).
If this trend continues, then the vaccines developed will provide immunity for people and prevent further widespread outbreaks. Covid-19 will become "just like the flu" in that you get a shot for it (possibly only 1 or 2), and your chances of catching it become low enough that even if you are exposed to someone with it, your immune system will kill it.
At which point the world goes back pretty much to exactly the way it was before, except that we have experienced a worldwide pandemic in "living memory" and there will be a crap ton of sovereign debt which is going to drag on the various economies of the world for a decade at least.
Things to watch for are the results of vaccine trials, and follow the genetic tracking with respect to the virus' use of its 'spike' to infect cells. Good results in vaccines and no change in the virus without also making it just a regular cold virus, and the world goes on.
That said, I was always a germophobe and always practiced social distancing on the train whenever I could so I support this.
Until there is either a vaccine that I have taken, or a complete eradication of the COVID-19 in London; then "the pub" or any other voluntary gathering of strangers in close quarters is an unnecessary risk that I will not be taking.
That is the reality of our situation. You have to face up to it, disbelieving it does not help anyone.
The problem with the thinking of "you do that, I'll do otherwise" is that with an infectious disease, what our neighbours do impacts us. To germs, there really is such a thing as human society.
We won't do it for years - that's a delusion, a fantasy that ignores how the human mind works.
It sounds like you don't want to take the risk of either contracting, or further spreading, the disease.
No-one _wants_ to take that risk.
But if the only alternative that you can suggest is deleting 1, 2, ... years of the prime of my life, staring at screens or meeting friends behind plexiglass, you've lost me completely, because you're describing the actions of a paperclip maximizer, not a human being. You're impacting others by expecting them to give up their lives.
In that world view, either I'm autistic or you are; we don't have the same brain chemistry; your experience of the world is _so far_ from my own and most people I know that a blanket policy for both of us makes no sense.
This is binary, black-or-white, false dicotomy thinking: either lockdown, or we all go to the pub, movies, gigs, football etc, like before.
I accept that it can't and won't be the full lockdown for years. But it won't be the other extreme until it's safe. It will be somewhere in-between.
> But if the only alternative that you can suggest is deleting 1, 2, ... years of the prime of my life, staring at screens or meeting friends behind plexiglass, you've lost me completely, because you're describing the actions of a paperclip maximizer, not a human being
You'd be surprised what people put up with in order to stay alive. Then again, I should say "some people" as there will be literal survivorship bias in that. People do need to realize that this is a period of relative hardship not seen in a few decades, and like WW1 it won't be "over by Christmas" and deal with it in ways that get us through.
I'm not and most people I know aren't. The 2 metre rule will kill off all of the cultural institutions I hold dear. The recent video of a Wetherspoons pub with 2m distancing has people guffawing up and down the country.
It doesn't make sense to me anyway - as I've said, a person in a vulnerable group will not wish to perform outdoor leisure activities, or work, etc, even with the 2-metre-rule in place.
We'll just have to agree to disagree.
So will people dying, far more effectively. What's your point?
> The recent video of a Wetherspoons pub with 2m distancing has people guffawing up and down the country.
And it's also insufficient. Not safe for hours in an enclosed space with strangers and recirculating air, not at 2 meters, or at 5 meters.
https://www.erinbromage.com/post/the-risks-know-them-avoid-t...
I don't think that "it raised a chuckle" is the devastating criticism of a deadly disease countermeasure that you seem to think it is. The virus won't care what you think.
I'll just end this by saying that some people are like you, some people are like me.
We're not going to stay in fear forever. You might. I hope whatever happens that you manage to find peace with it. Godspeed.
By "infrastructure" I guess they mean improvements to intercity rail connections, namely the high speed rail. I don't see those as localized improvements. Moreover they seem geared to decreasing commute times in/out of london (and a couple other of the largest cities). The net result is to allow rich londoners to live and commute from further afield. That isn't a move away from "peak capital", it's doubling down on that capital by further extending its influence, expanding the hinterlands on which it relies.
I was unaware of this until I recently discovered Gareth Dennis on twitter, who is doing a fantastic job of making up for HS2 ltd's appallingly lacking public engagement "strategy".
It initially doubles capacity and ultimately triples it https://assets.publishing.service.gov.uk/government/uploads/... (figure 4.2, p76)
What would "proper connection to Europe" have looked like to you? HS2 ends in London where eurostar begins. If HS2 terminated in say, Milton Keynes, I'd wholeheartedly agree with you.
> Linking it to a program of speed improvements on connecting commuter rail would have been a cheaper vote winner
Do you have any evidence for this? Any publicly available report showing even outline calculations? HS2 has always had cross party support.
> before covid19 made public transit irrelevant
In one way or another, the threat of covid will eventually pass. We'll still need public transport when it does.
Source: The traffic jams outside my front door are back and the lockdown isn’t even lifted yet.