Hacker News Reader

Comment by albybisy | Hacker News Reader

i would like to know how to "isolate the vulnerable"...?! We send to an island? we weld inside home? We should talk only if we have a realizable plan and not a "dream/idealistinc" plan.

View on HN

Well we were able to somewhat effectively isolate the entire country, so I would say have modified stay-home orders that target those who are most vulnerable. That, in addition to common sense acts like hand washing, isolating the sick etc. would go a long way to flatten the curve enough to not overwhelm the hospitals, which after-all was the original goal.

An interesting game theoretical interplay has been an almost irresistible force that draw almost all democracies towards the same behavior: if it was possible for 100% of confidence to separate the group of people at risk from the people whose risk factor is small (e.g. pick some threshold like smaller than the risk dying of any other cause), then sure, it would have worked.

But the moment a number of apparently healthy and young people start dying from it, people start thinking thateither a) it's hard to know in advance whether you're at risk (e.g. unknown pre-existing conditions) or b) the disease is stronger than previously thought.

And that's even if the actual cause has nothing to do with (a) or (b), i.e. if the data was just a statistical fluke or misattributed deaths (e.g. people dying from X who also had sars-cov-2 in their system). It doesn't matter; there is no time to get to the bottom of things. The authorities have to play it safe, least they will be proven to have acted recklessly. And even if they try to be "brave" and plow ahead, the public opinion will quickly sway towards playing ir safe.

This seems to be an especially strong force since people today have an unprecedented capability of communicating and broadcasting "gossip". Even China's strictly controlled public communications wasn't able to censor spontaneous outrage from the citizens. And the fact that China reacted they way they did, set a high bar; any country that wanted to act differently had to be play it pretty convincingly to their populace (e.g. "we can do it, because we're different, we are so disciplined we can pull it off")

For example, consider Sweden's approach. I have no idea whether their strategy is right or wrong, how should I know? experts disagree.

But it surely takes a lot of confidence to pull that off, knowing that opposition parties will feast on any opportunity to publicly decry your recklessness.

Covid-19 is real and it kills people, it's effects can be and will be measured.

We do make tradeoffs between economy and safety all the times, but we do that for things we're used to (traffic, pollution, diseases prevention, ...), so some people expect we can do the same kinds of tradeoffs with covid-19.

Again, I'm not an expert and have no idea on how to compute such a tradeoff.

But my point is that there is a inanimate force that is just pulling that card off the table.

It doesn't help that in some countries it also became such a heavily partisan topic.

I'm not from the US. I live in a country whose government has been very proactive and the population is generally supportive of the (re cently lifted) lockdown. And that's a country where rarely the populace has anything good to say about the government (a popular saying "it's raining, damned government!")

Playing it safe seems much more effective politically, that unless you want to play some "strong man" narrative like some governments did, there doesn't seem to be any advantage in taking excessive risks.

That raises the question of how to identify the sick. SARS-CoV-2 infections can be transmissible before the infected shows any symptoms, if they present at all.

Personally, I don't feel that there are many population centers in the US that are prepared to do the kind of testing that seems like would be needed to properly identify the sick.

Apparently this is not really the case any longer: https://www.cnbc.com/2020/06/08/asymptomatic-coronavirus-pat...

The problem is that you can't isolate the most vulnerable fully. The current lockdown works because it reduces the spread through the wider society, including all the people who are in contact with the most vulnerable. If you don't do that, then we have the Sweden scenario where inevitably there's someone young and fit and infected who brings the disease into the institutions that should be protected, because these young and fit and infected people work there or go there to deliver things.

Alternatively, you need a total quarantine isolation - e.g. anyone working in a care home should live there and can't touch their kids if they go to a school where will be spread because everyone else's parents are not on lockdown. Or the most vulnerable will die.

And has been widely discussed, Sweden has had a lot of excess deaths. Look at death rates compared to Finland, Norway, Denmark.

> i would like to know how to "isolate the vulnerable"...?!

We could start by NOT sending people with confirmed COVID-19 infections to live with them.

There are a lot of empty hotel and dorm rooms right now so that would be a good start. A lot of those who have died so far were infected in family homes with many people living in close quarters. We should focus our limited resources on providing safe living spaces where those at highest risk can isolate themselves if they voluntarily choose to do so.

Reply on news.ycombinator.com