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Comment by m4rtink | Hacker News Reader

This is what I thin many forget when they speak against lockdown and for "heard immunity" - that this would not only result in a huge ammount of unnecessary deaths, but also pretty much wear out if not outright kill a signifficant part of medical personel.

It's basically condemning them to working nonstop for months if not years, watching people die all day long & being in infection danger at all times while at work.

And you can't replace all the people that burn out, get ill or die quickly - training medical professionals takes many years.

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I think it is more complicated than that.

Almost all states very early on had some level of 'lock-down', stay at home order, or what have you. This has limited movement of people, and as a side effect, or maybe even direct order from governors, closed down/ limited many business. Including hospitals.

Hospitals in America, believe it nor not, are for profit businesses. It is un-intuitive, but many of them are in serious financial trouble, despite the influx of Covid-19 patients. At a cursory level, I think most people would assume the hospital business is booming, but this assumption couldn't be more wrong.

At this point, nobody wants to go in for routine examinations or non-emergency procedures. For-profit hospitals (almost all of them are) as a business, depend on providing these non-emergency services/ surgeries/ procedures. Hospitals across the country are laying off health-care workers en-masse.

So it is not correct to imagine all hospitals are running at full capacity, and burning out their workers. In fact, many health care professionals are drawing unemployment at this point.

I know this is doesn't make sense at the surface level, but it is something we all need to consider when continuing to advocate for lock-down or stay at home strategies. Our economy depends on movement of people/ goods/ services. That includes hospitals. I wish there was more serious discussion about this, and how we keep things moving as much as possible, while also protecting one another from spreading the virus.

Lock-down alone is not an solution. If your areas hospitals are at risk of reaching capacity, for sure close it down. But almost nowhere in America outside of NY/NJ is there a risk of that right now. We've tried it for a while, but now we have more understanding. Now I want us to re-imagine how we can continue a life of movement, and also reduce risk of infection.

Everything you wrote is weird and simply shows that you need a proper health care system over there.

America isn’t going to transform their healthcare market in the next several months.

We can be ideological and let hospitals fail and doctors and nurses get laid off, or we can be pragmatic and focus on what creates the best outcome as we navigate the reality we are in.

The US cannot even prevent its own law enforcement from maiming innocent citizens, so I would not hold my breath for any healthcare reform.

Americas healthcare system has it's flaws but the benefits amongst others is that it keeps being able to afford to invest in new research and methods and to specialize. It's the advantage of being a profit center.

This is much harder in universal healthcare systems that are cost centers and thus can't just decide to change to a newer better method. Furthermore, the universal healthcare system have to budget who gets what kind of medicine. So while all people gets treated the same way not all illnesses does.

Everything have pros and cons. The US system is much better in some ways and have shortfalls in others and vice versa.

I recently had a successful experimental surgery in this countries nationalised health service. Interestingly the idea had come from a study where the surgery I had was a control group and the 'real' group had a stem cell therapy as well. My problem was resolved, the single payer system didn't waste $100,000 on stem cell therapy. Good result. In the privatised system that carried out the original study the additional stem cell therapy is being done. It seems like optimising for profit optimises for cost.

I just wanted to add a story as well - my dad was diagnosed with a very rare type of stomach cancer called GIST about 15 years ago in Poland. At the time, he was one of ~6 other people in the entire country with this diagnosis, and the diagnosis was....bleak to say the least, I think the doctors were cautiously giving him 6-12 months max. However, company Novartis has just certified their "Glivec" drug specifically to use against GIST, since it targets the same cell pathways. Now, the problem - Poland does have nationalized healthcare, but Glivec was insanely expensive - basically a box of Glivec cost around as much as an annual pay for many people in Poland at the time....and my dad had to take two boxes per month. And no, because it hasn't been proven to work against GIST yet, it was not on the list of refunded drugs - so my dad was placed on a controlled trial conducted by the largest oncological hospital in Warsaw, where the study funded the drug for him. Long story short - the drug worked miracles, my dad not only recovered, he lived another decade after that(died of another cancer that sadly didn't have a miracle cure this time).

But - other people in this study didn't get the drug. I don't know if they were given placebo or just something else instead. My point being - they didn't survive, my dad did. After the study was concluded, the drug is now paid for by the national health service and anyone who needs Glivec can get it.

So why isn't this a critique of the nationalized system? Well, because the way I see it - in a private health care system, no one in this group would survive, because no one in Poland could ever afford this treatment. At least some of the people were still given a chance because the system has enough flexibility to at least try new and experimental treatments.

You're omitting that it's only a single digit % of the population that gets access to these expensive, specialized treatments.

The US has the best healthcare system in the world--if you're a millionaire.

Anecdotes and all that, but a friend of mine had Deep Brain Stimulation surgery for his essential tremor. The surgery was performed at Stanford and the total bill was in the hundreds of thousands of dollars. His out of pocket charge? ~$1200.

I have a hard time rationalizing his recent experience with the assertion that you have to be a millionaire to receive top-flight care.

Your friend must have outstanding insurance. Our out-of-pocket for a standard run-of-the-mill baby delivery with no complications was several thousand dollars--after what I thought was pretty good tech-company provided health insurance. I'll never forget my wife's reaction (who is not from the USA) at how absurd it is that someone would have to pay any money, let alone thousands of dollars, to have a baby.

I'm against the concept of privatised healthcare completely but within the privatised paradigm insurance only works properly to share risk across a population. A normal birth is not really an insurable event. Normal births are not a risk (in the sense of risk being a semi random events) since on average each women an America has about 2 in their life. In a privatised system insurance make sense as something to cover the risk of complications during a birth. So in a functioning privatised system with insurance working as it theoretically should any birth whether simple or with huge complications should cost the same amount of money. This is similar to dental most people spend X±Y amount of money over their life on dental work where X is high and Y is low. Insurance only works properly where X is lower and Y is higher (for example getting a rare cancer that costs $1million to treat is a very insurable event). Where dental is covered by 'insurance' the person paying for the insurance policy would be better just paying the dentist directly.

Meanwhile I am glad I live in a society with a nationalized health system where births cost nothing.

I have never figured out what "outstanding" insurance is, and my late father was a physician.

I just go with a PPO because that seems less crappy than the alternative. If anyone knows what metric leads to outcomes like my friend's (I'm not being facetious here), I would like to know.

Actually, over half of US hospitals are not-for-profit and another quarter are public. Only a small minority are for-profit. See https://en.m.wikipedia.org/wiki/Non-profit_hospital

This fact is missing something essential; Kaiser Permanente is a nonprofit but it sure isn't what you think of when you use that term. Also, it's something of a minor nit - nonprofit corporations need revenue too.

My wife is a nurse for Dignity Health (another "nonprofit" hospital here in California) and has been effectively laid off for the last couple months. It's great that the ER is empty, but in the mean time nurses are struggling and people aren't getting their cancer screenings. If this goes on long enough, our healthcare system will fall apart from atrophy, not from overuse.

> This fact is missing something essential; Kaiser Permanente is a nonprofit but it sure isn't what you think of when you use that term.

Why is that? You don't think they lay people off in Canada or Japan when there's no patients? Even single-payer systems can have private hospitals. They are simply paid by the govt instead of (or really in addition to) by patients. They still need business and to balance the books.

Canada has a similar mix of all kinds of hospitals like the US, though it may be more slanted in some way.

>Kaiser Permanente is a nonprofit but it sure isn't what you think of when you use that term.

Huh? It is exactly what I think of when I use the term non-profit in the context of a healthcare maintenance organization. I truly have no idea what you mean by your quoted statement.

He/she means: KP generates a lot of money for some important people, and their marketing and management strategy is as aggressive as for-profit institutions

Kaiser Permanente is a conglomerate that is a consortium of for-profit and not-for-profit entities. The health plans (insurance) and hospitals are not-for-profit. The physicians are organized into for-profit partnerships.

Source: https://en.wikipedia.org/wiki/Kaiser_Permanente#Operations

Oh, thanks. well maybe I’m wrong about the amount of for profit hospitals, I’ll look into it. I realize now that I could have left that part out in my rant. Either way, non profits are affected the same way from lack of traffic/ volume.

> At this point, nobody wants to go in for routine examinations or non-emergency procedures. For-profit hospitals (almost all of them are) as a business, depend on providing these non-emergency services/ surgeries/ procedures. Hospitals across the country are laying off health-care workers en-masse.

Nitpick: Over half of US hospitals are nonprofits or government owned [1] though I believe hospitals are vastly outnumbered by private clinics and independent practices. Doesn't change your overall point - even the hospitals run by governments, the Catholic church, and other institutions have budgets and are watching their main incomes disappear without much hope for the near future.

[1] https://www.aha.org/statistics/fast-facts-us-hospitals

While factually true, this does not defeat the point: those non-profit and public hospitals rely on paid procedures to pay their employees. And yes, those employees are furloughed and laid off en masse.

Thanks, I see now that I overstated the number of for profit hospitals. You are right, though. They all depend on us using them.

Government owned or Non-profit isn't as meaningful as you might think. End of the day, hospitals live on Medicare admissions for cash flow (ie. old people) and surgery for profit. Old people are staying home, people aren't hurting themselves on the couch, etc.

Government owned is only meaningful with the Federal government, which has unlimited resources.

"I know this is doesn't make sense at the surface level,"

No it makes perfect sense, and it doesn't matter if it's 'nonprofit or for-profit' - the inefficient use of resources is just the same.

Hospitals are the most expensive places in the world to run, with very highly trained personnel, gear, etc.. In a socialized system, if they are not used, it's a massive inefficiency.

Now imagine a system where 10's of millions of people are in economic pain - but they still have to foot the bill for unused medical services via taxes.

It's just shifting around deck chairs with respect to where the pain will be borne.

When a system is socialized, funding is also shifted so that the poorer taxpayers contribute less than the richer ones. So no, it's not just shifting around deck chairs. There's a balance to strike.

In a centralised system in an emergency, there shouldn't be idle capacity!

It seems like the root financial problem isn't for-profit versus non-profit, it's pay-per-procedure? This is like paying the fire department based on how many fires they put out. Medicare seems no better.

(I would guess that Kaiser might be doing somewhat better since they're paid monthly but their finances aren't easy to find.)

There are four scenarios at a very high level. It an uber complex system and the amount of time and money wasted in optimizing and managing revenue cycles is almost incalculable. If you compare it to any complex large scale system it's sickening to look at the waste -- even the military looks like an efficient machine in comparison. (In some ways)

Medicare pays on a set scale for performance. If you have a heart attack, they pay a fee for the surgery and x days of hospitalization and x days of rehab. If the hospital gets you home in x-3 days, they make money. If the hospital fucks up and you get an infection and stay for x+10 days, they eat it.

Medicaid is a PPO that pays on a per procedure basis. Their rates suck, but they don't care about quality for the most part. There's a billing optimization process to maximize revenue for poor old people. (Some things are better billed to Medicare, others to Medicaid)

Private insurance pays for whatever they cover at a rate of y+z% over the Medicare rate. The patient gets the bill for whatever else happens.

Uninsured get whatever treatment is legally necessary. They patch you up, take a loss, kick you out and do it again when you come back.

Lest someone think this is a US thing, this is true in India as well which has a fairly different medical system. Hospitals are struggling to stay afloat and many nurses and ancillary staff have been laid off. Doctors in India are typically independent contractors and not employed by hospitals.

Not only are no non-essential activities happening, many essential ones are also being pushed back and people are dying as a result. There are multiple stories of people not being able to go for dialysis because hospitals insist on a negative COViD test to admit you and authorities don't allow you to get tested if you are not showing COViD symptoms. It is a catch-22 that can be resolved only if you are well-connected or rich.

Also, in knock-on effects, immunization programs are severely impacted, and many infectious diseases are likely to make a huge comeback with the monsoon season since typical mitigating measures for those were put on hold. The non-COViD death toll will be massively above typical years.

Am from India & agree on this. Lockdowns helped slow the spread but aren't the perpetual answer. And the side-effects of lock-down (like essential services being pushed back) are taking lives. When evaluating lock-down's pros & cons, it always isn't life vs economy. It often also is Covid fatalities vs other fatalities. Atleast in India, that's happening.

Agreed.

People on the prudent/cautious camp are missing that lockdowns are really last-resort, expensive controls at the bottom of the pyramid, used when better controls fail.

We can't just netflix and chill for the next two years. But we can't just pretend nothing is wrong either!

Well, that's pretty screwed up. For comparison Czech hospitals also scrapped anything non essential during the worst part of the local outbreak, both to have capacity for treating coronavirus patients and to reduce the chance of infection spreading through hospitals. At the same time a strong lockdown was done country wide.

This was apparently effective with cases limited to a few clusters at the moment & most of the lockdown restrictions removed by now.

Were the hospitals affected ? They did report funding shortfals right after the lockdown due to all the cancelled elective procedures, so the ministry of health simply gave them extra money to cover the lockdown loses. And at the moment most hospitals are back to normal workflow.

Also, the people involved in directly handling the infection got bonuses as a thank you for doing the needed but dangerous work.

It's weird that this isn't more widely known. Alot of my friends are in the medical field, and they are taking a beating personally. Stuff like long term 15-20% pay reductions and furloughs in addition to layoffs.

Not only are hospitals for profit, but their part of cartel-like health networks. For some jobs, its hard to jump because 80% of the work is affiliated with two companies regionally.

Completely agree, we have to think of others not ourselves when we diligently put on our masks.

Through US government incompetence we missed our chance to contain and suppress the virus back in February. Now the pandemic is so widespread that it's impractical to do enough contract tracing and isolation to eradicate the virus. In many areas the authorities aren't even bothering to try. So we're on a path to herd immunity whether we like it or not.

Obviously this is a bad state of affairs. But it's important to understand the reality we're in rather than indulging in fantasies.

"But it's important to understand the reality we're in rather than indulging in fantasies."

This seems an important point to remember in most US public discussions. If people can't even agree on basic facts, how can you make decisions?

Indeed, the reality for the average person is you're confronted by different authorities that don't agree on facts or goals. The situation seems to promise a series of rolling disasters with Covid just being one.

Say the US gets to herd immunity and the rest of the world has done a really good job at containing the virus, e.g. New Zealand. What are they realistically going to do long term? Shut up their country until a vaccine arrives? Quarantine everyone coming in or going out for two weeks? Who is realistically going to want to travel into or out of there with those kind of restrictions. I seriously wonder if the short term pain isn’t just worth it. It’s cold and calloused but it’s either vaccine or a long drawn out constant state of fear and social distancing. The other option is short burst of mass deaths followed by a return to complete normalcy.

So my question is more like, how are countries that, in say six months, that’s population only have 10% exposed to COVID-19 going to coexist in a global world with countries that are past herd immunity and operating freely again.

https://en.m.wikipedia.org/wiki/Post-polio_syndrome

Covid is a new disease. Will it have long term effects?

Chickenpox -> shingles is another example.

And HIV -> AIDS of course.

Coronavirus are not a new type of disease though.

This one is. Colds seem to be inconsequential (although there are questions about ME). SARS and MERS are rare and were either very deadly or very life altering. Covid seems to fall in the middle. Hopefully the long term effects for the majority will be similar to colds.

No human vaccines have ever been tested for any coronavirus.

There are already articles of people who have recovered that will have to take anti-coagulants for the rest of their life.

Yes it seems that New Zealand will attempt to wait for a vaccine and in the mean time impose a quarantine on anyone who arrives from another country. Balaji Srinivasan thinks we will see the world divided into "red" zones where the virus is still widespread and ”green" zones where the virus has been contained. Travelers will be able to move fairly freely between green zones countries. So if you're in Taiwan you might be able to visit Australia or New Zealand without a quarantine.

https://podcasts.google.com/?feed=aHR0cHM6Ly9yc3MuYXJ0MTkuY2...

Considering for most countries the published numbers are very debatable (even in Europe there are plenty of arguments), imho that’s a foolish strategy. Quarantine should probably be implemented worldwide. I say that against my best interests, I am long overdue a holiday, but I don’t want to feel my lungs full of water.

> imho that’s a foolish strategy.

Possibly for most, but for New Zealand and Australia it looks ok.

This is already happening, see these rules for foreign travel published by the Czech ministry of health:

https://www.mvcr.cz/mvcren/article/coronavirus-information-o...

There is a map with green, orange and green countries.

UK and Sweden are red, most of western Europe orange.

For green countries, Czech citizens can go there and back without the need to present negative tests results and enter quarantine. Same thing for residents and nationals of those countries.

For orange countries, Czech citizens can go there and back without the need to present negative tests results and enter quarantine. Residents and nationals of those countries are banned from entering Czech Republic.

For red countries, Czech citizens can go there but need to present negative tests results and enter quarantine. Residents and nationals of those countries are banned from entering Czech Republic.

You're seriously saying that a "short burst of mass deaths" is a better option than getting your shit together and doing proper social distancing followed by proper contact tracing?

It's great that we've got rid of the virus for now in NZ, but yes, there are many questions, including whether there will still be an incentive to even try for a vaccine once major countries reach herd immunity (if and when that happens).

But it truly astonishes and depresses me that the US - the country that went to the moon, that invented the internet, that built a military capability that literally saved the world in ww2 - seems to have given up.

How hard would it really be to do proper contact tracing in a population of 300 million? Yes it's a big job, a very hard job, but the big jobs, the tough jobs, that's what Americans do!

> the US - the country that went to the moon, that invented the internet, that built a military capability that literally saved the world in ww2

two of those are in part result of propaganda

I've read a fair bit of military history, and I'm fairly confident the moon landings were not done using a green screen, so please elaborate on which 2 of these are not true.

Maybe "saved the world" and "invented" the internet? Because yeah of course, the internet has been "invented"! It was absolutely not a natural evolution of local networking based on known technology...

Through that sort of reasoning, computers have never been invented. They are just a natural evolution of mechanical calculators. I mean, sure, but that definition of "invent" is so narrow as to be meaningless.

Internet is a US invention as much as lightbulbs are a US invention.

I said partly. Regarding the internet the US had a central role in developing and implementing the technology and infrastructure, as is testified by the fact that our current domain system is still US-centric, but in a sense they did not invent it.

Regarding defeating the axis and specifically Germany (Italy was not a military colossus) there is data that shows that the USSR had a bigger impact in defeating the nazis.

No one denies the contributions of the US in both of those feats, but also it is undeniable that the narrative isn't always factually true.

>> the US - the country that went to the moon, that invented the internet, that built a military capability that literally saved the world in ww2 > two of those are in part result of propaganda

Eh, no.

We (the USA) did really go to the moon, though I know some USA citizens dispute that.

It was really USA universities and corporations (with DARPA funding) that built the foundations of Ethernet, TCP/IP and the Internet. Yes, plenty of contributions from others (including foreign grad students), but still, USA institutions.

The USA produced a lot of war material for all the Allies in WW2. A lot went to the USSR to keep them in the fight. This in no way should diminish the absolutely unprecedented loss and sacrifice of the USSR peoples in the Great Patriotic War, who bore the brunt of it. But without the USA, I really doubt the Allies could have stopped the Axis powers.

"I really doubt the Allies could have stopped the Axis powers"

It was a team effort - without combined efforts of the USA and the Soviets (and to a lesser extent the UK) the Axis powers might have prevailed.

Wow incredible! Apparently, the USA have also developed the world's most potent propaganda machine.

That has always been the case. George Washington and the cherry tree comes to mind. And so it began.

Sometime near the end of the cold war I realized that the West's propaganda machine was in fact better than the Soviet version. Nobody in the USSR believed "Pravda" but everybody believed the NBC Nightly News. :)

One might argue however that we need such a mechanism since in 2020, as the Scots might say:

"People can ni' agree on the color o' Shite"

In addition - regarding the European theater, the most important contribution of the US was keeping the USSR to the Elbe, otherwise the entirety of continental Europe would have fallen under communist rule.

Please don't take this as being directed explicitly towards your comment. But why does anyone think there is such a thing as herd immunity for Covid-19?

I've been following the research since December/January on New England Journal of Medicine, Virological.org, Lancet etc. And I think there is not yet enough evidence to suggest that there is immunity conferred by contracting Covid-19.

Does anyone know of any studies claiming that "herd" immunity is even possible with Covid-19? The latest article I could find is: COVID-19 and Postinfection Immunity https://jamanetwork.com/journals/jama/fullarticle/2766097

If there is no immunity or limited immunity conferred from infection then Covid-19 will be with the USA and other countries that have given up on control measures for a long time.

> But why does anyone think there is such a thing as herd immunity for Covid-19?

I suppose this depends on what the null hypothesis is? Is the null hypothesis "You have immunity after being infected" or is it "You don't have immunity after being infected". You assume it's the latter and you're saying there's not enough evidence to reject it. But you could just as well assume it is "You have immunity after being infected" and we're gathering evidence to see whether that can be rejected or not.

>It's basically condemning them to working nonstop for months if not years

how come? wouldn't without lockdown the herd immunity with that R0 would come in like 2-3 months (and during that period the vulnerable people would have to be locked down), while with lockdown we're already 3 months into it without reasonable lockdown based endgame in sight?

The US did not lock down. A portion opted to stay at home if they could afford it, several industries were deemed essential (often with ridiculous inclusions), and the brunt is being borne by folks in poverty. We had between 40% and 60% reduction in urban mobility, much less in rural areas, and an increase in stay at home rates on par with a census block groups median household income. Then we re-opened too early. This is why there is no endgame in site.

There is totally an endgame. Lockdown worked in NYC. That is huge. NYC is crushing the curve. 1 in 600 people in NYC have died of COVID (NOT GOOD). However, it is estimated that 1 in 5 is already immune. That's great news! A huge step towards herd immunity.

It means NYC must do this three times more to get to herd immunity, and strike the right balance each time. Still it is far from safe since people can come from the rest of the country so it’s not a real herd immunity.

Your comment implies that "do[ing] this three times more" would be very difficult. That's totally incorrect. As the level of immunity rises, R0 goes down naturally. The effect is huge at even 20%. Giant at 50%, etc., especially with moderate social distancing. Moreover, there is every reason to believe that some people are just naturally resistant/immune to the virus. I believe Bergamo never got above 57% sero-positivity and even the USS Rosevelt was around 60% sero-positivity. It seems impossible to believe the other 40% weren't exposed. If (okay a big BIG if) 40% just don't ever get COVID, and 50% get it but have mild moderate symptoms (the data strongly supports this), NYC is basically done with this emergency.

Will they be immune in one year? Two?

The data on long-term immunity for COVID is non-existent, that is why the experts are being cautious. However, the data on animal coronavirus vaccines (not COVID) is very suggestive that yes they will be immune in a year and two. Coronaviruses do mutate but do not mutate like the flu virus does.

On the other hand, with social distancing and masks, herd immunity comes at a lower level, even if mask-wearers still suffer >1 R0. So vastly fewer people die.

Simplistically, we don't want to lockdown or distance until we get to whatever that herd immunity level is. And then, a bit past that level, we might want to lockdown hard and then ease up to a steady-state lockdown, and then hold it there until the disease has passed.

The reason we'd lockdown hard and ease up is because, well, a continuity argument -- more lives are saved if you do a week of hard lockdown when 1000000 people are infected than if you wait until 10 cases remain.

More and more researchers start to believe that the virus (also) spreads as aerosols. They also believe the amount of virus that enters your body affects how sick you get. This might also be the reason that healthy health workers can get sick when they are exposed a lot.

So I have no doubt that working as health worker without enough protective gear is scary when you see healthy collegues getting sick.

But that does not mean that going for herd immunity is a bad thing. We know now that most people even don't know they have the virus when they were just exposed a little bit to it.

And if the virus travels like an aerosol it might even be true that the world wide protests that are going on in the open air won't lead to much more sick people.

But this also means that people inside a bad ventilated building are at risk.

Edit: an example of an article that explains this more in depth: https://www.webmd.com/lung/news/20200527/aerosol-scientist-c...

I think you are missing the point. We are long past the point of containment. We will get to herd immunity no matter what. The question becomes, how to do it safely. The answer is to have in place sufficient capacity. One can have sufficient capacity easily if R is kept low. There are other ways of getting there (i.e., actually increasing capacity), or a combination thereof.

We will hopefully not get hers immunity. Spain, Italy and Sweden are not close yet and they were pretty close to capacity, same with NYC. There is no safe way to get to herd immunity, it’s vaccine or nothing.

I agree with you. I have yet to see evidence that once somebody is infected, they cannot get re-infected.

Not to mention, the vaccine needs to work on the correct strain AND be administered to what, 70% of the population?

> But that does not mean that going for herd immunity is a bad thing.

One way or the other, end game is herd immunity. But when you let it just "go freely" you overshot - more people then is necessary for herd immunity will get sick.

Well the point is: it looks like we can go freely but only when we are not in closed spaces without good ventilation (and low humidity).

Studies [1] have shown that "20 percent of Covid-19 cases accounted for 80 percent of transmissions"

And those 20 percent were mostly 'Superspreading events'. We now know almost all those events were inside in bad ventilated areas.

[1] https://www.nytimes.com/2020/06/02/opinion/coronavirus-super...

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