The coronavirus pandemic isn’t ending – it’s surging | Hacker News Reader

The coronavirus pandemic isn’t ending – it’s surging

washingtonpost.com

84 pointsdeegles55 comments

It’s interesting to see the slowly growing disconnect between what public officials are saying and how individual citizens are feeling.

I live in Los Angeles. Officially, we are open for business. Personally our response was “haha, fuck off”. My office is still closed with no timetable to re-open, and a significant number of my colleagues and personal friends are utterly bewildered at the idea of returning to normal operations.

The general consensus among my group was “I’m not quite sure what it’ll take to make me comfortable returning to bars, but it’s not this”

I imagine this is very regional. People here in Utah seem to have largely gone back to life as normal. Anecdotally, I've seen mask usage go way down in the last couple weeks. Meanwhile, our cases have started sharply increasing.

It might even be more specific than regional, I’m sure there are different clusters of people with different views. There is one colleague of mine, who I’m sure has a whole social circle that agrees with him, that has long maintained that America should take the Sweden model. I’m sure he does not feel the public/personal gap that I do.

I've heard a lot of conservative voices calling for this too. The only problem is that the US is far from Sweden--no universal health care, no guaranteed sick leave, and no real safety net for workers. It would seem that if the US wanted to take the "hands-off" model, it would need to first implement these things.

A lot of places in the US are basically implementing the Sweden model already, but accidentally rather than intentionally. Which I think is a big mistake.

I don't think it's an accident. Most officials in the US have been pretty clear about what the plan is: we're going to make sure hospitals aren't overloaded, we're going to invest a lot of money in treatments and vaccines and contact tracing, and we're going to open up as much as possible while waiting for a vaccine or effective treatment. You can argue that we should have committed to eliminating the virus before going back to normal, but American officials were never really considering that as an option.

This is one of those scenarios where splitting the difference between two different systems is markedly worse than having picked one and gone with it. In our case, we've managed to both melt down the economy and fail to contain the virus, which isn't good at all.

The patchwork shutdowns should have been used to buy time to scale up testing, improve contact tracing, acquire as much PPE as possible, and equip hospitals as best as possible to handle excess demand. The reality is that the shutdowns were used to enforce social distancing (because apparently Americans can't understand how critical it is to prevent the spread) and display the appearance of testing and contact tracing.

What we ended up with was the illusion of a "win" when really we're just waiting to lose a second time and in a more dire way. I'm not sure the country will stomach another shutdown with a second wave, so I'm thinking that we'll just let the virus burn through and incur the high human cost it comes with.

I’ve said this before; any permanent social change caused by the virus alone (protests over police brutality did not enter my predictions) will come into existence due to any second waves that might occur. I think the snap back from “we’re reopening America” to mass casualties will be strong and sudden.

Now I can’t even begin to predict what that snap back will look like. A permanent growth of remote work seems plausible, but I’m sure there will be unexpected secondary and tertiary outcomes.

Has a snap back happened anywhere else in the world? While the unknown is scary, in this case it seems like we can look to our neighbors at home and abroad for comfort.

I don’t know, but I’m not heavily connected to any other culture to speak to that. It could be happening right now and I would miss it.

I’m not sure there is a difference between the two lockdown approaches.

On one hand, Sweden’s economy is no better off than the rest of Europe. On the other hand, US deaths are on an exponential decline, similar to Europe, albeit slower.

I think the meaningful difference is that European countries had more more extensive and effective programs to keep workers on payroll. If you want to point a finger at a US fuckup, look at chronic job insecurity and pushing unemployment insurance over employee retention.

For example, 40-50 percent of workers in France, New Zealand and Switzerland received payroll retention benefits.

The other major difference is that Swedish people trust their government.

Lockdown just slows the spread it doesn't stop it. Eventually you will need to get herd immunity.

People without health care or sick leave will still eventually get coronavirus. The reason for lockdown is to make sure that hospitals are not overrun. It doesn't solve America's other problems.

The idea that you can get the r value low enough that it dies out completely doesn't work because it would need to be consistent across states and countries. There will always be pockets of coronavirus unless you lockdown to the point of no economic return.

This is assuming no vaccine, no precautions possible, no improved treatment. This is an incorrect model.

We can stop it now--masks are required in public unless you have a doctor-diagnosed breathing disorder. Put some real teeth in the laws. That will drive R0 to below 1 and the virus will go away.

What’s the timescale? What “teeth” do the laws need? How do you manage the phenomenon of psychological reactance?

Asking because while the theory may be sound, translation isn’t a given. And pursuing a policy without regard to feasibility may be counterproductive.

I think anything more than a minor citation is probably not achievable, and even that might be bad.

Given the current state of policing in America, the idea of leaning on the police to enforce mask rules is personally unpalatable.

What we really need is a social change on this issue, but that requires leadership from the top that we’re not getting.

There won't be a vaccine within a reasonable timeframe. Improved treatment maybe.

Would the number of lives saved from improved treatment be better than the economic cost? You can call me heartless but in the end economic cost also equals lives lost.

If the US wanted to take the "hands-off" model responsibly and in a coherent fashion, that is. Unfortunately, due to politics, there's a long history of seemingly contradictory positions parts, or the whole country takes. Every time there a gun-related tragedy, the argument to keep guns is always balanced by "we should provide better access to mental healthcare" - except then to endlessly fight Obamacare. States which seek to restrict abortion as much as they can, don't then lavishly fund welfare programs to support unwanted babies.

The US is in the midst of implementing the "hands-off" model in the same fashion, discordant, with the respective parties playing the expected sides; battlegrounds drawn at state and county lines.

Is the Sweden model objectively successful? Last I heard their cases were spiking.

It is more a failure than anything else. Sweden has been hit as hard economically as anybody else, and now gets isolated by its Scandinavian cousins Denmark and Norway, which are opening up borders and easing travel restrictions right now...but they're keeping exceptions in place for Sweden because of the high virus activity over there.

I don't see how that can be counted as an objective success.

Idaho never really locked much down although they gave it lip service on TV. I've watched as mask usage over the last month has gone from 50%ish 4 weeks ago, to 1 in 5 or so two weeks ago, to 1 in 25 or more this week.

I think some states have suffered from a “we’re not NYC” mentality, causing them to under invest in preventative measures.

>Anecdotally, I've seen mask usage go way down in the last couple weeks

I've seen this too. A coffee shop I frequent literally went from masks one day to no masks the next in the last week. At the same time, cases are consistently going up in my county (Orange county CA)

Yeah, I flew between 4 different states last week. Montana, Washington, California & Minnesota. Definitely very regional, even between Orange County and LA for instance.

Some places are full sit down at the bar is acceptable (no masks) vs. getting kicked out of a take-out joint for not wearing a mask (Los Angles).

Right... lockdown de jure vs de facto.

This has been my experience here in Austin too. Some businesses are re-opening but my office has no plans yet to do so and we still virtually never leave the house.

Trump literally said we are experiencing the dying ashes of a pandemic. Meanwhile cases are doubling in Anerican cities every week. How can you so blatantly lie?

Where you have you been for the last 4 years.

Right.

What you are describing is also the essential nature of the economic effect of the epidemic - it is for the most part the public's individual reactions to the disease, not the lockdown orders, that have brought the economy so sharply to a halt.

And the economy will only resume at full flow when the fear of the disease realistically recedes - i.e. when there is effective treatment, or vaccine that people can actually get.

Yup, which is why the reopen crowd is doomed to failure. They can force the stores open and the workers into danger but they can't force the customers to come. Some will, but not enough to keep the places in the black. The worst of both worlds.

Looking at the LA County data, the number of deaths per day is the lowest it's been since they started keeping track. So things seem to be looking better.

https://covid19.lacounty.gov/dashboards/

I'd be curious to know how and whether the death rate has changed over time. We've learned a whole lot since the "first wave", including the fact that it doesn't seem to really be a respiratory illness at all, but some kind of autoimmune/blood illness. Have the resulting changes to treatment had a measurable impact on survivability yet?

Covid-19 is a respiratory illness. It has other systemic effects though.

It can be a respiratory illness and an immune response. It’s not without precedent; influenza can cause a hyperactive immune response that damages the lungs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711683/

Cytokines are a response to the illness.

Not even that, the virus itself is no illness. Cykotine causes the main illness, the dead cells in the lungs and elsewhere, which might cause bacterial infections. Of which you eventually die. The virus is just a dirty little unknown virus causing the immunosystem to overreact. In some cases. In most cases not.

The virus kills cells.

I've read only about 90% of all COVID-19 papers and I might have missed that one, which says that the virus itself kills cells, but the overwhelming data says the cytokinestorm kills infected cells. The virus is just an annoyance causing the immune system to run amok.

It’s difficult to calculate an exact death rate. For one, there’s limited testing. Without being able to test the entire population, a whole range of biases can skew the rate dramatically. The large number of asymptomatic cases that never go reported may be an indication that the reported mortality rate is too high. On the other hand, it’s likely many deaths due to COVID-19 have gone unreported. See, for example, the spike in overall deaths in Lombardy in Q1 2020 compared to prior years and how it exceeded the official COVID-19 death tally for that region by something like 4x. Then there’s the question of what deaths to attribute to the disease. If a drug overdose patient died because they couldn’t get access to a ventilator, would you include that in your death rate? You couldn’t if you were tracking the mortality rate of the disease to the people it infected, yet there are significant such cases of deaths that would not have occurred had this pandemic never begun. Those numbers won’t be captured in a naive calculation either.

That being said, I’ve found a good summary of some statistics on this page, which you may find helpful.

https://www.worldometers.info/coronavirus/coronavirus-death-...

I'm aware of all the complications with getting a precise number, I'm more just wondering if there's been a rough - or even anecdotal - improvement in outcomes for people who do end up in the hospital

Yes. From that linked website, among cases that had an outcome (recovered/died), deaths in April were around 20%. Today, around 10%.

> We've learned a whole lot since the "first wave",

We're still in the first wave.

The case count, though, doesn't tell us much because the cases come from testing. More testing mean more positives. The most important thing is whether the ICUs are being overwhelmed .

How do you know the test count increased? In Utah the rate of new cases has increased but the testing rate has slightly decreased.

https://twitter.com/AlexBerenson/status/1271135876379299848

Well if it was on Twitter, it has to be true.

No. But if you bother to read deeper, you'll find that he's done an excellent job of reporting on the topic. He's a former NYT reporter with great skills in writing succinctly about a difficult topic.

If you invest the money in his book -- it was #2 on Amazon last week -- you'll find all of the deeper bibliographic citations that I know you'll spend the weekend double checking.

I see nothing in that Twitter thread to support the idea that increased case counts are due to increased testing. Again, my state has both reduced testing and increased counts.

Very tightly worded denial. Berenson offers a detailed explanation of what's going on.

But if that's not to your taste, here's another factoid. Now which state are you from? And which window are you using to say that testing has been reduced but counts have risen?

"Tests have increased by about 37% in Florida in two weeks, but confirmed cases have risen 28%."

https://www.wsj.com/articles/the-second-wave-covid-scare-115...

Backing your argument up a sourceless source doesn't help

So sorry for those who can't read deeply. Berenson is a master of boiling things down to very pithy arguments. I find him to be excellent because he says things more succinctly than anyone.

To call him a sourceless source, though is calumny. His book on COVID-19 was the number 2 book on Amazon last week. The bibliography is a big percentage of the text. Buy it some time and be educated.

I feel like this is a result of lying in government. People made a contract to bend the curve and quickly it turned into tyranny.

That contract then turned into eliminating the disease all together. Also we know more now about who getting sick and whose dying so of course the same decisions wouldn't be made.

If you read the article, you’ll see that basically the virus is now surging outside of the developed world and into South Asia and South America. The West is still stuck with it, some areas definitely surging, but it’s hardly surging on the whole.

I think the public must get the message that there was no terror virus. This will let the idea terror virus disappear. People who are having the idea will have to realize that have been taken in by charlatans. This won't feel nice.

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