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Comment by mirimir | Hacker News Reader

Right. From what I've read, it seems like the most effective strategy would be locking down elder care homes tightly. And also tightly locking down staff at elder care homes. Because once one resident gets infected, there's no way to prevent other residents, and staff who care for them, from getting infected. At least, short of staff wearing ebola level protection, and changing between residents. Which would be impossibly expensive and time consuming.

Others in the general population who are at serious risk of complications, such as elderly and those with preexisting conditions, should also isolate themselves. As I gotta say, I have done.

But I suspect that it will turn out that general lockdown is neither good enough, nor worth the long term economic consequences. Except of course that those long term consequences will arguably mitigate global climate change.

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Don't forget that deaths are just one measure of the damage covid brings. My wife is/was a fit and healthy 40yo no underlying conditions - she had covid 4 months ago and has barely been able to climb the stairs some days. The 'crazy' thing is that her actual covid infection wasn't hat bad and she had no shortness of breath etc at the time. But here she is with symptoms very like ME some 100+ days later.

Obviously that doesn't happen to everyone but it appears a significant proportion of those getting ill have serious symptoms some time after the illness, with no clear end in sight.

Sorry :(

Maybe she carries that susceptibility sequence from Neanderthals. It'd also be good to focus on isolating people with that and other relevant genetic markers.

So basically focus on isolating all people above 60, all people with comorbidities, and any with genetic sequences that are ill-defined, likely many of them that we haven’t uncovered, and more expensive to test for than Covid screening?

Easy.

Or lockdowns, easy accessibility to testing and good contract tracing. Which has worked well in lots of countries

> Which has worked well in lots of countries

Has it really? Lots of people in LTC facilities have died, no?

I’m not talking about Sweden, or the US, or Italy or the UK or France, But NZ, Vietnam, China and Australia (current flare up not withstanding) have pursued policies of lockdowns, contract tracing and heavy testing. Your proposal is more convoluted and relies on the imperfect information we have regarding susceptibilities (genetic susceptibilities) being correct, and being able to scale tests to a couple billion people almost immediately so we can tell who should stay inside.

Sure, but it's likely that this won't be going away. So as soon as you relax lockdown, it may well come back. Unless there's a vaccine, which I'm not betting on. And then there's the chance of another zoonotic virus in a few years. Time will tell, but it may turn out that isolating vulnerable populations is the best long-term strategy.

You’re right that it’s a marathon not a race. But isolating the vulnerable (on a semi permenant Basis) is not easy or good for these people. With good testing infrastructure and contact tracing, we can minimise harm. We just have absolutely no definite idea who are those who are otherwise healthy who are going to end up hospitalised (say for my age group 30-40 males it currently looks like 1:500 will end up needing hospital support) and that’s even before you look at those who may do fine without hospital but still be carrying some serious consequences (ie original poster’s partner).

I for one would like to avoid getting this altogether

Maybe more than marathon. I mean, the influenza strain that caused the 1918 pandemic is still circulating. Notwithstanding herd immunity through vaccination.

Who knows - I have nearly 4 percent neanderthal dna (according to 23andme) which means I have more neanderthal dna than 99 percent of people alive today, and it didn't hit me at all.

It will be very interesting to see what we learn in a year or more, but it does appear that there is the possibility of physical for healthy people - on her slack group (with over 7000 'long haulers') some people are showing heart scaring, some lung damage, some kidney issues. The only commonalities for most is that while they felt ill with covid, most were not dangerously ill. And many are resting negative to the antibody tests as it appears their T cells fought the virus. The research can come too soon for us.

> But I suspect that it will turn out that general lockdown is neither good enough, nor worth the long term economic consequences.

Hang on, this is an article showing that a looser lockdown still ends up with your economy hammered anyway. This should not be surprising, analysts if the Spanish Flu pandemic showed that cities that locked down later and lighter actually suffered more economically. This is because the higher infection and death rate, and larger number of people caring for sick relatives. People ended up Locking themselves down anyway out of fear, and the epidemic dragged on for longer.

Now we know this wasn’t due to special conditions back then, it’s true now too. There simply isn’t an option to ‘choose the economy’.

It’s so simple. (1) Your economy will be hit whether or not you lockdown. People are gonna reduce their activity due to the threat of the disease.

The lockdown affects behavior at the margins. And at the margins, the economic gains are linear to the additional activity due to not having a lockdown, but the growth of the virus is exponential.

Then the fact that the virus persists longer means places without a lockdown that did not drastically reduce the spread of the disease continue suffering economically.

Those are good arguments. I'm very curious what the data will show over the next couple years. However, I'm concerned that data for incidence and mortality will be too incomparable to draw reliable conclusions.

> Hang on, this is an article showing that a looser lockdown still ends up with your economy hammered anyway.

Well, there is effectively no "looser lockdown" when you're part of the EU, and even more economically tied to the rest of Scandinavia.

But anyway, the most important point is that a general lockdown that doesn't adequately protect the elderly, and others with preexisting conditions, won't reduce the death rate very much.

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