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Comment by oramit | Hacker News Reader

I actually chose stomp over eradicate because I wanted to imply that there would still be some left but that it would be a manageable amount. That's interesting that you took it the opposite way; I'm sorry for the confusion.

I agree, eradication was probably impossible in the United States. What I thought we all agreed on at the start of this thing was to lock down so we could "flatten the curve". Remember that? While we were locked down there would be an enormous marshaling of resources so we could equip everyone with PPE/Masks, get testing going, and do contract tracing. But because we didn't lock down the entire nation we snuffed out the hot spots in Washington and New York but let new ones fester and they are now out of control.

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> because I wanted to imply that there would still be some left but that it would be a manageable amount.

Go for "decimated" next time, rare to see it used right ;)

Decimate means you kill 1 out of every 10. It's probable that we decimated the virus and more. It's just that doesn't really make a difference.

Decimate means leaving 1 out of 10 alive. A 90% reduction.

> Decimation was a form of Roman military discipline in which every tenth man in a group was executed by members of his cohort. ... The word decimation is derived from Latin meaning "removal of a tenth".

No it doesn’t. Look it up.

As in 10% reduction?

JFK international airport is a 20 minute ride from the heart of Manhattan and we have a "transportation security agency" that can't find physical contraband in a suitcase much less be expected to be gatekeepers of health for the nation.

Suppose we drastically lower transmission. How many times should NYC and the surrounding areas be locked down because someone flew in from a country with loose contagion protocols?

Besides waiting for a vaccine and mass infections of those unwilling or unable to stay at home, I haven't seen a concrete proposal from anyone on what we should have or should be doing next.

Logistically, it's easier to force everyone arriving into mandatory two-week quarantine, than finding a contraband whatever hidden in a sea of suitcases.

What's lacking is political willpower.

Australia does this. The border is somewhat porous, but it's worth mentioning that Australia is worrying about hundreds of cases right now.

Close the border, it's as simple as that. All countries that were able to lower infections did this.

In Europe this was done even between neighboring countries both part of Shengen.

Here in Canada it was even done between provinces. My region has a bubble of four small provinces with few cases. But even so to travel across a provincial border in the bubble you will need proof of residency.

We didn't snuff out hot spots. The virus was/is still in NYC and Washington. No matter how long we locked down for it would still be there waiting to emerge after the lock down ended. That was the problem with the lockdown. It was touted as a solution when its just a delaying tactic.

Schools are the same. Keeping them closed is just a delaying tactic. And like the lockdown, unless we delay until a vaccine then it's a pointless delay.

I don't remember lockdowns being touted as a solution. I always understood it as a delaying tactic so things could be brought back under some control. Flatten the curve and all that. NYC didn't eliminate the virus but they've kept their curve flat so it's not getting out of control again.

This delaying tactic is all we have for right now, its likely saved thousands of lives, and that's not nothing. What is your plan for the next stage?

It's not clear what the impact of the lockdowns are. You say that they've saved thousands, but in a lot of places we are back to where we were before the lockdown. Or even doing worse. I suspect that the lockdowns delayed deaths, but in most places will not have substantially reduced them.

The plan for the next stage is all of the public health measures that other countries have used to contain it. Masks, hygiene, social distancing, contact tracing, etc.

At this point we know how to stop it. Compliance is not there and every day that passes it goes down.

You’re right, that was all we could arrive at at the time. We don’t have the plan that says test everyone once a week, support the folks who need to quarantine as a result, and really fence this off for 3 months til it’s down to little pockets. We don’t have a plan that says follow the regions, the counties, the communities, and work hardest on suppressing it where it was and where it was heading.

We did choose a bad option, now people who’ve been locked down are exhausted and ornery while the ones who didn’t are finally getting the idea.

And for some reason “no shirt no shoes no service” is well understood, no blowing secondhand smoke is accepted all over, but the right to infect is held as culturally important.

What are you suggesting is a delaying tactic? What is the thing being delayed?

The delaying was so that we 'delayed' or avoided overfilling the hospitals and causing a lot of secondary death and damage. Delay people getting sick, reduce the max. Spread the infections out over time.

I don't think that's necessarily what the person I replied to is talking about, given their language, which is why I asked.

Well if you take eradication off the table, then you have to assume the entire susceptible population will eventually get the virus. So I guess, I don't see the benefit of "stomping" the virus down to some small level. It was at a very small level back in February, and then grew. If we get it back down to that small level, it will just grow again. There's no benefit to locking down for 3 months to have it grow in July instead of March.

A controlled burn approach makes a lot more sense, but that is not the same as "stomping" the virus.

If you stomp it down enough then a few relatively light measures (masks, some distancing, some contact tracing) are enough to keep it down. That's what's happening in Europe right now. Sure, eventually everyone would be infected at least once given infinite time. But that doesn't matter, what matters is how many people get infected before a vaccine is developed and widely deployed.

Effective testing and contact tracing is sufficient to dramatically reduce the spread of the virus.

If we're a year away from a vaccine or treatment, then we don't need to burn down society to stop it this month. But if we act in a way that causes millions of infections, we're inflicting unnecessary harm on thousands.

We've also learned more about how to keep people alive and how to slow the spread of the virus since February, so it's useful to postpone that exponential growth as long as possible.

If you keep the infection rate low enough you can keep the hospitals from being over capacity and also delay infections until after a vaccine is developed and administered, thus preventing the infection. Both of these states would have the benefit of reducing the total number of deaths. When the lockdown talk started, I thought that was the point.

Time does wonders. We have much better knowledge of treatment options than we had in March, which makes a real difference in lives lost. And eventually, we might (might!) get vaccines. So the longer the curve is flat, the more time we have to learn and craft better interventions.

https://www.nytimes.com/interactive/2020/science/coronavirus...

Stomping the virus down to a manageable level so it doesn't overwhelm hospitals was the main goal of "Flatten the curve". We actually succeeded in quite a few hot spots to do this - NYC being the biggest example. Covid still exists there and people are still dying but it's not out of control. If you stay on top of it, it doesn't just grow again.

I'm not sure why you say there was no benefit to locking down. It clearly did wonders for NYC. It's likely that thousands of people were saved by this action.

What you're describing may be a controlled burn approach under a different name. After a certain point, the virus infects the entire susceptible population, and then it stops because everyone susceptible has died or obtained immunity.

Suppose 30% of the population is susceptible to covid. If lockdown policy slows the spread of the virus to 1% of the population per month, it would take 30 months before the pandemic passes. That's a very long time to do lockdown, very damaging to the economy and people's livelihoods.

I've read a lot about overwhelmed hospitals. I'm not clear on if it's happened in any widespread fashion. The media coverage tends to emphasize the bad cases and ignore the boring cases. It doesn't seem like people are unable to get medical care. I have checked the Texas online dashboard now and then, and currently about 10,000 people in a state of 29,000,000 are hospitalized with covid.

Texas dashboard: https://txdshs.maps.arcgis.com/apps/opsdashboard/index.html#...

The logical policy would be let the virus pass through the population as fast as possible without overwhelming hospitals, given the specifics of any geography.

I'm sorry but you making one incorrect assumption after another.

No, it would not be logical to let the virus go. It would kill some people and causes other health effects. We don't want a few million deaths. Plus now there is clear evidence that some people don't have antibodies after they get it, a few months later, and this is not completely unknown in other diseases. Some people have some protection though. Plus there are people who get it a second time as far as we can tell.

There are not infinite number of hospital beds. In NY they were past the limits for a month, killing med staff and also ptsd for them. This was barely avoided in Seattle. It's happening now in Houston. The people sick with cv19 are blocking others from being treated, and some people stay home. The hospitals financial plans start to fail because all the other medical procedures are stopped because its dangerous to be at the hospital and they are repurposing say dermatologists to work in the cv19 wards.

> There are not infinite number of hospital beds. In NY they were past the limits for a month, killing med staff and also ptsd for them. This was barely avoided in Seattle

To be frank I've stopped caring enough to follow the news in detail anymore (which itself probably says something), so I don't know whether the rest of your comment is accurate or not. However, I can attest firsthand that this part pertaining to Seattle is completely false.

I live in Seattle and have had multiple friends/family members hospitalized with covid19. We were nowhere close to overwhelming hospital capacity. At the beginning of all of this, we had a massive field hospital in Century Link stadium set up and shut down without seeing a single patient, as well as a hospital ship which was supposed to harbor here but ended up being redirected (I believe to Los Angeles) because we didn't need it. Even now with the resurgence that's been happening, our metrics around ICU utilization are where we're performing best:

https://coronavirus.wa.gov/what-you-need-know/covid-19-risk-...

Metrics | Value | Goal | Meeting Goal

Percent of licensed beds occupied by patients | 60.3% | <80% | Yes

Percent of licensed beds occupied by COVID-19 cases | 3.7% | <10% | Yes

Other sources -

Field hospital being set up in Seattle: https://www.king5.com/article/news/health/coronavirus/centur...

That hospital torn down 2 days later with no record of serving a single patient: https://www.king5.com/article/news/health/coronavirus/centur...

U.S. Navy Hospital ship originally meant for Seattle redirected to Los Angeles: https://abcnews.go.com/Politics/us-navy-hospital-ship-depart...

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I'm assuming good faith and that you're simply worried just like everyone is, but you are spreading misinformation here. Again, I can't really attest with good knowledge to anything other than Seattle, but the fact that you are wrong about that makes me skeptical of the rest of your comment.

I think some of what you are saying is true, but you may be lacking some balance in your sources of information. For example you say:

> It would kill some people and causes other health effects. We don't want a few million deaths.

A few million deaths would be in the 2-3 million range. This doesn’t seem realistic based on the data we have so far. About 140,000 people in the United States have died from the virus after about 5 months. It would require a 20x increase to have 3 million people to die from it. That seems like a really big reach.

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