I live in locked-down Shanghai – here’s what life is like | Hacker News Reader

I live in locked-down Shanghai – here’s what life is like

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42 pointsRickJWagner39 comments

As a point of reference, in the US, about 0.3% of the population has already died due to COVID. Many more are disabled or debilitated. I won't get into that debate over specific numbers -- it can be anywhere from astronomical numbers due to long COVID, or very moderate numbers from people who are hospitalized, don't die, but have significant lung scarring (for each person who dies, several are hospitalized, recover, but have significant permanent lung damage).

Shanghai is just under 2% of China. China has had virtually no deaths.

What's worse?

* Having 2% of the population locked down to maintain COVID zero?

* Or having 0.3% of your population die, and several times that disabled?

That's a rhetorical question. The answer depends on your value system. Both answers are within the norms of cultural value systems around the world. Neither is unreasonable. It gets hard, in part, due to issues like differences in opinion on the importance of personal freedom versus collective good. Those go well beyond just the public health question.

I don't think the value-judgement China has made is at all unreasonable. It's well within how cultures differ. I'm not saying it needs to agree with your values -- just that we ought to accept that different countries and governments have different value systems. This seems well within those norms, rather than grotesque human rights violations as the Western press paints it.

Same thing bugs me reading Chinese press about the West.

It should be possible to tolerate differences like this without contempt for the other side.

> China has had virtually no deaths.

sure

Besides the virtually no deaths.

Distrust from the older, more vulnerable population, is pretty high.

You think welding people inside their homes is "well within norms"?

Locking 10 people up temporarily to save one life (and multiple people from disability)? Yes it is.

Not Western norms, but norms.

You do know there are vaccines now?

Ps. Locking a couple of million is more appropriate, not 10.

But they are grouping together to get tested for COVID ( and getting it then, it seems)

Vaccines effectively prevent death and hospitalization. Their impact on other after-effects is more limited. That's especially true for the Chinese vaccines.

At this point, we're even starting to understand why. A lot of the after-effects seem to come from early in the progression of the disease, before the adaptive immune system activates. Loss of small, which is a proxy for a lot of neurological impacts, comes before the vaccines does anything (unless you have still have antibodies, which is just a few weeks after the vaccination).

A lot of people in the original Wuhan infection are still suffering after-effects. I think China is basing their policies on that, but that's speculation.

> Shanghai is just under 2% of China. China has had virtually no deaths.

> What's worse?

> * Having 2% of the population locked down to maintain COVID zero?

...except that shanghai isn't the only city that's locked down:

> https://www.economist.com/img/b/300/383/90/sites/default/fil...

>A report by Gavekal Dragonomics, a research firm, found that all but 13 of China’s top 100 cities (by GDP) were implementing covid restrictions (see chart). Ten cities are in “severe lockdown”, meaning more than half of residents are confined to their homes. Changchun, Xuzhou and Shanghai were recently in full lockdown.

from https://www.economist.com/china/2022/04/16/the-way-chinese-t...

> * Or having 0.3% of your population die, and several times that disabled?

Aaaaand, also lock down for many, many more human-hours than China has.

The thing that drives me crazy about the 'liberty vs safety' debate in the west is that, by and large, the west has achieved neither.

If you want to avoid lockdowns, you either have to have zero covid, mass vaccination, or accept extremely high death tolls, and by that, I mean almost every single person who went to an ICU in the duration of the pandemic dies in a packed waiting room instead of recovering. There is no fourth option.

Zero-covid through tough restrictions, followed by vaccine rollout, preserves both liberty and safety, and I hope that next time round (and there will be a next time) people will realize that.

I agree with most everything, except I'm not quite sold on vaccines as the a silver bullet:

1) We don't quite understand the impact of a new disease on the vaccinated. /Many/ diseases have debilitating long-term effects. Some vaccines -- for example rabies -- prevent that. Others don't.

2) We don't know how well vaccines will work for future disease.

I view them more as part of a comprehensive solution. What I would have liked to see with COVID, and with future diseases, is a sufficient zero-COVID policy everywhere to stop the disease, as happened with smaller outbreaks in recent years.

My general conclusion is that we ought to have:

- Enough manufacturing capacity to provide everyone in the world with high-filtration masks, disinfecting wipes, plastic gloves, and similar basic supplies

- Enough vaccine manufacturing capacity to be able to roll out an mRNA vaccine to 7 billion people in a few months at most

- Enough manufacturing capacity to be able to spin out things like antigen and PCR tests quickly

- Some plan for supply chains to get everyone food if we need another lockdown

- Plans for contact tracing, ideally with practice drills.

- Perhaps, some plan for how our economy doesn't implode on a lockdown. This went surprisingly well with covid19, but I feel a little bit by fluke.

... and similar types of emergency precautions.

Well, I guess the (somewhat cynical) calculus most politicians/bureaucrats make is that however many people become ill in the long term, it's probably less expensive than lockdowns (even if lockdowns are less expensive than health system collapse and mass death).

As much as the long term health implications of covid are unfolding, so to are the economic effects: we're in a really weird and volatile economic situation, and things that move the needle on basics (food, fuel, etc) kill a lot of people.

…but will they ever be able to go out of lockdown? It seems like even if they get to zero C-19 again, it's a short matter of time before they have to have all this "fun" all over again.

There are several assumptions in your comparison that may or may not be true:

- the Shanghai lockdown happened in reaction to a number of infections. For these "zero covid" does not apply. How high was that number?

- the current variant is much harder to contain than earlier ones. So it might be that you have a lockdown now, then again in two months, again in two months,... until everybody had it (depending on how well the current chinese vac works against the current variant).

- An actual lockdown, much more than the tame western versions, has mental and health costs. How high is the damage of n weeks of lockdown compared to 0.3%? For which n?

- Financially, what n can you afford? Is that long enough?

China counts Covid deaths differently than most countries. Recent claims about them only having 3 deaths despite a surge in cases are, as far as I can tell, making the fundamental mistake that China has far more stringent requirements to call something a "Covid death". The true number of Chinese Covid deaths is likely higher - though I imagine still lower than in places like America.

Furthermore, the lockdowns have caused quite a few deaths on their own through things like delaying access to healthcare, and we don't have reliable stats here. One doctor is estimating 1000 diabetes patients will die from lack of healthcare access during the lockdowns (again, we do have to apply some skepticism to the numbers). Lockdowns aren't costless and merely keeping people locked in place for a short period.

Source: https://www.nytimes.com/2022/04/20/world/asia/covid-shanghai... (non-paywalled: https://archive.ph/GIDBw).

I won't disagree that there's a tradeoff you can consider for China's approach, but we all need to be very wary when trying to compare numbers between Western nations and China.

The videos of shanghai residents wailing from their balconies en masse suggest this is hardly a cultural difference. Many Chinese nationals are outraged.

You're making a number of assumptions, most which I think are utterly bogus

* Chinese numbers are genuine. They're not. They're probably not as bad as the US, but it's very difficult to tell. China does not release statistics necessary to validate their claims. They don't release, for example, excess death rates.

* China's policy here is going to work. It won't. It's an endemic disease now. This is going to happen all the time. Are they going to lockdown every time? What's the value of this?

* The economic fallout won't cause even greater harm. They're shutting down everything. They're already on the precipice of a real estate collapse.

The flip side is that we don't know the impacts of repeated COVID19 infections. If everyone caught COVID19 once a year, what happens? Is brain fog effecting susceptible individuals? Or would we all be in a daze and stupor.

It is endemic, but we're comparing two unknowns:

- Cost of lock-downs each time there's an outbreak

- Cost of outbreaks

I hope the zero COVID policies evolve over time to where they can maintain zero COVID without the draconian policies. I suspect universal N95 masks might be enough.

There is no scientific evidence to support your suspicion. There will never be any such thing as "universal" N95 masks. Many people are infected in private homes where obviously no one is going to wear masks. Everyone is doing to be exposed occasionally, just like with the other endemic human coronaviruses such as HCoV-OC43. It's time to accept reality and move on. Fortunately the vaccines and other treatments are fairly effective.

https://www.medpagetoday.com/opinion/vinay-prasad/94646

>>I suspect universal N95 masks might be enough.

We have no idea the damage that constant mask-wearing could do. This would be a very dangerous experiment, that interferes with basic the human functionality that we are adapted to.

https://www.cambridge.org/core/journals/journal-of-child-lan...

> We have no idea the damage that constant mask-wearing could do.

Pshaw. Many people wear masks constantly. I wear a mask for days at a time when I’m woodworking. Sculptors wear masks while creating their art. Surgeons wear masks for ages during complex operations. My dentist wears his mask all day every day. The guy who paints your house will wear a mask all day. It is simply ridiculous to suggest that we don’t know what mask-wearing will do.

None of what you describe is wearing masks constantly. This would be mask-wearing in all social situations, for years, for every one, including children.

And none of these tell us the population-wide effects of switching to mask-wearing, even for the limited scope that the people in occupations you mention wear masks, would be benign. For example, there is indication that emotional connections between doctors and patients are disrupted by masks:

https://pubmed.ncbi.nlm.nih.gov/24364989/

False dichotomy. You are still assuming that the lockdowns will be effective. That seems very unlikely given an endemic disease. Initial short term success doesn't mean much. How are you going to avoid flare up when it's commonplace all throughout the world?

Masking in flareups and vaccines and remote work where reasonable is the clear answer. Zero covid is impossible.

> about 0.3% of the population has already died due to COVID

Died from Covid or died with Covid?

This argument was put to bed as soon as excess mortality numbers started coming in. Spoiler: From COVID.

https://www.economist.com/graphic-detail/coronavirus-excess-...

In many places hospitals suspended non-emergency care and the fear of catching Covid would have made people reluctant to seek medical attention. If someone dies from a condition that would be diagnosed and treated in normal times, they would show up in the excess mortality figures. That still doesn't mean they died from Covid.

Yes, this was the argument the deniers went to after the excess mortality showed they were wrong about “covid numbers being over-counted”.

In the UK the evidence against this is here: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde...

Basically more people died at home than normal, but these people would have died in hospital anyway.

The claim that suicides had increased massively also did not pan out in the statistics.

There are a ton of countries that managed to keep their excess mortality low despite lockdowns, so there is plenty of evidence that lockdowns and restrictions themselves don’t cause excess mortality. Of course the deniers will claim that _their_ lockdown did, but I’ve given up any hope that these people will change their mind about anything at this point.

From the very same source: [0]

Because of the coronavirus (COVID-19) pandemic, our regular Deaths registered weekly in England and Wales release now provides a separate breakdown of the number of deaths involving COVID-19. That is, where COVID-19 or suspected COVID-19 was mentioned anywhere on the death certificate, including in combination with other health conditions.

If a death certificate mentions COVID-19, it will not always be the underlying (main) cause of death, but may be a contributory factor.

> Basically more people died at home than normal

Is exactly my point.

> but these people would have died in hospital anyway.

How do you know that? Again, how many died from Covid and how many died with Covid? You can't answer that because the data simply isn't good enough.

> so there is plenty of evidence that lockdowns and restrictions themselves don’t cause excess mortality.

Hospitals didn't stop taking non emergency cases for shits and giggles. Nobody shut down hospitals in lockdowns. In many cases the healthcare infrastructure was stretched to the breaking point because of high Covid case loads. The point of lockdowns was to flatten the curve and protect the healthcare system. They seemed to have worked in some places and they clearly failed in others. There are multiple factors at play including population demographics which greatly vary across geographies. And that is without even considering the second order effects.

Pretending that there are simple answers and explainations is equal parts disingenuous and delusional.

0: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde...

> How do you know that?

From the same source:

Our analysis shows that many of these deaths at home were people who, in a non-pandemic year, may have typically died elsewhere such as in hospital.

I’m not really sure what you’re getting at with the rest of your comment.

* Having 2% of the population locked down to maintain COVID zero? * Or having 0.3% of your population die, and several times that disabled?

This is a false premise. Their lockdown will only slow the virus spread, unless they stop all travel and trade in their country the virus will find a way in. Everyone in the world will be exposed to the virus eventually. So in the end they will bare the cost of the lockdown and the virus, not either or.

As opposed to indefinite periodic lockdowns, the period of severe damage of non-zero COVID is finite. Population-wide immunity increases with every wave, until there is some steady state like seen with influenza, where the threat is limited to the small virality edge that new variants provide before the population develops immunity to them. It is very likely, given the history of other coronavirus, that eventually the damage from COVID-19 will be comparable to other cold viruses (four of the major cold viruses are coronaviruses, and some evidence suggests they started as extremely deadly, and through mutation and/or growing-immunity, became milder).

Novel viruses are exceptionally dangerous, so the severity of COVID-19 infections is not an unusual situation. Influenza, when novel, caused the immensely deadly Spanish flu. We also know how viruses evolve, and how populations adapt to them, and based on that knowledge, we can safely assume that COVID-19 will not remain exceptionally dangerous once it becomes endemic.

You claim 0.3% of the US population have died from COVID, but present no source to back up that claim.

CDC puts this number at 1 million and you can be quite sure that figure doesn't distinguish between deaths from COVID and deaths where COVID was the secondary reason, source: https://covid.cdc.gov/covid-data-tracker/#datatracker-home

So it rather feels like an agenda to support unlimited lockdown, which no free democratic country should support given the nature of the COVID virus.

China is free to do as it pleases, but having abandoned the two-term policy for their leader, they are on the same course as Russia is with Putin.

Right now it's COVID, but tomorrow it could very well be the "inclusion" of Taiwan into the Chinese family.

EDIT: Updated due to calculation error, my bad. Still I don't think the 1 million deaths purely from COVID is accurate.

tl;dr: They have to stay at home, but still get food. When they are sick they're taken to a hospital.

People are angry because of the lack of agency, primarily. Or so the article claims :) It is a US publication, and they always have to be taken with a grain of salt when it comes to anything that isn't the US.

There are many stories about people dying in the waiting room because they had to wait for their covid test to come back negative before ERs in Shanghai were allowed to treat them.

This is a funny way to frame mass indefinite home detention, filthy quarantine centers, and the many, many reports of people not having enough to eat, and deaths from lack of access to medical care.

Did you know that only residents with official permission to be in Shanghai are getting food? What do you think is happening to everyone else?

> Did you know that only residents with official permission to be in Shanghai are getting food?

And even those are only nominally getting food. For every account of the Shanghai lockdown that includes regular food delivery, there are 5 accounts showing that their food delivery has been a packet of noodles and some cooking oil, once every two weeks.

> a packet of noodles and some cooking oil, once every two weeks.

Then everyone would be dead, so clearly this is not true.

Depends on the timeframe

Only if that's the only source of food.

The point is, contrary to this article, government food deliveries are nowhere close to enough.

You mean people without shanghai hukou do not get food? That is around 9 million people? Do you have a source for that, this sounds a bit like black propaganda.

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