Author Topic: How long can we wait while flattening the curve?  (Read 675133 times)

Abe

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Re: How long can we wait while flattening the curve?
« Reply #900 on: April 21, 2020, 12:42:47 PM »
@JGS1980 those are good points, but wanted to let people chime in what benchmarks people are using since “we” keep changing ours apparently (not actually but that’s the claim). Got to have two goalposts at a football stadium.

RWD

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Re: How long can we wait while flattening the curve?
« Reply #901 on: April 21, 2020, 01:29:10 PM »
Very interesting video (#HowWeReopen)
https://www.youtube.com/watch?v=HhRQxk9QA-o

Paper Chaser

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Re: How long can we wait while flattening the curve?
« Reply #902 on: April 21, 2020, 01:34:45 PM »
Another study of antibody test results has been published. This time, USC rather than Stanford, but the results are similar

https://news.usc.edu/168987/antibody-testing-results-covid-19-infections-los-angeles-county/

They're estimating that the number of total infections is 28-55 times the number of confirmed cases. Compare that to other studies previously linked, and it's becoming pretty evident that the number of total infections is likely 30-60 times the current confirmed number of cases.

US currently has 43k deaths and 800k confirmed cases for reference. So the number of actual infections is probably 24-40 million

So what?

How does this change things?

So if best case scenario the actual antibody folks are 40 Million, and assuming that that immunity is sustained for at least a few months, that means that 290 Million citizens can still be exposed.

If we have 42,000 deaths (and not done yet) with 40 Million people infected, than if everyone is exposed, we will get the minimal amount of 350,000 deaths (if the medical system isn't overwhelmed).

Doesn't change a thing as far as I'm concerned.

How is more info about this virus anything but a good thing? The reason everyone is clamoring for more testing, is to provide more data so we can gain more clarity in our decision making. Here we have people providing more data. It may not be what you want to hear, but that doesn't mean it's not helpful.

350k deaths is a massive number when talking about loss of human lives. It's also 0.1% of the population if we assume every American is infected at some point. I'm not sure that 100% infection is likely to occur, but it does give us a "worst case" to inform decision making.

Paper Chaser

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Re: How long can we wait while flattening the curve?
« Reply #903 on: April 21, 2020, 01:42:47 PM »
@Paper Chaser - the 2 studies released seem to have some flaws (as rushed research often does).

https://www.wired.com/story/new-covid-19-antibody-study-results-are-in-are-they-right/

I hope the results are as encouraging as those would seem, but there are problems with the studies in question. Which is why it is important not to jump to conclusions - peer review and replicating the results are very important parts of doing the science right.

And as @JGS1980 points out - the results as stated actually aren't that encouraging.

Fair enough. I'm considering the antibody tests as part of A composite picture, with the Diamond Princess study and the study done on Japanese citizens evacuated from Wuhan as another component (I've already linked to both in this thread). Both of those studies had more controls in place. They each found 40-55% of active cases were asymptomatic. And both saw infection rates that were well below 100% of the total sample.

So we have the two separate studies of active cases that indicate this virus has no symptoms at all in 1/3-1/2 of those infected. And now we have the antibody tests (after the fact) that seem to more or less confirm the two previous studies.
« Last Edit: April 21, 2020, 01:46:34 PM by Paper Chaser »

js82

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Re: How long can we wait while flattening the curve?
« Reply #904 on: April 21, 2020, 04:14:27 PM »
Another study of antibody test results has been published. This time, USC rather than Stanford, but the results are similar

https://news.usc.edu/168987/antibody-testing-results-covid-19-infections-los-angeles-county/

They're estimating that the number of total infections is 28-55 times the number of confirmed cases. Compare that to other studies previously linked, and it's becoming pretty evident that the number of total infections is likely 30-60 times the current confirmed number of cases.

US currently has 43k deaths and 800k confirmed cases for reference. So the number of actual infections is probably 24-40 million

I think some of these studies studies err on the high side.  When you reach factors of 50+ the math simply doesn't close with what we're seeing in locales like NYC - and in practice the ratios should be lower in locales like California (which has a much lower positive test rate) than NYC.  My own personal data analysis leads me to believe there's a factor of 15-20 in NYC.  NYC's curve wouldn't look like it does it the real ratio was 50.

Even tests with a modest false positive rate are extremely problematic from a data analysis perspective when the real positive rate is that low.  The sampling from that article was ~4.1% positive out of 800-some tests.  Unless you're dealing with a test with a <1% false positive rate, that alone can add significant noise to the data.

In NYC, as I think someone else posted, we've already had 0.16% of the entire city's population die of covid. (13,600 confirmed plus presumed covid deaths / 8.4million * 100%). And our infection rate isn't anywhere close to 100% of the entire population. We're over the peak but not over the first wave, with more dying each day, so the death rate continues to climb. Our hospitals are operating in crisis mode, so there probably are excess deaths from the chaos. But we haven't run out of ventilators, and the medical system hasn't collapsed.

The actual death rate from covid is almost certainly higher than 0.1% and probably higher than 0.2% too.

Agreed.  NYC provides pretty clear lower bounds on the death rate for this virus.  It's a pretty clear refutation of <0.15% death rates or 50+ actual-to-dected case ratios.

There was a study out of Germany that attempted to look at true numbers of infected (by population-level sampling, not just testing of the symptomatic) that estimated the "real" death rate at around 0.4% IIRC.  Based on the NYC data I think that figure is probably pretty close to the mark(assuming you don't run out of medical capacity).
« Last Edit: April 21, 2020, 04:20:33 PM by js82 »

Schaefer Light

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Re: How long can we wait while flattening the curve?
« Reply #905 on: April 21, 2020, 04:21:33 PM »
I think it's a balancing act.  IMO, we should open things up as much as possible without flooding the hospitals.  If they start to become overloaded, then put restrictions back in place.  I realize it's tricky to do this when the number of cases can grow so quickly.

GardenerB

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Re: How long can we wait while flattening the curve?
« Reply #906 on: April 21, 2020, 05:41:10 PM »
"I could care less about his predictions when reality is shouting something completely different"

I agree - and as I said there will be huge variances - like NYC or northern Italy, compared to say some states/provinces and even countries. Case by case they will have to analyze and decide what/which restrictions to lift.  Then, yes, there will be upticks in cases again.  NYC alone does not refute the overall (average) IFR/death rates.  And they/he is not ignoring overwhelming the system.  They increased capacity of beds 300% ahead of this and are still trying to flatten their curve given this capacity (to not overwhelm it).

GB

GardenerB

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Re: How long can we wait while flattening the curve?
« Reply #907 on: April 21, 2020, 06:05:59 PM »
And to JGS1980 my apologies.  I didn't mean to harp on just stats and averages, when most of us (and the world) has no clue just how bad it must be in NYC.

Literally right when I was posting my last reply I had a colleague ask 'why are we ruining the economy with shutdown when we have so few cases or deaths?'.  I had to point out that this IS why we are okay, and there are many places that are absolutely NOT okay...  It could have easily blown up in his own city too.

Abe

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Re: How long can we wait while flattening the curve?
« Reply #908 on: April 21, 2020, 06:09:36 PM »
Luckily it seems that in Georgia and South Carolina, a lot of businesses that are high risk have elected to stay closed despite the governors’ guidelines on reopening. They basically said they’re going to talk with scientists and health professionals, then decide.

This’ll really raise the question of liability (in the social/ethical, not legal sense) since some businesses are reopening and some are not, even in the same field.

Davnasty

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Re: How long can we wait while flattening the curve?
« Reply #909 on: April 21, 2020, 06:16:08 PM »
I think it's a balancing act.  IMO, we should open things up as much as possible without flooding the hospitals.  If they start to become overloaded, then put restrictions back in place.  I realize it's tricky to do this when the number of cases can grow so quickly.

By the time hospitals are becoming overloaded it would be much too late to turn the curve around before they're overwhelmed. Incubation periods range from 2-14 days before first symptoms appear and then it can be weeks after that before symptoms become severe enough to hospitalize the infected.

The cases that eventually overload hospitals would have been contracted several weeks prior. In the meantime the virus would have spread exponentially.

This is another reason why widespread testing is so important. If testing catches an outbreak in it's early stages there might be enough time to react and this balancing act would be possible.
« Last Edit: April 21, 2020, 06:18:26 PM by Davnasty »

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #910 on: April 21, 2020, 06:30:14 PM »
I'd turn the question on its head and ask everyone what number of dead (including potentially yourself) are acceptable casualties for reopening the economy? Absolute numbers or % of population figures would be appreciated. We agree it's not 0.0 or 0%, and probably the maximum estimated is 330m x 0.5% = 1.65 million.

My number for acceptable losses would be equal to half the annual number of cancer or heart disease deaths per year assuming that the COVID19 deaths are demographically distributed in roughly the same manner as heart disease / cancer. Of course, since people will still die during a lock down, this number needs to be the number in excess of those that would have died had a lock down been maintained.
 
For my state, current numbers for April 18-20 show about 15 deaths per day after a month of lock down. If we assume that number would stay constant for a full year of lock down (5,500), and then add half the number of cancer deaths (14,000/2) we get about 12,500 people, or 0.18% of the population.

The "acceptable deaths" argument has a particular fallacy. This pandemic is NOT like turning a faucet just a little warmer or a little colder as needed to achieve a goal of less than 200,000 deaths. This shit is EXPONENTIAL, which a lot of folks still don't understand. That means it can explode before you even realize you have a problem (like it just did last month). To extend the analogy, you can either get a trickle, or you'll get a firehose. Anything in between will be very difficult to control.

In my state (and country) the "exponential" part of the curve lasted one week and within 12 days the exponential growth had peaked and completely reversed. And we've only had 75 deaths nationwide. So just saying that something is exponential doesn't mean that it necessarily is going to get out of control. Refer to Wuhan. The total number of Chinese deaths has been modest in the scheme of things and they completely mismanaged the initial response.

Australia is now thawing out from lockdown because our current cases per day are about 1 case per 1 million residents. Perhaps Europe and the US can look to the Australian/New Zealand results over the next few weeks in calculating when to ease lockdown.

As for the question of how many deaths I'd be willing to tolerate, it would be approximately the size of the economic stimulus divided by $10 million.

bacchi

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Re: How long can we wait while flattening the curve?
« Reply #911 on: April 21, 2020, 06:52:24 PM »
Georgia is reopening gyms, among other businesses, this week. It will reopen theaters and dine-in restaurants early next week.

We'll know in ~3 weeks if this is a good idea or not.

https://www.worldometers.info/coronavirus/country/us/

Georgia covid deaths on 4/21 were 775 with at least a 5% increase today (4/22).

Gremlin

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Re: How long can we wait while flattening the curve?
« Reply #912 on: April 21, 2020, 06:54:24 PM »
Just in case those overseas are reading Bloop Bloop's posts and wondering how aligned he is with those actually making decisions here in Australia, this is what the Premier of Victoria (Bloop Bloop's state) said this morning.

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In too many places around the world, where they thought they had this under control, they eased off restrictions only to then have to employ even tougher lockdowns after that.

If we keep this performance going, though, if people keep doing the right thing, if people have that same sense of urgency and give this the importance that it absolutely deserves, and demands, then we will have options in a few weeks’ time, and we will be able to look very carefully at those options.

Let’s not give back all the progress we’ve made. Let’s certainly not close off those options by thinking that this is over. And that relative stability in our case numbers means we can go back to normal. We simply can’t.

We’ve all got to keep following the rules so that in a few weeks’ time we’ve got some options to ease some of these measures.

But I do again - I’m happy to try and give people that very real sense of hope, because there is hope here, but at the same time I don’t want to be making promises that can’t be kept.

And I certainly don’t want to be sending a message to any Victorian that it is over.

This is going to run for months. And the recovery will take years.

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #913 on: April 21, 2020, 06:58:18 PM »
The same premier also outlined that unemployment is going to rise from 5% to 11% and that our gross state product for the half year is going to be about $30 billion less than was previously forecast.

And more importantly, I think it is clear that if the lockdown continues, the economic damage will go up in linear fashion, whereas the current case numbers have dropped significantly (in the last 24 hours, my state with a population of 5 million people has recorded only 2 new cases).

So is it worth keeping 5 million people locked down, and keeping that linear course of economic damage, in a situation where we are recording single-digit new cases daily?

So by 11 May our stage 3 lockdown will ease, and not before time.

EDIT: By the way, what the Premier says changes day by day. Two weeks ago, stage 4 was looking likely:
https://www.theage.com.au/national/victoria/stage-four-lockdown-and-further-closures-remain-likely-andrews-warns-20200407-p54hys.html

Now that's not in the frame at all because the stage 3 response has been almost completely effective in wiping out transmissions. So I think it's clear that everyone needs to take a flexible and evidence-based approach to balancing the various interests involved.
« Last Edit: April 21, 2020, 07:03:07 PM by Bloop Bloop »

Paper Chaser

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Re: How long can we wait while flattening the curve?
« Reply #914 on: April 21, 2020, 07:08:59 PM »
Another study of antibody test results has been published. This time, USC rather than Stanford, but the results are similar

https://news.usc.edu/168987/antibody-testing-results-covid-19-infections-los-angeles-county/

They're estimating that the number of total infections is 28-55 times the number of confirmed cases. Compare that to other studies previously linked, and it's becoming pretty evident that the number of total infections is likely 30-60 times the current confirmed number of cases.

US currently has 43k deaths and 800k confirmed cases for reference. So the number of actual infections is probably 24-40 million

I think some of these studies studies err on the high side.  When you reach factors of 50+ the math simply doesn't close with what we're seeing in locales like NYC - and in practice the ratios should be lower in locales like California (which has a much lower positive test rate) than NYC.  My own personal data analysis leads me to believe there's a factor of 15-20 in NYC.  NYC's curve wouldn't look like it does it the real ratio was 50.

Even tests with a modest false positive rate are extremely problematic from a data analysis perspective when the real positive rate is that low.  The sampling from that article was ~4.1% positive out of 800-some tests.  Unless you're dealing with a test with a <1% false positive rate, that alone can add significant noise to the data.

In NYC, as I think someone else posted, we've already had 0.16% of the entire city's population die of covid. (13,600 confirmed plus presumed covid deaths / 8.4million * 100%). And our infection rate isn't anywhere close to 100% of the entire population. We're over the peak but not over the first wave, with more dying each day, so the death rate continues to climb. Our hospitals are operating in crisis mode, so there probably are excess deaths from the chaos. But we haven't run out of ventilators, and the medical system hasn't collapsed.

The actual death rate from covid is almost certainly higher than 0.1% and probably higher than 0.2% too.

Agreed.  NYC provides pretty clear lower bounds on the death rate for this virus.  It's a pretty clear refutation of <0.15% death rates or 50+ actual-to-dected case ratios.

There was a study out of Germany that attempted to look at true numbers of infected (by population-level sampling, not just testing of the symptomatic) that estimated the "real" death rate at around 0.4% IIRC.  Based on the NYC data I think that figure is probably pretty close to the mark(assuming you don't run out of medical capacity).

I guess the question is, how unique is NYC? Should we use their numbers to extrapolate what might happen elsewhere? Does an international travel hub with such dense population, and heavily used public transit represent the standard expectation for how this virus will spread? Or is it likely to be worse there than other places? If the data from studies in other places doesn't apply to NYC, does that make those studies wrong, or does it make NYC an exception? From a virus's perspective, huge dense cities like Wuhan, London and NYC seem like the ideal place to spread to me, and I wouldn't expect places with lower density, less public transit, etc to be as saturated by the virus. It may indeed spread in less populous areas, but I'd imagine the total rate of infection would be lower and slower simply because there are fewer hosts, and fewer shared/confined spaces.

Viking Thor

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Re: How long can we wait while flattening the curve?
« Reply #915 on: April 21, 2020, 07:30:10 PM »
We also don't know how many people were infected, other than its much higher than the reported case count.

I live in an NYC suburb and would not be surprised if anywhere from 10-50% of the area population has gotten COVID already. They have been telling people not to see a doctor or try to get tested unless they are so sick that they require hospital care. So the case counts are tip of the iceberg. There is of course a big difference between 10 and 50%.

There are already antibody testing studies in CA and other places that estimate infections 30x times higher than reported cases.

They need to do more serology testing and figure out the actual infection rate of the population. NY is starting one but the sample size they are doing seems a bit on the low side vs what would be optimal (3000 people that will be selected in a random/ statistically based manner).

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #916 on: April 21, 2020, 07:43:55 PM »

EDIT: By the way, what the Premier says changes day by day. Two weeks ago, stage 4 was looking likely:
https://www.theage.com.au/national/victoria/stage-four-lockdown-and-further-closures-remain-likely-andrews-warns-20200407-p54hys.html

Now that's not in the frame at all because the stage 3 response has been almost completely effective in wiping out transmissions. So I think it's clear that everyone needs to take a flexible and evidence-based approach to balancing the various interests involved.

The Victorian Premier has been the most "bearish" of all on this issue. For example, he shared "modelling" (really just an image of a curve with numbers drawn on it) which purported to show that had the restrictions not been put in place, 36,000 Victorians would have died. Proportional to population, that'd be worse than Italy or the US - it turns out this "model" consists of the multiplication "total population x virus mortality", which is one assuming that every single Victorian got infected, which couldn't happen unless we went around licking up each-other's sneezes.

He has as well along with the Queensland Premier slipped in firearm sales bans at the same time, claiming it was a decision of the National Cabinet - but it was just him and the other Labor Premier. Whether it's a good policy is neither here nor there, the point is that political leaders are using this crisis to further their own individual political agendas, it's not strictly about the medical advice etc. I'm sure the Liberal Premiers have slipped some of their own stuff in there, too.


Quote
So by 11 May our stage 3 lockdown will ease, and not before time.
11th May is where the current state of emergency ends. If not extended, then all restrictions will be lifted then. They won't want to lift all restrictions (it's not time to go to the MCG, that would be stupid) and so the state of emergency will be continued another 28 days. I think Andrews will keep Stage 3 going till he just politically can't, which would be June at the earliest. Possibly children will be allowed back to school for the last few weeks of the term, that'd be about the only change I could see him doing.

Lifting restrictions now or May 11th would be a tacit admission that Stage 3 and all the fines and so on were unnecessary.
« Last Edit: April 21, 2020, 07:45:38 PM by Kyle Schuant »

Abe

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Re: How long can we wait while flattening the curve?
« Reply #917 on: April 21, 2020, 07:55:01 PM »
Hey everyone, here's a heatmap I've made for your review.  I took the Johns Hopkins University (going to abbreviate it as JHU from now on) figures for COVID-19 deaths in each state, then determined the number of fatalities per day per million population from 4/1 until now. Let me know what you all think.

 

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #918 on: April 21, 2020, 07:58:54 PM »
Yes. Andrews has been incredibly bearish, because he's a good politician, and good politicians know that saving lives in the short-term will always win votes, whatever the economic damage in the long-term, as long as you can spin the narrative right.

It was Andrews who told Victorians that romantic partners who do not live together could not see each other (this advice was overridden by the chief medical officer).

It is Andrews who insists even now that non-essential travel in cars is forbidden despite there being no evidence that car travel does anything to either spread coronavirus or hamper coronavirus treatment (we have fewer than 30 patients statewide in hospital due to the virus so it's not like our hospitals are at capacity).

Yet, in an unprincipled move that exposed the shallowness of the car travel ban, Andrews did the convenient political backflip of allowing travel over the long weekend to holiday homes - which makes no sense.

He's politicising an issue which really is a medical + economic one.

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #919 on: April 21, 2020, 08:50:12 PM »
Yes. Andrews has been incredibly bearish, because he's a good politician, and good politicians know that saving lives in the short-term will always win votes, whatever the economic damage in the long-term, as long as you can spin the narrative right.
The next Victorian election is scheduled for late November 2022. This will be long enough for the virus crisis to be over, one way or another, but for the economic crisis to be strongly-felt. There'll be people who've been unemployed for more than two years. There'll be businesses who struggled through with the government handouts, but by then the handouts will have stopped, and they'll be closed. There'll be people who forget the lives saved, but remember the indignity of being harassed by police for everyday and (in disease-spreading terms) harmless activities.

You know that Dems video of Trump making stupid statements about how harmless the disease is as the death toll rises? If the opposition has any brains at all, they'll make one of Andrews making increasingly stupid statements about how many people are going to die and how restricted we have to be while the counter shows infections dropping, and the deaths counter barely moves. Perhaps one of him mocking people talking about golf, juxtaposed with people lining up for Centrelink. Not that the opposition has any brains at all, of course. Nor balls. But it's a nice thought. 

78 active cases today, 28 of whom are in hospital, thus 50 of whom in their homes self-isolating and infecting nobody outside their households; we don't know if it's 50 people in 50 single apartments, or 50 people in 10 different 5-person households. The federal CMO says we've got at least 84 and up to 92% of those actually infected, which means that 9 people are wandering around infected without symptoms and might unwittingly infect others.

frugalnacho

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Re: How long can we wait while flattening the curve?
« Reply #920 on: April 21, 2020, 10:52:30 PM »
Hey everyone, here's a heatmap I've made for your review.  I took the Johns Hopkins University (going to abbreviate it as JHU from now on) figures for COVID-19 deaths in each state, then determined the number of fatalities per day per million population from 4/1 until now. Let me know what you all think.

Did this thing go full walking dead and start raising people in Montana on 4/2?

dougules

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Re: How long can we wait while flattening the curve?
« Reply #921 on: April 21, 2020, 11:00:20 PM »
It's a completely false dichotomy to frame this as social distancing vs the economy.  If the virus is allowed to run rampant it will be quite bad for the economy, most likely worse than quarantines.  Nobody's going to go out to restaurants and movie theaters once they personally know people who have landed in a hospital too crowded to handle them.  Then do you think any countries that make sacrifices to control the virus are going to conduct trade freely with the countries that let it run rampant?

We will lose medical staff to the disease, and even if you don't care about their lives, it will exacerbate the ridiculous cost of healthcare in the US.  The death rate isn't the only story either.  Plenty of people will be left with disabilities from the lung scarring.  And then also there's the myth that the virus will go through the population and be done.  It is more likely that the pandemic would still come in multiple waves with each one wreaking economic havoc.  This is what happened in the 1918 pandemic, and the places that enforced more social distancing ended up better off economically in the long run.

If we buckle down now while putting everything we can into testing and tracing, the rest of us in the developed world might be able to make it to the place where South Korea and Taiwan are now with a decent amount of normalcy and almost nobody losing family members.  Both of those things also happen to be good for the economy.

Spud

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Re: How long can we wait while flattening the curve?
« Reply #922 on: April 22, 2020, 12:15:34 AM »
If we buckle down now while putting everything we can into testing and tracing, the rest of us in the developed world might be able to make it to the place where South Korea and Taiwan are now with a decent amount of normalcy and almost nobody losing family members.

Thing is testing is borderline useless without the tracing. Tracing requires way more infrastructure to be set up in terms of people making phone calls and coordinating things behind the scenes.

from the CDC website:

Quote
Key Concepts
* Trace and monitor contacts of infected people. Notify them of their exposure.
* Support the quarantine of contacts. Help ensure the safe, sustainable and effective quarantine of contacts to prevent additional transmission.
* Expand staffing resources. Contact tracing in the US will require that states, tribes, localities and territorial establish large cadres of contact tracers.
* Use digital tools. Adoption and evaluation of digital tools may expand reach and efficacy of contact tracers.

First point is that it takes a load of people to do. Is that being organised in America? I don't think it is being organised here in the UK.

Second point. It says support. People have to be WILLING to quarantine. Note that it doesn't says "imprison" or "enforce". It simply says support. For many people, "support" which basically means guidance, will be enough. For some people, they still won't get it and they will leave their home regardless of "support".

Third point is like the first point. You need an army of people to make this even remotely effective. Is someone coordinating this now in America? In at least some states?

Fourth point. This is about apps that people can have on their phones. I don't know what the apps do. I'm guessing they allow the contact tracers to communicate with the people in quarantine, but once again, are the apps being developed? Are they already being made available? Remember, an app won't force someone to stay in their home. They have to b willing to do so.

From a UK perspective, we have none of this. The government has set a stupid goal of performing 100,000 test per day by the end of April, and at the moment it's barely reaching 20,000 tests per day. The results take 2 to 4 days to come back and once they do, what then? We tell infected people to stay at home for 14 days and isolate and hope that they do it.

I'm not saying contact tracing is useless, people think it's something that automatically beats the virus. I think the countries where it has been effective are those that are organised, planned ahead of this pandemic i.e. were getting ready in January, and they are also those countries that have a national mindset that is compliant. People there are happy and willing to follow instructions. They are not rebellious. Germany, South Korea etc. Trying to implement this somewhere fractured, militant and disorganised like the US is a borderline impossible task. Same with the UK.

Unless the US and the UK are actively planning to set up all this infrastructure very soon, or are in the process of doing so right now, then all this talk about testing is nothing more than hot air, because without the tracing to support it, it's jut a bunch of random almost useless activity as far as I can make out.

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #923 on: April 22, 2020, 12:46:05 AM »
What Spud is saying is a good illustration of what I said earlier: if you put your measures in sooner you have more time and more options than if you put them in later. Australia, NZ and others locked things down - excessively, but we didn't know that then, though we do now even if we're ignoring it - early on, which bought us time to get testing and tracing happening, and build up the physical and human resources needed to deal with a larger spread of the disease. It may be a bit Hans Brinker, but it's better than shouting at a tsunami not to come inland.

Abe

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Re: How long can we wait while flattening the curve?
« Reply #924 on: April 22, 2020, 04:56:57 AM »
NYC seems to be on the downslope finally (both in new confirmed cases and deaths per day). NJ, PA and Connecticut are still going up with deaths per day, so the northeast will have to wait another 1-2 weeks to get this finally under control (if the others follow NY’s trajectory). They are all ramping up testing, so potentially can start reopening once it’s widely available (likely to happen here sooner than other parts of the country due to the testing infrastructure they’ve been forced to assemble).

Several retrospective studies have shown that hydroxychloroquine & azithromycin were not effective in treating the disease and had high rates of arrhythmia, so the NIH is now recommending against it. I think an RCT will be shut down soon also to focus on redesvimir. We are expecting some report on this soon since the RCT apparently finished recruiting over the weekend! (I am not involved in the trial).

Also, New York Presbyterian released their data as of April 14: https://www.medrxiv.org/content/10.1101/2020.04.15.20067157v1

1150 hospitalized, 257 went to ICU at some point (median 3 days after admission).
Of the 257, 122 were still being treated, leaving 135 with an outcome.
86 have died, 49 recovered out of ICU so presumably won’t die.
This gives a minimum of 7.5% hospital mortality and 33% ICU mortality. The majority did not have a major co-morbidity (though 63% had hypertension). 42% were under 60.
« Last Edit: April 22, 2020, 05:19:26 AM by Abe »

Kris

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Re: How long can we wait while flattening the curve?
« Reply #925 on: April 22, 2020, 06:13:46 AM »
Georgia is reopening gyms, among other businesses, this week. It will reopen theaters and dine-in restaurants early next week.

We'll know in ~3 weeks if this is a good idea or not.

https://www.worldometers.info/coronavirus/country/us/

Georgia covid deaths on 4/21 were 775 with at least a 5% increase today (4/22).

Here’s an interesting take on why the Governor of Georgia is reopening businesses.

https://heathercoxrichardson.substack.com/p/april-21-2020?token=eyJ1c2VyX2lkIjo4NDU4NTYzLCJwb3N0X2lkIjozOTYwNTAsIl8iOiJsWEZZRSIsImlhdCI6MTU4NzU1NzQyNiwiZXhwIjoxNTg3NTYxMDI2LCJpc3MiOiJwdWItMjA1MzMiLCJzdWIiOiJwb3N0LXJlYWN0aW9uIn0.P1LSs6KGiyFzm1xXb2Laeuq2qM2T6Aa7nMTCUn3Z00U&utm_source=substack&utm_medium=email&utm_content=share&action=share

OtherJen

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Re: How long can we wait while flattening the curve?
« Reply #926 on: April 22, 2020, 06:14:53 AM »
If we buckle down now while putting everything we can into testing and tracing, the rest of us in the developed world might be able to make it to the place where South Korea and Taiwan are now with a decent amount of normalcy and almost nobody losing family members.

Thing is testing is borderline useless without the tracing. Tracing requires way more infrastructure to be set up in terms of people making phone calls and coordinating things behind the scenes.

from the CDC website:

Quote
Key Concepts
* Trace and monitor contacts of infected people. Notify them of their exposure.
* Support the quarantine of contacts. Help ensure the safe, sustainable and effective quarantine of contacts to prevent additional transmission.
* Expand staffing resources. Contact tracing in the US will require that states, tribes, localities and territorial establish large cadres of contact tracers.
* Use digital tools. Adoption and evaluation of digital tools may expand reach and efficacy of contact tracers.

First point is that it takes a load of people to do. Is that being organised in America? I don't think it is being organised here in the UK.

Second point. It says support. People have to be WILLING to quarantine. Note that it doesn't says "imprison" or "enforce". It simply says support. For many people, "support" which basically means guidance, will be enough. For some people, they still won't get it and they will leave their home regardless of "support".

Third point is like the first point. You need an army of people to make this even remotely effective. Is someone coordinating this now in America? In at least some states?

Fourth point. This is about apps that people can have on their phones. I don't know what the apps do. I'm guessing they allow the contact tracers to communicate with the people in quarantine, but once again, are the apps being developed? Are they already being made available? Remember, an app won't force someone to stay in their home. They have to b willing to do so.

From a UK perspective, we have none of this. The government has set a stupid goal of performing 100,000 test per day by the end of April, and at the moment it's barely reaching 20,000 tests per day. The results take 2 to 4 days to come back and once they do, what then? We tell infected people to stay at home for 14 days and isolate and hope that they do it.

I'm not saying contact tracing is useless, people think it's something that automatically beats the virus. I think the countries where it has been effective are those that are organised, planned ahead of this pandemic i.e. were getting ready in January, and they are also those countries that have a national mindset that is compliant. People there are happy and willing to follow instructions. They are not rebellious. Germany, South Korea etc. Trying to implement this somewhere fractured, militant and disorganised like the US is a borderline impossible task. Same with the UK.

Unless the US and the UK are actively planning to set up all this infrastructure very soon, or are in the process of doing so right now, then all this talk about testing is nothing more than hot air, because without the tracing to support it, it's jut a bunch of random almost useless activity as far as I can make out.

So what do we do, then, if all available options are non-starters?

former player

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Re: How long can we wait while flattening the curve?
« Reply #927 on: April 22, 2020, 07:10:55 AM »
If we buckle down now while putting everything we can into testing and tracing, the rest of us in the developed world might be able to make it to the place where South Korea and Taiwan are now with a decent amount of normalcy and almost nobody losing family members.

Thing is testing is borderline useless without the tracing. Tracing requires way more infrastructure to be set up in terms of people making phone calls and coordinating things behind the scenes.

from the CDC website:

Quote
Key Concepts
* Trace and monitor contacts of infected people. Notify them of their exposure.
* Support the quarantine of contacts. Help ensure the safe, sustainable and effective quarantine of contacts to prevent additional transmission.
* Expand staffing resources. Contact tracing in the US will require that states, tribes, localities and territorial establish large cadres of contact tracers.
* Use digital tools. Adoption and evaluation of digital tools may expand reach and efficacy of contact tracers.

First point is that it takes a load of people to do. Is that being organised in America? I don't think it is being organised here in the UK.

Second point. It says support. People have to be WILLING to quarantine. Note that it doesn't says "imprison" or "enforce". It simply says support. For many people, "support" which basically means guidance, will be enough. For some people, they still won't get it and they will leave their home regardless of "support".

Third point is like the first point. You need an army of people to make this even remotely effective. Is someone coordinating this now in America? In at least some states?

Fourth point. This is about apps that people can have on their phones. I don't know what the apps do. I'm guessing they allow the contact tracers to communicate with the people in quarantine, but once again, are the apps being developed? Are they already being made available? Remember, an app won't force someone to stay in their home. They have to b willing to do so.

From a UK perspective, we have none of this. The government has set a stupid goal of performing 100,000 test per day by the end of April, and at the moment it's barely reaching 20,000 tests per day. The results take 2 to 4 days to come back and once they do, what then? We tell infected people to stay at home for 14 days and isolate and hope that they do it.

I'm not saying contact tracing is useless, people think it's something that automatically beats the virus. I think the countries where it has been effective are those that are organised, planned ahead of this pandemic i.e. were getting ready in January, and they are also those countries that have a national mindset that is compliant. People there are happy and willing to follow instructions. They are not rebellious. Germany, South Korea etc. Trying to implement this somewhere fractured, militant and disorganised like the US is a borderline impossible task. Same with the UK.

Unless the US and the UK are actively planning to set up all this infrastructure very soon, or are in the process of doing so right now, then all this talk about testing is nothing more than hot air, because without the tracing to support it, it's jut a bunch of random almost useless activity as far as I can make out.

So what do we do, then, if all available options are non-starters?
Carry on watching people die, of course.

OtherJen

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Re: How long can we wait while flattening the curve?
« Reply #928 on: April 22, 2020, 07:16:58 AM »
If we buckle down now while putting everything we can into testing and tracing, the rest of us in the developed world might be able to make it to the place where South Korea and Taiwan are now with a decent amount of normalcy and almost nobody losing family members.

Thing is testing is borderline useless without the tracing. Tracing requires way more infrastructure to be set up in terms of people making phone calls and coordinating things behind the scenes.

from the CDC website:

Quote
Key Concepts
* Trace and monitor contacts of infected people. Notify them of their exposure.
* Support the quarantine of contacts. Help ensure the safe, sustainable and effective quarantine of contacts to prevent additional transmission.
* Expand staffing resources. Contact tracing in the US will require that states, tribes, localities and territorial establish large cadres of contact tracers.
* Use digital tools. Adoption and evaluation of digital tools may expand reach and efficacy of contact tracers.

First point is that it takes a load of people to do. Is that being organised in America? I don't think it is being organised here in the UK.

Second point. It says support. People have to be WILLING to quarantine. Note that it doesn't says "imprison" or "enforce". It simply says support. For many people, "support" which basically means guidance, will be enough. For some people, they still won't get it and they will leave their home regardless of "support".

Third point is like the first point. You need an army of people to make this even remotely effective. Is someone coordinating this now in America? In at least some states?

Fourth point. This is about apps that people can have on their phones. I don't know what the apps do. I'm guessing they allow the contact tracers to communicate with the people in quarantine, but once again, are the apps being developed? Are they already being made available? Remember, an app won't force someone to stay in their home. They have to b willing to do so.

From a UK perspective, we have none of this. The government has set a stupid goal of performing 100,000 test per day by the end of April, and at the moment it's barely reaching 20,000 tests per day. The results take 2 to 4 days to come back and once they do, what then? We tell infected people to stay at home for 14 days and isolate and hope that they do it.

I'm not saying contact tracing is useless, people think it's something that automatically beats the virus. I think the countries where it has been effective are those that are organised, planned ahead of this pandemic i.e. were getting ready in January, and they are also those countries that have a national mindset that is compliant. People there are happy and willing to follow instructions. They are not rebellious. Germany, South Korea etc. Trying to implement this somewhere fractured, militant and disorganised like the US is a borderline impossible task. Same with the UK.

Unless the US and the UK are actively planning to set up all this infrastructure very soon, or are in the process of doing so right now, then all this talk about testing is nothing more than hot air, because without the tracing to support it, it's jut a bunch of random almost useless activity as far as I can make out.

So what do we do, then, if all available options are non-starters?
Carry on watching people die, of course.

Right. I live in a major hotspot (Wayne County, MI). Why bother trying to improve the situation if nothing has any hope of working?

ender

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Re: How long can we wait while flattening the curve?
« Reply #929 on: April 22, 2020, 07:27:46 AM »
I'm a little surprised the only options which seem to be considered are the extremes "fully quarantined" and "back to normal."

Maybe it's a case of the loudest voices always being on the extremes but it seems like there are a whole slew of options in the middle which are still very beneficial and less economically destructive.

Eventually, willing self isolation is going to stop. People will travel particularly as summer hits in the USA. There needs to be a pragmatic approach to this that isn't "everyone is quarantined until an undisclosed future time" or we're going to end up with martial law to enforce a quarantine or, just give up entirely.

There's a huge empathy gap on both sides of this equation. Which admittedly is par for the course in anything political, which this is becoming moreso by the week, but unless both "sides" are able to see and empathize with the concerns people advocating for full quarantine or a return to normal feel/experience, it's a guarantee societally we end up with a suboptimal outcome.

nereo

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Re: How long can we wait while flattening the curve?
« Reply #930 on: April 22, 2020, 07:41:00 AM »
I'm a little surprised the only options which seem to be considered are the extremes "fully quarantined" and "back to normal."

Maybe it's a case of the loudest voices always being on the extremes but it seems like there are a whole slew of options in the middle which are still very beneficial and less economically destructive.


While I agree with you in theory @ender, I'd argue that most places are already somewhere in between in the majority of places... and that's getting lost amid this discussion.

Speaking for my region, except for the biggest hot-spot people are able to come and go as they please, and many, many businesses are available for curb-side pickup and deliver, from restaurants to wine-and-cheese stores. After us educators were running around like headless chickens the schools have finally figured out what can (and can't) be done remotely, and so a truncated school year pushes on.  While the number of layoffs and furloughs have been massive, it's important to remember that ~80% of people continue to work.

Even our medical centers are back doing non-critical procedures and appointments, having shunted suspected Covid cases to a central testing/treatment area and leaving most other providers to see patients both in person and via webcam.

It's a far cry from "back to normal" but it's also miles away from "fully quarantined" like we've seen in areas of Wuhan, Italy, etc.

Davnasty

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Re: How long can we wait while flattening the curve?
« Reply #931 on: April 22, 2020, 07:50:27 AM »
I'm a little surprised the only options which seem to be considered are the extremes "fully quarantined" and "back to normal."

???

I can't recall a single post in this thread calling for either of those things.

Even if I missed it, they certainly aren't the only options being considered.

js82

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Re: How long can we wait while flattening the curve?
« Reply #932 on: April 22, 2020, 08:05:54 AM »

There's a huge empathy gap on both sides of this equation. Which admittedly is par for the course in anything political, which this is becoming moreso by the week, but unless both "sides" are able to see and empathize with the concerns people advocating for full quarantine or a return to normal feel/experience, it's a guarantee societally we end up with a suboptimal outcome.

100% agreed.

This sucks in a multitude of different ways for different people, depending on the particulars of their life.  For some it's their health(or a loved one's health).  For others it's their financial situation/job security.  For still others it's the mess that comes with trying to be a full-time employee and teacher all at once.  For others it's navigating the psychological space of isolation/loneliness.  All of these are difficult/painful in their own ways.

Everyone is struggling with this in different ways, and there is no perfect outcome.  Everyone's pain from this situation is real.   We can acknowledge the realness of one struggle without denying the validity of another.  This whole thing should be a lesson in collective empathy rather than "My struggle is more real than yours."

Spud

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Re: How long can we wait while flattening the curve?
« Reply #933 on: April 22, 2020, 08:31:13 AM »
So what do we do, then, if all available options are non-starters?
Carry on watching people die, of course.
Right. I live in a major hotspot (Wayne County, MI). Why bother trying to improve the situation if nothing has any hope of working?

In the US? You try as best you can to implement those measures at the State level immediately. Starting today.

The point I was attempting to make (perhaps badly) is that the ease of implementing these measures and the subsequent effectiveness of them is almost, not entirely, almost reliant on getting operational as preemptively as possible.

I was reading about Austria this morning and their approach to testing, tracing etc. Everything I read sounded incredibly well planned, coordinated and executed. It was done in such a way that the virus never really got a chance to take hold. They got out ahead of the virus and they've done a great job of beating it. They're probably going to be close to world leading in easing the lockdown and getting back to whatever normal is.

Check out the graph on this page of Active Cases. The curve isn't flat, it's bent downward.

https://www.worldometers.info/coronavirus/country/austria/

For the US and the UK, I believe that we should still attempt to do these things, because, as you rightly point out, we don't really have any other options but when it seems more time consuming, difficult and perhaps ineffective, we need to remember that it's only because the US and UK were too damn slow in all areas of "pandemic response". Simple as that.

The likes of Austria, Germany, South Korea etc, they're not magically better. It's what Kyle was saying earlier in the thread. It's about the timing of implementing these measures. We're effectively closing the barn door after the horse has already bolted.

Every day that goes by where someone isn't attempting to setup a state wide tracing effort is another day where it gets exponentially harder to do so. It's really difficult to make up the lost ground, it doesn't mean we shouldn't try.



Spud

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Re: How long can we wait while flattening the curve?
« Reply #934 on: April 22, 2020, 08:43:06 AM »
I've just read that the UK National Health Service is developing an app for contact tracing. No mention of when it will be up and running, but it is, allegedly, on the way. On one hand it's Good news. On the other hand it's too little, too late.


fattest_foot

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Re: How long can we wait while flattening the curve?
« Reply #935 on: April 22, 2020, 08:50:22 AM »
Luckily it seems that in Georgia and South Carolina, a lot of businesses that are high risk have elected to stay closed despite the governors’ guidelines on reopening. They basically said they’re going to talk with scientists and health professionals, then decide.

This’ll really raise the question of liability (in the social/ethical, not legal sense) since some businesses are reopening and some are not, even in the same field.

I mean, isn't this how it should be? Businesses and individuals decide whether the risk is worth it, not the government mandating it.

In before someone says we can't trust anyone else. May as well live in fear the rest of your life.

nereo

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Re: How long can we wait while flattening the curve?
« Reply #936 on: April 22, 2020, 09:12:48 AM »
I've just read that the UK National Health Service is developing an app for contact tracing. No mention of when it will be up and running, but it is, allegedly, on the way. On one hand it's Good news. On the other hand it's too little, too late.

I mean... it would have been fantastic had we had robust contact tracing two months ago.
But... this isn't over.  Our CDC is already warning about the potential for a huge wave next fall/winter.  Perhaps more importantly, this won't be the only infectious disease we face. Contact tracing will be critical for the next wave, and the next disease.

bacchi

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Re: How long can we wait while flattening the curve?
« Reply #937 on: April 22, 2020, 09:51:23 AM »
Georgia is reopening gyms, among other businesses, this week. It will reopen theaters and dine-in restaurants early next week.

We'll know in ~3 weeks if this is a good idea or not.

https://www.worldometers.info/coronavirus/country/us/

Georgia covid deaths on 4/21 were 775 with at least a 5% increase today (4/22).

Here’s an interesting take on why the Governor of Georgia is reopening businesses.

https://heathercoxrichardson.substack.com/p/april-21-2020?token=eyJ1c2VyX2lkIjo4NDU4NTYzLCJwb3N0X2lkIjozOTYwNTAsIl8iOiJsWEZZRSIsImlhdCI6MTU4NzU1NzQyNiwiZXhwIjoxNTg3NTYxMDI2LCJpc3MiOiJwdWItMjA1MzMiLCJzdWIiOiJwb3N0LXJlYWN0aW9uIn0.P1LSs6KGiyFzm1xXb2Laeuq2qM2T6Aa7nMTCUn3Z00U&utm_source=substack&utm_medium=email&utm_content=share&action=share

No surprise there. Florida may be in the same situation.

ReadySetMillionaire

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Re: How long can we wait while flattening the curve?
« Reply #938 on: April 22, 2020, 10:00:55 AM »
Georgia is reopening gyms, among other businesses, this week. It will reopen theaters and dine-in restaurants early next week.

We'll know in ~3 weeks if this is a good idea or not.

https://www.worldometers.info/coronavirus/country/us/

Georgia covid deaths on 4/21 were 775 with at least a 5% increase today (4/22).

Here’s an interesting take on why the Governor of Georgia is reopening businesses.

https://heathercoxrichardson.substack.com/p/april-21-2020?token=eyJ1c2VyX2lkIjo4NDU4NTYzLCJwb3N0X2lkIjozOTYwNTAsIl8iOiJsWEZZRSIsImlhdCI6MTU4NzU1NzQyNiwiZXhwIjoxNTg3NTYxMDI2LCJpc3MiOiJwdWItMjA1MzMiLCJzdWIiOiJwb3N0LXJlYWN0aW9uIn0.P1LSs6KGiyFzm1xXb2Laeuq2qM2T6Aa7nMTCUn3Z00U&utm_source=substack&utm_medium=email&utm_content=share&action=share

No surprise there. Florida may be in the same situation.

This is the economic reality for a lot of states.

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #939 on: April 22, 2020, 10:04:12 AM »
Imperial College London and Neil Ferguson are probably the main driver of current policy in the UK and the US.  He was the one that predicted literally millions of deaths (his predictions have since been discredited).

Apparently, he has made wildly inaccurate predictions before, many a time.

https://www.spectator.co.uk/article/six-questions-that-neil-ferguson-should-be-asked/amp

dandarc

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Re: How long can we wait while flattening the curve?
« Reply #940 on: April 22, 2020, 10:12:21 AM »
In case anyone is wondering, key line from the article:

Quote
“It’s about making sure people can’t file unemployment,” he wrote.

bacchi

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Re: How long can we wait while flattening the curve?
« Reply #941 on: April 22, 2020, 10:19:42 AM »
Georgia is reopening gyms, among other businesses, this week. It will reopen theaters and dine-in restaurants early next week.

We'll know in ~3 weeks if this is a good idea or not.

https://www.worldometers.info/coronavirus/country/us/

Georgia covid deaths on 4/21 were 775 with at least a 5% increase today (4/22).

Here’s an interesting take on why the Governor of Georgia is reopening businesses.

https://heathercoxrichardson.substack.com/p/april-21-2020?token=eyJ1c2VyX2lkIjo4NDU4NTYzLCJwb3N0X2lkIjozOTYwNTAsIl8iOiJsWEZZRSIsImlhdCI6MTU4NzU1NzQyNiwiZXhwIjoxNTg3NTYxMDI2LCJpc3MiOiJwdWItMjA1MzMiLCJzdWIiOiJwb3N0LXJlYWN0aW9uIn0.P1LSs6KGiyFzm1xXb2Laeuq2qM2T6Aa7nMTCUn3Z00U&utm_source=substack&utm_medium=email&utm_content=share&action=share

No surprise there. Florida may be in the same situation.

This is the economic reality for a lot of states.

Eventually, all of them. But Florida and Georgia (and probably Kansas) starved their unemployment funds for business tax cuts.

In Mustachian terms, that would be like keeping only a 1 month emergency fund because, hey, you haven't used it for 5 years -- why would you need more than that?


cerat0n1a

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Re: How long can we wait while flattening the curve?
« Reply #942 on: April 22, 2020, 10:27:52 AM »
Imperial College London and Neil Ferguson are probably the main driver of current policy in the UK and the US.  He was the one that predicted literally millions of deaths (his predictions have since been discredited).

Apparently, he has made wildly inaccurate predictions before, many a time.

https://www.spectator.co.uk/article/six-questions-that-neil-ferguson-should-be-asked/amp

I'd treat pretty much anything I read in the spectator as being the exact opposite of the truth.

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #943 on: April 22, 2020, 10:31:37 AM »
Imperial College London and Neil Ferguson are probably the main driver of current policy in the UK and the US.  He was the one that predicted literally millions of deaths (his predictions have since been discredited).

Apparently, he has made wildly inaccurate predictions before, many a time.

https://www.spectator.co.uk/article/six-questions-that-neil-ferguson-should-be-asked/amp

I'd treat pretty much anything I read in the spectator as being the exact opposite of the truth.

Thank you.  It is increasingly apparent that policy response is based not on science but political ideology. 

Unfortunately for functioning society, the left rather destroy the economy than deal rationally with cognitive dissonance. 

bacchi

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Re: How long can we wait while flattening the curve?
« Reply #944 on: April 22, 2020, 10:33:28 AM »
Imperial College London and Neil Ferguson are probably the main driver of current policy in the UK and the US.  He was the one that predicted literally millions of deaths (his predictions have since been discredited).

Apparently, he has made wildly inaccurate predictions before, many a time.

https://www.spectator.co.uk/article/six-questions-that-neil-ferguson-should-be-asked/amp

I'd treat pretty much anything I read in the spectator as being the exact opposite of the truth.

+1

They're still skeptical of climate change. Lol.

cerat0n1a

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Re: How long can we wait while flattening the curve?
« Reply #945 on: April 22, 2020, 10:35:47 AM »
Thank you.  It is increasingly apparent that policy response is based not on science but political ideology. 

A few seconds on google would show you that the spectator article is every bit as truthful as the rest of their output.

nereo

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Re: How long can we wait while flattening the curve?
« Reply #946 on: April 22, 2020, 10:36:17 AM »

Unfortunately for functioning society, the left rather destroy the economy than deal rationally with cognitive dissonance.


What makes you believe the left would prefer to destroy the economy?

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Re: How long can we wait while flattening the curve?
« Reply #947 on: April 22, 2020, 10:38:15 AM »
News in scare quotes. Attributing a phantom unavailability of case data to political reasons...

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Re: How long can we wait while flattening the curve?
« Reply #949 on: April 22, 2020, 12:23:49 PM »
It appears that some posters here just want an echo chamber.  We're already seeing the dismissing and passive aggressive personal attacks.  That's sad.

I've been on the fence since the start.

I do like Paper Chaser's recent posts which start making one think about the additional second or third order effects of this lockdown.

It adds even more complication to the already complicated direct effects.

I am curious how pro-conservative folks think we should proceed, and what do we do in a few Plan B's so to speak.

1.  Wait for a Vaccine.  How long is acceptable to wait? What if there is never an effective vaccine or it takes even longer than currently anticipated?
2.  Employ an antibody 'Passport'.  But what about those that don't have the antibody?  What % is OK to be forced to isolate?  Would they have to wait for a vaccine to get a 'passport'?
3.  Wait for a good treatment.  What defines good?  What % must the treatment be effective for? 
4.  Close borders.  Initiate harsh lockdowns again as needed when the eventual virus carrier slips though.  Does this work at a state level?
4.  Other? Wait for herd immunity which (according to this forum) takes anywhere from <1 year to generations. 
5.  Do we repeat stringent lockdowns on second, third, etc waves?  Do we think there will be no more waves?

It seems like the only real option is to wait for a vaccine and/or good treatment. 

There is another option:  Exercise social distancing until the peak has passed.  That way you don't overwhelm the medical system as we saw in Italy and other countries.  Then slowly open up the country in concert with an aggressive testing and contact tracing regimen.  When a positive case is detected, you can isolate just those people and their contacts, instead of keeping the whole country closed.   This will require at least triple if not 20 times our current testing capacity, and several hundred thousand workers. 

Hiring 200,000 thousand contact tracers is a big order, but we hire at least that many for the Census.   Can be done, plus it would a badly needed temporary jobs program.  Same with testing.  Need a lot of equipment and people, but South Korea did it.  Therefore it is possible. 

Unfortunately, our federal government is lead by incompetent buffoons.  We're buying ventilators from General Motors which will be delivered long after they were needed.  We should have ordered testing equipment.  Our president has stated several times there will be no federal testing program, leaving it up to the states.  But the states don't have budgets to ramp up programs like this.  So there won't be a big testing program.

Here's the problem as it relates to this thread:  It doesn't matter what the government orders people to do at this point.  Huge swaths of the economy are shut down and they are going to stay shut down until people feel safe to venture out.  Because our leaders don't want to do the thing that will make people feel safe, our economy will stay in the crapper for a long time.