Which is worse, another month of stay at home or going back to work May 4th

[EscapeVelocity2020]

So here we are folks, politicians are proclaiming that we are risking an even worse calamity by keeping up the social distancing due to the dire consequences on the economy.  I'm not callous to that argument, 16M+ have lost their jobs already and I'm in oil and gas where everybody's losing their white collar job and abandoning the industry.  We desperately need the economy to re-open with people on planes and in cars!  But on the other hand, it seems irresponsible to risk increasing loss of life while the coronavirus is not under control and there is no treatment for Covid-19. 

I have no idea how I'd vote in this poll myself just yet, but I'm tired of hearing talking heads and online news about it.  I'm much more interested to hear where the Mustachian community falls on this one!  I'm only keeping the poll open for 14 days and a single vote since this is a time sensitive and necessarily decisive decision (one Trump has called 'The biggest of his Presidency').  Shoot, everything is happening too quickly and without much opportunity to second guess these days, so this is the way the poll needs to be.

[js82]

I think the assumptions that:

1) There are only two states for the economy, "open", and "closed", and
2) That this change of states will happen everywhere at the same time

Are flat-out incorrect.

That said, there are 3 macro-level outcomes:

1a. Relax too much too soon - potentially the worst-case scenario: infections spike, we overwhelm hospitals, people freak out, AND we end up re-closing things on top of that(or things stay closed because people are scared to go out in public)
1b. 1a minus the panic: many, many more deaths, but the most aggressive economic economy
2. Keep too much closed too long - excess economic damage, businesses collapse, and it ripples due to loans imploding, etc.
3. Some sort of middle road, which involves reopening what we think can, where we think we can safely do so based on the situation on the ground.  This requires federal/state governments in supporting roles, developing guidelines, providing resources, and local governments executing.  The premise here is that not all businesses have an equal transmission risk vs. economic benefit tradeoff during a pandemic, and the needs of communities may be different based on certain risk factors(density, public transportation, etc.)

The basic premise behind #3 is that cramming a bunch of people into small spaces during a pandemic is a pretty terrible idea, but there are also a lot of businesses where that's not an issue, or can be mitigated significantly through changes to the way they operate - and that can get us started on a better trajectory.

[ysette9]

To me it seems that a middle ground would be to try to open up partially in such a way that keeps the hospitalizations in a given state/region within the medical capacity for that area. Naturally that would be complicated to figure out and would likely require adjustment along the way.

I’m curious about this on a personal level. If daycare opened tomorrow, would we send our kids, knowing there was a greater chance of them bringing covid home with them? If schools opened, would we keep her home? In an ideal state the shelter-in-place would be lifted when the danger has passed, but in reality the danger will probably increase when the SIP is lifted because it is being lifted. So all of us are going to be making these decisions for ourselves. Keep masks on? Continue to social distance where able? Reduce outings as much as possible for X months after opening up?

I’m just not sure myself. I’m glad I live in a responsible state with coherent leaders making fact-based decisions, because it takes some of this burden off me as I feel I can trust the voices of authority here. It would be much more challenging if you lived in a place like FL with a proven record of having leaders who care more about political toadying than evidence-based decision making for the common good.

[Fish Sweet]

Looking at the graphs of infected/dying for the US (where I'm located), it looks like we're still in for some more exciting exponential growth. Barring a sudden drop in infected individuals or a miracle vaccine being introduced in two weeks, I don't see what could possibly happen before May 4th that would make it a good idea to ~reopen the country~ as certain political figures would like.  If I had faith in federal leadership to conduct a controlled, slow reopening of businesses with guidelines (based on recommendations from a basis in science) in place to minimize risk, perhaps I would feel differently.  But considering that we have political leaders LITERALLY talking about how grandparents should happily sacrifice themselves for their grandchildren's financial betterment, I only expect the federal government to prioritize maximizing the amount of money that can be squeezed out of the economy and projecting a facade of 'everything is okay, look, we didn't completely mismanage this pandemic.'

That said my state, IMO, is handling COVID... pretty well, all things considered.  From my limited experience, I also feel like my friends/family/people in my city are taking 'safer at home' and social distancing pretty seriously. I would put more faith in a statewide initiative and directives to reopen in a controlled manner, just like I have some faith in my neighbors and friends to act courteously and carefully to take care of their own health/minimize unnecessary contact with other people.  That said, May 4th seems a bit too soon when the numbers are still only growing.

[former player]

It should be possible for some work activities to open up with minimal risk.  I have in mind people who work outdoors (other than farmers, of course, who have continued regardless).  No reason my tree surgeon neighbour shouldn't be working as long as he has a proper social distancing plan in place (he is still doing emergency work in any case).  Gardeners the same.  Fishing is trickier unless everyone on the boat is treated as part of the same "family" or self-isolates for a certain period before getting on the boat.  Construction workers working on the outside of buildings (roofers, for instance) should be able to work with an appropriate self-distancing plan although not those on the inside.  It should be a requirement that anyone who does go outside the home to work has an appropriate self-distancing plan already worked out, has appropriate protective equipment, and keeps a record of all contacts to enable tracing should they catch the virus.

[mwulff]

I'm in oil and gas where everybody's losing their white collar job and abandoning the industry.  We desperately need the economy to re-open with people on planes and in cars!  But on the other hand, it seems irresponsible to risk increasing loss of life while the corona-virus is not under control and there is no treatment for Covid-19. 

Actually we need people out of their cars and planes. We need to stop using oil. Right now. The Corona-virus at least shows us a world where meetings can be conducted in virtual, telecommuting can work.

So I expect people to commute and travel way less when this is over in 12-36 months.

That being said I am also in favor of slowly opening society over an extended period of time. But with the opening comes the risk of shutting it down again if the spread of the virus starts to increase again.

So in my completely uninformed opinion we need to figure out a way to flexibly open and close parts of society based on geography, hospitalbeds, infection rate, travel and so on going forward.

There is harm done with just closing society willy nilly and there is also a lot of harm done if you do nothing.

[Cranky]

I can't see myself being comfortable going out until there is a vaccine, or somehow no cases circulating, so "opening the economy" will not cause me to travel or go to the movies.

I'd like to go to the dentist (my regular appointment was cancelled) and get my hair cut, but not for a while.

[Sibley]

Without a vaccine, there really isn't a way to fully stop the virus. Actions taken or not taken will merely impact the speed with which it goes through the population. So, at least until we have a virus, the best option is to slow it down enough that medical systems can cope. If 100% of the population were to get infected, and 1% of that population were to die, then that won't change whether they get sick now or 6 months from now. The goal really should be to prevent it from being a 5% death rate because the hospitals collapsed.

People don't like this and the emotions take over and then they get mad. Which, I get. But you can't change the underlying facts - that individual X, if infected, WILL die, and individual Y will get very sick but with support will recover. Of course, we don't know this ahead of time, if we did then we could act accordingly. The problem comes in when you start assigning names to individuals.

Thus, without a vaccine, all we're doing is playing for time. Once we have an effective vaccine, that changes things.

[Jack0Life]

I think we can be somewhat normal until a vaccine is developed.
Look at cities like Tokyo, Taipei, HK, Singapore. They are just as crowed as any city here(beside NY) and they manage just fine without a lock down.
I honestly think if everyone takes precaution in protecting themselves from spreading the virus, the infection rate will stay low. All the states need to mandate that everyone in public should have facial protective gears on.

[stoaX]

I think the assumptions that:

1) There are only two states for the economy, "open", and "closed", and
2) That this change of states will happen everywhere at the same time

Are flat-out incorrect.

That said, there are 3 macro-level outcomes:

1a. Relax too much too soon - potentially the worst-case scenario: infections spike, we overwhelm hospitals, people freak out, AND we end up re-closing things on top of that(or things stay closed because people are scared to go out in public)
1b. 1a minus the panic: many, many more deaths, but the most aggressive economic economy
2. Keep too much closed too long - excess economic damage, businesses collapse, and it ripples due to loans imploding, etc.
3. Some sort of middle road, which involves reopening what we think can, where we think we can safely do so based on the situation on the ground.  This requires federal/state governments in supporting roles, developing guidelines, providing resources, and local governments executing.  The premise here is that not all businesses have an equal transmission risk vs. economic benefit tradeoff during a pandemic, and the needs of communities may be different based on certain risk factors(density, public transportation, etc.)

The basic premise behind #3 is that cramming a bunch of people into small spaces during a pandemic is a pretty terrible idea, but there are also a lot of businesses where that's not an issue, or can be mitigated significantly through changes to the way they operate - and that can get us started on a better trajectory.

Well said.  I would add that one of the negative consequences of keeping things closed for too long is the deferral of medical care for conditions other than covid-19.  How many breast cancers will be detected later due to deferred mammograms?   How many conditions will worsen because of restricted access to medical care or because patients are hesitant to seek treatment. Will mounting financial difficulties keep people from seeking care?   Will it lead to more"deaths of despair"? 

Gradual openings with attention paid to local conditions sounds like the path forward.

[Sibley]

I think we can be somewhat normal until a vaccine is developed.
Look at cities like Tokyo, Taipei, HK, Singapore. They are just as crowed as any city here(beside NY) and they manage just fine without a lock down.
I honestly think if everyone takes precaution in protecting themselves from spreading the virus, the infection rate will stay low. All the states need to mandate that everyone in public should have facial protective gears on.

The masks help, but so does robust testing, contact tracing and quarantines for the infected.

[MrGreen]

On a tangentially related note, I read an article a while back that said, statistically, the outbreak in Wuhan may have inevitably saved more people from dying prematurely due to the reduction in air pollution (apparently that kills a lot of people there) than the Coronavirus took. While it's seems like China has underreported deaths due to the virus it is an interesting thought experiment.

I'm sure there are people who are under greater stress due to the lockdown, leading to heart attacks, etc. but how many fewer car accidents and the like are happening right now. I'm sure it has to be a very interesting thing for an economist/scientist to seriously study. I know I'd be fascinated.

[mancityfan]

As we have all been experiencing, the situation is still changing radically by the hour and day. The next phase in the following week or so will be an understanding by state and federal government that the population - large majority - is simply not comfortable going back to work until large scale testing is in place. Testing is imminently going to be the main focus across the board.

[former player]

Here is Angela Merkel with a clear explanation of the fine margins involved in controlling the spread of the virus -

https://twitter.com/i/status/1250563198081740800

[BikeFanatic]

As Sisley said we need testing then quarantine and contact tracing, if we have that then we can re open. 3 million tests isn’t going to cut it.

[2sk22]

My wife works in a pharmaceutical company and they are in the process of scrambling to create teams to start work on screening compounds for use against covid. They are planning to reopen some of their labs by early May. But this will not be a full reopening of their campus - they will be selectively recalling the workers that they need the most and ensuring that all common areas are disinfected periodically etc.

[Laserjet3051]

I work in a very large multinational drug/vaccine development company and we have been open and working throughout the whole pandemic. Laboratory operations, pre-pandemic utilized N95 and surgical masks as appropriate. We still do the same during the pandemic. Social distancing during lab ops is virtually impossible. Office workers are encouraged to wear masks and socially distance.

Since the outbreak company operations have been running reelatively smoothly and at least at our very large site, we have not had a single known covid19 case. So, on May 4, i will continue to go to work each day as i have all year, applying social distancing principles, and have confidence, but not certainty, that we will be safe and be able to function to meet our corporate goals. No reason that other companies cannot also follow our model moving forward.

[penguintroopers]

I'm sure there are people who are under greater stress due to the lockdown, leading to heart attacks, etc. but how many fewer car accidents and the like are happening right now. I'm sure it has to be a very interesting thing for an economist/scientist to seriously study. I know I'd be fascinated.

I've also seen how some people who would have previously potentially had their heart attack at work or another public place and potentially could have received help to save their life aren't going to have that same possibility if they live at home alone...

I agree with comments above that reopening will be gradual. I know for us that our previously small spending has even decreased, and that it would take a little while for us to even ramp back up to what we were doing before... and its a relatively small swing. I'm pretty sure there are others who have drastically cut out a ton from their normal spending, and will take much longer to pull it back up to normal.

As for travelling, you best believe Mr. Penguintroopers and I will be on a plane within a couple of months after a vaccine. I'm sure there are others like us who would be in the same boat.

[EscapeVelocity2020]

Here is Angela Merkel with a clear explanation of the fine margins involved in controlling the spread of the virus -

https://twitter.com/i/status/1250563198081740800

Merkel for US President!  Seriously, it is refreshing to hear a clear, consistent, and respectful definition of what has to happen and why in order to protect citizens.  For those who don't click the link - Merkel explains that one person infecting only one person (a transmission rate of 1), or less of course, is manageable and flattens the curve.  At 1.1 (that is, one in ten people infecting two people, the other 9 only infecting one), the curve begins to climb and the capacity of Germany's current healthcare system is reached in October.  At 1.2, the healthcare system is overwhelmed by July, and at 1.3, it is reached in June.  That is just how thin the margin of error is.

So yeah, I voted more deaths if we open the country May 4th, unless there is a vaccine (which there won't be, since you can't give healthy people a vaccine that hasn't been extensively vetted).  Even with the current situation, the US seems unable to flatten the curve, getting people traveling and interacting and back in offices in a little over 2 weeks seems like suicide, even with mitigation measures.  The economy is going to suffer in either situation, might as well buy ourselves some time and slow the spread as long as possible.

[2sk22]

Merkel for US President!  Seriously, it is refreshing to hear a clear, consistent, and respectful definition of what has to happen and why in order to protect citizens.  For those who don't click the link - Merkel explains that one person infecting only one person (a transmission rate of 1), or less of course, is manageable and flattens the curve.  At 1.1 (that is, one in ten people infecting two people, the other 9 only infecting one), the curve begins to climb and the capacity of Germany's current healthcare system is reached in October.  At 1.2, the healthcare system is overwhelmed by July, and at 1.3, it is reached in June.  That is just how thin the margin of error is.

What a clear exposition of the risks involved! I wish all world leaders could be so articulate.

[Clever Name]

Honestly, I think that "re-opening" too early will not just lead to more deaths from COVID, but also more deaths from the resulting economic collapse. The economic ramifications of allowing COVID to ravage the country unchecked would be far worse than what we're seeing now.

[LWYRUP]

I think it depends on the job.

I am a commercial real estate lawyer.  What I have learned is that I can do most of my job just as efficiently at home.  More efficiently if I invested in some tech improvements (my setup is good, but with a couple thousand more I could get a big fancy desk and new top of the line tech -- but not worth the investment because I'm salaried and it would be out of my own pocket).  There's really no point in reopening office work, it will just result in more heating and cooling bills in HQ and (for folks other than me, I walk) lots of traffic and carbon emissions.

But there are other jobs where being on-site is more important, and perhaps those could be opened in select locations and with appropriate safety equipment. 

[LWYRUP]

I work in a very large multinational drug/vaccine development company and we have been open and working throughout the whole pandemic. Laboratory operations, pre-pandemic utilized N95 and surgical masks as appropriate. We still do the same during the pandemic. Social distancing during lab ops is virtually impossible. Office workers are encouraged to wear masks and socially distance.

Since the outbreak company operations have been running reelatively smoothly and at least at our very large site, we have not had a single known covid19 case. So, on May 4, i will continue to go to work each day as i have all year, applying social distancing principles, and have confidence, but not certainty, that we will be safe and be able to function to meet our corporate goals. No reason that other companies cannot also follow our model moving forward.

I hope other companies don't pointlessly require office workers to come in when there's no clear indication there will be any greater efficiency. 

[JLE1990]

On a tangentially related note, I read an article a while back that said, statistically, the outbreak in Wuhan may have inevitably saved more people from dying prematurely due to the reduction in air pollution (apparently that kills a lot of people there) than the Coronavirus took. While it's seems like China has underreported deaths due to the virus it is an interesting thought experiment.

I'm sure there are people who are under greater stress due to the lockdown, leading to heart attacks, etc. but how many fewer car accidents and the like are happening right now. I'm sure it has to be a very interesting thing for an economist/scientist to seriously study. I know I'd be fascinated.

I think it is interesting in general. How many people are saved by the economy being shutdown. How many traffic accidents, workplace incidents, shootings gone bad etc.? There must be 4-5000 people who are still alive because of the shut down. Of course suicides and things like that are probably up as well.

[By the River]

Another thing to note in the future is the number of diseases that are not being found early because of missing medical appointments.  I've missed a regular appointment and hope nothing is wrong which may have been found.  I'm sure with millions of appointments missed, some symptoms are missed leading to earlier deaths. 

[Caroline PF]

Here in the US, multiple states appear to be past their peak in both new cases and deaths. It would make sense to start opening up in phases in those locations, to test how it goes. They would need good testing and contact tracing, and be ready to close down again if cases start rising again. Those of us who have not yet peaked can learn from them.

[Linea_Norway]

If the main reason for not keeping the country open is to prevent overflowing of the health care system, like Merkel explains, then I think they have a plan to let everyone get in toych with the virus, just not too many at the same time, to save the hospitals. But we also know that not everyone will survive the virus, even with adequate hospital care. Lots of people in risk groups might be better off not getting infected. For those, it would be trouble to open up the country. The alternative is waiting for a vaccin, if they at all manage to make a vaccin that will be functioning over time. In Norway, it looks that they are starting to open op schools for young children, so the group with low risk of getting sick and low risk of spreading. Maybe the idea is to make them immune, but I think the main idea is to protect children's right to go to school.

For us personally, we think DH had symptoms very soon after we were asked to stop shaking hands, about the time the shutdown was implemented. Now we are like 5 weeks further and we will that we aren't in a risk group anymore, neither getting infected or infecting others. It feels to me like we could start normalizing a bit more. But had I been in a risk group, I would have stayed at home all the time.

[Alternatepriorities]

I voted for other as from what I've read the Swedes have chosen the reasonable sustainable response and it seems to be working at least as well as countries that have gone to extremes. 

An example: https://medium.com/@jacobbergdahl_47336/im-from-sweden-our-strategy-for-covid-19-is-a-bit-different-aa52134b7790

If there are any Swedes here who would like to share their perspective I for one would love to hear it.

[mancityfan]

I think you may want to hold your beer on whether Sweden has a better approach. The picture will be clearer in a couple of months. Their "numbers" are significantly higher than their Scandinavian neighbors even at this stage.

[Davnasty]

I voted for other as from what I've read the Swedes have chosen the reasonable sustainable response and it seems to be working at least as well as countries that have gone to extremes. 

An example: https://medium.com/@jacobbergdahl_47336/im-from-sweden-our-strategy-for-covid-19-is-a-bit-different-aa52134b7790

If there are any Swedes here who would like to share their perspective I for one would love to hear it.

@lemanfan ?

[des999]

why not look at the work places that have stayed open (grocery stores and others) and see how they've managed.  I haven't seen any thing that said Kroger has added multitudes of active cases b/c they stayed open.

I am sure we can open some businesses and be smart about it, but I don't know, just playing devils advocate.  Maybe that is causing a huge spike, I've not read that.  Seems we are going a little overboard imo.

[use2betrix]

I work on some construction sites with hundreds of workers at each site, and there hasn’t been a single case yet. We keep in very very close contact throughout the day, especially at meetings, sharing bathrooms, tables, etc.

People have said that as soon as someone gets it, there’s a good chance the projects may get shut down.

They have taken a lot of precautions to protect people. Water is no longer in coolers out on the site (less people sticking their hands into the container). Another good one was that everyone used to sign in and out on a clip board at the project entrance each day. Now, the person designated with the clipboard signs everyone in and out so it’s not hundreds of hands on that pen/board.

I am going to work 4-5 days a week and working from home 1-2 days a week. It’s not the “staying at home” part that bugs me, I don’t need work for fulfillment and I’ve LOVED my separate sabbaticals. What I do need, however, is access to places like beaches, state parks, RV parks, camp sites, gyms, and restaurants. If I lost my job tomorrow the only reason I would care is because I would likely have to sit at home for a while. I would be ok getting laid off if we could hook up our camping trailer and hit the road for the next 6 months.

What also isn’t a huge help, is that we live in an apartment. It’s very nice and comfortable, but it’s not like we have a lot of maintenance/chores we’re behind on that we could also be doing during this time. My wife is already a stay-at-home-wife, so our living place is very well kept regardless.

[Buffaloski Boris]

I picked “other” of course. Some things that people aren’t talking about so much:

- Noncompliance. You can have all the stay a home orders you want. If people don’t comply you get the worst of both worlds; a wrecked economy and the pestilence just the same. That’s where I think we’re headed right now. So, probably best to get ahead of it. 

- We treat this as one curve affair. It probably isn’t. So we beat this down in summer just to see it come back in the fall. There is some good that comes with delay. It gives us time to build up capacity, make PPE, get closer to a vaccine or treatments.

-the vaccine. Lots of folks are working on it and there is an assumption that there will be one. I just note that there is no vaccine for any of the other corona viruses out there, so maybe we aren’t going to get one?

In sum, I think the shut downs are going away. And while I realize I’m painting a grim picture, I’m optimistic. There’s a reason why our species numbers over 8 billion. We can be pretty clever when focused on a problem. We figured out a way to deal with hepatitis C and AIDS. And there are some truly creative thinkers out there.

[Steeze]

We have a good handle on our hospital capacity now. I think we can start to open parts of the country that are less impacted, and selectively open some occupations like construction in more impacted areas. Allow more people to go out knowing they will get infected while keeping an eye on hospital usage. Maintain a margin of safety in hospital capacity, but increase usage from current levels until a critical mass of people are immune. Meanwhile we will need to implement antibody testing on a large scale to get even more people who are unknowingly immune back in public.

Waiting for a new drug or vaccine will just take way too long. We have to ramp up as much as possible so long as we have the hospital capacity. Of course keep restrictions and protections in place for vulnerable populations to prevent the bulk of the deaths.

[Bloop Bloop]

I don't think anyone's done the modelling of the economic cost (and lost life-hours) of a widespread depression versus the economic cost / lost life-hours of having more people die by slightly relaxing the lockdown. It would be an interesting exercise and, I suggest, a moral imperative for us to consider.

[former player]

I don't think anyone's done the modelling of the economic cost (and lost life-hours) of a widespread depression versus the economic cost / lost life-hours of having more people die by slightly relaxing the lockdown. It would be an interesting exercise and, I suggest, a moral imperative for us to consider.

Politicians who explicitly trade economic activity for human lives will find that their careers end pretty quickly.  Most of the people agitating for opening things up will slink back into the shadows if large scale death is the result.

For every problem there is an answer which is easy, quick and wrong.

[Bloop Bloop]

You're trading human lives regardless. The lockdown persists and the 10-20% of extra unemployed people will be facing months or years of lost quality of life. There will be suicides due to financial distress.

The problem is that people aren't rational enough to see that there's a price to pay for activity and inactivity. Economic depression could well cause more pain and lost life-hours than the virus.

There has to be a middle way approach taken. I suspect that's what the US is doing - Trump is trying to get the engine room fire stoked for a reason.

[former player]

There is a rational approach to be taken which is not either total lockdown or total opening but sadly whatever Trump is doing cannot be described as "rational".

There are obviously some jobs which don't count as essential but could be opened up with less risk of enabling spread if proper precautions (social distancing, protective equipment, changed working methods to limit contacts, screening employees and customers for youth and health - and providing alternative ways forward for those screened out) are taken.  It's going to take a bit of time to work through all the changes necessary for safety, though: a wild west charge into total openness will do no-one any good.  Plus it only applies to those societies whose health care resources are not maxed out and who have spare supplies of protective equipment for community use.

It will be interesting to see what happens to suicide figures in future years.  There is an argument to be made that financial hardship due to extraordinary outside forces will not create an uptick in suicides because it will be widely seen as a societal problem imposed from the outside and will not be internalised in a way that leads to suicide or creates any loss of social standing.

[penguintroopers]

why not look at the work places that have stayed open (grocery stores and others) and see how they've managed.  I haven't seen any thing that said Kroger has added multitudes of active cases b/c they stayed open.

Call me crazy, but places like grocery stores have a direct economic incentive to not be labeled as a hot spot right now. People are rational (irrational?) enough to say "XYZ Grocer had been in the news because they had two cases, so I'm instead going to ABC supermarket", and then multiply across the entire town's population to see everyone at ABC and hardly anyone at XYZ, possibly just making the situation worse.

And we have seen places that remained open still having issues. Amazon, public transit workers, and the aforementioned grocery stores.

[Schaefer Light]

I don't think anyone's done the modelling of the economic cost (and lost life-hours) of a widespread depression versus the economic cost / lost life-hours of having more people die by slightly relaxing the lockdown. It would be an interesting exercise and, I suggest, a moral imperative for us to consider.

Politicians who explicitly trade economic activity for human lives will find that their careers end pretty quickly.  Most of the people agitating for opening things up will slink back into the shadows if large scale death is the result.

For every problem there is an answer which is easy, quick and wrong.

No politician running for re-election would say this, but it seems like we could save some money on Social Security and Medicare if a lot of older people were to die from the Chinese virus.

[Buffaloski Boris]

You're trading human lives regardless. The lockdown persists and the 10-20% of extra unemployed people will be facing months or years of lost quality of life. There will be suicides due to financial distress.

The problem is that people aren't rational enough to see that there's a price to pay for activity and inactivity. Economic depression could well cause more pain and lost life-hours than the virus.

There has to be a middle way approach taken. I suspect that's what the US is doing - Trump is trying to get the engine room fire stoked for a reason.

You're right.  There are going to be people who die as a result of the economic depression.  Just not those we would immediately expect.  Look I am NO fan of globalization, but it has been the way of the world for the last 20-40 years.  When our economy sputters, people who relied on it outside the US will suffer the brunt of it.  They won't have jobs and will not be able to pay for luxuries like food. Starvation is going to be a real threat in some places. It's terrible especially given that we were so close to finally stamping it out.

I think that President Trump is noting the importance of the economic side of the equation. There is no easy tradeoff.  Not shutting down kills people.  Staying shut down also kills people.  His attempts to seek a balance may seem ham-fisted, but he isn't wrong for trying to do so.

[Channel-Z]

Given the light traffic over the last month, I'm not ready the whole lot of you to return to the office.

[lemanfan]

I voted for other as from what I've read the Swedes have chosen the reasonable sustainable response and it seems to be working at least as well as countries that have gone to extremes. 

An example: https://medium.com/@jacobbergdahl_47336/im-from-sweden-our-strategy-for-covid-19-is-a-bit-different-aa52134b7790

If there are any Swedes here who would like to share their perspective I for one would love to hear it.

@lemanfan ?

Whoops, didn't see the notification until now.

I'm not really sure about what the question was, but in general the Medium article sumarizes things quite well.

All countries are different, but do remember that Sweden is a quite rural country, if you'd place it on the US east cost, it would stretch from Miami to Washington DC- with 10 million people.  Most people are living in the southern third, with the emphasis on the bigger cities.   Stockholm is most dense and live 2 hours south of Stockholm withing some sort of commuting distance meaning that the Stockholm outbreak of the disease also have made my city one of the most affected.  My parents live another hour or so south of here, and in their whole region they have very few confirmed cases and almost no ICU cases at all. Most rural parts of Sweden have not yet been struck more than lightly.  Sparse living has its advantages.

For the cultural and political aspects it's also good to know that we actually don't really have the laws in place to easily impose curfews or internal travel restrictions.  That's why the authorities started with what they could do - revoking permits for e.g. concerts and other events, and threatening to revoce liquor licenses for bars and resturants that misbehave.   The rest of the measures are largely "recommendations" with social shaming as the main penalty.

As for the social acceptance of the "recommendations" - it has been taken seriously, and e.g. my parents and their neighbours do behave as they are told to do even though there are no known cases in their county.  It has been said that it takes about one week from the issuance of new recommendations until they are taken seriously by most people.

The two main problem areas have (to my knowledge) both been based in our capital of Stockholm - the first are the "well off" who brought the virus back from their ski vacations in Italy and Austria back in the beginning, and the second are some immigrant groups living very densly and not speaking Swedish - good information in the immigrant languages took way too long to fix. (we've gotten a net immigration of approx 1 million people the last few years, and far from all speak Swedish).

We've not yet exhausted our ICU capacity, and people in general among my friends take this seriously.  Including the economical aspects. 

Was that a answer to the right question?

[mathlete]

You're trading human lives regardless. The lockdown persists and the 10-20% of extra unemployed people will be facing months or years of lost quality of life. There will be suicides due to financial distress.

The problem is that people aren't rational enough to see that there's a price to pay for activity and inactivity. Economic depression could well cause more pain and lost life-hours than the virus.

There has to be a middle way approach taken. I suspect that's what the US is doing - Trump is trying to get the engine room fire stoked for a reason.

We have solutions for financial distress though. Especially in the US. We can print money. We can borrow at negative real interest. We can pass more stimulus. We don't yet have a vaccine or viable treatments for COVID.

This is a pretty easy choice to me.

If we can find evidence-based ways to open up safely, then I'm all for that too.

[ice_beard]

C-19 ICU RN chiming in...

I really think people should not even consider vaccines or some sort of miracle drug at this point.  This is not going to impact the current situation, at least in regards to re-opening our economy.  There won't be a drug or vaccine any time soon, so we need to focus on the other things we can actually do.  We need to very systematically and cautiously re-open businesses and very carefully track new cases.  We are not even close to being ready to do this because of the lack of testing capabilities.  I take care of patients who have tested positive and are hacking up a lung all day and I cannot be tested for either the illness itself or if I have antibodies circulating in my blood.   This is because testing capabilities are incredibly limited.  This has to be fixed and the public needs to feel confident in this ability (at least here, not sure about other areas) before anyone is going to start to feel comfortable going to any of the places they used to spend money. 

People have been really pretty good about SIP and social distancing where I live.  But I think it's really starting to wear on people.  You can see there is more traffic, people are getting out more so these measures are only going to last so long, even in the most compliant places. 

Other observations from the hospital....  our positive testing rates have fallen.  We have a lot of rule outs, but not a lot of positives.  The positives we are getting are almost all coming from long term care facilities and were already known positives.  These places are getting hit very hard and the hardship is going to continue there for some time.  I really feel terrible for these families as they cannot see their loved ones even when they are about to pass.

There is emerging evidence that people are avoiding the emergency department or hospital for fear of contracting C-19 or that they are too busy to take care of them.  The opposite is true.  Patients with respiratory symptoms are quickly isolated and cohorted (kept together) until they are determined to be positive or negative.  People are ignoring stroke symptoms, signs of serious infections, etc and showing up to the ED when it is too late for treatment (i.e. TPA for stroke patients, infections becoming septic, etc.)  This is bad.  It's not because the hospitals don't have the capacity, here they do, people are just scared.

I trust in my local and state government to do this correctly and I ask people to please follow your local advisories as the situation is different from place to place.  Most hospitals haven't been over-run and the goal is for that to not ever happen.  I'm prepared for a long slog through the summer of wearing lots of PPE and taking care of these patients at a steady pace.  I can deal with that.  I can't deal with not having enough staff or beds to deal with a huge influx, so please be smart about this.  Rational thoughts over emotions.     

[EscapeVelocity2020]

C-19 ICU RN chiming in...

I really think people should not even consider vaccines or some sort of miracle drug at this point.  This is not going to impact the current situation, at least in regards to re-opening our economy.  There won't be a drug or vaccine any time soon, so we need to focus on the other things we can actually do.  We need to very systematically and cautiously re-open businesses and very carefully track new cases.  We are not even close to being ready to do this because of the lack of testing capabilities.  I take care of patients who have tested positive and are hacking up a lung all day and I cannot be tested for either the illness itself or if I have antibodies circulating in my blood.   This is because testing capabilities are incredibly limited.  This has to be fixed and the public needs to feel confident in this ability (at least here, not sure about other areas) before anyone is going to start to feel comfortable going to any of the places they used to spend money. 

People have been really pretty good about SIP and social distancing where I live.  But I think it's really starting to wear on people.  You can see there is more traffic, people are getting out more so these measures are only going to last so long, even in the most compliant places. 

Other observations from the hospital....  our positive testing rates have fallen.  We have a lot of rule outs, but not a lot of positives.  The positives we are getting are almost all coming from long term care facilities and were already known positives.  These places are getting hit very hard and the hardship is going to continue there for some time.  I really feel terrible for these families as they cannot see their loved ones even when they are about to pass.

There is emerging evidence that people are avoiding the emergency department or hospital for fear of contracting C-19 or that they are too busy to take care of them.  The opposite is true.  Patients with respiratory symptoms are quickly isolated and cohorted (kept together) until they are determined to be positive or negative.  People are ignoring stroke symptoms, signs of serious infections, etc and showing up to the ED when it is too late for treatment (i.e. TPA for stroke patients, infections becoming septic, etc.)  This is bad.  It's not because the hospitals don't have the capacity, here they do, people are just scared.

I trust in my local and state government to do this correctly and I ask people to please follow your local advisories as the situation is different from place to place.  Most hospitals haven't been over-run and the goal is for that to not ever happen.  I'm prepared for a long slog through the summer of wearing lots of PPE and taking care of these patients at a steady pace.  I can deal with that.  I can't deal with not having enough staff or beds to deal with a huge influx, so please be smart about this.  Rational thoughts over emotions.   

@ice_beard soooooo..... how did you vote??? (if you are willing to share)

[ice_beard]

@ice_beard soooooo..... how did you vote??? (if you are willing to share)

Forgot about the poll!  I voted for the second one, more deaths.  Not sure how many but to think there won't be more is probably naive.  We just need to keep the disaster scenarios like Lombardy from happening.  A steady flow of cases as this thing works through the population is probably about the best case, realistic scenario.   

[EscapeVelocity2020]

@ice_beard soooooo..... how did you vote??? (if you are willing to share)

Forgot about the poll!  I voted for the second one, more deaths.  Not sure how many but to think there won't be more is probably naive.  We just need to keep the disaster scenarios like Lombardy from happening.  A steady flow of cases as this thing works through the population is probably about the best case, realistic scenario.   

Thanks for the follow-up

[Bloop Bloop]

You're trading human lives regardless. The lockdown persists and the 10-20% of extra unemployed people will be facing months or years of lost quality of life. There will be suicides due to financial distress.

The problem is that people aren't rational enough to see that there's a price to pay for activity and inactivity. Economic depression could well cause more pain and lost life-hours than the virus.

There has to be a middle way approach taken. I suspect that's what the US is doing - Trump is trying to get the engine room fire stoked for a reason.

We have solutions for financial distress though. Especially in the US. We can print money. We can borrow at negative real interest. We can pass more stimulus. We don't yet have a vaccine or viable treatments for COVID.

This is a pretty easy choice to me.

If we can find evidence-based ways to open up safely, then I'm all for that too.

The money is not going to solve all the financial distress. It will only pay for a part of the workers' wages and they will have to pick up the pieces later on. Many might be left unemployed and that has a terrible effect on mental health regardless of whether you are getting a dole supplement. All that stimulus-related debt also has to be repaid down the track.

There is a price to pay for everything; it's worthwhile thinking carefully about the price we're prepared to pay and the duration and severity of the lockdown that gives us the best overall outcome.

[Kyle Schuant]

Another thing to note in the future is the number of diseases that are not being found early because of missing medical appointments.  I've missed a regular appointment and hope nothing is wrong which may have been found.  I'm sure with millions of appointments missed, some symptoms are missed leading to earlier deaths. 

In New York and London, paramedics are now told not to bring cardiac patients in. They get two rounds of CPR, if there's no resumption of circulation, declare DOA. Those patients don't have a good long-term survival rate anyway (certainly not compared to what you see on TV, this article looks at the difference), and being in a hospital full of covid-19 patients will doom them anyway.

This article talks about how, as a result of the shutdown, globally there will likely be less deaths due to air pollution this year.

Looking at the US from the outside, from your huge number of deaths we can't tell you have a lockdown at all. one confounding factor for the US in weighing this up is that other countries have more effective social safety nets, and have put in place stronger ones after this lockdown started. The US's welfare response has been just as ineffective, piecemeal and inconsistent as its healthcare response. It's one thing to tell people to stay at home as then give them $1,100 or $1,500 a fortnight, as in Australia; it's another thing to tell people to stay at home and give them nothing, or just food stamps, as in significant chunks of the US.


If I were told to stay at home and starve I'd probably be marching in the streets with firearms, too.