Youth also doesn't want to deal with this disease. I'm 23 y.o., healthy as far as I know, but I still don't want to catch this disease. Why spend 2 weeks on the bed dealing with the worst flu, risk getting hospitalized? After all, even young patients can be hospitalized, even though fatality rate is lower. I vote everyone stay home for the time being.
To acquire immunity while there are still hospital beds available in some places, in the unlikely event that you need one. That won't be the case a month from now.
Is it really? I've heard there's some logic to this…
If instead, we all stay home and quarantine, the second we start reducing the quarantine the virus flares back up again. If instead, we start acquiring immunity in low-risk populations, at a rate that the hospitals can sustain, we'll have a degree of herd immunity and a portion of the population that can no longer spread it.
I'm certainly not an epidemiologist though; anyone smarter than me that can way in on that thinking?
> If instead, we start acquiring immunity in low-risk populations, at a rate that the hospitals can sustain, we'll have a degree of herd immunity and a portion of the population that can no longer spread it.
A fair portion of low-risk people will require intervention. Given that a lot more people are low than high risk, you're still overwhelming the health system, and all those low-risk people are still going to interact with others while they are asymptomatic but transmissible.
Delaying the pandemic buys time. Time is the most critically short resource.
Time means more ICUs, more ventilators. It means industrial capacity can shift from making consumer goods to medical supplies like masks. It means medical personnel get training and experience with the disease instead of shooting in the dark. It means labs and research teams can give more informed treatment advice.
It means small businesses and industries can try to reallocate resources and jobs and maybe save part of the economy. It means more time to educate the population to avoid high risk activities, wear masks, wash hands and so forth.
In every way it’s better if we delay the pandemic now that we know about it than if we just let it peak exponentially and kill the maximum number of people.
Studies show it wouldn't work if _everyone_ thought like that at the same time. But studies also show that you need to "pulse" the infection rate among low-risk populations in order to get past this in a controllable fashion by temporarily and partially lifting the restrictions on those people and letting them acquire immunity, while carefully isolating and supporting the high risk populations. The fundamental truth of the situation is: 60-70% will have to go through the wringer before this is over. "When", "which subset", and "how" will determine the fatality rate. One thing is absolutely clear: we _must_ completely isolate (and support) the elderly and those with severe pre-existing conditions. Large numbers of immune people could help with that. Complete shutdown of the economy (if such a thing were even possible) would condemn a lot of the vulnerable people to die, since they still need food and a lot of them also need medical care, which could become unavailable, like in Italy.
And if that wants to get organized I can see how that would work. "Get sick to beat the rush", however, is not that - it's an action where the only good outcome would be if only you do it, which I think is a definition of selfishness.
Thats fine, but as things are right now, we're short on beds in a few places, and are wasting beds everywhere else. Seems like a waste of the precious resources to me.
You do realize that any decision made today will reap benefits in more than a week, right? Those beds may no longer be wasted by the time you're ready to take advantage of them.
I'm a big fan of selfishness so I'll represent the 'that is just a bad idea' argument:
1) Such an individual would be contracting an unknown virus in an environment where hospital staff are the least prepared and practiced at dealing with it.
2) Such an individual is still exposing themselves to high risk of mistiming the outbreak and hitting it at the peak.
3) They might accidentally catch a different disease thinking it is COVID. Then if they got COVID they'd have 2 diseases; which is probably going to be quite bad.
If we all avoid getting COVID-19 for, say, another 2 months it is likely we'll have an available and effective drug for treating it. There are something like 5 different candidates I've heard of, so even if the odds of any individual one working out are <30% there is still a good chance there will be effective treatment by mid year. The contain, delay and avoid strategy really is a better bet.
> it is likely we'll have an available and effective drug for treating it
I don't believe this is likely at all. At best we will have something that kinda sorta works in some patients. If this was likely we'd have a drug for the common flu long time ago. To remind you, the flu takes about 50K lives in the US every year.
There are effective drugs for common flu strains; including a set of vaccines. And if the US manages to get COVID-19 related deaths down to 50k lives for 2020 that will be pretty peachy.
There won't be a vaccine this year. That's pretty clear. Vaccines take a long time to get tested under the best of circumstances. If not tested properly and administered to millions of people (which they'd have to be in order to have effect) they could cause a lot of adverse reactions and deaths all on their own. Don't take this as antivax bullshit: I do take a flu vaccine every year myself, including this year, my kid is fully vaccinated also (+ flu vaccine last year - I told him to "be a man"). It's just the nature of the beast - immune system can really fuck one up once it really gets going.
We're not even on the "couple of weeks" scale here. Unless we have a drug that can effectively treat coronavirus, we will have to shelter in place until a vaccine is available. 12-18 months.
When did we switch from 'flattening the curve' to 'trying to keep anyone from getting sick'? I thought we were mostly all going to get it this year, but we didn't want everyone getting it in a 1 month period?
Well, never, but we have 20 ventilators per 100k people, "flattening the curve" so strongly that we can treat everybody was always a bit of a pipe dream. You need to flatten the curve almost to zero to get to a "sustainable" level of disease. They are nearly the same goal. Any non-trivial level of disease that is not controlled will rapidly push you past the "flatten the curve" threshold. And we will certainly be here for longer than 2-3 weeks.
It is a little white lie that is important to tell the public to help build compliance, the lower you can push it the fewer people will die, but hospitals simply are going to be overloaded regardless. The choice we can make is one between "very overwhelmed" and "overwhelmed to the point of non-functionality".
"shelter for 12-18 months" is a little bit of an exaggeration but not much. Simulations suggest that after an initial harsh quarantine period (up to several months) to get transmission under control, we will need to shelter for about 2/3rds of the time (2 months on, 1 month off) for 12-18 months, and other measures for 100% of the time. The vaccine will be what finally terminates the situation. https://www.imperial.ac.uk/media/imperial-college/medicine/s...
Even then that may be optimistic (especially if the population is not fully compliant). Italy is not just working from home and social distancing, they are straight up quarantining everyone, and they still have overloaded hospitals and bodies piling up faster than they can cremate them. Presumably the quarantine will slow things down on the order of weeks to months, but right now things are brutal.
The Chinese strategy of requiring everyone to get a phone app, to track them via GPS, doing widespread testing and then quarantining the people who have been in contact appears to be a much more effective strategy than blind quarantine or social distancing. No app, no uber, no groceries, no public transit, etc. The US citizenry absolutely will not stand for the mark of the beast though.
The Korean thing about masks and gloves probably helps too. Too bad the hospitals are down to about 11 days of masks let alone for the citizenry.
I'm not trying to be a downer but if chloroquine works that's a really fucking big deal, because that would give us a fairly straightforward alternative to treat cases or even prophylactically treat vulnerable populations. Unless you have a tool in your toolbox we are mostly just moving the deck chairs here and choosing between "really bad" and "oh shit".
The Chinese have an app for this? Why aren't we using that?
I'd happily be tracked 24/7, and I'm sure so would many many others, if it meant reducing the spread and getting back to some sense of normalcy a bit quicker.
The other thing is that other countries like Iran and Israel are just pulling the data directly from Google Location Services or from telcom location data. I assume the US will probably follow at some point, since that data can be accessed without a warrant since it's third-party-controlled data.
It's unprecedented and I tend to agree with you that at some point the economic carnage is going to force alternatives, but right now that's the plan. Not the plan they're telling you publicly, but the real one they're planning for and reacting to.
At the end of the day if that's the plan you'll go along with it because the men with guns will make you.
As I've commented elsewhere, an approach using contact-tracing via app and GPS data, backed by widespread testing (millions per week) and small-scale isolation of affected, along the lines of China or South Korea, seems to be more effective.
The US population is going to hate hate hate that one. But it's that or stay inside except for going to the grocery store for the next 12-18 months.
If we don't choose option A, and we don't choose option B, we implicitly choose option C: 20% of our seniors die in a single year. Choosing not to choose is still making a choice. I believe there's a song about that.
The all-cause mortality rate in Europe has been dropping in the past few weeks and is now well below normal levels. To me this looks like people have been overdoing the whole stay indoors and avoid any sort of risky behavior.
Europe is not Italy. Europe has a different population age mix (younger), and broader Europe is not under the same quarantine measures as Italy either.
> "To avoid a rebound in transmission, these policies will need to be maintained until large stocks of
vaccine are available to immunise the population – which could be 18 months or more"
That sounds very much like a "worst-case", afaik German CureVac are right now in the stage of selecting the last 2 candidates for a vaccine, they expect first clinical trials around June/July, I'd be surprised if they are the only ones that far along.
That's not meant to say this will be over the instant we have a vaccine, but finding one is right now the big X factor that makes all estimates veer on the rather pessimistic side.
The recovering youth are getting breathing problems that aren't going away as well. It would be in their interest not to get it.
It's also resetting our global warming clock. Something youth were keen about getting the world to do. If they can't handle staying at home for an extended time then global warming might not be that important after all.
This isn't resetting the global warming clock. Atmospheric CO2 is still going up not down. It's a temporary and small reduction in CO2 output coupled with a much more severe and much longer term reduction in scientific output that might actually solve global warming, and a much longer term and much more severe economic recession that limits our options to (further) hurt the economy to switch to greener means of energy production.
Either shutting down all Chinese factories for a period of time reduced CO2. Or they made no difference and we can run those factories without fear.
Wouldn't a global recession/depression reduce production?
Increased funding for scientific output or more climate models isn't going to make a difference. People have to buy and use less. You can't have it both ways here either.
If we set the rate of increase of atmospheric CO2 to 0, a far greater reduction than actually occurred, we would be pausing the clock on global warming, which is a very far cry from resetting the clock. Yes, the emissions reduction helped, but not a fraction as much as you claimed.
> Increased funding for scientific output or more climate models isn't going to make a difference. People have to buy and use less. You can't have it both ways here either.
The science I'm most interested in isn't climate models. It's better solar panels, or better wind turbines, or better batteries, or better fission reactors, or (useful) fusion reactors, or space based solar shades, or ways to remove CO2 from the atmosphere, and so on.
People buying and using enough less unfortunately does not seem to be a realistic solution to the problem. People buying less might be able to delay us hitting disastrous amounts of warming by a few years, but that only buys us time for the above kinds of research.
Aren't virologists predicting that 60-70% are going to get it, no matter what? What is the "extended time" that you are talking about?
Close to half of COVID infections result not even in a cough. Going by the mostly elderly population on the Diamond Princess, mortality with proper treatment is going to be significantly lower than 1%. Flatten the curve? Sure, but we can't be locking down the entire country indefinitely.
The youth already begrudge the elderly, locking them down for months will make them wish they were dead. Remember how a year felt like an eternity when you were 16?
Also, most youth don't care about global warming either. They're just virtue signaling. It really isn't that important, if they understood what they would have to give up on to stop it, they would embrace it and look forward to spring break in North Dakota.
> Close to half of COVID infections result not even in a cough.
Possibly?
> Going by the mostly elderly population on the Diamond Princess, mortality with proper treatment is going to be significantly lower than 1%.
If we're all sick at once can we all get proper treatment?
We're all making assumptions and treating our ideas like they have to be true. We still don't actually know, we will only know in retrospective, and that's important to keep in mind. We can't know what's going to happen, and I think we need to be more cautious than optimistic. Where's the line between that an insanity? I don't know, but we can't act like we know the math, especially when we're getting equal and opposite information every day.
For a couple of weeks, fine. However on the other end of this spectrum is "Millions starve".
At some point we need to ask is that fair to the youth? (note: I'm an old fart)