Coronavirus

[DuckIII]

Many people are very convinced about the damage the virus will do, but seem blissfully unaware of the damage social distancing will do if we have to remain on this path for any length of time.

Exactly.

Neither of those things are even remotely true of people who are doing even a modest amount of open minded research into what we are facing medically and economically.

Every rational argument you will see in the short term will begin with a confession of ignorance for the long
term.

And I agree with you 100% that both must be taken into consideration when setting policy.

[whonka]

All I can say as a front line medical worker seeing the deluge, your tune will likely change once you or someone you know is struggling to breath with no ICU beds available. How about arguing economic impact at that time?

This post exactly why people in the medical field should be part of the policy discussion but not determining policy.

You only see what's in front of you, which are the patients suffering from the virus. But you have no awareness of the social and economic impact of whatever policy you are advocating. You don't even consider those things.

So let me ask you, what is the effect of millions of people losing their jobs in the next two months? What strains does that cause on society? How many people die as a result? What happens to rate of violent crime?

At what point do the negative consequences of nationwide shutdowns outweigh the benefits of flattening the curve?

Or let me put it like you did: will your tune change if a family member is murdered as a result of mass rioting? Or if a family member commits suicide because he lost his job and can't care for his family?

Fine. I’m done here. Most of my colleagues are medical doctors as well literally begging people on social media, news. We are losing the battle. Italy is wrong, China is wrong. Every single medical and epidemiological expert in all counties of the world are wrong. Let’s let the present course continue, let millions die as long as the economy is ok.

You save lives. Then mitigate the rest with whatever you can.

[Mech Engineer]

Exactly. And if you don’t buy that time now, you cannot do it later. It has to be early to have any positive effect. That’s just a scientific fact based on how diseases spread, not an opinion. Indeed, the likely scenario is that we already started much later than we should have.

So far all explanation for social distancing I read about is flattening the curve. To flatten the curve you need to do it for a super long time.

I do think there is value in getting more information, or mass producing ventilators, or making tons of make shift hospital beds, or figuring out ways to ramp up the number of sick we can care for at once.

It worked in China after about 6-8 weeks of very tight restrictions. Same in South Korea, along with aggressive testing and aggressive tracking down who infected people came in contact with.

Yup...there's proof it works even if we discount the news filtering out of China. We need discipline right now. And, in a month, the weather will be better and hopefully that will help a little bit positively. Plus, a cure might be found for a majority of cases with more data.

Testing for anyone who wants it can help a lot. I am pretty sure there's so much anxiety going on...it will help to have more test kits and also a test to check who has the antibodies for this.

[dougthonus]

It worked in China after about 6-8 weeks of very tight restrictions. Same in South Korea, along with aggressive testing and aggressive tracking down who infected people came in contact with.

Will be interesting to see if they see it spike back up once all restrictions are gone again. I agree that social distancing slows infection rate, but I don't see any reason why that rate would remain slow once you stop unless you have immunized your population in the mean time (or you have come up with procedures that just stop the spread that you can implement) or you are so effective cases dropped to zero.

[dougthonus]

Neither of those things are even remotely true of people who are doing even a modest amount of open minded research into what we are facing medically and economically.

Just FYI, I've not seen any article yet where someone weighed the cost of social distancing against life years expected to be saved to try and determine a value of what we're doing. Not saying there isn't one out there, but if you find one I'd love to see it, because I'd be very interested in any experts modeling those things against each other.

[DuckIII]

All I can say as a front line medical worker seeing the deluge, your tune will likely change once you or someone you know is struggling to breath with no ICU beds available. How about arguing economic impact at that time?

This post exactly why people in the medical field should be part of the policy discussion but not determining policy.

You only see what's in front of you, which are the patients suffering from the virus. But you have no awareness of the social and economic impact of whatever policy you are advocating. You don't even consider those things.

So let me ask you, what is the effect of millions of people losing their jobs in the next two months? What strains does that cause on society? How many people die as a result? What happens to rate of violent crime?

At what point do the negative consequences of nationwide shutdowns outweigh the benefits of flattening the curve?

Or let me put it like you did: will your tune change if a family member is murdered as a result of mass rioting? Or if a family member commits suicide because he lost his job and can't care for his family?

Fine. I’m done here. Most of my colleagues are medical doctors as well literally begging people on social media, news. We are losing the battle. Italy is wrong, China is wrong. Every single medical and epidemiological expert in all counties of the world are wrong. Let’s let the present course continue, let millions die as long as the economy is ok.

You save lives. Then mitigate the rest with whatever you can.

Far more people here are interested in your perspective than a random naysayer. Please do the board a service and keep sharing your views. Most of us care about your input I assure you.

[DuckIII]

Neither of those things are even remotely true of people who are doing even a modest amount of open minded research into what we are facing medically and economically.

Just FYI, I've not seen any article yet where someone weighed the cost of social distancing against life years expected to be saved to try and determine a value of what we're doing. Not saying there isn't one out there, but if you find one I'd love to see it, because I'd be very interested in any experts modeling those things against each other.

I doubt you’ll find too many people doing “life years” as opposed to “lives” analysis given that our society generally rejects economic models based on a sliding scale valuation of human life. Kind of a Mengele-smelling way of going about it.

[dougthonus]

I doubt you’ll find too many people doing “life years” as opposed to “lives” analysis given that our society generally rejects economic models based on a sliding scale valuation of human life. Kind of a Mengele-smelling way of going about it.

Quality life years makes a lot more sense as a measuring stick when the COVID specifically targets immunocompromised elderly people whom have a much lower number of quality life years remaining than the median person in the country.

I did a quick search and was unable to find anything that really looked reasonably modeled by other metrics. At best, you see people with my view that is more or less: "Maybe social distancing is a good idea, but maybe it isn't, and we should really measure this". I did find a couple talking about potential consequences.

IT's hard to model, much like the pandemic itself.

Some things like, even if we stop the "shelter in place" restriction, how long will it take to people to really go back to normal? People may remain conservative for a long time no matter what and preserve cash. This may keep unemployment at a high rate even when shelter in place order ends.

Also, it isn't all or nothing either, if we didn't do any social distancing, on their own, people would have started with much of this behavior, canceling gym memberships, trips, eating out, we magnified these impacts, but they would have existed either way.

In the end, I'm not claiming to know what to do or that what we're doing is wrong, just that I don't think it has been properly evaluated on the financial end and has only been evaluated on the medical end.

I'd be much more encouraged if I read something that said "with 2 months of social distancing, we'll be able to double capacity of how many people we can treat" or "with 2 months of social distancing, we feel we can stamp out the COVID virus all together" or "with 2 months of social distancing, we can put in place procedures that will permanently slow the spread".

[Nikola]

Exactly. And if you don’t buy that time now, you cannot do it later. It has to be early to have any positive effect. That’s just a scientific fact based on how diseases spread, not an opinion. Indeed, the likely scenario is that we already started much later than we should have.

So far all explanation for social distancing I read about is flattening the curve. To flatten the curve you need to do it for a super long time and the economic impact to flatten the curve is catastrophic.

I do think there is value in getting more information, or mass producing ventilators, or making tons of make shift hospital beds, or figuring out ways to ramp up the number of sick we can care for at once. If you find a good treatment method and mass produce that as well then that also has tons of value.

I'm not against social distancing per se, I just don't think you can do it for an extended period of time. I think anything more than 2 months will be catastrophic and even 2 months might be catastrophic. You have to gain something in those 2 months that is meaningful, because you won't flatten the curve in that time.

Because of the media people are reacting with such fear of the virus they are not thinking rationally about this at all. It's very scary to have politicians decide what business to keep open. As someone who works in supply chain I know for certain that they have no clue what type of disruptions they are causing.

Be careful, keep distance, take precaution, try to flatten the curve. But keep in mind that the economic loss and supply chain disruptions we are looking at will cost lives as well. Love/Fear.

[Dresden]

It worked in China after about 6-8 weeks of very tight restrictions. Same in South Korea, along with aggressive testing and aggressive tracking down who infected people came in contact with.

Will be interesting to see if they see it spike back up once all restrictions are gone again. I agree that social distancing slows infection rate, but I don't see any reason why that rate would remain slow once you stop unless you have immunized your population in the mean time (or you have come up with procedures that just stop the spread that you can implement) or you are so effective cases dropped to zero.

A) During the shelter in place period, people need to be educated on how to take precautions when the order is lifted. A lot of infections can be prevented with some common sense and not that difficult practices, that won't necessarily stop businesses from operating. Limit large gatherings, frequent sanitizing, etc. I would bet infection rates could be cut down by 50% at least, just by following some of these simple precautions.

B) Extensive testing must also be done- which we are not doing- so that infected people can be self quarantined. And ideally, tracking of anyone in contact with an infected person. This is what So. Korea has done so effectively. But if it's not done early, then it becomes almost impossible to track down and isolate all individuals who had contact with someone infected. It might be too late for this in the USA. Almost assuredly is.

[DuckIII]

I doubt you’ll find too many people doing “life years” as opposed to “lives” analysis given that our society generally rejects economic models based on a sliding scale valuation of human life. Kind of a Mengele-smelling way of going about it.

Quality life years makes a lot more sense as a measuring stick when the COVID specifically targets immunocompromised elderly people whom have a much lower number of quality life years remaining than the median person in the country.

This is very Orwellian and I reject it outright as a basis for a policy discussion regardless of its medical accuracy.

We can also tremendously improve the economy and societal health by mandating that those with low life expectancies but healthy organs can be euthanized and harvested for the greater good.

A recent study in Chicago showed that the life expectancy in Streeterville was 90, in Englewood it was 60. Thats a pretty big “life years” gap as well. I wonder how we can implement that data to set policy?

Feel free to look for studies on how to minimize financial harm by minimizing life values for at risk citizens, but I doubt you’ll find much because that’s now how we do things.

[dougthonus]

A) During the shelter in place period, people need to be educated on how to take precautions when the order is lifted. A lot of infections can be prevented with some common sense and not that difficult practices, that won't necessarily stop businesses from operating. Limit large gatherings, frequent sanitizing, etc. I would bet infection rates could be cut down by 50% at least, just by following some of these simple precautions.

I agree here, hopefully we're all just a little smarter when we go back to work.

B) Extensive testing must also be done- which we are not doing- so that infected people can be self quarantined. And ideally, tracking of anyone in contact with an infected person. This is what So. Korea has done so effectively. But if it's not done early, then it becomes almost impossible to track down and isolate all individuals who had contact with someone infected. It might be too late for this in the USA. Almost assuredly is.

Well if you slow the rate enough after social distancing you should have a shot at this again. I agree if we could find a way to ramp up testing so anyone who wants a test can get one immediately with results nearly immediately that we'd be in much better shape to slow the spread.

Not sure if we have any reasonable plan to enable that though. Everyone knows we need better testing, but I don't know how we'd get to the level of better we need.

[Mech Engineer]

It's important to discuss all kinds of ideas...The government got into this mess by not believing this can cause disruption in the west by thinking it's a China problem. We need to think of everything and filter out the impractical ones.

I hear from my doctor friends on how they are running out of PPEs and some of them are scared because they cater to an elderly group of patients. That's why I was thinking of my healthy doctor is immune, she can treat her elderly patients without the fear of spreading to them. It's just a sad, fearful situation right now.

[League Circles]

I think the term "social distancing" is being used incorrectly by many. We could and should socially distance ourselves indefinitely. IMO, there is no meaningful economic cost to that.

Shutting down businesses is not synonymous with that. We can and should allow more and more businesses to become fully operational again as we get more data and allow the medical infrastructure to catch up, while still practicing social distancing until a vaccine and/or effective treatment has widespread availability, so perhaps 18 months.

The only businesses that will need to be affected by that, pretty much, are frankly bars and restaurants.

I'm very sympathetic to the people in those service industries, and public policy has got to find a way to get them back to work....... In other fields. The fragility of that industry shows pretty clearly that we had too many bars and restaurants as it was. No reason to prop them up at the expense of public health.

I think in general the economic impact of all this is going to be drastically overstated. As long as public policy can find an effective way to help those who would fall through the cracks (admittedly no small feat), we'll be OK. It will definitely force a major re-organization of our economy that was frankly needed anyways.

This may all sound harsh, and I definitely want to adjust public policy very substantially to help individuals, but IMO most viable businesses should be able to resume full operations soon enough.

People really need to reassess what businesses are fundamentally important. Those are basically food, water, power, sewer, and medical. Not much else. Not even housing. I'd bet there is housing for everyone in this country without another house being built for 20 years.

Society is going to look wildly different after this, and in many ways better IMO. We just have to really come together to manage the tremendous costs of the transition which first and foremost will be helping people who were working in fragile, non viable industries.

[coldfish]

So what is your alternative suggestion? This is a temporary measure so we can slow the spread while we increase testing and accumulate data on which to make subsequent decisions. I see a lot of complaining for complaint’s sake with absolutely no logically suggested alternative other than “do something less and hope for the best!”

The alternative is to let the virus go and deal with the consequences as best you can, which might be extremely poorly and result in 2 million people dying.

If we don't learn something that puts us fundamentally in a better position to treat this without social distancing in the next two months then the social distancing decision will have been an unmitigated disaster and probably the worst thing we could do.

Because then, you will be faced with two choices:
1: Continue social distancing. By 6 months of social distancing, you will probably in a national state of emergency with military control all over the nation to attempt to stop riots. You will probably end up with unemployment levels higher than the great depression and cause the complete economic collapse of the country.

2: Stop social distancing. Now instead of causing complete economic collapse, you've just caused a great recession, but you are also now going to see the virus do the exact same thing it would have done had you not social distanced at all, because you won't have flattened the curve, you will have just pushed the peak of the curve out by 2 months.

We have chosen a tactic that is only going to work if we're willing to go all in at it for a year or if we are able to learn something over the time we're doing it that puts us in a fundamentally better place. To take that gamble on new information coming, we've likely caused a global recession already. To take the gamble on going all in to really flatten the curve, we will probably cause the meltdown of the entire global economy and widespread loss of standard of living.

It's a difficult situation, and I am not pretending it's not. There are hard choices to make here.

"Some may look at [safety measures] and say they're going to be really inconvenient for people. Some will look and say, well, maybe we've gone a little bit too far? They were well thought out," he said. “I'll say it over and over again -- when you're dealing with an emerging infectious diseases outbreak, you are always behind where you think you are."

For someone whom thinks that we're understating the impact of the virus, he sure understates the impact of social distancing on society. "Inconvenient" is not a word I'd use to describe creating the worst economic conditions in the country since the great depression with upside to be the worst in the history of our nation. We're not there yet, but it sure looks likely that we're headed there.

Many people are very convinced about the damage the virus will do, but seem blissfully unaware of the damage social distancing will do if we have to remain on this path for any length of time.

Just so I understand, your proposed alternative is to do nothing and just hope for the best until we develop a vaccine. I’m not going to bother arguing that and I’m shocked that you consider it a legitimate option. I mean the notion that social distancing measures can only work if we commit to doing it for a year is pretty ridiculous considering that the primary reason for doing it is to permit the accumulation of data on which to base future decisions. It’s temporary because we know we are flying blind and need to try to get above the clouds to get a better view.

Also, I think you misunderstand the strategy behind flattening the curve. It’s in large part to help the healthcare community not be overburdened all at once. Spreading it out now does not mean it will immediately bulge once lifted. More importantly, in the meantime we can better equip hospitals to deal with an influx of cases. Trump, for example, is faced with using war powers to require manufacturers to produce healthcare equipment hospitals currently lack. If we buy time to prepare and equip, I.e., flatten the curve, the less likely we become tragically overburdened like the healthcare community in Italy.

The part of the Fauci quote that matters is the part about being behind where you think you are. The “inconvenient” part is outdated because he said it before the waive of shelter in place orders. He was referring to far milder measures. I should have cut that part out of the quote or noted that.

IMO, social distancing and lockdowns are not a solution. They are a stalling tactic to buy us time. I think everyone agrees there and doing so in the short term is better than what Italy is dealing with.

I think the real issue is that there seems to be no long term solution. Where are we going with this? People only have so much savings and there is only so many goods in inventory. At some point, these lockdowns are actually going to be doing even worse damage than the worst case scenarios of the virus. We are effectively turning ourselves into a third world country economically and there are legitimate and real reasons why mortality rates and lifespans are significantly worse in those parts of the world.

Personally, I think we have weeks. If this keeps rolling until the middle of April, the economic situation is going to be ridiculous.

I still have hope that within a few weeks, we will have much better capability, information and knowledge to allow us to open the economy back up without undue risk. Hell, if we just kept the lockdown for retirees only we would probably radically alter the trend of this virus without nearly as much damage.

[Bandit King]

So what is your alternative suggestion? This is a temporary measure so we can slow the spread while we increase testing and accumulate data on which to make subsequent decisions. I see a lot of complaining for complaint’s sake with absolutely no logically suggested alternative other than “do something less and hope for the best!”

The alternative is to let the virus go and deal with the consequences as best you can, which might be extremely poorly and result in 2 million people dying.

If we don't learn something that puts us fundamentally in a better position to treat this without social distancing in the next two months then the social distancing decision will have been an unmitigated disaster and probably the worst thing we could do.

Because then, you will be faced with two choices:
1: Continue social distancing. By 6 months of social distancing, you will probably in a national state of emergency with military control all over the nation to attempt to stop riots. You will probably end up with unemployment levels higher than the great depression and cause the complete economic collapse of the country.

2: Stop social distancing. Now instead of causing complete economic collapse, you've just caused a great recession, but you are also now going to see the virus do the exact same thing it would have done had you not social distanced at all, because you won't have flattened the curve, you will have just pushed the peak of the curve out by 2 months.

We have chosen a tactic that is only going to work if we're willing to go all in at it for a year or if we are able to learn something over the time we're doing it that puts us in a fundamentally better place. To take that gamble on new information coming, we've likely caused a global recession already. To take the gamble on going all in to really flatten the curve, we will probably cause the meltdown of the entire global economy and widespread loss of standard of living.

It's a difficult situation, and I am not pretending it's not. There are hard choices to make here.

"Some may look at [safety measures] and say they're going to be really inconvenient for people. Some will look and say, well, maybe we've gone a little bit too far? They were well thought out," he said. “I'll say it over and over again -- when you're dealing with an emerging infectious diseases outbreak, you are always behind where you think you are."

For someone whom thinks that we're understating the impact of the virus, he sure understates the impact of social distancing on society. "Inconvenient" is not a word I'd use to describe creating the worst economic conditions in the country since the great depression with upside to be the worst in the history of our nation. We're not there yet, but it sure looks likely that we're headed there.

Many people are very convinced about the damage the virus will do, but seem blissfully unaware of the damage social distancing will do if we have to remain on this path for any length of time.

2 million? Might a lot more then then! Italy mortality rate is like 8 percent.

[Nikola]

Neither of those things are even remotely true of people who are doing even a modest amount of open minded research into what we are facing medically and economically.

Just FYI, I've not seen any article yet where someone weighed the cost of social distancing against life years expected to be saved to try and determine a value of what we're doing. Not saying there isn't one out there, but if you find one I'd love to see it, because I'd be very interested in any experts modeling those things against each other.

I brought this up at the office and was considered a monster. People are really bad at math and irrational.

[Bandit King]

All I can say as a front line medical worker seeing the deluge, your tune will likely change once you or someone you know is struggling to breath with no ICU beds available. How about arguing economic impact at that time?

Do you see sick people that have only Corona or do most of them have other problems and Corona on top?

Sent from my POT-LX1 using RealGM mobile app

Most are older and with comorbid conditions. But there are a small number of younger or no comorbidities who get severely ill as well. Risk is lower in these people, but definitely not zero and it’s scary.

It will effect young people who smoke, vape or have diabetes because they don't gave good immunity.

[Bandit King]

Just wait until the virus starts to mutate!

[Habs72]

All I can say as a front line medical worker seeing the deluge, your tune will likely change once you or someone you know is struggling to breath with no ICU beds available. How about arguing economic impact at that time?

This post exactly why people in the medical field should be part of the policy discussion but not determining policy.

You only see what's in front of you, which are the patients suffering from the virus. But you have no awareness of the social and economic impact of whatever policy you are advocating. You don't even consider those things.

So let me ask you, what is the effect of millions of people losing their jobs in the next two months? What strains does that cause on society? How many people die as a result? What happens to rate of violent crime?

At what point do the negative consequences of nationwide shutdowns outweigh the benefits of flattening the curve?

Or let me put it like you did: will your tune change if a family member is murdered as a result of mass rioting? Or if a family member commits suicide because he lost his job and can't care for his family?

Yes. Lets sacrifice people in the altar of economics. Some people dont get it before it explodes on their faces, or in their faces. Maybe this will make your country start thinking more about their citizens than money spend on space programs and military expenses. Mind you this will make a huuuuge impact on healthcare, also other than infected people. Your country is about to start to hit the deep end with this next week or two, 14 500 new cases in the last update and youre only getting started with this.