Simple nomenclature correction. R is the reproduction rate. R0 is a viruses reproduction rate with no intervention. R0 never changes unless a virus changes. Isolation lowers R not R0.
Well the Wiki explains it as:
R0 is not a biological constant for a pathogen as it is also affected by other factors such as environmental conditions and the behaviour of the infected population.
https://en.wikipedia.org/wiki/Basic_reproduction_numberI would argue cultural practices and mitigation strategies like quarantine affect the R0. I could post additional quotes like the one from the CDC that Asterix did (I was preparing a stack of them), but I don't see the point of getting lost in the weeds. For the purposes of this discussion, I will accept which ever term you wish to agree upon. You can call it "Foo" if you want.
Also I am always wondering why people don't take the other side of the equation. I.E. 2 balancing issues economy vs virus.
I'm always balancing the cost:benefit. Believe me, it is not something I am taking lightly.
So the extreme arguments go:
1. What about the massive economic Depression that will result from all this quarantine? What about the failed business and lost retirements? What about the financial cost?
2. My argument in return would be: Well, can you give me the exact dollar value for the lives of your family members? We can't calculate the economic trade-off without that metric.
Those are both extreme arguments, but they both have a point. I always try to remind myself the numbers on that daily counter are real people. It may not be your loved one, yet, but each one is somebody's something. So when you see the numbers, pretend one of your loved ones is in that statistic. That is a cruel, but necessary discipline to make sure you are not over-abstracting the human cost. Put it in personal terms you can feel, because it is personal for someone.
But given that you have the ability to support X number people needing medical care. And if your current bed usage is only predicted to be 50 % of beds. Should you wish to increase the infection rate to minimize economic damage?
Are you forgetting about the human cost? A certain percentage of those will die. A certain percentage, even if they survive, will have lung damage and lower quality of life and possibly shortened life spans. Would you volunteer to see a member of your family in the hospital facing that to help our economic benefit? Sorry, I mean no disrespect, but it is what you are asking of others. It isn't just abstract numbers. I put my parents or my young niece in that mental model whenever I try and think about it. Just to keep the proper perspective.
So yeah, if it comes down to it, I will accept a very large amount of economic damage to keep your family, my family alive. If you lose your business, if I lose my business, if I lose my retirement, if we all end up living under a bridge, that is a perfectly acceptable trade-off to me to keep all those people alive. I'd rather dig my way out of an economic depression than dig graves.
No one has elected me King, but if I were here is my basic analysis.
We can always make money again later and rebuild businesses and retirements. We may never get back to what we thought we would have, but life is hard.
Once people are dead, they stay dead. There is no way to fix that. (Or if they don't stay dead, we have a whole different problem.)
If we have 2 million dead, the economy is toast any way. So you'd end up in the same place, but with a bunch more body bags.
If we were willing to spend as much on the crisis as
a percentage of our 2019 GDP (not raw dollar amount) as we spent on WWII as a percentage of our 1942 GDP, then I think we could get through this with a minimum of economic damage while minimizing the loss of human life. Yes, we'll end up with massive debt that has it's own pain, but pain isn't the same thing as death.
Royal Decree:
1. I'd keep things under quarantine probably until June/July until certain metrics are met. I'd follow the model I suggested in another thread that is also being used my many Northern European countries. Employees would be kept on payroll and the Gov would reimburse and subsidize the business for their salary and to keep them operational. That basically puts everything in stasis for a period so that things can ramp up quicker when we are ready to do so.
https://www.theatlantic.com/ideas/archive/2020/04/economy-ruined-it-didnt-have-be-way/609334/2. The quarantine would be maintained until:
a. We have clear evidence that we have bent the curve and pushed it well down below our medical capacity (which might include raising the medical capacity with emergency facilities).
b. Find some treatments with a cocktail of drugs that can give doctors some weapons to fight this instead of just ventilators and sedatives for the dying.
c. Get the supply/production of PPE up so that the medical system has plenty and employers can provide masks and gloves for workers they are asking to come back to work. And sufficient supplies so the general public can get them if you want them to risk going back into stores and getting about.
d. Wide spread, readily available free testing needs to be in place to identify and isolate infected, especially the asymptomatic super-spreaders. That is proving to be a key factor in good outcomes places like S.Korea and Germany.
So we trade debt for lives and pay it off later over time.
Get a minimal set of conditions in place so that easing the quarantine isn't just a cynical suicide pact.
That would allow us to open factories and and certain types of office work back up, but don't expect airlines or restaurants or cruise ships, or movie theaters, or mass sporting events to benefit. Those are toast anyway until we get a vaccine.