Well that sucks

[asterix]

And another one bites the dust. 

[Shuffler]

Yup some can't control themselves.

[CptTrips]

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_number


I 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.
   

[Shuffler]

While this spreads fairly easily, it seems that most survive it by far.

[hitech]

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.

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.

You apear to miss my point. My point assumes the following. I'm not stating these assumptions are correct.

1. No matter how much we slow the spread, the same amount of people will be infected in the end. (note infected not die)
 
2. All arguments I have seen are that we need to slow the spread to make sure the health system is not over run. I assume that as long as we do not over run the HCS the same number of people will die in the end.

3. The current implantation is drastically hurting the economy and will also cause people to die.

My argument is that in trying to find the balance. If you maximizing the use of hospitals (with out over running) to  minimize the duration you will save more lives because no more people will die because of the virus. And less will because of economics.

But my point is that I have not heard anyone discussing the benefits of trying to maximize with out overrunning the HCS.

HiTech

[Zimme83]

1. No that is not necessarily true. We can keep the number of infected down until we get a vaccine.
2. This is the most important, but we also want to protect the eldery etc in order to avoid as many deaths as possible
3. To be honest the ship has sailed already for most of US and you are going to fail on (2). Without enough protection for the health care staff the US face a serious risk of a collapse of the health care system. If you had taken the proper actions in time (social distancing, preparing the health care system etc) you could have kept the cost both in lives and money down.

however: A total lockdown is not necessarily the best move, it is something that should be done only if the situation is getting out of hand. 

[FLS]

Zimme aren't you in Sweden? Maybe things are better here, outside of NY city, than you realize.

There's good reason to treat different areas according to the local threat rather than statewide or nationally.  There is also the legal issue about mandating lock downs for healthy people who act responsibly.

[Zimme83]

I know that the situation is different in different locations. Even in Sweden -outside the capital the situation is very calm. We also dont have a lockdown, people can be out skiing etc as long as they maintain social distancing. Which an overwhelming majority is. But if your major cities are hurt its gonna hurt the rest of the country as well. And just because its calm now doesnt mean that you're gonna be ok. The virus will hit sooner or later so be sure to prepare and take the proper measures to deal with it.

[Shuffler]

Keeping the elderly home would suffice. Keeping folks that are out in the environment away from the elderly would suffice.

The problem comes from folks just not practicing distancing and washing hands. In regular times you even see folks in public restrooms who never wash their hands. The stay at home affects everyone but is meant for those not smart enough to control their poor habits. Adjusting for the weakest link. One tainted person, who does not care, walks through a group that follows all practices and the bets are off.

Hard closing businesses and hard not to. I am glad our business is essential due to military and oil/chemical industry. I feel for those that are not working. Down here so many are in essential industries that there is still a fair amount of traffic on the roads.

As of today there are 90 deaths due to this virus in Texas. Our state has 28.7 million folks in it at last count.

[Zimme83]

The grim reality is: it wont help keeping the eldery home. They are not the 'problem' (they die no matter what you do) the problem is that too many younger people get really sick and ends up in the ventilator. They are the ones thats overwhelms the health care system. And dont get fooled by "we only have 90 deaths", exponential growth is always slow in the beginning, only to explode and when it does it almost impossible to bring the numbers down again.

[Zimme83]

As i said: ive seen what this virus does to young and healthy people and trust me: You do _NOT_ want this

[CptTrips]

You apear to miss my point.

Or you're assuming that anyone who disagrees with your point must be missing your point. 

1. No matter how much we slow the spread, the same amount of people will be infected in the end. (note infected not die)

I reject that argument. 

You are ignoring the effort to develop a vaccine that would give people immunity. At that point they won't be getting infected at all.  It's a race between the two timelines.

By what ever amount you slow down the spread, a larger number of people will make it to the point an receiving a vaccine and then gain immunity.
So you CAN reduce the over all number of people who get the disease if you can delay them getting it until the vaccine arrives. 
Not everyone, but you might could reduce the numbers contrary to your claim.
 

2. All arguments I have seen are that we need to slow the spread to make sure the health system is not over run. I assume that as long as we do not over run the HCS the same number of people will die in the end.

I reject that argument. 

1.  Say through quarantine you slow the spread so that only 10k more people get infected before the vaccine arrives.  1% die: 100 deaths. Say you allow infections to increase another 100k until the health system is saturated before we get a vaccine.  1% die: 1000 deaths.  100 != 1000.

2.  The longer you slow the spread, the more time doctors have to find effective treatments and drugs to reduce the percentage of deaths.  So instead of 1%, maybe you get it down to 0.2%.  So all other factors equal, you would end up with less deaths before a vaccine arrives.

3. The current implantation is drastically hurting the economy and will also cause people to die.

I won't defend the current approach.  I defined in my previous post how I though it should be handled.
 
But even that would be preferable to letting the infection run, hoping you have such perfect control you could stop it on a dime right at the point of saturation.  My guess is you would let it get out of hand and overshoot considerably and get more people unnecessarily dead.

[Shuffler]

As i said: ive seen what this virus does to young and healthy people and trust me: You do _NOT_ want this

Lucky most folks survive having it I guess. Pneumonia is never a good thing. No matter if it is from being sick or after an operation.

[Zimme83]

Lucky most folks survive having it I guess. Pneumonia is never a good thing. No matter if it is from being sick or after an operation.

Yes. almost everyone of the younger patients survive, but thats not the point. We're still talking around 3 months at the hospital and God knows how your lungs is going to work afterwards. A severe pneumonia is counted as a mild case, a severe ends up in the ventilator.

[FLS]

I know that the situation is different in different locations. Even in Sweden -outside the capital the situation is very calm. We also dont have a lockdown, people can be out skiing etc as long as they maintain social distancing. Which an overwhelming majority is. But if your major cities are hurt its gonna hurt the rest of the country as well. And just because its calm now doesnt mean that you're gonna be ok. The virus will hit sooner or later so be sure to prepare and take the proper measures to deal with it.

You guys even kept the bars open correct? 

The virus is all over the country here but it's mostly NYC that's seeing serious problems so far and that's because local leaders chose to be late to act. 

We're also going to see the results of the general decline of competence in entry level workers but I don't expect a SHTF situation unless we get a lot of additional stress to the system like riots.

Even with increased testing the rate of doubling of confirmed cases is slowing and I see people mostly acting responsibly when I go out to shop. 

The majority of infected get better at home with no medical intervention and many of them have no symptoms at all.

The lack of medicine and equipment is a disgrace that will be corrected, hopefully worldwide, before a worse virus develops.