Comment by tuna-piano | Hacker News Reader

Comment by tuna-piano | Hacker News Reader

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I think this is a false choice.

As Bill gates said, we can't say- "Hey, keep going to restaurants, go buy new houses, ignore that pile of bodies over in the corner. We want you to keep spending because there’s maybe a politician who thinks GDP growth is all that counts"

The truth is that it seems our choice is relatively simple:

1) Allow the virus to spread rapidly, overload the health system, kill many people, until herd immunity is reached.

2)Do partial shut down measures, some partial efforts at testing and contact tracing, let the virus continue for a long time, and more slowly reach option 1.

3)Do strong shut down measures until the virus is able to be controlled by a strong testing+contact tracing regime.

Iran (seems to have?) chosen option 1.

Italy started with option 2, and will hopefully move into option 3.

Option 3 is the only acceptable option that doesn't destroy the economy and health systems.

Unchecked, 10 cases of this virus will turn into 100s of thousands. That is the same with 10 cases in March, or 10 cases in May or 10 cases in any month.

People just dont get exponentials. They don't understand that if you get a total of a million cases in a week's time, most of those cases appear on day 6. They can't see how 1/7th of those cases turns into a million. Every country should be hoping that whoever calls the shots understands math.

People just don’t get sigmoids. They don’t understand that herd immunity quickly starts to slow the local spread of a virus in a region, and that you can’t model the entire population of a country like bouncy balls in a box. Every country should be hoping that whomever calls the shots understands math better than the average HN commenter.

This might be a logistic curve in the long term. But if this runs wild it will look like an exponential for a while longer. If your doubling time is 3 and a bit days. You can't just sit back saying "the inflexion point is coming any day now!". You need to do something yesterday.

> ignore that pile of bodies over in the corner.

“That pile of bodies” is mainly the elderly and terminally ill, demographics that society already seems to have little problem ignoring. Even now the worry among most of the population seems to be that those demographics will overwhelm the health system, preventing everyone else from getting medical attention. But this could be solved by triaging, which is rumoured to already be the de facto standard in Italy (i.e. if you are over 60 and show coronavirus symptoms, other patients take priority over you).

The longer the lockdowns in various countries go on, the stronger I think societal pressure for solution 1) – with triaging to avoid overloading the health system – is going to get.

Still enough normal 30-49 olds are dying as well

You can also collect data on the risk groups during the current shutdown period, provide the infrastructure for isolating the risk groups (ie. setup delivery services, organise isolated accommodation, etc.), triage appropriately in the case of spikes and then transition in to plan 2.

Considering the numbers of infected people confirmed alone and the percentage of asymptomatic cases contact tracing and testing sounds about as realistic as waiting on a cure.

I generally agree with this assessment, but it's not certain the U.S. is choosing option 3.

How do we assess contingency levels, other than after-the-fact measure of fatalities? Contingency is highly variable across the country. Rural areas have a lot of personal distancing built in. Urban areas certainly aren't in China-style lockdown, or South Korea-style technology+culture distancing based on prior experience. Nationally, I think the U.S. is at best taking a "moderate contingency" approach.

Each state's governor has control over the contingency, short of the president declaring martial law. e.g. in Mississippi the governor has declared most businesses are "essential" and thus open for business, expressly contradicting local ordinances more strictly defining what is essential. We very likely will see localized variations in infection and fatality rates as a result of these variations. https://www.businessinsider.com/coronavirus-mississippi-gove...

Therefore I don't know whether the progression of the disease is even predictable.

There's no guarantee that option 3 can be accomplished in the US. We might aim for it and realize that we're only accomplishing #2 and now inflicted maximum economic damage on top of it.

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