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Given the incubation time, the virus has been spreading in the community for at least 1-2 weeks. Not a US citizen and don’t really understand how things work th

Given the incubation time, the virus has been spreading in the community for at least 1-2 weeks. Not a US citizen and don’t really understand how things work there, but you’d think it’s time for a response at scale to have any chance of containment. From a distance, it seems politics is interfering with this.

mullingitover 7y ago
The smart thing to do at this point would be to abandon the fool's hope that this will be contained in the US, stop trying to track cases and spread, and just work on shoring up the heath care system for when it's inevitably going to be overrun. Trying to keep it contained now is like putting up a truckload of sandbags to stop a tidal wave. If it wasn't possible to be reinfected, I'd say the wise thing to do would be to get yourself infected now, while you can still get a respirator in the hospital.
- 01100011 7y ago
  That assumes you can't get it twice, which we don't know yet. It also assumes there are no long-term effects, and there are already reports of lung fibrosis. You're better off delaying it as long as possible. Work from home if you can, and try to avoid non-essential travel while people work on better treatments.
  - mullingitover 7y ago
    > That assumes you can't get it twice I'm assuming you can get it twice, based on recent news[1], that's why I said: > If it wasn't possible to be reinfected [1] https://thehill.com/changing-america/well-being/prevention-cures/484942-japan-confirms-first-case-of-person-reinfected https://thehill.com/changing-america/well-being/prevention-c...
    - 01100011 7y ago
      Sorry, missed that.
  - alwillis 7y ago
    According to this podcast featuring a Harvard epidemiologist, someone can get it twice: https://pca.st//episode/ca05539a-1c01-4862-9e86-8882e5e42178 https://pca.st//episode/ca05539a-1c01-4862-9e86-8882e5e42178
  - cmurf 7y ago
    Short term reinfection is extremely unlikely. Natural immunity 1-3 years. https://twitter.com/florian_krammer/status/1233338746789036032 https://twitter.com/florian_krammer/status/12333387467890360... Long duration shedding even after recovery is a more likely explanation than than re-infection. But even that's not good news if someone is contagious after they've recovered. https://twitter.com/mlipsitch/status/1231662145156374528 https://twitter.com/mlipsitch/status/1231662145156374528
- gravelc 7y ago
  Slowing the spread via containment so the health system can be shored up seems sensible to me. Possibly those weeks could make a difference; I'd imagine vaccine development is highly parallelised relative to a normal year, and there may be something in the next 6 months. 4 weeks in that scenario could be huge.
  - mullingitover 7y ago
    It doesn't sound like a vaccine is going to save the day here[1]. > Marks said a real late-stage trial to test a vaccine is likely “months away.” One concern is that some previous coronavirus vaccines have caused worsening of the disease, not improvement. > “We have to make sure that as we proceed with development, we’re not creating problems,” Marks said. It might be realistic, he said, for studies of vaccines to begin by the summer, although that timeline is still aggressive. [1] https://www.statnews.com/2020/02/26/coronavirus-vaccines-are-far-off-fda-official-says-but-drugs-to-treat-patients-could-come-sooner/ https://www.statnews.com/2020/02/26/coronavirus-vaccines-are...
  - sveng 7y ago
    Experts say a vaccine is 12-18 months away for wide use. Then the task of manufacturing a billion or so for starters.
- remarkEon 7y ago
  >...Trying to keep it contained now is like putting up a truckload of sandbags to stop a tidal wave. I don't think this is true, and since we still don't know enough about true fatality rates outside of China (yet) it seems foolish to be fatalistic at this stage about containment. There's no "shoring up the [US] health care system". We can't build hospitals out of thin air (China's attempt notwithstanding), and we can't apparate more medical devices, whose supply chains are broken because of our dependence on China. Limiting infections - especially in higher risk demographics - seems critical at this point. >If it wasn't possible to be reinfected, I'd say the wise thing to do would be to get yourself infected now, while you can still get a respirator in the hospital. Uhhh no. This would needlessly stress the existing infrastructure. If you're young and healthy, don't soak up resources that should be used to care for at-risk populations. WFH and wash your hands.
  - ryandrake 7y ago
    > We can't build hospitals out of thin air (China's attempt notwithstanding), and we can't apparate more medical devices, whose supply chains are broken because of our dependence on China. Seems like a lot of “we can’t” assertions. If any country started seeing ~1M deaths per month or something, I bet they’d somehow figure out a way to do it.
    - remarkEon 7y ago
      Sure. It would take a WWII-level mobilization to do so, and some very hard trolley_problem.jpg choices about what to do. Even then I'm still skeptical. Let's take medical devices, for example. So we could, temporarily, nationalize a PCB fab in the US to make the circuit boards ... but do we even have the gerber files? Do we have the human capital to QA a new process? How long for tooling on the rest of the mechanicals? I hope that, deep in the Pentagon, someone is asking these questions. Not necessarily because of COVID-19, but just in general.
  - mullingitover 7y ago
    > Limiting infections - especially in higher risk demographics - seems critical at this point. We've already failed at this - it's in the community, cases are popping up with no known contact with an infected person. Asymptomatic cases are contagious for several days, and in a large chunk of patients it presents as a common cold that they won't go to the hospital for, and even if they could there isn't enough capacity to do the necessary testing. Game over.
- mc32 7y ago
  It's closer to the cold than the flu, so like the cold people have been reported to have been infected after having had it, then not had it, then to have it once more. Though, at this point it's not known if it was dormant or through new infection.

mullingitover 7y ago

The smart thing to do at this point would be to abandon the fool's hope that this will be contained in the US, stop trying to track cases and spread, and just work on shoring up the heath care system for when it's inevitably going to be overrun. Trying to keep it contained now is like putting up a truckload of sandbags to stop a tidal wave. If it wasn't possible to be reinfected, I'd say the wise thing to do would be to get yourself infected now, while you can still get a respirator in the hospital.

01100011 7y ago
That assumes you can't get it twice, which we don't know yet. It also assumes there are no long-term effects, and there are already reports of lung fibrosis. You're better off delaying it as long as possible. Work from home if you can, and try to avoid non-essential travel while people work on better treatments.
- mullingitover 7y ago
  > That assumes you can't get it twice I'm assuming you can get it twice, based on recent news[1], that's why I said: > If it wasn't possible to be reinfected [1] https://thehill.com/changing-america/well-being/prevention-cures/484942-japan-confirms-first-case-of-person-reinfected https://thehill.com/changing-america/well-being/prevention-c...
  - 01100011 7y ago
    Sorry, missed that.
- alwillis 7y ago
  According to this podcast featuring a Harvard epidemiologist, someone can get it twice: https://pca.st//episode/ca05539a-1c01-4862-9e86-8882e5e42178 https://pca.st//episode/ca05539a-1c01-4862-9e86-8882e5e42178
- cmurf 7y ago
  Short term reinfection is extremely unlikely. Natural immunity 1-3 years. https://twitter.com/florian_krammer/status/1233338746789036032 https://twitter.com/florian_krammer/status/12333387467890360... Long duration shedding even after recovery is a more likely explanation than than re-infection. But even that's not good news if someone is contagious after they've recovered. https://twitter.com/mlipsitch/status/1231662145156374528 https://twitter.com/mlipsitch/status/1231662145156374528
gravelc 7y ago
Slowing the spread via containment so the health system can be shored up seems sensible to me. Possibly those weeks could make a difference; I'd imagine vaccine development is highly parallelised relative to a normal year, and there may be something in the next 6 months. 4 weeks in that scenario could be huge.
- mullingitover 7y ago
  It doesn't sound like a vaccine is going to save the day here[1]. > Marks said a real late-stage trial to test a vaccine is likely “months away.” One concern is that some previous coronavirus vaccines have caused worsening of the disease, not improvement. > “We have to make sure that as we proceed with development, we’re not creating problems,” Marks said. It might be realistic, he said, for studies of vaccines to begin by the summer, although that timeline is still aggressive. [1] https://www.statnews.com/2020/02/26/coronavirus-vaccines-are-far-off-fda-official-says-but-drugs-to-treat-patients-could-come-sooner/ https://www.statnews.com/2020/02/26/coronavirus-vaccines-are...
- sveng 7y ago
  Experts say a vaccine is 12-18 months away for wide use. Then the task of manufacturing a billion or so for starters.
remarkEon 7y ago
>...Trying to keep it contained now is like putting up a truckload of sandbags to stop a tidal wave. I don't think this is true, and since we still don't know enough about true fatality rates outside of China (yet) it seems foolish to be fatalistic at this stage about containment. There's no "shoring up the [US] health care system". We can't build hospitals out of thin air (China's attempt notwithstanding), and we can't apparate more medical devices, whose supply chains are broken because of our dependence on China. Limiting infections - especially in higher risk demographics - seems critical at this point. >If it wasn't possible to be reinfected, I'd say the wise thing to do would be to get yourself infected now, while you can still get a respirator in the hospital. Uhhh no. This would needlessly stress the existing infrastructure. If you're young and healthy, don't soak up resources that should be used to care for at-risk populations. WFH and wash your hands.
- ryandrake 7y ago
  > We can't build hospitals out of thin air (China's attempt notwithstanding), and we can't apparate more medical devices, whose supply chains are broken because of our dependence on China. Seems like a lot of “we can’t” assertions. If any country started seeing ~1M deaths per month or something, I bet they’d somehow figure out a way to do it.
  - remarkEon 7y ago
    Sure. It would take a WWII-level mobilization to do so, and some very hard trolley_problem.jpg choices about what to do. Even then I'm still skeptical. Let's take medical devices, for example. So we could, temporarily, nationalize a PCB fab in the US to make the circuit boards ... but do we even have the gerber files? Do we have the human capital to QA a new process? How long for tooling on the rest of the mechanicals? I hope that, deep in the Pentagon, someone is asking these questions. Not necessarily because of COVID-19, but just in general.
- mullingitover 7y ago
  > Limiting infections - especially in higher risk demographics - seems critical at this point. We've already failed at this - it's in the community, cases are popping up with no known contact with an infected person. Asymptomatic cases are contagious for several days, and in a large chunk of patients it presents as a common cold that they won't go to the hospital for, and even if they could there isn't enough capacity to do the necessary testing. Game over.
mc32 7y ago
It's closer to the cold than the flu, so like the cold people have been reported to have been infected after having had it, then not had it, then to have it once more. Though, at this point it's not known if it was dormant or through new infection.