7 ms·

Social distancing is the only way to stop the coronavirus

73 points by Townley 7y ago

didibus 7y ago
I'd say I'm in the camp of cancelling everything right now, instead of waiting till the last minute. Seems doing so now would also have less of a social impact. That said, what I've yet to hear about is what the end game looks like? Do you cancel everything for a month or two, and then go back to normal? Wouldn't the virus just take hold again? So do we go on a routine monthly quarantine every quarter? Do we cancel everything until we find a vaccine? Do we quarantine the "at risk" and actually have everyone else interact even more so that all the healthy people get it quickly and recover to develop immunity? If anyone knows, I'd be curious, what kind of end game are we looking at here?
- jrd259 7y ago
  Explained in https://www.flattenthecurve.com/ https://www.flattenthecurve.com/ We cancel large meetings now to reduce the peak and delay it, so the health care system isn't totally overloaded. Eventually, a vaccine.
  - ken 7y ago
    From what I've heard from health officials, it'll be at least 6 months before trials can begin on any vaccine, and 12-24 months before it might be available. Is the plan to ask everyone to stay home for the next two years? As that page says, "Relative to Other Countries, US Labor and Healthcare Policies are a Perfect Storm for Pandemics". Small businesses in Seattle are already closing shop for good, in anticipation of the next month. I'm an hourly worker who depends on people going out, and I have zero upcoming work. Social Distancing is an excellent short-term plan. It's not an end game.
  - Animats 7y ago
    The total number of people getting sick is not reduced by that. The drastic measures take in China seem to be working.[1] China had 507 million people in full or partial lockdown at peak. "In the Hubei city of Huanggang, people caught in public without a mask or wandering outside without authorization have to pay a 1,000 yuan ($140) fine, and a fee of 40 yuan a day for two weeks of “forced study” classes, which are conducted in a sports stadium with students seated far apart, Huanggang residents said in interviews." Tracking of travel from phone info. Tracking devices on people's doors. Followup by cops and local Communist Party committees to keep people in line. New infections in China are dropping rapidly.[2] Restrictions are being slowly lifted and life is returning to normal. Yesterday, the only new infections found outside Wuhan came from people entering China. There's a good chance China will be mostly back to normal in a month, but with lots of testing to keep infections from getting going again. [1] http://archive.is/qWmFw http://archive.is/qWmFw [2] https://www.reuters.com/article/us-health-coronavirus-china-cases/mainland-china-reports-44-new-virus-cases-as-spread-continues-to-slow-at-epicenter-idUSKBN20V00X?feedType=RSS&feedName=worldNews https://www.reuters.com/article/us-health-coronavirus-china-...
    - sliken 7y ago
      "The total number of people getting sick is not reduced by that." Correct, or at least possibly so. But by flattening the curve you can greatly increase then number of people that survive. Entering respiratory distress because of serious case of corona virus in a overburdened hospital is likely to be fatal. Much less so if there's a bed in the pneumonia ward for you. Also early treatments are showing promise, in particular zinc + the malaria drug.
      - stareatgoats 7y ago
        Agree the aim must be to flatten the curve. As for treatments showing promise, please provide source.
- parrellel 7y ago
  Stretch out the initial infection spike until we've rebuilt the iron lung supply is one of the big things.
  - CydeWeys 7y ago
    Well, ventilators anyway. Iron lungs are for a different kind of respiratory issue that isn't occurring with COVID-19.
    - parrellel 7y ago
      Yeah, you're right. Point being there's less than a thousand sufficient beds according to the last thing I've read and 4ish percent of patients may need one. Which was just a wham line for me.
    - souprock 7y ago
      A simple nasal cannula with oxygen ought to work for most cases. Assuming you need physical help though: Iron lungs are superior. They avoid throat injury caused by tubes, they allow semi-normal talking and eating (time it right), and they generally make people more comfortable. We got rid of iron lungs for cost reasons. They are physically huge and heavy. They slow down all patient care that doesn't involve the head. There is a new device that is even better than an iron lung, but it is extremely uncommon. It operates the same way, but it is in the form of a body-conforming shell (like a turtle) and it has a push-pull action. It even has a button to request coughing, which turns out to be important. I feel that we ought to somehow pressure hospitals to upgrade. It isn't right that people have to suffer with tubes jammed down their throats when far superior alternatives are available.
      - CydeWeys 7y ago
        > They slow down all patient care that doesn't involve the head. That's an understatement. The entire body is in a pressure vessel and is inaccessible. You can't even easily give medication or draw blood. I wouldn't say iron lungs are "superior"; they're no longer used for good reasons that don't just boil down to cost/bulkiness reasons. Also, modern ventilators aren't that cheap anyway.
- senectus1 7y ago
  4 week long world wide vacation. only no travelling and you dont get paid for it.
- senthil_rajasek 7y ago
  The end game is to develop a vaccine. In the meantime, stop the spreading by quarantine, social distancing, washing hands etc.,
  - jshevek 7y ago
    I don't believe that we will be using the current extreme form of "social distancing" for as long as it takes to develop a vaccine. Vaccine could easily be a year and a half out. I think we will return to a more moderate social distancing, where appropriate, after tests have been deployed and we have a better sense of the actual rates of infection in different regions.
    - ken 7y ago
      The current "social distancing" can't continue indefinitely without massive changes. It's not sustainable. Beyond a few weeks, it'll put a lot of people out of work, and the system can't support long-term wide-spread unemployment.
      - jshevek 7y ago
        Yes. Testing is ramping up at the moment. I think we'll have a much better idea of actual infection rates and distribution before a few weeks.
- bcrosby95 7y ago
  I also wonder if giving people time to discover and sort out their health problems would save many people. I know more than one person that hasn't gotten a doctors checkup in years.
  - ken 7y ago
    Neither have I. There'd be no point. "One large-scale review, published in 2012, found that annual physical exams do nothing to improve a person’s disease and mortality risks" [1], while costing us billions of dollars, and taking doctors' time away from patients who actually need it. [1]: https://time.com/5095920/annual-physical-exam/ https://time.com/5095920/annual-physical-exam/ If people have health issues that need treating, then absolutely go see a doctor when you can. If it's simply been a year and they're not in a high-risk population and have no reason to believe anything has changed, then don't bother.
    - jshaqaw 7y ago
      Friend I went in for an annual checkup despite being in apparent perfect health. Blood test results led to some other tests which led to the discovery of precancerous growths early enough to stop things. I’m in my mid 40s with a young family. Be careful with advice like this.
- BurningFrog 7y ago
  It's not really complicated. You cancel things until the virus is gone. Not by a time limit.
  - deleted 7y ago
    [deleted]
- jshevek 7y ago
  If they make the test cheap enough, convenient enough, and in sufficient quantity, we can bring everything back online in a low risk manner long before we have a vaccine.
  - genrus00 7y ago
    The test is already cheap enough. At least, in Europe.
  - AstralStorm 7y ago
    The test has enough false positive rate to make it annoying to use in general population. It's being improved.
- opwieurposiu 7y ago
  The purpose of quarantine is not to save lives, the purpose is to expand the power of the state. This virus is a totalitarian dream come true. Agents of the state telling you who you can meet, where you can go, when you can leave the house. Expect the state to draw this one out as long as possible.
- nazgulnarsil 7y ago
  Time is critical. Vaccine research, time for hospital infrastructure to scale and establish procedure, research on novel mitigation methods (is there a particular wavelength of UV that is effective? Can we scale that to millions of handheld devices?), time for orgs working with vulnerable populations to change operations, time to train up additional staff, more spare capacity of areas less impacted to help out situations like Iran instead of worrying so much about their own, will summer give us a tailwind? etc etc. Essentially everyone who is already specialized in this area is getting slammed right now and alleviating their problems will be measured in lives saved.
seibelj 7y ago
I live in Boston, I'm in my 30's, and I've decided I won't cancel anything. If I get the virus, so what? I firmly believe it's unwarranted panic. I'll enjoy the empty metropolis and remember this event for the rest of my life, like I remember 9/11, the financial crash, and how my parents remember the JFK assassination and the Blizzard of '78. Strange times EDIT - Let me clarify. If I get the virus, I will quarantine (of course), but I'm not going to prematurely ruin my life in fear of this event, which is in itself not a death sentence - only 0.2% of those under 40 die at worst case https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/ https://www.worldometers.info/coronavirus/coronavirus-age-se... Everyone needs to RELAX
- Sebguer 7y ago
  You're incredibly selfishly increasing the risk to everyone else around you, but I get it. I was in the same camp just a few days ago.
  - seibelj 7y ago
    Nope - I wash my hands. You want me to self-quarantine already? I'm not going to be afraid of 0.00001% of my state being infected.
    - Sebguer 7y ago
      Ah, yes, washing your hands. The completely infallible way to prevent the spread of a disease. I don't want you to be afraid - I want you to minimize the risk that you get coronavirus and become another infection vector, endangering the at-risk populations around you. I want you to do that because it is the socially responsible thing to do, and it will decrease the chance of someone who is far more at risk of serious complications from the disease catching it.
      - seibelj 7y ago
        I took the subway today, and it was about 1/4 full for the time. But everyone there wasn't pulling their hair out in abject terror. Last night my wife and I ate dinner at a Thai restaurant, and it was pretty full. I'm just going with the huge portion of society that doesn't choose to be afraid.
opwieurposiu 7y ago
We have three septuagenarian candidates for the next president. CFR for this age group is around 15% (1/6). Roll three dice and you get a 42.13% chance of at least one six. Odds are pretty high we are headed for the next William Henry Harrison situation. https://en.wikipedia.org/wiki/William_Henry_Harrison https://en.wikipedia.org/wiki/William_Henry_Harrison
- votepaunchy 7y ago
  Note that this is effectively now two septuagenarian candidates. Sanders is at the point where he will not automatically be nominated at a brokered convention if Biden is unable to run.
blackrock 7y ago
I really don’t believe that washing your hands is the way to stay safe. I don’t touch my eyes, nose, or mouth with dirty hands. I’m not a kid that puts things in my mouth. But yet, I have always gotten sick during the winters at work, in an office setting. Always. The only winter where I didn’t get sick, was when I stayed home all winter, and avoided most public contact. And miraculously, I didn’t get sick that season. So the flu virus or whatever I caught, was likely, always via airborne transmissions. Either I was in the same room as someone that sneezed or coughed, and the virus diffused through the air inside, or it got transmitted through the ventilation system. Keeping your hands from your eyes, nose, and mouth, is important, but so is the usage of a face mask. If anything, it should at least try to stop or slow down some airborne viruses. And face masks will work better, when everyone is using it, so their germs stay localized to themselves.
- jerome-jh 7y ago
  Certainly washing hands is not the end of everything, but it cuts about 20% of the total number of transmissions, for flu at least. So it is significant, when you have a pandemic with a virus for which nobody has immunity. The second point is that the less you have fat on your hand skin, the shorter lived is the virus when it lands on it. That is the rational behind "wash your hands often" messages.
jerome-jh 7y ago
There are only two ways to stop the virus: vaccination, and everyone having been in contact with the virus and having built immunity. Everything else is only trying to slow the spreading. It is not useless though. And keep in mind that without a vaccine, there is a fair chance for the virus to come back another winter (assuming it stops spreading in the summer).

73 points by Townley 7y ago

I'd say I'm in the camp of cancelling everything right now, instead of waiting till the last minute. Seems doing so now would also have less of a social impact. That said, what I've yet to hear about is what the end game looks like? Do you cancel everything for a month or two, and then go back to normal? Wouldn't the virus just take hold again? So do we go on a routine monthly quarantine every quarter? Do we cancel everything until we find a vaccine? Do we quarantine the "at risk" and actually have everyone else interact even more so that all the healthy people get it quickly and recover to develop immunity? If anyone knows, I'd be curious, what kind of end game are we looking at here?

jrd259 7y ago
Explained in https://www.flattenthecurve.com/ https://www.flattenthecurve.com/ We cancel large meetings now to reduce the peak and delay it, so the health care system isn't totally overloaded. Eventually, a vaccine.
- ken 7y ago
  From what I've heard from health officials, it'll be at least 6 months before trials can begin on any vaccine, and 12-24 months before it might be available. Is the plan to ask everyone to stay home for the next two years? As that page says, "Relative to Other Countries, US Labor and Healthcare Policies are a Perfect Storm for Pandemics". Small businesses in Seattle are already closing shop for good, in anticipation of the next month. I'm an hourly worker who depends on people going out, and I have zero upcoming work. Social Distancing is an excellent short-term plan. It's not an end game.
- Animats 7y ago
  The total number of people getting sick is not reduced by that. The drastic measures take in China seem to be working.[1] China had 507 million people in full or partial lockdown at peak. "In the Hubei city of Huanggang, people caught in public without a mask or wandering outside without authorization have to pay a 1,000 yuan ($140) fine, and a fee of 40 yuan a day for two weeks of “forced study” classes, which are conducted in a sports stadium with students seated far apart, Huanggang residents said in interviews." Tracking of travel from phone info. Tracking devices on people's doors. Followup by cops and local Communist Party committees to keep people in line. New infections in China are dropping rapidly.[2] Restrictions are being slowly lifted and life is returning to normal. Yesterday, the only new infections found outside Wuhan came from people entering China. There's a good chance China will be mostly back to normal in a month, but with lots of testing to keep infections from getting going again. [1] http://archive.is/qWmFw http://archive.is/qWmFw [2] https://www.reuters.com/article/us-health-coronavirus-china-cases/mainland-china-reports-44-new-virus-cases-as-spread-continues-to-slow-at-epicenter-idUSKBN20V00X?feedType=RSS&feedName=worldNews https://www.reuters.com/article/us-health-coronavirus-china-...
  - sliken 7y ago
    "The total number of people getting sick is not reduced by that." Correct, or at least possibly so. But by flattening the curve you can greatly increase then number of people that survive. Entering respiratory distress because of serious case of corona virus in a overburdened hospital is likely to be fatal. Much less so if there's a bed in the pneumonia ward for you. Also early treatments are showing promise, in particular zinc + the malaria drug.
    - stareatgoats 7y ago
      Agree the aim must be to flatten the curve. As for treatments showing promise, please provide source.
parrellel 7y ago
Stretch out the initial infection spike until we've rebuilt the iron lung supply is one of the big things.
- CydeWeys 7y ago
  Well, ventilators anyway. Iron lungs are for a different kind of respiratory issue that isn't occurring with COVID-19.
  - parrellel 7y ago
    Yeah, you're right. Point being there's less than a thousand sufficient beds according to the last thing I've read and 4ish percent of patients may need one. Which was just a wham line for me.
  - souprock 7y ago
    A simple nasal cannula with oxygen ought to work for most cases. Assuming you need physical help though: Iron lungs are superior. They avoid throat injury caused by tubes, they allow semi-normal talking and eating (time it right), and they generally make people more comfortable. We got rid of iron lungs for cost reasons. They are physically huge and heavy. They slow down all patient care that doesn't involve the head. There is a new device that is even better than an iron lung, but it is extremely uncommon. It operates the same way, but it is in the form of a body-conforming shell (like a turtle) and it has a push-pull action. It even has a button to request coughing, which turns out to be important. I feel that we ought to somehow pressure hospitals to upgrade. It isn't right that people have to suffer with tubes jammed down their throats when far superior alternatives are available.
    - CydeWeys 7y ago
      > They slow down all patient care that doesn't involve the head. That's an understatement. The entire body is in a pressure vessel and is inaccessible. You can't even easily give medication or draw blood. I wouldn't say iron lungs are "superior"; they're no longer used for good reasons that don't just boil down to cost/bulkiness reasons. Also, modern ventilators aren't that cheap anyway.
senectus1 7y ago
4 week long world wide vacation. only no travelling and you dont get paid for it.
senthil_rajasek 7y ago
The end game is to develop a vaccine. In the meantime, stop the spreading by quarantine, social distancing, washing hands etc.,
- jshevek 7y ago
  I don't believe that we will be using the current extreme form of "social distancing" for as long as it takes to develop a vaccine. Vaccine could easily be a year and a half out. I think we will return to a more moderate social distancing, where appropriate, after tests have been deployed and we have a better sense of the actual rates of infection in different regions.
  - ken 7y ago
    The current "social distancing" can't continue indefinitely without massive changes. It's not sustainable. Beyond a few weeks, it'll put a lot of people out of work, and the system can't support long-term wide-spread unemployment.
    - jshevek 7y ago
      Yes. Testing is ramping up at the moment. I think we'll have a much better idea of actual infection rates and distribution before a few weeks.
bcrosby95 7y ago
I also wonder if giving people time to discover and sort out their health problems would save many people. I know more than one person that hasn't gotten a doctors checkup in years.
- ken 7y ago
  Neither have I. There'd be no point. "One large-scale review, published in 2012, found that annual physical exams do nothing to improve a person’s disease and mortality risks" [1], while costing us billions of dollars, and taking doctors' time away from patients who actually need it. [1]: https://time.com/5095920/annual-physical-exam/ https://time.com/5095920/annual-physical-exam/ If people have health issues that need treating, then absolutely go see a doctor when you can. If it's simply been a year and they're not in a high-risk population and have no reason to believe anything has changed, then don't bother.
  - jshaqaw 7y ago
    Friend I went in for an annual checkup despite being in apparent perfect health. Blood test results led to some other tests which led to the discovery of precancerous growths early enough to stop things. I’m in my mid 40s with a young family. Be careful with advice like this.
BurningFrog 7y ago
It's not really complicated. You cancel things until the virus is gone. Not by a time limit.
- deleted 7y ago
  [deleted]
jshevek 7y ago
If they make the test cheap enough, convenient enough, and in sufficient quantity, we can bring everything back online in a low risk manner long before we have a vaccine.
- genrus00 7y ago
  The test is already cheap enough. At least, in Europe.
- AstralStorm 7y ago
  The test has enough false positive rate to make it annoying to use in general population. It's being improved.
opwieurposiu 7y ago
The purpose of quarantine is not to save lives, the purpose is to expand the power of the state. This virus is a totalitarian dream come true. Agents of the state telling you who you can meet, where you can go, when you can leave the house. Expect the state to draw this one out as long as possible.
nazgulnarsil 7y ago
Time is critical. Vaccine research, time for hospital infrastructure to scale and establish procedure, research on novel mitigation methods (is there a particular wavelength of UV that is effective? Can we scale that to millions of handheld devices?), time for orgs working with vulnerable populations to change operations, time to train up additional staff, more spare capacity of areas less impacted to help out situations like Iran instead of worrying so much about their own, will summer give us a tailwind? etc etc. Essentially everyone who is already specialized in this area is getting slammed right now and alleviating their problems will be measured in lives saved.

seibelj 7y ago

I live in Boston, I'm in my 30's, and I've decided I won't cancel anything. If I get the virus, so what? I firmly believe it's unwarranted panic. I'll enjoy the empty metropolis and remember this event for the rest of my life, like I remember 9/11, the financial crash, and how my parents remember the JFK assassination and the Blizzard of '78. Strange times EDIT - Let me clarify. If I get the virus, I will quarantine (of course), but I'm not going to prematurely ruin my life in fear of this event, which is in itself not a death sentence - only 0.2% of those under 40 die at worst case https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/ https://www.worldometers.info/coronavirus/coronavirus-age-se... Everyone needs to RELAX

Sebguer 7y ago
You're incredibly selfishly increasing the risk to everyone else around you, but I get it. I was in the same camp just a few days ago.
- seibelj 7y ago
  Nope - I wash my hands. You want me to self-quarantine already? I'm not going to be afraid of 0.00001% of my state being infected.
  - Sebguer 7y ago
    Ah, yes, washing your hands. The completely infallible way to prevent the spread of a disease. I don't want you to be afraid - I want you to minimize the risk that you get coronavirus and become another infection vector, endangering the at-risk populations around you. I want you to do that because it is the socially responsible thing to do, and it will decrease the chance of someone who is far more at risk of serious complications from the disease catching it.
    - seibelj 7y ago
      I took the subway today, and it was about 1/4 full for the time. But everyone there wasn't pulling their hair out in abject terror. Last night my wife and I ate dinner at a Thai restaurant, and it was pretty full. I'm just going with the huge portion of society that doesn't choose to be afraid.

opwieurposiu 7y ago

We have three septuagenarian candidates for the next president. CFR for this age group is around 15% (1/6). Roll three dice and you get a 42.13% chance of at least one six. Odds are pretty high we are headed for the next William Henry Harrison situation. https://en.wikipedia.org/wiki/William_Henry_Harrison https://en.wikipedia.org/wiki/William_Henry_Harrison

votepaunchy 7y ago
Note that this is effectively now two septuagenarian candidates. Sanders is at the point where he will not automatically be nominated at a brokered convention if Biden is unable to run.

blackrock 7y ago

I really don’t believe that washing your hands is the way to stay safe. I don’t touch my eyes, nose, or mouth with dirty hands. I’m not a kid that puts things in my mouth. But yet, I have always gotten sick during the winters at work, in an office setting. Always. The only winter where I didn’t get sick, was when I stayed home all winter, and avoided most public contact. And miraculously, I didn’t get sick that season. So the flu virus or whatever I caught, was likely, always via airborne transmissions. Either I was in the same room as someone that sneezed or coughed, and the virus diffused through the air inside, or it got transmitted through the ventilation system. Keeping your hands from your eyes, nose, and mouth, is important, but so is the usage of a face mask. If anything, it should at least try to stop or slow down some airborne viruses. And face masks will work better, when everyone is using it, so their germs stay localized to themselves.

jerome-jh 7y ago
Certainly washing hands is not the end of everything, but it cuts about 20% of the total number of transmissions, for flu at least. So it is significant, when you have a pandemic with a virus for which nobody has immunity. The second point is that the less you have fat on your hand skin, the shorter lived is the virus when it lands on it. That is the rational behind "wash your hands often" messages.

jerome-jh 7y ago

There are only two ways to stop the virus: vaccination, and everyone having been in contact with the virus and having built immunity. Everything else is only trying to slow the spreading. It is not useless though. And keep in mind that without a vaccine, there is a fair chance for the virus to come back another winter (assuming it stops spreading in the summer).