4 ms·

Crazy line of thinking: I keep reading that because of how insanely transmissible covid is, this doesn't end until enough people have already had it that there

Crazy line of thinking: I keep reading that because of how insanely transmissible covid is, this doesn't end until enough people have already had it that there just aren't that many people around you to infect anymore. It's been described as "trying to stop the wind". We can maybe slow it down but not stop it, and in the US since our response has been so weak, we especially shouldn't hope to stop it unless we're willing to totally isolate our entire families. At the same time we're hearing that Italian hospitals are completely overwhelmed to where they are having to "choose who to let die" vs providing acute treatment. So... (1) is it fair to say that focusing on prevention is pointless and we should just focus on survival which is largely about staying healthy and receiving care and therefore (2) (this is the crazy part) does it actually make sense to get it now before hospitals are overwhelmed and you might be unlucky enough to be sick with something else. Basically choose the most opportune survivable situation to get it versus letting the virus and bad luck pick when you have to fight this battle? My gut tells me a bunch of people are going to crap all over this question but I'm not coming up with good counter-arguments off the top of my head. (one other point, I live in SF, a large dense city, and I have two little kids that get everything so I'm maybe more fatalistic about the idea that I and my family will eventually get it either way)

deleted 7y ago
[deleted]
austincheney 7y ago
Not exactly. Looking at Italy as a case study we need to limit the spread of this virus only for the reason of reducing stress on the medical industry at any given single moment while accepting everyone is likely to encounter this thing eventually. Aside from slowing the rate of transmission the guidance, from the medical experts, says to treat this no differently than the flu. The reality is that this virus will be everywhere because it is at least as transmissible as the flu but with more benign symptoms and a longer incubation period. The incubation period for the flu is generally 5-7 days but the early data from China was suggesting an incubation period of 10-14 days for corvid19. Both of those numbers are variable upon a given snapshot and environmental factors. On the other hand the earlier people encounter this thing means the earlier a population can build the necessary mass immunity resistance.
- hanche 7y ago
  This. What is urgently needed is to flatten the curve. Maybe we can't reduce the total number of people who get it, but if we can spread out the infection over a longer time period, we may be able to avoid overwhelming the health care system, to the benefit of all.
- eagsalazar2 7y ago
  That's a good point and highlights a possible misalignment of interests between individuals and the community: me intentionally getting it now, before there are many cases might help me and my family but speeding up spread by doing so might increase the size of the peak for everyone else. Related question: when I imagine the spread I feel like fast moving spread will burn itself out more quickly and completely. But if it slows down too much, might it become like the flu where if only 1/3 of the people get it in a given year we never hit that critical point where everyone is immune and it peters out within a season, giving it time to mutate and keep reinfecting populations year after year much like the flu does?
  - xur17 7y ago
    > me intentionally getting it now, before there are many cases might help me and my family but speeding up spread by doing so might increase the size of the peak for everyone else. It's also possible that we'll identify antiviral treatments, etc that will reduce the impact on our health system / death rate (in which case getting it later would be better).
- alkonaut 7y ago
  > the medical industry Somehow that term to me is more dystopian than “pandemic”.
andrewla 7y ago
What you're saying is close to the standard line -- "flatten the curve". By trying to prevent infection, you slow the process down, so that hospitals are not overwhelmed. An overwhelmed medical system means that every aspect is made worse; people are not contained so the spread accelerates, we don't do backtracing with the same effect, medical personnel get infected, people with easily treatable conditions are not treated, etc. The end state is that almost everyone will be exposed to it, most likely to mutated less deadly variants (because those have higher survivability in viral terms), but if the rate of exposure is slow enough then we can mitigate a disaster.
seankimdesign 7y ago
I've heard the "you can't escape it" argument too, but I'm not too sure if I believe it. Shouldn't we have to avoid it only until the vaccines are ready?
- Rury 7y ago
  The only way to ensure escape from a disease is to eradicate or contain it. A vaccine helps tremendously in that regards, but alone doesn't guarantee eradication; as we have flu vaccines since the 1930s, yet the flu still remains amongst us. However, this is arguably just a result of vaccination rates; if more people took the flu seriously and were regularly vaccinated, we may have eradicated the flu by now. Same for COVID-19. If people don't ever take this seriously enough, then I doubt we'll eradicate it. The virus is on every continent in ~120/195 of the world's countries, all of which happened in a few months, despite travel bans and quarantines setup to initial outbreak areas. To me that sounds like people need to take it more seriously and put more effort into containing this. Otherwise it looks like it'll end up being endemic just like the flu, and we may never eradicate it despite having a vaccine - as what evidence do we have that enough people will vaccinate themselves when we do have a vaccine, if people keep equating it to the flu...
greenshackle2 7y ago
It could take two weeks before you develop severe symptoms sending you to the hospital. After that you may need intensive care for a couple of weeks. How sure are you that your local hospitals won't be overwhelmed in 2-4 weeks? There are different strains of the virus and it's not clear if getting one of them gives you immunity to other strains.
dvirsky 7y ago
I've read that you need about 40% of the population to be immune to it, for this to die down. Suppose you will inevitably get there no matter what we do (barring a deus ex machina like a vaccine) - you want to do it at a pace that does not overwhelm the health system. Another thing to consider is, that this is like a friction coefficient. So maybe if people spend 80% less time outside, we can maybe equate that to having 25% of the people already immune or something like that, and then 10-15% actual immunity is enough to make it die down.
pbourke 7y ago
> (2) (this is the crazy part) does it actually make sense to get it now before hospitals are overwhelmed and you might be unlucky enough to be sick with something else. Basically choose the most opportune survivable situation to get it versus letting the virus and bad luck pick when you have to fight this battle? No. (1) If you get it, you may spread it, even if you're careful. That chain of spread may lead to additional burdens on the system, or deaths (2) No matter your age, you may become seriously ill, and may draw resources from the system because of irresponsible behavior (3) It's highly possible that after some time has passed, the mortality rate will drop significantly because doctors will develop a good protocol. If you get it now, you risk being treated in a system that is still figuring this thing out (4) If you get it, you will not be available to help anyone else if needed due to the required isolation period The only ethical thing to do is to try as best you can not to become sick and also to support your community through this difficult time with money or volunteer labor. So, if you are a highly-paid techie who can work from home and limit your interaction with others in the community, do so.
- etaioinshrdlu 7y ago
  Only number 3 is a potential benefit to the individual. The rest are for the community’s benefit. Remember we are on a site full of people with a rather “every man is an island” attitude...
  - baq 7y ago
    In line with ‘never waste a crisis’ policy maybe some of them will be swayed to a more community-oriented mindset.
MikeHolman 7y ago
Probably too late for that. Italy outbreak was only like 19 days ago, so I imagine US will be there in about 2 weeks. I would guess it takes at least a couple weeks from exposure to get into critical condition and treated.
rb808 7y ago
Yes if you're vulnerable it would be better to get it today than in a month when hospitals are full. However it would be even better not to get it at all or get in 6 months time when doctors know more about how to treat the disease and could have drugs that are known to work. It sounds like your family is young enough to not really be badly hurt, its more about how many people you'd pass it on to.
RealityVoid 7y ago
So I was on Youtube when WHO was holding the conference giving the promotion and I caught about 10 minutes off it. In there, the spokesperson said exactly concerning 1) that we SHOULD still enact containment measures, and that those containment measures could help nip it in the bud.
dahart 7y ago
> (2) (this is the crazy part) does it actually make sense to get it now before hospitals are overwhelmed and you might be unlucky enough to be sick with something else. I don't think that's crazy, it would be quite helpful to be able to plan to catch it, and you can quarantine yourself at home so you don't spread it to anyone. The big trick is to be able to avoid spreading it around during the symptomless incubation period. Catching the virus on purpose could help you do that. > (1) is it fair to say that focusing on prevention is pointless and we should just focus on survival I don't think so. The point is to lower the exponent. Buying time has a lot of value.
LZ_Khan 7y ago
No to number one as prevention is very important, as you wont receive care if hospitals are overwhelmed. Also, containing the virus is useless if in the end a vaccine is able to be developed. Number two makes more sense as not having access to care and equipment later on can be a problem.

deleted 7y ago

[deleted]

austincheney 7y ago

Not exactly. Looking at Italy as a case study we need to limit the spread of this virus only for the reason of reducing stress on the medical industry at any given single moment while accepting everyone is likely to encounter this thing eventually. Aside from slowing the rate of transmission the guidance, from the medical experts, says to treat this no differently than the flu. The reality is that this virus will be everywhere because it is at least as transmissible as the flu but with more benign symptoms and a longer incubation period. The incubation period for the flu is generally 5-7 days but the early data from China was suggesting an incubation period of 10-14 days for corvid19. Both of those numbers are variable upon a given snapshot and environmental factors. On the other hand the earlier people encounter this thing means the earlier a population can build the necessary mass immunity resistance.

hanche 7y ago
This. What is urgently needed is to flatten the curve. Maybe we can't reduce the total number of people who get it, but if we can spread out the infection over a longer time period, we may be able to avoid overwhelming the health care system, to the benefit of all.
eagsalazar2 7y ago
That's a good point and highlights a possible misalignment of interests between individuals and the community: me intentionally getting it now, before there are many cases might help me and my family but speeding up spread by doing so might increase the size of the peak for everyone else. Related question: when I imagine the spread I feel like fast moving spread will burn itself out more quickly and completely. But if it slows down too much, might it become like the flu where if only 1/3 of the people get it in a given year we never hit that critical point where everyone is immune and it peters out within a season, giving it time to mutate and keep reinfecting populations year after year much like the flu does?
- xur17 7y ago
  > me intentionally getting it now, before there are many cases might help me and my family but speeding up spread by doing so might increase the size of the peak for everyone else. It's also possible that we'll identify antiviral treatments, etc that will reduce the impact on our health system / death rate (in which case getting it later would be better).
alkonaut 7y ago
> the medical industry Somehow that term to me is more dystopian than “pandemic”.

andrewla 7y ago

What you're saying is close to the standard line -- "flatten the curve". By trying to prevent infection, you slow the process down, so that hospitals are not overwhelmed. An overwhelmed medical system means that every aspect is made worse; people are not contained so the spread accelerates, we don't do backtracing with the same effect, medical personnel get infected, people with easily treatable conditions are not treated, etc. The end state is that almost everyone will be exposed to it, most likely to mutated less deadly variants (because those have higher survivability in viral terms), but if the rate of exposure is slow enough then we can mitigate a disaster.

seankimdesign 7y ago

I've heard the "you can't escape it" argument too, but I'm not too sure if I believe it. Shouldn't we have to avoid it only until the vaccines are ready?

Rury 7y ago
The only way to ensure escape from a disease is to eradicate or contain it. A vaccine helps tremendously in that regards, but alone doesn't guarantee eradication; as we have flu vaccines since the 1930s, yet the flu still remains amongst us. However, this is arguably just a result of vaccination rates; if more people took the flu seriously and were regularly vaccinated, we may have eradicated the flu by now. Same for COVID-19. If people don't ever take this seriously enough, then I doubt we'll eradicate it. The virus is on every continent in ~120/195 of the world's countries, all of which happened in a few months, despite travel bans and quarantines setup to initial outbreak areas. To me that sounds like people need to take it more seriously and put more effort into containing this. Otherwise it looks like it'll end up being endemic just like the flu, and we may never eradicate it despite having a vaccine - as what evidence do we have that enough people will vaccinate themselves when we do have a vaccine, if people keep equating it to the flu...

greenshackle2 7y ago

It could take two weeks before you develop severe symptoms sending you to the hospital. After that you may need intensive care for a couple of weeks. How sure are you that your local hospitals won't be overwhelmed in 2-4 weeks? There are different strains of the virus and it's not clear if getting one of them gives you immunity to other strains.

dvirsky 7y ago

I've read that you need about 40% of the population to be immune to it, for this to die down. Suppose you will inevitably get there no matter what we do (barring a deus ex machina like a vaccine) - you want to do it at a pace that does not overwhelm the health system. Another thing to consider is, that this is like a friction coefficient. So maybe if people spend 80% less time outside, we can maybe equate that to having 25% of the people already immune or something like that, and then 10-15% actual immunity is enough to make it die down.

pbourke 7y ago

> (2) (this is the crazy part) does it actually make sense to get it now before hospitals are overwhelmed and you might be unlucky enough to be sick with something else. Basically choose the most opportune survivable situation to get it versus letting the virus and bad luck pick when you have to fight this battle? No. (1) If you get it, you may spread it, even if you're careful. That chain of spread may lead to additional burdens on the system, or deaths (2) No matter your age, you may become seriously ill, and may draw resources from the system because of irresponsible behavior (3) It's highly possible that after some time has passed, the mortality rate will drop significantly because doctors will develop a good protocol. If you get it now, you risk being treated in a system that is still figuring this thing out (4) If you get it, you will not be available to help anyone else if needed due to the required isolation period The only ethical thing to do is to try as best you can not to become sick and also to support your community through this difficult time with money or volunteer labor. So, if you are a highly-paid techie who can work from home and limit your interaction with others in the community, do so.

etaioinshrdlu 7y ago
Only number 3 is a potential benefit to the individual. The rest are for the community’s benefit. Remember we are on a site full of people with a rather “every man is an island” attitude...
- baq 7y ago
  In line with ‘never waste a crisis’ policy maybe some of them will be swayed to a more community-oriented mindset.

MikeHolman 7y ago

Probably too late for that. Italy outbreak was only like 19 days ago, so I imagine US will be there in about 2 weeks. I would guess it takes at least a couple weeks from exposure to get into critical condition and treated.

rb808 7y ago

Yes if you're vulnerable it would be better to get it today than in a month when hospitals are full. However it would be even better not to get it at all or get in 6 months time when doctors know more about how to treat the disease and could have drugs that are known to work. It sounds like your family is young enough to not really be badly hurt, its more about how many people you'd pass it on to.

RealityVoid 7y ago

So I was on Youtube when WHO was holding the conference giving the promotion and I caught about 10 minutes off it. In there, the spokesperson said exactly concerning 1) that we SHOULD still enact containment measures, and that those containment measures could help nip it in the bud.

dahart 7y ago

> (2) (this is the crazy part) does it actually make sense to get it now before hospitals are overwhelmed and you might be unlucky enough to be sick with something else. I don't think that's crazy, it would be quite helpful to be able to plan to catch it, and you can quarantine yourself at home so you don't spread it to anyone. The big trick is to be able to avoid spreading it around during the symptomless incubation period. Catching the virus on purpose could help you do that. > (1) is it fair to say that focusing on prevention is pointless and we should just focus on survival I don't think so. The point is to lower the exponent. Buying time has a lot of value.

LZ_Khan 7y ago

No to number one as prevention is very important, as you wont receive care if hospitals are overwhelmed. Also, containing the virus is useless if in the end a vaccine is able to be developed. Number two makes more sense as not having access to care and equipment later on can be a problem.