5 ms·

This is an unpopular opinion on HN, but government overreaction caused the crash. Rather than having at-risk people self-quarantine for a month, with governmen

This is an unpopular opinion on HN, but government overreaction caused the crash. Rather than having at-risk people self-quarantine for a month, with government financial assistance of course, while the rest of us build up antibody resistance, we collectively lost our shit and decided all people needed to self-quarantine for months -- just delaying the inevitable. It's actually quite easy to self-quarantine everyone over 70, since they're receiving government assistance anyway (Social Security). But now there are already thousands of job losses from young, healthy, productive people that have almost zero chance of dying from this disease. The UK will be mostly done with Covid-19 in two months, with much less dire economic consequences -- and the US will still be playing whack a mole and killing the economy with healthy 25 year-olds holed up in their apartment.

thepete2 7y ago
I estimate that it's quite risky to follow that strategy. If you allow the virus to spread uncontrolled among younger people, who is to say that the then smaller fraction of serious cases doesn't still overwhelm the health system? There are rare cases where perfectly healthy people are in need of hospitalization.
- nostromo 7y ago
  That's definitely a risk. And I think the NHS in the UK allows them to better respond to that risk by triaging patients and selecting who needs to stay at home and who needs to be admitted. But the point I keep hearing from knowledgable people is that rapid spread is inevitable at this point. So many or most of the dramatic actions taken by state and federal governments now are security theater.
  - jacobolus 7y ago
    > point I keep hearing from knowledgable people is that rapid spread is inevitable at this point. The point I keep hearing from every reputable epidemiologist, virologist, and public health expert around the world is that people need to stay the fuck at home because this virus is extremely dangerous and if left unchecked will completely overwhelm every hospital system in the world. Some public officials didn’t believe it when it was just Hubei, but after seeing the same happen in Lombardy, a rich region in Europe with a strong healthcare system, the situation became clearer. Edit: here’s a nice summary written by a Bay Area marketing executive (based on work by epidemiologists and others) https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
    - nostromo 7y ago
      I'm pointing to the decision made by the National Health Service -- and you're countering with a bay area marketing executive's hot take on Medium?
      - jacobolus 7y ago
        No, I’m responding with a piece written by a nonspecialist with a general data/technical background who is also an excellent writer, who spent a bunch of time reading and digesting data and arguments published by epidemiologists and public health experts, and then synthesized that into one clear and coherent summary aimed at a lay audience, including many links to the direct sources so that readers can click through to evaluate them. * * * If you spend some time hunting around for career epidemiologists and other experts to read, they are as far as I can tell unified in opposition to the British plan, and have been calling it out as sheer folly in published opinion pieces and ranting about it on twitter. For example, https://www.theguardian.com/commentisfree/2020/mar/15/uk-covid-19-strategy-questions-unanswered-coronavirus-outbreak https://www.theguardian.com/commentisfree/2020/mar/15/uk-cov... I guess we’ll all see how things play out in the next month or two, but I’d much rather be in South Korea or Taiwan than England right now.
      - jacobolus 7y ago
        If you want something more reputable, how about Imperial College London’s epidemiologists: https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf https://www.imperial.ac.uk/media/imperial-college/medicine/s...
- deleted 7y ago
  [deleted]
- nbardy 7y ago
  It's not just rare cases. 12% of the people in hospital in Italy are under age 50.
kube-system 7y ago
The UK health minister was on the news just the other day begging manufacturers for more ventilators. They'll get over it quicker, but at what cost? > We have around 5,000 ventilators and we think we need many times more than that. We are saying that if you produce a ventilator then we will buy it. No number is too high.
- raesene9 7y ago
  that bit was a really disappointing piece from the UK Gov. Did they really not realise until just now that they might need more ventilators. They've had at least a month of knowing this was coming...
pjc50 7y ago
Johnson is right now turning around this advice. https://www.bbc.co.uk/news/uk-51917562 https://www.bbc.co.uk/news/uk-51917562
jmull 7y ago
In case you’re sincere... I think you should take a look at what’s happening in Italy right now, and understand a lot of countries are going to experience the same thing. The basic issue is that as the virus spreads exponentially we’ll quickly run out of intensive care beds and ventilators. At that point, the mortality rate of Coronavirus goes way up and so does the mortality rate of many, many kinds of acute illnesses. Because there will be people in need of immediate care and there will literally be none available. The economic crash will be softer, shallower, and rebound quicker depending on how disruptive the Coronavirus ends up being. Strong, facts-based actions early will have a massive disproportionate effect for the better. I agree the US is screwed, but it’s because we have not and still are not taking this seriously. We’re still taking basic steps to ramp up testing capability when we should be desperately building out emergency ICU capacity.
- rlt 7y ago
  In principle you could isolate just the higher-risk individuals, but the age limit you'd want to avoid overwhelming the healthcare system is wayyyy lower than 70, probably around age 40 where the CFR is maybe 0.2% [1] 1. https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/ https://www.worldometers.info/coronavirus/coronavirus-age-se...
  - jmull 7y ago
    You could — if you thought that would slow things done enough to prevent overwhelming the healthcare system. At the moment it looks like we probably haven’t done enough, seems crazy to consider doing less. It’s not like younger people are a self-contained sub-population. Increased rate of transmission among younger people means an increased rate of transmission to older people too.
raesene9 7y ago
If you compare Italy and South Korea, I think you can see why governments are going for the quarantine approach. In Italy they initially took a relatively light approach to restrictions and the result was the Northern Italy's hospitals were quickly overwhelmed by cases. This has the effect of not just meaning increased mortality amongst covid-19 sufferers but also all the other patients who would usually be using those hospital facilities. In south Korea they seem to have had a much more draconian response (after the initial surge of cases) and as a result have got the rate of increase under control, allowing the more serious cases to be better treated. The difference in mortality rate between these two countries is stark, and whilst there are other factors (demographic ones) in play, it seems fair to say that gov. response plays a role. The other argument for a stronger response is the longer this goes the more likely effective treatments will be developed/validated, reducing mortality.
- nostromo 7y ago
  South Korea is not forcing at-home quarantine for everyone. Italy is. South Korea's success is all about their widespread testing. The difference in mortality rate is because South Korea knows how many people have it, and Italy has no clue. Which, again, is because of testing, not quarantine.
  - raesene9 7y ago
    South Korea has a load of infrastructure built up after SARS/MERS, no-one in Europe does, The option of "test/track all the people" is not on the table in Europe. Heck the UK, who's response I gather you favour, are cutting the sets of people they test, not increasing them.
- easytiger 7y ago
  I do t know if you made a mistake but you have got your characterization completely backwards vis a vis those countries respective responses
triceratops 7y ago
> It's actually quite easy to self-quarantine everyone over 70 Is it though? What about the ones in nursing homes? How do you quarantine the workers who work there? What about when the over-70s living at home have to go to the doctor, or for their chemotherapy or dilation treatments? How are they going to isolate themselves from all the people they'll interact with while doing that? > The UK will be mostly done with Covid-19 in two months Is what they're hoping. We won't really know for another 2 months. At that point they'll either look like geniuses or callous morons. And if it's the latter, it'll be too late to change course.
takeda 7y ago
For the self quarantine thing to work the testing would need to be effective, and we dropped the ball there, we refused to obtain test kits from WHO, we provided broken test kits from CDC. We made ridiculous restrictions to obtain tests. If we would follow South Korea's example, and test as many people as we could, we would be now over the hump.
theandrewbailey 7y ago
> It's actually quite easy to self-quarantine everyone over 70, since they're receiving government assistance anyway (Social Security). But now there are already thousands of job losses from young, healthy, productive people that have almost zero chance of dying from this disease. Your suggestion is indistinguishable from no quarantine at all (not to mention being incredibly ageist, as there are millions of economically productive 70+ year olds). You forgot the part where even a 'healthy' 25 year-old can spread the disease to others, even if mild or no symptoms appear.
- deleted 7y ago
  [deleted]
deleted 7y ago
[deleted]

thepete2 7y ago

I estimate that it's quite risky to follow that strategy. If you allow the virus to spread uncontrolled among younger people, who is to say that the then smaller fraction of serious cases doesn't still overwhelm the health system? There are rare cases where perfectly healthy people are in need of hospitalization.

nostromo 7y ago
That's definitely a risk. And I think the NHS in the UK allows them to better respond to that risk by triaging patients and selecting who needs to stay at home and who needs to be admitted. But the point I keep hearing from knowledgable people is that rapid spread is inevitable at this point. So many or most of the dramatic actions taken by state and federal governments now are security theater.
- jacobolus 7y ago
  > point I keep hearing from knowledgable people is that rapid spread is inevitable at this point. The point I keep hearing from every reputable epidemiologist, virologist, and public health expert around the world is that people need to stay the fuck at home because this virus is extremely dangerous and if left unchecked will completely overwhelm every hospital system in the world. Some public officials didn’t believe it when it was just Hubei, but after seeing the same happen in Lombardy, a rich region in Europe with a strong healthcare system, the situation became clearer. Edit: here’s a nice summary written by a Bay Area marketing executive (based on work by epidemiologists and others) https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
  - nostromo 7y ago
    I'm pointing to the decision made by the National Health Service -- and you're countering with a bay area marketing executive's hot take on Medium?
    - jacobolus 7y ago
      No, I’m responding with a piece written by a nonspecialist with a general data/technical background who is also an excellent writer, who spent a bunch of time reading and digesting data and arguments published by epidemiologists and public health experts, and then synthesized that into one clear and coherent summary aimed at a lay audience, including many links to the direct sources so that readers can click through to evaluate them. * * * If you spend some time hunting around for career epidemiologists and other experts to read, they are as far as I can tell unified in opposition to the British plan, and have been calling it out as sheer folly in published opinion pieces and ranting about it on twitter. For example, https://www.theguardian.com/commentisfree/2020/mar/15/uk-covid-19-strategy-questions-unanswered-coronavirus-outbreak https://www.theguardian.com/commentisfree/2020/mar/15/uk-cov... I guess we’ll all see how things play out in the next month or two, but I’d much rather be in South Korea or Taiwan than England right now.
    - jacobolus 7y ago
      If you want something more reputable, how about Imperial College London’s epidemiologists: https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf https://www.imperial.ac.uk/media/imperial-college/medicine/s...
deleted 7y ago
[deleted]
nbardy 7y ago
It's not just rare cases. 12% of the people in hospital in Italy are under age 50.

kube-system 7y ago

The UK health minister was on the news just the other day begging manufacturers for more ventilators. They'll get over it quicker, but at what cost? > We have around 5,000 ventilators and we think we need many times more than that. We are saying that if you produce a ventilator then we will buy it. No number is too high.

raesene9 7y ago
that bit was a really disappointing piece from the UK Gov. Did they really not realise until just now that they might need more ventilators. They've had at least a month of knowing this was coming...

pjc50 7y ago

Johnson is right now turning around this advice. https://www.bbc.co.uk/news/uk-51917562 https://www.bbc.co.uk/news/uk-51917562

jmull 7y ago

In case you’re sincere... I think you should take a look at what’s happening in Italy right now, and understand a lot of countries are going to experience the same thing. The basic issue is that as the virus spreads exponentially we’ll quickly run out of intensive care beds and ventilators. At that point, the mortality rate of Coronavirus goes way up and so does the mortality rate of many, many kinds of acute illnesses. Because there will be people in need of immediate care and there will literally be none available. The economic crash will be softer, shallower, and rebound quicker depending on how disruptive the Coronavirus ends up being. Strong, facts-based actions early will have a massive disproportionate effect for the better. I agree the US is screwed, but it’s because we have not and still are not taking this seriously. We’re still taking basic steps to ramp up testing capability when we should be desperately building out emergency ICU capacity.

rlt 7y ago
In principle you could isolate just the higher-risk individuals, but the age limit you'd want to avoid overwhelming the healthcare system is wayyyy lower than 70, probably around age 40 where the CFR is maybe 0.2% [1] 1. https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/ https://www.worldometers.info/coronavirus/coronavirus-age-se...
- jmull 7y ago
  You could — if you thought that would slow things done enough to prevent overwhelming the healthcare system. At the moment it looks like we probably haven’t done enough, seems crazy to consider doing less. It’s not like younger people are a self-contained sub-population. Increased rate of transmission among younger people means an increased rate of transmission to older people too.

raesene9 7y ago

If you compare Italy and South Korea, I think you can see why governments are going for the quarantine approach. In Italy they initially took a relatively light approach to restrictions and the result was the Northern Italy's hospitals were quickly overwhelmed by cases. This has the effect of not just meaning increased mortality amongst covid-19 sufferers but also all the other patients who would usually be using those hospital facilities. In south Korea they seem to have had a much more draconian response (after the initial surge of cases) and as a result have got the rate of increase under control, allowing the more serious cases to be better treated. The difference in mortality rate between these two countries is stark, and whilst there are other factors (demographic ones) in play, it seems fair to say that gov. response plays a role. The other argument for a stronger response is the longer this goes the more likely effective treatments will be developed/validated, reducing mortality.

nostromo 7y ago
South Korea is not forcing at-home quarantine for everyone. Italy is. South Korea's success is all about their widespread testing. The difference in mortality rate is because South Korea knows how many people have it, and Italy has no clue. Which, again, is because of testing, not quarantine.
- raesene9 7y ago
  South Korea has a load of infrastructure built up after SARS/MERS, no-one in Europe does, The option of "test/track all the people" is not on the table in Europe. Heck the UK, who's response I gather you favour, are cutting the sets of people they test, not increasing them.
easytiger 7y ago
I do t know if you made a mistake but you have got your characterization completely backwards vis a vis those countries respective responses

triceratops 7y ago

> It's actually quite easy to self-quarantine everyone over 70 Is it though? What about the ones in nursing homes? How do you quarantine the workers who work there? What about when the over-70s living at home have to go to the doctor, or for their chemotherapy or dilation treatments? How are they going to isolate themselves from all the people they'll interact with while doing that? > The UK will be mostly done with Covid-19 in two months Is what they're hoping. We won't really know for another 2 months. At that point they'll either look like geniuses or callous morons. And if it's the latter, it'll be too late to change course.

takeda 7y ago

For the self quarantine thing to work the testing would need to be effective, and we dropped the ball there, we refused to obtain test kits from WHO, we provided broken test kits from CDC. We made ridiculous restrictions to obtain tests. If we would follow South Korea's example, and test as many people as we could, we would be now over the hump.

theandrewbailey 7y ago

> It's actually quite easy to self-quarantine everyone over 70, since they're receiving government assistance anyway (Social Security). But now there are already thousands of job losses from young, healthy, productive people that have almost zero chance of dying from this disease. Your suggestion is indistinguishable from no quarantine at all (not to mention being incredibly ageist, as there are millions of economically productive 70+ year olds). You forgot the part where even a 'healthy' 25 year-old can spread the disease to others, even if mild or no symptoms appear.

deleted 7y ago
[deleted]

deleted 7y ago

[deleted]