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This works for a while, but we can't realistically expect to just shut the country down for the next year or so. Surely there is some kind of plan to try to ac
by rootusrootus 7y ago
This works for a while, but we can't realistically expect to just shut the country down for the next year or so. Surely there is some kind of plan to try to actively suppress the virus rather than just reduce the R0 slightly? While Congress throws around a trillion here, trillion there, why not make testing every last American (multiple times, as necessary) priority #1? Then we can get people back to work much sooner, and let the economy start to recover.
- hkmurakami 7y agoThere's a huge international effort to develop a vaccine or a suppressant, etc. The US doesn't have even close to the necessary number of testing kits or infrastructure to test 300 million people. They're working on ramping up production and availability of tests.
- forkexec 7y agoThere is no working vaccine. Multiple candidates will take a year and a half if everything works perfectly. It's possible that a vaccine will not be found.
- auspex 7y agoThey already have a corona virus vaccine for many live stock animals so at least that is promising
- arkitaip 7y agoHistorically, a reasonably safe vaccine has taken many years to develop. Rushing a vaccine through the system so it only takes months? Yeah, I not going to stand in line to get vaccinated.
- James_Henry 7y agoThere are promising treatments though, and these should show results within weeks or months.
- wy3yebdudu 7y agoFailure is a result that can be displayed, number of candidate treatments isn't a real metric for making predictions.
- James_Henry 7y agoI think I don't fully understand what you are saying, but there have been preliminary trials suggesting that some of these candidate treatments are helpful in treating the disease.
- brokensegue 7y agoeven just vaccinating the people in the high risk groups would be a huge win. and those people are much more likely to get in line.
- capkutay 7y agoHistorically, we've never seen the world's top researchers, governments, and pharmaceutical companies all racing to come up with a vaccine and treatment at once while sharing data at unprecedented scale. I understand allowing reasonable time to complete trials, but let's not act like this is just a routine drug approval.
- andrewingram 7y agoThere are already vaccine trials underway, the 12-18 months is the minimum amount of time we allow for making sure the cure isn't worse than the disease. We're basically talking about giving this vaccine to every at-risk person in the world. If it's not safe, that would be a really bad outcome. The unprecedented scale will allow more parallel efforts, to the point that the odds of a viable vaccine being available next year are much greater, but it won't speed up the minimum time.
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- capkutay 7y agoMy comment didn’t suggest otherwise. I was referring to both treatments and vaccines.
- hilbertseries 7y agoThe vaccine candidate didn't take very long, because researchers were able to re-use the initial work done for making a SARS vaccine. But it will still take 12-18 months to test the vaccine candidates.
- tomerico 7y agoThere is a reason vaccines take a long time to approve - if you are getting the general population vaccinated, you want to make sure the side effects a year down the road don't negate the benefit (if any, vaccines are not 100% effective)
- anonuser123456 7y agoThere aren't enough tests, and we need time to scale out the testing. So a 3-4 week period to put a tight clamp on transmission is probably not a bad idea. Frankly, I expect in 3 weeks people won't need the order because it will be like Italy and people will be terrified to go outside. But at that point, you STILL have 3-4 weeks before things turn around.
- Recursing 7y agoYoung people are still going outside in Milan today, it's a big problem, you need to take these measures
- blueboo 7y agoThis doesn’t put a tight clamp on it. We’re not systematically testing and quarantining so this is more akin to a light tap on the breaks. The UK PM wouldn’t even venture end of June as his most optimistic forecast for returning to normalcy. Prepare yourself.
- dimator 7y agoyou're right, testing is the long term solution. you can't control what you can't measure. the embarrassing point is that in the US, isolation is the only effective tool at this point. it's embarrassing because ramping up testing was what South Korea did, and they started much sooner, and that's why they are over the hump now. the US simply doesn't have the testing scaled up. https://www.reuters.com/article/us-health-coronavirus-testing-specialrep/special-report-how-korea-trounced-u-s-in-race-to-test-people-for-coronavirus-idUSKBN2153BW https://www.reuters.com/article/us-health-coronavirus-testin...
- pwned1 7y agoTesting is rising extremely quickly in the US. Over 27,000 in the last 24 hours: https://covidtracking.com/us-daily/ https://covidtracking.com/us-daily/
- m0zg 7y agoIMO it's a mistake to bring it up so quickly. Most people (and especially those downvoting this post :-) aren't very bright even under the normal circumstances, let alone in a full blown panic, they'll think that this is how many infections we're getting, whereas in fact those infections were already out there, we just couldn't confirm them. Some will conclude (likely incorrectly) that the current distancing measurements aren't doing jack shit.
- whatshisface 7y agoSure, so the solution to idiots misinterpreting the data is that we need to make it impossible for experts to record the data. /s
- dublinben 7y agoIt sounds like we should be doing more education, rather than less testing.
- luke0016 7y agoWhat's the alternative? Wallow in ignorance some more? I prefer to know what's actually going on.
- guerrilla 7y agoBesides supply issues, that hardly seems realistic when the US can barely manage to collect taxes, a trivial activity in other modern countries.
- vanusa 7y agoThis works for a while, but we can't realistically expect to just shut the country down for the next year or so. I read it more as a "Shut it all down please, then let's figure out which parts we can start to re-open in 4-6 weeks" order.
- caseysoftware 7y agoAnd 4-6 weeks is long enough for many of the infections to burn themselves out which decreases the R0 and decreases the likelihood of immuno-compromised people running into someone infected. It's the equivalent of firebreaks in forest fires. We know it's there, let's prevent it from spreading where/when we can.
- TechBro8615 7y agoNot a doctor, but I’m skeptical of the idea that the virus can “burn out” or that we can “starve it.” Is there any scientific evidence to support this theory? To me it seems like social distancing (“lowering the R0”) can delay propagation but has no effect on the underlying infection rate. It’s hard to see how we are not “delaying the inevitable” with social distancing. Can anyone clarify this? Sorry if it’s been asked multiple times.
- clairity 7y agoviruses “die” when they can no longer hold their infectious structure, presumably due to battling the elements (literally elements and molecules, heat, radiation, etc.), not to mention the active defenses of organisms. it seems this virus dies in a few hours/days outside of a cozy host environment. so yes, get the transmission rate down far enough and it can die out.
- TechBro8615 7y agoWhile that’s encouraging (also, username checks out)... I find it difficult to put myself the shoes of a 60-80 year old adult in 3 months. At what point will I feel confident enough that I can leave my house? It seems the most logical conclusion is that we’ll end up in a situation where the most vulnerable segment of the population remains self-quarantined at least until a therapeutic treatment becomes available, which could be over a year. I have a very hard time imagining people able to do this.
- capkutay 7y agoThe idea is just to buy as much time as possible. There are hundreds of clinical trials for treatments going on across the planet...it's possible chloroquine may even be identified as prophylactic. Also need to give our healthcare workers time to mobilize all their emergency measures to handle surge capacity. I'd imagine the Bay Area is about 2-3 weeks away from its peak number of cases given the quarantine just started last weekend.
- hkmurakami 7y agoThe hospitals are gearing up for it. A friend is a cardiologist and he's going to be "on the Frontline" in the next week or two. Specialists are going outside their normal duties to deal with the influx. Their family is discussing living separately to avoid infecting inside the family.
- scotty79 7y agoGood luck with suppressing the virus in the US while 5 billion people in the world get infected.
- zzleeper 7y ago??? China is down to zero cases. South America except for the two black sheep (Mexico and Brazil) is shutting down (Peru had curfew-in-place since the weekend; anyone even driving their car outside is arrested). Europe is also going there, plus Israel, several Arab countries, etc. Only big black sheeps right now are the US, parts of Europe, India, and Africa (which is only now getting their first wave).
- scotty79 7y ago> China is down to zero cases. Zero own cases, they still have imported cases. And that only means no cases that are symptomatic. And zero cases just means zero cases now not in the future. This thing spreads like a common cold. More infectious than a flu. You can't suppress common cold. Not forever. Humanity never eradicated a disease without a vaccine.
- MiroF 7y ago> Humanity never eradicated a disease without a vaccine. SARS within the last 2 decades? Look, I think eradication is a pipe dream at this point, but it'd be worth mildly checking your facts before posting. e: If I'm getting flagged, at least tell me why?
- hourislate 7y agoI don't think SARS was eradicated? They were able to contain it and it died out naturally, disappeared. But that doesn't mean the same virus couldn't come back. I could be wrong but that's how I remember it.
- scotty79 7y agoI'm not sure if SARS is considered eradicated. There were no human cases since 2004 but I don't think we dealt with it in original animal population. I think we don't get human cases because jumping to humans again is quite hard for SARS.
- ryanmccullagh 7y agoSince most tech workers can work remote, people like DHH, and the Base Camp boys [0] spew their ignorance about other industries and encourage a 'shut down' since it won't affect their business, or their day-to-day work. [0] https://twitter.com/jasonfried/status/1240818423795515393 https://twitter.com/jasonfried/status/1240818423795515393
- andbberger 7y agoscrew your business, millions of lives are at stake here.
- p1necone 7y agoLives are at stake from people losing their livelihood as well though, you need to weigh up the effects of the virus vs basically shutting down the economy. Of course if half of Americans didn't deride any sort of safety net as communism the situation might be less uncertain.
- inferiorhuman 7y agoIt's a lot easier to print money and work to get a hold on inflation than it is to bring someone back from the dead.
- MiroF 7y ago> why not make testing every last American (multiple times, as necessary) priority #1 These discussions are so far divorced from the reality of the interventions available to policymakers.
- omar_a1 7y agoIn practice it would look something like "Test every last American [with insurance coverage]" plus the usual assumptions about people without medical insurance not existing.
- MiroF 7y agoEven still, we just can't scale up PCR like that.
- dwaltrip 7y agoHow long does it take to build PCR machines? Why can't we build 100,000 of them (or whatever the appropriate number is)? If it costs tens of billion dollars, so be it. That's far cheaper than shutting the economy for months at time. This is essentially a war-time effort we are in. I believe government has the authority to mandate that companies with relevant manufacturing capability build and sell these machines in order to combat the virus.
- omar_a1 7y agoYea, having lab experience, I think as long as the equipment, reagents, and consumables are all available, lab techniques scale fairly well. You might be running your scientists ragged between installing the new instruments, keeping all the machines running and prepping assays, but it'll get done. However, sufficient availability of supplies and equipment for this scale of operation is a pretty big if.
- rootusrootus 7y agoThat may be true, but when Congress is willing to spend trillions of dollars on mitigating this pandemic, then it doesn't seem so far-fetched to me any more. How much would it cost to develop a test method that could be engineered to support testing the entire population of the United States? In normal times I'd say obviously this is a non-starter, but now I'm thinking we have a pretty big budget.
- anarazel 7y ago(not not an epidemiologist, just interested) Once testing becomes widespread enough that it's feasible to test a lot more people it's quite plausible to relax the restrictions. One big problem before the recent "shelter in place" state is that community transmission by asymptomatic people was/is out of control. If only strongly symptomatic people are "allowed" to be tested and health care professions aren't tested, it's basically impossible to restrict spread of something as infectious as covid-19. And once people with a lot of contacts have it, and stay in contact, further spread will obviously accelerate. If you look at the buildup of test capacity in the US (far far to late obviously), it's improving at a decent rate (from a totally embarrassing starting point): https://covidtracking.com/us-daily/ https://covidtracking.com/us-daily/ (there's a lot of differening sources, several lagging, but the trend is similar afaictl) So there finally does appear to be some serious and successful effort in building up test capacity. Testing everyone in the US seems far off still though. Given the rates of hospitalization and available beds / respirators, it'd however be insane to rely on testing at this point. Spread would be far too fast, and there's obviously not enough testing. But if infections slow down due to the isolation, and testing ramps up at the same time...
- jacobolus 7y agoIn particular, if we have serological tests we can find out who has had the disease with no symptoms or mild symptoms. Anyone who has had the disease and recovered can afterward go about their life again, as they cannot (for at least a few months, if not longer) be reinfected or spread the disease.
- chanchar 7y agoHave there been any studies on if the virus can mutate?
- selectodude 7y agoIt mutated its way from affecting bats to affecting people. Fortunately, the vast, vast majority of mutations either do nothing or make things actively worse. https://qbrc.swmed.edu/projects/2019ncov_immuneviewer/ https://qbrc.swmed.edu/projects/2019ncov_immuneviewer/ That's the chain of mutations for SARS-Cov-2 they've seen so far.
- ccktlmazeltov 7y agoTesting leads to panic. The threat number one to the US economy is panic. Whatever happens next, panic is much much more damaging for the economy and for stability. There's already a plan in place, and most people don't know it but there's already a timeline. At this point testing people is useless: hospitals already provide numbers to the government.
- jmull 7y agoIf we don’t test, that means doing nothing about it at all, letting it spread unrestricted. If everyone with serious symptoms got good care, we’re talking about 2 million dead. But, of course, a lot of Americans don’t have access to good care on a good day. Since the healthcare system will be massively overwhelmed, only a small percentage will get good care. So you’re talking about something like 5-10 million dead — in the course of months. I don’t think it would get quite that far, though, because once people start literally dying in the streets, people will be afraid and massively self-quarantine. So... maybe four million dead and the economy completely shuts down anyway. Really, the quicker and more aggressively we jump on this, the less the damage, both in terms of human life and economic impact. We’re too late to have a small impact. We’ll feel this for years. Let’s at least try to make something we’ll forget in a generation. Let’s especially make sure we don’t have something they’ll be talking about hundreds of years from now.
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- standardUser 7y agoThe more testing, the more you can control the transmission rate. This is all about the transmission rate (you may have heard "flatten the curve" several hundred times recently). Quarantines are a sucky but effective way to reduce the transmission rate. But with testing, isolation can be reduced, which is necessary because quarantines will only be tolerated for so long in Western nations.
- salty_biscuits 7y agoThe tests aren't perfect. False positive and negative rates are non negligible. Not saying that they are not useful, just they don't solve the problem on their own.
- Consultant32452 7y agoTesting is insufficient. There is no herd immunity to this and that is what they are building. With a disease this virulent, without herd immunity, it will just spread like wildfire again as soon as you loosen up restrictions. There's two paths to herd immunity: vaccine and everyone gets it. Vaccine is probably a year off and not guaranteed. Until then they will be going forward with a hopefully manageable rolling # of infected until herd immunity is built. We're at what, 14k have been infected so far? We're nowhere close to the end. In my opinion, until you start seeing herd immunity scale of people who have been infected and recovered, or a vaccine, we will see pretty stark differences in our lifestyles. Also consider the asymmetric knowledge here. The people in power surely know things they aren't telling you. Destroying the economy is not in their best interest. How bad must it have to be for them to be willing to destroy the global economy and potentially their own fortunes and power structures?
- closeparen 7y agoAs a software engineer, permanent WFH sounds great. As a young adult thinking I should build more cooking skills, this is the perfect opportunity. But as a household of one, isolation is terrifying. I'm not sure how long literally zero human contact is sustainable. I hope we can at least re-enable 1:1 social visits at home before too many months pass. It's also hard to imagine that couples who live apart are actually going to stay away from each other until the vaccine.
- maigret 7y agoWhen I was a student, I had a summer with a month with nothing to do, and I had a big backlog of 20+ books. I spent the month almost reading from morning to evening, read around 20 books during the month. It didn't feel like restricting anything, but I was meeting friends every few days still. Yesterday I had a good call with my oldest friend, and it felt good despite being far from each other and unable to meet. So yeah, 2/3 months should be doable. More will be hard.
- pgsbathhouse2 7y ago>This works for a while, but we can't realistically expect to just shut the country down for the next year or so. We didn't shut down. We stopped doing what's unnecessary. There's a big difference, and now that reality has made us "wake up" we should probably reevaluate how we structure our economy and society.
- gdubs 7y agoBill Gates did an AMA on Reddit and said the optimistic angle is that the antivirals and various therapeutics, etc, will come much faster than a vaccine and bring the rate of infection down. Clamping down now buys some time. Nothing is guaranteed of course, except for letting it “run its course” in which case the system risks collapse and you end up with bigger problems than we even face now. People treat this like a binary choice between “save the economy” and “save the elderly”, but if you’ve been following this at all it’s clear that there’s no simple answer in either direction.