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> A Nationwide lockdown might make sense if the goal was to snuff the infection out The goal needs to be to snuff the infection out. Otherwise, we will be like

> A Nationwide lockdown might make sense if the goal was to snuff the infection out The goal needs to be to snuff the infection out. Otherwise, we will be like this for the next year and a half while we wait for the vaccine, which IMO is not acceptable when a little extra short-term sacrifice can get us near eradication inside two months. Also, even if the curve is mediated by density, it seems clear enough that a lack of density is not going to be sufficient to prevent it from becoming a crisis. The infection is spreading even in less dense cities like Atlanta, New Orleans, and Saint Louis.

jeremyjh 7y ago
Snuffing the virus out is not an option at this point. Perhaps they could have done that in Wuhan in December, but it is not an choice we can make for the United States in March. And no, we aren't waiting for a vaccine. We will build herd immunity as people contract the virus, develop antibodies and recover from it. The goal now is to moderate the rate at which people acquire the disease so that the critical cases do not overflow health care capacity.
- asdfasgasdgasdg 7y ago
  Snuffing out the virus absolutely is an option. If we adopt a stance that makes R0 < 1, there is no other stochastically possible outcome. Whether we will is another question. > We will build herd immunity as people contract the virus, develop antibodies and recover from it. This is a pipe dream, at least outside the context where we are going to accept megadeaths or years of social distancing. The hospital capacity of the US is such that, if we were to run them all at 100% and somehow hold the virus exactly to the level that maximally utilizes ICUs, it would still take the better part of a decade before we got to the point of having herd immunity.
  - TheAdamAndChe 7y ago
    How is it possible to make R0 < 1 for rural Africa? Or for the remote areas of the world? For something more infectious than the flu? It's impossible, unfortunately. There are billions on the planet without even access to the internet. Many don't have running water or consistent food. How can we get R0 less than 1 there?
    - asdfasgasdgasdg 7y ago
      > How is it possible to make R0 < 1 for rural Africa? Or for the remote areas of the world? For something more infectious than the flu? That's not relevant to the United States if we eradicate domestically and close borders. That said, Africa managed to contain the Ebola epidemic. Let's not underestimate their resolve.
scrollaway 7y ago
> a little extra short-term sacrifice can get us near eradication inside two months. "Near eradication" is not enough if you want to "snuff it out". COVID-19 started with only a couple of cases. There was a patient zero. So no, "a little extra short-term sacrifice" would not be enough, because you are very unlikely to catch everything, especially worldwide. Health workers would inevitably catch it by treating patients, and you can't just tell the entire world to stay home for 3 weeks. Even if you could snap your fingers and do that and have everyone obey, we don't have the infrastructure to provide worldwide basic needs, for free, for everyone, in an automated way; billions would die. Mitigation until vaccine is the only sensible way we know of at this time. Gradual lockdowns to help contain the virus for cities and countries that don't have the testing infrastructure available to seriously prevent spread. We're lucky that this is treated in days/weeks (rather than months/years), and that we have already found a promising treatment (hydroxychloroquine). It'll help the mitigation phase a lot. Edit: To address "If we adopt a stance that makes R0 < 1, there is no other stochastically possible outcome.": This is untrue if you're time-bounding this to "before we make a generally-available vaccine".
- asdfasgasdgasdg 7y ago
  Oh, I don't think near eradication is an acceptable goal either. We need to actually eradicate it. I specified near eradication because we have proof by example that it is possible. As yet, nobody has actually eradicated the virus in their borders, so I don't want to presume it is possible. However, it needs to be the goal. > To address "If we adopt a stance that makes R0 < 1, there is no other stochastically possible outcome.": This is untrue if you're time-bounding this to "before we make a generally-available vaccine". Depends on what we get the value to. If we get it to 0.5 or below, as it appears China has done, then probably before we get the vaccine ready. But sure if it's at 0.95 then we will have to wait for the vaccine.
  - scrollaway 7y ago
    I think everyone would agree with you. The question is how long that realistically takes, in a minimally-damaging way. I don't think there's a world in which there's a better option than "waiting for the vaccine with various forms of mitigation". Boy would I love to be proven wrong.

jeremyjh 7y ago

Snuffing the virus out is not an option at this point. Perhaps they could have done that in Wuhan in December, but it is not an choice we can make for the United States in March. And no, we aren't waiting for a vaccine. We will build herd immunity as people contract the virus, develop antibodies and recover from it. The goal now is to moderate the rate at which people acquire the disease so that the critical cases do not overflow health care capacity.

asdfasgasdgasdg 7y ago
Snuffing out the virus absolutely is an option. If we adopt a stance that makes R0 < 1, there is no other stochastically possible outcome. Whether we will is another question. > We will build herd immunity as people contract the virus, develop antibodies and recover from it. This is a pipe dream, at least outside the context where we are going to accept megadeaths or years of social distancing. The hospital capacity of the US is such that, if we were to run them all at 100% and somehow hold the virus exactly to the level that maximally utilizes ICUs, it would still take the better part of a decade before we got to the point of having herd immunity.
- TheAdamAndChe 7y ago
  How is it possible to make R0 < 1 for rural Africa? Or for the remote areas of the world? For something more infectious than the flu? It's impossible, unfortunately. There are billions on the planet without even access to the internet. Many don't have running water or consistent food. How can we get R0 less than 1 there?
  - asdfasgasdgasdg 7y ago
    > How is it possible to make R0 < 1 for rural Africa? Or for the remote areas of the world? For something more infectious than the flu? That's not relevant to the United States if we eradicate domestically and close borders. That said, Africa managed to contain the Ebola epidemic. Let's not underestimate their resolve.

scrollaway 7y ago

> a little extra short-term sacrifice can get us near eradication inside two months. "Near eradication" is not enough if you want to "snuff it out". COVID-19 started with only a couple of cases. There was a patient zero. So no, "a little extra short-term sacrifice" would not be enough, because you are very unlikely to catch everything, especially worldwide. Health workers would inevitably catch it by treating patients, and you can't just tell the entire world to stay home for 3 weeks. Even if you could snap your fingers and do that and have everyone obey, we don't have the infrastructure to provide worldwide basic needs, for free, for everyone, in an automated way; billions would die. Mitigation until vaccine is the only sensible way we know of at this time. Gradual lockdowns to help contain the virus for cities and countries that don't have the testing infrastructure available to seriously prevent spread. We're lucky that this is treated in days/weeks (rather than months/years), and that we have already found a promising treatment (hydroxychloroquine). It'll help the mitigation phase a lot. Edit: To address "If we adopt a stance that makes R0 < 1, there is no other stochastically possible outcome.": This is untrue if you're time-bounding this to "before we make a generally-available vaccine".

asdfasgasdgasdg 7y ago
Oh, I don't think near eradication is an acceptable goal either. We need to actually eradicate it. I specified near eradication because we have proof by example that it is possible. As yet, nobody has actually eradicated the virus in their borders, so I don't want to presume it is possible. However, it needs to be the goal. > To address "If we adopt a stance that makes R0 < 1, there is no other stochastically possible outcome.": This is untrue if you're time-bounding this to "before we make a generally-available vaccine". Depends on what we get the value to. If we get it to 0.5 or below, as it appears China has done, then probably before we get the vaccine ready. But sure if it's at 0.95 then we will have to wait for the vaccine.
- scrollaway 7y ago
  I think everyone would agree with you. The question is how long that realistically takes, in a minimally-damaging way. I don't think there's a world in which there's a better option than "waiting for the vaccine with various forms of mitigation". Boy would I love to be proven wrong.