8 ms·

We're in for 2 Months

68 points by foobuzzHN 7y ago

riskneutral 7y ago
"The rate of growth at a given day is the number of new cases on this day, as a percentage of the number of cases from the previous day. The rate of growth is constant for an exponential evolution, and is 0 when there is no more growth. (Mathematically, it is the derivative of the function divided by the function itself.)" I don't think that's the curve they're talking about flattening. I think 2 months is just the lower bound.
- patd 7y ago
  The curve that we must flatten is the admissions to the ICU as that's the main bottleneck if we want to limit the number of deaths. And 2 months is probably not back to normal (international travel, etc). China is still fearing a second wave coming from the rest of the world.
  - humanrebar 7y ago
    I don't believe any country can eradicate the virus within its borders once it has spread sufficiently, at least without some form of herd immunity. I think China knows this and is already finding ways to blame foreigners. I think China could completely shut down its borders and still be at significant, if not inevitable, risk. Note that I think other countries will also play the blame game. I don't plan to buy into the finger pointing as it doesn't really solve anything.
SeekingMeaning 7y ago
> ... stop playing the game of "in our country it's going to be different than in China" ...
moneywoes 7y ago
Haven't cases started reappearing in China? And haven't they had to restart the lockdown.
chrisweekly 7y ago
I'm confused -- or rather, think the author may be -- about what's being measured and inferred. A rate of growth of 0 still means the number of new cases is increasing. The rate of growth needs to be negative before the rate of new cases can peak, slow, and (hopefully someday) stop. Acceleration vs velocity vs position. Right?
- monktastic1 7y ago
  > The rate of growth at a given day is the number of new cases on this day, as a percentage of the number of cases from the previous day. I haven't read the whole thing, but here he's defining "rate of growth" as the number of new cases. If there are 0 new cases each day, then eventually the number of total cases goes to zero.
  - chrisweekly 7y ago
    Thanks.
magnusmagnusson 7y ago
From economical perspective, I don' think United States can stay 'shut down' as it is now. 10 million+ jobless claims MINIMUM in past two weeks.. (since those not eligible are not counted) Gotta figure out a way to get healthy people to work. Or I mean, they could stay closed for 2-4 months but that would be quite a wild time.
- brianwawok 7y ago
  What’s interesting is the wage gap. Many (most) of the shut off jobs are the lower paying ones. Waiters and factory workers. Obviously some weird exceptions (pro athletes). Many of our nations higher paying jobs are either essential (doctors, nurses), or remote friendly (developers , to some extent lawyers and real estate agents). Even if 25% of our economy is not working, we can make near 90% of our GDP. Which isn’t ideal but it makes the lockdown perhaps less dire than it appears for the economy.
  - d4mi3n 7y ago
    Worth noting that many lawyers are also out of work due to courts being closed.
  - mynegation 7y ago
    It may be true for few weeks or so, but if this continues the fallout will be widespread. Lower wage jobs is the bedrock of the whole economy. How much lawyering can you do if you have to take care of your own food prep, childcare, or - simply put - your clients start disappearing one by one because they cannot pay? How much longer you can continue to pay to the banking staff if mortgages and business loans default like house of cards? How much longer can you pay to programmers at Facebook when advertisers like restaurants, spas, hotels are not paying for advertising?...
    - disgruntledphd2 7y ago
      Advertising is an incredibly recession resistant industry. Especially for FB and Goog, as they use second-price auctions, so anyone who measures their results will see performance improvement, make more money and thus (theoretically) invest more in advertising until it is no longer profitable. They'll lose some revenue, but it won't be anything ridiculously large; and even if it is, some of the previously priced out advertisers (less profitable mobile games, for instance) will return. Advertising is a hell of a business, especially online.
ckdarby 7y ago
Does anyone believe the numbers that China has given? I asked as I see everyone use them to compare against but then I see articles popping up talking about reporters who reported difference numbers just vanish over night.
- Tade0 7y ago
  There's a little trick a government can pull to at least make the death rates look smaller: https://www.who.int/classifications/icd/covid19/en/ https://www.who.int/classifications/icd/covid19/en/ Simply classify the cause of death to be the virus only in tested and confirmed cases (U07.1 COVID-19, virus identified). That's what my country's (Poland) government is doing and lo and behold - our numbers are relatively small.
  - nathell 7y ago
    That's no longer the case as of April 1st: https://www.pzh.gov.pl/wp-content/uploads/2020/04/wytyczne-do-karty-zgonu-01.04.2020-2.pdf https://www.pzh.gov.pl/wp-content/uploads/2020/04/wytyczne-d...
  - kgabis 7y ago
    Doctors are deciding what the cause of death was, not the government. The only way to find out how many people died due to this epidemics is to compare the average death rate before and during epidemics. It will also include people withot ncov-19 that died due to health care system being overloaded.
- jhpriestley 7y ago
  since the criticisms of the Chinese numbers tend to be wild derivations from urns or anonymously sourced US propaganda, yes I am inclined to believe the numbers. If you are seeing these articles "pop up" then you read fake news btw
  - RHSeeger 7y ago
    Given the number of times the Chinese government has been shown to lie and actively try to hide dissenting people/information when it tells a story they don't want told... I think it's fair to start from a point of distrust. Sure, it doesn't mean they're lying about the numbers here, but they started out this whole thing by lying about it, by throwing someone (a doctor?) that did speak out in jail.
drtillberg 7y ago
As long as there are a few cases in the community-- and there always will be-- the end of each lockdown potentially will trigger a surge of cases, and thus a new lockdown. I think what is really going on here is world leaders assume China is most knowledgeable about this virus, because goodness knows its labs probably have been studying it for 15 years, they don't have confidence that China is forthcoming about what it knows, and in a few nations globally the effect borders on catastrophic so it's not something to be ignored. So, governments have copied the more knowledgeable actor, which happens to be an autocratic communist government, in hopes that it's approach is the best informed and effective scientifically . Thus, the answer to 'when do the lockdowns end' really is: when we feel more knowledgeable about the virus than the nations that resorted to placing their populations under house arrest, and therefore feel confident enough to stop following China's example.
asiachick 7y ago
So we all lockdown and the rate goes down. It stop staying locked down won't the rate go back up? The only way the rate stays down is if we stop staying locked down is (a) most people already caught it and are immune (b) we develop a vaccine (c) we develop a cure that is easily mass produced and easily distributed. Until one of those happens we're in lockdown. No? And that means 12 to 24 months.
- hannasanarion 7y ago
  What were holding out for is testing capacity. Once tests are readily available, we can isolate people who catch it and all they people they've been in contact with, and the virus can be held down in quarantine while the rest of society goes on. This strategy has worked in China and South Korea, where life is now slowly resuming, but most other countries haven't caught up with their testing numbers yet. The reason we're all quarantined now is that there's presently no rapid reliable way to tell who needs to be quarantined and who doesn't.
  - standardUser 7y ago
    "What were holding out for is testing capacity." Really? Because I have heard of no plan at the federal or state level to implement a wide-scale test and trace program to contain the virus. This seems like a very good idea, but not one being implemented in the US.
    - ygra 7y ago
      The US is far beyond containment at this point. As are many other countries right now, as well. Only when the cases go down again due to successful measures is containment an option again, as you need enough resources to trace contacts and test every potential infection.
      - standardUser 7y ago
        "Only when the cases go down again due to successful measures is containment" We have already taken measures to contain the virus. So why aren't we preparing these needed resources for testing and tracing while the lockdowns are in effect? Two months will pass and we will be no better prepared than we are today because no government in the US is working towards this. The containment will be for nothing, just a temporary measure that will have to be repeated over and over because we aren't even trying to implement a better solution.
oDot 7y ago
From what I read, a single lockdown doesn't work, as even 1 patient is enough to destroy everything, and a lockdown can't guarantee he wouldn't exist. A solution seems to be selective lockdowns by area backed by a huge amount of testing.
- standardUser 7y ago
  "...as even 1 patient is enough to destroy everything" That implies we are trying to make the virus extinct, which we are not. We want the virus to spread, but at a manageable rate.
  - BlargMcLarg 7y ago
    Which would further imply that circumstances must change to get that manageable rate as long as group immunity is not proven and a vaccine is still lacking. The circumstances pre-lockdown allowed the virus to easily travel beyond China. Both measures and mindset in many Western countries are still incredibly lax. The symptoms mimicking those of cold, flu, etc. also don't help. People value their current freedom, privacy and hyper-mobility way too much for a manageable rate to come to fruition without locking down. Otherwise you'll just end up with a new trend of locking down things for 2 months, then opening up, only for a new patient 0 to lock down everything 2 months later.
  - oDot 7y ago
    Right, my point is that a single lockdown is not enough. You have to have good monitoring and intermittent lockdowns in different areas based on that monitoring
  - asdfasgasdgasdg 7y ago
    I don't think "we" have any desire so clearly defined and articulated as that. This virus so so extremely contagious and deadly that there isn't a manageable rate that is going to get us to a high fraction of immunity within the next two or three years. And the measures apparently required to keep it from growing explosively are pretty extreme. I think that China actually does intend to eradicate the virus domestically, and, tbh, short of a vaccine I'm not sure there's any other politically acceptable exit from this situation. Fwiw I don't think allowing millions of deaths is politically tenable, and I don't think that "lock down the only the vulnerable" is going to work. (I wish I could believe that contact tracing and partial lockdown were sufficient but even Singapore, which by all reports was doing these things, is now SIP with 1/4 as many cases per capita as the US. I think our best case if we can't eradicate is going to look a bit like SK, where schools are shut down and life is very different from what we would typically expect. But that is a best case scenario assuming competent and diligent institutions, which I'm not sure we have.)
burlesona 7y ago
Two months seems like the minimum. The really hard problem is that even if you reduce spread to near zero, it’s almost guaranteed that cases will continue to spread among the essential workers who are still active during the lockdown. As long as that’s the case, the end of the lockdown will result in the cycle starting over. It seems to me that what we’re really doing with the lockdown is buying the time to “mobilize,” in the military sense, our healthcare system. If we had the testing capacity to test everyone and contain only the sick, this would be less serious. If we had 10x as many ventilators, and 100x as much protective equipment, this would be less dangerous. If we had an effective treatment (like a Tamiflu for Covid), then this would be less dangerous. Etc. It seems to me unlikely that we will be locked down less than 2-3 months. But after that, I doubt the public will be willing to endure another global lockdown of this magnitude. Thus I think everything we’re doing now is really about delaying the inevitable long enough for us to get a coherent response in place. To the extent that anyone is a “winner” in a pandemic, it certainly appears to be Taiwan and South Korea, who responded fast enough to the first wave to keep it from requiring an authoritarian response (or, at least thus far).
- danieldk 7y ago
  If we had 10x as many ventilators, and 100x as much protective equipment, this would be less dangerous. Only up to some point, then you run out of specialized personnel who know how to properly treat each patient (including controlling said ventilators). (Re-)training personnel probably takes months to years.
  - SpicyLemonZest 7y ago
    The value of specialized personnel isn't as large as I think you're expecting. Most hospital care boils down to "put them in bed and deliver medication and food at the appropriate times", and patients who need more are likely to die no matter what care they get. It's tragic that some people will die who could have been saved with intensive specialized intervention - but once everyone can be intubated, there's probably no "overload threshold" where lots of people die when they would have otherwise left in good health.
captain_crabs 7y ago
If real information about China were to leak out, my guess is it would happen through the vector of internet/social media. Chances are, some other source would need to copy + repost it before being taken down. This is what I looked for. One such account which is purportedly doing this is https://twitter.com/truthabtchina https://twitter.com/truthabtchina. To summarize this, among other rumors: - lots more people have died that communicated (there's an estimate of ~22m due to missing cell phone contracts) - riots are happening between regions where lockdown occurred, and regions next to them) - lockdown isn't practically over in areas where resurgence of infection is happening (pending other containment approaches) edit: I've eaten dinner with some friends from China in the past month before lockdown started, and am in frequent contact with people traveling throughout SEA. I was trying to provide and summarize a potential semi-primary source. Added some more specific #'s, info, and removed inflammatory words. Sorry - I wasn't trying to be fear-mongery. However, I am trying to accurately reflect a harsher reality I do think it's quite reasonable to assume some areas of China are getting back to normal. I also think it's quite unreasonable to assume info _isn't_ being censored and controlled, especially post journalist-eviction.
- baron_harkonnen 7y ago
  Do people on HN really have no friends/connections in China? People post comments like this as if it's some mysterious information black hole where we can never know what's really happening. I communicate pretty often with people living in China and with family and living in China. Things, even close to Wuhan, are returning to normal. People are going out, eating out, socializing more. From all of the everyday people reporting there is no obvious or visible things not being reported. By and large people in China are primarily worried about America right now. It wouldn't shock me if there was some important information not being reported, but this conspiratorial "If real information where to leak out" is nonsense since you can very easy interact and talk with actual people living in China.
  - smacktoward 7y ago
    There is also the willingness of Chinese companies and individuals to ship PPE gear to the US. If the government there were really still in crisis mode, you would expect it to clamp down hard on that sort of thing.
hn_throwaway_99 7y ago
As others have pointed out, this only gets thing to a steady state while everyone is still locked down. All the countries that have loosened their lockdown restrictions had to tighten them back up after they had new "flare-ups". We're in this for many, many months. Somehow a lot of people have forgotten that "flattening the curve" greatly lengthens the time period of the curve. Also, the thesis behind flattening the curve is still that the same number of people eventually get it, and it's only once you get broad population immunity that the spread stops. We will be fighting this with social distancing until there is a vaccine.
- maxerickson 7y ago
  The area under the flat curve is dramatically smaller. The theory is not that the same number of people get it.
  - foobarbecue 7y ago
    That's not how I understand it. "Flattening the curve" refers to reducing the peak. In the models I've seen, at the end of the epidemic, the %of population who have been infected is roughly the same with and without intervention. The point is that there were fewer infected at the same time.
    - maxerickson 7y ago
      Reducing the load on the medical system is the immediate goal, but the total number of people infected will also be smaller. Take the extreme example of Taiwan. If reports are accurate and they maintain their current situation, the literally flat curve there will lead to a few thousand people getting infected out of 23 million. Or compare this outbreak to the first SARS, where asymptomatic spreading was much less of an issue. Very few people globally got SARS, exactly because interventions to stop the spread were effective.
      - hn_throwaway_99 7y ago
        > Very few people globally got SARS, exactly because interventions to stop the spread were effective. But SARS was also much less contagious than this virus, especially during the asymptomatic phase. SARS also was much more lethal, meaning people that got it had less of a chance of transmitting it, because they were dead. This virus is kind of the worst of all world's, in that it's very dangerous but only for a relatively small portion of the population, and that it can be spread by asymptomatic people much more easily. This means that it's very easy for any "embers" burning anywhere to eventually flare up into huge blazes wherever there are large number of people that still don't have immunity.
temac 7y ago
On one hands tons of countries locked down after China (relative to the number of serious cases or deaths - I understand there is a debate about Chinese numbers, but I don't find it relevant here, because Italy or France also did not test a lot and also under-reported deaths -- basically counting only cases that were tested and died in an hospital -- in the end given the dynamic of the epidemics and other uncertainties it does not change a lot rough date predictions even if there would be 3 times more deaths) So it even could take a few more weeks to get to the same low point again. Plus China had an extremely aggressive strategy, accumulating the measures, and even Italy did not use all of them. And France does less than Italy (non essential production has not been stopped by the government in France). On the other hand I doubt we are going to eradicate the disease (at least not in the immediate future and not only with worldwide lockdowns), so we might want to use another lifting strategy than what they did in China (if we manage to develop means to control the spread at a very low rate) 2 months is still a reasonable approximation, given all the unknowns. But I will not even be surprised if it ends up being 3, and 4 is not out of the question.
deleted 7y ago
[deleted]
animalnewbie 7y ago
If you're trusting China's numbers I don't know if I shoukd trust your analysis.
zabana 7y ago
What I'm worried about is the number of people who will suffer as a consequence of this worldwide lockdown. Depression, loneliness, suicide, addictive behaviours (alcohol, tobacco, recreational drugs), high stress due to varying economic factors, panic (media induced) etc ...
- arkitaip 7y ago
  China has already seen an increase in divorces due to covid-19 [0]. Domestic abuse has skyrocketed in France [1]. [0] https://www.bloomberg.com/news/articles/2020-03-31/divorces-spike-in-china-after-coronavirus-quarantines https://www.bloomberg.com/news/articles/2020-03-31/divorces-... [1] https://www.france24.com/en/20200330-france-to-put-domestic-violence-victims-in-hotels-as-numbers-soar-under-coronavirus-lockdown https://www.france24.com/en/20200330-france-to-put-domestic-...
- skat20phys 7y ago
  There have been studies of this from previous pandemics. Together with studies from the Great Recession / financial collapse the gist is there's definitely going to be an increase in mental health problems of all those sorts -- substance use, suicide, etc. The interesting thing is that in previous situations deaths attributable to these things was offset by a decrease in deaths due to automobile accidents, workplace stress-related incidents, etc. That doesn't make it ok at all, and it's possible this time around is worse socioeconomically so things aren't offset. But it might not show up in overall trends if you just looked at general disability or death.
vearwhershuh 7y ago
I'll say it again: We get it, we are going to have to shut down the main street economy for months, and potentially on and off for years. OK, we aren't rioting yet. So, elites, what's the plan to keep people from starving and being thrown out in the streets? A one time $1000 check at some point in the future isn't a plan. People who swarm criticize anyone saying "this is crazy" need to start presenting feasible economic plans, or they are gonna see fully operational crazy in a month or so.
- eof 7y ago
  It’s not really a one time payment though. Unemployment checks will be a much larger injection than the checks.
jellicle 7y ago
The author missed inter-family infection growth during a lockdown. If you have a family of 5 people and person 1 is infected, person 2 gets infected by 1 after one week, a week later person 2 infects 3, a week later person 3 infects 4, a week later person 4 infects 5. And only then does the infection cascade stop. This is also happening in hospitals, in nursing homes, in homeless shelters...all are also "families" for this purpose. If your "lockdown" was truly no contact between any two humans, the cascade would stop quicker. But that's not the case. Comparing the US to China is wrong, because the US isn't doing MOST of what China did to allow the lockdown to be lifted.
Touche 7y ago
What I want to know is how long after the lockdown is lifted will we know if it's going to spread again? 2 weeks?
kerkeslager 7y ago
I don't agree with the conclusion here. We can draw the conclusion from this that it takes two months for lockdown to work. But that doesn't mean we can start loosening lockdown restrictions after two months. There's a causal relationship between lockdown and slowing the spread: if you remove the lockdown, the spread will rise again. Some speculation: a big part of why lockdown takes that long to work is that it seems to take that long for people to start taking things seriously enough for lockdown to work. A few weeks ago in NYC there were still people coughing on each other in public and laughing about it, and my observation of a lot of people's behavior over time is that for some people, they need someone proximal to them to die of it before they will start complying. I don't say this judgmentally. Personally, I probably didn't take things seriously for about a week after I probably should have, and looking back at why, it wasn't because I didn't care, it was a fear reaction--one very human reaction to something scary is to downplay it or pretend it isn't happening.

68 points by foobuzzHN 7y ago

"The rate of growth at a given day is the number of new cases on this day, as a percentage of the number of cases from the previous day. The rate of growth is constant for an exponential evolution, and is 0 when there is no more growth. (Mathematically, it is the derivative of the function divided by the function itself.)" I don't think that's the curve they're talking about flattening. I think 2 months is just the lower bound.

patd 7y ago
The curve that we must flatten is the admissions to the ICU as that's the main bottleneck if we want to limit the number of deaths. And 2 months is probably not back to normal (international travel, etc). China is still fearing a second wave coming from the rest of the world.
- humanrebar 7y ago
  I don't believe any country can eradicate the virus within its borders once it has spread sufficiently, at least without some form of herd immunity. I think China knows this and is already finding ways to blame foreigners. I think China could completely shut down its borders and still be at significant, if not inevitable, risk. Note that I think other countries will also play the blame game. I don't plan to buy into the finger pointing as it doesn't really solve anything.

SeekingMeaning 7y ago

> ... stop playing the game of "in our country it's going to be different than in China" ...

moneywoes 7y ago

Haven't cases started reappearing in China? And haven't they had to restart the lockdown.

chrisweekly 7y ago

I'm confused -- or rather, think the author may be -- about what's being measured and inferred. A rate of growth of 0 still means the number of new cases is increasing. The rate of growth needs to be negative before the rate of new cases can peak, slow, and (hopefully someday) stop. Acceleration vs velocity vs position. Right?

monktastic1 7y ago
> The rate of growth at a given day is the number of new cases on this day, as a percentage of the number of cases from the previous day. I haven't read the whole thing, but here he's defining "rate of growth" as the number of new cases. If there are 0 new cases each day, then eventually the number of total cases goes to zero.
- chrisweekly 7y ago
  Thanks.

magnusmagnusson 7y ago

From economical perspective, I don' think United States can stay 'shut down' as it is now. 10 million+ jobless claims MINIMUM in past two weeks.. (since those not eligible are not counted) Gotta figure out a way to get healthy people to work. Or I mean, they could stay closed for 2-4 months but that would be quite a wild time.

brianwawok 7y ago
What’s interesting is the wage gap. Many (most) of the shut off jobs are the lower paying ones. Waiters and factory workers. Obviously some weird exceptions (pro athletes). Many of our nations higher paying jobs are either essential (doctors, nurses), or remote friendly (developers , to some extent lawyers and real estate agents). Even if 25% of our economy is not working, we can make near 90% of our GDP. Which isn’t ideal but it makes the lockdown perhaps less dire than it appears for the economy.
- d4mi3n 7y ago
  Worth noting that many lawyers are also out of work due to courts being closed.
- mynegation 7y ago
  It may be true for few weeks or so, but if this continues the fallout will be widespread. Lower wage jobs is the bedrock of the whole economy. How much lawyering can you do if you have to take care of your own food prep, childcare, or - simply put - your clients start disappearing one by one because they cannot pay? How much longer you can continue to pay to the banking staff if mortgages and business loans default like house of cards? How much longer can you pay to programmers at Facebook when advertisers like restaurants, spas, hotels are not paying for advertising?...
  - disgruntledphd2 7y ago
    Advertising is an incredibly recession resistant industry. Especially for FB and Goog, as they use second-price auctions, so anyone who measures their results will see performance improvement, make more money and thus (theoretically) invest more in advertising until it is no longer profitable. They'll lose some revenue, but it won't be anything ridiculously large; and even if it is, some of the previously priced out advertisers (less profitable mobile games, for instance) will return. Advertising is a hell of a business, especially online.

ckdarby 7y ago

Does anyone believe the numbers that China has given? I asked as I see everyone use them to compare against but then I see articles popping up talking about reporters who reported difference numbers just vanish over night.

Tade0 7y ago
There's a little trick a government can pull to at least make the death rates look smaller: https://www.who.int/classifications/icd/covid19/en/ https://www.who.int/classifications/icd/covid19/en/ Simply classify the cause of death to be the virus only in tested and confirmed cases (U07.1 COVID-19, virus identified). That's what my country's (Poland) government is doing and lo and behold - our numbers are relatively small.
- nathell 7y ago
  That's no longer the case as of April 1st: https://www.pzh.gov.pl/wp-content/uploads/2020/04/wytyczne-do-karty-zgonu-01.04.2020-2.pdf https://www.pzh.gov.pl/wp-content/uploads/2020/04/wytyczne-d...
- kgabis 7y ago
  Doctors are deciding what the cause of death was, not the government. The only way to find out how many people died due to this epidemics is to compare the average death rate before and during epidemics. It will also include people withot ncov-19 that died due to health care system being overloaded.
jhpriestley 7y ago
since the criticisms of the Chinese numbers tend to be wild derivations from urns or anonymously sourced US propaganda, yes I am inclined to believe the numbers. If you are seeing these articles "pop up" then you read fake news btw
- RHSeeger 7y ago
  Given the number of times the Chinese government has been shown to lie and actively try to hide dissenting people/information when it tells a story they don't want told... I think it's fair to start from a point of distrust. Sure, it doesn't mean they're lying about the numbers here, but they started out this whole thing by lying about it, by throwing someone (a doctor?) that did speak out in jail.

drtillberg 7y ago

As long as there are a few cases in the community-- and there always will be-- the end of each lockdown potentially will trigger a surge of cases, and thus a new lockdown. I think what is really going on here is world leaders assume China is most knowledgeable about this virus, because goodness knows its labs probably have been studying it for 15 years, they don't have confidence that China is forthcoming about what it knows, and in a few nations globally the effect borders on catastrophic so it's not something to be ignored. So, governments have copied the more knowledgeable actor, which happens to be an autocratic communist government, in hopes that it's approach is the best informed and effective scientifically . Thus, the answer to 'when do the lockdowns end' really is: when we feel more knowledgeable about the virus than the nations that resorted to placing their populations under house arrest, and therefore feel confident enough to stop following China's example.

asiachick 7y ago

So we all lockdown and the rate goes down. It stop staying locked down won't the rate go back up? The only way the rate stays down is if we stop staying locked down is (a) most people already caught it and are immune (b) we develop a vaccine (c) we develop a cure that is easily mass produced and easily distributed. Until one of those happens we're in lockdown. No? And that means 12 to 24 months.

hannasanarion 7y ago
What were holding out for is testing capacity. Once tests are readily available, we can isolate people who catch it and all they people they've been in contact with, and the virus can be held down in quarantine while the rest of society goes on. This strategy has worked in China and South Korea, where life is now slowly resuming, but most other countries haven't caught up with their testing numbers yet. The reason we're all quarantined now is that there's presently no rapid reliable way to tell who needs to be quarantined and who doesn't.
- standardUser 7y ago
  "What were holding out for is testing capacity." Really? Because I have heard of no plan at the federal or state level to implement a wide-scale test and trace program to contain the virus. This seems like a very good idea, but not one being implemented in the US.
  - ygra 7y ago
    The US is far beyond containment at this point. As are many other countries right now, as well. Only when the cases go down again due to successful measures is containment an option again, as you need enough resources to trace contacts and test every potential infection.
    - standardUser 7y ago
      "Only when the cases go down again due to successful measures is containment" We have already taken measures to contain the virus. So why aren't we preparing these needed resources for testing and tracing while the lockdowns are in effect? Two months will pass and we will be no better prepared than we are today because no government in the US is working towards this. The containment will be for nothing, just a temporary measure that will have to be repeated over and over because we aren't even trying to implement a better solution.

oDot 7y ago

From what I read, a single lockdown doesn't work, as even 1 patient is enough to destroy everything, and a lockdown can't guarantee he wouldn't exist. A solution seems to be selective lockdowns by area backed by a huge amount of testing.

standardUser 7y ago
"...as even 1 patient is enough to destroy everything" That implies we are trying to make the virus extinct, which we are not. We want the virus to spread, but at a manageable rate.
- BlargMcLarg 7y ago
  Which would further imply that circumstances must change to get that manageable rate as long as group immunity is not proven and a vaccine is still lacking. The circumstances pre-lockdown allowed the virus to easily travel beyond China. Both measures and mindset in many Western countries are still incredibly lax. The symptoms mimicking those of cold, flu, etc. also don't help. People value their current freedom, privacy and hyper-mobility way too much for a manageable rate to come to fruition without locking down. Otherwise you'll just end up with a new trend of locking down things for 2 months, then opening up, only for a new patient 0 to lock down everything 2 months later.
- oDot 7y ago
  Right, my point is that a single lockdown is not enough. You have to have good monitoring and intermittent lockdowns in different areas based on that monitoring
- asdfasgasdgasdg 7y ago
  I don't think "we" have any desire so clearly defined and articulated as that. This virus so so extremely contagious and deadly that there isn't a manageable rate that is going to get us to a high fraction of immunity within the next two or three years. And the measures apparently required to keep it from growing explosively are pretty extreme. I think that China actually does intend to eradicate the virus domestically, and, tbh, short of a vaccine I'm not sure there's any other politically acceptable exit from this situation. Fwiw I don't think allowing millions of deaths is politically tenable, and I don't think that "lock down the only the vulnerable" is going to work. (I wish I could believe that contact tracing and partial lockdown were sufficient but even Singapore, which by all reports was doing these things, is now SIP with 1/4 as many cases per capita as the US. I think our best case if we can't eradicate is going to look a bit like SK, where schools are shut down and life is very different from what we would typically expect. But that is a best case scenario assuming competent and diligent institutions, which I'm not sure we have.)

burlesona 7y ago

Two months seems like the minimum. The really hard problem is that even if you reduce spread to near zero, it’s almost guaranteed that cases will continue to spread among the essential workers who are still active during the lockdown. As long as that’s the case, the end of the lockdown will result in the cycle starting over. It seems to me that what we’re really doing with the lockdown is buying the time to “mobilize,” in the military sense, our healthcare system. If we had the testing capacity to test everyone and contain only the sick, this would be less serious. If we had 10x as many ventilators, and 100x as much protective equipment, this would be less dangerous. If we had an effective treatment (like a Tamiflu for Covid), then this would be less dangerous. Etc. It seems to me unlikely that we will be locked down less than 2-3 months. But after that, I doubt the public will be willing to endure another global lockdown of this magnitude. Thus I think everything we’re doing now is really about delaying the inevitable long enough for us to get a coherent response in place. To the extent that anyone is a “winner” in a pandemic, it certainly appears to be Taiwan and South Korea, who responded fast enough to the first wave to keep it from requiring an authoritarian response (or, at least thus far).

danieldk 7y ago
If we had 10x as many ventilators, and 100x as much protective equipment, this would be less dangerous. Only up to some point, then you run out of specialized personnel who know how to properly treat each patient (including controlling said ventilators). (Re-)training personnel probably takes months to years.
- SpicyLemonZest 7y ago
  The value of specialized personnel isn't as large as I think you're expecting. Most hospital care boils down to "put them in bed and deliver medication and food at the appropriate times", and patients who need more are likely to die no matter what care they get. It's tragic that some people will die who could have been saved with intensive specialized intervention - but once everyone can be intubated, there's probably no "overload threshold" where lots of people die when they would have otherwise left in good health.

captain_crabs 7y ago

If real information about China were to leak out, my guess is it would happen through the vector of internet/social media. Chances are, some other source would need to copy + repost it before being taken down. This is what I looked for. One such account which is purportedly doing this is https://twitter.com/truthabtchina https://twitter.com/truthabtchina. To summarize this, among other rumors: - lots more people have died that communicated (there's an estimate of ~22m due to missing cell phone contracts) - riots are happening between regions where lockdown occurred, and regions next to them) - lockdown isn't practically over in areas where resurgence of infection is happening (pending other containment approaches) edit: I've eaten dinner with some friends from China in the past month before lockdown started, and am in frequent contact with people traveling throughout SEA. I was trying to provide and summarize a potential semi-primary source. Added some more specific #'s, info, and removed inflammatory words. Sorry - I wasn't trying to be fear-mongery. However, I am trying to accurately reflect a harsher reality I do think it's quite reasonable to assume some areas of China are getting back to normal. I also think it's quite unreasonable to assume info _isn't_ being censored and controlled, especially post journalist-eviction.

baron_harkonnen 7y ago
Do people on HN really have no friends/connections in China? People post comments like this as if it's some mysterious information black hole where we can never know what's really happening. I communicate pretty often with people living in China and with family and living in China. Things, even close to Wuhan, are returning to normal. People are going out, eating out, socializing more. From all of the everyday people reporting there is no obvious or visible things not being reported. By and large people in China are primarily worried about America right now. It wouldn't shock me if there was some important information not being reported, but this conspiratorial "If real information where to leak out" is nonsense since you can very easy interact and talk with actual people living in China.
- smacktoward 7y ago
  There is also the willingness of Chinese companies and individuals to ship PPE gear to the US. If the government there were really still in crisis mode, you would expect it to clamp down hard on that sort of thing.

hn_throwaway_99 7y ago

As others have pointed out, this only gets thing to a steady state while everyone is still locked down. All the countries that have loosened their lockdown restrictions had to tighten them back up after they had new "flare-ups". We're in this for many, many months. Somehow a lot of people have forgotten that "flattening the curve" greatly lengthens the time period of the curve. Also, the thesis behind flattening the curve is still that the same number of people eventually get it, and it's only once you get broad population immunity that the spread stops. We will be fighting this with social distancing until there is a vaccine.

maxerickson 7y ago
The area under the flat curve is dramatically smaller. The theory is not that the same number of people get it.
- foobarbecue 7y ago
  That's not how I understand it. "Flattening the curve" refers to reducing the peak. In the models I've seen, at the end of the epidemic, the %of population who have been infected is roughly the same with and without intervention. The point is that there were fewer infected at the same time.
  - maxerickson 7y ago
    Reducing the load on the medical system is the immediate goal, but the total number of people infected will also be smaller. Take the extreme example of Taiwan. If reports are accurate and they maintain their current situation, the literally flat curve there will lead to a few thousand people getting infected out of 23 million. Or compare this outbreak to the first SARS, where asymptomatic spreading was much less of an issue. Very few people globally got SARS, exactly because interventions to stop the spread were effective.
    - hn_throwaway_99 7y ago
      > Very few people globally got SARS, exactly because interventions to stop the spread were effective. But SARS was also much less contagious than this virus, especially during the asymptomatic phase. SARS also was much more lethal, meaning people that got it had less of a chance of transmitting it, because they were dead. This virus is kind of the worst of all world's, in that it's very dangerous but only for a relatively small portion of the population, and that it can be spread by asymptomatic people much more easily. This means that it's very easy for any "embers" burning anywhere to eventually flare up into huge blazes wherever there are large number of people that still don't have immunity.

temac 7y ago

On one hands tons of countries locked down after China (relative to the number of serious cases or deaths - I understand there is a debate about Chinese numbers, but I don't find it relevant here, because Italy or France also did not test a lot and also under-reported deaths -- basically counting only cases that were tested and died in an hospital -- in the end given the dynamic of the epidemics and other uncertainties it does not change a lot rough date predictions even if there would be 3 times more deaths) So it even could take a few more weeks to get to the same low point again. Plus China had an extremely aggressive strategy, accumulating the measures, and even Italy did not use all of them. And France does less than Italy (non essential production has not been stopped by the government in France). On the other hand I doubt we are going to eradicate the disease (at least not in the immediate future and not only with worldwide lockdowns), so we might want to use another lifting strategy than what they did in China (if we manage to develop means to control the spread at a very low rate) 2 months is still a reasonable approximation, given all the unknowns. But I will not even be surprised if it ends up being 3, and 4 is not out of the question.

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animalnewbie 7y ago

If you're trusting China's numbers I don't know if I shoukd trust your analysis.

zabana 7y ago

What I'm worried about is the number of people who will suffer as a consequence of this worldwide lockdown. Depression, loneliness, suicide, addictive behaviours (alcohol, tobacco, recreational drugs), high stress due to varying economic factors, panic (media induced) etc ...

arkitaip 7y ago
China has already seen an increase in divorces due to covid-19 [0]. Domestic abuse has skyrocketed in France [1]. [0] https://www.bloomberg.com/news/articles/2020-03-31/divorces-spike-in-china-after-coronavirus-quarantines https://www.bloomberg.com/news/articles/2020-03-31/divorces-... [1] https://www.france24.com/en/20200330-france-to-put-domestic-violence-victims-in-hotels-as-numbers-soar-under-coronavirus-lockdown https://www.france24.com/en/20200330-france-to-put-domestic-...
skat20phys 7y ago
There have been studies of this from previous pandemics. Together with studies from the Great Recession / financial collapse the gist is there's definitely going to be an increase in mental health problems of all those sorts -- substance use, suicide, etc. The interesting thing is that in previous situations deaths attributable to these things was offset by a decrease in deaths due to automobile accidents, workplace stress-related incidents, etc. That doesn't make it ok at all, and it's possible this time around is worse socioeconomically so things aren't offset. But it might not show up in overall trends if you just looked at general disability or death.

vearwhershuh 7y ago

I'll say it again: We get it, we are going to have to shut down the main street economy for months, and potentially on and off for years. OK, we aren't rioting yet. So, elites, what's the plan to keep people from starving and being thrown out in the streets? A one time $1000 check at some point in the future isn't a plan. People who swarm criticize anyone saying "this is crazy" need to start presenting feasible economic plans, or they are gonna see fully operational crazy in a month or so.

eof 7y ago
It’s not really a one time payment though. Unemployment checks will be a much larger injection than the checks.

jellicle 7y ago

The author missed inter-family infection growth during a lockdown. If you have a family of 5 people and person 1 is infected, person 2 gets infected by 1 after one week, a week later person 2 infects 3, a week later person 3 infects 4, a week later person 4 infects 5. And only then does the infection cascade stop. This is also happening in hospitals, in nursing homes, in homeless shelters...all are also "families" for this purpose. If your "lockdown" was truly no contact between any two humans, the cascade would stop quicker. But that's not the case. Comparing the US to China is wrong, because the US isn't doing MOST of what China did to allow the lockdown to be lifted.

Touche 7y ago

What I want to know is how long after the lockdown is lifted will we know if it's going to spread again? 2 weeks?

kerkeslager 7y ago

I don't agree with the conclusion here. We can draw the conclusion from this that it takes two months for lockdown to work. But that doesn't mean we can start loosening lockdown restrictions after two months. There's a causal relationship between lockdown and slowing the spread: if you remove the lockdown, the spread will rise again. Some speculation: a big part of why lockdown takes that long to work is that it seems to take that long for people to start taking things seriously enough for lockdown to work. A few weeks ago in NYC there were still people coughing on each other in public and laughing about it, and my observation of a lot of people's behavior over time is that for some people, they need someone proximal to them to die of it before they will start complying. I don't say this judgmentally. Personally, I probably didn't take things seriously for about a week after I probably should have, and looking back at why, it wasn't because I didn't care, it was a fear reaction--one very human reaction to something scary is to downplay it or pretend it isn't happening.