5 ms·

> If lockdowns were determined on an individual / localized basis, the outcome might have been different. And medical systems would suffer from a horrific trag

> If lockdowns were determined on an individual / localized basis, the outcome might have been different. And medical systems would suffer from a horrific tragedy of the commons

dnautics 7y ago
You don't know that. As California chose to suggest staying at home (it's basically voluntary not even enforced particularly aggressively except for a handful of corner cases) earlier than the rest of the country, proving that decentralized authority can lead to better outcomes. Imagine if California chose to defer to federal authority; a huge chunk of 40 million people would have been put at higher risk.
- throwaway894345 7y ago
  Do we know that that is the driver of California’s improved outcomes vs (for example) climate? I believe illinois was similarly early (at least relative to its phase of progression if not absolute date) but I believe the outcomes are worse there, certainly on a population adjusted basis. EDIT: Californians, this is a genuine question, not trying to bruise your egos by suggesting suggesting you're perhaps equal to other Americans. Terribly sorry!
  - rovolo 7y ago
    > similarly early ... outcomes are worse It takes time to go from infection -> sick -> diagnosis -> death. IL and CA would have had inertia following the stay-at-home proclamations. CA started with 25% daily case growth and has now dropped to 12%, IL started with 40% case growth but has now dropped to 12%. IL's daily death rate increase is still higher than CA, but it is dropping. > population adjusted Population adjustment is much more important for assessing the final outcome. At early stages, the growth rate is far more important for knowing if it's under control. > climate Washington/Seattle had earlier outbreaks than CA, started distancing earlier, and have had a much lower growth than CA. We started at 30% case growth, but brought it down 20% by ~Mar 21 and 10% by Apr 1. I'm using the graphs at 91-divoc for the historical numbers, but I've found NYT to have the best looking graphs for growth rates. 91-divoc.com/pages/covid-visualization/ https://www.nytimes.com/interactive/2020/04/03/upshot/coronavirus-metro-area-tracker.html https://www.nytimes.com/interactive/2020/04/03/upshot/corona...
- slowmovintarget 7y ago
  We do know that, however, as we keep seeing it. The reason no one can find toilet paper is not because there isn't enough, it's because the public either went nuts mimicking Asian buying (they don't produce TP, they did have a shortage), went nuts overbuying due to the resulting apparent shortage, or went evil trying to take advantage of everyone else by reselling and price gouging. The same thing is happening with food now. Bread yeast that used to go for ~ $8 to $14 a box, can be found now only from resellers trying to charge upwards of $70 for it. In Massachusetts, early action on shelter-at-home, before the order went out, seems to have helped, as it has in California. But in Southern states the common thinking is that this is something that just happens to someone else. It's just the flu. What's horrific about that is that even if New York, for example, succeeds, it could come back anyway because of these folks. They'll know it's denial when reality kills them in the middle of their opinion-touting.
  - stcredzero 7y ago
    But in Southern states the common thinking is that this is something that just happens to someone else. If one is in a rural environment, this view is understandable. Not seeing one's neighbors (outside of now cancelled gatherings) may well be the norm. It's just the flu. What's horrific about that is that even if New York, for example, succeeds, it could come back anyway because of these folks. If there is an unlucky mutation and a 2nd go around, the likelihood of that is driven by population. It's the population centers like New York which would most likely produce this. They'll know it's denial when reality kills them in the middle of their opinion-touting. That's often how a free society works. People are free to make decisions, good and bad, and others can then learn from their mistakes. We must be willing to convince, not coerce, when we can.
swamp40 7y ago
I don't see any reason for that. Whatever authority locked them down would have to provide adequate resources. Fast local quarantines seems to me like a much better approach.
- cultus 7y ago
  You're really contracting nearly every public healthcare expert here.
  - swamp40 7y ago
    "Global Economic Shutdown with Shelter In Place" is the NEW approach, not fast local quarantines. Fast local quarantines are how we (public healthcare experts) stopped measles, smallpox, polio, etc outbreaks before vaccines were available. And we still use those methods (fast local quarantines) for eradication purposes when they spring up again. Just like our immune system. I'm sure stopping our heart would slow down the disease, but...
    - tanjtanjtanj 7y ago
      Is there any way to do this with a disease that can spread for a week before symptoms show when we don't have anywhere near adequate numbers of tests? The issue here is that unlike most other diseases, this one goes from one person somewhere has it to many, many people in many places have it before it can be detected in its original location.
    - cultus 7y ago
      Fast local quarantines and such as you are describing are great, if you catch it early. If strong measures are taken before it spreads, it is reasonable to quarantine all sick and people in contact with the sick. Taiwan was able to do this, and has had only minimal cases and minimal disruption. There is community spread basically everywhere now, so it is too late for local measures. It's almost as if people should have been listening to public health experts in January when it was clear where this was heading.

> If lockdowns were determined on an individual / localized basis, the outcome might have been different. And medical systems would suffer from a horrific tragedy of the commons

dnautics 7y ago

You don't know that. As California chose to suggest staying at home (it's basically voluntary not even enforced particularly aggressively except for a handful of corner cases) earlier than the rest of the country, proving that decentralized authority can lead to better outcomes. Imagine if California chose to defer to federal authority; a huge chunk of 40 million people would have been put at higher risk.

throwaway894345 7y ago
Do we know that that is the driver of California’s improved outcomes vs (for example) climate? I believe illinois was similarly early (at least relative to its phase of progression if not absolute date) but I believe the outcomes are worse there, certainly on a population adjusted basis. EDIT: Californians, this is a genuine question, not trying to bruise your egos by suggesting suggesting you're perhaps equal to other Americans. Terribly sorry!
- rovolo 7y ago
  > similarly early ... outcomes are worse It takes time to go from infection -> sick -> diagnosis -> death. IL and CA would have had inertia following the stay-at-home proclamations. CA started with 25% daily case growth and has now dropped to 12%, IL started with 40% case growth but has now dropped to 12%. IL's daily death rate increase is still higher than CA, but it is dropping. > population adjusted Population adjustment is much more important for assessing the final outcome. At early stages, the growth rate is far more important for knowing if it's under control. > climate Washington/Seattle had earlier outbreaks than CA, started distancing earlier, and have had a much lower growth than CA. We started at 30% case growth, but brought it down 20% by ~Mar 21 and 10% by Apr 1. I'm using the graphs at 91-divoc for the historical numbers, but I've found NYT to have the best looking graphs for growth rates. 91-divoc.com/pages/covid-visualization/ https://www.nytimes.com/interactive/2020/04/03/upshot/coronavirus-metro-area-tracker.html https://www.nytimes.com/interactive/2020/04/03/upshot/corona...
slowmovintarget 7y ago
We do know that, however, as we keep seeing it. The reason no one can find toilet paper is not because there isn't enough, it's because the public either went nuts mimicking Asian buying (they don't produce TP, they did have a shortage), went nuts overbuying due to the resulting apparent shortage, or went evil trying to take advantage of everyone else by reselling and price gouging. The same thing is happening with food now. Bread yeast that used to go for ~ $8 to $14 a box, can be found now only from resellers trying to charge upwards of $70 for it. In Massachusetts, early action on shelter-at-home, before the order went out, seems to have helped, as it has in California. But in Southern states the common thinking is that this is something that just happens to someone else. It's just the flu. What's horrific about that is that even if New York, for example, succeeds, it could come back anyway because of these folks. They'll know it's denial when reality kills them in the middle of their opinion-touting.
- stcredzero 7y ago
  But in Southern states the common thinking is that this is something that just happens to someone else. If one is in a rural environment, this view is understandable. Not seeing one's neighbors (outside of now cancelled gatherings) may well be the norm. It's just the flu. What's horrific about that is that even if New York, for example, succeeds, it could come back anyway because of these folks. If there is an unlucky mutation and a 2nd go around, the likelihood of that is driven by population. It's the population centers like New York which would most likely produce this. They'll know it's denial when reality kills them in the middle of their opinion-touting. That's often how a free society works. People are free to make decisions, good and bad, and others can then learn from their mistakes. We must be willing to convince, not coerce, when we can.

swamp40 7y ago

I don't see any reason for that. Whatever authority locked them down would have to provide adequate resources. Fast local quarantines seems to me like a much better approach.

cultus 7y ago
You're really contracting nearly every public healthcare expert here.
- swamp40 7y ago
  "Global Economic Shutdown with Shelter In Place" is the NEW approach, not fast local quarantines. Fast local quarantines are how we (public healthcare experts) stopped measles, smallpox, polio, etc outbreaks before vaccines were available. And we still use those methods (fast local quarantines) for eradication purposes when they spring up again. Just like our immune system. I'm sure stopping our heart would slow down the disease, but...
  - tanjtanjtanj 7y ago
    Is there any way to do this with a disease that can spread for a week before symptoms show when we don't have anywhere near adequate numbers of tests? The issue here is that unlike most other diseases, this one goes from one person somewhere has it to many, many people in many places have it before it can be detected in its original location.
  - cultus 7y ago
    Fast local quarantines and such as you are describing are great, if you catch it early. If strong measures are taken before it spreads, it is reasonable to quarantine all sick and people in contact with the sick. Taiwan was able to do this, and has had only minimal cases and minimal disruption. There is community spread basically everywhere now, so it is too late for local measures. It's almost as if people should have been listening to public health experts in January when it was clear where this was heading.