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A real plan would look like this https://imgur.com/spemOeG https://imgur.com/spemOeG specifying the levels of restrictions and the metrics we will use to track

A real plan would look like this https://imgur.com/spemOeG https://imgur.com/spemOeG specifying the levels of restrictions and the metrics we will use to track the metrics. This allows people to understand what to expect the best possible. We already have huge uncertainty, we don't need to add uncertainty of government response on top of uncertainty of the virus. I think there is huge room to debate the numbers and what goes in what level, but this is what a real roadmap looks like. This "roadmap" is quite scary as this is not a plan that would pass muster in in YC Boardroom. (1) The one chart with data is horribly innacurate: (a) It shows interventions causing worse than no interventions in the short term? (b) Shows hospitalizations increasing despite the fact that they have not for some time. (c) Shows "Surge Capacity" as a static value, which you would hope they are increasing if they really think this is the issue. (2) It does not specify in any fashion what the different levels of coming back are. When can medical procedures resume? When can non-essential work where social distancing is easy resume (e.g. Los Angeles apparently has banned gardeners, who don't need to get near a soul)? (3) If he believes masks work (as I do and as indicated in this presentation), why are masks not required and businesses shut down? Shouldn't we do the less painful and restrictive measure first before we shut down businesses? (4) Most importantly there is not an actual goal clearly articulated here. Is he going for suppression? Is he going for mitigation? I like many others are deeply upset by leadership from both parties, at all levels of government.

hartator 7y ago
> I like many others are deeply upset by leadership from both parties, at all levels of government. Yes, I agree. What’a really upsetting is they try to justify why less transparency is good thing. When they are using this only as way to impose their authority.
phkahler 7y ago
>> I like many others are deeply upset by leadership from both parties, at all levels of government. I'm sitting at home in Michigan where the governor has closed almost all businesses. Politicians bicker over weather governors or the president have the authority to reopen things. And yet there is no plan as far as I can see. No goals, no criteria to trigger next steps, nothing. Meanwhile the press just snipes at people.
- mchusma 7y ago
  It's also not like politicians are busy working on a cure. Almost their sole job right now is to communicate an exit strategy. And they can't even properly align text on slides (I don't actually care about that except as a symbol of how little attention to detail they put into this).
  - jml7c5 7y ago
    I doubt politicians are the ones putting together these slides. But yeah, the slide thing is kind of silly. Looks like they did most of the work with a 4:3 template, then realized halfway that it would be shown on a widescreen projector/TV.
- clairity 7y ago
  it's tough to have productive coordination when the president knows so little about civics and government. it's best to ignore the president in this case, especially since he constitutionally has very little say in a pandemic response. instead, focus on putting political pressure on your state and local politicians to come up with a concrete plan and timeline, as they're the ones who do hold power in this case.
  - lostmsu 7y ago
    I think this would be a very good advice in any other politically charged situation, that requires quick action. However, in the case of pandemic your own plan has to depend heavily on the worldwide plan. If my state would manage to kill 100% of the virus within its borders by quarantine-like measures, and then reopened the economy and everything else before other states and countries do the same, we'd quickly get the spread back on track. So if there's no federal/worldwide cooperation on that coming from the top, local politicians must push up as hard as they can for a global plan to be made. At the very least, there must be a plan per continent.
    - clairity 7y ago
      immediate and pervasive reinfection is just not a primary concern, given what we've learned over the past few months epidemiologically and politically. no governing body would open up everything immediately and let everyone go wild mixing it up. reopening will be controlled and coordinated enough to keep a lid on transmission rates (as implied by the CA roadmap), rather than attempting to eradicate all transmission in one globally-synchronous attempt. that would be wholly unrealistic.
charlesju 7y ago
The reason why your solution is not good is because it pigeon holes the government into expectations. The government doesn't have a crystal ball as to how this all plays out, they need to have the flexibility to change how they want to respond to each situation without having to defend an ultimatum. For example, even in your own example here are several situations you didn't account: -- The availability of tests for the public at large -- Whether we're doing temperature checks everywhere -- Whether we're requiring people to download a contact tracing app -- How much capacity we have in the hospital system even though cases are going down -- If we can find a drug that helps shorten the time people spend in a hospital -- If we find new information like masks don't help or they greatly help -- We run out of swabs but cases are low There are a lot of factors that has to go into how the government changes the rules and while it might make it easier for the public to be at ease when the rules are hard, it also makes it a lot harder to adjust the rules. I think being upset at the government is your right, but I also think you should channel your energy into something more productive and thank that at least in California we acted a lot faster than other areas of the country. I think Governor Cuomo said something very interesting the other day, to paraphrase, when he was asked whether he should've started stay at home earlier and if that would've saved lives. Of course it would have, but the interviewer is not taking into account compliance and public sentiment. Likewise, for you, I think you're viewing this problem from a very individualistic point of view to get strict rules on what happens when, but you're not accounting for the edge cases where the government needs a backdoor to change the rules with new information and to play it close to public sentiment.
- pfranz 7y ago
  The attached spreadsheet is basically I've been waiting to see. I figured from the title of this post that's what this would be. Everyone I talk to is asking, "Now what? Do we just keep doing this until there's a vaccine?" This post is "California's Roadmap" as in California the government, not California the public. They all seem like questions they should have been asking themselves at least a month ago. Sure, keep the green columns internal, but broadcast the "Levels" and restrictions, incorporate your bullet points (like temp checks). That way people can prepare for moving to "Level 4" with a rough timeline. With a possible second wave and next fall/winter being inevitable I don't think anyone would be surprised about moving backward. Personally, I'm not upset by this. It just doesn't seem very useful to the public.
marktangotango 7y ago
> Is he going for suppression? Is he going for mitigation? This is the factor that has been missing from all the reporting on this crises. The goal of suppressing the virus to zero and merely seeking mitigate the virus surge effect on available ICU beds leads to drastic differences in all metrics most notably “peak deaths”. If the goal is mitigation with rolling shutdowns, there will be many many more deaths. Virus suppression require several months of shutdown. This is the most basic result of the “models”. None of the major outlets have reported on this at all.
- SpicyLemonZest 7y ago
  The idea of suppressing the virus to zero just doesn't really exist outside of certain circles. Every government I'm aware of has acknowledged that there will be many more deaths, and all of my friends and family expect that.
  - makomk 7y ago
    Unfortunately, those "certain circles" seem to include the World Health Organization...
dmode 7y ago
I don't really understand your comment. This is more of a "vision" doc that sets a framework and principles on what the plan will look like. The next iteration will be a more detailed plan. It is fairly typical of tech product work, where you create your vision statement and then create a more detailed plan
- arbitrary_name 7y ago
  It's actually pretty effective management and leadership. As a strategy consultant, I counsel all my clients to communicate the intended end goal, and how they are going to achieve that, before getting in the weeds of implementation.
_vertigo 7y ago
I don't really think you fully appreciate what how your "real plan" or your accompanying nitpicks would be received by the average citizen. The biggest pitfall, as has already been pointed out by another reply, is that it creates concrete expectations that the government will be held accountable for. Secondly, most of your nitpicks are great if you want to nerd out over the details of the epidemic, but most people are not going to find small details like static versus dynamic surge capacity or suppression versus mitigation useful at all or relevant to them at all. A sprinkling of Dunning-Kruger here..
- mchusma 7y ago
  Thank you for your reply. I don't understand the objection that this is locking government in. Every level of government keeps setting dates then changing them, so I don't see how changing a criteria for a level is worse.
  - wbronitsky 7y ago
    That’s because you don’t understand what you are talking about. You have waded into a debate where people are informed and you are not, yet when faced with an informed opinion you dismiss it as it doesn’t make sense. This is type of argumentation is a disease, ruining our ability to learn things and expose ourselves to other opinions on HN
deleted 7y ago
[deleted]
wpietri 7y ago
> this is what a real roadmap looks like Sorry, but what's your expertise in what real public health plans look like? And why are you criticizing a slide deck as if it were a carefully considered public health plan? If you want to talk about what you'd like to see, great. We all want things, and communications can always be better. But I don't understand why you're treating your preferences as overriding, especially when you don't even know who the author is. (Hint: it's not a he.)
- mchusma 7y ago
  Governor Newsom, the governor of California, is a man (source https://en.wikipedia.org/wiki/Gavin_Newsom https://en.wikipedia.org/wiki/Gavin_Newsom). This slide deck was released as a part of his press conference today. If a female staff member created the slides I don't think that changes anything, and is a poor ad-hominum attack, as the governor has presented this as his plan. This issue (the issue of reopening) is not actually that much of a health discussion. It's a discussion about tradeoffs of a horrific deadly shutdown vs a horrific deadly disease. Health experts can help determine R0 and Rt and IFR, but they can't make these tradeoffs for us, it's ultimately a question for society. We have to change the conversation from yelling at each other to debating the real details.
  - wpietri 7y ago
    The author, according to the metadata, is Dr Sonia Angell, MD MPH, currently director of the CA Department of Public Health: https://www.cdph.ca.gov/meet-the-director https://www.cdph.ca.gov/meet-the-director Pointing out that you don't know the source is not an ad hominem, because you are apparently offering yourself as an expert as to what a good plan is here. You also don't appear to know the difference between medicine and public health. The latter, of course, is very much about the tradeoffs between medical and other societal factors. So I'll ask again: given that you are presenting your opinions as more pertinent than the experts here, what's the expertise you're basing that on?
kitotik 7y ago
It seems fairly obvious this is not, nor was it intended to be, a “plan”. This “Roadmap” was likely rushed out as part of a coordinated political response to threats made by the POTUS to override state decisions. It was framed in the local press even before it was announced that the governor would be discussing which metrics the state would be looking at to determine when and how to start opening things back up. It was shocking/hilarious/predictable to see the headlines streaming out even before Newsoms press conference was over that “California releases plan to reopen economy”. If I was expecting a plan, and then opened this PDF, I would want to rip it to shreds as well.
- mchusma 7y ago
  Well, I think we agree it would be a crap "plan". However I think for most people "California’s Roadmap to Modify the Stay-at-Home Order" is basically something like a plan. And Newsom's twitter seems to really allude to it being "like a plan" with tweets about this like: "@GavinNewsom lays out parameters and tools needed before the state modifies California’s statewide stay-at-home orders" https://twitter.com/CAgovernor/status/1250136291347324928?s=20 https://twitter.com/CAgovernor/status/1250136291347324928?s=... and they "announced a shared vision" https://twitter.com/CAgovernor/status/1250212300147101697?s=20 https://twitter.com/CAgovernor/status/1250212300147101697?s=.... A bunch of "parameters", "indicators", "vision", and "roadmap" to describe this one thing, means most people are going to expect something plan-like. Was this thing rushed out? Probably. But why? This is literally the most important thing that Newsom could have been working on for the last 3 weeks. He pre-announced this yesterday, he could literally have had his whole team work on nothing else. I mean if I had to make one of the top 10 most important announcements of my life tomorrow, I would really make sure it was good. But to be fair, and I think this was at least part of your point, maybe it is exactly what he wanted. This is a political document, not really meant for California citizens to understand what the goal of the state is, what measures will be taken, and what kinds of numbers will be looking at to make decisions.
  - kitotik 7y ago
    Roadmap v. Plan is an age old argument many PMs have had! If I draw out a map to Disneyland, even going as far to include which freeway exits to take, or maybe even going further as to plot out a few stops for gas, this still says nothing about when I will actually start the trip, how fast I’m going to drive, how much coffee I’m going to drink beforehand and how many bathroom breaks that will require, how many flat tires I’m going to get, how many times I’ll get rear ended by another driver who is playing with their phone, or how many times I will get pulled over by the cops on the way. Some of that information is impossible to know, and some of that information has a low ROI in planning further. > This is a political document I feel strongly this is the case.
hedora 7y ago
(5) In 1918, due to a combination of shelter in place, and seasonality the virus had time to mutate into something much deadlier before herd immunity was established. What is the plan for establishing herd immunity before the next strain of COVID arrives (~this fall)?
leetcrew 7y ago
requiring masks seems like a shitty policy when it's still pretty hard to get them. guess who will be disproportionately affected...

hartator 7y ago

> I like many others are deeply upset by leadership from both parties, at all levels of government. Yes, I agree. What’a really upsetting is they try to justify why less transparency is good thing. When they are using this only as way to impose their authority.

phkahler 7y ago

>> I like many others are deeply upset by leadership from both parties, at all levels of government. I'm sitting at home in Michigan where the governor has closed almost all businesses. Politicians bicker over weather governors or the president have the authority to reopen things. And yet there is no plan as far as I can see. No goals, no criteria to trigger next steps, nothing. Meanwhile the press just snipes at people.

mchusma 7y ago
It's also not like politicians are busy working on a cure. Almost their sole job right now is to communicate an exit strategy. And they can't even properly align text on slides (I don't actually care about that except as a symbol of how little attention to detail they put into this).
- jml7c5 7y ago
  I doubt politicians are the ones putting together these slides. But yeah, the slide thing is kind of silly. Looks like they did most of the work with a 4:3 template, then realized halfway that it would be shown on a widescreen projector/TV.
clairity 7y ago
it's tough to have productive coordination when the president knows so little about civics and government. it's best to ignore the president in this case, especially since he constitutionally has very little say in a pandemic response. instead, focus on putting political pressure on your state and local politicians to come up with a concrete plan and timeline, as they're the ones who do hold power in this case.
- lostmsu 7y ago
  I think this would be a very good advice in any other politically charged situation, that requires quick action. However, in the case of pandemic your own plan has to depend heavily on the worldwide plan. If my state would manage to kill 100% of the virus within its borders by quarantine-like measures, and then reopened the economy and everything else before other states and countries do the same, we'd quickly get the spread back on track. So if there's no federal/worldwide cooperation on that coming from the top, local politicians must push up as hard as they can for a global plan to be made. At the very least, there must be a plan per continent.
  - clairity 7y ago
    immediate and pervasive reinfection is just not a primary concern, given what we've learned over the past few months epidemiologically and politically. no governing body would open up everything immediately and let everyone go wild mixing it up. reopening will be controlled and coordinated enough to keep a lid on transmission rates (as implied by the CA roadmap), rather than attempting to eradicate all transmission in one globally-synchronous attempt. that would be wholly unrealistic.

charlesju 7y ago

The reason why your solution is not good is because it pigeon holes the government into expectations. The government doesn't have a crystal ball as to how this all plays out, they need to have the flexibility to change how they want to respond to each situation without having to defend an ultimatum. For example, even in your own example here are several situations you didn't account: -- The availability of tests for the public at large -- Whether we're doing temperature checks everywhere -- Whether we're requiring people to download a contact tracing app -- How much capacity we have in the hospital system even though cases are going down -- If we can find a drug that helps shorten the time people spend in a hospital -- If we find new information like masks don't help or they greatly help -- We run out of swabs but cases are low There are a lot of factors that has to go into how the government changes the rules and while it might make it easier for the public to be at ease when the rules are hard, it also makes it a lot harder to adjust the rules. I think being upset at the government is your right, but I also think you should channel your energy into something more productive and thank that at least in California we acted a lot faster than other areas of the country. I think Governor Cuomo said something very interesting the other day, to paraphrase, when he was asked whether he should've started stay at home earlier and if that would've saved lives. Of course it would have, but the interviewer is not taking into account compliance and public sentiment. Likewise, for you, I think you're viewing this problem from a very individualistic point of view to get strict rules on what happens when, but you're not accounting for the edge cases where the government needs a backdoor to change the rules with new information and to play it close to public sentiment.

pfranz 7y ago
The attached spreadsheet is basically I've been waiting to see. I figured from the title of this post that's what this would be. Everyone I talk to is asking, "Now what? Do we just keep doing this until there's a vaccine?" This post is "California's Roadmap" as in California the government, not California the public. They all seem like questions they should have been asking themselves at least a month ago. Sure, keep the green columns internal, but broadcast the "Levels" and restrictions, incorporate your bullet points (like temp checks). That way people can prepare for moving to "Level 4" with a rough timeline. With a possible second wave and next fall/winter being inevitable I don't think anyone would be surprised about moving backward. Personally, I'm not upset by this. It just doesn't seem very useful to the public.

marktangotango 7y ago

> Is he going for suppression? Is he going for mitigation? This is the factor that has been missing from all the reporting on this crises. The goal of suppressing the virus to zero and merely seeking mitigate the virus surge effect on available ICU beds leads to drastic differences in all metrics most notably “peak deaths”. If the goal is mitigation with rolling shutdowns, there will be many many more deaths. Virus suppression require several months of shutdown. This is the most basic result of the “models”. None of the major outlets have reported on this at all.

SpicyLemonZest 7y ago
The idea of suppressing the virus to zero just doesn't really exist outside of certain circles. Every government I'm aware of has acknowledged that there will be many more deaths, and all of my friends and family expect that.
- makomk 7y ago
  Unfortunately, those "certain circles" seem to include the World Health Organization...

dmode 7y ago

I don't really understand your comment. This is more of a "vision" doc that sets a framework and principles on what the plan will look like. The next iteration will be a more detailed plan. It is fairly typical of tech product work, where you create your vision statement and then create a more detailed plan

arbitrary_name 7y ago
It's actually pretty effective management and leadership. As a strategy consultant, I counsel all my clients to communicate the intended end goal, and how they are going to achieve that, before getting in the weeds of implementation.

_vertigo 7y ago

I don't really think you fully appreciate what how your "real plan" or your accompanying nitpicks would be received by the average citizen. The biggest pitfall, as has already been pointed out by another reply, is that it creates concrete expectations that the government will be held accountable for. Secondly, most of your nitpicks are great if you want to nerd out over the details of the epidemic, but most people are not going to find small details like static versus dynamic surge capacity or suppression versus mitigation useful at all or relevant to them at all. A sprinkling of Dunning-Kruger here..

mchusma 7y ago
Thank you for your reply. I don't understand the objection that this is locking government in. Every level of government keeps setting dates then changing them, so I don't see how changing a criteria for a level is worse.
- wbronitsky 7y ago
  That’s because you don’t understand what you are talking about. You have waded into a debate where people are informed and you are not, yet when faced with an informed opinion you dismiss it as it doesn’t make sense. This is type of argumentation is a disease, ruining our ability to learn things and expose ourselves to other opinions on HN

deleted 7y ago

[deleted]

wpietri 7y ago

> this is what a real roadmap looks like Sorry, but what's your expertise in what real public health plans look like? And why are you criticizing a slide deck as if it were a carefully considered public health plan? If you want to talk about what you'd like to see, great. We all want things, and communications can always be better. But I don't understand why you're treating your preferences as overriding, especially when you don't even know who the author is. (Hint: it's not a he.)

mchusma 7y ago
Governor Newsom, the governor of California, is a man (source https://en.wikipedia.org/wiki/Gavin_Newsom https://en.wikipedia.org/wiki/Gavin_Newsom). This slide deck was released as a part of his press conference today. If a female staff member created the slides I don't think that changes anything, and is a poor ad-hominum attack, as the governor has presented this as his plan. This issue (the issue of reopening) is not actually that much of a health discussion. It's a discussion about tradeoffs of a horrific deadly shutdown vs a horrific deadly disease. Health experts can help determine R0 and Rt and IFR, but they can't make these tradeoffs for us, it's ultimately a question for society. We have to change the conversation from yelling at each other to debating the real details.
- wpietri 7y ago
  The author, according to the metadata, is Dr Sonia Angell, MD MPH, currently director of the CA Department of Public Health: https://www.cdph.ca.gov/meet-the-director https://www.cdph.ca.gov/meet-the-director Pointing out that you don't know the source is not an ad hominem, because you are apparently offering yourself as an expert as to what a good plan is here. You also don't appear to know the difference between medicine and public health. The latter, of course, is very much about the tradeoffs between medical and other societal factors. So I'll ask again: given that you are presenting your opinions as more pertinent than the experts here, what's the expertise you're basing that on?

kitotik 7y ago

It seems fairly obvious this is not, nor was it intended to be, a “plan”. This “Roadmap” was likely rushed out as part of a coordinated political response to threats made by the POTUS to override state decisions. It was framed in the local press even before it was announced that the governor would be discussing which metrics the state would be looking at to determine when and how to start opening things back up. It was shocking/hilarious/predictable to see the headlines streaming out even before Newsoms press conference was over that “California releases plan to reopen economy”. If I was expecting a plan, and then opened this PDF, I would want to rip it to shreds as well.

mchusma 7y ago
Well, I think we agree it would be a crap "plan". However I think for most people "California’s Roadmap to Modify the Stay-at-Home Order" is basically something like a plan. And Newsom's twitter seems to really allude to it being "like a plan" with tweets about this like: "@GavinNewsom lays out parameters and tools needed before the state modifies California’s statewide stay-at-home orders" https://twitter.com/CAgovernor/status/1250136291347324928?s=20 https://twitter.com/CAgovernor/status/1250136291347324928?s=... and they "announced a shared vision" https://twitter.com/CAgovernor/status/1250212300147101697?s=20 https://twitter.com/CAgovernor/status/1250212300147101697?s=.... A bunch of "parameters", "indicators", "vision", and "roadmap" to describe this one thing, means most people are going to expect something plan-like. Was this thing rushed out? Probably. But why? This is literally the most important thing that Newsom could have been working on for the last 3 weeks. He pre-announced this yesterday, he could literally have had his whole team work on nothing else. I mean if I had to make one of the top 10 most important announcements of my life tomorrow, I would really make sure it was good. But to be fair, and I think this was at least part of your point, maybe it is exactly what he wanted. This is a political document, not really meant for California citizens to understand what the goal of the state is, what measures will be taken, and what kinds of numbers will be looking at to make decisions.
- kitotik 7y ago
  Roadmap v. Plan is an age old argument many PMs have had! If I draw out a map to Disneyland, even going as far to include which freeway exits to take, or maybe even going further as to plot out a few stops for gas, this still says nothing about when I will actually start the trip, how fast I’m going to drive, how much coffee I’m going to drink beforehand and how many bathroom breaks that will require, how many flat tires I’m going to get, how many times I’ll get rear ended by another driver who is playing with their phone, or how many times I will get pulled over by the cops on the way. Some of that information is impossible to know, and some of that information has a low ROI in planning further. > This is a political document I feel strongly this is the case.

hedora 7y ago

(5) In 1918, due to a combination of shelter in place, and seasonality the virus had time to mutate into something much deadlier before herd immunity was established. What is the plan for establishing herd immunity before the next strain of COVID arrives (~this fall)?

leetcrew 7y ago

requiring masks seems like a shitty policy when it's still pretty hard to get them. guess who will be disproportionately affected...