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I strongly suspect that attitudes to public health will change significantly in some places as a result of the current situation and our different experiences d

I strongly suspect that attitudes to public health will change significantly in some places as a result of the current situation and our different experiences dealing with it. One of the things I think will probably happen is that the US public will shift to be more favourable towards a primarily public health service such as many other countries have in one form or another. Unfortunately, I expect this to happen because the shortcomings of the current system are going to be painfully exposed and result in a lot of people dying unnecessarily in the US and in the coronavirus problem taking longer to deal with than it will in most developed nations. I also think there is a small but non-zero chance of much of the world blocking travel for people who have recently been in the US until they get their house in order. Under normal circumstances, this might sound preposterous, but clearly these are not normal circumstances. The virus doesn't care about American exceptionalism, and if the anti-science agenda that starts right at the top of the US federal government today continues, nations that do follow the science and support their healthcare professionals and ultimately get it under control to a useful level are going to be very wary of undermining that progress even if it means a big economic cost due to isolating the US that would never be seriously considered without the public health threat.

rpiguy 7y ago
I like your optimism, but I expect things to stay divided. Polling on COVID-19 is divided almost right down the middle like everything else in America with Democrats more afraid of COVID-19 and Republicans more likely to believe it’s like a flu. Furthermore, the heavily impacted areas are all already Democrat strongholds. Densely populated urban centers. The only country where socialized medicine appears to be outperforming is Germany. Right wingers will point to Italy, Spain, and the UK as failures of socialized medicine. They will point out that the healthcare systems in Democrat cities failed. All these points have good refutations, I’m just illustrating that I think this virus will divide us further, not bring us together. I am highly educated, top tier private university, etc., I have the profile of someone who would support mandatory testing and contact tracking, but I do not as a matter of civil liberty.
- Silhouette 7y ago
  I have the profile of someone who would support mandatory testing and contact tracking, but I do not as a matter of civil liberty. As a fellow believer in civil liberties, I understand where you are coming from here, and I am extremely wary of governments using this situation to claim "emergency" powers that they may be reluctant to give up afterwards. But as a believer in science, I'm not sure hundreds of thousands of lives lost in the near future in my country alone is a price worth paying for my concerns about what might happen to make lives worse later. The brutal reality is that the virus doesn't care. Fools posing in close proximity to each other with assault rifles but no protection against the virus are simply more likely to get themselves and their friends and families killed. Students who went on Spring Break and then spread the virus all across the country are more likely to get themselves and their friends and families killed. People who listen to politicians like Donald Trump and Mike Pence instead of epidemiologists are more likely... well, you get the picture. Right wingers will point to Italy, Spain, and the UK as failures of socialized medicine. They will point out that the healthcare systems in Democrat cities failed. I'm curious to know in what way(s) the systems in these countries are seen to have failed by those outside. With hindsight they would probably all have instituted lockdown measures sooner, but as they say, hindsight is 20/20.
  - rpiguy 7y ago
    The science, the actual hard number for mortality rate, is very low. It is the anecdotal evidence that is terrifying everyone (the terrible way in which it kills when it does kill, and the rate at which it spreads). I am personally not afraid of it, I wear a mask out of courtesy and not wanting to spread it if I happen to be one of the silent carriers. I've best seen it described by a mathametician as follows (wish I could find the link) - COVID-19 has comparable mortality to the flu, but you are 300 times more likely to contract it. For something with such a low mortality rate I do not support mandatory contact tracking or testing. I certainly would if the number starts sharply going in the other direction. I can't say for sure what will be pointed out specifically about socialized medicine in the UK, France, and Italy, but our numbers for the United States outside of NYC appear to be much better than those countries and I suspect that is where the right wing will come out and say our private system outperformed the public systems (i.e., cherry picking the countries with the highest mortalities for comparison with the US). They will point out that Italy had to triage beds and favored treating younger patients with higher chances of survival, allowing some older patients to die. It was the rational thing to do, but also unimaginable here in the US where you would be sued to high heaven. Can't you imagine the situation in Italy turned into a campaign add in Florida? "The Democrats want a health care system that lets seniors die" or some such with some pictures of overwhelmed Italian hospitals and a sad looking old man not being treated, but coughing and wheezing. I never said these were good arguments, I just know that they will say it, I've been following politics for a very long time. The only crises that bring both parties together are ones that hit everyone. Technically a virus hits everyone (does not discriminate as you say), but in fact it does discriminate. It spreads faster where population is denser and where there is mass transit. So just like everything in the US, this crisis is divided between urban and fly over. The urban people are literally worried for their lives, and the fly over people are worried about their jobs. This is a super broad generalization, but I am trying to make the point that the virus is not affecting all people the same way and it happens to be right down party lines.
thu2111 7y ago
One of the things I think will probably happen is that the US public will shift to be more favourable towards a primarily public health service such as many other countries have in one form or another. As a Brit, I am very sceptical of that. In the UK this crisis is painfully exposing the deep structural flaws of the NHS. The UK is now at the bottom of the world leaderboard for testing, because its 100% centralised and government run healthcare system has totally failed at scaling up capacity. One reason - it's actually refused and ignored testing capacity in the private sector. e.g. here's a firm saying they could run lots of tests but the government hasn't returned their calls https://www.telegraph.co.uk/news/2020/04/15/british-company-can-deliver-one-million-coronavirus-tests-per/ https://www.telegraph.co.uk/news/2020/04/15/british-company-... Here's another analysis that mentions private sector companies being baffled by lack of swabs being sent to them: https://reaction.life/why-is-the-uk-so-slow-at-increasing-testing/ https://reaction.life/why-is-the-uk-so-slow-at-increasing-te... Places like Germany have an apparently much lower death rate because they're testing far more aggressively. Why is that possible, well, because there's no ideological problem with involving the private sector in healthcare like there is in Britain. It's really hard to fail more severely than the UK has done. It's uniquely terrible at handling this crisis, and that's the fault of its unique healthcare system. Nobody rational in America will look at this performance and say, yep, that's what we need. nations that do follow the science and support their healthcare professionals and ultimately get it under control to a useful level are going to be very wary of undermining that progress So far the data says the epidemic is basically following the same path everywhere, regardless of what governments do. There appears to be no correlation between how governments reacted and outcomes, so no, nowhere is going to be blocking travel to the US because of coronavirus. As for "follow the science", that phrase is being used mostly to mean "listen to epidemiologists". But their models are all being disproven in real time, over and over again. Nobody is going to have any respect that so-called science when this is over. It simply is incapable of making accurate predictions. It's no more a science than economics is.
- Silhouette 7y ago
  There are some serious questions to be answered about the UK's response. However, those concerns mostly seem to originate with the political leadership (or, arguably, the lack of it) rather than the NHS itself. It has never been the case that the NHS was the only provider of healthcare facilities in the UK or that it did everything "in house". We have biotech firms and medical equipment providers and direct clinical healthcare services in our private sector, too, and the NHS works with many of them routinely. Some of the big questions seem to be about why the government and NHS aren't making use of the capabilities those organisations might be able to provide in this particular situation. I'm not sure the data we have so far does support your claim that everywhere is on the same path regardless of government response. Indeed, your own example of Germany suggests otherwise. There are also the (relative) success stories in Asia where they appear to have managed to avoid imposing the heavy restrictions we've seen in Europe without letting the virus get out of control. The widespread use of testing and the willingness to engage in population-scale track-and-trace programmes seem to be recurring themes in the places with better outcomes so far. It looks like the thinking from governments in the UK and other locked down European nations is rapidly evolving to these heavy lockdowns being unsustainable for more than a few weeks, but possibly being a useful bridge to a time when we can adopt a track-and-trace strategy with a manageable number of cases. This brings us back to the same questions yet again about testing and engagement by the UK leadership with other facilities that might be available.

rpiguy 7y ago

I like your optimism, but I expect things to stay divided. Polling on COVID-19 is divided almost right down the middle like everything else in America with Democrats more afraid of COVID-19 and Republicans more likely to believe it’s like a flu. Furthermore, the heavily impacted areas are all already Democrat strongholds. Densely populated urban centers. The only country where socialized medicine appears to be outperforming is Germany. Right wingers will point to Italy, Spain, and the UK as failures of socialized medicine. They will point out that the healthcare systems in Democrat cities failed. All these points have good refutations, I’m just illustrating that I think this virus will divide us further, not bring us together. I am highly educated, top tier private university, etc., I have the profile of someone who would support mandatory testing and contact tracking, but I do not as a matter of civil liberty.

Silhouette 7y ago
I have the profile of someone who would support mandatory testing and contact tracking, but I do not as a matter of civil liberty. As a fellow believer in civil liberties, I understand where you are coming from here, and I am extremely wary of governments using this situation to claim "emergency" powers that they may be reluctant to give up afterwards. But as a believer in science, I'm not sure hundreds of thousands of lives lost in the near future in my country alone is a price worth paying for my concerns about what might happen to make lives worse later. The brutal reality is that the virus doesn't care. Fools posing in close proximity to each other with assault rifles but no protection against the virus are simply more likely to get themselves and their friends and families killed. Students who went on Spring Break and then spread the virus all across the country are more likely to get themselves and their friends and families killed. People who listen to politicians like Donald Trump and Mike Pence instead of epidemiologists are more likely... well, you get the picture. Right wingers will point to Italy, Spain, and the UK as failures of socialized medicine. They will point out that the healthcare systems in Democrat cities failed. I'm curious to know in what way(s) the systems in these countries are seen to have failed by those outside. With hindsight they would probably all have instituted lockdown measures sooner, but as they say, hindsight is 20/20.
- rpiguy 7y ago
  The science, the actual hard number for mortality rate, is very low. It is the anecdotal evidence that is terrifying everyone (the terrible way in which it kills when it does kill, and the rate at which it spreads). I am personally not afraid of it, I wear a mask out of courtesy and not wanting to spread it if I happen to be one of the silent carriers. I've best seen it described by a mathametician as follows (wish I could find the link) - COVID-19 has comparable mortality to the flu, but you are 300 times more likely to contract it. For something with such a low mortality rate I do not support mandatory contact tracking or testing. I certainly would if the number starts sharply going in the other direction. I can't say for sure what will be pointed out specifically about socialized medicine in the UK, France, and Italy, but our numbers for the United States outside of NYC appear to be much better than those countries and I suspect that is where the right wing will come out and say our private system outperformed the public systems (i.e., cherry picking the countries with the highest mortalities for comparison with the US). They will point out that Italy had to triage beds and favored treating younger patients with higher chances of survival, allowing some older patients to die. It was the rational thing to do, but also unimaginable here in the US where you would be sued to high heaven. Can't you imagine the situation in Italy turned into a campaign add in Florida? "The Democrats want a health care system that lets seniors die" or some such with some pictures of overwhelmed Italian hospitals and a sad looking old man not being treated, but coughing and wheezing. I never said these were good arguments, I just know that they will say it, I've been following politics for a very long time. The only crises that bring both parties together are ones that hit everyone. Technically a virus hits everyone (does not discriminate as you say), but in fact it does discriminate. It spreads faster where population is denser and where there is mass transit. So just like everything in the US, this crisis is divided between urban and fly over. The urban people are literally worried for their lives, and the fly over people are worried about their jobs. This is a super broad generalization, but I am trying to make the point that the virus is not affecting all people the same way and it happens to be right down party lines.

thu2111 7y ago

One of the things I think will probably happen is that the US public will shift to be more favourable towards a primarily public health service such as many other countries have in one form or another. As a Brit, I am very sceptical of that. In the UK this crisis is painfully exposing the deep structural flaws of the NHS. The UK is now at the bottom of the world leaderboard for testing, because its 100% centralised and government run healthcare system has totally failed at scaling up capacity. One reason - it's actually refused and ignored testing capacity in the private sector. e.g. here's a firm saying they could run lots of tests but the government hasn't returned their calls https://www.telegraph.co.uk/news/2020/04/15/british-company-can-deliver-one-million-coronavirus-tests-per/ https://www.telegraph.co.uk/news/2020/04/15/british-company-... Here's another analysis that mentions private sector companies being baffled by lack of swabs being sent to them: https://reaction.life/why-is-the-uk-so-slow-at-increasing-testing/ https://reaction.life/why-is-the-uk-so-slow-at-increasing-te... Places like Germany have an apparently much lower death rate because they're testing far more aggressively. Why is that possible, well, because there's no ideological problem with involving the private sector in healthcare like there is in Britain. It's really hard to fail more severely than the UK has done. It's uniquely terrible at handling this crisis, and that's the fault of its unique healthcare system. Nobody rational in America will look at this performance and say, yep, that's what we need. nations that do follow the science and support their healthcare professionals and ultimately get it under control to a useful level are going to be very wary of undermining that progress So far the data says the epidemic is basically following the same path everywhere, regardless of what governments do. There appears to be no correlation between how governments reacted and outcomes, so no, nowhere is going to be blocking travel to the US because of coronavirus. As for "follow the science", that phrase is being used mostly to mean "listen to epidemiologists". But their models are all being disproven in real time, over and over again. Nobody is going to have any respect that so-called science when this is over. It simply is incapable of making accurate predictions. It's no more a science than economics is.

Silhouette 7y ago
There are some serious questions to be answered about the UK's response. However, those concerns mostly seem to originate with the political leadership (or, arguably, the lack of it) rather than the NHS itself. It has never been the case that the NHS was the only provider of healthcare facilities in the UK or that it did everything "in house". We have biotech firms and medical equipment providers and direct clinical healthcare services in our private sector, too, and the NHS works with many of them routinely. Some of the big questions seem to be about why the government and NHS aren't making use of the capabilities those organisations might be able to provide in this particular situation. I'm not sure the data we have so far does support your claim that everywhere is on the same path regardless of government response. Indeed, your own example of Germany suggests otherwise. There are also the (relative) success stories in Asia where they appear to have managed to avoid imposing the heavy restrictions we've seen in Europe without letting the virus get out of control. The widespread use of testing and the willingness to engage in population-scale track-and-trace programmes seem to be recurring themes in the places with better outcomes so far. It looks like the thinking from governments in the UK and other locked down European nations is rapidly evolving to these heavy lockdowns being unsustainable for more than a few weeks, but possibly being a useful bridge to a time when we can adopt a track-and-trace strategy with a manageable number of cases. This brings us back to the same questions yet again about testing and engagement by the UK leadership with other facilities that might be available.