5 ms·

Well the hospitals have plenty of excess capacity now. We’ve very successfully flattened the curve. It might be time to ease up. I thought this doctor explaine

Well the hospitals have plenty of excess capacity now. We’ve very successfully flattened the curve. It might be time to ease up. I thought this doctor explained the idea better than I could: https://medium.com/@jbgeach/eight-reasons-to-end-the-lockdowns-as-soon-as-possible-b7bb0bc94f00 https://medium.com/@jbgeach/eight-reasons-to-end-the-lockdow... But I’m just winging this like everyone. I could certainly be wrong.

ajross 7y ago
Only in some areas. New York is still teetering right at capacity. Active cases have not dropped much at all, in fact. It's the rate of new infections that has leveled off. This is good evidence that the exponential growth has been halted. No, it's not time to ease up. Unlike in February, we have effectively zero buffer in many areas. A sudden increase in cases (which is what "easing up" means!) would push us right over the edge. We ease up when the outbreak can be sustained. It can't now, and won't for several weeks, maybe two months more. Stay home.
- mrfusion 7y ago
  Wow that’s a much worse outlook than I’ve been hearing. Do you have a source on the zero buffer areas? I’ll have to read up more. I know in Florida we had to furlough a lot of medical staff because they didn’t get as many cases as expected and elective procedures are banned.
  - ryankemper 7y ago
    It really is highly ironic that by instituting a national lockdown and telling citizens to avoid the hospital across-the-board (instead of specifying high-impacted areas like New York), we destroyed tons of jobs in the medical industry. I dislike citing news articles, I'd prefer to cite real research, but here's a crappy source: https://www.usatoday.com/story/news/health/2020/04/02/coronavirus-pandemic-jobs-us-health-care-workers-furloughed-laid-off/5102320002/ https://www.usatoday.com/story/news/health/2020/04/02/corona... -- When I first started hearing about the Coronavirus and figuring out the situation, my initial reaction was that we need to foster herd immunity, and avoiding exposure is near-impossible over the long run therefore we should just "get it over with" - not going out of our way to get infected but also not hiding. Then as we heard about Italy, France, etc, my view shifted, and I viewed the lockdown as a necessary evil. I've now swung back the other way. Time will tell, but I really think that subsequent research we'll show that we took a huge problem - a covid pandemic - and turned it into two huge problems - a pandemic along with significant swaths of our economy getting destroyed. The argument to flatten the curve, beyond preventing exceeding hospital capacity, which is absolutely a critical goal, was also that those of us who are not at serious risk could spread to those who _are_ at risk, and therefore everyone needs to act in lockstep. Well, if you take a systems-level view, absolutely the best thing a non-at-risk person can do is get exposed to covid, fully quarantine themselves, and then return to daily life. Having a huge swath of the population with immunity is the best way to protect our at risk population. (In a perfect world, we could culture sars-cov-2 and voluntarily expose ourselves - basically a vaccine except you're exposing yourself to the real deal and not a virus rendered inert) Also, back on the "exceeding hospital capacity" point, it is precisely those at-risk who are filling up hospitals and needing intubation or ventilation. So we can have a huge portion of the population who is not at risk still living their lives (with some adjustments), and the effect on hospitalizations would really not be that bad as a result. I'll be closely following Sweden's data over the next months. I'm very curious how their strategy pans out.
    - pdonis 7y ago
      > if you take a systems-level view, absolutely the best thing a non-at-risk person can do is get exposed to covid, fully quarantine themselves, and then return to daily life The problem with this kind of "systems-level view" is that individual humans are not cogs in a system. What you propose here is asking every non-at-risk person to take an unknown, but possibly as high as a percent or two, risk of dying. I doubt many people will take you up on that. I certainly won't. I think the best you're going to get along these lines is to find out, once widespread antibody testing is available, how many people have already been exposed to the virus without knowing it. If that number of people turns out to be large enough, it will be a lot easier to get things back to something approaching normal.
      - ryankemper 7y ago
        > What you propose here is asking every non-at-risk person to take an unknown, but possibly as high as a percent or two, risk of dying. I doubt many people will take you up on that. I certainly won't. This is a complete farce. 1-2% of dying in not-at-risk individuals? We know that the diamond princess, the cruise where we tested everybody, had around a 1% mortality rate, and that was with a bunch of at-risk individuals (the elderly, in this case). That basically gives us an upper bound IFR, and other data coming out from places like Germany is putting us closer to .2-.6% IFR. But yes, if someone has extreme anxiety that they are going to die from covid, even despite evidence to the contrary, they should absolutely stay at home. No one should be forced to go outside, but unfortunately in many parts of the world people are being forbidden from going outside practically at all. The important thing here is the individual needs to be empowered to make an informed decision based off their personal risk tolerance. If someone decides that the unknowns are too overwhelming and they want to remain at home until a hypothetical future vaccine is hypothetically released, that's totally fine. But critically, I don't want to be living in a society that is forcing me to stay inside for reasons that are not based on evidence-based public health policy. And unfortunately so much of what we've seen (e.g. closing public parks, banning jogging, disallowing drive-thru church meetings until the decision was overturned) is not grounded in sane policy, but instead in panic-driven reactionism.
- ryankemper 7y ago
  Hmm. You seem to have repeatedly said that we should stay home, but didn't really make much of an argument for it, the one exception being this point: > we have effectively zero buffer in many areas. A sudden increase in cases (which is what "easing up" means!) would push us right over the edge. -- I think that this is not the best way to think about it. We need to contrast the benefit of lockdowns (decreased transmission of the disease) with the economic costs. And just to be clear, this isn't about investment returns, the stock market, etc, it's about the very real fact that poverty, stress, and economic uncertainty all eventually lead to deaths in their own right (either indirectly due to being reluctant to seek medical care, or directly through suicide). If you're willing to discuss further, can we see if we agree on these points? (1) This is a highly transmissible respiratory virus, and thus eradication is impossible (2) Given (1), the purpose of lockdowns and other measures is primarily to prevent us from exceeding our hospital capacity, at which point the number of deaths would go up dramatically (3) The vast majority of the globe will be exposed to this. Avoiding that is not possible, so it's just a matter of when Therefore, we should work to mitigate the _impact_ of Covid (NOT with the goal of eradicating it, which is impossible), but there is a point where the economic damage will far exceed the cost of lifting lockdown. BTW, it's not like ending lockdown means everything goes back to normal. We would still be banning large gatherings, at least for a short length of time, and we would still be advising at-risk individuals to self-isolate (and for a country like the US, I don't have any hard numbers here but that could easily still be 30-50% of the country who's considered at risk). Last point I want to make. Many of us here work jobs that allow us to work from home, and so we kept our jobs during this. We need to recognize that not only have tens of millions of Americans lost their jobs, but a significant chunk of those jobs will not be "coming back". Real value was destroyed. And those who lost their jobs are exactly those who are likely to be in lower socioeconomic classes and thus are much less equipped to weather events like this. (Sorry, the above was pretty rambly, so I hope there's still some value you can get out of it :P)
  - lifeformed 7y ago
    To prevent poverty and stress, it seems much safer and effective to just pause debt (not furlough) for a few months, than force everyone back into the mix and risk a new outbreak.
nimchimpsky 7y ago
but the curve will just steepen when everyone goes back to normal ... angela merkel summed it up nicely I thought : https://twitter.com/BenjAlvarez1/status/1250563198081740800 https://twitter.com/BenjAlvarez1/status/1250563198081740800
maxerickson 7y ago
Hospital capacity doesn't really help the most severely impacted: https://apnews.com/8ccd325c2be9bf454c2128dcb7bd616d https://apnews.com/8ccd325c2be9bf454c2128dcb7bd616d It's also not the case that reducing government mandated restrictions will just snap the economy back. Plenty of people are going to avoid sitting in restaurants and the like, regardless of what the government says. And hopefully businesses will keep lots of people working from home, so that we can limit the spread as much as possible while working towards better treatments and a vaccine.
- eru 7y ago
  > It's also not the case that reducing government mandated restrictions will just snap the economy back. Plenty of people are going to avoid sitting in restaurants and the like, regardless of what the government says. Yes. And that's a good argument in favour of gradually lifting government restrictions: the private sector will do some of its own lockdown as necessary.

ajross 7y ago

Only in some areas. New York is still teetering right at capacity. Active cases have not dropped much at all, in fact. It's the rate of new infections that has leveled off. This is good evidence that the exponential growth has been halted. No, it's not time to ease up. Unlike in February, we have effectively zero buffer in many areas. A sudden increase in cases (which is what "easing up" means!) would push us right over the edge. We ease up when the outbreak can be sustained. It can't now, and won't for several weeks, maybe two months more. Stay home.

mrfusion 7y ago
Wow that’s a much worse outlook than I’ve been hearing. Do you have a source on the zero buffer areas? I’ll have to read up more. I know in Florida we had to furlough a lot of medical staff because they didn’t get as many cases as expected and elective procedures are banned.
- ryankemper 7y ago
  It really is highly ironic that by instituting a national lockdown and telling citizens to avoid the hospital across-the-board (instead of specifying high-impacted areas like New York), we destroyed tons of jobs in the medical industry. I dislike citing news articles, I'd prefer to cite real research, but here's a crappy source: https://www.usatoday.com/story/news/health/2020/04/02/coronavirus-pandemic-jobs-us-health-care-workers-furloughed-laid-off/5102320002/ https://www.usatoday.com/story/news/health/2020/04/02/corona... -- When I first started hearing about the Coronavirus and figuring out the situation, my initial reaction was that we need to foster herd immunity, and avoiding exposure is near-impossible over the long run therefore we should just "get it over with" - not going out of our way to get infected but also not hiding. Then as we heard about Italy, France, etc, my view shifted, and I viewed the lockdown as a necessary evil. I've now swung back the other way. Time will tell, but I really think that subsequent research we'll show that we took a huge problem - a covid pandemic - and turned it into two huge problems - a pandemic along with significant swaths of our economy getting destroyed. The argument to flatten the curve, beyond preventing exceeding hospital capacity, which is absolutely a critical goal, was also that those of us who are not at serious risk could spread to those who _are_ at risk, and therefore everyone needs to act in lockstep. Well, if you take a systems-level view, absolutely the best thing a non-at-risk person can do is get exposed to covid, fully quarantine themselves, and then return to daily life. Having a huge swath of the population with immunity is the best way to protect our at risk population. (In a perfect world, we could culture sars-cov-2 and voluntarily expose ourselves - basically a vaccine except you're exposing yourself to the real deal and not a virus rendered inert) Also, back on the "exceeding hospital capacity" point, it is precisely those at-risk who are filling up hospitals and needing intubation or ventilation. So we can have a huge portion of the population who is not at risk still living their lives (with some adjustments), and the effect on hospitalizations would really not be that bad as a result. I'll be closely following Sweden's data over the next months. I'm very curious how their strategy pans out.
  - pdonis 7y ago
    > if you take a systems-level view, absolutely the best thing a non-at-risk person can do is get exposed to covid, fully quarantine themselves, and then return to daily life The problem with this kind of "systems-level view" is that individual humans are not cogs in a system. What you propose here is asking every non-at-risk person to take an unknown, but possibly as high as a percent or two, risk of dying. I doubt many people will take you up on that. I certainly won't. I think the best you're going to get along these lines is to find out, once widespread antibody testing is available, how many people have already been exposed to the virus without knowing it. If that number of people turns out to be large enough, it will be a lot easier to get things back to something approaching normal.
    - ryankemper 7y ago
      > What you propose here is asking every non-at-risk person to take an unknown, but possibly as high as a percent or two, risk of dying. I doubt many people will take you up on that. I certainly won't. This is a complete farce. 1-2% of dying in not-at-risk individuals? We know that the diamond princess, the cruise where we tested everybody, had around a 1% mortality rate, and that was with a bunch of at-risk individuals (the elderly, in this case). That basically gives us an upper bound IFR, and other data coming out from places like Germany is putting us closer to .2-.6% IFR. But yes, if someone has extreme anxiety that they are going to die from covid, even despite evidence to the contrary, they should absolutely stay at home. No one should be forced to go outside, but unfortunately in many parts of the world people are being forbidden from going outside practically at all. The important thing here is the individual needs to be empowered to make an informed decision based off their personal risk tolerance. If someone decides that the unknowns are too overwhelming and they want to remain at home until a hypothetical future vaccine is hypothetically released, that's totally fine. But critically, I don't want to be living in a society that is forcing me to stay inside for reasons that are not based on evidence-based public health policy. And unfortunately so much of what we've seen (e.g. closing public parks, banning jogging, disallowing drive-thru church meetings until the decision was overturned) is not grounded in sane policy, but instead in panic-driven reactionism.
ryankemper 7y ago
Hmm. You seem to have repeatedly said that we should stay home, but didn't really make much of an argument for it, the one exception being this point: > we have effectively zero buffer in many areas. A sudden increase in cases (which is what "easing up" means!) would push us right over the edge. -- I think that this is not the best way to think about it. We need to contrast the benefit of lockdowns (decreased transmission of the disease) with the economic costs. And just to be clear, this isn't about investment returns, the stock market, etc, it's about the very real fact that poverty, stress, and economic uncertainty all eventually lead to deaths in their own right (either indirectly due to being reluctant to seek medical care, or directly through suicide). If you're willing to discuss further, can we see if we agree on these points? (1) This is a highly transmissible respiratory virus, and thus eradication is impossible (2) Given (1), the purpose of lockdowns and other measures is primarily to prevent us from exceeding our hospital capacity, at which point the number of deaths would go up dramatically (3) The vast majority of the globe will be exposed to this. Avoiding that is not possible, so it's just a matter of when Therefore, we should work to mitigate the _impact_ of Covid (NOT with the goal of eradicating it, which is impossible), but there is a point where the economic damage will far exceed the cost of lifting lockdown. BTW, it's not like ending lockdown means everything goes back to normal. We would still be banning large gatherings, at least for a short length of time, and we would still be advising at-risk individuals to self-isolate (and for a country like the US, I don't have any hard numbers here but that could easily still be 30-50% of the country who's considered at risk). Last point I want to make. Many of us here work jobs that allow us to work from home, and so we kept our jobs during this. We need to recognize that not only have tens of millions of Americans lost their jobs, but a significant chunk of those jobs will not be "coming back". Real value was destroyed. And those who lost their jobs are exactly those who are likely to be in lower socioeconomic classes and thus are much less equipped to weather events like this. (Sorry, the above was pretty rambly, so I hope there's still some value you can get out of it :P)
- lifeformed 7y ago
  To prevent poverty and stress, it seems much safer and effective to just pause debt (not furlough) for a few months, than force everyone back into the mix and risk a new outbreak.

nimchimpsky 7y ago

but the curve will just steepen when everyone goes back to normal ... angela merkel summed it up nicely I thought : https://twitter.com/BenjAlvarez1/status/1250563198081740800 https://twitter.com/BenjAlvarez1/status/1250563198081740800

maxerickson 7y ago

Hospital capacity doesn't really help the most severely impacted: https://apnews.com/8ccd325c2be9bf454c2128dcb7bd616d https://apnews.com/8ccd325c2be9bf454c2128dcb7bd616d It's also not the case that reducing government mandated restrictions will just snap the economy back. Plenty of people are going to avoid sitting in restaurants and the like, regardless of what the government says. And hopefully businesses will keep lots of people working from home, so that we can limit the spread as much as possible while working towards better treatments and a vaccine.

eru 7y ago
> It's also not the case that reducing government mandated restrictions will just snap the economy back. Plenty of people are going to avoid sitting in restaurants and the like, regardless of what the government says. Yes. And that's a good argument in favour of gradually lifting government restrictions: the private sector will do some of its own lockdown as necessary.