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It’s Not Too Late to Go on Offense Against the Coronavirus
- tsbinz 7y ago> the transmission rate dropped again, to the point where any single case led to less than one more. Once that happens, an epidemic dies. Note that this can take a while. What the article suggests - getting back to the containment phase - is the stated goal of some countries. However, to get there quick you need very drastic measures. With the measures we adopted, it will take a bit of time - I read one estimate that the reproduction number in Switzerland has been around 0.59 since the lockdown was enacted, so you'd expect cases to drop by a factor of this per generation - it still takes weeks/months to go from 1000+ cases to below 100 (where they estimate they have enough resources for contact tracing).
- igorkraw 7y agoLiving in Switzerland and having friends in the surrounding countries, it has been kind of amazing to see how well the comparatively soft touch of the Swiss government has worked. We can still go out, hang out in groups <5 etc., but people are simply being reasonable. I keep waiting for the uptick in cases since they announced their plan for reopening though. I'm unconvinced we'll be through it so smoothly.
- jariel 7y ago"but people are simply being reasonable." The Swedes have taken this line as well, saying they 'trust' their citizens. I think it's not very rational, and also borderline chauvinist for people to say this. First - what evidence does anyone have that Swiss/Swedes or anyone for that matter are consistently behaving in one way or another that is more 'responsible' or 'sensible' than others? I don't see any evidence. A nationalist self-image of responsibility doesn't count as Science, and neither does a few images of fools on a Florida beach as it's all rather anecdotal. The other issue is that policy is material, not just 'responsibility' - for example - we know from Wuhan that restaurants and other places are a vector for transmission. So it doesn't matter if certain groups are 'behaving responsibly' so much - if they are going to restaurants, hotels, tanning salons etc. - even that otherwise 'responsible behaviour' inside the scope of 'following the rules' that is actually causing transmission. Given all of the variables we have to look at, the last place I think we can infer variation is with regards to who is 'being reasonable' by some arbitrary definition. That said - it would be really good to look at different nations varying policies and see how it works. It could be that <5 people is 'enough' to keep the R1 below 1, though there are obviously other factors. Maybe the Swiss have found the 'sweet spot'? In Canada, the problem was stopped, but there's already a continued second wave in long-term care homes, it's possible those are structured differently in Canada than other countries.
- tsbinz 7y agoPutting Switzerland and Sweden in the same bucket here isn't fair, IMO. In Switzerland, most things were closed down like in our neighbor countries (some things are reopening now, but still very limited). A difference was that while other countries said no groups of >2 people, in Switzerland the rule was no groups of >5 people, so in that sense it was more lax, but it's far more strict than Sweden's policy.
- VBprogrammer 7y agoI'm not sure what people are reacting negatively to in your post but I thought this was a really well stated point: "A nationalist self-image of responsibility doesn't count as Science"
- arcticbull 7y agoWhat counts as science is results, and Sweden is flattening the curve just as well as the UK and Canada, so the system is working, whatever it is. I mean, take a look: https://aatishb.com/covidtrends/?location=Canada&location=Denmark&location=Finland&location=Sweden&location=US&location=United+Kingdom https://aatishb.com/covidtrends/?location=Canada&location=De... I'm not sure why people are having such a hard time accepting that what Sweden is doing is in fact working, in the face of a pretty clear graph. Just because it appears counter-intuitive or possibly not in line with their preexisting ideas of what should be done? There's still 5 US states without any form of lockdown (the Dakotas, Nebraska, Iowa and Arkansas), too, so you could say they're "following the Swedish model." Wyoming, Utah and Oklahoma are only under regional partial lockdowns, too. Of course they only account for about 5% of the population but it remains notable.
- tsbinz 7y agoOk, I took a look and it doesn't look good ... Compare Sweden to the list of its Nordic neighbors: https://aatishb.com/covidtrends/?location=Denmark&location=Finland&location=Sweden&location=Norway https://aatishb.com/covidtrends/?location=Denmark&location=F... Or, for a more direct comparison: https://i.insider.com/5e9d6a5015ea4b315c0b4d0a?width=1100&format=jpeg&auto=webp https://i.insider.com/5e9d6a5015ea4b315c0b4d0a?width=1100&fo... (from https://www.businessinsider.com/how-sweden-and-norway-handled-coronavirus-differently-2020-4?r=US&IR=T https://www.businessinsider.com/how-sweden-and-norway-handle...) - Sweden's population is 2x that of Norway so keep that in mind when comparing, but the difference is really apparent.
- dwd 7y agoThe Australian approach has been fairly good but this virus is persistent. Once the lockdowns kicked in the doubling rate dropped dramatically and new case numbers went from a peak of around 500 a day to 10-20 day for a population 1/10 the US. From /r/coronavirusdownunder linking the stats with the lock-down measures gives a good idea of the timeframe involved. date cases growth doubling 2020-03-21 1071 1.22 3.1 2020-03-22 1352 1.26 3.3 <== 10 days ago, Tom Hanks 2020-03-23 1716 1.27 3.5 2020-03-24 2146 1.25 3.8 2020-03-25 2431 1.13 4.0 <== 10 days ago, overseas self-isolate 14 days 2020-03-26 2805 1.15 4.5 <== 10 days ago, Vic declare State of Emergency 2020-03-27 3179 1.13 5.3 2020-03-28 3639 1.14 6.4 2020-03-29 3985 1.1 7.0 <== 10 days ago, TAS self-isolation 14 days 2020-03-30 4250 1.07 8.0 <== 10 days ago, closing borders to all 2020-03-31 4560 1.07 9.3 <== 10 days ago, rule of 4 square metres 2020-04-01 4864 1.07 11.5 2020-04-02 5136 1.06 13.6 <== 10 days ago, no social gathering 2020-04-03 5358 1.04 15.6 <== 10 days ago, WA,SA closing border 2020-04-04 5552 1.04 18.7 2020-04-05 5687 1.02 22.9 2020-04-06 5795 1.02 28.1 2020-04-07 5908 1.02 33.1 2020-04-08 6013 1.02 38.8 <== 10 days ago, mandatory hotel quarantine 2020-04-09 6103 1.01 46.5 2020-04-10 6203 1.02 52.2 2020-04-11 6292 1.01 60.7 2020-04-12 6313 1.003 69.6 2020-04-13 6359 1.007 83.5 <== 10 days ago, QLD closing border 2020-04-14 6400 1.006 96.5 2020-04-15 6447 1.007 114.2 2020-04-16 6468 1.003 106.9 2020-04-17 6523 1.009 121.1 2020-04-18 6565 1.006 129.2 2020-04-19 6606 1.006 157.3 2020-04-20 6619 1.002 165.0 <== 10 days ago, Good Friday 2020-04-21 6645 1.004 210.6 2020-04-22 6649 1.001 247.4 2020-04-23 6661 1.002 307.7 2020-04-24 6675 1.002 301.3 2020-04-25 6695 1.003 350.7 2020-04-26 6711 1.002 298.7
- donavanm 7y agoYou should look at the breakdown of cases. I was very worried for Sydney in early to mid march. What I didnt see until later was the infection acquisition data. The majority of those march cases appeared to be infected citizens returning from overseas. Locally acquired infections were only 25% of cases at the peak. The local infection rate never really hit the scary 3 day numbers.
- gonzo41 7y agoMost of the issues in north west Tassie are related to the Ruby Princess, which is just a massive scandal that hopefully we'll learn from in the future.
- redis_mlc 7y ago> the transmission rate dropped again, to the point where any single case led to less than one more. Once that happens, an epidemic dies. Unless, you know, it's as contagious as corona. Then it only takes one person to infect an office or grocery store or hospital (as happened with SARS-1 in S. Korea.) I wish people would start using facts, instead of hope.
- lutorm 7y agoWhat do you mean? That statement is manifestly true. IF any single case leads to <1 additional case, then the numbers will decline. That's math. One person being able to infect an entire office just means it will be harder to get to that point.
- SpicyLemonZest 7y agoThe epidemic isn't "dead", in the author's words, until we stop having to take emergency measures to fight it. A plan that doesn't finish with "then we reopen sports stadiums and stop all social distancing" isn't a plan to end the epidemic, and social distancing is one of the author's five prongs.
- KMag 7y agoMore succintly: In the SIR (Susceptible, Infected, Resolved) epidimic model, r0 is the ratio of dI/dt / dR/dt. r0 < 1 means people are recovering at a rate faster than new people are getting sick. If each new case, on average results in less than one new case, and all cases eventually resolve (recovery or death), then it's a mathematical truth that the number of active cases must go down over time. The decrease isn't necessarily monotonic, but over a long enough time frame it's inevitable. The bursty nature of super-spreading will produce variance, but as long as these super-spreaders are accounted for in the observed r0, the variance itself doesn't change the long-term outcome. Now, the estimated/measured r0 is just a sample/estimate of the (unknowable) "true" r0, and r0 isn't constant, but those are separate issues.
- Animats 7y agoThis guy has an impressive track record. Read what he has to say.
- 0x8BADF00D 7y agoTruthfully, this is a puff piece for increased government spending. Let the money printers work overtime, devaluing the currency until it’s worth less than the paper it’s printed on. The government is incompetent at everything, why not let the private sector figure it out? All the nations he mentions are creditor nations that have savings to undertake huge public works projects in order to surveil those who might be infected. That’s why we can’t do similar programs in the US, we’re heavily indebted and collectively broke. Same story with the PIGS, if the EU dissolves these areas will succumb to hyperinflation too, and also why they can not implement similar programs.
- lnsru 7y agoIt’s totally different than agenda in Germany. Heads in the news can’t stop fantasizing about herd immunity. And this guy has a plan what to do right now.
- neuronic 7y agoNobody is taking the approach of herd immunity except some political figures who try to gain from the crisis (Armin Laschet, CDU, in particular).
- redis_mlc 7y agoActually, I am. Are you planning on lockdown until 2022?
- _ph_ 7y agoWe don't need a lockdown. We only need to have enough hygenic protections in place to keep the infection rate low. With sinking infection count, the infection rate drops to zero in many places - you do need to have contact with an infected person to get infected. Good hand hygene and wearing masks and keeping distances in most places go a long way towards preventing infections. Events like the Oktoberfest and other gatherings of thousands in direct contact might be cancelled for undetermined time, but the rest of the life can continue.
- aphextron 7y agoIt's absolutely depressing knowing that this all stems from a complete utter lack of leadership at the federal level. That states are having to implement their own policies and plans of attack for this virus is a total travesty. Massachusetts is undoubtedly leading the way here. But this is a global pandemic, that can only begin to be approached at the national level. With our society's level of interconnectedness, state level interventions are completely meaningless.
- redis_mlc 7y ago> It's absolutely depressing knowing that this all stems from a complete utter lack of leadership at the federal level. I only wish that was the half of it. Covid-19 appears to be a bioweapon engineered in the Wuhan Corona lab, and sponsored by the US govt. https://medium.com/@yurideigin/lab-made-cov2-genealogy-through-the-lens-of-gain-of-function-research-f96dd7413748 https://medium.com/@yurideigin/lab-made-cov2-genealogy-throu...
- mydongle 7y agoIt is ?
- twalla 7y agoI'm going to go ahead and pull the "extraordinary claims require extraordinary evidence" card on this one.
- olivermarks 7y agoprobably this https://www.dailymail.co.uk/news/article-8211291/U-S-government-gave-3-7million-grant-Wuhan-lab-experimented-coronavirus-source-bats.html https://www.dailymail.co.uk/news/article-8211291/U-S-governm... REVEALED: U.S. government gave $3.7million grant to Wuhan lab at center of coronavirus leak scrutiny that was performing experiments on bats from the caves where the disease is believed to have originated The US National Institutes of Health, a government agency, awarded a $3.7million research grant to the Wuhan Institute of Virology The lab is the center of several conspiracy theories that suggest it is the original source of the coronavirus outbreak The institute experimented on bats from the source of the coronavirus They were captured more than 1,000 miles away in Yunnan Sequencing of the Covid-19 genome has traced it to bats to Yunnan's caves The U.S. government funded research on coronavirus transmission in the lab over the past decade And https://www.israelhayom.com/2020/04/20/coronavirus-created-in-an-attempt-to-find-aids-vaccine-nobel-laureate-claims/ https://www.israelhayom.com/2020/04/20/coronavirus-created-i...
- throwaway888abc 7y agoPragmatic article. "This is a disease that will be circling the globe for a long time. The virus could very well become seasonal, like the flu—and, like the flu, it might mutate regularly, making it a moving target for vaccine researchers. Without a durable system in place, we may find ourselves trapped in a cycle of lockdown and stimulus, waiting and hoping, with no end in sight."
- axaxs 7y agoIt sounds like a good plan, but I can't see it working here. USA in general has strong individualism, I guess it's called. Basically the idea of look out for yourself, and screw everyone else. It's why you still can't buy paper products, why we don't have universal healthcare, why we have so many homeless, etc. Heck, I remember when cases first started in KY, at least two people defied orders to quarantine even after testing positive, to the point they sent police to keep them indoors. There's no way enough people will self quarantine to make this plan effective. Now, if you can somehow force quarantine people, we'd have a fighting chance, but that makes a lot of people uneasy, perhaps rightly.
- SpicyLemonZest 7y agoI don't know if "screw everyone else" is fair. It's the idea that living freely is a sacred value; that we won't and shouldn't take the path of the fewest deaths, if that path leads to a society we don't want to live in. That's not to defend people who actually have the virus breaking quarantine. Limited quarantines have always been compatible with freedom, that's just dumb selfishness. But if the proposal is that the 30k new infectees a day* and all their close contacts should be forced out of their homes into quarantine camps, yeah, that's not going to work here. * I know the real number is likely much higher than this.
- lbeltrame 7y ago> It's the idea that living freely is a sacred value; that we won't and shouldn't take the path of the fewest deaths, if that path leads to a society we don't want to live in. And you can see in Italy how the (hoped) path for the fewest deaths as opposed to (rather than along with) freedom led to a horrible result. The current PM has basically trampled on every constitutional right with authority that he should not have, and the effects of the policy (besides locking up people for at least 75 days) aren't that great. And let's not talk about the social / economical aspect. The authoritarian aspect of these moves was clearly shown when he threatened closing things again if infections rise (as if it's the fault of the people he's supposed to protect).
- pjc50 7y ago
- theredbox 7y agoKorea (KCDCD) basically says that covid19 will be seasonal.
- LatteLazy 7y agoUm, the author is relying on three things, none of which seem reliable: * that anything China claims is true, so far they've been lying constantly, we know this. * that we will be able to accurately contact trace. This is problematic because its easy to tell who I have had contact with. But it's much harder to tell who has used the same door knobs or shopping trollies that I have. It's also an exponentially larger number. You can quarantine the 50 people I've touched or spoken to in the last week, you can't quarantine the 2000 who went to the supermarket the same day as me. Not without just quarantining everyone anyway, so why bother contact tracing? * that I can be isolated if I am not sick. Imagine if your housemate got the disease, with proof via testing. Now what? You can't leave the house for 2 weeks? Good luck surviving off whatever is already in your cupboards, it's hard enough to keep people from doing things they shouldn't under social isolation, but mass house arrest is unenforceable, at least in the west. Also,the author perpetuates a myth that's risen about social isolation. Let's clarify: The plan is NOT to keep everyone locked away until the case count actually reaches zero, that will never happen. The plan is to work out how many infected people we can cope with at a time. If you have 25k ventilators, and 5% of patients need ventilation then you know you can have 500k people get the disease simultaneously. That way, the mortality stays at the minimum rate because everyone who needs treatment can get it. Any higher and you have to ration ventilators and the death rate spirals. So we will aim to have a certain number of people get it at a time. If we drop below this number, we will relax social distancing somewhat, maybe reopen schools or permit some use of restaurants in order to INCREASE transmission. But then reverse that when the infected load rises. This is the real reason testing is important. It's irrelevant whether you have the disease, it's very important to know how many people have it (especially how many people have it now and will need treatment in 1,4,7,14 etc days). Tests should be used for population monitoring not individuals. This was a key error from day one that is still happening today. Whatever your condition, YOU do not need to be tested. Eventually we will develop a herd immunity which will gradually allow more and more openness without increasing transmission rates. Until one day so many people have had it that no measures are needed to keep the rate low enough to deal with. That's when we return to normal. There are nuances to how we do this. High risk groups should remain more isolated for longer as they are more likely to die or need ventilation. We need population testing, something governments are stubbornly refusing to do. We don't know transmission rates under various levels of lockdown. All this needs to be managed semi-locally, so London might be opening up while Cornwall remains closed. This approach is clearly laid out and was at the beginning of the current measures both academically and generally. This is about control, not eradication, because eradication is not possible. Any attempt at eradication will fail when we're unable to find literally every case world wide, we relax quarantine and then suddenly it rockets back in. As soon as the author started talking about eradication, he left the scientific concensus. As soon as he claimed we could return to normal life if we got contact tracing working, he made a claim with no evidence to back it up. Contact tracing is a nice to have, but not important. The important things are healthcare capacity (aka ventilators) and population monitoring.
- tomohawk 7y ago> South Korea, which so far has managed the pandemic better than any other country Actually, Taiwan has done better. They've had no local cases for 14 days. https://taipeitimes.com/News/front/archives/2020/04/27/2003735362 https://taipeitimes.com/News/front/archives/2020/04/27/20037... They did it by ignoring the WHO's advice and locking down early and then aggressively containing all cases, preventing a general outbreak. They've been pursuing this since December 31st, when they issued a warning to the WHO about what was going on and locked down. The WHO ignored them. https://www.taipeitimes.com/News/front/archives/2020/04/12/2003734453 https://www.taipeitimes.com/News/front/archives/2020/04/12/2... They've taken 4 months to get to no new cases. From a much better starting point. With a much smaller population. I'm very skeptical about what this guy is advocating.
- senderista 7y agoOne difference is that you can't say the word "Taiwan" in places like the WHO, and this guy may have been afraid to for similar reasons.