6 ms·

How is Giesecke's approach of "so we should do what we can to slow it so the health service can cope, but let it pass" different than what is currently happenin

by yokaze 6y ago

How is Giesecke's approach of "so we should do what we can to slow it so the health service can cope, but let it pass" different than what is currently happening? As I understand it, that is what most countries do and achieve with various success. And as soon as there is any respite in the load of the hospitals, people are already pushing for a easing of restrictions in place.

softwarejosh 6y ago
most western countries
joe_the_user 6y ago
A few countries have eliminated the virus entirely. Most other countries are in lockdown as more or less a desperation move and effectively have no articulated plan. Maybe they'll get infection rate down and can get testing and contact tracing working enough to do elimination in heavily effected areas but in the US, certainly, all plans are vague and the authorities seem to be reacting to events rather than planning. I think WHO articulated the elimination path but again, who knows. But with all that, Giesecke's approach is more like getting the whole thing over with quickly, which would have brutal effect on the health care system, to say the least. IE, once this is done, all the doctors and nurses in the emergency care system are going to quit.
- bsder 6y ago
  > But with all that, Giesecke's approach is more like getting the whole thing over with quickly, which would have brutal effect on the health care system, to say the least. IE, once this is done, all the doctors and nurses in the emergency care system are going to quit. The point of lockdowns wasn't to stay locked until total control. That simply will not happen in the US, at this point. (And I'm not sure it's feasible anywhere other than South Korea, now.) The point was to give everybody time to react and get ready. It's been almost 45 days since the lockdowns started--healthcare workers should have all the gowns, wipes, masks, etc. that they need, by now. The fact that they don't is an indictment of most of the governments of most of the countries. In my opinion, we stay locked down until healthcare workers have what they need even if a gigantic wave hits. If enough healthcare workers die, we're all in deep shit even after Covid-19 reaches herd immunity. Want to unlock things? Start smacking some idiot leaders around about giving equipment to healthcare workers. When I see healthcare workers saying "Please, stop, we have all the equipment we need and then some," then I'll believe we can come out of a lockdown.
  - 2019-nCoV 6y ago
    The end-goal of lockdowns vary drastically by country. New Zealand just relaxed lockdown today and have declared "elimination" of all community transmission. Most countries are seeing death rates beginning to decrease after weeks of lockdown.
    - mikedilger 6y ago
      I noticed the article in the WSJ about New Zealand. But I (a kiwi) haven't seen any local news indicating that the government has declared any sort of elimination. If you have seen one, could you link it? I'm currently skeptical of the WSJ article. There were four new cases today. One confirmed by test and three presumptive cases which according to the experts probably have it. Plus there are hundreds of people in isolation/quarantine who are still sick. I wouldn't declare "elimination" just yet. Even if new cases dwindled down to zero, that doesn't imply elimination either. There might be many asymptomatic people who are not spreading it currently because of the lockdown, but who will start spreading it once they start interacting with people outside of their bubble.
      - 2019-nCoV 6y ago
        > Prime Minister Jacinda Ardern, who yesterday said the virus was "currently" eliminated, told Morning Report it was not unreasonable to use the term elimination - but that meant "zero tolerance for cases". https://www.rnz.co.nz/news/national/415278/covid-19-new-zealand-yet-to-define-elimination-despite-officials-comments https://www.rnz.co.nz/news/national/415278/covid-19-new-zeal...
  - taneq 6y ago
    > In my opinion, we stay locked down until healthcare workers have what they need even if a gigantic wave hits. Do you think that's practical? This virus has a hospitalisation rate of somewhere between 10% and 20% and an ICU rate of 4-10%, and people who are hospitalised need to be in there for 2-4 weeks. If a 'gigantic wave' is even 10% of your population (which realistically it would far exceed, given how contagious the virus is) you need 10-20 free hospital beds per 1000 population of which 4-10 are ICU beds. The United States has 800k hospital beds of which ~100k are ICU beds, for a population of 330 million (source: https://www.aha.org/statistics/fast-facts-us-hospitals https://www.aha.org/statistics/fast-facts-us-hospitals) That's 2.4 hospital beds per 1000 population, of which 0.3 are ICU beds. You're gonna need at least 10x as many additional beds as you currently have. At least. And that's for only 10% of your population getting sick. Edit: To be clear, I'm not saying that lockdowns are pointless. I'm saying that they need to be longer and more thorough to get to the point where the virus is entirely eliminated, or they need to remain at current levels indefinitely until an effective vaccine or other treatment is available.
- numlock86 6y ago
  > A few countries have eliminated the virus entirely. Cool. Any resources to read up on that? To my knowledge only a few countries have very few cases. But eliminated completely? Wow. I'd like to dive into this topic.
  - gadders 6y ago
    I think the statement needs a "... until travel restrictions are lifted."
    - alkonaut 6y ago
      Indeed. But NZ, unlike most places on the planet, could probably live with travel restrictions for 18 months without too much problems. A big rescue program for the tourism industry would be needed, but apart from that it seems doable. If Australia could manage the same thing, then they could have a common travel area (which would also help with the tourism somewhat). People flying in from elsewhere would need a long quarantine. Unless they believe that's sustainable for 18 months, their whole strategy of eradication wouldn't be feasible, so one would have to assume this is the plan.
  - pjc50 6y ago
    New Zealand I believe.
    - numlock86 6y ago
      New Zealand has "few cases" but not "entirely eliminated" it.
  - alphast0rm 6y ago
    "There is no widespread undetected community transmission in New Zealand. We have won that battle," Ardern said Monday. "But we must remain vigilant if we are to keep it that way." Asked whether New Zealand had eliminated COVID-19, Ardern replied: "currently." [1] https://www.npr.org/sections/coronavirus-live-updates/2020/04/27/845304917/new-zealand-says-it-has-won-battle-against-covid-19 https://www.npr.org/sections/coronavirus-live-updates/2020/0...
- argonaut 6y ago
  The health system is not currently overwhelmed in Sweden under their approach (obviously this could change etc. etc.)
- alkonaut 6y ago
  > But with all that, Giesecke's approach is more like getting the whole thing over with quickly, Wait are we saying that Giesecke is arguing for an (even) more relaxed approach than is currently happening? I assumed he was arguing for the status quo in Sweden, because hospitals are effectively at capacity now, and have been stable there for a while. A significant increase in new infections would be pretty bad so I don't think he's arguing for "business as usual". If I understand him correctly then what he's saying is that it's not good to minimize the number of infected, but rather one should only ensure hospitals aren't overwhelmed. A good outcome is if hospitals are never overwhelmed and a significant portion (enough to make a difference) have immunity. A poor outcome would be one where either people die from lack of available care or one where the outbreak is contained through means that aren't sustainable until a vaccine is available. Obviously if there are long term effects on the health care system from the situation where hospitals are not overwhelmed but just overworked so they quit or are burned out (e.g. many countries won't be able to give healthcare workers summer holiday this year) then that needs to be taken into account as well of course.

by yokaze 6y ago

softwarejosh 6y ago

most western countries

joe_the_user 6y ago

A few countries have eliminated the virus entirely. Most other countries are in lockdown as more or less a desperation move and effectively have no articulated plan. Maybe they'll get infection rate down and can get testing and contact tracing working enough to do elimination in heavily effected areas but in the US, certainly, all plans are vague and the authorities seem to be reacting to events rather than planning. I think WHO articulated the elimination path but again, who knows. But with all that, Giesecke's approach is more like getting the whole thing over with quickly, which would have brutal effect on the health care system, to say the least. IE, once this is done, all the doctors and nurses in the emergency care system are going to quit.

bsder 6y ago
> But with all that, Giesecke's approach is more like getting the whole thing over with quickly, which would have brutal effect on the health care system, to say the least. IE, once this is done, all the doctors and nurses in the emergency care system are going to quit. The point of lockdowns wasn't to stay locked until total control. That simply will not happen in the US, at this point. (And I'm not sure it's feasible anywhere other than South Korea, now.) The point was to give everybody time to react and get ready. It's been almost 45 days since the lockdowns started--healthcare workers should have all the gowns, wipes, masks, etc. that they need, by now. The fact that they don't is an indictment of most of the governments of most of the countries. In my opinion, we stay locked down until healthcare workers have what they need even if a gigantic wave hits. If enough healthcare workers die, we're all in deep shit even after Covid-19 reaches herd immunity. Want to unlock things? Start smacking some idiot leaders around about giving equipment to healthcare workers. When I see healthcare workers saying "Please, stop, we have all the equipment we need and then some," then I'll believe we can come out of a lockdown.
- 2019-nCoV 6y ago
  The end-goal of lockdowns vary drastically by country. New Zealand just relaxed lockdown today and have declared "elimination" of all community transmission. Most countries are seeing death rates beginning to decrease after weeks of lockdown.
  - mikedilger 6y ago
    I noticed the article in the WSJ about New Zealand. But I (a kiwi) haven't seen any local news indicating that the government has declared any sort of elimination. If you have seen one, could you link it? I'm currently skeptical of the WSJ article. There were four new cases today. One confirmed by test and three presumptive cases which according to the experts probably have it. Plus there are hundreds of people in isolation/quarantine who are still sick. I wouldn't declare "elimination" just yet. Even if new cases dwindled down to zero, that doesn't imply elimination either. There might be many asymptomatic people who are not spreading it currently because of the lockdown, but who will start spreading it once they start interacting with people outside of their bubble.
    - 2019-nCoV 6y ago
      > Prime Minister Jacinda Ardern, who yesterday said the virus was "currently" eliminated, told Morning Report it was not unreasonable to use the term elimination - but that meant "zero tolerance for cases". https://www.rnz.co.nz/news/national/415278/covid-19-new-zealand-yet-to-define-elimination-despite-officials-comments https://www.rnz.co.nz/news/national/415278/covid-19-new-zeal...
- taneq 6y ago
  > In my opinion, we stay locked down until healthcare workers have what they need even if a gigantic wave hits. Do you think that's practical? This virus has a hospitalisation rate of somewhere between 10% and 20% and an ICU rate of 4-10%, and people who are hospitalised need to be in there for 2-4 weeks. If a 'gigantic wave' is even 10% of your population (which realistically it would far exceed, given how contagious the virus is) you need 10-20 free hospital beds per 1000 population of which 4-10 are ICU beds. The United States has 800k hospital beds of which ~100k are ICU beds, for a population of 330 million (source: https://www.aha.org/statistics/fast-facts-us-hospitals https://www.aha.org/statistics/fast-facts-us-hospitals) That's 2.4 hospital beds per 1000 population, of which 0.3 are ICU beds. You're gonna need at least 10x as many additional beds as you currently have. At least. And that's for only 10% of your population getting sick. Edit: To be clear, I'm not saying that lockdowns are pointless. I'm saying that they need to be longer and more thorough to get to the point where the virus is entirely eliminated, or they need to remain at current levels indefinitely until an effective vaccine or other treatment is available.
numlock86 6y ago
> A few countries have eliminated the virus entirely. Cool. Any resources to read up on that? To my knowledge only a few countries have very few cases. But eliminated completely? Wow. I'd like to dive into this topic.
- gadders 6y ago
  I think the statement needs a "... until travel restrictions are lifted."
  - alkonaut 6y ago
    Indeed. But NZ, unlike most places on the planet, could probably live with travel restrictions for 18 months without too much problems. A big rescue program for the tourism industry would be needed, but apart from that it seems doable. If Australia could manage the same thing, then they could have a common travel area (which would also help with the tourism somewhat). People flying in from elsewhere would need a long quarantine. Unless they believe that's sustainable for 18 months, their whole strategy of eradication wouldn't be feasible, so one would have to assume this is the plan.
- pjc50 6y ago
  New Zealand I believe.
  - numlock86 6y ago
    New Zealand has "few cases" but not "entirely eliminated" it.
- alphast0rm 6y ago
  "There is no widespread undetected community transmission in New Zealand. We have won that battle," Ardern said Monday. "But we must remain vigilant if we are to keep it that way." Asked whether New Zealand had eliminated COVID-19, Ardern replied: "currently." [1] https://www.npr.org/sections/coronavirus-live-updates/2020/04/27/845304917/new-zealand-says-it-has-won-battle-against-covid-19 https://www.npr.org/sections/coronavirus-live-updates/2020/0...
argonaut 6y ago
The health system is not currently overwhelmed in Sweden under their approach (obviously this could change etc. etc.)
alkonaut 6y ago
> But with all that, Giesecke's approach is more like getting the whole thing over with quickly, Wait are we saying that Giesecke is arguing for an (even) more relaxed approach than is currently happening? I assumed he was arguing for the status quo in Sweden, because hospitals are effectively at capacity now, and have been stable there for a while. A significant increase in new infections would be pretty bad so I don't think he's arguing for "business as usual". If I understand him correctly then what he's saying is that it's not good to minimize the number of infected, but rather one should only ensure hospitals aren't overwhelmed. A good outcome is if hospitals are never overwhelmed and a significant portion (enough to make a difference) have immunity. A poor outcome would be one where either people die from lack of available care or one where the outbreak is contained through means that aren't sustainable until a vaccine is available. Obviously if there are long term effects on the health care system from the situation where hospitals are not overwhelmed but just overworked so they quit or are burned out (e.g. many countries won't be able to give healthcare workers summer holiday this year) then that needs to be taken into account as well of course.