3 ms·

I think there are serious issues which we need to start addressing in this lockdown discussion; 1) Hospitalization rates have been shown to be about an order o

by zaroth 7y ago

I think there are serious issues which we need to start addressing in this lockdown discussion; 1) Hospitalization rates have been shown to be about an order of magnitude lower than estimates. 2) The most effective treatment is no longer limited by availability of invasive ventilation but rather widely available non-invasive ventilation and frequent repositioning. 3) Hospitals across the country are mostly empty and furloughing workers because their “elective” (e.g. chemo and surgical) wards were all shut down and now everyone is afraid to go to the hospital even when they’re having a cardiac event or a stoke 4) A steady drumbeat of serological studies are showing IFR is lower than estimated, and asymptomatic or mild spread much more prevalent. NYC hospitalization rate is < 2% based on serology. 5) Now that the scale of the economic devastation is becoming clearer and the scale of non-COVID deaths caused by lockdown are coming into focus, a clearer headed calculation can be made about the true immediate trade-offs of a lockdown, to say nothing of long term effects. I’m personally concerned that we’re going to blow our chance to gain significant widespread immunity during summer months where IFI prevalence is low and vitamin D levels are high. A surge next winter concurrent with a flu spike is the worst case scenario. We’re also starting to see stress on the food supply chain, or if it wasn’t going to be an issue it probably is now with the latest media coverage enough to provoke some major hoarding of meats / protein in the coming weeks. It’s almost comedic when you can’t buy toilet paper, it’s a different kind of problem when major grocery staples go missing. These are all important points which weigh on the side of lightening up on restrictions. It’s a spectrum, and right now we are pressing full tilt to lockdown when the actual purported and scientific purpose of lockdown is no longer being served.

genidoi 7y ago
I'm from Australia where our government is slowly easing restrictions because our daily case count has been in the single digits for multiple consecutive days now, and even then it is very gradual. Reopening resturants and bars is still very far on the horizon. In the US, even with full lockdown restrictions for several weeks now, the daily death count has hovered at 2,000 for almost two infection cycles (first >2k death day was Apr 7th). If 'full' lockdown only achieves stabilisation of the death rate, how is easing restrictions, which as far as I can see only rationally relies on the still-shaky evidence from serology studies, what exactly is the plan? I genuinely ask this in a state of disbelief at the current "end lockdown" narrative circulating in the US. Here in AUS/NZ the Gov didn't fuck around; we locked down, had brutally strict measures for 6 weeks now, and at this point nobody is rushing to re-open (except for a few regional cities that haven't even had cases), while the US has been at 2,000 deaths a day.
- deleted 7y ago
  [deleted]
- zaroth 7y ago
  As long as you can keep your borders effectively shut for the next year or so I think you’ll be in great shape. That ship has sailed in the case of the US. As I understand it, there is a bimodal approach to managing an epidemic. You’re on a totally different pathway of successful suppression, where you’ve never actually seen exponential community spread. Your endpoint is not herd immunity. The US probably was seeing uncontrolled exponential community spread in ~January. There are major metro areas which have 20%+ prevalence. The only endpoint left for the US is herd immunity. So you would not expect the same measures to be taken, as long as AU is striving to maintain suppression I think that means your local measures will have to remain quite a bit stricter than a country trying to obtain herd immunity as quickly as possible. EDIT: (Since HN won’t let me reply) You’ve had a total of 6,700 detected cases and 63% of those were imported. Your total community spread over this entire time was what we see in two days in Massachusetts. You’ve done 500k tests total, the US is presently running 160k tests a day. Harvard just came out with a study saying they thought we would need to get to 5 million tests a day. This is what I mean by bimodal.
  - genidoi 7y ago
    We had an R0 greater than 1 for a long enough period that if the response wasn't on point, we'd be in a similar position to the US. One aspect that's missed is our testing rate - 500,000+ tests performed so far with a 1.2% positive rate. That's half of South Korea's. None of this is to blow my Aussie horn. Whilst I'm proud to live in a country that handled this crisis well, I can't help but feel frustration at many of the remarks that Trump has said, particulary comments such as "can you really believe the numbers coming out of these countries?" it's just baffling considering that the AU-US alliance is unshakeable and there is no reason to mistrust our figures. All stats sourced here: https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/coronavirus-covid-19-current-situation-and-case-numbers https://www.health.gov.au/news/health-alerts/novel-coronavir...
    - 7y ago

by zaroth 7y ago

genidoi 7y ago

I'm from Australia where our government is slowly easing restrictions because our daily case count has been in the single digits for multiple consecutive days now, and even then it is very gradual. Reopening resturants and bars is still very far on the horizon. In the US, even with full lockdown restrictions for several weeks now, the daily death count has hovered at 2,000 for almost two infection cycles (first >2k death day was Apr 7th). If 'full' lockdown only achieves stabilisation of the death rate, how is easing restrictions, which as far as I can see only rationally relies on the still-shaky evidence from serology studies, what exactly is the plan? I genuinely ask this in a state of disbelief at the current "end lockdown" narrative circulating in the US. Here in AUS/NZ the Gov didn't fuck around; we locked down, had brutally strict measures for 6 weeks now, and at this point nobody is rushing to re-open (except for a few regional cities that haven't even had cases), while the US has been at 2,000 deaths a day.

deleted 7y ago
[deleted]
zaroth 7y ago
As long as you can keep your borders effectively shut for the next year or so I think you’ll be in great shape. That ship has sailed in the case of the US. As I understand it, there is a bimodal approach to managing an epidemic. You’re on a totally different pathway of successful suppression, where you’ve never actually seen exponential community spread. Your endpoint is not herd immunity. The US probably was seeing uncontrolled exponential community spread in ~January. There are major metro areas which have 20%+ prevalence. The only endpoint left for the US is herd immunity. So you would not expect the same measures to be taken, as long as AU is striving to maintain suppression I think that means your local measures will have to remain quite a bit stricter than a country trying to obtain herd immunity as quickly as possible. EDIT: (Since HN won’t let me reply) You’ve had a total of 6,700 detected cases and 63% of those were imported. Your total community spread over this entire time was what we see in two days in Massachusetts. You’ve done 500k tests total, the US is presently running 160k tests a day. Harvard just came out with a study saying they thought we would need to get to 5 million tests a day. This is what I mean by bimodal.
- genidoi 7y ago
  We had an R0 greater than 1 for a long enough period that if the response wasn't on point, we'd be in a similar position to the US. One aspect that's missed is our testing rate - 500,000+ tests performed so far with a 1.2% positive rate. That's half of South Korea's. None of this is to blow my Aussie horn. Whilst I'm proud to live in a country that handled this crisis well, I can't help but feel frustration at many of the remarks that Trump has said, particulary comments such as "can you really believe the numbers coming out of these countries?" it's just baffling considering that the AU-US alliance is unshakeable and there is no reason to mistrust our figures. All stats sourced here: https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/coronavirus-covid-19-current-situation-and-case-numbers https://www.health.gov.au/news/health-alerts/novel-coronavir...
  - 7y ago