8 ms·

There's something that I'm not getting in all this: given the R0 for this virus, the situation isn't going to disappear until about 70% of the population has de

There's something that I'm not getting in all this: given the R0 for this virus, the situation isn't going to disappear until about 70% of the population has developed immunity. The purpose of all these isolation and social distancing measures is to slow down the process in order not to overwhelm hospitals. But the news reports I've been reading about hospitals is that in general, in developed countries, the hospitals aren't overwhelmed. If 70% or so haven't developed immunity, then the pandemic will just re-emerge as soon as the restrictions are lifted. It seems to me that eventually 70% are going to get it. Shouldn't we just let it loose and go through our destined suffering faster? So why are we making ourselves go through all this? ELI5?

supercanuck 6y ago
To prevent deaths.
defertoreptar 6y ago
Immunity isn't well understood, or at least it wasn't well understood when government guidelines came down. Also if the government risks hospital overcapacity by not imposing restrictions, and high deaths per capita resulted, then that would look very bad politically.
mhacct 6y ago
It’s a combination of factors. Flattening the curve is attempting to avoid exponential growth and making the situation completely untenable. This provides hospitals time to prepare protocols and obtain equipment. We didn’t know what we were up against. We arguably still don’t. We understand the disease 10% more than we did previously, and are using this information to establish guidelines like masks and social distancing, maybe eventually contact tracing. The ultimate intent is to suppress r0 long enough that we can develop a series of treatments and protocols (and eventually a vaccine) to minimize the negative effects of this virus. It would have been impossible to a) gather enough data in time and b) drive change in behavior in the mass population without a SIP ‘reset’ taking place.
magneticnorth 6y ago
I'm not an epidemiologist or involved in government policy decisions, but I agree with your assessment that we won't be able to truly go back to normal until we have 70%+ immunity, be that through infection or vaccine (2+ years away). My guess as to what is driving current policy decisions is that a few factors are in play: 1) If we just "let it loose" then we will quickly overwhelm hospitals and see greater loss of life than is necessary 2) We may be able to delay widespread infection until there are more effective treatments. And, given how much we don't know, it is almost certainly the case that a delay of a few months until widespread infection means that we will have a better understanding of how effective our current treatments are, allowing better treatment and better allocation of hospital resources 3) Slowly reopening allows high-risk groups to keep themselves safer, while people who are eager to get haircuts and play sports and aren't worried about the risk can volunteer themselves to be part of our herd immunity group.
- basch 6y ago
  Something like 80-90% of the deaths in some states are age 80+ and or at communal living situations. Is there a takeaway here, about more surgically precise lockdowns? Also, many projections appear to predict spread uniformly. Should spread be modeled more by frequency of travel and interaction, moreso assuming that people with frequent interactions are likely to be infected first? There has to be a way to model, predict, and account for the ebb and flow of which demographics are getting hit, and how to shape the spread with regard to capacity and risk. Hospitals are empty, open the gates a bit. Opening up restrictions on the lowest risk populations first, and tightening them back up as cases rise too fast. This would likely be predicated on a stronger welfare state, more equipped to serve people they are asking to stay locked down. "Stay inside, but we got your back" coupled with "your risk is low, go build herd immunity, stay away from the vulnerable." Maybe something like a pollen or wildfire indicator, or defcon, county by county. "Free to do anything. Slightly elevated risk. High risk quarantine. Quarantine for all" with week by week or day by day updates. I understand that such a volatile type of lockdown would be hard for businesses to adapt to.
  - magneticnorth 6y ago
xhkkffbf 6y ago
Dude-- there are some parts of society that don't seem to want to relax quarantine. No matter which data you mention, they keep pushing back hard and raising the specter of even greater deaths. First it was "in two weeks" and now it's "during the second wave." These folks are generally either retired or employed in a job that pays them to work from home in their pajamas. Or they work for a tech company that makes even more money because the government is banning their F2F competitors.
- qppo 6y ago
  I'm one of those people. I don't want my parents to die because some people couldn't suck it up for a few months. Get mad at your government, not people that are afraid for their loved ones and being unable to make it to their funerals. The reason hospitals aren't overwhelmed is because social distancing is working. All these "facts" are evidence of quarantine doing what it was intended to do. The quarantine we have is already extremely relaxed. I don't think there's any reason to relax it further without killing more people.
  - heavenlyblue 6y ago
    The people are losing jobs and their businesses, and you only care about your parents? I work for a startup, full-remote - I wish we all agreed upon the amount of people who could die from the epidemic and relaxed the rules. There’s just too many people I know who are not going to get their jobs back after all of this is over (this will affect their lives for way longer after it all ends). Dying is a natural part of living. Many people would prefer to die rather than continue living in isolation. The quarantine is doing it’s work, but isolation is not an answer because that’s not living.
    - qppo 6y ago
      I care about a lot of people, and me going about my business in public puts my family and your family at too much risk to justify it. Businesses can be rebuilt, jobs will come back. Lives won't. The government has the ability to keep society from collapsing and maintaining a decent quality of life in the meantime and we should be furious at them for their failure to do so. The quarantine is going to last only a few months likely, or a year at most. It's not indefinite, and I'd suggest anyone who'd rather die than accept reality should seek professional help.
deleted 6y ago
[deleted]
cjhopman 6y ago
Well first, you don't seem to understand how herd immunity works. That 70% you quote is only a useful number when there isn't an active epidemic. With an active epidemic you get significant overshoot. If we dropped all mitigation efforts, you should expect this to infect something like 95+% of people before effectively dying out. The amount of overshoot is going to depend on how widespread the infection is. Second, you can develop immunity without the bad effects of actually getting the disease (ya know, like a fucking vaccine). Saying that we need xx% of people to develop immunity doesn't mean that we need xx% of people to get this deadly disease.

supercanuck 6y ago

To prevent deaths.

defertoreptar 6y ago

Immunity isn't well understood, or at least it wasn't well understood when government guidelines came down. Also if the government risks hospital overcapacity by not imposing restrictions, and high deaths per capita resulted, then that would look very bad politically.

mhacct 6y ago

It’s a combination of factors. Flattening the curve is attempting to avoid exponential growth and making the situation completely untenable. This provides hospitals time to prepare protocols and obtain equipment. We didn’t know what we were up against. We arguably still don’t. We understand the disease 10% more than we did previously, and are using this information to establish guidelines like masks and social distancing, maybe eventually contact tracing. The ultimate intent is to suppress r0 long enough that we can develop a series of treatments and protocols (and eventually a vaccine) to minimize the negative effects of this virus. It would have been impossible to a) gather enough data in time and b) drive change in behavior in the mass population without a SIP ‘reset’ taking place.

magneticnorth 6y ago

I'm not an epidemiologist or involved in government policy decisions, but I agree with your assessment that we won't be able to truly go back to normal until we have 70%+ immunity, be that through infection or vaccine (2+ years away). My guess as to what is driving current policy decisions is that a few factors are in play: 1) If we just "let it loose" then we will quickly overwhelm hospitals and see greater loss of life than is necessary 2) We may be able to delay widespread infection until there are more effective treatments. And, given how much we don't know, it is almost certainly the case that a delay of a few months until widespread infection means that we will have a better understanding of how effective our current treatments are, allowing better treatment and better allocation of hospital resources 3) Slowly reopening allows high-risk groups to keep themselves safer, while people who are eager to get haircuts and play sports and aren't worried about the risk can volunteer themselves to be part of our herd immunity group.

basch 6y ago
Something like 80-90% of the deaths in some states are age 80+ and or at communal living situations. Is there a takeaway here, about more surgically precise lockdowns? Also, many projections appear to predict spread uniformly. Should spread be modeled more by frequency of travel and interaction, moreso assuming that people with frequent interactions are likely to be infected first? There has to be a way to model, predict, and account for the ebb and flow of which demographics are getting hit, and how to shape the spread with regard to capacity and risk. Hospitals are empty, open the gates a bit. Opening up restrictions on the lowest risk populations first, and tightening them back up as cases rise too fast. This would likely be predicated on a stronger welfare state, more equipped to serve people they are asking to stay locked down. "Stay inside, but we got your back" coupled with "your risk is low, go build herd immunity, stay away from the vulnerable." Maybe something like a pollen or wildfire indicator, or defcon, county by county. "Free to do anything. Slightly elevated risk. High risk quarantine. Quarantine for all" with week by week or day by day updates. I understand that such a volatile type of lockdown would be hard for businesses to adapt to.
- magneticnorth 6y ago

xhkkffbf 6y ago

Dude-- there are some parts of society that don't seem to want to relax quarantine. No matter which data you mention, they keep pushing back hard and raising the specter of even greater deaths. First it was "in two weeks" and now it's "during the second wave." These folks are generally either retired or employed in a job that pays them to work from home in their pajamas. Or they work for a tech company that makes even more money because the government is banning their F2F competitors.

qppo 6y ago
I'm one of those people. I don't want my parents to die because some people couldn't suck it up for a few months. Get mad at your government, not people that are afraid for their loved ones and being unable to make it to their funerals. The reason hospitals aren't overwhelmed is because social distancing is working. All these "facts" are evidence of quarantine doing what it was intended to do. The quarantine we have is already extremely relaxed. I don't think there's any reason to relax it further without killing more people.
- heavenlyblue 6y ago
  The people are losing jobs and their businesses, and you only care about your parents? I work for a startup, full-remote - I wish we all agreed upon the amount of people who could die from the epidemic and relaxed the rules. There’s just too many people I know who are not going to get their jobs back after all of this is over (this will affect their lives for way longer after it all ends). Dying is a natural part of living. Many people would prefer to die rather than continue living in isolation. The quarantine is doing it’s work, but isolation is not an answer because that’s not living.
  - qppo 6y ago
    I care about a lot of people, and me going about my business in public puts my family and your family at too much risk to justify it. Businesses can be rebuilt, jobs will come back. Lives won't. The government has the ability to keep society from collapsing and maintaining a decent quality of life in the meantime and we should be furious at them for their failure to do so. The quarantine is going to last only a few months likely, or a year at most. It's not indefinite, and I'd suggest anyone who'd rather die than accept reality should seek professional help.

deleted 6y ago

[deleted]

cjhopman 6y ago

Well first, you don't seem to understand how herd immunity works. That 70% you quote is only a useful number when there isn't an active epidemic. With an active epidemic you get significant overshoot. If we dropped all mitigation efforts, you should expect this to infect something like 95+% of people before effectively dying out. The amount of overshoot is going to depend on how widespread the infection is. Second, you can develop immunity without the bad effects of actually getting the disease (ya know, like a fucking vaccine). Saying that we need xx% of people to develop immunity doesn't mean that we need xx% of people to get this deadly disease.