6 ms·

I would like to get an official explanation for two things: 1) What is the goal(s) of the "stay-at-home" order? 2) How well it is achieved compared to other cou

by lsh123 6y ago

I would like to get an official explanation for two things: 1) What is the goal(s) of the "stay-at-home" order? 2) How well it is achieved compared to other counties/countries with different policies?

atian 6y ago
Not on here.
ceejayoz 6y ago
1. To flatten the infection curve, in order to keep healthcare systems from becoming overwhelmed like those in northern Italy. 2. Thus far, it's worked to keep hospitals functioning. We're doing worse than most other countries (https://91-divoc.com/pages/covid-visualization/ https://91-divoc.com/pages/covid-visualization/).
- icelancer 6y ago
  >> 1. To flatten the infection curve, in order to keep healthcare systems from becoming overwhelmed like those in northern Italy. Very few regions have had anything close to overwhelmed hospitals. More regions have had to lay off hospital staff than have been overwhelmed. Some like UW medicine now face a $500 million budget shortfall due to the ban on elective procedures. Social distancing measures may have an effect on r_t as low as 0.1 per analysis by Nate Silver. Others show a negative or no correlation between government lockdowns and reduction of r_t. It is fair to question if these lockdowns - as instituted - have done anything.
  - Teknoman117 6y ago
    > $500 million budget shortfall due to the ban on elective procedures. I feel like that's a symptom of a much larger problem...
  - sirbranedamuj 6y ago
    The entire hospital staff doesn't just sit around waiting for a pandemic. Most elective procedures have been postponed during this. Large portions of the healthcare system are idle _because_ everyone is at home. The parts of the hospital that can handle the symptoms of the virus are what we're trying to reduce the burden on.
  - ceejayoz 6y ago
    > More regions have had to lay off hospital staff than have been overwhelmed. That's a bit of a red herring. Hospitals aren't laying off ER and ICU staff. They're furloughing in areas like dermatology, plastic surgery, and the like - parts of the hospital that see largely elective procedures.
    - nostromo 6y ago
      > furloughing in areas like dermatology, plastic surgery, and the like Stop. This is incredibly misleading. Elective just means that you can choose the time to do the surgery. It doesn't mean they are optional for health. Elective surgeries include inguinal hernia surgery, cataract surgery, mastectomy for breast cancer, kidney transplant, and hip surgery. Most surgeries are elective. Don't minimize this as a bunch of delayed facelifts.
      - ceejayoz 6y ago
        I'd be happy to wager there are substantially more dermatology visits in your average hospital than there are kidney transplants. There's a range of severity in "elective" procedures, certainly. There are a lot of procedures folks will willingly postpone right now, and it's not surprising that hospitals are furloughing staff that service them. It is disingenuous to suggest that furloughs in these elective areas demonstrate an excess of capacity in the ER/ICU.
        jdminhbg 6y ago
        Dermatology is real medicine with real consequences. Even Jerry Seinfeld found out the hard way: https://youtu.be/EmzM0bz3PWc https://youtu.be/EmzM0bz3PWc
        ceejayoz 6y ago
        Certainly, but you'll likely find it has a higher proportion of elective procedures that can be held off than, say, the NICU. Which will mean that department's staff - docs, nurses, receptionists, billers, cleaners, etc. - will be more likely to be on the furlough lists than the ER or ICU.
  - deleted 6y ago
    [deleted]
  - Rebelgecko 6y ago
    It looks like all of LA County has about 30 empty ICU beds today. To me that seems pretty low (although not "overwhelmed").
- gjs278 6y ago
  you are a literal npc. the hospitals are empty. the curve is at zero. you need to have people get sick to keep the curve going. stop parroting what people are telling you.
- xienze 6y ago
  > 1. To flatten the infection curve, in order to keep healthcare systems from becoming overwhelmed like those in northern Italy. I could buy this line of reasoning if there was any indication that hospitals outside of NYC were at any point “whelmed”, nevermind “overwhelmed.” All across the country you’ve got doctors and nurses getting their hours cut, furloughed, and laid off. And the ones who actually are in the hospitals have enough time to coordinate elaborate dance videos on TikTok.
  - ceejayoz 6y ago
    That's the nature of exponential growth. Becoming overwhelmed happens very quickly. Successful mitigation almost always looks like an overreaction.
    - xienze 6y ago
      Do you think anyone in their wildest dreams back in March imagined that hospitals all over the country would look like ghost towns? I’m pretty sure we were expecting hospitals to at the very least be experiencing high loads in the midst of these lockdowns. You know, it IS possible for both “lockdowns work” and “the models and experts were a bit off base” to be correct.
      - ceejayoz 6y ago
        It's not surprising the models weren't perfect in the first go-around. It's good they were flawed in this direction, and I'm glad hospitals aren't collapsing as a result. I hope we don't overcorrect, open up too soon and too much, and get to see what the other side of getting it wrong looks like.
        gjs278 6y ago
        you literally have zero expertise or proof this would have went exponential. turn your computer off and stop posting.
  - sirbranedamuj 6y ago
- dabbledash 6y ago
  1 is insufficiently clear. Is the endgame 1) getting new infections down to such a small number that they can be individually detected and isolated, 2) keeping hospital utilization from overrunning capacity while allowing the population to reach herd immunity, or 3) staying in lockdown until we have a vaccine or cure? Until this question is answered clearly and officials show that whatever goal they set is achievable in a reasonable timeframe, I think it’s unreasonable to expect people to continue to comply.
  - ceejayoz 6y ago
    #1 likely isn't possible in the US. The actions you take for #2 and #3 are similar, and which one you wind up implementing depends largely on how long the vaccine takes to develop.
    - dabbledash 6y ago
      I agree that 1 seems impossible. I think 3 is impossible without complete economic and social collapse. 2 would involve loosening restrictions and allowing spread that doesn’t quite max out capacity. It looks like 2 is functionally what the states are going to pursue, while no one admits it out loud, and the people who thought we were doing #1 express horror. Edited: meant to say states are doing 2 (comment initially said they are doing 3)
      - deleted 6y ago
        [deleted]
      - ceejayoz 6y ago
        No reason you can't do #2 while waiting for #3 to work.
        Zach_the_Lizard 6y ago
        The longer you do #2, the less you need #3, if the goal of #2 is to keep hospitals being utilized at the highest sustainable capacity with whatever safety margins are required. As more people become immune, the spread naturally gets slower, reducing the likelihood of hospitals being overwhelmed in the first place and thus reducing the desire to maintain stricter control. The individual risk of any given social interaction is reduced. Conversely, the more infected, the more dead, meaning the number of life-years that would be saved via a stricter lockdown until a vaccine or effective treatment gets developed gets smaller and smaller. I believe the shortest time it has taken to develop a new vaccine is the 5 years it took to develop one for Ebola, so I don't think one will be available in any meaningful way for this pandemic, though I'd love to be wrong.
- _-david-_ 6y ago
  That link you provided doesn't look like its taking into account the population size of those countries. The US has ~330 million people. For example, Russia looks like its #2 on the page but Russia has less than half the population of the US. If you look at per capita Russia would be above the US according to your graph.
  - ceejayoz 6y ago
    The more important aspects of that chart than raw case numbers are a) how long does it take to flatten the curve and b) is the curve coming back down. (There's also one further down, "normalized by country population", in which we still don't look great.)
    - _-david-_ 6y ago
      I didn't scroll down all the way so I didn't see the normalized chart. Thanks for that. I think that the number of cases which is the default isn't all that important. In fact the higher number who are infected could make herd immunity happen sooner. The number of deaths is far more important. When you look at that on your chart the US is behind many Western European countries and it definitely doesn't look as bad. Its not great but it could be worse. Do you have a chart that is looking at population density? I think that would also be a useful comparison when comparing different areas. Its not fair to compare NYC with Nebraska for example. I am not really sure how the European countries compare and am interested in a comparison if you know of one.
unethical_ban 6y ago
This is the best response. We know the answer to #1 from the feds earlier on, but we need to make sure states and cities are on the same page. There is no way to prevent all death. We won't and can't get to zero deaths in the short term - testing, tracing and vaccines are all far out from useful yet. Given that we don't have a government like Denmark, that can support all workers staying at home with job security, we have the tough choice of "rot at home and lose our jobs and businesses" or "take some risk, try to be smart, and keep hospitals from getting slammed". Protect the old and the immuno-compromised, and give them the support they need. Mandate mask use in crowded areas until we hit certain non-pandemic levels of new infection. Continue heightened production of PPE, sanitizer, etc. and work to allow small-medium in-person gatherings to be feasible again. If we do have large events, or open nightclubs, I could see requiring contact tracing apps. Like, give us your name/number so if you get infected, we know about it and can track it; if we(the club) cause an outbreak, we can notify people. But we can't sit at home much longer, financially or psychologically.
choward 6y ago
> What is the goal(s) of the "stay-at-home" order? This is my biggest complaint. The press briefings and the media have been worthless for trying to figure this out. I want to now the exact plan and I realize it will need to adapt over time but that should be explained by the plan. All the White House wants to talk about is the economy. I just want to know, are we going to wait for everyone to get vaccinated or tested for antibodies? How is the progress on those things? I don't care if some idiot who's not a doctor thinks some malaria drugs might help because he stands to benefit from that. Or is our goal to fully go to 0 new cases and just hope it doesn't pop up again. That seems unlikely since I don't know how that's possible without a complete lockdown for at least two weeks. Also, is there any possibility that this just goes away on its own? Saying we're opening things up just because of the economy seems completely moronic to me. I want to know what the actual plan is. Everything seems just arbitrary right now.
- lbeltrame 6y ago
  > I don't care if some idiot who's not a doctor thinks some malaria drugs might help because he stands to benefit from that. Not everyone is this shady. There's a real trial (University of Minnesota) trying to determine if HCQ works or not as post-exposure prophylaxis. Sadly, it only needs 150ish more people but it's struggling to get them (at least according to its PI).

by lsh123 6y ago

atian 6y ago

Not on here.

ceejayoz 6y ago

1. To flatten the infection curve, in order to keep healthcare systems from becoming overwhelmed like those in northern Italy. 2. Thus far, it's worked to keep hospitals functioning. We're doing worse than most other countries (https://91-divoc.com/pages/covid-visualization/ https://91-divoc.com/pages/covid-visualization/).

icelancer 6y ago
>> 1. To flatten the infection curve, in order to keep healthcare systems from becoming overwhelmed like those in northern Italy. Very few regions have had anything close to overwhelmed hospitals. More regions have had to lay off hospital staff than have been overwhelmed. Some like UW medicine now face a $500 million budget shortfall due to the ban on elective procedures. Social distancing measures may have an effect on r_t as low as 0.1 per analysis by Nate Silver. Others show a negative or no correlation between government lockdowns and reduction of r_t. It is fair to question if these lockdowns - as instituted - have done anything.
- Teknoman117 6y ago
  > $500 million budget shortfall due to the ban on elective procedures. I feel like that's a symptom of a much larger problem...
- sirbranedamuj 6y ago
  The entire hospital staff doesn't just sit around waiting for a pandemic. Most elective procedures have been postponed during this. Large portions of the healthcare system are idle _because_ everyone is at home. The parts of the hospital that can handle the symptoms of the virus are what we're trying to reduce the burden on.
- ceejayoz 6y ago
  > More regions have had to lay off hospital staff than have been overwhelmed. That's a bit of a red herring. Hospitals aren't laying off ER and ICU staff. They're furloughing in areas like dermatology, plastic surgery, and the like - parts of the hospital that see largely elective procedures.
  - nostromo 6y ago
    > furloughing in areas like dermatology, plastic surgery, and the like Stop. This is incredibly misleading. Elective just means that you can choose the time to do the surgery. It doesn't mean they are optional for health. Elective surgeries include inguinal hernia surgery, cataract surgery, mastectomy for breast cancer, kidney transplant, and hip surgery. Most surgeries are elective. Don't minimize this as a bunch of delayed facelifts.
    - ceejayoz 6y ago
      I'd be happy to wager there are substantially more dermatology visits in your average hospital than there are kidney transplants. There's a range of severity in "elective" procedures, certainly. There are a lot of procedures folks will willingly postpone right now, and it's not surprising that hospitals are furloughing staff that service them. It is disingenuous to suggest that furloughs in these elective areas demonstrate an excess of capacity in the ER/ICU.
      - jdminhbg 6y ago
        Dermatology is real medicine with real consequences. Even Jerry Seinfeld found out the hard way: https://youtu.be/EmzM0bz3PWc https://youtu.be/EmzM0bz3PWc
        ceejayoz 6y ago
        Certainly, but you'll likely find it has a higher proportion of elective procedures that can be held off than, say, the NICU. Which will mean that department's staff - docs, nurses, receptionists, billers, cleaners, etc. - will be more likely to be on the furlough lists than the ER or ICU.
- deleted 6y ago
  [deleted]
- Rebelgecko 6y ago
  It looks like all of LA County has about 30 empty ICU beds today. To me that seems pretty low (although not "overwhelmed").
gjs278 6y ago
you are a literal npc. the hospitals are empty. the curve is at zero. you need to have people get sick to keep the curve going. stop parroting what people are telling you.
xienze 6y ago
> 1. To flatten the infection curve, in order to keep healthcare systems from becoming overwhelmed like those in northern Italy. I could buy this line of reasoning if there was any indication that hospitals outside of NYC were at any point “whelmed”, nevermind “overwhelmed.” All across the country you’ve got doctors and nurses getting their hours cut, furloughed, and laid off. And the ones who actually are in the hospitals have enough time to coordinate elaborate dance videos on TikTok.
- ceejayoz 6y ago
  That's the nature of exponential growth. Becoming overwhelmed happens very quickly. Successful mitigation almost always looks like an overreaction.
  - xienze 6y ago
    Do you think anyone in their wildest dreams back in March imagined that hospitals all over the country would look like ghost towns? I’m pretty sure we were expecting hospitals to at the very least be experiencing high loads in the midst of these lockdowns. You know, it IS possible for both “lockdowns work” and “the models and experts were a bit off base” to be correct.
    - ceejayoz 6y ago
      It's not surprising the models weren't perfect in the first go-around. It's good they were flawed in this direction, and I'm glad hospitals aren't collapsing as a result. I hope we don't overcorrect, open up too soon and too much, and get to see what the other side of getting it wrong looks like.
      - gjs278 6y ago
        you literally have zero expertise or proof this would have went exponential. turn your computer off and stop posting.
- sirbranedamuj 6y ago
dabbledash 6y ago
1 is insufficiently clear. Is the endgame 1) getting new infections down to such a small number that they can be individually detected and isolated, 2) keeping hospital utilization from overrunning capacity while allowing the population to reach herd immunity, or 3) staying in lockdown until we have a vaccine or cure? Until this question is answered clearly and officials show that whatever goal they set is achievable in a reasonable timeframe, I think it’s unreasonable to expect people to continue to comply.
- ceejayoz 6y ago
  #1 likely isn't possible in the US. The actions you take for #2 and #3 are similar, and which one you wind up implementing depends largely on how long the vaccine takes to develop.
  - dabbledash 6y ago
    I agree that 1 seems impossible. I think 3 is impossible without complete economic and social collapse. 2 would involve loosening restrictions and allowing spread that doesn’t quite max out capacity. It looks like 2 is functionally what the states are going to pursue, while no one admits it out loud, and the people who thought we were doing #1 express horror. Edited: meant to say states are doing 2 (comment initially said they are doing 3)
    - deleted 6y ago
      [deleted]
    - ceejayoz 6y ago
      No reason you can't do #2 while waiting for #3 to work.
      - Zach_the_Lizard 6y ago
        The longer you do #2, the less you need #3, if the goal of #2 is to keep hospitals being utilized at the highest sustainable capacity with whatever safety margins are required. As more people become immune, the spread naturally gets slower, reducing the likelihood of hospitals being overwhelmed in the first place and thus reducing the desire to maintain stricter control. The individual risk of any given social interaction is reduced. Conversely, the more infected, the more dead, meaning the number of life-years that would be saved via a stricter lockdown until a vaccine or effective treatment gets developed gets smaller and smaller. I believe the shortest time it has taken to develop a new vaccine is the 5 years it took to develop one for Ebola, so I don't think one will be available in any meaningful way for this pandemic, though I'd love to be wrong.
_-david-_ 6y ago
That link you provided doesn't look like its taking into account the population size of those countries. The US has ~330 million people. For example, Russia looks like its #2 on the page but Russia has less than half the population of the US. If you look at per capita Russia would be above the US according to your graph.
- ceejayoz 6y ago
  The more important aspects of that chart than raw case numbers are a) how long does it take to flatten the curve and b) is the curve coming back down. (There's also one further down, "normalized by country population", in which we still don't look great.)
  - _-david-_ 6y ago
    I didn't scroll down all the way so I didn't see the normalized chart. Thanks for that. I think that the number of cases which is the default isn't all that important. In fact the higher number who are infected could make herd immunity happen sooner. The number of deaths is far more important. When you look at that on your chart the US is behind many Western European countries and it definitely doesn't look as bad. Its not great but it could be worse. Do you have a chart that is looking at population density? I think that would also be a useful comparison when comparing different areas. Its not fair to compare NYC with Nebraska for example. I am not really sure how the European countries compare and am interested in a comparison if you know of one.

unethical_ban 6y ago

This is the best response. We know the answer to #1 from the feds earlier on, but we need to make sure states and cities are on the same page. There is no way to prevent all death. We won't and can't get to zero deaths in the short term - testing, tracing and vaccines are all far out from useful yet. Given that we don't have a government like Denmark, that can support all workers staying at home with job security, we have the tough choice of "rot at home and lose our jobs and businesses" or "take some risk, try to be smart, and keep hospitals from getting slammed". Protect the old and the immuno-compromised, and give them the support they need. Mandate mask use in crowded areas until we hit certain non-pandemic levels of new infection. Continue heightened production of PPE, sanitizer, etc. and work to allow small-medium in-person gatherings to be feasible again. If we do have large events, or open nightclubs, I could see requiring contact tracing apps. Like, give us your name/number so if you get infected, we know about it and can track it; if we(the club) cause an outbreak, we can notify people. But we can't sit at home much longer, financially or psychologically.

choward 6y ago

> What is the goal(s) of the "stay-at-home" order? This is my biggest complaint. The press briefings and the media have been worthless for trying to figure this out. I want to now the exact plan and I realize it will need to adapt over time but that should be explained by the plan. All the White House wants to talk about is the economy. I just want to know, are we going to wait for everyone to get vaccinated or tested for antibodies? How is the progress on those things? I don't care if some idiot who's not a doctor thinks some malaria drugs might help because he stands to benefit from that. Or is our goal to fully go to 0 new cases and just hope it doesn't pop up again. That seems unlikely since I don't know how that's possible without a complete lockdown for at least two weeks. Also, is there any possibility that this just goes away on its own? Saying we're opening things up just because of the economy seems completely moronic to me. I want to know what the actual plan is. Everything seems just arbitrary right now.

lbeltrame 6y ago
> I don't care if some idiot who's not a doctor thinks some malaria drugs might help because he stands to benefit from that. Not everyone is this shady. There's a real trial (University of Minnesota) trying to determine if HCQ works or not as post-exposure prophylaxis. Sadly, it only needs 150ish more people but it's struggling to get them (at least according to its PI).