4 ms·

> we would have to implement extremely strict lockdowns... if we assume that the goal is not to flatten the curve but to completely stop the virus in its track

> we would have to implement extremely strict lockdowns... if we assume that the goal is not to flatten the curve but to completely stop the virus in its tracks. Most people and countries don't have this goal. Edit: To those downvoting, I'll just say that my statement is factual, so argue the facts. Long-term, we want a vaccine, yes. In the meantime, most people and countries are simply not willing to do what it takes to completely eliminate this virus. They think it would be nice if the virus went away, but they are not working towards that as their goal.

jennyyang 6y ago
If the virus were truly airborne, which it isn't, then simply walking through an empty room could get you infected. The levels of people getting infected, and subsequently getting hospitalized would be far worse than the worst scenes we saw in Italy and NYC. Lockdowns absolutely would have been mandatory for months upon months. Coronavirus is not by itself a tremendously deadly disease. The problem is how infectious it is, and how quickly it can overrun a limited hospital system. Even at a sub-10% hospitalization rate for people younger than 60, we are seeing many hospitals getting full. It being truly airborne would make things worse by many orders of magnitude. The way coronavirus spreads is basically the same mechanism as the flu and the cold, yet the levels of people getting infected are much much worse. Imagine if simply walking through a room could get you infected. The spread would be undeniably worse than anything we had every seen before. Even stores like Costco and all factories would have to shut down. So yes, very strict lockdowns would need to be in place. Thank goodness it's not.
- mensetmanusman 6y ago
  Um.. it is airborne, that is why there are multiple super-spreader events that can’t be explained by someone interacting within 3-6 feet for 10 minutes. (e.g. cases of 1 to 100, 1:500 case reported as well). If you walked into an empty hospital room that was just used with high air-virion density, you could get infected, that is why they decontaminate with the equipment you see. I think the main reason this isn’t being communicated is because we will never have enough N95 masks to mitigate this (would need 5-10 years of 24/6 production to fill govt. stockpiles).
  - deleted 6y ago
    [deleted]
  - guscost 6y ago
    I would bet that you are right, but it is still a controversial opinion, and droplet transmission is probably still a major factor. Plenty of research supports the claim, although some studies conclude that it is only significant when the spreader has a high viral load: https://www.nature.com/articles/s41598-020-69286-3 https://www.nature.com/articles/s41598-020-69286-3 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768712 https://jamanetwork.com/journals/jamanetworkopen/fullarticle... https://www.medrxiv.org/content/10.1101/2020.07.16.20155572v1 https://www.medrxiv.org/content/10.1101/2020.07.16.20155572v... https://www.medrxiv.org/content/10.1101/2020.07.13.20153049v1 https://www.medrxiv.org/content/10.1101/2020.07.13.20153049v...
  - sgt101 6y ago
    Ok - these multiple superspreader events... do you mean 100's or 10's or a few? And when you say "can't be explained " really? Can you provide some back up to this information?
    - mensetmanusman 6y ago
      https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768712 https://jamanetwork.com/journals/jamanetworkopen/fullarticle... https://www.vox.com/21296067/coronavirus-covid-symptoms-superspreaders-superspreading-contagious-bars-restaurants https://www.vox.com/21296067/coronavirus-covid-symptoms-supe... (put the air purifiers in the bathroom it seems...)
- clairity 6y ago
  thanks for continuing to tease out the nuance. nearly all coverage and discussion of covid is an exercise in frustration, one way or the other. the unrealistic desire for riskless, surefire mitigations had led us exactly into the ping-ponging uncertainty that such longing tries so strenuously to avoid. it's wreaking havoc on our social and economic lives, let alone politically. taking into account what we know so far, the best bang-for-buck rule is still "distance (inside), and when you can't, mask.", not shutdown, or mask outside and all the time, or never mask or distance, or business as usual, or wipe down surfaces incessantly, or reconfigure every hvac system. the simplicity of that one rule belies a lot of understanding packed into it, unfortunately, leading to an unnecessary yearning for more. there isn't more that we ordinary folks can do than that. that's not to say don't be cognizant of the progress we're making, but does suggest we need to stop fretting while we wait for more effective treatments, herd immunity, and/or a vaccine.
- throwaway_pdp09 6y ago
  > If the virus were truly airborne, which it isn't why do you say this? The article is saying otherwise, quite literally "The coronavirus reproduces in our upper and lower respiratory tracts, and is emitted when we breathe, talk, sing, cough, or sneeze" > then simply walking through an empty room could get you infected You're presuming it has to be empty. If you walked through a full room without touching anyone or anything and you caught covid, would you accept that it is airborne? Or are you saying that is impossible? Do I misunderstand you?
  - jennyyang 6y ago
    Yes you are misunderstanding me.
  - rtx 6y ago
    That's where the six feet distance part comes in.
  - prox 6y ago
    It’s because it seems to be mostly ballistic droplets, except for a (small?) percentage were it is not. This is also stated in text for measles (that spreads throughout a house) which Corona seems to not do.
    - throwaway_pdp09 6y ago
      From the article, that's exactly what's being questioned: "There is a big dispute in the scientific community, however, about both the size and the behavior of these particles, and the resolution of that question would change many recommendations about staying safe. Many scientists believe that the virus is emitted from our mouths also in much smaller particles, which are infectious but also tiny enough that they can remain suspended in the air, float around, be pushed by air currents, and accumulate in enclosed spaces"
      - prox 6y ago
        Yes but, and this is the important part : not as potent as for instance measles (which spreads and infects 90%) Or we’d see far more indoor cases. And we do see in events with lots of expiration, where there is singing for example, very potent transmission.
- hcurtiss 6y ago
  >Even stores like Costco and all factories would have to shut down. That would kill a lot of people too. It's not obvious to me which would be worse, particularly in the face of such a low IFR.
- throwaway_pdp09 6y ago
  WTF is going on here? You claim "If the virus were truly airborne, which it isn't" yet provide no evidence. But looking at you history you have provided exactly evidence that it is airborne "Video showing microdroplets suspending in air (vimeo.com)" a few months ago (https://news.ycombinator.com/item?id=22776194 https://news.ycombinator.com/item?id=22776194) And to quote from another commenter "The part showing how a single cough can create a room-wide cloud of virus that lingers for 20+ minutes in spaces with poor circulation was especially enlightening." Having watched the vid I can confirm that's what they show, at least as a simulation. Even the main article says (I'm re-quoting from another of my posts): "There is a big dispute in the scientific community, however, about both the size and the behavior of these particles, and the resolution of that question would change many recommendations about staying safe. Many scientists believe that the virus is emitted from our mouths also in much smaller particles, which are infectious but also tiny enough that they can remain suspended in the air, float around, be pushed by air currents, and accumulate in enclosed spaces" which directly opposes what you say. How is your parent post not either plain wrong or deliberately sowing confusion? I'm flagging you.
DoofusOfDeath 6y ago
> Edit: To those downvoting, I'll just say that my statement is factual, so argue the facts. I wonder if the downvotes were caused by the phrasing of this statement: > Most people and countries don't have this goal. At first I thought you were saying that people didn't actually want to stop the virus in its tracks. It took me a minute to realize that you're saying people have accepted full-stoppage-in-tracks as being infeasible, and therefore don't consider it an attainable goal.
- scubbo 6y ago
  > At first I thought you were saying that people didn't actually want to stop the virus in its tracks. No, I think that's precisely what they were saying. I don't think that this is unattainable - I think it would have a greater economic cost, particularly to the wealthy, than many countries are willing to bear. It's not unattainable - it would cost them more than those lives are perceived as being worth. Big conceptual difference.
  - dorgo 6y ago
    It's not only economic cost. To get results like in china you have to be (like) china. It's easy to sell drastic measures to the population if the infection (and death) numbers look scary. But if the numbers stagnate at low values nobody is going to accept drastic measures. You would need to fight against your own population to stop the virus altogether. And even if you achive this, the virus will return (tourist/travelers).
deleted 6y ago
[deleted]
pjc50 6y ago
> I'll just say that my statement is factual > assume > goal An assumption is not a fact. A goal isn't a fact either. While total elimination is probably impossible, plenty of places have managed almost complete suppression to the point where it's more like E. Coli; occasional outbreaks, but action taken to contain it. "flatten the curve" is now associated with "herd immunity" and other discredited ideas.
- scubbo 6y ago
  I think you may have responded a little hastily and misunderstood the comment. --- > An assumption is not a fact. Correct, and the person you were replying to never implied that it was. I'll rewrite the comment more explicitly for you, instead of using the implied context of the quotation: > If the goal was not to flatten the curve but to completely stop the virus in its tracks, we would have to implement extremely strict lockdowns. Most people and countries don't have this goal [to completely stop the virus] --- > A goal isn't a fact either "Entity X has goal Y" is, indeed, a fact. (EDIT: Or, rather, a statement - which may or not be factual) The person you were replying to claims "Most people and countries do not have the goal to completely stop the virus" as a fact. Neither you, nor they, have provided evidence for or against the factuality of this statement. --- Can you elaborate on what, exactly, is discredited about "flattening the curve" - shorthand for "reducing the rate-of-increase of new cases, so that the throughput of new cases is within the carrying capacity of the country-in-question's medical infrastructure"?
- nradov 6y ago
  Almost all countries are pursuing a herd immunity strategy by default, just at varying rates. Only a handful of countries are actually taking steps to eradicate the virus within their borders.
cactus2093 6y ago
The whole "flatten the curve" messaging always seemed like we were barreling toward a misunderstanding, and I think this comment and the disagreeing downvotes are a perfect example of that. Back when US public health messaging really went all-in on that phrase it was like late February when we thought the transmission level was minimal. "Flattening" the curve at a minimal level would have been fine, and if we got the reproduction rate even just barely below 1 the infection would have died out. Flattening the curve when there are 10,000 people dying a week is a very different situation, and I don't think ending up there was ever explicitly anyone's goal (except for famously Sweden). But that's what we finally ended up achieving in April, and everyone basically patted themselves on the back for it and started treating the pandemic as over. It should have been very clear to anybody paying even a little bit of attention that once we started approaching and then surpassed "running out of ICU beds"-level of crisis in some places, that flattening the curve anywhere near that level would not be good, and when we did start to plateau at only like 30% down from the peaks we were nowhere near in the clear. But for whatever reason we just ignored that inconvenient fact and acted as if our lockdown had worked. After all, we had "flattened the curve". Obviously the world is quite complicated and this is impossible to predict, but I genuinely wonder what would have happened if a more ambitious catchphrase had caught on instead like "zero out the curve". It's well-known that laypersons are naturally bad at reasoning about exponential growth, but I also think the public health "experts" really let us down as well in their failure to properly account for the exponential growth as well.
- WalterSear 6y ago
  Flattening the curve was about preventing the hospital system from being overwhelmed. It was about solving the crisis from the point of view of civic administrators and politicians. So, keeping people safe was a secondary goal: the primary purpose was to keep the system from failing outright. IMHO, consequent to the misinterpretation of this, people assumed that if the curve was flattening, the problem was being solved, since they thought that the curve was about their safety, rather than about stretching the deaths out so that queues didn't form.

jennyyang 6y ago

If the virus were truly airborne, which it isn't, then simply walking through an empty room could get you infected. The levels of people getting infected, and subsequently getting hospitalized would be far worse than the worst scenes we saw in Italy and NYC. Lockdowns absolutely would have been mandatory for months upon months. Coronavirus is not by itself a tremendously deadly disease. The problem is how infectious it is, and how quickly it can overrun a limited hospital system. Even at a sub-10% hospitalization rate for people younger than 60, we are seeing many hospitals getting full. It being truly airborne would make things worse by many orders of magnitude. The way coronavirus spreads is basically the same mechanism as the flu and the cold, yet the levels of people getting infected are much much worse. Imagine if simply walking through a room could get you infected. The spread would be undeniably worse than anything we had every seen before. Even stores like Costco and all factories would have to shut down. So yes, very strict lockdowns would need to be in place. Thank goodness it's not.

mensetmanusman 6y ago
Um.. it is airborne, that is why there are multiple super-spreader events that can’t be explained by someone interacting within 3-6 feet for 10 minutes. (e.g. cases of 1 to 100, 1:500 case reported as well). If you walked into an empty hospital room that was just used with high air-virion density, you could get infected, that is why they decontaminate with the equipment you see. I think the main reason this isn’t being communicated is because we will never have enough N95 masks to mitigate this (would need 5-10 years of 24/6 production to fill govt. stockpiles).
- deleted 6y ago
  [deleted]
- guscost 6y ago
  I would bet that you are right, but it is still a controversial opinion, and droplet transmission is probably still a major factor. Plenty of research supports the claim, although some studies conclude that it is only significant when the spreader has a high viral load: https://www.nature.com/articles/s41598-020-69286-3 https://www.nature.com/articles/s41598-020-69286-3 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768712 https://jamanetwork.com/journals/jamanetworkopen/fullarticle... https://www.medrxiv.org/content/10.1101/2020.07.16.20155572v1 https://www.medrxiv.org/content/10.1101/2020.07.16.20155572v... https://www.medrxiv.org/content/10.1101/2020.07.13.20153049v1 https://www.medrxiv.org/content/10.1101/2020.07.13.20153049v...
- sgt101 6y ago
  Ok - these multiple superspreader events... do you mean 100's or 10's or a few? And when you say "can't be explained " really? Can you provide some back up to this information?
  - mensetmanusman 6y ago
    https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768712 https://jamanetwork.com/journals/jamanetworkopen/fullarticle... https://www.vox.com/21296067/coronavirus-covid-symptoms-superspreaders-superspreading-contagious-bars-restaurants https://www.vox.com/21296067/coronavirus-covid-symptoms-supe... (put the air purifiers in the bathroom it seems...)
clairity 6y ago
thanks for continuing to tease out the nuance. nearly all coverage and discussion of covid is an exercise in frustration, one way or the other. the unrealistic desire for riskless, surefire mitigations had led us exactly into the ping-ponging uncertainty that such longing tries so strenuously to avoid. it's wreaking havoc on our social and economic lives, let alone politically. taking into account what we know so far, the best bang-for-buck rule is still "distance (inside), and when you can't, mask.", not shutdown, or mask outside and all the time, or never mask or distance, or business as usual, or wipe down surfaces incessantly, or reconfigure every hvac system. the simplicity of that one rule belies a lot of understanding packed into it, unfortunately, leading to an unnecessary yearning for more. there isn't more that we ordinary folks can do than that. that's not to say don't be cognizant of the progress we're making, but does suggest we need to stop fretting while we wait for more effective treatments, herd immunity, and/or a vaccine.
throwaway_pdp09 6y ago
> If the virus were truly airborne, which it isn't why do you say this? The article is saying otherwise, quite literally "The coronavirus reproduces in our upper and lower respiratory tracts, and is emitted when we breathe, talk, sing, cough, or sneeze" > then simply walking through an empty room could get you infected You're presuming it has to be empty. If you walked through a full room without touching anyone or anything and you caught covid, would you accept that it is airborne? Or are you saying that is impossible? Do I misunderstand you?
- jennyyang 6y ago
  Yes you are misunderstanding me.
- rtx 6y ago
  That's where the six feet distance part comes in.
- prox 6y ago
  It’s because it seems to be mostly ballistic droplets, except for a (small?) percentage were it is not. This is also stated in text for measles (that spreads throughout a house) which Corona seems to not do.
  - throwaway_pdp09 6y ago
    From the article, that's exactly what's being questioned: "There is a big dispute in the scientific community, however, about both the size and the behavior of these particles, and the resolution of that question would change many recommendations about staying safe. Many scientists believe that the virus is emitted from our mouths also in much smaller particles, which are infectious but also tiny enough that they can remain suspended in the air, float around, be pushed by air currents, and accumulate in enclosed spaces"
    - prox 6y ago
      Yes but, and this is the important part : not as potent as for instance measles (which spreads and infects 90%) Or we’d see far more indoor cases. And we do see in events with lots of expiration, where there is singing for example, very potent transmission.
hcurtiss 6y ago
>Even stores like Costco and all factories would have to shut down. That would kill a lot of people too. It's not obvious to me which would be worse, particularly in the face of such a low IFR.
throwaway_pdp09 6y ago
WTF is going on here? You claim "If the virus were truly airborne, which it isn't" yet provide no evidence. But looking at you history you have provided exactly evidence that it is airborne "Video showing microdroplets suspending in air (vimeo.com)" a few months ago (https://news.ycombinator.com/item?id=22776194 https://news.ycombinator.com/item?id=22776194) And to quote from another commenter "The part showing how a single cough can create a room-wide cloud of virus that lingers for 20+ minutes in spaces with poor circulation was especially enlightening." Having watched the vid I can confirm that's what they show, at least as a simulation. Even the main article says (I'm re-quoting from another of my posts): "There is a big dispute in the scientific community, however, about both the size and the behavior of these particles, and the resolution of that question would change many recommendations about staying safe. Many scientists believe that the virus is emitted from our mouths also in much smaller particles, which are infectious but also tiny enough that they can remain suspended in the air, float around, be pushed by air currents, and accumulate in enclosed spaces" which directly opposes what you say. How is your parent post not either plain wrong or deliberately sowing confusion? I'm flagging you.

DoofusOfDeath 6y ago

> Edit: To those downvoting, I'll just say that my statement is factual, so argue the facts. I wonder if the downvotes were caused by the phrasing of this statement: > Most people and countries don't have this goal. At first I thought you were saying that people didn't actually want to stop the virus in its tracks. It took me a minute to realize that you're saying people have accepted full-stoppage-in-tracks as being infeasible, and therefore don't consider it an attainable goal.

scubbo 6y ago
> At first I thought you were saying that people didn't actually want to stop the virus in its tracks. No, I think that's precisely what they were saying. I don't think that this is unattainable - I think it would have a greater economic cost, particularly to the wealthy, than many countries are willing to bear. It's not unattainable - it would cost them more than those lives are perceived as being worth. Big conceptual difference.
- dorgo 6y ago
  It's not only economic cost. To get results like in china you have to be (like) china. It's easy to sell drastic measures to the population if the infection (and death) numbers look scary. But if the numbers stagnate at low values nobody is going to accept drastic measures. You would need to fight against your own population to stop the virus altogether. And even if you achive this, the virus will return (tourist/travelers).

deleted 6y ago

[deleted]

pjc50 6y ago

> I'll just say that my statement is factual > assume > goal An assumption is not a fact. A goal isn't a fact either. While total elimination is probably impossible, plenty of places have managed almost complete suppression to the point where it's more like E. Coli; occasional outbreaks, but action taken to contain it. "flatten the curve" is now associated with "herd immunity" and other discredited ideas.

scubbo 6y ago
I think you may have responded a little hastily and misunderstood the comment. --- > An assumption is not a fact. Correct, and the person you were replying to never implied that it was. I'll rewrite the comment more explicitly for you, instead of using the implied context of the quotation: > If the goal was not to flatten the curve but to completely stop the virus in its tracks, we would have to implement extremely strict lockdowns. Most people and countries don't have this goal [to completely stop the virus] --- > A goal isn't a fact either "Entity X has goal Y" is, indeed, a fact. (EDIT: Or, rather, a statement - which may or not be factual) The person you were replying to claims "Most people and countries do not have the goal to completely stop the virus" as a fact. Neither you, nor they, have provided evidence for or against the factuality of this statement. --- Can you elaborate on what, exactly, is discredited about "flattening the curve" - shorthand for "reducing the rate-of-increase of new cases, so that the throughput of new cases is within the carrying capacity of the country-in-question's medical infrastructure"?
nradov 6y ago
Almost all countries are pursuing a herd immunity strategy by default, just at varying rates. Only a handful of countries are actually taking steps to eradicate the virus within their borders.

cactus2093 6y ago

The whole "flatten the curve" messaging always seemed like we were barreling toward a misunderstanding, and I think this comment and the disagreeing downvotes are a perfect example of that. Back when US public health messaging really went all-in on that phrase it was like late February when we thought the transmission level was minimal. "Flattening" the curve at a minimal level would have been fine, and if we got the reproduction rate even just barely below 1 the infection would have died out. Flattening the curve when there are 10,000 people dying a week is a very different situation, and I don't think ending up there was ever explicitly anyone's goal (except for famously Sweden). But that's what we finally ended up achieving in April, and everyone basically patted themselves on the back for it and started treating the pandemic as over. It should have been very clear to anybody paying even a little bit of attention that once we started approaching and then surpassed "running out of ICU beds"-level of crisis in some places, that flattening the curve anywhere near that level would not be good, and when we did start to plateau at only like 30% down from the peaks we were nowhere near in the clear. But for whatever reason we just ignored that inconvenient fact and acted as if our lockdown had worked. After all, we had "flattened the curve". Obviously the world is quite complicated and this is impossible to predict, but I genuinely wonder what would have happened if a more ambitious catchphrase had caught on instead like "zero out the curve". It's well-known that laypersons are naturally bad at reasoning about exponential growth, but I also think the public health "experts" really let us down as well in their failure to properly account for the exponential growth as well.

WalterSear 6y ago
Flattening the curve was about preventing the hospital system from being overwhelmed. It was about solving the crisis from the point of view of civic administrators and politicians. So, keeping people safe was a secondary goal: the primary purpose was to keep the system from failing outright. IMHO, consequent to the misinterpretation of this, people assumed that if the curve was flattening, the problem was being solved, since they thought that the curve was about their safety, rather than about stretching the deaths out so that queues didn't form.