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I would love for this whole thing to end as much as anyone, but I don't see how this gets anything back to normal. In January of this year, there were a neglig

by xscott 6y ago

I would love for this whole thing to end as much as anyone, but I don't see how this gets anything back to normal. In January of this year, there were a negligible amount of people in the US with Covid. Let's say now in November everyone gets tested every day, and you have an unbelievable compliance for self quarantining on positive results. It would never happen, but pretend it's 99.9% of people following the rules to "drive the virus towards elimination within weeks". Great, now you think you've beaten it back to where it came from. How does this do anything other than reset the clock back to last January just in time for next January? As soon as everyone lowers their guard and goes back to normal, it's going to spread again. We need immunity from a vaccine or from it running its course to be done with this. What am I missing? Are we going to setup nationwide contact tracing this time? Just a few visitors from other countries, and we're at it again.

taeric 6y ago
This is my problem with most every success story so far. For how quickly this spreads where it spreads, and that it is a corona virus, I'm not seeing any panacea here. I say this as someone that is fine complying with my states restrictions. I even think they are correct, if only as something to try. I'm just not seeing the end game here. :(
- threeseed 6y ago
  End game is pretty obvious. US will simply let another few hundred thousand more people die until the vaccine is widespread.
bluGill 6y ago
You need to get positives down to zero for two weeks before you declare success. Daily testing, with quarantine of any positives and then contact tracing two levels (everyone you contacted and then their contacts could get to zero quickly. But the quarantine step is required for every one to pull that off. Of course this works out easy in a post. Good luck implementing it in real life. People violate quarantine if they can.
- xscott 6y ago
  No, that's exactly my point. Even if it went according to your best possible plan, all you do is reset it back to Jan 2019. Or did you mean we're all going to do daily testing and contact tracing forever?
  - bluGill 6y ago
    I mean daily testing until we have two weeks of zero cases. Worldwide (or mandatory two weeks isolated quarantine at customs). This is what new Zealand did, so it is possible, but it is logically very hard for anyone not an isolated island.
    - xscott 6y ago
      Worldwide with quarantines from customs is virtually impossible. Customs can't stop human or cocaine trafficking from making it into the country, much less undocumented immigration. All you need is a half dozen sick people who are trying to hide from the authorities, and you're back to square one. Most countries are not islands.
      - bluGill 6y ago
        Like I said, logistically impossible, but it would work.
pmoriarty 6y ago
"How does this do anything other than reset the clock back to last January just in time for next January?" First, that alone would be HUGE progress. "As soon as everyone lowers their guard and goes back to normal, it's going to spread again." Yeah, but this time you're not going to have whining, tantrum-throwing, conspiracy-mongering, megalomaniacal, science-denying children in charge. We've yet to see if they wind up being more competent and actually make a difference, but the chance to do proper contact tracing on the relatively few people that get infected will be there, and hopefully the country will take it more seriously the second time around. I'm not hugely optimistic, but if they actually followed through and were competent in dealing with it this time, it could save millions of lives.
- xscott 6y ago
  And then what? We're going to impose 2 week quarantines on every flight into the US? Have a dedicated branch of the CDC perform contact tracing on everyone who crosses the borders? I think you greatly overestimate how politics plays into this. It never ends until we're immune.
  - pmoriarty 6y ago
    No. You just keep testing people, and do isolation and contact tracing on the ones that get sick. In the meantime, vaccines will start to roll out. Curbing this pandemic is perfectly practical and within reach, given the will to do it.
threeseed 6y ago
> Just a few visitors from other countries, and we're at it again So just do what we do in Australia and quarantine them in hotels. If you manage it properly it can be highly effective.
- gameswithgo 6y ago
  americans start throwing hissy fits at suggestions far far less intrusive than that. maybe we will die off and the world will be better off. our last screams from this hill of freedom that we die on.
  - chii 6y ago
    > americans start throwing hissy fits well there's your problem. People are unwilling to make the least bit of self-sacrifice for a common cause. And it's not even that big of a sacrifice - it's just staying in a hotel for 2 weeks, and not leaving! I'm like WTF why is it such a big deal?
- xscott 6y ago
  Australia's borders are oceans. It's a different thing altogether.
vmurthy 6y ago
Agree this won't get everything back to normal but think of it as an equivalent of "defence-in-depth" of info sec. Rapid testing and isolating (I doubt the US could "enforce" it but you have to give the benefit of doubt that a percentage of people do care for others and will isolate - FWIW, I've seen this happen in Oz where a large %-age of people did isolate) will reduce/delay the infection surge and give time for the healthcare system to recover from the second shock this year. In addition, with the EUAs in flight by Jan '21 (hopefully), this one-two punch should drastically cut both infections and deaths. Remember, in the world of exponentials, both increase and decrease are exponential.
ScottBurson 6y ago
What you're missing is that a rapid test like this can be used as an entry check at restaurants and other public venues, allowing them to go back into business. Even if the vaccines turn out not to work for some reason, we can have our economy back, while limiting spread of the virus. It's not so much about getting people to fully self-quarantine, although that would be nice, as about eliminating super-spreader events.
- xscott 6y ago
  I didn't see the turn around time in the article. Just something about "less sensitive test with results today". I think it's optimistic to assume this could be used as an entry check for a restaurant.
  - ScottBurson 6y ago
    I have read elsewhere about researchers at least trying to develop 15-minute tests. Not sure what the status of their work is, but some think it's possible -- and they're specifically targeting entry checks.
    - xscott 6y ago
      Well, that'd be fast enough for some venues. I'm still skeptical it'd work in practice.
jlokier 6y ago
> or from it running its course to be done with this. A nitpick, but it deals with a pervasive idea that should be updated. The virus will most likely never "run its course" to give us collective immunity without technological intervention. That's because herd immunity is only known to have ever occurred as a result of deliberate vaccination, and even then it disappears in areas where vaccination stops. It has never been observed to occur naturally as a result of infection. In other words, the "natural herd immunity solution" is simply not something most of the scientific community believes to be an option right now. Instead the prevailing theory is that if we let it "run its course" it would in fact continue circulating endlessly, gradually mutating. Epidemiologists do perform calculations to estimate how natural herd immunity might arise, but it has never yet been observed to actually happen, and the calculations are intrinsically rather unreliable. From "The false promise of herd immunity for COVID-19" (21st October 2020, https://www.nature.com/articles/d41586-020-02948-4 https://www.nature.com/articles/d41586-020-02948-4): > never before have we reached herd immunity via natural infection Also maybe relevant, if herd immunity could occur naturally, then the calculations done around it lead to: > proposals to largely let the virus run its course [...] could bring “untold death and suffering”
- xscott 6y ago
  This is interesting, and I hadn't heard this about herd immunity before. However, I kind of imagine that at some point in history a lot of our ancestors died from things we don't even think of as more than nuisances now.

by xscott 6y ago

taeric 6y ago

This is my problem with most every success story so far. For how quickly this spreads where it spreads, and that it is a corona virus, I'm not seeing any panacea here. I say this as someone that is fine complying with my states restrictions. I even think they are correct, if only as something to try. I'm just not seeing the end game here. :(

threeseed 6y ago
End game is pretty obvious. US will simply let another few hundred thousand more people die until the vaccine is widespread.

bluGill 6y ago

You need to get positives down to zero for two weeks before you declare success. Daily testing, with quarantine of any positives and then contact tracing two levels (everyone you contacted and then their contacts could get to zero quickly. But the quarantine step is required for every one to pull that off. Of course this works out easy in a post. Good luck implementing it in real life. People violate quarantine if they can.

xscott 6y ago
No, that's exactly my point. Even if it went according to your best possible plan, all you do is reset it back to Jan 2019. Or did you mean we're all going to do daily testing and contact tracing forever?
- bluGill 6y ago
  I mean daily testing until we have two weeks of zero cases. Worldwide (or mandatory two weeks isolated quarantine at customs). This is what new Zealand did, so it is possible, but it is logically very hard for anyone not an isolated island.
  - xscott 6y ago
    Worldwide with quarantines from customs is virtually impossible. Customs can't stop human or cocaine trafficking from making it into the country, much less undocumented immigration. All you need is a half dozen sick people who are trying to hide from the authorities, and you're back to square one. Most countries are not islands.
    - bluGill 6y ago
      Like I said, logistically impossible, but it would work.

pmoriarty 6y ago

"How does this do anything other than reset the clock back to last January just in time for next January?" First, that alone would be HUGE progress. "As soon as everyone lowers their guard and goes back to normal, it's going to spread again." Yeah, but this time you're not going to have whining, tantrum-throwing, conspiracy-mongering, megalomaniacal, science-denying children in charge. We've yet to see if they wind up being more competent and actually make a difference, but the chance to do proper contact tracing on the relatively few people that get infected will be there, and hopefully the country will take it more seriously the second time around. I'm not hugely optimistic, but if they actually followed through and were competent in dealing with it this time, it could save millions of lives.

xscott 6y ago
And then what? We're going to impose 2 week quarantines on every flight into the US? Have a dedicated branch of the CDC perform contact tracing on everyone who crosses the borders? I think you greatly overestimate how politics plays into this. It never ends until we're immune.
- pmoriarty 6y ago
  No. You just keep testing people, and do isolation and contact tracing on the ones that get sick. In the meantime, vaccines will start to roll out. Curbing this pandemic is perfectly practical and within reach, given the will to do it.

threeseed 6y ago

> Just a few visitors from other countries, and we're at it again So just do what we do in Australia and quarantine them in hotels. If you manage it properly it can be highly effective.

gameswithgo 6y ago
americans start throwing hissy fits at suggestions far far less intrusive than that. maybe we will die off and the world will be better off. our last screams from this hill of freedom that we die on.
- chii 6y ago
  > americans start throwing hissy fits well there's your problem. People are unwilling to make the least bit of self-sacrifice for a common cause. And it's not even that big of a sacrifice - it's just staying in a hotel for 2 weeks, and not leaving! I'm like WTF why is it such a big deal?
xscott 6y ago
Australia's borders are oceans. It's a different thing altogether.

vmurthy 6y ago

Agree this won't get everything back to normal but think of it as an equivalent of "defence-in-depth" of info sec. Rapid testing and isolating (I doubt the US could "enforce" it but you have to give the benefit of doubt that a percentage of people do care for others and will isolate - FWIW, I've seen this happen in Oz where a large %-age of people did isolate) will reduce/delay the infection surge and give time for the healthcare system to recover from the second shock this year. In addition, with the EUAs in flight by Jan '21 (hopefully), this one-two punch should drastically cut both infections and deaths. Remember, in the world of exponentials, both increase and decrease are exponential.

ScottBurson 6y ago

What you're missing is that a rapid test like this can be used as an entry check at restaurants and other public venues, allowing them to go back into business. Even if the vaccines turn out not to work for some reason, we can have our economy back, while limiting spread of the virus. It's not so much about getting people to fully self-quarantine, although that would be nice, as about eliminating super-spreader events.

xscott 6y ago
I didn't see the turn around time in the article. Just something about "less sensitive test with results today". I think it's optimistic to assume this could be used as an entry check for a restaurant.
- ScottBurson 6y ago
  I have read elsewhere about researchers at least trying to develop 15-minute tests. Not sure what the status of their work is, but some think it's possible -- and they're specifically targeting entry checks.
  - xscott 6y ago
    Well, that'd be fast enough for some venues. I'm still skeptical it'd work in practice.

jlokier 6y ago

> or from it running its course to be done with this. A nitpick, but it deals with a pervasive idea that should be updated. The virus will most likely never "run its course" to give us collective immunity without technological intervention. That's because herd immunity is only known to have ever occurred as a result of deliberate vaccination, and even then it disappears in areas where vaccination stops. It has never been observed to occur naturally as a result of infection. In other words, the "natural herd immunity solution" is simply not something most of the scientific community believes to be an option right now. Instead the prevailing theory is that if we let it "run its course" it would in fact continue circulating endlessly, gradually mutating. Epidemiologists do perform calculations to estimate how natural herd immunity might arise, but it has never yet been observed to actually happen, and the calculations are intrinsically rather unreliable. From "The false promise of herd immunity for COVID-19" (21st October 2020, https://www.nature.com/articles/d41586-020-02948-4 https://www.nature.com/articles/d41586-020-02948-4): > never before have we reached herd immunity via natural infection Also maybe relevant, if herd immunity could occur naturally, then the calculations done around it lead to: > proposals to largely let the virus run its course [...] could bring “untold death and suffering”

xscott 6y ago
This is interesting, and I hadn't heard this about herd immunity before. However, I kind of imagine that at some point in history a lot of our ancestors died from things we don't even think of as more than nuisances now.