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You would not have to quarantine millions if governments had acted decisively like Taiwan. I think Taiwan shows the endgame, how to eradicate. For an idea in ho

You would not have to quarantine millions if governments had acted decisively like Taiwan. I think Taiwan shows the endgame, how to eradicate. For an idea in how to deal with mass community spread, listen to Michael Mina.

timr 6y ago
Taiwan has not eradicated the virus. Their quarantine systems are good, but not perfect: https://thediplomat.com/2021/01/taiwan-tightens-pandemic-measures-after-first-local-covid-19-case-since-april/ https://thediplomat.com/2021/01/taiwan-tightens-pandemic-mea... While they have certainly come closer than most places, the downside of this approach is that it comes at a debilitating economic cost (edit: for most countries...Taiwan specifically may be able to get away with it for a while because they're a manufacturing hub), and literally any minor slip up can lead to the virus spreading like wildfire through the population. Again, considering the vast differences in scale and complexity here, it's pushing the bounds of credulity to claim that the United States could do something similar. Even a "science-following" state like New York can't conduct a quarantine of remotely similar strictness. Pretty much the only equivalent thing the US might have done would be to stop all immigration in January. Neither political party would have supported such a thing.
- m_mueller 6y ago
  > debilitating economic cost citation needed. Their internal economy works normally, they never had any lockdown. Far lower impact than those states that just let the virus go rampant every couple of months, followed by months of lockdown. And yes, you could eradicate with this strategy, if enough places would adopt it and work together. I'd imagine a list of trusted covid free countries that can reintroduce bilateral travel without quarantine.
  - timr 6y ago
    > they never had any lockdown ...and that's largely irrelevant in a tiny country whose economy is mostly making stuff for the west. As I said, they've stopped essentially all international travel. They've benefitted from the US-China trade war, and have been able to boost exports: https://www.wsj.com/articles/taiwan-shrugs-off-pandemic-to-deliver-surprise-growth-11604063439 https://www.wsj.com/articles/taiwan-shrugs-off-pandemic-to-d... > Taiwanese manufacturers have been relocating back home from China over the last two years, lured by subsidies and hoping to dodge tariffs and other complications from U.S.-China tensions over trade and technology. The resulting boost to production capacity has put Taiwan in a good position to meet voracious demand for electronics as work-from-home professionals place orders for additional computers, monitors and smartphones, analysts said. > Domestic consumption was still holding back the island’s economy in the third quarter, but much less than before. Private consumption contracted 1.5% from a year earlier in the third quarter, compared with a slump of nearly 5% in the previous quarter, according to the statistics bureau. My point was that if you do the same thing in the US, it would be a debilitating economic cost. > And yes, you could eradicate with this strategy, if enough places would adopt it and work together. And if ifs and buts were candy and nuts, we'd all have a very merry Christmas. String enough speculative hypotheticals together, and you can justify anything. Again, very few countries can adopt such a strategy. It's a strategy that works...tenuously...for an island country with the population of a single US state, who can afford to be isolated from the world for a year or more. Hawaii tried the same approach, and it nearly bankrupted them in a few months: https://www.npr.org/2020/10/20/925795410/facing-economic-devastation-hawaii-attempts-to-revive-tourism https://www.npr.org/2020/10/20/925795410/facing-economic-dev...
    - m_mueller 6y ago
      Please read my initial comment again. I'm not arguing for the US, in its current state, to adopt the Taiwanese strategy. Once community spread is such high as it is now, another strategy is needed. And I'd say the current lockdown & reopen has been proven inefficient in sufficiently many places now. Michael Mina has a much different idea: Cheap mass testing at home, regularly, for the whole family. Even with less sensitive quick tests it should be possible to suppress ~50% of new transmissions this way, which could bring case numbers down to traceable levels in 1-2 months. The key would be cost and availability of these tests - that's a problem that can be solved, as production is simple and is already currently costed at $1 a pop. From a regulatory standpoint it should be treated more like toothpaste and less like a medical good (i.e. certify the efficacy but don't go overboard). After all else has pretty much failed, all western governments are now just betting on the vaccine. This is a dangerous proposition - all you need is a resistant mutation and we're back at square one. Plus, vaccination at current rate will take 1-2 years - I don't think that's a good place to be in both in health terms and economically. There needs to be a backup plan put in place, as well as lessons learned taken for the next pandemic.
      - timr 6y ago
        > Cheap mass testing at home, regularly, for the whole family. Even with less sensitive quick tests it should be possible to suppress ~50% of new transmissions this way, which could bring case numbers down to traceable levels in 1-2 months. I agree it's a good idea, but doubt that it would bring case numbers "down to traceable levels"...we know that the vast majority of transmission (>70%) is happening in the home, and the vast majority of interactions (>90%) don't produce more than a single infection. You essentially have to catch the connecting edges on a sparsely connected graph -- you don't have to miss very many for the problem to be unsolvable. I do think it would go a long way to making life more normal. It's completely idiotic that we're killing restaurants (for example) when we could be making mandatory rapid testing a pre-requisite to indoor dining, instead. The same goes for nursing home and hospital staff -- nosocomial infection has been a huge problem, and most fatalities are out of nursing homes. I get why you don't want to depend entirely on quick tests that have an elevated false-negative rate, but when it takes days to get back a PCR result, it's useless for screening staff.

timr 6y ago

Taiwan has not eradicated the virus. Their quarantine systems are good, but not perfect: https://thediplomat.com/2021/01/taiwan-tightens-pandemic-measures-after-first-local-covid-19-case-since-april/ https://thediplomat.com/2021/01/taiwan-tightens-pandemic-mea... While they have certainly come closer than most places, the downside of this approach is that it comes at a debilitating economic cost (edit: for most countries...Taiwan specifically may be able to get away with it for a while because they're a manufacturing hub), and literally any minor slip up can lead to the virus spreading like wildfire through the population. Again, considering the vast differences in scale and complexity here, it's pushing the bounds of credulity to claim that the United States could do something similar. Even a "science-following" state like New York can't conduct a quarantine of remotely similar strictness. Pretty much the only equivalent thing the US might have done would be to stop all immigration in January. Neither political party would have supported such a thing.

m_mueller 6y ago
> debilitating economic cost citation needed. Their internal economy works normally, they never had any lockdown. Far lower impact than those states that just let the virus go rampant every couple of months, followed by months of lockdown. And yes, you could eradicate with this strategy, if enough places would adopt it and work together. I'd imagine a list of trusted covid free countries that can reintroduce bilateral travel without quarantine.
- timr 6y ago
  > they never had any lockdown ...and that's largely irrelevant in a tiny country whose economy is mostly making stuff for the west. As I said, they've stopped essentially all international travel. They've benefitted from the US-China trade war, and have been able to boost exports: https://www.wsj.com/articles/taiwan-shrugs-off-pandemic-to-deliver-surprise-growth-11604063439 https://www.wsj.com/articles/taiwan-shrugs-off-pandemic-to-d... > Taiwanese manufacturers have been relocating back home from China over the last two years, lured by subsidies and hoping to dodge tariffs and other complications from U.S.-China tensions over trade and technology. The resulting boost to production capacity has put Taiwan in a good position to meet voracious demand for electronics as work-from-home professionals place orders for additional computers, monitors and smartphones, analysts said. > Domestic consumption was still holding back the island’s economy in the third quarter, but much less than before. Private consumption contracted 1.5% from a year earlier in the third quarter, compared with a slump of nearly 5% in the previous quarter, according to the statistics bureau. My point was that if you do the same thing in the US, it would be a debilitating economic cost. > And yes, you could eradicate with this strategy, if enough places would adopt it and work together. And if ifs and buts were candy and nuts, we'd all have a very merry Christmas. String enough speculative hypotheticals together, and you can justify anything. Again, very few countries can adopt such a strategy. It's a strategy that works...tenuously...for an island country with the population of a single US state, who can afford to be isolated from the world for a year or more. Hawaii tried the same approach, and it nearly bankrupted them in a few months: https://www.npr.org/2020/10/20/925795410/facing-economic-devastation-hawaii-attempts-to-revive-tourism https://www.npr.org/2020/10/20/925795410/facing-economic-dev...
  - m_mueller 6y ago
    Please read my initial comment again. I'm not arguing for the US, in its current state, to adopt the Taiwanese strategy. Once community spread is such high as it is now, another strategy is needed. And I'd say the current lockdown & reopen has been proven inefficient in sufficiently many places now. Michael Mina has a much different idea: Cheap mass testing at home, regularly, for the whole family. Even with less sensitive quick tests it should be possible to suppress ~50% of new transmissions this way, which could bring case numbers down to traceable levels in 1-2 months. The key would be cost and availability of these tests - that's a problem that can be solved, as production is simple and is already currently costed at $1 a pop. From a regulatory standpoint it should be treated more like toothpaste and less like a medical good (i.e. certify the efficacy but don't go overboard). After all else has pretty much failed, all western governments are now just betting on the vaccine. This is a dangerous proposition - all you need is a resistant mutation and we're back at square one. Plus, vaccination at current rate will take 1-2 years - I don't think that's a good place to be in both in health terms and economically. There needs to be a backup plan put in place, as well as lessons learned taken for the next pandemic.
    - timr 6y ago
      > Cheap mass testing at home, regularly, for the whole family. Even with less sensitive quick tests it should be possible to suppress ~50% of new transmissions this way, which could bring case numbers down to traceable levels in 1-2 months. I agree it's a good idea, but doubt that it would bring case numbers "down to traceable levels"...we know that the vast majority of transmission (>70%) is happening in the home, and the vast majority of interactions (>90%) don't produce more than a single infection. You essentially have to catch the connecting edges on a sparsely connected graph -- you don't have to miss very many for the problem to be unsolvable. I do think it would go a long way to making life more normal. It's completely idiotic that we're killing restaurants (for example) when we could be making mandatory rapid testing a pre-requisite to indoor dining, instead. The same goes for nursing home and hospital staff -- nosocomial infection has been a huge problem, and most fatalities are out of nursing homes. I get why you don't want to depend entirely on quick tests that have an elevated false-negative rate, but when it takes days to get back a PCR result, it's useless for screening staff.