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> But I’d say all northern hemisphere countries should do their best to focus on local elimination in summer 2021. This isn’t realistic. Fatigue with COVID res

> But I’d say all northern hemisphere countries should do their best to focus on local elimination in summer 2021. This isn’t realistic. Fatigue with COVID restrictions has already set in across Europe: people are wearing masks in sloppy ways (not covering the nose, or even just putting the mask over their chin) and returning to socializing or even leisure travel. The authorities know this, and while they can do things like keep restaurants and theatres closed, they appear to feel little democratic mandate for using the police to enforce strict social separation between individuals. And that is in the winter: once the warm weather comes back, expect even more flaunting of restrictions.

graeme 6y ago
That happened summer 2020 and look where things ended up. There are a few factors I think you’re missing: 1. The virus is seasonal. Substantially less restrictions are needed over the summer. Outdoor socialization really isn’t high risk 2. School is out. This naturally lowers spread 3. A bunch of people will be vaccinated. This will surely make it easier 4. We’ll probably have new rapid tests by the summer. They go a long way to reducing spread without much inconvenience. Michael Mina has been banging his head against the wall for months to get people to listen: these can be as effective as lockdowns and much less burdensome. 5. At least some countries will figure this out, go for elimination, and require a vaccine/negative test for entry and make travel arrangements with other covid zero areas Now it might be the vaccines work perfectly, no mutant strains escape them, and we won’t have a repeat of this in fall/winter 2021/22. But if that scenario does seem likely them elimination is overwhelmingly the best option. And society that can’t pull itself together to do that will live in a purgatory.
- disabled 6y ago
  > 4. We’ll probably have new rapid tests by the summer. They go a long way to reducing spread without much inconvenience. Michael Mina has been banging his head against the wall for months to get people to listen: these can be as effective as lockdowns and much less burdensome. The “inconvenience” in the USA (besides outright coronavirus deniers and people who flout restrictions in contempt of expert and professional public health officials) is that there is no guaranteed paid sick/isolation leave if one is ordered to go into isolation. Given that 40% of Americans have less than $400 for a “rainy day”, going to work while sick may be necessary. Also, in a lot of cases, no job: no health insurance, which is tragic and consequential during a pandemic. You also need to have a strong public health system in place well in advance, where citizens already have been following and adhering to prevention programs for a long time, along with trust in the system. The EU countries generally do better with this, in the most general sense, but it depends on the country. For example, there are published reports of what percent of the country’s population washes their hands every time after they use the restroom. Some of the more “eastern” EU countries (which are now westernized) do way better that west/north Europe. Also, some countries routinely issue self-isolation orders for 14 days, and the police will check, multiple times. In some countries these fines are over $1,200 for the first offense, and for the second offense, it’s $20,000. Both of these fines are unaffordable for the majority of the population. Anyways, my point is that rapid self tests do work, but it requires a properly functioning government, with a strong public health system, and a cooperative public that trusts their officials and adheres to public health recommendations well before a pandemic occurs.
  - graeme 6y ago
    This is true about the US. Nonetheless, every day people need to be hospitalized with covid or stay home because they’re too sick to work. So over the long run there’s much more turmoil of the type you speak of. But I agree the US needs a better system for letting the contagious stay home. Perfect needn’t be the enemy of the good though. If, say, 45% of people could isolate, then having them know they’re positive could help too.

graeme 6y ago

That happened summer 2020 and look where things ended up. There are a few factors I think you’re missing: 1. The virus is seasonal. Substantially less restrictions are needed over the summer. Outdoor socialization really isn’t high risk 2. School is out. This naturally lowers spread 3. A bunch of people will be vaccinated. This will surely make it easier 4. We’ll probably have new rapid tests by the summer. They go a long way to reducing spread without much inconvenience. Michael Mina has been banging his head against the wall for months to get people to listen: these can be as effective as lockdowns and much less burdensome. 5. At least some countries will figure this out, go for elimination, and require a vaccine/negative test for entry and make travel arrangements with other covid zero areas Now it might be the vaccines work perfectly, no mutant strains escape them, and we won’t have a repeat of this in fall/winter 2021/22. But if that scenario does seem likely them elimination is overwhelmingly the best option. And society that can’t pull itself together to do that will live in a purgatory.

disabled 6y ago
> 4. We’ll probably have new rapid tests by the summer. They go a long way to reducing spread without much inconvenience. Michael Mina has been banging his head against the wall for months to get people to listen: these can be as effective as lockdowns and much less burdensome. The “inconvenience” in the USA (besides outright coronavirus deniers and people who flout restrictions in contempt of expert and professional public health officials) is that there is no guaranteed paid sick/isolation leave if one is ordered to go into isolation. Given that 40% of Americans have less than $400 for a “rainy day”, going to work while sick may be necessary. Also, in a lot of cases, no job: no health insurance, which is tragic and consequential during a pandemic. You also need to have a strong public health system in place well in advance, where citizens already have been following and adhering to prevention programs for a long time, along with trust in the system. The EU countries generally do better with this, in the most general sense, but it depends on the country. For example, there are published reports of what percent of the country’s population washes their hands every time after they use the restroom. Some of the more “eastern” EU countries (which are now westernized) do way better that west/north Europe. Also, some countries routinely issue self-isolation orders for 14 days, and the police will check, multiple times. In some countries these fines are over $1,200 for the first offense, and for the second offense, it’s $20,000. Both of these fines are unaffordable for the majority of the population. Anyways, my point is that rapid self tests do work, but it requires a properly functioning government, with a strong public health system, and a cooperative public that trusts their officials and adheres to public health recommendations well before a pandemic occurs.
- graeme 6y ago
  This is true about the US. Nonetheless, every day people need to be hospitalized with covid or stay home because they’re too sick to work. So over the long run there’s much more turmoil of the type you speak of. But I agree the US needs a better system for letting the contagious stay home. Perfect needn’t be the enemy of the good though. If, say, 45% of people could isolate, then having them know they’re positive could help too.