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Re:Chloroquine, past and present by paulmd on Friday March 20, 2020 @07:32PM (#22642821)
Well, never, but we have 20 ventilators per 100k people, "flattening the curve" so strongly that we can treat everybody was always a bit of a pipe dream. You need to flatten the curve almost to zero to get to a "sustainable" level of disease. They are nearly the same goal. Any non-trivial level of disease that is not controlled will rapidly push you past the "flatten the curve" threshold. And we will certainly be here for longer than 2-3 weeks.

It is a little white lie that is important to tell the public to help build compliance, the lower you can push it the fewer people will die, but hospitals simply are going to be overloaded regardless. The choice we can make is one between "very overwhelmed" and "overwhelmed to the point of non-functionality".

"shelter for 12-18 months" is a little bit of an exaggeration but not much. Simulations suggest that after an initial harsh quarantine period (up to several months) to get transmission under control, we will need to shelter for about 2/3rds of the time (2 months on, 1 month off) for 12-18 months, and other measures for 100% of the time. The vaccine will be what finally terminates the situation. https://www.imperial.ac.uk/media/imperial-college/medicine/s...

Even then that may be optimistic (especially if the population is not fully compliant). Italy is not just working from home and social distancing, they are straight up quarantining everyone, and they still have overloaded hospitals and bodies piling up faster than they can cremate them. Presumably the quarantine will slow things down on the order of weeks to months, but right now things are brutal.

https://vimeo.com/398334975

https://mobile.twitter.com/foxmulder22791/status/12404540564...

The Chinese strategy of requiring everyone to get a phone app, to track them via GPS, doing widespread testing and then quarantining the people who have been in contact appears to be a much more effective strategy than blind quarantine or social distancing. No app, no uber, no groceries, no public transit, etc. The US citizenry absolutely will not stand for the mark of the beast though.

The Korean thing about masks and gloves probably helps too. Too bad the hospitals are down to about 11 days of masks let alone for the citizenry.

I'm not trying to be a downer but if chloroquine works that's a really fucking big deal, because that would give us a fairly straightforward alternative to treat cases or even prophylactically treat vulnerable populations. Unless you have a tool in your toolbox we are mostly just moving the deck chairs here and choosing between "really bad" and "oh shit".

Re:Chloroquine, past and present by notatoad on Friday March 20, 2020 @08:45PM (#22643250)
The Chinese have an app for this? Why aren't we using that?

I'd happily be tracked 24/7, and I'm sure so would many many others, if it meant reducing the spread and getting back to some sense of normalcy a bit quicker.

Re:Chloroquine, past and present by paulmd on Friday March 20, 2020 @08:51PM (#22643278)
https://twitter.com/CarolYujiaYin/status/1239583581325778944 (deffo not propaganda /s)

https://www.nytimes.com/2020/03/01/business/china-coronaviru...

The other thing is that other countries like Iran and Israel are just pulling the data directly from Google Location Services or from telcom location data. I assume the US will probably follow at some point, since that data can be accessed without a warrant since it's third-party-controlled data.

Re:Chloroquine, past and present by drstewart on Friday March 20, 2020 @08:54PM (#22643292)
Thinking the entire world will quarantine for 12-18 months is a pipe dream. That will never happen.
Re:Chloroquine, past and present by paulmd on Friday March 20, 2020 @09:05PM (#22643353)
US DHHS: "18 months or longer" https://int.nyt.com/data/documenthelper/6819-covid-19-respon...

UK government: "at least a year." https://news.sky.com/story/coronavirus-social-distancing-nee...

Modelling: "2 months on 1 month off until a vaccine is developed". https://www.imperial.ac.uk/media/imperial-college/medicine/s...

/shrug

It's unprecedented and I tend to agree with you that at some point the economic carnage is going to force alternatives, but right now that's the plan. Not the plan they're telling you publicly, but the real one they're planning for and reacting to.

At the end of the day if that's the plan you'll go along with it because the men with guns will make you.

As I've commented elsewhere, an approach using contact-tracing via app and GPS data, backed by widespread testing (millions per week) and small-scale isolation of affected, along the lines of China or South Korea, seems to be more effective.

https://twitter.com/CarolYujiaYin/status/1239583581325778944 (deffo not propaganda /s)

https://www.nytimes.com/2020/03/01/business/china-coronaviru...

The US population is going to hate hate hate that one. But it's that or stay inside except for going to the grocery store for the next 12-18 months.

If we don't choose option A, and we don't choose option B, we implicitly choose option C: 20% of our seniors die in a single year. Choosing not to choose is still making a choice. I believe there's a song about that.

Re:Chloroquine, past and present by postalrat on Saturday March 21, 2020 @01:13AM (#22644649)
http://www.euromomo.eu/

The all-cause mortality rate in Europe has been dropping in the past few weeks and is now well below normal levels. To me this looks like people have been overdoing the whole stay indoors and avoid any sort of risky behavior.

Re:Chloroquine, past and present by paulmd on Saturday March 21, 2020 @01:49AM (#22644816)
Europe is not Italy. Europe has a different population age mix (younger), and broader Europe is not under the same quarantine measures as Italy either.
Re:Chloroquine, past and present by freeflight on Saturday March 21, 2020 @03:15AM (#22645123)
> "To avoid a rebound in transmission, these policies will need to be maintained until large stocks of vaccine are available to immunise the population – which could be 18 months or more"

That sounds very much like a "worst-case", afaik German CureVac are right now in the stage of selecting the last 2 candidates for a vaccine, they expect first clinical trials around June/July, I'd be surprised if they are the only ones that far along.

That's not meant to say this will be over the instant we have a vaccine, but finding one is right now the big X factor that makes all estimates veer on the rather pessimistic side.