That's what I'm thinking. People all over the world knowingly make unhealthy decisions because it makes our lives more enjoyable in the short term, at the expense of usually shortening your lifespan. I don't see people putting up with forced isolation for very long, especially when the vast majority of people won't die from it.

Exactly. We all make these tradeoffs all the time and sacrifice lives for convenience and financial reasons. For example, close to 40K die in the us in traffic accidents every year. That number could be reduced to almost nothing with a 5 mph speed limit. of course, we've decided to take that calculated risk - the benefits of driving at speeds up to 65 or 70 outweigh the low number of annual deaths.

The problem is the risks are orders of magnitude more than the "tradeoffs we make all the time", and clearly not enough people understand this. 40K/300M is 0.013%. It's nothing compared to coronavirus hospitalization or even death rates.

That's an annual number while Coronavirus is one and done. A better comparison would be lifetime risk of dying in a car accident.

Okay, feel free to slice and dice it however you want and share the results.

The lifetime risk of dying in a car accident is about 1% in the US, according to https://www.iii.org/fact-statistic/facts-statistics-mortalit... .

And you're equating a lifetime chance with a < 1 year chance because... why? Is having a 1% chance of dying in the next hour the same to you as having a 1% chance of dying in the next 100 years? Is having a 99% chance of dying in the next hour the same to you as having a 99% chance of dying in the next 100 years?

I'd assume when you apply that comparison to society at large it becomes close to the same thing.

Approximately 200,000 people will die. All of us will know someone that got sick. Most of us will know someone that died. I think Americans will get over it.

Pretty sure being dead isn't something you just "get over".

Try applying some reading comprehension and reading the response again within the context of the overall discussion.

2,813,503 people died in 2017

https://www.cdc.gov/nchs/fastats/deaths.htm

State your point clearly please.

That is the number that will die if the lockdowns continue.

If they don't, a hell of a lot more will.

I don't know where these numbers come from. But given a the current 1.1% case-fatality-rate in America (even before hospitals are overwhelmed) and that more than half of the population is estimated to get it, I don't see how it'd be less than 1% * .5 * 350million = 1.75 million people, with or without lockdown.

I suspect politicians are trying to "ease into" the honest numbers, because I guess "a million" sounds like a lot to people.

It's hard to say anything with certainty, but I personally can't find any math that explains how social distancing can reduce that by more than 10%, short of a cure or vaccine being developed within 60 days.

Plasma would be the best hope of this.

I have seen a few seriously sourced articles discussing the possibility of various forms of airborne transmission during certain stages of certain strains. If stuff like this is the reality then the truth is that social distancing can't be as effective as we'd like, even on top of whatever inherent flaws it has, but it's probably still the best/only advice that can actually be given, taking our woeful preparedness into account. Masks probably should have been the recommendation from day 1 but clearly economic priorities and lack of skilled preparation and leadership overruled longer term judgment.

It seems to me some are expecting business as usual to resume quickly because under normal circumstances, where the heads of each department hadn't been chosen for their desire to shut it down ASAP, that is probably more what would happen, but the reality of today's government is vastly different. I completely agree they're trying to slow roll the actual truth here.

Your CFR is with respect to diagnosed cases. Many cases are mild and have no symptoms. The real CFR is likely an order of magnitude lower.

That's one theory, but the evidence is mixed. For example, I believe in cruise ships, where everybody was tested the CFR was ~ 3%. However maybe the age distribution was older.

There are a lot of factors, some cause underestimating of cfr (he died of pneumonia, didn't have a test to spare, cause of death pneumonia).

Lockdown requires an eventual vaccine to really save lives, and at minimum universal testing to be effective, to prevent a second wave. Otherwise, once lockdown ends, we go exponential again.

I mean this is hard to say. I'm in grad school and I don't really feel that disrupted. Instead of hiding in my office all day I just stay home. Meetings and classes are all over Zoom, which means my advisor actually has more time to talk (WOW!). And I do CS, so all my work is on a computer anyways, where I'm usually remoting into another machine to run my experiments. I can still get takeout. I have more time to cook. The only real disruption is that I'm not going to the climbing gym. On the other hand, my cat is super excited that I'm around more often. And as a millennial, I'm already used to living in existential dread.

I'm just trying to say that it is hard to measure what this disruption means for a lot of people. If I was in a big city, like NYC, I'm sure this would be completely different. I don't think this is an easy topic and in such "Americans" is far too broad of a term to have much meaning.

Let's get the virus on the phone and explain that we don't wanna. I'm sure it will be understanding.

Lives will be disrupted either way, lifting restrictions too early will result in more deaths, which is the ultimate disruption of life.

I think the parent was implying people are more willing to risk coronavirus death than to be stuck at home for as long as they're expected to.

This may be true for now when most peoples' lives are as yet still unaffected by it, but it's very much not going to be true after a month of uncontrolled pandemic when everyone will know many people who've died from it.

I agree, though it'll be a little late at that point.

You're overestimating the impact. The worst case scenario is more like 1 out of every 100-200 Americans dying. Concentrated mostly in the elderly. The majority won't have anyone close to them die and few will have "many".

No, the worst case scenario is much worse than that. Hospitals won't have room to take care of most people with the virus or other illnesses for that matter, and many will die as a result of just that. The hospitalization rate is quite a bit more than 1%, and that becomes the death rate when no hospital can take care of you. These have all been repeated in the media many, many times by now. I'm in fascination of how people are receiving the memo so slowly in 2020.

Not to mention 1/100 is enough for a lot of people to result in at least one person they know dying.

>No, the worst case scenario is much worse than that

It's really not. People just don't seem to grasp that the rates for positive cases are drastically different than the rates for people infected. We aren't doing nearly enough testing to catch even all the symptomatic cases let alone the asymptomatic and mild ones.

The infection fatality rate is almost certainly under 1% and not everyone will get infected even in the worst case.

>Not to mention 1/100 is enough for a lot of people to result in at least one person they know dying.

Only if we use a very broad definition of what "know" means.

Look at parts of Italy--there are areas that have already had 1% of the population die. Note that most of these are not being reported as Covid-19 deaths (presumably because of the overload, they never got tested), we simply see it in excess mortality.

>Look at parts of Italy--there are areas that have already had 1% of the population die

Which parts are that?

Nembro, Italy. Pop. 11000, 152 deaths. 1.38% of the population died. In March.

Isn't that the part of Italy where hospital collapse actually happened? And in the same article they conjecture they are now at ~herd immunity. And the demographics are skewed towards the elderly so again they themselves estimated the death rate being consistent with 1%, age-adjusted. And they counted ALL the surplus dead. This is an upper bound of the absolute worst case, as far as I can tell.

Nobody there is going to die in April from covid?

They are past the peak (again based on the info from the original article), so it doesn't seem likely the numbers will change a lot; not to the level of 6%/3%/other numbers being suggested in other sources.

A small town doesn't really count as a "part" of a country.

It's also probably just a statistical outlier. Even if the overall IFR is 0.5% you will see some areas with rates higher or lower than that from chance or their demographics.

It's still early on in the pandemic. The vast majority of the people who will die from it still haven't yet. It's way too early to be putting ceilings on the overall death rate.

I believe there are more examples, but that is one of them.

You appear to be taking about the mortality rate when medical care is available. What is the rate after the hospitals are full?

First, the uncontrolled number is more like 4% because the healthcare system crashes. 1% is what you get when the healthcare system still works.

And most people have family members that are in the high risk group.

It's amazing how many people are willing to sacrifice millions of people on the altar of the economy--when it wouldn't even work very well because people are going to be minimizing risk anyway.

A useful question I've found is "So which of your friends and family are you prepared to sacrifice so we can all get back to normal?" Statistically speaking, with a rapid uncontrolled pandemic, everyone is gonna know at least several people who end up dying.

That’s unfair unless you also answer which of your friends you’re willing to sacrifice to unemployment, poverty, homelessness, depression, etc. so we can go on lockdown for longer.

I hate this framing that makes it seem like it’s a choice between caring about people and caring about money. When the economy crashes it causes real misery for real people.

None of my friends are family are being sacrificed to any of those things. Most are able to work from home or are classified as essential workers and are still working for that reason (e.g. I know some nurses and police officers), and the ones who were in the service sector are furloughed and are getting unemployment. None of this holds a candle to them dying.

What do you think is the overall right length of time for the lockdown? Do you think we should already be getting back to work now?

So basically you think there won’t be too much contagion and people who have jobs or are getting unemployment benefits now will still be in that state after a few months? And that the unemployment system can handle an almost overnight order of magnitude increase in demand? And that essential services like farms, shipping and grocery stores will survive long term despite the major supply chain disruption? That seems crazy optimistic to me but I guess I can’t convince you.

Please read up on the Great Depression. Economic downturns can be pretty bad. If they could have solved it by just giving everyone unemployment, they would have.

Edit:

> What do you think is the overall right length of time for the lockdown?

I don’t know dude, I’m not an economist. I just think the economic effects should be properly taken into account and weighed against the health effects. Yes, there is some amount of economic damage that it’s worth some number of people dying to avoid. That seems obvious to me, but people act like you’re a Nazi if you point it out.

The economic consequences of the shutdown will not be remotely as harmful as the deaths from not shutting down.

How do you know?

Like guns the virus is much more of a problem in urban places than rural places. Americans not in cities aren’t going to take much more of this shutdown imo.

This is misguided. The capacity of the healthcare system in rural areas will be even easier to overwhelm.

I think, actually, this statement is misguided, for a couple reasons. Its very likely that people are underestimating the average city's "hospital beds per capita" metric; frankly, a ton of people live in the average city (duh). Are there enough beds in many of America's tier-2 (say, Austin) and tier-3 (say, Cleveland) cities to cover all of the population?

By comparison, outside of cities, the spread will be far, far slower than within. Yes, healthcare is worse, but there's an order of magnitude fewer cases. People travel less. They go to the store once every two weeks, not every 4 days, even when there isn't a quarantine. They don't visit the new hipster restaurant down the street. They don't live twenty feet away from their neighbors.

NYC has 25% of all of the United State's cases, despite having ~2% of the US's population. This is the same story that is playing out in every state. Let's take Indiana as an example, being that they're having a relatively moderate outbreak with mostly rural areas surrounding a top 15 US city by population: Indianapolis has 41% of the state's cases, despite representing ~12% of the state's population.

This shouldn't be a surprise; diseases spread faster in cities. But, what you're asserting is that, eventually, rural areas will see the same spread that cities are. This feels misguided. That isn't to say that some, or even most, rural hospitals wont be "running hot" for a really long time, and that the virus wont spread and these areas, but its simply unlikely that the situation will ever be as bad as in major cities.

Confirmed cases depend on testing. What’s the testing capacity in Indianapolis vs rural areas?

There’s also a time lag. I think it hit New York first because of all the travel connections.

But why would rural areas be immune? People do still meet each other. They do go to church.

Tellingly, flu death rates tend to be higher in rural areas:

https://www.washingtonpost.com/nation/2020/03/19/rural-areas...

Yep everyone in rural places blindly goes to church no matter every Sunday (eye roll).

Legal action has had to been taken already to prevent gatherings at churches.

https://www.foxnews.com/us/louisiana-pastor-who-defied-coron...

Many US states do not currently have restrictions on churches. I was replying to the point that people in rural areas are spread out. My point was that some activities, like church, bring people together into an enclosed space.

My position is based on the unpredictability of exponential phenomena and the fact that the healthcare system in rural areas has been in the process of being hollowed out for quite some time. The incubation period of COVID-19 (estimated median 6 days last I checked?), coupled with the fact that most people who carry it are asymptomatic means that it's only a matter of time before it hits rural areas whose capacity is like, what? 0.5 ICU beds per county? If you need a ventilator out there you're gonna fucking die.

The majority of COVID-19 patients who need a ventilator are going to die regardless of whether they actually get a ventilator or not. Hopefully that will change as more effective treatments are developed, but that's the current reality. By all means let's do whatever it takes to deploy more ventilators, but they're not a panacea.

I've been curious on this. Do you have numbers for people that have been put on them?

New York has 1,600 ICU beds; there are a bunch of counties in rural America that have zero. The CFR in these counties if the virus gets out of hand will be appalling.

Of course it's misguided. Which country handled this crisis worse than US? Misguided is an understatement.

Maybe Brazil?

> "We're all going to die one day"[0]

> “I’m sorry, some people will die, they will die, that’s life,” Bolsonaro said in a television interview on Friday night. “You can’t stop a car factory because of traffic deaths.”[1]

> Bolsonaro has compared the new coronavirus to a "little flu," condemned the reaction to it as "hysteria," and said Brazilians' immune systems are so strong they can swim in raw sewage and "don't catch a thing."[2]

> He has called the virus a “measly cold.” “Some will die” from it, he said, because “such is life.” [3]

> ..more than 20 members of Bolsonaro’s U.S. delegation have tested positive for the coronavirus. Bolsonaro ignored his own health ministry’s advice to self-isolate for a couple of weeks and to discourage large gatherings. He made a defiant show of shaking hands and taking selfies at a rally that attracted hundreds of his supporters. [4]

[0] https://www.marketwatch.com/story/brazils-bolsonaro-downplay...

[1] https://www.nytimes.com/reuters/2020/03/27/world/americas/27...

[2] https://www.afp.com/en/news/15/bolsonaro-takes-down-virus-sh...

[3] https://www.nytimes.com/2020/04/01/world/americas/brazil-bol...

[4] https://www.theatlantic.com/politics/archive/2020/03/bolsona...

If I use the words that I think are appropriate for the obstinate middlebrow skepticism of HN in the face of an uncontrolled pandemic, I get flagged :^)

Our death rate per capita is substantially lower than China and Italy for example.

Y'all need to understand what an exponential function looks like.

Y’all need to not compare absolute case numbers on an exponential curve between countries with vastly different populations.

I find it odd that people are comparing "worst" by number of cases and not accounting population. The US has 320mn people while Italy has 60.5, Spain has 46.8, and Germany has 83.8. These are the countries with the most cases and by population the US is doing the best out of all of them and Spain the worst. If we look at deaths, Germany is only slightly better than the US but Spain and Italy are each much higher.

The US sure has a lot of problems, but that doesn't mean everything we do is the worst.

The US spread is a few weeks behind the other countries. People are projecting based on incubation time and mitigation response what will happen. The US growth rate is on track to make everyone else look peachy keen.

I doubt there is any definitively proven date of the start of the spread. It very well could have started sooner than claims.

Every one except SK Israel and perhaps Germany.

Blue collar Americans in the cities are within a couple of weeks to telling everyone to shove it. These are people who had less than a $1000 dollars extra in their bank accounts. They have been out of a job for one paycheck already.

Credit card companies are slashing credit lines. Postal service is failing to deliver mail in some locations. Unemployment numbers/systems work as well as Healthcare.gov did upon launch.

We are one to two weeks away from massive civil unrest when thousands of people have no money to pay for food.

It is somewhat amazing to me that politicians don't seem to understand this. The solution is so simple: give people money directly, give money directly to businesses with the promise that they will not fire anyone, and do it yesterday.

Perhaps I'm simply misreading the situation and am in a bad mood, but it seems that whenever we see a government program rolled out, politicians seem more interested in preventing fraud, misuse, and politically sensitive spending than they are in seeing the program actually succeed / solve it's stated problem. This results in layers of complexity, regulations, and bullshit that impede the program from functioning efficiently. I would rather a cash transfer program have a 25% fraudulent claim rate and a 90% legitimate claim success rate than a 2% fraudulent claim rate and a 50% legitimate claim success rate. Politicians seem to want the latter. Further, there were arguments during the negotiations about the 2 trillion dollar bail out about abortions and oil subsidies ffs. These guys need to get their heads out of their asses and join us in the real world.

They actually are doing both of those points. Everyone's heard of the $1200 checks to individuals, but they also created the Paycheck Protection Program[1] which advertises itself as a small business loan program but "will forgive loans if all employees are kept on the payroll for eight weeks and the money is used for payroll, rent, mortgage interest, or utilities." In other words, if you run a small business, Uncle Sam will cover your payroll for 2 months if you don't fire anyone.

It's the "do it yesterday" part that they're having trouble with. Major banks are saying that the government isn't forthcoming with the details they need to actually implement the lending program, so they've had to delay its launch.

[1] https://www.sba.gov/funding-programs/loans/coronavirus-relie...

[2] https://www.forbes.com/sites/brianthompson1/2020/04/03/no-sm...

There has never been a single program administered by the SBA that was not comically broken.

There are two possibilities:

1. This program is going to continue the great tradition of government epic failures of providing help to small businesses

2. This time around it works and small businesses get an immediate ( in a commercial sense of the word ) help in record time.

One won't need to be a genius to figure out the implication of 2. Personally, I think it would be 1.

> The solution is so simple: give people money directly, give money directly to businesses with the promise that they will not fire anyone, and do it yesterday.

The CARES act did do this, and it did it yesterday.

Passed != Implemented

> It is somewhat amazing to me that politicians don't seem to understand this.

Since we are now awaiting implementation, politicians are no longer in the picture. They understood what needed to be done, and did their jobs. It is now up to the bureaucrats.

This isn't an accurate picture of the US Federal government.

Now that congress has passed the law, it's up to the EXECUTIVE BRANCH of the government to make it happen. There's a politician at the head of that - POTUS.

People wanted an outsider in the White House, someone who would "shake things up", and this is the consequence. This is what it means.

The POTUS can and should be making this implement faster.

> Now that congress has passed the law, it's up to the EXECUTIVE BRANCH of the government to make it happen. There's a politician at the head of that - POTUS.

This is implemented through the agencies of the Executive branch, the operations for which are almost entirely run by bureaucrats. When Trump entered office, he didn't just fire all of the bureaucrats at the Department of Labor, he just replaced its head.

The folks that work on the day-to-day operations of processing unemployment insurance claims, or maintaining/improving the systems remain largely unchanged. Their employment is a function of the budget and funding, which is determined by Congress, and then assented by the POTUS.

In the case of CARES, the Senate unanimously passed it, and POTUS quickly signed it into law. He is not going to micro-manage its implementation. It's now up to the bureaucrats.

If you don't want this unrest, start giving people food. The solution is obvious, and is only unpalatable to idealogues.

There's no centralized system to do this. Everything relies on thousands of little trading businesses. Those businesses are now closed. It will take at best a couple of months to get a different system in place.

If that system gets rolled out, the US as the country is over because it is an admission that the US is not capable of maintaining it's existing economic system.

All the groceries are currently open. All the farms are currently working, minus migrant labourers, because we would rather have crops rot in the field, than let them into the country. All the truckers are currently hauling.

The only part of the distribution system that isn't working very well because of the shutdown is the part that distributes dollars.

Any service disruptions right now are not due to the shutdown - they are due to the actual effects of the virus. Look at the MTA. Half of its employees are sick, and the other half have called in sick. Train service has been reduced, and passengers are now packed like sardines in a can on the trains that are still running. Look at the supply chain disruptions - they aren't caused by people being stopped from coming in to work - they are because people can't, or are afraid to come into work.

As well they should be, given the state of healthcare in this country. Who is going to pay for their care if they are one of the 20% that need hospitalization after catching it?

Yes, the issue is becoming dollars. There are programs in place that seek to do this. Specifically "food stamps" -> the latest bill funds these a lot more.

But due to years of people handwringing over abuse, and "economists" encouraging thrift, the process to get food stamps isn't speedy, it's state-by-state, and now it's overwhelmed.

Due to the general anthemia among the GOP for welfare type programs, different states are going to see different levels of urgency with boosting the food stamp programs. It's much the same as how some GOP led states refused the medicaid expansion that was part of the ACA.

Hopefully this will reveal new information to voters of those states as they slowly starve and as they realize that certain other states are doing better - what's the difference? Competent governance. You can't buy it, but you can vote for it.

> All the groceries are currently open.

That's a talking point.

Chinatown grocery stores are mostly closed in both Manhattan and Queens. Patels is closed everywhere.

Edit: Downvotes don't protect from reality

https://www.patelbros.com/coronavirus

Enough grocery stores are still open, and grocery delivery services are doing roaring business. We're not remotely (yet?) at risk of people starving from inability to obtain food.

Non-gigantic grocery stores are going to start closing because contrary to the official positions logistics is broken. Smaller grocery stores have very small margins and operate on COD basis. A friend of mine owns one. His distributors raised prices between 10-50% across the board and removed all the incentives. He does not have enough money to stock up at the new price points so he is slowing the buys, cleaning out inventory and is going to close unless the social distancing goes away by the end of the month. Anecdotally, other small supermarket operators are thinking about doing the same.

Effective grocery store prices are 2x - all of the sales have been removed. Eggs in Queens went from $1.69/dozen to $7.99 a dozen.

$1200 tax credit for 2020 ( this is what it actually is ) is nothing for people who live and support high cost areas which are the people who allow for the white collar jobs to exist.

Are those logistics broken because the government shut the logistics operators down, or because people running them have fallen ill, or are afraid of falling ill?

Every state with shutdown orders considers logistics essential services. Nobody but the virus is preventing the people working in them from going to work.

I'll repeat it: Nobody working in food production and distribution is forbidden from going to work.

If prices are rising, it has nothing to do with the shutdown, and everything to do with the fact that there's a global pandemic... Which will be made worse if lift the shutdown orders.

Are you planning on ordering these people back to work at gunpoint, to lower the price of eggs? Or are you going to instead, consider extending a short-term loan, so that the grocer can absorb the price hike? The number of hens laying eggs hasn't changed over the past four weeks.

You keep repeating talking points from TV.

> I'll repeat it: Nobody working in food production and distribution is forbidden from going to work.

That is not the message that is being repeated on TV and on the news. The message is "stay home. if you are close to people you are going to be infected and die. stay home". The message is not "Stay home unless you work in list in blah blah blah. Also, unless you have comorbidity such as diabetes, heart disease, compromised lunges you are going to be fine". If you keep repeating that people are going to die, people are going to believe you even though the number of people who are going to die that do not have comorbidity factors have a very low risk. That's how you destroy logistic.

Right now Amazon, objectively a logistics company, has an equivalent of the ground hold on all non-essentials. I cannot get a frying pan delivered until April 24th.

> I'll repeat it: Nobody working in food production and distribution is forbidden from going to work.

We are at 10% of seasonal flu death numbers heading head first into a wall.

> You keep repeating talking points from TV.

This is a very weird line of argumentation. Do you think there is some media-wide conspiracy in favor of containment? To what end?

These "talking points" are also what the epidemiologists and politicians are saying. Just because you are in the minority that doesn't agree with it doesn't make you right and everyone else wrong.

> Right now Amazon, objectively a logistics company, has an equivalent of the ground hold on all non-essentials. I cannot get a frying pan delivered until April 24th.

Amazon is having a hold because demand for everything is up, because people are trying to avoid going outside to shop... And because their employees are concerned about their personal safety. No government agency has stepped in to shut down an Amazon warehouse. If you lift the shutdowns, you will actually increase their concerns about personal safety.

> If you keep repeating that people are going to die, people are going to believe you even though the number of people who are going to die that do not have comorbidity factors have a very low risk.

Those people have relatives who are at risk, or may not be interested in rolling the dice on ending up in the hospital. This virus has a much higher hospitalization rate than the flu. Are you ready to pay for all their medical bills? Has socialized medicine finally found its moment to arrive on the shores of the United States? Or, alternatively, are you personally ready to take a job lifting boxes in a warehouse for $15/hour with no medical benefits? One that you commute to in a subway car that's packed shoulder-to-shoulder with sick people?

The MTA is unable to operate the NYC subway, because they have so many sick employees. Do you think a Krelminesque order to stop broadcasting bad news on the telly is going to defy reality, and get the subway running at full capacity, again?

> We are at 10% of seasonal flu death numbers heading head first into a wall.

Italy has, over the span of 4 weeks, hit 300% of their regular seasonal flu deaths, and 50% of the hospitalizations, despite a lockdown but this apparently does not stop people on the internet from drawing false equivalences to the flu.

Do you have a better plan for dealing with a virus that sends more people to the hospital in 4 weeks, than the flu does in half a year? How many hospitalizations and deaths do you think they would have hit if cases continued to double every three days?

> Amazon is having a hold because demand for everything is up, because people are trying to avoid going outside to shop... And because their employees are concerned about their personal safety.

You cannot have it both ways - either employees are concerned for their safety and logistics therefore is affected or they are not and logistics is not affected.

> The MTA is unable to operate the NYC subway, because they have so many sick employees. Do you think a Krelminesque order to stop broadcasting bad news on the telly is going to defy reality, and get the subway running at full capacity, again?

MTA decided to cut the service on NYC subway because it projected a drop of demand. It is an organization has been been mismanaged for decades. I find it very difficult to believe that it would suddenly be making marginally optimal decisions in "the stay at home" environment.

> Italy has, over the span of 4 weeks, hit 300% of their regular seasonal flu deaths, and 50% of the hospitalizations, despite a lockdown but this apparently does not stop people on the internet from drawing false equivalences to the flu.

The vast majority of hospitalizations and deaths come from comorbidity.

> Do you have a better plan for dealing with a virus that sends more people to the hospital in 4 weeks, than the flu does in half a year? How many hospitalizations and deaths do you think they would have hit if cases continued to double every three days?

Order a stay at home for at risk population and population with comorbidity. Lift it from anyone else. Eat 10-15% hit to the economy rather than a total devastation. The mass poverty creating economic hit is going to destroy the medical system much faster than COVID-19.

Of course there is. It's called the National Guard. It's called the US Army, Airforce, and Navy. It's called FEMA. I'm sure there are plenty of other centralized systems with tons of funding ready to do this on a moment's notice. What we don't have is leadership, with an idiot leading this country who said the pandemic is a "hoax."

The optics of the National Guard (read: men with guns) delivering food for months in the entire United States would trigger a nearly immediate break down of economic ties both internally in the US and between the US and the rest of the world

What do you think FEMA does after a hurricane?

Difference is the orders of magnitude

Where does the food come from if nobody is picking it, transporting it, processing it or selling it?

Food production and distribution has not ceased, nor is there any reason it will. Getting that food to people who cannot afford it is a different issue.

Anyone looking at this as just a New York or LA or Miami problem will learn soon enough. The cities were hit first for obvious reasons but it viruses don't self-isolate to population centers.

Honestly, my life in the suburbs hasn't been much different since this all started. It's basically been business as usual, except for things like stores not having as much food variety, fast food places being drive through only, and big box stores being less crowded. I think people in the cities will be most effected because of the large number of small shops and independent restaurants that had to close, but out in the suburbs the impact hasn't been any worse than when we get a big snow fall.

I've been thinking about this and how talking about the US as a homogenous entity is a mistake. The R0 of a big city is going to be higher than in a smaller city, suburb or the country side. For example, even before the shutdowns I could go to the grocery and count on one hand the number of people I might be within 6' of. Now it's even less. In a place like NYC, that seems impossible.

I and all the people I know are taking all the precautions, but density has to play into how fast something can spread.

And yet there have been very dense, urbanized countries that have gotten a handle on it well (such as Singapore and Hong Kong). We could do it here, but we don't have enough testing or enough masks. The density of the country is not the main driving factor behind which countries are getting hardest hit and which are not.

On the other hand, many rural communities are vastly less capable of providing the care for even a small fraction of the big cities. Many rural counties in Colorado and Idaho have the highest rate of death and are most overwhelmed in their states because they have far less capacity.

Less likely to get it vs less likely to get medical treatment.

Logically it make sense to want more rural. If you test positive go to the nearest big city for treatment.

Assuming their hospital isn't already overwhelmed.

That's true up until someone brings it to their church, a funeral, school graduation and the entire community gets it and it's like a small bomb going off. Truck drivers still go through small towns, packages still come in and out, they get food.

This is flat-out not true. People in rural areas still congregate with other people enough to cause bad epidemiological outbreaks. Past pandemics have not only hit the city and spared the countryside.

I grew up rural bet you didn’t.

I suspect rural folks are more likely to go to church, but I could be wrong.

Stereotype much?

I hope that's true because the country needs food. I don't think rural communities without any protections will be any better off though. Rural communities still gather in stores, bars, restaurants so I don't see why the spread would be any less impactful.

Because they interact less and interact less with world travellers, have less world class workers imported from around the globe. They are spread out more, take public transit less. Doesn't mean it won't spread but in a rural setting you see thousands of people less per day on average.

Shouldn't this be asterisked with a "So far"? The black plague devastated rural communities along with urban.

The Black Plague was spread by rodents. Coronavirus currently required a human carrier. I do agree about the "So Far" bit though, if precautions aren't taken, eventually someone will catch it and it'll spread.

It's already happened in a few places.

https://www.nytimes.com/2020/03/30/us/coronavirus-funeral-al...

Those will also be the locations with less preparedness. How many small towns even have ICUs?

Americans are not taking this shutdown at the moment, anyway. I live in Boston, other than that people who can work from home, work from home and restaurants/bars are close, absolutely nothing seems to have changed.

My roommate works in a random thrift shop, they're classified as "essential business" so he still shows up to work every day to read book.

I don't know why a thrift shop would be classified as "essential". Here in Minnesota they are not.

Alright well when urban Americans start talking about breaking up the country over this I don't want to hear any kvetching from the rural areas.

I have a feeling rural folk will be a-ok with that.

Until the subsidy checks run out.

My money is on the group that controls the food supply.

The people that own the food supply live far away from where it is produced.

Agree, I am saying rural America controls the food supply and is armed.

Not all US states are doing it the same way so it’ll be interesting to see how things go.

That's armchair quarterbacking from people with more than enough money for shelter and food.

Exactly.

I see most of the advocates for "shelter in place until we're safe!" are white collar people with space at home and direct deposit.. not hourly workers who just lost their livelihoods with kids at home and the only internet is on their phone.

White collar carnage will start by the end of this month.

You'd be surprised how many people are already willing to let the death rate increase. The perception is that this virus mainly wipes out sick people and boomers. If there's one thing millennials hate, it's boomers.

20% hospitalization rate is what everyone should focus on. CFR is 3% but hospitalization of young adults is extremely high. When young people have to get treatment and they can't - they'll suffer and have serious consequences if not death.

Edit: Listen to the person replying to me. It is not 20%, but 3.3%. I am off by an order of magnitude.

None of those numbers are accurate. Latest research: https://www.thelancet.com/journals/laninf/article/PIIS1473-3...

.66% CFR, with 3.3% hospitalized (and fewer ICU) under age of 40. Even in the >80 age range, hospitalization is < 20%.

If you're going to make a point, make the point with accurate numbers -- those are off by an order of magnitude.

3.3% is still insanely high. If 50% of US population is under the age of 40, that's 5 million people in hospitals.

This changes nothing.

> This changes nothing.

It literally changes everything, as you're spreading false information. Instead of 20%, it's 3.3% - that doesn't change anything? It's the difference of tens of millions of lives just in the United States!

Yes, 3.3% is still high, but it's not even in the same ballpark as 20%. And not everyone will be hospitalized at once, which is the entire point of flattening the curve.

The point is that 20% or 3.3%, the amount of hospitalizations would far exceed the capacity. We shouldn’t get there in the first place. So the proposed idea of opening things up is a non starter.

I’ve already edited my comment to concede on 20%. Why get so combative in responding? I’m not trying to spread false information and willing to concede when new factual information is reported. Jeez.

> Why get so combative in responding?

Because you were arguing tens of millions of deaths "changes nothing."

The data I've seen so far shows that it's mostly young people with complications. If you're one of those people with such complications, you can self select out and remain quarantined while the rest of the country tries to return to work.

That's not to say that a few young people with no health issues might be harmed. There will be some, but from what I've see thus far, all other potential causes of death in the next year from things like cars accidents are more likely than dying of COVID19 in the next year for those young people with no co-morbidities.

Just saying young people in general have a CFR of 3% isn't helpful.

The crazy think is I still see plenty of young people smoking and vaping. WTF? Now might be a good time to take care of your lungs.

Except most of the people willing to take the risk ARE the boomers and elderly. The millenials are the ones sheltering in place and posting about it on Twitter.

I really doubt anyone has the data to make such a claim.

He has data, it's on Twitter...

I think in both cases it’s a minority but a noticeable or vocal minority who engage in this sparring. Also the spring breakers are not the boomer age group.

There are zero hospitals in America that over capacity right now including NYC.

The NYTimes article seems to disagree with you [1]

> Across the city, hospitals are overrun. Patients have died in hallways before they could even be hooked up to one of the few available ventilators in New York. Doctors and nurses, who have had to use the same protective gear again and again, are getting sick. So many people are dying that the city is running low on body bags.

[1] https://www.nytimes.com/2020/04/02/nyregion/ny-coronavirus-u...

You do understand that the outbreak has exponential growth which has not peaked anywhere? Even NYC cases will likely double this week before their peak. If anywhere in fact is "over capacity" now then they'll be in much deeper shit than they are now, which is already pretty deep.

I'm not sure what you mean by "over capacity", either. If you're talking beds, ICU slots, and ventilators, maybe not yet. If you're talking lack of staffing, lack of PPE availability, general workload, then I think many are straining or over capacity now.

I am talking about the former which is true. I concede there is a strain on staff. There seems to be a belief out there that hospitals are already full which is not true.

It's also impossible to know if we if we have peaked or not. It's just like trying to time the stock market. The only thing that really matters is the death rate. The rate of cases doesn't matter and is likely under counted. We are testing more and more people which increases the case rate. If we tested everyone including those with no cases and found a lot more people than expected have the virus the death percentage would go down.

I am also skeptical of how the start of the spread in the US was determined. It's possible it was much earlier and early cases were confused with Flu and we are in fact near the peak of the death rate.

I'm in NYC and I have no idea what you're talking about. Many of our hospitals are well beyond capacity, the most well reported on example being Elmhurst Hospital. Go look it up.

The operative words are "right now", with the current evolution of the virus and the population not taking the measures seriously, how long do you think that is going to last?

25,000 cases to 250,000 cases in two weeks.

Give it another two weeks. Thank god people with foresight and basic math skills are the ones planning for increased hospital capacity.

More and more tests means more and more cases. More cases with less deaths means the mortality percentage is lower. The number of cases does not matter at all.

BTW God should be capitalized it's a proper noun.

How much of that is due to hospitals clearing out and refitting themselves to support what they knew was coming? Do you expect that trend to continue?

But the ones who will go against lockdowns will be the one who have no savings and that means mostly young people who virus affects with less severity than older ones.

It seems old ones are also the people who have most real estate in America?!

So if virus is passed on to old people and they die. Then natural consequence will be that, their property will be passed onto their kids who will most likely sell it immediately and cash out why? Because kids of most wealthy suburban families usually live in huge Metropolitan cities so they are unlikely to hold onto property in suburb.

And does it mean soon lots of cheap properties will be available for sale in suburb?

For those without saving lockdown means that everything is paused. Right now in many places landlords cannot charge late fees, services can't be cut off. Additionally there's lots of sympathy for those in need. While isolation persists we'll see more programs like NYC provided 3 meals a day.

Once isolation ends then the bill collectors will start coming and the free meals will be come rare but people will remain severally unemployeed.

The people with no savings are the ones that are going to most want this to last since there's no going back to the way things were right now. Many of the jobs lost will not be immediately replaced when the isolation stops.

Nothing is paused. You will still have to pay for everything, maybe latter, but eventually you will get kicked out.

I will probably go to prison, child support is still enforced. There is ZERO sympathy.

What do you think about the real estate?

Do you expect more properties to come on market for younger folks? Will it become cheaper to buy new property?

Do you have a source for that? I think we are doing all this, so some people can live 3 years longer.

A few more months like this and people will start dying from other causes (crime, hunger...).

That's false. Death is the natural and inevitable outcome of life. The people who would die of COVID are nearly exclusively people who would die relatively soon anyway. For an average 85 years old person, the risk of dying due to COVID if no mitigation is attempted is 6.3% [1], less than the risk of dying of other causes during the next year (9.6%) [2].

A 20 years old is more likely to be struck by lightning than to be killed by COVID.

The life expectancy saved by the lockdown is just so small. I find it extremely hard to believe that the lockdown will cause less loss of life than the new virus would have.

[1] https://www.thelancet.com/action/showPdf?pii=S1473-3099%2820...

[2] https://www.ssa.gov/oact/STATS/table4c6.html#fn1

Are people expected to suffer the disruption of having a substantial number of people taking two weeks off to recover from this disease with a non-trivial chance of needing medical intervention?

Are you going to be willing to postpone all medical interventions for the next three months because there's just not going to be available hospital capacity for your broken tooth?

It's substantially more than two weeks for people who get a worse case of it, by the way. I had a mild case and was off for two weeks. If you get a more severe case, and especially if you need hospitalization, you're looking at at least a month of recovery. This virus attacks your lungs, which take a lot longer to recover from than your typical cold or even flu. The best comparison as to how long you're out of commission for is pneumonia.

You're getting downvoted, but while it may not be pretty to think about, these other factors are important to consider. Even the expected years of life lost (which are factors found in medical literature). Unfortunately COVID-19 does affect younger people to a degree (40-50's) who could live healthy productive lives for decades, so it's not going to be pretty numbers.

Still "Flattening the curve" seems to be the only thing epidemiologists are focusing on, but ignoring the death toll from unemployment, domestic abuse, depression/suicide, and others. Not to mention how many people will die from exposure to being evicted due to being unable to pay rent or hunger from buying groceries. Or the long term effects of depressions or social anxiety from being locked down, etc. These are real factors.

The CDC's lack of modeling of these factors is disconcerting, if not bordering on _incompetence_. I've been searching for models (preferably using STAN or similar to calculate adjusted statistical likelihoods) to estimate holistic effect of lockdowns on overall death rates adjusted for those factors. So far I haven't found anything, or very limited research.

It sucks, but as a society, we have to be able to critically analyze the situation, including the tough factors of triage at a societal level.

My assumption was that at least part of the reason for isolation measures is to prevent what happened with the Spanish Flu, where unfettered transmission created the conditions for a mutation that turned the U curve for mortality into a W curve.

I think it's mostly to avoid the bad press of having to do triage at hospitals, long-term consequences be damned.

Is Covid-19 more likely to suddenly mutate and become more lethal to young adults than, say, some strain of influenza doing that (again)?

The opposite. It mutates more slowly than the flu.

> The people who would die of COVID are nearly exclusively people who would die relatively soon anyway.

Why are we building emergency mortuaries?

It doesn't matter how long the period of isolation lasts, we're emerging from it to face a economic crisis that will far exceed the great depression. That crisis hasn't even started to materialize yet.

There's no normal to return to, and the immediate future after this will be bleaker than the time we're all in isolation. While isolation continues people won't be kicked out of their apartments, communities will help those in need with food, and nobody will have to worry about those bills that are pilling up. The second everything starts again, all of those debts will be unpaused, all of that community support will dry up, and people will be back to fending for themselves rather than in this together.

There will someday be a normal again but it won't resemble the normal we had in February in US any more than the world returned to "normal" after 9-11, of WWII for that matter.

The second isolation ends then reality will really set in.

edit: Can someone explain the downvotes? Is there anyone that thinks the claim that the economic consequences of this will be horrific is downvote worthy?

"Our baseline forecast does not see GDP reverting to its pre-virus levels until late 2021 in the US and Europe." [0]

[0] https://www.fitchratings.com/research/sovereigns/deep-global...

I think we'll have to find ways to loosen things, though. Maybe everyone, or almost everyone, just wears a mask in public and we use the defense production act to keep the supply up. Maybe sick leave becomes mandatory and businesses restructure to stay open while keeping people physically apart.

Maybe we phase in and out restrictions and get rid of the ones that have the most harm and least impact. Maybe that drug Trump was pushing really does enough to keep people from dying from this. I dunno, but we probably can't just hide for two years and let half of the country be out of work.

Hopefully we do a lot more vaccine work, too. Ideally we'd wipe out some other scary threats like Ebola while we're at it.

Which is why we won't ever fix climate change.

I agree with you in that the climate crisis and pandemics are major emergencies that require species-level thinking in order to mitigate effectively. That said, your comment could use some context.

Yeah, you're right. Mostly I was trying to spur conversation and perhaps I wasn't giving enough context to do so.

What we're all doing globally right now is only a small step in the right direction for tackling climate change. We could stay on this path right now, and continue to work to restrict ourselves and reimagine what an economy could look like and end up with some really impactful change. But we don't seem to be interested in doing any of that; instead we're more interested in how to get back to commuting to work, buying more stuff, getting supply chains back in order, manufacturing cars, extracting cobalt from the earth and on and on.

I think whether or not they are willing is not a major concern in these governors’ minds. They have all activated the national guard for a reason...

The state cannot hold back the majority with the army

So far, there's strong public support up here in Canada for the measures. According to polls, the great majority believe breaking the public health orders should be a crime, at least in serious cases. There may be period of time where the government still has a strong, popular mandate to enforce distancing, but there is increasing non-compliance and resistance.

Just the folks who start to snap mentally over the next weeks and months will be a serious and growing problem, even if everyone who stays mostly-rational wants to continue to maintain distancing.

I agree - up here folks are being quite cooperative, someone even recently painted a mural of Bonnie Henry & Dr. Tam[1]. That all said, some parts of America are quite different from Canada with some churches openly protesting the orders[2] (and putting the most vulnerable at risk).

My big concern down there in America is, if folks get crazy and LEOs need to step in and enforce quarantine it will make that quarantine ineffective and LEOs will become the new disease vector. Additionally if any significant portion of the population decides to violate the order than the LEOs, National Guard and even standing army won't be sufficient to enforce the peace - because the peace can't be enforced, peaceable society can only be accomplished through voluntary social contracts.

1. https://www.citynews1130.com/2020/03/31/fans-paint-murals-dr...

2. https://www.theadvocate.com/baton_rouge/news/coronavirus/art...

I feel like that's a strong differentiator of Canada and the United States - America seems like it's always holding its breath and waiting for the next revolution which will change everything, while we here in Canada just want things to get back to normal.

I’m sure for now people are willing to go along (also who would tell a pollster they want people to die, but that’s a separate point). If this goes on for months expect public opinion to change.

That's kind of my point. The public opinion may change, but until it mounts to a point that government policy changes, they'll probably keep enforcing the distancing measures with increasing heavy-handedness.

It may also become increasingly polarized with strong "I don't want to die!" and "I just want to talk to someone!" factions becoming increasingly set in their beliefs.

Civil unrest could occur at that point.

So, unfortunately, I think as soon as actual force is necessary we lose - but while increasing heavy-handedness involves fines and parking a patrol car outside someone's house to make them adhere to self-isolation I think we'll be alright.

What majority? If the majority of people are stupid enough to rise against the tyranny of social distancing, they deserve what they get. At least, I hope that doesn't happen.

Distancing for what, months, years? Lose businesses, homes, future because there's a risk that 1% might die?

Noth Korea begs to differ.

willing to bet that the vast majority of NK agree with the Dear Leader if polled. Why is a different story