But this only works with a very low infection rate. Once your testing capacity (which is still, basically everywhere, much smaller than hospitals' ability to treat the same outbreak) is overwhelmed, you lose control and end up back where everyone else is.

People are watching this closely.

Your statement implies that if we could guarantee hospitals would never get overwhelmed we would happily let this wash over the whole population and kill 1% of us. That should be avoided (and would also hurt the economy just like the lockdown is, it’s not an either/or choice).

In the Netherlands there are approximately 1.100.000 people between 30 and 34 years old (inclusive). Of those people 150 entered the hospital. That’s 0.01%. Most of these people are not dying (in fact only 3 of them did, which is 0.0003%) and while there isn’t a number of people with the chronic problems it definitely isn’t all of them.

By the way slightly more than 0.1% of the population dies every year due to smoking. I have yet to see the massive safety efforts.

Respectfully, I do not agree. New Zealand went on lockdown March 23 when they jumped overnight from 66 to 102 confirmed cases. They have 1144 as of yesterday.

There are now 1.3 million cases in the U.S., almost that many in Western Europe. There are not even enough tests to know the real number. Antibody tests are indicating that a couple tens of millions of people may have already been exposed.

I know of no precedent for using quarantines to eradicating a disease that is already so widespread. There is no evidence that such a thing is possible. It would have been at some point in the past, when there were some hundreds of known cases, but not any more.

What to do from this moment forward? Did you mean to imply that you thought we could stay locked down until this is eradicated?

I wonder if there are models that can give us covid predictions based on continuing the existing lockdowns versus easing of lockdowns, with a vaccine in 12 months versus a vaccine in 4 years, and estimated economic and social costs of lockdowns. I don't think it's responsible to make these big decisions without objectively weighing all the data, and the data is fuzzy, refined over time. (Although I am pleased at how much data is publicly available.)

But yes, it could end before herd immunity. Or it could be like the flu, and mutate / continue indefinitely.

I gather that is unlikely, coronaviruses don't mutate like the flu.

In fact, according to experts, it is most likely that this coronavirus will decrease in severity over time and become endemic like the other several coronaviruses that are responsible for 15% of common colds. Or, alternatively, occasionally returning like a bad flu year. https://www.statnews.com/2020/02/04/two-scenarios-if-new-cor...

I remember reading in other places this may have happened before, something about a really bad flu year in the 1870's that may have been another coronavirus introducing itself to humanity.

Thats exactly what will happen. Based on sampling its much much less like .1% to .5% but there not much of an option. It would be like saying no one should smoke or drive cause people will die.

It eventually will be if R0 is greater 1.0. The government's position is that it needs to stay below one. The official metric to that effect is the number of new infections per 100,000 people. If it crosses above 50 for any administrative district, lockdown measures ought to be tightened. As of today, there are four above that threshold.

Just because the US and UK can’t get their act together doesn’t mean it’s impossible.

China is still finding new cases so it isn’t eliminated. New Zealand can keep the virus out because it’s an island (but they better be prepared to live without tourism).

It’s all just not very sustainable.

Otherwise we should have tried to keep it in an acceptable very low level. I personally find it astonishing that we are accepting >100 deaths per day.

We spend enormous amounts of money because we "don't accept" the high fatality rates seen in automobiles. And it works. Check out the charts here for very clear proof: https://en.wikipedia.org/wiki/Motor_vehicle_fatality_rate_in...

And now we're doing the same kind of thing (in, obviously, very different ways) to fight the covid pandemic. And it's working too, though better in some areas than others. Germany in TFA is worried that maybe their R0 might have slipped above 1.0 and started growing again. Outside NYC, the US epidemic is still large and still growing.

And it's the same thing with COVID-19. We can't quarantine everyone indefinitely, this is unlikely to end without us reaching herd immunity, and the quarantine itself causes non-negligible suffering. We have to approach this rationally.

Why is trying to minimize a US death toll on the order of hundreds of thousands[1] at the cost of a 20% GDP hit not a "rational" choice? It may not be your personal choice, but it seems to be to most people. And it's absolutely a well-understood tradeoff by everyone involved. No one went into this blind to the costs.

[1] Maybe only ("only") mid-tens-of-thousands if you use the kind of life-years-saved metric that seems to be en vogue among the "open up" set.

a) they are not going to "save hundreds of thousands of deaths", because quarantine doesn't stop the virus it only slows it down, in other-words quarantine will spread out those deaths in time, but many of those deaths are still going to happen (in due time)

b) 20% GDP hit will inevitably directly and indirectly kill, make homeless and starve a lot of people

c) in 2nd and 3rd world contries the distruption of the global economy to this degree will kill a metric ton of people

d) it's impossible to keep quarantine for extended periods of time, because then it's going to be way more than 20% GDP hit.

The only question is which approach is going to kill more people and do more damage in the long run.

To me it seems obvious that extended general quarantine is going to do an order of magnitude more damage (than doing the sane thing - like isolating at risk groups).

They literally (literally literally!) already have. What do you think would have happened in late March if the lockdowns hadn't bent the curves? Why do you think the high exponent mode (doubling every 3-6 days) stopped, if you don't think the lockdowns did it?

The problem with the "anti-quarantine" arguments is that they confuse the death rates of the status quo (locked-down semi-containment) with those that obtain from an unrestricted economy. That's not how it works.

> The only question is which approach is going to kill more people and do more damage in the long run.

Find a serious person with numbers that support your case. I think you'll be surprised.

If quarantine made the virus go away (which it doesn't) - or it bought enough time to make vaccines or effective treatments, then it would make sense, but it doesn't.

All it does it make it seem like you are saving lives, while in effect the deaths are just spread across a longer timeframe and now you're killing, starving and impoverishing people from the severe and dire economic consequences.

For... the TFA is literally about Germany, a nation that had its outbreak R0 drop below one (i.e. their outbreak was shrinking), far, far, far underneath the herd immunity threshold. It's simply not true that Germany didn't prevent any deaths, that analysis is straight wrong. The same holds for most of east asia.

The only reason, quite frankly, that this doesn't seem to be happening in the US is because there is a segment of the population being led to believe that lockdowns are impossible, or that they don't work, or that they're an imposition on fundamental freedoms. So we're doing it badly. But it can absolutely be done well, as nations like Germany show.

If you take 1000 deaths and spread them across a 6months or a year instead of 2weeks, no lives have been "saved".

Similarly the act of spreading it out via general extended quarantine, does massive economic damage that will result in deaths, starvation, homelessness and impoverishment that arguably will completely eclipse whatever lives are actually saved by the quarantine (due to say availability of ventilators and medical care not being overrun).

Maybe that damage isn't as large in some developed countries like Germany who can maybe afford it, but it is in many other countries.

That is not the effect of a lockdown. There is your misunderstanding. The proof is in the linked article (or data for Hong Kong, Korea, Taiwan, Hawaii, all of whom also contained the virus before reaching herd immunity).

If those measures are not feasible long term (this seems to be the case), that means they R0 can be held below zero only briefly. In other words, the spread of the virus is only slowed down (or even reversed briefly, with R0 < 0) and delayed, and in essence the most deaths are simply delayed and not saved.

While the deaths from the quarantine measures itself doesn't seem to ever get accounted for.

And that is the problem - those quarantine measure/economic damage deaths doesn't ever seem to be put into equation as if they don't exist or are negligible.

Which makes me question if quarantine does net-benefit or does more harm in log term when all the externalities and knock on effects are actually accounted for.

Or am I missing something?

Secondly, why is nobody ever talking about the amount of deaths, starvation, homelessness and impoverishment that will result from economic damage of general quarantine. This always gets completely ignored and negated as if it doesn't exist.

You can't say that quarantine saves lives unless you quantify how many people are killed and are going to be killed by it.

My argument is that this by far will kill, starve and impoverish way more people than whatever number of people will get saved by having access to a ventilator.

Rt is below 1 in all states except Minnesota and Nebraska [1]. So the US epidemic is still large, but already shrinking. With that said, when lockdowns are eased, Rt can increase again.

[1] https://rt.live

https://91-divoc.com/pages/covid-visualization/?chart=states...

Edit: in fact I went back and spot-checked Iowa. That link you posted says that Rt dropped below 1.0 20 days ago. In fact the real world new case rate is almost three times higher than it was 20 days ago! I'll just say it: that site you linked is garbage.

I'm sorry. Those graphs you linked are pretty, but they're just dead wrong.

I'm serious: that site is bad. It's a bad model. You have to stop reading and linking it. The only way to make it "right" is to assume (as you are) wild divergence between measured case incidence and "actual" unmeasured infection statistics, which isn't borne out in any papers I'm aware of from any outbreaks anywhere.

Basically: I'm telling you that measured data makes this model very wrong. And your response is to tell me that this is because measured data is itself extremely (like 3x!) wrong. That's bad science.

https://en.m.wikipedia.org/wiki/Motor_vehicle_fatality_rate_...

(Incidentally, using traffic death numbers as a baseline for a rate of fatalities we should accept is bad anyway because those numbers are also higher than we should tolerate, IMO.)

https://www.asirt.org/safe-travel/road-safety-facts/

38,000 a year ~= 104 / day

(based on 120,000 preventable deaths in 2016: https://www.oecd.org/germany/health-at-a-glance-germany-EN.p... )

Close to a million people die in Germany in any given year, we're always accepting >100 deaths per day. The question in 12 months will be whether the death rate significantly increased or whether it primarily moved the cause of death, so more people died from Covid-19 and less died of atypical pneumonia, old age, cancer, heart disease or the flu.

But note this includes estimates from February, with a lot more unknowns, and fails to take into account improved treatments (Remdisivir, Plasma, ventilator use improvements, etc).

Moving forward, given treatment improvements, I think a consensus IFR range would likely be 0.1% to 0.7%.

Who is we? In the UK, for example, the baseline expected death rate is around 2000 per day. Sure, adding another 500 to that is a big deal, but it is maybe not as big a deal as everyone seems to think it is.

The death toll due to covid is already is visible on all averaged yearly death per day/week charts and we have not even gotten to 1% of population having gotten the disease. That is a big deal.

Only when one year is taken into account. How about decade averages? I bet tobacco is #1 on the list and covid does not even make top 10

And of course, we should have kept up the social distancing.