Addendum: I posted this fully understanding how unpopular it would be with this crowd. If we ever get hit with a a more fatal and contagious virus this may be our only way of preserving life. And as things stand with our industrial meat processes I suspect we will have more viruses to contend with.
It is not this simple. You can't, in our current system, shift wealth that readily and quickly. Even if you could, how would you approach possibly selling this in a democracy? And assuming it was feasible, and we could get popular support for it, how would it be implemented? Rationing cards? Government ran food stores?
This is NOT the Spanish Flu. It is very different in its behavior. There is currently no evidence to expect a more deadly, virulent second wave. Please remember that the Spanish Flu was anomalous because it had a more deadly second wave. Almost all viruses, as a function of evolution, become less deadly over time.
And this ignores all of the vast improvements in our understanding of sickness and hygiene, our availability of clean, sanitary conditions etc. Hell, even the change in density between 1918 and 2021 is massively changed.
The Fed seems to be doing just that
This has been proposed by legitimate legislators. https://twitter.com/SenSanders/status/1270000771132731397
As for your claim to a lack of a second wave, I'll have to defer to the experts on that. I'm looking at a historical case for a worse case scenario which I think is prudent to consider.
Alternatively, you need a total quarantine isolation - e.g. anyone working in a care home should live there and can't touch their kids if they go to a school where will be spread because everyone else's parents are not on lockdown. Or the most vulnerable will die.
But the moment a number of apparently healthy and young people start dying from it, people start thinking thateither a) it's hard to know in advance whether you're at risk (e.g. unknown pre-existing conditions) or b) the disease is stronger than previously thought.
And that's even if the actual cause has nothing to do with (a) or (b), i.e. if the data was just a statistical fluke or misattributed deaths (e.g. people dying from X who also had sars-cov-2 in their system). It doesn't matter; there is no time to get to the bottom of things. The authorities have to play it safe, least they will be proven to have acted recklessly. And even if they try to be "brave" and plow ahead, the public opinion will quickly sway towards playing ir safe.
This seems to be an especially strong force since people today have an unprecedented capability of communicating and broadcasting "gossip". Even China's strictly controlled public communications wasn't able to censor spontaneous outrage from the citizens. And the fact that China reacted they way they did, set a high bar; any country that wanted to act differently had to be play it pretty convincingly to their populace (e.g. "we can do it, because we're different, we are so disciplined we can pull it off")
But it surely takes a lot of confidence to pull that off, knowing that opposition parties will feast on any opportunity to publicly decry your recklessness.
Covid-19 is real and it kills people, it's effects can be and will be measured.
We do make tradeoffs between economy and safety all the times, but we do that for things we're used to (traffic, pollution, diseases prevention, ...), so some people expect we can do the same kinds of tradeoffs with covid-19.
Again, I'm not an expert and have no idea on how to compute such a tradeoff.
But my point is that there is a inanimate force that is just pulling that card off the table.
It doesn't help that in some countries it also became such a heavily partisan topic.
I'm not from the US. I live in a country whose government has been very proactive and the population is generally supportive of the (re cently lifted) lockdown. And that's a country where rarely the populace has anything good to say about the government (a popular saying "it's raining, damned government!")
Playing it safe seems much more effective politically, that unless you want to play some "strong man" narrative like some governments did, there doesn't seem to be any advantage in taking excessive risks.
Personally, I don't feel that there are many population centers in the US that are prepared to do the kind of testing that seems like would be needed to properly identify the sick.
We could start by NOT sending people with confirmed COVID-19 infections to live with them.
With cheaper testing, pooled testing protocols, etc. we could potentially test every household in the US every couple of weeks for less than we spend on auto insurance.
To fully isolate you would need workers to go through quarantine periods before entering on shifts. Many vulnerable live at home so you'd have to provide support to isolate their cohabitants as well or something else. Physician specialists that serve vulnerable and non-vulnerable populations without enough overlap to split duties with similar doctors between both populations would need to operate inside a bubble boy setup or something.
The vulnerable also include people with pre-diabetes, heart conditions, etc. that may not be diagnosed, though maybe you just treat them as those not to be isolated.
To protect 90%, it's sufficient if you reduce the rate of spread below 1, which means that it's sufficient to have a (realistically achievable) "quarantine" that reduces the number of contacts 3-4 times. It's possible to have much less contact with people, it's very limiting to have no contact at all.
There's a huge world of difference between the contact limitations required for a true quarantine (essentially, zero contact) and what "lockdown" has meant in most places, with most people continuing to work with other people just with much less contact.
Have we forgotten that "this is all a liberal hoax"? Remember HCQ is a cure-all? That's not being consistent--that's completely ignoring science.
The right in the US has been consistent about tailoring its message to AI driven talking points that drive social media engagement. Nothing more.
How about a "free market" solution? Give everybody who earns under $40K a year $2,000 per month unconditionally for the next 6 months. And let businesses reopen. Now, people who want to can go back to work and have a $2K bonus per month on top. Or they can forgo that and sit at home.
Let's see how people actually vote with their feet and wallets.
Trying to thread needles like this is disingenuous, at best, and makes you look like an apologist, at worst.
You have a set of political leaders actively hunting for a hook that is sufficiently platable and plausible that they can get people to swallow in order to be exploited for their own power gain. Giving cover to that deserves neither praise nor quarter.
There are plausible solutions that have scientific backing. There are also plausible economic solutions. There are also degrees to those solutions--Switzerland shows this even though it is now matching the US in per capita Covid cases.
NONE of those solutions that would benefit the people have been proposed at the federal level here in the US.
I don't think that was being consistent about "tailoring the response according to risk [from the virus]," but rather being consistent about tailoring the response to pre-existing policy preferences. An ideal lock-down requires significant temporary bottom-up government economic intervention, which the right opposes on principle. The policy of "those...at risk should isolate and everyone else should resume work" fits nicely with existing right wing ideas: keep government intervention to a minimum by maximally individualizing health burdens. The difficulty is that might not actually attack the problem very well.
Well, that's true of the left as well. A "bottom-up government economic intervention" fits nicely with existing left wing ideas.
That's true, but the different political ideologies are better at handling different kinds of problems. Public health emergencies like this one are the kind of thing that benefits from a properly-resourced, centrally coordinated response; a solution that happens to lean left.
"Lockdown" is New York where R0 is 0.75. "Lockdown" is not California or Texas where R0 basically sits at 1.0.
R0 of 0.75 after the last 3 months would basically mean Covid cases in the single digits basically everywhere in the US. But, no, we can't actually get people's attention before we start piling body bags in the streets.
The people in the US who are "Open all the things!" are also the "I'll be damned if I'm wearing a mask." Ummm.
You can argue about the finer points all you want, but when you can't get people to do the basics, you're sunk.
This likely has much more to do with relative densities than lockdown strategy. Texas is low density, and it was necessary to have looser restrictions in many areas due to distance to essentials like groceries. And indeed for Texas this seems to have been a fine call.
And Texas still has a declining rate of new cases despite continuing to reopen, and we have been in a decline for over 30 days despite bars and restaurants being open.
The complaints against mask wearing have primarily been against legal mandates. I wear a mask but I don't support fining or jailing Americans if they choose not to, especially since they are likely to be old, poor or a minority.
I don't believe anyone has been piling bodybags in the streets, though it's an excellent scaremongering claim. Remember lockdown was planned for a few weeks to flatten hospitalization rate - which it did.
[^1]:https://www.wsj.com/articles/the-numerical-language-of-covid...
They do have per state R values. This does show that NY is at about 0.8. Texas is 1.02 currently. The one negative with their calcs is their R values seem too sensitive to daily conditions. It's a great visualization of infection rates too, please look at that.
To look at the daily infection numbers, find Texas, click on the "show new cases" tab. Texas has about 1500 new cases per day now. They've had a steady increase in new cases per day since mid April, when they were about 750 new pos cases/day. They are really growing. I'm not sure where your stats about Texas doing well are. It looks to me like the positive cases are unfortunately increasing there steadily, and it's a precursor to increasing hospitilization. I have family there, I'm increasingly concerned.
They get their data feed from https://covidtracking.com/api/v1/states/daily.csv which is downloadable. Look at TX (some days have multiple updates, you have to calculate the delta yourself). US date style, positives: 6/7 74978, 6/6 73553, 6/5 71613, the increases are very clear in daily positive cases; those counts are total pos counts to that date of course.
Another place to see per state (such as Texas) is https://www.worldometers.info/coronavirus/usa/texas/. Go down to 'daily new cases in texas' click on 7 day moving average. They've really been growing per day in new positive cases. One note, different websites show the current day's data differently (some show values that up dated in the middle of the day, others show one day late, so looking at the very latest rhs data point is sometimes confusing).
Texas absolutely shows the potential of opening up increasing infection rates. Alabama is another state that is hurting but reached a top, see Arkansas too. Florida was down but is now showing highest per day infection rates historically (7 day average, looks like new records beating 2 months ago). Some states are better, plenty are getting worse.
Then that just means that we are likely underestimating R0--possibly by a huge amount. Okay, I agree with you.
Infections aren't LESS than the diagnosed cases and positive test results. So, all the calculations from data about the estimates of R0 are all a lower bound, not an upper one.
As such, our estimates of R0 are likely painting a much rosier picture than reality. Probably not the point you were trying to make.
If we somehow magically started accounting for those cases the R0 would immediately go up (more cases per unit time means increased R0) unless the number of those cases is zero.
Thus, the R0 estimates we have are currently all underestimates. Covid is likely more contagious than we are calculating, not less.
Now, this doesn't matter to the people who recover, of course. And it effectively is correct in that people who simply recover aren't a big problem and so the R0 is roughly "correct" in the aggregate.
However, that incorrect R0 DOES matter when you start talking about vulnerable populations and how far you need to go to protect them.
I'm going to share some quotes from the code.
> Our goal is to translate positive test counts to the dates where they likely occured. Since we have the distribution, we can distribute case counts back in time according to that distribution. To accomplish this, we reverse the case time series, and convolve it using the distribution of delay from onset to confirmation. Then we reverse the series again to obtain the onset curve.
> We assume a poisson likelihood function and feed it what we believe is the onset curve based on reported data. We model this onset curve based on the same math in the previous notebook
> We calculate this by figuring out how many cases we'd expect there to be yesterday total when adjusted for bias and plugging it into the first equation above. We then have to re-bias this number back down to get the expected amount of onset cases observed that day.
I don't want to invalidate efforts to build models because models are important, but it's also important to frame models as being statistical models and in this attempting to resolve R0 values from self-reported data, across districts with dramatically altered reporting methodology is extraordinarily fraught with peril. Even the model authors indicate this and have made several improvements, and models will naturally evolve over time.
Then let's touch on some of the stats we're looking at. Remember we are dealing with a sampled phenomenon - as our sampling rate changes (the amount of testing we're doing), our case rate will naturally rise. We want more testing because it helps us determine more accurate numbers, but it also means we need to understand we may see spikes in our daily reported cases. We therefore want to be careful with using small samples (3 or 4 days).
You'll also notice we have natural declines that align with the weekends - it's not because the disease takes the weekends off. One of the dangers of reading the worldometers graphs is that they're inclusive of all the data, including data from March/April which is probably underestimate.
Texas started lessening quarantine restrictions on May 16th, and indeed until about the 29th we see a pretty consistent decline (well past any incubation time). From the 30th to today's data (and always take the current day with a grain of salt because reporting isn't always instant) we do see a growth, primarily due to several abnormal spikes in the last week. When we compare that against deaths we don't see those same spikes represented - and in the last two days of the series (excluding today) we see a declining pattern again (but two days a pattern does not make).
So it's wrong to say "Texas has about 1500 new cases per day now. They've had a steady increase in new cases per day since mid April, when they were about 750 new pos cases/day. They are really growing.". The 7 day average keeps us at 1200 or less, with the exception of the last few days.
I pulled the hospitalization data from [^2] (xlsx format unfortunately) and while hospitalizations are technically increasing as a whole, that is almost entirely in the TSA of Houston (though Dallas/Ft Worth and Longview/Tyler show some increase as well) with 19 other TSAs declining or remaining steady. So, I wouldn't be overly concerned for your family, the data indicates things are generally going quite well.
I would be careful in how we read data.
New York was. Although the point wasn't intended to be about scaremongering, it was more about how people don't seem to have the ability to pay attention unless life kicks them personally in the balls.
Most people in the Northeast knew someone personally who died of Covid--when someone's Grandma you know dies of Covid, you'll put your mask on and stay locked down so yours doesn't, and you'll get mad about the people who won't.
That's why I chose California, which nominally has a lockdown, to contrast against Texas, which nominally doesn't, to contrast against New York, which really locked down, to show that the US really didn't lockdown very well.
I was in California after the orders--"Hey, we can't hang out inside the coffee shop. I got it! Let's hang out on the sidewalk outside!" <facepalm> Or, "Hey let's have a Mother's Day party"--two of which now account for more than 50% of the Covid cases in Santa Cruz county.
And all this is because we didn't have a unified response in the US to make people pay fucking attention.
And, even in "Open all the things!" Texas, it's not helping much. Most businesses run until they get a Covid case in the employees and then shut down for several weeks--lather, rinse, repeat. So, instead of everybody shutting down simultaneously and cutting down the number of cases, we have individual businesses shutting down hodgepodge which still hammers people's jobs and as a bonus doesn't help bring the Covid numbers down.
Yes, I'm glad we shut down to prevent overrunning the medical system. However, that was just "Step 1".
"Step 2" was not supposed to be "Do nothing else and then throw up your hands in 90 days."
To call it "right in this regard" is, in this regard, wrong. These countries are leading the per-capita corpse count. In the case of Sweden, deaths are about ten-fold that of neighbouring and rather similar Norway. And people are still dying at peak levels in Sweden, while Norway now goes a week without deaths.
Of course it's "right" to "keep vulnerable people away from danger". It just doesn't work. Elderly people in care homes need, well, care. Also food, and medical attention, and housecleaning, and maybe even social contact. All of those needs are provided by young people. How is this separation supposed to work?
At this point, with COVID and the riots, its a matter of life and death.
You mean splitting into 2 countries (blue USA and red USA)? Then whichever country fares worse economically will find a way to blame the more prosperous one, and it could mean war.
of course that hasn’t really been the case over the last week or so.
… at very low risk of death, but there seems to be increasing evidence that some COVID-19 survivors, including children, suffer serious, and possibly permanent health effects.
Again, I fear people don't realize that this isn't a game. This is disastrously bad and getting worse every. single. day.
I don't believe any significant number actually thinks that, it's their counter to "everybody will die, the science is settled". They will aim for something on the opposite extreme, that is a pretty common reaction.
Imho: if you don't try to convince them that an asteroid is about to crash into earth, but instead tell them that lots of people are scared to death of an asteroid crashing into earth, they'll have a much easier time saying "okay, sure, I don't want them to be scared, I can wear a mask when I go shopping, I guess".
> Again, I fear people don't realize that this isn't a game. This is disastrously bad and getting worse every. single. day.
Where you live, maybe. Where I live, we haven't had a case in 10 days in the county of 330k people, we've had laughably low deaths to begin with, the curve was pretty much flattened the moment we went into constraints ... and we still have mandatory masks with no end in sight, and our local government still does not go back to normal mode, the trash is still getting picked up on irregular schedules etc.
It's neither disastrous here, and it's not getting worse. But a lot of people are still scared out of their mind. And we need to help them to breathe and calm down, and tell them that it was scary, but that it's okay to go back outside. And at some point we'll have to tell them that they need to go back outside because we can't keep society running around them without them.
Seasonal flu happens every year. Novel virus pandemics happen once per century. Seasonal flu is much more deadly, just spread out over longer timeline. And estimated covid mortality rate for my age group falls every week. I'm still not convinced it's measurably worse than the flu (for my age group).
The recent hydroxychloroquine is an obvious example [1]; The Lancet should never have published something with data so obviously questionable, and the media should not have picked it up so immediately as political ammunition. But the result is that the media appears to be "once again" lying to the public.
I'm only a layperson but it doesn't seem too far-fetched that they could extrapolate from how those countries "flattened the curve" to come up with a ballpark estimate of global fatalities averted. After all, other countries mostly followed a similar "curve flattening" pattern (as far as I'm aware).
At the very least, I don't see anything inherently disingenuous.
Side note: FWIW, the study itself says the authors last "updated" it on May 13th (not the data itself though it appears).
1. Density. China and South Korea are far more dense than most of the western world. Seoul has a density of 42,000 per square mile. New York City, the densest city in the US, has a density of 23,000 per square mile. The next top 10 most populous cities in the USA have an average density of 5,000 per square mile. Over half of South Koreans live in an urban environment, while less than 25% of Americans do. Density, and the number of interactions someone has in a day, is a major determining factor in the spread of any airborne virus.
Density also has implications for transit use, which in NYC was shown to be a large source of transmission.
2. Demographics. Italy, the United States and Sweden all have very different demographics and cultures. In Italy, many people live in multi-generational housing, and nursing home usage is far lower than the United States. The average age of Italy is also higher. Sweden is more like the US in terms of nursing homes, but still lower. As the older folks are far more likely to die from this, or even have detectable infections, the way each country manages their aging population will have a huge impact on mortality.
For example, people going about their day like normal, and then returning to their shared home with their Grandma would put Grandma at a much higher risk of infection. That is the Italy scenario. In the United States, where the old either live independently or in a group home, their vectors are much more limited. Test and trace everyone going to and working at a nursing home. It should also be noted that the areas if NYC most heavily hit are also more multi-generational than the rest of the city and country.
So see, you can't take one nation and extrapolate it out to the world. That is a faulty model and those who championed it should know better.
I'm wondering though, are you saying it because the study did indeed fail to account for all those factors or are you basing it my (probably poor) interpretation/description of it? :-) If you're going off my comments, I may have done a disservice as my laypersons understanding of the topic is pretty rudimentary.
FWIW, the study does indeed model other countries like the US and Italy so I'd be surprised if much of what you speak of was not taken into account.
I certainly don't think they modeled one nation and simply extrapolated that out into the world without other considerations. I apologise if my words gave that impression... Even I can see how stupid that would be.
Here's the link if anyone is interested https://www.nature.com/articles/s41586-020-2404-8_reference....
Not sure if you are comfortable with R or Python, but you can look at the code here: https://codeocean.com/capsule/1887579/tree/v1
They do not seem to be taking cultural or demographic information into account. A lot of the data is sourced from the Johns Hopkins data set and fed into an SRI type model, with some data about when and how strict lockdowns where.
It is actually pretty sloppy to be given so much weight.
Fully agree here. I'm aware of Heterodox Academy trying to tackle this problem in the academic world--is there an analog solving for media bias?
It's actually proceeding apace. By its very nature, being slick TV shows and edited textual content, it'll superficially look like everything's fine until the very end, but the layoffs continue to roll through, marginal outlets are closing, the viewership drops, the respect keeps finding new lows... it's still looking good and may even come sooner than you think.
This does not, on its own, solve the problem, but it makes the problem possible to solve.
In the UK the Daily Telegraph is giving back the government furlough/support money as it doesn't need it. So is The Spectator. Interestingly these are the right wing newspapers. Why give up free money? Because the government really needs it but the newspapers don't, given that they are profitable and subscriptions have been rising, not falling.
https://www.spectator.co.uk/article/a-statement-from-the-cha...
The Daily Telegraph has doubled subscriptions in March alone.
How about, we have national regulations for safe interactions, rules requiring ppe when appropriate, and available ppe. Your company has to provide it if you work together. It turns out its very very hard to provide ppe that protects people when they work closely together (see the meat packing plants, see hospitals). My families economic safety is also impacted if I'm dead or in the hospital with covid, even if they are all in your 'safe' category. Only a few 100 kids will die unnecessarily so we can open the economy?
[2] is a great article about how different cities in 1918 made various choices about socially isolating and the impact of that.
1. https://www.cdc.gov/flu/about/burden/index.html
2. https://www.smithsonianmag.com/history/journal-plague-year-1...
My point is, if you stratify death rates by age[1] you see that children are at a very, very low risk from COVID-19. This is the nuanced approach that universal lockdowns trample over.
You literally employed the "think of the children" fallacy[2] (technically appeal to emotion) when you know well that children are at a low risk.
I mentioned flu, TB, and malaria because they kill legions of children every year. TB killed 200,000 children in 2018[3]. Malaria kills .5 million children a year worldwide[4]. So don't tell me you care about the children. Unless of course you mean American or European children, in which case make your case but admit to yourself that you are viewing the world through a lens of personal risk, not actual risk.
Either you want to save the children, in which case we need to dedicate 20% of our GDP to combating TB, malaria and flu worldwide, or you only care about local children, in which case you are okay with burning through 20% of our GDP to prevent kids from getting a disease which isn't dangerous to them.
[1] https://twitter.com/daniellevitt22/status/126945491074919628...
[2] https://en.wikipedia.org/wiki/Think_of_the_children
[3] https://www.who.int/news-room/fact-sheets/detail/tuberculosi...
One of my favorite pet daydreams is trying to figure out a way of abolishing political parties altogether...
I think this is the wrong take away. The corona debate in Sweden is pretty healthy. Not very partisan and neither side has dug their heels in.
Roughly Conservatives don't like change (lockdown) Liberals like change (lockdown)
This “pox on both houses” post, in which you try to blame both sides equally (while also ignoring the fact that only one controls the executive branch of the Federal government), does not comport with my lived reality.
Yes, the (lack of) organized Federal response influenced the severity of the issue in the early days, but we can't lay blame at that level for what has taken place in each state since that time.
The issue isn't whether lockdowns work. Of course they do. People spread disease to one another, limit the number of people that contact each other and the disease will abate. That isn't what is worthy of debate. Rather, we should be debating if lockdowns are worth the cost, and what other methods could we use to mitigate the disease while still maintaining some amount of normalcy.
If we have that debate, it needs to be super local. Density is the driver of any pandemic with human to human transmission. NYC is the most dense city in the United States, and has a huge reliance on densely packed public transit. Dallas is incredibly sprawled and has very little transit use. They need fundamentally different responses.
It is this lack of nuance that is troubling.
This isn’t even close to complete, and it’s just the official response. I won’t even get into the totally catastrophic and shifting moral leadership we received from the White House, the weird stuff about opening for Easter. And ugh, the fact that close allies of WH cabinet members were deliberately funding astroturf “anti-lockdown” movements that argued for opening up even against the administration’s own recommendations [4].
Honestly, from your response I can only assume that you haven’t been reading the news since January.
[0] https://www.snopes.com/fact-check/trump-fire-pandemic-team/ [1] https://www.google.com/amp/s/www.nytimes.com/2020/03/28/us/t... [2] https://www.google.com/amp/s/www.vox.com/platform/amp/2020/4... [3] https://www.google.com/amp/s/amp.cnn.com/cnn/2020/04/30/poli... [4] https://www.google.com/amp/s/www.nytimes.com/2020/04/22/opin...
However, that does not change where we are today. It would have probably helped us get to "today" a lot earlier, and it would have probably saved many, many lives which were unfortunately lost. But my argument is how we respond _today_ to new information, and how the partisanship endemic in our culture today does not allow for us to pivot in a meaningful way. If we knew what we know today 160 days ago, I doubt we would still want to lock down in the same way that we did. But unfortunately, despite now being armed with that knowledge, we are not pivoting on the plan we made back in March.
Even our knowledge of treating it has improved. The CFR is down across the board. We now know oxygen replacement therapy is better than invasive ventilators. We know that a majority of the spread is in nosocomial or in nursing homes. We know that remdisivir shows promise. We know that treating with anti-inflammatory drugs is helpful. We know better ways to prevent cytokin storms. We know better how to respond to clotting. Focusing just on the ventilator learnings, we can treat people with oxygen replacement therapy without them being in the ICU, while invasive ventilator treatment requires an ICU. This lowers the number of ICU beds needed, and thus should shift the hospital capacity discussion.
But I am seeing none of that. It is all partisan bickering over "full lockdown" or "full reopen" and both sides claiming the other is "anti-science"
I will ignore the personal attack, beyond saying that questioning someones understanding of a topic at such a basic level has no place in proper debate.
I don't know how to respond to that - I technically agree with you, the loudest least educated voices probably wouldn't have wanted to lock down. The lack of info and the panic level probably positively contributed to saving more lives. I'm totally okay with that. I believe that knowing then what we know now, we absolutely should have done what we did, and then some. We didn't have enough testing capacity. We know that if we had locked down even earlier, we would have saved a significant number of additional lives.
It's true that part of the argument was based on hospital capacity. But the models today are still consistent with the view that the capacity in many areas would have been overwhelmed in many places had we done nothing. I think the key there is that civilians were going to "do something" and stay at home even if the government didn't tell them to, no matter what.
> But I am seeing none of that. It is all partisan bickering over "full lockdown" or "full reopen" and both sides claiming the other is "anti-science"
It's best to step away from that kind of absolutist language (none, all) - it just tends to bait people.
Please keep in mind also, that for states that are not in (NY, NJ, CA, MI, LA) there hasn't been a _first wave_. We need to keep that in mind before we point to states like FL and GA as having a 2nd wave. Their waves were largely curtailed by the stay-home orders in place. We need to either admit we want these orders to last until there is a vaccine, or increase our threshold for acceptable case levels.
Now there’s superficial (early) evidence that many of the low-cases states are entering a second stage of exponential growth. There may not be much room for us to simply manage the caseload at some “acceptable level” if those states really catch fire. The problem is that the only tool we have to manage this — if indeed it bears out and hospitals become overwhelmed - is another lockdown. But the lockdowns have become a political hot potato, and at least one side is dead-set against them. It seems unlikely that we’ll be able to use this tool again until things get Very Bad.
Compare this to most of continental Europe, where both high-case and low-case nations have succeeded with lockdowns, and governments are moving into a phase where careful management is likely to control the epidemic entirely going forward.
I don’t think this is an actual strategy. If there is a diversity of views, which experts do you listen to? Also, experts in which field? Epidemiologists have generally recommended very strict shutdowns, but they are not economists and are not experts on the economic ramifications. Some economists agree with strict lockdowns, others do not. So it’s not at all clear what “listen to the experts” means in this case.
The epidemiologist isn't trained in thinking about the persisting scar on opportunity left by lockdowns. A response to a pandemic that solely cares about limiting lives lost due to the virus stands to inflict massive harm as people lose their jobs and social unrest triggered by the suspension of civil liberties.
Medical professionals are experts in medicine. Not in making holistic decisions about the course of society. They absolutely should have a prominent spot in sharing information with the leaders of society, but their advice needs to be weighed against the costs of carrying out that advice.
https://www.nytimes.com/2020/04/14/opinion/coronavirus-reope...
> Why WOULDN'T we consider the economic ramifications?
He's not saying that. He's talking about who should be giving the marching orders. Let me put it another way: in a war, the generals decide what equipment the military needs and the economists figure out how to produce it. You don't have the economists saying: the economy is good at making buses, it makes sense to us to weld extra armor to them rather than to design a tank from scratch, so go fight the war in armored buses.
You're leaning a bit too hard on the analogy: you can't negotiate with a virus. The pandemic is more akin to an attack by an irrationally implacable enemy with a couple months advance warning of the threat at the border. In the analogy, the policy options are: resist, Y/N? If Y, then how effectively?
When a country is attacked, does its leadership typically first consult with its economists to determine if resistance is cost effective vs. just letting the enemy take territory or kill citizens with little opposition? Usually the generals evaluate what they can achieve, and if success unachievable, then alternatives are considered. Surrender is always an option, but it's usually towards the bottom of the list.
Yes, countries very often let the enemy take territory or kill citizens because resistance wouldn't be cost effective. All countries of course try to project the image that they wouldn't, that their territory and the lives of their citizens are priceless. But border skirmishes happen all the time and the vast majority of them don't lead to war.
Now look at Texas where their daily positive covid 19 detection has double in the past weeks from about 750 a day to 1500 a day. They are going to have a lot more people getting really sick, because that just following from daily exposure. See https://www.worldometers.info/coronavirus/usa/texas/ (go to daily new cases in texas, click on 7 day average). You can se e the same data at rt.live (find Teaxs, click on per day).
See https://www.covidexitstrategy.org/. As you see on this page, many states are increasing absolute number of tests - Texas is actually steady for a week at around 18k tests per day. But the % of people testing positive is increasing (see that same website).
On that page scroll to 'how is my state doing on testing' and look at Texas, it's interesting to compare states. Notice last week number of daily tests was around 18k/day. Test positivity went from 5.5% to 7.7%.
This isn't a political issue, it's just the actual numbers. Compare to say Wyoming (increased tests unlike Texas from 472 to 690 per day, test positivity went down there). Oregon is getting worse (2.4k tests/day, in the last week 1.5% to 3.4% of tests are pos).
Texas is having increasing covid-19 positive tests, it's not from increasing the number of tests and icu bed space is going down. This website gives the data source so you can look at it yourself.
Oregon recently had an outbreak at a seafood plant, and retirement center. The seafood outbreak infected around 125 people, the retirement center around 35. There is also a smaller outbreak at a food processing plant in Washington County, with I believe 5-10 infections.
Here is the secret, Oregon is _now_ doing contact tracing. So _everyone_ at Pacific Seafood was tested, despite a vast majority showing no symptoms. These people would _not_ have been tested two weeks ago. Two weeks ago, testing was generally voluntary and people would request tests if they felt they needed one. Now, people who have confirmed interaction with infected individuals are being tested by state mandate. So of course, now Oregon will have more cases discovered and more positive tests.
You see how your "actual numbers" still don't tell the whole story? There is context in every single state, city, county that you miss just looking at raw numbers. Without that context you make generalizations about what the data is telling you. Stop that.
Yes, Texas should be watched, but the health authority in Texas does not seem to be worried. My own governor, Kate Brown, who has taken this (imo) too seriously, has stated publicly that she _fully expects_ an increase in cases over the coming weeks as we reopen. But now, we have the hospital and treatment capacity to handle it.
And about the Texas example, where ICU beds are decreasing. The site you linked does not seem to really mention what those ICU patients are in for. When states reopen, so do car wrecks, workplace injuries, major surgeries etc. A bypass surgery will require a few days in an ICU, so now that major surgeries are happening again, of course ICU capacity would be taxed. Again, as I've been saying, you lack context. This time last year, what was the ICU bed utilization in Texas? Now that we see that intubation and invasive ventilators actually worsens outcomes, how many COVID patients can be treated _outside_ of an ICU?
As I said in my original post, we are not updating our metrics to meet new understandings. ICU beds are a silly metric now, but they sure are scary!
Yes but (assuming I understand your point correctly) the U.S. federal government isn't in control of the country either in this context. They certainly could have been more cooperative with states in terms of distributing supplies and communicating new developments as they came in but, short of bringing in troops and asserting themselves by force, they lack the authority to implement a hard nation wide lockdown. Given the early panic over the virus it's hard to imagine a federal level quarantine not resulting in violence.
>No one would say NY would be better off if they hadn't cut it down a lot and shut down.<
I'm not sure if I phrased my first post badly or if we agree here. When I said the lockdowns were egregious compared to Rep. states I was speaking relative to the present. I agree things would have been much worse if early and cautious action hadn't been taken.
>Now look at Texas where their daily positive covid 19 detection has double in the past weeks from about 750 a day to 1500 a day. They are going to have a lot more people getting really sick, because that just following from daily exposure.<
This is basically the entire national debate. We've seen increasingly that just getting the corona virus isn't a death sentence for most people. Texas' infections have been rising, which will by extension lead to some amount of additional deaths, but Texas also has an extremely low death toll compared to other states in terms of deaths per million people (going by Worldometer). The significance of this is that most infected arent going to die and dying after infection, for the most part, isn't a random lottery and so whether it's wise or not to continue to force people to remain in lock-down is a value/political judgement rather than a distinctly scientific one. This holds especially true when people in need are refraining from visiting hospitals for fear of getting the virus and instances of depression and suicide have risen dramatically as a consequence of lock-down policies. You can argue fewer people might still die with heavy lock-down measures in the present but those deaths arent the same people and so what's ultimately being dicussed is whether or not it's fair to drive certain individuals to death or unnecessary physical suffering in order to save people they largrly have no relation with. And that's before discussing the small business owners who have lost their life's work due to government mandates (consumers didn't stop going out by choice after all).
My point about the parties themselves was purely meant to highlight that at this stage both sides could probably be managing their policies better (regardless of value distinctions) but neither wants to make it look like the other team was correct. The irony is that neither side would be taking the same actions since for Dem states like California this would be loosening up a little while for Rep stated it would be tightening up or at least implementing financial support for at-risk individuals and their cohabitants. From here, my broader point was that it's an election year and so, regardless of if any particular state is actually beholden to a particular plan of action, anyone who breaks too far off from the party line (in a manner that risks bad optics) is going to lose clout within their party. I'm not endorsing that as the way things should be but that's the apparent state of things going by the predominantly partisan split in terms of current lock-down action.
As the article somewhat loosely implies, the problem is that all new data becomes suspect when all of our institutions are openly politicized.
You think these biases only exist with respect to COVID? The marginalized right (consider the viceral response you're about to have to reading these next sentences) has been saying the same thing about academia for at least a decade. That goes for climate change and much of modern psychological theory. And no, these aren't extreme far right Nazis/incels as people like to stereotype, these are near center moderates, these are (typically in the minority) doctors, scientists, engineers, this is the so called silent majority that is denied a voice on most modern platforms. And part of the reason that our society is gridlocked is that the majority has decided that this minority is not allowed a voice because in a one dimensional two party system one side falls closer to morally repugnant views, so we throw the baby out with the bathwater.
Our institutions are collapsing because actors are no longer operating in good faith. And those in power believe there are morally justified in suppressing opposing views.
Edit: and I'd like to add, another contribution to gridlock is the tendency for black and white thinking that at this point I'm starting to accept is extremely common human nature - there is a world of nuance between criticism and outright denial that is inevitably ignored almost any time someone expresses criticism for, say, climate change resources or the media (explicitly not scientist) derived predictions.
I agree, groupthink is a natural artifact of groups. If there are more liberal people in a group, their groupthink will be more liberal. Couple this with confirmation bias and we have a problem. Couple _that_ with the fact that there are actors, both from a profit motive and for other motives, that are attempting to exacerbate and increase that divide, and we have an even larger problem.
The right has also raised awareness about this in the media, and I (moderate liberal) couldn't agree more. We can't begin to really solve these problems and get everyone on board so long as we have openly partisan epistemological institutions--bias is the enemy of truth and we're maximizing it when we should be minimizing it. Those on the left will be quick to accuse the right of being anti-science and there's certainly some truth there, but I'm very suspicious of the idea that the falling political diversity is a function of the right selecting out of these fields rather than explicit or implicit discrimination (and at least within certain fields of academia, preliminary studies indicate a majority of faculty are willing to openly admit that they would discriminate against conservative candidates).
EDIT: I’m definitely not being downvoted out of the same kind of partisan tribalism that TFA is calling out. ◔̯◔
As a card-carrying (ANTIFA, laminated) member of the left, I consider countries like Austria, South Korea, or maybe Germany the gold standard: lockdown, yes, but continually adjusted, exchanging the most draconian measures with lesser ones when more knowledge allows more targeting, or when infection numbers sink.
All those countries have now effectively exited lockdowns, at levels of single-digit daily deaths. This allows further lockdown-free reduction by amassing resources for contact tracing every single infection.
Meanwhile, the US, UK, Brasil, and other countries are seeing thousands of deaths daily because they stopped maybe two or three weeks too early, and/or did it half-heatedly and/or failed to use that time to stand up alternatives to lockdown.
This has won them absolutely nothing, economically, as far as I can tell: Germany is at +3% unemployment (6.6% total) while the US is on >15%. And except hoping for the weather to make a difference, they will either continue to see people dying and incurring the cost of people self-quarantine. Or they'll change course, do another round of sustained lockdowns after all, and use that time to think of an excuse for wasting three months and 100,000 lives on a thought process that took competently managed countries the better part of the last in-person meeting they had this year.
Does it help to jump to conclusions about the cause being lockdown variations, or weather, or sunlight, or political leanings?
Anybody can cherry-pick their example countries to support their argument, but so far I can find counter-examples to their points whenever I look. I do agree lockdowns have their place (e.g. New Zealand has eliminated the disease using a lockdown, and the Asian success stories).
Of course, there are multiple causes, and trying to pin variation in infection rates or deaths on a single factor would be silly. Hopefully we find the driving factors... Spring or vitamin D could explain why Italy doctors are opining that the disease is less deadly now than in March.
This isn't a game. This has life and death consequences so far beyond COVID-19, and the lack of foresight that the partisans are demonstrating will have reverberations for generations. We are playing the life of real people, we are risking the financial security of real people, who have families and debts and dreams.
Finally, the fact that the public health sector has devolved into partisanship really has me worried for when we _actually_ have a repeat of Spanish Flu, or a more virulent Ebola etc. Then we are screwed.
Edit: fixed a typo