I actually chose stomp over eradicate because I wanted to imply that there would still be some left but that it would be a manageable amount. That's interesting that you took it the opposite way; I'm sorry for the confusion.

I agree, eradication was probably impossible in the United States. What I thought we all agreed on at the start of this thing was to lock down so we could "flatten the curve". Remember that? While we were locked down there would be an enormous marshaling of resources so we could equip everyone with PPE/Masks, get testing going, and do contract tracing. But because we didn't lock down the entire nation we snuffed out the hot spots in Washington and New York but let new ones fester and they are now out of control.

> because I wanted to imply that there would still be some left but that it would be a manageable amount.

Go for "decimated" next time, rare to see it used right ;)

Decimate means you kill 1 out of every 10. It's probable that we decimated the virus and more. It's just that doesn't really make a difference.

Decimate means leaving 1 out of 10 alive. A 90% reduction.

> Decimation was a form of Roman military discipline in which every tenth man in a group was executed by members of his cohort. ... The word decimation is derived from Latin meaning "removal of a tenth".

No it doesn’t. Look it up.

As in 10% reduction?

JFK international airport is a 20 minute ride from the heart of Manhattan and we have a "transportation security agency" that can't find physical contraband in a suitcase much less be expected to be gatekeepers of health for the nation.

Suppose we drastically lower transmission. How many times should NYC and the surrounding areas be locked down because someone flew in from a country with loose contagion protocols?

Besides waiting for a vaccine and mass infections of those unwilling or unable to stay at home, I haven't seen a concrete proposal from anyone on what we should have or should be doing next.

Logistically, it's easier to force everyone arriving into mandatory two-week quarantine, than finding a contraband whatever hidden in a sea of suitcases.

What's lacking is political willpower.

Australia does this. The border is somewhat porous, but it's worth mentioning that Australia is worrying about hundreds of cases right now.

Close the border, it's as simple as that. All countries that were able to lower infections did this.

In Europe this was done even between neighboring countries both part of Shengen.

Here in Canada it was even done between provinces. My region has a bubble of four small provinces with few cases. But even so to travel across a provincial border in the bubble you will need proof of residency.

We didn't snuff out hot spots. The virus was/is still in NYC and Washington. No matter how long we locked down for it would still be there waiting to emerge after the lock down ended. That was the problem with the lockdown. It was touted as a solution when its just a delaying tactic.

Schools are the same. Keeping them closed is just a delaying tactic. And like the lockdown, unless we delay until a vaccine then it's a pointless delay.

I don't remember lockdowns being touted as a solution. I always understood it as a delaying tactic so things could be brought back under some control. Flatten the curve and all that. NYC didn't eliminate the virus but they've kept their curve flat so it's not getting out of control again.

This delaying tactic is all we have for right now, its likely saved thousands of lives, and that's not nothing. What is your plan for the next stage?

You’re right, that was all we could arrive at at the time. We don’t have the plan that says test everyone once a week, support the folks who need to quarantine as a result, and really fence this off for 3 months til it’s down to little pockets. We don’t have a plan that says follow the regions, the counties, the communities, and work hardest on suppressing it where it was and where it was heading.

We did choose a bad option, now people who’ve been locked down are exhausted and ornery while the ones who didn’t are finally getting the idea.

And for some reason “no shirt no shoes no service” is well understood, no blowing secondhand smoke is accepted all over, but the right to infect is held as culturally important.

It's not clear what the impact of the lockdowns are. You say that they've saved thousands, but in a lot of places we are back to where we were before the lockdown. Or even doing worse. I suspect that the lockdowns delayed deaths, but in most places will not have substantially reduced them.

The plan for the next stage is all of the public health measures that other countries have used to contain it. Masks, hygiene, social distancing, contact tracing, etc.

At this point we know how to stop it. Compliance is not there and every day that passes it goes down.

What are you suggesting is a delaying tactic? What is the thing being delayed?

The delaying was so that we 'delayed' or avoided overfilling the hospitals and causing a lot of secondary death and damage. Delay people getting sick, reduce the max. Spread the infections out over time.

I don't think that's necessarily what the person I replied to is talking about, given their language, which is why I asked.

Well if you take eradication off the table, then you have to assume the entire susceptible population will eventually get the virus. So I guess, I don't see the benefit of "stomping" the virus down to some small level. It was at a very small level back in February, and then grew. If we get it back down to that small level, it will just grow again. There's no benefit to locking down for 3 months to have it grow in July instead of March.

A controlled burn approach makes a lot more sense, but that is not the same as "stomping" the virus.

Stomping the virus down to a manageable level so it doesn't overwhelm hospitals was the main goal of "Flatten the curve". We actually succeeded in quite a few hot spots to do this - NYC being the biggest example. Covid still exists there and people are still dying but it's not out of control. If you stay on top of it, it doesn't just grow again.

I'm not sure why you say there was no benefit to locking down. It clearly did wonders for NYC. It's likely that thousands of people were saved by this action.

What you're describing may be a controlled burn approach under a different name. After a certain point, the virus infects the entire susceptible population, and then it stops because everyone susceptible has died or obtained immunity.

Suppose 30% of the population is susceptible to covid. If lockdown policy slows the spread of the virus to 1% of the population per month, it would take 30 months before the pandemic passes. That's a very long time to do lockdown, very damaging to the economy and people's livelihoods.

I've read a lot about overwhelmed hospitals. I'm not clear on if it's happened in any widespread fashion. The media coverage tends to emphasize the bad cases and ignore the boring cases. It doesn't seem like people are unable to get medical care. I have checked the Texas online dashboard now and then, and currently about 10,000 people in a state of 29,000,000 are hospitalized with covid.

Texas dashboard: https://txdshs.maps.arcgis.com/apps/opsdashboard/index.html#...

The logical policy would be let the virus pass through the population as fast as possible without overwhelming hospitals, given the specifics of any geography.

I'm sorry but you making one incorrect assumption after another.

No, it would not be logical to let the virus go. It would kill some people and causes other health effects. We don't want a few million deaths. Plus now there is clear evidence that some people don't have antibodies after they get it, a few months later, and this is not completely unknown in other diseases. Some people have some protection though. Plus there are people who get it a second time as far as we can tell.

There are not infinite number of hospital beds. In NY they were past the limits for a month, killing med staff and also ptsd for them. This was barely avoided in Seattle. It's happening now in Houston. The people sick with cv19 are blocking others from being treated, and some people stay home. The hospitals financial plans start to fail because all the other medical procedures are stopped because its dangerous to be at the hospital and they are repurposing say dermatologists to work in the cv19 wards.

I think some of what you are saying is true, but you may be lacking some balance in your sources of information. For example you say:

> It would kill some people and causes other health effects. We don't want a few million deaths.

A few million deaths would be in the 2-3 million range. This doesn’t seem realistic based on the data we have so far. About 140,000 people in the United States have died from the virus after about 5 months. It would require a 20x increase to have 3 million people to die from it. That seems like a really big reach.

> There are not infinite number of hospital beds. In NY they were past the limits for a month, killing med staff and also ptsd for them. This was barely avoided in Seattle

To be frank I've stopped caring enough to follow the news in detail anymore (which itself probably says something), so I don't know whether the rest of your comment is accurate or not. However, I can attest firsthand that this part pertaining to Seattle is completely false.

I live in Seattle and have had multiple friends/family members hospitalized with covid19. We were nowhere close to overwhelming hospital capacity. At the beginning of all of this, we had a massive field hospital in Century Link stadium set up and shut down without seeing a single patient, as well as a hospital ship which was supposed to harbor here but ended up being redirected (I believe to Los Angeles) because we didn't need it. Even now with the resurgence that's been happening, our metrics around ICU utilization are where we're performing best:

https://coronavirus.wa.gov/what-you-need-know/covid-19-risk-...

Metrics | Value | Goal | Meeting Goal

Percent of licensed beds occupied by patients | 60.3% | <80% | Yes

Percent of licensed beds occupied by COVID-19 cases | 3.7% | <10% | Yes

Other sources -

Field hospital being set up in Seattle: https://www.king5.com/article/news/health/coronavirus/centur...

That hospital torn down 2 days later with no record of serving a single patient: https://www.king5.com/article/news/health/coronavirus/centur...

U.S. Navy Hospital ship originally meant for Seattle redirected to Los Angeles: https://abcnews.go.com/Politics/us-navy-hospital-ship-depart...

---

I'm assuming good faith and that you're simply worried just like everyone is, but you are spreading misinformation here. Again, I can't really attest with good knowledge to anything other than Seattle, but the fact that you are wrong about that makes me skeptical of the rest of your comment.

Effective testing and contact tracing is sufficient to dramatically reduce the spread of the virus.

If we're a year away from a vaccine or treatment, then we don't need to burn down society to stop it this month. But if we act in a way that causes millions of infections, we're inflicting unnecessary harm on thousands.

We've also learned more about how to keep people alive and how to slow the spread of the virus since February, so it's useful to postpone that exponential growth as long as possible.

If you stomp it down enough then a few relatively light measures (masks, some distancing, some contact tracing) are enough to keep it down. That's what's happening in Europe right now. Sure, eventually everyone would be infected at least once given infinite time. But that doesn't matter, what matters is how many people get infected before a vaccine is developed and widely deployed.

If you keep the infection rate low enough you can keep the hospitals from being over capacity and also delay infections until after a vaccine is developed and administered, thus preventing the infection. Both of these states would have the benefit of reducing the total number of deaths. When the lockdown talk started, I thought that was the point.

Time does wonders. We have much better knowledge of treatment options than we had in March, which makes a real difference in lives lost. And eventually, we might (might!) get vaccines. So the longer the curve is flat, the more time we have to learn and craft better interventions.

https://www.nytimes.com/interactive/2020/science/coronavirus...

It appears to have worked for New Zealand, though notably, not anywhere else, even Australia.

So you can argue that it was infeasible, and I would have to agree with you. But you can't argue it was impossible.

Not infeasible no, I agree.

But, if you want to know what draconian policy really is, you can look at NZ. That place is no joke. It's state-managed isolation or a quarantine facility for at least 14 days and until you test negative.

There are a bunch of reports of people breaking out of these facilities after having been there for more than a month. Just zero chance this would work in America.

Thats overstating it a little. or even a lot.

Nobody has been in those places for more than a month, its 2 weeks.

The 'escapees' so far have been an alcoholic (went to the nearest bottle store) and a couple of people with mental issues.

The REASON those people escaped is because the places aren't prisons, or even close. They were hotels, high quality hotels in some places...with no police presence at all...

There was a bunch of fuss made by the public because it was eventually realised that people were being allowed out without testing to attend funerals under a compassionate exemption.

Your description makes it sound like something very different to the reality.

Its toughening up a little now, because everyone in NZ wanted them to toughen up, but for a long while the reality was that all you had to do to leave was decide that you wanted to leave.

Most people didn't, of course, because most people aren't dicks.

Island.

Yes, exactly.

But Australia is also an island, in the relevant sense for this discussion, and didn't succeed in eradication.

Hawaii also had considerable success, albeit recently undermined. Much to my chagrin, since I live here.

My conclusion is that eradicating this virus is very difficult, even with all the advantages.

But again, not impossible.

Adding an Australian perspective here. Our politicians did not share the same approach as New Zealand (which started with a level 4 lockdown and stayed there for 6-8 weeks). The approach here has certainly been more unified than the US, but states are encouraged to pursue their own approaches, with some states (WA, SA, Queensland) having much more success than others (NSW, Victoria). The plan here was never to pursue eradication, but to flatten the curve and keep infection rates manageable. I wish we'd considered eradication more seriously. As a country we have the resources to support the country through that 6 week period, and the national government would have done a decent enough job in ensuring the population had sufficient support through that period.

Australia's is an interesting case because the recent spike coincides (~2 week lag) with the lifting of most of the restrictions. It's also only really spiking in one state (although NSW may be slipstreaming Victoria).

This is evidence that the lockdown rules were having a significant effect on suppression, and eradication may have been within reach had the easing been delayed another month or two.

Sorry is the implication that the US is in the state it’s in because infected people are continuously walking across the border and infecting more people?

If no, then being an island isn’t really relevant here.

No, it’s because 100 different people (according to genetic studies) started separate chains of infections in New York City due to international travel, immediately overwhelming any efforts to do contact tracing.

I invite you to spend some time with Hawaii's COVID statistics before coming to the conclusion that being an island, or not, is irrelevant to US outcomes.

https://www.hawaiidata.org/covid19

Vietnam. Long border with China, two million people cross every year, population of 95 million, zero covid deaths because they got serious early and everyone more masks.

There is absolutely no chance that they had 0 covid related deaths anywhere in the country of 95 million. None. Not to say that they didn’t act well and where prepared though.

Perhaps not, but Western reporters have confirmed that they're not noticeable problems at all.

Complete eradication is not what Europe nor China are doing and have better results.

This. And maybe we shouldn't trust China's reported data, but Europe is almost doing miraculously well if you compare to the USA. Not going for eradication, but containment.

With containment, everything else is possible (healthcare system not overloaded, economy can be opened up, schools can reopen, etc.).

The US has capitulated completely, and even containment isn't really on the table nationally; on a state-by-state basis, some states may achieve a level of containment, but others are simply not even trying (or like Georgia, actively banning containment measures like local mask enforcement orders).

> but Europe is almost doing miraculously well if you compare to the USA.

This is totally at odds with the data. The UK, France, Spain, and Italy, among others, have higher deaths per capita than the US.

Providing a source to confirm your statement: https://www.statista.com/statistics/1104709/coronavirus-deat...

IMO, the US will almost certainly make up a lot of ground on the deaths per capita metric (or leapfrog entirely), given the explosion of new cases starting in June and the lagging growth in deaths that comes after cases. Scroll down to the "Deaths" section with the weekly per capita "heat spectrum" of sorts, and the US recently has reached red hot over the past few weeks, while European counterparts have been much cooler: https://www.nytimes.com/interactive/2020/world/coronavirus-m...

Older populations?

That helps, but at least for Spain and Italy, the hypothesis seems to be that the virus was already widely spread by the time lock-down started, so a lot of transmission still happened during lock-down until it got under control. I think it's the same for UK and France. but I'm less familiar.

Other EU countries like Germany, Austria or Poland fared much better than Spain, France, UK and Italy.

Maybe different cultures (e.g. how people relate, how compliant they are, how many people willingly ignore measures, etc.) also play a role.

Where in the US is the health care system overwhelmed?

Texas https://www.texastribune.org/2020/07/14/texas-hospitals-coro...

Arizona https://www.azcentral.com/story/news/local/arizona-health/20...

Florida https://www.theguardian.com/us-news/2020/jul/10/florida-coro...

Georgia https://www.npr.org/sections/coronavirus-live-updates/2020/0...

Right now, I'm aware of problems in Texas. Don't know how widespread or if other states are, though.

The main thing Europe is doing, is border lockdowns. Some borders are open, but in general only those to countries with low Covid cases. Other travelers get quarantine, policed to various degrees.

All of this is completely unworkable in the US.

It's not really clear they are having better results. I don't know what the numbers are out of China, but certainly in Europe they had really big outbreaks in Italy, France, the UK, Spain, and other places as well. Their outcomes are pretty similar, in terms of deaths per capita, to the United States.

I think most media outlets are over-emphasizing the impact of government interventions, and under-emphasizing the impact of other factors that affect the severity of the virus. These could be factors like the health of the population--do they have a lot of smokers? obesity?, the age of the population, or other factors like the use of public transit.

It's appealing to assume that the most important factor in deciding outcomes is government policy. This is reassuring because we (society) can control government policy. But I haven't seen any good data to suggest that government policy is the most impactful factor compared to other hypotheses.

> Their outcomes are pretty similar, in terms of deaths per capita, to the United States.

Except that they are all now on downward trajectories while being more open (as opposed to the US, which is on an upward trajectory). Travel is allowed in Europe. Schools are open. Bars are open. And they are still on a downward trajectory.

And furthermore, there are locations in the United States that have handled the virus pretty well and are powerless to stop people from coming up there and messing it all up.

“Mike, from Old Town, who did not want to share his last name, ordered a vodka Red Bull before getting back in line with friends at Old Crow Smokehouse’s curbside bar. He had just gotten back from a vacation in Dallas, Texas, with a friend, where he left a day early due to the spike in cases and the state’s rolling back on its openings.

“[It feels] like I’m the problem,” he said with a nervous laugh as he talked about being out and about amid the pandemic. Looking around at the throngs of people drinking and walking around Wrigleyville, he said it is concerning.”

What the hell are we supposed to do about that with zero national plan? All the local shutdowns in the world are useless unless we can put the interstate commerce clause on hold for a bit.

> What the hell are we supposed to do about that with zero national plan?

Looking at California, a state where borders are mostly in remote areas that aren't especially porous (compared to NYC/NJ), there's still be a huge surge, and nothing points to borders being the reason. It's mostly state and county-level policy. States around NYC seem to have stomped it down relatively well, despite there being three states involved.

The US is huge and diverse, so you're not going to get a "national plan." The best you can hope for is guidance.

The one national level thing Trump could and should have done, but didn’t, is ban international and interstate travel.

> as opposed to the US, which is on an upward trajectory

You have the wrong scale in mind. The US is closer to the EU than a single country here - individual states have totally different trajectories. For example, Illinois, where I am, looks like those European countries that were hit hard early and is also opening up.

Except that big outbreaks were used as learning experience by other places who managed to contain issue before it became big and are opening now. While having enough testing capacitiy and experimenting with exact rules that allow them to open up.

No place in the world is handling this as poorly as we have. Well.. maybe Brazil?

What about Iran?

The US has higher case and death counts than Iran, both in absolute terms as well as per-capita. The US also looks to be on a worse trajectory.

Yeah, based on the self reported numbers out of Iran, which you can trust about as much as you can their state news agency on any number of topics. Let’s not forget they were simultaneously denying the virus’ prevalence while their political leaders were dropping like flies and they were digging mass graves that could be seen from space.

With the White House issuing orders for hospitals to report directly to them instead of the CDC, I'm not sure how long we'll be able to trust the US numbers.

Iran managed to get over a first wave, but they had to re-open prematurely because their economy is in the toilet partially due to economic sanctions.

The same thing is experienced in Turkey without economic sanctions...

Other countries have done far better than the US. We could have done the same.

But if everyone had stayed locked in for 6 weeks and if that had prevented 50000 deaths, how is that not worth it?

It depends on the denominator. There is no free lunch. If there is an estimate for death prevention, what is the estimated cost in lives?

Given that death is a certainty for all, how many lost person-days do the 50k deaths represent? Since the lock down means no normal activities such as routine doctor visits, how many person-days would be lost due to undetected illness or delayed treatment?

Staying locked in is a strategy for preventing excess deaths from overwhelming a health system. It isn't a long term strategy for eliminating all virus related death.

Here's the other side - How many deaths are acceptable? If death is a certainty for all, should we just get rid of the health care systems? Should we stop research into some of the diseases? Which ones? How many person-days/productivity has been lost because of preventable deaths?

We are talking about a 4/6/8 week lockdown, that's not long term, that's immediate term.

No, no, please don’t waste time constructing persons of straw. One insinuating that my position is “get rid of healthcare” is especially odious since the counterfactual I raised was one considering impacts of preventative care missed due to lockdowns. You made a rhetorical claim: “locked in for 6 weeks and if that had prevented 50000 deaths, how is that not worth it?”

How do you know if it is worth it or not if you don’t know the cost of being locked in for 6 weeks? Ignoring the other track doesn’t seem a path to a well considered decision.

https://en.wikipedia.org/wiki/Trolley_problem

So you make an exception for essential services, and count health care as an essential service. Tune the lock down so that it makes sense.

I'm not sure if it's worth it or not, but after you end the lockdown, you have the same situation you did at the start of the lockdown.

I think there's a huge misconception in many media sources that lockdown will somehow eliminate the virus. It can change the onset pattern of the virus, but that's it.

It's amazing to wonder whether any step, any inconvenience is worth saving even lives when the magnitude of that is in the thousands. Countries have literally been bombed over far fewer deaths.

> Countries have literally been bombed over far fewer deaths.

This virus, itself, isn't anti-American or "terrorist" enough for the U.S. to wage war against, yet it's far deadlier.

Such a good point. Ppl really do not seem to understand this.

One of the main points of the lockdowns were to get the infection rate down to a level where testing and tracing is tractable, not to outright eliminate the virus necessarily. It seems like most states in the US were not prepared for that when they decided to open back up, and now places like FL are in this impossible situation — how do you trace 10k+ infections a day?

Especially if it takes a week to get a test result.

The way that tracing was presented bred a lot of mistrust at least in the midwest.

Even if the US is in the same situation now as we were at the start of the SIP orders in March, given that many other advanced countries have the virus under control, we should have an easier time getting materials and equipment to deal with the virus now.

Plus we have more evidence to base our decisions on. We can look at specific other countries and see what works, assuming people don't turn it into politics like they did with masks. It's really sad that some people believe wearing a cloth mask decreases your blood oxygen saturation, regardless of their education or previous interactions with doctors/dentists/etc that already wore masks on a regular basis pre-pandemic.

How could that possibly have happened? Food needs to be planted, harvested(in many situations primarily by migratory workers from other countries) and delivered, power needs to be kept up, necessary medical supplies needs manufactoring, water needs to be cleaned and delivered. There's no scenario where the world gets to collectively take a break

Right, but the world could have refrained from partying on the beaches [1]

[1] - https://www.usatoday.com/story/travel/news/2020/07/16/vacati...

Did beaches make a difference? They did that in Florida during spring break in March, but Florida has low cases until just recently.

Weren't the spring breakers mostly from out of state?

They could have also refrained from protesting and rioting over a demonstrably false narrative of death-by-police.

And beer must be drank "Bar lives matters", as Austin Texas bar owner said.

But if everyone had of x for y weeks and that prevented z deaths, how is that not worth it?

x=stopped driving y=52 z=34,000

or

x=not gone skiing y=4 months z=41

I'm not sure where the line is, but there are a number of things we could ban to lower the death rate. That doesn't mean I disagree with your assessment, but I'm just not sure I have any logical cut off point for what I would support and what I wouldn't other than just the way it feels looking at the numbers and how much it inconveniences me personally. (And I happen to like lockdown...)

If you're talking about US, that's 275,688 person days in lockdown per death prevented, although that seems so extreme I'm afraid my math is off.

Is this a serious question?