Sorry, the risk of a relaxation is that you get 500 new cases, and they turn into thousands. What then? The thousands turn into tens of thousand. Of course, tesating and tracing will check it.
Probably true, quetz. Unnderlying that is a worrying increase in deliberate irrationality. "Bloody intellectuals, what do they know? I was never all that great at maths but it hasn't stopped me getting on".
Yes, the lockdown is working, because it's reducing the R0 to below 1. But without accurate statistics, by date and by cause of death, then any decision made on when to relax or end the restrictions will inevitably be made on false assumptions.
If the FT is right, and we've had over 41,000 deaths, then the numbers might be falling, but from an unacceptably high level that precludes any loosening of the ties.
The lockdown is working because fewer people are getting infected, but that does not change the R₀.
The R₀ is how infectious a disease potentially is, not how many people are actually getting infected at a given time.
You just copied and pasted that from wikipedia without ever understanding it. Well done.
R0 has two modes, basic and effective. The effective R0 is literally what every layperson is talking about when they talk about R0 - the actual rate of transmission.
Effective R₀ from healthknowledge.org.uk
Effective reproductive number (R)
A population will rarely be totally susceptible to an infection in the real world. Some contacts will be immune, for example due to prior infection which has conferred life-long immunity, or as a result of previous immunisation. Therefore, not all contacts will become infected and the average number of secondary cases per infectious case will be lower than the basic reproduction number. The effective reproductive number (R) is the average number of secondary cases per infectious case in a population made up of both susceptible and non-susceptible hosts. If R>1, the number of cases will increase, such as at the start of an epidemic. Where R=1, the disease is endemic, and where R<1 there will be a decline in the number of cases.
The effective reproduction number can be estimated by the product of the basic reproductive number and the fraction of the host population that is susceptible (x). So:
R = R0x
For example, if R0 for influenza is 12 in a population where half of the population is immune, the effective reproductive number for influenza is 12 x 0.5 = 6. Under these circumstances, a single case of influenza would produce an average of 6 new secondary cases.1
To successfully eliminate a disease from a population, R needs to be less than 1.\
Stil not a measure of daily infection rate. And definitely not a measure of the efficacy of a lockdown.
You make it sound as if an outbreak going on for months or years is a good thing. Lengthening the curve may be the lesser of two evils, but unless we can make it so flat that it's no more than a minor nuisance, it's still far from appealing. Ideally we need to find a way to reduce the area under the curve (flattening it does of course give us more time in which to do that).
I don't think anyone suggests it's a good thing. The view is that it's a better thing. A long slow outbreak = not overwhelming the health system.
Frankly, survival rates will be better if everyone who needs a ventilator can get a ventilator.
If it is, then it suggests that lockdown was an effective "flatten the curve" strategy. But that also has the lockdown-lifting implications you mention. And if it isn't, then people will complain the lockdown was a huge economic and mental waste of time. This really is like the Y2K bug.
Yup. I worked on Y2K--nothing fancy: checking on compliance for a corporation, its building systems (e.g., elevators), its vendors, etc. Afterwards, we were told not to mention it on our resumes, because so many people didn't believe it was a problem in the first place.
Yes, the lockdown is working, because it's reducing the R0 to below 1. But without accurate statistics, by date and by cause of death, then any decision made on when to relax or end the restrictions will inevitably be made on false assumptions.
If the FT is right, and we've had over 41,000 deaths, then the numbers might be falling, but from an unacceptably high level that precludes any loosening of the ties.
The lockdown is working because fewer people are getting infected, but that does not change the R₀.
The R₀ is how infectious a disease potentially is, not how many people are actually getting infected at a given time.
You just copied and pasted that from wikipedia without ever understanding it. Well done.
R0 has two modes, basic and effective. The effective R0 is literally what every layperson is talking about when they talk about R0 - the actual rate of transmission.
Effective R₀ from healthknowledge.org.uk
Effective reproductive number (R)
A population will rarely be totally susceptible to an infection in the real world. Some contacts will be immune, for example due to prior infection which has conferred life-long immunity, or as a result of previous immunisation. Therefore, not all contacts will become infected and the average number of secondary cases per infectious case will be lower than the basic reproduction number. The effective reproductive number (R) is the average number of secondary cases per infectious case in a population made up of both susceptible and non-susceptible hosts. If R>1, the number of cases will increase, such as at the start of an epidemic. Where R=1, the disease is endemic, and where R<1 there will be a decline in the number of cases.
The effective reproduction number can be estimated by the product of the basic reproductive number and the fraction of the host population that is susceptible (x). So:
R = R0x
For example, if R0 for influenza is 12 in a population where half of the population is immune, the effective reproductive number for influenza is 12 x 0.5 = 6. Under these circumstances, a single case of influenza would produce an average of 6 new secondary cases.1
To successfully eliminate a disease from a population, R needs to be less than 1.\
Stil not a measure of daily infection rate. And definitely not a measure of the efficacy of a lockdown.
It's not a direct measure of daily infection rate, but it is correlated.
As to why you think it's doesn't measure the efficacy of a lockdown, I've no idea. Why do you think we're having lockdowns, if not to reduce the opportunity of an infected person to infect other people?
This morning several news sites in the US reported that Autopsies in California showed the virus was in the states about three weeks before the official recorded coronavirus case was reported. Think of it. This could explain why US cases have been so high. The disease was spreading like wildfire long before we realized it. NPR reported they are going as far back as December now to see if any unexplained deaths could be related to the virus.
Last night our governor of Washington State, Gov. Inslee, gave what I thought was a well-reasoned description of what to expect when the state begins to open up. He said it will be more like dialing back the restrictions gradually instead of flipping the switch. I was encouraged by his remarks. How about you @mousethief?
I'm not sure what good that will do. The rate of infection is directly correlated to how many people each person comes into contact with, but at some point there is a threshold beyond which it doesn't matter anymore. Half the restaurants or all the restaurants, the effective rate of transmission won't be changed. My gut feeling, based on all I've heard and have read, is that that threshold is very very low. We still haven't seen a significant drop-off of daily new diagnoses at the national level, and already they're talking about opening things up? Our state is doing very well, and daily diagnoses are trending downwards (on a very bumpy curve), but we're not in a vacuum. People move back and forth between states. I'm not sanguine about opening anything back up at this point.
That said I admire Inslee and think he did an excellent job shutting things down as early as he did. And I'm looking forward in a morbid way to seeing how many of the "protesters" of the last 4 days die in the next 4 weeks.
X. Country - [# of known cases] ([active] / [recovered] / [dead]) [%fatality rate]
Fatality rates are only listed for countries where the number of resolved cases (recovered + dead) exceeds the number of known active cases by a ratio of at least 2:1. Italics indicate authoritarian countries whose official statistics are suspect. Other country's statistics are suspect if their testing regimes are substandard.
If American states were treated as individual countries eighteen of them would be on that list. New York would be ranked at #2, between "everywhere in the U.S. except New York" (#1) and Spain (#3). New Jersey would be between Turkey and Iran.
For some reason the UK has very few cases it considers "recovered", which means that it is second only to the US in active cases.
Mexico, Poland, Singapore, and Pakistan have joined the 10,000 case club since the last compilation.
"Speak the truth. Speak it clearly. Speak it with compassion. Speak it with empathy for what folks are going through.”
Obama, speaking to a group of Mayors.
Obama also pushed the mayors to bring in as many smart advisers and experts as possible.
"The more smart people you have around you, and the less embarrassed you are to ask questions, the better your response is going to be," Obama said.
Following up on Croesos' summary and looking at the final worldometer summary for the USA for 22 April.
There were just under 30,000 new cases. 42 States reported more than 50, 39 more than 100 and 7 more than 1000.
mousethief, I think you are right about relaxing controls. The virus is very infectious, even when the infected person is asymptomatic and even limited relaxation will push up new case numbers.
Harsh though it is to say, the only way out of this before a vaccine becomes generally available is to accept a reality. With some measures of social distancing control all we can hope to try to do is manage the pace of infection at a level which the health services can cope with. And that's a tough ask. The lockdown cannot be sustained until a vaccine becomes generally available.
@Barnabas62 - do you mean 'the lockdown must be sustained etc...'? (Or words to that effect).
Obviously, I'm not @Barnabas62 but, I think there would be such severe practical considerations that we're simply unable to maintain the current restrictions for the next 12 months. There are too many people unable to access financial support from the government who will need to return to work to pay their bills. Or, simply because people need to work, their ability to cope with inactivity decreases with the time they're forced to be idle. Or, it was hard enough with families unable to get together for Easter, imagine that for Christmas. We might manage to keep going for 12 weeks, with difficulty, but 12 months is a long time, and I don't think we'll manage that. There will come a point where the benefits of relaxing the stay at home restrictions will exceed the risks.
@Barnabas62 - do you mean 'the lockdown must be sustained etc...'? (Or words to that effect).
Obviously, I'm not @Barnabas62 but, I think there would be such severe practical considerations that we're simply unable to maintain the current restrictions for the next 12 months. There are too many people unable to access financial support from the government who will need to return to work to pay their bills. Or, simply because people need to work, their ability to cope with inactivity decreases with the time they're forced to be idle. Or, it was hard enough with families unable to get together for Easter, imagine that for Christmas. We might manage to keep going for 12 weeks, with difficulty, but 12 months is a long time, and I don't think we'll manage that. There will come a point where the benefits of relaxing the stay at home restrictions will exceed the risks.
There's a big difference between locking down for another 12 months and opening things up right now and going back to normal immediately. Three weeks or a month more might reduce new daily cases quite a bit and give time for testing and tracking procedures to be further developed and put in place and hopefully accepted by the public.
We may be free of some restrictions in around 3 weeks in Australia and we have far less daily new cases (I almost have a sort of survivor's guilt at how much better things are going here due to having caught this earlier and perhaps because it is not flu season yet - whether a lift on restrictions plus winter weather and less sunlight might affect things, if at all, remains to be seen). But even with much lower numbers and acceptance that we may not be able to totally eradicate the disease without a vaccine, there's very little argument about keeping the restrictions for now, even among small business owners who have been affected.
Points at WWII - what is this idea that we can not maintain special measures if we need to ?
A different situation. 1939-45 didn't see the majority of the working population prevented from working, quite the opposite there were jobs to be done and not enough people to do them rather than having people wanting to work but not allowed to. Nor, neighbours only able to talk from a distance or children prevented from seeing their friends at school or playing together in the streets for weeks at a time, or not being able to visit grandparents. 1939-45 allowed people to socialise, when they had the time, the pubs were open and many dance halls and the like, people met up with their friends and did what they could to continue enjoying life. Young men dated young women, got married and had family and friends at the ceremony. People died, and those family who were nearby attended the funeral, widows and widowers were comforted by family giving them hugs and neighbours popping in for a cup of tea. Children were born and their grandparents held their new grandchildren.
Alan read me right. Perhaps I should have said this level of lockdown cannot be sustained until we have a vaccine. But any measures of relaxation, however cautious, seem likely to lead to an upturn in new infections. Only if the new infection rate is very low and detected early by testing will tracing and isolating of other contacts be effective. We're nowhere near that in the UK
Therefore, if we wish to strike some kind of sustainable short term balance between sustainable lockdown and necessary economic activity, we need to accept both some measure of relaxation and the fact that this will lead to some measure of increased sickness and death. How much depends on both health service capability and public assent to the risk. The worst case scenario is swamping the health service.
Yes, the lockdown is working, because it's reducing the R0 to below 1. But without accurate statistics, by date and by cause of death, then any decision made on when to relax or end the restrictions will inevitably be made on false assumptions.
If the FT is right, and we've had over 41,000 deaths, then the numbers might be falling, but from an unacceptably high level that precludes any loosening of the ties.
The lockdown is working because fewer people are getting infected, but that does not change the R₀.
The R₀ is how infectious a disease potentially is, not how many people are actually getting infected at a given time.
You just copied and pasted that from wikipedia without ever understanding it. Well done.
R0 has two modes, basic and effective. The effective R0 is literally what every layperson is talking about when they talk about R0 - the actual rate of transmission.
Effective R₀ from healthknowledge.org.uk
Effective reproductive number (R)
A population will rarely be totally susceptible to an infection in the real world. Some contacts will be immune, for example due to prior infection which has conferred life-long immunity, or as a result of previous immunisation. Therefore, not all contacts will become infected and the average number of secondary cases per infectious case will be lower than the basic reproduction number. The effective reproductive number (R) is the average number of secondary cases per infectious case in a population made up of both susceptible and non-susceptible hosts. If R>1, the number of cases will increase, such as at the start of an epidemic. Where R=1, the disease is endemic, and where R<1 there will be a decline in the number of cases.
The effective reproduction number can be estimated by the product of the basic reproductive number and the fraction of the host population that is susceptible (x). So:
R = R0x
For example, if R0 for influenza is 12 in a population where half of the population is immune, the effective reproductive number for influenza is 12 x 0.5 = 6. Under these circumstances, a single case of influenza would produce an average of 6 new secondary cases.1
To successfully eliminate a disease from a population, R needs to be less than 1.\
Stil not a measure of daily infection rate. And definitely not a measure of the efficacy of a lockdown.
It's not a direct measure of daily infection rate, but it is correlated.
As to why you think it's doesn't measure the efficacy of a lockdown, I've no idea. Why do you think we're having lockdowns, if not to reduce the opportunity of an infected person to infect other people?
Lockdowns only become part of the equation if they become typical behaviour. We are having lockdowns to spread the infection numbers out (aka flatten the curve) and reduce deaths, not change how infectious the virus is.
Nicola Surgeon has said that aspects of lockdown in Scotland i.e. large gatherings, are likely to remain in force until the end of the year, or possibly longer.
I thought the big risk is of a pile-up of deaths. This would mean that many people would either die at home, or in a hospital corridor. If you're lucky, you might get morphine, while you drown.
Presumably, this is considered uncivilized by many people, so the deaths are stretched out. It's up to the scientists to determine this, isn't it? So far, they have avoided it, except in care homes, maybe, but I assume morphine is available there.
There will come a point where the benefits of relaxing the stay at home restrictions will exceed the risks.
I've been saying that for weeks. Are we finally ready to discuss when that point may be reached?
At present, the restrictions we have in place in the UK have let the health service cope with the number of hospitalisations - just, it turns out we have enough ICU beds and ventilators with the steps put in very early to increase capacity, but it's simpler things like gloves and masks that are insufficient, plus the usual problems of staff numbers and we can't keep going with our NHS staff working longer shifts without time off nor rely on the services of those who had retired (plus many have contracted the virus and had to come off work for several weeks, too many have died). The benefits of maintaining the current restrictions for a couple of weeks more are that we'll further reduce the number of patients in hospital and we may even be able to give some staff a few days holiday before the numbers start to rise again when restrictions are eased a wee bit.
We're already seeing some marginally essential businesses re-opening with social distancing measures (eg: B&Q here just re-opened), I suspect that unless the government starts to say "hey, you're not essential" that process will slowly continue. Probably the next step is for the government to formally allow non-essential businesses to re-open if they can maintain social distancing - of course, that will still mean that anyone who can work from home should still do so, and the numbers returning to work won't be the full workforce (some will still be self-isolating having displayed symptoms, others will need to remain at home to look after children as I'd be surprised if schools reopen).
We'll probably see some form of school re-opening after the summer (possibly with kids in for staggered periods, with reduced hours, to keep the number in any one room down to something where social distancing is at least possible, but also needing to cope with reduced teacher numbers). Unless there's a miracle (ie: an effective, safe vaccine developed, tested and in mass production such that we have millions of doses given by the end of October) then we'll still be under some form of significant restriction at Christmas.
There will come a point where the benefits of relaxing the stay at home restrictions will exceed the risks.
I've been saying that for weeks. Are we finally ready to discuss when that point may be reached?
Interesting interview along those lines with Carolyn Goodman, the mayor of Las Vegas. She advocates opening everything up immediately and leaving it to individual casinos to figure out how to maintain social distancing. She claims that the magic of the market will work to shut down any businesses that become COVID-19 hotspots, since we know that employers always take workplace safety seriously. She literally hand-waves away the idea that by the time a business is known to be a COVID-19 hotspot two weeks have passed and a bunch of casino-goers have now brought the virus back to their home locations.
For those who don't have twenty-five minutes to watch the whole interview the choice bit was about 22 minutes in when the mayor offered her citizens (and the tourists she hoped to attract) as a "control group" to find out if social distancing really does help reduce the rate of transmission. This is followed by her explanation about why she personally wouldn't want to go to a newly opened casino, but the workers should be fine.
I thought the big risk is of a pile-up of deaths. This would mean that many people would either die at home, or in a hospital corridor. If you're lucky, you might get morphine, while you drown.
Presumably, this is considered uncivilized by many people, so the deaths are stretched out. It's up to the scientists to determine this, isn't it? So far, they have avoided it, except in care homes, maybe, but I assume morphine is available there.
It can also reduce the total number of infections and deaths.
We are having lockdowns to spread the infection numbers out (aka flatten the curve) and reduce deaths, not change how infectious the virus is.
Spreading the infection numbers out is changing how infectious the virus is.(*)
AIUI if you lower the R rate but it stays above 1 it will still get through the whole population just more slowly(**). If you get it significantly below 1 it will peter out before it gets through the whole population.
(*) I suppose you could in theory use 'how infectious a virus is' to describe how likely a person is to contract it if you squirt a fixed small quantity up their nose. But that would be a piece of information of no practical use to anybody.
(**) Not quite the whole population. The proportion of the population needed for effective herd immunity will be lower.
I'm not sure about reducing total deaths. If it lasts 5 years, you may end up with 150 000 or 200 000 deaths, but you have avoided the horror of people asphyxiating at home without treatment.
I'm not sure about reducing total deaths. If it lasts 5 years, you may end up with 150 000 or 200 000 deaths, but you have avoided the horror of people asphyxiating at home without treatment.
As @Dafydpoints out if you can "flatten the curve" enough that R < 1 the infection will go away. There's also the fact that the more time we have the better medical professionals will get at treating COVID-19. Experience, lessons learned, better treatments developed, etc. You've got a better chance of surviving something that doctors and scientists have been studying for six month than you do of surviving something they've never seen before.
I'm not sure about reducing total deaths. If it lasts 5 years, you may end up with 150 000 or 200 000 deaths, but you have avoided the horror of people asphyxiating at home without treatment.
You will reduce total deaths. If we roughly equate "asphyxiating at home" with "needs ICU", and ICU admissions have a 50% survival rate, then 50% of the AAH group will be saved if they can be treated in ICU instead - i.e. if there aren't too many of them at once.
Interesting interview along those lines with Carolyn Goodman, the mayor of Las Vegas. She advocates opening everything up immediately and leaving it to individual casinos to figure out how to maintain social distancing. She claims that the magic of the market will work to shut down any businesses that become COVID-19 hotspots, since we know that employers always take workplace safety seriously. She literally hand-waves away the idea that by the time a business is known to be a COVID-19 hotspot two weeks have passed and a bunch of casino-goers have now brought the virus back to their home locations.
For those who don't have twenty-five minutes to watch the whole interview the choice bit was about 22 minutes in when the mayor offered her citizens (and the tourists she hoped to attract) as a "control group" to find out if social distancing really does help reduce the rate of transmission. This is followed by her explanation about why she personally wouldn't want to go to a newly opened casino, but the workers should be fine.
I saw that interview on CNN last night. Jaw dropping. Anderson Cooper's face was a picture as she came out with this dangerous nonsense, all with a smile on her face. But the Governor of Nevada was given some rebuttal time later and did a good job.
I liked your use of "interesting" to describe the interview. Reminded me of Rowan and Martin's Laugh-in. "Verrry interesssting. And also Stoopid".
I thought the big risk is of a pile-up of deaths. This would mean that many people would either die at home, or in a hospital corridor. If you're lucky, you might get morphine, while you drown.
Presumably, this is considered uncivilized by many people, so the deaths are stretched out. It's up to the scientists to determine this, isn't it? So far, they have avoided it, except in care homes, maybe, but I assume morphine is available there.
The big risk is that we overwhelm and burn out the health care system. There is only so much capacity. Overtop that, and we have the situation in Italy where doctors have to decide who lives and who dies. That is tough on a doctor; will they get fed up and quit? Also the more we stress and overwork our medical care professionals the more susceptible they will be to the disease, the more of them will die, and the lower our already-maxed-out capacity will become. Many are having to accept pay cuts as their workload and work hours are being stretched to, perhaps beyond, the max they can endure. This is a death spiral in more ways than one.
Points at WWII - what is this idea that we can not maintain special measures if we need to ?
A different situation. 1939-45 didn't see the majority of the working population prevented from working, quite the opposite there were jobs to be done and not enough people to do them rather than having people wanting to work but not allowed to. Nor, neighbours only able to talk from a distance or children prevented from seeing their friends at school or playing together in the streets for weeks at a time, or not being able to visit grandparents. 1939-45 allowed people to socialise, when they had the time, the pubs were open and many dance halls and the like, people met up with their friends and did what they could to continue enjoying life. Young men dated young women, got married and had family and friends at the ceremony. People died, and those family who were nearby attended the funeral, widows and widowers were comforted by family giving them hugs and neighbours popping in for a cup of tea. Children were born and their grandparents held their new grandchildren.
I don’t think the soldiers could see there children or their grandparents - and I doubt the socialising was worth your house getting bombed to shit. The fact is a lot of nonessential work stopped during the war, whilst reserved occupations continued. Evacuated children were separated from family for a long period of time and it was horrible.
It is a different set of risks, with a different set of privations - but I think the idea that is impossible to maintain special measures until we have a mass produced vaccine is not true.
It maybe there are good reasons to ease lockdown in a phased fashion prior to a vaccine - but I don’t think that reason should simply be, this is difficult and expensive. Imagine we just hired everyone out of work or furloughed into the army, are we really spending so much more money as a proportion of GDP than we would have done in a war ?
There is a persistent political and social problem that we are apparently willing to spend unimaginable sums of money for immense periods of time (*stares at a century of near continuous industrialised warfare, NATO & Trident*) in order to be able to kill large numbers of people - but contemplating spending that same money, time, personal and collective effort on trying to save lives is somehow unimaginable.
Folk willing to die for their country, apparently unwilling to be unemployed for it - or bored, or annoyed, or frustrated, or whatever.
I haven't discussed much what I do for work, but I will just a bit. I got into the trauma and related injury field for some personal reasons. One of my roles is consulting re health care policies and programs. We're going in the direction of occupational stress ± injury versus trauma/PTSD, and we also have presumptive acceptance of mental health injury in this province for treatment and wage replacement. If you're interested, have a look at Psychological First Aid. This link is to the "field guide", and it doesn't apply strictly because of the nature of the Covid19 situation. But there's lots of useful information and help within. It's not the only resource.
Folk willing to die for their country, apparently unwilling to be unemployed for it - or bored, or annoyed, or frustrated, or whatever.
I'm reminded of a conversation from the end of Asimov's first Foundation novel, where Hober Mallow outlines his plan to bring an enemy nation to heel through economic pressure.
"People endure a great deal in war."
"Very true. They do. They'll send their sons out in unlimited numbers to die horribly on broken spaceships. They'll bear up under enemy bombardment, if it means the have to live on stale bread and foul water in caves half a mile deep. But it's very hard to bear up under the little things when imminent danger is not present. It's going to be a stalemate. There will be no casualties, no bombardments, no battles."
There is imminent danger to ourselves and others, but the enemy is invisible and insidious. It takes imagination and trust to see that - until you or someone you love becomes a victim.
Or, worse, you find out that you've made someone else (a loved one or a stranger) seriously ill (or even killed them) by infecting them all unknowing.
Too late to do anything then, other than mourn and regret. I've always liked the Foundation series and the Hober Mallow quote is a good one.
Not quite the whole population. The proportion of the population needed for effective herd immunity will be lower.
But "lower" here probably still means north of 80% before we can go back to pre-virus behaviour.
Yes. If you go back to pre-virus behaviour while the virus is still circulating then the proportion of the population you need for herd immunity will be the level you need with pre-virus behaviour, not the level you need for herd immunity with social distancing measures in place.
There is imminent danger to ourselves and others, but the enemy is invisible and insidious. It takes imagination and trust to see that - until you or someone you love becomes a victim.
That's the problem. The parts of the brain that process visual input (like explosions or enemy soldiers) evolved at least 400 million years ago. The prefrontal cortex, the part of our brain that processes things like CDC analyses or exponential growth projections, is at most 2.5 million years old. We are, evolutionarily speaking, more predisposed to believe things we see than things we have to figure out.
Spot on. A really important insight. The word instinctive is a bit approximate but it describes defensive or aggressive immediate responses to immediate sensory stimuli.
Figuring things out is hard work; we need the mental equipment plus the belief that it is valuable to do that work. The Mayor of Las Vegas seemed to lack both.
It is a different set of risks, with a different set of privations - but I think the idea that is impossible to maintain special measures until we have a mass produced vaccine is not true.
I would agree -- it seems to be an assumption about other people's (and it is usually other people) behaviour - which I think isn't bourne out by the support that these policies have in many countries.
I think America is a special case, primarily because the American state is experiencing internecine warfare.
It is a different set of risks, with a different set of privations - but I think the idea that is impossible to maintain special measures until we have a mass produced vaccine is not true.
I would agree -- it seems to be an assumption about other people's (and it is usually other people) behaviour - which I think isn't bourne out by the support that these policies have in many countries.
I think America is a special case, primarily because the American state is experiencing internecine warfare.
We've been encouraged to believe whatever blatant lies we want, particularly those that appeal to our own self-interest. And some of us aren't very bright.
Comments
Besides, you can't trust clever people.
I don't think anyone suggests it's a good thing. The view is that it's a better thing. A long slow outbreak = not overwhelming the health system.
Frankly, survival rates will be better if everyone who needs a ventilator can get a ventilator.
Yup. I worked on Y2K--nothing fancy: checking on compliance for a corporation, its building systems (e.g., elevators), its vendors, etc. Afterwards, we were told not to mention it on our resumes, because so many people didn't believe it was a problem in the first place.
Never mind that stuff actually happened: Here's Wikipedia's list of "Documented Errors" from the "Year 2000 problem" article. There were even some problems at the beginning of 2020 (listed), because "2019" was sometimes used as a fix.
It's an older series--1996-2000. I just checked "TV early edition", and there are fan sites, places to watch online, etc.
It's not a direct measure of daily infection rate, but it is correlated.
As to why you think it's doesn't measure the efficacy of a lockdown, I've no idea. Why do you think we're having lockdowns, if not to reduce the opportunity of an infected person to infect other people?
I'm not sure what good that will do. The rate of infection is directly correlated to how many people each person comes into contact with, but at some point there is a threshold beyond which it doesn't matter anymore. Half the restaurants or all the restaurants, the effective rate of transmission won't be changed. My gut feeling, based on all I've heard and have read, is that that threshold is very very low. We still haven't seen a significant drop-off of daily new diagnoses at the national level, and already they're talking about opening things up? Our state is doing very well, and daily diagnoses are trending downwards (on a very bumpy curve), but we're not in a vacuum. People move back and forth between states. I'm not sanguine about opening anything back up at this point.
That said I admire Inslee and think he did an excellent job shutting things down as early as he did. And I'm looking forward in a morbid way to seeing how many of the "protesters" of the last 4 days die in the next 4 weeks.
The listings are in the format:
X. Country - [# of known cases] ([active] / [recovered] / [dead]) [%fatality rate]
Fatality rates are only listed for countries where the number of resolved cases (recovered + dead) exceeds the number of known active cases by a ratio of at least 2:1. Italics indicate authoritarian countries whose official statistics are suspect. Other country's statistics are suspect if their testing regimes are substandard.
If American states were treated as individual countries eighteen of them would be on that list. New York would be ranked at #2, between "everywhere in the U.S. except New York" (#1) and Spain (#3). New Jersey would be between Turkey and Iran.
For some reason the UK has very few cases it considers "recovered", which means that it is second only to the US in active cases.
Mexico, Poland, Singapore, and Pakistan have joined the 10,000 case club since the last compilation.
Obama, speaking to a group of Mayors.
Obama also pushed the mayors to bring in as many smart advisers and experts as possible.
"The more smart people you have around you, and the less embarrassed you are to ask questions, the better your response is going to be," Obama said.
There were just under 30,000 new cases. 42 States reported more than 50, 39 more than 100 and 7 more than 1000.
mousethief, I think you are right about relaxing controls. The virus is very infectious, even when the infected person is asymptomatic and even limited relaxation will push up new case numbers.
Harsh though it is to say, the only way out of this before a vaccine becomes generally available is to accept a reality. With some measures of social distancing control all we can hope to try to do is manage the pace of infection at a level which the health services can cope with. And that's a tough ask. The lockdown cannot be sustained until a vaccine becomes generally available.
Yes, ISWYM. Thx.
Post in haste...be corrected at leisure...
We may be free of some restrictions in around 3 weeks in Australia and we have far less daily new cases (I almost have a sort of survivor's guilt at how much better things are going here due to having caught this earlier and perhaps because it is not flu season yet - whether a lift on restrictions plus winter weather and less sunlight might affect things, if at all, remains to be seen). But even with much lower numbers and acceptance that we may not be able to totally eradicate the disease without a vaccine, there's very little argument about keeping the restrictions for now, even among small business owners who have been affected.
Therefore, if we wish to strike some kind of sustainable short term balance between sustainable lockdown and necessary economic activity, we need to accept both some measure of relaxation and the fact that this will lead to some measure of increased sickness and death. How much depends on both health service capability and public assent to the risk. The worst case scenario is swamping the health service.
I've been saying that for weeks. Are we finally ready to discuss when that point may be reached?
Presumably, this is considered uncivilized by many people, so the deaths are stretched out. It's up to the scientists to determine this, isn't it? So far, they have avoided it, except in care homes, maybe, but I assume morphine is available there.
We're already seeing some marginally essential businesses re-opening with social distancing measures (eg: B&Q here just re-opened), I suspect that unless the government starts to say "hey, you're not essential" that process will slowly continue. Probably the next step is for the government to formally allow non-essential businesses to re-open if they can maintain social distancing - of course, that will still mean that anyone who can work from home should still do so, and the numbers returning to work won't be the full workforce (some will still be self-isolating having displayed symptoms, others will need to remain at home to look after children as I'd be surprised if schools reopen).
We'll probably see some form of school re-opening after the summer (possibly with kids in for staggered periods, with reduced hours, to keep the number in any one room down to something where social distancing is at least possible, but also needing to cope with reduced teacher numbers). Unless there's a miracle (ie: an effective, safe vaccine developed, tested and in mass production such that we have millions of doses given by the end of October) then we'll still be under some form of significant restriction at Christmas.
Interesting interview along those lines with Carolyn Goodman, the mayor of Las Vegas. She advocates opening everything up immediately and leaving it to individual casinos to figure out how to maintain social distancing. She claims that the magic of the market will work to shut down any businesses that become COVID-19 hotspots, since we know that employers always take workplace safety seriously. She literally hand-waves away the idea that by the time a business is known to be a COVID-19 hotspot two weeks have passed and a bunch of casino-goers have now brought the virus back to their home locations.
For those who don't have twenty-five minutes to watch the whole interview the choice bit was about 22 minutes in when the mayor offered her citizens (and the tourists she hoped to attract) as a "control group" to find out if social distancing really does help reduce the rate of transmission. This is followed by her explanation about why she personally wouldn't want to go to a newly opened casino, but the workers should be fine.
It can also reduce the total number of infections and deaths.
AIUI if you lower the R rate but it stays above 1 it will still get through the whole population just more slowly(**). If you get it significantly below 1 it will peter out before it gets through the whole population.
(*) I suppose you could in theory use 'how infectious a virus is' to describe how likely a person is to contract it if you squirt a fixed small quantity up their nose. But that would be a piece of information of no practical use to anybody.
(**) Not quite the whole population. The proportion of the population needed for effective herd immunity will be lower.
As @Dafyd points out if you can "flatten the curve" enough that R < 1 the infection will go away. There's also the fact that the more time we have the better medical professionals will get at treating COVID-19. Experience, lessons learned, better treatments developed, etc. You've got a better chance of surviving something that doctors and scientists have been studying for six month than you do of surviving something they've never seen before.
You will reduce total deaths. If we roughly equate "asphyxiating at home" with "needs ICU", and ICU admissions have a 50% survival rate, then 50% of the AAH group will be saved if they can be treated in ICU instead - i.e. if there aren't too many of them at once.
I saw that interview on CNN last night. Jaw dropping. Anderson Cooper's face was a picture as she came out with this dangerous nonsense, all with a smile on her face. But the Governor of Nevada was given some rebuttal time later and did a good job.
I liked your use of "interesting" to describe the interview. Reminded me of Rowan and Martin's Laugh-in. "Verrry interesssting. And also Stoopid".
The big risk is that we overwhelm and burn out the health care system. There is only so much capacity. Overtop that, and we have the situation in Italy where doctors have to decide who lives and who dies. That is tough on a doctor; will they get fed up and quit? Also the more we stress and overwork our medical care professionals the more susceptible they will be to the disease, the more of them will die, and the lower our already-maxed-out capacity will become. Many are having to accept pay cuts as their workload and work hours are being stretched to, perhaps beyond, the max they can endure. This is a death spiral in more ways than one.
I don’t think the soldiers could see there children or their grandparents - and I doubt the socialising was worth your house getting bombed to shit. The fact is a lot of nonessential work stopped during the war, whilst reserved occupations continued. Evacuated children were separated from family for a long period of time and it was horrible.
It is a different set of risks, with a different set of privations - but I think the idea that is impossible to maintain special measures until we have a mass produced vaccine is not true.
It maybe there are good reasons to ease lockdown in a phased fashion prior to a vaccine - but I don’t think that reason should simply be, this is difficult and expensive. Imagine we just hired everyone out of work or furloughed into the army, are we really spending so much more money as a proportion of GDP than we would have done in a war ?
There is a persistent political and social problem that we are apparently willing to spend unimaginable sums of money for immense periods of time (*stares at a century of near continuous industrialised warfare, NATO & Trident*) in order to be able to kill large numbers of people - but contemplating spending that same money, time, personal and collective effort on trying to save lives is somehow unimaginable.
Folk willing to die for their country, apparently unwilling to be unemployed for it - or bored, or annoyed, or frustrated, or whatever.
But "lower" here probably still means north of 80% before we can go back to pre-virus behaviour.
I'm reminded of a conversation from the end of Asimov's first Foundation novel, where Hober Mallow outlines his plan to bring an enemy nation to heel through economic pressure.
Or, worse, you find out that you've made someone else (a loved one or a stranger) seriously ill (or even killed them) by infecting them all unknowing.
Too late to do anything then, other than mourn and regret. I've always liked the Foundation series and the Hober Mallow quote is a good one.
That's the problem. The parts of the brain that process visual input (like explosions or enemy soldiers) evolved at least 400 million years ago. The prefrontal cortex, the part of our brain that processes things like CDC analyses or exponential growth projections, is at most 2.5 million years old. We are, evolutionarily speaking, more predisposed to believe things we see than things we have to figure out.
Figuring things out is hard work; we need the mental equipment plus the belief that it is valuable to do that work. The Mayor of Las Vegas seemed to lack both.
I would agree -- it seems to be an assumption about other people's (and it is usually other people) behaviour - which I think isn't bourne out by the support that these policies have in many countries.
I think America is a special case, primarily because the American state is experiencing internecine warfare.
We've been encouraged to believe whatever blatant lies we want, particularly those that appeal to our own self-interest. And some of us aren't very bright.