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Old 05-09-2020, 08:47 AM
dflower is offline
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Why quarantine now and not with other recent epidemics?


Why did the government, federal, local, and global, choose to use quarantine as the response to this epidemic?
There have been major flu epidemics in 1957, 1968, and 2009 that were widespread and deadly. In none of those did governments issue stay at home orders. There was no lockdown, mass business closings, or mass panic as far as I can recall.
Why did we react this way to this virus?
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Old 05-09-2020, 09:12 AM
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Mostly because they were not as deadly. Currently, with lock-downs, many nations are not getting their death rates as low as those flu outbreaks achieved without any lock-down.

As has been noted many times, this particular virus has the unusual and nasty property that people infected with it are asymptomatic whilst being infectious for some days before they become ill. This drastically changes the problem. Just isolating the sick doesn't help. Usually people are self isolating because they get sick about the same time as they become really infectious.

Overall this virus had the making of a Spanish flu; which wasn't in your list, and arguably should be if you want to do a historical comparison.

Can't recall much mass panic other than toilet paper buying. People are odd.
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Old 05-09-2020, 09:15 AM
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I asked my parents a couple of weeks ago what they remembered about the 1957 and 1968 flu pandemics. Nothing, as it turns out. They were as surprised to learn that one-million-plus people had died both times as I was. After a while, my mom said "Well, you have to realize epidemics happened all the time -- measles, German measles, mumps..." and I think that's basically the answer. People tend to react a whole lot more to unfamiliar dangers than familiar ones, and infectious disease was a familiar danger back then. (This doesn't fully explain 2009, but there were a lot fewer people who died in 2009, and I think it does make a difference if it's called "flu" rather than something new and scary.)
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Old 05-09-2020, 10:01 AM
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Originally Posted by Fretful Porpentine View Post
They were as surprised to learn that one-million-plus people had died both times as I was.
That's 1 million plus deaths world wide over the course of each of those epidemics with perhaps ~100k in the US. Rather than the course of an entire flu season, we've gotten close to those numbers in the US in just over a single month and may yet see a future month like that. That's several times worse in terms of fatalities since a bad flu season will be spread out over a good portion of an entire year.

It's not the case of familiarity or acceptance. This really is proving far deadlier than any of those disease outbreaks by a sizable and alarming margin.

Last edited by Great Antibob; 05-09-2020 at 10:02 AM.
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Old 05-09-2020, 10:24 AM
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There were quarantines for polio in the 40s and 50s. Because of the nature of transmission they did not affect us in the same way nationwide all at the same time. Many of those at higher risk because of age have been through something similar before. It is not their first rodeo.

Last edited by DinoR; 05-09-2020 at 10:25 AM.
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Old 05-09-2020, 10:30 AM
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I agree that this is more deadly, but I'm not sure that fully accounts for the difference in public reaction. (My back-of-the-envelope math suggests that roughly one in every 1,550 people in the US died in the 1557-58 pandemic; scaled to today's population, that would be more than 220,000 people, which is the sort of death toll people will perceive as staggeringly, unacceptably high if it happens with COVID-19 [and it certainly might].) I do think there have been some real societal changes, both in terms of what people see as an acceptable level of death from contagious disease, and the extent to which they percieve it's possible to do something about it.
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Old 05-09-2020, 10:42 AM
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I think the main reason was that we'd seen it overwhelm developed health care systems in areas slow(er) to react.

The pictures of makeshift tent hospitals in China and stories of Italian hospitals prioritizing which deadly ill patients would get a ventilator is enough of an explanation.
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Old 05-09-2020, 10:49 AM
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Originally Posted by Great Antibob View Post
That's 1 million plus deaths world wide over the course of each of those epidemics with perhaps ~100k in the US. Rather than the course of an entire flu season, we've gotten close to those numbers in the US in just over a single month and may yet see a future month like that. That's several times worse in terms of fatalities since a bad flu season will be spread out over a good portion of an entire year.

It's not the case of familiarity or acceptance. This really is proving far deadlier than any of those disease outbreaks by a sizable and alarming margin.
I think this is the reason. It's an issue of hospital capacity. The difference between this pandemic and past pandemics is the time element; Covid 19, if left unaddressed, would cause a lot of people to all become critically ill at the same time and there isn't enough hospital capacity to treat them.

Let's say we have enough hospital capacity to treat a hundred thousand people and we can save ninety percent of patients with treatment.

If a million people get ill but it's spread out over five months with only a hundred thousand people being sick at any one time, we can treat everyone in a hospital. A hundred thousand people die and nine hundred thousand recover.

If a million people get ill and it's all in the same two week period, we can only treat a hundred thousand people in a hospital. Ten thousand people die in hospital and ninety thousand recover. And nine hundred thousand people die because they were unable to receive treatment.

The purpose of quarantine has been to slow down the progression of the disease so we can treat people as they become sick.

With previous pandemics, that has been the natural progression of the disease. They spread over the course of months rather than days.
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Old 05-09-2020, 10:52 AM
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None of these other pandemics ended up with ICU wards being overwhelmed with patients often requiring several weeks of ventilator and extracorporeal life support, mass mortality incidents in elder care facilities, physicians and nurses (and first responders, and grocery store clerks) succumbing to the virus with severe morbidity, and a pathogen so novel and infectious that we are neither able to understand the pathogenesis of how it causes the severe and often unexpected conditions nor able to track and trace infected persons to limit the spread to less than epidemic proportions.

Does that answer the question of the o.p.?

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Old 05-09-2020, 11:01 AM
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Quote:
Originally Posted by dflower View Post
Why did the government, federal, local, and global, choose to use quarantine as the response to this epidemic?
There have been major flu epidemics in 1957, 1968, and 2009 that were widespread and deadly. In none of those did governments issue stay at home orders. There was no lockdown, mass business closings, or mass panic as far as I can recall.
Why did we react this way to this virus?
The 1968 pandemic was slightly worse than the normal flu rate in the US.

As to this pandemic the initial expectation was a doubling every 6 days but what we saw was a death rate that doubled every 3 days. Even though we have the largest number of ICU beds per capita in the world the concern was that we would overwhelm the system beyond large metropolitan areas. It's one thing to overload a handful of major cities. If that were the extent of it we can relocate the sick to other locations to other states. We did this in NYC. But if it spreads to smaller cities at the same rate then our health care system collapses. What was needed was time. Time to ease the strain on the health care system, develop vaccines, and develop a treatment protocol.

And we didn't quarantine anyone in the true sense of the word. Even "Shelter at home" was limited to those considered non-essential and those people were allowed to travel and mingle with essential people. So "quarantine" in this case was something more like social crowd control. We really don't have a specific word for it.

Last edited by Magiver; 05-09-2020 at 11:03 AM.
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Old 05-09-2020, 11:29 AM
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I think the answer is, “Once you know better, you do better.” We know much more today, about what’s required to stop the spread than they knew then. I mean during those times people were still largely using reusable hankies, for one tiny example.
  #12  
Old 05-09-2020, 01:40 PM
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To the OP. We really don't know just how bad this may be. We are much more social now than 100 years ago. We travel constantly. Back during the Spanish flu, it would be a trip to travel more than 10 miles from your house. Today 1000 miles is no big deal. In 1918, you may meet 10 people on that trip. Today, you will be in contact with 1000 or more. And so on and so on...

Best site for the data I have found is here. (best in Chrome, IE does not like it) Lots of ways to look at the data and graph it out.

Some people say that 78,000 deaths is no big deal. Ok. After all, we have about half that from car accidents. - in a year.

COVID has killed 60,000 in the US in the last month. Not a year. A month.

Looking at the stats, it's been averaging (back of the envelope, I have not run the numbers but data can be downloaded from the site above) ~ 1600 deaths a day. Or ~ about 600,000 a year. Just in the USA. That's the City of Denver or Seattle (not including suburbs).

My local (small by most standards) grocery store confirmed that 17 of their workers are infected. That's not good at all.

This could be a bit of a problem, and it's right to take it seriously.
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Old 05-09-2020, 01:56 PM
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Magiver is correct for once. We're not "under quarantine" unless confined for some weeks with no escape options. What I see instead are rules aimed (however roughly) to minimize viral exposure. Nothing stops one from entering a gocery and inhaling deeply while standing too close to an unmasked person - slow Russian Roulette. Be non-suicidal: mask and distance to protect others, and distance and sanitize to protect ourselves. Logical.
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Old 05-09-2020, 02:17 PM
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Quote:
Originally Posted by dflower View Post
...
There have been major flu epidemics in 1957, 1968, and 2009 that were widespread and deadly. In none of those did governments issue stay at home orders. ...

We could see early on by what was happening in other countries that this one, the novel corona virus, was a mudderfugger. We had advance notice that, as mentioned above, our hospitals and morgues could easily become overburdened. "Overburdened". That's putting it lightly. The 2009 H1N1 flu killed 12.5 thousand Americans in a year.
https://www.cdc.gov/flu/pandemic-res...-pandemic.html That's a lot of people, but so far in what, 3 months or so, Covid-19 has killed 75,000 Americans, and the death toll has yet to level off.

Last edited by bobot; 05-09-2020 at 02:17 PM.
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Old 05-09-2020, 02:32 PM
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Magiver is correct for once. We're not "under quarantine" unless confined for some weeks with no escape options. What I see instead are rules aimed (however roughly) to minimize viral exposure. Nothing stops one from entering a gocery and inhaling deeply while standing too close to an unmasked person - slow Russian Roulette. Be non-suicidal: mask and distance to protect others, and distance and sanitize to protect ourselves. Logical.
  #16  
Old 05-09-2020, 02:36 PM
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When I was a wee tot, it was expected that, by the time you reached adulthood, if you were lucky to get that far, you would inevitably have had measles, chickenpox, mumps, and maybe whooping cough and Og forbid, polio. There was absolutely no protection from most of those. About the only one you didn't worry about (because there was a vaccine) was smallpox. A child born post-2000 has none of those worries and is unlikely to catch any of these diseases.

My own mother, born early in the 20th Century, survived Scarlet Fever, rare nowadays.
Quote:
In the early 20th century, before antibiotics were available, [Scarlet Fever] was a leading cause of death in children
A child born post-2000 has a far better chance of growing up than one born in 1900, but most people don't think about that.

Our collective memory is faulty sometimes.
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Old 05-09-2020, 02:58 PM
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A child born post-2000 has a far better chance of growing up than one born in 1900, but most people don't think about that.

Our collective memory is faulty sometimes.
It can be strange reading biographies of people in the eighteenth or nineteenth century and seeing how common the death of a family member was. It was pretty much normal back then for everyone to have a dead parent, a dead sibling, or a dead child.
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Old 05-09-2020, 04:51 PM
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Originally Posted by bobot View Post
The 2009 H1N1 flu killed 12.5 thousand Americans in a year.
https://www.cdc.gov/flu/pandemic-res...-pandemic.html That's a lot of people, but so far in what, 3 months or so, Covid-19 has killed 75,000 Americans, and the death toll has yet to level off.
It's not nearly 3 months, though: there were only 2 deaths before February 28th, and we've only known about those 2 a few days. It's only taken 10 weeks and a day to kill 78,616 people.
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