…any plan to “reopen America” needs to be predicated on a simple premise: that the US Federal government is essentially dysfunctional, an irrational actor, and incapable of providing the support that the States need to be able to start to reopen businesses again. This is something that Americans are still struggling to accept: but when you finally do the path forward becomes clearer.
And we are already starting to see this play out. California are forming a partnership/alliance with Oregon and Washington State. And the The East Coast initiative will probably be New York, New Jersey, Connecticut, Pennsylvania, Delaware and Rhode Island. Each of these independent groupings will figure out their own way to move out of lockdown based on shared analysis of what is going on in each individual state. I anticipate that states that don’t get this under control will start to get “walled off” from the rest. And you will start to see those states start to form alliances as well, with the difference being those other states will get substantially more support from the Federal government.
There will be no “global” reopening of the economy in the United States, not unless this current administration is voted out at the next election. Each state (or group of States) will need to take the initiative themselves.
Find a case in the literature where someone got shingles within months of having chicken pox.
I stated very clearly that people do not get reinfected within months. There are viruses for which we attain limited immunity, but everywhere I’ve read that is expected to be on the order of years, not even months or weeks.
If a vaccine is 18 months away (a big if), 2 years of immunity is all we need.
If a vaccine does not come around, there is a chance we all get exposed every year and, just a guess, that resets our biological clock for immunity. That really is just a guess, though.
One thing I keep wondering (and I want to strenuously underline that this is out of pure intellectual curiosity, NOT because I would in any way advocate such an approach): how would we deal with all this if we were an absolutely pragmatic, hardcore utilitarian culture like the common depiction of ancient Sparta? Like if people didn’t really sweat it too much if older or “weaker” people died? I’m not necessarily imagining a scenario where people don’t get any medical care at all, but where they go to the hospital as needed, ruthless triage is practiced, funerals are held, and then after mourning for a couple days people went back out to movies, restaurants, etc. I have a feeling in such a case it wouldn’t make a huge dent in our economy, but of course this is impossible given social psychology in the modern world (and, again, I don’t wish it were otherwise).
Brilliant! Well played.
I loved your earlier post comparing the economy to a computer in “safe mode”, but you lost me here. This is exactly what Trump is claiming he has the authority to do, but governors, legal scholars, and the news media all say he’s full of shit (as do I).
I don’t believe they are deliberately misleading the public. But the premise of your argument about that is fatally flawed. If they were ideologues bent on misleading the public in pursuit of political aims, that’s exactly the sort of person one would expect to work for less pay in a government position rather than seeking profit in the private sector.
Controlled exposure is like trying to fill teacups with a firehose. You’ve got to be pretty nimble and you don’t get many practice shots.
Flatten the curve, then mitigate transmission with stuff that doesn’t disrupt the economy horribly and then test, track and quarantine the virus.
We are getting one positive for every 3 or 4 tests we administer. Korea/Taiwan/Singapore/etc is getting one positive for every hundred to 200 tests they administer. We have to be tracking down potential infections and testing them the way Korea&co are doing if we want to keep our economy going until we get a vaccine.
To which I would add (c) a vaccine that is widely available, safe, and effective. I think you need at least two out of three. And speaking of having faith, you can damn well bet that CT nutjobs will spring up everywhere claiming that the COVID-19 vaccine causes {insanity; autism; mind control by aliens, etc. – pick any one) – but hopefully they’ll be an insignificant minority.
I think the best we can do until then is carefully manage essential businesses, and maybe if this thing stabilizes so that hospital capacity is assured, cautiously open up a few more business with the same careful limitations. It’s easy to forget how much of modern life and the general economy is incompatible with “social distancing” and self-isolation at home. As an example, I asked my son recently if he thought his small business – which was thriving before the shit hit the fan – would survive this, and he said he didn’t know, even though lots of government assistance is being offered. That was sort of a moment of epiphany for me, evaporating my smugness about being retired and on a small but safe retirement income.
We are not in the US but his business would be classified as “arts, entertainment, and recreation” under US BLS guidelines, a category which includes a wide variety of things like major sports, live theater, concerts, movie theaters, film production itself, TV shows with live audiences, and countless other things that involve large numbers of people in close proximity. These kinds of things tend to evoke images of highly paid millionaires, but in the US alone 2.4 million people are dependent on what could broadly be called the entertainment industry, and most of them are not working and many are hurting. How are you going to fix that with a plague ravaging the country? How about the whole restaurant business?
Uh, herd immunity, on average can take up to 2 years to be established. If there is lasting immunity conferred. The flu does not, you can get it over and over. The common cold does not either and can be caused by 2 different corona viruses. Other viruses do give lasting immunity to people. We don’t know yet if covid-19 gives lasting immunity or not. It might. I’ll be following Sweden’s experience.
Not an attack.
I keep hearing lots of talk about testing to help control this.
I don’t understand how testing is going to help us. It is a serious question. If we could magically have the capacity to be doing 2,000,000 tests per day. Maybe we could even be doing 5,000,000 serology tests per day. Then what?
The next statement is always, then we can track and quarantine and isolate people. How? I got to the store and I’m asymptomatic. I pass this thing off to 3 other people in the store. 1 of them is asymptomatic, and passes it along to others.
At 2,000,000 tests per day it would take half a year to test each person in the US once. We apparently need to test everyone multiple times. How do you test everyone?
I hear we need to test travelers at airports. How? We can’t even scan bags at airports efficiently and that is with machines that operate at 1 to 5 seconds/bag.
I’d like to hear realistic testing plans, not just “test everyone”, because even with millions of tests available per day, we’d need people to administer the tests and then to act on the results.
What reliability do we need to have on these tests to make them useful? If you are testing 2,000,000/day, and you get 0.1% false negatives and 10% of the people actually have the virus, you’ve let 200 people through to go infect another 450 people. If you have a 99% accuracy rate, maybe 0.1% are false positives. So now you need to track 2,000 cases that aren’t even real. how many times am I going to have to self quarantine at home for 14 days because I happened to be on a bus with someone that was falsely identified at having the virus?
Yeah, there’s no way we’re going to have some system where everybody just tests themselves before they go to work that morning. Someone mentioned pregnancy test as an example for the ease of pumping out test kits. Looks like they move about 30M units a year. Constantly testing everyone would take an order of magnitude or two more tests than that every year. And that doesn’t factor in whether these tests need to be sent to a lab.
The only remotely realistic idea for mass testing to get people back to work is concentrating on hospital and nursing home staff.
I just noticed the pregnancy test was referenced regarding antibody testing, which isn’t an unreasonable comparison. But I still say mass testing for the virus looks crazy logistically. Mass surveillance is not as unthinkable as many might assume but might be tricky legally.
The Vox article linked above seems to reflect my mild fatalism. These assorted guesses at “best practices” aren’t remotely doable. We can cry about the damn idiocy of the masses and the money grubbing corporations but it doesn’t matter. Some muddle of a middle ground will happen and then who knows. We’ll start to open up, do more testing and just try to keep our head on a swivel for awhile.
It doesn’t really answer my questions. The article and the simulation by Romer who is calling for 22 million tests a day, doesn’t say anything about how to actually do 22 million tests per day. It doesn’t say how we’ll identify the 22 million people we’ll test nor how we can force them to go to testing centers or wherever they’ll need to go. Even if you could get 22 million people to go, how long before they get results?
It talked about a 7% testing rate with a 1% false positive rate. 231,000 people EVERY DAY will be told to go home and isolate that will not need to be isolated. For how long? Two weeks? In two weeks that would mean 1.6 million people are self isolating for no reason at all. Who is going to pay their rent, food, bills while they are taking 2 weeks at home? Who is going to watch their kids or take care of the parents they are caring for while they are at home?
I just don’t see how we can practically pull off getting millions of people tested every day. Especially voluntarily.
There have been proposals where you need a certificate of some sort that would allow you to be out and about. No certificate? You get a ticket. But how often does the certificate need to be renewed? I can come into contact with literally hundreds of people in a 2 day span, infecting a dozen more people.
The concept of testing works great on paper. I do not see how it can be put into actual practice, which is why I’m asking. If anyone has thoughts on what I’m missing I’d really like to hear it.
As far as certificates goes, I’ve only heard that in the context of there being lasting immunity after recovery and you’d get one if you test positive for the antibody.
I’m not sure how even a home test kit would work. We can’t get people in this country to wash their hands on a regular basis, let alone piss on a stick every morning. How do they get the kit? Mom and dad are frantically in a rush to get the kids off to school and themselves to work and they are going to have Johnny, Janie and Jason piss on a stick and wait around for results? Doubtful. The most vulnerable to this, those in assisted living or retirement communities, aren’t likely to do regular testing of themselves, either. They have enough difficulty just going to the bathroom and we expect they’ll want to take a stick with them and piss on it? And then interpret the results? I had a terrible time trying to explain the concept of “tabs” in Chrome to my 83 year old ex mother-in-law.
Some nurse assistant making $10/hour pisses on a stick and finds out she is positive. She is going to call into work and say she can’t make it and give up two weeks of pay? She can barely pay her bills now.
All of a sudden I envision a large spike in positive test results as many people decide they’d prefer to stay home and get the state benefit than go to work.
Don’t get me wrong, those are all good questions. You can add, “how the fuck will we even manufacture 22 MM tests per day” to the good, unanswered question list. All the Romer report was answering was how testing 22 MM / day could be sufficient to snuff out the virus.
I would point out, though, that having 1.6 MM people self-isolating for no reason at all is a pretty good improvement over what we actually have now.
I frankly don’t think any of these surveillance or testing protocols will end up happening, because humans in general and Americans in particular just don’t have the patience or the impulse control. What I foresee happening in the US will be more seat-of-the-pants and less scientific. Once the curve shows several weeks of flattening or dipping, we’ll:
[ul]
[li]Allow nonessential stores, restaurants and bars to re-open, with tight capacity limits[/li][li]If the infected rate doesn’t soar after after a few weeks, relax those limits and allow businesses to bring workers back on site[/li][li]If the infected rate stays manageable, loosen more restrictions, etc[/li][/ul]
The last things to go will be travel restrictions and bans on sports and other crowded live events. If at any point in this process the infected rate shows signs of climbing, we slam the doors shut again.
I know this process will result in a far higher death toll, and will probably have several false starts accompanied by more of the same complaints that we already have. It’s not what I would recommend, but I fear it’s the best we’ll be able to pull off.