I sure hope the epidemiological literature addresses this somewhere. I am sure may of you are familiar with the rope-a-dope metaphor often made to compare a situation to a situation in boxing:
How do the epidemiologists recommending all of these closures know now is the time for all the places they now recommend it? What if things have to open up again to prevent economic collapse, but it was way too early to close things in some places, and then we can’t afford to shut down again when the virus moves to those areas? Have they accounted for this aspect in their models?
This is why the lack of testing is such a scandal. We don’t know which places should be closed and which can remain open, because we don’t know where the virus is or how it’s spreading. If we had better data, we could focus efforts where they’re most needed. But we don’t, so we’re closing everything everywhere out of an abundance of caution.
Will this approach come back to bite us? Quite possibly. Way too many unknowns to be sure.
Back up a moment. Most of these closures aren’t being recommended by epidemiologists. For instance, the CDC recommends closing a school when there’s a diagnosis of a student or staff member. The governor of Ohio closed all schools in the state when there were a total of five diagnoses in the state.
There is a problem there, but this is an Act of God and you have to treat it that way. The concerned governments need to extend money to the citizens and business to cover them. There is plenty of money available to lend, tons of it. Hence our low interest rates! So take that money and use it now. The idea that we can’t afford to shut down anything given societies’ current level of productivity is erroneous. We certainly can, handled rightly.
Without proper testing etc (which we don’t have in USA) shutdown is the right approach.
I’m not sure if you are being sarcastic. It seems the panic is from people saying: watch out, case numbers are going to explode, and hospitals won’t be able to treat all the pneumonia cases. I think people put out of work should be given the option of paid training and then be paid to help out in the hospitals if/when they are hit. And if too much of it isn’t in China already to start it here, people put out of work should also be offered jobs manufacturing ventilators and antiviral medicines, etc.
AIUIt, it’s a question of balancing what’s known about the rate of increase in cases against the known or surmised willingness of everybody else to stick with restrictions for the likely period of infectivity. Impose too much too soon and people will start drifting back into old habits just at the time when incidence is approaching its peak, which is exactly what we don’t want.
The UK scientific advisers say they have behavioural scientists working on the public tolerance for restrictions, but there must be a fair degree of guesswork as well. And they haven’t been too forthcoming about getting into debates about exactly what evidence they’re relying on, other than that we appear to be about four weeks behind other European countries, so it’s not yet the time to get too draconian. Which is not to say that we won’t fairly soon.
At this stage, we are just starting up our own infectious curve. The thinking is, if we can get folks to stay home, we MIGHT be able to break the cycle of spreading the infection. 3 weeks buys us time. Time to perhaps slow down the rate of infection, time to get testing in the pipeline (something we should have already had but don’t, fully), time to find out who is currently infected but asymptomatic. Just time. It also puts us closer to the spring/summer when these sorts of viral outbreaks die down. I HOPE we use that time to feverishly get everything we need because come fall/winter, this sort of thing can spring back up like a wild fire, and is often worse than the initial outbreak.
BTW, I don’t think this is ‘epidemiologists’ who are recommending this by and large. Mostly, these seem to be political decisions to close at this time. But it’s not the wrong move, IMHO, and there is some thought and logic to doing what they are doing now, instead of waiting another 2 weeks for things to really get bad. Not that they aren’t likely to be bad anyway, but sending people home is going to help I think.
Of course since no one is being tested, we don’t actually know whether those 5 diagnoses are actually all that there are (they aren’t) or whether there are actually 5,000 cases indicating a 0.1% infection rate so that most schools probably do have at least one infected student or staff.
Seems to me that the earlier the better on this stuff, since it has a way of getting out of hand super-fast.
To use the school analogy, they’re looking to limit the spread within the school, but stopping earlier than that could block spread within the school.
And since children, even asymptomatic ones, are generally disease vectors par excellence, shutting schools earlier than later seems like a prudent thing to do. So does enforced work from home policies and the rest of the stuff. The idea is that if one family gets it, they won’t spread it beyond themselves, regardless of how they caught it.
Another reason for this is the thought that there might be asymptomatic carriers- either fully asymptomatic, or immediately prior to showing symptoms. Keeping everybody forcibly separate would seriously limit the transmission by them.
I remember a mathematician explaining exponential growth, and he used the example of a jar of bacteria that doubled every minute, filling up in one hour. He said that instinctively, we’d guess the jar to be half full at around 30 minutes, but that’s not how it works. It would be half full after 59 minutes. In the last minute, it doubles one more time and now the jar is at full capacity.
When you have an exponential curve, you must act earlier than seems necessary to prevent the worst. Have we shut down the economy too fast? The unfortunate thing is that if our shutdown is successful, it will certainly look like we overreacted to a large portion of the population.
Epidemiologists aren’t economists. They can only tell us “here is what you need to do if you don’t want 90% of the country calling in sick/dead next month”. Viruses don’t care if you miss a mortgage payment. What’s happening is what’s happening.
The day this OP was posted, there were 900 new COVID cases in the US. Yesterday alone there were 16,900. That was only 2 weeks ago, and the rate is only accelerating. I think that makes it pretty clear that we underreacted, and we’re still underreacting. At this point it’s a virtual guarantee that half of us are going to get it, and our best-case scenario is avoiding a situation where everybody has it at the same time.
People just have to get a grasp on the meaning of exponential growth. I don’t know how to get through to conservatives on this. Maybe think of the virus as money, and the US population as a savings account that pays 20% interest. Think about how excited you’d feel about this kind of get-rich-quick scheme. Then remember it’s a get-sick-quick scheme, and start feeling the opposite of excited.
Insufficient attention is paid to responders. Yes, medics - nurses, EMTs, MDs, therapists - will sicken. But also cops, firefighters, any providing safety and health services requiring public exposure. How does “the economy” fare when they’re all at 10% staffing? Have veterinarians yet been drafted to treat people? Will they be soon?
I just read that the number of confirmed cases in the US is doubling every 3 days. That would mean it would go up by a factor of 1000 in one month. If there are 10,000 cases today, there will be 10,240,000 cases on the last day of April. And lack of testing opens the possibility that we are seriously under counting cases. (At the same time, we might be seriously over counting the death rate.) The attempt is to flatten that number so that the hospitals don’t collapse. If you think that 3,500,000 deaths are worth it to save the economy, go right ahead.
There is an interesting experiment going on. Thirty states, majority blue, have at least partial shutdowns. The other twenty, almost all red, do not. At the end, we can compare death rates. Of course it will be complicated by the fact that most of those red states have rejected Medicaid expansion.
It’s further complicated by the fact that most of the major outbreaks are in blue states, most notably New York and California. This is due to them being major destination spots for people from around the world, while some place in the mid-west…not so much. So, I don’t think comparing death rates or numbers of deaths is going to be particularly meaningful for what you are trying to demonstrate. Red states, most likely, with a few exceptions, simply aren’t going to be nearly as hard hit as a few key blue states.
Also, not all red states are going against the social distancing ‘closure rope-a-dope’, and not all blue states are in complete lock step doing it either. The real problem is that not all politicians and state political machines are seeing the threat the same way, so the response has, as always in the US, been non-uniform. I do think it’s having an effect, but it’s going to be a hell of a lot worse before it’s better. BTW, I read something today that said the rate in New York is doubling every day, so your 3 days thing is overall…some places are much worse, some not nearly as bad.
There is a vast difference in population density relating to red/blue as well. I would imagine at the end of this all if you did a study between average time a person spent in a elevator-and rate of spread you would find a strong correlation. There are places where people really don’t spent much time within 6 feet of anyone in a normal day, vs places where people do it on a regular basis daily.
Just for the record, I don’t think Korea had a general lockdown.
AFAICT, people went to work every day.
Everyone wore masks all the time.
People engaged in social distancing.
If you came down with a fever, you got tested and if you were confirmed you isolated yourself and they tested everyone you had contact with in the 72 hours before you had symptoms.
The compliance rate on these precautions were nearly universal.
Our first case of coronavirus was the day after korea’s first case.
We are a zillion miles further away from Wuhan than korea and their mortality rate is and will likely continue to be much much lower than ours.
Our problem is an unresponsive government
A population that doesn’t understand how exponential growth works
An anti-authoritarian streak in our culture with a very strong sense of individual freedoms
Dumbshit kids that think licking a toilet and going home to grandma is perfectly fine if it will get them like on tiktok