How will people react if Covid-19 flares up when the lockdown ends?

The flu question has been well answered by now - mainly because flu’s impact is a somewhat known entity with little risk perceived of completely overwhelming the system (even if it sometimes gets closer to it than many appreciate) nor of flaring to several times that level.

So to address the structured recoveries that the states are pursuing. In most states nothing much has changed that would impact the course of the disease in the population since starting the control measures. Just stopping with nothing different means you start right up. So structured in ways that prevent getting too hot and overwhelming the system minimally seems like something you’d endorse.

A reason to be cautious is that while we do not know with any confidence exactly which of the variety of things done for mitigation have been of actual little impact vs higher cost (and can/should be dialed back safely), we also have no idea which have been the extremely effective ones that can’t be. We can make guesses maybe decent educated ones, but they are guesses.

Which is more likely to gain compliance of enough people in these politically charged times - disciplined gradual release without having to back track or trying to reimpose restrictions because case rates have jumped and hospitalization rates are increasing (but before jumps in deaths which would be too late for changes to be very effective), or having to reimpose and back track?

Assume that a controlled slow burn is the least poor achievable choice, it needs to be controlled - impatient slapdash approaches without any discipline don’t seem like the way to accomplish that. And [pick your state] aint Las Vegas - what happens there doesn’t stay there.

Unless you are comparing “financially destroyed” to “actually dead”, I’m not sure where this comparison comes from. What about the current situation causes me to choose between the death of the 28 year old or the 84 year old?

My state is gradually starting businesses up and is imposing guidelines on how they proceed. We now have more medical equipment and ppe supplies. I’m not sure what you’re proposing but that is a controlled return.

But they AREN’T. In Texas, it actually looked like we were going to be sane, but then the governor and Ted Cruz lost their shit when a hairdresser was put in jail–not because she opened her salon ahead of the schedule the governor himself set, not because she publicly ripped up the cease and desist letter the court sent, but because she told the judge to his face she wouldn’t apologize for ripping it up, pay any fine, or agree to delay reopening a couple weeks, to the day it was scheduled. So rather than go to jail for mocking the court, the Lieutenant governor personally paid her fine and Ted Cruz flew up for a haircut.

Lip service is being paid to “structured” but it’s not. And there is NO information campaign that would even help people make good personal choices. It seems to me that my state, at least, is actively avoiding discouraging people from going back to “normal”. I can kind of understand letting people decide what risks they think they should take–but they need good information.

?

It “comes from” the post it quoted that it was responding to.

Which I stated is not was is actually the choice being presented by anyone.
Magiver. Maybe then instead of broad brushstrokes we can discuss the specifics of particular states?

Even if there was a comprehensive information campaign to inform people how to protect themselves it is being undermined by public figures that have decided to characterize such measures as a partisan restriction on Constitutional freedoms.

Washington Post: “Colorado restaurant illegally reopens with no social distancing and hundreds of customers”

  • The restaurant’s reopening on Mother’s Day, with apparently no social distancing precautions, is the latest example of small businesses bucking their states’ executive orders while fearing for their survival. Under Polis’s “Safer at Home” order, restaurants are still prohibited from offering dine-in service. Colorado has seen more than 19,700 cases of covid-19, along with 973 deaths.
    The move drew swift backlash, as state and local officials condemned the restaurant’s disregard for public health protections and some Castle Rock residents feared the restaurant could have worsened covid-19 in the community. A spokeswoman for the governor’s office said in a statement to The Washington Post that the restaurant’s conduct is “endangering the lives of their staff, customers and community." The Tri-County Health Department told CBS Denver it would be following up with the restaurant to take whatever steps necessary to ensure it complies with Polis’s order.

But the restaurant also had plenty of supporters. Among them was state Rep. Patrick Neville (R), who is also among a number of conservative lawmakers nationwide who have joined their constituents in acts of defiance. He said on Facebook later that he found it “shocking” that, after taking a photograph of himself with Arellano at the restaurant on Sunday, the “left mob is coming after me over this hardcore."*

When the people who are supposed to be leading are encouraging defiance, no information campaign or ‘structured reopening’ is going to be effective.

Stranger

We’re currently not overwhelming the health care system. We ARE currently in a serious financial situation and we’re restoring businesses in an orderly manner.

It occurred to me that the use of “people” in the OP kind of assumes that most of all Americans in general will eventually be both touched by this pandemic and convinced of its seriousness should a second wave happen. Is there a reason to be confident of this other than “well, it HAS to happen… right?” (Yes, I know there will definitely be a non-zero number of people who will never be affected or convinced, but I’m just not completely certain that this number can’t or won’t be significant. I also know that there aren’t many of these people in, say, Italy, but as we keep saying, the US has a pretty distinct geographic and political landscape.)

But this isn’t an example of structured reopening. It’s an example of people just defying lockdown. In no way is this example an argument against structured reopening.

Look, the facts are these:

  1. There is no vaccine and there isn’t going to be one anytime soon. It’s time to accept that. I would be pleasantly surprised if there was one in less than three years. I know they’re saying “eighteen months.” That’s extremely optimistic, and even those wildly optimistic guesses don’t include the odds that it just won’t be something we can do at all, the fact that it then takes awhile to roll the vaccine out to billions of people.

  2. You can’t continue lockdown until there’s a vaccine, because either there isn’t going to be one, or it’ll be years in the future. A lockdown for two months has been pretty harmful. A lockdown for a year wouldn’t happen; people would simply not tolerate it, and the apparatus of state would be existentially imperiled if they tried to enforce it. Like a boiling kettle, pressure needs to be let off or it’ll explode.

Society has to open up. The only question is how, and I already have part of that answer; NOT ALL AT ONCE. That’ll just spike infections even worse than before. So what’s your plan? We’re just arguing over details.

So we should expand the economy until the healthcare system is overwhelmed?

That is exactly my point. I am open to the argument that there are ways we can relatively safely widen economic activity. But it’s not politically possible because we don’t have the national will or leadership to do so. The Powers That Be don’t seem to really want to restrict economic activity AT ALL, so every measure is diluted before it’s established and then the diluted measure is further undercut immediately upon its establishment.

New York City, however, DID get overwhelmed (not as bad as Lombardy did, but it wasn’t pretty), and the same thing could happen again in other areas of the country. Yes, we are in a serious financial situation, but reopening too soon isn’t going to help that much, and in too many places, it’s less an orderly reopening as a panicked one: “people are complaining, we gotta do something, REOPEN.” In Texas, for example, the number of new cases each day is one-and-a-half to two times what it was a couple of weeks ago, and the number of active cases has not fallen by much at all. An apparent improvement in late April was due to improving numbers in Houston; outside that area, cases are surging in the rest of the state. (cite) Reopening the state is not really likely to help that, and if rural Texas sees an outbreak like Houston’s, the economic consequences will be at least as devastating as the lockdown, so the state will have financial ruin AND deaths.

No, and I wasn’t arguing that it was. It is, however, an example of the lack of political will and responsible leadership to manage a ‘structured reopening’. If we had a more cognizant public lead by responsible leaders who were implementing a careful plan of staged reductions in lockdown combined with a comprehensive testing and tracking program, we could have the kind of ‘controlled burn’ that DSeid is recommending where we essentially allow a certain amount of the population to be infected at a given time, accept the minimum of casualties that will inevitably occur but be prepared with good medical interventions to help those who can be saved and protect those that are at most risk (which we still need a good, science-based criteria to identify, because this is not just “an old peoples’ disease”). Unfortunately, there are too many people like Magiver who insist that we’ve endured enough lockdown and we just need to reopen as quickly as possible regardless of consequences, which will essentially maximize mortality. And this has rapidly become a partisan issue where the science has been excluded in favor of appeals to “freedom” and “the Constitution” as if either of those things is going to protect people from getting sick and dying where they could be saved.

Although there has been a lot of hype and promotion that we may have a vaccine by the end of the year, maybe in twelve months, or eighteen months, I think we need to proceed at this point under the assumption that an effective and safe vaccine may not ever be available. In that vein, we need to a) start implementing comprehensive occupational protections to minimize spread where people have to work in public facing or group work roles, including wearing effective masks (not just cloth face coverings that do very little to prevent the spread of aerosols), b) develop effective and accurate near-real-time antigen testing and a qualified antibody test that can be used to correlate immunity to exposure so that we can have some hard evidence whether and for how long immunity from exposure will protect someone instead of guessing, c) implement long-term changes in social behaviors and environs to minimize spread, and d) have a comprehensive infection surveillance system in place so we can not only track outbreaks of COVID-19 but other potential epidemics including influenza and other highly transmissible diseases, because having a bad flu season would magnify the effects of a COVID-19 outbreak manyfold.

To do all of this, we need to have a plan. The plan needs to be flexible to allow for different conditions in different regions, but every single state needs to buy into that plan and follow it. The Federal government needs to support the states so that they can implement said plan instead of telling them to declare bankruptcy, and we need political leaders to stop turning this into a partisan issue about freedom and Constitutional rights.

Another thing we need, and that relatively few people have talked about, is some kind of oversight on information that is collected to make sure it isn’t used for the wrong purposes, because there is an incredible potential for abuse from surveillance, and not addressing that just feeds into the fears of people who are concerned about government overreach. Of course, many of those people are not going to be convinced regardless, and there is little way to compel people to report or provide data necessary for comprehensive tracking & tracing, which means we’re going to have to make that a secondary effort to tracking epidemic spread in the aggregate…which is problematic because of how much latency and asymptomatic spread this virus is capable of. Which means…having to have very localized and controlled relaxation of isolation and stay-at-home criteria.

If we could be assured of better reporting and widespread compliance with effective measures to limit spread, we could open up more like Sweden, but as can be seen from the link in the previous post, and in countless other incidents where even the most basic physical distancing protocols are flaunted by people who don’t even ‘believe’ in essential facts, that kind of social responsibility just doesn’t exist for a large and vocal segment of the US population (many of which are aligned with a particularly political part and/or ideological movement), and so all of the planning is probably for naught. With the current non-plan of many states opening up now I’ll frankly be surprised if we don’t get up to a rate of 3k deaths/day by mid-June, and if we aren’t looking at a mortality count approaching 400k before we get to influenza season, and then…who knows.

Stranger

Dead customers notwithstanding, businesses that open up sooner have a huge economic advantage over ones that open later. They get a head start. Who decides who gets to open first? How do you prevent businesses from all reopening at the same time, given the defiance shown in the Mother’s Day example?

I basically agree with your post, RickJay.

I think some countries and jurisdictions are going to be better equipped to respond than others. One advantage the US has is that it’s pretty well set-up to social distance if people and groups choose to do so, and can commit to it. We have a pretty good set up for working and shopping from home, and it’s become part of our culture. I’m sure the US isn’t alone in this regard.

But our God-awful system of health insurance that is tethered to employment and our patchwork hospital system has finally caught up with us. It’s a disaster in the making, and honestly, a part of me hope it lights the match, pours the kerosene, and burns the fucking thing to the ground (sorry if this is considered to be too political for this forum).

I agree that a complete shutdown won’t work indefinitely, and it’s questionable as to the extent to which it can work even now. One thing we’re discovering is that many patients believe that they were sufficiently self-isolating and still got sick. They obviously came into contact with someone at some point, but it shows that a total lock-down is something that people won’t accept for longer than 4-6 weeks.

For now solutions would include having office spaces allowing people to telework as much as possible and encouraging people to use curbside and delivery as much as possible. Office culture will have to accept and encourage the wearing of masks. Lots of other changes.

I don’t know the guy, but does he actually say that? Isn’t he the guy who keeps saying “Structured reopening”?

I realize a lot of people of a certain political persuasion DO say that - or worse - but let’s make sure we’re actually accusing people of saying things they really said.

Well, there’s the real difficulty in a federal country. Canada faces, in theory, a similar problem, though geographically it’s in a more advantageous position as there aren’t as many large towns and cities across borders near one another. In both cases most public heath law is made not at a federal level but at the state/provincial level, and if you’ve got “it’s all a hoax” morons in one legislature they can screw it up for the sober ones.

Federal leadership can help in this regard; even where the feds lack Constitutional power, they can use influence. I’ve gone too far in this forum before in making political comments, so just… uh, follow that thought to its logical conclusion given current events.

This is a really good question. I mean, regarding the Mother’s Day nonsense, one would hope the police would enforce the fucking law.

That said, even legal reopening is going to screw people over, Walmart is absolutely killing it around here because by law a WalMart was never required to close, since they sell groceries. They wer,e consequently, getting bonus sales in every other department WalMarts have; they could sell you a TV, or bathroom fixtures, or toys, while most stores that sell those items could not. Rolling out gradual openings will likely result in similar inequities as you go.

Good grief, there’s a law for THAT now?

Did you miss this part of the post you responded to?

Dr. Drake’s post was in response this post:

So, effectively, old people need to deal with the fact that we’re opening this shit up so that young people don’t go broke.

Therefore the comparison is the livelihood of the 28 year old to the life of the 80 year old. To me that is a pretty easy answer, and the 28 year old may not be happy with my choice.

That’s assuming their customers don’t get sick. If a store opens too early, and an outbreak is traced to them, (especially a restaurant) they are going to have serious problems. It seems a lot of store owners in Georgia (based on credit card information) didn’t open thinking it was too early.

This what behavioral economists call signaling. Cruz is signalling that Covid-19 is over. So is Pence by not wearing a mask. So is Trump by having his aides standing close together. So is anyone supporting the maskless crammed together protesters.
You are not going to get social distancing when the leaders say it is bullshit. Where I live, on the other hand, our leaders are serious about it, and people follow the guidelines very well.