No, we don't all need to "get it eventually"

The Quarantine Zone
21

So, there is not one farmer in all of China’s 2,607 mile border who isn’t sneaking into Mongolia to tussle in the hay with his neighbor’s daughter? You’re absolutely sure?

There are no pangolins wandering in and out of Laos? You can guarantee that?

Saying that you have shut down the border is a vastly different thing from doing it. By similar token, we guard our Southern border, have a wall along large stretches of it, and have absolutely criminalized undocumented migration into our country. ABSOLUTELY ZERO ILLEGAL IMMIGRANTS IN AMERICA!

22

Help me out, too, please? Barring a vaccine, how is it not inevitable that we end up with herd immunity at 50-70% of the population having had the disease? I thought right now we are trying to minimize avoidable deaths–that is, deaths that would happen if proper medical attention was not available.

We could eliminate a vast number of deaths by communicable disease with quarantine. We don’t because we need a functioning society.

23

Donkey Football could save the NFL season as long as the donkeys maintain distance.

I read that 70% of the US economy is consumption-driven. I expect Americans to remain as materialistic as ever. Keep those consumers alive and healthy!

I doubt we’re even through phase one of the pandemic expansion. In a few months, we’ll look back on March-April as The Good Old Days. What happens when a large portion of “essential” workers are too sick to function?

24

Because R0 is not immutable. There’s been discussion about culture differences affecting the spread, e.g. people kiss each other in Italy to say hello but bow to each other in Japan. I think there’s still questions about the effect of those customs on the actual spread but what’s definitely true is that the current R0 estimates of 2 to 2.5 aren’t fixed in stone. If we adopt a few long term changes it may be possible to get the R0 down to under 1, at which point it would be controllable. Nobody knows for sure if that’s possible, nor do we know what those long term changes would be, but it’s not unrealistic to think that there’s a future where we’re practicing some reasonable social distancing guidelines + increased sanitation measures + better testing and localized containment that result in us being able to get back to work without 200 million of us becoming infected.

25

Americans won’t stay in shelter for 18 months. Mid-to-late May, we’re busting out of jail and it’s up to granny to keep herself under quarantine if she’s worried.

26

Sorry, too late. Even Andrew Cuomo has said that 40-80% of Americans will eventually get it.

This was always about merely making it so that everyone who needs treatment can get treatment, not hiding out in your mom’s basement for 18 months to avoid getting it all together. And there’s hope anyway that we might have some therapies in the next few months to reduce the mortality of the most severe cases.

We all have to take small risks to live in a functioning and enriched society. 3 million Americans die every year from various causes. This will just become yet another one of them.

The main difference with this situation and what would have made it so tragic is that the hospitals would have had to left people to die, a lot of them, had it spread uncontrolled at first. Imagine the civil unrest and destruction to society that would have ensued. That’s why governments were so willing to destroy their economies to prevent this.

27

False dichotomy.

28

A false dichotomy is when I present two options and say that those are the only options.

I said what will occur. I might be wrong, but I’d put it at around 75% likelihood and the chance that we’ll stay on lockdown for 18 months at 0%.

Do you believe that we’ll stay on lockdown for 18 months?

Do you believe that every country on the planet will do likewise?

Do you believe that we’ll keep all the planes on the ground and protect all the borders to perfect capacity right through to summer 2021?

29

The false dichotomy is that we’re either on lockdown or we’re not on lockdown. The post of line that you quoted describes a different scenario than either of those extremes

30

A) I’m going to stop being a fat bastard.
B) That’s a false dichotomy. You’re a person with a BMI of 30 and a body fat percentage of 26%. You’re only giving yourself the option of being a fat bastard and that’s not a proper classifier for your status.
A) Ja.

Let’s consider the option where I’m calling our current status “lockdown” when I say, “We’re going to stop doing what we’re currently doing and break out of lockdown.”

31

If it’s one farmer, no we don’t care. I’m not gonna tell that to all farmers, but the virus lasts for a limited time.

100 farmers have COVID. 90 of them self isolate and don’t pass it on. The other 10 pass it on to an average of 2.5 people. At the end of the month, the original 100 are done, and the 10 passed it on to 25 others.

25 farmers have COVID. 22 of them self isolate and don’t pass it on. The other 3 pass it on to 8 other people. At the end of the month, these 25 are done and 8 more have it.

8 farmers have COVID. 7 of them self isolate and don’t pass it on. The other one passes it on to 3 other people. At the end of the month, these 8 are done and 3 more have it.

3 farmers have COVID. All of them self isolate and don’t pass it on. At the end of the month, these 3 are done and you have no more new cases.

32

Flattening the curve extends the duration of the epidemic (or pandemic, if the flattening was worldwide, which, unhappily, it ain’t) It saves the lives of a bunch of old farts, if that matters to you. (Being an old fart myself, my opinion on that is biased.) If the mechanics of isolation measures were the entire story, it would still be a method to consider. But of course it isn’t. For reasons which cannot be examined in this forum, the United States medical community was entirely unready for something entirely predictable. They are spooling up now. The medical research community had not even started preparing for creating vaccines, much less safety and effectivity testing, production, distribution, and public policy education about vaccine use. That is . . . sort of improving, a little bit, in some sectors. A one hundred billion dollar emergency pandemic infrastructure in place a year ago, looks like a bargain against two trillion so far for consequences of not having it.

33

And what about the real world? How many thousands of people do you think cross the border of China every day? How many thousands of animals? What about after they begin to re-open things? Is the USA approaching the level of China in terms of how strict we are about our measures and protecting our borders? Do you think that we’ll surpass them and maintain that consistently for the next 18 months?

34

The best way to protect people is to be honest. Fantastical solutions that would work in a vacuum with no gravity are informative but, fundamentally, aren’t real.

In the real world, we’re not under individual quarantine, we’ve decreased movement by 40% not 100%, other countries (and even states) are doing worse at keeping things under control, once we pass peak and the numbers start to go down everyone’s going to sprint out their door and find an orgy to join, and we’ll have planes flying in from India by Christmas, even though a vaccine won’t be developed until summer of next year.

If you’re an old fart, you should stock up on supplies. Right now, you can go out and keep away from people to some extent. By end of May, if you go out you’re going to be bumping into people left-and-right. You need to be able to survive without going out.

35

Emphasis mine
Y’all are arguing over how many people are going to get it eventually, and how long we can keep people at home, and no one is addressing the core message here.
It’s “flatten the curve” vs. “Let’s just get this over with, like ripping a bandage off”

My response to the latter would be:

Ok, so - get it over with - we all go out and find someone who’s sick and shake their hand, or give them a kiss, or maybe go volunteer at a hospital right now, so that you’re actually being helpful while you risk your life.
So, lets say that .1 percent - or 1 in a 1000, get sick enough to need to go to the hospital, from 5-10 days of starting this.

In DFW (where I live, so that’s what I’ll use), that’s 6300 people arriving at the area hospitals in a 5 day range, or 1260 people a day.

According to this article, DFW hospitals usually has about ~5000 free beds. But only 1750 of those are ICU beds.

So, if you are on the tail end of that push, you’d better hope that 1300 people have already moved on… somehow. But good luck with that - Unlike other respiratory illnesses, course tends to be more prolonged, with some patients 2-3 weeks into their illness still requiring significant supplemental oxygen.

Oh yeah. You also better hope that even if you don’t get noticeably ill at that time, that you will not have an auto accident, a heart attack, appendicitis, or any other emergency medical conditions, because the hospitals are going to be overflowing, and the healthcare people are going to be overburdened. Any pregnant women who have difficulties giving birth? Sucks to be them, I guess.

36

Two months of isolation later, 1 infected but asymptomatic farmer has a birthday party with a 20 people from all parts of a city of 2 million. What now?

37

I started stocking up on supplies in 2013, when I had storage for the first time in my life. It wasn’t about emergencies, it was about FIFO stocking, and maximizing the effect of my fixed income by purchasing non perishables at the optimum cost. I haven’t bought toilet paper since last year, and I’m still not out. Bread runs out every time it snows. It’s not hard to predict. Flour water and yeast last for years, if you store them properly. Milk now keeps for six months or more, if you need it for anything but a beverage. Buying during panic times isn’t optimal planning. Now I pay a premium for some items because any planned inventory experiences inventory shortages due to market availability, and I am unwilling to bump fenders with panic buyers, and willing to pay the premium for bulk purchase for delivery. The toilet paper manufacturers are not ramping up production, because they are aware that folks don’t actually use more toilet paper during emergencies. (the annual market is practically flat, really.)
Bagels, though. I’m gonna miss good fresh bagles.

38

Are you at all familiar with China and how people cross its borders, even to and from Mongolia?

39

Nope. But I know how long it is, what the sort of cost would be to guard something like that, and the value in doing so.

40

Nitpick.
R[sub]0[/sub] is the initial reproduction rate. It is set in stone as it is the rate at day one. (We might not have a perfectly good handle of its value, but whatever it was on day one, is what it was.) R - the current rate, is dependent upon current circumstances. And of course as the pandemic continues it will eventually drop - if for no other reason than the fraction of already infected goes up enough. Get it below 1 for an extended time and the pandemic eventually fizzles out. Herd immunity is one way of pushing it below 1. But social isolating, restricted movement, test and isolate etc etc all act to push R down. But not in a linear manner - which is a big part of the problem.

The problem “do we all need to get it eventually” is a serious one. I don’t think there is a sensible answer yet. Here in Oz we are promised that the government will be providing the next step plan in a few weeks. And we are luckily in a good place. As an island we can close borders more easily, and we concentrate in a few large cities with big gaps between them. We have already closed off interstate travel. With enough testing, we might be able to operate with a closed borders plus test and isolate strategy. But most places on the planet will find this much harder through to unviable. There is no clear answer, and in many places the answers they currently see are probably all different kinds of bad. Opening up and letting the virus run after a solid lockdown may be political suicide. The wave of deaths that follows becomes directly linked to the person making the decision to open up.