Looking at the charts, cased around the world have generally stopped increasing exponentially and now range from decreasing to increasing, but at a steady linear rate. I.e cases in the USA increase rapidly until around mid April to about 30,000 day, and have slowly decreased since. The virus hasn’t gone away. But the charts would suggest that even in places like New York or Italy, the worst is well over. Normalized by population, most states are around 200 cases per million people or less with no signs of the massive peaks previously seen around the greater NYC area.
So I guess my question is this. Can we assume that this flattening is due to the strict(ish) “social distancing” practices, or is there something else in play here? I’m not an epidemiologist, but it seems to me that baring some other factor, these charts should continue to rise, even with social distancing, given that quarantine isn’t perfect. Especially in places like NYC or where I live in Hoboken, NJ. I mean I’m not so naïve to believe some silly mask provides total protection against the virus when I live in a building of 1000 people, pass people on the street, in the take-out line, etc.
Georgia has been reopened for 3 weeks and doesn’t appear to have seen an increase.
Referencing these charts here
I don’t know why “herd immunity” has gained such traction as a possible solution. Other than it is a fancy way of saying “do nothing”. As **Stranger On A Train **pointed out, that isn’t a “strategy”. Let’s assume 50% is required. That’s still 160 million Americans, which presumes somewhere between 1 to 6 million will die.
Not to be cruel, but I think I just have to say it. This is a pandemic. A metric shit ton of people will die. It is certainly tragic and every loss is someone’s family member. But death is a part of life and until very recently, young deaths were a real part of life.
A lot of comparisons are made to the 1918 pandemic. I looked up my family tree again and was struck by something. My great-great grandparents had 10 children, and a full 6 of them died from some childhood illness. My great-great grandfather died at age 35 in 1908 from typhoid fever, and his wife died at age 44 in 1917 from the measles. And this was not untypical.
This was the reality that people in 1918 were dealing with. We have grown up pretty spoiled. We all expect to live into old age. Sure, we hear about people getting cancer or having heart attacks and dying at a young age, but that won’t be us or anyone we know. We will all live a long time.
We are simply not prepared for the reality that for as much progress we have made, landing men on the moon and so forth, there are some things that can kill a whole bunch of us. And this thing will kill a whole bunch of us, and my understanding was that we were simply “flattening the curve” so that the hospitals were not overwhelmed and giving more of us a chance, not that we were going to be locked up so that nobody or very few people died.
And we have further advantages. Vulnerable people can continue to stay at home no matter what restrictions are being lifted in the community. Unlike my great great grandfather who had to go to town for supplies when typhoid fever was ripping through the town, people today can get their groceries via Instacart or get delivery of food and even alcohol through Uber Eats or other methods and get almost anything in the world shipped to them by Amazon.
Again, I’m not trying to be dire or insensitive, but a lot of people will die no matter what. But we just cannot bear to hear politicians say that so we have what is, IMHO, false comfort being put out there that if we only did this, if we had more testing, if we only did that, if we only would cripple the economy further that everything would be unicorns and rainbows. This is a pandemic. That is bad shit.
I don’t think anyone knows what percentage of the population needs to be immune to covid for true herd immunity, and I think, based on so many other diseases requiring 85-95% immunity to achieve that, a figure of 70% is wishful thinking at best.
Meanwhile, we don’t really know - aside from advanced age - how to really determine who is at high risk and who isn’t, except in the most broad of terms (do you realize how many people in the US have diabetes, high blood pressure, COPD, and so forth?) and even then, the lives of “at risk” people should not be considered less worthy than the lives of those at low risk. So very many of the high risk and the dead were NOT debilitated, already-dying people but folks who were able bodied for most purposes and probably with years of life ahead of them if the virus hadn’t taken them.
Social distancing, better hygiene, masks, etc. Sure, the new cases are decreasing - because nearly the entire planet is sheltering in place. The “worst is over” ONLY because of the lockdowns. If we throw off the facemasks, forget about social distancing, and go back to the way things were before cases will spike. As has been demonstrated in various areas that tried just that and turned into mini-hotspots in 1-2 weeks after that.
No, you’re not an epidemiologist. Neither am I, to be fair, but honestly, quarantine doesn’t have to be perfect to reduce the number of new cases. If it was perfect new cases would be zero, but they aren’t.
While I may quibble on the details, this is one of the few times I agree with UltraVires. No one wants to hear the truth. This is a world-wide disaster, even if it’s sort of in slow motion. There are no good answers. Our choices here are between one sort of bad and another sort of bad. We can do some damage control and/or mitigation, but this is not fixable.
The arguments should be about how we’re going to limit damage and what trade-offs are tolerable. But instead we get bullshit.
I am so tired of it already but best case I think we’re only about 5 months into a 24-36 month marathon.
100% agreed with the conclusion but the “simple calculation” and “assumes that” needs much emphasis. Simple fact: NO ONE KNOWS at what point in which particular society with which particular set of circumstances there would be enough in the “Recovered” bucket to slow transmission. The expert consensus quoted has usually gone with extrapolating from 1918 and predicted 40 to 60% but that has been just one way to guess.
It may be much higher … or much lower. No matter how simple or complex the calculations and modeling the actual facts needed to do more than make it up remain unknown.
How lasting and complete or incomplete is immunity after infection? What is the true infection rate? How contagious are those who never get symptomatic? What is the range of contagiousness inclusive of the fraction who are super-spreaders and those who functional dead-ends to further transmissibility? How much cross-immunity occurs from infections with the other common cold causing coronaviruses? Does that cross-immunity prevent infection, modify severity, modify transmissibility, all, or least likely, none? What is the magnitude of seasonal forcing on this specific virus? Are kids in fact only relatively fractionally contagious when they get it? What fraction?
ALL OF THOSE are necessary things to know for the experts to run models that actually mean shit about predicting where/when herd immunity becomes a factor in slowing spread in specific circumstances. Different answers to ANY of them could alter calculation results dramatically.
That though only supports your conclusion. We are walking in darkness tapping a stick ahead of us. Sitting still until the lights turn on at some unknown if ever future time is not an option. Literally not possible as in it won’t happen, compliance with that is not possible. Rushing headlong into the darkness would be idiotic. Our only choice is to feel our way through it.
I have heard insufficient discussion of how this pandemic relates to our modern attitude towards death, or expectations of modern medicine, and our willingness to fund whatever efforts we feel necessary.
Instead, we’ve seen our willingness as a species to fail to plan, while expecting last minute “Hail Mary” solutions, at whatever the cost. Maybe part of that cost ought to be that a lot of people die, who might not have had to had we invested previously.
Although many people appear to have forgotten, we have been in the middle of a pandemic for nearly four decades. The AIDS epidemic was first recognized in July 1981 and has been going strong ever since. It took the better part of of a decade to characterize the basic pathogenesis of the human immunodeficiency virus
and we’re still learning new things about it (as we are all viruses). We’ve yet to trial an effective vaccine but public awareness campaigns and therapeutics have reduced the incidence in developed countries below the epidemic threshold and allowed infected persons to lead long and productive lives (not so good in developing nations, unfortunately, due to lack of education and basic medical services, prejudice, and superstition), and we’ll never have herd immunity for HIV without a vaccine because an infected patient continues to shed the virus for their lifetime to greater or lesser degree.
Now, it is true that HIV is less contagious than SARS-CoV-2 by nature of transmission, but there are measures that we can take short of full lockdown to limit the spread of the latter, and with development of rapid testing an early intervention with effective therapeutics under development we may be able to drive severe morbidity and mortality down to levels of seasonal influenza. This is not a situation of herd immunity or apocalypse, especially if it remains that most people only experience mild or no symptoms, although that is obviously not good for those who are vulnerable.
The “social distancing” can help flatten the curve even if they are not comprehensively followed just because there are segments of the population that are limiting contact. If you broke down the population by behavioral demographics that would probably be clear. Of course, there could be other factors such as weather that play a part (though we’ve seen no clear reduction in tropical and subtropical countries) and no other changes in the pathology of virus variants that would suggest a reduction in virulence, so the null hypothesis is that the distancing and isolation measures in play are the primary driver but with states in various phases and degrees of reopening we will have pretty clear evidence to falsify that hypothesis (again, provided that the data being reported is accurate).
Yeah, the simple model is at least inaccurate, and I’ve been surprised that the belated and often-indifferently imposed distancing measures have been as effective as they have been, but that also means we ought to tread lightly on releasing them lest we simply return to a potential wide scale epidemic outbreak.
Ideally, only a few states, or areas of states, would open up first and all preparations would be made to support those states with medical services and protective equipment on reserve, but apparently we’ve decided to just open everything up with only a handful of states taking significant measures to phase openings and very few people actually following recommended handling practices with mask-wearing and distancing if they are bothering at all, but I guess that will tell us things, too, albeit maybe answers we don’t like.
In any case, there are some long term changes we are going to have to make to restructure our economy and alter workplaces and social spaces, and a dose of cold reality may be what is necessary to drive home that necessity. We can just hope that governments will be more honest than not, and political leaders will respond to guidance from public health authorities rather than to push their own agendas.
It is relatively easy for a person to reduce the possibility of their getting AIDS to truly miniscule levels. The R factor can be kept very low without shutting down parts of the economy. That cannot be done with SARS-CoV-2. If we cannot become immune, we will all get it eventually, and, worse, keep getting it. As it stands, it’s really quite likely most of us will get it anyway.
Could we come up with effective therapeutic approaches? Maybe. One hopes so because if we cannot become immune and there’s no therapy beyond drinking a lot of fluids and hoping for the best, we’re boned, pal.
Which still means that people get their groceries and booze from other people.
Not saying you’re doing this, but I’ve seen way too much of this “out of sight, out of mind” stuff here in my own city. In my neighborhood, people by and large don’t give a shit anymore, and aren’t even trying. The same is true, as far as I can tell, in all of brownstone and hipster Brooklyn.
It appalls me that we’re being forced to accept a false dichotomy, everything goes back to ‘normal’ or forced total quarantine.
Doesn’t seem like anyone wants to talk about limiting the number of cases (if only because there is no guaranty that you will survive an infection unscathed) and using the time bought to come up with increasingly more effective treatment protocols (while working ‘our’ asses off on a vaccine).
AIUI we’ve already realized that vents are not a particularly good treatment choice compared to sufficiently high levels of oxygen and NIPPVs.
Isn’t that how it works for most respiratory diseases anyway, before COVID19? While not yet proven, not gaining immunity to something we are exposed to is not how we understand how our immune system works. It’s likely we will all get it just like we all get a cold; since this is new, we are dealing with the virus burning thru virgin territory, with a high level of unpredictability with higher impacts on some vulnerable populations. This is about as contagious as the cold and more deadly than the flu. A vaccine will certainly accelerate getting it into the background, so until then caution is warranted, but it is here now and it will be difficult for most of us to avoid it entirely. IMHO.
I certainly hope they’re working on vaccines and medicines. Again, I was speaking to a hypothetical, not a certainty.
The number of cases needs to be limited to below the capacity of the health care system to treat people with serious conditions. That’s the objective whether or not there’s a vaccine, in part because we must proceed on the assumption there will never be a vaccine.
One misleading graph does not invalidate the general argument. The moving average number of deaths per day attributed to COVID 19 in Georgia has not increased since the April 24th reopening:
I get what you’re saying, but given the timeline this also sounds a bit like “We’ve tried nothing, and we’re all out of ideas.”
Based on the IFR numbers NY released a few weeks back, which are still barely more than a blind guess, something like 1.5 million Americans will eventually die of COVID-19 if we just let it run its course. That’s a sufficiently large number that I think any time we spend delaying the “inevitable” while looking for better options is probably worth it.
The problem is that we’ve sorta rushed through 2 Coronavirus relief bills and then left the states to run out of money on their own. That’s a far cry from the national 4 year effort to defeat fascism that we saw during WWII, or the lengths we went to as a nation to stop the red menace, or even the trillions we’ve spent trying to prevent another terrorist attack on US soil. It wasn’t even 2 weeks into most lockdowns when the “we can’t stay locked down forever” crowd took over the national conversation.
Two months is all America is willing to tolerate in terms of sacrifice before throwing its collective hands up in the air and saying, “Well, I guess we just need to let this happen.” That’s pretty pathetic.
This is also not 1918. I like to think that we have the ability to a more proactive approach than simply let the healthcare system collapse so we have patients in FEMA tents in the street and have to bury bodies in giant lime pits.
It’s also a mistake to decouple the economic issue from the health issue. If cases start to spread and workers start to get sick, states won’t need to shut stuff down. People will stop going to work and frequenting businesses on their own and the economy will tank anyway. The more testing we have, the more we know who is safe and who needs to be isolated. That way we don’t have to shut everything down because everyone thinks they will get sick and die as soon as they step out of their yard.
The problem with easing restrictions is that if a further wave occurs then a significant part of the population will restrict their economic activities - which means they won’t go out and spend on leisure which knocks on to a whole load of other consumer items.
The Western economies all rely heavily on consumer confidence, and that confidence needs to be right across the population - if there is a loss of faith in just 20% of a population because they consider themselves vulnerable it will be a disaster - it will lead to deep rooted unemployment in service industries which in turn will knock confidence for larger purchases such as cars and other finance related items such as housing.
If any state is massaging or out and out lying then it will bite them so very hard indeed - better to take a hit now than an ongoing depression that might last for years due to Covid being endemic. This will all eventually come out and the finger pointing will not be merciful - woe betide the incumbents of political office.
Should this occur then the political elites are going to have a very tough time indeed - mass unemployment, low economic activity, little prospect of a recovery and a population that will find a readjustment away from addictive consumerism extremely difficult indeed.
Sure. I agree 100%. That is also another uncomfortable truth. If my great-great grandfather was a rich man he could have hired a servant to go to town in the middle of a typhoid epidemic. There will always be an “us” and a “them.” Many of us are able to do our jobs from home on Zoom while others have to be out working in grocery stores or meat packing plants.
If you have ideas to change that, then I am all ears, but even the most zealous lockdown proponents have not said that we should cut all food production, even though that puts people in harm’s way. I’m not trying to be a “Let them eat cake” sort of guy, but at least the modern system allows more people to stay safe.