Covid-19 Politics

[broncofan]

I think it was clear about 6 weeks into lockdown that people wanted restrictions to be reduced. Local governments kept talking about finding ways to loosen restrictions and open up without causing a spike in cases.

If we had contact tracing, which I understand is a staple of infectious disease control, we would have some sense what sorts of activities were leading to spikes in cases.

It may be that certain businesses, like bars, cannot safely open because the entire purpose of the business is for people to fraternize with people they don't know. Other businesses, on the other hand, can open up if they have safety protocols and people are required to wear masks.

Part of the problem is not just that politicians are not being led by public health experts, but that the public is not being educated about relative risk. There is no such thing as zero risk for most activities but some activities are on average so much more hazardous to the spread of the virus that you can't engage in them without causing outbreaks.

There are also measures people can take without any cost. It costs nothing to a person without breathing difficulty to wear a mask, to talk to someone from a distance, and to be somewhat cautious.

There is also the issue of "end-game" which was brought up here and which I heard brought up elsewhere. The question is, "will we have to live like this forever and if everyone is going to get sick anyway, why prolong it."

Two points:
1. If there is no effective treatment in the Fall, but the vaccine is ready for distribution by early next year, it will be unlikely that more than 20% of the public would be infected by that time. If we had done a better job it would be far lower than that. But the difference between 20% and 60% which is the low end estimate of herd immunity is substantial. Actually, with ifr of 1%, and 40% (the margin) of the population being about 120 million, could be a difference of over a million lives. There was never really an option to do nothing.

2. There is a reasonable chance that there is a somewhat effective antibody treatment approved and if we're lucky ready to be distributed by fall. Don't know how effective it will be, but I'd guess something shows statistically significant efficacy.

[Stavros]

I think it was clear about 6 weeks into lockdown that people wanted restrictions to be reduced. Local governments kept talking about finding ways to loosen restrictions and open up without causing a spike in cases.

This, in two sentences is the perfect summary of the dilemma decision makers have faced, and too often chosen to ignore, or convince themselves they can have freedom and responsibility at the same time. Even at this stage it seems people cannot understand how cruelly effective this virus is in passing from one person to another, and either don't understand or don't care that even if someone infected does not die, their lives may be impacted by health complications for years to come. David Miliband calls this the 'Age of Impunity', but maybe we are moving into an 'Age of Indifferece' in which other people's problems are dismised as irrelevant, even as the relevance of other people standing or sitting next to me on the bus or the train is undeniable -and in the rush hour (on the London Underground, for example) 'in your face', something most people never liked anyway. Is it any wonder people from large cities like London and New York are looking at re-locating to the suburbs and small towns?

[blackchubby38]

Hypothetically speaking, is this idea that I have seen on Twitter even feasibly possible:

Just shut everything down, suspend all mortgage and rent payments, give everybody $2k a month regardless of employment or means and call the rest of the year off. Otherwise we’re doomed.

[broncofan]

I know this thread is a bit all over the place but I came upon this explanation of different immune responses to the virus, from a professor, and it was the clearest explanation I've seen about what types of immune responses vaccine makers want to elicit. He said there seems to be a robust t cell response to covid, as opposed to antibody, which doesn't prevent reinfection but tends to be long-lasting and may prevent serious disease in reinfection. Anyhow, short thread, take a look.

https://twitter.com/BallouxFrancois/status/1277885591376535553


https://twitter.com/ScottGottliebMD/...14331785142273

Here's Scott Gottlieb, former FDA head, saying he thinks vaccines will be available by early next year and with recommendations on virus suppression. For my part, I think the South should close, and places with early outbreaks need to start taking measures to control outbreaks, from mandatory mask wearing to closing certain kinds of businesses.

[Laphroaig]

Hypothetically speaking, is this idea that I have seen on Twitter even feasibly possible:

Just shut everything down, suspend all mortgage and rent payments, give everybody $2k a month regardless of employment or means and call the rest of the year off. Otherwise we’re doomed.

In a word no.

There will always be critical sectors required to work, utilities, health care, food supplies to name but three.

One thing I have seen on Twitter is a few posts resenting the fact that they've worked throughout this pandemic so far whilst others have "sat on their arse" or enjoyed themselves at the beach" while on furlough.

[blackchubby38]

In a word no.

There will always be critical sectors required to work, utilities, health care, food supplies to name but three.

One thing I have seen on Twitter is a few posts resenting the fact that they've worked throughout this pandemic so far whilst others have "sat on their arse" or enjoyed themselves at the beach" while on furlough.

I thought the idea was just wishful thinking. No only for the reasons that you have given, but there is no feasible way to pay for it and for a majority of people, $2,000 a month is not going take care of all of their expenses.

On a side note, you want to see a society quickly crumble, shut off the power. Then we will truly be in the middle of an apocalypse.

[blackchubby38]

I think it was clear about 6 weeks into lockdown that people wanted restrictions to be reduced. Local governments kept talking about finding ways to loosen restrictions and open up without causing a spike in cases.

If we had contact tracing, which I understand is a staple of infectious disease control, we would have some sense what sorts of activities were leading to spikes in cases.

It may be that certain businesses, like bars, cannot safely open because the entire purpose of the business is for people to fraternize with people they don't know. Other businesses, on the other hand, can open up if they have safety protocols and people are required to wear masks.

Part of the problem is not just that politicians are not being led by public health experts, but that the public is not being educated about relative risk. There is no such thing as zero risk for most activities but some activities are on average so much more hazardous to the spread of the virus that you can't engage in them without causing outbreaks.

There are also measures people can take without any cost. It costs nothing to a person without breathing difficulty to wear a mask, to talk to someone from a distance, and to be somewhat cautious.

There is also the issue of "end-game" which was brought up here and which I heard brought up elsewhere. The question is, "will we have to live like this forever and if everyone is going to get sick anyway, why prolong it."

Two points:
1. If there is no effective treatment in the Fall, but the vaccine is ready for distribution by early next year, it will be unlikely that more than 20% of the public would be infected by that time. If we had done a better job it would be far lower than that. But the difference between 20% and 60% which is the low end estimate of herd immunity is substantial. Actually, with ifr of 1%, and 40% (the margin) of the population being about 120 million, could be a difference of over a million lives. There was never really an option to do nothing.

2. There is a reasonable chance that there is a somewhat effective antibody treatment approved and if we're lucky ready to be distributed by fall. Don't know how effective it will be, but I'd guess something shows statistically significant efficacy.

There are certain industries that are going to be in more trouble with another lockdown and/or further restrictions:

Bars
Non-chain restaurants
Movie theaters
Hotels
Amusement Parks
Sporting events
Concerts.

Then when you factor in the symbiotic relationship that the leisure, dining, and travel industries have with other industries and with each other, the economic impact of a lockdown and restrictions gets even worse.

The key is trying to find a balance between saving as many lives of those who are at risk as we can, but at the same time protecting the majority of livelihoods and physical/mental well being of the rest of population.

If we can't do that for the industries that I have mentioned, then Congress may seriously have to consider a bailout for them.

As for what the endgame is. Remember it was about flattening the curve so the healthcare system wouldn't be overrun. It wasn't supposed to be about ceasing to live our lives.

[broncofan]

If we can't do that for the industries that I have mentioned, then Congress may seriously have to consider a bailout for them.

As for what the endgame is. Remember it was about flattening the curve so the healthcare system wouldn't be overrun. It wasn't supposed to be about ceasing to live our lives.

How do you think the U.S. is doing compared to the rest of the world? You can find some countries with more deaths per capita but they also faced earlier outbreaks, have much higher population density, and aren't seeing a second peak.

In my view the object should have been to find a balance between lives saved and quality of life with an emphasis on the former. The fact that there are countries with a fraction the number of deaths per capita who have not suffered any more economic hardship suggests that more aggressive action to save lives would have been better.

The people bringing up the question of endgame often weren't interested in what kinds of public health measures could mitigate the outbreaks, what kinds of treatments could reduce death rates, and what vaccines were in the pipeline that could end the crisis. The question was generally a rhetorical one proposing fatalism or its epidemiological equivalent, herd immunity....this would only make sense if modest public health efforts weren't very effective, if there weren't clinical trials taking place right now, and if we didn't have ongoing the greatest global effort in history to develop vaccines.

I agree that Congress should be acting aggressively to stave off economic hardship and to save industries that need bailouts in the meantime. For me personally, I look at the south and don't think that people bowling and going to bars is going to be viable for some time...I also don't think with reasonable stewardship you'd see outbreaks that large this late, but that's just me.

[blackchubby38]

How do you think the U.S. is doing compared to the rest of the world? You can find some countries with more deaths per capita but they also faced earlier outbreaks, have much higher population density, and aren't seeing a second peak.

In my view the object should have been to find a balance between lives saved and quality of life with an emphasis on the former. The fact that there are countries with a fraction the number of deaths per capita who have not suffered any more economic hardship suggests that more aggressive action to save lives would have been better.

The people bringing up the question of endgame often weren't interested in what kinds of public health measures could mitigate the outbreaks, what kinds of treatments could reduce death rates, and what vaccines were in the pipeline that could end the crisis. The question was generally a rhetorical one proposing fatalism or its epidemiological equivalent, herd immunity....this would only make sense if modest public health efforts weren't very effective, if there weren't clinical trials taking place right now, and if we didn't have ongoing the greatest global effort in history to develop vaccines.

I agree that Congress should be acting aggressively to stave off economic hardship and to save industries that need bailouts in the meantime. For me personally, I look at the south and don't think that people bowling and going to bars is going to be viable for some time...I also don't think with reasonable stewardship you'd see outbreaks that large this late, but that's just me.

I think as a whole, the country has done fine.

Total Cases.- 2,727,853
Deaths.- 130,122
Total Recovered.- 1,143,334
Active Cases.- 1,454,397
Serious Critical.- 15,935

I have read first hand what the Corona Virus has done to people. When the disease is at its worst, I wouldn't want mine or anyone's loved ones to suffer like that and most of time the patient wound up dying in the hospital.

But I have also read cases about people who have survived the worst and were discharged safely home. I have also read cases about people who weren't as bad as those in the ICU and/or required hospitalization and they recovered. Although they're still dealing with some lingering effects.

Then there have been the mild cases where people were treated as outpatients.

Could we have a done better job in preventing the spread of the disease, yes. Maybe states should have started locking down a week earlier than we did. Or maybe we should have locked everything for 2-3 weeks while we had companies manufacture enough masks for everyone and then slowly re-open with states requiring people wear them in public. While the most vulnerable of the population continued to shelter in place.

But overall, I'm okay with the job this country has done as whole.

Just out of curiosity, what aggressive actions would you have liked seen taken.

[broncofan]

Just out of curiosity, what aggressive actions would you have liked seen taken.

Sure I just want to respond to your belief that we're doing well.

The EU has a population of 446 million people. Below is a graph from a week ago of the EU's new cases compared to ours. At the time we had 25000 new cases per day. We now have more than 40000 a day.

https://twitter.com/profwolff/status...40862665072640

Remember when Italy was the worst hit country. Italy had 142 new cases today. We not only have more than 40000 new cases per day but are experiencing exponential growth in at least five states. We have 4% of the world's population and 25% of the deaths from covid. Doesn't that tell you something is wrong? Why should we be overrepresented in deaths per capita by 6X? Nearly every country that had an early outbreak like we did has far fewer new cases per capita.

So not only have we not done as well as the countries who have done the best job, we've done far worse than average. What do you think the consensus would be if we conducted a poll of epidemiologists and virologists from the top twenty research institutes in the country about the job we've done? I follow a bunch of them on twitter. I haven't seen one who thinks we've done even a reasonable job.

https://www.worldometers.info/coronavirus/#countries

Here's what I think our response would have been had it been guided by public health experts instead of Trump:

Shut downs the first week of March running for six weeks. Contact tracing in the largest cities once we opened up. Some counties have tried to get those efforts started but the CDC should have marshalled their resources to help. Mandatory mask wearing in businesses. People attended a rally for Trump in Tulsa and most people weren't wearing masks. Mask wearing in public should have been a bipartisan norm and it's something public health experts have recommended for well over two months. As soon as epidemiologists realized there was presymptomatic spread mask wearing should have become mandatory except for people who literally cannot on account of some health condition.

Opening up businesses based on reaching benchmarks set for number of cases per million residents and when those benchmarks break down, closing businesses that have contributed to outbreaks. If you actually set benchmarks based on case numbers relative to population density, there are no surprises.

Mask wearing could save 5% of gdp. People are so concerned about businesses, then why aren't people wearing masks?

https://www.washingtonpost.com/busin...source=twitter

Finally, what should signify that we're doing well is that we either have fewer deaths per capita than average or have fared better than other countries in some quality of life metric. Have we?